Healthcare groups urge CMS to revise 2027 outpatient payment rules

Healthcare organizations are urging the Centers for Medicare & Medicaid Services (CMS) to revise its proposed 2027 payment rule for hospital outpatient prospective payment systems and ambulatory surgical centers (ASCs).

The Ambulatory Surgery Center Association (ASCA) warns that proposed reimbursement reductions could limit access to lower-cost outpatient care. While the proposal includes an average 2.4% payment update and adds 618 procedures to the ASC covered list, ASCA projects payment declines for 85 of the 100 most frequently performed procedures. The association is calling for the elimination of the ASC weight scalar, permanent alignment of annual payment updates between ASCs and hospitals, and extended wage-index protections for rural centers.

Similarly, the Healthcare Financial Management Association (HFMA) expressed concerns that several proposals within the rule could cause significant financial and operational disruption. HFMA is evaluating the policy against principles of quality, fairness, and sustainability, specifically highlighting concerns regarding payment adequacy under the 340B drug payment policy, site-neutral payment accuracy, and the cumulative impact of these changes on provider capacity and beneficiary access.