AHA shares recommendations with CMS on CY 2027 outpatient PPS proposed rule

The AHA Aug. 28 shared concerns with the Centers for Medicare & Medicaid Services regarding the calendar year 2027 hospital outpatient prospective payment system and ambulatory surgical center payment system proposed rule, explaining why the proposed net payment update of 2.4% is not adequate given the financial challenges hospitals and health systems face.

“We are particularly concerned with the large proposed productivity cut of 0.8 percentage points, and urge CMS to work with Congress to reduce the magnitude of it for CY 2027 or eliminate the adjustment altogether,” the AHA wrote in its letter. “Moreover, we are concerned about other proposals that would negatively impact beneficiary access to hospital-level care and new technologies, while also greatly increasing regulatory burden.”

The AHA discussed its opposition to a proposal to reduce payment for imaging without contrast services furnished by off-campus excepted outpatient departments, and commented on other proposals in the rule regarding the inpatient-only list, a proposed expansion of prior authorization to apply to additional botulinum toxin injection codes, a proposed expansion of the ASC covered procedures list, and the requirement for hospitals to obtain a separate national provider identifier for each of their off-campus outpatient departments.