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This audio is auto-generated. Please let us know if you have feedback<\/a>.<\/p>\n Hospitals could get $8 billion more in Medicare reimbursement for outpatient services next year under a new proposed rule that would raise rates by 2.4%.<\/p>\n Hospital groups aren\u2019t pleased, with the American Hospital Association calling the pay bump inadequate. The hospital lobby also criticized steps towards site neutrality in the regulation, which would cut into the more generous reimbursement hospitals currently receive from the federal insurance program for offering care in outpatient settings compared to non-hospital facilities.<\/p>\n Regulators also proposed stricter price transparency disclosures, a priority for the Trump administration. The CMS also wants to shorten the timeline for clawing back past overpayments to hospitals related to the 340B drug discount program.<\/p>\n \u201cWe are building on our efforts to modernize Medicare payments by advancing site neutrality, simplifying hospital billing, and ensuring real prices \u2014 not estimates \u2014 are available to patients,\u201d Chris Klomp, CMS deputy administrator and director of Medicare, said in a statement<\/a>\u00a0Tuesday. \u201cThese changes help make hospital care more predictable, accountable, and affordable.\u201d<\/p>\n Overall, the pay increase to hospital outpatient departments reflects a market basket increase of 3.2%, minus a 0.8 percentage point productivity adjustment.<\/p>\n If finalized, ambulatory surgery centers will also have their pay rates increase by 2.4%, a $480 million increase compared to 2025.<\/p>\n Inpatient only list, site-neutral payments<\/p>\n The Trump administration is proposing to expand some site-neutral payment policies. Currently, under Medicare, hospital outpatient departments receive higher reimbursement than independent physician offices and ambulatory surgery centers for providing the same care.<\/p>\n The discrepancy is a source of frustration for spending watchdogs and some lawmakers who argue aligning payment rates across settings would drive down patient costs while saving Medicare money.<\/p>\n On Tuesday, the CMS proposed phasing out the inpatient only list, a list of which surgical procedures have to\u00a0<\/strong>be furnished in hospitals.<\/p>\n The government wants to phase out the list over a three-year period, beginning with removing 285 procedures, mostly musculoskeletal, for 2026.<\/p>\n \u201cCMS believes that the evolving nature of the practice of medicine allows more procedures to be performed on an outpatient basis with a shorter recovery time,\u201d the agency said in a fact sheet on the rule<\/a>.\u00a0\u201cThis proposal would allow for these services to be paid by Medicare in the hospital outpatient setting when determined to be clinically appropriate, giving physicians greater flexibility in determining the most appropriate site of service.\u201d<\/p>\n The proposal is a concern for hospitals, especially acute care facilities that have benefited from Medicare designing them the appropriate site of care for surgeries, according to analysts.<\/p>\n However, it would benefit surgery facility operators like Surgery Partners and Tenet Healthcare\u2019s United Surgical Partners International though potentially higher volumes.<\/p>\n The proposed rule also expands a 2019 policy from the CMS that attempted to control increases in the volume of clinic visits to off-campus provider-based departments. PBDs are outpatient departments and considered part of hospitals, even if they\u2019re not physically located onsite.<\/strong><\/p>\n If finalized, off-campus PBDs would be reimbursed at physician rates for drug administration services, not hospital outpatient rates. The CMS estimates this would save $280 million.<\/p>\n The AHA pushed back on both policies, saying they \u201cfail to account for the real and crucial differences between hospital outpatient departments and other sites of care.\u201d<\/p>\n Price transparency<\/p>\n The proposed rule also includes several possible changes to price transparency. If finalized, hospitals starting in January would be required to post the 10th percentile allowed amount, the median allowed amount and the 90th percentile allowed amount of charges negotiated with payers.<\/p>\n The goal is to more accurately account for the variance in actual prices<\/a>\u00a0that hospitals receive for providing services, the CMS said.<\/p>\n Hospitals would also have to disclose the data used to determine those charges, and attest that they\u2019ve included all payer-specific negotiated charges to the best of their ability.<\/p>\n The Trump administration has long focused on hospital price transparency. In President Donald Trump\u2019s first term, he ordered hospitals to publicly disclose prices for services. In February, Trump released an executive order tapping three federal agencies to \u201crapidly implement and enforce<\/a>\u201d regulations he first proposed in his first term.<\/p>\n Although the government has attempted to hold hospitals accountable for price transparency, compliance has lagged. Only 21.1% of hospitals were fully in compliance with price transparency regulations<\/a> in November, according to a report by Patient Rights Advocate.<\/p>\n An updated 340B fix<\/p>\n The proposal also includes a change to an earlier regulation linked to the 340B drug discount program,\u00a0which requires drugmakers to give providers that serve a large number of low-income patients a discount on outpatient drugs.<\/p>\n