CMS proposes cutting 340B hospital payments, expanding site-neutral policies in 2027 OPPS rule

CMS issued its proposed 2027 Outpatient Prospective Payment System rule, which includes two major structural changes. First, the agency proposes to permanently slash Medicare reimbursement for 340B-acquired drugs in hospital outpatient departments, a move it estimates would save $5.7 billion. Second, the rule expands site-neutral payment policies, proposing to pay the same rate for clinic visits in any outpatient department setting regardless of hospital ownership. The proposals are part of a broader push to reduce Medicare spending on outpatient care and curb hospital consolidation. The rule is open for comment; final provisions will directly impact hospital margins and could influence referral patterns for independent practices working with hospital outpatient departments.