Saturday, July 11, 2026

CMS has released the proposed 2027 Outpatient Prospective Payment System (OPPS) rule, including a proposal to reduce reimbursement for 340B-acquired drugs. The agency also intends to expand site-neutral payment policies. The proposed rule details the agency's payment update for next year. The comment period will open upon formal publication in the Federal Register. Hospital billing managers should monitor the final rule, expected in November, to model the financial impact on outpatient drug revenue.

CMS has issued the proposed Home Health Prospective Payment System rule for 2027. The agency seeks to increase clarity around palliative care provision in the home health setting. The proposal outlines the planned payment update and operational requirements for next year. Home health agencies should review the proposed rule's provisions on palliative care documentation and billing. The comment period will allow for provider input ahead of the final rule.

More than 50,000 patients could lose in-network access to UT Health East Texas facilities if the system and UnitedHealthcare do not reach a new contract agreement. The contract is set to expire soon. Practices in the region that refer to UT Health East Texas should prepare for potential patient inquiries and coverage changes. Billers should verify UHC patients' network status for scheduled procedures at these facilities and be ready to discuss out-of-network implications or assist with prior authorizations for alternative sites if needed.

New Jersey has enacted a Medicaid-linked employer fee, charging employers a per-employee fee for workers who are enrolled in Medicaid. The move, part of a growing trend among states, aims to recoup some of the public costs of providing healthcare coverage to low-wage workers. Several other states are considering similar measures. For practices in New Jersey, this could indirectly affect the local labor market and insurance landscape, as employers may face new cost pressures. The fee structure and implementation timeline are now subject to state rulemaking.

A rural Alabama hospital has filed for bankruptcy, joining a string of closures and financial failures in the state and across the country. The filing underscores the persistent financial strain on rural facilities, which face low patient volumes, high percentages of government-payer patients, and rising operational costs. This collapse shrinks local access to emergency and inpatient care, potentially shifting patient volumes and acuity to remaining hospitals and clinics in the region. For independent practices, it signals a further contraction of the rural referral network and may increase pressure on remaining outpatient sites.