Priorities in 2026 MPFS and OPPS Proposed Rules

In July, the Trump Administration proposed major changes to how Medicare pays for hospital care and physician services in the Outpatient Prospective Payment System and Medicare Physician Fee Schedule.

This webinar covers the proposed rules that take important steps forward in paying better for primary care and stopping payment distortions that drive hospital consolidation. At the same time, these rules roll back important requirements that drive health equity improvements.

CMS is proposing to:

• Enact site neutral payments for drug administration services, to ensure consumers pay the same price for the same service for physician administered drugs in more outpatient care settings, reining in a key driver of health care consolidation and high hospital prices.
• Make critical changes to the physician fee schedule that increases payments for primary care and behavioral health services which will strengthen the health care workforce and ensure families have access to a usual source of high-quality primary care.
• Repeal critical quality measures that would have held hospitals accountable for health equity and the social drivers of health, undermining our ability to drive high value health care and improve health outcomes.
• Weaken price transparency rules that undermine the ability for people to know the price of health care before they receive medical services. They would do this by allowing hospitals to post algorithms and price estimates, instead of actual prices in dollars and cents.

Along with help from our partners, we must continue administrative advocacy and call on Congress to prioritize affordability and lower health care costs for our nation’s families, including by enacting pro-consumer reforms that take on corporate greed and address the fundamental drivers of unaffordable health care. Share your story on high hospital bills and health care pricing abuses to stories@familiesusa.org.

Presenters:

• Jane Sheehan, Deputy Senior Director of Government Relations
• Aaron Plotke, Associate Director of Healthcare Innovation
• Alicia Camaliche, Senior Policy Analyst
• Mike Persley, Strategic Partnerships Campaign Manager