2025-13360Proposed RuleSignificantWallet

Medicare Wants Hospitals to Rate Wellness and Spoon-Fed Nutrition

Published Date: 7/17/2025

Proposed Rule

Summary

Starting in 2026, hospitals and surgery centers will see updates to how Medicare pays for outpatient and surgical services, with new rules to make quality reporting clearer and prices more transparent. These changes affect hospitals, rural emergency centers, and ambulatory surgical centers, aiming to improve care and help patients understand costs better. Expect some new payment tweaks and quality measures, with important deadlines coming soon for reporting and price sharing.

Analyzed Economic Effects

3 provisions identified: 2 benefits, 0 costs, 1 mixed.

Medicare OPPS and ASC Payment Changes

Starting for calendar year 2026, the rule would revise how Medicare pays hospitals and ambulatory surgical centers by changing the amounts and factors used to set payment rates under the Hospital Outpatient Prospective Payment System (OPPS) and the Ambulatory Surgical Center (ASC) payment system. These payment updates apply to hospitals, rural emergency hospitals, and ASCs and affect Medicare-covered outpatient and surgical services.

Clearer Hospital Quality Reporting and Star Ratings

The rule would update and refine requirements for the Hospital Outpatient Quality Reporting Program, the Rural Emergency Hospital Quality Reporting Program, the Ambulatory Surgical Center Quality Reporting Program, and the Overall Hospital Quality Star Rating to make quality reporting clearer. These changes apply to hospitals and related programs and are intended to produce clearer quality information for patients and the public.

Hospital Price Transparency Enforcement

The rule would update requirements for hospitals to make public their standard charge information and would update enforcement of hospital price transparency. This applies beginning in calendar year 2026 and affects hospitals' obligations to publish price information for services.

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Key Dates

Published Date
Effective Date
7/17/2025
1/1/2026

Department and Agencies

Department
Independent Agency
Agency
Health and Human Services Department
Centers for Medicare & Medicaid Services
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