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.
Your PRIA Score
Personalized for You
How does this regulation affect your finances?
Sign up for a PRIA Policy Scan to see your personalized alignment score for this federal register document and every other regulation we track. We analyze your financial profile against policy provisions to show you exactly what matters to your wallet.
Key Dates
Department and Agencies
Related Federal Register Documents
2026-10292 — Medicaid Program; Medicaid Managed Care State Directed Payments and Medicaid Fee-for-Service Targeted Medicaid Practitioner Payments
This proposed rule changes how states can pay Medicaid managed care plans and certain doctors to make sure payments are fair, efficient, and encourage enough providers to offer quality care. It affects states, Medicaid managed care organizations, and targeted Medicaid practitioners, aiming to keep payments balanced and services available. Comments on these changes are open until July 21, 2026, so stakeholders have time to weigh in before it’s finalized.
2026-10050 — Patient Protection and Affordable Care Act, HHS Notice of Benefit and Payment Parameters for 2027; and Basic Health Program
Starting in 2027, health insurance plans on federal and state marketplaces will see new rules to make coverage fairer and easier to use. These changes affect insurance companies, agents, and people buying plans, including new fees, penalties, and better protections for those with hardships. Expect updates on plan quality, dental coverage limits, and longer-term catastrophic plans, all aiming to keep your health coverage solid and affordable.
2026-07205 — Medicare and Medicaid Programs; Patient Protection and Affordable Care Act; Interoperability Standards and Prior Authorization for Drugs for Medicare Advantage Organizations, Medicaid Managed Care Plans, State Medicaid Agencies, Children's Health Insurance Program (CHIP) Agencies and CHIP Managed Care Entities, and Issuers of Qualified Health Plans on the Federally-Facilitated Exchanges
This new rule will help Medicare, Medicaid, CHIP, and health plan companies share patient info more easily and speed up drug approval requests. It affects Medicare Advantage, Medicaid, CHIP, and health plans on federal exchanges, aiming to make care smoother and faster. These changes will start soon and could save time and money by cutting red tape.
2026-04797 — Medicare and Medicaid Programs; CY 2026 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; and Medicare Prescription Drug Inflation Rebate Program; Correction
This document fixes some typos and technical mistakes in the Medicare and Medicaid payment rules for 2026. It affects doctors, healthcare providers, and anyone using Medicare Part B by clarifying payment policies and program requirements starting January 1, 2026. These corrections help make sure payments and coverage rules are clear and accurate, so everyone gets paid right and on time.
2026-04467 — Patient Protection and Affordable Care Act, HHS Notice of Benefit and Payment Parameters for 2027; and Basic Health Program; Correction
This correction fixes some missing labels in important tables from the 2027 health insurance rules under the Affordable Care Act. It mainly affects insurance companies and people using marketplace plans by clarifying how risk and payments are calculated. These fixes take effect right away on March 6, 2026, ensuring everyone has clear info before the 2027 plan year starts.
2025-23081 — Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2026 and Updates to the IRF Quality Reporting Program; Correction
This correction fixes some math and typo mistakes in the Medicare payment rules for inpatient rehab facilities starting October 1, 2025. It mainly affects rehab centers by updating their payment rates and quality reporting details to be fair and accurate. These changes ensure providers get the right money and info for the 2026 fiscal year.
Previous / Next Documents
Previous: 2025-13343 — Air Plan Approval; Ohio; Second Maintenance Plan for the Ohio Portion of the Campbell-Clermont, KY-OH SO2 Maintenance Area
The EPA is set to approve Ohio’s plan to keep the air clean in Pierce Township, Clermont County, for another 10 years by controlling sulfur dioxide pollution. This plan helps make sure the air stays safe and healthy through 2034 without extra costs for residents or businesses. If you live or work there, you can breathe easier knowing the air quality rules are staying strong!
Next: 2025-13384 — School-Based Mental Health Services Grant Program
The Department of Education is updating the rules for the School-Based Mental Health Services Grant to help more school psychologists work in high-need schools. These changes will start with grant competitions in fiscal year 2025 and aim to boost mental health support for students. If you’re part of a local school agency, get ready for new priorities and requirements that could bring more funding and support your way!