New CMS OPPS Proposal Alters 340B Drug Pricing Impacting Healthcare Providers

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On July 13, 2026, the Advisory Board announced that the Centers for Medicare & Medicaid Services (CMS) released the proposed rule for the Outpatient Prospective Payment System (OPPS) and ambulatory surgical centers (ASCs) for the 2027 calendar year. This proposal includes significant updates impacting the 340B Drug Pricing Program, with far-reaching implications for industry compliance and provider reimbursement models.

The OPPS/ASC proposal outlines a 2.4% increase in OPPS payment rates, incorporating a projected 3.2% hospital market basket increase, slightly offset by a 0.8 percentage point productivity reduction. Ambulatory surgical centers are expected to see a corresponding 2.4% rise in payment rates. A notable component of the proposed regulation involves major changes to the reimbursement policies for 340B medications. CMS currently reimburses the average sales price of 340B drugs plus 6%; however, the new proposal suggests a shift to average sales price minus 33.4%, potentially altering the financial landscape for hospital providers utilizing these medications.