Finalized CMS Rule Means Billions Saved

Statement from Mark E. Miller, executive vice president of Health Care at Arnold Ventures, on the recently finalized rule from the Centers for Medicare & Medicaid Services

Washington, D.C. (November 21, 2025) – The Centers for Medicare & Medicaid Services (CMS) issued the Calendar Year (CY) 2026 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Final Rule (CMS-1834‑F), representing an important step toward lowering health care costs for Medicare patients and taxpayers. 

“Finalizing the rule to adopt site-neutral payment for drug administration services in hospital-owned, off-campus locations is a key step in making Medicare more affordable, and we applaud the administration for acting on long overdue reforms. This policy will save money for taxpayers and beneficiaries by lowering premiums and copays. It is particularly important for patients with high utilization of physician-administered drugs, like cancer patients undergoing chemotherapy. They will see significant and welcome reductions in costs by no longer having copays up to 4 times more simply based on who happens to own the building where the service is provided. 

“Now more than ever, Americans need relief from the rising health care costs that burden us all. We hope the administration will continue its efforts and adopt site neutrality for other services in future rules. We also encourage both the administration and Congress to work together to enact more comprehensive site-neutral reforms that would reduce incentives for further health system consolidation, protect patients, and lower the cost of care for taxpayers and employers.”