Health Policy Report – July 14, 2026

OPPS Proposed Rule Advances Site Neutral Pay, 340B Reforms

On July 2, the Centers for Medicare & Medicaid Services (CMS) released its 2027 proposed rule for the Hospital Outpatient Prospective Payment System (OPPS). The proposed rule would increase payments to hospitals and ambulatory surgical centers by 2.4% (3.2% market basket minus 0.8% productivity adjustment).

If finalized, the proposed rule would apply Physician Fee Schedule (PFS)-equivalent rates for HCPCS codes assigned to imaging without contract APCs when provided at hospital outpatient departments (HOPDs). The Network celebrates this milestone in our long-standing advocacy to equalize payments across sites of service.

CMS has also taken steps to reform the 340B program by updating payment rates to better reflect what hospitals pay for these medications. Specifically, 340B payments would also be reduced to average sales price minus 33.4%. Since the statute requires budget neutrality, CMS would raise outpatient payments for non-drug services by an equivalent amount.

The proposed rule also accelerates the timeline for recovery of $7.8 billion in extra non-drug payments to hospitals received from 2018 to 2022. Under the proposed 340B remedy offset, payments for services at hospitals subject to the 340B remedy offset would be reduced by 3%.

The Network continues to review the OPPS proposed rule and will provide feedback to the agency in forthcoming comments due on August 31, 2026.

To read a fact sheet, CLICK HERE.

To read the proposed rule, CLICK HERE.  

Patients and Providers United Advocates for H.R. 4299

Patients and Providers United – a non-partisan platform supporting community-based care – is advocating in support of the Protecting Patient Access to Cancer and Complex Therapies Act (H.R. 4299).

Patients and Providers United brings together patients, providers, and caregivers to protect access to quality care for the millions of Americans who are battling complex and chronic diseases like cancer. This support for H.R. 4299 comes as part of the organization’s broader mission to advance policies that guarantee every patient receives the right care at the right time.  

The Network encourages physicians to follow Patients and Providers United on social media and share this platform with patients.

To visit the Patients and Providers United website, CLICK HERE.

To follow Patients and Providers United on X, CLICK HERE.

To follow Patients and Providers United on LinkedIn, CLICK HERE.

To follow Patients and Providers United on Instagram, CLICK HERE.

To follow Patients and Providers United on Facebook, CLICK HERE.

Florida Cancer Specialists & Research Institute Hosts Rep. Aaron Bean (R-FL) for Site Visit

On July 9, Florida Cancer Specialists & Research Institute hosted Representative Aaron Bean (R-FL) for a site visit at its Fleming Island practice. During the tour, Dr. Augusto Villegas, Holly Lee, and Eired Eddy expressed appreciation for the Congressman’s support of the Protecting Patient Access to Cancer and Complex Therapies Act (H.R. 4299). Another important topic of discussion was the need to allow patients to receive oncolytics by mail or through a trusted caregiver, as proposed in the Seniors’ Access to Critical Medications Act (H.R. 2484).

The visit provided a valuable opportunity to showcase the benefits of community oncology in delivering affordable, high-quality care close to home. As a member of the House Committee on Ways & Means, Rep. Bean is influential in shaping federal health policy. The Network looks forward to continuing this meaningful discussion on how policy decisions influence patient care.

If your practice is interested in hosting a site visit, please contact Angela Storseth at angela.storseth@usoncology.com.

Dr. Paul Fishkin Pens LTE in Peoria Journal Star

On July 5, Dr. Paul Fishkin penned a letter to the editor in the Peoria Journal Star thanking Representative Darin LaHood (R-IL) for co-sponsoring H.R. 4299. In his LTE, Dr. Fishkin explained that upcoming changes to Medicare payments for Part B drugs could strain independent oncology practices’ ability to care for patients.

“Drug policy issues are complex, but the implications are straightforward. Cuts to reimbursement risk limiting patients’ access to local cancer care, forcing them to travel farther for treatment, face longer wait times and receive care in more expensive hospital settings,” he wrote.

Dr. Fishkin went on to describe how H.R. 4299 would maintain payments for independent oncologists while keeping treatment affordable for patients. He concluded by thanking Rep. LaHood for his support and urging Congress to advance the bill.

To read the LTE, CLICK HERE.

Dr. Wayne Winegarden Authors Op-Ed in Support of H.R. 4299

Wayne Winegarden, Ph.D., Senior Fellow at the Pacific Research Institute, recently published an op-ed in the Washington Times in support of the Protecting Patient Access to Cancer and Complex Therapies Act (H.R. 4299).

In the article, Dr. Winegarden explains how the Inflation Reduction Act shifted Medicare Part B drug reimbursement from the Average Sales Price (ASP) to Maximum Fair Price (MFP).

He highlighted that this issue has extended beyond federal policy and into states. “States such as Nevada, Virginia and Illinois have attempted to implement a flawed maximum-fair-price-based reimbursement cap, modeled on the Inflation Reduction Act, on certain prescription drugs,” he said. Dr. Winegarden also emphasized that this reimbursement structure could limit incentives for investment in new treatments or stretch practices’ ability to enroll patients in clinical trials.

To address these issues, Dr. Winegarden urged lawmakers to advance the Protecting Patient Access to Cancer and Complex Therapies Act (H.R. 4299).

“Ultimately, policymakers should not force patients, physicians and independent community practices to shoulder the unintended consequences of federal drug pricing policies. Patients deserve access to lower-cost care, and physicians deserve a reimbursement system that allows them to deliver it,” he concluded.

To read the op-ed, CLICK HERE.

Murphy, Gray Author Op-Ed in Support of H.R. 4299

On July 6, Representatives Greg Murphy, M.D (R-NC) and Adam Gray (D-CA), House sponsors of the Protecting Patient Access to Cancer and Complex Therapies Act (H.R. 4299), co-authored an op-ed in Medical Economics emphasizing how the bill would protect access to affordable care.  

“This system was designed to ensure that physicians can continue to provide treatments in community settings while keeping costs predictable for Medicare. However, recent changes tied to the new Medicare drug negotiation program unintentionally disrupt that balance,” they wrote.

The lawmakers went on to highlight how these changes could upend practice viability, unintentionally pushing independent practices out of the market and accelerating healthcare consolidation.

Representatives Murphy and Gray called on Congress to pass H.R. 4299, which would maintain the long-standing reimbursement structure for Medicare Part B drugs while preserving savings for patients. “By passing our bill now, Congress can ensure Medicare reforms deliver on their promise to lower costs for seniors without putting access to critical treatments at risk.”

To read the op-ed, CLICK HERE.

House Lawmakers Introduce SECURE 340B Act

Representatives Scott Peters (D-CA) and John Joyce, MD (R-PA) released bill text for the Strengthening the Exercise of Controls and Upgrading Requirements for Efficiency (SECURE) 340B Act.

If passed, the SECURE 340B Act would establish eligibility requirements for patients who receive discounted drugs through 340B. It would also require hospitals to share data on the number of 340B drugs prescribed and the charity care provided.  

“The SECURE 340B Act closes the loopholes that have allowed the program to drift from its mission, stops the legal chaos that plagues the program today, and puts in place the kind of transparency and accountability that will keep 340B strong for decades to come,” Peters said in a statement.

To read the full bill text, CLICK HERE.

To read the statement, CLICK HERE.

Judge Blocks Price Cap Implemented by Colorado PDAB

On July 1, a federal judge temporarily blocked Colorado’s prescription drug affordability board from setting a price limit on Enbrel, a rheumatoid arthritis and autoimmune disorder drug.

Last year, Colorado’s PDAB voted to cap Enbrel at its maximum fair price established by the Centers for Medicare & Medicaid Services (CMS) during its first round of Medicare drug negotiation cycles. In response, Amgen filed a lawsuit, arguing that the cap violates federal patent law and would cause the company economic harm.

The Colorado judge agreed with this claim, writing that the PDAB is “right that the system is convoluted, confusing, and often counterintuitive. But it is not necessary to unravel the entire system to understand that, as a result of Colorado’s cap, Amgen will receive less money from its wholesalers and will fare more poorly in negotiations with other purchasers in Colorado and elsewhere.”

The injunction temporarily blocks the cap from taking effect. The Network will continue to monitor this lawsuit and similar efforts to cap drug prices in other states.

To read more, CLICK HERE.

House Committee on Ways & Means Advances Tax-Exempt Hospital Transparency Act

On July 1, the House Committee on Ways & Means held a hearing on seven tax bills, advancing the Tax-Exempt Hospital Transparency Act (H.R. 9504) out of committee.

If passed, H.R. 9504 would increase transparency of nonprofit hospitals by strengthening reporting requirements and ensuring that funding is directly serving communities in need. The legislation would require nonprofit hospitals to disclose information on spending, data on financial assistance applications, and the numbers of individuals receiving drugs through the 340B Drug Pricing Program. Large tax-exempt hospitals would be required to report additional information.

“Tax-exempt hospitals, who are supposed to care for needy patients at a low cost or no charge in exchange for their lucrative tax break, do not always reveal how much charity care is provided,” Representative Jason Smith (R-MO), Chair of the Ways & Means Committee, said in a hearing. “What we do know is tax-exempt hospitals look less like hospitals and more like hedge funds.”

The bill will now go to the House floor for consideration.

To read the committee press release, CLICK HERE.

To read the full bill text, CLICK HERE.