2027 OPPS proposed rule: Hospitals could face major cuts to payments, more complex price transparency rules

Wed, 07/08/2026
Revenue Integrity Insider
Policies and Procedures, Revenue Integrity, Reimbursement and Payment Methodologies, Program Management, Billing and Claims, News, Monitoring and Audits, Coverage, Compliance, Coding and Documentation, Chargemaster and Charge Capture

Hospitals could be facing lower reimbursement for non-drug items and services, 340B drugs, excepted off-campus provider-based department (PBD) services, as well as additional price transparency and prior authorization requirements, according to CMS’ 2027 Outpatient Prospective Payment System (OPPS) proposed rule.

Download the July 2026 issue of the NAHRI Journal

Wed, 07/01/2026
NAHRI Journal - Volume 10, Issue 3
Policies and Procedures, Revenue Integrity, Reimbursement and Payment Methodologies, Program Management, Billing and Claims, Monitoring and Audits, Coverage, Compliance, Coding and Documentation, Chargemaster and Charge Capture

Set revenue integrity in motion.

A bigger picture: A closer look at CMS’ 2027 IPPS proposed rule

Wed, 07/01/2026
NAHRI Journal - Volume 10, Issue 3
Policies and Procedures, Revenue Integrity, Reimbursement and Payment Methodologies, Billing and Claims, Coverage, Compliance, Coding and Documentation, Chargemaster and Charge Capture

Understand the implications of the 2027 IPPS proposed rule.

Don’t leave money on the table: Solving out-of-network and zero-balance recovery

Wed, 07/01/2026
NAHRI Journal - Volume 10, Issue 3
Policies and Procedures, Revenue Integrity, Billing and Claims, Monitoring and Audits, Compliance

Gain insights into how to optimize systems and shore up revenue.

Dissecting the impact of the IPO list elimination

Wed, 07/01/2026
NAHRI Journal - Volume 10, Issue 3
Policies and Procedures, Revenue Integrity, Reimbursement and Payment Methodologies, Billing and Claims, Coverage, Compliance, Coding and Documentation, Chargemaster and Charge Capture

Learn how the elimination of the inpatient-only list could affect hospitals.

Rethinking the middle revenue cycle: Aligning coding, charging, and the EHR—without losing control

Wed, 07/01/2026
NAHRI Journal - Volume 10, Issue 3
Policies and Procedures, Revenue Integrity, Program Management, Billing and Claims, Coding and Documentation, Chargemaster and Charge Capture

Apply these tips to improve work queue management.

Code it, charge it, bill it: MACs double down on HCPCS Level II requirements

Wed, 07/01/2026
NAHRI Journal - Volume 10, Issue 3
Policies and Procedures, Revenue Integrity, Reimbursement and Payment Methodologies, Billing and Claims, Compliance, Coding and Documentation

Brush up on the latest coding and billing guidance for HCPCS Level II codes.

Evaluating the impact of skin substitute payment reform in 2026: What revenue integrity teams should consider

Wed, 07/01/2026
NAHRI Journal - Volume 10, Issue 3
Revenue Integrity, Reimbursement and Payment Methodologies, Billing and Claims, Denials and Appeals, Coverage, Compliance, Coding and Documentation, Chargemaster and Charge Capture

Understand how recent changes to skin substitute payments affect processes.

Unpacking the 2027 IPPS Proposed Rule

Thu, 06/25/2026 - 10:07
Webinars
Revenue Integrity, Reimbursement and Payment Methodologies, Program Management, Billing and Claims, Monitoring and Audits, Coverage, Compliance, Coding and Documentation, Chargemaster and Charge Capture

CMS issues an annual Inpatient Prospective Payment System (IPPS) proposed rule, which details proposed changes to Medicare inpatient coding and billing.

During this 60-minute webinar, expert speakers Kimberly A. Hoy, JD, CPC, and Teri Rice, MSN, MHA, MBA, RN, CHC...

How to accurately report Allo-HSC acquisition costs

Wed, 06/24/2026
Revenue Integrity Insider
Policies and Procedures, Billing and Claims, Coding and Documentation

Subsection (d) hospitals that furnish inpatient allogeneic hematopoietic stem cell (Allo-HSC) transplants must accurately report acquisition costs on their Medicare Cost Report.

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