Where the fights stand
Every rule the hospital lobby is fighting, where it stands, and who is winning. Updated as rules land.
| The fight | Status | What's next |
|---|---|---|
| Site-neutral pay: drug administration at off-campus hospital departments | In effect | Jan. 1, 2026 · Final rule. Paid at the physician-office rate. |
| Site-neutral pay: imaging without contrast | Final | Nov. 4, 2026 · CY2027 Medicare outpatient final rule. Physician-office rates from Jan. 1, 2027; rural sole community hospitals exempt. |
| Hospital price transparency | Enforced | Apr. 1, 2026 · Hospitals must post actual allowed amounts; a senior official attests. |
| 340B program: Medicare payment cut | Final | Nov. 4, 2026 · 340B drugs paid at ASP minus 28% from Jan. 1, 2027, down from ASP plus 6%. CMS had proposed minus 33.4%. |
| 340B program: rebate model | In court | Oct. 9, 2026 · AHA sued to stop the revised pilot set to start Jan. 1, 2027. |
| Physician-owned hospital ban | Unchanged | Nov. 2026 · Physician-led competitors stay locked out. |
| Medicaid provider taxes and state-directed payments | Enacted | July 4, 2025 · New provider-tax cap began Oct. 1, 2026; payment cuts start 2028. |
| Certificate of need | State by state | 2026 sessions · Where repeal and reform stand in every CON state. |