The Centers for Medicare & Medicaid Services has announced that its Advisory Panel on Hospital Outpatient Payment, known as the HOP Panel, will convene for a virtual meeting on Monday, August 24, 2026. This gathering represents a critical juncture for Medicare's Hospital Outpatient Prospective Payment System, or OPPS, and the Ambulatory Surgical Center, or ASC, payment system. The Panel's deliberations directly advise the Secretary of the Department of Health and Human Services on the intricate details of outpatient payment, setting a course for future reimbursement policies that affect countless healthcare providers and millions of beneficiaries.
Mandate and Mission of the HOP Panel
The HOP Panel operates under a dual mandate derived from Section 1833(t)(9)(A) of the Social Security Act and Section 222 of the Public Health Service Act. These statutory provisions compel the Secretary to consult with an expert outside panel on the clinical integrity of Ambulatory Payment Classification, or APC, groups and their associated payment weights. APCs are fundamental to how Medicare pays for outpatient services, grouping similar services together for reimbursement. The Panel also advises on the appropriate level of supervision for hospital outpatient therapeutic services. Governed by the Federal Advisory Committee Act, the Panel serves as a vital technical resource, informing CMS's development of proposed and final rules for the upcoming calendar year's OPPS updates. This process ensures that payment policies reflect current clinical practice and resource utilization.
Key Areas of Discussion for the August 2026 Meeting
The August 24 agenda is comprehensive, focusing on several technical issues central to the fairness and efficiency of the OPPS. Primary topics include assessing whether procedures within an APC group are clinically similar and share comparable resource use, a foundational aspect of APC integrity. The Panel will also discuss potential reconfigurations of APCs and the evaluation of their relative payment weights. Another significant area is the methodology and impact of "packaging" costs, which involves bundling the costs of items and services, including drugs and devices, into a larger procedure's payment. This can profoundly affect how hospitals are reimbursed for necessary supplies and medications.
Furthermore, the Panel will address the ongoing process of removing procedures from the Inpatient Only List, potentially shifting them to be paid under the OPPS. This change has broad implications for care settings and provider revenue. The utilization of claims and cost report data for determining APC group costs will be examined, ensuring that payment rates are grounded in accurate financial data. Technical issues concerning APC structure will also be reviewed. Lastly, the Panel will evaluate the required level of supervision for hospital outpatient services and review OPPS APC rates as they pertain to covered ASC procedures. These discussions collectively aim to fine-tune the payment system, balancing access, quality, and cost containment.
Public Participation and Submission Guidelines
CMS is actively soliciting public input, offering stakeholders the opportunity to submit presentations or comment letters. The deadline for these submissions is 5:00 p.m. Eastern Daylight Time on Friday, July 31, 2026. All submissions must be made through the dedicated "Hospital Outpatient Payment (HOP) Panel Meeting Presentation & Comment Letters" module on the MEARIS platform. CMS emphasizes that only submissions via MEARIS will be accepted, and form CMS-20017 is no longer required. Submissions must adhere strictly to the Panel's scope, avoiding topics such as the conversion factor, charge compression, or new technology applications, which are outside the Panel's purview. Presentations are limited to five minutes, and public comments during the meeting will be restricted to one minute per individual and three minutes per organization. A crucial aspect of the submission process is Section 508 compliance, ensuring that all materials are accessible to individuals with disabilities. This requirement reflects a commitment to inclusivity in federal advisory processes.
Evolution of the Panel's Membership
In preparation for its continuous advisory role, the Panel was rechartered in 2024 for a two-year term, extending through November 20, 2026. It consists of a chair and up to fifteen members, typically full-time employees of hospitals, hospital systems, or other Medicare providers subject to the OPPS. The Panel may also include representatives with ASC expertise to advise on relevant OPPS APC rates, and members representing critical access hospitals for supervision deliberations. CMS has announced two new appointments: Adam Levin, MD, MBA, and Douglas O'Brien, both beginning terms on June 1, 2026, and extending through May 31, 2030. These new members join an existing body of experts, including CMS Chairperson E.L. Hambrick, MD, JD, and other professionals with diverse backgrounds in healthcare. The agency maintains a continuous nomination process to fill future vacancies, seeking a balanced membership in accordance with Federal Advisory Committee Act guidelines.
Implications and Outlook
The HOP Panel's August meeting carries significant weight for the entire healthcare ecosystem. Its recommendations will directly influence how hospitals and ASCs are reimbursed for outpatient services, potentially leading to adjustments in service offerings, operational strategies, and financial planning. Changes to APC groups, payment weights, or packaging policies could shift revenue streams and affect provider margins. For beneficiaries, these policy refinements can impact access to specific treatments or the out-of-pocket costs associated with care. The discussions regarding supervision levels are particularly relevant for patient safety and the scope of practice for various healthcare professionals. As CMS continues to refine the OPPS, the Panel's expert technical advice plays an indispensable role in translating complex clinical and financial realities into sustainable and equitable payment policies. Stakeholder engagement in this process is paramount for ensuring that a wide range of perspectives informs these crucial federal decisions.
