Communications

(June 2, 2026) - The Centers for Medicare & Medicaid Services has released the Final Rule for the 2027 Notice of Benefit and Payment Parameters. This final rule primarily focuses on the Affordable Care Act Marketplace and the individual insurance market. While it does not directly regulate hospital payment rates, several provisions could affect Kansas hospitals by changing network design, patient coverage, uncompensated care and provider contracting.  The most consequential provision for Kansas hospitals is CMS's approval of non-network insurance plans on the Marketplace. While these plans may create additional coverage options for consumers, they introduce significant uncertainty regarding provider reimbursement, patient cost-sharing and hospital revenue cycle operations. Rural hospitals, safety-net providers and hospitals with a high share of individual-market patients could be particularly affected if insurers use low benefit amounts or if Marketplace enrollment declines due to the rule's eligibility changes.  A full summary of the proposal can be found here.