CMS Finalizes the 2027 Outpatient Payment Rule: What Hospitals Should Model Now
November 8, 2026Worth knowing: a federal court has vacated the extra “medical frailty” test CMS built into its Medicaid work-requirement rule, but the broader eligibility-verification framework under the One Big Beautiful Bill Act still stands.
For providers, coverage churn and documentation risk are still coming, and front-end eligibility verification is about to matter even more.
HFMA summary of the ruling: https://www.hfma.org/payment-reimbursement-and-managed-care/medicaid-work-requirement-medical-frailty-ruling/


