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More specifically, as discussed in the CY 2026 OPPS/ASC proposed rule (90 FR 33808) and applied to this situation, in Step 1 the hospital would use its most recent MRF as of the hospital's cost report filing date to identify the MAO payer-specific negotiated charge under 45 CFR 180.50(b)(2)(ii) that the hospital has negotiated with its MAOs for the discharge