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Update to the Extraordinary Circumstances Exception (ECE) Policy for the Hospital OQR, REHQR, and ASCQR Programs In the CY 2026 OPPS/ASC proposed rule (90 FR 33756 through 33757), we proposed to update the current Hospital OQR, REHQR, and ASCQR Program ECE policies codified at 42 CFR 419.46(e)

Using odourless "bacteriostatic water" for multi-dose protocols is functionally equivalent to using plain sterile waterit provides no safety margin for contamination and turns every subsequent draw into a contamination risk