CMS has just announced the agency is ending the Part D premium stabilization demonstration after 2026. The demo provided extra subsidies to Part D stand-alone drug plan sponsors amid uncertainty about the impact on plan bids from the IRA's changes to the Part D benefit. www.cms.gov/files/docume...

CMS has just announced that the BALANCE program for GLP-1 coverage will not launch in Medicare Part D in 2027 and the BRIDGE program will be extended through 2027 (it was set to run from July-Dec 2026). This could add billions to Medicare spending in 2027. www.kff.org/quick-take/w...

What Medicare's Temporary Program Covering GLP-1s for Obesity Means for Beneficiaries

CMS’s efforts to expand Medicare coverage of GLP-1s for obesity could provide substantial benefits to millions of Medicare beneficiaries, given the potential demand for these highly effective medicati...

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Today, April 20, is the deadline for Medicare Part D plans to apply to participate in the BALANCE model for Medicare coverage of GLP-1 obesity drugs. Without robust plan participation, the model will not move forward in 2027. See our @kff.org brief for details. www.kff.org/medicare/wha...

What to Know About the BALANCE Model for GLP-1s in Medicare and Medicaid | KFF

This brief describes current coverage of GLP-1s in Medicare and Medicaid, the Centers for Medicare & Medicaid Services’ (CMS) efforts to expand access and lower costs for GLP-1s through temporary demo...

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CMS is shutting down the National Training Program, whose mission is "to communicate Medicare and other CMS-program information that...can be used to effectively train the public." The site will be discontinued Oct 15, the first day of Medicare 2026 open enrollment cmsnationaltrainingprogram.cms.gov

🚨CMS just announced that Medicare will NOT move forward with a proposal to require coverage of drugs used to treat obesity. This proposal was issued at the end of the Biden administration but it was up to the Trump administration to finalize, or not. www.cms.gov/newsroom/fac...

CMS makes it official: the Innovation Center will not move forward with the Medicare $2 drug list model, a Biden administration plan to test whether improved access to low-cost drugs would improve health outcomes, which Trump moved to cancel on day one of his second term. www.cms.gov/newsroom/fac...

With news that Social Security is implementing major workforce reductions, it's worth noting that the agency plays a big role in helping people enroll in Medicare by processing applications for Part A and B, as well as for the Part D drug benefit's extra help program. www.kff.org/faqs/medicar...

🚨 Round 2 of Medicare's drug price negotiation program just kicked off. The popular diabetes and obesity drugs Ozempic and Wegovy are at the top of the list. Medicare price negotiation could play a key role in increasing affordability and access to these drugs. www.kff.org/quick-take/w...

Why Medicare Drug Price Negotiation Matters for Potential Medicare Coverage of Obesity Drugs

It’s quite likely that one of these popular anti-obesity medications will be selected for negotiation in the next round of Medicare’s relatively new drug price negotiation program.

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This proposal would also expand coverage under state Medicaid programs, which currently can but aren't *required* to cover drugs to treat obesity. Our new policy watch explains the implications of this proposed change for Medicare and Medicaid coverage and costs. www.kff.org/policy-watch...

Proposed Coverage of Anti-Obesity Drugs in Medicare and Medicaid Would Expand Access to Millions of People with Obesity | KFF

This policy watch examines the implications of new proposed regulations that would allow Medicare and require Medicaid to cover drugs used to treat obesity, including a relatively new class of highly ...

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Juliette Cubanski@jcubanski.bsky.social · 2y ago

The Biden administration has proposed to allow Medicare to cover anti-obesity drugs, which is currently prohibited by law. The proposals hinges on reinterpreting the statutory language to allow coverage when these drugs are used to treat obesity, which is now commonly regarded as a disease.

The Biden administration has proposed to allow Medicare to cover anti-obesity drugs, which is currently prohibited by law. The proposals hinges on reinterpreting the statutory language to allow coverage when these drugs are used to treat obesity, which is now commonly regarded as a disease.

With 2 weeks left in #Medicare open enrollment, people in stand-alone #PartD drug plans are facing a lot of changes in the market, with fewer choices overall and higher premiums for some plans but lower premiums for others. More details in our analysis of the 2025 market: www.kff.org/medicare/iss...

Medicare Part D in 2025: A First Look at Prescription Drug Plan Availability, Premiums, and Cost Sharing | KFF

Medicare Part D is a voluntary outpatient prescription drug benefit for people with Medicare provided through private plans, including stand-alone prescription drug plans and Medicare Advantage plans ...

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For Medicare D, the law defines what drugs will and won't be covered >> drugs and vaccines that are approved by the Food & Drug Administration (with a few exceptions, like anti-obesity drugs). So Congress would need to change the law in order to change what drugs and vaccines Medicare covers.

Julia Métraux@juliametraux.bsky.social · 2y ago

Dr. Oz, CMS head nominee, has some…silly views on medication. But, there are mechanisms in place that would prevent him from hastily putting supplements under Medicare coverage and taking actual medications off. My latest for @motherjones.com. www.motherjones.com/politics/202... .

NEW @kff.org calculator tool shows how much more ACA enrollees will pay if enhanced subsidies to expire www.kff.org/interactive/...

How Much More Would People Pay in Premiums if the ACA's Enhanced Subsidies Expired? | KFF

Enhanced Affordable Care Act (ACA) subsidies lower premium payments for ACA Marketplace coverage by boosting existing ACA subsidies and making some people newly eligible. Enrollees across incomes bene...

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A key deadline for Medicare's drug price negotiation program will come soon after President-elect Trump is inaugurated: releasing the list of up to 15 drugs selected for round 2 of negotiation by Feb 1, 2025. Our updated FAQs has a timeline of key activities to watch. www.kff.org/medicare/iss...