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Posts tagged with "BALANCE model"

CMS Launches Temporary 18-Month Medicare GLP-1 Pilot with $50 Monthly Copay CMS Rules

CMS Launches Temporary 18-Month Medicare GLP-1 Pilot with $50 Monthly Copay

On July 1, the Centers for Medicare and Medicaid Services (CMS) launched a temporary program to cover GLP-1 agonist drugs for obese Medicare beneficiaries. The program is called the Medicare GLP-1 Bridge and will allow eligible beneficiaries to access the drugs for a $50 monthly copayment. The program is slated to run from July 2026...
CMS Rules

MA Plans Say No to Coverage of GLP-1s, CMS Pivots and Member and Medicare to Pay

As insurance companies raise flags about the cost of GLP-1 weight loss drugs in coordination with government payer programs, the Trump administration has rescinded its plan to have insurance companies fund coverage of the obesity drugs and will have Medicare pay the cost instead. Last year, the White House announced a landmark deal...
National News

CMS Releases RFA to Medicaid & Part D Plans - New BALANCE Model May Lower GLP-1 Prices by Summer

Last week, the Centers for Medicare and Medicaid Services released requests for applications (RFAs) for state Medicaid plans and Medicare Part D plans that would be interested in participating in the new Better Approaches to Lifestyle and Nutrition for Comprehensive hEalth (BALANCE) Model which focuses on lowering prices for GLP-1 drugs....
CMS Announces Drug Pricing Models As Wegovy Pill Gains FDA Approval CMS Rules

CMS Announces Drug Pricing Models As Wegovy Pill Gains FDA Approval

The Centers for Medicare and Medicaid Services announced a new drug pricing model to allow state Medicaid agencies and Medicare Part D plans to cover GLP-1 drugs at lower costs. The announcement comes as Novo Nordisk seeks to regain lost ground in the race for dominance in the American GLP-1 market and its pill version of Wegovy is...
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8:00 am The Future of Benefits: People, ... @ Talking Stick Resort
The Future of Benefits: People, ... @ Talking Stick Resort
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Join Arizona’s premier conference for insurance, employee benefits, and HR professionals as we explore the trends, legislation, innovation, and strategies shaping the future of healthcare and employee benefits. Spend the day learning from nationally recognized[...]
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all-day Az HFMA 2026 Fall Conference @ Venue8600
Az HFMA 2026 Fall Conference @ Venue8600
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Save the date! Az HFMA 2026 Fall Conference September 17-18th Venue8600 8600 East Anderson Drive Scottsdale, AZ 85255 Stay connected for more details!!   
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all-day AzHHA 2026 Arizona Hospital Lead... @ El Conquistador Hilton Resort in Tucson, AZ
AzHHA 2026 Arizona Hospital Lead... @ El Conquistador Hilton Resort in Tucson, AZ
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AzHHA 2026 Arizona Hospital Leadership Conference @ El Conquistador Hilton Resort in Tucson, AZ
The AzHHA Foundation’s 2026 Arizona Hospital Leadership Conference will be held Oct. 21-23, 2026, at the exquisite El Conquistador Tucson, A Hilton Resort in Tucson, Ariz. This educational event is dedicated to supporting a vibrant[...]
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