CMS Launches Voluntary Model to Expand Access to Life-Changing Medicines, Promote Healthier Living
The Centers for Medicare & Medicaid Services announced the BALANCE Model, a voluntary alternative payment model under which CMS will negotiate directly with GLP-1 manufacturers for lower net prices, capped out-of-pocket costs, and standardized coverage criteria for Medicare Part D and state Medicaid programs. A companion 'Medicare GLP-1 Bridge' demonstration launches July 1, 2026, offering eligible beneficiaries access at a $50 monthly copay ahead of BALANCE's full Medicaid rollout (as early as May 2026) and Part D rollout (January 2027).
This is a summary. The reporting is Centers for Medicare & Medicaid Services's, and the link below goes to the original article.
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