(Dec. 24, 2025) – CMS Releases Transparency in Coverage Proposed Rule
The Centers for Medicare & Medicaid Services released a proposed rule that would change payer price transparency regulations to improve the accessibility of pricing disclosures for participants, beneficiaries and enrollees in a health plan.
The rule also includes additional standardization and improves the reliability of public pricing disclosures from non-grandfathered group health plans and from health insurance issuers offering non-grandfathered group and individual health insurance coverage.
Comments are due 60 days after publication within the Federal Register.
CMS Innovation Center Announces Medicare Part A, Part B Drug Models
The Centers for Medicare & Medicaid Services Innovation Center announced two new mandatory programs to mitigate rising drug costs.
The Guarding U.S. Medicare Against Rising Drug Costs or GUARD Model is designed to test drugs using international drug pricing information to identify a benchmark that reflects prices paid in a set of economically comparable countries. The GUARD Model would begin Jan. 1, 2027.
The Global Benchmark for Efficient Drug Pricing or GLOBE Model is designed to test whether a payment model that uses an alternative method to calculate Part B inflation rebate amounts for certain payable Medicare Part B drugs and biologicals would reduce costs for Medicare fee-for-service beneficiaries. The GLOBE Model would begin Oct. 1, 2026.
Comments on both rules will be due 60 days after publication within the Federal Register.
Before You Go ...
- The American Hospital Association's Forever Grateful campaign offers resources to help hospitals and health systems recognize and thank health care professionals this holiday season. Visit the campaign webpage to find a social media toolkit with ready-to-use graphics and posts that can be shared or customized.
- The Opioid Response Network, led by the American Academy of Addiction Psychiatry in collaboration with national partners, is offering a new initiative, "Advancing Behavioral Health Professionals Expertise in Identifying and Treating Substance Use Disorders." The program includes two free online courses designed to strengthen clinical skills and improve screening, diagnosis and treatment of substance use disorders. Continuing education credits are available. Registration is required.