Centers for Medicare & Medicaid Services

Rule Changes

Administering BALANCE model to expand GLP-1 access

Medicare has been banned from covering weight loss drugs since 2003. CMS launched BALANCE in December 2025, a voluntary model offering $50-per-month Ozempic and Wegovy access for 10% of Medicare enrollees starting July 2026.

Updated 1 hour ago

Rule Changes

Linked to a new CBD access pilot described alongside the executive order

Trump's executive order instructing DOJ to fast-track marijuana's move to Schedule III immediately triggered a familiar split. Public health and industry groups cheered the potential research and tax impacts, while House Republicans organized opposition, urging Trump to keep marijuana in Schedule I.

Updated Yesterday

Rule Changes

Issuing proposed procedural notice; TCET pathway paused for new candidates

For nearly a decade, medical device makers have faced the same bottleneck: the FDA clears a breakthrough device, and then Medicare spends another year or more deciding whether to pay for it. On April 23, 2026, the two agencies jointly announced the Regulatory Alignment for Predictable and Immediate Device (RAPID) pathway to collapse that gap to as little as two months — and simultaneously paused the existing Transitional Coverage for Emerging Technologies (TCET) program for new applicants, consolidating all breakthrough-device coverage work under the new pathway.

Updated Apr 24

Rule Changes

Source of baseline spending projections and historical data

For decades, American health care spending grew faster than the economy, seemingly without limit. Government actuaries projected in 2010 that health care would consume 21.2 percent of gross domestic product (GDP) by 2024—roughly $6.3 trillion. The actual figure: 18 percent, about $977 billion less than expected. A new analysis presented at the Brookings Institution on March 27, 2026, concludes that the United States has genuinely bent its health care cost curve for the first time in the modern era.

Updated Apr 12

New Capabilities

Determining reimbursement rates for blood tests

For decades, diagnosing Alzheimer's meant either a $5,000 brain scan with radiation exposure or a painful spinal tap. In October 2025, the FDA cleared Roche's blood test for use in primary care—a simple blood draw that rules out Alzheimer's 97.9% of the time. It's the second blood test approved in five months, transforming a diagnosis that once required specialists and imaging centers into something your family doctor can order.

Updated Jan 9