01/21/2026

CMS-Medicare

Recent Oncology Related Articles

CMS Proposed Model Test Would Lower Drugs Costs for Medicare Part D 

CMS announces the newly proposed Guarding U.S. Medicare Against Rising Drug Costs (GUARD) Model that would lower net costs of certain prescription drugs covered by Medicare Part D to reflect prices paid in economically comparable countries.

Why It Matters: GUARD would help make critical prescriptions more accessible for people with Medicare Part D, better enabling them to follow their prescribed care for optimal health outcomes, and alleviating financial strain on Medicare.

What to Expect: CMS is seeking public comment on GUARD by February 23, 2026; see the proposed rule.

Physicians & Non-Physicians: Comment on Medicare Enrollment Application by February 17 

CMS requests your comments on the Medicare Enrollment Application for Physician and Non-Physician Practitioners (Form CMS-855I) by February 17. Visit the PRA Listing webpage to get the supporting statement and related forms.

Health Professional Shortage Area: CY 2026 Bonus Payments

See ZIP Codes designated as Health Professional Shortage Areas in 2026 that are eligible for a Medicare Physician Bonus:

• Visit Physician Bonuses
• Use the Medicare Physician Bonus Payment Eligibility Analyzer

See the instruction to your Medicare Administrative Contractor (PDF).

Transparency in Coverage Proposed Rule 

Consistent with the President’s Executive Order 14221, “Making America Healthy Again by Empowering Patients with Clear, Accurate, and Actionable Healthcare Pricing Information,” on December 19, 2025, CMS, in partnership with the Department of Labor and the Department of the Treasury jointly proposed changes to the payer price transparency regulations to improve the accessibility of pricing disclosures to participants, beneficiaries, and enrollees, and the standardization and reliability of the public pricing disclosures from non-grandfathered group health plans and health insurance issuers offering non-grandfathered group and individual health insurance coverage. 

More Information:

• Full fact sheet
• Press release
• Proposed rule

Additional Articles of Interest

• CMS Announces $50 Billion in Awards to Strengthen Rural Health in All 50 States
• CMS Announces Establishment of the Office of Rural Health Transformation
• New CMS LEAD Model Aims to Expand Access to Accountable Care, Improve Health Outcomes
• CMS Proposed Model Test Would Lower Certain Medicare Part B Prescription Drugs
• CMS BALANCE Model Aims to Expand Access to GLP-1 Medications for People with Medicare Part D & Medicaid
• Hospitals: Submit Data for OPPS Drug Acquisition Cost Survey by March 31
• Hospitals: Apply for Additional Residency Positions by March 31
• Medicare-Funded Physician Residency Positions Awarded
• Information for Critical Access Hospitals

• MM14226 - Laboratory National Coverage Determination Edit Software: January 2026 Update

• MM14247 - Chimeric Antigen Receptor T-Cell Therapy Billing Instructions: Medicare Claims Processing Manual Update

• MM14326 - DMEPOS Fee Schedule: CY 2026 Update

• MM13923 - Payment for Medicare Part B Preventive Vaccines & Their Administration for Rural Health Clinics & Federally Qualified Health Centers

• MM14313 - ESRD & Acute Kidney Injury Dialysis: CY 2026 Update