07/15/2026

CMS-Medicare

Recent Oncology Related Articles

CMS Launches Medicare GLP-1 Bridge, Expanding Access to GLP-1 Medications

Eligible Medicare beneficiaries may now get certain GLP-1 medications for $50 per month through the Medicare GLP-1 Bridge, a new CMS initiative designed to expand access to innovative treatments and test the impacts of increased access to GLP-1 drugs for weight management on the Medicare program.

More Information:

• Full press release
• Medicare GLP-1 Bridge webpage for providers and pharmacies
• Prescriber Fact Sheet (PDF): Key information for prescribers referring patients to the Medicare GLP-1 Bridge
• Pharmacy Fact Sheet (PDF): Guidance for pharmacies on billing and dispensing under the demonstration
• Prior Authorization Form (PDF): Outline of clinical criteria for Medicare GLP-1 Bridge eligibility
• Weight loss drugs information for your patients

Hospital Price Transparency: New Resources

CMS posted Guidance on Encoding Outlier Contracting Clauses in a Hospital’s Machine-Readable File (PDF) with instructions for encoding information about outlier provisions. We also published updated Hospital Price Transparency FAQs (PDF) with additional information on encoding standard charge information in a hospital’s machine-readable file.

Visit the Hospital Price Transparency Resources webpage for more information.

CMS Proposed Rule Locks in Lower Prices & Fosters Innovation for the Medicare Drug Price Negotiation Program

A new proposal from CMS would establish a permanent framework for the Medicare Drug Price Negotiation Program, creating a more transparent and sustainable process for lowering drug costs for millions of Medicare beneficiaries. The proposed rule would also create greater long-term certainty for drug manufacturers that participate in negotiations. It includes policies for negotiating and renegotiating high-cost, single-source drugs beginning with initial price applicability year 2029, while continuing to support innovation and strengthen the program.

More information:

• Full press release
• Proposed rule
• Fact sheet (PDF)
• Timeline: Medicare Drug Price Negotiation Program Proposed Rule (CMS-4215-P) (PDF)
• Medicare Drug Price Negotiation Program 

Medicare Coverage Determination Process

The National Coverage Determination (NCD) Dashboard has been updated to reflect current lists of open NCDs, finalized NCDs, pending Transitional Coverage for Emerging Technologies (TCET) topics, and accepted NCD requests. https://www.cms.gov/files/document/ncddashboard.pdf

RARCs, CARCs, Medicare Remit Easy Print & PC Print: July Update

Get updated remittance advice remark codes (RARCs) and claim adjustment reason codes (CARCs). Watch for software updates if you use Medicare Remit Easy Print or PC Print.