CMS announces GENEROUS drug payment model aimed at lowering Medicaid drug prices

New Medicaid work requirements could lead to 1.6 million missed cancer screenings over two years

New Medicaid work requirements included in President Donald Trump’s “One Big Beautiful Bill Act” could result in as many as 1.6 million missed screenings for breast, colon, and lung cancers within the first two years, researchers at the University of Chicago reported in a paper published in JAMA Oncology earlier this month.

When “safe and effective” is not “reasonable and necessary”
We can curb excessive drug dosing and improve the quality of cancer care

By law, the Food and Drug Administration is required to determine whether a drug, device, biologic, or medical device is “safe and effective.” But the FDA determination does not control whether the Centers for Medicare & Medicaid Services will pay for it. To satisfy CMS, medical products and services must be “reasonable and necessary,” meaning...

January 16, 2026

Vol.52 No.02

By Mark J. Ratain and David A. Hyman

Cancer Policy

CMS awards $50 billion for rural health care after states compete for funding

The Centers for Medicare and Medicaid Services is awarding $50 billion to all 50 states as part of the Rural Health Transformation Program—funding established through the One Big Beautiful Bill passed in July.

Federal judge orders temporary block on 340B drug rebate pilot program

A federal judge has blocked the Health Resources and Services Administration from rolling out a pilot program that would reimburse safety net hospitals that get a discount on drugs through the 340B program via a rebate, as opposed to the status quo of up-front savings. The preliminary injunction was issued on Dec. 29, just a few days before the program was slated to begin on Jan 1.

CMS cuts deal on four oncology drugs under Medicare

The Center for Medicare and Medicaid Services said it has negotiated down the price of 15 drugs, including significant discounts to four costly cancer treatment drugs, according to an announcement from Nov. 25.

Medicare Part B premiums expected to rise almost 10% in 2026

Centers for Medicare and Medicaid Services has announced that monthly premiums for Medicare Part B will begin costing patients $202.09 per month next year—a 9.7% rise up from $185 in 2025—for individuals making an annual income of $109,000 or less.

December 05, 2025

Vol.51 No.44

By Sara Willa Ernst

CMS announces GENEROUS drug payment model aimed at lowering Medicaid drug prices

YOU MAY BE INTERESTED IN

New Medicaid work requirements could lead to 1.6 million missed cancer screenings over two years

When “safe and effective” is not “reasonable and necessary”
We can curb excessive drug dosing and improve the quality of cancer care

CMS awards $50 billion for rural health care after states compete for funding

Federal judge orders temporary block on 340B drug rebate pilot program

CMS cuts deal on four oncology drugs under Medicare

Medicare Part B premiums expected to rise almost 10% in 2026

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CMS announces GENEROUS drug payment model aimed at lowering Medicaid drug prices

YOU MAY BE INTERESTED IN

New Medicaid work requirements could lead to 1.6 million missed cancer screenings over two years

When “safe and effective” is not “reasonable and necessary”We can curb excessive drug dosing and improve the quality of cancer care

CMS awards $50 billion for rural health care after states compete for funding

Federal judge orders temporary block on 340B drug rebate pilot program

CMS cuts deal on four oncology drugs under Medicare

Medicare Part B premiums expected to rise almost 10% in 2026

Never miss an issue!

Login

When “safe and effective” is not “reasonable and necessary”
We can curb excessive drug dosing and improve the quality of cancer care