CMS has added 13 new modifiers and extended the one of one, as indicated in the January 2011 Integrated Outpatient Code Editor. Most of the new modifiers went into effect Jan. 1, but one new modifier ...
On December 19, 2025, the Centers for Medicare & Medicaid Services (CMS) released GLOBE (Global Benchmark for Efficient Drug Pricing Model) and GUARD (Guarding U.S. Medicare Against Rising Drug Costs) ...
On December 19, 2025, the Centers for Medicare & Medicaid Services (“CMS”) proposed two mandatory Center for Medicare and Medicaid Innovation (“CMMI”) drug payment models to test whether alternative ...
The Centers for Medicare & Medicaid Services offered the first look at the potential savings generated by the first crop of Medicare drug price negotiations. On Thursday morning, the agency released ...
CMS recently announced the next 15 drugs that will be subject to price negotiations under the Inflation Reduction Act of 2022 (IRA). These are negotiations in name only because CMS can levy penalties ...
Managed care plans, which contract with states to cover three-quarters of Medicaid enrollees, play a crucial role in addressing the drug epidemic in the United States. However, substance use disorder ...
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