Insights: Policy

Despite President Trump’s request for a 40% reduction in NIH funding for FY26, Congressional appropriators are preliminarily moving in the direction of keeping NIH funding flat to modestly positive next fiscal year.

340B Drug Discount Program

The Health Resources and Services Administration (HRSA) has begun accepting applications for a voluntary 340B Rebate Model Pilot Program that will allow drug manufacturers to provide 340B-discounted drug prices using a rebate mechanism. The pilot is set to begin January 1, 2026 and last at least one year. In practice, such rebate models have the...

The Center for Medicare & Medicaid Innovation (CMMI) is in the process of developing a demonstration program which would test allowing Medicare Part D plans and state Medicaid program to cover GLP-1 products for weight loss purposes. Reports suggest the demonstration could begin as soon as Q2 next year for state Medicaid programs (~2027 for...

Drug Pricing/Most-Favored Nation

The Trump administration is escalating its efforts to compel drugmakers to offer most-favored nation (MFN) prices to American consumers (i.e., prices equivalent to those offered in the markets of countries comparable to the U.S. economically/developmentally). In recent days, the White House issued letters to more than a dozen drugmakers demanding...

Medicare Hospice Reimbursement

As part of the FY26 hospice final rule, CMS will increase hospice payments by 2.6% ($750m) relative to FY25 levels and set the annual per beneficiary payment cap at $35,361.44 (increased from $34,465.34 in FY25).

Medicare Skilled Nursing Facility (SNF) Reimbursement

As part of the FY26 SNF final rule, CMS will increase SNF payments by 3.2% ($1.16b) relative to FY25.