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CY 2026 Physician Fee Schedule Final Rule Update: Preliminary ASP Reasonable Assumption and BFSF Certification Forms Available

On October 31, 2025, the Centers for Medicare & Medicaid Services (CMS) issued the physician fee schedule (PFS) final rule for calendar year (CY) 2026 (Final Rule). ...more

CMS announces voluntary “GENEROUS” Medicaid most-favored-nation drug pricing model, planned to launch in 2026

On November 6, 2025, the Centers for Medicare & Medicaid Services (CMS) announced a new drug payment model designed to make Most Favored Nation (MFN)-level prices available to state Medicaid programs via manufacturer rebates....more

2026 Medicare Physician Fee Schedule Final Rule adopts some but not all Average Sales Price proposals and revised Medicare...

On October 31, 2025, the Centers for Medicare & Medicaid Services (CMS) issued the physician fee schedule (PFS) final rule for calendar year (CY) 2026 (Final Rule). It has been several years since this annual rulemaking...more

CMS Issues Final Guidance on IPAY 2028 Drug Price Negotiation Program, 2026-28 MFP Effectuation

On September 30, 2025, the Centers for Medicare & Medicaid Services (CMS) issued final guidance (Final Guidance) for initial price applicability year (IPAY) 2028 of the Inflation Reduction Act (IRA) Drug Price Negotiation...more

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