{"id":598989,"date":"2026-04-22T05:19:13","date_gmt":"2026-04-22T05:19:13","guid":{"rendered":"https:\/\/www.newsbeep.com\/us\/598989\/"},"modified":"2026-04-22T05:19:13","modified_gmt":"2026-04-22T05:19:13","slug":"cms-cancels-medicare-pilot-offering-glp-1s-to-seniors-at-discount","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/us\/598989\/","title":{"rendered":"CMS cancels Medicare pilot offering GLP-1s to seniors at discount"},"content":{"rendered":"<p>WASHINGTON \u2014 The Trump administration had planned for insurers to provide cheap weight loss drugs to seniors through a Medicare pilot program. Insurers said no, so the government will instead cover the drugs outside of the Medicare Part D drug benefit.<\/p>\n<p>Last year, the Trump administration <a href=\"https:\/\/www.statnews.com\/2025\/11\/06\/trump-drug-price-deal-burning-questions\/\" rel=\"nofollow noopener\" target=\"_blank\">struck a deal with Eli Lilly and Novo Nordisk<\/a> to lower the prices of their popular obesity drugs <a href=\"https:\/\/www.statnews.com\/2025\/11\/06\/trumprx-weight-loss-drug-discounts-wegovy-zepbound\/\" rel=\"nofollow noopener\" target=\"_blank\">in exchange for expanding access<\/a> to those drugs in Medicare and Medicaid. Medicare is prohibited from covering weight loss drugs, but the administration proposed waiving that restriction to test whether covering the medications would save tmoney or improve health outcomes at no additional cost.<\/p>\n<p>\t\t\t<img decoding=\"async\" width=\"768\" height=\"432\" src=\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2025\/11\/GettyImages-1690305257-768x432.jpg\" class=\"attachment-article-main-medium-large size-article-main-medium-large\" alt=\"\" loading=\"lazy\"  \/>\t\t<\/p>\n<p>\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.statnews.com\/wp-content\/themes\/stat\/images\/home\/statplus.svg\" width=\"19\" height=\"16\" alt=\"\"\/><br \/>\n\t\t\t\t<a href=\"https:\/\/www.statnews.com\/2025\/11\/06\/trumprx-weight-loss-drug-discounts-wegovy-zepbound\/\" rel=\"nofollow noopener\" target=\"_blank\">STAT Plus: Trump announces deal with Lilly, Novo to expand access to weight loss drugs, cut prices<\/a><\/p>\n<p>The hitch was that insurers had to agree to participate in the pilot, called <a href=\"https:\/\/www.cms.gov\/priorities\/innovation\/innovation-models\/balance\" target=\"_blank\" rel=\"noopener nofollow\">BALANCE<\/a>, even though they would likely have faced a financial strain from doing so. The drugmakers agreed to sell the treatments for $245 a month in Medicare and Medicaid, but Medicare promised that\u00a0 beneficiaries would only pay $50 each month.\u00a0<\/p>\n<p class=\"restricted-text\">STAT+ Exclusive Story<\/p>\n<p class=\"restricted-login\">Already have an account? <a href=\"https:\/\/www.statnews.com\/login\/\" data-stat-login=\"\" data-stat-paywall-cta=\"breaker login cta\" rel=\"nofollow noopener\" target=\"_blank\">Log in<\/a><\/p>\n<p>\t\t\t<img decoding=\"async\" class=\"restricted-content-breaker-bg\" src=\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2025\/12\/1765280600_844_stat-plus-breaker-bg.png\" alt=\"STAT+\"\/><\/p>\n<p>\t\t\t\t\t<a href=\"https:\/\/www.statnews.com\/stat-plus\/\" rel=\"nofollow noopener\" target=\"_blank\"><br \/>\n\t\t\t\t\t\t<img decoding=\"async\" class=\"stat-plus-logo\" src=\"https:\/\/www.statnews.com\/wp-content\/themes\/stat\/images\/stat-plus-logo-white.svg\" alt=\"STAT+\"\/><br \/>\n\t\t\t\t\t<\/a><\/p>\n<p>\t\t\t\tThis article is exclusive to STAT+ subscribers<br \/>\n\t\t\t\tUnlock this article \u2014 plus daily coverage and analysis of the biotech sector \u2014 by subscribing to STAT+.<\/p>\n<p class=\"restricted-content-breaker-wrapper-cta mobile\">Already have an account? <a href=\"https:\/\/www.statnews.com\/login\/\" data-stat-login=\"\" data-stat-paywall-cta=\"breaker login cta mobile\" rel=\"nofollow noopener\" target=\"_blank\">Log in<\/a><\/p>\n<p>\t\t\t\t\t\tIndividual plans<\/p>\n<p>\t\t\t\t\t\tGroup plans<\/p>\n<p>\t\t\t\t<a href=\"https:\/\/www.statnews.com\/stat-plus\/\" class=\"stat-button view-all\" data-stat-paywall-cta=\"breaker view all plans\" aria-label=\"View All Plans\" rel=\"nofollow noopener\" target=\"_blank\">View All Plans<\/a><\/p>\n<p class=\"restricted-content-text\">\n\t\t\t\t\t\tTo read the rest of this story subscribe to STAT+.\t\t\t\t\t<\/p>\n<p>\t\t\t\t\t<a href=\"https:\/\/www.statnews.com\/stat-plus\/\" class=\"stat-button restricted-button\" data-stat-paywall-cta=\"breaker subscribe cta 1\" rel=\"nofollow noopener\" target=\"_blank\">Subscribe<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"WASHINGTON \u2014 The Trump administration had planned for insurers to provide cheap weight loss drugs to seniors through&hellip;\n","protected":false},"author":2,"featured_media":598990,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[59],"tags":[10212,10790,48123,97,252,253,1342,9046,247,1343,248],"class_list":{"0":"post-598989","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-health-care","8":"tag-cms","9":"tag-drug-prices","10":"tag-eli-lilly","11":"tag-health","12":"tag-health-care","13":"tag-healthcare","14":"tag-medicare","15":"tag-novo-nordisk","16":"tag-pharmaceuticals","17":"tag-policy","18":"tag-stat"},"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts\/598989","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/comments?post=598989"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts\/598989\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/media\/598990"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/media?parent=598989"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/categories?post=598989"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/tags?post=598989"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}