Regulatory NewsBREAK: CMS Issues Status Update on the BRIDGE Demo and BALANCE Model in Part D for CY 2027

Topic(s):

Legislation & Regulation

On April 21, 2026, the Centers for Medicare & Medicaid Services (CMS) issued a Status Update on the Medicare GLP-1 BRIDGE Demo and BALANCE Model in Part D for CY 2027.

The GLP-1 Bridge demonstration will start on July 1, 2026 and is being extended through December 31, 2027. This program will provide eligible Part D beneficiaries with access to certain GLP-1 medications outside of the Part D benefit coverage and payment flow.

Implementation of the Medicare Part D portion of the BALANCE Model for CY 2027 is delayed pending further evaluation and data collection.

Part D sponsors should not indicate participation in the BALANCE Model for CY 2027 in the Health Plan Management System or Bid Pricing Tool.

The CMS Innovation Center will accept BALANCE Model applications from State Medicaid Agencies through July 31, 2026; states can start participation between May 1, 2026, and January 1, 2027.

States not joining by January 1, 2027 will need CMS authorization, at its discretion, to participate later.

Additional guidance and stakeholder materials for the GLP-1 Bridge will be released in the coming weeks.

CMS will issue further guidance ahead of the July 1, 2026 launch of the extended GLP‑1 Bridge.

More on This Topic:

Status Update
BALANCE Model
BRIDGE Demo
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