Author(s):
On February 3, 2026, a broad, bipartisan federal government funding package was signed into law by President Trump, advancing several provisions supported by ACCC members that are important to cancer care teams and patients with cancer.
Telehealth
The law includes a 2-year extension of Medicare telehealth flexibilities through December 31, 2027. This means that Medicare patients can continue to receive telehealth visits in their homes during this period, among other flexibilities for patients and providers.1
Multi-Cancer Early Detection Screening
Routine screening has the potential to detect several types of cancer earlier, making it more likely that treatment will be successful. However, currently, routine screening is only available for 5 types of cancer.2 To combat this, the Nancy Gardner Sewell Medicare Multi-Cancer Early Detection (MCED) Screening Coverage Act was included in the final government funding package. This legislation establishes a pathway for Medicare coverage of MCED tests, provided a test has received FDA approval.3 ACCC worked with a coalition of more than 550 advocacy organizations over several years to advocate for Medicare coverage of these tests.
ACCC is grateful for the leadership of several bipartisan co-sponsors of this legislation, including Representatives Jodey Arrington (R-Texas) and Terri Sewell (D-Alabama), and Senators Michael Crapo (R-Idaho) and Ron Wyden (D-Oregon), along with many members of Congress, whose support led to the passage of this important law.
Funding for the NCI and the NIH
The legislation provided $7.35 billion in funding for the National Cancer Institute (NCI), an increase of $128 million from FY 2025.4 It also included $30 million in funding for the Childhood Cancer STAR Act and $50 million for the Childhood Cancer Data Initiative, among other provisions.5 In total, the National Institutes of Health (NIH) received $48.7 billion in funding.6
Centers for Medicare & Medicaid Services Activity on Drug Pricing
In December 2025, the Centers for Medicare & Medicaid Services’ (CMS) Center for Medicaid and Medicare Innovation released 2 proposed models that incorporate international drug prices in their methodologies—Global Benchmark for Efficient Drug Pricing (GLOBE) (Part B) and Guarding US Medicare Against Rising Drug Costs (Part D). The agency expects to reduce Medicare spending by introducing international pricing benchmarks into the calculation of manufacturer rebates under the Inflation Reduction Act (IRA). It also anticipates that the models will lower out-of-pocket drug costs for beneficiaries.7,8
The GLOBE model uses legal authority to waive certain provisions of the IRA to implement payment reforms on certain Medicare Part B drugs being used by certain Medicare beneficiaries.9 Many ACCC members administer Medicare Part B drugs, and therefore, these models may affect their patients. Key aspects of this model are highlighted below.
GLOBE Model
The GLOBE model targets high-cost singlesource drugs and biological products in select therapeutic categories that are subject to the Medicare Part B Drug Inflation Rebate Program, including drugs used in oncology, rheumatology, and immunology therapies.10 Drugs must have Medicare Part B Fee-forService (FFS) spending greater than $100 million over a 12-month period. The model excludes drugs that have a (negotiated) maximum fair price in effect.9
GLOBE covers beneficiaries with traditional FFS Medicare Part B selected by geographic and coverage criteria. This comprises approximately 25% of Medicare Part B FFS beneficiaries.11
Under the GLOBE model, manufacturers would owe a rebate when the model’s international pricing-based rebate formula yields a result greater than that under the existing statutory inflation rebate calcula-tion.11 The GLOBE rebate calculation is based on international prices from economically comparable countries (non-US, Organisation for Economic Co-operation and Development [OECD] countries) with a gross domestic product (GDP) per capita of at least 60% of that of the United States, and an annual aggregate GDP of at least $400 billion. The following reference countries are listed as meeting the specified criteria: Australia, Austria, Belgium, Canada, the Czech Republic, Denmark, France, Germany, Ireland, Israel, Italy, Japan, the Netherlands, Norway, South Korea, Spain, Sweden, Switzerland, and the United Kingdom.
The proposal would calculate a rebate relative to international prices in certain developed countries in 2 distinct ways, and the default international benchmark would be the greater of the 2 prices.9 The total GLOBE rebate amount is the international benchmark amount subtracted from the Medicare average sales price–based payment amount minus the inflation rebate amount. Manufacturers would therefore owe any incremental amount in excess of any Medicare Part B inflation rebate amount.11
Providers would continue to buy and bill drugs as they do now. If the model results in a lower coinsurance amount for a beneficiary, Medicare would make an upward adjustment to the Part B payment to the provider.12 The model states that it aims to reduce beneficiary coinsurance payments along with Medicare spending.12 However, the eligibility criteria do not distinguish between the vast majority of beneficiaries who have supplemental health care coverage versus those who do not.12,13 Additionally, CMS acknowledges that the model could have spillover effects that result in higher cost-sharing and reduced supplemental benefits for beneficiaries enrolled in Medicare Advantage.9,11,12 Hence, CMS acknowledges that the GLOBE model could have both direct and indirect effects, some of which may negatively impact beneficiaries.
The proposed model will have a 5-year performance period, running from October 2026 through September 2031, with rebate invoicing, payment, and reconciliation continuing through September 2033, for a 7-year model period overall.11 ACCC has provided comments on the GLOBE model to CMS, including concerns about its use of international drug pricing for calculating Medicare Part B–related rebates, and the risks of certain negative impacts on Medicare beneficiaries.
Nicole Tapay, JD, is the director of cancer care delivery and health policy for the Association of Cancer Care Centers in Rockville, Maryland.
References
1. Telehealth policy updates. U.S. Department of Health and Human Services. Accessed February 23, 2026. https://telehealth.hhs.gov/providers/ telehealth-policy/telehealth-policy-updates
2. ACCC urges Congress to pass the Multi-Cancer Early Detection Act. ACCC. January 21, 2026. Accessed February 23, 2026. https://www. accc-cancer.org/view/ accc-urges-congress-to-pass-the-multi-cancerearly-detection-act
3. On World Cancer Day, Rep. Sewell celebrates signing of the Nancy Gardner Sewell Multi-Cancer Early Detection Act. Office of Representative Terri Sewell. February 4, 2026. Accessed February 23, 2026. https://sewell.house.gov/2026/2/ on-world-cancer-day-rep-sewell-celebratessigning-of-the-nancy-gardner-sewell-multi-cancerearly-detection-act
4. NCI budget and appropriations. National Cancer Institute. February 5, 2026. Accessed February 23, 2026. https://www.cancer.gov/about-nci/budget
5. Kean J. Signed into law: new hope for kids with cancer. Children’s Cancer Cause. February 5, 2026. Accessed February 23, 2026. https://www. childrenscancercause.org/blog/ signed-into-law-new-hope-for-kids-with-cancer
6. Congress approves FY 2026 labor, HHS, education appropriations bill. U.S. Senate Committee on Appropriations. February 3, 2026. Accessed February 23, 2026. https://www.appropriations.senate.gov/ news/majority/congress-approves-fy-2026-laborhhs-education-appropriations-bill
7. GUARD (guarding U.S. Medicare against rising drug costs) model. Centers for Medicare and Medicaid Services. December 29, 2025. Accessed February 23, 2026. https://www.cms.gov/priorities/ innovation/innovation-models/guard
8. GLOBE (global benchmark for efficient drug pricing) model. Centers for Medicare and Medicaid Services. December 29, 2025. Accessed February 23, 2026. https://www.cms.gov/priorities/innovation/ innovation-models/globe
9. Martin K, Sachs R. Administration releases proposed Medicare international drug reference pricing models. Health Affairs. December 24, 2025. Accessed February 23, 2026. https://www.healthaffairs.org/content/forefront/administration-releases-proposed-medicareinternational-drug-reference-pricingmodels#:~:text=On%20Friday%2C%20December%2019%2C%20the,Administration%E2%80%99s%20drug%20pricing%20reform%20strategy
10. Proposed Medicare drug pricing models aim to align U.S. drug prices with costs in other countries. ASCO. January 13, 2026. Accessed February 23, 2026. https://www.asco.org/news-initiatives/policynews-analysis/proposed-medicare-drug-pricing-modelsaim-align-us-drug-costs
11. Curran AV, Bianchi MK, Roberts BL, et al. CMS issues mandatory Medicare models implementing most favored nation drug pricing: GLOBE (Part B) and GUARD (Part D). Hogan Lovells. December 30, 2025. Accessed February 23, 2026. https://www. hoganlovells.com/en/publications/ cms-issues-mandatory-medicare-modelsimplementing-most-favored-nation-drug-pricing
12. Federal Register, 60244. Vol 90, No 244. December 23, 2025. Accessed February 23, 2025. https://www.govinfo.gov/content/pkg/FR-2025-12- 23/pdf/2025-23702.pdf
13. Ochieng N, Cubanski J, Neuman T; KFF. A snapshot of sources of coverage among Medicare beneficiaries. December 19, 2025. Accessed February 23, 2026. https://www.kff.org/medicare/a-snapshot-of-sourcesof-coverage-among-medicare-beneficiaries/
