CMS Proposes Voluntary Medicaid and Medicare GLP-1 Coverage Trial
CMS is proposing a five-year demonstration project to allow state Medicaid programs and Medicare Part D plans to voluntarily cover GLP-1 medications for weight management, including drugs like Ozempic, Wegovy, Mounjaro, Zepbound, and potentially Eli Lilly's oral GLP-1, Orforglipron. The initiative, managed by the Center for Medicare and Medicaid Innovation, aims to begin in April 2026 for Medicaid and January 2027 for Part D plans. This proposal follows CMS's earlier decision to not proceed with broader coverage of anti-obesity medications due to cost concerns, though it keeps the possibility open for future rulemaking.