Health Policy Report – January 13, 2026

The US Oncology Network Releases 2025 Recap Video

The Network has released a new end-of-year video highlighting our advocacy efforts in Washington, D.C., and across the states in 2025.

The video features footage from our PAC Board and Surgeon Fly-Ins in Washington, D.C., as well as our State Days at the Capitol in Nevada and Texas. It also spotlights key achievements—including a bill signing with Governor Wes Moore. Interviews include insights from Dr. Les Busby, Chief Medical Officer, and Network physicians such as Dr. Joseph Mock of Blue Ridge Cancer Care and Dr. Jennifer Gordon of Willamette Valley Cancer Institute & Research Center.

“In states across the country, we’ve championed efforts to pass nearly a dozen bills that protect patient access to timely care and ensure PBM transparency. At the federal level, The Network has played a central role in the success of recent site neutral payment reform that levels the playing field between hospitals and community practices. We’ve also been fighting for comprehensive physician payment reform that aligns annual payments with inflation,” said Ben Jones, Senior Vice President of Government and Marketing. 

Thank you to the Network physicians and practice staff who contributed to our advocacy in 2025! We look forward to another successful year ahead. 

SCRI Oncology Partners Hosts Members of Tennessee State Legislature 

On January 5, SCRI Oncology Partners hosted Tennessee Senators Johnson and Reeves, as well as Representatives Lamberth, Love, Hemmer, Mitchell, and Clemmons for a clinic tour in Nashville, Tennessee. Dr. David Spigel, Dr. Melissa Johnson, Dr. Erika Hamilton, and Dr. Meredith McKean led a tour and discussion with the lawmakers, highlighting the importance of expanded access to clinical trials in the community setting. 

Additionally, SCRI Oncology Partners highlighted the importance of biomarker testing in cancer care, as lawmakers are considering a bill that would require coverage for biomarker testing for patients with metastatic cancer. Senator Reeves was in attendance and is the sponsor of this bill in the Senate. Representative Hemmer was also in attendance and is a co-prime sponsor of the House version.

We thank these lawmakers – who hold a wide variety of leadership roles in the Tennessee Legislature – for taking the time to visit, listen, and engage with our providers. If your practice is interested in hosting a site visit, please contact Angela Storseth at angela.storseth@usoncology.com.

To read more, CLICK HERE. 

Community Oncology Has a Seat in Minnesota’s Health Care Cost Conversations 

Dr. Amy McNally of Minnesota Oncology and The US Oncology Network’s Chief Surgical Officer has recently been appointed to Minnesota’s Provider & Payer Task Force under the Center for Health Care Affordability, bringing front line cancer care experience directly into the state’s affordability work.

Dr. McNally also serves on Minnesota’s Prescription Drug Affordability Advisory Council (PDAAC), which advises the state’s Prescription Drug Affordability Board (PDAB) on drug cost issues, another forum where community oncology can push for practical, patient first solutions.

Community oncology clinics face the consequences of prior authorizations, drug pricing, and benefit design every day. Having a physician voice in the room will help Minnesota craft cost strategies that protect local access for patients, cut waste, and reflect the realities of community of cancer care.

CMS Announces GLOBE and GUARD MFN Models

On December 19, President Trump announced nine new “most favored nation” (MFN) drug pricing agreements with pharmaceutical companies—Bristol Myers Squibb (BMS), Gilead Sciences, Merck, Novartis, Amgen, Sanofi, Boehringer Ingelheim, and GSK.

Shortly after the announcement, the Centers for Medicare & Medicaid Innovation (CMMI) released two new notices of proposed rulemaking for mandatory drug pricing models, titled the Global Benchmark for Efficient Drug Pricing (GLOBE) and Guarding U.S. Medicare Against Rising Drug Costs (GUARD). Both models provide for a 60-day comment period. 

GLOBE proposes a new Medicare payment model to test an alternative method for calculating Part B inflation rebate amounts for certain Medicare Part B drugs and biological products. To qualify for inclusion, these drugs must have Medicare Part B fee-for-service (FFS) spending exceeding $100 million over a 12-month period. Beneficiaries eligible for the model are identified based on their residence in the selected geographic areas and enrollment in traditional Medicare Part B FFS. Those enrolled in Medicare Advantage plans or who have other primary coverage are excluded from the model.

Participation in the model is mandatory for manufacturers of GLOBE Model drugs. While providers and suppliers continue to bill and receive payment as usual, beneficiaries within the model cohort see reduced coinsurance, lowering their out-of-pocket costs.

GLOBE is a 5-year model, which would launch on October 1, 2026, and run through 2031, with rebate invoicing and reconciliation continuing into 2033.

GUARD also proposed a new payment model to test an alternative method for calculating inflation rebates for certain Medicare Part D drugs and biological products, focusing on sole-source drugs and biologicals within specific therapeutic categories. The model targets approximately 25% of Medicare Part D enrollees residing in randomly selected geographic areas and requires mandatory participation from manufacturers of included drugs. GUARD would be tested over a 5-year performance period that would launch January 1, 2027, and run through December 31, 2031, with rebate invoicing and reconciliation continuing into 2033.

The Network will continue to review both Proposed Rules and provide comments prior to the Monday, February 23, 2026 deadline.To read more about the Notice of Proposed Rule Making on GLOBE, CLICK HERE.

To read the Proposed Rule on GLOBE in its entirety, CLICK HERE.

To read more about the Notice of Proposed Rule Making on GUARD, CLICK HERE.

To read the Proposed Rule on GUARD in its entirety, CLICK HERE.

Congress Reconvenes with Looming Funding Deadline

As Congress reconvenes, lawmakers are working to avoid another government shutdown ahead of the funding deadline on January 31.

The expired Affordable Care Act (ACA) credits – which were at the center of last year’s government shutdown – remain a contentious issue. On January 8, the House of Representatives advanced a three-year extension of ACA credits, sending the proposal to the Senate, where negotiations are ongoing and a path forward on the House extension remains unclear.

Health care remains at the forefront of spending negotiations and is likely to remain a top issue on Capitol Hill this year. According to reports, policymakers are increasingly coalescing around plans to expand site neutral payment reforms, which would equalize payment between the hospital outpatient department (HOPD) and physician office setting. Last year, the Centers for Medicare & Medicaid Services (CMS) moved ahead with plans to align payments for drugs across settings.

To read more, CLICK HERE.

340B Rebate Program Put on Hold

The 340B rebate program proposed by the Department of Health & Human Services (HHS) has been put on hold after a federal court issued an order temporarily blocking the Trump administration from moving ahead with the model.

The pilot program, if enacted, would have required hospitals to purchase 340B-eligible drugs at full price and then receive rebates from several drug companies in the trial program. Hospitals sued to block the pilot program in early December, arguing that the Trump administration had illegally rushed it into implementation.

On December 29, a U.S. District Court judge issued a preliminary injunction preventing the program from going into effect on January 1, as proposed. HHS immediately filed an appeal challenging that ruling with the First Circuit Court of Appeals.

Soon after, HHS dropped the appeal. “The parties are engaged in discussions about returning the approvals challenged in this litigation to the agency for reconsideration. The agency intends to resolve such proceedings promptly. Therefore, the parties do not believe that expediting this appeal is warranted at this time and plan to dismiss the appeal in short order,” an attorney representing HHS wrote in a letter.

At this point, the matter will be returned to HHS and the Health Resources and Services Administration (HRSA) for further consideration. It is unclear whether the matter will be tabled or amended.

To read more, CLICK HERE.