Description

CMS GLOBE Model 2027: Understanding the New Mandatory Medicare Part B Drug Payment & International Pricing Rules

The Centers for Medicare & Medicaid Services (CMS) has finalized the Global Benchmark for Efficient Drug Pricing (GLOBE) Model, a mandatory payment model designed to test an alternative approach to calculating rebates for certain high-cost prescription drugs covered under Original Medicare Part B.

Effective January 1, 2027, the GLOBE Model will use an international pricing benchmark to calculate manufacturer rebates for eligible drugs when applicable prices exceed those paid in economically comparable countries. The model focuses on selected Part B drugs typically administered in clinical settings, including certain cancer therapies and medications used to treat autoimmune conditions and arthritis.

The model is intended to reduce Medicare spending on selected drugs and lower out-of-pocket costs for eligible beneficiaries while preserving access to necessary treatments and quality of care. Its implementation introduces important considerations for Medicare reimbursement, drug billing, claims processing, beneficiary coinsurance, and revenue cycle management.

This webinar will provide a practical overview of the CMS GLOBE Model, its international pricing methodology, implementation timeline, eligible drug considerations, and potential implications for healthcare providers, medical coders, billers, auditors, and revenue cycle professionals.

Agenda:-

• Introduction to the CMS GLOBE Model
• Medicare Part B Drug Spending and the Rationale for the Model
• International Pricing Benchmarks and Manufacturer Rebates
• Eligible Drugs, Key Exclusions, and Geographic Applicability
• Medicare Payment, Beneficiary Coinsurance, and Financial Implications
• Implementation Timeline and Provider Operational Readiness
• Live Question & Answer.

Learning Objectives:-

• Explain the purpose, scope, and objectives of the CMS GLOBE Model.
• Understand the international pricing benchmark and alternative manufacturer rebate methodology.
• Identify the categories of Medicare Part B drugs addressed by the model and key exclusions.
• Review the model's implementation timeline, geographic selection, and beneficiary applicability.
• Understand the potential impact on Medicare Part B drug reimbursement and beneficiary coinsurance.
• Recognize operational considerations for drug billing, claims processing, and revenue cycle management.
• Identify official CMS resources for monitoring implementation requirements and updates.

Session Highlights:-

• Overview of the finalized CMS GLOBE Model
• International drug pricing and rebate methodology
• Selected Medicare Part B drugs and model exclusions
• Geographic selection and beneficiary applicability
• Potential reimbursement and coinsurance implications
• Key implementation dates and operational considerations
• Practical insights for billing, coding, auditing, and RCM teams.

Who Should Attend?

• Physicians and Healthcare Providers
• Medical Coders and Billers
• Coding Auditors and Compliance Professionals
• Revenue Cycle Management Professionals
• Physician Practice Managers
• Healthcare Administrators
• Medicare Billing and Reimbursement Specialists
• Healthcare Consultants and Educators.