GLOBE final model: manufacturer rebates and selected Part B drug coinsurance preparation

What happened

CMS published the GLOBE final rule October 2, with regulatory effectiveness November 30, 2026. The model begins January 1, 2027 with voluntary manufacturer international net-pricing data submission; its five performance years run April 1, 2027 through March 31, 2032, with associated rebate payment and reconciliation extending through March 31, 2034. It tests an alternative calculation for manufacturer Part B inflation rebates on selected separately payable drugs. Eligible single- or sole-source products must meet specified drug-category and spending criteria, beginning with a $100 million threshold, subject to exclusions including negotiated-price drugs, qualifying orphan-only indications, listed cell/gene therapies and plasma-derived products.

CMS selects geographic areas by ZIP-based random assignment representing about 25 percent of Original Medicare Part B beneficiaries, then determines individual eligibility. Original Medicare Part B must be primary; Medicare Advantage, cost/prepayment plans and other primary group coverage are excluded. Providers, suppliers and beneficiaries are not the manufacturer model participants, and providers continue buying and billing drugs while CMS determines applicable coinsurance adjustments. Reduced coinsurance uses the lesser relevant benchmark/inflation-adjusted amount when the statutory comparison triggers it, with Medicare payment adjusted accordingly and other claim adjustments and the deductible preserved. As of October 4, drug and beneficiary selection and implementation guidance remain necessary before changing patient estimates; the model is not a universal replacement of Part B rates.

Why it matters

Manufacturer rebate obligations and provider collection changes involve different actors and dates, and patient liability depends on selected drugs and beneficiaries.

Implementation playbook

1. Inventory potentially affected drugs and contracts, monitor CMS selection and implementation guidance, and test beneficiary coinsurance workflows before the applicable payment quarter. Finance · Due 2027-01-01
2. Record the applicability assessment and validate the affected workflow with its operational owner. This is an internal review target, not an additional statutory deadline. Compliance · Due 2026-10-12

Sources

• Global Benchmark for Efficient Drug Pricing (GLOBE) ModelOfficial · Health and Human Services Department, Centers for Medicare & Medicaid Services · 2026-10-02 · Source review 2026-10-05
• CMS finalizes GLOBE drug payment modelOfficial · CMS · 2026-09-30 · Source review 2026-10-04