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

What happened

The October 2 final rule is effective November 30. The model begins January 1, 2027 with an initial reporting quarter for voluntary manufacturer-submitted international net-pricing data. Its five-year performance period begins April 1, 2027 and ends March 31, 2032; the payment period runs from April 1, 2027 through March 31, 2034 or completion of payment activities, if later, subject to the rule's early-termination provisions. Manufacturer rebate duties and beneficiary-facing payment operations therefore need to be distinguished from the initial voluntary data submission.

The model covers a defined Original Medicare Part B population rather than every Medicare beneficiary, and its coinsurance calculation concerns separately payable units of included model drugs furnished to model beneficiaries. CMS compares the payment amount with the lesser of the model benchmark and inflation-adjusted amount for the quarter. When the payment amount exceeds that comparison amount, coinsurance is calculated as twenty percent of the comparison amount; otherwise the specified ordinary coinsurance applies. Excluded drugs do not receive the model adjustment, and adjusted Medicare payment remains subject to other claim adjustments and the Part B deductible. These gates preclude a universal January change to all Part B patient estimates.

Why it matters

Infusion and specialty practices need to determine affected drugs and beneficiaries before changing billing or patient estimates. The final model is not a general replacement of every Part B payment rate.

Implementation playbook

1. Separate November rule effectiveness, January manufacturer data collection and April beneficiary/payment operations. Identify CMS-selected drugs and beneficiaries and test applicable coinsurance only after the quarter-specific instructions are available. Finance · Due 2027-04-01
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 2026-10-11
• CMS finalizes GLOBE drug payment modelOfficial · CMS · 2026-09-30 · Source review 2026-10-04