CMS: Guarding U.S. Medicare Against Rising Drug Costs (GUARD) Model

Federal Register

Dec 23, 2025

Notice from the Centers for Medicare & Medicaid Services (CMS) seeking comments on a proposed rule implementing the Guarding U.S. Medicare Against Rising Drug Costs (GUARD) Model to test a new Medicare payment model under section 1115A of the Social Security Act. The model proposes a test of an alternative payment method for calculating inflation rebates for certain Part D drugs and biological products. The proposed GUARD Model would test whether changing the calculation of the Part D inflation rebate would reduce costs for the Medicare program while preserving or enhancing quality of care for Part D enrollees. Comments are due by February 23, 2026.

Medicare · Pharmacy and prescription drugs · Policy · Reimbursement and payment models