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What CMS is planning to do Through the BALANCE Model, CMS plans to: Work with voluntary GLP-1 manufacturers to establish pricing and access terms Create a standardized pathway for participating Medicaid programs and Medicare plans to cover these medications Pair medication access with lifestyle and nutrition supports grounded in current scientific evidence Evaluate how the model affects access to care, health outcomes, costs and peoples experiences Key dates to know What we dont know yet Several important details have not been finalized, including: When beneficiaries will know whether their state Medicaid program or Medicare plan is participating What the enrollment process will look like The exact clinical criteria for individual eligibility to the programs What lifestyle and nutrition supports will be offered Whether lifestyle and nutrition supports will differ by drug manufacturer Because participation is voluntary for manufacturers and plans, we dont know how many people will participate in the programs An important first step Most people living with obesity who rely on Medicare or Medicaid face barriers to accessing obesity treatments

Study overview: Researchers from Alliance Medical (Europe) analyzed oncologic PET-CT scans in patients receiving GLP-1 therapy and observed abnormal fluorodeoxyglucose (FDG) uptake patterns that could easily be mistaken for pathological hot spots. In some cases, what appears to be malignant metabolic activity may, in fact, represent drug-induced metabolic redistributionlikely linked to delayed gastric emptying and altered glucose metabolism caused by GLP-1 agonism

Last reviewed 2026-07-03

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