NAMD Comments on Proposed Rule that Would Require Medicaid Coverage of Anti-Obesity Medications

In December 2024, CMS issued a proposed rule, Medicare and Medicaid Programs; Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All Inclusive Care for the Elderly.

In this rule, CMS proposes to reinterpret the statutory exclusion of weight loss drugs to require Medicaid and to allow Medicare Part D to cover these drugs when they are used for the treatment of obesity. Medicaid agencies report significant concerns over the fiscal impacts of this proposal and strongly recommend that CMS maintain the current state option to cover or not cover anti-obesity medications. CMS also proposes changes to improve care coordination for individuals who are dually eligible for Medicare and Medicaid. Medicaid agencies generally support these changes.

You can read NAMD’s full comments here.