Congress Passes Slimmed-Down Continuing Resolution, Extends Telehealth Flexibilities and Includes PBM Reform

Continuing Resolution (CR) Passed:
Congress has passed a short-term CR that extends government funding until March 14, 2025, and includes several healthcare provisions23.

Telehealth Flexibilities Extended:
The CR extends Medicare telehealth flexibilities and the Acute Hospital Care at Home (AHCAH) program through March 31, 202523.

PBM Reform Included:
The bill includes significant reforms for pharmacy benefit managers (PBMs), such as prohibiting "spread pricing" in Medicaid, requiring full rebate pass-through to plan sponsors in the commercial market, and delinking PBM compensation from drug prices in Medicare Part D35.

Other Healthcare Provisions:
The CR also delays Medicaid disproportionate share hospital (DSH) pay cuts until January 1, 2027, and temporarily increases the Medicare physician fee schedule by 2.5% for 20253.

Limited Scope:
The CR does not include broader healthcare reforms, such as permanent telehealth flexibilities or comprehensive prior authorization reforms, which were advocated for by various healthcare groups24.

Future Advocacy:
Healthcare organizations will continue to advocate for longer-term extensions and more comprehensive reforms in the future24.

Sources:

2. https://www.americantelemed.org/press-releases/new-continuing-resolution-passes-keeps-some-telehealth-flexibilities-alive/

3. https://www.beckershospitalreview.com/finance/congress-healthcare-package-key-wins-for-hospitals-telehealth-and-physician-pay.html

4. https://www.acr.org/Media-Center/ACR-News-Releases/2024/Lawmakers-Pass-Short-Term-Resolution-to-Fund-Government-With-Minimal-Healthcare-Provisions

5. https://www.managedhealthcareexecutive.com/view/pbm-reform-is-part-of-congress-end-of-year-bill