Biden Signs Funding Bill Extending Telehealth Flexibilities, but no Relief for Doctors — or PBM Reform

Healthcare Dive / By Rebecca Pifer

President Joe Biden signed a stripped down funding bill on Saturday, averting a government shutdown during the holiday season.

Congress agreed to a sweeping package earlier last week that included a number of important healthcare provisions, including an extension of telehealth flexibilities, relief from scheduled Medicare cuts for physicians and reform for controversial pharmacy benefit managers.

However, of the major healthcare changes only an extension of virtual care waivers made it into the final bill, after President-elect Donald Trump and billionaire Elon Musk panned the initial package as overly expensive.

Physicians slammed Congress for failing to prevent the Medicare cuts from going into effect.

“For the fifth consecutive year, Congress has adjourned and allowed Medicare cuts. What will be the result? Patients struggling to access health care. Physicians closing or selling their private practices while others opt to leave the profession,” said Bruce Scott, the president of the American Medical Association, in a statement.

Congress has to step in at the end of the year and avert scheduled cuts due to statutory requirements around how Medicare pays doctors. That creates significant stress for physicians, who have amplified calls for a permanent fix to the situation.

Without relief in the stopgap funding bill, physicians’ Medicare funding will fall by 2.8% in 2025.

With that cut, Medicare rates have fallen 33% over the past two decades when adjusted for physician costs, according to the AMA.

“The Medicare payment system is broken,” Scott said. “Congress must enact meaningful long-term reforms.”

Physician groups support tying annual reimbursement hikes to a measure of inflation, a policy backed by some members of Congress and influential advisory groups.

Reform will likely be on the table in Congress next year. There’s also a chance lawmakers could pass relief in 2025 that’s applied retroactively, making physicians whole for some or all of the 2.8% cut…

Read Full Article