Bipartisan Lawmakers Announce Deal To Keep Government Open
A bipartisan deal was announced that would keep the federal government open for the rest of federal fiscal 2026 (to Septemeber 30) and enact long-sought healthcare changes. Given the bipartisan and bicameral nature of the deal, the bill likely can be passed by the end of July when the government would otherwise partially shut down. But some fear conservatives in each chamber could oppose the deal on budgetary grounds.
Medicare telehealth coverage would be extended for two years. The Medicare hospital-at-home program would be extended for five years. The bill would also move further toward site-neutral payments in Medicare.
Medicare Advantage (MA) plans would be required to maintain accurate provider lists and patients who visit providers erroneously due to bad data would only have to pay in-network rates. The bill doesn’t include limits on MA prior authorization.
The bill also boosts pay to physicians participating in Medicare alternative payment models and enacts pharmacy benefits manager (PBM) reform (including transparency and flat compensation fees).
The package does not address extending the enhanced Exchange subsidies in any form. Medicare physician pay is not broached, either. Trump’s “Great Healthcare Plan elements are not included but would likely be in a GOP only reconciliation bill later.
Additional article: https://www.fiercehealthcare.com/regulatory/house-appropriations-committee-releases-health-funding-proposal
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#governmentshutdown #congress #healthcare #coverage #pbms #medicare #siteneutral #medicareadvantage
— Marc S. Ryan
