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Senate Democrats Plan to Introduce Pharmacy Benefit Manager Reforms as Health Provisions are Removed from December Spending Bill

Photo credit: thehill.com

Senate Democrats Unveil New Health Policy Legislation

On Thursday, Senate Democrats are set to introduce standalone legislation that includes a series of health policy reforms, specifically targeting the pharmacy benefit manager (PBM) sector, which was omitted from the December government spending bill.

This initiative, spearheaded by Senator Ron Wyden (D-Ore.) and several colleagues, aims to breath new life into bipartisan reforms and extensions of healthcare funding, seeking to do so independently of any continuing resolution efforts.

As Congress navigates a landscape largely dominated by discussions surrounding reconciliation, the possibility of garnering support from GOP leaders for this initiative remains uncertain. Many are suggesting that a straightforward funding bill, devoid of PBM reforms or other healthcare extensions, is the most likely outcome.

“Senator Wyden is eager to push forward bipartisan healthcare priorities that have faced unjust delays due to unrelated issues. Introducing this legislation marks the beginning of a process for the Senate to take prompt action,” a spokesperson for Wyden stated.

In mid-December, bipartisan health leaders had reached an agreement on a comprehensive health package, which incorporated PBM reforms, continuity of Medicare telehealth services, reauthorizations to combat pandemics and the opioid crisis, increased funding for community health centers, and the reversal of cuts to physician payments.

Unfortunately, the larger funding bill that contained these provisions faced opposition from GOP lawmakers and prominent figures such as Elon Musk and then-President-elect Donald Trump, who criticized it for being excessively lengthy and complex.

The reduced version of the bill that eventually passed omitted various healthcare provisions in favor of a more streamlined approach to government funding, which is set to last until later this month.

The newly proposed package includes reauthorizations of significant legislation such as the SUPPORT Act aimed at combating opioid addiction and the Pandemic and All Hazards Preparedness Act. Historically, bipartisan support has characterized the pandemic legislation; however, its previous attempt at inclusion in the spending bill drew a backlash fueled by misleading online narratives, some of which were amplified by Musk.

Additionally, the GOP chose to discard a proposed increase in Medicare physician payments and a measure aimed at enhancing hospital billing transparency that were part of the original health package.

In anticipation of the ongoing budget discussions, House GOP doctors are advocating vigorously for the inclusion of the “doc fix” in the upcoming continuing resolution, which is anticipated to be released this weekend.

Source
thehill.com

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