Summary
Over the weekend, President Trump signed the Full-Year Continuing Appropriations Act of 2025 (H.R. 1968), which provides government funding through September 30, 2025, and includes a package of health care extenders. The House and Senate are in recess this week, but when Congress resumes on March 24, it will return its attention to advancing the budget reconciliation package and confirming the Trump Administration’s Department of Health and Human Services (HHS) nominees, including Dr. Oz as Centers for Medicare and Medicaid Services (CMS) Administrator.
Bipartisan Health Care Package Introduced as Standalone Bill
Last week, Senate Finance Committee Chair, Ron Wyden (D-OR) introduced the Bipartisan Health Care Act (S. 891), which contains most of the provisions from the 2024 end of the year health care package (Impact Summary) that were ultimately excluded from the American Relief Act (H.R. 10545). Highlights of the introduced bill include the following:
- Extending the Medicare telehealth flexibilities until December 31, 2026;
- An increase to the Medicare Physician Fee Schedule conversion factor of 3.5 percent for services furnished between March 1, 2025, and December 31, 2025, bringing the overall payment update to 0.7 percent.
- Requiring a national provider identifier (NPI) and an attestation for each off-campus outpatient department of a hospital;
- The reauthorization of the Pandemic and All-Hazards Preparedness Act (PAHPA) and the SUPPORT Act;
- Several pharmacy benefit manager (PBM) provisions, including Medicare and commercial transparency requirements, delinking in Part D, prohibiting spread pricing in Medicaid, requiring rebate pass through for PBMs that contract with ERISA plans; and
- A package of Medicaid provisions encompassing pharmacy, eligibility and enrollment, and maternal health provisions.
On Friday, Sen. Wyden sought unanimous consent to pass the bill as part of the government funding bill, but this effort was ultimately blocked by Senator Rick Scott (R-FL) without any explanation. However, overall Republican support remains less clear. House Energy and Commerce (E&C) Committee Chair Rep. Brett Guthrie (R-KY) previously expressed interest in advancing the provisions of the year-end package, while other Republicans are considering the inclusion of some of the package’s provisions, such as the “doc fix” and PBM reform in their budget reconciliation efforts.
Regulatory Update
The Office of Management and Budget (OMB) is reviewing the following:
- CY 2026 Medicare Advantage: Final rule making changes to Medicare Advantage and the Medicare Prescription Drug Benefit (Part D) and the CY 2026 Rate Notice, which is statutorily required to be released by April 7.
- FY 2026 Medicare Payment Rules: Proposed rules updating payments for acute care hospitals and long-term care hospitals, hospice providers, inpatient psychiatric facilities, inpatient rehabilitation facilities, and skilled nursing facilities. The proposed rules are slated for April.