Congress Advances Sweeping Health Bill Targeting PBM Practices

The bipartisan package includes reforms to pharmacy benefit managers, Medicare telehealth extensions, and opioid crisis funding.

Lawmakers have attached a comprehensive health care package to a year-end government funding bill, comprising over 500 pages of provisions.
Key reforms target pharmacy benefit managers (PBMs), banning compensation tied to Medicare drug list prices and requiring full pass-through of rebates to employers or health plans.
The bill mandates increased transparency in PBM operations, including reporting requirements on drug costs, reimbursements, and fees to group health plans.
Other provisions include a two-year extension of Medicare telehealth flexibilities, reauthorization of opioid crisis legislation, and reversal of most physician payment cuts in Medicare.
The reforms aim to address longstanding bipartisan concerns over PBM practices, which impact drug affordability and access for millions of Americans.