Overview

• 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.