Congress prepares a bipartisan health care package with AMA priorities

Congressional leaders have agreed to a bicameral, bipartisan package of health care proposals that includes parts of the American Medical Association's (AMA) policy agenda.

"To get the finish line, individual negotiators didn't get everything they wanted, perhaps, yet good policy emerged from the negotiations. These proposals will benefit our patients in their everyday encounters with physicians," said David H. Aizuss, MD, chair of the AMA Board of Trustees. "Whether it's telehealth, or diabetes, or Medicare directories, these policies have real-world, beneficial impacts."

Specifically, the package includes the following provisions that would:

• Renew Medicare telehealth coverage for two years. Following the disruptive, 43-day lapse during the 2025 government shutdown, this extension helps restore continuity of telehealth services for Medicare patients. The AMA strongly supports this extension and continues to advocate for permanent authorization of Medicare telehealth flexibilities.
• Restore a 3.1% bonus for physicians participating in Medicare alternative payment models that expired in 2024 for one year. These provisions strengthen physician participation in value-based care by restoring meaningful incentives and reducing barriers to entry.
• Adopt AMA-endorsed legislation that expands access to the Medicare Diabetes Prevention Program (MDPP). For the first time, CDC-recognized virtual diabetes prevention programs will be included in the MDPP expanded model on a trial basis from January 1, 2026, through December 31, 2029. This expansion addresses longstanding access barriers created by in-person participation requirements and improves access for Medicare beneficiaries in rural and underserved communities.
• Require Medicare Advantage plans to maintain accurate, regularly updated provider directories and publicly report directory accuracy.
• Extend the Acute Hospital Care at Home waiver for five years, through 2030. The extension preserves a proven, physician-led model that delivers hospital-level care safely in the home, improving outcomes and patient satisfaction.
• Expands the Dr. Lorna Breen Health Care Provider Protection Act for five years, through FY 2030. The legislation continues funding, mandates annual stigma-reduction campaigns and broadens grant eligibility to address administrative burden. The AMA has supported this program since its inception and strongly supports its reauthorization.
• Introduce targeted pharmacy benefit manager (PBM) reforms that enhance transparency, curb abusive Medicare drug rebate practices, and strengthen enforcement against anti-competitive behavior. These provisions represent tangible progress toward lowering prescription drug costs and improving fairness in the drug supply chain for patients and physicians.

"The AMA commends congressional leaders for finding common ground," Dr. Aizuss said. "As physicians, we know that the best results come from focused attention on what is best for patients. That's what happened here."