Congress Zones in on Health-Care Package With Issues APMA Supports

Congressional leaders have unveiled a new bipartisan package of health-care reforms, which includes issues APMA has advocated for. The package is tied to a larger $1.2 trillion government spending package that funds the Department of Health and Human Services (HHS), Department of Labor, and other agencies through fiscal year 2026. The package includes policies that would:

• Extend pandemic-era Medicare telehealth coverage for two additional years. APMA supports the permanent extension of Medicare telehealth coverage.

• Reinstate the 3.1 percent bonus for physicians who participate in Medicare alternative payment models (APMs). The provision would expand incentives that encourage physicians to engage in value-based care.

• Adopt S. 2211, Special Diabetes Program Reauthorization Act of 2025, which extends the Special Diabetes Program (SDP), which funds crucial services for populations disproportionately impacted by diabetes. It also adopts the PREVENT DIABETES Act (HR 1523), which would allow healthcare entities to provide virtual services under the Medicare Diabetes Prevention Program (MDDP) through 2029.

• Require Medicare Advantage (MA) plans to regularly update provider directories, ensuring beneficiaries have up-to-date information.

• Strengthen oversight and transparency for pharmacy benefit managers (PBMs).

• Increase funding for the National Institutes of Health (NIH) by $195 million and operational funding for the Centers for Medicare and Medicaid (CMS) by $195 million.

Contact the APMA Advocacy team with any questions at [email protected].