Feb 4: late Feb 3, the House passed a funding bill that includes the following:
Health Extenders
- Medicare telehealth flexibilities –2-years
- Acute Hospital-At-Home –5-years
- Medicaid Disproportionate Share Hospital (DSH) scheduled cuts –elimination of 2-years, revisions to formula
- Medicare Low-Volume Hospital (LVH) and Medicare Dependent Hospital (MDH) –1-year
- Community Health Center–1-year with increase; Teaching Health Center Graduate Medical Education (THCGME) -5-years
- National Health Service Corps (NHSC) –2-years; Special Diabetes programs –1-year
- Clinical lab payment reductions –1-year delay
New Policies
- PBM Reform, Including requiring PBMs that have an “affiliate that is a retail, mail order, or specialty pharmacy” and have an agreement with a 340B covered entity to disclose (to the government and to the plan sponsor) a list of covered Part D drugs covered by said agreement
- Establishes National Provider Identifier for site neutrality purposes
- Include Multi-Cancer Early Detection Act and Accelerating Kids Access to Care Act (and 5-year extension of Pediatric Review Vouchers)
Feb 3, 2026: Medicare telehealth flexibilities expired on Jan. 30. The Senate has passed legislation that would extend the flexibilities through Dec., 31, 2027, but it still needs to pass the House to be signed into law.
- Legislation that would fund the HHS through September and enact other healthcare policies, including pharmacy benefit manager reforms, was stalled for several days over funding for the Department of Homeland Security
- The federal government entered a partial shutdown on Saturday, allowing telehealth flexibilities in Medicare and waivers for acute hospital-at-home care to lapse.
Key Medicare Telehealth Extension Details (Proposed):
- Duration: Extension through December 31, 2027 (from the Jan 30, 2026, deadline).
- What's Extended: Waiving geographic/originating site restrictions, allowing audio-only, broadening provider eligibility, and extending FQHC/RHC flexibilities.
- Status: Passed the House in the Consolidated Appropriations Act, 2026; awaits Senate action.
- Risk: Congressional disagreements could cause a temporary lapse (like in late 2025) before a final bill is passed, requiring providers to follow CMS guidance from the previous lapse.
Separately, DEA/HHS waivers for prescribing controlled substances via telemedicine were extended through December 31, 2026, allowing remote prescribing without prior in-person visits for another year.
DEA/HHS Controlled Substance Waivers:
- Duration: Extended through December 31, 2026.
- What's Extended: Allows remote prescribing of Schedule II-V controlled substances via telemedicine without a prior in-person visit.
- Purpose: Gives agencies more time to develop permanent rules for safe telemedicine prescribing.
What This Means:
- Providers should watch for final congressional approval of the main Medicare bill to avoid disruptions.
- For controlled substances, the current remote prescribing rules are secure until the end of 2026.