Among other key provisions of the bill:

The statutory increase of 1.25% for Medicare physician fee schedule services in 2024 would increase to 2.5% .This would amount to reducing the 4% cut in the conversion factorto 2.15%, thereby slightly increasing the physician payment rate.
Eligibility for bonuses under the Health Professional Shortage Area program would be extended to certain mental health and substance use disorder services provided by non-physician health-care professionals.
The HHS secretary would be required to provide information on licensing requirements for furnishing telehealth services under Medicare and Medicaid, including guidance on clinicians who are providing care by telehealth to patients in neighboring states.
Each network-based Medicare Advantage plan would need to verify provider directory information at least every 90 days.
Beginning in 2028, a Medicare Part D plan sponsor offering preferred pharmacy networks would be required to contract with at least 80% of essential retail pharmacies in the plan's service area that are independent community pharmacies, and 50% of essential retail pharmacies in the plan's service area that are not independent community pharmacies.
Another provision would require that Part D plans base enrollee drug copays on the drug's net price — including projected manufacturer rebates — rather than their Part D negotiated price.

Related: Will new Senate bill curb the power of the PBMs – and drive down drug costs?

"This comprehensive legislation will reduce out-of-pocket medication costs for seniors, enhance accountability in our federal health-care programs, improve access to high-quality mental health services and extend critical support for clinicians and suppliers," said Sen. Mike Crapo, R-Idaho, the committee's ranking member.

Instant Insights /

PBM reform is on, as Senate advances new bill that forces pharmacies to report costs

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