RNS Advocacy: Capitol Update – December 2023

Congress adjourned for the holidays having checked the National Defense Authorization Act off its to-do list, but there’s a long list of items waiting when they return in the new year. Of interest to the healthcare community, the Medicare Physician Fee Schedule will be subject to an almost -3.4% reduction in reimbursement unless Congress acts to avert or mitigate that cut in January. The House Energy and Commerce Committee and the Senate Finance Committee each advanced provisions to partially avert the cut, while a bipartisan group of House Members introduced legislation to stop the full -3.4% reduction. Unfortunately, none of these proposals made it across the finish line, moving this issue to the top of the list for Congress in January. Whatever final shape it takes, the fix will likely be attached to the government funding vehicle that must move by January 19th, which is the first of two deadlines included in the most recent temporary extension of government funding.

At that time, Congress will have to either extend the date again on a short-term basis or enact a long-term funding package. If the latter occurs, there may be an opportunity to attach additional policy reforms to that funding package. However, whether substantive reforms will be included depends on both chambers – as well as the committees of jurisdiction – reaching consensus, which is a tall order between now and mid-January. Despite these variables, on the list for potential inclusion is pharmacy benefit manager (PBM) reform, which could include the Safe Step Act, since that legislation was incorporated into a bigger PBM reform bill by a Senate healthcare committee. RNS has long supported the Safe Step Act because it would reform step therapy protocols for certain employer plans, so we’re hopeful it’ll make the short list for inclusion. The Safe Step Coalition, of which RNS is an active member, has been tireless in its outreach to increase co-sponsorship.

As of now, both the Senate and the House are scheduled to return the week of January 9th. Happy holidays!