PBM reform, telehealth extension, doctor pay in federal spending deal

WASHINGTON — After two years of haggling, Congress has nearly reached a deal to rein in the drug-industry middlemen known as pharmacy benefit managers.

Lawmakers agreed to extend telehealth flexibilities, fund public health programs, and enact these major PBM changes as part of a government funding package they are planning to pass before the end of the year, according to four health care industry sources and two congressional aides. The language of the government funding package has not been publicly released, and could still change.

Passage of laws to address pharmacy middlemen has been the top priority of the pharmaceutical industry, particularly after they suffered a stinging defeat when Democrats passed their drug pricing law in 2022. The pharma industry spent millions on advertising to promote PBM legislation, and it appears it will get most of what it wanted.