Bipartisan Budget Deal Delivers Wins for Healthcare, Addresses Key AMA Priorities
A recently passed federal government funding package includes a bipartisan agreement on several key healthcare proposals, addressing priorities long advocated by the American Medical Association (AMA). The deal, finalized to avert a potential government shutdown, encompasses provisions related to Medicare telehealth coverage, physician payment, diabetes prevention, hospital care at home, physician well-being, prescription drug costs and maternal health.
The agreement extends Medicare telehealth coverage for two years, restoring continuity of services following a 43-day lapse during a 2025 government shutdown. The AMA continues to advocate for permanent authorization of these telehealth flexibilities, highlighting their role in improving care access, and efficiency.
Physicians participating in Medicare alternative payment models (APMs) will see a 3.1% bonus restored for one year, a provision that expired in 2024. This aims to strengthen physician engagement in value-based care by reinstating incentives and reducing barriers to entry.
Access to the Medicare Diabetes Prevention Program will be expanded to include, for the first time, Centers for Disease Control and Prevention-recognized virtual programs on a trial basis through December 31, 2029. This expansion addresses access barriers and aims to improve care for Medicare beneficiaries in rural and underserved communities.
The issue of inaccurate Medicare Advantage provider directories, often referred to as “ghost networks,” is also addressed. Medicare Advantage plans will now be required to maintain accurate, regularly updated directories and publicly report their accuracy, providing patients with reliable information about in-network physicians.
The Acute Hospital Care at Home waiver has been extended for five years, through 2030, preserving a physician-led model that allows for hospital-level care to be delivered safely in patients’ homes, improving outcomes and satisfaction.
Supporting Physician Well-being and Addressing PBM Abuses
The Dr. Lorna Breen Health Care Provider Protection Act has been extended for five years, through fiscal year 2030, continuing funding for programs that address physician burnout and promote mental health support. The act mandates annual stigma-reduction campaigns and broadens grant eligibility to address administrative burdens. The AMA has been a strong supporter of this program since its inception.
The budget deal also introduces targeted reforms to address pharmacy benefit manager (PBM) practices, aiming to enhance transparency, curb abusive Medicare drug rebate practices, and strengthen enforcement against anticompetitive behavior. These provisions represent a step toward lowering prescription drug costs and improving fairness in the drug supply chain.
Investing in Maternal Health and Preterm Birth Research
Funding for maternal health initiatives has also been increased. The budget deal reauthorizes the PREEMIE Reauthorization Act to expand federal research on preterm birth and improve outcomes for premature infants. The Preventing Maternal Deaths Act has been reauthorized with increased funding—authorized to $100 million annually through 2030—expanding the scope of state maternal mortality review committees and directing federal agencies to disseminate best practices.
In a statement released in January, David H. Aizuss, MD, chair of the AMA Board of Trustees, lauded the bipartisan agreement. “The AMA commends congressional leaders for finding common ground,” he said. “As physicians, we know that the best results come from focused attention on what is best for patients. That’s what happened here.” Dr. Aizuss emphasized that the proposals will have “real-world, beneficial impacts” on patients.
The AMA is actively engaged in advocating for physicians and patients, with hundreds of physicians scheduled to gather in Washington, D.C., February 23–25 for the AMA National Advocacy Conference. Key topics to be discussed include Medicare payment reform, prior authorization fixes, food as medicine, and protecting access to care in Medicaid.
The organization encourages physicians to join their advocacy efforts and stay informed about ongoing initiatives through the AMA Advocacy in Action website.
