MEDICARE REFORMS EN ROUTE — The first results of a Medicare payment reform effort in the Senate are expected next week, Daniel reports. According to a person familiar with the committee's plans, the Finance Committee plans to release a white paper outlining its plans to update the way Medicare pays health providers. That effort, closely watched by hospitals, doctors and insurers alike, could have significant implications for the cost and process of providing care in the U.S. What do you know about the reform efforts? Let us know at dpayne@politico.com. EASING TELEHEALTH RULES AIN’T EASY — The House Ways and Means Committee wants to ease Medicare telehealth rules, but how to do it is still in flux, Ben reports. How we got here: Expanded coverage for virtual care in Medicare and commercial plans under pandemic rules expires at the end of the year, as does the acute hospital care at-home program. On Wednesday, the committee considered legislation from Reps. David Schweikert (R-Ariz.) and Mike Thompson (D-Calif.) that would extend the virtual care rules in Medicare through 2026 and hospital at home through 2029. It advanced out of the committee in a 41-0 vote despite some division over several provisions. Lawmakers support — with caution — making expanded virtual care access permanent. Thompson, co-chair of the Congressional Telehealth Caucus, said telehealth should be permanent in Medicare partly because it can save money for the program, but he supports further studying virtual care use. Many offsets to pay for the bill are still up in the air, which has several pay-fors. But lawmakers can’t agree on which offsets should be included in the final language. Lawmakers on both sides of the aisle often zeroed in on curbing fraud related to virtual care. The legislation would increase scrutiny of providers that bill for pricey durable medical equipment to curb fraud and require a watchdog report on lab tests at high risk for fraud. Those can be a target for fraudsters in federal health care programs. So far, watchdog reports haven’t uncovered widespread telehealth billing issues. Insurers’ response: AHIP, which represents insurers, pushed back on the offset proposals in the legislation, saying in a statement that they would “undermine plan sponsors’ flexibility to develop value-based programs and shared-savings arrangements that benefit patients and taxpayers.” COLE TAKES A SECOND LOOK — House Appropriations Chair Tom Cole (R-Okla.) has been clear about his interest in reviving House earmarks in the Labor-HHS-Education funding bill, even though GOP leaders decided to forgo them again for fiscal 2025, POLITICO’s Caitlin Emma and Jennifer Scholtes report. Cole’s predecessor, Rep. Kay Granger (R-Texas), banned earmarks in the bill — but that doesn’t impact the Senate earmarks process. Cole wants to keep that debate going in the coming months. “It hurt us not to be able to earmark Labor-H,” Cole told reporters this week.
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