Two Important Bills Passed by House Ways & Means
The House Ways & Means Committee passed two important bills out of Committee last week, including the H.R. 4313, the Hospital Inpatient Services Modernization Act, and H.R. 5343, the Ensuring Patient Access to Critical Breakthrough Products Act.
- The Hospital Inpatient Services Modernization Act would extend the Acute Hospital Care at Home (AHCaH) Program for five years, through 2030.
- The Ensuring Patient Access to Critical Breakthrough Products Act which would guarantee four years of Medicare coverage for FDA-designated breakthrough technologies.
ATA Action supports both these bills and released a press statement in response.
Prescription Digital Therapeutics Meetings on Capitol Hill
Members of ATA Action’s Advancing Digital Health Coalition were on Capitol Hill last week to discuss PDURS, the U.S. Food and Drug Administration’s framework for pairing Prescription Digital Therapeutics with Pharmaceutical products. Edward Cox from Pfizer and Ridwana Isla, PMP, from Boehringer Ingelheim, joined our own Andy Molnar and Alexis Apple for meetings with a number of our bill sponsors, Congressional committees of jurisdiction, and agencies to advance our top priorities:
- Educate our Senate and House champions on PDURS to illustrate synergies with our overall DTx regulatory and reimbursement goals.
- Move towards finalizing the FDA PDURS guidance.
- Ensure that key stakeholders are aware of the national attention PDURS has received from the largest healthcare companies.
- Extend our thanks to key legislators for championing Digital Therapeutics.
Medicare Administrative Contractor (MAC) DMHT Code Awareness Update
Over 30 letters have been distributed to MAC medical directors offering assistance with the timely implementation of the new digital mental health treatment (DMHT) supply code (G0552). Thus far responses have been mixed. But we are excited to share that our federal policy team met with medical directors from two MACs who mentioned multiple times they are hearing from medical societies regarding clinical assessments, protocols, and other information relevant to the determination of medical necessity, so we believe their participation is a key factor for success. There is a strong desire for standard metrics, guidelines, and protocols integrating DMHTs into care for various conditions, along with data (real-world evidence and randomized clinical trials were mentioned) to show the product’s effectiveness.
Next week, ATA Action has its first meeting with medical directors from another MAC to explain how DMHTs, which are meaningfully different from "wellness apps," fit into the health ecosystem and discuss the organization's approach to DMHT implementation, to identify open questions and potential barriers that could extend the timeline.
In our comments to the CY 2026 Physician Fee Schedule proposed rule, we asked CMS to provide guidance to the MACs regarding DMHT implementation and we are continuing to parallel track our advocacy efforts alongside provider associations, with the goal of implementing DMHT codes at scale.
Remote Prescribing of Controlled Substances for Veterans Affairs
The Protecting Veteran Access to Telemedicine Services Act of 2025 introduced by U.S. Representatives Steve Womack and Stanford Bishop in February 2025, would permanently authorize certain Department of Veterans Affairs (VA) healthcare professionals to use telemedicine to deliver, distribute, or dispense controlled substances, without an in-person medical examination. This legislation was passed by the House of Representatives last week and is currently under consideration in the Senate. ATA Action is closely monitoring this legislation as it progresses.