Overhauling the way PBMs are paid may be a bipartisan priority. What's sometimes overlooked is that doing that in itself may not actually save Medicare money, lobbyists tell Victoria.

Why it matters: To make the math work and get a favorable CBO score, "delinking" has to be connected to transparency measures like requiring PBMs to disclose the cost and reimbursement of drugs and any fees or discounts involved, they say.

• That prerequisite will be crucial if PBM reforms get wrapped into a year-end health policy deal.

Driving the news: The House Ways and Means Committee just approved a telehealth package that included language delinking PBM compensation from the price of the drug and instead paying a flat fee.

• The Senate Finance Committee has already advanced its version of PBM delinking last year, which is projected to save $702 million.

Between the lines: One health lobbyist told Axios that congressional health committee staff have been warned by the CBO that delinking policies don't save money unless they are attached to the transparency measures.

• The PBM industry lobby, PCMA, has also recently highlighted analyses arguing that delinking wouldn't save money for patients but just shift costs to health plans that would then raise premiums.
• Rep. John Larson raised similar concerns about premium hikes at the Ways and Means markup last week.

The big picture: The two-pronged requirement could complicate prospects for PBM legislation down the road.

• Transparency requirements increase visibility of how money flows into the drug supply chain, driven by the belief that PBMs are driving up patient costs.
• But critics say the could have the effect of reducing competition and increasing health care costs by forcing PBMs to comply with costly and time-consuming reporting mandates.

The bottom line: That could make a bipartisan priority a much heavier lift as the session winds down.

An updated version of the Biosecure Act would grandfather existing U.S. research arrangements with Chinese biotech companies through the beginning of 2032 while adding a fifth firm to its list of "companies of concern," Axios' Adriel Bettelheim reports.

Why it matters: The draft, which is due to be marked up by the House Oversight and Accountability Committee on Wednesday, could be seen as more conciliatory to drug manufacturers and biotechs that are heavily reliant on the contract research firms.

What's inside: The measure would effectively lock certain Chinese companies out of the U.S. by prohibiting life sciences companies from contracting with them.

• It wouldn't apply to biotechnology equipment or services produced or provided before Jan. 1, 2032.
• An executive agency could also waive prohibitions for up to a year, in consultation with the White House and Defense Department.
• The language adds WuXi Biologics to the list of targeted companies, joining BGI, MGI, Complete Genomics and WuXi AppTec.

What they're saying: Lead sponsors Reps. Brad Wenstrup and Raja Krishnamoorthi said the bill would ensure American patient data and taxpayer dollars do not fall into the hands of foreign adversaries.

• They noted WuXi AppTec makes over 60% of its revenue from the U.S. market while posing a national security risk.
• They also noted BGI operates over 100 genetic collection laboratories in over 20 countries — infrastructure that the U.S.-China Economic and Security Review Commission declared was providing "genetic data to serve PRC ambitions to dominate biotech."

What we're watching: The legislation could come up for a floor vote later this month and is expected to be folded into the annual defense authorization bill.

1. China biotech: The House Oversight and Accountability Committee is due to mark up the new version of the Biosecure Act that would crack down on certain Chinese biotech firms on Wednesday at 10am ET.

2. Becerra at E&W: The House Education and the Workforce Committee will grill HHS Secretary Xavier Becerra Wednesday at 10:15am ET at a hearing Chair Virginia Foxx said will cover gender-affirming care, parental rights and religious freedoms.

3. NIH grants: The Select Subcommittee on the Coronavirus Pandemic has a hearing on how NIH funds and oversees research, as well as its relationship with the nonprofit EcoHealth Alliance on Thursday at 9am ET.

4. Dental care: The Senate HELP Committee has a hearing on the affordability and availability of dental care on Thursday at 10am ET.

5. Rural health: The Senate Finance Committee holds a hearing titled "Rural Health Care: Supporting Lives and Improving Communities" on Thursday at 10am ET.