BLUE CROSS AND BLUE SHIELD ASSOCIATION for BLUE CROSS AND BLUE SHIELD ASSOCIATION

Health Issues HCR

Affordable Care Act Issues - Chronic Care Innovations; Payment reform; 2017 Notice of Benefit and Payment Parameters (NBPP); ACA Regulations; Implementation; Cyber Security;Open Enrollment; Market Stability; Department of Labor Fiduciary Rule; Grace Periods; Special Enrollment Periods (SEPs); Reinsurance; Taskforce; Premiums; Health Reimbursement Arrangements (HRAs) Legislation; Individual Market Reform Other Health Care Issues - Mental Health Parity; Opioid Education; End Stage Renal Disease (ESRD); Zika Virus; Air Ambulances Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM HR 928 Introduced February 12, 2015 by Charles Boustany (R-LA) This bill repeals a provision of the Patient Protection and Affordable Care Act that imposes an annual fee on a health insurance provider based on its net premium income. HR 1934 Cancer Care Payment Reform Act of 2015 Introduced April 22, 2015 by Cathy McMorris Rodgers To amend title XVIII of the Social Security Act to establish a national Oncology Medical Home Demonstration Project under the Medicare program for the purpose of changing the Medicare payment for cancer care in order to enhance the quality of care and to improve cost efficiency, and for other purposes. HR 2488 Medicare Beneficiary Preservation of Choice Act of 2015 Introduced May 21, 2015 by Keith Rothfus (R-PA) This bill amends title XVIII (Medicare) of the Social Security Act to expand and modify enrollment and disenrollment options for Medicare Advantage (MA) eligible individuals. Specifically, the bill extends the annual period in which an individual enrolled in MA may elect to instead receive benefits under the original Medicare fee-for-service (FFS) program as well as elect to change qualified prescription drug coverage. Furthermore, any MA-eligible individual (whether or not enrolled in MA) may once per period change a previous election with respect to receiving benefits through MA or Medicare FFS, including changing from one MA plan to another. Unsolicited marketing during this period is prohibited. HR 2646 Helping Families in Mental Health Crisis Act of 2015 Introduced May 4, 2015 by Tim Murphy (R-PA) To make available needed psychiatric, psychological, and supportive services for individuals with mental illness and families in mental health crisis, and for other purposes HR 3244 Providing Innovative Care for Complex Cases Demonstration Act of 2015 Introduced July 28, 2015 by Cathy McMorris Rodgers (R-WA) To amend title XVIII of the Social Security Act to establish a pilot program to improve care for the most costly Medicare fee-for-service beneficiaries through the use of comprehensive and effective care management while reducing costs to the Federal Government for these beneficiaries, and for other purposes. HR 3463 Aligning Childrens Dental Coverage Act Introduced September 9, 2015 by H. Griffith (R-VA) To amend title XXVII of the Public Health Service Act to clarify the treatment of pediatric dental coverage in the individual and group markets outside of Exchanges established under the Patient Protection and Affordable Care Act, and for other purposes as introduced. HR 3742 Access to Marketplace Insurance Act Introduced October 9, 2015 by Kevin Cramer (R-ND) To amend the Patient Protection and Affordable Care Act to allow for certain third party payments. HR 4275 Medicare Advantage Quality Payment Relief Act of 2015 Introduced December 16, 2015 by Mike Kelly (R-PA) To amend title XVIII of the Social Security Act to eliminate a provision under the Medicare Advantage program that inadvertently penalizes Medicare Advantage plans for providing high quality care to Medicare beneficiaries. HR 5273 Helping Hospitals Improve Patient Care Act of 2016 Introduced May 18, 2016 by Patrick Taberi (R-OH) To amend title XVIII of the Social Security Act to provide for regulatory relief under the Medicare program for certain providers of services and suppliers and increased transparency in hospital coding and enrollment data, and for other purposes. HR 5410 Health Coverage State Flexibility Act of 2016 Introduced June 8, 2016 by Bill Flores (R-TX) to amend the Patient Protection and Affordable Care Act to better align the grace period required for non-payment of premiums before discontinuing coverage under qualified health plans with such grace periods provided for under State law. HR 5447 Small Business Health Care Relief Act of 2016 Introduced June 21, 2016 by Charles Boustany, Jr. (R-LA) To provide an exception from certain group health plan requirements for qualified small employer health reimbursement arrangements. HR 5506 Introduced June 15, 2016 by Todd Young (R-IN) To amend title XVIII of the Social Security Act to establish a demonstration program to provide integrated care for Medicare beneficiaries with end-stage renal disease, and for other purposes. HR 5547 Health Care Price Transparency Promotion Act of 2016 Introduced by Michael Burgess (R-IN) To amend title XIX of the Social Security Act to provide for increased price transparency of hospital information and to provide for additional research on consumer information on charges and out-of-pocket costs. HR 5589 Plan Verification and Fairness Act of 2016 Introduced June 28, 2016 by Marsha Blackburn (R-TN) To amend title I of the Patient Protection and Affordable Care Act to require verification for eligibility for enrollment during special enrollment periods in PPACA insurance plans, and for other purposes. S. 524 Comprehensive Addiction and Recovery Act of 2016 Introduced February 12, 2015 by Sheldon Whitehouse (D-RI) Overdoses from heroin, prescription drugs, and opioid pain relievers last year surpassed car accidents as the leading cause of injury-related death in America, according to the Centers for Disease Control. Deaths have reached their highest levels of the 21st century in 2014, the most recent year for which data is available, according to the National Institute on Drug Abuse. Heroin overdoses have more than tripled in the last five years, an issue receiving outsize attention nationally but especially during the presidential campaign season as New Hampshire has been one of the hardest-hit states. S. 1697 Small Business Healthcare Relief Act Introduced June 25, 2015 by Charles Grassley (R-IA) A bill to provide an exception from certain group health plan requirements to allow small businesses to use pre-tax dollars to assist employees in the purchase of policies in the individual health insurance market, and for other purposes. S. 1945 Mental Health Reform Act of 2015 Introduced August 5, 2015 by Bill Cassidy (R-LA) A bill to make available needed psychiatric, psychological, and supportive services for individuals with mental illness and families in mental health crisis, and for other purposes. S. 2713 Introduced March 17, 2016 by Lamar Alexander (R-TN) Advancing Precision Medicine Act of 2016 A bill to provide for the implementation of a Precision Medicine Initiative.

Contacted: HOUSE OF REPRESENTATIVES; Health & Human Services, Dept of (HHS); SENATE; White House Office; Centers For Medicare and Medicaid Services (CMS)

Bills named: H.R. 1934 (114th), H.R. 5273 (114th), H.R. 4275 (114th), H.R. 3463 (114th), H.R. 3742 (114th), H.R. 5547 (114th), H.R. 5410 (114th), H.R. 5447 (114th), H.R. 3244 (114th), H.R. 5506 (114th), S. 2713 (114th), H.R. 928 (114th), H.R. 5589 (114th), H.R. 2646 (114th), S. 524 (114th), S. 1697 (114th), H.R. 2488 (114th), S. 1945 (114th)

Taxation/Internal Revenue Code TAX

833; Health Insurance Tax (HIT Tax); Cadillac Tax HR 928 Introduced February 12, 2015 by Charles Boustany (R-LA) This bill repeals a provision of the Patient Protection and Affordable Care Act that imposes an annual fee on a health insurance provider based on its net premium income.

Contacted: SENATE; Centers For Medicare and Medicaid Services (CMS); HOUSE OF REPRESENTATIVES; Health & Human Services, Dept of (HHS); White House Office

Bills named: H.R. 928 (114th)

Medicare/Medicaid MMM

Medigap; Medicare Advantage; CHIP Reform; Medicare Access & CHIP Reauthorization Act of 2015 (MACRA); Chronic Care Reform; Exchanges; ICD-10; Site-neutral Payments; Medicare Fraud; Quality Improvement Strategy for QHPs; Rate Notice and Call Letter; Medical Billing; Transparency Tools; QHP Quality Rating System (QRS) HR 2488 Medicare Beneficiary Preservation of Choice Act of 2015 Introduced May 21, 2015 by Keith Rothfus (R-PA) This bill amends title XVIII (Medicare) of the Social Security Act to expand and modify enrollment and disenrollment options for Medicare Advantage (MA) eligible individuals. Specifically, the bill extends the annual period in which an individual enrolled in MA may elect to instead receive benefits under the original Medicare fee-for-service (FFS) program as well as elect to change qualified prescription drug coverage. Furthermore, any MA-eligible individual (whether or not enrolled in MA) may once per period change a previous election with respect to receiving benefits through MA or Medicare FFS, including changing from one MA plan to another. Unsolicited marketing during this period is prohibited. HR 2895 Introduced June 25, 2015 by Mike Pompeo (R-KS) Medicare Patient Access to Cancer Treatment Act of 2015 To amend title XVIII of the Social Security Act to establish payment parity under the Medicare program for ambulatory cancer care services furnished in the hospital outpatient department and the physician office setting. HR 3716 Introduced October 8, 2015 by Larry Bucshon (R-IN) To amend title XIX of the Social Security Act to require States to provide to the Secretary of Health and Human Services certain information with respect to provider terminations, and for other purposes. HR 4588 Introduced February 23, 2016 by Gene Green (D-TX) To amend title XIX of the Social Security Act to provide the same level of Federal matching assistance for every State that chooses to expand Medicaid coverage to newly eligible individuals, regardless of when such expansion takes place. HR 5273 Helping Hospitals Improve Patient Care Act of 2016 Introduced May 18, 2016 by Patrick Taberi (R-OH) To amend title XVIII of the Social Security Act to provide for regulatory relief under the Medicare program for certain providers of services and suppliers and increased transparency in hospital coding and enrollment data, and for other purposes.

Contacted: Health & Human Services, Dept of (HHS); HOUSE OF REPRESENTATIVES; Centers For Medicare and Medicaid Services (CMS); White House Office; SENATE

Bills named: H.R. 4588 (114th), H.R. 3716 (114th), H.R. 2488 (114th), H.R. 5273 (114th), H.R. 2895 (114th)

Budget/Appropriations BUD

Risk Corridors; Risk Corridor Funding; Federal Health Employee Health Benefits Plan (FEHBP) Regional PPO Language; ACA Reinsurance; Postal reform

Contacted: Centers For Medicare and Medicaid Services (CMS); White House Office; SENATE; Health & Human Services, Dept of (HHS); HOUSE OF REPRESENTATIVES

Pharmacy PHA

Opioid Abuse; Opioid Education; Prescription Drugs; Pharmaceutical Innovation HR 953 Introduced February 12, 2015 by James Sensenbrenner, Jr. (R-WI) Comprehensive Addiction and Recovery Act of 2015 Overdoses from heroin, prescription drugs, and opioid pain relievers last year surpassed car accidents as the leading cause of injury-related death in America, according to the Centers for Disease Control. Deaths have reached their highest levels of the 21st century in 2014, the most recent year for which data is available, according to the National Institute on Drug Abuse. Heroin overdoses have more than tripled in the last five years, an issue receiving outsize attention nationally but especially during the presidential campaign season as New Hampshire has been one of the hardest-hit states. New legislation aims to tackle this epidemic. The Comprehensive Addiction and Recovery Act, S. 524 and H.R. 953, was introduced by Sen. Sheldon Whitehouse (D-RI) and Rep. Jim Sensenbrenner (R-WI5) and will receive a hearing on Thursday from the Senate Judiciary Committee. HR 2805 Heroin and Prescription Opioid Abuse Prevention, Education, and Enforcement -Act of 2015 Introduced June 17, 2915 by Susan Brooks (R-IN) This bill requires the Department of Health and Human Services (HHS), in cooperation with the Department of Veterans Affairs, the Department of Defense, and the Drug Enforcement Administration (DEA), to convene a Pain Management Best Practices Inter-Agency Task Force to develop and study best practices for pain management and prescription of pain medication. HR 4499 Introduced February 9, 2016 by Alex Mooney (R-VA) Promoting Responsible Opioid Prescribing Act of 2016. To amend title XVIII of the Social Security Act to remove consideration of certain pain-related issues from calculations under the Medicare hospital value-based purchasing program, and for other purposes.

Contacted: HOUSE OF REPRESENTATIVES; White House Office; SENATE; Health & Human Services, Dept of (HHS); Centers For Medicare and Medicaid Services (CMS)

Bills named: H.R. 953 (114th), H.R. 2805 (114th), S. 524 (114th), H.R. 4499 (114th)