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

Pharmacy PHA

Covid Therapeutics; Cell & Gene therapy; Step Therapy H.R.5372 - Expanding Seniors' Access to Lower Cost Medicines Act of 2023 To amend Title XVIII of the Social Security Act to facilitate midyear formulary changes for biosimilars. Sponsor: Rep. Joyce, John [R-PA-13] H.R.7312 - EPCS 2.0 Act To provide for requirements for electronic-prescribing for controlled substances under group health plans and group and individual health insurance coverage. Sponsor: Rep. Kuster, Ann M. [D-NH-2] H.R.5376 - Inflation Reduction Act of 2022 Prescription Drug Pricing Reform Sponsor: Rep. Yarmuth, John A. [D-KY-3] S. 1067 Ensuring Timely Access to Generics Act To amend the Federal Food, Drug, and Cosmetic Act with respect to citizen petitions. Sponsor: Sen. Shaheen, Jeanne [D-NH] S. 1114, Expanding Access to Low-Cost Generics Act To amend the Federal Food, Drug, and Cosmetic Act with respect to the 180-day exclusivity period. Sponsor: Sen. Smith, Tina [D-MN] " S.1339 - Pharmacy Benefit Manager Reform Act To provide for increased oversight of entities that provide pharmacy benefit management services on behalf of group health plans and health insurance coverage. Sponsor: Sen. Sanders, Bernard [I-VT] S. 150 - Affordable Prescriptions for Patients Act of 2023 To amend the Federal Trade Commission Act to prohibit product hopping, and for other purposes. Sponsor: Sen. Cornyn, John [R-TX] S. 2305 - Biosimilar Red Tape Elimination Act To improve the requirements for making a determination of interchangeability of a biological product and its reference product. Sponsor: Sen. Lee, Mike [R-UT] S. 127 - Pharmacy Benefit Manager Transparency Act of 2023 To prevent unfair and deceptive acts or practices and the dissemination of false information related to pharmacy benefit management services for prescription drugs, and for other purposes. Sponsor: Sen. Cantwell, Maria [D-WA] HR 6094 PROTECT Act To amend titles XVIII and XIX of the Social Security Act and title XXVII of the Public Health Service Act to refine the set of information sources for determining coverage of certain drugs and biologicals used in the treatment or management of a rare disease or condition, and for other purposes. Sponsor: Rep. Matsui, Doris O. [D-CA-7]

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

Bills named: S. 1339 (118th), S. 127 (118th), S. 1114 (118th), H.R. 7312 (118th), S. 1067 (118th), H.R. 5372 (118th), S. 150 (118th), S. 2305 (118th), H.R. 5376 (118th), H.R. 6094 (118th)

Health Issues HCR

Affordable Care Act (ACA); ACA subsidies and tax credits; Telehealth & telehealth flexibilities; Mental Health Care; Youth Mental Health; Site neutral payment reform; Transparency in coverage; Surprise Billing; 2025 Proposed NBPP/Individual Market/ACA exchanges; Rural healthcare; Prior Authorization; Hospital Consolidation; Health Equity Index reward factor; Employer-provided health coverage; Cyber Attack; Birthing-Friendly Designation; Provider Directories; HIPAA Modernization; Artificial Intelligence S.2556 - Improving CARE for Youth Act To amend title XIX of the Social Security Act to ensure Medicaid coverage of mental health services and primary care services furnished on the same day. Sponsor: Sen. Carper, Thomas R. [D-DE] H.R.3226 - PREEMIE Reauthorization Act of 2023 To reauthorize the Prematurity Research Expansion and Education for Mothers who deliver Infants Early Act. Sponsor: Rep. Eshoo, Anna G. [D-CA-16] H.R.3838 - Preventing Maternal Deaths Reauthorization Act of 2023 To amend title III of the Public Health Service Act to reauthorize Federal support of States in their work to save and sustain the health of mothers during pregnancy, childbirth, and the postpartum period, to eliminate disparities in maternal health outcomes for pregnancy-related and pregnancy-associated deaths, to identify solutions to improve health care quality and health outcomes for mothers, and for other purposes. Sponsor: Rep. Burgess, Michael C. [R-TX-26] H.R.2708 - Latonya Reeves Freedom Act of 2023 To prohibit discrimination against individuals with disabilities who need long-term services and supports, and for other purposes. Sponsor: Rep. Cohen, Steve [D-TN-9] H.R.6412 - Down Syndrome Diagnosis Act To amend title XXVII of the Public Health Service Act to provide certain informational resources related to Down syndrome. Sponsor: Rep. Molinaro, Marcus J. [R-NY-19] S.1869 - SITE Act To amend title XVIII of the Social Security Act and title XXVII of the Public Health Service Act to ensure fair billing practice for items and services furnished by off-campus hospital locations, to amend such title XVIII to provide for payments for graduate nursing education costs, and for other purposes. Sponsor: Sen. Braun, Mike [R-IN] H.R.3417 - FAIR Act To ensure fair billing practices for items and services furnished by off-campus outpatient departments of a provider. Sponsor: Rep. Hern, Kevin [R-OK-1] H.R. 5378 Lower Costs, More Transparency Act To promote price transparency in the health care sector, and for other purposes. Sponsor: Rep. McMorris Rodgers, Cathy [R-WA-5] H.R.4531 - Support for Patients and Communities Reauthorization Act To reauthorize certain programs that provide for opioid use disorder prevention, recovery, and treatment, and for other purposes. Sponsor: Rep. Guthrie, Brett [R-KY-2] S.652 - Safe Step Act To amend the Employee Retirement Income Security Act of 1974 to require a group health plan or health insurance coverage offered in connection with such a plan to provide an exceptions process for any medication step therapy protocol, and for other purposes. Sponsor: Sen. Murkowski, Lisa [R-AK] S. 1001 Telehealth Expansion Act of 2023 To amend the Internal Revenue Code of 1986 to permanently extend the exemption for telehealth services from certain high deductible health plan rules. Sponsor: Sen. Daines, Steve [R-MT] H.R.3630 - No Surprises Act To amend title XXVII of the Public Health Service Act to protect health care consumers from surprise billing practices, and for other purposes. Sponsor: Rep. Pallone, Frank, Jr. [D-NJ-6] S. 3393 - SUPPORT for Patients and Communities Reauthorization Act To reauthorize the SUPPORT for Patients and Communities Act, and for other purposes. Sponsor: Sen. Sanders, Bernard [I-VT] S.2016 - CONNECT for Health Act of 2023 To amend title XVIII of the Social Security Act to expand access to telehealth services, and for other purposes. Sponsor: Sen. Schatz, Brian [D-HI] S. 1451 Healthy Competition for Better Care Act To ban anticompetitive terms in facility and insurance contracts that limit access to higher quality, lower cost care. Sponsor: Sen. Braun, Mike [R-IN] S.1606 - Black Maternal Health Momnibus Act To end preventable maternal mortality, severe maternal morbidity, and maternal health disparities in the United States, and for other purposes. Sponsor: Sen. Booker, Cory A. [D-NJ] H.R.7153 - Dr. Lorna Breen Health Care Provider Protection Reauthorization Act To reauthorize the Dr. Lorna Breen Health Care Provider Protection Act, and for other purposes. The Lorn Breen Act established grants and required other activities to improve mental and behavioral health among health care providers. Sponsor: Rep. Wild, Susan [D-PA-7] H.R.2923 - Living Donor Protection Act of 2023 To promote and protect from discrimination living organ donors. Sponsor: Rep. Nadler, Jerrold [D-NY-12] HR 6465 PLASMA Act To amend title XVIII of the Social Security Act to provide a phase-in for plasma-derived products under the manufacturer discount program. Sponsor: Rep. Hudson, Richard [R-NC-9]

Contacted: Centers For Medicare and Medicaid Services (CMS); Executive Office of the President (EOP); Office of Management & Budget (OMB); Labor, Dept of (DOL); Health & Human Services, Dept of (HHS); White House Office; HOUSE OF REPRESENTATIVES; SENATE

Bills named: S. 1869 (118th), H.R. 5378 (118th), S. 2556 (118th), S. 652 (118th), H.R. 3226 (118th), H.R. 7153 (118th), H.R. 3630 (118th), H.R. 3838 (118th), H.R. 4531 (118th), H.R. 6465 (118th), H.R. 6412 (118th), H.R. 2923 (118th), H.R. 2708 (118th), S. 1606 (118th), S. 2016 (118th), S. 3393 (118th), H.R. 3417 (118th), S. 1001 (118th), S. 1451 (118th)

Medicare/Medicaid MMM

Medicaid Redeterminations & renewals; Same-day billing restrictions in Medicaid; Medicare Advantage (MA) & MA Rate Notice; 340B Program/Transparency; Managed Care Organizations; Draft duals legislation H.R.5746 - Addressing Whole Health in Medicare Advantage Act To amend title XVIII of the Social Security Act to expand the availability of supplemental benefits to certain Medicare Advantage enrollees. Sponsor: Rep. Bilirakis, Gus M. [R-FL-12] H.R.5386 - Cutting Copays Act To amend title XVIII of the Social Security Act to provide for adjustments to the Medicare part D cost-sharing reductions for low-income individuals. Sponsor: Rep. McGarvey, Morgan [D-KY-3] H.R.5380 - To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage. To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage. Sponsor: Rep. Sarbanes, John P. [D-MD-3] H.R.2880 - Protecting Patients Against PBM Abuses Act To amend title XVIII of the Social Security Act to establish certain requirements for pharmacy benefit managers under part D of the Medicare program. Sponsor: Rep. Carter, Earl L. "Buddy" [R-GA-1] H.R.5385 - Medicare PBM Accountability Act To amend title XVIII of the Social Security Act to establish pharmacy benefit manager reporting requirements with respect to prescription drug plans and MA-PD plans under Medicare part D. Sponsor:Rep. Landsman, Greg [D-OH-1] H.R.5388 - Supporting Innovation for Seniors Act To amend title XVIII of the Social Security Act to provide coverage of certain technologies and medical devices under the Medicare program. Sponsor: Rep. Balderson, Troy [R-OH-12] H.R.5663 - ALS Better Care Act To amend title XVIII of the Social Security Act to provide coverage of ALS-related services under the Medicare program for individuals diagnosed with amyotrophic lateral sclerosis, and for other purposes. Sponsor: Rep. Schakowsky, Janice D. [D-IL-9] H.R.4758 - Accelerating Kids Access to Care Act To amend title XIX of the Social Security Act to streamline enrollment under the Medicaid program of certain providers across State lines, and for other purposes. Sponsor: Rep. Trahan, Lori [D-MA-3] S.2973 - Modernizing and Ensuring PBM Accountability Act To amend titles XVIII and XIX of the Social Security Act to establish requirements relating to pharmacy benefit managers under the Medicare and Medicaid programs, and for other purposes. Sponsor: Sen. Wyden, Ron [D-OR] HR 5663 ALS Better Care Act To amend title XVIII of the Social Security Act to provide coverage of ALS-related services under the Medicare program for individuals diagnosed with amyotrophic lateral sclerosis, and for other purposes. Sponsor: Rep. Schakowsky, Janice D. [D-IL-9] HR 4758 Accelerating Kids Access to Care Act To amend title XIX of the Social Security Act to streamline enrollment under the Medicaid program of certain providers across State lines, and for other purposes. Sponsor: Rep. Trahan, Lori [D-MA-3]

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

Bills named: H.R. 5388 (118th), H.R. 5380 (118th), H.R. 4758 (118th), H.R. 5386 (118th), H.R. 2880 (118th), H.R. 5663 (118th), S. 2973 (118th), H.R. 5746 (118th), H.R. 5385 (118th)