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

Pharmacy PHA

Insulin Out of Pocket Charges; Finance PBM Framework Proposals; Covid Vaccines S. 150 - Affordable Prescriptions for Patients Act of 2023 A bill to amend the Federal Trade Commission Act to prohibit product hopping, and for other purposes. Sponsor: Sen. John Cornyn (R-TX) S. 127 - Pharmacy Benefit Manager Transparency Act of 2023 A bill 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. Maria Cantwell (D-WA) S.1067 - Ensuring Timely Access to Generics Act of 2023 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 of 2023 To amend the Federal Food, Drug, and Cosmetic Act with respect to the 180-day exclusivity period. Sponsor: Sen. Smith, Tina [D-MN] S.1269 - INSULIN Act of 2023 To reduce the price of insulin and provide for patient protections with respect to the cost of insulin. Sponsor: Sen. Shaheen, Jeanne [D-NH] 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.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]

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

Bills named: S. 127 (118th), S. 1067 (118th), S. 2305 (118th), S. 1114 (118th), S. 1269 (118th), S. 1339 (118th), S. 150 (118th)

Health Issues HCR

Affordability; Affordable Care Act; Mental health/Youth Mental Health; Maternal Health; Health Equity; Site Neutrality/site neutral payment reform; Fair Hospital Billing; Transparency in coverage; Surprise Billing; Government shutdown; Rural healthcare access; 340B transparency; HIPAA modernization; Artificial intelligence (AI); Preventative services 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. 3561, The Patient Act of 2023 To promote hospital and insurer price transparency, and for other purposes. Sponsor: Rep. McMorris Rodgers, Cathy [R-WA-5] 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.4822 Health Care Price Transparency Act of 2023 To improve price transparency with respect to certain health care services, and for other purposes. Sponsor: Rep. Smith, Jason [R-MO-8] 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] H.R.4509 - Transparency in Billing Act To amend the Employee Retirement Income Security Act of 1974 to require group health plans and health insurance issuers offering group health insurance coverage to only pay claims submitted by hospitals that have in place policies and procedures to ensure accurate billing practices, and for other purposes. Sponsor: Rep. Foxx, Virginia [R-NC-5] H.R.4508 - Hidden Fee Disclosure Act To amend the Employee Retirement Income Security Act of 1974 to clarify and strengthen the application of certain employer-sponsored health plan disclosure requirements. Sponsor: Rep. Courtney, Joe [D-CT-2] H.R.4507 - Transparency in Coverage Act of 2023 To amend the Employee Retirement Income Security Act of 1974 to promote transparency in health coverage and reform pharmacy benefit management services with respect to group health plans, and for other purposes. Sponsor: Rep. Good, Bob [R-VA-5] H.R.4527 - Health DATA Act To amend the Employee Retirement Income Security Act of 1974 to ensure plan fiduciaries may access de-identified information relating to health claims, and for other purposes. Sponsor: Rep. Chavez-DeRemer, Lori [R-OR-5] H.R.5647 - Childhood Cancer Clinical Trials Act To amend title XXVII of the Public Health Service Act to require out-of-network coverage for qualified individuals diagnosed with a rare pediatric disease participating in approved clinical trials, and for other purposes. Sponsor: Rep. McCaul, Michael T. [R-TX-10] 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] H.R.5688 - Bipartisan HSA Improvement Act of 2023 To amend the Internal Revenue Code of 1986 to improve health savings accounts. Sponsor: Rep. Smucker, Lloyd [R-PA-11] H.R.5687 - HSA Modernization Act of 2023 To amend the Internal Revenue Code of 1986 to modernize health savings accounts. Sponsor: Rep. Van Duyne, Beth [R-TX-24]

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

Bills named: H.R. 4531 (118th), H.R. 4507 (118th), S. 1869 (118th), H.R. 4509 (118th), H.R. 5378 (118th), H.R. 4527 (118th), H.R. 3561 (118th), H.R. 3417 (118th), S. 652 (118th), H.R. 5687 (118th), H.R. 5688 (118th), H.R. 4508 (118th), H.R. 5647 (118th), H.R. 4822 (118th)

Medicare/Medicaid MMM

Provider Directories; Medicaid Redeterminations; Draft Duals legislation; Same-day billing restrictions in Medicaid; IRA copay smoothing; Medicare Advantage Health Equity Index S.1038/H.R.1613 - Drug Price Transparency in Medicaid Act of 2023 To amend title XIX of the Social Security Act to improve transparency and prevent the use of abusive spread pricing and related practices in the Medicaid program. Sponsor: Sen. Welch, Peter [D-VT]; Sponsor: Rep. Carter, Earl L. "Buddy" [R-GA-1] H.R.3284 - Providers and Payers COMPETE Act To require the Secretary of Health and Human Services to submit an annual report on the impact of certain Medicare regulations on provider and payer consolidation. Sponsor: Rep. Burgess, Michael C. [R-TX-26] 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]

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

Bills named: H.R. 3284 (118th), S. 1038 (118th), H.R. 1613 (118th), H.R. 5746 (118th)