BLUE CROSS BLUE SHIELD OF MICHIGAN

HCR · Health Issues

Issues: Affordable Care Act (ACA), ACA subsidies and tax credits; Telehealth/ telehealth flexibilities; ACA Fraud; Transparency in coverage; Surprise Billing; 2025 Proposed NBPP/Individual Market/ACA exchanges; Rural healthcare; Prior Authorization; Hospital Consolidation; Employer-provided health coverage; Cyber Attack/ Cyber Security; Provider Directories; Health Equity + Maternal Health; Hospital Billing; Anti-tiering, Anti-steering; Health Equity; Program integrity in the individual marketplace; Federal Budget Process; Artificial Intelligence; Vaccine Coverage; Marketplace Renewal Notices; Cell and Gene Therapies; Food as Medicine Bills: S.2903 - 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.1869 - SITE Act (118th) 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 (118th) 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] (118th) H.R. 5378 Lower Costs, More Transparency Act (118th) To promote price transparency in the health care sector, and for other purposes. Sponsor: Rep. McMorris Rodgers, Cathy [R-WA-5] H.R.2483 - Support for Patients and Communities Reauthorization Act To reauthorize certain programs that provide for opioid use disorder prevention, treatment, and recovery, and for other purposes. Sponsor: Rep. Guthrie, Brett [R-KY-2] S.2121 - SUPPORT for Patients and Communities Reauthorization Act of 2025 To reauthorize certain programs that provide for opioid use disorder prevention, treatment, and recovery, and for other purposes. Sponsor: Sen. Cassidy, Bill [R-LA] S.1261 - CONNECT for Health Act of 2025 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] H.R.4206 - CONNECT for Health Act of 2025 To amend title XVIII of the Social Security Act to expand access to telehealth services, and for other purposes. Sponsor: Rep. Thompson, Mike [D-CA-4] S.46 - Health Care Affordability Act of 2025 A bill to amend the Internal Revenue Code of 1986 to expand eligibility for the refundable credit for coverage under a qualified health plan. Sponsor: Sen. Shaheen, Jeanne [D-NH] H.R.247 - Health Care Affordability Act of 2025 To amend the Internal Revenue Code of 1986 to expand eligibility for the refundable credit for coverage under a qualified health plan. Sponsor: Rep. Underwood, Lauren [D-IL-14] S.5535 - No Surprises Act Enforcement Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to increase penalties for group health plans and health insurance issuers for practices that violate balance billing requirements, and for other purposes. Sponsor: Sen. Marshall, Roger [R-KS] S.1973 - Treat and Reduce Obesity Act of 2025 To amend title XVIII of the Social Security Act to provide for the coordination of programs to prevent and treat obesity, and for other purposes. Sponsor: Sen. Cassidy, Bill [R-LA] H.R.4231 - Treat and Reduce Obesity Act of 2025 To amend title XVIII of the Social Security Act to provide for the coordination of programs to prevent and treat obesity, and for other purposes. Sponsor: Rep. Kelly, Mike [R-PA-16] H.R.2571 - Self-Insurance Protection Act To amend the Employee Retirement Income Security Act of 1974 to exclude from the definition of health insurance coverage certain medical stop-loss insurance obtained by certain plan sponsors of group health plans, and for other purposes. Sponsor: Rep. Onder, Robert [R-MO-3] H.R.4710 - No Surprises Act Enforcement Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to increase penalties for group health plans and health insurance issuers for practices that violate balance billing requirements, and for other purposes. Sponsor: Rep. Murphy, Gregory F. [R-NC-3] S.2420 - No Surprises Act Enforcement Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to increase penalties for group health plans, health insurance issuers, and nonparticipating providers or facilities for practices that violate balance billing requirements, and for other purposes. Sponsor: Sen. Marshall, Roger [R-KS] H.R.3419 To amend the Public Health Service Act to reauthorize the telehealth network and telehealth resource centers grant programs. Sponsor: Rep. Valadao, David G. [R-CA-22] H.R.2493 - Improving Care in Rural America Reauthorization Act of 2025 To reauthorize certain programs regarding rural health care. Sponsor: Rep. Carter, Earl L. "Buddy" [R-GA-1] S.2301 - Improving Care in Rural America Reauthorization Act of 2025 To reauthorize certain programs regarding rural health care. Sponsor: Sen. Scott, Tim [R-SC] H.R.2528 - Association Health Plans Act To amend the Employee Retirement Income Security Act of 1974 to clarify the treatment of certain association health plans as employers, and for other purposes. Sponsor: Rep. Walberg, Tim [R-MI-5] S.2355 - Patients Deserve Price Tags Act To amend the Public Health Service Act to provide for hospital and insurer price transparency. Sponsor: Sen. Marshall, Roger [R-KS] H.R.2509 - COMPLETE Care Act To amend title XVIII of the Social Security Act to provide incentives for behavioral health integration. Sponsor: Rep. Malliotakis, Nicole [R-NY-11] S.931 - COMPLETE Care Act To amend title XVIII of the Social Security Act to provide incentives for behavioral health integration. Sponsor: Sen. Cortez Masto, Catherine [D-NV]

Literal federal measure citations: S.2903, S.1869, H.R.3417, H.R. 5378, H.R.2483, S.2121, S.1261, H.R.4206, S.46, H.R.247, S.5535, S.1973, H.R.4231, H.R.2571, H.R.4710, S.2420, H.R.3419, H.R.2493, S.2301, H.R.2528, S.2355, H.R.2509, S.931

MMM · Medicare/Medicaid

Issues: Same-day billing restrictions in Medicaid; Medicare Advantage & MA Rate Notice; Medicare/Transparency; Medicaid Cuts; Mental Health Care, Youth Mental Health; Site neutral payment reform; Health Equity Index reward factor; Health Equity Index for MA plans; MA Reform; Medicaid Provider Taxes Bills: H.R.5746 - Addressing Whole Health in Medicare Advantage Act (118th) 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.1 - One Big Beautiful Bill Act This bill reduces taxes, reduces or increases spending for various federal programs, increases the statutory debt limit, and otherwise addresses agencies and programs throughout the federal government. Sponsor: Rep. Arrington, Jodey C. [R-TX-19] S.1105 - No UPCODE Act To amend title XVIII of the Social Security Act to improve risk adjustment under Medicare Advantage. Sponsor: Sen. Cassidy, Bill [R-LA] H.R.4077 - GUARD Veterans Health Care Act To amend title 38, United States Code, and the Social Security Act to permit recovery from the Department of Veterans Affairs of costs from Medicare Advantage and Medicare prescription drug plans and to modify the authority for recovery by the United States of reasonable charges for certain care or services furnished to veterans for non-service-connected disabilities, and for other purposes. Sponsor: Rep. Doggett, Lloyd [D-TX-37] S.2145 - GUARD Veterans Health Care Act To amend title 38, United States Code, and the Social Security Act to permit recovery from the Department of Veterans Affairs of costs from Medicare Advantage and Medicare prescription drug plans and to modify the authority for recovery by the United States of reasonable charges for certain care or services furnished to veterans for non-service-connected disabilities, and for other purposes. Sponsor: Sen. Warren, Elizabeth [D-MA] S.683 - More Behavioral Health Providers Act of 2025 To amend title XVIII of the Social Security Act to expand eligibility for incentives under the Medicare health professional shortage area bonus program to practitioners furnishing mental health and substance use disorder services. Sponsor: Sen. Peters, Gary C. [D-MI]

Literal federal measure citations: H.R.5746, H.R.1, S.1105, H.R.4077, S.2145, S.683

PHA · Pharmacy

Issues: 340B Program/Transparency; generics access; Pharmacy Benefit Managers; Prescription Drug Cost; Step Therapy Bills: S. 775, Increasing Transparency in Generic Drug Applications To provide for increased transparency in generic drug applications. Sponsor: Sen. Hassan, Margaret Wood [D-NH] H.R.3839 - To amend the Federal Food, Drug, and Cosmetic Act to increase transparency in generic drug applications. To amend the Federal Food, Drug, and Cosmetic Act to increase transparency in generic drug applications. Sponsor: Rep. Dunn, Neal P. [R-FL-2] S. 1067, Ensuring Timely Access to Generics Act (118th) To amend the Federal Food, Drug, and Cosmetic Act with respect to citizen petitions. Sponsor: Sen. Shaheen, Jeanne [D-NH] S.1041 - Affordable Prescriptions for Patients Act A bill to amend title 35, United States Code, to address the infringement of patents that claim biological products, and for other purposes. Sponsor: Sen. Cornyn, John [R-TX] S.1040 - Drug Competition Enhancement Act A bill to amend the Federal Trade Commission Act to prohibit product hopping, and for other purposes. Sponsor: Sen. Cornyn, John [R-TX] S.1096 - Preserve Access to Affordable Generics and Biosimilars Act A bill to prohibit brand name drug companies from compensating generic drug companies to delay the entry of a generic drug into the market, and to prohibit biological product manufacturers from compensating biosimilar and interchangeable companies to delay the entry of biosimilar biological products and interchangeable biological products. Sponsor: Sen. Klobuchar, Amy [D-MN] S.2658 - Medication Affordability and Patent Integrity Act To require sponsors of drug applications and holders of approved applications to provide certain submissions and communications to the Food and Drug Administration and the United States Patent and Trademark Office. Sponsor: Sen. Hassan, Margaret Wood [D-NH] S.1302 - Increasing Transparency in Generic Drug Applications Act To provide for increased transparency in generic drug applications. Sponsor: Sen. Hassan, Margaret Wood [D-NH] H.R.1843 - Increasing Transparency in Generic Drug Applications Act To amend the Federal Food, Drug, and Cosmetic Act to increase transparency in generic drug applications. Sponsor: Rep. Dunn, Neal P. [R-FL-2]

Literal federal measure citations: S. 775, H.R.3839, S. 1067, S.1041, S.1040, S.1096, S.2658, S.1302, H.R.1843