GUIDEWELL MUTUAL HOLDING CORPORATION

MMM · Medicare/Medicaid

Issues: Same-day billing restrictions in Medicaid; Medicare Advantage & MA Rate Notice; Medicare/Transparency; Mental Health Care, Youth Mental Health; Site neutral payment reform; Program Fraud, Waste, and Abuse Bills: 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] H.R.668 - Coordinating Care for Senior Veterans and Wounded Warriors Act To require the Secretary of Veterans Affairs to carry out a pilot program to coordinate, navigate, and manage care and benefits for veterans enrolled in both the Medicare program and the system of annual patient enrollment of the Department of Veterans Affairs. Sponsor: Rep. Ciscomani, Juan [R-AZ-6] S.506 - Coordinating Care for Senior Veterans and Wounded Warriors Act This bill requires the Department of Veterans Affairs (VA) to implement a three-year pilot program to coordinate, navigate, and manage care and benefits for veterans who are enrolled in both the Medicare program and the VA health care system. Sponsor: Sen. Moran, Jerry [R-KS] H.R.9392 - Medicare Advantage Cost Transparency Act To amend title XVIII of the Social Security Act to require the inclusion of certain information in Medicare Advantage encounter data. Sponsor: Rep. DeGette, Diana [D-CO-1] H.R. 5243 - Supplemental Benefits Transparency Bill To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage. Sponsor: Rep. McClellan, Jennifer L. [D-VA-4] H.R.3514 - Improving Seniors Timely Access to Care Act of 2025 To amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Sponsor: Rep. Kelly, Mike [R-PA-16] H.R.8883 - Protecting Seniors and Stopping Fraudsters Act To amend title XVIII of the Social Security Act to provide for additional oversight of hospice programs and home health agencies under the Medicare program, and for other purposes. Sponsor: Rep. Van Duyne, Beth [R-TX-24] H.R.8871 - DME Scammer Prevention Act of 2026 To amend title XVIII of the Social Security Act to promote Medicare program integrity with respect to certain medical equipment and supplies. Sponsor: Rep. Bean, Aaron [R-FL-4] H.R.9693 - Patients First Act of 2026 To amend title XVIII of the Social Security Act to modify certain physician payments under the Medicare program. Sponsor: Rep. Joyce, John [R-PA-13] H.R.8375 - Medicare Advantage Improvement Act of 2026 To amend title XVIII of the Social Security Act to provide for certain reforms under the Medicare Advantage program, and for other purposes. Sponsor: Rep. Joyce, John [R-PA-13] S.4384 - Medicare Advantage Improvement Act of 2026 To amend title XVIII of the Social Security Act to provide for certain reforms under the Medicare Advantage program, and for other purposes. Sponsor: Sen. Marshall, Roger [R-KS]

Literal federal measure citations: H.R.4077, S.2145, H.R.668, S.506, H.R.9392, H.R. 5243, H.R.3514, H.R.8883, H.R.8871, H.R.9693, H.R.8375, S.4384

PHA · Pharmacy

Issues: Generics access; Prescription Drug Cost; PBM Reform and Prescription Drug Policy Bills: S.1954 - 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.3014 - Ensuring Timely Access to Generics Act of 2025 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.1095 - Stop STALLING Act A bill to enable the Federal Trade Commission to deter filing of sham citizen petitions to cover an attempt to interfere with approval of a competing generic drug or biosimilar, to foster competition, and facilitate the efficient review of petitions filed in good faith to raise legitimate public health concerns, and for other purposes. Sponsor: Sen. Klobuchar, Amy [D-MN] S.1097 - Interagency Patent Coordination and Improvement Act of 2025 To amend title 35, United States Code, to establish an interagency task force between the United States Patent and Trademark Office and the Food and Drug Administration for purposes of sharing information and providing technical assistance with respect to patents, and for other purposes. Sponsor: Sen. Durbin, Richard J. [D-IL] H.R.4570 - Interagency Patent Coordination and Improvement Act of 2025 To amend title 35, United States Code, to establish an interagency task force between the United States Patent and Trademark Office and the Food and Drug Administration for purposes of sharing information and providing technical assistance with respect to patents, and for other purposes. Sponsor: Rep. Neguse, Joe [D-CO-2] 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] H.R.7895 - PBM Kickback Prohibition Act To amend section 408 of the Employee Retirement Income Security Act of 1974 to prohibit kickbacks to pharmacy benefit managers. Sponsor: Rep. Allen, Rick W. [R-GA-12] S.4189 - INSULIN Act of 2026 To reduce the price of insulin and provide for patient protections with respect to the cost of insulin. Sponsor: Sen. Shaheen, Jeanne [D-NH]

Literal federal measure citations: S.1954, S.3014, S.1041, S.1040, S.1096, S.1095, S.1097, H.R.4570, S.1302, H.R.1843, H.R.7895, S.4189