HORIZON BLUE CROSS BLUE SHIELD OF NEW JERSEY

HCR · Health Issues

Affordable Care Act (ACA), ACA subsidies and tax credits; Transparency in Coverage, Rural healthcare; Marketplace Renewal Notices; Surprise Billing; Prior Authorization; Managed Care Organizations; Maternal Health; Artificial Intelligence; Hospital billing; Individual Market Reforms and eAPTC Extension; Healthcare Affordability. 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.8684 - Transparency in Billing Act of 2026 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.9393 - Lower Costs, More Transparency Act of 2026 To promote price transparency in the health care sector. Sponsor: Rep. Guthrie, Brett [R-KY-2] H.R.9396 - Prior Authorization Accountability 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 require the displaying of claim denial rates. Sponsor: Rep. Goldman, Craig A. [R-TX-12] H.R.7973 - Momnibus Act To end preventable maternal mortality, severe maternal morbidity, and maternal health disparities in the United States, and for other purposes. Sponsor: Rep. Underwood, Lauren [D-IL-14]

Literal federal measure citations: H.R.4710, S.2420, H.R.8684, H.R.9393, H.R.9396, H.R.7973

MMM · Medicare/Medicaid

Medicare Advantage; Medicare/Transparency; Medicaid Cuts; Medicaid Managed Care; Medicare Advantage & MA Rate Notice; Youth Mental Health; community engagement implementation; Site neutral payment reform; Fraud, Waste, and Abuse. 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] 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.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]

Literal federal measure citations: H.R.4077, H.R.9392, H.R.3514

PHA · Pharmacy

Generics access; Prescription Drug Cost; PBM Reform and Prescription Drug Policy 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] H.R. 6837 - PBM FAIR Act To amend the Employee Retirement Income Security Act of 1974 to ensure that pharmacy benefit managers are considered fiduciaries, and for other purposes. Sponsor: Rep. Auchincloss, Jake [D-MA-4]

Literal federal measure citations: H.R.1843, H.R.7895, H.R. 6837