HIGHMARK INC

Amortization of Research and Experimental Expenditures S. 866 - The American Innovation and Jobs Act This bill revises and expands the deductibility of research and experimental expenditures to allow immediate expensing of such expenditures. It also allows the amortization over a period of at least 60 months of certain other types of research and experimental expenditures not treated as expenses.

Issues: Affordability of Coverage, Affordable Care Act Tax Credits, Telehealth, Mental Health, Workforce Shortages, Transparency in Coverage, Site-Neutral Payments, Hospital Billing, Social Determinants of Health, Hunger/Nutrition, Food as Medicine, Medical Loss Ratio, Artificial Intelligence, Prior Authorization Bills: H.R. 5378 - The Lower Costs, More Transparency Act - A bill to require health care providers and insurers to disclose certain information about health care costs. It also establishes requirements for certain payment methodologies under Medicare and Medicaid and extends several public health programs. H.R. 3417 - FAIR Act - A bill to ensure fair billing practices for items and services furnished by off-campus outpatient departments of a provider. S.1869 - SITE Act - A bill 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. S.2840 - Bipartisan Primary Care and Health Workforce Act - A bill to improve access to and the quality of primary health care, expand the health workforce, and for other purposes. H.R. 1843/S. 1001 - The Telehealth Expansion Act - This bill permanently exempts high deductible health plans from the requirement of a deductible for telehealth and other remote care services. H.R.9774 - The Health Care Affordability Act - To amend the Internal Revenue Code of 1986 to expand eligibility for the refundable credit for coverage under a qualified health plan (ACA Enhanced Tax Credits)

Issues: Insulin Copay Caps, Drug Pricing, Pharmacy Benefit Manager (PBM) Reform, Generic Drug Manufacturing, GLP-1s Bills: Senate Finance Committee PBM Reform Framework H.R. 5378 - The Lower Costs, More Transparency Act - A bill to require health care providers and insurers to disclose certain information about health care costs. It also establishes requirements for certain payment methodologies under Medicare and Medicaid and extends several public health programs. H.R. 1488/S. 954 - The Affordable Insulin Now Act -- A bill to provide for appropriate cost-sharing for insulin products covered under private health plans, and to establish a program to support health care providers and pharmacies in providing discounted insulin products to uninsured individuals. S. 127. - The Pharmacy Benefit Manager Transparency Act - This bill generally prohibits pharmacy benefit managers (PBMs) from engaging in certain practices when managing the prescription drug benefits under a health insurance plan, including charging the plan a different amount than the PBM reimburses the pharmacy. S.1339 - The Pharmacy Benefit Manager Reform Act - A bill to provide for increased oversight of entities that provide pharmacy benefit management services on behalf of group health plans and health insurance coverage. H.R.2679 - The Pharmacy Benefits Manager Accountability Act - A bill to amend the Public Health Service Act, the Employee Retirement Income Security Act, and the Internal Revenue Code of 1984 to increase oversight of pharmacy benefits manager services, and for other purposes. H.R. 3561 - PATIENT Act of 2023 - This bill expands hospital price transparency requirements and establishes additional reporting requirements with respect to prescription drugs and pharmacy benefit managers (PBMs). H.R. 2630/S. 652 - The Safe Step Act -- This bill requires a group health plan to establish an exception to medication step-therapy protocol in specified cases. A medication step-therapy protocol establishes a specific sequence in which prescription drugs are covered by a group health plan or a health insurance issuer. H.R. 830/S. 1375 - The HELP Copays Act -- This bill requires health insurance plans to apply certain payments made by, or on behalf of, a plan enrollee toward a plan's cost-sharing requirements. Specifically, plans must apply third-party payments, financial assistance, discounts, product vouchers, and other reductions in out-of-pocket expenses toward the requirements. H.R. 2880 - Protecting Patients Against PBM Abuses Act -- This bill establishes requirements for Medicare pharmacy benefit managers (PBMs) with respect to remuneration, payments, and fees. Specifically, the bill restricts PBMs that are under contract with plans under the Medicare prescription drug benefit or Medicare Advantage from (1) receiving income for their services other than flat dollar amount service fees; (2) basing any service fees on the prices of covered drugs or any associated discounts, rebates, or other remuneration; (3) charging plan sponsors for ingredient costs or dispensing fees in amounts that are different than what is reimbursed to the pharmacy; or (4) reimbursing network pharmacies for less than that what is reimbursed to PBM-affiliated pharmacies.

Issues: Medicare Advantage, Risk Adjustment, Star Ratings, Health Equity Index, Prior Authorization, Medicaid Redeterminations, Site Neutral Payments, Social Determinants of Health, Telehealth Bills: Senate Finance Committee PBM Reform Framework H.R.5746 - Addressing Whole Health in Medicare Advantage Act - A bill To amend title XVIII of the Social Security Act to expand the availability of supplemental benefits to certain Medicare Advantage enrollees. S.1038/H.R.1613 - Drug Price Transparency in Medicaid Act - A bill 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. H.R. 8702/S. 4532 -- Improving Seniors Timely Access to Care Act - to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. H.R. 7623 -- Telehealth Modernization Act of 2024 - This bill modifies requirements relating to coverage of telehealth services under Medicare.

Affordability of Coverage, Affordable Care Act Subsidies, Telehealth, Mental Health, Workforce Shortages, Transparency in Coverage, Site-Neutral Payments, Hospital Billing, Social Determinants of Health, Hunger/Nutrition, Food as Medicine, Medical Loss Ratio, Artificial Intelligence, Prior Authorization H.R. 5378 - The Lower Costs, More Transparency Act - A bill to require health care providers and insurers to disclose certain information about health care costs. It also establishes requirements for certain payment methodologies under Medicare and Medicaid and extends several public health programs. H.R. 3417 - FAIR Act - A bill to ensure fair billing practices for items and services furnished by off-campus outpatient departments of a provider. S.1869 - SITE Act - A bill 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. S.2840 - Bipartisan Primary Care and Health Workforce Act - A bill to improve access to and the quality of primary health care, expand the health workforce, and for other purposes. H.R. 1843/S. 1001 - The Telehealth Expansion Act - This bill permanently exempts high deductible health plans from the requirement of a deductible for telehealth and other remote care services.