PBM Reform, transparency S. 1414, Expedited Access to Biosimilars Act - A bill to provide that clinical studies required for licensure of biological products as biosimilar shall not be required to include the assessment of immunogenicity, pharmacodynamics, or comparative clinical efficacy. S.4189 - INSULIN Act of 2026 - A bill to reduce the price of insulin and provide for patient protections with respect to the cost of insulin. H.R.7895 - PBM Kickback Prohibition Act - A bill to prohibit kickbacks to pharmacy benefit managers.
Affordability of Coverage, Site-Neutral Payments, Hospital Billing, Artificial Intelligence, Prior Authorization, Surprise Billing, Vertical Integration, Transparency, Anti-Steering/Tiering S.3822 - Break Up Big Medicine Act - A bill to prohibit pharmacy benefit managers, insurers, and prescription drug or medical device wholesalers from being under common ownership with certain medical service providers, and for other purposes. H.R. 5582/S.2355 - Patients Deserve Price Tags Act - A bill to provide for hospital and insurer price transparency. H.R. 6248/S.4027 - Healthy Competition for Better Care Act - A bill to ban anticompetitive terms in facility and insurance contracts that limit access to higher quality, lower cost care. H.R.4710 - No Surprises Act Enforcement Act - A bill to increase penalties for group health plans and health insurance issuers for practices that violate balance billing requirements, and for other purposes. H.R. 9393, Lower Costs, More Transparency Act - A bill to require group health plans, individual market issuers, PBMs, hospitals, clinical laboratories, imaging service providers, and ambulatory surgical centers, to publicly disclose pricing and other specified information. H.R.9396 - Prior Authorization Accountability Act - A bill to require the displaying of claim denial rates. H.R.9397 - Premium Transparency Act - A bill to ensure health insurer accountability through publishing of overhead costs and claim payments, and to direct the Secretary of Health and Human Services to issue guidance on the provision of certain insurance information. H.R.9645 - Health Care Price Certainty for All Americans Act - A bill To promote health care price transparency, and for other purposes.
Medicaid Reform Implementation, Medicare Advantage, Risk Adjustment, Star Ratings, Prior Authorization, Site Neutral Payments, Prompt Pay, Provider Directories, Transparency H.R.8375 - Medicare Advantage Improvement Act of 2026 - A bill to provide for certain reforms under the Medicare Advantage program, and for other purposes. S. 1105 - No Unreasonable Payments, Coding, Or Diagnoses for the Elderly Act (No UPCODE) Act - This bill modifies certain factors that are used to determine Medicare Advantage (MA) payments, particularly relating to health status and related data. H.R. 4077/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. H.R. 3514/S. 1816 - 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. S. 3848/H.R. 4093 - Apples to Apples Comparison Act of 2025 - to require the Secretary of Health and Human Services to publish information on expenditures under the Medicare program, and for other purposes. H.R.5243 - A bill to increase data transparency for supplemental benefits under Medicare Advantage. H.R. 9392, Medicare Advantage Cost Transparency Act - A bill to require MA plans to report specified information on encounter data submitted to CMS. H.R. 9395, Transparency in Medicare Advantage Steering Act - Requires MA plans to annually identify individuals enrolled by an agent, broker or other third-party and report information about compensation paid.