2025 fourth_quarter Filing

Medicare Advantage & MA Rate Notice; Medicare/Transparency; Site neutral payment reform; Community Health Index reward factor; Community Health Index for MA plans; MA Reform 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. S.1105 - No UPCODE Act To amend title XVIII of the Social Security Act to improve risk adjustment under Medicare Advantage. Discussions regarding Inappropriate use of skin substitute products in Medicare and policy approaches to reduce inappropriate utilization and spending. Discussed the community engagement requirements

Affordable Care Act (ACA), ACA subsidies and tax credits; ACA Fraud; Transparency in coverage; Surprise Billing; 2025 Proposed NBPP/Individual Market/ACA exchanges; Rural healthcare; Prior Authorization; Hospital Consolidation; Employer-provided health coverage; Hospital Billing; Program integrity in the individual marketplace; Federal Budget Process; Artificial Intelligence; Marketplace Renewal Notices; Individual Market Reforms and eAPTC Extension. H.R.3417 - FAIR Act (118th) To ensure fair billing practices for items and services furnished by off-campus outpatient departments of a provider. H.R. 5378 Lower Costs, More Transparency Act (118th) To promote price transparency in the health care sector, and for other purposes. H.R.3237 To amend title XVIII of the Social Security Act to require each off-campus outpatient department of a provider to include a unique identifier on claims for items and services, and to require providers with a department of a provider to submit to the Centers for Medicare & Medicaid Services an attestation with respect to each such department. H.R.6703 - Lower Health Care Premiums for All Americans Act To ensure access to affordable health insurance. S.2497 - Fair Billing Act To amend title XVIII of the Social Security Act to require a separate identification number and an attestation for each off-campus outpatient department of a provider. H.R.5972 - Right to Enroll Act of 2025 To direct the Secretary of Health and Human Services to extend the annual open enrollment period for enrolling in a qualified health plan offered by an Exchange for plan year 2026. H.R.6232 - HOPE Act To amend the Internal Revenue Code of 1986 to extend and modify the enhanced premium tax credit, and to amend the Patient Protection and Affordable Care Act to make certain adjustments to the operation of the Exchanges established under such Act. S.958 - Tech to Save Moms Act To support the use of technology in maternal health care, and for other purposes. H.R.5463 - Choice Arrangement To amend the Internal Revenue Code of 1986 to provide for the treatment of employer-provided health reimbursement arrangements that are integrated with individual market coverage, and for other purposes.