Healthcare-Transparency

👀 I’m Just a Bill — Lower Costs, More Transparency Act A Liana Banyan “I’m Just a Bill” Bounty Poster What is this bill? Healthcare-cost transparency and Pharmacy Benefit Manager (PBM) reform legislation in the 119th Congress. Focuses on hospital-price transparency, PBM transparency, and direct-to-consumer drug pricing. What does it actually do? Hospital price transparency: Strengthens existing CMS price-transparency rules; adds enforcement. PBM transparency: Requires PBMs to disclose rebate structures and pass-through pricing arrangements. Drug coupons: Modifies Medicare/Medicaid treatment of manufacturer drug coupons. Site-neutral payments: Adjusts Medicare payment differentials between hospital-outpatient and physician-office settings for the same procedures. PBM reform: Specific provisions limiting PBM “spread pricing” and clawback practices. Who votes when? House Energy & Commerce + Ways & Means + Senate Finance + HELP active consideration. How does this affect cooperative-class families? Composes directly with three cooperative-healthcare initiatives: ...

👀 I’m Just a Bill — Medicare Advantage Transparency Act A Liana Banyan “I’m Just a Bill” Bounty Poster What is this bill? Medicare Advantage (MA) transparency legislation in the 119th Congress, addressing documented patterns of denial-of-care, prior-authorization friction, and provider-network adequacy gaps in MA plans. What does it actually do? Prior authorization: Caps prior-auth response times; requires denial reasons in plain language. Network adequacy: Strengthens enforcement of provider-network requirements. Marketing transparency: Limits misleading marketing practices for MA plans. Star ratings: Modifies the CMS Star Ratings methodology to weight beneficiary-experience metrics more heavily. Risk adjustment: Addresses upcoding documented in OIG investigations. Who votes when? Senate Finance + House Ways & Means + Energy & Commerce active consideration. How does this affect cooperative-class families? The cooperative does not endorse positions on Medicare structural reform. The Council exists to provide accurate plain-language explanation of what bills do. ...