Some lawmakers in New York are calling for increased transparency and oversight over a controversial federal drug discount program that benefits many of the state’s larger hospitals, as a nationwide debate over prescription drug pricing intensifies.
A proposal by Gov. Ned Lamont to cap the amount residents pay for out-of-network medical care is facing strong pushback from providers and hospital administrators who say the bill will result in reduced access for patients, financial burdens for providers and increased leverage for an already-powerful insurance industry.
In late March, Representatives Mark Green, MD, (R, Tenn.) and Kim Schrier, MD, (D-Wash.) reintroduced H.R. 2433, the Reducing Medically Unnecessary Delays in Care Act of 2025. The bill calls for additional transparency in prior authorization determinations, and would also require that Medicare, Medicare Advantage and Medicare Part D plans make decisions based on medical necessity and written clinical criteria.
Nevada lawmakers are discussing nearly 10 bills aimed at reforming prior authorization requests for medical care through requiring quicker response times, increasing transparency, and creating regulations for artificial intelligence in decision-making.
Some of Florida’s most vulnerable people who rely on Medicaid may wind up having their care flow through managed care organizations under a bill the Legislature passed this session.