In this edition of Health Policy Breakroom, Sarah Raaii and Rachel Stauffer join Julia Grabo to explore a crucial virtual care provision from the recently enacted One Big Beautiful Bill Act, exploring its effects on patients, employers, and the broader landscape of virtual care policy.
Health insurers recently announced steps to improve the prior authorization process, a move that was praised by US Department of Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. and Centers for Medicare & Medicaid Services (CMS) Administrator Mehmet Oz. This initiative responds to longstanding complaints from patients and providers about the complexity and burden of prior authorization, which often leads to denied coverage for necessary care. While CMS and HHS have already implemented regulations to address these issues, the question remains whether the new industry commitments add anything beyond what is already required.
On June 18, 2025, the Supreme Court of the United States ruled in United States v. Skrmetti, upholding Tennessee’s SB1 law that limits access to gender-affirming care for minors. The court’s 6-3 decision, written by Chief Justice John Roberts, deemed the law constitutional under a rational basis review, determining it classifies based on age and medical use rather than sex or transgender status.
These FAQs highlight key implications for healthcare providers, hospitals, health systems, health plans, and employer plan sponsors navigating the ruling’s consequences.
Vermont’s governor recently signed S 30 into law. The legislation, which goes into effect on September 1, 2025, requires that health insurance plans provide coverage for healthcare and dental services delivered through telemedicine to the same extent as if the services were provided through in-person consultations. Health insurance plans must also provide the same reimbursement rate for services billed using equivalent procedure codes and modifiers, subject to the terms of the health insurance plan and provider contract, regardless of whether the service was provided in person or through telemedicine.
For more updates on state legislative and regulatory developments related to telehealth, check out the latest Trending in Telehealth published by the Health & Life Sciences Group.
On May 22, 2025, the US House of Representatives passed its reconciliation package, now known as H.R.1, One Big Beautiful Bill Act, by a 215 – 214 – 1 vote, advancing an agenda that extends and builds on tax cuts enacted in President Trump’s first term. The bill contains several policies impacting group health insurance plans, health savings accounts, and employer tax credits for paid family and medical leave.
Read more about these proposed policy changes and others in this comprehensive report, which highlights the health-related provisions in the House reconciliation package.
On May 19, 2025, the Internal Revenue Service (IRS) released Internal Revenue Bulletin 2025-21. It includes Revenue Procedure 2025-19, which provides the 2026 inflation-adjusted amounts for health savings accounts (HSAs) as determined under Code § 223, as well as the maximum amount that may be made newly available for excepted benefit health reimbursement arrangements (HRAs) under Code § 54.9831-1(c)(3)(viii). Revenue Procedure 2025-19 is effective for HSAs for the 2026 calendar year and for excepted benefit HRAs beginning in 2026.
Learn more about other new IRS guidance in this Weekly IRS Roundup published by McDermott’s Tax Group.
In May, the Trump administration issued guidance and requests for information (RFIs) to enhance healthcare price transparency, focusing on both hospitals and health plans. For hospitals, the guidance reiterates the need to provide actual dollar amounts for payer-specific negotiated charges in machine-readable files (MRFs) rather than percentages, and it seeks input on improving the accuracy and completeness of MRF data. For health plans, the RFI addresses concerns about file size and data integrity, and it explores the implementation of net prices for covered prescription drugs, indicating that the administration plans to issue revised schemas and may pursue further transparency rulemaking.
The US House of Representatives passed its One Big Beautiful Bill Act on May 22, 2025 (the Act), but nonprofit health systems may not find much about the Act that’s attractive. If passed by the US Senate and signed into law, the Act would threaten already thin operating margins at nonprofit hospitals and health systems by expanding the executive compensation excise tax, taxing parking, and similar employee benefits.
The topic of “food as medicine” has gained increased attention recently, driven by a growing recognition of the role nutrition plays in preventing and managing chronic diseases. However, marketplace participants continue to face various hurdles, such as funding and reimbursement, in launching initiatives and demonstrating their value and beneficial impact on global health and well-being.
On April 15, 2025, President Trump signed an executive order (EO) aimed at addressing the cost of prescription drugs. This EO, titled “Lowering Drug Prices by Once Again Putting Americans First,” outlines specific directives designed to reduce drug prices and improve access for US patients. Of particular note for sponsors and providers of employer health plans, the EO tasks the US secretary of labor with proposing regulations to improve employer health plan fiduciary transparency into direct and indirect compensation received by pharmacy benefit managers.
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