Reducing Barriers to Learning Act of 2009

Education and support for population-based health programs, such as disease and care management in FFS Medicare and Medicare Advantage, including Special Needs Plans (specifically, the reauthorization of Chronic Care Special Needs Plans, or C-SNPs, the incorporation of reasonable process measures and standards for SNP evaluation, and recommendations for CMS' Chronic Conditions SNP Panel); Medicare pilots and demonstrations such as the Medicare Medical Home Demonstration, Senior Risk Reduction Dem- onstration, Medicare Physician Group Practice Demonstration, Medicare Electronic Health Records Demonstration, the Medicare Coordinated Care Demonstration (MCCD, as authorized under Section 4016 of the Balanced Budget Act of 1997), and Medicare Health Support (as authorized under Section 721 of the Medicare Prescription Drug, Improvement and Modernization Act (MMA), which created the "Voluntary Chronic Care Improvement Program" now called Medicare Health Support) - specifically, the 18-month Report to Congress on Medicare Health Support. Provision of suggestions and recommendations for consideration of the broader inclusion of coordinated chronic care and health service stakeholder expertise in the feasibility study of a Medicare Chronic Care Practice Research Network demonstration program and in outcomes reporting for comparative effectiveness research (authorized in the Medicare Improvements for Patients and Providers Act of 2008). Analysis and discussions regarding the expanded hospital re-admission reporting requirements included in Final IPPS & OPPS Rules. Analysis of Congressional Budget Office reports on health care reform key issues and budget options, and promotion of successful outcomes in population health improvement programs as a component of national reform of care delivery, financing and design, particularly in public sector programs. Promotion of alternative modeling might more fully capture the true costs and savings associated with innovative prevention and treatment techniques in health care. Promotion of consideration of alternative models to assess and adjust risk scores related to the illnesses of beneficiaries in the Medicare program. Support for funding of prevention and wellness programs and initiatives as provided for in the American Recovery and Reinvestment Act of 2009 as passed by the House and Senate. Support for modifying provisions related to HIPAA Privacy rule and security for personal health information as established in the Health-e Information Technology Act (HITECH Act) as part of the American Recovery & Reinvestment Act (ARRA). Encouragement of efforts to preserve HIPAA provisions permitting exchange of protected health information for care coordination and disease management, efforts to advance health information technology deployment, particularly as it would affect individuals with chronic conditions, including e-prescribing, and the creation of interoperability standards and priority use cases and best practices for technology deployment and promotion in care coordination. Support for the exemption of disease management and care coordination efforts from economic stimulus provision that would have required the HHS Secretary to issue new health care operations rules. Analysis and submission of comments regarding the Genetic Information Nondiscrimination Act (GINA) and the creation of regulations by the EEOC defining the employer wellness program exception as provided for in GINA. Education regarding effectiveness of chronic condition care and its benefits to Medicaid and other populations via the sharing of published quality improvement studies that reported cost or utilization outcomes from the intervention and which are target clinical conditions relevant for Medicaid programs. Advocacy for priorities of all stakeholders providing services along the care continuum toward the goal of population health improvement in proposed and realized legislation, including S. 3613 & H.R. 7114, the Independence at Home Act of 2008; S. 631 & H.R. 5765, the Remote Monitoring Access Act of 2007; S. 334, the Healthy Americans Act; S. 1340, the Geriatric Assessment and Chronic Care Coordination Act of 2007; S. 1753, the Healthy Workforce Act of 2007; H.R. 3800, the Wired for Healthcare Quality Act; H.R. 6357, Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology PRO(TECH)T Act of 2008; H.R. 6898, the Health-e Information Technology Act of 2008 (HITECH Act); H.R. 5442, TRUST in Health Information Act of 2008; S. 3101, Medicare Improvements for Patients and Providers Act of 2008; S. 3118, Preserving Access to Medicare Act of 2008; H.R. 853, Wellness and Prevention Act of 2007; H.R.6331, Medicare Improvements for Patients and Providers Act of 2008; the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA); the American Recovery & Reinvestment Act (ARRA); initiatives pertaining to the treatment and prevention of obesity as a chronic disease generally and as a component of population health improvement approaches to addressing the obesity epidemic. Advocacy and support for expansion of Medicare-covered clinical preventive services as recommended by the U.S. Preventive Services Task Force and provided for in the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA). Endorsement of the Healthy Workforce Act of 2009 and promotion of the legislation through the Healthy Workplace Alliance. General advocacy for population health improvement as a tool to improve the quality of health care and health care outcomes, and reduce preventable health care costs, and promotion of health promotion, wellness, and care coordination programs at the White House Regional Health Reform Summits.

Client expense: $135,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE, White House Office