High-Risk Pool Fairness Act

Implementation of healthcare reform laws - Executive Branch actions re PL 111-148 and PL 111-152. Repeal Patient Protection and Affordable Health Care Acts (PL 111-148/PL 111-152) - HR 4901, To repeal the Patient Protection and Affordable Care Act; HR 4903, To repeal the Patient Protection and Affordable Care Act; HR 4910, To repeal the Patient Protection and Affordable Care Act and enact the Empowering Patients First Act in order to provide incentives to encourage health insurance coverage; HR 4919, To repeal the Patient Protection and Affordable Care Act; HR 4972, To repeal the Patient Protection and Affordable Care Act; HR 5005, To repeal the Patient Protection and Affordable Care Act; HR 5073, To repeal the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 and enact the OPTION Act of 2009; HR 5216, To repeal the Patient Protection and Affordable Care Act; HR 5421, To repeal the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010, repeal the 7.5 percent threshold on the deduction for medical expenses, provide for increased funding for high-risk pools, allow acquiring health insurance across State lines, and allow for the creation of association health plans; HR 5424, Reform Americans Can Afford Act of 2010 ; HR 5444, Private Option Health Care Act; HR 6355, STAT Act of 2010; S 3147, Patient Choice Restoration Act; S 3152, A bill to repeal the Patient Protection and Affordable Care Act. *High risk pools - HR 5664, High-Risk Pool Fairness Act. *Effective date for prohibitionon rescissions - HR 5761, To amend the Patient Protection and Affordable Care Act to expedite the application of the provision prohibiting rescissions of health insurance coverage. *Government-run plan - HR 5808, To amend the Patient Protection and Affordable Care Act to establish a public health insurance option. *Guarantee-issue and open enrollment for Medigap policies - HR 5844, Fairness in Medigap Options Act of 2010. *Regulations of LTC insurance - HR 5890, Long-Term Care Insurance Reform Act of 2010. *Third-party review of LTC insurance disputed claims - S 1626, A bill to require issuers of long term care insurance to establish third party review processes for disputed claims. *Model disclosure forms for LTC insurance - S 1636, A bill to develop a model disclosure form to assist consumers in purchasing long-term care insurance. *Model Disclosure form for long-term care insurance - HR 4078, To require the Secretary of Health and Human Services to develop a national model disclosure form to assist consumers in purchasing long-term care insurance. *Federal rate review process - HR 4757, Health Insurance Rate Authority Act of 2010; S 3078, Health Insurance Rate Authority Act of 2010. *Changes to individual coverage requirement, grandfathered plans, immediate insurance reforms, premium assistance, CLASS Act, coverage issues, quality improvements, delivery system reforms - HR 4872, Health Care and Education Reconciliation Act of 2010. *Requirements for dental coverage - HR 5000, Dental Coverage Value and Transparency Act of 2010. *Requirements for private disability insurers - HR 6066, Preventing Social Security Fraud Act of 2010. *Supplemental disability insurance for Federal employees - HR 6368, Federal Employee Disability Insurance Act of 2010. *FTC authority - S 3685, Insurance Competition and Transparency Act of 2010. *Health coverage tax credit - S 3793, Job Creation and Tax Cuts Act of 2010. *State innovation waivers - S 3958, Empowering States to Innovate Act. *Disclosure of coverage exclusions - HR 1253, To require that limitations and restrictions on coverage under group health plans be timely disclosed to group health plan sponsors and timely communicated to participants and beneficiaries under such plans in a form that is easily understandable. *McCarran Ferguson reforms - HR 1583, To further competition in the insurance industry; S 1681, Health Insurance Industry Antitrust Enforcement Act of 2009. *Recissions, hospital stays for breast cancer patients - HR 1691, To require that health plans provide coverage for a minimum hospital stay for mastectomies, lumpectomies, and lymph node dissection for the treatment of breast cancer and coverage for secondary consultations; S 688, A bill to require that health plans provide coverage for a minimum hospital stay for mastectomies, lumpectomies, and lymph node dissection for the treatment of breast cancer and coverage for secondary consultations. *Coverage requirement for cancer screening - HR 4563, Cancer Screening Coverage Act of 2009. *MCCarran-Ferguson antitrust exemption - HR 4626, Health Insurance Industry Fair Competition Act. *LTC consumer protections - S 1177, A bill to improve consumer protections for purchasers of long-term care insurance, and for other purposes. *National marketplace - HR 3217, Health Care Choice Act of 2009; S 1459, A bill to amend the Public Health Service Act to provide for cooperative governing of individual health insurance coverage offered in interstate commerce. *Reinstatement of coverage upon payment of overdue premiums - HR 3584, To amend the Public Health Service Act to require reinstatement upon payment of all premiums due of group or individual health insurance coverage terminated by reason of nonpayment of premiums. *Changes to McCarran-Ferguson Act - HR 3596, To ensure that health insurance issuers and medical malpractice insurance issuers cannot engage in price fixing, bid rigging, or market allocations to the detriment of competition and consumers; S 1681, A bill to ensure that health insurance issuers and medical malpractice insurance issuers cannot engage in price fixing, bid rigging, or market allocations to the detriment of competition and consumers.

Client expense: Not reported · Firm income: $100,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1253, Health Insurance Restrictions and Limitations Clarification Act (Burgess) disclosure of coverage exclusions; H.R. 1583, Insurance Industry Competition Act (DeFazio) McCarran-Ferguson reforms (cont.) H.R. 1691, Breast Cancer Patient Protection Act (DeLauro) hospital stays for breast cancer patients; H.R. 1880, National Insurance Consumer Protection Act (Bean) regulatory reform; H.R. 2609, Insurance Information Act (Kanjorski) Federal Office of Insurance Information; H.R. 3217, Health Care Choice Act (Shadegg) national marketplace; H.R. 3584, Health Care Consumer Protection Act (Forbes) reinstatement of coverage upon payment of overdue premiums; H.R. 3596, Health Insurance Industry Antitrust Enforcement Act (Conyers) McCarran-Ferguson reforms; H.R. 4078, Long-Term Care Insurance Disclosure Act (Perriello) model disclosure form for long-term care insurance; H.R. 4563, Cancer Screening Coverage Act (Maloney) coverage requirement for cancer screening; H.R. 4626, Health Insurance Industry Fair Competition Act (Perriello) McCarran-Ferguson reforms; H.R. 4757, Health Insurance Rate Authority Act (Schakowsky) federal rate review process; H.R. 5000, Dental Coverage Value and Transparency Act (Andrews) requirements for dental coverage; H.R. 5297, Small Business Jobs Act (Frank) amendments on employer reporting requirement and individual coverage requirement; H.R. 5664, High Risk Pool Fairness Act (Ellsworth ) high risk pools; H.R. 5761 (Melancon) effective date for prohibition on rescissions; H.R. 5808 (Woolsey) government-run plan; H.R. 5844, Fairness in Medigap Options Act (Rothman) guarantee issue and open enrollment for Medigap policies; H.R. 5853, Fiscal Responsibility and Retirement Security Act (Boustany) delaying implementation of the CLASS program; H.R. 5890, Long-Term Care Insurance Reform Act (Doggett) regulation of LTC insurance; H.R. 5982, Small Business Tax Relief Act (Levin) employer reporting requirements; H.R. 6066, Preventing Social Security Fraud Act (Sanchez) requirements for private disability insurers; H.R. 6368, Federal Employee Disability Insurance Act (Holmes-Norton) supplemental disability insurance for federal employees; S. 688, Breast Cancer Patient Protection Act (Snowe) hospital stays for breast cancer patients; S. 1177, Confidence in Long-Term Care Insurance Act (Kohl) LTC consumer protections; S. 1459, Health Care Choice Act (DeMint) national marketplace; S. 1626, Long Term Care Insurance Integrity Act (Klobuchar) third party review of LTCI disputed claims; S. 1636, Long-Term Care Insurance Consumer Right-to-Know Act (Klobuchar) model disclosure forms for LTC insurance; S. 1681, Health Insurance Industry Antitrust Enforcement Act (Leahy) McCarran-Ferguson reforms; S. 3078, Health Insurance Rate Authority Act (Feinstein) federal rate review process; S. 3685 Insurance Competition and Transparency Act (Pryor) FTC authority; and S. 3793, Job Creation and Tax Cuts Act (Baucus) health coverage tax credit. INS (Regulatory) Insurance regulatory reform; issues related to the coordination of private and public disability income benefits; disability risk management; issues relating to the coordination of benefits between private health insurance plans and Medicaid; Medigap claims processing and crossover fees; implementation of Medigap standardized plan offerings; Medigap carrier recoveries related to CMS fraud and abuse enforcement activities, and issues related to Medigap educational materials; implementation of the Mental Health Parity Act requirements; issues related to COBRA subsidy requirements, issues related to genetic nondiscrimination; medical loss ratios; review of rates for reasonableness; health insurance exchanges; pre-existing condition insurance plans; accountable care organizations; internal claims and appeals and external review processes; coverage of preventive services; pre-existing condition exclusions; lifetime and annual dollar limits on benefits rescissions; patient protections; grandfathered health plan provisions; health insurance web portal requirements; dependent coverage; and other issues relating to health care reform implementation.

Client expense: $2,330,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Personnel Management (OPM), SENATE, Social Security Administration (SSA), Treasury, Dept of

Implementation of healthcare reform legislation, health insurance cooperatives, multi-State plans, insurance market reforms, health insurance exchanges, benefit packages, medical loss ratios, CLASS Act, regulatory reform, individual coverage requirement, premium assistance, Federal rate review process restrictions on recissions, healthcare choice compacts, appeals procedures, disclosure requirements, high risk pool program - Executive Branch actions re PL 111-148 and PL 111-152. *Disclosure of coverage exclusions - HR 1253, To require that limitations and restrictions on coverage under group health plans be timely disclosed to group health plan sponsors and timely communicated to participants and beneficiaries under such plans in a form that is easily understandable. *McCarran Ferguson reforms - HR 1583, To further competition in the insurance industry; S 1681, Health Insurance Industry Antitrust Enforcement Act of 2009. *Recissions, hospital stays for breast cancer patients - HR 1691, To require that health plans provide coverage for a minimum hospital stay for mastectomies, lumpectomies, and lymph node dissection for the treatment of breast cancer and coverage for secondary consultations; S 688, A bill to require that health plans provide coverage for a minimum hospital stay for mastectomies, lumpectomies, and lymph node dissection for the treatment of breast cancer and coverage for secondary consultations. *Coverage requirement for cancer screening - HR 4563, Cancer Screening Coverage Act of 2009. *MCCarran-Ferguson antitrust exemption - HR 4626, Health Insurance Industry Fair Competition Act. *Regulatory reform - HR 1880, To establish a system of regulation and supervision for insurers, insurance agencies, and insurance producers chartered or licensed under Federal law that ensures the stability and financial integrity of those insurers, agencies, and producers and that protects policyholders and other consumers served by such insurers, agencies, or producers. *LTC consumer protections - S 1177, A bill to improve consumer protections for purchasers of long-term care insurance, and for other purposes. *Federal office of insurance information - HR 2609, To establish an Office of Insurance Information in the Department of the Treasury. *National marketplace - HR 3217, Health Care Choice Act of 2009; S 1459, A bill to amend the Public Health Service Act to provide for cooperative governing of individual health insurance coverage offered in interstate commerce. *Reinstatement of coverage upon payment of overdue premiums - HR 3584, To amend the Public Health Service Act to require reinstatement upon payment of all premiums due of group or individual health insurance coverage terminated by reason of nonpayment of premiums. *Changes to McCarran-Ferguson Act - HR 3596, To ensure that health insurance issuers and medical malpractice insurance issuers cannot engage in price fixing, bid rigging, or market allocations to the detriment of competition and consumers; S 1681, A bill to ensure that health insurance issuers and medical malpractice insurance issuers cannot engage in price fixing, bid rigging, or market allocations to the detriment of competition and consumers. *High risk pools - HR 5664, High-Risk Pool Fairness Act. *Effective date for prohibitionon rescissions - HR 5761, To amend the Patient Protection and Affordable Care Act to expedite the application of the provision prohibiting rescissions of health insurance coverage. *Government-run plan - HR 5808, To amend the Patient Protection and Affordable Care Act to establish a public health insurance option. *Guarantee-issue and open enrollment for Medigap policies - HR 5844, Fairness in Medigap Options Act of 2010. *Delaying implementation of the CLASS program - HR 5853, Fiscal Responsibility and Retirement Security Act. *Regulations of LTC insurance - HR 5890, Long-Term Care Insurance Reform Act of 2010. *Third-party review of LTC insurance disputed claims - S 1626, A bill to require issuers of long term care insurance to establish third party review processes for disputed claims. *Model disclosure forms for LTC insurance - S 1636, A bill to develop a model disclosure form to assist consumers in purchasing long-term care insurance. *Model Disclosure form for long-term care insurance - HR 4078, To require the Secretary of Health and Human Services to develop a national model disclosure form to assist consumers in purchasing long-term care insurance. *Federal rate review process - HR 4757, Health Insurance Rate Authority Act of 2010; S 3078, Health Insurance Rate Authority Act of 2010. *Changes to individual coverage requirement, grandfathered plans, immediate insurance reforms, premium assistance, CLASS Act, coverage issues, quality improvements, delivery system reforms - HR 4872, Health Care and Education Reconciliation Act of 2010. *Requirements for dental coverage - HR 5000, Dental Coverage Value and Transparency Act of 2010. *Employer reporting requirements - HR 5982, Small Business Tax Relief Act of 2010. *Requirements for private disability insurers - HR 6066, Preventing Social Security Fraud Act of 2010. *Supplemental disability insurance for Federal employees - HR 6368, Federal Employee Disability Insurance Act of 2010. *FTC authority - S 3685, Insurance Competition and Transparency Act of 2010. *Health coverage tax credit - S 3793, Job Creation and Tax Cuts Act of 2010.

Client expense: Not reported · Firm income: $100,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE