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Part D Off-Label Prescription Parity Act
Legislative Progress
Momentum (last 30 days)
0
score
0 actions · 0 new cosponsors · 0 votes
Speed vs cohort
37pct
6d open
vs 6,662 other HR bills in the 112th — cohort avg 39d
No CRS summary is available for this bill yet. The source title, actions, sponsors, and text versions below come from Congress.gov.
These links require the bill number to appear in the filing's source-reported specific issue text. Client expenses and lobbying-firm income are separate disclosure fields.
Filing registrants (4)
2012 · fourth_quarter · Medicare/Medicaid
Support American Society of Consultant Pharmacists and "Short Cycle Dispensing Coalition" recommendations regarding the delay and study of new long-term care pharmacy dispensing rules and the impact of those rules on Medicare and Medicaid patients. Support H.R. 1055, the Part D Off-Label Prescription Drug Parity Act. Continue to oppose cuts to Medicare benefits, and continue to oppose the Independent Payment Advisory Board (IPAB). Support Medicare Access for Patients Rx (MAPRx) recommendations to Centers for Medicare and Medicaid Services (CMS) all regarding Medicare Part D. Those MAPRx recommendations are in regard to: Improved beneficiary protections; Better, more transparent Specialty Tier guidance including the threshold for inclusion on this tier and the inclusion of data for newly approved drugs; New, more realistic co-pay thresholds; Automatic disenrollment from Special Needs Plans; Proposed plan rating criteria; and Approval of six-tier formularies. These are in addition to MAPRx concerns regarding: The Part D Medicare appeals process and the handling of enrollee complaints; Drug dispensing rules for Part D beneficiaries in long-term care facilities; the Authority to deny bids and potential additional restrictions; and Compound Drug Policy. Support repeal of IPAB (H.R. 452). Support changes to the Medicare Shared Savings Program: Accountable Care Organization (ACO) proposed regulations, to provide additional safeguards to guarantee patient access to needed care, and to ensure that ACO's support the adoption of new treatments and cures for patients. Also support the addition of new Alzheimer's disease focused ACO quality measures, new ACO measures of provider evidence of competency in Geriatrics and Dementia, as well as a guarantee that Alzheimer's and Dementia patients under ACO care will have access to the newest pharmaceutical and biological treatments. Support repeal of Section 6001 of the PPACA and remove all restrictions on physician-owned hospitals. (Support H.R. 1159 and H.R. 1186) Oppose federal budget cuts that would increase co-payments for home health care services under Medicare and/or Medicaid Support the Preservation of Access to Osteoporosis Testing for Medicare Beneficiaries Act of 2011 (S. 1096 and H.R. 2020) Support MAPRx suggestions to CMS on Medicare Part D Prescription Drug Program regarding new beneficiary-friendly point-of-sale notices that address problems in filling prescriptions and clear, instructive remedies for beneficiaries. Oppose proposals that would reduce payments to providers of drugs and biologics under Medicare Part B. Oppose proposals to increase Medicare Part D cost-sharing, raise Part D coinsurance, and/or freeze income thresholds. Oppose efforts to require Medicaid-type drug rebates from any Medicare Part D providers and all other kinds of mandated or negotiated Part D price controls that will harm beneficiaries and increase costs in other areas of Medicare. Support efforts to focus Medicare cost-saving efforts on eliminating improper payments, waste, fraud, and abuse first -- before cutting benefits, cutting payments to providers, or raising premium and coinsurance costs for beneficiaries. Support H.R. 3613 - Medicare Part D Beneficiary Appeals Fairness Act. Urged the "Super Committee" to resist proposals to erode beneficiary protections in Part D that ensure broad and accessible prescription drug formularies. Supported an extension of legislation to preserve access to osteoporosis testing for Medicare beneficiaries in the the final conference report on the Temporary Payroll Tax Cut Continuation Act of 2011 (H.R. 3630). Joined other patient advocate organizations to urge the National Government Services to to reconsider its policy regarding blanket denials under the Current Procedural Terminology (CPT) health and behavioral assessment and intervention codes (96150-96155) which restrict those medically appropriate services to Medicare beneficiaries with Alzheimer's disease. Support the MAPRx comments regarding the Draft 2013 Medicare Call Letter regarding proposed actions related to the Part D Prescription Drug Program. These included improved comments on beneficiary protections; Specialty Tiers; Co-pay Thresholds; Tier Labeling; Plan Rating Criteria; Medicare Therapy Management; and Drug Utilization Review Controls in Part D. Oppose Centers for Medicare and Medicaid Services (CMS) regulation that subjects dual-eligible Medicare/Medicaid beneficiaries to new state programs that may well diminish their Medicare protections and lessen their access to quality health care services. This includes passive enrollment into a managed care plan and disruptions to the continuity of care. Support "unique naming" requirements for all biologic drugs, especially biosimilar drugs, as a matter of patient safety. Support full Medicare funding for dual energy x-ray absorptiometry (DXA) test reimbursement to fight osteoporosis. Support new extended funding (as under the expired Medicare Improvements for Patients and Providers Act or MIPPA) for Medicare low-income outreach and enrollment activities. Support the Medicare Part D prescription drug benefit program and the needed improvements to correct its limitations; including gaps in coverage, onerous cost-shifting created by specialty tiers, and restrictive utilization management tools. Robust formularies, coverage of the six protected drug classes, strong oversight, and transparency for consumers are also critical, as is a process for notice of non-coverage, and an appeals and exceptions process that is patient and provider friendly. Support all measures making Alzheimer's disease a continued top priority at the U.S. Food and Drug Administration (FDA).
Bills with similar content found using semantic analysis.
Sources: Congress.gov
Client expense: $42,249 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2012 · fourth_quarter · Medicare/Medicaid
HR 891/S 274 - legislation that would expand the existing medication therapy management program in Medicare Part D; S 31/S 44/HR 2248/HR 6392 - legislation taht would require or allow the federal government to negotiate prescription drug prices on behalf of Medicare Part D plan sponsors; HR 999/S 560 - legislation that would establish a nationwide Part D plan administered by the federal government; HR 1055 - legislation that would allow Part D plans to offer "off-label" coverage HR 2190/S 1206 - legislation that would require prescription drug manufacturers to pay Medicaid "best price" revates for covered prescription drugs purchased by dual eligibles under Medicare Part D; HR 3613 - legislation that would require Part D plans to establish an exceptions process for patient cost-sharing amounts; HR 4215 - legislation that would establish audit requirements and other transparency requirements for Part D plan sponsors; worked on proposed legislative language, which included consultation with Senate committee staff and discussions with personal staff of House and Senate members, that would amend the current prompt payment rules in Part D in the interest of preventing fraud.
Client expense: $170,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2012 · fourth_quarter · Medicare/Medicaid
Support American Society of Consultant Pharmacists and "Short Cycle Dispensing Coalition" recommendations regarding the delay and study of new long-term care pharmacy dispensing rules and the impact of those rules on Medicare and Medicaid patients. Support H.R. 1055, the Part D Off-Label Prescription Drug Parity Act. Continue to oppose cuts to Medicare benefits, and continue to oppose the Independent Payment Advisory Board (IPAB). Support Medicare Access for Patients Rx (MAPRx) recommendations to Centers for Medicare and Medicaid Services (CMS) all regarding Medicare Part D. Those MAPRx recommendations are in regard to: Improved beneficiary protections; Better, more transparent Specialty Tier guidance including the threshold for inclusion on this tier and the inclusion of data for newly approved drugs; New, more realistic co-pay thresholds; Automatic disenrollment from Special Needs Plans; Proposed plan rating criteria; and Approval of six-tier formularies. These are in addition to MAPRx concerns regarding: The Part D Medicare appeals process and the handling of enrollee complaints; Drug dispensing rules for Part D beneficiaries in long-term care facilities; the Authority to deny bids and potential additional restrictions; and Compound Drug Policy. Support repeal of IPAB (H.R. 452). Support changes to the Medicare Shared Savings Program: Accountable Care Organization (ACO) proposed regulations, to provide additional safeguards to guarantee patient access to needed care, and to ensure that ACO's support the adoption of new treatments and cures for patients. Also support the addition of new Alzheimer's disease focused ACO quality measures, new ACO measures of provider evidence of competency in Geriatrics and Dementia, as well as a guarantee that Alzheimer's and Dementia patients under ACO care will have access to the newest pharmaceutical and biological treatments. Support repeal of Section 6001 of the PPACA and remove all restrictions on physician-owned hospitals. (Support H.R. 1159 and H.R. 1186) Oppose federal budget cuts that would increase co-payments for home health care services under Medicare and/or Medicaid Support the Preservation of Access to Osteoporosis Testing for Medicare Beneficiaries Act of 2011 (S. 1096 and H.R. 2020) Support MAPRx suggestions to CMS on Medicare Part D Prescription Drug Program regarding new beneficiary-friendly point-of-sale notices that address problems in filling prescriptions and clear, instructive remedies for beneficiaries. Oppose proposals that would reduce payments to providers of drugs and biologics under Medicare Part B. Oppose proposals to increase Medicare Part D cost-sharing, raise Part D coinsurance, and/or freeze income thresholds. Oppose efforts to require Medicaid-type drug rebates from any Medicare Part D providers and all other kinds of mandated or negotiated Part D price controls that will harm beneficiaries and increase costs in other areas of Medicare. Support efforts to focus Medicare cost-saving efforts on eliminating improper payments, waste, fraud, and abuse first -- before cutting benefits, cutting payments to providers, or raising premium and coinsurance costs for beneficiaries. Support H.R. 3613 - Medicare Part D Beneficiary Appeals Fairness Act. Urged the "Super Committee" to resist proposals to erode beneficiary protections in Part D that ensure broad and accessible prescription drug formularies. Supported an extension of legislation to preserve access to osteoporosis testing for Medicare beneficiaries in the the final conference report on the Temporary Payroll Tax Cut Continuation Act of 2011 (H.R. 3630). Joined other patient advocate organizations to urge the National Government Services to to reconsider its policy regarding blanket denials under the Current Procedural Terminology (CPT) health and behavioral assessment and intervention codes (96150-96155) which restrict those medically appropriate services to Medicare beneficiaries with Alzheimer's disease. Support the MAPRx comments regarding the Draft 2013 Medicare Call Letter regarding proposed actions related to the Part D Prescription Drug Program. These included improved comments on beneficiary protections; Specialty Tiers; Co-pay Thresholds; Tier Labeling; Plan Rating Criteria; Medicare Therapy Management; and Drug Utilization Review Controls in Part D. Oppose Centers for Medicare and Medicaid Services (CMS) regulation that subjects dual-eligible Medicare/Medicaid beneficiaries to new state programs that may well diminish their Medicare protections and lessen their access to quality health care services. This includes passive enrollment into a managed care plan and disruptions to the continuity of care. Support "unique naming" requirements for all biologic drugs, especially biosimilar drugs, as a matter of patient safety. Support full Medicare funding for dual energy x-ray absorptiometry (DXA) test reimbursement to fight osteoporosis. Support new extended funding (as under the expired Medicare Improvements for Patients and Providers Act or MIPPA) for Medicare low-income outreach and enrollment activities. Support the Medicare Part D prescription drug benefit program and the needed improvements to correct its limitations; including gaps in coverage, onerous cost-shifting created by specialty tiers, and restrictive utilization management tools. Robust formularies, coverage of the six protected drug classes, strong oversight, and transparency for consumers are also critical, as is a process for notice of non-coverage, and an appeals and exceptions process that is patient and provider friendly. Support all measures making Alzheimer's disease a continued top priority at the U.S. Food and Drug Administration (FDA).
Client expense: Not reported · Firm income: $6,710
Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2012 · third_quarter · Medicare/Medicaid
Support American Society of Consultant Pharmacists and "Short Cycle Dispensing Coalition" recommendations regarding the delay and study of new long-term care pharmacy dispensing rules and the impact of those rules on Medicare and Medicaid patients. Support H.R. 1055, the Part D Off-Label Prescription Drug Parity Act. Continue to oppose cuts to Medicare benefits, and continue to oppose the Independent Payment Advisory Board (IPAB). Support Medicare Access for Patients Rx (MAPRx) recommendations to Centers for Medicare and Medicaid Services (CMS) all regarding Medicare Part D. Those MAPRx recommendations are in regard to: Improved beneficiary protections; Better, more transparent Specialty Tier guidance including the threshold for inclusion on this tier and the inclusion of data for newly approved drugs; New, more realistic co-pay thresholds; Automatic disenrollment from Special Needs Plans; Proposed plan rating criteria; and Approval of six-tier formularies. These are in addition to MAPRx concerns regarding: The Part D Medicare appeals process and the handling of enrollee complaints; Drug dispensing rules for Part D beneficiaries in long-term care facilities; the Authority to deny bids and potential additional restrictions; and Compound Drug Policy. Support repeal of IPAB (H.R. 452). Support changes to the Medicare Shared Savings Program: Accountable Care Organization (ACO) proposed regulations, to provide additional safeguards to guarantee patient access to needed care, and to ensure that ACO's support the adoption of new treatments and cures for patients. Also support the addition of new Alzheimer's disease focused ACO quality measures, new ACO measures of provider evidence of competency in Geriatrics and Dementia, as well as a guarantee that Alzheimer's and Dementia patients under ACO care will have access to the newest pharmaceutical and biological treatments. Support repeal of Section 6001 of the PPACA and remove all restrictions on physician-owned hospitals. (Support H.R. 1159 and H.R. 1186) Oppose federal budget cuts that would increase co-payments for home health care services under Medicare and/or Medicaid Support the Preservation of Access to Osteoporosis Testing for Medicare Beneficiaries Act of 2011 (S. 1096 and H.R. 2020) Support MAPRx suggestions to CMS on Medicare Part D Prescription Drug Program regarding new beneficiary-friendly point-of-sale notices that address problems in filling prescriptions and clear, instructive remedies for beneficiaries. Oppose proposals that would reduce payments to providers of drugs and biologics under Medicare Part B. Oppose proposals to increase Medicare Part D cost-sharing, raise Part D coinsurance, and/or freeze income thresholds. Oppose efforts to require Medicaid-type drug rebates from any Medicare Part D providers and all other kinds of mandated or negotiated Part D price controls that will harm beneficiaries and increase costs in other areas of Medicare. Support efforts to focus Medicare cost-saving efforts on eliminating improper payments, waste, fraud, and abuse first -- before cutting benefits, cutting payments to providers, or raising premium and coinsurance costs for beneficiaries. Support H.R. 3613 - Medicare Part D Beneficiary Appeals Fairness Act. Urged the "Super Committee" to resist proposals to erode beneficiary protections in Part D that ensure broad and accessible prescription drug formularies. Supported an extension of legislation to preserve access to osteoporosis testing for Medicare beneficiaries in the the final conference report on the Temporary Payroll Tax Cut Continuation Act of 2011 (H.R. 3630). Joined other patient advocate organizations to urge the National Government Services to to reconsider its policy regarding blanket denials under the Current Procedural Terminology (CPT) health and behavioral assessment and intervention codes (96150-96155) which restrict those medically appropriate services to Medicare beneficiaries with Alzheimer's disease. Support the MAPRx comments regarding the Draft 2013 Medicare Call Letter regarding proposed actions related to the Part D Prescription Drug Program. These included improved comments on beneficiary protections; Specialty Tiers; Co-pay Thresholds; Tier Labeling; Plan Rating Criteria; Medicare Therapy Management; and Drug Utilization Review Controls in Part D. Oppose Centers for Medicare and Medicaid Services (CMS) regulation that subjects dual-eligible Medicare/Medicaid beneficiaries to new state programs that may well diminish their Medicare protections and lessen their access to quality health care services. This includes passive enrollment into a managed care plan and disruptions to the continuity of care.
Client expense: $75,187 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2012 · third_quarter · Medicare/Medicaid
HR 891 and S 274 - legislation that would expand the existing medication therapy management program in Medicare Part D; S 31 and S 44 and HR 2248 and HR 3638 - legislation that would require or allow the federal government to negotiate prescription drug prices on behalf of Medicare Part D plan sponsors; HR 999 and S 560 - legislation that would establish a nationwide Part D plan administered by the federal government; HR 1055 - legislation that would allow Part D plan sponsors to offer "off-label" coverage HR 2190 and S 1206 - legislation that would require prescription drug manufacturers to pay Medicaid "best price" rebates for covered prescription drugs purchased by dual eligibles under Medicare Part D; HR 3613 - legislation that would require Medicare Part D plans to establish an exceptions process for patient cost-sharing amounts; HR 4215 - legislation that would establish audit requirements and other transparency requirements for Medicare part D plan sponsors; HR 6392 - legislation that would allow the federal government to negotiate prescription drug prices on behalf of Medicare Part D plan sponsors; Worked on proposed legislative language, work which included consultation with Senate committee staff, that would amend the current prompt payment rules in Medicare Part D in the interest of preventing fraud.
Client expense: $170,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2012 · third_quarter · Medicare/Medicaid
Support American Society of Consultant Pharmacists and "Short Cycle Dispensing Coalition" recommendations regarding the delay and study of new long-term care pharmacy dispensing rules and the impact of those rules on Medicare and Medicaid patients. Support H.R. 1055, the Part D Off-Label Prescription Drug Parity Act. Continue to oppose cuts to Medicare benefits, and continue to oppose the Independent Payment Advisory Board (IPAB). Support Medicare Access for Patients Rx (MAPRx) recommendations to Centers for Medicare and Medicaid Services (CMS) all regarding Medicare Part D. Those MAPRx recommendations are in regard to: Improved beneficiary protections; Better, more transparent Specialty Tier guidance including the threshold for inclusion on this tier and the inclusion of data for newly approved drugs; New, more realistic co-pay thresholds; Automatic disenrollment from Special Needs Plans; Proposed plan rating criteria; and Approval of six-tier formularies. These are in addition to MAPRx concerns regarding: The Part D Medicare appeals process and the handling of enrollee complaints; Drug dispensing rules for Part D beneficiaries in long-term care facilities; the Authority to deny bids and potential additional restrictions; and Compound Drug Policy. Support repeal of IPAB (H.R. 452). Support changes to the Medicare Shared Savings Program: Accountable Care Organization (ACO) proposed regulations, to provide additional safeguards to guarantee patient access to needed care, and to ensure that ACO's support the adoption of new treatments and cures for patients. Also support the addition of new Alzheimer's disease focused ACO quality measures, new ACO measures of provider evidence of competency in Geriatrics and Dementia, as well as a guarantee that Alzheimer's and Dementia patients under ACO care will have access to the newest pharmaceutical and biological treatments. Support repeal of Section 6001 of the PPACA and remove all restrictions on physician-owned hospitals. (Support H.R. 1159 and H.R. 1186) Oppose federal budget cuts that would increase co-payments for home health care services under Medicare and/or Medicaid Support the Preservation of Access to Osteoporosis Testing for Medicare Beneficiaries Act of 2011 (S. 1096 and H.R. 2020) Support MAPRx suggestions to CMS on Medicare Part D Prescription Drug Program regarding new beneficiary-friendly point-of-sale notices that address problems in filling prescriptions and clear, instructive remedies for beneficiaries. Oppose proposals that would reduce payments to providers of drugs and biologics under Medicare Part B. Oppose proposals to increase Medicare Part D cost-sharing, raise Part D coinsurance, and/or freeze income thresholds. Oppose efforts to require Medicaid-type drug rebates from any Medicare Part D providers and all other kinds of mandated or negotiated Part D price controls that will harm beneficiaries and increase costs in other areas of Medicare. Support efforts to focus Medicare cost-saving efforts on eliminating improper payments, waste, fraud, and abuse first -- before cutting benefits, cutting payments to providers, or raising premium and coinsurance costs for beneficiaries. Support H.R. 3613 - Medicare Part D Beneficiary Appeals Fairness Act. Urged the "Super Committee" to resist proposals to erode beneficiary protections in Part D that ensure broad and accessible prescription drug formularies. Supported an extension of legislation to preserve access to osteoporosis testing for Medicare beneficiaries in the the final conference report on the Temporary Payroll Tax Cut Continuation Act of 2011 (H.R. 3630). Joined other patient advocate organizations to urge the National Government Services to to reconsider its policy regarding blanket denials under the Current Procedural Terminology (CPT) health and behavioral assessment and intervention codes (96150-96155) which restrict those medically appropriate services to Medicare beneficiaries with Alzheimer's disease. Support the MAPRx comments regarding the Draft 2013 Medicare Call Letter regarding proposed actions related to the Part D Prescription Drug Program. These included improved comments on beneficiary protections; Specialty Tiers; Co-pay Thresholds; Tier Labeling; Plan Rating Criteria; Medicare Therapy Management; and Drug Utilization Review Controls in Part D. Oppose Centers for Medicare and Medicaid Services (CMS) regulation that subjects dual-eligible Medicare/Medicaid beneficiaries to new state programs that may well diminish their Medicare protections and lessen their access to quality health care services. This includes passive enrollment into a managed care plan and disruptions to the continuity of care.
2012 · second_quarter · Medicare/Medicaid
HR 891 and S 274 - legislation that would expand the existing medication therapy management program in Medicare Part D; S 31 and S 44 and HR 2248 and HR 3638 - legislation that would require or allow the federal government to negotiate prescription drug prices on behalf of Medicare Part D plan sponsors; HR 999 and S 560 - legislation that would establish a nationwide Part D plan administered by the federal government; HR 1055 - legislation that would allow Part D plan sponsors to offer "off-label" coverage HR 2190 and S 1206 - legislation that would require prescription drug manufacturers to pay Medicaid "best price" rebates for covered prescription drugs purchased by dual eligibles under Medicare Part D; HR 3613 - legislation that would require Medicare Part D plans to establish an exceptions process for patient cost-sharing amounts; HR 4215 - legislation that would establish audit requirements and other transparency requirements for Medicare part D plan sponsors; Worked on proposed legislative language, work which included consultation with Senate committee staff, that would amend the current prompt payment rules in Medicare Part D in the interest of preventing fraud.
Client expense: $150,000 · Firm income: Not reported
2012 · second_quarter · Medicare/Medicaid
Support American Society of Consultant Pharmacists and "Short Cycle Dispensing Coalition" recommendations regarding the delay and study of new long-term care pharmacy dispensing rules and the impact of those rules on Medicare and Medicaid patients. Support H.R. 1055, the Part D Off-Label Prescription Drug Parity Act. Continue to oppose cuts to Medicare benefits, and continue to oppose the Independent Payment Advisory Board (IPAB). Support Medicare Access for Patients Rx (MAPRx) recommendations to Centers for Medicare and Medicaid Services (CMS) all regarding Medicare Part D. Those MAPRx recommendations are in regard to: Improved beneficiary protections; Better, more transparent Specialty Tier guidance including the threshold for inclusion on this tier and the inclusion of data for newly approved drugs; New, more realistic co-pay thresholds; Automatic disenrollment from Special Needs Plans; Proposed plan rating criteria; and Approval of six-tier formularies. These are in addition to MAPRx concerns regarding: The Part D Medicare appeals process and the handling of enrollee complaints; Drug dispensing rules for Part D beneficiaries in long-term care facilities; the Authority to deny bids and potential additional restrictions; and Compound Drug Policy. Support repeal of IPAB (H.R. 452). Support changes to the Medicare Shared Savings Program: Accountable Care Organization (ACO) proposed regulations, to provide additional safeguards to guarantee patient access to needed care, and to ensure that ACO's support the adoption of new treatments and cures for patients. Also support the addition of new Alzheimer's disease focused ACO quality measures, new ACO measures of provider evidence of competency in Geriatrics and Dementia, as well as a guarantee that Alzheimer's and Dementia patients under ACO care will have access to the newest pharmaceutical and biological treatments. Support repeal of Section 6001 of the PPACA and remove all restrictions on physician-owned hospitals. (Support H.R. 1159 and H.R. 1186) Oppose federal budget cuts that would increase co-payments for home health care services under Medicare and/or Medicaid Support the Preservation of Access to Osteoporosis Testing for Medicare Beneficiaries Act of 2011 (S. 1096 and H.R. 2020) Support MAPRx suggestions to CMS on Medicare Part D Prescription Drug Program regarding new beneficiary-friendly point-of-sale notices that address problems in filling prescriptions and clear, instructive remedies for beneficiaries. Oppose proposals that would reduce payments to providers of drugs and biologics under Medicare Part B. Oppose proposals to increase Medicare Part D cost-sharing, raise Part D coinsurance, and/or freeze income thresholds. Oppose efforts to require Medicaid-type drug rebates from any Medicare Part D providers and all other kinds of mandated or negotiated Part D price controls that will harm beneficiaries and increase costs in other areas of Medicare. Support efforts to focus Medicare cost-saving efforts on eliminating improper payments, waste, fraud, and abuse first -- before cutting benefits, cutting payments to providers, or raising premium and coinsurance costs for beneficiaries. Support H.R. 3613 - Medicare Part D Beneficiary Appeals Fairness Act. Urged the "Super Committee" to resist proposals to erode beneficiary protections in Part D that ensure broad and accessible prescription drug formularies. Supported an extension of legislation to preserve access to osteoporosis testing for Medicare beneficiaries in the the final conference report on the Temporary Payroll Tax Cut Continuation Act of 2011 (H.R. 3630). Joined other patient advocate organizations to urge the National Government Services to to reconsider its policy regarding blanket denials under the Current Procedural Terminology (CPT) health and behavioral assessment and intervention codes (96150-96155) which restrict those medically appropriate services to Medicare beneficiaries with Alzheimer's disease. Support the MAPRx comments regarding the Draft 2013 Medicare Call Letter regarding proposed actions related to the Part D Prescription Drug Program. These included improved comments on beneficiary protections; Specialty Tiers; Co-pay Thresholds; Tier Labeling; Plan Rating Criteria; Medicare Therapy Management; and Drug Utilization Review Controls in Part D. Oppose Centers for Medicare and Medicaid Services (CMS) regulation that subjects dual-eligible Medicare/Medicaid beneficiaries to new state programs that may well diminish their Medicare protections and lessen their access to quality health care services. This includes passive enrollment into a managed care plan and disruptions to the continuity of care.
2012 · second_quarter · Medicare/Medicaid
Support American Society of Consultant Pharmacists and "Short Cycle Dispensing Coalition" recommendations regarding the delay and study of new long-term care pharmacy dispensing rules and the impact of those rules on Medicare and Medicaid patients. Support H.R. 1055, the Part D Off-Label Prescription Drug Parity Act. Continue to oppose cuts to Medicare benefits, and continue to oppose the Independent Payment Advisory Board (IPAB). Support Medicare Access for Patients Rx (MAPRx) recommendations to Centers for Medicare and Medicaid Services (CMS) all regarding Medicare Part D. Those MAPRx recommendations are in regard to: Improved beneficiary protections; Better, more transparent Specialty Tier guidance including the threshold for inclusion on this tier and the inclusion of data for newly approved drugs; New, more realistic co-pay thresholds; Automatic disenrollment from Special Needs Plans; Proposed plan rating criteria; and Approval of six-tier formularies. These are in addition to MAPRx concerns regarding: The Part D Medicare appeals process and the handling of enrollee complaints; Drug dispensing rules for Part D beneficiaries in long-term care facilities; the Authority to deny bids and potential additional restrictions; and Compound Drug Policy. Support repeal of IPAB (H.R. 452). Support changes to the Medicare Shared Savings Program: Accountable Care Organization (ACO) proposed regulations, to provide additional safeguards to guarantee patient access to needed care, and to ensure that ACO's support the adoption of new treatments and cures for patients. Also support the addition of new Alzheimer's disease focused ACO quality measures, new ACO measures of provider evidence of competency in Geriatrics and Dementia, as well as a guarantee that Alzheimer's and Dementia patients under ACO care will have access to the newest pharmaceutical and biological treatments. Support repeal of Section 6001 of the PPACA and remove all restrictions on physician-owned hospitals. (Support H.R. 1159 and H.R. 1186) Oppose federal budget cuts that would increase co-payments for home health care services under Medicare and/or Medicaid Support the Preservation of Access to Osteoporosis Testing for Medicare Beneficiaries Act of 2011 (S. 1096 and H.R. 2020) Support MAPRx suggestions to CMS on Medicare Part D Prescription Drug Program regarding new beneficiary-friendly point-of-sale notices that address problems in filling prescriptions and clear, instructive remedies for beneficiaries. Oppose proposals that would reduce payments to providers of drugs and biologics under Medicare Part B. Oppose proposals to increase Medicare Part D cost-sharing, raise Part D coinsurance, and/or freeze income thresholds. Oppose efforts to require Medicaid-type drug rebates from any Medicare Part D providers and all other kinds of mandated or negotiated Part D price controls that will harm beneficiaries and increase costs in other areas of Medicare. Support efforts to focus Medicare cost-saving efforts on eliminating improper payments, waste, fraud, and abuse first -- before cutting benefits, cutting payments to providers, or raising premium and coinsurance costs for beneficiaries. Support H.R. 3613 - Medicare Part D Beneficiary Appeals Fairness Act. Urged the "Super Committee" to resist proposals to erode beneficiary protections in Part D that ensure broad and accessible prescription drug formularies. Supported an extension of legislation to preserve access to osteoporosis testing for Medicare beneficiaries in the the final conference report on the Temporary Payroll Tax Cut Continuation Act of 2011 (H.R. 3630). Joined other patient advocate organizations to urge the National Government Services to to reconsider its policy regarding blanket denials under the Current Procedural Terminology (CPT) health and behavioral assessment and intervention codes (96150-96155) which restrict those medically appropriate services to Medicare beneficiaries with Alzheimer's disease. Support the MAPRx comments regarding the Draft 2013 Medicare Call Letter regarding proposed actions related to the Part D Prescription Drug Program. These included improved comments on beneficiary protections; Specialty Tiers; Co-pay Thresholds; Tier Labeling; Plan Rating Criteria; Medicare Therapy Management; and Drug Utilization Review Controls in Part D. Oppose Centers for Medicare and Medicaid Services (CMS) regulation that subjects dual-eligible Medicare/Medicaid beneficiaries to new state programs that may well diminish their Medicare protections and lessen their access to quality health care services. This includes passive enrollment into a managed care plan and disruptions to the continuity of care.
2012 · first_quarter · Medicare/Medicaid
Support American Society of Consultant Pharmacists and "Short Cycle Dispensing Coalition" recommendations regarding the delay and study of new long-term care pharmacy dispensing rules and the impact of those rules on Medicare and Medicaid patients. Support H.R. 1055, the Part D Off-Label Prescription Drug Parity Act. Continue to oppose cuts to Medicare benefits, and continue to oppose the Independent Payment Advisory Board (IPAB). Support Medicare Access for Patients Rx (MAPRx) recommendations to Centers for Medicare and Medicaid Services (CMS) all regarding Medicare Part D. Those MAPRx recommendations are in regard to: Improved beneficiary protections; Better, more transparent Specialty Tier guidance including the threshold for inclusion on this tier and the inclusion of data for newly approved drugs; New, more realistic co-pay thresholds; Automatic disenrollment from Special Needs Plans; Proposed plan rating criteria; and Approval of six-tier formularies. These are in addition to MAPRx concerns regarding: The Part D Medicare appeals process and the handling of enrollee complaints; Drug dispensing rules for Part D beneficiaries in long-term care facilities; the Authority to deny bids and potential additional restrictions; and Compound Drug Policy. Support repeal of IPAB (H.R. 452). Support changes to the Medicare Shared Savings Program: Accountable Care Organization (ACO) proposed regulations, to provide additional safeguards to guarantee patient access to needed care, and to ensure that ACO's support the adoption of new treatments and cures for patients. Also support the addition of new Alzheimer's disease focused ACO quality measures, new ACO measures of provider evidence of competency in Geriatrics and Dementia, as well as a guarantee that Alzheimer's and Dementia patients under ACO care will have access to the newest pharmaceutical and biological treatments. Support repeal of Section 6001 of the PPACA and remove all restrictions on physician-owned hospitals. (Support H.R. 1159 and H.R. 1186) Oppose federal budget cuts that would increase co-payments for home health care services under Medicare and/or Medicaid Support the Preservation of Access to Osteoporosis Testing for Medicare Beneficiaries Act of 2011 (S. 1096 and H.R. 2020) Support MAPRx suggestions to CMS on Medicare Part D Prescription Drug Program regarding new beneficiary-friendly point-of-sale notices that address problems in filling prescriptions and clear, instructive remedies for beneficiaries. Oppose proposals that would reduce payments to providers of drugs and biologics under Medicare Part B. Oppose proposals to increase Medicare Part D cost-sharing, raise Part D coinsurance, and/or freeze income thresholds. Oppose efforts to require Medicaid-type drug rebates from any Medicare Part D providers and all other kinds of mandated or negotiated Part D price controls that will harm beneficiaries and increase costs in other areas of Medicare. Support efforts to focus Medicare cost-saving efforts on eliminating improper payments, waste, fraud, and abuse first -- before cutting benefits, cutting payments to providers, or raising premium and coinsurance costs for beneficiaries. Support H.R. 3613 - Medicare Part D Beneficiary Appeals Fairness Act. Urged the "Super Committee" to resist proposals to erode beneficiary protections in Part D that ensure broad and accessible prescription drug formularies. Supported an extension of legislation to preserve access to osteoporosis testing for Medicare beneficiaries in the the final conference report on the Temporary Payroll Tax Cut Continuation Act of 2011 (H.R. 3630). Joined other patient advocate organizations to urge the National Government Services to to reconsider its policy regarding blanket denials under the Current Procedural Terminology (CPT) health and behavioral assessment and intervention codes (96150-96155) which restrict those medically appropriate services to Medicare beneficiaries with Alzheimer's disease. Support the MAPRx comments regarding the Draft 2013 Medicare Call Letter regarding proposed actions related to the Part D Prescription Drug Program. These included improved comments on beneficiary protections; Specialty Tiers; Co-pay Thresholds; Tier Labeling; Plan Rating Criteria; Medicare Therapy Management; and Drug Utilization Review Controls in Part D.
2012 · first_quarter · Medicare/Medicaid
Support American Society of Consultant Pharmacists and "Short Cycle Dispensing Coalition" recommendations regarding the delay and study of new long-term care pharmacy dispensing rules and the impact of those rules on Medicare and Medicaid patients. Support H.R. 1055, the Part D Off-Label Prescription Drug Parity Act. Continue to oppose cuts to Medicare benefits, and continue to oppose the Independent Payment Advisory Board (IPAB). Support Medicare Access for Patients Rx (MAPRx) recommendations to Centers for Medicare and Medicaid Services (CMS) all regarding Medicare Part D. Those MAPRx recommendations are in regard to: Improved beneficiary protections; Better, more transparent Specialty Tier guidance including the threshold for inclusion on this tier and the inclusion of data for newly approved drugs; New, more realistic co-pay thresholds; Automatic disenrollment from Special Needs Plans; Proposed plan rating criteria; and Approval of six-tier formularies. These are in addition to MAPRx concerns regarding: The Part D Medicare appeals process and the handling of enrollee complaints; Drug dispensing rules for Part D beneficiaries in long-term care facilities; the Authority to deny bids and potential additional restrictions; and Compound Drug Policy. Support repeal of IPAB (H.R. 452). Support changes to the Medicare Shared Savings Program: Accountable Care Organization (ACO) proposed regulations, to provide additional safeguards to guarantee patient access to needed care, and to ensure that ACO's support the adoption of new treatments and cures for patients. Also support the addition of new Alzheimer's disease focused ACO quality measures, new ACO measures of provider evidence of competency in Geriatrics and Dementia, as well as a guarantee that Alzheimer's and Dementia patients under ACO care will have access to the newest pharmaceutical and biological treatments. Support repeal of Section 6001 of the PPACA and remove all restrictions on physician-owned hospitals. (Support H.R. 1159 and H.R. 1186) Oppose federal budget cuts that would increase co-payments for home health care services under Medicare and/or Medicaid Support the Preservation of Access to Osteoporosis Testing for Medicare Beneficiaries Act of 2011 (S. 1096 and H.R. 2020) Support MAPRx suggestions to CMS on Medicare Part D Prescription Drug Program regarding new beneficiary-friendly point-of-sale notices that address problems in filling prescriptions and clear, instructive remedies for beneficiaries. Oppose proposals that would reduce payments to providers of drugs and biologics under Medicare Part B. Oppose proposals to increase Medicare Part D cost-sharing, raise Part D coinsurance, and/or freeze income thresholds. Oppose efforts to require Medicaid-type drug rebates from any Medicare Part D providers and all other kinds of mandated or negotiated Part D price controls that will harm beneficiaries and increase costs in other areas of Medicare. Support efforts to focus Medicare cost-saving efforts on eliminating improper payments, waste, fraud, and abuse first -- before cutting benefits, cutting payments to providers, or raising premium and coinsurance costs for beneficiaries. Support H.R. 3613 - Medicare Part D Beneficiary Appeals Fairness Act. Urged the "Super Committee" to resist proposals to erode beneficiary protections in Part D that ensure broad and accessible prescription drug formularies. Supported an extension of legislation to preserve access to osteoporosis testing for Medicare beneficiaries in the final conference report on the Temporary Payroll Tax Cut Continuation Act of 2011 (H.R. 3630). Joined other patient advocate organizations to urge the National Government Services to reconsider its policy regarding blanket denials under the Current Procedural Terminology (CPT) health and behavioral assessment and intervention codes (96150-96155) which restrict those medically appropriate services to Medicare beneficiaries with Alzheimer's disease. Support the MAPRx comments regarding the Draft 2013 Medicare Call Letter regarding proposed actions related to the Part D Prescription Drug Program. These included improved comments on beneficiary protections; Specialty Tiers; Co-pay Thresholds; Tier Labeling; Plan Rating Criteria; Medicare Therapy Management; and Drug Utilization Review Controls in Part D.
2012 · first_quarter · Medicare/Medicaid
HR 891 and S 274 - legislation that would expand the existing medication therapy management program in Medicare Part D S 31 and S 44 and HR 2248 and HR 3638 - legislation that would require or allow the federal government to negotiate prescription drug prices on behalf of Medicare Part D plan sponsors HR 999 and S 560 - legislation that would establish a nationwide Part D plan administered by the federal government HR 1055 - legislation that would allow Part D plan sponsors to offer "off-label" coverage of medications HR 2190 and S 1206 - legislation that would require prescription drug manufacturers to pay Medicaid "best price" rebates for covered prescription drugs purchased by dual eligibles under Medicare Part D HR 3613 - legislation that would require Medicare Part D plans to establish an exceptions process for patient cost-sharing amounts. HR 4215 - legislation that would establish audit requirements and other transparency requirements for Medicare Part D plan sponsors. Worked on proposed legislative language, work which included consultation with Senate committee staff, that would amend the current prompt payment rules in Medicare Part D in the interest of preventing fraud.
Client expense: $190,000 · Firm income: Not reported
2011 · fourth_quarter · Medicare/Medicaid
Support American Society of Consultant Pharmacists and "Short Cycle Dispensing Coalition" recommendations regarding the delay and study of new long-term care pharmacy dispensing rules and the impact of those rules on Medicare and Medicaid patients. Support H.R. 1055, the Part D Off-Label Prescription Drug Parity Act. Continue to oppose cuts to Medicare benefits, and continue to oppose the Independent Payment Advisory Board (IPAB). Support Medicare Access for Patients Rx (MAPRx) recommendations to Centers for Medicare and Medicaid Services (CMS) all regarding Medicare Part D. Those MAPRx recommendations are in regard to: Improved beneficiary protections; Better, more transparent Specialty Tier guidance including the threshold for inclusion on this tier and the inclusion of data for newly approved drugs; New, more realistic co-pay thresholds; Automatic disenrollment from Special Needs Plans; Proposed plan rating criteria; and Approval of six-tier formularies. These are in addition to MAPRx concerns regarding: The Part D Medicare appeals process and the handling of enrollee complaints; Drug dispensing rules for Part D beneficiaries in long-term care facilities; the Authority to deny bids and potential additional restrictions; and Compound Drug Policy. Support repeal of IPAB (H.R. 452). Support changes to the Medicare Shared Savings Program: Accountable Care Organization (ACO) proposed regulations, to provide additional safeguards to guarantee patient access to needed care, and to ensure that ACO's support the adoption of new treatments and cures for patients. Also support the addition of new Alzheimer's disease focused ACO quality measures, new ACO measures of provider evidence of competency in Geriatrics and Dementia, as well as a guarantee that Alzheimer's and Dementia patients under ACO care will have access to the newest pharmaceutical and biological treatments. Support repeal of Section 6001 of the PPACA and remove all restrictions on physician-owned hospitals. (Support H.R. 1159 and H.R. 1186) Oppose federal budget cuts that would increase co-payments for home health care services under Medicare and/or Medicaid Support the Preservation of Access to Osteoporosis Testing for Medicare Beneficiaries Act of 2011 (S. 1096 and H.R. 2020) Support MAPRx suggestions to CMS on Medicare Part D Prescription Drug Program regarding new beneficiary-friendly point-of-sale notices that address problems in filling prescriptions and clear, instructive remedies for beneficiaries. Oppose proposals that would reduce payments to providers of drugs and biologics under Medicare Part B. Oppose proposals to increase Medicare Part D cost-sharing, raise Part D coinsurance, and/or freeze income thresholds. Oppose efforts to require Medicaid-type drug rebates from any Medicare Part D providers and all other kinds of mandated or negotiated Part D price controls that will harm beneficiaries and increase costs in other areas of Medicare. Support efforts to focus Medicare cost-saving efforts on eliminating improper payments, waste, fraud, and abuse first -- before cutting benefits, cutting payments to providers, or raising premium and coinsurance costs for beneficiaries. Support H.R. 3613 - Medicare Part D Beneficiary Appeals Fairness Act. Urged the "Super Committee" to resist proposals to erode beneficiary protections in Part D that ensure broad and accessible prescription drug formularies.
2011 · fourth_quarter · Medicare/Medicaid
Support American Society of Consultant Pharmacists and "Short Cycle Dispensing Coalition" recommendations regarding the delay and study of new long-term care pharmacy dispensing rules and the impact of those rules on Medicare and Medicaid patients. Support H.R. 1055, the Part D Off-Label Prescription Drug Parity Act. Continue to oppose cuts to Medicare benefits, and continue to oppose the Independent Payment Advisory Board (IPAB). Support Medicare Access for Patients Rx (MAPRx) recommendations to Centers for Medicare and Medicaid Services (CMS) all regarding Medicare Part D. Those MAPRx recommendations are in regard to: Improved beneficiary protections; Better, more transparent Specialty Tier guidance including the threshold for inclusion on this tier and the inclusion of data for newly approved drugs; New, more realistic co-pay thresholds; Automatic disenrollment from Special Needs Plans; Proposed plan rating criteria; and Approval of six-tier formularies. These are in addition to MAPRx concerns regarding: The Part D Medicare appeals process and the handling of enrollee complaints; Drug dispensing rules for Part D beneficiaries in long-term care facilities; the Authority to deny bids and potential additional restrictions; and Compound Drug Policy. Support repeal of IPAB (H.R. 452). Support changes to the Medicare Shared Savings Program: Accountable Care Organization (ACO) proposed regulations, to provide additional safeguards to guarantee patient access to needed care, and to ensure that ACO's support the adoption of new treatments and cures for patients. Also support the addition of new Alzheimer's disease focused ACO quality measures, new ACO measures of provider evidence of competency in Geriatrics and Dementia, as well as a guarantee that Alzheimer's and Dementia patients under ACO care will have access to the newest pharmaceutical and biological treatments. Support repeal of Section 6001 of the PPACA and remove all restrictions on physician-owned hospitals. (Support H.R. 1159 and H.R. 1186) Oppose federal budget cuts that would increase co-payments for home health care services under Medicare and/or Medicaid Support the Preservation of Access to Osteoporosis Testing for Medicare Beneficiaries Act of 2011 (S. 1096 and H.R. 2020) Support MAPRx suggestions to CMS on Medicare Part D Prescription Drug Program regarding new beneficiary-friendly point-of-sale notices that address problems in filling prescriptions and clear, instructive remedies for beneficiaries. Oppose proposals that would reduce payments to providers of drugs and biologics under Medicare Part B. Oppose proposals to increase Medicare Part D cost-sharing, raise Part D coinsurance, and/or freeze income thresholds. Oppose efforts to require Medicaid-type drug rebates from any Medicare Part D providers and all other kinds of mandated or negotiated Part D price controls that will harm beneficiaries and increase costs in other areas of Medicare. Support efforts to focus Medicare cost-saving efforts on eliminating improper payments, waste, fraud, and abuse first -- before cutting benefits, cutting payments to providers, or raising premium and coinsurance costs for beneficiaries. Support H.R. 3613 - Medicare Part D Beneficiary Appeals Fairness Act. Urged the "Super Committee" to resist proposals to erode beneficiary protections in Part D that ensure broad and accessible prescription drug formularies.
2011 · fourth_quarter · Medicare/Medicaid
HR 891 and S 274 - legislation that would expand the exisiting medication therapy management program in Medicare Part D S 31 and S 34 - legislation that would require or allow the federal government to negotiate prescription drug prices on behalf of Medicare Part D plan sponsors HR 999 and S 560 - legislation that would establish a nationwide Part D plan administered by the federal government HR 2190 and S 1206 - legislation that would require prescription drug manufacturers to pay Medicaid "best price" rebates for covered prescription drugs purchased by dual eligibles under Medicare Part D. HR 1055 - legislation that would allow Part D plan sponsors to offer "off-label" coverage of medications Worked on proposed legislative language, work which included consultation with Senate committee staff, that would amend the current prompt payment rules in Medicare Part D in the interest of preventing fraud.
Client expense: $210,000 · Firm income: Not reported
Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, SENATE
2011 · third_quarter · Health Issues
--H.R. 2595/S. 425, National Neurological Diseases Surveillance System Act, support all provisions. --H.R. 833/S. 495, Adult Day Achievement Center Enhancement Act, support all provisions. --S. 597, A bill to amend title XVIII of the Social Security Act to include neurologists as primary care physicians for purposes of incentive payments for primary care services under the Medicare program, support all provisions. --H.R. 2224, Improving Physician Access in Teaching Hospitals (PATH) Act, support all provisions. --H.R. 1055, Part D Off-Label Prescription Parity Act, support all provisions.
Client expense: $58,638 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2011 · third_quarter · Medicare/Medicaid
--S. 597, A bill to amend title XVIII of the Social Security Act to include neurologists as primary care physicians for purposes of incentive payments for primary care services under the Medicare program, support all provisions. --H.R. 2224, Improving Physician Access in Teaching Hospitals (PATH) Act, support all provisions. --H.R. 1055, Part D Off-Label Prescription Parity Act, support all provisions. --S. 365, Budget Control Act of 2011, urge protection of MS research in the CDMRP, NIH, Medicaid, Medicare, and Social Security for persons living with disabilities.
Client expense: $58,638 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2011 · third_quarter · Medicare/Medicaid
Support American Society of Consultant Pharmacists and "Short Cycle Dispensing Coalition" recommendations regarding the delay and study of new long-term care pharmacy dispensing rules and the impact of those rules on Medicare and Medicaid patients. Support H.R. 1055, the Part D Off-Label Prescription Drug Parity Act. Continue to oppose cuts to Medicare benefits, and continue to oppose the Independent Payment Advisory Board (IPAB). Support Medicare Access for Patients Rx (MAPRx) recommendations to Centers for Medicare and Medicaid Services (CMS) all regarding Medicare Part D. Those MAPRx recommendations are in regard to: Improved beneficiary protections; Better, more transparent Specialty Tier guidance including the threshold for inclusion on this tier and the inclusion of data for newly approved drugs; New, more realistic co-pay thresholds; Automatic disenrollment from Special Needs Plans; Proposed plan rating criteria; and Approval of six-tier formularies. These are in addition to MAPRx concerns regarding: The Part D Medicare appeals process and the handling of enrollee complaints; Drug dispensing rules for Part D beneficiaries in long-term care facilities; the Authority to deny bids and potential additional restrictions; and Compound Drug Policy. Support repeal of IPAB (H.R. 452). Support changes to the Medicare Shared Savings Program: Accountable Care Organization (ACO) proposed regulations, to provide additional safeguards to guarantee patient access to needed care, and to ensure that ACO's support the adoption of new treatments and cures for patients. Also support the addition of new Alzheimer's disease focused ACO quality measures, new ACO measures of provider evidence of competency in Geriatrics and Dementia, as well as a guarantee that Alzheimer's and Dementia patients under ACO care will have access to the newest pharmaceutical and biological treatments. Support repeal of Section 6001 of the PPACA and remove all restrictions on physician-owned hospitals. (Support H.R. 1159 and H.R. 1186) Oppose federal budget cuts that would increase co-payments for home health care services under Medicare and/or Medicaid Support the Preservation of Access to Osteoporosis Testing for Medicare Beneficiaries Act of 2011 (S. 1096 and H.R. 2020) Support MAPRx suggestions to CMS on Medicare Part D Prescription Drug Program regarding new beneficiary-friendly point-of-sale notices that address problems in filling prescriptions and clear, instructive remedies for beneficiaries. Oppose proposals that would reduce payments to providers of drugs and biologics under Medicare Part B. Oppose proposals to increase Medicare Part D cost-sharing, raise Part D coinsurance, and/or freeze income thresholds. Oppose efforts to require Medicaid-type drug rebates from any Medicare Part D providers and all other kinds of mandated or negotiated Part D price controls that will harm beneficiaries and increase costs in other areas of Medicare. Support efforts to focus Medicare cost-saving efforts on eliminating improper payments, waste, fraud, and abuse first -- before cutting benefits, cutting payments to providers, or raising premium and coinsurance costs for beneficiaries.
2011 · third_quarter · Medicare/Medicaid
HR 891 and S 274 - legislation that would expand the exisiting medication therapy management program in Medicare Part D S 31 and S 34 - legislation that would require or allow the federal government to negotiate prescription drug prices on behalf of Medicare Part D plan sponsors HR 999 and S 560 - legislation that would establish a nationwide Part D plan administered by the federal government HR 2190 and S 1206 - legislation that would require prescription drug manufacturers to pay Medicaid "best price" rebates for covered prescription drugs purchased by dual eligibles under Medicare Part D. HR 1055 - legislation that would allow Part D plan sponsors to offer "off-label" coverage of medications Worked on proposed legislative language, work which included consultation with Senate committee staff, that would amend the current prompt payment rules in Medicare Part D in the interest of preventing fraud.
Client expense: $190,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2011 · third_quarter · Medicare/Medicaid
Support American Society of Consultant Pharmacists and "Short Cycle Dispensing Coalition" recommendations regarding the delay and study of new long-term care pharmacy dispensing rules and the impact of those rules on Medicare and Medicaid patients. Support H.R. 1055, the Part D Off-Label Prescription Drug Parity Act. Continue to oppose cuts to Medicare benefits, and continue to oppose the Independent Payment Advisory Board (IPAB). Support Medicare Access for Patients Rx (MAPRx) recommendations to Centers for Medicare and Medicaid Services (CMS) all regarding Medicare Part D. Those MAPRx recommendations are in regard to: Improved beneficiary protections; Better, more transparent Specialty Tier guidance including the threshold for inclusion on this tier and the inclusion of data for newly approved drugs; New, more realistic co-pay thresholds; Automatic disenrollment from Special Needs Plans; Proposed plan rating criteria; and Approval of six-tier formularies. These are in addition to MAPRx concerns regarding: The Part D Medicare appeals process and the handling of enrollee complaints; Drug dispensing rules for Part D beneficiaries in long-term care facilities; the Authority to deny bids and potential additional restrictions; and Compound Drug Policy. Support repeal of IPAB (H.R. 452). Support changes to the Medicare Shared Savings Program: Accountable Care Organization (ACO) proposed regulations, to provide additional safeguards to guarantee patient access to needed care, and to ensure that ACO's support the adoption of new treatments and cures for patients. Also support the addition of new Alzheimer's disease focused ACO quality measures, new ACO measures of provider evidence of competency in Geriatrics and Dementia, as well as a guarantee that Alzheimer's and Dementia patients under ACO care will have access to the newest pharmaceutical and biological treatments. Support repeal of Section 6001 of the PPACA and remove all restrictions on physician-owned hospitals. (Support H.R. 1159 and H.R. 1186) Oppose federal budget cuts that would increase co-payments for home health care services under Medicare and/or Medicaid Support the Preservation of Access to Osteoporosis Testing for Medicare Beneficiaries Act of 2011 (S. 1096 and H.R. 2020) Support MAPRx suggestions to CMS on Medicare Part D Prescription Drug Program regarding new beneficiary-friendly point-of-sale notices that address problems in filling prescriptions and clear, instructive remedies for beneficiaries. Oppose proposals that would reduce payments to providers of drugs and biologics under Medicare Part B. Oppose proposals to increase Medicare Part D cost-sharing, raise Part D coinsurance, and/or freeze income thresholds. Oppose efforts to require Medicaid-type drug rebates from any Medicare Part D providers and all other kinds of mandated or negotiated Part D price controls that will harm beneficiaries and increase costs in other areas of Medicare. Support efforts to focus Medicare cost-saving efforts on eliminating improper payments, waste, fraud, and abuse first -- before cutting benefits, cutting payments to providers, or raising premium and coinsurance costs for beneficiaries.
2011 · second_quarter · Medicare/Medicaid
Support American Society of Consultant Pharmacists and "Short Cycle Dispensing Coalition" recommendations regarding the delay and study of new long-term care pharmacy dispensing rules and the impact of those rules on Medicare and Medicaid patients. Support H.R. 1055, the Part D Off-Label Prescription Drug Parity Act. Continue to oppose cuts to Medicare benefits, and continue to oppose the Independent Payment Advisory Board (IPAB). Support Medicare Access for Patients Rx (MAPRx) recommendations to Centers for Medicare and Medicaid Services (CMS) all regarding Medicare Part D. Those MAPRx recommendations are in regard to: Improved beneficiary protections; Better, more transparent Specialty Tier guidance including the threshold for inclusion on this tier and the inclusion of data for newly approved drugs; New, more realistic co-pay thresholds; Automatic disenrollment from Special Needs Plans; Proposed plan rating criteria; and Approval of six-tier formularies. These are in addition to MAPRx concerns regarding: The Part D Medicare appeals process and the handling of enrollee complaints; Drug dispensing rules for Part D beneficiaries in long-term care facilities; the Authority to deny bids and potential additional restrictions; and Compound Drug Policy. Support repeal of IPAB (H.R. 452). Support changes to the Medicare Shared Savings Program: Accountable Care Organization (ACO) proposed regulations, to provide additional safeguards to guarantee patient access to needed care, and to ensure that ACO's support the adoption of new treatments and cures for patients. Also support the addition of new Alzheimer's disease focused ACO quality measures, new ACO measures of provider evidence of competency in Geriatrics and Dementia, as well as a guarantee that Alzheimer's and Dementia patients under ACO care will have access to the newest pharmaceutical and biological treatments. Support repeal of Section 6001 of the PPACA and remove all restrictions on physician-owned hospitals. (Support H.R. 1159 and H.R. 1186) Oppose federal budget cuts that would increase co-payments for home health care services under Medicare and/or Medicaid Support the Preservation of Access to Osteoporosis Testing for Medicare Beneficiaries Act of 2011 (S. 1096 and H.R. 2020)
2011 · second_quarter · Health Issues
--S. 425, National Neurological Diseases Surveillance System Act, support all provisions. --H.R. 833/S. 495, Adult Day Achievement Center Enhancement Act, support all provisions. --S. 597, A bill to amend title XVIII of the Social Security Act to include neurologists as primary care physicians for purposes of incentive payments for primary care services under the Medicare program, support all provisions. --H.R. 2224, Improving Physician Access in Teaching Hospitals (PATH) Act, support all provisions. --H.R. 1055, Part D Off-Label Prescription Parity Act, support all provisions. --H.R. 1546/S.829, Medicare Access to Rehabilitation Services Act, support all provisions.
Client expense: $64,548 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2011 · second_quarter · Medicare/Medicaid
--S. 597, A bill to amend title XVIII of the Social Security Act to include neurologists as primary care physicians for purposes of incentive payments for primary care services under the Medicare program, support all provisions. --H.R. 2224, Improving Physician Access in Teaching Hospitals (PATH) Act, support all provisions. --H.R. 1055, Part D Off-Label Prescription Parity Act, support all provisions. --H.R. 1546/S.829, Medicare Access to Rehabilitation Services Act, support all provisions. --H. Con. Res. 34, oppose capping or block granting the Medicaid program and/or fundamentally altering the Medicare program in a manner that would negatively impact persons living with MS.
Client expense: $64,548 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2011 · second_quarter · Medicare/Medicaid
Support American Society of Consultant Pharmacists and "Short Cycle Dispensing Coalition" recommendations regarding the delay and study of new long-term care pharmacy dispensing rules and the impact of those rules on Medicare and Medicaid patients. Support H.R. 1055, the Part D Off-Label Prescription Drug Parity Act. Continue to oppose cuts to Medicare benefits, and continue to oppose the Independent Payment Advisory Board (IPAB). Support Medicare Access for Patients Rx (MAPRx) recommendations to Centers for Medicare and Medicaid Services (CMS) all regarding Medicare Part D. Those MAPRx recommendations are in regard to: Improved beneficiary protections; Better, more transparent Specialty Tier guidance including the threshold for inclusion on this tier and the inclusion of data for newly approved drugs; New, more realistic co-pay thresholds; Automatic disenrollment from Special Needs Plans; Proposed plan rating criteria; and Approval of six-tier formularies. These are in addition to MAPRx concerns regarding: The Part D Medicare appeals process and the handling of enrollee complaints; Drug dispensing rules for Part D beneficiaries in long-term care facilities; the Authority to deny bids and potential additional restrictions; and Compound Drug Policy. Support repeal of IPAB (H.R. 452). Support changes to the Medicare Shared Savings Program: Accountable Care Organization (ACO) proposed regulations, to provide additional safeguards to guarantee patient access to needed care, and to ensure that ACO's support the adoption of new treatments and cures for patients. Also support the addition of new Alzheimer's disease focused ACO quality measures, new ACO measures of provider evidence of competency in Geriatrics and Dementia, as well as a guarantee that Alzheimer's and Dementia patients under ACO care will have access to the newest pharmaceutical and biological treatments. Support repeal of Section 6001 of the PPACA and remove all restrictions on physician-owned hospitals. (Support H.R. 1159 and H.R. 1186) Oppose federal budget cuts that would increase co-payments for home health care services under Medicare and/or Medicaid Support the Preservation of Access to Osteoporosis Testing for Medicare Beneficiaries Act of 2011 (S. 1096 and H.R. 2020)
2011 · first_quarter · Medicare/Medicaid
Support American Society of Consultant Pharmacists and "Short Cycle Dispensing Coalition" recommendations regarding the delay and study of new long-term care pharmacy dispensing rules and the impact of those rules on Medicare and Medicaid patients. Support H.R. 1055, the Part D Off-Label Prescription Drug Parity Act. Continue to oppose cuts to Medicare benefits, and continue to oppose the Independent Payment Advisory Board (IPAB). Support Medicare Access for Patients Rx (MAPRx) recommendations to Centers for Medicare and Medicaid Services (CMS) all regarding Medicare Part D. Those MAPRx recommendations are in regard to: Improved beneficiary protections; Better, more transparent Specialty Tier guidance including the threshold for inclusion on this tier and the inclusion of data for newly approved drugs; New, more realistic co-pay thresholds; Automatic disenrollment from Special Needs Plans; Proposed plan rating criteria; and Approval of six-tier formularies. These are in addition to MAPRx concerns regarding: The Part D Medicare appeals process and the handling of enrollee complaints; Drug dispensing rules for Part D beneficiaries in long-term care facilities; the Authority to deny bids and potential additional restrictions; and Compound Drug Policy.
Client expense: $68,922 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2011 · first_quarter · Health Issues
--S. 425, National Neurological Diseases Surveillance System Act, support all provisions. --H.R. 833/S. 495, Adult Day Achievement Center Enhancement Act, support all provisions. --S. 597, A bill to amend title XVIII of the Social Security Act to include neurologists as primary care physicians for purposes of incentive payments for primary care services under the Medicare program, support all provisions. --H.R. 1055, Part D Off-Label Prescription Parity Act, support all provisions.
Client expense: $264,298 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2011 · first_quarter · Medicare/Medicaid
--H.R. 1055, Part D Off-Label Prescription Parity Act, support all provisions. --H. Con. Res. 34, oppose capping or block granting the Medicaid program and/or fundamentally altering the Medicare program in a manner that would negatively impact persons living with MS.
Client expense: $264,298 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2011 · first_quarter · Medicare/Medicaid
Support American Society of Consultant Pharmacists and "Short Cycle Dispensing Coalition" recommendations regarding the delay and study of new long-term care pharmacy dispensing rules and the impact of those rules on Medicare and Medicaid patients. Support H.R. 1055, the Part D Off-Label Prescription Drug Parity Act. Continue to oppose cuts to Medicare benefits, and continue to oppose the Independent Payment Advisory Board (IPAB). Support Medicare Access for Patients Rx (MAPRx) recommendations to Centers for Medicare and Medicaid Services (CMS) all regarding Medicare Part D. Those MAPRx recommendations are in regard to: Improved beneficiary protections; Better, more transparent Specialty Tier guidance including the threshold for inclusion on this tier and the inclusion of data for newly approved drugs; New, more realistic co-pay thresholds; Automatic disenrollment from Special Needs Plans; Proposed plan rating criteria; and Approval of six-tier formularies. These are in addition to MAPRx concerns regarding: The Part D Medicare appeals process and the handling of enrollee complaints; Drug dispensing rules for Part D beneficiaries in long-term care facilities; the Authority to deny bids and potential additional restrictions; and Compound Drug Policy.
Client expense: Not reported · Firm income: $12,925
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
| Republican |
| TX |
| Michael H. Michaud | Democratic | ME |
| Nan A. S. Hayworth | Republican | NY |
| Russ Carnahan | Democratic | MO |
Client expense: Not reported · Firm income: $9,625
Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
Government targets: HOUSE OF REPRESENTATIVES, SENATE
Client expense: Not reported · Firm income: $10,808
Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
Client expense: $61,150 · Firm income: Not reported
Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
Client expense: $83,191 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
Client expense: Not reported · Firm income: $12,238
Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
Government targets: HOUSE OF REPRESENTATIVES, SENATE
Client expense: Not reported · Firm income: $15,510
Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
Client expense: $37,740 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
Client expense: $69,590 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
Client expense: Not reported · Firm income: $12,760
Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
Client expense: $62,145 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
Client expense: Not reported · Firm income: $14,355
Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE