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Restoring Access to Medication 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.
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Sources: Congress.gov
2013 · second_quarter · Taxation/Internal Revenue Code
Flexible spending arrangements (FSA) and health savings accounts (HSA)H.R. 1248/S. 610 - Family Health Care Flexibility Act. Repeals prohibition in Patient Protection and Affordable Care Act (P.L. 111-148, P.L. 111-152) against use of flexible spending arrangement (FSA) and health savings account (HSA) funds on over-the-counter medications; all sections. Re-introduction of H.R. 2529/S. 1368 - Restoring Access to Medication Act (112th Congress). Would also repeal prohibition in Patient Protection and Affordable Care Act (P.L. 111-148, P.L. 111-152) against use of flexible spending arrangement (FSA) and health savings account (HSA) funds on over-the-counter medications; all sections.
Client expense: $290,000 · Firm income: Not reported
Government targets: Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Office of Natl Drug Control Policy (NDCP), SENATE
2013 · first_quarter · Health Issues
Preserving Access to Primary Care Services: Address the shortage of primary care physicians; designate primary care as a shortage profession; provide scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas; provide grants for medical school mentorship programs and primary care training in community health centers; increase Title VII funding for primary care health programs; increase funding for the National Health Service Corps,provide regulatory relief for primary care physicians; H.R. 7192/S. 1174, the Preserving Patient Access to Primary Care Act (111th Congress). Support Implementation and Improvement of the Affordable Care Act (P.L. 111-148, P.L. 111-152) by: Expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; public and private health insurers should encourage preventive health care by providing full coverage, with no cost-sharing, for preventive services recommended by an expert advisory group, such as the U.S. Preventive Services Task Force; Ensuring access to primary care physicians; and beginning to bend the cost curve; Prohibiting insurers from excluding or charging excessive rates to children based on pre-existing conditions, which later will be expanded to all persons; Covering young adults on their parents' plans; Eliminating lifetime and annual limits on health insurance coverage; Requiring that health insurers spend more on patient care and less on administration; support enactment of S. 248, the Empowering States to Innovate Act, which amends the Patient Protection and Affordable Care Act (ACA) to: (1) allow states to apply for waivers of certain health insurance coverage requirements in such Act (including requirements for the establishment of qualified health plans and health insurance exchanges) for plan years beginning on or after January 1, 2014 (currently, January 1, 2017), and (2) require the waiver application process to begin not later than 180 days after the enactment of this Act; Phasing out the Medicare Part D doughnut hole; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Establishing a new Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Creating a new Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes; Training more primary care physicians through the National Health Service Corps, Title VII health professions funding, and redistributing unused graduate medical education positions to primary care specialties facing shortages; Beginning in 2014, ensuring that nearly all Americans have access to coverage either through subsidized private health insurance offered by state health exchanges or through Medicaid, if they don't already have access to coverage through an employer, Medicare, or another public program. Medicare Physician Payment Reform: Increase Medicare Fee Schedule payments to make primary care competitive in the market with other physician career and specialty choices; create a fast track authority to develop and implement new physician payment models that better align payment with effective, efficient, patient-centered care such as the Patient Centered Medical Home; provide a voluntary shared savings program, Accountable Care Organizations, that promotes accountability for services delivered to a defined Medicare fee-for-service (FFS) patient population with the goals of increasing the quality and efficiency of services delivered; provide separate Medicare payment for specific care coordination services provided principally by primary care physicians; revise Medicare budget neutrality rules to recognize the value of primary care in reducing Medicare baseline spending; increase the accuracy of physician work relative value units under the Medicare physician fee schedule; improve the accuracy of practice expense RVUs under the Medicare Fee Schedule; increase Medicare bonus payments for primary care services provided in designated shortage areas; provide stable, positive, predictable updates under Medicares reimbursement formula; and replacing the Sustainable Growth Rate (SGR) formula with a long term solution that provides for stable, predictable updates for physicians (H.R. 3961). Specifically, beginning in April 2011, urged Congress to enact legislation that would provide stable payments for all physician specialties for at least five years while providing higher updates for undervalued evaluation and management services, require that different payment models (including Patient-Centered Medical Homes) be pilot-tested on a voluntary basis during the five year period of stable payments, and designate a specific transition period for broad adoption of the new models that have been shown to be the most effective based on the pilots. Urged action on legislation to provide stability and predictability for the Medicare physician payments at least through 2012; Advocated for repealing the SGR and using the Overseas Contingency Operation (OCO) funds to offset the cost. Urged enactment of the Medicare Physician Payment Innovation Act (H.R. 574), as introduced in Feb. 2013 by Representatives Allyson Schwartz (D-PA) and Joe Heck (R-NV). This legislation would eliminate the SGR once and for all and transition to better payment and delivery systems that are aligned with value. Specifically, H.R. 574 would repeal the SGR formula, provide more than 5 years of stable physician payments, with positive increases for all physician services, and higher payments for primary care, preventive and care coordination services, and establishes a process for practices to transition to new, more effective, models of care by 2018.In July 2012 testimony; advocated for the Patient-Centered Medical Home model should be scaled up for broad Medicare adoption, recognized, through the medical neighborhood concept, that specialty and subspecialty practices, hospitals, and other healthcare professionals and entities that provide treatment to the patient need to be recognized and provided with incentivesboth non-financial and financialfor engaging in patient-centered practices that complement and support the efforts of the PCMH to provide high quality, efficient, coordinated care; advocated for ACPs High Value, Cost-Conscious Care Initiative, which includes clinical, public policy, and educational components, designed to help physicians and patients understand the benefits, harms, and costs of an intervention and whether it provides good value, as well as to slow the unsustainable rate of health care cost increases while preserving high-value, high-quality care. Advocated for halting the nearly 25 percent cut in physician payments resulting from the flawed SGR formula, which is scheduled to take effect on January 1, 2014. Sequestration: October 2012 through March 2013, advocated strongly that Congress develop and pass a fiscally responsible, bipartisan agreement to prevent the implementation of across-the-board budget sequestration cuts that would endanger critical programs related to medical research, public health, workforce, food and drug safety, and health care for military families, as well as trigger cuts in Medicare payments to physicians and graduate medical education programs that will endanger patient access to care. Instead, policymakers should embrace an alternative approach that addresses the true cost drivers behind rising health care costs. They should work to improve the effectiveness of care provided, make necessary and appropriate changes in entitlement programs, including Medicare cost-sharing, reform payment and delivery systems, and support the proven value of primary care. Medical Education: Provide incentives to medical schools, community health centers, or hospitals, to increase the numbers of physicians choosing primary care; authorize HHS to selectively eliminate Graduate Medical Education (GME) caps for residency programs in primary care, advocated for S. 1627, which would increase the number of Medicare-supported training positions for medical residents by 15 percent (approximately 15,000 slots) over five years, requiring at least 50 percent of the new positions to be allocated to specialties facing a current shortage. FY2014 Budget: Recommended funding of $65 billion for discretionary public health and health research programs (Function 550) in the FY 2014 budget resolution; Urged the Administration to continue to prioritize investments in the nations health care workforce through Titles VII and VIII in the FY2014 budget. Appropriations for FY 2013: Advocated for the highest level of funding possible for the Labor-HHS-Education bill within the discretionary cap established by the Budget Control Act (BCA); Urged appropriators to preserve full funding for the Health Resources and Services Administration (HRSA)s Title VII health professions and Title VIII nursing workforce development programs in FY2013 appropriations. Supported $520 million for Title VII Health Professions and Title VIII Nursing Programs to the House and Senate Labor-HHS-Education Appropriations Subcommittees; Supported $400 million to "improve health care quality, enhance consumer choice, advance patient safety, improve efficiency, reduce medical errors, and broaden access to essential services; Advocated for a base, discretionary budget of $400 million in FY 2013 for AHRQ; Advocated for at least $7.0 billion for the Health Resources and Services Administration (HRSA); Specifically, the College supported Title VII, Section 747, Primary Care Training and Enhancement, at no less than $71 million; National Health Service Corps, $535,087,442 million in discretionary funding, in addition to the $300 million in enhanced funding through the Community Health Centers Fund; National Health Care Workforce Commission, $3 million; and Centers for Medicare and Medicaid Services, Operations and Management of Exchanges, $574.5 million. Fund the National Institutes of Health (NIH), at $32 billion, which represents the minimum investment necessary to avoid further loss of promising research and at the same time allows the NIH's budget to keep pace with biomedical inflation. Fund the Centers for Disease Control (CDC), at $7.8 billion, which reflects the minimal amount CDC will need to fulfill its core missions for fiscal year 2013, which are essential to protect the health of the American people. Preserve funding for GME in FY 2013; Urged Congress not to terminate AHRQ. Appropriations for FY 2014: Urged appropriators to provide at least $7.0 billion for discretionary Health Resources and Services Administration programs in the FY 2014 Labor, Health and Human Services, Education, and Related Agencies Appropriations bill.Public Health Programs and Funding: Increase funding to accomplish the core missions and activities of the major federal public health agencies, including: biomedical and behavioral research, disease prevention and health promotion, access to safety net health care services, health professions education, mental health and substance abuse, health services research, health care for American Indians and Alaska natives, food and drug safety. In January 2013, advocated to federal health agencies that wellness programs must not be used as a means to discriminate against the sick and vulnerable. Wellness programs must be developed to encourage prevention and improve health rather than penalize those who are medically unable to meet wellness program goals; Further advocated in January 2013 that employers and health plans should fund programs proven to be effective in reducing obesity, stopping smoking, deterring alcohol abuse, and promoting wellness and providing coverage or subsidies for individuals to participate in such programs. Improving Access to Primary Care in the Context of Comprehensive Healthcare Reform Legislation (H.R. 3962/H.R. 3590/H.R. 4872): Ensure that all Americans will have access to affordable coverage: Provide sliding scale subsidies based on income to buy coverage from qualified plans; Qualified plans should: provide evidence-based benefits, including preventive services; and be prohibited from excluding persons with pre-existing conditions, charging them more, cherry-picking enrollees, or cancelling or failing to renew coverage; Expand Medicaid to cover all persons below the Federal Poverty Level and ensure fair payments to participating physicians; As coverage becomes affordable, all persons should participate and coverage should be guaranteed; Responsibility for financing should be shared by individuals, employers and government. Regarding the Essential Health Benefits Bulletin, issued by the Department of Health and Human Services (HHS) on December 16, 2011, the College advocated for striking a balance between comprehensiveness and affordability while giving States some freedom to determine a package that best serve the needs of residents. The College believes that strong oversight is needed when determining the initial benchmark plan (and whether it reflects the coverage requirements of the Affordable Care Act) and how the package will be updated, particularly if insurers are given the ability to substitute benefits within and across categories. State and the federal government must work in concert with physicians, health care providers and payers to determine and promote use of clinically effective and cost-effective services that result in improved patient health while bending the cost curve. Essential Health Benefits: Commented on the proposed rule regarding essential benefits, actuarial value, and accreditation as issued by the U.S. Department of Health & Human Services on November 20, 2012; Advocated that strong oversight is needed when determining the initial benchmark plan (and whether it reflects the coverage requirements of the Affordable Care Act) and how the package will be updated, particularly if insurers are given the ability to substitute benefits within categories. State and the federal government must work in concert with physicians, health care providers and payers to determine and promote use of clinically effective and cost-effective services that result in improved patient health while bending the cost curve. Pilot test new Medicare payment models that re-align incentives to support effective, efficient, patient-centered, coordinated care. Priority should be given to models designed to support the value of services provided by primary care physicians as well as to models that would create incentives, across physician specialties and sites of services, to improve the quality, effectiveness, and efficiency of care provided. Policy criteria for selecting the most promising models for pilot testing should be developed, in consultation with outside experts; The Patient-Centered Medical Home (PCMH), which has shown great promise in meeting the policy objectives suggested above, should be among the models selected for broader testing on a national pilot basis; the establishing of a new CMS Innovation Center to pilot-test new payment models, such as the medical home; the use of the medical home model for treatment or services under private health plans, the requirement of health plans to provide incentives to promote and report on medical home services provided, the establishment of community health teams and a primary care extension program to educate and support primary care practices in the delivery of medical home services, and the establishment of a demonstration project to educate physicians and other clinicians in training in the competencies required to deliver care consistent with the medical home care model. National workforce policy to ensure sufficient numbers of primary care and other physicians: Urged support for a national workforce commission to recommend national goals relating to the numbers and distribution of physicians and other health care professionals, including increasing the supply of primary care physicians; Fully fund the commission at levels authorized in the Affordable Care Act;Increase the number of Medicare-funded graduate medical education positions available each year in adult primary care specialties; Provide new loan repayment and medical school scholarship programs in exchange for primary care service in critical shortage health facilities, or in critical shortage areas of the country; Increase funding for scholarships and loan repayment programs under Title VII as well as increase funding for the National Health Service Corps (NHSC); Provide new practice-entry bonus for scholarship or loan repayment award recipients who remain in underserved communities after completion of service obligation. Reform the medical liability system and the enormous costs associated with frivolous lawsuits and defensive medicine: Impose caps on non-economic damages; and test and fund new models--like health courts, which would have cases heard by an expert panel rather than by a lay jury; Urge enactment of H.R. 5, the HEALTH Act, as initially introduced, which would set national standards for medical malpractice, including a $250,000 cap on non-economic damages. The Restoring Access to Medication Act (H.R. 2529 in the 112th Congress): Advocated for this legislation, and signed on to similar letters, that overturns the restrictions placed on tax-preferred accounts reimbursing for over-the-counter (OTC) medicines without first getting a prescription. This legislation will restore efficiencies in the healthcare system and consumer access to vital, frontline medicines that were disrupted by ACA. The Primary Care Workforce Access and Improvement Act (H.R. 3667 in the 112th Congress): Supported this legislation that would authorize the Secretary of Health and Human Services (HHS) to conduct a five year Medicare pilot project that would direct a share of Graduate Medical Education funding to medical education entities to test different models of primary care training. This legislation would give the Secretary of HHS the authority to test new models of care that demonstrate the capability of improving the quality, quantity, and distribution of primary care physicians.
2013 · first_quarter · Health Issues
Preserving Access to Primary Care Services: Address the shortage of primary care physicians; designate primary care as a shortage profession; provide scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas; provide grants for medical school mentorship programs and primary care training in community health centers; increase Title VII funding for primary care health programs; increase funding for the National Health Service Corps,provide regulatory relief for primary care physicians; H.R. 7192/S. 1174, the Preserving Patient Access to Primary Care Act (111th Congress). Support Implementation and Improvement of the Affordable Care Act (P.L. 111-148, P.L. 111-152) by: Expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; public and private health insurers should encourage preventive health care by providing full coverage, with no cost-sharing, for preventive services recommended by an expert advisory group, such as the U.S. Preventive Services Task Force; Ensuring access to primary care physicians; and beginning to bend the cost curve; Prohibiting insurers from excluding or charging excessive rates to children based on pre-existing conditions, which later will be expanded to all persons; Covering young adults on their parents' plans; Eliminating lifetime and annual limits on health insurance coverage; Requiring that health insurers spend more on patient care and less on administration; support enactment of S. 248, the Empowering States to Innovate Act, which amends the Patient Protection and Affordable Care Act (ACA) to: (1) allow states to apply for waivers of certain health insurance coverage requirements in such Act (including requirements for the establishment of qualified health plans and health insurance exchanges) for plan years beginning on or after January 1, 2014 (currently, January 1, 2017), and (2) require the waiver application process to begin not later than 180 days after the enactment of this Act; Phasing out the Medicare Part D doughnut hole; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Establishing a new Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Creating a new Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes; Training more primary care physicians through the National Health Service Corps, Title VII health professions funding, and redistributing unused graduate medical education positions to primary care specialties facing shortages; Beginning in 2014, ensuring that nearly all Americans have access to coverage either through subsidized private health insurance offered by state health exchanges or through Medicaid, if they don't already have access to coverage through an employer, Medicare, or another public program. Medicare Physician Payment Reform: Increase Medicare Fee Schedule payments to make primary care competitive in the market with other physician career and specialty choices; create a fast track authority to develop and implement new physician payment models that better align payment with effective, efficient, patient-centered care such as the Patient Centered Medical Home; provide a voluntary shared savings program, Accountable Care Organizations, that promotes accountability for services delivered to a defined Medicare fee-for-service (FFS) patient population with the goals of increasing the quality and efficiency of services delivered; provide separate Medicare payment for specific care coordination services provided principally by primary care physicians; revise Medicare budget neutrality rules to recognize the value of primary care in reducing Medicare baseline spending; increase the accuracy of physician work relative value units under the Medicare physician fee schedule; improve the accuracy of practice expense RVUs under the Medicare Fee Schedule; increase Medicare bonus payments for primary care services provided in designated shortage areas; provide stable, positive, predictable updates under Medicares reimbursement formula; and replacing the Sustainable Growth Rate (SGR) formula with a long term solution that provides for stable, predictable updates for physicians (H.R. 3961). Specifically, beginning in April 2011, urged Congress to enact legislation that would provide stable payments for all physician specialties for at least five years while providing higher updates for undervalued evaluation and management services, require that different payment models (including Patient-Centered Medical Homes) be pilot-tested on a voluntary basis during the five year period of stable payments, and designate a specific transition period for broad adoption of the new models that have been shown to be the most effective based on the pilots. Urged action on legislation to provide stability and predictability for the Medicare physician payments at least through 2012; Advocated for repealing the SGR and using the Overseas Contingency Operation (OCO) funds to offset the cost. Urged enactment of the Medicare Physician Payment Innovation Act (H.R. 574), as introduced in Feb. 2013 by Representatives Allyson Schwartz (D-PA) and Joe Heck (R-NV). This legislation would eliminate the SGR once and for all and transition to better payment and delivery systems that are aligned with value. Specifically, H.R. 574 would repeal the SGR formula, provide more than 5 years of stable physician payments, with positive increases for all physician services, and higher payments for primary care, preventive and care coordination services, and establishes a process for practices to transition to new, more effective, models of care by 2018.In July 2012 testimony; advocated for the Patient-Centered Medical Home model should be scaled up for broad Medicare adoption, recognized, through the medical neighborhood concept, that specialty and subspecialty practices, hospitals, and other healthcare professionals and entities that provide treatment to the patient need to be recognized and provided with incentivesboth non-financial and financialfor engaging in patient-centered practices that complement and support the efforts of the PCMH to provide high quality, efficient, coordinated care; advocated for ACPs High Value, Cost-Conscious Care Initiative, which includes clinical, public policy, and educational components, designed to help physicians and patients understand the benefits, harms, and costs of an intervention and whether it provides good value, as well as to slow the unsustainable rate of health care cost increases while preserving high-value, high-quality care. Advocated for halting the nearly 25 percent cut in physician payments resulting from the flawed SGR formula, which is scheduled to take effect on January 1, 2014. Sequestration: October 2012 through March 2013, advocated strongly that Congress develop and pass a fiscally responsible, bipartisan agreement to prevent the implementation of across-the-board budget sequestration cuts that would endanger critical programs related to medical research, public health, workforce, food and drug safety, and health care for military families, as well as trigger cuts in Medicare payments to physicians and graduate medical education programs that will endanger patient access to care. Instead, policymakers should embrace an alternative approach that addresses the true cost drivers behind rising health care costs. They should work to improve the effectiveness of care provided, make necessary and appropriate changes in entitlement programs, including Medicare cost-sharing, reform payment and delivery systems, and support the proven value of primary care. Medical Education: Provide incentives to medical schools, community health centers, or hospitals, to increase the numbers of physicians choosing primary care; authorize HHS to selectively eliminate Graduate Medical Education (GME) caps for residency programs in primary care, advocated for S. 1627, which would increase the number of Medicare-supported training positions for medical residents by 15 percent (approximately 15,000 slots) over five years, requiring at least 50 percent of the new positions to be allocated to specialties facing a current shortage. FY2014 Budget: Recommended funding of $65 billion for discretionary public health and health research programs (Function 550) in the FY 2014 budget resolution; Urged the Administration to continue to prioritize investments in the nations health care workforce through Titles VII and VIII in the FY2014 budget. Appropriations for FY 2013: Advocated for the highest level of funding possible for the Labor-HHS-Education bill within the discretionary cap established by the Budget Control Act (BCA); Urged appropriators to preserve full funding for the Health Resources and Services Administration (HRSA)s Title VII health professions and Title VIII nursing workforce development programs in FY2013 appropriations. Supported $520 million for Title VII Health Professions and Title VIII Nursing Programs to the House and Senate Labor-HHS-Education Appropriations Subcommittees; Supported $400 million to "improve health care quality, enhance consumer choice, advance patient safety, improve efficiency, reduce medical errors, and broaden access to essential services; Advocated for a base, discretionary budget of $400 million in FY 2013 for AHRQ; Advocated for at least $7.0 billion for the Health Resources and Services Administration (HRSA); Specifically, the College supported Title VII, Section 747, Primary Care Training and Enhancement, at no less than $71 million; National Health Service Corps, $535,087,442 million in discretionary funding, in addition to the $300 million in enhanced funding through the Community Health Centers Fund; National Health Care Workforce Commission, $3 million; and Centers for Medicare and Medicaid Services, Operations and Management of Exchanges, $574.5 million. Fund the National Institutes of Health (NIH), at $32 billion, which represents the minimum investment necessary to avoid further loss of promising research and at the same time allows the NIH's budget to keep pace with biomedical inflation. Fund the Centers for Disease Control (CDC), at $7.8 billion, which reflects the minimal amount CDC will need to fulfill its core missions for fiscal year 2013, which are essential to protect the health of the American people. Preserve funding for GME in FY 2013; Urged Congress not to terminate AHRQ. Appropriations for FY 2014: Urged appropriators to provide at least $7.0 billion for discretionary Health Resources and Services Administration programs in the FY 2014 Labor, Health and Human Services, Education, and Related Agencies Appropriations bill.Public Health Programs and Funding: Increase funding to accomplish the core missions and activities of the major federal public health agencies, including: biomedical and behavioral research, disease prevention and health promotion, access to safety net health care services, health professions education, mental health and substance abuse, health services research, health care for American Indians and Alaska natives, food and drug safety. In January 2013, advocated to federal health agencies that wellness programs must not be used as a means to discriminate against the sick and vulnerable. Wellness programs must be developed to encourage prevention and improve health rather than penalize those who are medically unable to meet wellness program goals; Further advocated in January 2013 that employers and health plans should fund programs proven to be effective in reducing obesity, stopping smoking, deterring alcohol abuse, and promoting wellness and providing coverage or subsidies for individuals to participate in such programs. Improving Access to Primary Care in the Context of Comprehensive Healthcare Reform Legislation (H.R. 3962/H.R. 3590/H.R. 4872): Ensure that all Americans will have access to affordable coverage: Provide sliding scale subsidies based on income to buy coverage from qualified plans; Qualified plans should: provide evidence-based benefits, including preventive services; and be prohibited from excluding persons with pre-existing conditions, charging them more, cherry-picking enrollees, or cancelling or failing to renew coverage; Expand Medicaid to cover all persons below the Federal Poverty Level and ensure fair payments to participating physicians; As coverage becomes affordable, all persons should participate and coverage should be guaranteed; Responsibility for financing should be shared by individuals, employers and government. Regarding the Essential Health Benefits Bulletin, issued by the Department of Health and Human Services (HHS) on December 16, 2011, the College advocated for striking a balance between comprehensiveness and affordability while giving States some freedom to determine a package that best serve the needs of residents. The College believes that strong oversight is needed when determining the initial benchmark plan (and whether it reflects the coverage requirements of the Affordable Care Act) and how the package will be updated, particularly if insurers are given the ability to substitute benefits within and across categories. State and the federal government must work in concert with physicians, health care providers and payers to determine and promote use of clinically effective and cost-effective services that result in improved patient health while bending the cost curve. Essential Health Benefits: Commented on the proposed rule regarding essential benefits, actuarial value, and accreditation as issued by the U.S. Department of Health & Human Services on November 20, 2012; Advocated that strong oversight is needed when determining the initial benchmark plan (and whether it reflects the coverage requirements of the Affordable Care Act) and how the package will be updated, particularly if insurers are given the ability to substitute benefits within categories. State and the federal government must work in concert with physicians, health care providers and payers to determine and promote use of clinically effective and cost-effective services that result in improved patient health while bending the cost curve. Pilot test new Medicare payment models that re-align incentives to support effective, efficient, patient-centered, coordinated care. Priority should be given to models designed to support the value of services provided by primary care physicians as well as to models that would create incentives, across physician specialties and sites of services, to improve the quality, effectiveness, and efficiency of care provided. Policy criteria for selecting the most promising models for pilot testing should be developed, in consultation with outside experts; The Patient-Centered Medical Home (PCMH), which has shown great promise in meeting the policy objectives suggested above, should be among the models selected for broader testing on a national pilot basis; the establishing of a new CMS Innovation Center to pilot-test new payment models, such as the medical home; the use of the medical home model for treatment or services under private health plans, the requirement of health plans to provide incentives to promote and report on medical home services provided, the establishment of community health teams and a primary care extension program to educate and support primary care practices in the delivery of medical home services, and the establishment of a demonstration project to educate physicians and other clinicians in training in the competencies required to deliver care consistent with the medical home care model. National workforce policy to ensure sufficient numbers of primary care and other physicians: Urged support for a national workforce commission to recommend national goals relating to the numbers and distribution of physicians and other health care professionals, including increasing the supply of primary care physicians; Fully fund the commission at levels authorized in the Affordable Care Act; Increase the number of Medicare-funded graduate medical education positions available each year in adult primary care specialties; Provide new loan repayment and medical school scholarship programs in exchange for primary care service in critical shortage health facilities, or in critical shortage areas of the country;Increase funding for scholarships and loan repayment programs under Title VII as well as increase funding for the National Health Service Corps (NHSC); Provide new practice-entry bonus for scholarship or loan repayment award recipients who remain in underserved communities after completion of service obligation. Reform the medical liability system and the enormous costs associated with frivolous lawsuits and defensive medicine: Impose caps on non-economic damages; and test and fund new models--like health courts, which would have cases heard by an expert panel rather than by a lay jury; Urge enactment of H.R. 5, the HEALTH Act, as initially introduced, which would set national standards for medical malpractice, including a $250,000 cap on non-economic damages. The Restoring Access to Medication Act (H.R. 2529 in the 112th Congress): Advocated for this legislation, and signed on to similar letters, that overturns the restrictions placed on tax-preferred accounts reimbursing for over-the-counter (OTC) medicines without first getting a prescription. This legislation will restore efficiencies in the healthcare system and consumer access to vital, frontline medicines that were disrupted by ACA. The Primary Care Workforce Access and Improvement Act (H.R. 3667 in the 112th Congress): Supported this legislation that would authorize the Secretary of Health and Human Services (HHS) to conduct a five year Medicare pilot project that would direct a share of Graduate Medical Education funding to medical education entities to test different models of primary care training. This legislation would give the Secretary of HHS the authority to test new models of care that demonstrate the capability of improving the quality, quantity, and distribution of primary care physicians.
2013 · first_quarter · Taxation/Internal Revenue Code
Flexible spending arrangements (FSA) and health savings accounts (HSA)H.R. 1248/S. - Family Health Care Flexibility Act. Repeals prohibition in Patient Protection and Affordable Care Act (P.L. 111-148, P.L. 111-152) against use of flexible spending arrangement (FSA) and health savings account (HSA) funds on over-the-counter medications; all sections. Re-introduction of H.R. 2529/S. 1368 - Restoring Access to Medication Act (112th Congress). Would also repeal prohibition in Patient Protection and Affordable Care Act (P.L. 111-148, P.L. 111-152) against use of flexible spending arrangement (FSA) and health savings account (HSA) funds on over-the-counter medications; all sections.
Client expense: $260,000 · Firm income: Not reported
Government targets: Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Office of Natl Drug Control Policy (NDCP), SENATE
2012 · fourth_quarter · Health Issues
Various issues related to the Patient Protection and Affordable Care Act (P.L. 111-148) and Health Care and Education Reconciliation Act of 2010 (P.L. 111-152); H.R. 1744/S. 20 employer mandate repeal; H.R. 1063/S. 1718 Medicare Secondary Payer reform; H.R. 2206 auto enrollment repeal; consumer directed health products; H.R. 436; H.R. 5842; H.R. 2529; H.R. 1004; H.R. 5858; H.R. 2010; S. 1098; S. 1368; H.R. 605; S. 312; H.R. 450
Client expense: $1,060,000 · Firm income: Not reported
Government targets: Commerce, Dept of (DOC), Consumer Product Safety Commission (CPSC), Equal Employment Opportunity Commission (EEOC), Federal Reserve System, Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Labor Relations Board (NLRB), Office of Management & Budget (OMB), Office of the Comptroller of the Currency (OCC), SENATE, Securities & Exchange Commission (SEC), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Customs & Border Protection, U.S. International Trade Commission (ITC), U.S. Trade Representative (USTR), White House Office
| Republican |
| OH |
| Bill Posey | Republican | FL |
| Blaine Luetkemeyer | Republican | MO |
| Bob Goodlatte | Republican | VA |
| Brett Guthrie | Republican | KY |
| Brian P. Bilbray | Republican | CA |
| Bruce L. Braley | Democratic | IA |
| Cathy McMorris Rodgers | Republican | WA |
| Cory Gardner | Republican | CO |
| Cynthia M. Lummis | Republican | WY |
| Dan Benishek | Republican | MI |
| Dan Burton | Republican | IN |
| David B. McKinley | Republican | WV |
| David P. Roe | Republican | TN |
| Dennis A. Ross | Republican | FL |
| Diane Black | Republican | TN |
| Frank A. LoBiondo | Republican | NJ |
| Geoff Davis | Republican | KY |
| Greg Walden | Republican | OR |
| Howard Coble | Republican | NC |
| Jeff Miller | Republican | FL |
| Jim Gerlach | Republican | PA |
| Joe Walsh | Republican | IL |
| John Barrow | Democratic | GA |
| John J. Duncan, Jr. | Republican | TN |
| John Sullivan | Republican | OK |
| Joseph J. Heck | Republican | NV |
| Kevin Brady | Republican | TX |
| Larry Kissell | Democratic | NC |
| Lynn A. Westmoreland | Republican | GA |
| Marsha Blackburn | Republican | TN |
| Michael C. Burgess | Republican | TX |
| Michael T. McCaul | Republican | TX |
| Mike Coffman | Republican | CO |
| Mike Pompeo | Republican | KS |
| Mike Rogers | Republican | MI |
| Patrick J. Tiberi | Republican | OH |
| Paul A. Gosar | Republican | AZ |
| Paul C. Broun | Republican | GA |
| Randy Hultgren | Republican | IL |
| Renee L. Ellmers | Republican | NC |
| Rick Berg | Republican | ND |
| Robert E. Latta | Republican | OH |
| Robert J. Wittman | Republican | VA |
| Rodney Alexander | Republican | LA |
| Ron Paul | Republican | TX |
| Shelley Berkley | Democratic | NV |
| Shelley Moore Capito | Republican | WV |
| Steve Austria | Republican | OH |
| Steve Chabot | Republican | OH |
| Steve Stivers | Republican | OH |
| Steven C. LaTourette | Republican | OH |
| Sue Wilkins Myrick | Republican | NC |
| Thomas E. Petri | Republican | WI |
| Walter B. Jones | Republican | NC |
Client expense: $259,678 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), President of the U.S., SENATE
Client expense: $106,421 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), President of the U.S., SENATE
2012 · fourth_quarter · Taxation/Internal Revenue Code
H.R.369, Health Savings and Affordability Act (Austria) - HSA improvements, H.R. 436, Health Care Cost Reduction Act (Paulsen) - HSA, HRA, FSA provisions, ACA provisions, H.R. 450, Restoring Assistance for Families' and Seniors' Health Expenses Act (Reichert) - repeal of HSA and FSA restrictions, H.R. 524, Restoring Consumer-driven Health Care Act (Quayle) - repeal of HSA restrictions, H.R. 605, Patients' Freedom to Choose Act (Paulsen) - repeal of HSA and FSA restrictions, H.R. 1004, Health Flexible Spending Arrangements Improvements Act (Boustany) -- distribution of unused amounts from a Health FSA, H.R. 1370, Repeal of ACA Premium Tax (Boustany), H.R. 2010, Family and Retirement Health Investment Act (Paulsen) - HSA and FSA improvements, H.R. 2529, Restoring Access to Medication Act (Jenkins) - use of HSA funds and FSA funds to purchase OTC medications, H.R. 5842, Restoring Access to Medication Act (Jenkins) - use of HSA, HRA, and FSA funds for over-the-counter medications, H.R. 5858, Health Savings Accounts Improvements Act (Herger) - HSA provisions, H.R. 6005, Long-Term Care and Retirement Security Act (Courtney) - tax incentives for purchase of LTC insurance, consumer protections, H.R. 6088, Repeal of the Unfair Taxes on Health Care Act (Schweikert) - repeal of ACA premium tax and restrictions on HSAs / FSAs, H.R. 6137, Helping Save Americans' Health Care Choices Act (Fleming) - HSA and FSA provisions, H.R. 6162, Ensuring Women's Access to Free-Market Healthcare Act (Cassidy) - pregnancy-related coverage by HSA plans, S. 312, Patients' Freedom to Choose Act (Hutchison) - repeal of HSA and FSA restrictions, S. 1098, Family and Retirement Health Investment Act (Hatch) - HSA and FSA improvements, S. 1368, Restoring Access to Medication Act (Roberts) - use of HSA funds and FSA funds to purchase OTC medications, S. 1880, Jobs and Premium Protection Act (Barrasso) - repeal of health insurance premium tax, S. 2237, Small Business Jobs and Tax Relief Act (Reid) - amendment to repeal ACA premium tax, S. 2516, the FDA Safety and Innovation Act (Harkin) - pharmaceutical, medical device issues, S. 3187, the FDA Safety and Innovation Act (Harkin) - pharmaceutical, medical device issues.
Client expense: Not reported · Firm income: $60,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2012 · fourth_quarter · Taxation/Internal Revenue Code
Flexible spending arrangements (FSA) and health savings accounts (HSA) H.R. 2529/S. 1368 - Restoring Access to Medication Act. Repeals prohibition in Patient Protection and Affordable Care Act (P.L. 111-148, P.L. 111-152) against use of flexible spending arrangement (FSA) and health savings account (HSA) funds on over-the-counter medications; all sections. H.R. 2529 reintroduced as H.R. 5842, then included in House consideration and approval of H.R. 436 - Health Care Cost Reduction Act; Section 3. H.R. 605/S. 312 - Patients' Freedom to Choose Act. Repeals prohibition in Patient Protection and Affordable Care Act (P.L. 111-148, P.L. 111-152) against use of flexible spending arrangement (FSA) and health savings account (HSA) funds on over-the-counter medications; all sections. H.R. 2010/S. 1098 - Family and Retirement Health Investment Act of 2011. Repeals prohibition in Patient Protection and Affordable Care Act (P.L. 111-148, P.L. 111-152) against use of flexible spending arrangement (FSA) and health savings account (HSA) funds on over-the-counter medications; all sections.
Client expense: $170,000 · Firm income: Not reported
Government targets: Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Office of Natl Drug Control Policy (NDCP), SENATE
2012 · fourth_quarter · Taxation/Internal Revenue Code
H.R.369, Health Savings and Affordability Act (Austria) HSA improvements 16. Specific Lobbying Issues (continued): H.R. 436, Health Care Cost Reduction Act (Paulsen) HSA, HRA, FSA provisions, ACA provisions H.R. 450, Restoring Assistance for Families' and Seniors' Health Expenses Act (Reichert) repeal of HSA and FSA restrictions H.R. 524, Restoring Consumer-driven Health Care Act (Quayle) repeal of HSA restrictions H.R. 605, Patients' Freedom to Choose Act (Paulsen) repeal of HSA and FSA restrictions H.R. 1004, Health Flexible Spending Arrangements Improvements Act (Boustany) -- distribution of unused amounts from a Health FSA H.R. 1370, Repeal of ACA Premium Tax (Boustany) H.R. 2010, Family and Retirement Health Investment Act (Paulsen) HSA and FSA improvements H.R. 2529, Restoring Access to Medication Act (Jenkins) use of HSA funds and FSA funds to purchase OTC medications H.R. 5842, Restoring Access to Medication Act (Jenkins) use of HSA, HRA, and FSA funds for over-the-counter medications H.R. 5858, Health Savings Accounts Improvements Act (Herger) HSA provisions H.R. 6005, Long-Term Care and Retirement Security Act (Courtney) tax incentives for purchase of LTC insurance, consumer protections H.R. 6088, Repeal of the Unfair Taxes on Health Care Act (Schweikert) repeal of ACA premium tax and restrictions on HSAs / FSAs H.R. 6137, Helping Save Americans' Health Care Choices Act (Fleming) HSA and FSA provisions H.R. 6162, Ensuring Women's Access to Free-Market Healthcare Act (Cassidy) pregnancy-related coverage by HSA plans S. 312, Patients' Freedom to Choose Act (Hutchison) repeal of HSA and FSA restrictions S. 1098, Family and Retirement Health Investment Act (Hatch) HSA and FSA improvements S. 1368, Restoring Access to Medication Act (Roberts) use of HSA funds and FSA funds to purchase OTC medications S. 1880, Jobs and Premium Protection Act (Barrasso) repeal of health insurance premium tax S. 2237, Small Business Jobs and Tax Relief Act (Reid) amendment to repeal ACA premium tax S. 2516, the FDA Safety and Innovation Act (Harkin) pharmaceutical, medical device issues S. 3187, the FDA Safety and Innovation Act (Harkin) pharmaceutical, medical device issues Regulatory Issues: Annual insurer provider fees; issues concerning the patient-centered outcomes research fee; employer coverage mandate, W-2 reporting requirements, health insurer fee, and other issues relating to health care reform implementation.
Client expense: $2,020,000 · Firm income: Not reported
Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Federal Bureau of Investigation (FBI), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Pension & Welfare Benefits Administration, SENATE, Treasury, Dept of, White House Office
2012 · fourth_quarter · Taxation/Internal Revenue Code
- Issues regarding tax reform. - HR 605, "The Patients' Freedom to Choose Act", regarding all provisions. - HR 436, "Protect Medical Innovation Act of 2011", regarding all provisions. - HR 488, "Save Our Medical Devices Act of 2011", regarding all provisions. - HR 734, "To amend the Internal Revenue Code of 1986 to repeal the medical device tax, and for other purposes", regarding all provisions. - S 17, "Medical Device Access and Innovation Protection Act", regarding all provisions. - S 262, "A bill to repeal the excise tax on medical device manufacturers", regarding all provisions. - HR 942, "American Research and Competitiveness Act of 2011", regarding all provisions - Issues related to tax legislation. - Issues related to the President's proposed "Job Bill" (2011) - S 1368/ HR 2529, "Restoring Access to Medication Act", regarding all provisions. - S 1584, "Drug Safety and Accountability Act of 2011", regarding all provisions. - HR 2245, "Preserving Access to Life-Saving Medication Act", regarding all provisions. - Issues related to Ways and Means tax reform discussion draft. - HR 2735, "To amend the Internal Revenue Code of 1986 to make permanent the look-through treatment of payments between related controlled foreign corporations", regarding all provisions. - S 1577, "Greater Research Opportunities With Tax Help Act", regarding all provisions. - PL 112-96, "Middle Class Tax Relief and Job Creation Act of 2012", provisions regarding Medicare clinical laboratory services. - HR 1864, "Mobile Workforce State Income Tax Simplification Act of 2011", regarding all provisions. - S 2091, "United States Job Creation and International Tax Reform Act of 2012", regarding all provisions.
Client expense: $880,000 · Firm income: Not reported
Government targets: Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, SENATE, U.S. Trade Representative (USTR)
2012 · fourth_quarter · Health Issues
H.R. 2, Repealing the Job-Killing Health Care Law Act H.R. 4, Small Business Paperwork Mandate Elimination Act of 2011 H.R. 5, Protecting Access to Healthcare Act H.R. 436, Health Care Cost Reduction Act of 2012 H.R. 450, Restoring Assistance for Families and Seniors Health Expenses Act of 2011 H.R. 452, Medicare Decisions Accountability Act of 2011 H.R. 605 / S. 312, Patients Freedom Choose Act H.R. 1051, Medicare Beneficiary Freedom to Choose Act of 2011 H.R. 1173, Fiscal Responsibility and Retirement Security Act of 2011 H.R. 1370, To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act. H.R. 1509, Medicare Identity Theft Prevention Act of 2011 H.R. 1744 / S. 20, American Job Protection Act H.R. 1845 / S. 960, Medicare IVIG Access Act H.R. 2010, Family and Retirement Health Investment Act of 2011 H.R. 2077, MLR Repeal Act of 2011 H.R. 2529 / S.1368, Restoring Access to Medication Act H.R. 2590, Seniors Protection Act of 2011 H.R. 2676, Small Business Health Relief Act of 2011 H.R. 3682, Patient Centered Healthcare Savings Act of 2011 H.R. 4095 / S. 2002, Online Pharmacy Safety Act H.R. 4626, Health Insurance Fair Competition Act H.R. 5141/S. 3578, Small Business Paperwork Mandate Elimination Act H.R. 5651, Food and Drug Administration Reform Act of 2012 H.R. 5842, Restoring Access to Medication Act of 2012 H.R. 5853, Fiscal Responsibility and Retirement Security Act H.R. 5906, To amend the Internal Revenue Code of 1986 to repeal the excise tax on medical devices H.R. 6048, Healthcare Tax Relief and Mandate Repeal Act S. 17, Medical Device Access and Innovation Protection Act S. 312, Patients Freedom to Choose Act S. 510, FDA Food Safety Modernization Act, including provisions relating to 1099 reporting amendments S. 668, Health Care Bureaucrats Elimination Act S. 720, Repeal the CLASS Entitlement Act S. 848, Consumer Information Enhancement Act of 2011 S. 1049, Small Business Health Relief Act of 2011 S. 1098, Family and Retirement Health Investment Act of 2011 S. 1880, Jobs and Premium Protection Act S. 2068, Access to Independent Health Insurance Advisors Act of 2012 S. 3187, Food and Drug Administration Safety and Innovation Act S. 3501, American Job Protection Act S. 3673, Patients Freedom Choice Act Notice of Proposed Rulemaking and Notice of Public Hearing Regarding Fees on Health Insurance Policies and Self-Insured Plans for the Patient-Centered Outcomes Research Trust Fund (77 Fed. Reg. 22691-22706, Apr. 17, 2012) Notice and Request for Comments on Minimum Value of an Employer-Sponsored Plan (Notice 2012-31, Apr. 26, 2012) Request for Information Regarding Stop Loss Coverage (77 Fed. Reg. 25788-25790, May 1, 2012) Notice and Request for Comments on Reporting of Health Insurance Coverage (Notice 2012-32, May 14, 2012) Notice and Request for Comments on Reporting by Applicable Large Employers on Health Insurance Coverage Under Employer-Sponsored Plans (Notice 2012-33, May 14, 2012) Final Regulations on Health Insurance Premium Tax Credit (77 Fed. Reg. 30377-30400, May 23, 2012 (to be codified at 26 C.F.R. pts 1 and 602)) Notice and Request for Comments on Health Flexible Spending Arrangements (Notice 2012-40, May 30, 2012) Notice and Request for Comments on the Guidance on 90-Day Waiting Period Limitation (DOL Technical Release 2012-02, Aug. 31, 2012) Notice and Request for Comments on Determining Full-Time Employees For Purposes of Shared Responsibility for Employers Regarding Health Coverage (Notice 2012-58, Aug. 31, 2012) Proposed Regulation on the Patient Protection and Affordable Care Act; Standards Related to Essential Health Benefits, Actuarial Value, and Accreditation (77 Fed. Reg. 70,644-70,676, November 26, 2012 (to be codified at 45 CFR pts 147, 155, and 156)) Proposed Rule on the Health Insurance Market Rules; Rate Review (77 Fed. Reg. 70,584-70,617, November 26, 2012 (to be codified at 45 CFR pts 144, 147, and 150)) Proposed Rule on the HHS Notice of Benefit and Payment Parameters for 2014 (77 Fed. Reg. 73,118-73,218, December 7, 2012 (to be codified at 45 CFR pts 153, 155, 156, 157 and 158)) Various issues relating to the implementation of the Patient Protection and Affordable Care Act (P.L. 111-148), including implementation of regulatory process, legislative corrections, coverage, financing, delivery reform, 1099 reporting, Grandfathering, HSA and FSA changes, CMS claims database, IPAB, CLASS program, employer mandate, medical loss ratio, medical malpractice reform, exchanges, and flexible spending accounts and health savings accounts; regulatory process and legislative corrections to Health Care and Education Affordability Reconciliation Act of 2010 (P.L. 111-152), including ERISA preemption and the impact on small business
Client expense: $29,510,000 · Firm income: Not reported
Government targets: Agriculture, Dept of (USDA), Commerce, Dept of (DOC), Commodity Futures Trading Commission (CFTC), Defense, Dept of (DOD), Education, Dept of, Energy, Dept of, Environmental Protection Agency (EPA), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Federal Deposit Insurance Corporation (FDIC), Federal Highway Administration (FHA), Federal Reserve System, Federal Trade Commission (FTC), Federal Transit Administration (FTA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Interior, Dept of (DOI), Justice, Dept of (DOJ), Labor, Dept of (DOL), Maritime Administration (MARAD), Natl Economic Council (NEC), Natl Institute of Standards & Technology (NIST), Natl Labor Relations Board (NLRB), Natl Security Council (NSC), Office of Management & Budget (OMB), Patent & Trademark Office (PTO), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Small Business Administration (SBA), State, Dept of (DOS), Transportation Security Administration (TSA), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Copyright Office, U.S. Customs & Border Protection, U.S. Trade Representative (USTR), White House Office
2012 · fourth_quarter · Health Issues
HR. 1744, American Job Protection Act, all provisions related to employer mandate. HR. 2206, Auto Enroll Repeal Act, all provisions related to auto-enrollment. HR. 2529 / S. 1368, Restoring Access to Medication Act, all provisions related to over-the-counter (OTC) medicine purchases with flexible spending account (FSA) debit cards.
Client expense: $8,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2012 · fourth_quarter · Taxation/Internal Revenue Code
H.R. 2529: Restoring Access to Medication Act.
Client expense: Not reported · Firm income: $30,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2012 · fourth_quarter · Taxation/Internal Revenue Code
H.R.2529/S.1368, Restoring Access to Medication Act. Issues related to insuring access to over-the-counter drugs and Flexible Spending Accounts/Health Savings Accounts.
Client expense: Not reported · Firm income: $20,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2012 · fourth_quarter · Health Issues
Various issues related to the Patient Protection and Affordable Care Act (P.L. 111-148) and Health Care and Education Reconciliation Act of 2010 (P.L. 111-152); H.R. 1744/S. 20 employer mandate repeal; H.R. 1063/S. 1718 Medicare Secondary Payer reform; H.R. 2206 auto enrollment repeal; consumer directed health products; H.R. 436; H.R. 5842; H.R. 2529; H.R. 1004; H.R. 5858; H.R. 2010; S. 1098; S. 1368; H.R. 605; S. 312; H.R. 450
Client expense: $1,010,000 · Firm income: Not reported
Government targets: Commerce, Dept of (DOC), Consumer Product Safety Commission (CPSC), Equal Employment Opportunity Commission (EEOC), Federal Reserve System, Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Labor Relations Board (NLRB), Office of Management & Budget (OMB), Office of the Comptroller of the Currency (OCC), SENATE, Securities & Exchange Commission (SEC), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Customs & Border Protection, U.S. International Trade Commission (ITC), U.S. Trade Representative (USTR), White House Office
2012 · fourth_quarter · Health Issues
H.R. 1513 and S.810 - Great Ape Protection and Cost Savings Act, provisions related to pre-clinical testing H.R. 1930 and S. 1799 - Access to Appropriate Immunizations for Veterans Act of 2011, provisions related to extending VA performance measure to include all federally recommended vaccine H.R. 2245, S. 296 - Preserving Access to Life-Savings Medicines Act of 2011, provisions related to drug shortages H.R. 2405 and S. 1855 - Pandemic and All Hazards Preparedness Act, provisions relating to influenza vaccine innovative technologies H.R. 2529 and S. 1368 - Restoring Access to Medication Act, provisions relating to reimbursement of OTC drugs under flexible spending and health savings accounts H.R. 2674 - 340B Program Improvement Act, provisions related to the 340B program H.R. 4132 - FAST Act, provisions related to accelerated approval and other FDA matters H.R. 4156 amd S. 2281 - Expanding and Promoting Expertise in Rare Treatments Act of 2012, provisions related to strengthening the FDA's ability to seek advice from external experts regarding rare diseases H.R. 4223 and S. 1002 - Strengthening and Focusing Enforcement to Deter Organized Stealing and Enhance Safety Act (SAFE DOSES), provisions related to supply chain security H.R. 4274 - BPCA and PREA Reauthorization Act of 2012, Provisions related to amending title IV of the Public Health Service Act and title V of the Federal Food, Drug, and Cosmetic Act to permanently extend the provisions of the Best Pharmaceuticals for Children Act and the Pediatric Research Equity Act H.R. 5651 - Food and Drug Administration Reform Act of 2012, provisions related to user fee reauthorization and FDA reform H.R. 6190 - Asthma Inhalers Relief Act of 2012, provisions relating to the removal of Essential-Use Designation for epinephrine H.R. 6611 - Patients Access to Drugs in Shortage Act of 2012, provisions to promote public notification and provide incentives to reduce drug shortages S. 1584 - Drug Safety and Accountability Act of 2011, provisions related to drug safety S. 1699- Prescription Drug Cost Reduction Act, provisions related to 340B and drug rebates S. 1752 - Freedom to Breath Act of 2011, provisions relating to the removal of Essential-Use Designation for epinephrine S. 2113 - Transforming the Regulatory Environment to Accelerate Access to Treatments (TREAT) Act, provisions related to accelerated approval and other FDA matters S. 2236 - Advancing Breakthrough Therapies for Patients Act of 2012, provisions related to FDA regulation S. 2281 - Expanding and Promoting Expertise in Rare Treatments Act, provisions related to FDA regulation S. 2289 - The Better Pharmaceuticals and Devices for Children Act, provisions related to amending the Federal Food, Drug, and Cosmetic Act with respect to pediatric provisions S. 3187 - Food and Drug Administration Safety and Innovation Act of 2012, provisions related to user fee reauthorization and FDA reform PL 111-148, PL 111-152 - Patient Protection and Affordable Care Act, ACA implementation, Independent Payment Advisory Board (IPAB), comparative effectiveness, health information technology, disease prevention/wellness, sunshine and innovation provisions Federal Food, Drug, and Cosmetic Act, section related to FDA and regulation of nicotine replacement therapies Comparative effectiveness policy issues H.R. 6687, To amend the Internal Revenue Code of 1986 to include vaccines against seasonal influenza within the definition of taxable vaccines
Client expense: $1,370,000 · Firm income: Not reported
Government targets: Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, SENATE, U.S. Trade Representative (USTR), White House Office
2012 · fourth_quarter · Health Issues
Advocated as part of Health Choices Coalition in favor of H.R. 2529 and S. 1368 allowing use of flexible spending accounts to purchase over-the-coalition medications.
Client expense: $180,000 · Firm income: Not reported
Government targets: Army, Dept of (Other), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Office of Government Ethics (OGE), SENATE, White House Office
2012 · fourth_quarter · Taxation/Internal Revenue Code
H.R. 605, Patients' Freedom to Choose Act S. 312, Patients' Freedom to Choose Act H.R. 450, Restoring Assistance for Families and Seniors Health Expenses Act of 2011 H.R. 2529, Restoring Access to Medication Act S. 1098, Family and Retirement Health Investment Act of 2011 S. 1368, Restoring Access to Medication Act H.R. 2010, Family and Retirement Health Investment Act of 2011
Client expense: $440,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Federal Reserve System, Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), SENATE
2012 · fourth_quarter · Health Issues
Health Care Reform regulatory implementation and compliance issues from the Patient Protection and Affordable Care Act (PPACA) Public Law No: 111-148 & the Health Care and Education Reconciliation Act of 2010 (HCERA) Public Law No: 111-152 Health Flexible Spending Arrangements Improvements Act of 2012 H.R. 1004 Medicare Beneficiary Freedom to Choose Act of 2011 H.R. 1051 Preserving our Hometown Independent Pharmacies Act of 2011 H.R. 1946 Family and Retirement Health Investment Act of 2011 H.R. 2010 Tax Parity for Health Plan Beneficiaries Act of 2011 H.R. 2088/S. 1171 Restoring Access to Medication Act of 2012 H.R. 2529/5842 Health Savings Accounts Improvements Act of 2012 H.R. 5858 Empowering States to Innovate Act S. 248 Patients Freedom to Choose Act S. 312 Family and Retirement Health Investment Act S. 1098 Other Issues Health care provider compensation Internal Revenue Code Section 162 (m) (6) Electronic disclosure, communication by employee benefit plans Consumer directed health care plans HDHPs, HSAs, HRAs FSA Plan Year Limit transition guidance Mental Health Parity Rules
Client expense: $328,952 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Commodity Futures Trading Commission (CFTC), Equal Employment Opportunity Commission (EEOC), Federal Accounting Standards Advisory Board (FASAB), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Treasury, Dept of, White House Office
2012 · fourth_quarter · Health Issues
Preserving Access to Primary Care Services: Address the shortage of primary care physicians; designate primary care as a shortage profession; provide scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas; provide grants for medical school mentorship programs and primary care training in community health centers; increase Title VII funding for primary care health programs; increase funding for the National Health Service Corps, provide regulatory relief for primary care physicians; H.R. 7192/S. 1174, the Preserving Patient Access to Primary Care Act (111th Congress). Support Implementation and Improvement of the Affordable Care Act (P.L. 111-148, P.L. 111-152) by: Expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; Ensuring access to primary care physicians; and beginning to bend the cost curve; Prohibiting insurers from excluding or charging excessive rates to children based on pre-existing conditions, which later will be expanded to all persons; Covering young adults on their parents' plans; Eliminating lifetime and annual limits on health insurance coverage; Requiring that health insurers spend more on patient care and less on administration; support enactment of S. 248, the Empowering States to Innovate Act, which amends the Patient Protection and Affordable Care Act (ACA) to: (1) allow states to apply for waivers of certain health insurance coverage requirements in such Act (including requirements for the establishment of qualified health plans and health insurance exchanges) for plan years beginning on or after January 1, 2014 (currently, January 1, 2017), and (2) require the waiver application process to begin not later than 180 days after the enactment of this Act; Phasing out the Medicare Part D doughnut hole; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Establishing a new Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Creating a new Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes; Training more primary care physicians through the National Health Service Corps, Title VII health professions funding, and redistributing unused graduate medical education positions to primary care specialties facing shortages; Beginning in 2014, ensuring that nearly all Americans have access to coverage either through subsidized private health insurance offered by state health exchanges or through Medicaid, if they don't already have access to coverage through an employer, Medicare, or another public program. Medicare Physician Payment Reform: Increase Medicare Fee Schedule payments to make primary care competitive in the market with other physician career and specialty choices; create a fast track authority to develop and implement new physician payment models that better align payment with effective, efficient, patient-centered care such as the Patient Centered Medical Home; provide a voluntary shared savings program, Accountable Care Organizations, that promotes accountability for services delivered to a defined Medicare fee-for-service (FFS) patient population with the goals of increasing the quality and efficiency of services delivered; provide separate Medicare payment for specific care coordination services provided principally by primary care physicians; revise Medicare budget neutrality rules to recognize the value of primary care in reducing Medicare baseline spending; increase the accuracy of physician work relative value units under the Medicare physician fee schedule; improve the accuracy of practice expense RVUs under the Medicare Fee Schedule; increase Medicare bonus payments for primary care services provided in designated shortage areas; provide stable, positive, predictable updates under Medicares reimbursement formula; and replacing the Sustainable Growth Rate (SGR) formula with a long term solution that provides for stable, predictable updates for physicians (H.R. 3961). Specifically, beginning in April 2011, urged Congress to enact legislation that would provide stable payments for all physician specialties for at least five years while providing higher updates for undervalued evaluation and management services, require that different payment models (including Patient-Centered Medical Homes) be pilot-tested on a voluntary basis during the five year period of stable payments, and designate a specific transition period for broad adoption of the new models that have been shown to be the most effective based on the pilots. Urged action on legislation to provide stability and predictability for the Medicare physician payments at least through 2011; The Medicare and Medicaid Extenders Act of 2010, H.R. 4994, prevents the 25 percent physician payment cuts under Medicare, brought on by the flawed Sustainable Growth Rate (SGR) formula, from going into effect on Jan.1, 2011, and continues current rates through Dec. 31, 2011; Advocated for a proposal released by Rep. Allyson Schwartz (D-PA) in Nov 2011 that would eliminate Medicare's flawed SGR formula and transition to new physician payment models that are aligned with value; Advocated for repealing the SGR and using the Overseas Contingency Operation (OCO) funds to offset the cost. Urged enactment of the Medicare Physician Payment Innovation Act (H.R. 5707), as introduced on May 9 by Representatives Allyson Schwartz (D-PA) and Joe Heck (R-NV). This legislation would eliminate the SGR once and for all and transition to better payment and delivery systems that are aligned with value. Specifically, H.R. 5707 would repeal the SGR formula, provide more than 5 years of stable physician payments, with positive increases for all physician services, and higher payments for primary care, preventive and care coordination services, and establishes a process for practices to transition to new, more effective, models of care by 2018. In July 2012 testimony; advocated for the Patient-Centered Medical Home model should be scaled up for broad Medicare adoption, recognized, through the medical neighborhood concept, that specialty and subspecialty practices, hospitals, and other healthcare professionals and entities that provide treatment to the patient need to be recognized and provided with incentivesboth non-financial and financialfor engaging in patient-centered practices that complement and support the efforts of the PCMH to provide high quality, efficient, coordinated care; advocated for ACPs High Value, Cost-Conscious Care Initiative, which includes clinical, public policy, and educational components, designed to help physicians and patients understand the benefits, harms, and costs of an intervention and whether it provides good value, as well as to slow the unsustainable rate of health care cost increases while preserving high-value, high-quality care. Advocated for halting the 26.5 percent cut in physician payments resulting from the flawed SGR formula, which was scheduled to take effect on January 1, 2013. Sequestration: October through December 2012, advocated strongly that Congress develop and pass a fiscally responsible, bipartisan agreement to prevent the implementation of across-the-board budget sequestration cuts that would endanger critical programs related to medical research, public health, workforce, food and drug safety, and health care for military families, as well as trigger cuts in Medicare payments to physicians and graduate medical education programs that will endanger patient access to care. Instead, policymakers should embrace an alternative approach that addresses the true cost drivers behind rising health care costs. They should work to improve the effectiveness of care provided, make necessary and appropriate changes in entitlement programs, including Medicare cost-sharing, reform payment and delivery systems, and support the proven value of primary care. Medical Education: Provide incentives to medical schools, community health centers, or hospitals, to increase the numbers of physicians choosing primary care; authorize HHS to selectively eliminate Graduate Medical Education (GME) caps for residency programs in primary care, advocated for S. 1627, which would increase the number of Medicare-supported training positions for medical residents by 15 percent (approximately 15,000 slots) over five years, requiring at least 50 percent of the new positions to be allocated to specialties facing a current shortage. Appropriations for FY 2013: Advocated for the highest level of funding possible for the Labor-HHS-Education bill within the discretionary cap established by the Budget Control Act (BCA); Supported $520 million for Title VII Health Professions and Title VIII Nursing Programs to the House and Senate Labor-HHS-Education Appropriations Subcommittees; Supported $400 million to "improve health care quality, enhance consumer choice, advance patient safety, improve efficiency, reduce medical errors, and broaden access to essential services; Advocated for a base, discretionary budget of $400 million in FY 2013 for AHRQ; Advocated for at least $7.0 billion for the Health Resources and Services Administration (HRSA); Specifically, the College supported Title VII, Section 747, Primary Care Training and Enhancement, at no less than $71 million; National Health Service Corps, $535,087,442 million in discretionary funding, in addition to the $300 million in enhanced funding through the Community Health Centers Fund; National Health Care Workforce Commission, $3 million; and Centers for Medicare and Medicaid Services, Operations and Management of Exchanges, $574.5 million. Fund the National Institutes of Health (NIH), at $32 billion, which represents the minimum investment necessary to avoid further loss of promising research and at the same time allows the NIH's budget to keep pace with biomedical inflation. Fund the Centers for Disease Control (CDC), at $7.8 billion, which reflects the minimal amount CDC will need to fulfill its core missions for fiscal year 2013, which are essential to protect the health of the American people. Preserve funding for GME in FY 2013; Urged Congress not to terminate AHRQ. Public Health Programs and Funding: Increase funding to accomplish the core missions and activities of the major federal public health agencies, including: biomedical and behavioral research, disease prevention and health promotion, access to safety net health care services, health professions education, mental health and substance abuse, health services research, health care for American Indians and Alaska natives, food and drug safety. Improving Access to Primary Care in the Context of Comprehensive Healthcare Reform Legislation (H.R. 3962/H.R. 3590/H.R. 4872): Ensure that all Americans will have access to affordable coverage. Provide sliding scale subsidies based on income to buy coverage from qualified plans; Qualified plans should: provide evidence-based benefits, including preventive services; and be prohibited from excluding persons with pre-existing conditions, charging them more, cherry-picking enrollees, or cancelling or failing to renew coverage; Expand Medicaid to cover all persons at or below 133 percent of the Federal Poverty Level and ensure fair payments to participating physicians, as enacted in the ACA; As coverage becomes affordable, all persons should participate and coverage should be guaranteed; Responsibility for financing should be shared by individuals, employers and government. Regarding the Essential Health Benefits Bulletin, issued by the Department of Health and Human Services (HHS) on December 16, 2011, the College advocated for striking a balance between comprehensiveness and affordability while giving States some freedom to determine a package that best serve the needs of residents. The College believes that strong oversight is needed when determining the initial benchmark plan (and whether it reflects the coverage requirements of the Affordable Care Act) and how the package will be updated, particularly if insurers are given the ability to substitute benefits within and across categories. State and the federal government must work in concert with physicians, health care providers and payers to determine and promote use of clinically effective and cost-effective services that result in improved patient health while bending the cost curve. Essential Health Benefits: Commented on the proposed rule regarding essential benefits, actuarial value, and accreditation as issued by the U.S. Department of Health & Human Services on November 20, 2012; Advocated that strong oversight is needed when determining the initial benchmark plan (and whether it reflects the coverage requirements of the Affordable Care Act) and how the package will be updated, particularly if insurers are given the ability to substitute benefits within categories. State and the federal government must work in concert with physicians, health care providers and payers to determine and promote use of clinically effective and cost-effective services that result in improved patient health while bending the cost curve. Pilot test new Medicare payment models that re-align incentives to support effective, efficient, patient-centered, coordinated care. Priority should be given to models designed to support the value of services provided by primary care physicians as well as to models that would create incentives, across physician specialties and sites of services, to improve the quality, effectiveness, and efficiency of care provided. Policy criteria for selecting the most promising models for pilot testing should be developed, in consultation with outside experts; The Patient-Centered Medical Home (PCMH), which has shown great promise in meeting the policy objectives suggested above, should be among the models selected for broader testing on a national pilot basis; the establishing of a new CMS Innovation Center to pilot-test new payment models, such as the medical home; the use of the medical home model for treatment or services under private health plans, the requirement of health plans to provide incentives to promote and report on medical home services provided, the establishment of community health teams and a primary care extension program to educate and support primary care practices in the delivery of medical home services, and the establishment of a demonstration project to educate physicians and other clinicians in training in the competencies required to deliver care consistent with the medical home care model. National workforce policy to ensure sufficient numbers of primary care and other physicians: Urged support for a national workforce commission to recommend national goals relating to the numbers and distribution of physicians and other health care professionals, including increasing the supply of primary care physicians; Fully fund the commission at levels authorized in the Affordable Care Act; Increase the number of Medicare-funded graduate medical education positions available each year in adult primary care specialties; Provide new loan repayment and medical school scholarship programs in exchange for primary care service in critical shortage health facilities, or in critical shortage areas of the country; Increase funding for scholarships and loan repayment programs under Title VII as well as increase funding for the National Health Service Corps (NHSC); Provide new practice-entry bonus for scholarship or loan repayment award recipients who remain in underserved communities after completion of service obligation. Reform the medical liability system and the enormous costs associated with frivolous lawsuits and defensive medicine: Impose caps on non-economic damages; and test and fund new models--like health courts, which would have cases heard by an expert panel rather than by a lay jury; Urge enactment of H.R. 5, the HEALTH Act, as initially introduced, which would set national standards for medical malpractice, including a $250,000 cap on non-economic damages. The Restoring Access to Medication Act (H.R. 2529): Advocated for this legislation that overturns the restrictions placed on tax-preferred accounts reimbursing for over-the-counter (OTC) medicines without first getting a prescription. This legislation will restore efficiencies in the healthcare system and consumer access to vital, frontline medicines that were disrupted by ACA. The Primary Care Workforce Access and Improvement Act of 2011 (H.R. 3667): Supported this legislation that would authorize the Secretary of Health and Human Services (HHS) to conduct a five year Medicare pilot project that would direct a share of Graduate Medical Education funding to medical education entities to test different models of primary care training. This legislation, H.R. 3667, would give the Secretary of HHS the authority to test new models of care that demonstrate the capability of improving the quality, quantity, and distribution of primary care physicians. Physician Fee Schedule/August 2012: Advocated on an on-going basis that policies to improve payment for undervalued evaluation and management services should not be restricted to a designated subset of specialties (as defined by their self-designation) or impose other restrictive criteria that could exclude physicians who legitimately and appropriately provide such services to their patients. Rather, the objective should be to pay more appropriately for evaluation and care coordination services that bring value to the patient, no matter the specialty of the physician who is billing for the service.
Client expense: $254,554 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), President of the U.S., SENATE
2012 · fourth_quarter · Health Issues
Preserving Access to Primary Care Services: Address the shortage of primary care physicians; designate primary care as a shortage profession; provide scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas; provide grants for medical school mentorship programs and primary care training in community health centers; increase Title VII funding for primary care health programs; increase funding for the National Health Service Corps, provide regulatory relief for primary care physicians; H.R. 7192/S. 1174, the Preserving Patient Access to Primary Care Act (111th Congress). Support Implementation and Improvement of the Affordable Care Act (P.L. 111-148, P.L. 111-152) by: Expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; Ensuring access to primary care physicians; and beginning to bend the cost curve; Prohibiting insurers from excluding or charging excessive rates to children based on pre-existing conditions, which later will be expanded to all persons; Covering young adults on their parents' plans; Eliminating lifetime and annual limits on health insurance coverage; Requiring that health insurers spend more on patient care and less on administration; support enactment of S. 248, the Empowering States to Innovate Act, which amends the Patient Protection and Affordable Care Act (ACA) to: (1) allow states to apply for waivers of certain health insurance coverage requirements in such Act (including requirements for the establishment of qualified health plans and health insurance exchanges) for plan years beginning on or after January 1, 2014 (currently, January 1, 2017), and (2) require the waiver application process to begin not later than 180 days after the enactment of this Act; Phasing out the Medicare Part D doughnut hole; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Establishing a new Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Creating a new Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes; Training more primary care physicians through the National Health Service Corps, Title VII health professions funding, and redistributing unused graduate medical education positions to primary care specialties facing shortages; Beginning in 2014, ensuring that nearly all Americans have access to coverage either through subsidized private health insurance offered by state health exchanges or through Medicaid, if they don't already have access to coverage through an employer, Medicare, or another public program. Medicare Physician Payment Reform: Increase Medicare Fee Schedule payments to make primary care competitive in the market with other physician career and specialty choices; create a fast track authority to develop and implement new physician payment models that better align payment with effective, efficient, patient-centered care such as the Patient Centered Medical Home; provide a voluntary shared savings program, Accountable Care Organizations, that promotes accountability for services delivered to a defined Medicare fee-for-service (FFS) patient population with the goals of increasing the quality and efficiency of services delivered; provide separate Medicare payment for specific care coordination services provided principally by primary care physicians; revise Medicare budget neutrality rules to recognize the value of primary care in reducing Medicare baseline spending; increase the accuracy of physician work relative value units under the Medicare physician fee schedule; improve the accuracy of practice expense RVUs under the Medicare Fee Schedule; increase Medicare bonus payments for primary care services provided in designated shortage areas; provide stable, positive, predictable updates under Medicares reimbursement formula; and replacing the Sustainable Growth Rate (SGR) formula with a long term solution that provides for stable, predictable updates for physicians (H.R. 3961). Specifically, beginning in April 2011, urged Congress to enact legislation that would provide stable payments for all physician specialties for at least five years while providing higher updates for undervalued evaluation and management services, require that different payment models (including Patient-Centered Medical Homes) be pilot-tested on a voluntary basis during the five year period of stable payments, and designate a specific transition period for broad adoption of the new models that have been shown to be the most effective based on the pilots. Urged action on legislation to provide stability and predictability for the Medicare physician payments at least through 2011; The Medicare and Medicaid Extenders Act of 2010, H.R. 4994, prevents the 25 percent physician payment cuts under Medicare, brought on by the flawed Sustainable Growth Rate (SGR) formula, from going into effect on Jan.1, 2011, and continues current rates through Dec. 31, 2011; Advocated for a proposal released by Rep. Allyson Schwartz (D-PA) in Nov 2011 that would eliminate Medicare's flawed SGR formula and transition to new physician payment models that are aligned with value; Advocated for repealing the SGR and using the Overseas Contingency Operation (OCO) funds to offset the cost. Urged enactment of the Medicare Physician Payment Innovation Act (H.R. 5707), as introduced on May 9 by Representatives Allyson Schwartz (D-PA) and Joe Heck (R-NV). This legislation would eliminate the SGR once and for all and transition to better payment and delivery systems that are aligned with value. Specifically, H.R. 5707 would repeal the SGR formula, provide more than 5 years of stable physician payments, with positive increases for all physician services, and higher payments for primary care, preventive and care coordination services, and establishes a process for practices to transition to new, more effective, models of care by 2018. In July 2012 testimony; advocated for the Patient-Centered Medical Home model should be scaled up for broad Medicare adoption, recognized, through the medical neighborhood concept, that specialty and subspecialty practices, hospitals, and other healthcare professionals and entities that provide treatment to the patient need to be recognized and provided with incentivesboth non-financial and financialfor engaging in patient-centered practices that complement and support the efforts of the PCMH to provide high quality, efficient, coordinated care; advocated for ACPs High Value, Cost-Conscious Care Initiative, which includes clinical, public policy, and educational components, designed to help physicians and patients understand the benefits, harms, and costs of an intervention and whether it provides good value, as well as to slow the unsustainable rate of health care cost increases while preserving high-value, high-quality care. Advocated for halting the 26.5 percent cut in physician payments resulting from the flawed SGR formula, which was scheduled to take effect on January 1, 2013. Sequestration: October through December 2012, advocated strongly that Congress develop and pass a fiscally responsible, bipartisan agreement to prevent the implementation of across-the-board budget sequestration cuts that would endanger critical programs related to medical research, public health, workforce, food and drug safety, and health care for military families, as well as trigger cuts in Medicare payments to physicians and graduate medical education programs that will endanger patient access to care. Instead, policymakers should embrace an alternative approach that addresses the true cost drivers behind rising health care costs. They should work to improve the effectiveness of care provided, make necessary and appropriate changes in entitlement programs, including Medicare cost-sharing, reform payment and delivery systems, and support the proven value of primary care. Medical Education: Provide incentives to medical schools, community health centers, or hospitals, to increase the numbers of physicians choosing primary care; authorize HHS to selectively eliminate Graduate Medical Education (GME) caps for residency programs in primary care, advocated for S. 1627, which would increase the number of Medicare-supported training positions for medical residents by 15 percent (approximately 15,000 slots) over five years, requiring at least 50 percent of the new positions to be allocated to specialties facing a current shortage. Appropriations for FY 2013: Advocated for the highest level of funding possible for the Labor-HHS-Education bill within the discretionary cap established by the Budget Control Act (BCA); Supported $520 million for Title VII Health Professions and Title VIII Nursing Programs to the House and Senate Labor-HHS-Education Appropriations Subcommittees; Supported $400 million to "improve health care quality, enhance consumer choice, advance patient safety, improve efficiency, reduce medical errors, and broaden access to essential services; Advocated for a base, discretionary budget of $400 million in FY 2013 for AHRQ; Advocated for at least $7.0 billion for the Health Resources and Services Administration (HRSA); Specifically, the College supported Title VII, Section 747, Primary Care Training and Enhancement, at no less than $71 million; National Health Service Corps, $535,087,442 million in discretionary funding, in addition to the $300 million in enhanced funding through the Community Health Centers Fund; National Health Care Workforce Commission, $3 million; and Centers for Medicare and Medicaid Services, Operations and Management of Exchanges, $574.5 million. Fund the National Institutes of Health (NIH), at $32 billion, which represents the minimum investment necessary to avoid further loss of promising research and at the same time allows the NIH's budget to keep pace with biomedical inflation. Fund the Centers for Disease Control (CDC), at $7.8 billion, which reflects the minimal amount CDC will need to fulfill its core missions for fiscal year 2013, which are essential to protect the health of the American people. Preserve funding for GME in FY 2013; Urged Congress not to terminate AHRQ. Public Health Programs and Funding: Increase funding to accomplish the core missions and activities of the major federal public health agencies, including: biomedical and behavioral research, disease prevention and health promotion, access to safety net health care services, health professions education, mental health and substance abuse, health services research, health care for American Indians and Alaska natives, food and drug safety. Improving Access to Primary Care in the Context of Comprehensive Healthcare Reform Legislation (H.R. 3962/H.R. 3590/H.R. 4872): Ensure that all Americans will have access to affordable coverage. Provide sliding scale subsidies based on income to buy coverage from qualified plans; Qualified plans should: provide evidence-based benefits, including preventive services; and be prohibited from excluding persons with pre-existing conditions, charging them more, cherry-picking enrollees, or cancelling or failing to renew coverage; Expand Medicaid to cover all persons at or below 133 percent of the Federal Poverty Level and ensure fair payments to participating physicians, as enacted in the ACA; As coverage becomes affordable, all persons should participate and coverage should be guaranteed; Responsibility for financing should be shared by individuals, employers and government. Regarding the Essential Health Benefits Bulletin, issued by the Department of Health and Human Services (HHS) on December 16, 2011, the College advocated for striking a balance between comprehensiveness and affordability while giving States some freedom to determine a package that best serve the needs of residents. The College believes that strong oversight is needed when determining the initial benchmark plan (and whether it reflects the coverage requirements of the Affordable Care Act) and how the package will be updated, particularly if insurers are given the ability to substitute benefits within and across categories. State and the federal government must work in concert with physicians, health care providers and payers to determine and promote use of clinically effective and cost-effective services that result in improved patient health while bending the cost curve. Essential Health Benefits: Commented on the proposed rule regarding essential benefits, actuarial value, and accreditation as issued by the U.S. Department of Health & Human Services on November 20, 2012; Advocated that strong oversight is needed when determining the initial benchmark plan (and whether it reflects the coverage requirements of the Affordable Care Act) and how the package will be updated, particularly if insurers are given the ability to substitute benefits within categories. State and the federal government must work in concert with physicians, health care providers and payers to determine and promote use of clinically effective and cost-effective services that result in improved patient health while bending the cost curve. Pilot test new Medicare payment models that re-align incentives to support effective, efficient, patient-centered, coordinated care. Priority should be given to models designed to support the value of services provided by primary care physicians as well as to models that would create incentives, across physician specialties and sites of services, to improve the quality, effectiveness, and efficiency of care provided. Policy criteria for selecting the most promising models for pilot testing should be developed, in consultation with outside experts; The Patient-Centered Medical Home (PCMH), which has shown great promise in meeting the policy objectives suggested above, should be among the models selected for broader testing on a national pilot basis; the establishing of a new CMS Innovation Center to pilot-test new payment models, such as the medical home; the use of the medical home model for treatment or services under private health plans, the requirement of health plans to provide incentives to promote and report on medical home services provided, the establishment of community health teams and a primary care extension program to educate and support primary care practices in the delivery of medical home services, and the establishment of a demonstration project to educate physicians and other clinicians in training in the competencies required to deliver care consistent with the medical home care model. National workforce policy to ensure sufficient numbers of primary care and other physicians: Urged support for a national workforce commission to recommend national goals relating to the numbers and distribution of physicians and other health care professionals, including increasing the supply of primary care physicians; Fully fund the commission at levels authorized in the Affordable Care Act; Increase the number of Medicare-funded graduate medical education positions available each year in adult primary care specialties; Provide new loan repayment and medical school scholarship programs in exchange for primary care service in critical shortage health facilities, or in critical shortage areas of the country; Increase funding for scholarships and loan repayment programs under Title VII as well as increase funding for the National Health Service Corps (NHSC); Provide new practice-entry bonus for scholarship or loan repayment award recipients who remain in underserved communities after completion of service obligation. Reform the medical liability system and the enormous costs associated with frivolous lawsuits and defensive medicine: Impose caps on non-economic damages; and test and fund new models--like health courts, which would have cases heard by an expert panel rather than by a lay jury; Urge enactment of H.R. 5, the HEALTH Act, as initially introduced, which would set national standards for medical malpractice, including a $250,000 cap on non-economic damages. The Restoring Access to Medication Act (H.R. 2529): Advocated for this legislation that overturns the restrictions placed on tax-preferred accounts reimbursing for over-the-counter (OTC) medicines without first getting a prescription. This legislation will restore efficiencies in the healthcare system and consumer access to vital, frontline medicines that were disrupted by ACA. The Primary Care Workforce Access and Improvement Act of 2011 (H.R. 3667): Supported this legislation that would authorize the Secretary of Health and Human Services (HHS) to conduct a five year Medicare pilot project that would direct a share of Graduate Medical Education funding to medical education entities to test different models of primary care training. This legislation, H.R. 3667, would give the Secretary of HHS the authority to test new models of care that demonstrate the capability of improving the quality, quantity, and distribution of primary care physicians. Physician Fee Schedule/August 2012: Advocated on an on-going basis that policies to improve payment for undervalued evaluation and management services should not be restricted to a designated subset of specialties (as defined by their self-designation) or impose other restrictive criteria that could exclude physicians who legitimately and appropriately provide such services to their patients. Rather, the objective should be to pay more appropriately for evaluation and care coordination services that bring value to the patient, no matter the specialty of the physician who is billing for the service.
Client expense: $122,487 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), President of the U.S., SENATE
2012 · fourth_quarter · Health Issues
H.R. 605/S. 312 To amend the Patient Protection and Affordable Care Act to repeal provisions that change the treatment of over-the-counter medicines purchased with a Flexible Spending Account debit card. S. 1098/H.R. 2010 To amend the Patient Protection and Affordable Care Act to repeal provisions that change the treatment of over-the-counter medicines purchased with a Flexible Spending Account debit card S. 1368/ H.R. 2529 - Restoring Access to Medication Act H.R. 5842 Restoring Access to Medication Act Patient Protection and Affordable Care Act (P.L. 111148) - Sections 1201, 1301, 1302, 1303, 1304, 1311, 1401, 1411, 1412, 1414, 1502, 1512, 1513, 1514, 4205 Section 4980H H.R. 6174 / S. 3574 - Common Sense Nutrition Disclosure Act of 2012 H.R. 1744 - American Job Protection Act H.R. 2206 - Auto Enroll Repeal Act H.R. 1845 - Medicare IVIG Access and Strengthening Medicare and Repaying Taxpayers Act of 2012 (SMART Act)
Client expense: $160,000 · Firm income: Not reported
Government targets: Agriculture, Dept of (USDA), Executive Office of the President (EOP), Federal Reserve System, 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), Office of Management & Budget (OMB), SENATE, Small Business Administration (SBA), Treasury, Dept of, White House Office
2012 · fourth_quarter · Taxation/Internal Revenue Code
Flexible spending arrangements (FSA) and health savings accounts (HSA) H.R. 2529/S. 1368 - Restoring Access to Medication Act. Repeals prohibition in Patient Protection and Affordable Care Act (P.L. 111-148, P.L. 111-152) against use of flexible spending arrangement (FSA) and health savings account (HSA) funds on over-the-counter medications; all sections. H.R. 2529 reintroduced as H.R. 5842, then included in House consideration and approval of H.R. 436 - Health Care Cost Reduction Act; Section 3. H.R. 605/S. 312 - Patients' Freedom to Choose Act. Repeals prohibition in Patient Protection and Affordable Care Act (P.L. 111-148, P.L. 111-152) against use of flexible spending arrangement (FSA) and health savings account (HSA) funds on over-the-counter medications; all sections. H.R. 2010/S. 1098 - Family and Retirement Health Investment Act of 2011. Repeals prohibition in Patient Protection and Affordable Care Act (P.L. 111-148, P.L. 111-152) against use of flexible spending arrangement (FSA) and health savings account (HSA) funds on over-the-counter medications; all sections.
Client expense: $150,000 · Firm income: Not reported
Government targets: Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Office of Natl Drug Control Policy (NDCP), SENATE
2012 · fourth_quarter · Health Issues
HR 605 Patients Freedom to Choose S. 312 Patients Freedom to Choose HR 2529 Restoring Access to Medication Act; S. 1368 Restoring Access to Medication Act NPLEx policies -- [National Precursor Log Exchange] a real-time electronic logging system used by pharmacies and law enforcement to track sales of Pseudoephedrine
Client expense: Not reported · Firm income: $45,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2012 · third_quarter · Taxation/Internal Revenue Code
Flexible spending arrangements (FSA) and health savings accounts (HSA) H.R. 2529/S. 1368 - Restoring Access to Medication Act. Repeals prohibition in Patient Protection and Affordable Care Act (P.L. 111-148, P.L. 111-152) against use of flexible spending arrangement (FSA) and health savings account (HSA) funds on over-the-counter medications; all sections. H.R. 2529 reintroduced as H.R. 5842, then included in House consideration and approval of H.R. 436 - Health Care Cost Reduction Act; Section 3. H.R. 605/S. 312 - Patients' Freedom to Choose Act. Repeals prohibition in Patient Protection and Affordable Care Act (P.L. 111-148, P.L. 111-152) against use of flexible spending arrangement (FSA) and health savings account (HSA) funds on over-the-counter medications; all sections. H.R. 2010/S. 1098 - Family and Retirement Health Investment Act of 2011. Repeals prohibition in Patient Protection and Affordable Care Act (P.L. 111-148, P.L. 111-152) against use of flexible spending arrangement (FSA) and health savings account (HSA) funds on over-the-counter medications; all sections.
Client expense: $204,598 · Firm income: Not reported
Government targets: Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Office of Natl Drug Control Policy (NDCP), SENATE
2012 · third_quarter · Taxation/Internal Revenue Code
H.R.369, Health Savings and Affordability Act (Austria) - HSA improvements. H.R. 436, Health Care Cost Reduction Act (Paulsen) - HSA, HRA, FSA provisions, ACA provisions. H.R. 450, Restoring Assistance for Families' and Seniors' Health Expenses Act (Reichert) - repeal of HSA and FSA restrictions. H.R. 524, Restoring Consumer-driven Health Care Act (Quayle) - repeal of HSA restrictions. H.R. 605, Patients' Freedom to Choose Act (Paulsen) - repeal of HSA and FSA restrictions. H.R. 1004, Health Flexible Spending Arrangements Improvements Act (Boustany) -- distribution of unused amounts from a Health FSA. H.R. 1370, Repeal of ACA Premium Tax (Boustany). H.R. 2010, Family and Retirement Health Investment Act (Paulsen) - HSA and FSA improvements. H.R. 2529, Restoring Access to Medication Act (Jenkins) - use of HSA funds and FSA funds to purchase OTC medications. H.R. 5842, Restoring Access to Medication Act (Jenkins) - use of HSA, HRA, and FSA funds for over-the-counter medications. H.R. 5858, Health Savings Accounts Improvements Act (Herger) - HSA provisions. H.R. 6005, Long-Term Care and Retirement Security Act (Courtney) - tax incentives for purchase of LTC insurance, consumer protections. H.R. 6088, Repeal of the Unfair Taxes on Health Care Act (Schweikert) - repeal of ACA premium tax and restrictions on HSAs / FSAs. H.R. 6137, Helping Save Americans' Health Care Choices Act (Fleming) - HSA and FSA provisions. H.R. 6162, Ensuring Women's Access to Free-Market Healthcare Act (Cassidy) - pregnancy-related coverage by HSA plans. S. 312, Patients' Freedom to Choose Act (Hutchison) - repeal of HSA and FSA restrictions. S. 1098, Family and Retirement Health Investment Act (Hatch) - HSA and FSA improvements. S. 1368, Restoring Access to Medication Act (Roberts) - use of HSA funds and FSA funds to purchase OTC medications. S. 1880, Jobs and Premium Protection Act (Barrasso) - repeal of health insurance premium tax. S. 2237, Small Business Jobs and Tax Relief Act (Reid) - amendment to repeal ACA premium tax. S. 2516, the FDA Safety and Innovation Act (Harkin) - pharmaceutical, medical device issues. S. 3187, the FDA Safety and Innovation Act (Harkin) - pharmaceutical, medical device issues.
Client expense: Not reported · Firm income: $60,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2012 · third_quarter · Taxation/Internal Revenue Code
- Issues regarding tax reform. - HR 605, "The Patients' Freedom to Choose Act", regarding all provisions. - HR 436, "Protect Medical Innovation Act of 2011", regarding all provisions. - HR 488, "Save Our Medical Devices Act of 2011", regarding all provisions. - HR 734, "To amend the Internal Revenue Code of 1986 to repeal the medical device tax, and for other purposes", regarding all provisions. - S 17, "Medical Device Access and Innovation Protection Act", regarding all provisions. - S 262, "A bill to repeal the excise tax on medical device manufacturers", regarding all provisions. - HR 942, "American Research and Competitiveness Act of 2011", regarding all provisions - Issues related to tax legislation. - Issues related to the President's proposed "Job Bill" (2011) - S 1368/ HR 2529, "Restoring Access to Medication Act", regarding all provisions. - S 1584, "Drug Safety and Accountability Act of 2011", regarding all provisions. - HR 2245, "Preserving Access to Life-Saving Medication Act", regarding all provisions. - Issues related to Ways and Means tax reform discussion draft. - HR 2735, "To amend the Internal Revenue Code of 1986 to make permanent the look-through treatment of payments between related controlled foreign corporations", regarding all provisions. - S 1577, "Greater Research Opportunities With Tax Help Act", regarding all provisions. - PL 112-96, "Middle Class Tax Relief and Job Creation Act of 2012", provisions regarding Medicare clinical laboratory services. - HR 1864, "Mobile Workforce State Income Tax Simplification Act of 2011", regarding all provisions. - S 2091, "United States Job Creation and International Tax Reform Act of 2012", regarding all provisions.
Client expense: $1,420,000 · Firm income: Not reported
Government targets: Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, SENATE, U.S. Trade Representative (USTR)
2012 · third_quarter · Health Issues
H.R. 2, Repealing the Job-Killing Health Care Law Act H.R. 4, Small Business Paperwork Mandate Elimination Act of 2011 H.R. 5, Protecting Access to Healthcare Act H.R. 436, Health Care Cost Reduction Act of 2012 H.R. 450, Restoring Assistance for Families and Seniors Health Expenses Act of 2011 H.R. 452, Medicare Decisions Accountability Act of 2011 H.R. 605 / S. 312, Patients Freedom to Choose Act H.R. 1051, Medicare Beneficiary Freedom to Choose Act of 2011 H.R. 1173, Fiscal Responsibility and Retirement Security Act of 2011 H.R. 1370, To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act H.R. 1744 / S. 20, American Job Protection Act H.R. 2010, Family and Retirement Health Investment Act of 2011 H.R. 2077, MLR Repeal Act of 2011 H.R. 2112, Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, Vitter Amendment (#769 - prescription drug reimportation) H.R. 2529, Restoring Access to Medication Act H.R. 2590, Seniors Protection Act of 2011 H.R. 2676, Small Business Health Relief Act of 2011 H.R. 3487, Job Creation Act of 2011 H.R. 3682, Patient Centered Healthcare Savings Act of 2011 H.R. 4095 / S. 2002, Online Pharmacy Safety Act H.R. 4626, Health Insurance Fair Competition Act H.R. 5141/S. 3578, Small Business Paperwork Mandate Elimination Act H.R. 5651, Food and Drug Administration Reform Act of 2012 H.R. 5842, Restoring Access to Medication Act of 2012 H.R. 5853, Fiscal Responsibility and Retirement Security Act H.R. 6048, Healthcare Tax Relief and Mandate Repeal Act H.R. 6079, Repeal of Obamacare Act S. 17, Medical Device Access and Innovation Protection Act S. 20, American Job Protection Act S. 223, FAA Air Transportation Modernization and Safety Improvement Act, including the Amendment offered by Senator McConnell to repeal P.L. 111-148, the Patient Protection and Affordable Care Act and an Amendment offered by Senator Stabenow which would repeal Section 9006 of the Patient Protection and Affordable Care Act S. 493, SBIR/STTR Reauthorization Act of 2011, including an Amendment offered by Senator Johanns which would fully repeal Section 9006 of the Patient Protection and Affordable Care Act and Amendment Number 197 offered by Senator Hutchison S. 510, FDA Food Safety Modernization Act, issues related to 1099 reporting amendments S. 668, Health Care Bureaucrats Elimination Act S. 720, Repeal the CLASS Entitlement Act S. 848, Consumer Information Enhancement Act of 2011 S. 1049, Small Business Health Relief Act of 2011 S. 1098, Family and Retirement Health Investment Act of 2011 S. 1368, Restoring Access to Medication Act S. 1880, Jobs and Premium Protection Act S. 2068, Access to Independent Health Insurance Advisors Act of 2012 S. 3187, Food and Drug Administration Safety and Innovation Act S. 3501, American Job Protection Act S. 3673, Patients Freedom Choice Act Filed comments and met with relevant agencies on regulations implementing health care reform (P.L. 111-148 and P.L. 111-152) Notice of Proposed Rulemaking and Notice of Public Hearing Regarding Fees on Health Insurance Policies and Self-Insured Plans for the Patient-Centered Outcomes Research Trust Fund (77 Fed. Reg. 22691-22706, Apr. 17, 2012) Notice and Request for Comments on Minimum Value of an Employer-Sponsored Plan (Notice 2012-31, Apr. 26, 2012) Request for Information Regarding Stop Loss Coverage (77 Fed. Reg. 25788-25790, May 1, 2012) Notice and Request for Comments on Reporting of Health Insurance Coverage (Notice 2012-32, May 14, 2012) Notice and Request for Comments on Reporting by Applicable Large Employers on Health Insurance Coverage Under Employer-Sponsored Plans (Notice 2012-33, May 14, 2012) Final Regulations on Health Insurance Premium Tax Credit (77 Fed. Reg. 30377-30400, May 23, 2012 (to be codified at 26 C.F.R. pts 1 and 602)) Notice and Request for Comments on Health Flexible Spending Arrangements (Notice 2012-40, May 30, 2012) Notice and Request for Comments on the Guidance on 90-Day Waiting Period Limitation (DOL Technical Release 2012-02, Aug. 31, 2012) Notice and Request for Comments on Determining Full-Time Employees For Purposes of Shared Responsibility for Employers Regarding Health Coverage (Notice 2012-58, Aug. 31, 2012) Various issues relating to the implementation of the Patient Protection and Affordable Care Act (P.L. 111-148), including implementation of regulatory process, legislative corrections, coverage, financing, delivery reform, 1099 reporting, grandfathering, CMS claims database, IPAB, CLASS program, employer mandate, medical loss ratio, mandated insurance requirements, medical malpractice reform, exchanges, Medicare reform, regulatory reform, essential health benefits package, health insurance tax, medical device tax, flexible spending accounts and health savings accounts, cost impact analyses, lack of quantified benefit analysis, and the need for empirical data sources on which to base cost and benefits; regulatory process and legislative corrections to Health Care and Education Affordability Reconciliation Act of 2010 (P.L. 111-152), including ERISA preemption and the impact on small business
Client expense: $31,650,000 · Firm income: Not reported
Government targets: Agriculture, Dept of (USDA), Commerce, Dept of (DOC), Commodity Futures Trading Commission (CFTC), Defense, Dept of (DOD), Education, Dept of, Energy, Dept of, Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Federal Highway Administration (FHA), Federal Reserve System, Federal Trade Commission (FTC), Federal Transit Administration (FTA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Interior, Dept of (DOI), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Maritime Administration (MARAD), Natl Economic Council (NEC), Natl Institute of Standards & Technology (NIST), Natl Labor Relations Board (NLRB), Natl Security Council (NSC), Office of Management & Budget (OMB), Office of the Vice President of the United States, Patent & Trademark Office (PTO), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Small Business Administration (SBA), State, Dept of (DOS), Transportation Security Administration (TSA), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Copyright Office, U.S. Customs & Border Protection, U.S. Trade Representative (USTR), White House Office
2012 · third_quarter · Health Issues
Various issues related to the Patient Protection and Affordable Care Act (P.L. 111-148) and Health Care and Education Reconciliation Act of 2010 (P.L. 111-152); H.R. 1744/S. 20 employer mandate repeal; H.R. 1063/S. 1718 Medicare Secondary Payer reform; H.R. 2206 auto enrollment repeal; consumer directed health products; H.R. 436; H.R. 5842; H.R. 2529; H.R. 1004; H.R. 5858; H.R. 2010; S. 1098; S. 1368; H.R. 605; S. 312; H.R. 450.
Client expense: $1,080,000 · Firm income: Not reported
Government targets: Commerce, Dept of (DOC), Consumer Product Safety Commission (CPSC), Equal Employment Opportunity Commission (EEOC), Federal Reserve System, Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Labor Relations Board (NLRB), Office of Management & Budget (OMB), Office of Thrift Supervision (OTS), Office of the Comptroller of the Currency (OCC), SENATE, Securities & Exchange Commission (SEC), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Customs & Border Protection, U.S. Trade Representative (USTR), White House Office
2012 · third_quarter · Health Issues
H.R. 1744, American Job Protection Act, all provisions relating to employer mandate. H.R. 2206, Auto Enroll Repeal Act, all provisions related to auto-enrollment. H.R. 2529 / S. 1368, Restoring Access to Medication Act, all provisions related to over-the-counter (OTC) medicine purchases with flexible spending account (FSA) debit cards.
Client expense: $7,500 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2012 · third_quarter · Taxation/Internal Revenue Code
H.R. 605, Patients' Freedom to Choose Act S. 312, Patients' Freedom to Choose Act H.R. 450, Restoring Assistance for Families and Seniors Health Expenses Act of 2011 H.R. 2529, Restoring Access to Medication Act S. 1098, Family and Retirement Health Investment Act of 2011 S. 1368, Restoring Access to Medication Act H.R. 2010, Family and Retirement Health Investment Act of 2011
Client expense: $440,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Federal Reserve System, Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), SENATE
2012 · third_quarter · Taxation/Internal Revenue Code
H.R.369, Health Savings and Affordability Act (Austria) HSA improvements 16. Specific Lobbying Issues (continued): H.R. 436, Health Care Cost Reduction Act (Paulsen) HSA, HRA, FSA provisions, ACA provisions H.R. 450, Restoring Assistance for Families' and Seniors' Health Expenses Act (Reichert) repeal of HSA and FSA restrictions H.R. 524, Restoring Consumer-driven Health Care Act (Quayle) repeal of HSA restrictions H.R. 605, Patients' Freedom to Choose Act (Paulsen) repeal of HSA and FSA restrictions H.R. 1004, Health Flexible Spending Arrangements Improvements Act (Boustany) -- distribution of unused amounts from a Health FSA H.R. 1370, Repeal of ACA Premium Tax (Boustany) H.R. 2010, Family and Retirement Health Investment Act (Paulsen) HSA and FSA improvements H.R. 2529, Restoring Access to Medication Act (Jenkins) use of HSA funds and FSA funds to purchase OTC medications H.R. 5842, Restoring Access to Medication Act (Jenkins) use of HSA, HRA, and FSA funds for over-the-counter medications H.R. 5858, Health Savings Accounts Improvements Act (Herger) HSA provisions H.R. 6005, Long-Term Care and Retirement Security Act (Courtney) tax incentives for purchase of LTC insurance, consumer protections H.R. 6088, Repeal of the Unfair Taxes on Health Care Act (Schweikert) repeal of ACA premium tax and restrictions on HSAs / FSAs H.R. 6137, Helping Save Americans' Health Care Choices Act (Fleming) HSA and FSA provisions H.R. 6162, Ensuring Women's Access to Free-Market Healthcare Act (Cassidy) pregnancy-related coverage by HSA plans S. 312, Patients' Freedom to Choose Act (Hutchison) repeal of HSA and FSA restrictions S. 1098, Family and Retirement Health Investment Act (Hatch) HSA and FSA improvements S. 1368, Restoring Access to Medication Act (Roberts) use of HSA funds and FSA funds to purchase OTC medications S. 1880, Jobs and Premium Protection Act (Barrasso) repeal of health insurance premium tax S. 2237, Small Business Jobs and Tax Relief Act (Reid) amendment to repeal ACA premium tax S. 2516, the FDA Safety and Innovation Act (Harkin) pharmaceutical, medical device issues S. 3187, the FDA Safety and Innovation Act (Harkin) pharmaceutical, medical device issues Regulatory Issues: Annual insurer provider fees; issues concerning the patient-centered outcomes research fee; employer coverage mandate, W-2 reporting requirements, and other issues relating to health care reform implementation.
Client expense: $2,630,000 · Firm income: Not reported
Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Federal Bureau of Investigation (FBI), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Pension & Welfare Benefits Administration, SENATE, Treasury, Dept of, White House Office
2012 · third_quarter · Health Issues
Patients Freedom to Choose Act H.R. 605 Health Flexible Spending Arrangements Improvements Act of 2012 H.R. 1004 Medicare Beneficiary Freedom to Choose Act of 2011 H.R. 1051 Preserving our Hometown Independent Pharmacies Act of 2011 H.R. 1946 Family and Retirement Health Investment Act of 2011 H.R. 2010 Tax Parity for Health Plan Beneficiaries Act of 2011 H.R. 2088 Restoring Access to Medication Act of 2012 H.R. 2529/5842 Health Savings Accounts Improvements Act of 2012 H.R. 5858 Health Care Reform regulatory implementation and compliance issues from the Patient Protection and Affordable Care Act (PPACA) Public Law No: 111-148 & the Health Care and Education Reconciliation Act of 2010 (HCERA) Public Law No: 111-152 Senate State Leadership in Health Act S. 73 State Health Care Choice Act S. 244 Empowering States to Innovate Act S. 248 Patients Freedom to Choose Act S. 312 Family and Retirement Health Investment Act S. 1098 Tax Parity for Health Plan Beneficiaries Act of 2011 S. 1171 Restoring Access to Medication Act S. 1368 Health Care Reform regulatory implementation and compliance issues from the Patient Protection and Affordable Care Act (PPACA) Public Law No: 111-148 & the Health Care and Education Reconciliation Act of 2010 (HCERA) Public Law 111-152 Regulatory Proposed Health Information Technology for Economic and Clinical Health (HITECH) Act regulations for HIPAA Accounting of Disclosures Request for Information (RFI) streamlining regulations to reduce regulatory burdens - Improving Regulation and Regulatory Review Executive Order 13563 Semi-Annual Regulatory Agendas HHS, Treasury Guidance for and implementation of the Patient Protection and Affordable Care Act (PPACA) & the Health Care and Education Reconciliation Act of 2010 (HCERA) Frequently Asked Questions (FAQs), employer responsibility provisions (shared responsibility, pay to play), quality improvement efforts, Essential Health Benefits (EHB), W2 informational reporting, Summary of Benefits and Coverage Requirements & uniform glossary requirements, automatic enrollment, waiting periods, medical loss ratios (MLRs), contraceptive coverage, state waivers, state health exchanges, reinsurance assessment, public reporting and accountability related to hospital patient safety measures, Patient-Centered Outcomes Research Institute (PCORI), request for transition relief for health flexible spending arrangements (health FSAs) in non-calendar years, Health Insurance Premium Tax Credit, minimum value of an employer sponsored health plan, health insurance premium tax credit/effect of wellness incentive programs, definition of Full-Time Employee, 90-Day waiting period Medicare and Medicaid Programs; Electronic Health Record Incentive Program Stage 2, Health IT Meaningful Use project Health care provider compensation Internal Revenue Code Section 162 (m) (6) Electronic disclosure, communication by employee benefit plans Consumer directed health care plans HDHPs, HSAs, HRAs FSA Plan Year Limit transition guidance Mental Health Parity Rules
Client expense: $216,050 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Commodity Futures Trading Commission (CFTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Treasury, Dept of, White House Office
2012 · third_quarter · Health Issues
Preserving Access to Primary Care Services: Address the shortage of primary care physicians; designate primary care as a shortage profession; provide scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas; provide grants for medical school mentorship programs and primary care training in community health centers; increase Title VII funding for primary care health programs; increase funding for the National Health Service Corps, provide regulatory relief for primary care physicians; H.R. 7192/S. 1174, the Preserving Patient Access to Primary Care Act (111th Congress). Support Implementation and Improvement of the Affordable Care Act (P.L. 111-148, P.L. 111-152) by: Expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; Ensuring access to primary care physicians; and beginning to bend the cost curve; Prohibiting insurers from excluding or charging excessive rates to children based on pre-existing conditions, which later will be expanded to all persons; Covering young adults on their parents' plans; Eliminating lifetime and annual limits on health insurance coverage; Requiring that health insurers spend more on patient care and less on administration; support enactment of S. 248, the Empowering States to Innovate Act, which amends the Patient Protection and Affordable Care Act (ACA) to: (1) allow states to apply for waivers of certain health insurance coverage requirements in such Act (including requirements for the establishment of qualified health plans and health insurance exchanges) for plan years beginning on or after January 1, 2014 (currently, January 1, 2017), and (2) require the waiver application process to begin not later than 180 days after the enactment of this Act; Phasing out the Medicare Part D doughnut hole; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Establishing a new Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Creating a new Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes; Training more primary care physicians through the National Health Service Corps, Title VII health professions funding, and redistributing unused graduate medical education positions to primary care specialties facing shortages; Beginning in 2014, ensuring that nearly all Americans have access to coverage either through subsidized private health insurance offered by state health exchanges or through Medicaid, if they don't already have access to coverage through an employer, Medicare, or another public program. Medicare Physician Payment Reform: Increase Medicare Fee Schedule payments to make primary care competitive in the market with other physician career and specialty choices; create a fast track authority to develop and implement new physician payment models that better align payment with effective, efficient, patient-centered care such as the Patient Centered Medical Home; provide a voluntary shared savings program, Accountable Care Organizations, that promotes accountability for services delivered to a defined Medicare fee-for-service (FFS) patient population with the goals of increasing the quality and efficiency of services delivered; provide separate Medicare payment for specific care coordination services provided principally by primary care physicians; revise Medicare budget neutrality rules to recognize the value of primary care in reducing Medicare baseline spending; increase the accuracy of physician work relative value units under the Medicare physician fee schedule; improve the accuracy of practice expense RVUs under the Medicare Fee Schedule; increase Medicare bonus payments for primary care services provided in designated shortage areas; provide stable, positive, predictable updates under Medicares reimbursement formula; and replacing the Sustainable Growth Rate (SGR) formula with a long term solution that provides for stable, predictable updates for physicians (H.R. 3961). Specifically, beginning in April 2011, urged Congress to enact legislation that would provide stable payments for all physician specialties for at least five years while providing higher updates for undervalued evaluation and management services, require that different payment models (including Patient-Centered Medical Homes) be pilot-tested on a voluntary basis during the five year period of stable payments, and designate a specific transition period for broad adoption of the new models that have been shown to be the most effective based on the pilots. Urged action on legislation to provide stability and predictability for the Medicare physician payments at least through 2011; The Medicare and Medicaid Extenders Act of 2010, H.R. 4994, prevents the 25 percent physician payment cuts under Medicare, brought on by the flawed Sustainable Growth Rate (SGR) formula, from going into effect on Jan.1, 2011, and continues current rates through Dec. 31, 2011; Advocated for a proposal released by Rep. Allyson Schwartz (D-PA) in Nov 2011 that would eliminate Medicare's flawed SGR formula and transition to new physician payment models that are aligned with value; Advocated for repealing the SGR and using the Overseas Contingency Operation (OCO) funds to offset the cost;. Urged enactment of the Medicare Physician Payment Innovation Act (H.R. 5707), as introduced on May 9 by Representatives Allyson Schwartz (D-PA) and Joe Heck (R-NV). This legislation would eliminate the SGR once and for all and transition to better payment and delivery systems that are aligned with value. Specifically, H.R. 5707 would repeal the SGR formula, provide more than 5 years of stable physician payments, with positive increases for all physician services, and higher payments for primary care, preventive and care coordination services, and establishes a process for practices to transition to new, more effective, models of care by 2018. In July 2012 testimony; advocated for the Patient-Centered Medical Home model should be scaled up for broad Medicare adoption, recognized, through the medical neighborhood concept, that specialty and subspecialty practices, hospitals, and other healthcare professionals and entities that provide treatment to the patient need to be recognized and provided with incentivesboth non-financial and financialfor engaging in patient-centered practices that complement and support the efforts of the PCMH to provide high quality, efficient, coordinated care; advocated for ACPs High Value, Cost-Conscious Care Initiative, which includes clinical, public policy, and educational components, designed to help physicians and patients understand the benefits, harms, and costs of an intervention and whether it provides good value, as well as to slow the unsustainable rate of health care cost increases while preserving high-value, high-quality care. Medical Education: Provide incentives to medical schools, community health centers, or hospitals, to increase the numbers of physicians choosing primary care; authorize HHS to selectively eliminate Graduate Medical Education (GME) caps for residency programs in primary care, advocated for S. 1627, which would increase the number of Medicare-supported training positions for medical residents by 15 percent (approximately 15,000 slots) over five years, requiring at least 50 percent of the new positions to be allocated to specialties facing a current shortage. Appropriations for FY 2013: Advocated for the highest level of funding possible for the Labor-HHS-Education bill within the discretionary cap established by the Budget Control Act (BCA); Supported $520 million for Title VII Health Professions and Title VIII Nursing Programs to the House and Senate Labor-HHS-Education Appropriations Subcommittees; Supported $400 million to "improve health care quality, enhance consumer choice, advance patient safety, improve efficiency, reduce medical errors, and broaden access to essential services; Advocated for a base, discretionary budget of $400 million in FY 2013 for AHRQ; Advocated for at least $7.0 billion for the Health Resources and Services Administration (HRSA); Specifically, the College supported Title VII, Section 747, Primary Care Training and Enhancement, at no less than $71 million; National Health Service Corps, $535,087,442 million in discretionary funding, in addition to the $300 million in enhanced funding through the Community Health Centers Fund; National Health Care Workforce Commission, $3 million; and Centers for Medicare and Medicaid Services, Operations and Management of Exchanges, $574.5 million. Fund the National Institutes of Health (NIH), at $32 billion, which represents the minimum investment necessary to avoid further loss of promising research and at the same time allows the NIH's budget to keep pace with biomedical inflation. Fund the Centers for Disease Control (CDC), at $7.8 billion, which reflects the minimal amount CDC will need to fulfill its core missions for fiscal year 2013, which are essential to protect the health of the American people. Preserve funding for GME in FY 2013; Urged Congress not to terminate the Agency for Healthcare Research and Quality. Public Health Programs and Funding: Increase funding to accomplish the core missions and activities of the major federal public health agencies, including: biomedical and behavioral research, disease prevention and health promotion, access to safety net health care services, health professions education, mental health and substance abuse, health services research, health care for American Indians and Alaska natives, food and drug safety. Improving Access to Primary Care in the Context of Comprehensive Healthcare Reform Legislation (H.R. 3962/H.R. 3590/H.R. 4872): Ensure that all Americans will have access to affordable coverage. Provide sliding scale subsidies based on income to buy coverage from qualified plans; Qualified plans should: provide evidence-based benefits, including preventive services; and be prohibited from excluding persons with pre-existing conditions, charging them more, cherry-picking enrollees, or cancelling or failing to renew coverage; Expand Medicaid to cover all persons below the Federal Poverty Level and ensure fair payments to participating physicians; As coverage becomes affordable, all persons should participate and coverage should be guaranteed; Responsibility for financing should be shared by individuals, employers and government. Regarding the Essential Health Benefits Bulletin, issued by the Department of Health and Human Services (HHS) on December 16, 2011, the College advocated for striking a balance between comprehensiveness and affordability while giving States some freedom to determine a package that best serve the needs of residents. The College believes that strong oversight is needed when determining the initial benchmark plan (and whether it reflects the coverage requirements of the Affordable Care Act) and how the package will be updated, particularly if insurers are given the ability to substitute benefits within and across categories. State and the federal government must work in concert with physicians, health care providers and payers to determine and promote use of clinically effective and cost-effective services that result in improved patient health while bending the cost curve. Advocated for the Empowering States to Innovate Act (S. 248, H.R. 844): This legislation would amend the ACA by moving up by three years (from 2017 to 2014) a provision in the ACA that already allows states to opt out of most of the laws mandates if they can develop a program that offers comparable coverage to their residents. Pilot test new Medicare payment models that re-align incentives to support effective, efficient, patient-centered, coordinated care. Priority should be given to models designed to support the value of services provided by primary care physicians as well as to models that would create incentives, across physician specialties and sites of services, to improve the quality, effectiveness, and efficiency of care provided. Policy criteria for selecting the most promising models for pilot testing should be developed, in consultation with outside experts; The Patient-Centered Medical Home (PCMH), which has shown great promise in meeting the policy objectives suggested above, should be among the models selected for broader testing on a national pilot basis; the establishing of a new CMS Innovation Center to pilot-test new payment models, such as the medical home; the use of the medical home model for treatment or services under private health plans, the requirement of health plans to provide incentives to promote and report on medical home services provided, the establishment of community health teams and a primary care extension program to educate and support primary care practices in the delivery of medical home services, and the establishment of a demonstration project to educate physicians and other clinicians in training in the competencies required to deliver care consistent with the medical home care model. National workforce policy to ensure sufficient numbers of primary care and other physicians: Urged support for a national workforce commission to recommend national goals relating to the numbers and distribution of physicians and other health care professionals, including increasing the supply of primary care physicians; Fully fund the commission at levels authorized in the Affordable Care Act; Increase the number of Medicare-funded graduate medical education positions available each year in adult primary care specialties; Provide new loan repayment and medical school scholarship programs in exchange for primary care service in critical shortage health facilities, or in critical shortage areas of the country; Increase funding for scholarships and loan repayment programs under Title VII as well as increase funding for the National Health Service Corps (NHSC); Provide new practice-entry bonus for scholarship or loan repayment award recipients who remain in underserved communities after completion of service obligation. Reform the medical liability system and the enormous costs associated with frivolous lawsuits and defensive medicine: Impose caps on non-economic damages; and test and fund new models--like health courts, which would have cases heard by an expert panel rather than by a lay jury; Urge enactment of H.R. 5, the HEALTH Act, as initially introduced, which would set national standards for medical malpractice, including a $250,000 cap on non-economic damages. The Restoring Access to Medication Act (H.R. 2529): Advocated for this legislation that overturns the restrictions placed on tax-preferred accounts reimbursing for over-the-counter (OTC) medicines without first getting a prescription. This legislation will restore efficiencies in the healthcare system and consumer access to vital, frontline medicines that were disrupted by ACA. The Primary Care Workforce Access and Improvement Act of 2011 (H.R. 3667): Supported this legislation that would authorize the Secretary of Health and Human Services (HHS) to conduct a five year Medicare pilot project that would direct a share of Graduate Medical Education funding to medical education entities to test different models of primary care training. This legislation would give the Secretary of HHS the authority to test new models of care that demonstrate the capability of improving the quality, quantity, and distribution of primary care physicians. Hospital Outpatient Proposed Rule/August 2012: ACP expressed concern to CMS of the increased frequency of beneficiaries in hospital settings being categorized as outpatients receiving observation services rather than regular inpatient admissions; recommended current general admission criteria be replaced or at least clarified through the use of the large number of evidence based guidelines covering a variety of conditions frequently involved in the hospitalization decision-making process (e.g., chest pain, heart failure, chronic obstructive pulmonary disease) offered through the Agency for Healthcare Research and Quality (AHRQ) National Guidelines Clearinghouse, the opinion of the admitting physician be given increased weight in the coverage determination process, prior to any denial of admission by a Medicare contractor, the denial should be reviewed and confirmed by a physician, need improved clear and transparent inpatient admission criteria. Health Information Technology/August 2012: Provided suggestions on Stage 3 of Meaningful Use, including: Refine and evolve existing measures rather than add new measures; do not introduce new functions without appropriate testing; choose additional documentation requirements wisely and seek to reduce existing requirements that do not add value to the patient record; require usability testing with a specific focus on reducing data collection burdens; do not add functional requirements that have not been adequately defined; understand the implications of intensively focusing vendors programming capacity on Meaningful Use requirements. Physician Fee Schedule/August 2012: Advocated that policies to improve payment for undervalued evaluation and management services should not be restricted to a designated subset of specialties (as defined by their self-designation) or impose other restrictive criteria that could exclude physicians who legitimately and appropriately provide such services to their patients. Rather, the objective should be to pay more appropriately for evaluation and care coordination services that bring value to the patient, no matter the specialty of the physician who is billing for the service. Sequestration: Opposed automatic across-the-board cuts (known as sequestration) scheduled to hit federal agencies in January 2013 to the tune of $100 billion. Across-the-board cuts, which do not take into consideration the importance or effectiveness of any particular program or activity, are not an appropriate method of governing. Instead, policymakers should embrace an alternative approach that addresses the true cost drivers behind rising health care costs. They should work to improve the effectiveness of care provided, make necessary and appropriate changes in entitlement programs, including Medicare cost-sharing, reform payment and delivery systems, and support the proven value of primary care.
Client expense: $266,710 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), President of the U.S., SENATE
2012 · third_quarter · Health Issues
Preserving Access to Primary Care Services: Address the shortage of primary care physicians; designate primary care as a shortage profession; provide scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas; provide grants for medical school mentorship programs and primary care training in community health centers; increase Title VII funding for primary care health programs; increase funding for the National Health Service Corps, provide regulatory relief for primary care physicians; H.R. 7192/S. 1174, the Preserving Patient Access to Primary Care Act (111th Congress). Support Implementation and Improvement of the Affordable Care Act (P.L. 111-148, P.L. 111-152) by: Expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; Ensuring access to primary care physicians; and beginning to bend the cost curve; Prohibiting insurers from excluding or charging excessive rates to children based on pre-existing conditions, which later will be expanded to all persons; Covering young adults on their parents' plans; Eliminating lifetime and annual limits on health insurance coverage; Requiring that health insurers spend more on patient care and less on administration; support enactment of S. 248, the Empowering States to Innovate Act, which amends the Patient Protection and Affordable Care Act (ACA) to: (1) allow states to apply for waivers of certain health insurance coverage requirements in such Act (including requirements for the establishment of qualified health plans and health insurance exchanges) for plan years beginning on or after January 1, 2014 (currently, January 1, 2017), and (2) require the waiver application process to begin not later than 180 days after the enactment of this Act; Phasing out the Medicare Part D doughnut hole; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Establishing a new Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Creating a new Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes; Training more primary care physicians through the National Health Service Corps, Title VII health professions funding, and redistributing unused graduate medical education positions to primary care specialties facing shortages; Beginning in 2014, ensuring that nearly all Americans have access to coverage either through subsidized private health insurance offered by state health exchanges or through Medicaid, if they don't already have access to coverage through an employer, Medicare, or another public program. Medicare Physician Payment Reform: Increase Medicare Fee Schedule payments to make primary care competitive in the market with other physician career and specialty choices; create a fast track authority to develop and implement new physician payment models that better align payment with effective, efficient, patient-centered care such as the Patient Centered Medical Home; provide a voluntary shared savings program, Accountable Care Organizations, that promotes accountability for services delivered to a defined Medicare fee-for-service (FFS) patient population with the goals of increasing the quality and efficiency of services delivered; provide separate Medicare payment for specific care coordination services provided principally by primary care physicians; revise Medicare budget neutrality rules to recognize the value of primary care in reducing Medicare baseline spending; increase the accuracy of physician work relative value units under the Medicare physician fee schedule; improve the accuracy of practice expense RVUs under the Medicare Fee Schedule; increase Medicare bonus payments for primary care services provided in designated shortage areas; provide stable, positive, predictable updates under Medicares reimbursement formula; and replacing the Sustainable Growth Rate (SGR) formula with a long term solution that provides for stable, predictable updates for physicians (H.R. 3961). Specifically, beginning in April 2011, urged Congress to enact legislation that would provide stable payments for all physician specialties for at least five years while providing higher updates for undervalued evaluation and management services, require that different payment models (including Patient-Centered Medical Homes) be pilot-tested on a voluntary basis during the five year period of stable payments, and designate a specific transition period for broad adoption of the new models that have been shown to be the most effective based on the pilots. Urged action on legislation to provide stability and predictability for the Medicare physician payments at least through 2011; The Medicare and Medicaid Extenders Act of 2010, H.R. 4994, prevents the 25 percent physician payment cuts under Medicare, brought on by the flawed Sustainable Growth Rate (SGR) formula, from going into effect on Jan.1, 2011, and continues current rates through Dec. 31, 2011; Advocated for a proposal released by Rep. Allyson Schwartz (D-PA) in Nov 2011 that would eliminate Medicare's flawed SGR formula and transition to new physician payment models that are aligned with value; Advocated for repealing the SGR and using the Overseas Contingency Operation (OCO) funds to offset the cost. Urged enactment of the Medicare Physician Payment Innovation Act (H.R. 5707), as introduced on May 9 by Representatives Allyson Schwartz (D-PA) and Joe Heck (R-NV). This legislation would eliminate the SGR once and for all and transition to better payment and delivery systems that are aligned with value. Specifically, H.R. 5707 would repeal the SGR formula, provide more than 5 years of stable physician payments, with positive increases for all physician services, and higher payments for primary care, preventive and care coordination services, and establishes a process for practices to transition to new, more effective, models of care by 2018. In July 2012 testimony; advocated for the Patient-Centered Medical Home model should be scaled up for broad Medicare adoption, recognized, through the medical neighborhood concept, that specialty and subspecialty practices, hospitals, and other healthcare professionals and entities that provide treatment to the patient need to be recognized and provided with incentivesboth non-financial and financialfor engaging in patient-centered practices that complement and support the efforts of the PCMH to provide high quality, efficient, coordinated care; advocated for ACPs High Value, Cost-Conscious Care Initiative, which includes clinical, public policy, and educational components, designed to help physicians and patients understand the benefits, harms, and costs of an intervention and whether it provides good value, as well as to slow the unsustainable rate of health care cost increases while preserving high-value, high-quality care. Medical Education: Provide incentives to medical schools, community health centers, or hospitals, to increase the numbers of physicians choosing primary care; authorize HHS to selectively eliminate Graduate Medical Education (GME) caps for residency programs in primary care, advocated for S. 1627, which would increase the number of Medicare-supported training positions for medical residents by 15 percent (approximately 15,000 slots) over five years, requiring at least 50 percent of the new positions to be allocated to specialties facing a current shortage. Appropriations for FY 2013: Advocated for the highest level of funding possible for the Labor-HHS-Education bill within the discretionary cap established by the Budget Control Act (BCA); Supported $520 million for Title VII Health Professions and Title VIII Nursing Programs to the House and Senate Labor-HHS-Education Appropriations Subcommittees; Supported $400 million to "improve health care quality, enhance consumer choice, advance patient safety, improve efficiency, reduce medical errors, and broaden access to essential services; Advocated for a base, discretionary budget of $400 million in FY 2013 for AHRQ; Advocated for at least $7.0 billion for the Health Resources and Services Administration (HRSA); Specifically, the College supported Title VII, Section 747, Primary Care Training and Enhancement, at no less than $71 million; National Health Service Corps, $535,087,442 million in discretionary funding, in addition to the $300 million in enhanced funding through the Community Health Centers Fund; National Health Care Workforce Commission, $3 million; and Centers for Medicare and Medicaid Services, Operations and Management of Exchanges, $574.5 million. Fund the National Institutes of Health (NIH), at $32 billion, which represents the minimum investment necessary to avoid further loss of promising research and at the same time allows the NIH's budget to keep pace with biomedical inflation. Fund the Centers for Disease Control (CDC), at $7.8 billion, which reflects the minimal amount CDC will need to fulfill its core missions for fiscal year 2013, which are essential to protect the health of the American people. Preserve funding for GME in FY 2013; Urged Congress not to terminate the Agency for Healthcare Research and Quality. Public Health Programs and Funding: Increase funding to accomplish the core missions and activities of the major federal public health agencies, including: biomedical and behavioral research, disease prevention and health promotion, access to safety net health care services, health professions education, mental health and substance abuse, health services research, health care for American Indians and Alaska natives, food and drug safety. Improving Access to Primary Care in the Context of Comprehensive Healthcare Reform Legislation (H.R. 3962/H.R. 3590/H.R. 4872): Ensure that all Americans will have access to affordable coverage. Provide sliding scale subsidies based on income to buy coverage from qualified plans; Qualified plans should: provide evidence-based benefits, including preventive services; and be prohibited from excluding persons with pre-existing conditions, charging them more, cherry-picking enrollees, or cancelling or failing to renew coverage; Expand Medicaid to cover all persons below the Federal Poverty Level and ensure fair payments to participating physicians; As coverage becomes affordable, all persons should participate and coverage should be guaranteed; Responsibility for financing should be shared by individuals, employers and government. Regarding the Essential Health Benefits Bulletin, issued by the Department of Health and Human Services (HHS) on December 16, 2011, the College advocated for striking a balance between comprehensiveness and affordability while giving States some freedom to determine a package that best serve the needs of residents. The College believes that strong oversight is needed when determining the initial benchmark plan (and whether it reflects the coverage requirements of the Affordable Care Act) and how the package will be updated, particularly if insurers are given the ability to substitute benefits within and across categories. State and the federal government must work in concert with physicians, health care providers and payers to determine and promote use of clinically effective and cost-effective services that result in improved patient health while bending the cost curve. Advocated for the Empowering States to Innovate Act (S. 248, H.R. 844): This legislation would amend the ACA by moving up by three years (from 2017 to 2014) a provision in the ACA that already allows states to opt out of most of the laws mandates if they can develop a program that offers comparable coverage to their residents. Pilot test new Medicare payment models that re-align incentives to support effective, efficient, patient-centered, coordinated care. Priority should be given to models designed to support the value of services provided by primary care physicians as well as to models that would create incentives, across physician specialties and sites of services, to improve the quality, effectiveness, and efficiency of care provided. Policy criteria for selecting the most promising models for pilot testing should be developed, in consultation with outside experts; The Patient-Centered Medical Home (PCMH), which has shown great promise in meeting the policy objectives suggested above, should be among the models selected for broader testing on a national pilot basis; the establishing of a new CMS Innovation Center to pilot-test new payment models, such as the medical home; the use of the medical home model for treatment or services under private health plans, the requirement of health plans to provide incentives to promote and report on medical home services provided, the establishment of community health teams and a primary care extension program to educate and support primary care practices in the delivery of medical home services, and the establishment of a demonstration project to educate physicians and other clinicians in training in the competencies required to deliver care consistent with the medical home care model. National workforce policy to ensure sufficient numbers of primary care and other physicians: Urged support for a national workforce commission to recommend national goals relating to the numbers and distribution of physicians and other health care professionals, including increasing the supply of primary care physicians; Fully fund the commission at levels authorized in the Affordable Care Act; Increase the number of Medicare-funded graduate medical education positions available each year in adult primary care specialties; Provide new loan repayment and medical school scholarship programs in exchange for primary care service in critical shortage health facilities, or in critical shortage areas of the country; Increase funding for scholarships and loan repayment programs under Title VII as well as increase funding for the National Health Service Corps (NHSC); Provide new practice-entry bonus for scholarship or loan repayment award recipients who remain in underserved communities after completion of service obligation. Reform the medical liability system and the enormous costs associated with frivolous lawsuits and defensive medicine: Impose caps on non-economic damages; and test and fund new models--like health courts, which would have cases heard by an expert panel rather than by a lay jury; Urge enactment of H.R. 5, the HEALTH Act, as initially introduced, which would set national standards for medical malpractice, including a $250,000 cap on non-economic damages. The Restoring Access to Medication Act (H.R. 2529): Advocated for this legislation that overturns the restrictions placed on tax-preferred accounts reimbursing for over-the-counter (OTC) medicines without first getting a prescription. This legislation will restore efficiencies in the healthcare system and consumer access to vital, frontline medicines that were disrupted by ACA. The Primary Care Workforce Access and Improvement Act of 2011 (H.R. 3667): Supported this legislation that would authorize the Secretary of Health and Human Services (HHS) to conduct a five year Medicare pilot project that would direct a share of Graduate Medical Education funding to medical education entities to test different models of primary care training. This legislation would give the Secretary of HHS the authority to test new models of care that demonstrate the capability of improving the quality, quantity, and distribution of primary care physicians. Hospital Outpatient Proposed Rule/August 2012: ACP expressed concern to CMS of the increased frequency of beneficiaries in hospital settings being categorized as outpatients receiving observation services rather than regular inpatient admissions; recommended current general admission criteria be replaced or at least clarified through the use of the large number of evidence based guidelines covering a variety of conditions frequently involved in the hospitalization decision-making process (e.g., chest pain, heart failure, chronic obstructive pulmonary disease) offered through the Agency for Healthcare Research and Quality (AHRQ) National Guidelines Clearinghouse, the opinion of the admitting physician be given increased weight in the coverage determination process, prior to any denial of admission by a Medicare contractor, the denial should be reviewed and confirmed by a physician, need improved clear and transparent inpatient admission criteria. Health Information Technology/August 2012: Provided suggestions on Stage 3 of Meaningful Use, including: Refine and evolve existing measures rather than add new measures; do not introduce new functions without appropriate testing; choose additional documentation requirements wisely and seek to reduce existing requirements that do not add value to the patient record; require usability testing with a specific focus on reducing data collection burdens; do not add functional requirements that have not been adequately defined; understand the implications of intensively focusing vendors programming capacity on Meaningful Use requirements. Physician Fee Schedule/August 2012: Advocated that policies to improve payment for undervalued evaluation and management services should not be restricted to a designated subset of specialties (as defined by their self-designation) or impose other restrictive criteria that could exclude physicians who legitimately and appropriately provide such services to their patients. Rather, the objective should be to pay more appropriately for evaluation and care coordination services that bring value to the patient, no matter the specialty of the physician who is billing for the service. Sequestration: Opposed automatic across-the-board cuts (known as sequestration) scheduled to hit federal agencies in January 2013 to the tune of $100 billion. Across-the-board cuts, which do not take into consideration the importance or effectiveness of any particular program or activity, are not an appropriate method of governing. Instead, policymakers should embrace an alternative approach that addresses the true cost drivers behind rising health care costs. They should work to improve the effectiveness of care provided, make necessary and appropriate changes in entitlement programs, including Medicare cost-sharing, reform payment and delivery systems, and support the proven value of primary care.
Client expense: $143,679 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), President of the U.S., SENATE
2012 · third_quarter · Health Issues
H.R. 397: Reform Americans Can Afford Act of 2011 High cost plan tax, employer provisions. H.R. 436: Health Care Cost Reduction Act of 2012 Repeal $2500 FSA limit. H.R. 439, S.73: State Leadership in Health Care Act To prevent Employee Retirement Income Security Act (ERISA) from being waived. H.R. 605: Patients' Freedom to Choose Act (Sec. 1-3, repeal restrictions on Health Savings Accounts, Medicare Set Asides and Health Flexible Spending Arrangements enacted in Affordable Care Act.) H.R. 1050: Small Business Health Fairness Act of 2011 (Sec. 1-6, creating association health plans.) H.R. 1173: Fiscal Responsibility and Retirement Security Act of 2011 (Sec. 1-2, repeal Community Living Assistance Services and Supports Act, CLASS Act Federal Disability Program.) H.R. 2529, S. 1368: Restoring Access to Medication Act Repeal FSA restriction on OTC drugs. H.R. 5842: Restoring Access to Medication Act of 2012 Repeal FSA restriction on OTC drugs. S. 244: State Health Care Choice Act To prevent Employee Retirement Income Security Act (ERISA) from being waived. S. 248: Empowering States to Innovate Act To prevent Employee Retirement Income Security Act (ERISA) from being waived. S. 312: Patients' Freedom to Choose Act Sec. 1-3, repeal restrictions on Health Savings Accounts, Medicare Set Asides and Health Flexible Spending Arrangements enacted in Affordable Care Act.
Client expense: $683,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2012 · third_quarter · Taxation/Internal Revenue Code
H.R. 2529: Restoring Access to Medication Act. H.R. 436: Health Care Cost Reduction Act of 2012.
Client expense: Not reported · Firm income: $30,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2012 · third_quarter · Health Issues
General issues regarding implementation of Public Law 111-148 "Patient Protection and Affordable Care Act" including the Independent Payment Advisory Board (IBAP); awareness & issues related to diabetes and patient access to diabetes care; general issues related to prescription drug safety; H.R. 2529 "Restoring Access to Medication Act" - all provisions; H.R. 3627 and S. 1884 "School Access to Emergency Epinephrine Act" - all provisions; issues related to efforts to move pseudoephedrine products to prescription drug status; education and awareness of influenze pandemic and biodefense funding in FY2012 funding bills; education and awareness and general issues related to the reauthorization of the Pandemic and All Hazards Preparation Act; H.R. 2405 and S. 1855 education and awareness of Dengue; H.R. 4223 "Strengthening and Focusing Enforcement to deter Organized Stealing and Enhance Safety Act of 2012" or "Safe Doses Act"; H. Res. 295 "Promoting increased awareness, diagnosis and treatment of atrial fibrillation to address the high morbidity and mortality rates and to prevent avoidable hospitalizations associated with the disease; H.R. 436 "Healthcare Cost Reduction Act of 2012"; awareness and issues related to diabetes and patient access to diabetes care.
Client expense: Not reported · Firm income: $40,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2012 · third_quarter · Taxation/Internal Revenue Code
H.R.2529/S.1368, Restoring Access to Medication Act. Issues related to insuring access to over-the-counter drugs and Flexible Spending Accounts/Health Savings Accounts.
Client expense: Not reported · Firm income: $50,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2012 · third_quarter · Health Issues
S.2236 - Advancing Breakthrough Therapies for Patients Act of 2012 - provisions related to FDA regulation S.2113 - Transforming the Regulatory Environment to Accelerate Access to Treatments (TREAT) Act - provisions related to accelerated approval and other FDA matters S. 2289 - The Better Pharmaceuticals and Devices for Children Act - "Provisions related to amending the Federal Food, Drug, and Cosmetic Act with respect to pediatric provisions" H.R.4274 - BPCA and PREA Reauthorization Act of 2012 - Provisions related to amending title IV of the Public Health Service Act and title V of the Federal Food, Drug, and Cosmetic Act to permanently extend the provisions of the Best Pharmaceuticals for Children Act and the Pediatric Research Equity Act H.R.4156, S.2281 - Expanding and Promoting Expertise in Rare Treatments Act of 2012 - provisions related to strengthening the FDA's ability to seek advice from external experts regarding rare diseases H.R.4132 - FAST Act - provisions related to accelerated approval and other FDA matters H.R.3839 - Drug Shortage Prevention Act of 2012 - provisions related to prescription drug shortages H.R.2674 - 340B Program Improvement Act - provisions related to the 340B program PL 111-148, PL 111-152 - Patient Protection and Affordable Care Act - ACA implementation, Independent Payment Advisory Board (IPAB), comparative effectiveness, health information technology, disease prevention/wellness, sunshine and innovation provisions H.R.2405, S.1855 - Pandemic and All Hazards Preparedness Act - provisions relating to influenza vaccine innovative technologies H.R.4223, S.1002 - Strengthening and Focusing Enforcement to Deter Organized Stealing and Enhance Safety Act (SAFE DOSES) provisions related to supply chain security H.R.1483 - The Drug Safety Enhancement Act of 2011 - provisions related to supply chain security H.R.1930, S.1799 - Access to Appropriate Immunizations for Veterans Act of 2011 - provisions related to extending VA performance measure to include all federally recommended vaccine H.R.3202 - Water Protection and Reinvestment Act - provisions pertaining to pharmaceuticals in the environment H.R.2245, S.296 - Preserving Access to Life-Savings Medicines Act of 2011 - provisions related to drug shortages H.R.2939 - Pharmaceutical Stewardship Act of 2011 - provisions related to drug safety H.R.5651 - Food and Drug Administration Reform Act of 2012 - provisions related to user fee reauthorization and FDA reform S. 3187 - Food and Drug Administration Safety and Innovation Act of 2012 - provisions related to user fee reauthorization and FDA reform H.R.2529, S.1368 - Restoring Access to Medication Act - provisions relating to reimbursement of OTC drugs under flexible spending and health savings accounts S.1584 - Drug Safety and Accountability Act of 2011 - provisions related to drug safety No bill # assigned - Federal Food, Drug, and Cosmetic Act - section related to FDA and regulation of nicotine replacement therapies S.1699 - Prescription Drug Cost Reduction Act - provisions related to 340B and drug rebates H.R.3204 - Guidance Accountability and Transparency Act - provisions to set forth interpretation policy of FDA guidance S.810 - Great Ape Protection and Cost Savings Act of 2011 - provisions related to pre-clinical testing H.R.6190 - Asthma Inhalers Relief Act of 2012 - provisions relating to the removal of Essential-Use Designation for epinephrine S.1752 - Freedom to Breath Act of 2011 - provisions relating to the removal of Essential-Use Designation for epinephrine No bill # assigned - Comparative effectiveness policy issues No bill # assigned - Efforts to amend the National Childhood Vaccine Injury Act of 1986 (26 USC 4132(N)) to include any vaccine against seasonal influenza.
Client expense: $890,000 · Firm income: Not reported
Government targets: Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, Natl Security Council (NSC), SENATE, State, Dept of (DOS), U.S. Trade Representative (USTR), White House Office
2012 · third_quarter · Health Issues
H.R. 605/S. 312 To amend the Patient Protection and Affordable Care Act to repeal provisions that change the treatment of over-the-counter medicines purchased with a Flexible Spending Account debit card. S. 1098/H.R. 2010 To amend the Patient Protection and Affordable Care Act to repeal provisions that change the treatment of over-the-counter medicines purchased with a Flexible Spending Account debit card S. 1368/ H.R. 2529 - Restoring Access to Medication Act H.R. 5842 Restoring Access to Medication Act Patient Protection and Affordable Care Act (P.L. 111148) - Sections 1201, 1301, 1302, 1303, 1304, 1311, 1401, 1411, 1412, 1414, 1502, 1512, 1513, 1514, 4205 Section 4980H H.R. 6174 / S. 3574 - Common Sense Nutrition Disclosure Act of 2012 H.R. 1744 - American Job Protection Act H.R. 2206 - Auto Enroll Repeal Act
Client expense: $180,000 · Firm income: Not reported
Government targets: Agriculture, Dept of (USDA), Executive Office of the President (EOP), Federal Reserve System, 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), Office of Management & Budget (OMB), SENATE, Small Business Administration (SBA), Treasury, Dept of, White House Office
2012 · fourth_quarter · Medical/Disease Research/Clinical Labs
H.R.2529/S.1368, Restoring Access to Medication Act; S.3376, PACT Act; issues related to preventing abuse or diversion of over-the-counter drugs; S.3187, Food and Drug Administration Safety and Innovation Act; Issues related to insuring access to over-the-counter drugs, Flexible Spending Accounts/Health Savings Accounts and the FDA.
Client expense: Not reported · Firm income: Not reported
2012 · fourth_quarter · Health Issues
H.R.2529/S.1368, Restoring Access to Medication Act; S.3376, PACT Act; issues related to preventing abuse or diversion of over-the-counter drugs; S.3187, Food and Drug Administration Safety and Innovation Act; Issues related to insuring access to over-the-counter drugs, Flexible Spending Accounts/Health Savings Accounts and the FDA.
Client expense: Not reported · Firm income: Not reported
2012 · fourth_quarter · Taxation/Internal Revenue Code
H.R.2529/S.1368, Restoring Access to Medication Act; S.3376, PACT Act; issues related to preventing abuse or diversion of over-the-counter drugs; S.3187, Food and Drug Administration Safety and Innovation Act; Issues related to insuring access to over-the-counter drugs, Flexible Spending Accounts/Health Savings Accounts and the FDA.
Client expense: Not reported · Firm income: Not reported
2012 · second_quarter · Health Issues
H.R. 2529/S.1368 - the "Restoring Access to Medication Act," all provisions regarding repealing provisions of the Patient Protection and Affordable Care Act that limits payments for medications from health savings accounts, medical savings accounts, and health felxible spending arrangements to only prescriotion drugs or insulin. H.R. 5651 - the FDA Reform Act of 2012, all provisions regarding reauthorizing and establishing new FDA prescription drug user-fee programs and revises requirements related to prescription, pediatric and generic drugs; medical devices; biosimilar biological products; new infectious disease drugs and drug manufacturer reporting. H.R. 5842 - the Restoring Access to Medication Act, all provisions regarding repealing provisions of PPACA that limit payments for medications from health savings accounts and health flexible spending arrangements and reimbursement arrangements to only prescription drugs or insulin. H.R. 436 - the Health Care Cost Reduction Act, all provisions regarding repealing provisions of PPACA that limit payments for medications from health savings accounts and health flexible spending arrangements and reimbursement arrangements to only prescription drugs or insulin. S.3187/S.2516 - the FDA Safety and Innovation Act, all provisions regarding reauthorizing and establishing new FDA prescription drug user-fee programs and revises requirements related to prescription, pediatric and generic drugs; medical devices; biosimilar biological products; new infectious disease drugs and drug manufacturer reporting.
Client expense: $540,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2012 · first_quarter · Health Issues
Patient Protection and Affordable Care Act (P.L. 111-148, P.L. 111-152); HR 2; ERISA regulations; HR 1744; S 20; HR 2010; S 1098; HR 1370; FSA/HSA changes; HR 1063; Medicare Secondary Payer; HR 2529; S 1368; HR 605; S 312; Budget Control Act; HR 2206; S 1880; HR 450; HR 1004; HR 524
Client expense: $880,000 · Firm income: Not reported
Government targets: Commerce, Dept of (DOC), Consumer Product Safety Commission (CPSC), Equal Employment Opportunity Commission (EEOC), Federal Reserve System, Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Labor Relations Board (NLRB), Office of Management & Budget (OMB), Office of Thrift Supervision (OTS), Office of the Comptroller of the Currency (OCC), SENATE, Securities & Exchange Commission (SEC), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Customs & Border Protection, U.S. Trade Representative (USTR), White House Office
2012 · second_quarter · Health Issues
Various issues related to the Patient Protection and Affordable Care Act (P.L. 111-148) and Health Care and Education Reconciliation Act of 2010 (P.L. 111-152); H.R. 1744/S. 20 employer mandate repeal; H.R. 1063/S. 1718 Medicare Secondary Payer reform; H.R. 2206 auto enrollment repeal; consumer directed health products; H.R. 436; H.R. 5842; H.R. 2529; H.R. 1004; H.R. 5858; H.R. 2010; S. 1098; S. 1368; H.R. 605; S. 312; H.R. 450; Small Business Health Options Program.
Client expense: $900,000 · Firm income: Not reported
Government targets: Commerce, Dept of (DOC), Consumer Product Safety Commission (CPSC), Equal Employment Opportunity Commission (EEOC), Federal Reserve System, Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Labor Relations Board (NLRB), Office of Management & Budget (OMB), Office of Thrift Supervision (OTS), Office of the Comptroller of the Currency (OCC), SENATE, Securities & Exchange Commission (SEC), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Customs & Border Protection, U.S. Trade Representative (USTR), White House Office
2012 · second_quarter · Health Issues
HR 397: Reform Americans Can Afford Act of 2011 High cost plan tax, employer provisions. H.R. 436: Health Care Cost Reduction Act of 2012 H.R. 439, S.73: State Leadership in Health Care Act To prevent Employee Retirement Income Security Act (ERISA) from being waived. H.R. 524: Restoring Consumer-driven Health Care Act of 2011 HR 605: Patients' Freedom to Choose Act (Sec. 1-3, repeal restrictions on Health Savings Accounts, Medicare Set Asides and Health Flexible Spending Arrangements enacted in Affordable Care Act.) HR 1050: Small Business Health Fairness Act of 2011 (Sec. 1-6, creating association health plans.) HR 1173: Fiscal Responsibility and Retirement Security Act of 2011 (Sec. 1-2, repeal Community Living Assistance Services and Supports Act, CLASS Act.) H.R. 2529, S. 1368: Restoring Access to Medication Act H.R. 5842: Restoring Access to Medication Act of 2012 S. 244: State Health Care Choice Act To prevent Employee Retirement Income Security Act (ERISA) from being waived. S. 248: Empowering States to Innovate Act To prevent Employee Retirement Income Security Act (ERISA) from being waived. S. 312: Patients' Freedom to Choose Act Sec. 1-3, repeal restrictions on Health Savings Accounts, Medicare Set Asides and Health Flexible Spending Arrangements enacted in Affordable Care Act.
Client expense: $688,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2012 · second_quarter · Taxation/Internal Revenue Code
H.R.369, Health Savings and Affordability Act (Austria) HSA improvements H.R. 436, Health Care Cost Reduction Act (Paulsen) HSA, HRA, FSA provisions, ACA provisions H.R. 450, Restoring Assistance for Families' and Seniors' Health Expenses Act (Reichert) repeal of HSA and FSA restrictions 16. Specific Lobbying Issues (continued): H.R. 524, Restoring Consumer-driven Health Care Act (Quayle) repeal of HSA restrictions H.R. 605, Patients' Freedom to Choose Act (Paulsen) repeal of HSA and FSA restrictions H.R. 1004, Health Flexible Spending Arrangements Improvements Act (Boustany) -- distribution of unused amounts from a Health FSA H.R. 1370, Repeal of ACA Premium Tax (Boustany) H.R. 2010, Family and Retirement Health Investment Act (Paulsen) HSA and FSA improvements H.R. 2529, Restoring Access to Medication Act (Jenkins) use of HSA funds and FSA funds to purchase OTC medications H.R. 5842, Restoring Access to Medication Act (Jenkins) use of HSA, HRA, and FSA funds for over-the-counter medications H.R. 5858, Health Savings Accounts Improvements Act (Herger) HSA provisions H.R. 6005, Long-Term Care and Retirement Security Act (Courtney) tax incentives for purchase of LTC insurance, consumer protections H.R. 5651, FDA Reform Act (Upton) pharmaceutical, medical device issues S. 312, Patients' Freedom to Choose Act (Hutchison) repeal of HSA and FSA restrictions S. 1098, Family and Retirement Health Investment Act (Hatch) HSA and FSA improvements S. 1368, Restoring Access to Medication Act (Roberts) use of HSA funds and FSA funds to purchase OTC medications S. 1880, Jobs and Premium Protection Act (Barrasso) repeal of health insurance premium tax S. 2516, the FDA Safety and Innovation Act (Harkin) pharmaceutical, medical device issues S. 3187, the FDA Safety and Innovation Act (Harkin) pharmaceutical, medical device issues Regulatory Issues: Annual insurer provider fees; issues concerning the patient-centered outcomes research fee; employer coverage mandate, W-2 reporting requirements, and other issues relating to health care reform implementation.
Client expense: $2,240,000 · Firm income: Not reported
Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Federal Bureau of Investigation (FBI), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Pension & Welfare Benefits Administration, SENATE, Treasury, Dept of, White House Office
2012 · second_quarter · Health Issues
H.R. 1370 / S. 1880, To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act (Public Law 111-148); H.R. 1744 / S. 20, the American Job Protection Act; H.R. 2529, Restoring Access to Medication Act; S. 720, Repeal the CLASS Entitlement Act; H.R. 5, Protecting Access to Healthcare Act; H.R. 436, Health Care Cost Reduction Act of 2012; H.R. 5842, Restoring Access to Medication Act of 2012; H.R. 5858, Health Savings Accounts Improvements Act of 2012; Center for Consumer Information and Insurance Oversight and Centers for Medicare and Medicaid Services: General Guidance on Federally-Facilitated Exchanges; Repealing over the counter restrictions included in the Patient Protection and Affordable Care Act;
Client expense: $470,000 · Firm income: Not reported
Government targets: Defense, Dept of (DOD), Environmental Protection Agency (EPA), Equal Employment Opportunity Commission (EEOC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE
2012 · second_quarter · Taxation/Internal Revenue Code
H.R.2529/S.1368, Restoring Access to Medication Act. Issues related to insuring access to over-the-counter drugs and Flexible Spending Accounts/Health Savings Accounts.
Client expense: Not reported · Firm income: $50,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE