Medicare DMEPOS Competitive Bidding Improvement Act of 2014

H.R. 4920 - Medicare DMEPOS Competitive Bidding Improvement Act of 2014. Proposals to reform the Medicare New Technology add-on payment provision for inpatient services.

Client expense: $580,000 · Firm income: Not reported

Government targets: Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, SENATE, State, Dept of (DOS), U.S. Trade Representative (USTR)

Discussed the Suicide Prevention Research INnovaTion Act (S. 2035). Supported the Mental Health First Aid Act of 2013 (S. 153). Supported ensuring network adequacy and protections for pediatric benefits within ACA's essential health benefits. Supports providing improved guidance around notification on Medicare eligibility to individuals not yet collecting Social Security benefits. Supports improving health benefit designs and a guarantee that there is health insurance plan transparency for Affordable Care Act enrollees. Supports protecting the definition of habilitative services and ensuring nondiscrimination as its relates to the provision of health benefits and services. Continues to discuss the 21st Century Cures Initiative with Congress. This initiative attempts to ensure improved access in the discovery, development and delivery of pharmaceutical therapies for the spinal cord injury community. Supports improved access to durable medical equipment and assistive technologies. Supports the Food and Drug Administration (FDA) addressing patient safety issues and the need for more guidance from the FDA on how biologics and biosimilars are being tested and made available to the public. Urges Congress to repeal the cap on therapy services under Medicare. Urges Congress to pursue passage of Ensuring Access To Quality Complex Rehabilitation Technology Act (HR 942/S. 948). Urges Congress to pass HR 4920 - The DMEPOS Medicare Improvement Act - requires state licenses for providers of durable medical equipment (DME) providers and requires that DME companies contracted with the Centers for Medicare and Medicaid must be bound by that contract to provide services and equipment to Medicare and Medicaid beneficiaries. Supports S. 1027 - improved co-ordination of disability and rehabilitation research funding at the National Institutes of Health. Opposes site-neutral payments under Medicare. Supports CMS including a broader range of remote access technologies in the basic health benefit packages offered under CMS.

Client expense: Not reported · Firm income: $75,000

H.R. 4920: ACE Kids Act of 2014; issues related to CHIP HR. 5364; S. 2461 Issues related to CHIP H.R. 2810- Medicare Patient Access and Quality Improvement Act; Sustainable Growth Rate provision H.R. 3077: Telehealth Enhancement Act of 2013 H.R. 3991: Critical Access Hospital Relief Act of 2014; provisions on 96-hour physician certification requirement H.R. 4302 Protecting Access to Medicare Act of 2014 CMS-1606-P Inpatient Psychiatric Facilities Prospective Payment System H.R. 5558: ACO Improvement Act H.R. 4851: FLEX-IT Act; provisions related to "Meaningful Use"

Client expense: Not reported · Firm income: $5,850

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R 4920- ACE Kids Act of 2014; issues related to CHIP H.R. 5364: S. 2461- Issues related to CHIP H.R. 2810 Meducare Patient Access and Quality Improvement Act; Sustainable Growth Rate Provisions H.R. 3077- Telehealth Enhancement Act of 2013 H.R. 3991- Critical Access Hospital Relief Act of 2014; provisions on 96-hour physician certification requirement H.R. 4302- Protecting Access to Medicare Act of 2014 CMS-1606-P Inpatient Psychiatric Facilities Prospective Payment System- Update for FY 2015 H.R. 5558- ACO Improvement Act H.R. 4851 FLEX-IT Act; provisions related to "Meaningful Use" H.R. 1180; S. 577 Resident Physician Shortage Reduction Act; issues related to Graduate Medical Education slots, criteria, and funding H.R. 1201 Training Tomorrow's Doctors Today; issues related to Graduate Medical Education slots, criteria, and funding

Client expense: Not reported · Firm income: $34,400

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 4920- ACE Kids Act of 2014; issues related to CHIP H.R. 5364; S. 2461- Issues related to CHIPH.R. 2810- Medicare Patient Access and Quality Improvement Act; Sustainable Growth Rate Provisions H.R. 3077-Telehealth Enhancement Act of 2013 H.R. 3991- Critical Access Hospital Relief Act of 2014; provisions on 96-hour physician certification requirement H.R. 4302- Protecting Access to Medicare Act of 2014 CMS-1606-P Inpatient Psychiatric Facilities Prospective Payment System-Update for Fiscal Year Beginning October 1, 2014 H.R. 5558- ACO Improvement Act H.R. 4851- FLEX-IT Act; provsions related to "Meaningful Use" H.R. 1180; S. 577 Resident Physician Shortage Reduction Act; issues related to Graduate Medical Education slots, criteria, and funding H.R. 1201- Training Tomorrow's Doctors Today; issues related to Graduate medical Education slots, criteria, and funding

Client expense: $60,391 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 5780: Protecting the Integrity of Medicare Act of 2014. H.R. 4920: Medicare DMEPOS Competitive Bidding Improvement Act of 2014.

Client expense: Not reported · Firm income: $50,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 942 and S. 948, Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013; H.R.1717, Medicare DMEPOS Market Pricing Program Act of 2013; H.R. 2375, Transparency and Accountability in Medicare Bidding Act of 2013; H.R. 4920 and S. 2975 Medicare DMEPOS Competitive Bidding Improvement Act

Client expense: $109,572 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

HR 3509: Patient Protection and Affordable Care Act of 2010 - various provisions including: Medical Device Excise Tax, various reimbursement cuts and policy proposals for medical imaging; remote monitoring technology in the context of accountable care organizations, medical homes and post acute bundling; transparency HR 3692: The Affordable Health Care for America Act: Imaging cuts, device tax transparency and remote monitoringHR 4695 Medicare OSA Sleep Testing Bill HR 1932 Better Care, Lower Cost Act PL 110-275: "Medicare Improvements for Patient and Providers Act" (sec. 135) - Medical imaging accreditations program; medical imaging clinical appropriateness demonstration program Decline in growth rate of Medicare non-hospital imaging services S 596 - The FITT Act of 2013 (Fostering Independence Through Technology Act) - specifically the telehealth provisions HR 2914 - Imaging self-referral HR 1717 - The Medicare DMEPOS - Marketing Pricing Program Act of 2013 HR 8 - "American Tax Payer Relief Act of 2012" - Medicare Imaging Cuts & Sustainable Growth Rate Extension Site-neutrality in payments (no bill number yet) HR 2375 - The Transparency and Accountability in Medicare Bidding Act of 2013 HR 4015 - Long-term Sustainable Growth Rate (SGR) replacement legislation Appropriate Use Criteria CT Dose Optimization HR 6179 - "The Telehealth Promotion Act of 2012" HR 6626 - "The Health Care Innovation and Marketplace Technologies Act of 2012" - Telemedicine provisions. Drafts in the House and Senate addressing the SGR formula - potential telehealth provisions. HR 4920 - The Medicare DMEPOS Competitive Bidding Improvement Act of 2014 HR 5083 The Medicare DMEPOS Audit Improvement and Reform Act

Client expense: $370,000 · Firm income: Not reported

Issues pertaining to durable medical equipment including: bidding, power wheelchairs, oxygen, diabetic supplies, negative pressure wound therapy, Medicare audits, sequestration, and fraud abuse; H.R. 942/S. 948- Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013, all provisions; H.R. 1250/S. 1012- Medicare Audit Improvement Act of 2013, all provisions; H.R. 27- Small Supplier Fairness in Bidding Competition Act of 2013, all provisions; H.R. 1717- Medicare DMEPOS Market Pricing Program Act of 2013, all provisions; H.R. 2375- Transparency and Accountability in Medicare Bidding Act of 2013, all provisions; H.R. 2810 - SGR Repeal and Medicare Beneficiary Access Act of 2013, all provisions; S. 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013, all provisions; H.R. 4302 - Protecting Access to Medicare Act of 2014, all provisions; H.R. 4920/ H.R. 5809/S.2975 Medicare DMEPOS Competitive Bidding Improvement Act of 2014.

Client expense: $70,000 · Firm income: Not reported

Discussed the Suicide Prevention Research Innovation Act (S. 2035). Supported the Mental Health First Aid Act of 2013 (S. 153). Signed on to a letter to the U.S. Department of Transportation and the U.S. Department of Health and Human Services asking for all modes of public transportation to announce the Suicide Prevention Lifeline for passengers on World Suicide Prevention Day. United Spinal highlighted improved clinical outcomes for rehabilitative care at in-patient rehab facilities over skilled nursing facilities for individuals with spinal cord injuries and other conditions such as brain injury and stroke. United Spinal discussed the 21st Century Cure initiative of Chairman Fred Upton (R-MI-6th) focusing on patient centered care. United Spinal supports Lifespan Respite Care Reauthorization Act (H.R.4683), a free-standing bill that reauthorizes the Lifespan Respite Care Program at $15 million a year for five years. United Spinal discussed the need to provide clarity and certainty for appropriate, risk-based oversight of health information technology.United Spinal supports HR 3077, the TeleMed Act, which allows Medicare providers licensed in one state to provide telemedicine services to certain Medicare beneficiaries across state lines. CMS has proposed a rule to expand prior authorization for DME affecting power wheelchairs, lower limb prostheses and negative pressure wound therapy. United Spinal is in general support of prior authorization is a process that certifies DME suppliers with CMS before they provide equipment and services to Medicare beneficiaries. United Spinal highlighted improved clinical outcomes for rehabilitative care at in-patient rehab facilities over skilled nursing facilities for individuals with spinal cord injuries and other conditions such as brain injury and stroke. United Spinal supports Ensuring Access to Quality Complex Rehabilitation Technology Act/HR 942/ S 948. which creates a separate benefit under Medicare for customized equipment known as complex rehab technology needed by people with significant disabilities. United Spinal discussed the negative impact capped rental agreements for medical equipment and supplies have on access to equipment for individuals with disabilities. United Spinal supports action on improving benefit designs, including cost-sharing options, and guarantee that there is plan transparency for ACA enrollees. United Spinal discussed the 21st Century Cure initiative of Chairman Fred Upton (R-MI-6th) focusing on patient centered care with Congressional staff. United Spinal discussed ACA enrollment and reenrollment matters with HHS. Discussed state of managed care in NYC for dual eligibles and potential improvements in the short term. United Spinal supports greater transparency in Medicare's competitive acquisition program for DMEPOS program as to how providers are evaluated by the Centers for Medicare and Medicaid Services and how the health of beneficiaries are being evaluated. United Spinal supports Medicare Demonstration of Coverage for Low Vision Devices Act of 2013 (H.R. 3749) which would establish a demonstration under the Medicare program for coverage of low vision aids. United Spinal supports HR 713/ S. 367 - Medicare Access to Rehabilitation Services Act of 2013 which eliminates therapy caps for rehabilitative services under Medicare without requiring an exceptions process. United Spinal presented recommendations to the Centers for Medicare and Medicaid Services regarding improvements to the Home and Community Based Services (HCBS) rule which was implemented in January 2014. The rule enhances the quality of HCBS, provides additional protections to HCBS program participants, and ensures that individuals receiving services through HCBS programs have full access to the benefits of community living. The letters recommendations include: ensuring transparency throughout the process; maintaining consistency with Olmstead [The Olmstead Supreme Court decision requires states to provide people with disabilities with the most integrated setting appropriate to their needs]; issuing necessary guidance promptly; clarifying consumer rights and ensuring that states properly identify and categorize settings. United Spinal supports the Community Integration Act/S. 2515. The Act would support the rebalancing of policies to ensure individuals with disabilities can leave institutions and live in the setting of their choosing. United Spinal supports HR 4920, the DMEPOS Medicare Improvement Act of 2014 which requires that providers of durable medical equipment, in areas known as competitive bidding areas, must be licensed in the states that they provide equipment and services and must be bound to the contract that they submitted to CMS if they are awarded a contract to provide equipment and services to Medicare beneficiaries. United Spinal discussed and presented recommendations to the Centers of Medicare and Medicaid Services to proceed with extreme caution when implementing a reimbursement cut in the provision of wound care therapy due to the effects of implementation on beneficiary access to NPWT. Supports making improvements to Medicare trust funds regarding liability settlements.

Discussed the Suicide Prevention Research Innovation Act (S. 2035). Supported the Mental Health First Aid Act of 2013 (S. 153). Signed on to a letter to the U.S. Department of Transportation and the U.S. Department of Health and Human Services asking for all modes of public transportation to announce the Suicide Prevention Lifeline for passengers on World Suicide Prevention Day. United Spinal highlighted improved clinical outcomes for rehabilitative care at in-patient rehab facilities over skilled nursing facilities for individuals with spinal cord injuries and other conditions such as brain injury and stroke. United Spinal discussed the 21st Century Cure initiative of Chairman Fred Upton (R-MI-6th) focusing on patient centered care. United Spinal supports Lifespan Respite Care Reauthorization Act (H.R.4683), a free-standing bill that reauthorizes the Lifespan Respite Care Program at $15 million a year for five years. United Spinal discussed the need to provide clarity and certainty for appropriate, risk-based oversight of health information technology.United Spinal supports HR 3077, the TeleMed Act, which allows Medicare providers licensed in one state to provide telemedicine services to certain Medicare beneficiaries across state lines. CMS has proposed a rule to expand prior authorization for DME affecting power wheelchairs, lower limb prostheses and negative pressure wound therapy. United Spinal is in general support of prior authorization is a process that certifies DME suppliers with CMS before they provide equipment and services to Medicare beneficiaries. United Spinal highlighted improved clinical outcomes for rehabilitative care at in-patient rehab facilities over skilled nursing facilities for individuals with spinal cord injuries and other conditions such as brain injury and stroke. United Spinal supports Ensuring Access to Quality Complex Rehabilitation Technology Act/HR 942/ S 948. which creates a separate benefit under Medicare for customized equipment known as complex rehab technology needed by people with significant disabilities. United Spinal discussed the negative impact capped rental agreements for medical equipment and supplies have on access to equipment for individuals with disabilities. United Spinal supports action on improving benefit designs, including cost-sharing options, and guarantee that there is plan transparency for ACA enrollees. United Spinal discussed the 21st Century Cure initiative of Chairman Fred Upton (R-MI-6th) focusing on patient centered care with Congressional staff. United Spinal discussed ACA enrollment and reenrollment matters with HHS. Discussed state of managed care in NYC for dual eligibles and potential improvements in the short term. United Spinal supports greater transparency in Medicare's competitive acquisition program for DMEPOS program as to how providers are evaluated by the Centers for Medicare and Medicaid Services and how the health of beneficiaries are being evaluated. United Spinal supports Medicare Demonstration of Coverage for Low Vision Devices Act of 2013 (H.R. 3749) which would establish a demonstration under the Medicare program for coverage of low vision aids. United Spinal supports HR 713/ S. 367 - Medicare Access to Rehabilitation Services Act of 2013 which eliminates therapy caps for rehabilitative services under Medicare without requiring an exceptions process. United Spinal presented recommendations to the Centers for Medicare and Medicaid Services regarding improvements to the Home and Community Based Services (HCBS) rule which was implemented in January 2014. The rule enhances the quality of HCBS, provides additional protections to HCBS program participants, and ensures that individuals receiving services through HCBS programs have full access to the benefits of community living. The letters recommendations include: ensuring transparency throughout the process; maintaining consistency with Olmstead [The Olmstead Supreme Court decision requires states to provide people with disabilities with the most integrated setting appropriate to their needs]; issuing necessary guidance promptly; clarifying consumer rights and ensuring that states properly identify and categorize settings. United Spinal supports the Community Integration Act/S. 2515. The Act would support the rebalancing of policies to ensure individuals with disabilities can leave institutions and live in the setting of their choosing. United Spinal supports HR 4920, the DMEPOS Medicare Improvement Act of 2014 which requires that providers of durable medical equipment, in areas known as competitive bidding areas, must be licensed in the states that they provide equipment and services and must be bound to the contract that they submitted to CMS if they are awarded a contract to provide equipment and services to Medicare beneficiaries. United Spinal discussed and presented recommendations to the Centers of Medicare and Medicaid Services to proceed with extreme caution when implementing a reimbursement cut in the provision of wound care therapy due to the effects of implementation on beneficiary access to NPWT. Supports making improvements to Medicare trust funds regarding liability settlements.

HR 3509: Patient Protection and Affordable Care Act of 2010 - various provisions including: Medical Device Excise Tax, various reimbursement cuts and policy proposals for medical imaging; remote monitoring technology in the context of accountable care organizations, medical homes and post acute bundling; transparency HR 3692: The Affordable Health Care for America Act: Imaging cuts, device tax transparency and remote monitoringHR 4695 Medicare OSA Sleep Testing Bill HR 1932 Better Care, Lower Cost Act PL 110-275: "Medicare Improvements for Patient and Providers Act" (sec. 135) - Medical imaging accreditations program; medical imaging clinical appropriateness demonstration program Decline in growth rate of Medicare non-hospital imaging services S 596 - The FITT Act of 2013 (Fostering Independence Through Technology Act) - specifically the telehealth provisions HR 2914 - Imaging self-referral HR 1717 - The Medicare DMEPOS - Marketing Pricing Program Act of 2013 HR 8 - "American Tax Payer Relief Act of 2012" - Medicare Imaging Cuts & Sustainable Growth Rate Extension Site-neutrality in payments (no bill number yet) HR 2375 - The Transparency and Accountability in Medicare Bidding Act of 2013 HR 4015 - Long-term Sustainable Growth Rate (SGR) replacement legislation Appropriate Use Criteria CT Dose Optimization HR 6179 - "The Telehealth Promotion Act of 2012" HR 6626 - "The Health Care Innovation and Marketplace Technologies Act of 2012" - Telemedicine provisions. Drafts in the House and Senate addressing the SGR formula - potential telehealth provisions. HR 4920 - The Medicare DMEPOS Competitive Bidding Improvement Act of 2014 HR 5083 The Medicare DMEPOS Audit Improvement and Reform Act

Client expense: $350,000 · Firm income: Not reported

H.R. 942 and S. 948, Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013; H.R.1717, Medicare DMEPOS Market Pricing Program Act of 2013; H.R. 2375, Transparency and Accountability in Medicare Bidding Act of 2013; H.R. 4920 Medicare DMEPOS Competitive Bidding Improvement Act

Client expense: $115,439 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Issues pertaining to durable medical equipment including: bidding, power wheelchairs, oxygen, diabetic supplies, negative pressure wound therapy, Medicare audits, sequestration, and fraud abuse; H.R. 942/S. 948- Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013, all provisions; H.R. 1250/S. 1012- Medicare Audit Improvement Act of 2013, all provisions; H.R. 27- Small Supplier Fairness in Bidding Competition Act of 2013, all provisions; H.R. 1717- Medicare DMEPOS Market Pricing Program Act of 2013, all provisions; H.R. 2375- Transparency and Accountability in Medicare Bidding Act of 2013, all provisions; H.R. 2810 - SGR Repeal and Medicare Beneficiary Access Act of 2013, all provisions; S. 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013, all provisions; H.R. 4302 - Protecting Access to Medicare Act of 2014, all provisions; H.R. 4920 Medicare DMEPOS Competitive Bidding Improvement Act of 2014.

Client expense: $90,000 · Firm income: Not reported

Issues pertaining to durable medical equipment including: bidding, power wheelchairs, oxygen, diabetic supplies, negative pressure wound therapy, Medicare audits, sequestration, and fraud abuse; H.R. 942/S. 948- Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013, all provisions; H.R. 1250/S. 1012- Medicare Audit Improvement Act of 2013, all provisions; H.R. 27- Small Supplier Fairness in Bidding Competition Act of 2013, all provisions;H.R. 1717- Medicare DMEPOS Market Pricing Program Act of 2013, all provisions; H.R. 2375- Transparency and Accountability in Medicare Bidding Act of 2013, all provisions; H.R. 2810 - SGR Repeal and Medicare Beneficiary Access Act of 2013, all provisions; S. 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013, all provisions; H.R. 4302 - Protecting Access to Medicare Act of 2014, all provisions; H.R. 4920 Medicare DMEPOS Competitive Bidding Improvement Act of 2014.

Client expense: $80,000 · Firm income: Not reported

Issues pertaining to durable medical equipment including: bidding, power wheelchairs, oxygen, diabetic supplies, negative pressure wound therapy, Medicare audits, sequestration, and fraud abuse; H.R. 942/S. 948- Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013, all provisions; H.R. 1250/S. 1012- Medicare Audit Improvement Act of 2013, all provisions; H.R. 27- Small Supplier Fairness in Bidding Competition Act of 2013, all provisions;H.R. 1717- Medicare DMEPOS Market Pricing Program Act of 2013, all provisions; H.R. 2375- Transparency and Accountability in Medicare Bidding Act of 2013, all provisions; H.R. 2810 - SGR Repeal and Medicare Beneficiary Access Act of 2013, all provisions; S. 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013, all provisions; H.R. 4302 - Protecting Access to Medicare Act of 2014, all provisions; H.R. 4920 Medicare DMEPOS Competitive Bidding Improvement Act of 2014.

Client expense: $80,000 · Firm income: Not reported

H.R. 942 and S. 948, Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013; H.R.1717, Medicare DMEPOS Market Pricing Program Act of 2013; H.R. 2375, Transparency and Accountability in Medicare Bidding Act of 2013; H.R. 4920 Medicare DMEPOS Competitive Bidding Improvement Act

Client expense: $151,710 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE