VBID for Better Care Act of 2014

HR 81, HR 105, HR.RES.17, HR 344, HR 544, HR 582, HR 607, HR 675, HR 762, HR 763, HR 903, HR 1076, HR 1200, HR 1205, HR 1239, HR 1248, HR 1254, HR 1342, HR 1549, HR 1558, HR 2328, HR 2527, HR 2575, HR 2577, HR 2667, HR 2995, HR 2988, HR 3362, HR 3367, HR 4244, HR 4128, HR 4144, HR 2453, HR 4160, HR 4302, HR 1179, HR 5183, HR 5557, S.CON. RES.8, S24, S351, S399, S.AMDT.409, S482, S603, S650, S701, S764, S1188, S1729, S2069, S2173, S2174, S2175, S2546,S2783, H.R.5860, H.R. 3512

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Treasury, Dept of, White House Office

HR 81, HR 105, HR.RES.17, HR 344, HR 544, HR 582, HR 607, HR 675, HR 762, HR 763, HR 903, HR 1076, HR 1200, HR 1205, HR 1239, HR 1248, HR 1254, HR 1342, HR 1549, HR 1558, HR 2328, HR 2527, HR 2575, HR 2577, HR 2667, HR 2995, HR 2988, HR 3362, HR 3367, HR 4244, HR 4128, HR 4144, HR 2453, HR 4160, HR 4302, HR 1179, HR 5183, HR 5557, S.CON. RES.8, S24, S351, S399, S.AMDT.409, S482, S603, S650, S701, S764, S1188, S1729, S2069, S2173, S2174, S2175, S2546,S2783

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE, Treasury, Dept of, White House Office

H.R. 162, Medicaid Integrity Act (Bachmann) - Medicaid health plan audits H.R. 670, Puerto Rico Medicare Part B Equity Act (Pierluisi) H.R. 928, Medicare Prescription Drug Savings and Choice Act (Schakowsky) - Medicare Part D changes H.R. 1024, Medication Therapy Management Empowerment Act (McMorris Rodgers) - medication therapy management programs H.R. 1179, Improving Access to Medicare Coverage Act (Courtney) - Medicare coverage of skilled nursing care H.R. 1102, Medicare Prescription Drug Price Negotiation Act (Welch) - Medicare Part D price negotiations H.R. 1853, Medicaid Accountability and Care Act (Cassidy) -federal financing of state Medicaid programs H.R. 2305, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Roskam-Carney) - fighting fraud and abuse H.R. 2453, Medicare Beneficiary Preservation of Choice Act (Rothfus-Schrader) - MA enrollment rules H.R. 2524, Medicare Better Health Rewards Program Act (Paulsen-Kind) - wellness incentives H.R. 2753, Securing Care for Seniors Act (Black) - MA payment and enrollment issues, wellness incentives H.R, 2960, Medicare Prescription Drug Integrity Act of 2013 (Pallone) - Part D drug utilization review H.R. 3512, Seniors' Health Care Choice Act (Heck) - MA open enrollment period H.R. 3890, Better Care, Lower Cost Act (Paulsen-Welch) - delivery models for Medicare beneficiaries with chronic conditions H.R. 4015, SGR Repeal and Medicare Provider Payment Modernization Act (Burgess) - SGR repeal, quality- and value-based payment reforms, ACA individual mandate delay H.R. 4160, Keep the Promise to Seniors Act (Ellmers) - blocking Medicare Part D proposed rule H.R. 4302, Protecting Access to Medicare Act (Pitts) - 12-month Medicare SGR patch, Medicare Advantage Special Needs Plans, Appropriate Use Criteria for Advanced Diagnostic Imaging, Medicare sequestration cuts, Other Medicare-Medicaid Extenders H.R. 4484, Strengthening Healthcare Options for Vulnerable Populations Act (Sinema) - MA special needs plans H.R. 4998, MA Participant Bill of Rights Act (DeLauro) - MA plan provider networks H.R. 5113, Protecting Seniors' Medicare Choices from Obamacare Act (Coffman) - MA stabilization program H.R. 5183, Value Based Insurance Design for Better Care Act (Black) - MA demonstration to test VBID methodologies H.R. 5364, CHIP Extension and Improvement Act (Pallone) - federal CHIP funding Draft Bill, Protecting the Integrity of Medicare Act (Brady) - preventing fraud in Medicare and Medicaid S. 11, Fiscal Sustainability Act (Corker) - Medicare, Medigap, Medicaid issues S. 25 (Hatch) - extension of Medicare sequestration cuts S. 117, Medicare Prescription Drug Price Negotiation Act (Klobuchar) - Medicare Part D price negotiations S. 324, Puerto Rico Medicare Part B Equity Act (Schumer) S. 408, Medicare Prescription Drug Savings and Choice Act (Durbin) - Medicare Part D changes S. 569, Improving Access to Medicare Coverage Act (Brown) - Medicare coverage of skilled nursing care S. 1123, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Carper-Coburn) - fighting fraud and abuse S. 1228, Medicare Better Health Rewards Program Act (Wyden-Portman) - wellness incentives S. 1787, Medicaid Managed Care Responsibility and Equity Act (Rockefeller) - medical loss ratio requirement for Medicaid managed care organizations S. 1871, SGR Repeal and Medicare Beneficiary Access Act (Senate Finance Committee) - SGR repeal, quality- and value-based payment reforms, MA Special Needs Plans, Cost Plans, QI and TMA programs S. 1932, Better Care, Lower Cost Act (Wyden-Isakson) - delivery models for Medicare beneficiaries with chronic conditions S. 1980, Medicaid and CHIP Continuous Quality Act (Rockefeller) - 12 month continuous enrollment S. 2000, SGR Repeal and Medicare Provider Payment Modernization Act (Senate Finance Committee) - SGR repeal, quality- and value-based payment reforms S. 2110, SGR Repeal and Medicare Provider Payment Modernization Act (Wyden) - SGR repeal, quality- and value-based payment reforms, Medicare and Medicaid extenders S. 2122, Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act (Hatch) - SGR repeal, quality- and value-based payment reforms, ACA individual mandate repeal S. 2361, Stop SCAMS Act (Nelson-Collins) - reducing Medicare fraud S. 2461, CHIP Extension Act (Rockefeller) --- federal CHIP funding S. 2552, MA Participant Bill of Rights Act (Brown-Blumenthal) - MA plan provider networks S. 2783, Value Based Insurance Design for Better Care Act (Thune) - MA demonstration to test VBID methodologies Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, encounter data and other data-related issues, and audit issues; bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, and audits); in-home health risk assessments; Medicare Medical Loss Ratio issues; implementation of sequestration under the Medicare Advantage and Part D programs; implications of the health insurer fee for MA and Part D plans; application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, SSA and CMS premium withhold processing issues, enrollment rules, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible Special Needs Plans (SNPs); Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, Part D coverage gap discount program, including employer group waiver plan (EGWP) issues, and other operational issues; issues raised by Part D coverage of new specialty drugs, the Part D non-interference policy and related issues (e.g., preferred pharmacy and any willing pharmacy requirements, standards for network pharmacy reimbursement, and policies regarding sponsor negotiation of pharmacy price concessions); Medication Therapy Management Program requirements; Part D requirements for offering basic and enhanced alternative plans; MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; issues relating to MA and Part D Star Rating system including measures, the methodology for calculating ratings, and the role of the ratings for payment purposes; implementation of the Affordable Care Act (ACA) changes to the Part D coverage gap; ongoing implementation issues for the Medicare cost plan program including enrollment, marketing materials review and approval and other operational issues;implementation issues for the Medicare Retiree Drug Subsidy program; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education Program; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; Medicare clinical trials; Medicare/Medicaid integration for dual eligibles, including the Capitated Financial Alignment Demonstration; Medicaid managed care regulations and policies, including the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, fraud and abuse compliance, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including block grants, the calculation of the federal medical assistance (federal matching) percentage (FMAP), and intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost issues affecting Medicaid health plans including issues raised by Medicaid coverage of new specialty drugs; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues and CHIP reauthorization; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including Medicaid managed care organization provider tax issues; standards for electronic prescribing; implementation of Medicaid changes of interest to Medicaid health plans made in the ACA including Medicaid expansion, the managed care organization (MCO) prescription drug rebate provisions, minimum payments to primary care providers (PCPs), interactions between the Medicaid program and health insurance exchanges, and Medicaid and CHIP maintenance of effort (MOE) requirements; implications of the health insurer fee for Medicaid health plans ; issues related to Medigap coverage financing for infectious disease such as Ebola; and other issues relating to health care reform implementation. *AddMACPACtoAgencyList

H.R. 162, Medicaid Integrity Act (Bachmann) - Medicaid health plan audits. H.R. 670, Puerto Rico Medicare Part B Equity Act (Pierluisi). H.R. 928, Medicare Prescription Drug Savings and Choice Act (Schakowsky) - Medicare Part D changes. H.R. 1024, Medication Therapy Management Empowerment Act (McMorris Rodgers) - medication therapy management programs. H.R. 1179, Improving Access to Medicare Coverage Act (Courtney) - Medicare coverage of skilled nursing care. H.R. 1102, Medicare Prescription Drug Price Negotiation Act (Welch) - Medicare Part D price negotiations. H.R. 1853, Medicaid Accountability and Care Act (Cassidy) -federal financing of state Medicaid programs. H.R. 2305, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Roskam-Carney) - fighting fraud and abuse. H.R. 2453, Medicare Beneficiary Preservation of Choice Act (Rothfus-Schrader) - MA enrollment rules. H.R. 2524, Medicare Better Health Rewards Program Act (Paulsen-Kind) - wellness incentives. H.R. 2753, Securing Care for Seniors Act (Black) - MA payment and enrollment issues, wellness incentives. H.R, 2960, Medicare Prescription Drug Integrity Act of 2013 (Pallone) - Part D drug utilization review. H.R. 3512, Seniors' Health Care Choice Act (Heck) - MA open enrollment period. H.R. 3890, Better Care, Lower Cost Act (Paulsen-Welch) - delivery models for Medicare beneficiaries with chronic conditions. H.R. 4015, SGR Repeal and Medicare Provider Payment Modernization Act (Burgess) - SGR repeal, quality- and value-based payment reforms, ACA individual mandate delay. H.R. 4160, Keep the Promise to Seniors Act (Ellmers) - blocking Medicare Part D proposed rule. H.R. 4302, Protecting Access to Medicare Act (Pitts) - 12-month Medicare SGR patch, Medicare Advantage Special Needs Plans, Appropriate Use Criteria for Advanced Diagnostic Imaging, Medicare sequestration cuts, Other Medicare-Medicaid Extenders . H.R. 4484, Strengthening Healthcare Options for Vulnerable Populations Act (Sinema) - MA special needs plans. H.R. 4998, MA Participant Bill of Rights Act (DeLauro) - MA plan provider networks. H.R. 5113, Protecting Seniors' Medicare Choices from Obamacare Act (Coffman) - MA stabilization program. H.R. 5183, Value Based Insurance Design for Better Care Act (Black) - MA demonstration to test VBID methodologies. H.R. 5364, CHIP Extension and Improvement Act (Pallone) - federal CHIP funding. Draft Bill, Protecting the Integrity of Medicare Act (Brady) - preventing fraud in Medicare and Medicaid. S. 11, Fiscal Sustainability Act (Corker) - Medicare, Medigap, Medicaid issues. S. 25 (Hatch) - extension of Medicare sequestration cuts. S. 117, Medicare Prescription Drug Price Negotiation Act (Klobuchar) - Medicare Part D price negotiations. S. 324, Puerto Rico Medicare Part B Equity Act (Schumer). S. 408, Medicare Prescription Drug Savings and Choice Act (Durbin) - Medicare Part D changes. S. 569, Improving Access to Medicare Coverage Act (Brown) - Medicare coverage of skilled nursing care. S. 1123, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Carper-Coburn) - fighting fraud and abuse. S. 1228, Medicare Better Health Rewards Program Act (Wyden-Portman) - wellness incentives. S. 1787, Medicaid Managed Care Responsibility and Equity Act (Rockefeller) - medical loss ratio requirement for Medicaid managed care organizations. S. 1871, SGR Repeal and Medicare Beneficiary Access Act (Senate Finance Committee) - SGR repeal, quality- and value-based payment reforms, MA Special Needs Plans, Cost Plans, QI and TMA programs. S. 1932, Better Care, Lower Cost Act (Wyden-Isakson) - delivery models for Medicare beneficiaries with chronic conditions. S. 1980, Medicaid and CHIP Continuous Quality Act (Rockefeller) - 12 month continuous enrollment. S. 2000, SGR Repeal and Medicare Provider Payment Modernization Act (Senate Finance Committee) - SGR repeal, quality- and value-based payment reforms. S. 2110, SGR Repeal and Medicare Provider Payment Modernization Act (Wyden) - SGR repeal, quality- and value-based payment reforms, Medicare and Medicaid extenders. S. 2122, Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act (Hatch) - SGR repeal, quality- and value-based payment reforms, ACA individual mandate repeal. S. 2361, Stop SCAMS Act (Nelson-Collins) - reducing Medicare fraud. S. 2461, CHIP Extension Act (Rockefeller) --- federal CHIP funding. S. 2552, MA Participant Bill of Rights Act (Brown-Blumenthal) - MA plan provider networks. S. 2783, Value Based Insurance Design for Better Care Act (Thune) - MA demonstration to test VBID methodologies.

S.452, Medicare Diabetes Prevention Act - Discussed bill with Senate. Discussed draft language on senior mental health with Senate HELP Committee staff. (no bill) Discussed Medicare Reform (no bill) Discussed Age Rating in the ACA and rate shock. (no bill)Labor, HHS Appropriations bill, 2015-Lobbied on preserving funding for the ACA; defended meaningful use of the ACA. (no bill) Discussed need to increase health information technology quality measurements and access to qualified systems. (no bill) H.R. 1099, To repeal the Prevention and Public Health Fund - Lobbied against the repeal of the Prevention and Public Health Trust Fund, an important component in state and community efforts to prevent illness and promote health. Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. Lobbied in support of Medicare physician payment reform. Discussed legislation to make prescription drugs more affordable to older Americans. S. 1416/H.R. 2645 (112th Congress), Medigap Medical Loss Ratio Improvement Act of 2011. Discussed coverage for screening depression and screening and counseling for alcohol misuse. (no bill) Discussed consumer operated and oriented plan programs. (no bill) Discussed standards related to risk adjustment, reinsurance, and risk mitigation as they relate to exchanges. (no bill) H.R.2077, MLR Repeal Act of 2011 - Expressed opposition to the elimination of provision in the Affordable Care Act (P.L. 111-148)Discussed opposition to draft legislation regarding the elimination of grandfathered status. (no bill) Discussed association health plans with DOL, HHS and DOT. (no bill) Discussed quality and care coordination with HHS. (no bill) Discussed Essential Health Benefits with HHS. (no bill) Discussed employer affordability safe harbor. (no bill) Discussed health insurance exchanges - eligibility, enrollment, premium tax credits. (no bill) Discussed Basic Health Plans. (no bill) Discussed Medigap reform. (no bill) Discussed Pre-existing Condition Insurance Program. (no bill) Discussed role of grandfathered plans. (no bill) Discussed reauthorization of the Older Americans Act and other amendments to the OAA. (no bill) Discussed dual eligibles. (no bill) Discussed S.1119, Positive Aging Act of 2013. H.R. 2641, Farm Program bill-Discussed the severed nutrition programs from Farm Bill. S. 562, Seniors Mental Health Access Improvement Act - Discussed the bill for eventual endorsement. Discussed need to suport family caregivers and long-term services and supports. (no bill) Discussed repeal of medical device tax. (no bill) Discussed proposed regulation relating to Medicaid expansion coverage and minimum essential coverage. (no bill) Discussed Affordable Care Act Medicaid expansion issues, including AARP comments on state 1115 waiver proposals to use premium assistance authority to expand Medicaid. (no bill) Discussed Medicare-Medicaid integration efforts and financial alignment demonstrations, other CMS demonstration initiatives. (no bill) H.R.3850/S. 1562, Discussed Older Americans Act reauthorization legislation. H.R.3662, the Mental Health Access Improvement Act - Sent letter of endorsement. H.R.4879, the Research for All Act - Sent letter of endorsement. S.2348, the Removing Barriers to Colorectal Cancer Screening Act - Sent letter of endorsement. Discussed legislation to address health disparities. (no bill) H.R.5294 - Discussed Health Equity & Accountability Act of 2014; no endorsement due to budget implications. H.R. 83, Consolidated and Further Continuing Appropriations, 2015 - Lobbied to protect various healthcare programs serving seniors from disproportionate reduction.Discussed FTC participation in state scope of practice issues. Also sent follow-up items for their review. (no bill) Discussed Social Security programs. (no bill) Lobbied against cuts to the health care prevention fund. (no bill) Discussed deficit reduction issues dealing with Medicare and Medicaid including concerns over increasing Medicare's age of eligibility, chained CPI, and cuts to Medicaid. (no bill) Discussed Affordable Care Medicaid expansion issues. Centers for Medicare and Medicaid Services, Center for Medicaid and CHIP Services. Discussed Medicaid reform, Medicare-Medicaid integration efforts and financial alignment demonstrations, other CMS demonstration initiatives. (no bill) Discussed Medicaid expansion implementation, as included in the ACA (P.L. 111-140). Discussed Medicaid including concerns over cuts to Medicaid flexibility and Medicaid structural reforms to. (no bill) Discussed implementation of the Affordable Care Act, its provisions and H.R. 95 to repeal the Patient Protection and Affordable Care Act. Labor, Health and Human Services Appropriations Act, 2015 - Lobbied to protect employment, health and human services and energy assistance programs for seniors, disabled and low income assistance. (no bill) Discussed Affordable Care Act Medicaid expansion issues, including questions related to the use of premium assistance authority to expand Medicaid. (no bill) H.R. 1263, Excellence in Mental Health Act - Discussed the bill for eventual endorsement. Discussed Affordable Care Act Medicaid expansion issues, including AARP comments on state 1115 waiver proposals to use premium assistance authority to expand Medicaid, Centers for Medicare and Medicaid Services, Center for Medicaid and CHIP Services. Discussed perspectives on proposed ideas for legislation to address health disparities with HHS and CMS officials. Discussed H.R. 3717, the Helping Families in Mental Health Crisis Act. Discussed Affordable Care Act Medicaid expansion issues, including AARP comments on state 1115 waiver proposals to use premium assistance authority to expand Medicaid. Centers for Medicare and Medicaid Services, Center for Medicaid and CHIP Services. Discussed Medicare-Medicaid integration efforts and financial alignment demonstrations, other CMS demonstration initiatives. (no bill) Discussed the Convention on the Rights of Persons with Disabilities. (no bill) H.R. 2835/S. 1647, Restoring Access to Medication Act of 2013 - Urged co-sponsorship of these bills. Discussed hospital readmissions. (no bill) Discussed Affordable Care Act Medicaid expansion issues, including AARP comments on state 1115 waiver proposals to use premium assistance authority to expand Medicaid. Discussed Medicare-Medicaid integration efforts and financial alignment demonstrations, other CMS demonstration initiatives. (no bill) H. R. 3850 - Discussed Older Americans Act reauthorization legislation. H.R. 5183, Better Care Act - Discussed legislation with staff regarding the bill. H.R. 5232, Notice of Observation Treatment & Implication for Care Eligibility (Notice Act) - Discussed legislation with staff. Discussed oral health and older adulsts. (no bill)

H.R. 4, Jobs for America Act H.R. 45, To repeal the Patient Protection and Affordable Care Act and health care-related provisions in the Health Care and Education Reconciliation Act of 2010 H.R. 523, Protect Medical Innovation Act of 2013 H.R. 581, First Responder Medical Device Tax Relief Act H.R. 582, Healthcare Tax Relief and Mandate Repeal Act H.R. 763, To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act H.R. 781, Medicare Identity Theft Prevention Act of 2013 H.R. 903 / S. 399, American Job Protection Act H.R. 1248 / S. 610, Family Health Care Flexibility Act H.R. 1254, Auto Enroll Repeal Act H.R. 1295, Medical Device Tax Elimination Act H.R. 1558 / S. 24, Small Business Health Relief Act of 2013 H.R. 1735, In It All Together Act H.R. 1780, To provide that the only health plans that the Federal Government may make available to the President, Vice President, Members of Congress, and Federal employees are those created under the Patient Protection and Affordable Care Act or offered through a health insurance exchange H.R. 2575, Save American Workers Act H.R. 2667, Authority for Mandate Delay Act H.R. 2668, Fairness for American Families Act H.R. 2674, Job Creation Act of 2013 H.R. 2835, Restoring Access to Medication Act of 2013 H.R. 2925, Strengthening Medicare Anti-Fraud Measures Act of 2013 H.R. 2988 / S. 701 / S. 1188, Forty Hours Is Full Time Act of 2013 H.R. 3077, TELE-MED Act of 2013 H.R. 3121, American Health Care Reform Act of 2013 H.R. 3124, Investing in Permanency for Youth in Foster Care Act H.R. 3204, Drug Quality and Security Act H.R. 3367, To amend section 9010 of the Patient Protection and Affordable Care Act to delay the application of the health insurance provider annual fee until 2016 and to provide a process to return to consumers any amounts attributable to the expected application of the annual fee to 2014 or 2015 H.R. 3419, Small Business Fairness in Obamacare Act H.R. 3462 / S. 1735, Self-Insurance Protection Act H.R. 3522, Employee Health Care Protection Act of 2013 H.R. 4118, Suspending the Individual Mandate Penalty Law Equals Fairness (SIMPLE) Act H.R. 4160, Keep the Promise to Seniors Act of 2014 H.R. 4302, Protecting Access to Medicare Act of 2014 H.R. 4414, Expatriate Health Coverage Clarification Act of 2014 H.R. 5183 / S. 2783, Value Based Insurance Design for Better Care Act of 2014 H.R. 5557, Streamlining Verification for Americans Act H.R. 5860, Small Business Healthcare Relief Act of 2014 S. 232, Medical Device Access and Innovation Protection Act S. 603, Jobs and Premium Protection Act S. 612, Social Security Number Protection Act of 2011 S. 1031, Family and Retirement Health Investment Act of 2013 S. 1488, A bill to delay the application of the individual health insurance mandate, to delay the application of the employer health insurance mandate, and for other purposes S. 1647, Restoring Access to Medication Act Final Regulation on Incentives for Nondiscriminatory Wellness Programs in Group Health Plans (78 Fed. Reg. 33,157-33,176, June 3, 2013) (to be codified at 26 C.F.R. pt. 54) 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 C.F.R. pts. 147, 155, 156) Proposed Regulation on the Health Insurance Market Rules; Rate Review (77 Fed. Reg. 70,584-70,617, November 26, 2012) (to be codified at 45 C.F.R. pts. 144, 147, 150) Proposed Regulation 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 C.F.R. pts. 153, 155, 156, 157, 158) Proposed Regulation on Medicaid, Children's Health Insurance Programs, and Exchanges: Essential Health Benefits in Alternative Benefit Plans, Eligibility Notices, Fair Hearing and Appeal Processes for Medicaid and Exchange Eligibility Appeals and Other Provisions Related to Eligibility and Enrollment for Exchanges, Medicaid and CHIP, and Medicaid Premiums and Cost Sharing (78 Fed. Reg. 4,594-4,724, January 22, 2013) (to be codified at 42 C.F.R. Parts 430, 431, 433, 435, 440, 447, 457) Proposed Regulation on Shared Responsibility for Employers Regarding Health Coverage (78 Fed. Reg. 218-253, January 2, 2013) (to be codified at 26 C.F.R. pts. 1, 54, 301) Proposed Regulation on Information Reporting of Minimum Essential Coverage (78 Fed. Reg. 54,986-54,996, September 9, 2013) (to be codified at 26 C.F.R. pts. 1, 301) Proposed Regulation on Information Reporting by Applicable Large Employers on Health Insurance Coverage Offered Under Employer-Sponsored Plans (78 Fed. Reg. 54,996-55,013, September 9, 2013) (to be codified at 26 C.F.R. pt. 301) Proposed Regulation regarding the Establishment of Exchanges and Qualified Health Plans; Small Business Health Options Program (78 Fed. Reg. 15,553-15,558, March 11, 2013) (to be codified at 45 C.F.R. pts. 155, 156) Proposed Regulation on the Health Insurance Providers Fee (78 Fed. Reg. 14,034-14,046, March 4, 2013) (to be codified at 26 C.F.R. pt. 57) Proposed Regulation on Minimum Value of Eligible Employer-Sponsored Plans and Other Rules Regarding the Health Insurance Premium Tax Credit (78 Fed. Reg. 25,909-25,916, May 3, 2013) (to be codified at 26 C.F.R. pt. 1) Proposed Regulation on Contract Year 2015 Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Program, (79 Fed. Reg. 1,918-2,073, January 10, 2014) (to be codified at 42 C.F.R. pts. 409, 417, 422 et al.) Proposed Regulation on Exchange and Insurance Market Standards for 2015 and Beyond (79 Fed. Reg. 15,808-15,879, March 21, 2014) (to be codified at 45 C.F.R. pts. 146, 147, 148 et al.) Proposed Regulation on Minimum Essential Coverage and Other Rules Regarding Shared Responsibility Payment for Individuals (79 Fed. Reg. 4,302-4,308, January 27, 2014) (to be codified at 26 C.F.R. pt. 1) Proposed Regulation on HHS Notice of Benefit and Payment Parameters for 2016 (79 Fed. Reg. 70,674-70,760, November 26, 2014) (to be codified at 45 C.F.R. pts. 144, 147 et al.) Various issues relating to the Patient Protection and Affordable Care Act (P.L. 111-148) and the Health Care and Education Reconciliation Act of 2010 (P.L. 111-152), including caps on compensation deductibility required under section 9014, implementation of regulatory process, legislative corrections, coverage, financing, delivery reform, 1099 reporting, Grandfathering, health savings accounts (HSAs) and flexible spending accounts (FSAs) changes, CMS claims database, IPAB, CLASS program, employer mandate, medical loss ratio, medical malpractice reform, exchanges, impact on small business, provider network adequacy, definition of small group market, reporting requirements for issuers and applicable large employers, premium stabilization programs, the Small Business Tax Credit, incompleteness or inaccuracy of cost impact analyses, lack of quantified benefit analysis, need for empirical data sources on which to base costs and benefits, ERISA preemption, HSA and FSA accounts; Public Health Service Act (P.L. 78-410), Internal Revenue Code and the Employee Retirement Income Security Act (ERISA) (P.L. 93-406), including regulatory process and legislative corrections to the ERISA preemption; deliver reform changes to Medicare Advantage and Medicare Prescription Drug (Part D) programs, including rebates and non-interference with prescription drug prices; entitlement reform; health information technology; legal protections against certain self-referral to physician owned hospitals

H.R. 351, Protecting Seniors Access to Medicare Act of 2013: Provisions related to the Independent Payment Advisory Board H.R. 460, Patients Access to Treatments Act: Provisions related to cost sharing in the specialty tier H.R. 928, Medicare Prescription Drug Savings and Choice Act of 2013: Provisions related to Part D issues H.R. 1024, Medication Therapy Management Empowerment Act of 2013: Provisions related to medication therapy management in Part D H.R. 1102, Medicare Prescription Drug Price Negotiation Act of 2013: Provisions related to Part D issues and non-interference H.R. 1588, Medicare Drug Savings Act of 2013: Provisions related to Part D issues H.R. 2753 Securing Care for Seniors Act: Provisions related to Value Based Insurance Design H.R. 2810, Medicare Patient Access and Quality Improvement Act: Provisions related to SGR reform H.R. 2827, To amend title XVIII of the Social Security Act to allow for fair application of the exceptions process for drugs in tiers in formularies in prescription drug plans under Medicare part D: Provisions related to Medicare Part D Drug Tier Formularies H.R. 2925, Strengthening Medicare Anti-Fraud Measures Act of 2013: Provisions related to Office of Inspector General (OIG) enforcement of fraud and abuse laws H.R. 3392, Medicare Part D Patient Safety and Drug Abuse Prevention Act of 2013: Provisions related to lock-in programs H.R. 3796, Comprehensive Care Payment Innovation Act: Provisions related to alternative payment models H.R. 3890 Better Care, Lower Cost Act: Provisions related to Part D, value-based insurance design, and chronic disease H.R. 4015, SGR Repeal and Medicare Provider Payment Modernization Act of 2014: Provisions related to sustainable growth rate (SGR) and Medicare provider payment reform H.R. 4160, Keep the Promise to Seniors Act of 2014: Provisions related to Part D issues H.R. 4302, Protecting Access to Medicare Act of 2014: Provisions related to the biopharmaceutical industry H.R. 4577, Ensuring Seniors Access to Local Pharmacies Act of 2014: Provisions related to Part D preferred pharmacy networks H.R. 5183, Value Based Insurance Design for Better Care Act of 2014: Provisions related to valued base insurance design demonstration program H.R. 5558 ACO Improvement Act: Provisions related to alternate payment models H.R. 5780, Protecting Integrity in Medicare Act of 2014: Provisions related to addressing fraud and prescription drug abuse S. 117, Medicare Prescription Drug Price Negotiation Act of 2013: Provisions related to Part D issues and non-interference S. 351, Protecting Seniors Access to Medicare Act of 2013: Provisions related to Independent Payment Advisory Board S. 408, Medicare Prescription Drug Savings and Choice Act of 2013: Provision related to Part D issues S. 557, Medication Therapy Management Empowerment Act of 2013: Provisions related to Part D and medication therapy management S. 740, Medicare Drug Savings Act of 2013: Provisions related to Part D issues Deficit reduction policy issues S. 882, Stop Trafficking of Pills (STOP) Act: Provisions related to lock-in programs (112th Congress) S. 1365, Part D Beneficiary Appeals Fairness Act: Provisions related to the specialty tier in Part D S. 1871, SGR Repeal and Medicare Beneficiary Access Act of 2013: Provisions related to reforming Medicare physician payments S. 1932, Better Care, Lower Cost Act: Provisions related to Part D, value-based insurance design, and chronic disease S. 2000, SGR Repeal and Medicare Provider Payment Modernization Act of 2014: Provisions related to SGR reform S. 2110, Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014: Provisions related to SGR reform Hospital Improvements for Payment (HIP) Act of 2014: Provisions related to Medicare reform (no bill number) Medicare Prescription Drug Diversion and Abuse Prevention Act: Provisions related to diversion and abuse (no bill number) Contract Year 2015 Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefits Programs: Provisions related to Part D Proposals to increase co-payments for Part D beneficiaries receiving the low-income subsidy Medicaid Program, Covered Outpatient Drugs rulemaking Medicare sustainable growth rate policy issues Implementation issues relating to the Physician Payment Sunshine Act, including Medicare, Medicaid, Childrens Health Insurance Programs; Transparency Reports and Reporting of Physician Ownership or Investment Interests rulemaking Issues related to better use of medicine and adherence

HR 81, HR 105, HR.RES.17, HR 344, HR 544, HR 582, HR 607, HR 675, HR 762, HR 763, HR 903, HR 1076, HR 1200, HR 1205, HR 1239, HR 1248, HR 1254, HR 1342, HR 1549, HR 1558, HR 2328, HR 2527, HR 2575, HR 2577, HR 2667, HR 2995, HR 2988, HR 3362, HR 3367, HR 4244, HR 4128, HR 4144, HR 2453, HR 4160, HR 4302, HR 1179, HR 5183, HR 5557, S.CON. RES.8, S24, S351, S399, S.AMDT.409, S482, S603, S650, S701, S764, S1188, S1729, S2069, S2173, S2174, S2175, S2546,S2783, H.R.5860, H.R. 3512

Client expense: $45,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Treasury, Dept of, White House Office

"Accessing Medicare Therapies Act" - H.R.1239 "To require the Secretary of Health and Human Services to provide for recommendations for the development and use of clinical data registries for the improvement of patient care" - H.R.5214 "The Value-Based Insurance Design (VBID) for Better Care Act of 2014" - H.R.5183 "Patients' Access to Treatment" - H.R.460 "FDA Safety Over Sequestration Act" - H.R.2725/S 1413 "Preserving Access to Orphan Act" - S.1128/H.R. 2315 "Medical Foods for Inborn Errors of Metabolism"

Client expense: Not reported · Firm income: Not reported

Government targets: Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, SENATE, Social Security Administration (SSA)

Issues related to NCHC's policy priorities of health care transparency, SGR and physician payment reform, care coordination in Medicare, prescription drug pricing, consumer engagement and CHIP reauthorization; Advocacy related to specific legislation including HR 5183, the VBID for Better Care Act of 2014, HR 4994/S 2553 the IMPACT Act of 2014, and the discussion draft of the Protecting Integrity in Medicare Act of 2014; a proposed community-based Medicare Advantage Special Needs Plan demonstration designed to provide better care at lower cost to low-income beneficiaries with LTSS needs; issues related to a strong biosimilar pathway and the use of identical international non-propietary names (INNs) for biosimilar products

Client expense: Not reported · Firm income: Not reported

Government targets: Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, SENATE

Advocated for fairness in Medicare Advantage Stars Quality measurements; opposed cuts to Medicare Advantage rates; S. 2501, Hospital Readmissions Program Accuracy and Accountability Act of 2014; H.R. 4484, Strengthening Healthcare Options for Vulnerable Populations Act; H.R. 5183, VBID for Better Care Act of 2014.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 4, Jobs for America Act H.R. 45, To repeal the Patient Protection and Affordable Care Act and health care-related provisions in the Health Care and Education Reconciliation Act of 2010 H.R. 523, Protect Medical Innovation Act of 2013 H.R. 581, First Responder Medical Device Tax Relief Act H.R. 582, Healthcare Tax Relief and Mandate Repeal Act H.R. 763, To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act H.R. 781, Medicare Identity Theft Prevention Act of 2013 H.R. 903 / S. 399, American Job Protection Act H.R. 1248 / S. 610, Family Health Care Flexibility Act H.R. 1254 /S. 2546, Auto Enroll Repeal Act H.R. 1295, Medical Device Tax Elimination Act H.R. 1558 / S. 24, Small Business Health Relief Act of 2013 H.R. 1735, In It All Together Act H.R. 1780, To provide that the only health plans that the Federal Government may make available to the President, Vice President, Members of Congress, and Federal employees are those created under the Patient Protection and Affordable Care Act or offered through a health insurance exchange H.R. 2194 / S. 1031, Family and Retirement Health Investment Act of 2013 H.R. 2575, Save American Workers Act H.R. 2667, Authority for Mandate Delay Act H.R. 2668, Fairness for American Families Act H.R. 2674, Job Creation Act of 2013 H.R. 2835, Restoring Access to Medication Act of 2013 H.R. 2925, Strengthening Medicare Anti-Fraud Measures Act of 2013 H.R. 2988 / S. 701 / S. 1188, Forty Hours Is Full Time Act of 2013 H.R. 3077, TELE-MED Act of 2013 H.R. 3121, American Health Care Reform Act of 2013 H.R. 3124, Investing in Permanency for Youth in Foster Care Act H.R. 3204, Drug Quality and Security Act H.R. 3367, To amend section 9010 of the Patient Protection and Affordable Care Act to delay the application of the health insurance provider annual fee until 2016 and to provide a process to return to consumers any amounts attributable to the expected application of the annual fee to 2014 or 2015 H.R. 3419, Small Business Fairness in Obamacare Act H.R. 3462 / S. 1735, Self-Insurance Protection Act H.R. 3522, Employee Health Care Protection Act of 2013 H.R. 4118, Suspending the Individual Mandate Penalty Law Equals Fairness (SIMPLE) Act H.R. 4160, Keep the Promise to Seniors Act of 2014 H.R. 4302, Protecting Access to Medicare Act of 2014 H.R. 4414, Expatriate Health Coverage Clarification Act of 2014 H.R. 5183 / S. 2783, Value Based Insurance Design for Better Care Act of 2014 H.R. 5213, Simplifying Technical Aspects Regarding Seasonality (STARS) Act of 2014 H.R. 5557, Streamlining Verification for Americans Act S. 232, Medical Device Access and Innovation Protection Act S. 603, Jobs and Premium Protection Act S. 612, Social Security Number Protection Act of 2011 S. 1031, Family and Retirement Health Investment Act of 2013 S. 1488, A bill to delay the application of the individual health insurance mandate, to delay the application of the employer health insurance mandate, and for other purposes S. 1647, Restoring Access to Medication Act 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 C.F.R. pts. 147, 155, 156) Proposed Regulation on the Health Insurance Market Rules; Rate Review (77 Fed. Reg. 70,584-70,617, November 26, 2012) (to be codified at 45 C.F.R. pts. 144, 147, 150) Proposed Regulation 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 C.F.R. pts. 153, 155, 156, 157, 158) Proposed Regulation on the 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 C.F.R. pts. 147, 155, 156) Proposed Regulation on Medicaid, Children's Health Insurance Programs, and Exchanges: Essential Health Benefits in Alternative Benefit Plans, Eligibility Notices, Fair Hearing and Appeal Processes for Medicaid and Exchange Eligibility Appeals and Other Provisions Related to Eligibility and Enrollment for Exchanges, Medicaid and CHIP, and Medicaid Premiums and Cost Sharing (78 Fed. Reg. 4,594-4,724, January 22, 2013) (to be codified at 42 C.F.R. pts. 430, 431, 433, 435, 440, 447, 457) Proposed Regulation on Incentives for Nondiscriminatory Wellness Programs in Group Health Plans (77 Fed. Reg. 70,620-70,642, November 26, 2012) (to be codified at 26 C.F.R. pt. 54) Proposed Regulation on Shared Responsibility for Employers Regarding Health Coverage (78 Fed. Reg. 218-253, January 2, 2013) (to be codified at 26 C.F.R. pts. 1, 54, 301) Proposed Regulation on Information Reporting of Minimum Essential Coverage (78 Fed. Reg. 54,986-54,996, September 9, 2013) (to be codified at 26 C.F.R. pts. 1, 301) Proposed Regulation on Information Reporting by Applicable Large Employers on Health Insurance Coverage Offered Under Employer-Sponsored Plans (78 Fed. Reg. 54,996-55,013, September 9, 2013) (to be codified at 26 C.F.R. pt. 301) Proposed Regulation regarding the Establishment of Exchanges and Qualified Health Plans; Small Business Health Options Program (78 Fed. Reg. 15,553-15,558, March 11, 2013) (to be codified at 45 C.F.R. pts. 155, 156) Proposed Regulation on the Health Insurance Providers Fee (78 Fed. Reg. 14,034-14,046, March 4, 2013) (to be codified at 26 C.F.R. pt. 57) Proposed Regulation on Minimum Value of Eligible Employer-Sponsored Plans and Other Rules Regarding the Health Insurance Premium Tax Credit (78 Fed. Reg. 25,909-25,916, May 3, 2013) (to be codified at 26 C.F.R. pt. 1) Proposed Regulation on HHS Notice of Benefit and Payment Parameters for 2015 (78 Fed. Reg. 72,322-72,392, December 2, 2013) (to be codified at 45 C.F.R. pts. 144, 147, 153, 155, 156) Proposed Regulation on Amendments to Excepted Benefits (78 Fed. Reg. 77,632-77,642, December 24, 2013) (to be codified at 29 C.F.R. pt. 2590) Proposed Regulation on Contract Year 2015 Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Program, (79 Fed. Reg. 1,918-2,073, January 10, 2014) (to be codified at 42 C.F.R. pts. 409, 417, 422 et. al.) Proposed Regulation on Exchange and Insurance Market Standards for 2015 and Beyond (79 Fed. Reg. 15,808-15,879, March 21, 2014) (to be codified at 45 C.F.R. pts. 146, 147, 148 et al.) Proposed Regulation on Ninety-Day Waiting Period Limitation (79 Fed. Reg. 10,320-10,325, February 24, 2014) (to be codified at 29 C.F.R. pt. 2590; 45 C.F.R. pt. 147; and 26 C.F.R. pt. 147) Proposed Regulation on Minimum Essential Coverage and Other Rules Regarding Shared Responsibility Payment for Individuals (79 Fed. Reg. 4,302-4,308, January 27, 2014) (to be codified at 26 C.F.R. pt. 1) Draft Guidance Notices on Self-Monitoring Blood Glucose Test Systems for Over-the-Counter Use (79 Fed. Reg. 829-830, January 7, 2014) Statement for the Record in Response to a Notice of Meeting on Employee welfare and Pension Benefit Plans (79 Fed. Reg. 28,555-28,556, May 16, 2014) Various issues relating to the Patient Protection and Affordable Care Act (P.L. 111-148), including implementation of regulatory process, legislative corrections, coverage, financing, delivery reform, 1099 reporting, ERISA preemption, Grandfathering, health savings accounts (HSAs), health reimbursement accounts (HRAs), and flexible spending accounts (FSAs) changes, CMS claims database, IPAB, CLASS program, employer mandate, reporting requirements, medical loss ratio, medical malpractice reform, exchanges, the impact on small business, the Small Business Tax Credit, caps on compensation deductibility required under section 9014; Health Care and Education Affordability Reconciliation Act of 2010 (P.L. 111-152), including regulatory process and legislative corrections to the ERISA preemption, the impact on small business, the small business tax credit, insurance coverage, financing, delivery reform; changes to Medicare Advantage and Medicare Prescription Drug (Part D) programs non-interference with prescription drug prices; entitlement reform; forty-hour work week; health information technology

H.R. 351, Protecting Seniors Access to Medicare Act of 2013: Provisions related to the Independent Payment Advisory Board H.R. 460, Patients Access to Treatments Act: Provisions related to cost sharing in the specialty tier H.R. 928, Medicare Prescription Drug Savings and Choice Act of 2013: Provisions related to Part D issues H.R. 1024, Medication Therapy Management Empowerment Act of 2013: Provisions related to medication therapy management in Part D H.R. 1102, Medicare Prescription Drug Price Negotiation Act of 2013: Provisions related to Part D issues and non-interference H.R. 1588, Medicare Drug Savings Act of 2013: Provisions related to Part D issues H.R. 2753 Securing Care for Seniors Act: Provisions related to Value Based Insurance Design H.R. 2810, Medicare Patient Access and Quality Improvement Act: Provisions related to SGR reform H.R. 2827, To amend title XVIII of the Social Security Act to allow for fair application of the exceptions process for drugs in tiers in formularies in prescription drug plans under Medicare part D: Provisions related to Medicare Part D Drug Tier Formularies H.R. 2925, Strengthening Medicare Anti-Fraud Measures Act of 2013: Provisions related to fraud and abuse H.R. 3392, Medicare Part D Patient Safety and Drug Abuse Prevention Act of 2013: Provisions related to lock-in programs H.R. 3796, Comprehensive Care Payment Innovation Act: Provisions related to alternative payment models H.R. 3890 Better Care, Lower Cost Act: Provisions related to Part D, value-based insurance design, and chronic disease H.R. 4015, SGR Repeal and Medicare Provider Payment Modernization Act of 2014: Provisions related to sustainable growth rate (SGR) and Medicare provider payment reform H.R. 4160, Keep the Promise to Seniors Act of 2014: Provisions related to Part D issues H.R. 4302, Protecting Access to Medicare Act of 2014: Provisions related to the biopharmaceutical industry H.R. 4577, Ensuring Seniors Access to Local Pharmacies Act of 2014: Provisions related to Part D preferred pharmacy networks H.R. 5183, Value Based Insurance Design for Better Care Act of 2014: Provisions related to valued base insurance design demonstration program H.R. 5558 ACO Improvement Act: Provisions related to alternate payment models S. 117, Medicare Prescription Drug Price Negotiation Act of 2013: Provisions related to Part D issues and non-interference S. 351, Protecting Seniors Access to Medicare Act of 2013: Provisions related to Independent Payment Advisory Board S. 408, Medicare Prescription Drug Savings and Choice Act of 2013: Provision related to Part D issues S. 557, Medication Therapy Management Empowerment Act of 2013: Provisions related to Part D and medication therapy management S. 740, Medicare Drug Savings Act of 2013: Provisions related to Part D issues Deficit reduction policy issues S. 882, Stop Trafficking of Pills (STOP) Act: Provisions related to lock-in programs (112th Congress) S. 1365, Part D Beneficiary Appeals Fairness Act: Provisions related to the specialty tier in Part D S. 1871, SGR Repeal and Medicare Beneficiary Access Act of 2013: Provisions related to reforming Medicare physician payments S. 1932, Better Care, Lower Cost Act: Provisions related to Part D, value-based insurance design, and chronic disease S. 2000, SGR Repeal and Medicare Provider Payment Modernization Act of 2014: Provisions related to SGR reform S. 2110, Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014: Provisions related to SGR reform Medicare Prescription Drug Diversion and Abuse Prevention Act: Provisions related to diversion and abuse (no bill number) Contract Year 2015 Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefits Programs: Provisions related to Part D Proposals to increase co-payments for Part D beneficiaries receiving the low-income subsidy Medicaid Program, Covered Outpatient Drugs rulemaking Medicare sustainable growth rate policy issues Implementation issues relating to the Physician Payment Sunshine Act, including Medicare, Medicaid, Childrens Health Insurance Programs; Transparency Reports and Reporting of Physician Ownership or Investment Interests rulemaking Issues related to better use of medicine and adherence Protecting Integrity in Medicare Act of 2014 (no bill number): Provisions related to addressing fraud, prescription drug abuse, and other issues Lock-in concepts generally

H.R. 162, Medicaid Integrity Act (Bachmann) - Medicaid health plan audits H.R. 670, Puerto Rico Medicare Part B Equity Act (Pierluisi) H.R. 928, Medicare Prescription Drug Savings and Choice Act (Schakowsky) - Medicare Part D changes H.R. 1179, Improving Access to Medicare Coverage Act (Courtney) - Medicare coverage of skilled nursing care H.R. 1102, Medicare Prescription Drug Price Negotiation Act (Welch) - Medicare Part D price negotiations H.R. 1853, Medicaid Accountability and Care Act (Cassidy) -federal financing of state Medicaid programs H.R. 2305, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Roskam-Carney) - fighting fraud and abuse H.R. 2453, Medicare Beneficiary Preservation of Choice Act (Rothfus-Schrader) - MA enrollment rules H.R. 2524, Medicare Better Health Rewards Program Act (Paulsen-Kind) - wellness incentives H.R. 2753, Securing Care for Seniors Act (Black) - MA payment and enrollment issues, wellness incentives H.R, 2960, Medicare Prescription Drug Integrity Act of 2013 (Pallone) - Part D drug utilization review H.R. 3512, Seniors' Health Care Choice Act (Heck) - MA open enrollment period H.R. 3890, Better Care, Lower Cost Act (Paulsen-Welch) - delivery models for Medicare beneficiaries with chronic conditions H.R. 4015, SGR Repeal and Medicare Provider Payment Modernization Act (Burgess) - SGR repeal, quality- and value-based payment reforms, ACA individual mandate delay H.R. 4160, Keep the Promise to Seniors Act (Ellmers) - blocking Medicare Part D proposed rule H.R. 4302, Protecting Access to Medicare Act (Pitts) - 12-month Medicare SGR patch, Medicare Advantage Special Needs Plans, Appropriate Use Criteria for Advanced Diagnostic Imaging, Medicare sequestration cuts, Other Medicare-Medicaid Extenders H.R. 4484, Strengthening Healthcare Options for Vulnerable Populations Act (Sinema) - MA special needs plans H.R. 4998, MA Participant Bill of Rights Act (DeLauro) - MA plan provider networks H.R. 5113, Protecting Seniors' Medicare Choices from Obamacare Act (Coffman) - MA stabilization program H.R. 5183, Value Based Insurance Design for Better Care Act (Black) - MA demonstration to test VBID methodologies H.R. 5364, CHIP Extension and Improvement Act (Pallone) - federal CHIP funding Draft Bill, Protecting the Integrity of Medicare Act (Brady) - preventing fraud in Medicare and Medicaid S. 11, Fiscal Sustainability Act (Corker) - Medicare, Medigap, Medicaid issues S. 25 (Hatch) - extension of Medicare sequestration cuts S. 117, Medicare Prescription Drug Price Negotiation Act (Klobuchar) - Medicare Part D price negotiations S. 324, Puerto Rico Medicare Part B Equity Act (Schumer) S. 408, Medicare Prescription Drug Savings and Choice Act (Durbin) - Medicare Part D changes S. 569, Improving Access to Medicare Coverage Act (Brown) - Medicare coverage of skilled nursing care S. 1123, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Carper-Coburn) - fighting fraud and abuse S. 1228, Medicare Better Health Rewards Program Act (Wyden-Portman) - wellness incentives S. 1787, Medicaid Managed Care Responsibility and Equity Act (Rockefeller) - medical loss ratio requirement for Medicaid managed care organizations S. 1871, SGR Repeal and Medicare Beneficiary Access Act (Senate Finance Committee) - SGR repeal, quality- and value-based payment reforms, MA Special Needs Plans, Cost Plans, QI and TMA programs S. 1932, Better Care, Lower Cost Act (Wyden-Isakson) - delivery models for Medicare beneficiaries with chronic conditions S. 1980, Medicaid and CHIP Continuous Quality Act (Rockefeller) - 12 month continuous enrollment S. 2000, SGR Repeal and Medicare Provider Payment Modernization Act (Senate Finance Committee) - SGR repeal, quality- and value-based payment reforms S. 2110, SGR Repeal and Medicare Provider Payment Modernization Act (Wyden) - SGR repeal, quality- and value-based payment reforms, Medicare and Medicaid extenders S. 2122, Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act (Hatch) - SGR repeal, quality- and value-based payment reforms, ACA individual mandate repeal S. 2361, Stop SCAMS Act (Nelson-Collins) - reducing Medicare fraud S. 2461, CHIP Extension Act (Rockefeller) --- federal CHIP funding S. 2552, MA Participant Bill of Rights Act (Brown-Blumenthal) - MA plan provider networks S. 2783, Value Based Insurance Design for Better Care Act (Thune) - MA demonstration to test VBID methodologies Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, encounter data and other data-related issues, and audit issues; bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, and audits); in-home health risk assessments; Medicare Medical Loss Ratio issues; implementation of sequestration under the Medicare Advantage and Part D programs; implications of the health insurer fee for MA and Part D plans; application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, SSA and CMS premium withhold processing issues, enrollment rules, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible Special Needs Plans (SNPs); Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, Part D coverage gap discount program, including employer group waiver plan (EGWP) issues, and other operational issues; issues raised by Part D coverage of new specialty drugs, the Part D non-interference policy and related issues (e.g., preferred pharmacy and any willing pharmacy requirements, standards for network pharmacy reimbursement, and policies regarding sponsor negotiation of pharmacy price concessions); Medication Therapy Management Program requirements; Part D requirements for offering basic and enhanced alternative plans; MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; issues relating to MA and Part D Star Rating system including measures, the methodology for calculating ratings, and the role of the ratings for payment purposes; implementation of the Affordable Care Act (ACA) changes to the Part D coverage gap; ongoing implementation issues for the Medicare cost plan program including enrollment, marketing materials review and approval and other operational issues; Medicare creditable drug coverage reporting requirements; implementation issues for the Medicare Retiree Drug Subsidy program; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education Program; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; Medicare clinical trials; Medicare/Medicaid integration for dual eligibles, including the Capitated Financial Alignment Demonstration; Medicaid managed care regulations and policies, including the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, fraud and abuse compliance, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including block grants, the calculation of the federal medical assistance (federal matching) percentage (FMAP), and intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost issues affecting Medicaid health plans including issues raised by Medicaid coverage of new specialty drugs; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues and CHIP reauthorization; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including Medicaid managed care organization provider tax issues; standards for electronic prescribing; implementation of Medicaid changes of interest to Medicaid health plans made in the ACA including Medicaid expansion, the managed care organization (MCO) prescription drug rebate provisions, minimum payments to primary care providers (PCPs), interactions between the Medicaid program and health insurance exchanges, and Medicaid and CHIP maintenance of effort (MOE) requirements; implications of the health insurer fee for Medicaid health plans ; issues related to Medigap coverage; issues relating to "meaningful use" requirements for health information technology; and other issues relating to health care reform implementation.

S.452, Medicare Diabetes Prevention Act - Discussed bill with Senate. Discussed draft language on senior mental health with Senate HELP Committee staff. (no bill) Discussed Medicare Reform (no bill) Discussed Age Rating in the ACA and rate shock. (no bill)Labor, HHS Appropriations bill, 2015-Lobbied on preserving funding for the ACA; defended meaningful use of the ACA. (no bill) Discussed need to increase health information technology quality measurements and access to qualified systems. (no bill) H.R. 1099, To repeal the Prevention and Public Health Fund - Lobbied against the repeal of the Prevention and Public Health Trust Fund, an important component in state and community efforts to prevent illness and promote health. Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. Lobbied in support of Medicare physician payment reform. Discussed legislation to make prescription drugs more affordable to older Americans. S. 1416/H.R. 2645 (112th Congress), Medigap Medical Loss Ratio Improvement Act of 2011. Discussed coverage for screening depression and screening and counseling for alcohol misuse. (no bill) Discussed consumer operated and oriented plan programs. (no bill) Discussed standards related to risk adjustment, reinsurance, and risk mitigation as they relate to exchanges. (no bill) H.R.2077, MLR Repeal Act of 2011 - Expressed opposition to the elimination of provision in the Affordable Care Act (P.L. 111-148)Discussed opposition to draft legislation regarding the elimination of grandfathered status. (no bill) Discussed association health plans with DOL, HHS and DOT. (no bill) Discussed quality and care coordination with HHS. (no bill) Discussed Essential Health Benefits with HHS. (no bill) Discussed employer affordability safe harbor. (no bill) Discussed health insurance exchanges - eligibility, enrollment, premium tax credits. (no bill) Discussed Basic Health Plans. (no bill) Discussed Medigap reform. (no bill) Discussed Pre-existing Condition Insurance Program. (no bill) Discussed role of grandfathered plans. (no bill) Discussed reauthorization of the Older Americans Act and other amendments to the OAA. (no bill) Discussed dual eligibles. (no bill) Discussed S.1119, Positive Aging Act of 2013. H.R. 2641, Farm Program bill-Discussed the severed nutrition programs from Farm Bill. S. 562, Seniors Mental Health Access Improvement Act - Discussed the bill for eventual endorsement. Discussed need to suport family caregivers and long-term services and supports. (no bill) Discussed repeal of medical device tax. (no bill) Discussed proposed regulation relating to Medicaid expansion coverage and minimum essential coverage. (no bill) Discussed Affordable Care Act Medicaid expansion issues, including AARP comments on state 1115 waiver proposals to use premium assistance authority to expand Medicaid. (no bill) Discussed Medicare-Medicaid integration efforts and financial alignment demonstrations, other CMS demonstration initiatives. (no bill) H.R.3850/S. 1562, Discussed Older Americans Act reauthorization legislation. H.R.3662, the Mental Health Access Improvement Act - Sent letter of endorsement. H.R.4879, the Research for All Act - Sent letter of endorsement. S.2348, the Removing Barriers to Colorectal Cancer Screening Act - Sent letter of endorsement. Discussed legislation to address health disparities. (no bill) H.R.5294 - Discussed Health Equity & Accountability Act of 2014; no endorsement due to budget implications. H.J. Res. 124, Continuing Appropriations Resolution, 2015 - Lobbied to protect various healthcare programs serving seniors from disproportionate reduction under Continuing Resolution.Discussed FTC participation in state scope of practice issues. Also sent follow-up items for their review. (no bill) Discussed Social Security programs. (no bill) Lobbied against cuts to the health care prevention fund. (no bill) Discussed deficit reduction issues dealing with Medicare and Medicaid including concerns over increasing Medicare's age of eligibility, chained CPI, and cuts to Medicaid. (no bill) Discussed Affordable Care Medicaid expansion issues. Centers for Medicare and Medicaid Services, Center for Medicaid and CHIP Services. Discussed Medicaid reform, Medicare-Medicaid integration efforts and financial alignment demonstrations, other CMS demonstration initiatives. (no bill) Discussed Medicaid expansion implementation, as included in the ACA (P.L. 111-140). Discussed Medicaid including concerns over cuts to Medicaid flexibility and Medicaid structural reforms to. (no bill) Discussed implementation of the Affordable Care Act, its provisions and H.R. 95 to repeal the Patient Protection and Affordable Care Act. Labor, Health and Human Services Appropriations Act, 2015 - Lobbied to protect employment, health and human services and energy assistance programs for seniors, disabled and low income assistance. (no bill) Discussed Affordable Care Act Medicaid expansion issues, including questions related to the use of premium assistance authority to expand Medicaid. (no bill) H.R. 1263, Excellence in Mental Health Act - Discussed the bill for eventual endorsement. Discussed Affordable Care Act Medicaid expansion issues, including AARP comments on state 1115 waiver proposals to use premium assistance authority to expand Medicaid, Centers for Medicare and Medicaid Services, Center for Medicaid and CHIP Services. Discussed perspectives on proposed ideas for legislation to address health disparities with HHS and CMS officials. Discussed H.R. 3717, the Helping Families in Mental Health Crisis Act. Discussed Affordable Care Act Medicaid expansion issues, including AARP comments on state 1115 waiver proposals to use premium assistance authority to expand Medicaid. Centers for Medicare and Medicaid Services, Center for Medicaid and CHIP Services. Discussed Medicare-Medicaid integration efforts and financial alignment demonstrations, other CMS demonstration initiatives. (no bill) Discussed the Convention on the Rights of Persons with Disabilities. (no bill) H.R. 2835/S. 1647, Restoring Access to Medication Act of 2013 - Urged co-sponsorship of these bills. Discussed hospital readmissions. (no bill) Discussed Affordable Care Act Medicaid expansion issues, including AARP comments on state 1115 waiver proposals to use premium assistance authority to expand Medicaid. Discussed Medicare-Medicaid integration efforts and financial alignment demonstrations, other CMS demonstration initiatives. (no bill) H. R. 3850 - Discussed Older Americans Act reauthorization legislation. H.R. 5183, Better Care Act - Discussed legislation with staff regarding the bill. H.R. 5232, Notice of Observation Treatment & Implication for Care Eligibility (Notice Act) - Discussed legislation with staff.

H.R. 162, Medicaid Integrity Act (Bachmann) - Medicaid health plan audits. H.R. 670, Puerto Rico Medicare Part B Equity Act (Pierluisi). H.R. 928, Medicare Prescription Drug Savings and Choice Act (Schakowsky) - Medicare Part D changes. H.R. 1179, Improving Access to Medicare Coverage Act (Courtney) - Medicare coverage of skilled nursing care. H.R. 1102, Medicare Prescription Drug Price Negotiation Act (Welch) - Medicare Part D price negotiations. H.R. 1853, Medicaid Accountability and Care Act (Cassidy) -federal financing of state Medicaid programs. H.R. 2305, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Roskam-Carney) - fighting fraud and abuse. H.R. 2453, Medicare Beneficiary Preservation of Choice Act (Rothfus-Schrader) - MA enrollment rules. H.R. 2524, Medicare Better Health Rewards Program Act (Paulsen-Kind) - wellness incentives. H.R. 2753, Securing Care for Seniors Act (Black) - MA payment and enrollment issues, wellness incentives. H.R, 2960, Medicare Prescription Drug Integrity Act of 2013 (Pallone) - Part D drug utilization review. H.R. 3512, Seniors' Health Care Choice Act (Heck) - MA open enrollment period. H.R. 3890, Better Care, Lower Cost Act (Paulsen-Welch) - delivery models for Medicare beneficiaries with chronic conditions. H.R. 4015, SGR Repeal and Medicare Provider Payment Modernization Act (Burgess) - SGR repeal, quality- and value-based payment reforms, ACA individual mandate delay. H.R. 4160, Keep the Promise to Seniors Act (Ellmers) - blocking Medicare Part D proposed rule. H.R. 4302, Protecting Access to Medicare Act (Pitts) - 12-month Medicare SGR patch, Medicare Advantage Special Needs Plans, Appropriate Use Criteria for Advanced Diagnostic Imaging, Medicare sequestration cuts, Other Medicare-Medicaid Extenders. H.R. 4484, Strengthening Healthcare Options for Vulnerable Populations Act (Sinema) - MA special needs plans. H.R. 4998, MA Participant Bill of Rights Act (DeLauro) - MA plan provider networks. H.R. 5113, Protecting Seniors' Medicare Choices from Obamacare Act (Coffman) - MA stabilization program. H.R. 5183, Value Based Insurance Design for Better Care Act (Black) - MA demonstration to test VBID methodologies. H.R. 5364, CHIP Extension and Improvement Act (Pallone) - federal CHIP funding. Draft Bill, Protecting the Integrity of Medicare Act (Brady) - preventing fraud in Medicare and Medicaid. S. 11, Fiscal Sustainability Act (Corker) - Medicare, Medigap, Medicaid issues. S. 25 (Hatch) - extension of Medicare sequestration cuts. S. 117, Medicare Prescription Drug Price Negotiation Act (Klobuchar) - Medicare Part D price negotiations. S. 324, Puerto Rico Medicare Part B Equity Act (Schumer). S. 408, Medicare Prescription Drug Savings and Choice Act (Durbin) - Medicare Part D changes. S. 569, Improving Access to Medicare Coverage Act (Brown) - Medicare coverage of skilled nursing care. S. 1123, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Carper-Coburn) - fighting fraud and abuse. S. 1228, Medicare Better Health Rewards Program Act (Wyden-Portman) - wellness incentives. S. 1787, Medicaid Managed Care Responsibility and Equity Act (Rockefeller) - medical loss ratio requirement for Medicaid managed care organizations. S. 1871, SGR Repeal and Medicare Beneficiary Access Act (Senate Finance Committee) - SGR repeal, quality- and value-based payment reforms, MA Special Needs Plans, Cost Plans, QI and TMA programs. S. 1932, Better Care, Lower Cost Act (Wyden-Isakson) - delivery models for Medicare beneficiaries with chronic conditions. S. 1980, Medicaid and CHIP Continuous Quality Act (Rockefeller) - 12 month continuous enrollment. S. 2000, SGR Repeal and Medicare Provider Payment Modernization Act (Senate Finance Committee) - SGR repeal, quality- and value-based payment reforms. S. 2110, SGR Repeal and Medicare Provider Payment Modernization Act (Wyden) - SGR repeal, quality- and value-based payment reforms, Medicare and Medicaid extenders. S. 2122, Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act (Hatch) - SGR repeal, quality- and value-based payment reforms, ACA individual mandate repeal. S. 2361, Stop SCAMS Act (Nelson-Collins) - reducing Medicare fraud. S. 2461, CHIP Extension Act (Rockefeller) --- federal CHIP funding. S. 2552, MA Participant Bill of Rights Act (Brown-Blumenthal) - MA plan provider networks. S. 2783, Value Based Insurance Design for Better Care Act (Thune) - MA demonstration to test VBID methodologies.

HR 5183/S. 2738 "Value-Based Insurance Design for Better Care Act of 2014" - entire bill

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

Government targets: Economic Development Administration, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

HR 81, HR 105, HR.RES.17, HR 344, HR 544, HR 582, HR 607, HR 675, HR 762, HR 763, HR 903, HR 1076, HR 1200, HR 1205, HR 1239, HR 1248, HR 1254, HR 1342, HR 1549, HR 1558, HR 2328, HR 2527, HR 2575, HR 2577, HR 2667, HR 2995, HR 2988, HR 3362, HR 3367, HR 4244, HR 4128, HR 4144, HR 2453, HR 4160, HR 4302, HR 1179, HR 5183, HR 5557, S.CON. RES.8, S24, S351, S399, S.AMDT.409, S482, S603, S650, S701, S764, S1188, S1729, S2069, S2173, S2174, S2175, S2546,S2783

Client expense: $45,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE, Treasury, Dept of, White House Office

Discussion of issues related to HR 4015/S 2000 the SGR Repeal and Medicare Provider Payment Modernization Act; HR 4994/S 2553 the Improving Medicare Post-Acute Care Transformation Act of 2014, HR 5183 The Value-Based Insurance Design Act of 2014, The CHIP Extension Act of 2014, and HR 4418 Expanding the Availability of Medicare Data Act.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE