Medicare Dental, Vision, and Hearing Benefit Act of 2016

Medicare and Medicaid reform; Medicare competitive bidding; PL 108-173: Medicare Prescription Drug and Modernization Act of 2003; Budget Resolutions; Community Choice Act; PL 111-148: Patient Protection and Affordable Care Act; PL 111-152, 124 Stat. 1029: Health Care and Education Reconciliation Act of 2010; HR 132: ObamaCare Repeal Act; S 2449/HR 4631: Autism CARES (Collaboration, Accountability, Research, Education and Support) Act of 2014; S 539/HR 775: Medicare Access to Rehabilitation Services Act; HR 2339: To amend title XIX of the Social Security Act to clarify the treatment of lottery winnings and other lump sum income for purposes of income eligibility under the Medicaid program, and for other purposes; HR 3229: To amend title XVIII of the Social Security Act to provide for the non-application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs and accessories; and HR 5396: Medicare Dental, Vision and Hearing Act of 2015.

Client expense: $157,721 · Firm income: Not reported

Government targets: Administration for Children & Families (ACF), Defense, Dept of (DOD), Education, Dept of, Equal Employment Opportunity Commission (EEOC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Council on Disability, SENATE, Transportation, Dept of (DOT), U.S. Architectural & Transportation Barriers Compliance Board (ACCESS), Veterans Affairs, Dept of (VA), White House Office

Preservation of Medicaid as an entitlement program and avoiding cuts, including per capita caps and block grants. Expansion of Medicare benefits to include dental, vision, and hearing (H.R. 5396) Improving Medicaid care coordination for medically complex children (H.R. 546, S. 298) Implementation of and improving the Achieving a Better Life Experience Act, P.L. 113-295 Implementation of the Affordable Care Act, P.L. 111-148 and P.L. 111-192 HCBS Settings Rule S. 1604 Transition to Independence Medicaid Buy-In Option. ABLE Age Adjustment Act, S. 2704 and H.R. 4813 ABLE Financial Planning Act, S. 2703 and H.R. 4794 ABLE to Work Act, S. 2702 and H.R. 4795

Client expense: $40,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Education, Dept of, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Social Security Administration (SSA), Treasury, Dept of, White House Office

HR 2446- Electronic visit verification for personal care services Improving Access to Quality Long-Term Care Services HR 2646- Helping Families in Mental Health Crisis Act S 2680- Mental Health Reform Act of 2016 S 2787- States Achieve Medicaid Expansion (SAME) Act of 2016 HR 5396- Medicare Dental, Vision, and Hearing Benefit Act Medicaid Payments and Upper Payment Limits Improving Medicare benefits HR 5367- Seniors' Security Act of 2016 ACA and tax treatment of health care; alternatives to the ACA, tax exclusion for employer-provided health care, policies to rein in prescription drug costs S 2579- Funding for water infrastructure and other aid to address lead crisis in Flint, MI Medicaid funding and benefits Medicare funding, benefits, policy, eligibility age, means tests, spending equity across jurisdictions

Client expense: $650,000 · Firm income: Not reported

Medicare Privatization. (No bill.) Proposals to transform traditional Medicare to a private insurance carrier program. Medicare Benefit Redesign. (No bill.) Proposals pertaining to Parts A and B deductibles; premiums, including means-testing; a catastrophic cap on out-of-pocket spending; the eligibility age; and proposals to privatize Medicare. Medicare Eligibility Age. (No bill.) Proposals to raise the eligibility age for Medicare from 65 to 67. Medicare Drug Savings. S. 1083, H.R. 2005, the Medicare Drug Savings Act: proposals to extend the application of Medicaid drug rebates to prescription drugs paid for by Medicare and used by Medicare-Medicaid eligible beneficiaries (dual-eligibles), and by people receiving the Medicare Part D Low-Income Subsidy. Medicare Prescription Drug Price Negotiation. H.R. 3061, S. 31, the Medicare Prescription Drug Price Negotiation Act of 2015: proposals to authorize the Secretary of the Department of Health and Human Services to negotiate discounts, rebates, and other price concessions to lower the cost paid by Medicare to pharmaceutical manufacturers. Medicare Prescription Drug Price Negotiation. H.R. 4207, Medicare Fair Drug Pricing Act of 2015: proposal to allow the Secretary of HHS to negotiate prices with manufacturers where little or no competition exists for drugs. Medicare Prescription Drug Plan Option. H.R. 3261, S. 1884, the Medicare Prescription Drug Savings and Choice Act of 2015: proposals to create one or more Medicare-administered drug plans with uniform premiums, providing seniors with the opportunity to purchase drugs directly through the Medicare program; requires the federal government to use its purchasing power to negotiate lower prices on prescription drugs for beneficiaries who enroll in the Medicare-administered plan. Medicare Home Health Benefits. (No bill.) Proposals pertaining to copayments for beneficiaries receiving the Medicare home health benefit. Medicare Observation Status. S. 843, H.R. 1571, Improving Access to Medicare Coverage Act of 2015: proposal to count days in the hospital in observation status toward meeting the three-day prior hospitalization requirement for skilled nursing facility (SNF) care eligibility. Comprehensive Health Care Reform. P.L. 111-148, Patient Protection and Affordable Care Act; P.L. 111-152, Health Care and Education Reconciliation Act of 2010: implementation of provisions reducing Medicare Advantage plan payments; requiring higher income Medicare beneficiaries to pay an increased share of Medicare Parts B and D premium costs; expanding benefits for low-income beneficiaries under the Medicare Savings Programs and the Part D Low-Income Subsidy (LIS); expanding coverage of prevention services; testing payment and delivery system reforms; and providing expanded Medicaid coverage. Patent Reform. S. 1137, Patent Act; H.R. 9, Innovation Act: proposal to carve brand-named pharmaceutical manufacturers out of an expedited United States Patent and Trademark Office (USPTO) review process that allows generic companies to bypass costly litigation when challenging drug patents. Expanding Drug Monopolies. H.R. 6, 21st Century Cures Act: proposal to extend orphan drug market exclusivity for existing drugs to new indications. Reducing Prescription Drug Costs. S. 2023, H.R. 3513, Prescription Drug Affordability Act: proposals to allow Medicare to negotiate drug prices, to allow Medicare and Medicaid to receive additional rebates from brand and generic drugs, and to allow for the re-importation of drugs from Canada. Reducing the cost of biologics. H.R. 5573, S. 3094, Price, Innovation and Competition for Essential Drugs (PRICED) Act: proposal to reduce the marketing exclusivity period for biologics from 12 to 7 years. Drug payment under Medicare Part B. H.R. 5122, to prohibit further action on the proposed rule regarding testing of Medicare Part B prescription drug models: proposal to prohibit implementation of a proposed demonstration testing new ways of paying physicians for drugs in order to eliminate incentives to unnecessarily prescribe high cost drugs. Medicare Fraud. H.R. 5340, Fighting Medicare Fraud Act: Legislation to close off a loophole allowing Medicare fraud offenders to evade enforcement authority when they move to a new company. Out-of-pocket drug costs. S.2864, RXCAP Act of 2016: proposal to cap out-of-pocket costs for Part D enrollees. Chronic Care Coordination. (No bill.) Proposals to facilitate the delivery of high-quality care for people with Medicare living with multiple chronic conditions. Medicare Vision, Dental and Hearing Coverage. H.R. 3308, Seniors Have Eyes, Ears and Teeth Act; H.R. 5396, the Medicare Dental, Vision, and Hearing Benefit Act of 2016: proposals to provide Medicare coverage for vision, hearing and dental services. Medicare Hearing Coverage. H.R. 1653, the Medicare Hearing Aid Coverage Act of 2015; H.R. 2748, the Help Extend Auditory Relief (HEAR) Act of 2015: proposals to provide Medicare coverage for the cost of hearing aids and examinations, to amend Medicare to cover aural rehabilitation services, hearing aids, audiology rehabilitation services, and related hearing services. Medicare Dental Coverage. S. 570, H.R. 1055, the Comprehensive Dental Reform Act: proposal to extend comprehensive dental coverage to all Medicare, Medicaid, and VA beneficiaries. Medicare Care Planning. S. 1549, the Care Planning Act of 2015: proposals to create a Medicare benefit for care planning, the coordination of services, to fill gaps in quality measurement in the advanced illness field. Medicare Private Plan Notification Improvements. (No bill.) Proposals to improve the annual notification Medicare private plans promulgate to Parts C and D enrollees pertaining to plan changes that will raise enrollee costs or limit access to products and services. Medicare Part B Payment Reforms. H.R. 5122: proposals to change the way Medicare pays doctors for administering drugs to eliminate incentives to prescribe drugs based on their expense instead of clinical need. Medicare Advantage Payment Reforms. (No bill.) Proposals to eliminate discrepancies in how much Medicare pays for services for similarly situated individuals in traditional Medicare and in Medicare Advantage plans. Medicare Access and CHIP Reauthorization Act. (Public Law 114-10). Comments to CMS/HHS proposing ways the proposed rule can be strengthened to ensure the new Quality Payment Program delivers on the promise of health system transformation. Medicaid Expansion. H.R. 4588 and S. 2787: proposal to provide a higher level of federal Medicaid funding for states that did not choose to expand Medicaid when the Affordable Care Act (ACA) first launched Medicaid expansion in 2014.