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State Health Flexibility Act of 2017
Legislative Progress
Momentum (last 30 days)
0
score
0 actions · 0 new cosponsors · 0 votes
Speed vs cohort
76pct
35d open
vs 7,393 other HR bills in the 115th — cohort avg 50d
State Health Flexibility Act of 2017 This bill amends the Social Security Act (SSAct) to replace federal requirements for Medicaid and the Children's Health Insurance Program (CHIP) with health care block grants to states. A state may use block grant funds to: (1) provide health care services to indigent individuals; (2) fund risk adjustment mechanisms for the purpose of subsidizing the cost of private health insurance for the high-risk population; and (3) support other welfare-related programs, as specified by the bill. In addition to repealing titles XIX (Medicaid) and XXI (CHIP) of the SSAct, the bill repeals: (1) the Patient Protection and Affordable Care Act, and (2) the Health Care and Educational Reconciliation Act of 2010. With respect to an alien not lawfully admitted for permanent residence in the United States, a state may use grant funds to provide only emergency health care services, as specified by the bill. A state shall contract with an approved auditing entity for annual audits of its grant fund expenditures. The bill limits the authority of any federal agency to supervise a state's use of funds received under the block grant program.
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Filing registrants (3)
2017 · fourth_quarter · Medicare/Medicaid
Better Care Reconciliation Act (Enzi) - ACA repeal and replace issues; Medicaid provisions S. 413, Improving Transparency and Accuracy in Medicare Part D Spending Act (Capito) -PDP/MA-PD payments on clean claims from pharmacies S. 428, ACE Kids Act (Grassley) - coordinated care for children with complex medical conditions S. 870, CHRONIC Care Act (Hatch-Wyden) - chronic care reforms, Medicare Advantage and Part D provisions S. 1016, CONNECT For Health Act (Schatz) - telehealth S. 1688, Empowering Medicare Seniors to Negotiate Drug Prices Act (Klobuchar) - Part D price negotiations S. 1804, Medicare for All Act (Sanders) - single payer health system S. 1827, Keep Kids Insurance Dependable and Secure Act (Hatch-Wyden) - federal CHIP funding S. 1890, Chronic Kidney Disease Improvement in Research and Treatment and Medigap Access (Cardin) - Medigap coverage for beneficiaries with end-stage renal disease S. 2027, Medicaid Third Party Liability Act (Portman) - Medicaid third party liability S. 2227, EMPOWER Care Act (Portman-Cantwell) - Medicaid Money Follows the Person Demonstration Draft Medicare Extenders Bill (Senate Finance Committee) - continuation of expiring Medicare provisions H.R. 352, State Health Flexibility Act (Rokita) - Medicaid block grants H.R. 849, Protecting Seniors Access to Medicare Act (Roe) - Independent Payment Advisory Board H.R. 908, Medicare Advantage Quality Payment Relief Act (Kelly) - MA payment cap H.R. 1038, Improving Transparency and Accuracy in Medicare Part D Spending Act (Griffith) - PDP/MA-PD payments on clean claims from pharmacies H.R. 1148, FAST Act (Griffith) - access to telehealth-eligible stroke services under Medicare H.R. 1316, Prescription Drug Price Transparency Act (Collins) - PBM standards for MA and PDP plans H.R. 1370, Continuing Resolution (Frelinghuysen) - 6-month CHIP funding extension, community health center funding, paygo exemption to prevent sequestration cuts H.R. 1628, American Health Care Act (Black) - ACA repeal and replace issues; Medicaid provisions H.R. 1995, V-BID for Better Care Act (Black) - value-based insurance design in Medicare Advantage H.R. 2556, CONNECT For Health Act (Black) - telehealth H.R. 2644, Chronic Kidney Disease Improvement in Research and Treatment and Medigap Access (Marino) - Medigap coverage for beneficiaries with end-stage renal disease H.R. 3044, Supplemental Benefits for Chronically Ill Medicare Advantage Enrollees (Meehan) H.R. 3168, Special Needs Plans (Tiberi-Levin) - SNP reauthorization H.R. 3263, Medicare Independence at Home Model of Care (Burgess) - demonstration program H.R. 3325, ACE Kids Act (Barton) - coordinated care for children with complex medical conditions H.R. 3360, Telehealth Enhancement Act (Harper) - telehealth in Medicare H.R. 3727, Increasing Telehealth Access in Medicare Act (Black) - telehealth in MA plans H.R. 3921, HEALTHY KIDS Act (Burgess) - CHIP funding H.J.Res. 123, Continuing Resolution (Frelinghuysen) - redistribution of unused CHIP allotments H.J.Res. 124, Continuing Resolution (Frelinghuysen) -extension of federal CHIP funding Medicare Extenders Package (House Ways and Means Committee) - reauthorization of Special Needs Plans, telehealth, CMS authority to terminate MA contracts Regulatory Issues: Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, network adequacy and provider directories, 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, Part D direct and indirect remuneration (DIR), and audits); proposed calendar year 2019 policy and technical regulation for MA and Part D; 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, enrollment rules, requirements for notice and denial forms, 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 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); CMS's proposed Part B drug demonstration program; Medication Therapy Management Program requirements and the Center for Medicare and Medicaid Innovation (CMMI) Demonstration; MA EGWP issues; CMMI's value-based insurance design (VBID) demonstration; 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; 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; new payment system for physicians under MACRA, including implications for MA and Part D plans; Medicare clinical trials; Medicare/Medicaid integration for dual eligibles, including implementation of the Capitated Financial Alignment Demonstration and related issues (e.g., quality ratings); Medicaid managed care regulations and policies, including CMS' substantial revisions to the managed care regulations, mental health parity rules, 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 Medicaid Managed long-term care including home and community-based waiver services (HCBS); expanding the availability of Medicare Advantage and Medicaid health plan telemedicine programs; implications of the new non-discrimination rules for health plans participating in public programs; issues related to Medigap coverage; issues related to business continuity in relation to pandemics or natural events (e.g., hurricane, tornado, etc.); cybersecurity; provider directories; value-based insurance design models; Part D prescriber enrollment requirements; Part D recovery audit contractor programs; issues relating to enrollment of beneficiaries with ESRD into MA plans; socioeconomic status impacts on star ratings related to MA and Part D programs; and other issues relating to health care reform implementation.
Referred to the Subcommittee on Indian, Insular and Alaska Native Affairs.
Referred to the Subcommittee on Health.
Referred to the Subcommittee on Health.
Referred to the Committee on Energy and Commerce, and in addition to the Committees on Rules, Ways and Means, Education and the Workforce, the Judiciary, Natural Resources, House Administration, and Appropriations, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Congress.gov source codes: H11100, H11100-A
Introduced in House
Congress.gov source codes: 1000, Intro-H
Bills with similar content found using semantic analysis.
Sources: Congress.gov
Client expense: $1,710,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Council of Economic Advisers (CEA), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Economic Council (NEC), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), SENATE, Treasury, Dept of, White House Office
2017 · third_quarter · Medicare/Medicaid
Better Care Reconciliation Act (Enzi) - ACA repeal and replace issues; Medicaid provisions S. 413, Improving Transparency and Accuracy in Medicare Part D Spending Act (Capito) -PDP/MA-PD payments on clean claims from pharmacies S. 428, ACE Kids Act (Grassley) - coordinated care for children with complex medical conditions S. 870, CHRONIC Care Act (Hatch-Wyden) - chronic care reforms, Medicare Advantage and Part D provisions S. 1016, CONNECT For Health Act (Schatz) - telehealth S. 1688, Empowering Medicare Seniors to Negotiate Drug Prices Act (Klobuchar) - Part D price negotiations S. 1804, Medicare for All Act (Sanders) - single payer health system S. 1827, Keep Kids Insurance Dependable and Secure Act (Hatch-Wyden) - federal CHIP funding S. 1890, Chronic Kidney Disease Improvement in Research and Treatment and Medigap Access (Cardin) - Medigap coverage for beneficiaries with end-stage renal disease H.R. 352, State Health Flexibility Act (Rokita) - Medicaid block grants H.R. 908, Medicare Advantage Quality Payment Relief Act (Kelly) - MA payment cap H.R. 1038, Improving Transparency and Accuracy in Medicare Part D Spending Act (Griffith) - PDP/MA-PD payments on clean claims from pharmacies H.R. 1148, FAST Act (Griffith) - access to telehealth-eligible stroke services under Medicare H.R. 1316, Prescription Drug Price Transparency Act (Collins) - PBM standards for MA and PDP plans H.R. 1628, American Health Care Act (Black) - ACA repeal and replace issues; Medicaid provisions H.R. 1995, V-BID for Better Care Act (Black) - value-based insurance design in Medicare Advantage H.R. 2556, CONNECT For Health Act (Black) - telehealth H.R. 2644, Chronic Kidney Disease Improvement in Research and Treatment and Medigap Access (Marino) - Medigap coverage for beneficiaries with end-stage renal disease H.R. 3044, Supplemental Benefits for Chronically Ill Medicare Advantage Enrollees (Meehan) H.R. 3168, Special Needs Plans (Tiberi-Levin) - SNP reauthorization H.R. 3263, Medicare Independence at Home Model of Care (Burgess) - demonstration program H.R. 3325, ACE Kids Act (Barton) - coordinated care for children with complex medical conditions H.R. 3360, Telehealth Enhancement Act (Harper) - telehealth in Medicare H.R. 3727, Increasing Telehealth Access in Medicare Act (Black) - telehealth in MA plans H.R. 3921, HEALTHY KIDS Act (Burgess) - CHIP funding Regulatory Issues: Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, network adequacy and provider directories, 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, Part D direct and indirect remuneration (DIR), 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, enrollment rules, requirements for notice and denial forms, 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 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); CMS's proposed Part B drug demonstration program; Medication Therapy Management Program requirements and the Center for Medicare and Medicaid Innovation (CMMI) Demonstration; MA EGWP issues; CMMI's value-based insurance design (VBID) demonstration; 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; 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; new payment system for physicians under MACRA, including implications for MA and Part D plans; Medicare clinical trials; Medicare/Medicaid integration for dual eligibles, including implementation of the Capitated Financial Alignment Demonstration and related issues (e.g., quality ratings); Medicaid managed care regulations and policies, including CMS' substantial revisions to the managed care regulations, mental health parity rules, 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 Medicaid Managed long-term care including home and community-based waiver services (HCBS); expanding the availability of Medicare Advantage and Medicaid health plan telemedicine programs; implications of the new non-discrimination rules for health plans participating in public programs; issues related to Medigap coverage; issues related to business continuity in relation to pandemics or natural events (e.g., hurricane, tornado, etc.); cybersecurity; provider directories; value-based insurance design models; Part D prescriber enrollment requirements; Part D recovery audit contractor programs; issues relating to enrollment of beneficiaries with ESRD into MA plans; socioeconomic status impacts on star ratings related to MA and Part D programs; and other issues relating to health care reform implementation.
Client expense: $1,470,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Treasury, Dept of, White House Office
2017 · third_quarter · Health Issues
H.R. 173: Legislation to repeal the Cadillac/Excise tax H.R. 246: Legislation to repeal the annual fee on health insurance providers; Health Insurance Tax (HIT) H.R. 1628: The American Health Care Act of 2017 (AHCA) H.R. 175: ObamaCare Repeal Act H.R 242: Medicare Prescription Drug Price Negotiation Act of 2017 H.R. 277: American Health Care Reform Act of 2017 H.R. 314: Health Care Choice Act H.R. 352: State Health Flexibility Act of 2017 H.R. 372: Competitive Health Insurance Reform Act of 2017 H.R. 432: Small Business Tax Credit Accessibility Act H.R. 521: Protection from Insurance Exchange Monopolies Act H.R. 551: Amends the ACA to permit insurers to offer catastrophic coverage plans to anyone H.R. 552: Affordable Limited Health Coverage Act H.R. 633: Patient Fairness and Relief Act of 2017 H.R. 661: Employee Fairness and Relief Act H.R. 708: State Age Rating Flexibility Act of 2017 H.R. 710: Health Coverage State Flexibility Act of 2017 H.R. 749: Lower Drug Costs through Competition Act H.R. 1072: ObamaCare Replacement Act H.R 1101: Small Business Health Fairness Act of 2017 H.R. 1121: Pre-existing Conditions Protection Act of 2017 H.R. 1215: Protecting Access to Care Act of 2017 H.R. 1245: Affordable and Safe Prescription Drug Importation Act H.R. 1275: World's Greatest Healthcare Plan of 2017 H.R. 1304: Self-Insurance Protection Act H.R. 1313: Preserving Employee Wellness Programs Act H.R. 1314: Health Care Choice Act of 2017 H.R. 1421: Improving Access to Medicare Coverage Act of 2017 S. 58: Legislation to repeal the Cadillac/Excise tax S. 106: ObamaCare Repeal Act S. 40: Middle Class Health Benefits Tax Repeal Act S. 41: Medicare Prescription Drug Price Negotiation Act of 2017 S. 92: Safe and Affordable Drugs from Canada Act of 2017 S. 124: Preserve Access to Affordable Generics Act S. 147: Obamacare Taxpayer Bailout Prevention Act S. 191: Patient Freedom Act of 2017 S. 222: Obamacare Replacement Act S. 297: Increasing Competition in Pharmaceuticals Act S. 469: Affordable and Safe Prescription Drug Importation Act S. 568: Improving Access to Medicare Coverage Act of 2017 S. 761: Health Care Options Act of 2017 S. 870 Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017 H.R.1995 - V-BID for Better Care Act of 2017 H.R. 3044 To amend title XVIII of the Social Security Act to expand supplemental benefits to meet the needs of chronically ill Medicare Advantage enrollees under the Medicare program, and for other purposes. H.R. 3168 To amend title XVIII of the Social Security Act to provide continued access to specialized Medicare Advantage plans for special needs individuals, and for other purposes. H.R.2575 Beneficiary Enrollment Notification and Eligibility Simplification Act S.1254 Health Care for Small Business Act H.R.2823 - Affordable Retirement Advice for Savers Act S.1462, The Marketplace Certainty Act S.1354 - Individual Health Insurance Marketplace Improvement Act S.1201 - Health Care Options for All Act H.R.2770 - Health Care Options for All Act H.R.676 - Expanded & Improved Medicare For All Act H.R. 3919 - Commonsense Reporting Act of 2017 S. 1908 - Commonsense Reporting Act of 2017 S. 1804 - Medicare for All Act of 2017 S. 1835 - Lower Premiums Through Reinsurance Act of 2017 S. 1782 - Forty Hours Is Full Time Act of 2017 H.R. 3181 - Medicare Choices Empowerment and Protection Act S. 1827 - KIDS Act of 2017 S. 1681 - A bill to require persons who undertake Federally funded research and development of drugs to enter into reasonable pricing agreements with the Secretary of Health and Human Services S. 1909 - BENES Act of 2017 H.R. 3877 - Fair Billing Act of 2017 S. 1859 - Healthcare Tax Relief Act H.R. 3780 - Air Ambulance Quality and Accountability Act H.R. 3748 - Medicare Buy-In and Health Care Stabilization Act of 2017 H.R. 3378 - Ensuring Access to Air Ambulance Services Act of 2017 H.R. 3311 - Individual Health Insurance Marketplace Improvement Act H.R. 3258 - Marketplace Certainty Act S. 1546 - Commonsense Competition and Access to Health Insurance Act
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
2017 · third_quarter · Immigration
S. 36 S. 37 S. 45 S. 51 S. 52 S. 87 S. 127 S. 128 S. 146 S. 179 S. 180 S. 211 S. 229 S. 232 S. 274 S. 281 S. 303 S. 349 S. 354 S. 668 S. 725 S. 748 H.R. 22 H.R. 60 H.R. 80 H.R. 81 H.R. 82 H.R. 83 H.R.114 H.R. 120 H.R. 140 H.R. 170 H.R. 174 H.R. 176 H.R. 178 H.R. 241 H.R. 278 H.R. 281 H.R. 300 H.R. 352 H.R. 361 H.R. 391 H.R. 392 H.R. 400 H.R. 425 H.R. 441 H.R. 454 H.R. 483 H.R. 486 H.R. 495 H.R. 496 H.R. 505 H.R. 514 H.R. 532 H.R. 546 H.R. 565 H.R. 574 H.R. 591 H.R. 604 H.R. 639 H.R. 641 H.R. 643 H.R. 670 H.R. 705 H.R. 724 H.R. 730 H.R. 739 H.R. 748 H.R. 819 H.R. 824 H.R. 837 H.R. 844 H.R. 858 H.R. 912 H.R. 913 H.R. 920 H.R. 1006 H.R. 1036 H.R. 1125 H.R. 1149 H.R. 1178 H.R. 1236 H.R. 1446 H.R. 1470 H.R. 1608 H.R. 1627 H.R. 1741 H.R. 1941 H.R. 1970 H.R. 1985 H.R. 2073
Client expense: $41,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2017 · second_quarter · Medicare/Medicaid
Discussion Draft Better Care Reconciliation Act (Enzi) - ACA repeal and replace issues; Medicaid provisions S.Con.Res. 3, Budget Resolution (Enzi) - ACA repeal and replace issues; Medicaid provisions S. 413, Improving Transparency and Accuracy in Medicare Part D Spending Act (Capito) -PDP/MA-PD payments on clean claims from pharmacies S. 428, ACE Kids Act (Grassley) - coordinated care for children with complex medical conditions S. 870, CHRONIC Care Act (Hatch-Wyden) - chronic care reforms, Medicare Advantage and Part D provisions S. 3168, Reauthorization of Medicare Advantage Special Needs Plans (Tiberi-Levin) H.R. 352, State Health Flexibility Act (Rokita) - Medicaid block grants H.R. 908, Medicare Advantage Quality Payment Relief Act (Kelly) - MA payment cap H.R. 1038, Improving Transparency and Accuracy in Medicare Part D Spending Act (Griffith) - PDP/MA-PD payments on clean claims from pharmacies H.R. 1316, Prescription Drug Price Transparency Act (Collins) - PBM standards for MA and PDP plans H.R. 1628, American Health Care Act (Black) - ACA repeal and replace issues; Medicaid provisions H.R. 1995, V-BID for Better Care Act (Black) - value-based insurance design in Medicare Advantage H.R. 3044, Supplemental Benefits for Chronically Ill Medicare Advantage Enrollees (Meehan) Regulatory Issues: Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, network adequacy and provider directories, 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, Part D direct and indirect remuneration (DIR), 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, enrollment rules, requirements for notice and denial forms, 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 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); CMS's proposed Part B drug demonstration program; Medication Therapy Management Program requirements and the Center for Medicare and Medicaid Innovation (CMMI) Demonstration; MA EGWP issues; CMMI's value-based insurance design (VBID) demonstration; 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; 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; new payment system for physicians under MACRA, including implications for MA and Part D plans; Medicare clinical trials; Medicare/Medicaid integration for dual eligibles, including implementation of the Capitated Financial Alignment Demonstration and related issues (e.g., quality ratings); Medicaid managed care regulations and policies, including CMS' substantial revisions to the managed care regulations, mental health parity rules, 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 Medicaid Managed long-term care including home and community-based waiver services (HCBS); expanding the availability of Medicare Advantage and Medicaid health plan telemedicine programs; implications of the new non-discrimination rules for health plans participating in public programs; issues related to Medigap coverage; issues related to business continuity in relation to pandemics or natural events (e.g., hurricane, tornado, etc.); cybersecurity; provider directories; value-based insurance design models; Part D prescriber enrollment requirements; Part D recovery audit contractor programs; issues relating to enrollment of beneficiaries with ESRD into MA plans; socioeconomic status impacts on star ratings related to MA and Part D programs; and other issues relating to health care reform implementation.
Client expense: $1,700,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Treasury, Dept of
2017 · second_quarter · Immigration
S. 36 S. 37 S. 45 S. 51 S. 52 S. 87 S. 127 S. 128 S. 146 S. 179 S. 180 S. 211 S. 229 S. 232 S. 274 S. 281 S. 303 S. 349 S. 354 S. 668 S. 725 S. 748 H.R. 22 H.R. 60 H.R. 80 H.R. 81 H.R. 82 H.R. 83 H.R.114 H.R. 120 H.R. 140 H.R. 170 H.R. 174 H.R. 176 H.R. 178 H.R. 241 H.R. 278 H.R. 281 H.R. 300 H.R. 352 H.R. 361 H.R. 391 H.R. 392 H.R. 400 H.R. 425 H.R. 441 H.R. 454 H.R. 483 H.R. 486 H.R. 495 H.R. 496 H.R. 505 H.R. 514 H.R. 532 H.R. 546 H.R. 565 H.R. 574 H.R. 591 H.R. 604 H.R. 639 H.R. 641 H.R. 643 H.R. 670 H.R. 705 H.R. 724 H.R. 730 H.R. 739 H.R. 748 H.R. 819 H.R. 824 H.R. 837 H.R. 844 H.R. 858 H.R. 912 H.R. 913 H.R. 920 H.R. 1006 H.R. 1036 H.R. 1125 H.R. 1149 H.R. 1178 H.R. 1236 H.R. 1446 H.R. 1470 H.R. 1608 H.R. 1627 H.R. 1741 H.R. 1941 H.R. 1970 H.R. 1985 H.R. 2073
Client expense: $53,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2017 · second_quarter · Health Issues
H.R. 173: Legislation to repeal the Cadillac/Excise tax H.R. 246: Legislation to repeal the annual fee on health insurance providers; Health Insurance Tax (HIT) H.R. 1628: The American Health Care Act of 2017 (AHCA) H.R. 175: ObamaCare Repeal Act H.R 242: Medicare Prescription Drug Price Negotiation Act of 2017 H.R. 277: American Health Care Reform Act of 2017 H.R. 314: Health Care Choice Act H.R. 352: State Health Flexibility Act of 2017 H.R. 372: Competitive Health Insurance Reform Act of 2017 H.R. 432: Small Business Tax Credit Accessibility Act H.R. 521: Protection from Insurance Exchange Monopolies Act H.R. 551: Amends the ACA to permit insurers to offer catastrophic coverage plans to anyone H.R. 552: Affordable Limited Health Coverage Act H.R. 633: Patient Fairness and Relief Act of 2017 H.R. 661: Employee Fairness and Relief Act H.R. 708: State Age Rating Flexibility Act of 2017 H.R. 710: Health Coverage State Flexibility Act of 2017 H.R. 749: Lower Drug Costs through Competition Act H.R. 1072: ObamaCare Replacement Act H.R 1101: Small Business Health Fairness Act of 2017 H.R. 1121: Pre-existing Conditions Protection Act of 2017 H.R. 1215: Protecting Access to Care Act of 2017 H.R. 1245: Affordable and Safe Prescription Drug Importation Act H.R. 1275: World's Greatest Healthcare Plan of 2017 H.R. 1304: Self-Insurance Protection Act H.R. 1313: Preserving Employee Wellness Programs Act H.R. 1314: Health Care Choice Act of 2017 H.R. 1421: Improving Access to Medicare Coverage Act of 2017 S. 58: Legislation to repeal the Cadillac/Excise tax S. 106: ObamaCare Repeal Act S. 40: Middle Class Health Benefits Tax Repeal Act S. 41: Medicare Prescription Drug Price Negotiation Act of 2017 S. 92: Safe and Affordable Drugs from Canada Act of 2017 S. 124: Preserve Access to Affordable Generics Act S. 147: Obamacare Taxpayer Bailout Prevention Act S. 191: Patient Freedom Act of 2017 S. 222: Obamacare Replacement Act S. 297: Increasing Competition in Pharmaceuticals Act S. 469: Affordable and Safe Prescription Drug Importation Act S. 568: Improving Access to Medicare Coverage Act of 2017 S. 761: Health Care Options Act of 2017 S. 870 Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017 H.R.1995 - V-BID for Better Care Act of 2017 H.R. 3044 To amend title XVIII of the Social Security Act to expand supplemental benefits to meet the needs of chronically ill Medicare Advantage enrollees under the Medicare program, and for other purposes. H.R. 3168 To amend title XVIII of the Social Security Act to provide continued access to specialized Medicare Advantage plans for special needs individuals, and for other purposes. H.R.2575 Beneficiary Enrollment Notification and Eligibility Simplification Act S.1254 Health Care for Small Business Act H.R.2823 - Affordable Retirement Advice for Savers Act S.1462, The Marketplace Certainty Act S.1354 - Individual Health Insurance Marketplace Improvement Act S.1201 - Health Care Options for All Act H.R.2770 - Health Care Options for All Act H.R.676 - Expanded & Improved Medicare For All Act
2017 · first_quarter · Immigration
S. 36 S. 37 S. 45 S. 51 S. 52 S. 87 S. 127 S. 128 S. 146 S. 179 S. 180 S. 211 S. 229 S. 232 S. 274 S. 281 S. 303 S. 349 S. 354 S. 668 S. 725 S. 748 H.R. 22 H.R. 60 H.R. 80 H.R. 81 H.R. 82 H.R. 83 H.R.114 H.R. 120 H.R. 140 H.R. 170 H.R. 174 H.R. 176 H.R. 178 H.R. 241 H.R. 278 H.R. 281 H.R. 300 H.R. 352 H.R. 361 H.R. 391 H.R. 392 H.R. 400 H.R. 425 H.R. 441 H.R. 454 H.R. 483 H.R. 486 H.R. 495 H.R. 496 H.R. 505 H.R. 514 H.R. 532 H.R. 546 H.R. 565 H.R. 574 H.R. 591 H.R. 604 H.R. 639 H.R. 641 H.R. 643 H.R. 670 H.R. 705 H.R. 724 H.R. 730 H.R. 739 H.R. 748 H.R. 819 H.R. 824 H.R. 837 H.R. 844 H.R. 858 H.R. 912 H.R. 913 H.R. 920 H.R. 1006 H.R. 1036 H.R. 1125 H.R. 1149 H.R. 1178 H.R. 1236 H.R. 1446 H.R. 1470 H.R. 1608 H.R. 1627 H.R. 1741 H.R. 1941 H.R. 1970 H.R. 1985 H.R. 2073
Client expense: $111,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2017 · first_quarter · Medicare/Medicaid
S.Con.Res. 3, Budget Resolution (Enzi) - ACA repeal and replace issues; Medicaid provisions S. 413, Improving Transparency and Accuracy in Medicare Part D Spending Act (Capito) -PDP/MA-PD payments on clean claims from pharmacies S. 428, ACE Kids Act (Grassley) - coordinated care for children with complex medical conditions H.R. 352, State Health Flexibility Act (Rokita) - Medicaid block grants H.R. 908, Medicare Advantage Quality Payment Relief Act (Kelly) - MA payment cap H.R. 1038, Improving Transparency and Accuracy in Medicare Part D Spending Act (Griffith) - PDP/MA-PD payments on clean claims from pharmacies H.R. 1316, Prescription Drug Price Transparency Act (Collins) - PBM standards for MA and PDP plans H.R. 1628, American Health Care Act (Black) - ACA repeal and replace issues; Medicaid provisions Regulatory Issues: Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, network adequacy and provider directories, 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, Part D direct and indirect remuneration (DIR), 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, enrollment rules, requirements for notice and denial forms, 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 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); CMS's proposed Part B drug demonstration program; Medication Therapy Management Program requirements and the Center for Medicare and Medicaid Innovation (CMMI) Demonstration; MA EGWP issues; CMMI's value-based insurance design (VBID) demonstration; 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; 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; new payment system for physicians under MACRA, including implications for MA and Part D plans; Medicare clinical trials; Medicare/Medicaid integration for dual eligibles, including implementation of the Capitated Financial Alignment Demonstration and related issues (e.g., quality ratings); Medicaid managed care regulations and policies, including CMS' substantial revisions to the managed care regulations, mental health parity rules, 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 Medicaid Managed long-term care including home and community-based waiver services (HCBS); expanding the availability of Medicare Advantage and Medicaid health plan telemedicine programs; implications of the new non-discrimination rules for health plans participating in public programs; issues related to Medigap coverage; issues related to business continuity in relation to pandemics or natural events (e.g., hurricane, tornado, etc.); cybersecurity; provider directories; value-based insurance design models; Part D prescriber enrollment requirements; Part D recovery audit contractor programs; issues relating to enrollment of beneficiaries with ESRD into MA plans; socioeconomic status impacts on star ratings related to MA and Part D programs; and other issues relating to health care reform implementation.
2017 · first_quarter · Health Issues
H.R. 173: Legislation to repeal the Cadillac/Excise tax H.R. 246: Legislation to repeal the annual fee on health insurance providers; Health Insurance Tax (HIT) H.R. 1628: The American Health Care Act of 2017 (AHCA) H.R. 175: ObamaCare Repeal Act H.R 242: Medicare Prescription Drug Price Negotiation Act of 2017 H.R. 277: American Health Care Reform Act of 2017 H.R. 314: Health Care Choice Act H.R. 352: State Health Flexibility Act of 2017 H.R. 372: Competitive Health Insurance Reform Act of 2017 H.R. 432: Small Business Tax Credit Accessibility Act H.R. 521: Protection from Insurance Exchange Monopolies Act H.R. 551: Amends the ACA to permit insurers to offer catastrophic coverage plans to anyone H.R. 552: Affordable Limited Health Coverage Act H.R. 633: Patient Fairness and Relief Act of 2017 H.R. 661: Employee Fairness and Relief Act H.R. 708: State Age Rating Flexibility Act of 2017 H.R. 710: Health Coverage State Flexibility Act of 2017 H.R. 749: Lower Drug Costs through Competition Act H.R. 1072: ObamaCare Replacement Act H.R 1101: Small Business Health Fairness Act of 2017 H.R. 1121: Pre-existing Conditions Protection Act of 2017 H.R. 1215: Protecting Access to Care Act of 2017 H.R. 1245: Affordable and Safe Prescription Drug Importation Act H.R. 1275: World's Greatest Healthcare Plan of 2017 H.R. 1304: Self-Insurance Protection Act H.R. 1313: Preserving Employee Wellness Programs Act H.R. 1314: Health Care Choice Act of 2017 H.R. 1421: Improving Access to Medicare Coverage Act of 2017 S. 58: Legislation to repeal the Cadillac/Excise tax S. 106: ObamaCare Repeal Act S. 40: Middle Class Health Benefits Tax Repeal Act S. 41: Medicare Prescription Drug Price Negotiation Act of 2017 S. 92: Safe and Affordable Drugs from Canada Act of 2017 S. 124: Preserve Access to Affordable Generics Act S. 147: Obamacare Taxpayer Bailout Prevention Act S. 191: Patient Freedom Act S. 222: Obamacare Replacement Act S. 297: Increasing Competition in Pharmaceuticals Act S. 469: Affordable and Safe Prescription Drug Importation Act S. 568: Improving Access to Medicare Coverage Act of 2017 S. 761: Health Care Options Act of 2017
| Referred to |
| January 6, 2017 |
| Committee on House Administration | House | Referred to | January 6, 2017 |
| Judiciary Committee | House | Referred to | January 6, 2017 |
| Education and the Workforce Committee | House | Referred to | January 6, 2017 |
| Rules Committee | House | Referred to | January 6, 2017 |
| Republican |
| MI |
| Blake Farenthold | Republican | TX |
| Bob Gibbs | Republican | OH |
| Bruce Westerman | Republican | AR |
| Chris Stewart | Republican | UT |
| Dana Rohrabacher | Republican | CA |
| Dave Brat | Republican | VA |
| David A. Trott | Republican | MI |
| David Schweikert | Republican | AZ |
| Diane Black | Republican | TN |
| Earl L. "Buddy" Carter | Republican | GA |
| Jason Smith | Republican | MO |
| Jeff Duncan | Republican | SC |
| Jim Banks | Republican | IN |
| Jodey C. Arrington | Republican | TX |
| Jody B. Hice | Republican | GA |
| John R. Moolenaar | Republican | MI |
| John Ratcliffe | Republican | TX |
| Ken Buck | Republican | CO |
| Kevin Cramer | Republican | ND |
| Luke Messer | Republican | IN |
| Mark Meadows | Republican | NC |
| Matt Gaetz | Republican | FL |
| Pete Olson | Republican | TX |
| Rick W. Allen | Republican | GA |
| Rob Bishop | Republican | UT |
| Robert Pittenger | Republican | NC |
| Scott DesJarlais | Republican | TN |
| Stevan Pearce | Republican | NM |
| Steven M. Palazzo | Republican | MS |
| Ted Poe | Republican | TX |
| Tom Cole | Republican | OK |
| Tom McClintock | Republican | CA |
| Trent Franks | Republican | AZ |
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
Client expense: $1,650,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Treasury, Dept of
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