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Local Coverage Determination Clarification Act of 2018
Legislative Progress
Momentum (last 30 days)
0
score
0 actions · 0 new cosponsors · 0 votes
Speed vs cohort
97pct
412d open
vs 7,393 other HR bills in the 115th — cohort avg 50d
Local Coverage Determination Clarification Act of 2017 This bill amends title XVIII (Medicare) of the Social Security Act to revise the process by which Medicare administrative contractors (MACs) issue and reconsider local coverage determinations (LCDs) that: (1) are new, (2) restrict or substantively revise existing LCDs, or (3) are otherwise specified in regulation. (MACs are private insurers that process Medicare claims within specified geographic areas.) Before such an LCD may take effect, the MAC issuing the determination must, with respect to each geographic area to which the determination applies: publish online a proposed version of the determination and other specified, related information; convene one or more public meetings to review the draft determination, receive comments, and secure the advice of an expert panel; post online a record of the minutes from each such meeting; provide a period for submission of written public comments; and post online specified information related to the rationale for the final determination. Upon the filing of an applicable request by an interested party with regard to the reconsideration of a specified LCD, the MAC that issued the determination shall: provide specified information related to whether the determination failed to correctly apply qualifying relevant evidence, exceeds the scope of its intended purpose, fails to apply as intended, or is otherwise erroneous; preserve the determination, modify the determination, or rescind the determination in part; and make publicly available a written description of such action. An interested party may appeal a reconsideration decision to the Centers for Medicare & Medicaid Services (CMS). The CMS shall appoint a Medicare Reviews and Appeals Ombudsman to carry out specified duties with regard to LCDs.
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Filing registrants (26)
Received in the Senate and Read twice and referred to the Committee on Finance.
Motion to reconsider laid on the table Agreed to without objection.
On motion to suspend the rules and pass the bill, as amended Agreed to by voice vote. (text: CR H8122-8124)
Passed/agreed to in House: On motion to suspend the rules and pass the bill, as amended Agreed to by voice vote.(text: CR H8122-8124)
DEBATE - The House proceeded with forty minutes of debate on H.R. 3635.
Considered under suspension of the rules. (consideration: CR H8122-8124)
Ms. Jenkins (KS) moved to suspend the rules and pass the bill, as amended.
Placed on the Union Calendar, Calendar No. 724.
Committee on Energy and Commerce discharged.
Committee on Energy and Commerce discharged.
Bills with similar content found using semantic analysis.
Sources: Congress.gov
2019 · first_quarter · Medicare/Medicaid
Valid Act discussion draft (LDTs) HR 5812 - Creating Opportunities that Necessitate ew and Enhance Connections that Improve Opioid Navigation Strategies Act of 2018 S 2680 - Opioid Crisis Response Act of 2018 HR 3635 - Local Coverage Determination (LCD) Clarification Act of 2017 Promoting Integrity in Medicare Act (HR 2066) Protecting Seniors' Access to Medicare Act (HR849) Protecting Access to Medicare Act Protecting Patients from Surprise Medical Bills (Cassidy Language) FDA Technical Assistance to DAIA S 2582 - Consumer Health Insurance Protection Act S 284- End Surprise Billing Act CMS Physician Fee Schedule Registry Measures
Client expense: $312,556 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2018 · fourth_quarter · Medicare/Medicaid
H.R. 807/S.253 Medicare Access to Rehabilitation Services Act (Medicare Appeals Procedures) QPP Prevention Initiatives for Fraud and Abuse in The Medicare program Accountable health care organizations/patient centered medical homes Electronic health records/health information technology incentives for Physical Therapists Local coverage determinations/EMG NCCI Edits Protection of programs related to physical therapy in deficit reduction Medicare Advantage PCORI National priority for research and research agenda Health information technology Functional Limitation Reporting Therapy Cap: Targeted Medical Review Essential Health Benefits MIPS/PPP Medicaid essential health benefits EHR/LTPAC settings: transitions of care Medicare improvement standards Bundled payment models/CJR Common assessment tool for Medicare post-acute care Medicare appeals process Inclusion of physical therapists in quality programs Self-referral Coverage of telehealth APTA Registry Quality Programs Accelerating Innovation in Medicine Act (AIM) IMPACT Medicare Pilot Programs Chronic Care Management New evaluation and reevaluation CPT codes & misvalued codes Orthotics and Prosthetics Medicare Private Contracting S.870 - Chronic Care Act SNF 3-Day Rule Registry- ACI HR 2042 - Frontline Act Youth Concussion Management DME HR 3446 RBI Act H.R. 5261 Teach Act Opioid related H.R. 5197 Alto Act Opioid related Administrative Burden H.R. 5686, Medicare Clear Health Options in Care for Enrollees Act H.R. 5773, Preventing Addiction for Susceptible Seniors Act H.R. 5774, Combating Opioid Abuse for Care in Hospitals Act H.R. 5718, Perioperative Reduction for Opioids Act H.R. 5719, Reduce Overprescribing Opioids in Treatment Act H.R. 5722, Dr. Todd Graham Pain Management Improvement Act H.R. 6, Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act. S. 3120, HEAL Act S. 2680, Opioid Crisis Response Act PTA Differential in Medicare Prior Authorization in Medicare Advantage Plans Alternative payment models Certified EHR technology HR 7217 Improving Medicaid Programs and Opportunities for Eligible Beneficiaries Act (IMPROVE ACT) S. 3458: Improvements to Home Health HR 3635: Local Coverage Determination Clarification Act of 2018
2018 · fourth_quarter · Medicare/Medicaid
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. 1016, CONNECT For Health Act (Schatz) - telehealth S. 1169, Medicaid CARE Act (Durbin-Portman) - changes to Medicaid IMD exclusion 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. 1890, Chronic Kidney Disease Improvement in Research and Treatment and Medigap Access (Cardin) - Medigap coverage for beneficiaries with end-stage renal disease S. 1909, BENES Act (Casey) - notifications of Medicare eligibility S. 2027, Medicaid Third Party Liability Act (Portman) - Medicaid third party liability S. 2051, Medicare Care Coordination Improvement Act of 2017 (Portman) - barriers to payment reform models S. 2227, EMPOWER Care Act (Portman-Cantwell) - Medicaid Money Follows the Person Demonstration S. 2707, Informing Seniors About Opioids Act (Nelson) - opioid issues S. 2901, Expanding Telehealth Response to Ensure Addiction Treatment Act (Thune) - opioid issues S. 2904, Medicaid Substance Use Disorder Treatment Via Telehealth Act (Carper) - opioid issues S. 2908, Electronic Prior Authorization in Medicare Part D Act (Roberts) - opioid issues S. 3327, SENIOR Communities Protection Act (Cortez Masto) - preventing fraudulent opioid prescriptions S. 3496, Improving Seniors Access to Quality Benefits Act (Daines-King) - study on MA benchmark cap S. 3497, Medicare Advantage Quality Payment Relief Act (Daines-King) - MA benchmark cap S. 3702, Right Rebate Act (Wyden-Grassley) - Medicaid drug rebate program Draft Bill: Medicare Long-Term Care Services and Supports Act (Pallone) - Long-Term Services and Supports Program H.R. 6, SUPPORT Patients and Families Act (Walden) - opioid initiatives, Medicare and Medicaid issues, budget offsets H.R. 695, Continuing Appropriations Act (Schiff) - Money Follows the Person demonstration, spousal impoverishment protections 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. 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. 2575, BENES Act (Ruiz) - notifications of Medicare eligibility 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. 2687, Medicaid CARE Act (Foster-Fitzpatrick) - changes to Medicaid IMD exclusion H.R. 3044, Supplemental Benefits for Chronically Ill Medicare Advantage Enrollees (Meehan) H.R. 3263, Medicare Independence at Home Model of Care (Burgess) - demonstration program H.R. 3325, ACE Kids Act (Barton) - health homes for children with complex medical conditions H.R. 3360, Telehealth Enhancement Act (Harper) - telehealth in Medicare H.R. 3635, Local Coverage Determination Clarification Act (Jenkins) - procedures for Medicare administrative contractors H.R. 3727, Increasing Telehealth Access in Medicare Act (Black) - telehealth in MA plans H.R. 4143, Dialysis PATIENTS Demonstration Act (Smith) - alternative care delivery models and payment methodologies for patients with end-stage renal disease H.R. 4952, Improving Seniors Access to Quality Benefits Act (Kelly) - MA benchmark cap study H.R. 5306, EMPOWER Care Act (Guthrie) - extension of Money Follows the Person demonstration H.R. 5603, Access to Telehealth Services for Substance Use Disorders Act (Matsui) - opioid issues H.R. 5605, Advancing High Quality Treatment for Opioid Use Disorders in Medicare Act (Ruiz) - opioid issues H.R. 5675, drug management programs for at-risk Medicare beneficiaries (Bilirakis) - opioid issues H.R. 5676, SENIOR Communities Protection Act (MacArthur) - preventing fraudulent opioid prescriptions H.R. 5684, Protecting Seniors from Opioid Abuse Act (Kelly) - opioid issues H.R. 5685, Medicare Opioid Safety Education Act (Faso) - opioid issues H.R. 5686, Medicare Clear Health Options in Care for Enrollees Act (Paulsen) - opioid issues H.R. 5715, Strengthening Partnerships to Prevent Opioid Abuse Act (Renacci) - communication between Medicare plan sponsors and CMS H.R. 5773, Preventing Addiction for Susceptible Seniors Act (Roskam) - opioid issues H.R. 5797, IMD CARE Act (Walters) - Medicaid IMD exclusion H.R. 5798, Opioid Screening and Chronic Pain Management Alternatives for Seniors Act (Bucshon) - opioid issues H.R. 5799, Medicaid Drug Review, Utilization, Good Governance Improvement Act (Blackburn) - opioid issues H.R. 5800, Medicaid IMD ADDITIONAL INFO Act (Upton) - opioid issues H.R. 5804, Post-Surgical Injections as an Opioid Alternative Act (Shimkus) - opioid issues H.R. 5808, Medicaid Pharmaceutical Home Act (Bilirakis) - opioid issues H.R. 5809, Postoperative Opioid Prevention Act (Peters) - opioid issues H.R. 5810, Medicaid Health Homes for Opioid-Use-Disorder Medicaid Enrollees Encouraged Act (Lance) - opioid issues H.R. 5812, Improving Medicaid Data Timeliness Act (Griffith) - opioid issues H.R. 6431, Medigap Consumer Protection Act (Levin) - reforms to Medicare supplemental insurance H.R. 6561, Comprehensive Care for Seniors Act (Walorski) -- Program of All-Inclusive Care for the Elderly H.R. 6563, Lower Out-of-Pocket Costs for Seniors Act (Pallone-Neal) - Medicare Part D cliff H.R. 6662, Empowering Seniors Decision Enrollment Act (Paulsen) - special enrollment period for non-deemed Medicare Cost Plan enrollees H.R. 6690, Fighting Fraud to Protect Care for Seniors Act (Roskam) - Medicare pilot program for smart card technology H.R. 7122, Shared Accountability for Improved Patient Outcomes Act (Paulsen) - value-based payment and delivery arrangements H.R. 7217, IMPROVE Act (Barton) - Money Follows the Person demonstration, ACE Kids Act, Medicare drug rebate program, spousal impoverishment protections H.R. 7223, Right Rebate Act (Schrader-Welch) - Medicaid drug rebate program H.R. 7247, Incentivizing Shared Risk in Medicare Advantage Act (Brady) - MA prior authorization H.R. 7249, Better Prior Authorization Notification Act (Reed) - MA prior authorization H.R. 7250, Prior Authorization Improvement Act (Kelly) - MA prior authorization 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); calendar year 2020 policy and technical regulation for MA and Part D; MA and Part D proposed rule on drug pricing changes for 2020; CMSs price transparency proposal for direct-to-consumer advertisements; issues relating to 2019 Rate Notice and Call Letter; 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; Bipartisan Budget Act of 2018 changes to 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) and the Bipartisan Budget Act of 2018 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's 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; issues relating to prescription drug price blueprint; 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.
2018 · fourth_quarter · Medicare/Medicaid
Issues related to Medicare's ESRD Program Charitable Assistance Programs Use of telehealth in Medicare Living Organ Donation S. 794/H.R. 3635, Local Coverage Determination Act
Client expense: Not reported · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE
2018 · fourth_quarter · Health Issues
Issues surrounding the enactment or repeal of the Affordable Care Act. Medicare reimbursement reform for providers including the Medicare Access and CHIP Reauthorization Act (MACRA). Medicare Part B Drug Reimbursement. FDA issues. Implementation of The Breast Cancer Patient Education Act. The Palliative Care and Hospice Education and Training Act. Draft legislation to reform the FDA's regulation of cosmetics and draft legislation. Legislation to address physician workforce shortage (HR 2267, S. 1301). Legislation to address the medical liability system (HR 1565, HR 1876/S 781, HR 548/S 527). Legislation to reform the US Preventative Services Task Force (HR 539). HR 880/S.1022 Mission Zero Act. HR 3635/S.794 Local Coverage Determination Clarification Act. Legislation to address the opioid crisis. Reauthorization of the Pandemic and All Hazards Preparedness Act (PAHPA), Educating Congressional offices on bleeding control training.
Client expense: Not reported · Firm income: $20,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
Reported (Amended) by the Committee on Ways and Means. H. Rept. 115-933, Part I.
Congress.gov source codes: 5000, H12200
Ordered to be Reported in the Nature of a Substitute by Voice Vote.
Committee Consideration and Mark-up Session Held.
Referred to the Subcommittee on Health.
Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, 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.
Introduced in House
Congress.gov source codes: 1000, Intro-H
| Markup by |
| September 5, 2018 |
| Energy and Commerce Committee | House | Referred to | August 1, 2017 |
| Ways and Means Committee | House | Referred to | August 1, 2017 |
| August 1, 2017 |
| Republican |
| MD |
| Ann M. Kuster | Democratic | NH |
| Austin Scott | Republican | GA |
| Bennie G. Thompson | Democratic | MS |
| Bill Flores | Republican | TX |
| Bill Huizenga | Republican | MI |
| Bobby L. Rush | Democratic | IL |
| Brad R. Wenstrup | Republican | OH |
| Bradley Byrne | Republican | AL |
| Brendan F. Boyle | Democratic | PA |
| Bruce Poliquin | Republican | ME |
| Bruce Westerman | Republican | AR |
| C. A. Dutch Ruppersberger | Democratic | MD |
| Carlos Curbelo | Republican | FL |
| Collin C. Peterson | Democratic | MN |
| Dave Brat | Republican | VA |
| David Kustoff | Republican | TN |
| David Loebsack | Democratic | IA |
| David P. Roe | Republican | TN |
| David Schweikert | Republican | AZ |
| David Young | Republican | IA |
| Debbie Lesko | Republican | AZ |
| Diana DeGette | Democratic | CO |
| Diane Black | Republican | TN |
| Doris O. Matsui | Democratic | CA |
| Earl Blumenauer | Democratic | OR |
| Earl L. "Buddy" Carter | Republican | GA |
| Eddie Bernice Johnson | Democratic | TX |
| Eleanor Holmes Norton | Democratic | DC |
| Eliot L. Engel | Democratic | NY |
| Emanuel Cleaver | Democratic | MO |
| Eric A. "Rick" Crawford | Republican | AR |
| Erik Paulsen | Republican | MN |
| Fred Upton | Republican | MI |
| G. K. Butterfield | Democratic | NC |
| Glenn Thompson | Republican | PA |
| Gregg Harper | Republican | MS |
| Gus M. Bilirakis | Republican | FL |
| Jaime Herrera Beutler | Republican | WA |
| James B. Renacci | Republican | OH |
| Janice D. Schakowsky | Democratic | IL |
| Jerry McNerney | Democratic | CA |
| John J. Duncan, Jr. | Republican | TN |
| Joseph Crowley | Democratic | NY |
| Joseph P. Kennedy III | Democratic | MA |
| Kathleen M. Rice | Democratic | NY |
| Kenny Marchant | Republican | TX |
| Kevin Cramer | Republican | ND |
| Leonard Lance | Republican | NJ |
| Markwayne Mullin | Republican | OK |
| Marsha Blackburn | Republican | TN |
| Michael F. Doyle | Democratic | PA |
| Mike Bishop | Republican | MI |
| Mike Coffman | Republican | CO |
| Mike Kelly | Republican | PA |
| Mike Thompson | Democratic | CA |
| Neal P. Dunn | Republican | FL |
| Patrick Meehan | Republican | PA |
| Paul Cook | Republican | CA |
| Paul Tonko | Democratic | NY |
| Pete Sessions | Republican | TX |
| Peter A. DeFazio | Democratic | OR |
| Raul Ruiz | Democratic | CA |
| Ro Khanna | Democratic | CA |
| Roger Marshall | Republican | KS |
| Ron Kind | Democratic | WI |
| Ryan A. Costello | Republican | PA |
| Scott DesJarlais | Republican | TN |
| Scott H. Peters | Democratic | CA |
| Scott R. Tipton | Republican | CO |
| Sean Patrick Maloney | Democratic | NY |
| Seth Moulton | Democratic | MA |
| Steve Stivers | Republican | OH |
| Terri A. Sewell | Democratic | AL |
| Tim Walberg | Republican | MI |
| Tony Cárdenas | Democratic | CA |
| Will Hurd | Republican | TX |
| Yvette D. Clarke | Democratic | NY |
Client expense: $252,000 · Firm income: Not reported
Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Small Business Administration (SBA), Veterans Affairs, Dept of (VA), White House Office
Client expense: $1,550,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), 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
2018 · fourth_quarter · Medicare/Medicaid
HR 6836, Clinical Treatment Act HR 3635, Local Coverage Determinations Act Prior Authorization S.2425-Patient Access and Medicare Protection Act (PAMPA) implementation. Support for legislation to freeze radiation therapy payments through the end of 2019, increase funding for the NIH for FY 2018 and FY 2019, and simplify the MIPS program; Balanced Budget Act of 2018 (HR 1892). Support for legislation to ensure patient safety and preserve the integrity of the Medicare program by ending abuses of the physician self-referral law for radiation therapy services; Protecting Integrity in Medicare Act (H.R. 2066) Support for structural changes that lead to delivering high-quality care for patients while increasing efficiencies and promoting Medicare sustainability; oppose radiation oncology benefit managers. Support for ensuring radiation oncologists participation in the Medicare electronic health record incentive program. Support for reforming the way Medicare pays for radiation oncology services by tying payments to quality and value. Implementation of H.R. 2, the Medicare Access and CHIP Reauthorization Act of 2015 Support the elimination of abuse to the Medicare program by closing the in-office ancillary services exception to the Stark Law for radiation oncology services. S. 794 Local Coverage Determination Clarification Act of 2017
Client expense: $189,038 · 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), Natl Institutes of Health (NIH), Nuclear Regulatory Commission (NRC), Office of Management & Budget (OMB), SENATE
2018 · fourth_quarter · Medicare/Medicaid
Legislation and policies related to: Physician/nurse practitioner reimbursement Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Implementation of the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 (P.L. 114-10) including policies related to the Quality Payment Program Adoption of recommendations of the Institute of Medicine report, The Future of Nursing: Leading Change, Advancing Health Medicare Shared Savings Program beneficiary assignment requirements Medicare-Medicaid hospital conditions of participation Evaluation of the Medicare Graduate Nurse Education demonstration Medicare-Medicaid Program Integrity policies Medicaid maintenance of effort requirements Medicaid eligibility expansion and state options Medicaid waiver application procedures Medicaid per capita cap policy options H.R. 1160 - ACO Assignment Improvement Act of 2017 H.R. 3178 - Medicare Part B Improvement Act of 2017 H.R. 3635 - Local Coverage Determination Clarification Act of 2017 H.R. 5306/S. 2227 - Ensuring Medicaid Provides Opportunities for Widespread Equity, Resources (EMPOWER) and Care Act H.R. 7217 - Improving Medicaid Programs and Opportunities for Eligible Beneficiaries (IMPROVE) Act S. 445/H.R. 1825 - Home Health Care Planning Improvement Act of 2017 S. 428/H.R. 3325 - Advancing Care for Exceptional Kids (ACE Kids) Act S. 870 - Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017 S. 1227/H.R. 2628 - Stabilize Medicaid and CHIP Coverage Act of 2017 S. 3067/H.R. 1617 - Promoting Access to Diabetic Shoes Act
Client expense: Not reported · Firm income: $23,450
Government targets: Agriculture, Dept of (USDA), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Justice, Dept of (DOJ), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA)
2018 · fourth_quarter · Health Issues
Outreach and monitoring related to the implementation of the Patient Protection and Affordable Care Act (P.L. 111-148). Outreach and monitoring related to federal and legislative activity related to health care and reauthorization of National All Schedules Prescription Electronic Reporting Act (NASPER) (P.L. 109-60). Outreach and monitoring related to federal and legislative activity related to Medicare Reimbursement. Outreach and monitoring related to federal issues and legislation associated with health care policy. Outreach and monitoring related to federal issues and legislation associated with opioids. H.R. 6, SUPPORT for Patients and Communities Act. (P.L. 115-271) H.R. 3635, Local Coverage Determination Clarification Act of 2017. H.R. 5804, Post-Surgical Injections as an Opioid Alternative Act. S. 794, Local Coverage Determination Clarification Act of 2017.
Client expense: Not reported · Firm income: $40,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2018 · fourth_quarter · Medical/Disease Research/Clinical Labs
Outreach and monitoring related to the implementation of the Patient Protection and Affordable Care Act (P.L. 111-148). Outreach and monitoring related to federal and legislative activity related to health care and reauthorization of National All Schedules Prescription Electronic Reporting Act (NASPER) (P.L. 109-60). Outreach and monitoring related to federal and legislative activity related to Medicare Reimbursement. Outreach and monitoring related to federal issues and legislation associated with health care policy. Outreach and monitoring related to federal issues and legislation associated with opioids. H.R. 6, SUPPORT for Patients and Communities Act. (P.L. 115-271) H.R. 3635, Local Coverage Determination Clarification Act of 2017. H.R. 5804, Post-Surgical Injections as an Opioid Alternative Act. S. 794, Local Coverage Determination Clarification Act of 2017.
Client expense: Not reported · Firm income: $40,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2018 · fourth_quarter · Budget/Appropriations
Outreach and monitoring related to the implementation of the Patient Protection and Affordable Care Act (P.L. 111-148). Outreach and monitoring related to federal and legislative activity related to health care and reauthorization of National All Schedules Prescription Electronic Reporting Act (NASPER) (P.L. 109-60). Outreach and monitoring related to federal and legislative activity related to Medicare Reimbursement. Outreach and monitoring related to federal issues and legislation associated with health care policy. Outreach and monitoring related to federal issues and legislation associated with opioids. H.R. 6, SUPPORT for Patients and Communities Act. (P.L. 115-271) H.R. 3635, Local Coverage Determination Clarification Act of 2017. H.R. 5804, Post-Surgical Injections as an Opioid Alternative Act. S. 794, Local Coverage Determination Clarification Act of 2017.
Client expense: Not reported · Firm income: $40,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2018 · fourth_quarter · Medicare/Medicaid
Outreach and monitoring related to the implementation of the Patient Protection and Affordable Care Act (P.L. 111-148). Outreach and monitoring related to federal and legislative activity related to health care and reauthorization of National All Schedules Prescription Electronic Reporting Act (NASPER) (P.L. 109-60). Outreach and monitoring related to federal and legislative activity related to Medicare Reimbursement. Outreach and monitoring related to federal issues and legislation associated with health care policy. Outreach and monitoring related to federal issues and legislation associated with opioids. H.R. 6, SUPPORT for Patients and Communities Act. (P.L. 115-271) H.R. 3635, Local Coverage Determination Clarification Act of 2017. H.R. 5804, Post-Surgical Injections as an Opioid Alternative Act. S. 794, Local Coverage Determination Clarification Act of 2017.
Client expense: Not reported · Firm income: $40,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2018 · fourth_quarter · Medicare/Medicaid
Physician and pharmacy reimbursement issues; Legislation to amend Part B of title XVII of the Social Security Act to exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price for drugs and biological under Medicare; Site neutral payment reforms;Issues related to physician reimbursement for Part B drugs;Support for increased transparency and accountability in Medicare's local determination process (S.794/H.R. 3635); Issues as they relate to opioid abuse policy; General Medicare/Medicaid Issues; Issues related to reimbursement for radiation therapy services; 340B, education related to need for sensible reforms in 340B that protect indigent beneficiaries and community oncology practices; Pandemic and All Hazards Preparedness Act reauthorization; issues related to step therapy policies in Medicare Advantage plans; Medicare physician payment; Issues related to an alternative payment model for radiation oncology services; Issues related to the Center for Medicare and Medicaid Innovation; Issues related to the ANPRM International Pricing Index Model for Medicare Part B Drugs.
Client expense: $210,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE
2018 · fourth_quarter · Medicare/Medicaid
Medicare physician payment; new/alternative payment models; Medicare coverage, including coverage policies pertaining to transcatheter aortic valve replacement, transcathether mitral valve repair, and ambulatory blood pressure monitoring; Medicare hospital payment; access to Medicare claims data; Ways & Means Committee hospital payment project; physician and hospital quality; electronic health record incentive program; clinical data registries; health care quality; medical imaging and prior authorization, including HR 4841, Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018; the Stark Law and the in-office ancillary services exception, including HR 4206/S 2051, the Medicare Care Coordination Improvement Act; Promoting Integrity in Medicare Act, HR 2066; Medicare Access and CHIP Reauthorization Act implementation and oversight; Bipartisan Budget Act of 2015 and Medicare site of service policy; HR 1155/S 1361, a bill to amend title XVIII of the Social Security Act to allow physician assistants, nurse practitioners, and clinical nurse specialists to supervise cardiac, intensive cardiac, and pulmonary rehabilitation programs; S 46, the Strengthening Medicare Intensive Cardiac Rehabilitation Programs Act of 2017; HR 3325/S 428, The Advancing Care for Exceptional Kids Act of 2017 (or ACE Kids Act), a bill to allow a state, at its option, to elect to provide medical assistance for items and services furnished to eligible children with medically complex conditions enrolled in a Medicaid Children's Care Coordination (MCCC) program; Senate Finance Committee chronic care project; graduate medical education policy including HR 2267/S 1301, Resident Physician Shortage Reduction Act of 2017; end of life care, including HR 2797/S 1334, the Patient Choice and Quality Care Act of 2017; Puerto Rico Oversight, Management, and Economic Stability Act (PROMESA) implementation; oversight and implementation of the Protecting Access to Medicare Act of 2014, including Appropriate Use Criteria; physician-owned hospital policy, including HR 1156/S 1133, the Patient Access to High Quality Care Act of 2017; Medicaid coverage and eligibility, including HR 829, Prioritizing the Most Vulnerable Over Lottery Winners Act of 2017, HR 181, Close Annuity Loopholes in Medicaid Act, and HR 705, Verify Eligibility Coverage Act; HR 3163, Medicare Part B Home Infusion Services Temporary Transitional Payment Act; Affordable Care Act repeal/replace/reform efforts; HR 3767 and S 989, the Ensuring Childrens Access to Specialty Care Act of 2017; HR 3635, the Local Coverage Determination Clarification Act of 2017; Ways and Means Committee Medicare extenders policy/legislation.
Client expense: $480,000 · Firm income: Not reported
Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, White House Office
2018 · fourth_quarter · Budget/Appropriations
Monitor implementation of the Patient Protection and Affordable Care Act (P.L. 111-148). Monitor federal and legislative activity related to Medicare Reimbursement. Monitor federal issues and legislation associated with health care policy. Monitor implementation of Medicare Access and CHIP Reauthorization Act of 2015 (P.L. 114-10). Monitor implementation of 21st Century Cures Act (P.L. 114-255). H.J. Res. 143, Continuing appropriations for fiscal year 2019. (P.L. 115-298) H.R. 6, SUPPORT for Patients and Communities Act. (P.L. 115-271) H.R. 849, Protecting Seniors' Access to Medicare Act of 2017. H.R. 1038, Improving Transparency and Accuracy in Medicare Part D Spending Act. H.R. 1316, Prescription Drug Price Transparency Act. H.R. 1628, American Health Care Act of 2017. H.R. 1703, Medical Product Communications Act of 2017. H.R. 1898, To improve access to, and utilization of, bone mass measurement benefits. H.R. 1920, To amend part B of title XVIII of the Social Security Act to exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price for drugs and biologicals under Medicare, and for other purposes. H.R.2077, Restoring the Patient's Voice Act of 2017. H.R. 2141, Conrad State 30 and Physician Access Reauthorization Act. H.R. 2267, Resident Physician Shortage Reduction Act of 2017. H.R. 2641, Promoting Life-Saving New Therapies for Neonates Act of 2017. H.R. 2999, Patients' Access to Treatments Act of 2017. H.R. 3635, Local Coverage Determination Clarification Act of 2017. H.R. 3728, EMPOWER Act of 2017. H.R. 3767, Ensuring Children's Access to Specialty Care Act of 2017. H.R. 4841, Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018. H.R. 5150, Protecting Medicare from Excessive Price Increases Act of 2018. H.R.6157, Defense and Labor, Health and Human Services Consolidated Appropriations Act, 2019. (P.L. 115-245) H.R. 6470, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2019. S. 251, Protecting Medicare from Executive Action Act of 2017. S. 260, Protecting Seniors' Access to Medicare Act of 2017. S. 637, Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2017. S. 794, Local Coverage Determination Clarification Act of 2017. S. 898, Conrad State 30 and Physician Access Reauthorization Act. S. 989, Ensuring Children's Access to Specialty Care Act of 2017. S. 1301, Resident Physician Shortage Reduction Act of 2017. S. 1304, A bill to amend part B of title XVIII of the Social Security Act to exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price for drugs and biologicals under Medicare, and for other purposes. S. 2553, Know the Lowest Price Act of 2018 (P.L. 115-262). S. 2554, Patient Right to Know Drug Prices Act (P.L. 115-263). S. 2908, To provide for electronic prior authorization under Medicare part D for covered part D drugs, and for other purposes. S. 3158, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2019. S. 3159, Department of Defense Appropriations Act, 2019. S. 3160, To improve access to, and utilization of, bone mass measurement benefits.
Client expense: $110,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2018 · fourth_quarter · Medicare/Medicaid
Monitor implementation of the Patient Protection and Affordable Care Act (P.L. 111-148). Monitor federal and legislative activity related to Medicare Reimbursement. Monitor federal issues and legislation associated with health care policy. Monitor implementation of Medicare Access and CHIP Reauthorization Act of 2015 (P.L. 114-10). Monitor implementation of 21st Century Cures Act (P.L. 114-255). H.R. 6, SUPPORT for Patients and Communities Act. H.R. 849, Protecting Seniors' Access to Medicare Act of 2017. H.R. 1038, Improving Transparency and Accuracy in Medicare Part D Spending Act. H.R. 1316, Prescription Drug Price Transparency Act. H.R. 1628, American Health Care Act of 2017. H.R. 1703, Medical Product Communications Act of 2017. H.R. 1898, To improve access to, and utilization of, bone mass measurement benefits. H.R. 1920, To amend part B of title XVIII of the Social Security Act to exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price for drugs and biologicals under Medicare, and for other purposes. H.R.2077, Restoring the Patient's Voice Act of 2017. H.R. 2141, Conrad State 30 and Physician Access Reauthorization Act. H.R. 2267, Resident Physician Shortage Reduction Act of 2017. H.R. 2641, Promoting Life-Saving New Therapies for Neonates Act of 2017. H.R. 2999, Patients' Access to Treatments Act of 2017. H.R. 3635, Local Coverage Determination Clarification Act of 2017. H.R. 3728, EMPOWER Act of 2017. H.R. 3767, Ensuring Children's Access to Specialty Care Act of 2017. H.R. 4841, Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018. H.R. 5150, Protecting Medicare from Excessive Price Increases Act of 2018. H.R.6157, Defense and Labor, Health and Human Services Consolidated Appropriations Act, 2019. H.R. 6470, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2019. S. 251, Protecting Medicare from Executive Action Act of 2017. S. 260, Protecting Seniors' Access to Medicare Act of 2017. S. 637, Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2017. S. 794, Local Coverage Determination Clarification Act of 2017. S. 898, Conrad State 30 and Physician Access Reauthorization Act. S. 989, Ensuring Children's Access to Specialty Care Act of 2017. S. 1301, Resident Physician Shortage Reduction Act of 2017. S. 1304, A bill to amend part B of title XVIII of the Social Security Act to exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price for drugs and biologicals under Medicare, and for other purposes. S. 2553, Know the Lowest Price Act of 2018 (P.L. 115-262). S. 2554, Patient Right to Know Drug Prices Act (P.L. 115-263). S. 2908, To provide for electronic prior authorization under Medicare part D for covered part D drugs, and for other purposes. S. 3158, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2019. S. 3160, To improve access to, and utilization of, bone mass measurement benefits.
Client expense: $110,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2018 · fourth_quarter · Health Issues
Monitor implementation of the Patient Protection and Affordable Care Act (P.L. 111-148). Monitor federal and legislative activity related to Medicare Reimbursement. Monitor federal issues and legislation associated with health care policy. Monitor implementation of Medicare Access and CHIP Reauthorization Act of 2015 (P.L. 114-10). Monitor implementation of 21st Century Cures Act (P.L. 114-255). H.J. Res. 143, Continuing appropriations for fiscal year 2019. (P.L. 115-298) H.R. 6, SUPPORT for Patients and Communities Act. (P.L. 115-271) H.R. 849, Protecting Seniors' Access to Medicare Act of 2017. H.R. 1038, Improving Transparency and Accuracy in Medicare Part D Spending Act. H.R. 1316, Prescription Drug Price Transparency Act. H.R. 1628, American Health Care Act of 2017. H.R. 1703, Medical Product Communications Act of 2017. H.R. 1898, To improve access to, and utilization of, bone mass measurement benefits. H.R. 1920, To amend part B of title XVIII of the Social Security Act to exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price for drugs and biologicals under Medicare, and for other purposes. H.R.2077, Restoring the Patient's Voice Act of 2017. H.R. 2141, Conrad State 30 and Physician Access Reauthorization Act. H.R. 2267, Resident Physician Shortage Reduction Act of 2017. H.R. 2641, Promoting Life-Saving New Therapies for Neonates Act of 2017. H.R. 2999, Patients' Access to Treatments Act of 2017. H.R. 3635, Local Coverage Determination Clarification Act of 2017. H.R. 3728, EMPOWER Act of 2017. H.R. 3767, Ensuring Children's Access to Specialty Care Act of 2017. H.R. 4841, Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018. H.R. 5150, Protecting Medicare from Excessive Price Increases Act of 2018. H.R.6157, Defense and Labor, Health and Human Services Consolidated Appropriations Act, 2019. (P.L. 115-245) H.R. 6470, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2019. S. 251, Protecting Medicare from Executive Action Act of 2017. S. 260, Protecting Seniors' Access to Medicare Act of 2017. S. 637, Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2017. S. 794, Local Coverage Determination Clarification Act of 2017. S. 898, Conrad State 30 and Physician Access Reauthorization Act. S. 989, Ensuring Children's Access to Specialty Care Act of 2017. S. 1301, Resident Physician Shortage Reduction Act of 2017. S. 1304, A bill to amend part B of title XVIII of the Social Security Act to exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price for drugs and biologicals under Medicare, and for other purposes. S. 2553, Know the Lowest Price Act of 2018 (P.L. 115-262). S. 2554, Patient Right to Know Drug Prices Act (P.L. 115-263). S. 2908, To provide for electronic prior authorization under Medicare part D for covered part D drugs, and for other purposes. S. 3158, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2019. S. 3159, Department of Defense Appropriations Act, 2019. S. 3160, To improve access to, and utilization of, bone mass measurement benefits.
Client expense: $110,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2018 · fourth_quarter · Health Issues
Public Law No. 113-93, Protecting Access to Medicare Act of 2014 Coverage and reimbursement for molecular diagnostics Local Coverage Determination Clarification Act of 2018 (HR 3635/S 794)
Client expense: Not reported · Firm income: $60,000
Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, SENATE
2018 · fourth_quarter · Medicare/Medicaid
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. 1016, CONNECT For Health Act (Schatz) - telehealth S. 1169, Medicaid CARE Act (Durbin-Portman) - changes to Medicaid IMD exclusion 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. 1890, Chronic Kidney Disease Improvement in Research and Treatment and Medigap Access (Cardin) - Medigap coverage for beneficiaries with end-stage renal disease S. 1909, BENES Act (Casey) - notifications of Medicare eligibility S. 2027, Medicaid Third Party Liability Act (Portman) - Medicaid third party liability S. 2051, Medicare Care Coordination Improvement Act of 2017 (Portman) - barriers to payment reform models S. 2227, EMPOWER Care Act (Portman-Cantwell) - Medicaid Money Follows the Person Demonstration S. 2707, Informing Seniors About Opioids Act (Nelson) - opioid issues S. 2901, Expanding Telehealth Response to Ensure Addiction Treatment Act (Thune) - opioid issues S. 2904, Medicaid Substance Use Disorder Treatment Via Telehealth Act (Carper) - opioid issues S. 2908, Electronic Prior Authorization in Medicare Part D Act (Roberts) - opioid issues S. 3327, SENIOR Communities Protection Act (Cortez Masto) - preventing fraudulent opioid prescriptions S. 3496, Improving Seniors Access to Quality Benefits Act (Daines-King) - study on MA benchmark cap S. 3497, Medicare Advantage Quality Payment Relief Act (Daines-King) - MA benchmark cap S. 3702, Right Rebate Act (Wyden-Grassley) - Medicaid drug rebate program Draft Bill: Medicare Long-Term Care Services and Supports Act (Pallone) - Long-Term Services and Supports Program H.R. 6, SUPPORT Patients and Families Act (Walden) - opioid initiatives, Medicare and Medicaid issues, budget offsets H.R. 695, Continuing Appropriations Act (Schiff) - Money Follows the Person demonstration, spousal impoverishment protections 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. 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. 2575, BENES Act (Ruiz) - notifications of Medicare eligibility 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. 2687, Medicaid CARE Act (Foster-Fitzpatrick) - changes to Medicaid IMD exclusion H.R. 3044, Supplemental Benefits for Chronically Ill Medicare Advantage Enrollees (Meehan) H.R. 3263, Medicare Independence at Home Model of Care (Burgess) - demonstration program H.R. 3325, ACE Kids Act (Barton) - health homes for children with complex medical conditions H.R. 3360, Telehealth Enhancement Act (Harper) - telehealth in Medicare H.R. 3635, Local Coverage Determination Clarification Act (Jenkins) - procedures for Medicare administrative contractors H.R. 3727, Increasing Telehealth Access in Medicare Act (Black) - telehealth in MA plans H.R. 4143, Dialysis PATIENTS Demonstration Act (Smith) - alternative care delivery models and payment methodologies for patients with end-stage renal disease H.R. 4952, Improving Seniors Access to Quality Benefits Act (Kelly) - MA benchmark cap study H.R. 5306, EMPOWER Care Act (Guthrie) - extension of Money Follows the Person demonstration H.R. 5603, Access to Telehealth Services for Substance Use Disorders Act (Matsui) - opioid issues H.R. 5605, Advancing High Quality Treatment for Opioid Use Disorders in Medicare Act (Ruiz) - opioid issues H.R. 5675, drug management programs for at-risk Medicare beneficiaries (Bilirakis) - opioid issues H.R. 5676, SENIOR Communities Protection Act (MacArthur) - preventing fraudulent opioid prescriptions H.R. 5684, Protecting Seniors from Opioid Abuse Act (Kelly) - opioid issues H.R. 5685, Medicare Opioid Safety Education Act (Faso) - opioid issues H.R. 5686, Medicare Clear Health Options in Care for Enrollees Act (Paulsen) - opioid issues H.R. 5715, Strengthening Partnerships to Prevent Opioid Abuse Act (Renacci) - communication between Medicare plan sponsors and CMS H.R. 5773, Preventing Addiction for Susceptible Seniors Act (Roskam) - opioid issues H.R. 5797, IMD CARE Act (Walters) - Medicaid IMD exclusion H.R. 5798, Opioid Screening and Chronic Pain Management Alternatives for Seniors Act (Bucshon) - opioid issues H.R. 5799, Medicaid Drug Review, Utilization, Good Governance Improvement Act (Blackburn) - opioid issues H.R. 5800, Medicaid IMD ADDITIONAL INFO Act (Upton) - opioid issues H.R. 5804, Post-Surgical Injections as an Opioid Alternative Act (Shimkus) - opioid issues H.R. 5808, Medicaid Pharmaceutical Home Act (Bilirakis) - opioid issues H.R. 5809, Postoperative Opioid Prevention Act (Peters) - opioid issues H.R. 5810, Medicaid Health Homes for Opioid-Use-Disorder Medicaid Enrollees Encouraged Act (Lance) - opioid issues H.R. 5812, Improving Medicaid Data Timeliness Act (Griffith) - opioid issues H.R. 6431, Medigap Consumer Protection Act (Levin) - reforms to Medicare supplemental insurance H.R. 6561, Comprehensive Care for Seniors Act (Walorski) -- Program of All-Inclusive Care for the Elderly H.R. 6563, Lower Out-of-Pocket Costs for Seniors Act (Pallone-Neal) - Medicare Part D cliff H.R. 6662, Empowering Seniors Decision Enrollment Act (Paulsen) - special enrollment period for non-deemed Medicare Cost Plan enrollees H.R. 6690, Fighting Fraud to Protect Care for Seniors Act (Roskam) - Medicare pilot program for smart card technology H.R. 7122, Shared Accountability for Improved Patient Outcomes Act (Paulsen) - value-based payment and delivery arrangements H.R. 7217, IMPROVE Act (Barton) - Money Follows the Person demonstration, ACE Kids Act, Medicare drug rebate program, spousal impoverishment protections H.R. 7223, Right Rebate Act (Schrader-Welch) - Medicaid drug rebate program H.R. 7247, Incentivizing Shared Risk in Medicare Advantage Act (Brady) - MA prior authorization H.R. 7249, Better Prior Authorization Notification Act (Reed) - MA prior authorization H.R. 7250, Prior Authorization Improvement Act (Kelly) - MA prior authorization 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); calendar year 2020 policy and technical regulation for MA and Part D; MA and Part D proposed rule on drug pricing changes for 2020; CMSs price transparency proposal for direct-to-consumer advertisements; issues relating to 2019 Rate Notice and Call Letter; 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; Bipartisan Budget Act of 2018 changes to 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) and the Bipartisan Budget Act of 2018 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's 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; issues relating to prescription drug price blueprint; 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: $1,540,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), 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
2018 · fourth_quarter · Medicare/Medicaid
H.R.5812 - Creating Opportunities that Necessitate New and Enhanced Connections That Improve Opioid Navigation Strategies Act of 2018 H.R. 6 - Opioid Package S.2680 - Opioid Crisis Response Act of 2018 H.R.3635 - Local Coverage Determination Clarification Act of 2017 Local Coverage Determination (LCD) Clarification Act (S. 794) Promoting Integrity in Medicare Act (HR 2066) Protecting Seniors' Access to Medicare Act (HR 849) Protecting Access to Medicare Act Protecting Patients from Surprise Medical Bills (Cassidy Language) FDA Technical Assistance to DAIA S. 2582 - Consumer Health Insurance Protection Act S. 284 - End Surprise Billing Act CMS Physician Fee Schedule Registry Measures
Client expense: $325,721 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2018 · fourth_quarter · Budget/Appropriations
Monitor implementation of the Patient Protection and Affordable Care Act (P.L. 111-148). Monitor federal and legislative activity related to Medicare Reimbursement. Monitor federal issues and legislation associated with health care policy. Monitor implementation of Medicare Access and CHIP Reauthorization Act of 2015 (P.L. 114-10). Monitor implementation of 21st Century Cures Act (P.L. 114-255). H.J. Res. 143, Continuing appropriations for fiscal year 2019. (P.L. 115-298) H.R. 6, SUPPORT for Patients and Communities Act. (P.L. 115-271) H.R. 849, Protecting Seniors' Access to Medicare Act of 2017. H.R. 1038, Improving Transparency and Accuracy in Medicare Part D Spending Act. H.R. 1316, Prescription Drug Price Transparency Act. H.R. 1628, American Health Care Act of 2017. H.R. 1703, Medical Product Communications Act of 2017. H.R. 1898, To improve access to, and utilization of, bone mass measurement benefits. H.R. 1920, To amend part B of title XVIII of the Social Security Act to exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price for drugs and biologicals under Medicare, and for other purposes. H.R.2077, Restoring the Patient's Voice Act of 2017. H.R. 2141, Conrad State 30 and Physician Access Reauthorization Act. H.R. 2267, Resident Physician Shortage Reduction Act of 2017. H.R. 2641, Promoting Life-Saving New Therapies for Neonates Act of 2017. H.R. 2999, Patients' Access to Treatments Act of 2017. H.R. 3635, Local Coverage Determination Clarification Act of 2017. H.R. 3728, EMPOWER Act of 2017. H.R. 3767, Ensuring Children's Access to Specialty Care Act of 2017. H.R. 4841, Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018. H.R. 5150, Protecting Medicare from Excessive Price Increases Act of 2018. H.R.6157, Defense and Labor, Health and Human Services Consolidated Appropriations Act, 2019. (P.L. 115-245) H.R. 6470, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2019. S. 251, Protecting Medicare from Executive Action Act of 2017. S. 260, Protecting Seniors' Access to Medicare Act of 2017. S. 637, Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2017. S. 794, Local Coverage Determination Clarification Act of 2017. S. 898, Conrad State 30 and Physician Access Reauthorization Act. S. 989, Ensuring Children's Access to Specialty Care Act of 2017. S. 1301, Resident Physician Shortage Reduction Act of 2017. S. 1304, A bill to amend part B of title XVIII of the Social Security Act to exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price for drugs and biologicals under Medicare, and for other purposes. S. 2553, Know the Lowest Price Act of 2018 (P.L. 115-262). S. 2554, Patient Right to Know Drug Prices Act (P.L. 115-263). S. 2908, To provide for electronic prior authorization under Medicare part D for covered part D drugs, and for other purposes. S. 3158, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2019. S. 3159, Department of Defense Appropriations Act, 2019. S. 3160, To improve access to, and utilization of, bone mass measurement benefits.
Client expense: Not reported · Firm income: $60,000
Government targets: Defense, Dept of (DOD), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2018 · fourth_quarter · Health Issues
Monitor implementation of the Patient Protection and Affordable Care Act (P.L. 111-148). Monitor federal and legislative activity related to Medicare Reimbursement. Monitor federal issues and legislation associated with health care policy. Monitor implementation of Medicare Access and CHIP Reauthorization Act of 2015 (P.L. 114-10). Monitor implementation of 21st Century Cures Act (P.L. 114-255). H.J. Res. 143, Continuing appropriations for fiscal year 2019. (P.L. 115-298) H.R. 6, SUPPORT for Patients and Communities Act. (P.L. 115-271) H.R. 849, Protecting Seniors' Access to Medicare Act of 2017. H.R. 1038, Improving Transparency and Accuracy in Medicare Part D Spending Act. H.R. 1316, Prescription Drug Price Transparency Act. H.R. 1628, American Health Care Act of 2017. H.R. 1703, Medical Product Communications Act of 2017. H.R. 1898, To improve access to, and utilization of, bone mass measurement benefits. H.R. 1920, To amend part B of title XVIII of the Social Security Act to exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price for drugs and biologicals under Medicare, and for other purposes. H.R.2077, Restoring the Patient's Voice Act of 2017. H.R. 2141, Conrad State 30 and Physician Access Reauthorization Act. H.R. 2267, Resident Physician Shortage Reduction Act of 2017. H.R. 2641, Promoting Life-Saving New Therapies for Neonates Act of 2017. H.R. 2999, Patients' Access to Treatments Act of 2017. H.R. 3635, Local Coverage Determination Clarification Act of 2017. H.R. 3728, EMPOWER Act of 2017. H.R. 3767, Ensuring Children's Access to Specialty Care Act of 2017. H.R. 4841, Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018. H.R. 5150, Protecting Medicare from Excessive Price Increases Act of 2018. H.R.6157, Defense and Labor, Health and Human Services Consolidated Appropriations Act, 2019. (P.L. 115-245) H.R. 6470, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2019. S. 251, Protecting Medicare from Executive Action Act of 2017. S. 260, Protecting Seniors' Access to Medicare Act of 2017. S. 637, Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2017. S. 794, Local Coverage Determination Clarification Act of 2017. S. 898, Conrad State 30 and Physician Access Reauthorization Act. S. 989, Ensuring Children's Access to Specialty Care Act of 2017. S. 1301, Resident Physician Shortage Reduction Act of 2017. S. 1304, A bill to amend part B of title XVIII of the Social Security Act to exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price for drugs and biologicals under Medicare, and for other purposes. S. 2553, Know the Lowest Price Act of 2018 (P.L. 115-262). S. 2554, Patient Right to Know Drug Prices Act (P.L. 115-263). S. 2908, To provide for electronic prior authorization under Medicare part D for covered part D drugs, and for other purposes. S. 3158, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2019. S. 3159, Department of Defense Appropriations Act, 2019. S. 3160, To improve access to, and utilization of, bone mass measurement benefits.
Client expense: Not reported · Firm income: $60,000
Government targets: Defense, Dept of (DOD), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2018 · fourth_quarter · Medicare/Medicaid
Medicare, oncology, radiation and imaging reimbursement issues Medicare physician payments prompt pay discount Oncology payment disparities in Medicare and protecting access to community based cancer care Reimbursement of cancer care services by the Veterans Administration Issues related to physician reimbursement for Part B drugs Support for increased transparency and accountability in Medicare's local determination process (S.794/H.R. 3635) 340B, education related to need for sensible reforms in 340B that protect indigent beneficiaries and community oncology practices
Client expense: Not reported · Firm income: $60,000
Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Veterans Affairs, Dept of (VA)
2018 · fourth_quarter · Medicare/Medicaid
PL 111-148 - The Patient Protection and Affordable Care Act, PL 111-152 - The reconciliation Act of 2010, implementation S. 794 - Medicare coverage S. 870 - Chronic Care H.R. 3921 - Healthy Kids Act S. 1827 - Kids Act of 2017 S. 787 - Telehealth Innovation and Improvement Act H.R. 3635/S. 794 - Local Coverage Determination Clarification Act Ensuring Access to Critical Breakthrough Products ***, no specific bill(s), diagnostics, Medicare Physician Reimbursement; reimbursement for imaging and technology; value based purchasing, Accountable Care Organizations, Sunshine Act, bundling, PODs, Cost centers, Stark, anti-kickback, telehealth, unique device identifier, pain management, coverage, DME, pass through payments
Client expense: Not reported · Firm income: $30,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2018 · fourth_quarter · Health Issues
Local Coverage Determination Clarification Act of 2018 (HR 3635/S 794)
Client expense: Not reported · Firm income: $20,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2018 · fourth_quarter · Medicare/Medicaid
HR 807 and SB 253 -- Part B Therapy cap Better Care Reconciliation Act Affordable Care Act Issues regarding Medicaid reform HR 2810--National Defense Authorization Act for Fiscal Year 2018 S. AMDT. 621 (HR 2810)--Authorization of Physical Therapist Assistants and Occupational Therapy Assistants to Provide Services Under the TRICARE Program HR 1361/S 486--Protecting Beneficiary Access to Complex Rehab Technology Act of 2017 HR 3635/S 794--Local Coverage Determination Act of 2017 Trusted Exchange Framework and Common Agreement (TEFCA)
Client expense: $39,516 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2018 · fourth_quarter · Medicare/Medicaid
H.R. 3635, S. 794- Local Coverage Determination Clarification Act of 2017 H.R. 2881 Medicare Access to Rural Anesthesiology Act of 2017
Client expense: Not reported · Firm income: $40,000
Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2018 · fourth_quarter · Medicare/Medicaid
H.R. 807/S.253 Medicare Access to Rehabilitation Services Act (Medicare Appeals Procedures) QPP Prevention Initiatives for Fraud and Abuse in The Medicare program Accountable health care organizations/patient centered medical homes Electronic health records/health information technology incentives for Physical Therapists Local coverage determinations/EMG NCCI Edits Protection of programs related to physical therapy in deficit reduction Medicare Advantage PCORI National priority for research and research agenda Health information technology Functional Limitation Reporting Therapy Cap: Targeted Medical Review Essential Health Benefits MIPS/PPP Medicaid essential health benefits EHR/LTPAC settings: transitions of care Medicare improvement standards Bundled payment models/CJR Common assessment tool for Medicare post-acute care Medicare appeals process Inclusion of physical therapists in quality programs Self-referral Coverage of telehealth APTA Registry Quality Programs Accelerating Innovation in Medicine Act (AIM) IMPACT Medicare Pilot Programs Chronic Care Management New evaluation and reevaluation CPT codes & misvalued codes Orthotics and Prosthetics Medicare Private Contracting S.870 - Chronic Care Act SNF 3-Day Rule Registry- ACI HR 2042 - Frontline Act Youth Concussion Management DME HR 3446 RBI Act H.R. 5261 Teach Act Opioid related H.R. 5197 Alto Act Opioid related Administrative Burden H.R. 5686, Medicare Clear Health Options in Care for Enrollees Act H.R. 5773, Preventing Addiction for Susceptible Seniors Act H.R. 5774, Combating Opioid Abuse for Care in Hospitals Act H.R. 5718, Perioperative Reduction for Opioids Act H.R. 5719, Reduce Overprescribing Opioids in Treatment Act H.R. 5722, Dr. Todd Graham Pain Management Improvement Act H.R. 6, Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act. S. 3120, HEAL Act S. 2680, Opioid Crisis Response Act PTA Differential in Medicare Prior Authorization in Medicare Advantage Plans Alternative payment models Certified EHR technology HR 7217 Improving Medicaid Programs and Opportunities for Eligible Beneficiaries Act (IMPROVE ACT) S. 3458: Improvements to Home Health HR 3635: Local Coverage Determination Clarification Act of 2018
Client expense: $252,000 · Firm income: Not reported
Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Small Business Administration (SBA), Veterans Affairs, Dept of (VA), White House Office
2018 · fourth_quarter · Medicare/Medicaid
HR 6836, Clinical Treatment Act HR 3635, Local Coverage Determinations Act Prior Authorization S.2425-Patient Access and Medicare Protection Act (PAMPA) implementation. Support for legislation to freeze radiation therapy payments through the end of 2019, increase funding for the NIH for FY 2018 and FY 2019, and simplify the MIPS program; Balanced Budget Act of 2018 (HR 1892). Support for legislation to ensure patient safety and preserve the integrity of the Medicare program by ending abuses of the physician self-referral law for radiation therapy services; Protecting Integrity in Medicare Act (H.R. 2066) Support for structural changes that lead to delivering high-quality care for patients while increasing efficiencies and promoting Medicare sustainability; oppose radiation oncology benefit managers. Support for ensuring radiation oncologists participation in the Medicare electronic health record incentive program. Support for reforming the way Medicare pays for radiation oncology services by tying payments to quality and value. Implementation of H.R. 2, the Medicare Access and CHIP Reauthorization Act of 2015 Support the elimination of abuse to the Medicare program by closing the in-office ancillary services exception to the Stark Law for radiation oncology services. S. 794 Local Coverage Determination Clarification Act of 2017
Client expense: $189,038 · 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), Natl Institutes of Health (NIH), Nuclear Regulatory Commission (NRC), Office of Management & Budget (OMB), SENATE
2018 · third_quarter · Medicare/Medicaid
HR 807 and SB 253 -- Part B Therapy cap Better Care Reconciliation Act Affordable Care Act Issues regarding Medicaid reform HR 2810--National Defense Authorization Act for Fiscal Year 2018 S. AMDT. 621 (HR 2810)--Authorization of Physical Therapist Assistants and Occupational Therapy Assistants to Provide Services Under the TRICARE Program HR 1361/S 486--Protecting Beneficiary Access to Complex Rehab Technology Act of 2017 HR 3635/S 794--Local Coverage Determination Act of 2017
Client expense: $39,516 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2018 · third_quarter · Health Issues
Issues surrounding the enactment or repeal of the Affordable Care Act. Medicare reimbursement reform for providers including the Medicare Access and CHIP Reauthorization Act (MACRA). Medicare Part B Drug Reimbursement. FDA issues. Implementation of The Breast Cancer Patient Education Act. The Palliative Care and Hospice Education and Training Act. Draft legislation to reform the FDA's regulation of cosmetics and draft legislation. Legislation to address physician workforce shortage (HR 2267, S. 1301). Legislation to address the medical liability system (HR 1565, HR 1876/S 781, HR 548/S 527). Legislation to reform the US Preventative Services Task Force (HR 539). HR 880/S.1022 Mission Zero Act. HR 3635/S.794 Local Coverage Determination Clarification Act. Legislation to address the opioid crisis. Reauthorization of the Pandemic and All Hazards Preparedness Act (PAHPA), Educating Congressional offices on bleeding control training.
Client expense: Not reported · Firm income: $20,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2018 · third_quarter · Medicare/Medicaid
Legislation and policies related to: Physician/nurse practitioner reimbursement Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Implementation of the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 (P.L. 114-10) including policies related to the Quality Payment Program Adoption of recommendations of the Institute of Medicine report, The Future of Nursing: Leading Change, Advancing Health Medicare Shared Savings Program beneficiary assignment requirements Medicare-Medicaid hospital conditions of participation Evaluation of the Medicare Graduate Nurse Education demonstration Medicare-Medicaid Program Integrity policies Medicaid maintenance of effort requirements Medicaid eligibility expansion and state options Medicaid waiver application procedures Medicaid per capita cap policy options H.R. 1160 - ACO Assignment Improvement Act of 2017 H.R. 3178 - Medicare Part B Improvement Act of 2017 H.R. 3635 - Local Coverage Determination Clarification Act of 2017 H.R. 5306/S. 2227 - Ensuring Medicaid Provides Opportunities for Widespread Equity, Resources (EMPOWER) and Care Act S. 445/H.R. 1825 - Home Health Care Planning Improvement Act of 2017 S. 428/H.R. 3325 - Advancing Care for Exceptional Kids (ACE Kids) Act S. 870 - Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017 S. 1227/H.R. 2628 - Stabilize Medicaid and CHIP Coverage Act of 2017 S. 3067/H.R. 1617 - Promoting Access to Diabetic Shoes Act
Client expense: Not reported · Firm income: $23,450
Government targets: Agriculture, Dept of (USDA), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Justice, Dept of (DOJ), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA)
2018 · third_quarter · Budget/Appropriations
Monitor implementation of the Patient Protection and Affordable Care Act (P.L. 111-148). Monitor federal and legislative activity related to Medicare Reimbursement. Monitor federal issues and legislation associated with health care policy. Monitor implementation of Medicare Access and CHIP Reauthorization Act of 2015 (P.L. 114-10). Monitor implementation of 21st Century Cures Act (P.L. 114-255). H.R. 6, SUPPORT for Patients and Communities Act. H.R. 849, Protecting Seniors' Access to Medicare Act of 2017. H.R. 1038, Improving Transparency and Accuracy in Medicare Part D Spending Act. H.R. 1316, Prescription Drug Price Transparency Act. H.R. 1628, American Health Care Act of 2017. H.R. 1703, Medical Product Communications Act of 2017. H.R. 1898, To improve access to, and utilization of, bone mass measurement benefits. H.R. 1920, To amend part B of title XVIII of the Social Security Act to exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price for drugs and biologicals under Medicare, and for other purposes. H.R.2077, Restoring the Patient's Voice Act of 2017. H.R. 2141, Conrad State 30 and Physician Access Reauthorization Act. H.R. 2267, Resident Physician Shortage Reduction Act of 2017. H.R. 2641, Promoting Life-Saving New Therapies for Neonates Act of 2017. H.R. 2999, Patients' Access to Treatments Act of 2017. H.R. 3635, Local Coverage Determination Clarification Act of 2017. H.R. 3728, EMPOWER Act of 2017. H.R. 3767, Ensuring Children's Access to Specialty Care Act of 2017. H.R. 4841, Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018. H.R. 5150, Protecting Medicare from Excessive Price Increases Act of 2018. H.R.6157, Defense and Labor, Health and Human Services Consolidated Appropriations Act, 2019. H.R. 6470, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2019. S. 251, Protecting Medicare from Executive Action Act of 2017. S. 260, Protecting Seniors' Access to Medicare Act of 2017. S. 637, Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2017. S. 794, Local Coverage Determination Clarification Act of 2017. S. 898, Conrad State 30 and Physician Access Reauthorization Act. S. 989, Ensuring Children's Access to Specialty Care Act of 2017. S. 1301, Resident Physician Shortage Reduction Act of 2017. S. 1304, A bill to amend part B of title XVIII of the Social Security Act to exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price for drugs and biologicals under Medicare, and for other purposes. S. 2553, Know the Lowest Price Act of 2018 (P.L. 115-262). S. 2554, Patient Right to Know Drug Prices Act (P.L. 115-263). S. 2908, To provide for electronic prior authorization under Medicare part D for covered part D drugs, and for other purposes. S. 3158, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2019. S. 3159, Department of Defense Appropriations Act, 2019. S. 3160, To improve access to, and utilization of, bone mass measurement benefits.
Client expense: $110,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Veterans Affairs, Dept of (VA)
2018 · third_quarter · Health Issues
Monitor implementation of the Patient Protection and Affordable Care Act (P.L. 111-148). Monitor federal and legislative activity related to Medicare Reimbursement. Monitor federal issues and legislation associated with health care policy. Monitor implementation of Medicare Access and CHIP Reauthorization Act of 2015 (P.L. 114-10). Monitor implementation of 21st Century Cures Act (P.L. 114-255). H.R. 6, SUPPORT for Patients and Communities Act. H.R. 849, Protecting Seniors' Access to Medicare Act of 2017. H.R. 1038, Improving Transparency and Accuracy in Medicare Part D Spending Act. H.R. 1316, Prescription Drug Price Transparency Act. H.R. 1628, American Health Care Act of 2017. H.R. 1703, Medical Product Communications Act of 2017. H.R. 1898, To improve access to, and utilization of, bone mass measurement benefits. H.R. 1920, To amend part B of title XVIII of the Social Security Act to exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price for drugs and biologicals under Medicare, and for other purposes. H.R.2077, Restoring the Patient's Voice Act of 2017. H.R. 2141, Conrad State 30 and Physician Access Reauthorization Act. H.R. 2267, Resident Physician Shortage Reduction Act of 2017. H.R. 2641, Promoting Life-Saving New Therapies for Neonates Act of 2017. H.R. 2999, Patients' Access to Treatments Act of 2017. H.R. 3635, Local Coverage Determination Clarification Act of 2017. H.R. 3728, EMPOWER Act of 2017. H.R. 3767, Ensuring Children's Access to Specialty Care Act of 2017. H.R. 4841, Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018. H.R. 5150, Protecting Medicare from Excessive Price Increases Act of 2018. H.R.6157, Defense and Labor, Health and Human Services Consolidated Appropriations Act, 2019. H.R. 6470, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2019. S. 251, Protecting Medicare from Executive Action Act of 2017. S. 260, Protecting Seniors' Access to Medicare Act of 2017. S. 637, Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2017. S. 794, Local Coverage Determination Clarification Act of 2017. S. 898, Conrad State 30 and Physician Access Reauthorization Act. S. 989, Ensuring Children's Access to Specialty Care Act of 2017. S. 1301, Resident Physician Shortage Reduction Act of 2017. S. 1304, A bill to amend part B of title XVIII of the Social Security Act to exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price for drugs and biologicals under Medicare, and for other purposes. S. 2553, Know the Lowest Price Act of 2018 (P.L. 115-262). S. 2554, Patient Right to Know Drug Prices Act (P.L. 115-263). S. 2908, To provide for electronic prior authorization under Medicare part D for covered part D drugs, and for other purposes. S. 3158, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2019. S. 3159, Department of Defense Appropriations Act, 2019. S. 3160, To improve access to, and utilization of, bone mass measurement benefits.
Client expense: $110,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Veterans Affairs, Dept of (VA)
2018 · third_quarter · Medicare/Medicaid
Monitor implementation of the Patient Protection and Affordable Care Act (P.L. 111-148). Monitor federal and legislative activity related to Medicare Reimbursement. Monitor federal issues and legislation associated with health care policy. Monitor implementation of Medicare Access and CHIP Reauthorization Act of 2015 (P.L. 114-10). Monitor implementation of 21st Century Cures Act (P.L. 114-255). H.R. 6, SUPPORT for Patients and Communities Act. H.R. 849, Protecting Seniors' Access to Medicare Act of 2017. H.R. 1038, Improving Transparency and Accuracy in Medicare Part D Spending Act. H.R. 1316, Prescription Drug Price Transparency Act. H.R. 1628, American Health Care Act of 2017. H.R. 1703, Medical Product Communications Act of 2017. H.R. 1898, To improve access to, and utilization of, bone mass measurement benefits. H.R. 1920, To amend part B of title XVIII of the Social Security Act to exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price for drugs and biologicals under Medicare, and for other purposes. H.R.2077, Restoring the Patient's Voice Act of 2017. H.R. 2141, Conrad State 30 and Physician Access Reauthorization Act. H.R. 2267, Resident Physician Shortage Reduction Act of 2017. H.R. 2641, Promoting Life-Saving New Therapies for Neonates Act of 2017. H.R. 2999, Patients' Access to Treatments Act of 2017. H.R. 3635, Local Coverage Determination Clarification Act of 2017. H.R. 3728, EMPOWER Act of 2017. H.R. 3767, Ensuring Children's Access to Specialty Care Act of 2017. H.R. 4841, Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018. H.R. 5150, Protecting Medicare from Excessive Price Increases Act of 2018. H.R.6157, Defense and Labor, Health and Human Services Consolidated Appropriations Act, 2019. H.R. 6470, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2019. S. 251, Protecting Medicare from Executive Action Act of 2017. S. 260, Protecting Seniors' Access to Medicare Act of 2017. S. 637, Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2017. S. 794, Local Coverage Determination Clarification Act of 2017. S. 898, Conrad State 30 and Physician Access Reauthorization Act. S. 989, Ensuring Children's Access to Specialty Care Act of 2017. S. 1301, Resident Physician Shortage Reduction Act of 2017. S. 1304, A bill to amend part B of title XVIII of the Social Security Act to exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price for drugs and biologicals under Medicare, and for other purposes. S. 2553, Know the Lowest Price Act of 2018 (P.L. 115-262). S. 2554, Patient Right to Know Drug Prices Act (P.L. 115-263). S. 2908, To provide for electronic prior authorization under Medicare part D for covered part D drugs, and for other purposes. S. 3158, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2019. S. 3159, Department of Defense Appropriations Act, 2019. S. 3160, To improve access to, and utilization of, bone mass measurement benefits.
Client expense: $110,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Veterans Affairs, Dept of (VA)
2018 · third_quarter · Medicare/Medicaid
Physician and pharmacy reimbursement issues; Legislation to amend Part B of title XVII of the Social Security Act to exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price for drugs and biological under Medicare; Site neutral payment reforms; Issues related to physician reimbursement for Part B drugs; Support for increased transparency and accountability in Medicare's local determination process (S.794/H.R. 3635); Issues as they relate to opioid abuse policy; General Medicare/Medicaid Issues; Issues related to reimbursement for radiation therapy services; 340B, education related to need for sensible reforms in 340B that protect indigent beneficiaries and community oncology practices; Pandemic and All Hazards Preparedness Act reauthorization; issues related to step therapy policies in Medicare Advantage plans; Medicare physician payment.
Client expense: $210,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE
2018 · third_quarter · Medicare/Medicaid
H.R. 242: Medicare Prescription Drug Price Negotiation Act of 2017 - Provisions related to Part D and drug pricing negotiation H.R. 1316: Prescription Drug Price Transparency Act - Provisions related to transparency of payment methodologies H.R. 3635: Local Coverage Deteremination Clarification Act of 2018 H.R. 4005: Medicaid Reentry Act H.R. 5150: Protecting Medicare from Excessive Price Increases Act of 2018 - To require drug manufacturers to pay a Medicare part B rebate for certain drugs H.R. 5675: To amend title XVIII of the Social Security Act to require prescription drug plan sponsors under the Medicare program to establish drug management programs for at-risk beneficiaries. H.R. 5797: Individuals in Medicaid Deserve Care that is Appropriate and Responsible in its Executive Act H.R. 5799: Medicaid Drug Review, Utilization, Good Governance Improvement Act H.R. 5801: Medicaid PARTNERSHIP Act H.R. 5808: Medicaid Pharmaceutical Home Act of 2018 H.R. 6505: Medicare Negotiation and Competitive Licensing Act of 2018 H.R. 6642: To amend title XIX of the Social Security Act to sunset the limit on the maximum rebate amount for single source drugs and innovator multiple source drugs H.R. __: To amend title XIX of the Social Security Act to provide the Medicare Payment Advisory Commission with access to certain drug rebate information S. 41: Medicare Prescription Drug Price Negotiation Act of 2017 - Provisions related to Part D and drug pricing negotiation S. 348: Prescription Drug and Health Improvement Act of 2017 - Provisions related to Part D S. 637: Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2017 - Provisions related to transparency of prescription drug pricing and pharmacy benefit managers S. 870: CHRONIC Care Act of 2017 - Provisions related to Medicare and chronic care S. 1348: Stopping the Pharmaceutical Industry from Keeping Drugs Expensive (SPIKE) Act of 2017 - Provisions related to increases in the wholesale acquisition costs of prescription drugs S. 1688: Empowering Medicare Seniors to Negotiate Drugs Prices Act of 2017 - Part D and non-interference provisions S. 3000: Patient Advocacy Transparency Act - Social Security Act amendments Department of Health and Human Services (HHS) drug policy issues and regulatory policy issues Part D policy issues including non-interference and rebates policy issues Part B reform including MedPAC recommendations and other policy issues and local coverage decisions Drug cost and pricing policy issues Transparency policy issues Alternative payment models policy issues Value-based purchasing arrangements policy issues Anti-Kickback Statute policy issues Center for Medicare and Medicaid Innovation (CMMI) policy issues Medicaid rebates and waiver policy issues Prescription drug abuse policy issues Final Rule; Calendar Year (CY) 2018 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System final rule with comment period (CMS-1678-FC) - Revisions to the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for CY 2018 Proposed Rule; Medicare Program; Contract Year 2019 Policy and Technical Changes to the Medicare Advantage, Medicare Cost Plan, Medicare Fee-for-Service, the Medicare Prescription Drug Benefit Programs, and the PACE Program (CMS-4182-P) Request for Information: Medicare and State Health Care Programs: Fraud and Abuse; Request for Information Regarding the Anti-Kickback Statute and Beneficiary Inducements CMP; 83 Fed. Reg. 43607 (Aug. 27, 2018) Removal of Safe Harbor Protection for Rebates to Plans or PBMs Involving Prescription Pharmaceuticals and Creation of New Safe Harbor Protection (RIN 0936-AA08) Medicare Part D Doughnut Hole Medicare Part D Cliff S 974/HR 2212 - CREATES Act340B Drug Pricing Program Medicare Part D Six Protected Classes
Client expense: $1,130,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2018 · third_quarter · Medicare/Medicaid
Medicare physician payment; new/alternative payment models; Medicare coverage, including coverage policies pertaining to implantable cardioverter-defibrillators and transcatheter aortic valve replacement; Medicare hospital payment; access to Medicare claims data; Ways & Means Committee hospital payment project; physician and hospital quality; electronic health record incentive program; clinical data registries; health care quality; medical imaging and prior authorization, including HR 4841, Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018; the Stark Law and the in-office ancillary services exception, including HR 4206/S 2051, the Medicare Care Coordination Improvement Act; Promoting Integrity in Medicare Act, HR 2066; Medicare Access and CHIP Reauthorization Act implementation and oversight; Bipartisan Budget Act of 2015 and Medicare site of service policy; HR 1155/S 1361, a bill to amend title XVIII of the Social Security Act to allow physician assistants, nurse practitioners, and clinical nurse specialists to supervise cardiac, intensive cardiac, and pulmonary rehabilitation programs; S 46, the Strengthening Medicare Intensive Cardiac Rehabilitation Programs Act of 2017; HR 3325/S 428, The Advancing Care for Exceptional Kids Act of 2017 (or ACE Kids Act), a bill to allow a state, at its option, to elect to provide medical assistance for items and services furnished to eligible children with medically complex conditions enrolled in a Medicaid Children's Care Coordination (MCCC) program; Senate Finance Committee chronic care project; graduate medical education policy including HR 2267/S 1301, Resident Physician Shortage Reduction Act of 2017; end of life care, including HR 2797/S 1334, the Patient Choice and Quality Care Act of 2017; Puerto Rico Oversight, Management, and Economic Stability Act (PROMESA) implementation; oversight and implementation of the Protecting Access to Medicare Act of 2014, including Appropriate Use Criteria; physician-owned hospital policy, including HR 1156/S 1133, the Patient Access to High Quality Care Act of 2017; Medicaid coverage and eligibility, including HR 829, Prioritizing the Most Vulnerable Over Lottery Winners Act of 2017, HR 181, Close Annuity Loopholes in Medicaid Act, and HR 705, Verify Eligibility Coverage Act; HR 3163, Medicare Part B Home Infusion Services Temporary Transitional Payment Act; Affordable Care Act repeal/replace/reform efforts; HR 3767 and S 989, the Ensuring Childrens Access to Specialty Care Act of 2017; HR 3635, the Local Coverage Determination Clarification Act of 2017; Ways and Means Committee Medicare extenders policy/legislation.
Client expense: $750,000 · Firm income: Not reported
Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, White House Office
2018 · third_quarter · Medicare/Medicaid
H.R. 242: Medicare Prescription Drug Price Negotiation Act of 2017 - Provisions related to Part D and drug pricing negotiation H.R. 1316: Prescription Drug Price Transparency Act - Provisions related to transparency of payment methodologies H.R. 3192: CHIP Mental Health Parity Act H.R. 3635: Local Coverage Determination Clarification Act of 2018 H.R. 4005: Medicaid Reentry Act H.R. 5150: Protecting Medicare from Excessive Price Increases Act of 2018 - To require drug manufacturers to pay a Medicare part B rebate for certain drugs H.R. 5590: Opioid Addiction Action Plan Act H.R. 5605: Advancing High Quality Treatment for Opioid Use Disorders in Medicare Act H.R. 5675: To amend title XVIII of the Social Security Act to require prescription drug plan sponsors under the Medicare program to establish drug management programs for at-risk beneficiaries. H.R. 5797: Individuals in Medicaid Deserve Care that is Appropriate and Responsible in its Executive Act H.R. 5799: Medicaid Drug Review, Utilization, Good Governance Improvement Act H.R. 5801: Medicaid PARTNERSHIP Act H.R. 5808: Medicaid Pharmaceutical Home Act of 2018 H.R. 5810: Medicaid Health Homes for Opioid-Use-Disorder Medicaid Enrollees Encouraged Act H.R. 6505: Medicare Negotiation and Competitive Licensing Act of 2018 H.R. 6642: To amend title XIX of the Social Security Act to sunset the limit on the maximum rebate amount for single source drugs and innovator multiple source drugs H.R. __: To amend title XIX of the Social Security Act to provide the Medicare Payment Advisory Commission with access to certain drug rebate information S. 41: Medicare Prescription Drug Price Negotiation Act of 2017 - Provisions related to Part D and drug pricing negotiation S. 348: Prescription Drug and Health Improvement Act of 2017 - Provisions related to Part D S. 637: Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2017 - Provisions related to transparency of prescription drug pricing and pharmacy benefit managers S. 870: CHRONIC Care Act of 2017 - Provisions related to Medicare and chronic care S. 1348: Stopping the Pharmaceutical Industry from Keeping Drugs Expensive (SPIKE) Act of 2017 - Provisions related to increases in the wholesale acquisition costs of prescription drugs S. 1688: Empowering Medicare Seniors to Negotiate Drugs Prices Act of 2017 - Part D and non-interference provisions S. 3000: Patient Advocacy Transparency Act - Social Security Act amendments Medicare Access and Childrens Health Insurance Program (CHIP) reauthorization policy issues Department of Health and Human Services (HHS) drug policy issues and regulatory policy issues Part D policy issues including non-interference and rebates policy issues Part B reform including MedPAC recommendations and other policy issues and local coverage decisions Drug cost and pricing policy issues Transparency policy issues Alternative payment models policy issues Value-based purchasing arrangements policy issues Anti-Kickback Statute policy issues Center for Medicare and Medicaid Innovation (CMMI) policy issues Medicaid rebates and waiver policy issues Prescription drug abuse policy issues Final Rule; Calendar Year (CY) 2018 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System final rule with comment period (CMS-1678-FC) - Revisions to the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for CY 2018 Proposed Rule; Medicare Program; Contract Year 2019 Policy and Technical Changes to the Medicare Advantage, Medicare Cost Plan, Medicare Fee-for-Service, the Medicare Prescription Drug Benefit Programs, and the PACE Program (CMS-4182-P) Request for Information: Medicare and State Health Care Programs: Fraud and Abuse; Request for Information Regarding the Anti-Kickback Statute and Beneficiary Inducements CMP; 83 Fed. Reg. 43607 (Aug. 27, 2018) Removal of Safe Harbor Protection for Rebates to Plans or PBMs Involving Prescription Pharmaceuticals and Creation of New Safe Harbor Protection (RIN 0936-AA08)
Client expense: $5,990,000 · 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), Office of Management & Budget (OMB), Patent & Trademark Office (PTO), SENATE
2018 · third_quarter · Medicare/Medicaid
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. 1016, CONNECT For Health Act (Schatz) - telehealth S. 1169, Medicaid CARE Act (Durbin-Portman) - changes to Medicaid IMD exclusion 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 S. 2707, Informing Seniors About Opioids Act (Nelson) - opioid issues S. 2901, Expanding Telehealth Response to Ensure Addiction Treatment Act (Thune) - opioid issues S. 2904, Medicaid Substance Use Disorder Treatment Via Telehealth Act (Carper) - opioid issues S. 2908, Electronic Prior Authorization in Medicare Part D Act (Roberts) - opioid issues S. 3327, SENIOR Communities Protection Act (Cortez Masto) - preventing fraudulent opioid prescriptions S. 3496, Improving Seniors Access to Quality Benefits Act (Daines-King) - study on MA benchmark cap S. 3497, Medicare Advantage Quality Payment Relief Act (Daines-King) - MA benchmark cap Draft Bill: Medicare Long-Term Care Services and Supports Act (Pallone) - Long-Term Services and Supports Program Draft Bills: Prior Authorization in Medicare Advantage (House Ways and Means Committee) - prior authorization notifications, report to Congress S. 2051: Medicare Care Coordination Improvement Act of 2017 (Portman) - barriers to payment reform models 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. 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. 2687, Medicaid CARE Act (Foster-Fitzpatrick) - changes to Medicaid IMD exclusion 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) - health homes for children with complex medical conditions H.R. 3360, Telehealth Enhancement Act (Harper) - telehealth in Medicare H.R. 3635, Local Coverage Determination Clarification Act (Jenkins) - procedures for Medicare administrative contractors H.R. 3727, Increasing Telehealth Access in Medicare Act (Black) - telehealth in MA plans H.R. 4143, Dialysis PATIENTS Demonstration Act of 2017 (Smith) - alternative care delivery models and payment methodologies for patients with end-stage renal disease H.R. 4952, Improving Seniors Access to Quality Benefits Act (Kelly) - MA benchmark cap study H.R. 5306, EMPOWER Care Act (Guthrie) - extension of Money Follows the Person Act H.R. 5603, Access to Telehealth Services for Substance Use Disorders Act (Matsui) - opioid issues H.R. 5605, Advancing High Quality Treatment for Opioid Use Disorders in Medicare Act (Ruiz) - opioid issues H.R. 5675, drug management programs for at-risk Medicare beneficiaries (Bilirakis) - opioid issues H.R. 5676, SENIOR Communities Protection Act (MacArthur) - preventing fraudulent opioid prescriptions H.R. 5684, Protecting Seniors from Opioid Abuse Act (Kelly) - opioid issues H.R. 5685, Medicare Opioid Safety Education Act (Faso) - opioid issues H.R. 5686, Medicare Clear Health Options in Care for Enrollees Act (Paulsen) - opioid issues H.R. 5715, Strengthening Partnerships to Prevent Opioid Abuse Act (Renacci) - communication between Medicare plan sponsors and CMS H.R. 5773, Preventing Addiction for Susceptible Seniors Act (Roskam) - opioid issues H.R. 5797, IMD CARE Act (Walters) - Medicaid IMD exclusion H.R. 5798, Opioid Screening and Chronic Pain Management Alternatives for Seniors Act (Bucshon) - opioid issues H.R. 5799, Medicaid Drug Review, Utilization, Good Governance Improvement Act (Blackburn) - opioid issues H.R. 5800, Medicaid IMD ADDITIONAL INFO Act (Upton) - opioid issues H.R. 5804, Post-Surgical Injections as an Opioid Alternative Act (Shimkus) - opioid issues H.R. 5808, Medicaid Pharmaceutical Home Act (Bilirakis) - opioid issues H.R. 5809, Postoperative Opioid Prevention Act (Peters) - opioid issues H.R. 5810, Medicaid Health Homes for Opioid-Use-Disorder Medicaid Enrollees Encouraged Act (Lance) - opioid issues H.R. 5812, Improving Medicaid Data Timeliness Act (Griffith) - opioid issues H.R. 6431, Medigap Consumer Protection Act (Levin) - reforms to Medicare supplemental insurance H.R. 6561, Comprehensive Care for Seniors Act (Walorski) -- Program of All-Inclusive Care for the Elderly H.R. 6563, Lower Out-of-Pocket Costs for Seniors Act (Pallone-Neal) - Medicare Part D cliff H.R. 6662, Empowering Seniors Decision Enrollment Act (Paulsen) - special enrollment period for non-deemed Medicare Cost Plan enrollees H.R. 6690, Fighting Fraud to Protect Care for Seniors Act (Roskam) - Medicare pilot program for smart card technology 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); calendar year 2019 policy and technical regulation for MA and Part D; issues relating to 2019 Rate Notice and Call Letter; 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; Bipartisan Budget Act of 2018 changes to 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) and the Bipartisan Budget Act of 2018 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; issues relating to prescription drug price blueprint; 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. *Add MACPAC to Agency List.
Client expense: $1,500,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Treasury, Dept of
2018 · third_quarter · Medicare/Medicaid
Medicare, oncology, radiation and imaging reimbursement issues Medicare physician payments prompt pay discount Oncology payment disparities in Medicare and protecting access to community based cancer care Reimbursement of cancer care services by the Veterans Administration Issues related to physician reimbursement for Part B drugs Support for increased transparency and accountability in Medicare's local determination process (S.794/H.R. 3635) 340B, education related to need for sensible reforms in 340B that protect indigent beneficiaries and community oncology practices
Client expense: Not reported · Firm income: $60,000
Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Veterans Affairs, Dept of (VA)
2018 · third_quarter · Medicare/Medicaid
PL 111-148 - The Patient Protection and Affordable Care Act, PL 111-152 - The reconciliation Act of 2010, implementation S. 794 - Medicare coverage S. 870 - Chronic Care H.R. 3921 - Healthy Kids Act S. 1827 - Kids Act of 2017 S. 787 - Telehealth Innovation and Improvement Act H.R. 3635/S. 794 - Local Coverage Determination Clarification Act Ensuring Access to Critical Breakthrough Products ***, no specific bill(s), diagnostics, Medicare Physician Reimbursement; reimbursement for imaging and technology; value based purchasing, Accountable Care Organizations, Sunshine Act, bundling, PODs, Cost centers, Stark, anti-kickback, telehealth, unique device identifier, pain management, coverage, DME, pass through payments
Client expense: Not reported · Firm income: $70,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2018 · third_quarter · Health Issues
American Competitiveness in Biotechnology Local Coverage Determination Clarification Act of 2018 (HR 3635/S 794)
Client expense: Not reported · Firm income: $20,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2018 · third_quarter · Health Issues
Public Law No. 113-93, Protecting Access to Medicare Act of 2014 Coverage and reimbursement for molecular diagnostics Local Coverage Determination Clarification Act of 2018 (HR 3635/S 794)
Client expense: Not reported · Firm income: $60,000
Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, SENATE
2018 · third_quarter · Medicare/Medicaid
H.R.5812 - Creating Opportunities that Necessitate New and Enhanced Connections That Improve Opioid Navigation Strategies Act of 2018 H.R. 6 - Opioid Package S.2680 - Opioid Crisis Response Act of 2018 H.R.3635 - Local Coverage Determination Clarification Act of 2017 Local Coverage Determination (LCD) Clarification Act (S. 794) Promoting Integrity in Medicare Act (HR 2066) Protecting Seniors' Access to Medicare Act (HR 849) Protecting Access to Medicare Act Protecting Patients from Surprise Medical Bills (Cassidy Language) FDA Technical Assistance to DAIA S. 2582 - Consumer Health Insurance Protection Act S. 284 - End Surprise Billing Act CMS Physician Fee Schedule Registry Measures
Client expense: $371,117 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2018 · third_quarter · Medicare/Medicaid
Section 216(a) of the Protecting Access to Medicare Act of 2014 (PAMA)(PL 113-93); payment, coding and coverage for laboratory tests HR 3635, Local Coverage Determination Clarification Act of 2017; LCD process for laboratory tests
Client expense: $60,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, SENATE
2018 · third_quarter · Medicare/Medicaid
H.R. 6, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act or the SUPPORT for Patients and Communities Act: Medicare coverage for non-opioid treatments for pain H.R.3635, Local Coverage Determination Clarification Act of 2017: Medicare coverage policy process No Bill: Medicare regulatory relief, including repeal/delay of appropriate use criteria for advanced diagnostic imaging No Bill: Prior authorization reform in Medicare Advantage No Bill: Opposition to CMS proposal to change Evaluation and Management (office visit) codes in Medicare
Client expense: $40,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2018 · third_quarter · Budget/Appropriations
Monitor implementation of the Patient Protection and Affordable Care Act (P.L. 111-148). Monitor federal and legislative activity related to Medicare Reimbursement. Monitor federal issues and legislation associated with health care policy. Monitor implementation of Medicare Access and CHIP Reauthorization Act of 2015 (P.L. 114-10). Monitor implementation of 21st Century Cures Act (P.L. 114-255). H.R. 6, SUPPORT for Patients and Communities Act. H.R. 849, Protecting Seniors' Access to Medicare Act of 2017. H.R. 1038, Improving Transparency and Accuracy in Medicare Part D Spending Act. H.R. 1316, Prescription Drug Price Transparency Act. H.R. 1628, American Health Care Act of 2017. H.R. 1703, Medical Product Communications Act of 2017. H.R. 1898, To improve access to, and utilization of, bone mass measurement benefits. H.R. 1920, To amend part B of title XVIII of the Social Security Act to exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price for drugs and biologicals under Medicare, and for other purposes. H.R.2077, Restoring the Patient's Voice Act of 2017. H.R. 2141, Conrad State 30 and Physician Access Reauthorization Act. H.R. 2267, Resident Physician Shortage Reduction Act of 2017. H.R. 2641, Promoting Life-Saving New Therapies for Neonates Act of 2017. H.R. 2999, Patients' Access to Treatments Act of 2017. H.R. 3635, Local Coverage Determination Clarification Act of 2017. H.R. 3728, EMPOWER Act of 2017. H.R. 3767, Ensuring Children's Access to Specialty Care Act of 2017. H.R. 4841, Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018. H.R. 5150, Protecting Medicare from Excessive Price Increases Act of 2018. H.R.6157, Defense and Labor, Health and Human Services Consolidated Appropriations Act, 2019. H.R. 6470, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2019. S. 251, Protecting Medicare from Executive Action Act of 2017. S. 260, Protecting Seniors' Access to Medicare Act of 2017. S. 637, Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2017. S. 794, Local Coverage Determination Clarification Act of 2017. S. 898, Conrad State 30 and Physician Access Reauthorization Act. S. 989, Ensuring Children's Access to Specialty Care Act of 2017. S. 1301, Resident Physician Shortage Reduction Act of 2017. S. 1304, A bill to amend part B of title XVIII of the Social Security Act to exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price for drugs and biologicals under Medicare, and for other purposes. S. 2553, Know the Lowest Price Act of 2018 (P.L. 115-262). S. 2554, Patient Right to Know Drug Prices Act (P.L. 115-263). S. 2908, To provide for electronic prior authorization under Medicare part D for covered part D drugs, and for other purposes. S. 3158, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2019. S. 3159, Department of Defense Appropriations Act, 2019. S. 3160, To improve access to, and utilization of, bone mass measurement benefits.
Client expense: Not reported · Firm income: $60,000
Government targets: Defense, Dept of (DOD), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Veterans Affairs, Dept of (VA)
2018 · third_quarter · Health Issues
Monitor implementation of the Patient Protection and Affordable Care Act (P.L. 111-148). Monitor federal and legislative activity related to Medicare Reimbursement. Monitor federal issues and legislation associated with health care policy. Monitor implementation of Medicare Access and CHIP Reauthorization Act of 2015 (P.L. 114-10). Monitor implementation of 21st Century Cures Act (P.L. 114-255). H.R. 6, SUPPORT for Patients and Communities Act. H.R. 849, Protecting Seniors' Access to Medicare Act of 2017. H.R. 1038, Improving Transparency and Accuracy in Medicare Part D Spending Act. H.R. 1316, Prescription Drug Price Transparency Act. H.R. 1628, American Health Care Act of 2017. H.R. 1703, Medical Product Communications Act of 2017. H.R. 1898, To improve access to, and utilization of, bone mass measurement benefits. H.R. 1920, To amend part B of title XVIII of the Social Security Act to exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price for drugs and biologicals under Medicare, and for other purposes. H.R.2077, Restoring the Patient's Voice Act of 2017. H.R. 2141, Conrad State 30 and Physician Access Reauthorization Act. H.R. 2267, Resident Physician Shortage Reduction Act of 2017. H.R. 2641, Promoting Life-Saving New Therapies for Neonates Act of 2017. H.R. 2999, Patients' Access to Treatments Act of 2017. H.R. 3635, Local Coverage Determination Clarification Act of 2017. H.R. 3728, EMPOWER Act of 2017. H.R. 3767, Ensuring Children's Access to Specialty Care Act of 2017. H.R. 4841, Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018. H.R. 5150, Protecting Medicare from Excessive Price Increases Act of 2018. H.R.6157, Defense and Labor, Health and Human Services Consolidated Appropriations Act, 2019. H.R. 6470, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2019. S. 251, Protecting Medicare from Executive Action Act of 2017. S. 260, Protecting Seniors' Access to Medicare Act of 2017. S. 637, Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2017. S. 794, Local Coverage Determination Clarification Act of 2017. S. 898, Conrad State 30 and Physician Access Reauthorization Act. S. 989, Ensuring Children's Access to Specialty Care Act of 2017. S. 1301, Resident Physician Shortage Reduction Act of 2017. S. 1304, A bill to amend part B of title XVIII of the Social Security Act to exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price for drugs and biologicals under Medicare, and for other purposes. S. 2553, Know the Lowest Price Act of 2018 (P.L. 115-262). S. 2554, Patient Right to Know Drug Prices Act (P.L. 115-263). S. 2908, To provide for electronic prior authorization under Medicare part D for covered part D drugs, and for other purposes. S. 3158, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2019. S. 3159, Department of Defense Appropriations Act, 2019. S. 3160, To improve access to, and utilization of, bone mass measurement benefits.
Client expense: Not reported · Firm income: $60,000
Government targets: Defense, Dept of (DOD), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Veterans Affairs, Dept of (VA)
2018 · third_quarter · Medicare/Medicaid
Outreach and monitoring related to the implementation of the Patient Protection and Affordable Care Act (P.L. 111-148). Outreach and monitoring related to federal and legislative activity related to health care and reauthorization of National All Schedules Prescription Electronic Reporting Act (NASPER) (P.L. 109-60). Outreach and monitoring related to federal and legislative activity related to Medicare Reimbursement. Outreach and monitoring related to federal issues and legislation associated with health care policy. Outreach and monitoring related to federal issues and legislation associated with opioids. H.R. 6, SUPPORT for Patients and Communities Act. H.R. 1628, The Better Care Reconciliation Act of 2017. H.R. 3635, Local Coverage Determination Clarification Act of 2017. H.R. 5804, Post-Surgical Injections as an Opioid Alternative Act. S. 794, Local Coverage Determination Clarification Act of 2017.
Client expense: Not reported · Firm income: $50,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2018 · third_quarter · Medical/Disease Research/Clinical Labs
Outreach and monitoring related to the implementation of the Patient Protection and Affordable Care Act (P.L. 111-148). Outreach and monitoring related to federal and legislative activity related to health care and reauthorization of National All Schedules Prescription Electronic Reporting Act (NASPER) (P.L. 109-60). Outreach and monitoring related to federal and legislative activity related to Medicare Reimbursement. Outreach and monitoring related to federal issues and legislation associated with health care policy. Outreach and monitoring related to federal issues and legislation associated with opioids. H.R. 6, SUPPORT for Patients and Communities Act. H.R. 1628, The Better Care Reconciliation Act of 2017. H.R. 3635, Local Coverage Determination Clarification Act of 2017. H.R. 5804, Post-Surgical Injections as an Opioid Alternative Act. S. 794, Local Coverage Determination Clarification Act of 2017.
Client expense: Not reported · Firm income: $50,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE