Medicare Home Health Flexibility Act of 2017

S. 977/HR 3820 and HR 6225: Medicare Home Health Flexibility Act - Advocate for passage . HR 2550: Medicare Telehealth Parity Act of 2017 - Advocated for the inclusion of occupational therapy as part of telehealth legislation that would allow for reimbursement of certain telehealth services under Medicare. HR2556: Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act; S787: A bill to require the Center for Medicare and Medicaid Innovation to test the effect of including telehealth services in Medicare health care delivery reform models; HR3360: Telehealth Enhancement Act; HR3482: Evidence-Based Telehealth Expansion Act; S1016: Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act; and HR3727: A bill to amend title XVIII of the Social Security Act to include additional telehealth services for purposes of MA organization bids, and for other purposes. - Advocated for the inclusion of occupational therapy as part of telehealth legislation that would allow for reimbursement of certain telehealth services under Medicare. No bill# Red Tape Reduction Initiative from Ways and Means Committee: Submitted following priorities for occupational therapy red tape reduction - 1) Initiation of Home Health Therapy Services Under Medicare (S. 977/HR 3820 now HR 6225), 2) Recognition of Occupational Therapy as a Primary Rehab Service (no bill number), 3) Permanently Eliminate Outside Certification Requirement for Occupational Therapists to Fabricate Custom Orthotics and Prosthetic Items (no bill number), 4) Modify or Eliminate Claims-Based Data Collection of Functional Limitation Information for Therapy Services (no bill number), 5) Add Doctor-prescribed Compression Supplies to the Durable Medical Equipment category (S 497/HR 930), and 6) Medicare Opt-out Option (no bill number). No Bill: Discussed how Stark laws affect the ability of occupational therapy practitioners to provide coordinated care services, particularly as it relates to the management of chronic conditions. S. 497/HR 930: Lymphedema Treatment Act - Support passage. No bill: Advocate for role of skilled therapy in changing reimbursement under Medicare Part A and Part B. HR 6, HR 5722, HR 5774, HR 5776, HR 6110, S 3008 and S 3120: (Various Bills on Opioids) Educate Members of Congress about the role of occupational therapy in the non-pharmacological management of pain, and advocate for any legislation that includes studies or funding for these alternatives, includes occupational therapy. Discussed and examined the effect of changes to reimbursement for occupational therapy assistants included in the Bi-partisan Budget Act, and possibly requesting a report from the GAO.

Client expense: $130,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Natl Institutes of Health (NIH), SENATE

S. J. Res. 16 a joint resolution approving the discontinuation of the process for consideration and automatic implementation of the annual proposal of the independent payment Medicare advisory board H.J. Res 51/S. J. Res 17 Independent Payment Advisory Board Repeal H.R 1995 Value Based Insurance Design for Better Care Act H.R. 1038/S. 413 Improving Transparency and Accuracy in Medicare Part D Spending H.R. 1072/S. 222 Obamacare Replacement Act H.R. 1148/S. 431 Furthering Access to Stroke Telemedicine (FAST) Act H.R. 1628 American Health Care Act H.R. 1953/S. 830 Treat and Reduce Obesity Act H.R. 2267/S. 1301 Resident Physician Shortage Reduction Act H.R. 2550 Medicare Telehealth Parity Act H.R. 2556/S. 1016 CONNECT for Health Act H.R. 2797/S. 1334 Patient Choice and Quality Care Act H.R. 2824 Increasing Opportunity and Success for Children and Parents Through Evidence-Based Home Visiting Act H.R. 284 Advancing Medical Resident Training in Community Hospitals Act H.R. 2953/S. 2164 Preventive Health Savings Act H.R. 3044 to expand supplemental benefits to meet the needs of chronically ill Medicare Advantage enrollees H.R. 3059/S. 1441 Community Health Center and Primary Care Workforce Expansion Act H.R. 3124/S. 1299 Preventing Diabetes in Medicare Act H.R. 3168 to provide continued access to Medicare Advantage plans for special needs H.R. 3224 Critical Access and Rural Equity Act H.R. 3245 Medicare Civil and Criminal Penalties Act H.R. 3263 to extend the Medicare independence at home medical demonstration program H.R. 3358/S. 1771 Fiscal Year 2018 Labor-Health and Human Services-Education Appropriations Bill H.R. 3394 Teaching Health Centers Graduate Medical Education Extension Act H.R. 3447 Furthering Access to Coordinated Treatment for Seniors Act H.R. 3726 Stark Administrative Simplification Act of 2017 H.R. 3728 Empowering Medical Professionals and Optimizing Workforce Efficiency and Readiness Act H.R. 3820/S. 977 Medicare Home Health Flexibility Act H.R. 3862 National Health Service Corps Strengthening Act H.R. 3921 Helping Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable Act H.R. 3922 Continuing Community Health and Medical Professional Programs to Improve Our Nation, Increase National Gains, and Help Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable Act H.R. 4541 Continuing Community Health and Medical Professional Programs to Improve Our Nation and Keep Insurance Delivery Stable H.R. 4613 Ensuring Patient Access to Healthcare Records Act H.R. 4619 to provide temporary relief from the annual fee imposed on health insurance providers, to the extent that such fee is due to Puerto Rican health insurance H.R. 4620 Protecting Families and Small Businesses Act H.R. 4006 Community-Based Independence for Seniors Act of 2017 H.R. 4520 to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2017 H.R. 4552/S. 1291 Advancing Medical Training in Community Hospitals Act H.R. 4105 to extend the health professions workforce demonstration project H.R. 592/S. 109 Pharmacy and Medically Underserved Areas Enhancement Act H.R. 741/S. 243 Rural Hospital Regulatory Relief Act H.R. 766 Amend Title XVII of the Social Security Act to expand telehealth in Medicare H.R. 849/S. 260 Protecting Seniors' Access to Medicare Act H.R. 908 Medicare Advantage Quality Payment Relief Act H.R.3727 To amend title XVIII of the Social Security Act to include additional telehealth services for purposes of MA organization bids, and for other purposes H.R. 4206/S. 2051 Medicare Care Coordination Improvement Act Introduction of the Healthcare Cybersecurity Improvement Act Introduction of the Stark Law Modernization Act of 2017 Pub L. 114-198 Comprehensive Addiction and Recovery Act Pub L. 115-31 Fiscal Year 2017 Consolidated Appropriations Act Pub L. 115-80 National Clinical Care Commission Act Pub. L. 102-143 Telephone Consumer Protection Act Pub. L. 111-148 Patient Protection and Affordable Care Act (PPACA) Pub. L. 111-5 The American Recovery and Reinvestment Act Pub. L. 114-10 Medicare Access and CHIP Reauthorization Act (MACRA) Pub. L. 114-255, 21st Century Cures Act Pub. L. 114-270 Expanding Capacity for Health Outcomes Act (ECHO) Pub L. 115-63 Disaster Relief and Airway Extension Act Pub. L. 115-96 2018 Continuing Resolution Reintroduction of TELE-MED Act of 2015 S. 1754 Training the Next Generation of Primary Care Doctors Act S. 1827 Keep Kids' Insurance Dependable and Secure Act S. 1829 Strong Families Act S. 1859 Healthcare Tax Relief Act S. 1899 to reauthorize and extend funding for community health centers and the National Health Service Corps S. 1967 Mandate Relief Act S. 191 Patient Freedom Act S. 251 Protecting Medicare from Executive Action Act S. 309 Community Based Independence for Seniors Act S. 464 Independence at Home Act S. 787 Telehealth Innovation and Improvement Act S. 870 Creating High-Quality Results and Outcomes Necessary to Improve Chronic Care Act S. 1978 Small Business and Family Health Tax Relief Act

H. Res. 142/S. Res. 63 National Obesity Care Week Resolution S. Res. 325 National Obesity Care Week Resolution S. J. Res. 16 a joint resolution approving the discontinuation of the process for consideration and automatic implementation of the annual proposal of the independent payment Medicare advisory board H.J. Res 51/S. J. Res 17 Independent Payment Advisory Board Repeal H.R 1995 Value Based Insurance Design for Better Care Act H.R. 1004 Regulatory Integrity Act H.R. 1009/S. 676 OIRA Insight, Reform, and Accountability Act H.R. 1038/S. 413 Improving Transparency and Accuracy in Medicare Part D Spending H.R. 1072/S. 222 Obamacare Replacement Act H.R. 1101 Small Business Health Fairness Act H.R. 1121 Pre-Existing Conditions Protection Act H.R. 1148/S. 431 Furthering Access to Stroke Telemedicine (FAST) Act H.R. 1215 Protecting Access to Care Act H.R. 1267/S. 482 Personal Health Investment Today Act H.R. 1304 Self-Insurance Protection Act H.R. 1313 Preserving Employee Wellness Programs Act H.R. 1554 Jessie's Law H.R. 1565 Saving Lives, Saving Costs Act H.R. 1628 American Health Care Act H.R. 1703 Medical Product Communications Act H.R. 184 Protect Medical Innovation Act H.R. 1953/S. 830 Treat and Reduce Obesity Act H.R. 2267/S. 1301 Resident Physician Shortage Reduction Act H.R. 246/S. 183 Jobs and Premium Protection Act H.R. 2550 Medicare Telehealth Parity Act H.R. 2556/S. 1016 CONNECT for Health Act H.R. 2797/S. 1334 Patient Choice and Quality Care Act H.R. 2824 Increasing Opportunity and Success for Children and Parents Through Evidence-Based Home Visiting Act H.R. 284 Advancing Medical Resident Training in Community Hospitals Act H.R. 2953/S. 2164 Preventive Health Savings Act H.R. 3044 to expand supplemental benefits to meet the needs of chronically ill Medicare Advantage enrollees H.R. 3059/S. 1441 Community Health Center and Primary Care Workforce Expansion Act H.R. 3120 to reduce the volume of future electronic health record-related significant hardship requests H.R. 3124/S. 1299 Preventing Diabetes in Medicare Act H.R. 3168 to provide continued access to Medicare Advantage plans for special needs H.R. 3224 Critical Access and Rural Equity Act H.R. 3245 Medicare Civil and Criminal Penalties Act H.R. 3263 to extend the Medicare independence at home medical demonstration program H.R. 3358/S. 1771 Fiscal Year 2018 Labor-Health and Human Services-Education Appropriations Bill H.R. 3394 Teaching Health Centers Graduate Medical Education Extension Act H.R. 3447 Furthering Access to Coordinated Treatment for Seniors Act H.R. 3545 Overdoes Prevention and Patient Safety Act H.R. 3726 Stark Administrative Simplification Act of 2017 H.R. 3728 Empowering Medical Professionals and Optimizing Workforce Efficiency and Readiness Act H.R. 3820/S. 977 Medicare Home Health Flexibility Act H.R. 3862 National Health Service Corps Strengthening Act H.R. 3921 Helping Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable Act H.R. 3922 Continuing Community Health and Medical Professional Programs to Improve Our Nation, Increase National Gains, and Help Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable Act H.R. 4541 Continuing Community Health and Medical Professional Programs to Improve Our Nation and Keep Insurance Delivery Stable H.R. 4613 Ensuring Patient Access to Healthcare Records Act H.R. 4616 to provide for a temporary moratorium on the employer mandate and to provide for a delay in the implementation of the excise tax on high cost employer-sponsored health coverage H.R. 4617 to provide for a temporary moratorium on the medical device excise tax H.R. 4618 to provide for a temporary moratorium on certain taxes affecting purchases of prescription medication H.R. 4619 to provide temporary relief from the annual fee imposed on health insurance providers, to the extent that such fee is due to Puerto Rican health insurance H.R. 4620 Protecting Families and Small Businesses Act H.R. 4006 Community-Based Independence for Seniors Act of 2017 H.R. 4200/S. 2052 Healthcare Market Certainty and Mandate Relief Act H.R. 4520 to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2017 H.R. 4552/S. 1291 Advancing Medical Training in Community Hospitals Act H.R. 4105 to extend the health professions workforce demonstration project H.R. 592/S. 109 Pharmacy and Medically Underserved Areas Enhancement Act H.R. 706 Plan Verification and Fairness Act H.R. 741/S. 243 Rural Hospital Regulatory Relief Act H.R. 749 Lower Drug Costs Through Competition Act H.R. 766 Amend Title XVII of the Social Security Act to expand telehealth in Medicare H.R. 849/S. 260 Protecting Seniors' Access to Medicare Act H.R. 908 Medicare Advantage Quality Payment Relief Act H.R. 998 Searching for and Cutting Regulations that are Unnecessarily Burdensome (SCRUB) Act H.R.3545 Overdose Prevention and Patient Safety Act H.R.3727 To amend title XVIII of the Social Security Act to include additional telehealth services for purposes of MA organization bids, and for other purposes H.R. 4206/S. 2051 Medicare Care Coordination Improvement Act Introduction of the Healthcare Cybersecurity Improvement Act Introduction of the Stark Law Modernization Act of 2017 Pub L. 114-198 Comprehensive Addiction and Recovery Act Pub L. 115-31 Fiscal Year 2017 Consolidated Appropriations Act Pub L. 115-80 National Clinical Care Commission Act Pub. L. 102-143 Telephone Consumer Protection Act Pub. L. 111-148 Patient Protection and Affordable Care Act (PPACA) Pub. L. 111-5 The American Recovery and Reinvestment Act Pub. L. 114-10 Medicare Access and CHIP Reauthorization Act (MACRA) Pub. L. 114-255, 21st Century Cures Act Pub. L. 114-270 Expanding Capacity for Health Outcomes Act (ECHO) Pub. L. 114-328 National Defense Authorization Act for Fiscal Year Pub. L. 114-329 American Innovation and Competitiveness Act Pub L. 115-63 Disaster Relief and Airway Extension Act Pub. L. 115-96 2018 Continuing Resolution Pub. L. 115-97 Tax Cuts and Jobs Act Reintroduction of TELE-MED Act of 2015 S. 108 Medical Device Access and Innovation Protection Act S. 297 Increasing Competition in Pharmaceuticals Act S. 1754 Training the Next Generation of Primary Care Doctors Act S. 1827 Keep Kids' Insurance Dependable and Secure Act S. 1829 Strong Families Act S. 1850 Protecting Jessica Grubbs Legacy Act (The Legacy Act) S. 1859 Healthcare Tax Relief Act S. 1899 to reauthorize and extend funding for community health centers and the National Health Service Corps S. 1967 Mandate Relief Act S. 191 Patient Freedom Act S. 251 Protecting Medicare from Executive Action Act S. 309 Community Based Independence for Seniors Act S. 464 Independence at Home Act H .R. 1933/S. 761 Health Care Options Act of 2017 S. 787 Telehealth Innovation and Improvement Act S. 870 Creating High-Quality Results and Outcomes Necessary to Improve Chronic Care Act S. 1978 Small Business and Family Health Tax Relief Act S. Con. Res. 3 Budget Resolution

Issues related to home care and hospice, telehealth, Medicare reimbursement and state's health insurance program legislation. Oppose home health and hospice payment cuts and co-pays. Legislative and regulatory proposals affecting home care and hospice. Physician face to face encounter requirement. Home health rural add on payment adjustment. Value based purchasing and bundling. Case mix creep payment cuts. Hospice payment policy. Home health non-physician certification authority. S. 353, Preserve Access to Medicare Rural Home Health Services Act. H.R. 1825/S. 445, Home Health Care Planning Improvement Act. H.R. 1676/S. 693, Palliative Care and Hospice Education and Training Act. H.R. 1284/S. 2214, Medicare Patient Access to Hospice Act. H.R. 1828/S. 980, Rural Access to Hospice Act. H.R. 2663, Home Health Documentation and Program Improvement Act. Medicare Post-Acute Value-Based Purchasing Act (pending). H.R. 3820/S. 977, Medicare Home Health Flexibility Act of 2017. S. 870, CHRONIC Care Act. Chronic care management proposals. Medicare Advantage hospice proposals. CMS Home Health Conditions of Participation. Home Health Pre-Claim Review Demonstration program. H.R. 2797/S. 1334, Patient Choice and Quality Care Act of 2017. Disposal of controlled substances. CY2019 Home Health Groupings Model (HHGM) included in CMS CY2018 Home Health Prospective Payment System proposed rule. H.R. 3992, Rural Health Extension and Regulatory Relief Act. H.R. 1628, American Health Care Act, including proposed Graham-Cassidy amendment. Medicare and Other Health and Human Services Extender provisions. S. 1028, RAISE Family Caregivers Act.

Client expense: Not reported · Firm income: $60,000

S. 977/HR 3820 and HR 6225: Medicare Home Health Flexibility Act - Advocate for passage . HR 2550: Medicare Telehealth Parity Act of 2017 - Advocated for the inclusion of occupational therapy as part of telehealth legislation that would allow for reimbursement of certain telehealth services under Medicare. HR2556: Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act; S787: A bill to require the Center for Medicare and Medicaid Innovation to test the effect of including telehealth services in Medicare health care delivery reform models; HR3360: Telehealth Enhancement Act; HR3482: Evidence-Based Telehealth Expansion Act; S1016: Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act; and HR3727: A bill to amend title XVIII of the Social Security Act to include additional telehealth services for purposes of MA organization bids, and for other purposes. - Advocated for the inclusion of occupational therapy as part of telehealth legislation that would allow for reimbursement of certain telehealth services under Medicare. No bill# Red Tape Reduction Initiative from Ways and Means Committee: Submitted following priorities for occupational therapy red tape reduction - 1) Initiation of Home Health Therapy Services Under Medicare (S. 977/HR 3820 now HR 6225), 2) Recognition of Occupational Therapy as a Primary Rehab Service (no bill number), 3) Permanently Eliminate Outside Certification Requirement for Occupational Therapists to Fabricate Custom Orthotics and Prosthetic Items (no bill number), 4) Modify or Eliminate Claims-Based Data Collection of Functional Limitation Information for Therapy Services (no bill number), 5) Add Doctor-prescribed Compression Supplies to the Durable Medical Equipment category (S 497/HR 930), and 6) Medicare Opt-out Option (no bill number). No Bill: Discussed how Stark laws affect the ability of occupational therapy practitioners to provide coordinated care services, particularly as it relates to the management of chronic conditions. S. 497/HR 930: Lymphedema Treatment Act - Support passage. No bill: Advocate for role of skilled therapy in changing reimbursement under Medicare Part A. HR 6, HR 5722, HR 5774, HR 5776, HR 6110, S 3008 and S 3120: (Various Bills on Opioids) Educate Members of Congress about the role of occupational therapy in the non-pharmacological management of pain, and advocate for any legislation that includes studies or funding for these alternatives, includes occupational therapy. Discussed and examined the effect of changes to reimbursement for occupational therapy assistants included in the Bi-partisan Budget Act, and possibly requesting a report from the GAO.

Support for S.253 / H.R. 807 - Medicare Access to Rehabilitation Services Act of 2017. Support for S. 977 / H.R. 3820 - Medicare Home Health Flexibility Act of 2017. Support for Section 50202 of H.R. 1892 - Bipartisan Budget Act of 2018.

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Oppose home health and hospice payment cuts and co-pays. Legislative and regulatory proposals affecting home care and hospice. Recognition and payment for telehealth services under Medicare and Medicaid. Physician face to face encounter requirement. Home health rural add on payment adjustment. Value based purchasing and bundling. Advance care planning services. Appropriations for family caregiver support programs. Case mix creep payment cuts. Hospice payment policy. Home health non-physician certification authority. S. 353, Preserve Access to Medicare Rural Home Health Services Act. H.R. 1825/S. 445, Home Health Care Planning Improvement Act. H.R. 1676/S. 693, Palliative Care and Hospice Education and Training Act. H.R. 1284/S. 2214, Medicare Patient Access to Hospice Act. H.R. 1828/S. 980, Rural Access to Hospice Act. H.R. 2663, Home Health Documentation and Program Improvement Act. Medicare Post-Acute Value-Based Purchasing Act (pending). H.R. 3820/S. 977, Medicare Home Health Flexibility Act of 2017. S. 870, CHRONIC Care Act. Chronic care management proposals. Medicare Advantage hospice proposals. CMS Home Health Conditions of Participation. Home Health Pre-Claim Review Demonstration program. H.R. 2797/S. 1334, Patient Choice and Quality Care Act of 2017. Disposal of controlled substances. CY2019 Home Health Groupings Model (HHGM) included in CMS CY2018 Home Health Prospective Payment System proposed rule. H.R. 3992, Rural Health Extension and Regulatory Relief Act. H.R. 1628, American Health Care Act, including proposed Graham-Cassidy amendment. Medicare and Other Health and Human Services Extender provisions. H.R. 3728, EMPOWER Act. Medicare Part D Auto-escalation. Independent Payment Advisory Board Repeal. Protection for recipients of home and community-based services against spousal impoverishment. H.R. 3493, Care Corps Demonstration Act of 2017. S. 1028, RAISE Family Caregivers Act. H.R. 1892, Bipartisan Budget Act of 2018. H.R. 1625, Consolidated Appropriations Act of 2018.

S 253/HR 807 - Medicare Access to Rehabilitation Services Act of 2017: Support passage to repeal the Medicare Part B Therapy cap on outpatient rehabilitation, including occupational therapy. S. 977/HR 3820: Medicare Home Health Flexibility Act - Advocate for passage HR 2550: Medicare Telehealth Parity Act of 2017 - Advocated for the inclusion of occupational therapy as part of telehealth legislation that would allow for reimbursement of certain telehealth services under Medicare. HR2556: Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act; S787: A bill to require the Center for Medicare and Medicaid Innovation to test the effect of including telehealth services in Medicare health care delivery reform models; HR3360: Telehealth Enhancement Act; HR3482: Evidence-Based Telehealth Expansion Act; S1016: Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act; and HR3727: A bill to amend title XVIII of the Social Security Act to include additional telehealth services for purposes of MA organization bids, and for other purposes. - Advocated for the inclusion of occupational therapy as part of telehealth legislation that would allow for reimbursement of certain telehealth services under Medicare. No bill# Red Tape Reduction Initiative from Ways and Means Committee: Submitted following priorities for occupational therapy red tape reduction - 1) Initiation of Home Health Therapy Services Under Medicare (HR 3820), 2) Recognition of Occupational Therapy as a Primary Rehab Service (no bill number), 3) Permanently Eliminate Outside Certification Requirement for Occupational Therapists to Fabricate Custom Orthotics and Prosthetic Items (no bill number), 4) Modify or Eliminate Claims-Based Data Collection of Functional Limitation Information for Therapy Services (no bill number), 5) Add Doctor-prescribed Compression Supplies to the Durable Medical Equipment category (S 497/HR 930), and 6) Medicare Opt-out Option (no bill number). S. 497/HR 930: Lymphedema Treatment Act - Support passage. HR 1892 - Bipartisan Budget Act of 2018: support of Medicare Outpatient Part B Therapy Cap Repeal, opposition to home health payment reform treatment of therapy services, and changes to occupational therapy assistant reimbursement for Medicare Part B. HR 1625 - Fiscal 2018 Omnibus Appropriations: opposition to proposed changes to payment for group and concurrent therapy in skilled nursing facilities. No bill: Advocate for role of skilled therapy in changing reimbursement under Medicare Part A.

S. J. Res. 16 a joint resolution approving the discontinuation of the process for consideration and automatic implementation of the annual proposal of the independent payment Medicare advisory board H.J. Res 51/S. J. Res 17 Independent Payment Advisory Board Repeal H.R 1995 Value Based Insurance Design for Better Care Act H.R. 1004 Regulatory Integrity Act H.R. 1009/S. 676 OIRA Insight, Reform, and Accountability Act H.R. 1038/S. 413 Improving Transparency and Accuracy in Medicare Part D Spending H.R. 1148/S. 431 Furthering Access to Stroke Telemedicine (FAST) Act H.R. 1215 Protecting Access to Care Act H.R. 1554 Jessie's Law H.R. 1565 Saving Lives, Saving Costs Act H.R. 1628 American Health Care Act H.R. 1953/S. 830 Treat and Reduce Obesity Act H.R. 2267/S. 1301 Resident Physician Shortage Reduction Act H.R. 246/S. 183 Jobs and Premium Protection Act H.R. 2550 Medicare Telehealth Parity Act H.R. 2556/S. 1016 CONNECT for Health Act H.R. 2797/S. 1334 Patient Choice and Quality Care Act H.R. 284 Advancing Medical Resident Training in Community Hospitals Act H.R. 2953/S. 2164 Preventive Health Savings Act H.R. 3044 to expand supplemental benefits to meet the needs of chronically ill Medicare Advantage enrollees H.R. 3059/S. 1441 Community Health Center and Primary Care Workforce Expansion Act H.R. 3120 to reduce the volume of future electronic health record-related significant hardship requests H.R. 3124/S. 1299 Preventing Diabetes in Medicare Act H.R. 3168 to provide continued access to Medicare Advantage plans for special needs H.R. 3224 Critical Access and Rural Equity Act H.R. 3245 Medicare Civil and Criminal Penalties Act H.R. 3263 to extend the Medicare independence at home medical demonstration program H.R. 3394 Teaching Health Centers Graduate Medical Education Extension Act H.R. 3447 Furthering Access to Coordinated Treatment for Seniors Act H.R. 3726 Stark Administrative Simplification Act of 2017 H.R. 3728 Empowering Medical Professionals and Optimizing Workforce Efficiency and Readiness Act H.R. 3820/S. 977 Medicare Home Health Flexibility Act H.R. 3862 National Health Service Corps Strengthening Act H.R. 3921 Helping Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable Act H.R. 3922 Continuing Community Health and Medical Professional Programs to Improve Our Nation, Increase National Gains, and Help Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable Act H.R. 4541 Continuing Community Health and Medical Professional Programs to Improve Our Nation and Keep Insurance Delivery Stable H.R. 4613 Ensuring Patient Access to Healthcare Records Act H.R. 4618 to provide for a temporary moratorium on certain taxes affecting purchases of prescription medication H.R. 4619 to provide temporary relief from the annual fee imposed on health insurance providers, to the extent that such fee is due to Puerto Rican health insurance H.R. 4620 Protecting Families and Small Businesses Act H.R. 4006 Community-Based Independence for Seniors Act of 2017 H.R. 4520 to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2017 H.R. 4552/S. 1291 Advancing Medical Training in Community Hospitals Act H.R. 4105 to extend the health professions workforce demonstration project H.R. 4841 Standardizing Electronic Prior Authorization for Safe Prescribing Act H.R. 592/S. 109 Pharmacy and Medically Underserved Areas Enhancement Act H.R. 741/S. 243 Rural Hospital Regulatory Relief Act H.R. 766 Amend Title XVII of the Social Security Act to expand telehealth in Medicare H.R. 849/S. 260 Protecting Seniors' Access to Medicare Act H.R. 908 Medicare Advantage Quality Payment Relief Act H.R. 998 Searching for and Cutting Regulations that are Unnecessarily Burdensome (SCRUB) Act H.R. 2687/S. 1169 Medicaid Coverage for Addiction Recovery Expansion Act H.R.3727 To amend title XVIII of the Social Security Act to include additional telehealth services for purposes of MA organization bids, and for other purposes H.R. 4206/S. 2051 Medicare Care Coordination Improvement Act Pub L. 114-198 Comprehensive Addiction and Recovery Act Pub. L. 115-120 Fiscal Year 2018 Continuing Resolution Pub L. 115-123 Bipartisan Budget Act Pub L. 115-141 Fiscal Year 2018 Omnibus Appropriations Act Pub. L. 111-148 Patient Protection and Affordable Care Act (PPACA) Pub. L. 111-5 The American Recovery and Reinvestment Act Pub. L. 114-10 Medicare Access and CHIP Reauthorization Act (MACRA) Pub. L. 114-255 21st Century Cures Act Pub. L. 114-270 Expanding Capacity for Health Outcomes Act (ECHO) Pub L. 115-63 Disaster Relief and Airway Extension Act Reintroduction of TELE-MED Act of 2015 S. 1754 Training the Next Generation of Primary Care Doctors Act S. 1827 Keep Kids' Insurance Dependable and Secure Act S. 1859 Healthcare Tax Relief Act S. 1899 to reauthorize and extend funding for community health centers and the National Health Service Corps S. 251 Protecting Medicare from Executive Action Act S. 309 Community Based Independence for Seniors Act S. 464 Independence at Home Act S. 787 Telehealth Innovation and Improvement Act S. 870 Creating High-Quality Results and Outcomes Necessary to Improve Chronic Care Act S. 1978 Small Business and Family Health Tax Relief Act S. Con. Res. 3 Budget Resolution H.R. 3545 Overdose Prevention and Patient Safety Act H.R. 4613 Ensuring Patient Access to Healthcare Records Act S.1850 Jessie's Law H.R. 4206/S.2501 Medicare Care Coordination Improvement Act

S. J. Res. 16 a joint resolution approving the discontinuation of the process for consideration and automatic implementation of the annual proposal of the independent payment Medicare advisory board H.J. Res 51/S. J. Res 17 Independent Payment Advisory Board Repeal H.R 1995 Value Based Insurance Design for Better Care Act H.R. 1004 Regulatory Integrity Act H.R. 1009/S. 676 OIRA Insight, Reform, and Accountability Act H.R. 1038/S. 413 Improving Transparency and Accuracy in Medicare Part D Spending H.R. 1101 Small Business Health Fairness Act H.R. 1121 Pre-Existing Conditions Protection Act H.R. 1148/S. 431 Furthering Access to Stroke Telemedicine (FAST) Act H.R. 1215 Protecting Access to Care Act H.R. 1267/S. 482 Personal Health Investment Today Act H.R. 1304 Self-Insurance Protection Act H.R. 1313 Preserving Employee Wellness Programs Act H.R. 1554 Jessie's Law H.R. 1565 Saving Lives, Saving Costs Act H.R. 1628 American Health Care Act H.R. 1703 Medical Product Communications Act H.R. 184 Protect Medical Innovation Act H.R. 1876 Good Samaritan Health Professionals Act H.R. 1953/S. 830 Treat and Reduce Obesity Act H.R. 2267/S. 1301 Resident Physician Shortage Reduction Act H.R. 246/S. 183 Jobs and Premium Protection Act H.R. 2550 Medicare Telehealth Parity Act H.R. 2556/S. 1016 CONNECT for Health Act H.R. 2797/S. 1334 Patient Choice and Quality Care Act H.R. 284 Advancing Medical Resident Training in Community Hospitals Act H.R. 2953/S. 2164 Preventive Health Savings Act H.R. 3044 to expand supplemental benefits to meet the needs of chronically ill Medicare Advantage enrollees H.R. 3059/S. 1441 Community Health Center and Primary Care Workforce Expansion Act H.R. 3120 to reduce the volume of future electronic health record-related significant hardship requests H.R. 3124/S. 1299 Preventing Diabetes in Medicare Act H.R. 3168 to provide continued access to Medicare Advantage plans for special needs H.R. 3224 Critical Access and Rural Equity Act H.R. 3245 Medicare Civil and Criminal Penalties Act H.R. 3263 to extend the Medicare independence at home medical demonstration program H.R. 3394 Teaching Health Centers Graduate Medical Education Extension Act H.R. 3447 Furthering Access to Coordinated Treatment for Seniors Act H.R. 3726 Stark Administrative Simplification Act of 2017 H.R. 3728 Empowering Medical Professionals and Optimizing Workforce Efficiency and Readiness Act H.R. 3820/S. 977 Medicare Home Health Flexibility Act H.R. 3862 National Health Service Corps Strengthening Act H.R. 3921 Helping Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable Act H.R. 3922 Continuing Community Health and Medical Professional Programs to Improve Our Nation, Increase National Gains, and Help Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable Act H.R. 4541 Continuing Community Health and Medical Professional Programs to Improve Our Nation and Keep Insurance Delivery Stable H.R. 4613 Ensuring Patient Access to Healthcare Records Act H.R. 4616 to provide for a temporary moratorium on the employer mandate and to provide for a delay in the implementation of the excise tax on high cost employer-sponsored health coverage H.R. 4617 to provide for a temporary moratorium on the medical device excise tax H.R. 4618 to provide for a temporary moratorium on certain taxes affecting purchases of prescription medication H.R. 4619 to provide temporary relief from the annual fee imposed on health insurance providers, to the extent that such fee is due to Puerto Rican health insurance H.R. 4620 Protecting Families and Small Businesses Act H.R. 4006 Community-Based Independence for Seniors Act of 2017 H.R. 4200/S. 2052 Healthcare Market Certainty and Mandate Relief Act H.R. 4520 to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2017 H.R. 4552/S. 1291 Advancing Medical Training in Community Hospitals Act H.R. 4105 to extend the health professions workforce demonstration project H.R. 4841 Standardizing Electronic Prior Authorization for Safe Prescribing Act H.R. 592/S. 109 Pharmacy and Medically Underserved Areas Enhancement Act H.R. 706 Plan Verification and Fairness Act H.R. 741/S. 243 Rural Hospital Regulatory Relief Act H.R. 749 Lower Drug Costs Through Competition Act H.R. 766 Amend Title XVII of the Social Security Act to expand telehealth in Medicare H.R. 849/S. 260 Protecting Seniors' Access to Medicare Act H.R. 908 Medicare Advantage Quality Payment Relief Act H.R. 998 Searching for and Cutting Regulations that are Unnecessarily Burdensome (SCRUB) Act H.R. 2687/S. 1169 Medicaid Coverage for Addiction Recovery Expansion Act H.R.3727 To amend title XVIII of the Social Security Act to include additional telehealth services for purposes of MA organization bids, and for other purposes H.R. 4206/S. 2051 Medicare Care Coordination Improvement Act H.R. 5138 Bipartisan Health Savings Accounts Improvement Act Introduction of the Healthcare Cybersecurity Improvement Act Introduction of the Stark Law Modernization Act Pub L. 114-198 Comprehensive Addiction and Recovery Act Pub. L. 115-120 Fiscal Year 2018 Continuing Resolution Pub L. 115-80 National Clinical Care Commission Act Pub L. 115-123 Bipartisan Budget Act Pub L. 115-141 Fiscal Year 2018 Omnibus Appropriations Act Pub. L. 102-143 Telephone Consumer Protection Act Pub. L. 111-148 Patient Protection and Affordable Care Act (PPACA) Pub. L. 111-5 The American Recovery and Reinvestment Act Pub. L. 114-10 Medicare Access and CHIP Reauthorization Act (MACRA) Pub. L. 114-255 21st Century Cures Act Pub. L. 114-270 Expanding Capacity for Health Outcomes Act (ECHO) Pub. L. 114-329 American Innovation and Competitiveness Act Pub L. 115-63 Disaster Relief and Airway Extension Act Pub. L. 115-97 Tax Cuts and Jobs Act Reintroduction of TELE-MED Act of 2015 S. 108 Medical Device Access and Innovation Protection Act S. 297 Increasing Competition in Pharmaceuticals Act S. 1754 Training the Next Generation of Primary Care Doctors Act S. 1827 Keep Kids' Insurance Dependable and Secure Act S. 1829 Strong Families Act S. 1859 Healthcare Tax Relief Act S. 1899 to reauthorize and extend funding for community health centers and the National Health Service Corps S. 1967 Mandate Relief Act S. 251 Protecting Medicare from Executive Action Act S. 2278 State Offices of Rural Health Reauthorization Act S. 309 Community Based Independence for Seniors Act S. 464 Independence at Home Act H .R. 1933/S. 761 Health Care Options Act S. 787 Telehealth Innovation and Improvement Act S. 870 Creating High-Quality Results and Outcomes Necessary to Improve Chronic Care Act S. 1978 Small Business and Family Health Tax Relief Act S. Con. Res. 3 Budget Resolution H.R. 3545 Overdose Prevention and Patient Safety Act H.R. 4613 Ensuring Patient Access to Healthcare Records Act S.1850 Jessie's Law H.R. 4206/S.2501 Medicare Care Coordination Improvement Act

Oppose home health and hospice payment cuts and co-pays. Legislative and regulatory proposals affecting home care and hospice. Recognition and payment for telehealth services under Medicare and Medicaid. Face to Face Physician Encounter Requirement. Home health rural add on payment adjustment. Value based purchasing and bundling. Advance care planning services. Appropriations for family caregiver support programs. Case mix creep payment cuts. S. 353, Preserve Access to Medicare Rural Home Health Services Act. H.R. 1825/S. 445, Home Health Care Planning Improvement Act. H.R. 1676/S. 693, Palliative Care and Hospice Education and Training Act. H.R. 1284/S. 2214, Medicare Patient Access to Hospice Act. H.R. 1828/S. 980, Rural Access to Hospice Act. Medicare Home Health Rebasing Relief and Reassessment Act (pending). H.R. 2663, Home Health Documentation and Program Improvement Act. Medicare Post-Acute Value-Based Purchasing Act (pending). Home Health Access Protection Act (draft legislation) Verifying Electronically the Receipt of In-Home Care for Individuals Act or the VERIFI Act (pending). H.R. 3820/S. 977, Medicare Home Health Flexibility Act of 2017. S. 870, CHRONIC Care Act. Chronic care management proposals. Audit and Appeals Fairness, Integrity, and Reforms in Medicare (AFIRM) Act (pending). Medicare Advantage hospice proposals. CMS Home Health Conditions of Participation. Home Health Pre-Claim Review Demonstration program. H.R. 2797/S. 1334, Patient Choice and Quality Care Act of 2017. Disposal of controlled substances. CY2019 Home Health Groupings Model (HHGM) included in CMS CY2018 Home Health Prospective Payment System proposed rule. H.R. 3992, Rural Health Extension and Regulatory Relief Act. H.R. 1628, American Health Care Act, including proposed Graham-Cassidy amendment. Medicare and Other Health and Human Services Extender provisions. S. 227, EMPOWER Act. Medicare Part D Auto-escalation. Independent Payment Advisory Board Repeal. Cuts to Medicare and Medicaid via tax reform. Protection for recipients of home and community-based services against spousal impoverishment. H.R. 3493, Care Corps Demonstration Act of 2017. S. 1028, RAISE Family Caregivers Act.

S 253/HR 807 - Medicare Access to Rehabilitation Services Act of 2017: Support passage to repeal the Medicare Part B Therapy cap on outpatient rehabilitation, including occupational therapy. S. 977/HR 3820: Medicare Home Health Flexibility Act - Advocate for passage and introduction in House of Representatives. HR 2550: Medicare Telehealth Parity Act of 2017 - Advocated for the inclusion of occupational therapy as part of telehealth legislation that would allow for reimbursement of certain telehealth services under Medicare. HR2556: Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act; S787: A bill to require the Center for Medicare and Medicaid Innovation to test the effect of including telehealth services in Medicare health care delivery reform models; HR3360: Telehealth Enhancement Act; HR3482: Evidence-Based Telehealth Expansion Act; S1016: Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act; and HR3727: A bill to amend title XVIII of the Social Security Act to include additional telehealth services for purposes of MA organization bids, and for other purposes. - Advocated for the inclusion of occupational therapy as part of telehealth legislation that would allow for reimbursement of certain telehealth services under Medicare. No bill# Red Tape Reduction Initiative from Ways and Means Committee: Submitted following priorities for occupational therapy red tape reduction - 1) Initiation of Home Health Therapy Services Under Medicare (HR 3820), 2) Recognition of Occupational Therapy as a Primary Rehab Service (no bill number), 3) Permanently Eliminate Outside Certification Requirement for Occupational Therapists to Fabricate Custom Orthotics and Prosthetic Items (no bill number), 4) Modify or Eliminate Claims-Based Data Collection of Functional Limitation Information for Therapy Services (no bill number), 5) Add Doctor-prescribed Compression Supplies to the Durable Medical Equipment category (S 497/HR 930), and 6) Medicare Opt-out Option (no bill number). HR 1628: American Health Care Act - Advocated for mandatory Medicaid benefits such as EPSDT, Medicaid reimbursement in schools, and essential health benefits such as rehab/habilitation and mental health. Better Care Reconciliation Act, no bill# - Advocated for mandatory Medicaid benefits such as EPSDT, Medicaid reimbursement in schools, and essential health benefits such as rehab/habilitation and mental health. Graham/Cassidy health care bill,no bill# - Advocated for mandatory Medicaid benefits such as EPSDT, Medicaid reimbursement in schools, and essential health benefits such as rehab/habilitation and mental health. S. 497/HR 930: Lymphedema Treatment Act - Support passage. HR 2810 - National Defense Authorization Act of 2018: Advocated for the inclusion of occupational therapy and physical therapist assistants under Tricare coverage and Senate amendments. HR 1 (PL 115-97), Tax Cuts and Jobs Act: advocated against changes to the tax status of tuition assistance programs included in the House bill; advocated for pay-go to be waived concurrent with the passage of the bill.

Support for S.253 / H.R. 807 - Medicare Access to Rehabilitation Services Act of 2017. Support for S. 977 / H.R. 3820 - Medicare Home Health Flexibility Act of 2017.

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. J. Res. 16 a joint resolution approving the discontinuation of the process for consideration and automatic implementation of the annual proposal of the independent payment Medicare advisory board H.J. Res 51/S. J. Res 17 Independent Payment Advisory Board Repeal H.R 1995 Value Based Insurance Design for Better Care Act H.R. 1038/S. 413 Improving Transparency and Accuracy in Medicare Part D Spending H.R. 1072/S. 222 Obamacare Replacement Act H.R. 1148/S. 431 Furthering Access to Stroke Telemedicine (FAST) Act H.R. 1628 American Health Care Act H.R. 1953/S. 830 Treat and Reduce Obesity Act H.R. 2267/S. 1301 Resident Physician Shortage Reduction Act H.R. 2550 Medicare Telehealth Parity Act H.R. 2556/S. 1016 CONNECT for Health Act H.R. 2797/S. 1334 Patient Choice and Quality Care Act H.R. 2824 Increasing Opportunity and Success for Children and Parents Through Evidence-Based Home Visiting Act H.R. 284 Advancing Medical Resident Training in Community Hospitals Act H.R. 2953/S. 2164 Preventive Health Savings Act H.R. 3044 to expand supplemental benefits to meet the needs of chronically ill Medicare Advantage enrollees H.R. 3059/S. 1441 Community Health Center and Primary Care Workforce Expansion Act H.R. 3124/S. 1299 Preventing Diabetes in Medicare Act H.R. 3168 to provide continued access to Medicare Advantage plans for special needs H.R. 3224 Critical Access and Rural Equity Act H.R. 3245 Medicare Civil and Criminal Penalties Act H.R. 3263 to extend the Medicare independence at home medical demonstration program H.R. 3358/S. 1771 Fiscal Year 2018 Labor-Health and Human Services-Education Appropriations Bill H.R. 3394 Teaching Health Centers Graduate Medical Education Extension Act H.R. 3447 Furthering Access to Coordinated Treatment for Seniors Act H.R. 3726 Stark Administrative Simplification Act of 2017 H.R. 3728 Empowering Medical Professionals and Optimizing Workforce Efficiency and Readiness Act H.R. 3820/S. 977 Medicare Home Health Flexibility Act H.R. 3862 National Health Service Corps Strengthening Act H.R. 3921 Helping Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable Act H.R. 3922 Continuing Community Health and Medical Professional Programs to Improve Our Nation, Increase National Gains, and Help Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable Act H.R. 4541 Continuing Community Health and Medical Professional Programs to Improve Our Nation and Keep Insurance Delivery Stable H.R. 4613 Ensuring Patient Access to Healthcare Records Act H.R. 4619 to provide temporary relief from the annual fee imposed on health insurance providers, to the extent that such fee is due to Puerto Rican health insurance H.R. 4620 Protecting Families and Small Businesses Act H.R. 4006 Community-Based Independence for Seniors Act of 2017 H.R. 4520 to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2017 H.R. 4552/S. 1291 Advancing Medical Training in Community Hospitals Act H.R. 4105 to extend the health professions workforce demonstration project H.R. 592/S. 109 Pharmacy and Medically Underserved Areas Enhancement Act H.R. 741/S. 243 Rural Hospital Regulatory Relief Act H.R. 766 Amend Title XVII of the Social Security Act to expand telehealth in Medicare H.R. 849/S. 260 Protecting Seniors' Access to Medicare Act H.R. 908 Medicare Advantage Quality Payment Relief Act H.R.3727 To amend title XVIII of the Social Security Act to include additional telehealth services for purposes of MA organization bids, and for other purposes H.R. 4206/S. 2051 Medicare Care Coordination Improvement Act Introduction of the Healthcare Cybersecurity Improvement Act Introduction of the Stark Law Modernization Act of 2017 Pub L. 114-198 Comprehensive Addiction and Recovery Act Pub L. 115-31 Fiscal Year 2017 Consolidated Appropriations Act Pub L. 115-80 National Clinical Care Commission Act Pub. L. 102-143 Telephone Consumer Protection Act Pub. L. 111-148 Patient Protection and Affordable Care Act (PPACA) Pub. L. 111-5 The American Recovery and Reinvestment Act Pub. L. 114-10 Medicare Access and CHIP Reauthorization Act (MACRA) Pub. L. 114-255, 21st Century Cures Act Pub. L. 114-270 Expanding Capacity for Health Outcomes Act (ECHO) Pub L. 115-63 Disaster Relief and Airway Extension Act Pub. L. 115-96 2018 Continuing Resolution Reintroduction of TELE-MED Act of 2015 S. 1754 Training the Next Generation of Primary Care Doctors Act S. 1827 Keep Kids' Insurance Dependable and Secure Act S. 1829 Strong Families Act S. 1859 Healthcare Tax Relief Act S. 1899 to reauthorize and extend funding for community health centers and the National Health Service Corps S. 1967 Mandate Relief Act S. 191 Patient Freedom Act S. 251 Protecting Medicare from Executive Action Act S. 309 Community Based Independence for Seniors Act S. 464 Independence at Home Act S. 787 Telehealth Innovation and Improvement Act S. 870 Creating High-Quality Results and Outcomes Necessary to Improve Chronic Care Act S. 1978 Small Business and Family Health Tax Relief Act

H. Res. 142/S. Res. 63 National Obesity Care Week Resolution S. Res. 325 National Obesity Care Week Resolution S. J. Res. 16 a joint resolution approving the discontinuation of the process for consideration and automatic implementation of the annual proposal of the independent payment Medicare advisory board H.J. Res 51/S. J. Res 17 Independent Payment Advisory Board Repeal H.R 1995 Value Based Insurance Design for Better Care Act H.R. 1004 Regulatory Integrity Act H.R. 1009/S. 676 OIRA Insight, Reform, and Accountability Act H.R. 1038/S. 413 Improving Transparency and Accuracy in Medicare Part D Spending H.R. 1072/S. 222 Obamacare Replacement Act H.R. 1101 Small Business Health Fairness Act H.R. 1121 Pre-Existing Conditions Protection Act H.R. 1148/S. 431 Furthering Access to Stroke Telemedicine (FAST) Act H.R. 1215 Protecting Access to Care Act H.R. 1267/S. 482 Personal Health Investment Today Act H.R. 1304 Self-Insurance Protection Act H.R. 1313 Preserving Employee Wellness Programs Act H.R. 1554 Jessie's Law H.R. 1565 Saving Lives, Saving Costs Act H.R. 1628 American Health Care Act H.R. 1703 Medical Product Communications Act H.R. 184 Protect Medical Innovation Act H.R. 1953/S. 830 Treat and Reduce Obesity Act H.R. 2267/S. 1301 Resident Physician Shortage Reduction Act H.R. 246/S. 183 Jobs and Premium Protection Act H.R. 2550 Medicare Telehealth Parity Act H.R. 2556/S. 1016 CONNECT for Health Act H.R. 2797/S. 1334 Patient Choice and Quality Care Act H.R. 2824 Increasing Opportunity and Success for Children and Parents Through Evidence-Based Home Visiting Act H.R. 284 Advancing Medical Resident Training in Community Hospitals Act H.R. 2953/S. 2164 Preventive Health Savings Act H.R. 3044 to expand supplemental benefits to meet the needs of chronically ill Medicare Advantage enrollees H.R. 3059/S. 1441 Community Health Center and Primary Care Workforce Expansion Act H.R. 3120 to reduce the volume of future electronic health record-related significant hardship requests H.R. 3124/S. 1299 Preventing Diabetes in Medicare Act H.R. 3168 to provide continued access to Medicare Advantage plans for special needs H.R. 3224 Critical Access and Rural Equity Act H.R. 3245 Medicare Civil and Criminal Penalties Act H.R. 3263 to extend the Medicare independence at home medical demonstration program H.R. 3358/S. 1771 Fiscal Year 2018 Labor-Health and Human Services-Education Appropriations Bill H.R. 3394 Teaching Health Centers Graduate Medical Education Extension Act H.R. 3447 Furthering Access to Coordinated Treatment for Seniors Act H.R. 3545 Overdoes Prevention and Patient Safety Act H.R. 3726 Stark Administrative Simplification Act of 2017 H.R. 3728 Empowering Medical Professionals and Optimizing Workforce Efficiency and Readiness Act H.R. 3820/S. 977 Medicare Home Health Flexibility Act H.R. 3862 National Health Service Corps Strengthening Act H.R. 3921 Helping Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable Act H.R. 3922 Continuing Community Health and Medical Professional Programs to Improve Our Nation, Increase National Gains, and Help Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable Act H.R. 4541 Continuing Community Health and Medical Professional Programs to Improve Our Nation and Keep Insurance Delivery Stable H.R. 4613 Ensuring Patient Access to Healthcare Records Act H.R. 4616 to provide for a temporary moratorium on the employer mandate and to provide for a delay in the implementation of the excise tax on high cost employer-sponsored health coverage H.R. 4617 to provide for a temporary moratorium on the medical device excise tax H.R. 4618 to provide for a temporary moratorium on certain taxes affecting purchases of prescription medication H.R. 4619 to provide temporary relief from the annual fee imposed on health insurance providers, to the extent that such fee is due to Puerto Rican health insurance H.R. 4620 Protecting Families and Small Businesses Act H.R. 4006 Community-Based Independence for Seniors Act of 2017 H.R. 4200/S. 2052 Healthcare Market Certainty and Mandate Relief Act H.R. 4520 to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2017 H.R. 4552/S. 1291 Advancing Medical Training in Community Hospitals Act H.R. 4105 to extend the health professions workforce demonstration project H.R. 592/S. 109 Pharmacy and Medically Underserved Areas Enhancement Act H.R. 706 Plan Verification and Fairness Act H.R. 741/S. 243 Rural Hospital Regulatory Relief Act H.R. 749 Lower Drug Costs Through Competition Act H.R. 766 Amend Title XVII of the Social Security Act to expand telehealth in Medicare H.R. 849/S. 260 Protecting Seniors' Access to Medicare Act H.R. 908 Medicare Advantage Quality Payment Relief Act H.R. 998 Searching for and Cutting Regulations that are Unnecessarily Burdensome (SCRUB) Act H.R.3545 Overdose Prevention and Patient Safety Act H.R.3727 To amend title XVIII of the Social Security Act to include additional telehealth services for purposes of MA organization bids, and for other purposes H.R. 4206/S. 2051 Medicare Care Coordination Improvement Act Introduction of the Healthcare Cybersecurity Improvement Act Introduction of the Stark Law Modernization Act of 2017 Pub L. 114-198 Comprehensive Addiction and Recovery Act Pub L. 115-31 Fiscal Year 2017 Consolidated Appropriations Act Pub L. 115-80 National Clinical Care Commission Act Pub. L. 102-143 Telephone Consumer Protection Act Pub. L. 111-148 Patient Protection and Affordable Care Act (PPACA) Pub. L. 111-5 The American Recovery and Reinvestment Act Pub. L. 114-10 Medicare Access and CHIP Reauthorization Act (MACRA) Pub. L. 114-255, 21st Century Cures Act Pub. L. 114-270 Expanding Capacity for Health Outcomes Act (ECHO) Pub. L. 114-328 National Defense Authorization Act for Fiscal Year Pub. L. 114-329 American Innovation and Competitiveness Act Pub L. 115-63 Disaster Relief and Airway Extension Act Pub. L. 115-96 2018 Continuing Resolution Pub. L. 115-97 Tax Cuts and Jobs Act Reintroduction of TELE-MED Act of 2015 S. 108 Medical Device Access and Innovation Protection Act S. 297 Increasing Competition in Pharmaceuticals Act S. 1754 Training the Next Generation of Primary Care Doctors Act S. 1827 Keep Kids' Insurance Dependable and Secure Act S. 1829 Strong Families Act S. 1850 Protecting Jessica Grubbs Legacy Act (The Legacy Act) S. 1859 Healthcare Tax Relief Act S. 1899 to reauthorize and extend funding for community health centers and the National Health Service Corps S. 1967 Mandate Relief Act S. 191 Patient Freedom Act S. 251 Protecting Medicare from Executive Action Act S. 309 Community Based Independence for Seniors Act S. 464 Independence at Home Act H .R. 1933/S. 761 Health Care Options Act of 2017 S. 787 Telehealth Innovation and Improvement Act S. 870 Creating High-Quality Results and Outcomes Necessary to Improve Chronic Care Act S. 1978 Small Business and Family Health Tax Relief Act S. Con. Res. 3 Budget Resolution

Oppose home health and hospice payment and co-pays. Legislative and regulatory proposals affection home care and hospice. Recognition and payment for telehealth services under Medicare and Medicaid. Face to Face Physician Encounter Requirement. Home health rural add on payment adjustment. Value based purchasing and bundling. Medicare reimbursement of advanced care planning services. Appropriations for family caregiver support programs. Case mix creep payment cuts. S. 353, Preserve Access to Medicare Rural Home Health Services Act. S. 445, Home Health Care Planning Improvement Act. S. 693, Palliative Care and Hospice Education and Training Act. H.R. 1284, Medicare Patient Access to Hospice Act. H.R. 1676, Palliative Care and Hospice Education and Training Act. H.R. 1825, Home Health Care Planning Improvement Act. H.R. 1828/S. 980, Rural Access to Hospice Act. Medicare Home Health Rebasing Relief and Reassessment Act (pending). H.R. 2663, Home Health Documentation and Program Improvement Act. Medicare Post-Acute Value-Based Purchasing Act (pending). Home Health Access Protection Act (draft legislation) Verifying Electronically the Receipt of In-Home Care for Individuals Act or the VERIFI Act (pending). H.R. 3820/S. 977, Medicare Home Health Flexibility Act of 2017. S. 870, CHRONIC Care Act. Chronic care management proposals. Audit and Appeals Fairness, Integrity, and Reforms in Medicare (AFIRM) Act (pending). Medicare Advantage hospice proposals. CMS Home Health Conditions of Participation. Home Health Pre-Claim Review Demonstration program. Pre-Claim Undermines Seniors Health (PUSH) Act (pending). H.R. 2797/S. 1334, Patient Choice and Quality Care Act of 2017. Disposal of controlled substances. CY2019 Home Health Groupings Model (HHGM) included in CMS CY2018 Home Health Prospective Payment System proposed rule. H.R. 3992, Rural Health Extension and Regulatory Relief Act. H.R. 1628, American Health Care Act, including proposed Graham-Cassidy amendment.

S 253/HR 807 - Medicare Access to Rehabilitation Services Act of 2017: Support passage to repeal the Medicare Part B Therapy cap on outpatient rehabilitation, including occupational therapy. S. 977/HR 3820: Medicare Home Health Flexibility Act - Advocate for passage and introduction in House of Representatives. HR 2550: Medicare Telehealth Parity Act of 2017 - Advocated for the inclusion of occupational therapy as part of telehealth legislation that would allow for reimbursement of certain telehealth services under Medicare. HR2556: Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act; S787: A bill to require the Center for Medicare and Medicaid Innovation to test the effect of including telehealth services in Medicare health care delivery reform models; HR3360: Telehealth Enhancement Act; HR3482: Evidence-Based Telehealth Expansion Act; S1016: Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act; and HR3727: A bill to amend title XVIII of the Social Security Act to include additional telehealth services for purposes of MA organization bids, and for other purposes. - Advocated for the inclusion of occupational therapy as part of telehealth legislation that would allow for reimbursement of certain telehealth services under Medicare. No bill# Red Tape Reduction Initiative from Ways and Means Committee: Submitted following priorities for occupational therapy red tape reduction - 1) Initiation of Home Health Therapy Services Under Medicare (HR 3820), 2) Recognition of Occupational Therapy as a Primary Rehab Service (no bill number), 3) Permanently Eliminate Outside Certification Requirement for Occupational Therapists to Fabricate Custom Orthotics and Prosthetic Items (no bill number), 4) Modify or Eliminate Claims-Based Data Collection of Functional Limitation Information for Therapy Services (no bill number), 5) Add Doctor-prescribed Compression Supplies to the Durable Medical Equipment category (S 497/HR 930), and 6) Medicare Opt-out Option (no bill number). HR 1628: American Health Care Act - Advocated for mandatory Medicaid benefits such as EPSDT, Medicaid reimbursement in schools, and essential health benefits such as rehab/habilitation and mental health. Better Care Reconciliation Act, no bill# - Advocated for mandatory Medicaid benefits such as EPSDT, Medicaid reimbursement in schools, and essential health benefits such as rehab/habilitation and mental health. Graham/Cassidy health care bill,no bill# - Advocated for mandatory Medicaid benefits such as EPSDT, Medicaid reimbursement in schools, and essential health benefits such as rehab/habilitation and mental health. S. 497/HR 930: Lymphedema Treatment Act - Support passage. HR 2810 - National Defense Authorization Act of 2018: Advocated for the inclusion of occupational therapy and physical therapist assistants under Tricare coverage and Senate amendments.

Support for S.253 / H.R. 807 - Medicare Access to Rehabilitation Services Act of 2017. Support for S. 977 / H.R. 3820 - Medicare Home Health Flexibility Act of 2017.

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H. Con. Res. 71 Fiscal Year 2018 Budget Resolution H. Res. 142/S. Res. 63 National Obesity Care Week Resolution S. J. Res. 16 a joint resolution approving the discontinuation of the process for consideration and automatic implementation of the annual proposal of the independent payment Medicare advisory board H.J. Res 51/S. J. Res 17 Independent Payment Advisory Board Repeal H.R 1995 Value Based Insurance Design for Better Care Act H.R. 1004 Regulatory Integrity Act H.R. 1009/S. 676 OIRA Insight, Reform, and Accountability Act H.R. 1038/S. 413 Improving Transparency and Accuracy in Medicare Part D Spending H.R. 1072/S. 222 Obamacare Replacement Act H.R. 1101 Small Business Health Fairness Act H.R. 1121 Pre-Existing Conditions Protection Act H.R. 1148/S. 431 Furthering Access to Stroke Telemedicine (FAST) Act H.R. 1215 Protecting Access to Care Act H.R. 1245/S. 469 Affordable and Safe Prescription Drug Importation Act H.R. 1267/S. 482 Personal Health Investment Today Act H.R. 1304 Self-Insurance Protection Act H.R. 1313 Preserving Employee Wellness Programs Act H.R. 1554/S. 581 Jessie's Law H.R. 1565 Saving Lives, Saving Costs Act H.R. 1617 Promoting Access to Diabetic Shoes Act H.R. 1628 American Health Care Act H.R. 1703 Medical Product Communications Act H.R. 1776/S. 771 Improving Access to Affordable Prescription Drugs Act H.R. 184 Protect Medical Innovation Act H.R. 1953/S. 830 Treat and Reduce Obesity Act H.R. 2192/S. 1569 to eliminate the non-application of certain state waiver provisions to members of Congress and Congressional staff H.R. 2212/S. 974 Creating and Restoring Equal Access to Equivalent Samples Act H.R. 2267/S. 1301 Resident Physician Shortage Reduction Act H.R. 2372 Veterans Equal Treatment Ensures Relief and Access Now Act H.R. 246/S. 183 Jobs and Premium Protection Act H.R. 2550 Medicare Telehealth Parity Act H.R. 2556/S. 1016 CONNECT for Health Act H.R. 2579 Broader Options for Americans Act H.R. 2581 Verify First Act H.R. 2797/S. 1334 Patient Choice and Quality Care Act H.R. 2824 Increasing Opportunity and Success for Children and Parents Through Evidence -Based Home Visiting Act H.R. 284/S. 1291 Advancing Medical Resident Training in Community Hospitals Act H.R. 2953 Preventive Health Savings Act H.R. 3044 to expand supplemental benefits to meet the needs of chronically ill Medicare Advantage enrollees H.R. 3059/S. 1441 Community Health Center and Primary Care Workforce Expansion Act H.R. 309/S. 920 National Clinical Care Commission Act H.R. 3120 to reduce the volume of future electronic health record-related significant hardship requests H.R. 3124/S. 1299 Preventing Diabetes in Medicare Act H.R. 3168 to provide continued access to Medicare Advantage plans for special needs H.R. 3224 Critical Access and Rural Equity Act H.R. 3245 Medicare Civil and Criminal Penalties Act H.R. 3263 to extend the Medicare independence at home medical demonstration program H.R. 3271/S. 1914 Protecting Access to Diabetes Supplies Act H.R. 3358/S. 1771 Fiscal Year 2018 Labor-Health and Human Services-Education Appropriations Bill H.R. 3394 Teaching Health Centers Graduate Medical Education Extension Act H.R. 3447 Furthering Access to Coordinated Treatment for Seniors Act H.R. 3536/S.1681 to require persons who undertake federally funded research and development of drugs to enter into reasonable pricing agreements H.R. 372 Competitive Health Insurance Reform Act H.R. 3726 Stark Administrative Simplification Act of 2017 H.R. 3728 Empowering Medical Professionals and Optimizing Workforce Efficiency and Readiness Act H.R. 3820/S. 977 Medicare Home Health Flexibility Act H.R. 3862 National Health Service Corps Strengthening Act H.R. 3921 Helping Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable Act H.R. 4006 Community-Based Independence for Seniors Act of 2017 H.R. 592/S. 109 Pharmacy and Medically Underserved Areas Enhancement Act H.R. 706 Plan Verification and Fairness Act H.R. 741/S. 243 Rural Hospital Regulatory Relief Act H.R. 749 Lower Drug Costs Through Competition Act H.R. 766 Amend Title XVII of the Social Security Act to expand telehealth in Medicare H.R. 849/S. 260 Protecting Seniors' Access to Medicare Act H.R. 908 Medicare Advantage Quality Payment Relief Act H.R. 998 Searching for and Cutting Regulations that are Unnecessarily Burdensome(SCRUB) Act H.R.3545 Overdose Prevention and Patient Safety Act H.R.3727 To amend title XVIII of the Social Security Act to include additional telehealth services for purposes of MA organization bids, and for other purposes Introduction of the Stark Law Modernization Act of 2017 Pub L. 114-198 Comprehensive Addiction and Recovery Act Pub L. 115-31 Fiscal Year 2017 Consolidated Appropriations Act Pub. L. 102-143 Telephone Consumer Protection Act Pub. L. 111-148 Patient Protection and Affordable Care Act (PPACA) Pub. L. 111-5 The American Recovery and Reinvestment Act Pub. L. 114-10 Medicare Access and CHIP Reauthorization Act (MACRA) Pub. L. 114-255, 21st Century Cures Act Pub. L. 114-270 Expanding Capacity for Health Outcomes Act (ECHO) Pub. L. 114-329 American Innovation and Competitiveness Act Pub L. 115-63 Disaster Relief & Airway Extension Act S. 108 Medical Device Access and Innovation Protection Act S. 297 Increasing Competition in Pharmaceuticals Act S. 1688 Empowering Medicare Seniors to Negotiate Drug Prices Act S. 1754 Training the Next Generation of Primary Care Doctors Act S. 1804 Medicare for All Act S. 1827 Keep Kids' Insurance Dependable and Secure Act S. 1829 Strong Families Act S. 1850 Protecting Jessica Grubbs Legacy Act, (The Legacy Act) S. 1859 Healthcare Tax Relief Act S. 1899 to reauthorize and extend funding for community health centers and the National Health Service Corps S. 191 Patient Freedom Act S. 251 Protecting Medicare from Executive Action Act S. 309 Community Based Independence for Seniors Act S. 464 Independence at Home Act S. 64 Safe and Affordable Drugs from Canada Act H .R. 1933/S. 761 Health Care Options Act of 2017 S. 787 Telehealth Innovation and Improvement Act S. 870 Creating High-Quality Results and Outcomes Necessary to Improve Chronic Care Act S. Con. Res. 3 Budget Resolution

S. J. Res. 16 a joint resolution approving the discontinuation of the process for consideration and automatic implementation of the annual proposal of the independent payment Medicare advisory board H.J. Res 51/S. J. Res 17 Independent Payment Advisory Board Repeal H.R. 1038Improving Transparency and Accuracy in Medicare Part D Spending S. 413 Improving Transparency and Accuracy in Medicare Part D Spending H.R. 1148 Furthering Access to Stroke Telemedicine (FAST) Act S. 431 Furthering Access to Stroke Telemedicine (FAST) Act H.R. 2550 Medicare Telehealth Parity Act H.R. 2556 CONNECT for Health Act S. 1016 CONNECT for Health Act H.R. 3044 to expand supplemental benefits to meet the needs of chronically ill Medicare Advantage enrollees H.R. 3124 Preventing Diabetes in Medicare Act S. 1299 Preventing Diabetes in Medicare Act H.R. 3168 to provide continued access to Medicare Advantage plans for special needs H.R. 3245 Medicare Civil and Criminal Penalties Act H.R. 3263 to extend the Medicare independence at home medical demonstration program H.R. 3447 Furthering Access to Coordinated Treatment for Seniors Act H.R. 3726 Stark Administrative Simplification Act of 2017 H.R. 3820 Medicare Home Health Flexibility Act S. 977 Medicare Home Health Flexibility Act H.R. 4006 Community-Based Independence for Seniors Act of 2017 H.R. 766 Amend Title XVII of the Social Security Act to expand telehealth in Medicare H.R. 849 Protecting Seniors' Access to Medicare Act S. 260 Protecting Seniors' Access to Medicare Act H.R. 908 Medicare Advantage Quality Payment Relief Act H.R.3727 To amend title XVIII of the Social Security Act to include additional telehealth services for purposes of MA organization bids, and for other purposes Introduction of the Stark Law Modernization Act of 2017 S. 1688 Empowering Medicare Seniors to Negotiate Drug Prices Act S. 251 Protecting Medicare from Executive Action Act S. 309 Community Based Independence for Seniors Act S. 464 Independence at Home Act S. 787 Telehealth Innovation and Improvement Act S. 870 Creating High-Quality Results and Outcomes Necessary to Improve Chronic Care Act