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Individuals in Medicaid Deserve Care that is Appropriate and Responsible in its Execution Act
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37d open
vs 7,393 other HR bills in the 115th — cohort avg 50d
Individuals in Medicaid Deserve Care that is Appropriate and Responsible in its Execution Act or the IMD CARE Act (Sec. 2) This bill temporarily allows states to apply to receive federal Medicaid payment for services provided in institutions for mental diseases (IMDs) and for other medically necessary services for enrollees (aged 21 to 64) with opioid-use or cocaine-use disorders. Services may be covered for a total of up to 30 days in a 12-month period for an eligible enrollee. States must include specified information in their applications, including plans to improve access to outpatient care. Current law generally prohibits federal payment under Medicaid for services provided in IMDs for individuals under the age of 65 (although states may receive payment through certain mechanisms, such as through a Medicaid demonstration waiver). (Sec. 3) Additionally, the bill temporarily eliminates the enhanced federal matching rate for Medicaid expenditures regarding specified medical services provided by certain managed care organizations.
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Filing registrants (31)
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 passage Passed by the Yeas and Nays: 261 - 155 (Roll no. 276).
HousePassed/agreed to in House: On passage Passed by the Yeas and Nays: 261 - 155 (Roll no. 276).
HouseOn motion to recommit with instructions Failed by the Yeas and Nays: 190 - 226 (Roll no. 275).
HouseConsidered as unfinished business. (consideration: CR H5344-5345)
POSTPONED PROCEEDINGS - At the conclusion of debate on Castor (FL) motion to recommit with instructions, the Chair put the question on the motion, and by voice vote, announced that the noes had prevailed. Ms. Castor (FL) demanded the yeas and nays and the Chair postponed further proceedings on the motion to recommit with instructions until a time to be announced.
DEBATE - The House proceeded with 10 minutes of debate on the Castor motion to recommit with instructions pending a reservation of a point of order. The instructions contained in the motion seek to require the bill to be reported back to the House with an amendment to strike all that follows after section 1 and insert a section entitled Medicaid State Plan Option to Provide Services for Certain Individuals with Substance Use Disorders in Qualified Institutions for Mental Diseases. Subsequently, the reservation was removed.
Bills with similar content found using semantic analysis.
Sources: Congress.gov
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: $1,550,000 · 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
Issues related to the improvements in the treatment of the United States territories under the Medicare and Medicaid programs - no specific legislation. Issues related to health insurance provider fees, extending funding for the Children's Health Insurance Program, Medicare and Medicaid issues - no specific legislation. H.R. 6, the SUPPORT for Patients and Communities Act - entire bill. H.R. 5797, the IMD CARE Act - entire bill. H.R. 6082, the Overdose Prevention and Patient Safety Act - entire bill. H.R. 5801, the Medicaid PARTNERSHIP Act - entire bill. H.R. 5963, To delay the reimposition of the annual fee on health insurance providers until after 2020 - entire bill. S. 3063, Health Insurance Tax Relief Act of 2018 - entire bill. H.R. 246 - To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act - entire bill. H.R. 6042, to amend title XIX of the Social Security Act to delay the reduction in federal medical assistance percentage for Medicaid personal care services furnished without an electronic visit verification system, and for other purposes- entire bill. H.R. 3325 - ACE Kids Act - Entire bill.
Client expense: $330,000 · Firm income: Not reported
2018 · fourth_quarter · Health Issues
Opioid issues (S. 2680, the Opioid Crisis Response Act of 2018; H.R. 5176, Preventing Overdoses While in Emergency Rooms (POWER) Act; H.R. 5197, Alternatives to Opioids (ALTO) in the Emergency Department Act; H.R. 5009, Jessies Law; H.R. 5818 / S. 2843, the Opioid Workforce Act; H.R. 5797, the IMD CARE Act; H.R. 6082/H.R. 5795, the Overdose Prevention and Patient Safety Act; S. 2905, Strengthening Partnerships to Prevent Opioid Abuse Act; S. 2460, Every Prescription Conveyed Securely Act; S. 2920, Commit to Opioid Medical Prescriber Accountability and Safety for Seniors Act; H.R. 5582, the Abuse Deterrent Access Act; H.R. 5685, the Medicare Opioid Safety Education Act; Helping to End Addiction and Lessen (HEAL) Substance Use Disorders Act of 2018; H.R. 6, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act; S. 2899, Caring Recovery for Infants and Babies Act; S. 2898, Medication-Assisted Treatment Improvement Act; S.2911, Enhancing Patient Access to Non-Opioid Treatment Options) Draft Protecting Patients from Surprise Medical Bills Act HIPAA policy in mental and behavioral health information sharing 21st Century Cures Act implementation Pandemic and All Hazards Preparedness Reauthorization, including Hospital Preparedness Program (S. 2852, the Pandemic and All-Hazards Preparedness and Advancing Innovation Act (PAHPAI) of 2018) S.781/ HR 1876. Good Samaritan Health Professional Act of 2017 Health workforce reauthorizations (H.R. 959, the Title VIII Nursing Workforce Reauthorization Act; H.R. 3728, the Educating Medical Professionals and Optimizing Workforce Efficiency Readiness (EMPOWER) Act; H.R. 1676, the Palliative Care and Hospice Education and Training Act Liver allocation policy (H.R. 6458 National Organ Transplant Act Amendments of 2018; H.R. 6517 Fairness in Liver Allocation Act of 2018) H.R. 5678, Rural Emergency Medical Center (REMC) Act of 2018) Disproportionate share hospital payments (H.R. 1892, Bipartisan Budget Act of 2018; implementation of the S-10 worksheet) H.R. 2267 / S. 1301, Resident Physician Shortage Reduction Act H.R. 5818 / S. 2843, Opioid Workforce Act Telehealth payment (H.R. 1892, Bipartisan Budget Act of 2018; H.R. 6, SUPPORT for Patients and Communities Act) Stark law reform Hospital outpatient payment policy Site neutral payment policy included in outpatient prospective payment system proposed rule Physician fee schedule rule Evaluation and management coding and payment policy in physician fee schedule rule S. 2597 / H.R. 5385, Children's Hospital GME Support Reauthorization Act of 2018 Opioid funding (CARA implementation; S. 2004, Combating the Opioid Epidemic Act; H.R. 1892, Bipartisan Budget Act of 2018; Consolidated Appropriations Act, 2018) Behavioral health funding (H.R. 1892, Bipartisan Budget Act of 2018; Consolidated Appropriations Act, 2018; H.R. 6157) HR 6470 Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2019 H.R. 5645, the Standard Merger and Acquisition Reviews Through Equal Rules (SMARTER) Act Public Charge proposed rule Q4 Submitted Letters SUBJECT: DHS Docket No. USCIS-2010-0012, Inadmissibility on Public Charge Grounds; Proposed Rule SUBJECT: Docket No. FDA-2018-N-3272, Identifying the Root Causes of Drug Shortages and Finding Enduring Solutions SUBJECT: CMS-1701-P, Medicare Program: Medicare Shared Savings Program; Accountable Care Organizations Pathways to Success Proposed Rule SUBJECT: OIG-0803-N, Request for Information Regarding Anti-Kickback Statute and Beneficiary Inducements CMP SUBJECT: CMS-3346-P, Regulatory Provisions to Promote Program Efficiency, Transparency, and Burden Reduction SUBJECT: Notice of Proposed Rulemaking, 340B Drug Pricing Program Ceiling Price and Manufacturer Civil Monetary Penalties Effective Date Change
2018 · fourth_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 HR 1892 - Bipartisan Budget Act of 2018, provision related to Medicare Part D Doughnut Hole H.R. 3192: CHIP Mental Health Parity Act 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 - Drug pricing 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. 7217: Improving Medicaid Programs and Opportunities for Eligible Beneficiaries Act or IMPROVE Act 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 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 False Claims Act policy issues Center for Medicare and Medicaid Innovation (CMMI) policy issues Medicaid rebates and waiver policy issues Prescription drug abuse policy issues ANPRM; Medicare Program; International Pricing Index Model for Medicare Part B Drugs (CMS-5528-ANPRM) Proposed Rule; Medicare and Medicaid Programs; Regulation To Require Drug Pricing Transparency (CMS-4187-P) Proposed Rule; Contract Year (CY) 2020 Medicare Advantage and Part D Drug Pricing (CMS-4180-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) Final Rule; Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System changes for 2019 (CMS-1695-FC) Contract Year (CY) 2020 Medicare Advantage and Part D Drug Pricing Proposed Rule (CMS-4180-P) Medicare Part D/Medicare Part B Medicaid Protected Classes
2018 · fourth_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. 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 - Drug pricing 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. 7217: Improving Medicaid Programs and Opportunities for Eligible Beneficiaries Act or IMPROVE Act 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 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 False Claims Act policy issues Center for Medicare and Medicaid Innovation (CMMI) policy issues Medicaid rebates and waiver policy issues Changes to the Medicare Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs Prescription drug abuse policy issues ANPRM; Medicare Program; International Pricing Index Model for Medicare Part B Drugs (CMS-5528-ANPRM) Proposed Rule; Medicare and Medicaid Programs; Regulation To Require Drug Pricing Transparency (CMS-4187-P) Proposed Rule; Contract Year (CY) 2020 Medicare Advantage and Part D Drug Pricing (CMS-4180-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)
Ms. Castor (FL) moved to recommit with instructions to the Committee on Energy and Commerce. (text: CR H5342-5343)
The House adopted the amendments en gross as agreed to by the Committee of the Whole House on the state of the Union.
The previous question was ordered pursuant to the rule.
The House rose from the Committee of the Whole House on the state of the Union to report H.R. 5797.
DEBATE - Pursuant to the provisions of H.Res. 949, the Committee of the Whole proceeded with 10 minutes of debate on the Fitzpatrick amendment No. 3.
DEBATE - Pursuant to the provisions of H.Res. 949, the Committee of the Whole proceeded with 10 minutes of debate on the Kildee amendment No. 2.
DEBATE - Pursuant to the provisions of H.Res. 949, the Committee of the Whole proceeded with 10 minutes of debate on the Rush amendment No. 1.
GENERAL DEBATE - The Committee of the Whole proceeded with one hour of general debate on H.R. 5797.
The Speaker designated the Honorable Mike Bost to act as Chairman of the Committee.
House resolved itself into the Committee of the Whole House on the state of the Union pursuant to H. Res. 949 and Rule XVIII.
Rule provides for consideration of H.R. 6, H.R. 5797 and H.R. 6082. Rule provides for consideration of H.R. 6 and H.R.5797 under structured rules; and provides for consideration of H.R. 6082 under a closed rule. Additionally, the rule directs the Clerk to, in the engrossment of H.R. 6, add the text of H.R. 2851, H.R. 5735, and H.R. 5797 as passed by the House as a new matter at the end of H.R. 6.
Considered under the provisions of rule H. Res. 949. (consideration: CR H5335-5344; text of amendment in the nature of a substitute: CR H5338-5339)
Rules Committee Resolution H. Res. 949 Reported to House. Rule provides for consideration of H.R. 6, H.R. 5797 and H.R. 6082. Rule provides for consideration of H.R. 6 and H.R.5797 under structured rules; and provides for consideration of H.R. 6082 under a closed rule. Additionally, the rule directs the Clerk to, in the engrossment of H.R. 6, add the text of H.R. 2851, H.R. 5735, and H.R. 5797 as passed by the House as a new matter at the end of H.R. 6.
Placed on the Union Calendar, Calendar No. 558.
Reported (Amended) by the Committee on Energy and Commerce. H. Rept. 115-723.
Congress.gov source codes: 5000, H12200
Ordered to be Reported (Amended) by Voice Vote.
Committee Consideration and Mark-up Session Held.
Referred to the House Committee on Energy and Commerce.
Introduced in House
Congress.gov source codes: 1000, Intro-H
| Referred to |
| May 15, 2018 |
| May 15, 2018 |
| Republican |
| TN |
| Stephen Knight | Republican | CA |
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
Client expense: $317,828 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Social Security Administration (SSA)
Client expense: $920,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, U.S. Trade Representative (USTR)
Client expense: $6,030,000 · 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, U.S. Trade Representative (USTR)
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 · Health Issues
340B Drug Pricing Program Opioid issues (S. 2680, the Opioid Crisis Response Act of 2018; H.R. 5176, Preventing Overdoses While in Emergency Rooms (POWER) Act; H.R. 5197, Alternatives to Opioids (ALTO) in the Emergency Department Act; H.R. 5009, Jessies Law; H.R. 5818 / S. 2843, the Opioid Workforce Act; H.R. 5797, the IMD CARE Act; H.R. 6082/H.R. 5795, the Overdose Prevention and Patient Safety Act; S. 2905, Strengthening Partnerships to Prevent Opioid Abuse Act; S. 2460, Every Prescription Conveyed Securely Act; S. 2920, Commit to Opioid Medical Prescriber Accountability and Safety for Seniors Act; H.R. 5582, the Abuse Deterrent Access Act; H.R. 5685, the Medicare Opioid Safety Education Act; Helping to End Addiction and Lessen (HEAL) Substance Use Disorders Act of 2018; H.R. 6, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act; S. 2899, Caring Recovery for Infants and Babies Act; S. 2898, Medication-Assisted Treatment Improvement Act; S.2911, Enhancing Patient Access to Non-Opioid Treatment Options) Draft Protecting Patients from Surprise Medical Bills Act HIPAA policy in mental and behavioral health information sharing 21st Century Cures Act implementation Pandemic and All Hazards Preparedness Reauthorization, including Hospital Preparedness Program (S. 2852 / H.R. 6378, H.R. 7328, the Pandemic and All-Hazards Preparedness and Advancing Innovation Act (PAHPAI) of 2018) S.781/ HR 1876. Good Samaritan Health Professional Act of 2017 Health workforce reauthorizations (H.R. 959, the Title VIII Nursing Workforce Reauthorization Act; H.R. 3728, the Educating Medical Professionals and Optimizing Workforce Efficiency Readiness (EMPOWER) Act; H.R. 1676, the Palliative Care and Hospice Education and Training Act Liver allocation policy S.2554, Patient Right to Know Drug Prices Act Consumer-directed health care proposals (Associations Health Plans, Short-term Limited Duration Insurance plans, Section 1332 waivers) Maternal health legislation (H.R. 315, Improving Access to Maternity Care Act and H.R. 1318, Preventing Maternal Deaths Act)
Client expense: $70,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2018 · fourth_quarter · Medicare/Medicaid
Support for Graduate Medical Education (GME) funding including the Resident Physician Shortage Reduction Act (S. 1301/H.R. 2267) and the Opioid Workforce Act of 2018 (H.R. 5818/S. 2843) Support for legislation to address opioid epidemic (SUPPORT for Patients and Communities Act (H.R. 6)) including bills to modify to institute of mental disease exclusion (H.R. 5797) and to align 42 CFR Part 2 with the Health Insurance Portability and Accountability Act (H.R. 6082) and policies to expand ability to prescribe buprenorphine treatment Support for full protection of Critical Access Hospital payments Support for REMC Act of 2018 (H.R. 5678) Support for Fairness in Liver Allocation Act (H.R. 6517) Support for changes to Medicare Volume Decrease Adjustment calculation Support for correction of erroneous reductions of GME residency positions Opposition to 340B program reductions in Centers for Medicare and Medicaid Services (CMS) 2018 Outpatient Prospective Payment System (OPPS) proposed rule [CMS-1678-P] and support for legislation (H.R. 4392, H.R. 6071) to halt these payment cut Opposition to changes to 340B program (H.R. 4710, H.R. 6240) Opposition to site-neutral payment reductions to hospital outpatient departments proposed in CMS 2019 OPPS proposed rule [CMS-1695-P] Support for policies to preserve Medicare Disproportionate Share Hospital funding as part of CMS 2019 Inpatient Prospective Payment System proposed rule [CMS-1694-P] Opposition to Department of Homeland Security Proposed Rule on Inadmissibility on Public Charge Grounds [DHS Docket No. USCIS-2010-0012]
Client expense: $150,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2018 · fourth_quarter · Medicare/Medicaid
Hospital and Medicaid issues related to repeal and replace of the Affordable Care Act (ACA), including opposition to the American Health Care Act (House), the Better Care Reconciliation Act (Senate), the Graham-Cassidy-Heller-Johnson bill, and President Trumps FY 2019 Budget Proposal. Graduate Medical Education (GME) issues, including the Resident Physician Shortage Reduction Act of 2017 (support) (H.R. 2267/S. 1301), the Opioid Workforce Act of 2018 (support) (H.R. 5818/S. 2843), and the cuts and changes to Medicare and Medicaid GME programs in President Trumps FY 2019 budget proposal (oppose). Medicaid Disproportionate Share Hospital (DSH) cuts issues, including supporting the inclusion of a DSH cut delay in the Bipartisan Budget Act of 2018 (support) (H.R. 1892) and the continuation of DSH cuts in President Trumps FY 2019 Budget Proposal (oppose). Provide comments to CMS and OMB to advocate for a delay in further use of S-10 data for allocation of the Medicare DSH uncompensated care pool. Oppose legislation and regulations that would harm the 340B Drug Discount Program, including the cuts outlined in President Trumps FY 2019 Budget Proposal. Provide comments to CMS addressing payments to off-campus hospital outpatient departments. Support legislation to reverse the cuts to the 340B Drug Discount Program in CMS Final 2017 OPPS Rule, the SERV Communities Act (support) (H.R. 6071) and H.R. 4392 (support) Support Federal funding for Puerto Ricos Medicaid program and for Medicaid for individuals and families displaced by hurricanes. Oppose legislation that would harm Medicaid GME programs including the Medicaid Graduate Medical Education Transparency Act (oppose). Support legislation to repeal the Medicaid IMD exclusion, the Individuals in Medicaid Deserve Care that is Appropriate and Responsible in its Execution Act (support) (H.R. 5797), and support the inclusion of the legislation in the SUPPORT for Patients and Communities Act (support) (H.R. 6) and the Opioid Crisis Response Act of 2018 (support) (S. 2680). Support the inclusion of legislation to increase GME funding, the Opioid Workforce Act of 2018 (support) (H.R. 5818/S. 2843), in the SUPPORT for Patients and Communities Act (support) (H.R. 6) and the Opioid Crisis Response Act of 2018 (support) (S. 2680). Oppose the FY 2020-2025 Medicaid DSH cuts, and support proposals that would delay or repeal the scheduled cuts. Support legislative proposals to reverse the site-neutral provisions in the CMS OPPS final rule for 2019. Oppose 340b and site-neutral provisions in the CMS OPPS proposed and final rules for 2019. Sent comment letter to HHS regarding its OPPS proposed rule for CY 2019. The letter addressed issues related to site-neutral policies, 340B, WAC-based payments, packaging for non-opioid pain treatments, and changes to the IPO list, among other topics.
Client expense: $580,000 · Firm income: Not reported
Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Office of Management & Budget (OMB), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), White House Office
2018 · fourth_quarter · Insurance
The Childrens Health Insurance Program, including the reauthorization of the program in the January 2018 continuing resolution to fund the Federal government (support) (H.R. 195) and the extension of the program in the Bipartisan Budget Act of 2018 (support) (H.R. 1892). Support legislation to repeal the Medicaid IMD exclusion, the Individuals in Medicaid Deserve Care that is Appropriate and Responsible in its Execution Act (support) (H.R. 5797), and support the inclusion of the legislation in the SUPPORT for Patients and Communities Act (support) (H.R. 6) and the Opioid Crisis Response Act of 2018 (support) (S. 2680).
Client expense: $580,000 · Firm income: Not reported
Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Office of Management & Budget (OMB), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), White House Office
2018 · fourth_quarter · Health Issues
Hospital and Medicaid issues related to repeal and replace of the Affordable Care Act (ACA), including opposition to The American Health Care Act (House), the Better Care Reconciliation Act (Senate) (H.R. 1628), the Graham-Cassidy-Heller-Johnson bill, and the Trump Administration's FY 2019 budget proposal. Organ donation issues, including the liver transplant allocation system and in support of new proposed UNOS system. Discussions with HHS and DHS regarding cybersecurity issues. Advocated for individual marketplace stabilization measures, including the funding of ACA cost sharing reduction payments in standalone legislation and in FY 2018 funding legislation. Graduate Medical Education (GME) issues, including the Resident Physician Shortage Reduction Act of 2017 (support) (H.R. 2267/S. 1301), the Opioid Workforce Act of 2018 (support) (H.R. 5818/S. 2843), the Medicaid Graduate Medical Education Transparency Act (oppose), and the cuts and changes to Medicare and Medicaid GME programs in President Trumps FY 2019 budget proposal (oppose). Support the inclusion of legislation to increase GME funding, the Opioid Workforce Act of 2018 (support) (H.R. 5818/S. 2843), in the SUPPORT for Patients and Communities Act (support) (H.R. 6) and the Opioid Crisis Response Act of 2018 (support) (S. 2680). Support legislation to repeal the Medicaid IMD exclusion, the Individuals in Medicaid Deserve Care that is Appropriate and Responsible in its Execution Act (support) (H.R. 5797), and support the inclusion of the legislation in the SUPPORT for Patients and Communities Act (support) (H.R. 6) and the Opioid Crisis Response Act of 2018 (support) (S. 2680). Support legislation to align 42 CFR Part 2 regulations with the Health Insurance Portability and Accountability Act (HIPAA), The Overdose Prevention and Patient Safety Act (support) (H.R. 6082), and support the inclusion of the legislation in the SUPPORT for Patients and Communities Act (support) (H.R. 6) and the Opioid Crisis Response Act of 2018 (support) (S. 2680). Support the SUPPORT for Patients and Communities Act (support) (H.R. 6). Support the Opioid Crisis Response Act of 2018 (support) (S. 2680). Lobby HHS, HRSA, OPTN and UNOS on liver allocation reforms. Support liver allocation reforms, including the Fairness in Liver Allocation Act (support) (H.R. 6517). Oppose legislation to amend the National Organ Transplant Act, the National Organ Transplant Act Amendments of 2018 (oppose) (H.R. 6458), and the inclusion of language that would amend the National Organ Transplant Act in the Labor-HHS appropriations bill (H.R. 6157). Oppose the FY 2020-2025 Medicaid DSH cuts, and support proposals that would delay or repeal the scheduled cuts. Support proposals that would increase funding levels for programs related to hospital infrastructure, access to capital, workforce issues, health information technology, and telehealth. Support legislative proposals to reverse the site-neutral provisions in the CMS OPPS final rule for 2019. Oppose 340b and site-neutral provisions in the CMS OPPS proposed and final rules for 2019. Raise awareness about surprise billing laws on both the federal and state levels.
Client expense: $580,000 · Firm income: Not reported
Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Office of Management & Budget (OMB), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), White House Office
2018 · fourth_quarter · Medicare/Medicaid
H.R.6505 - Medicare Negotiation and Competitive Licensing Act - require the Secretary of Health and Human Services to negotiate prices of prescription drugs furnished under part D of the Medicare program Oral health -Medicare dental benefit; Medicare coverage of medically necessary oral health care S.3770 - Medicaid Drug Decisions Transparency Act - expand the scope of transparency reporting requirements related to the ownership or investment interests of health care providers and others, and to increase the penalties associated with violating such requirements H.R. 7217 - IMPROVE Act - extend the Medicaid HCBS spousal impoverishment protections through March and reauthorize the Money Follows the Person Program with 3 months of funding H.R. 6 - Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act - Section 5021, 5022 - H.R. 3192, the CHIP Mental Health Parity Act; Section 5031, 5032 - H.R. 4005, the Medicaid Reentry Act; S.3462 - Improving Coverage for Substance Use Disorder Recovery Expansion Act - provide States with the option to provide medical assistance for substance use disorder treatment services to individuals; modification of IMD exclusion H.R. 5797 - Individuals in Medicaid Deserve Care that is Appropriate and Responsible in its Execution Act - partial removal of IMD exclusion Legislation to expand Medicare coverage Legislation around discounts the pharmaceutical industry must provide for drugs purchased in the Medicare Part D donut hole
Client expense: $30,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2018 · fourth_quarter · Insurance
1.S. 2317/H.R. 3692 - Addiction Treatment Access Improvement Act - amend the Controlled Substances Act to provide for additional flexibility with respect to medication-assisted treatment for opioid use disorders, and for other purposes. 2.H.R. 6 - SUPPORT for Patients and Communities Act - provide for opioid use disorder prevention, recovery, and treatment, and for other purposes. 3.S. 2608 - Opioid Crisis Response Act - address the opioid crisis 4.H.R. 5605 - Advancing High Quality Treatment for Opioid Use Disorders in Medicare Act - provide for an opioid use disorder treatment demonstration program, and for other purposes 5.H.R. 5797 - Individuals in Medicaid Deserve Care that is Appropriate and Responsible in its Execution Act - provide under Medicaid services for certain individuals with opioid use disorders in institutions for mental diseases. 6.H.R. 5800 - the Medicaid IMD ADDITIONAL INFO Act - require the Medicaid and CHIP Payment and Access Commission to conduct an exploratory study and report on requirements applicable to and practices of institutions for mental diseases under the Medicaid program. 7.H.R. 5483 - Special Registration for Telemedicine Clarification Act - impose a deadline for the promulgation of interim final regulations in accordance with section 311(h) of the Controlled Substances Act (21 U.S.C. 831(h)) specifying the circumstances in which a special registration may be issued to a practitioner to engage in the practice of telemedicine, and for other purposes. 8.H.R. 5272 - a bill to ensure that programs and activities that are funded by a grant, cooperative agreement, loan, or loan guarantee from the Department of Health and Human Services, and whose purpose is to prevent or treat a mental health or substance use disorder, are evidence-based 9.S. 2524/H.R. 5102, Substance Use Disorder Workforce Loan Repayment Act - amend the Public Health Service Act to authorize a loan repayment program for substance use disorder treatment employees, and for other purposes 10.H.R. 4005 - the Medicaid Reentry Act - promote State innovations to ease transitions to the community for individuals who are inmates of a public institution and eligible for medical assistance under the Medicaid program. 11.S. 2253/H.R. 3192 - the CHIP Mental Health Parity Act - amend title XXI of the Social Security Act to ensure access to mental health services for children under the Childrens Health Insurance Program, and for other purposes 12.N/A 13.N/A 14.S. 2711, the Enhancing Access to Addiction Treatment Act - amend section 303 of the Controlled Substances Act to facilitate waivers of the separate registration requirement for physicians dispensing narcotic drugs to individuals for maintenance treatment or detoxification treatment 15.H.R. 5776 - Medicare and Opioid Safe Treatment Act - provide access to Medication-Assisted Treatment (MAT) in Medicare through bundled payments made to Opioid Treatment Programs for holistic service 16.S. 2875 - Comprehensive Opioid Management and Bundled Addiction Treatment Act of 2018 - amend title XVIII of the Social Security Act to provide for Medicare coverage of certain services furnished by opioid treatment programs, and for other purposes 17.S. 2843/H.R. 5818 - Opioid Workforce Act - amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions to help combat the opioid crisis 18. S.3462 - Improving Coverage for Substance Use Disorder Recovery Expansion Act-amend title XIX of the Social Security Act to provide States with the option to provide medical assistance for substance use disorder treatment services to individuals between the ages of 21 and 64 with substance use disorders, and for other purposes 19. H.R. 3545/6082 - the Overdose Prevention and Patient Safety Act amends the Public Health Service Act to align federal privacy standards for substance use disorder (SUD) patient records more closely with standards under the Health Insurance Portability and Accountability Act (HIPAA). 20. Provided technical assistance on draft bills regarding grants for medication-assisted treatment/recovery programs for incarcerated individuals 21. Advocated for techinical changes to allow DATA waivered practitioners to treat hospitalized patients with OUD as a primary diagnosis with medications via hospital orders/controlled substance stock 22. Advocated for eligibility clarification to include addiction medicine physicians under current loan repayment/scholarship programs 23. Advocated for rapid healthcare response teams after clinics are shut down; DEA agent education around buprenorphine prescribing
Client expense: $60,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), Justice, Dept of (DOJ), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)
2018 · fourth_quarter · Health Issues
1.S. 2317/H.R. 3692 - Addiction Treatment Access Improvement Act - amend the Controlled Substances Act to provide for additional flexibility with respect to medication-assisted treatment for opioid use disorders, and for other purposes. 2.H.R. 6 - SUPPORT for Patients and Communities Act - provide for opioid use disorder prevention, recovery, and treatment, and for other purposes. 3.S. 2608 - Opioid Crisis Response Act - address the opioid crisis 4.H.R. 5605 - Advancing High Quality Treatment for Opioid Use Disorders in Medicare Act - provide for an opioid use disorder treatment demonstration program, and for other purposes 5.H.R. 5797 - Individuals in Medicaid Deserve Care that is Appropriate and Responsible in its Execution Act - provide under Medicaid services for certain individuals with opioid use disorders in institutions for mental diseases. 6.H.R. 5800 - the Medicaid IMD ADDITIONAL INFO Act - require the Medicaid and CHIP Payment and Access Commission to conduct an exploratory study and report on requirements applicable to and practices of institutions for mental diseases under the Medicaid program. 7.H.R. 5483 - Special Registration for Telemedicine Clarification Act - impose a deadline for the promulgation of interim final regulations in accordance with section 311(h) of the Controlled Substances Act (21 U.S.C. 831(h)) specifying the circumstances in which a special registration may be issued to a practitioner to engage in the practice of telemedicine, and for other purposes. 8.H.R. 5272 - a bill to ensure that programs and activities that are funded by a grant, cooperative agreement, loan, or loan guarantee from the Department of Health and Human Services, and whose purpose is to prevent or treat a mental health or substance use disorder, are evidence-based 9.S. 2524/H.R. 5102, Substance Use Disorder Workforce Loan Repayment Act - amend the Public Health Service Act to authorize a loan repayment program for substance use disorder treatment employees, and for other purposes 10.H.R. 4005 - the Medicaid Reentry Act - promote State innovations to ease transitions to the community for individuals who are inmates of a public institution and eligible for medical assistance under the Medicaid program. 11.S. 2253/H.R. 3192 - the CHIP Mental Health Parity Act - amend title XXI of the Social Security Act to ensure access to mental health services for children under the Childrens Health Insurance Program, and for other purposes 12.N/A 13.N/A 14.S. 2711, the Enhancing Access to Addiction Treatment Act - amend section 303 of the Controlled Substances Act to facilitate waivers of the separate registration requirement for physicians dispensing narcotic drugs to individuals for maintenance treatment or detoxification treatment 15.H.R. 5776 - Medicare and Opioid Safe Treatment Act - provide access to Medication-Assisted Treatment (MAT) in Medicare through bundled payments made to Opioid Treatment Programs for holistic service 16.S. 2875 - Comprehensive Opioid Management and Bundled Addiction Treatment Act of 2018 - amend title XVIII of the Social Security Act to provide for Medicare coverage of certain services furnished by opioid treatment programs, and for other purposes 17.S. 2843/H.R. 5818 - Opioid Workforce Act - amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions to help combat the opioid crisis 18. S.3462 - Improving Coverage for Substance Use Disorder Recovery Expansion Act-amend title XIX of the Social Security Act to provide States with the option to provide medical assistance for substance use disorder treatment services to individuals between the ages of 21 and 64 with substance use disorders, and for other purposes 19. H.R. 3545/6082 - the Overdose Prevention and Patient Safety Act amends the Public Health Service Act to align federal privacy standards for substance use disorder (SUD) patient records more closely with standards under the Health Insurance Portability and Accountability Act (HIPAA). 20. Provided technical assistance on draft bills regarding grants for medication-assisted treatment/recovery programs for incarcerated individuals 21. Advocated for techinical changes to allow DATA waivered practitioners to treat hospitalized patients with OUD as a primary diagnosis with medications via hospital orders/controlled substance stock 22. Advocated for eligibility clarification to include addiction medicine physicians under current loan repayment/scholarship programs 23. Advocated for rapid healthcare response teams after clinics are shut down; DEA agent education around buprenorphine prescribing
Client expense: $60,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), Justice, Dept of (DOJ), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)
2018 · fourth_quarter · Medicare/Medicaid
1.S. 2317/H.R. 3692 - Addiction Treatment Access Improvement Act - amend the Controlled Substances Act to provide for additional flexibility with respect to medication-assisted treatment for opioid use disorders, and for other purposes. 2.H.R. 6 - SUPPORT for Patients and Communities Act - provide for opioid use disorder prevention, recovery, and treatment, and for other purposes. 3.S. 2608 - Opioid Crisis Response Act - address the opioid crisis 4.H.R. 5605 - Advancing High Quality Treatment for Opioid Use Disorders in Medicare Act - provide for an opioid use disorder treatment demonstration program, and for other purposes 5.H.R. 5797 - Individuals in Medicaid Deserve Care that is Appropriate and Responsible in its Execution Act - provide under Medicaid services for certain individuals with opioid use disorders in institutions for mental diseases. 6.H.R. 5800 - the Medicaid IMD ADDITIONAL INFO Act - require the Medicaid and CHIP Payment and Access Commission to conduct an exploratory study and report on requirements applicable to and practices of institutions for mental diseases under the Medicaid program. 7.H.R. 5483 - Special Registration for Telemedicine Clarification Act - impose a deadline for the promulgation of interim final regulations in accordance with section 311(h) of the Controlled Substances Act (21 U.S.C. 831(h)) specifying the circumstances in which a special registration may be issued to a practitioner to engage in the practice of telemedicine, and for other purposes. 8.H.R. 5272 - a bill to ensure that programs and activities that are funded by a grant, cooperative agreement, loan, or loan guarantee from the Department of Health and Human Services, and whose purpose is to prevent or treat a mental health or substance use disorder, are evidence-based 9.S. 2524/H.R. 5102, Substance Use Disorder Workforce Loan Repayment Act - amend the Public Health Service Act to authorize a loan repayment program for substance use disorder treatment employees, and for other purposes 10.H.R. 4005 - the Medicaid Reentry Act - promote State innovations to ease transitions to the community for individuals who are inmates of a public institution and eligible for medical assistance under the Medicaid program. 11.S. 2253/H.R. 3192 - the CHIP Mental Health Parity Act - amend title XXI of the Social Security Act to ensure access to mental health services for children under the Childrens Health Insurance Program, and for other purposes 12.N/A 13.N/A 14.S. 2711, the Enhancing Access to Addiction Treatment Act - amend section 303 of the Controlled Substances Act to facilitate waivers of the separate registration requirement for physicians dispensing narcotic drugs to individuals for maintenance treatment or detoxification treatment 15.H.R. 5776 - Medicare and Opioid Safe Treatment Act - provide access to Medication-Assisted Treatment (MAT) in Medicare through bundled payments made to Opioid Treatment Programs for holistic service 16.S. 2875 - Comprehensive Opioid Management and Bundled Addiction Treatment Act of 2018 - amend title XVIII of the Social Security Act to provide for Medicare coverage of certain services furnished by opioid treatment programs, and for other purposes 17.S. 2843/H.R. 5818 - Opioid Workforce Act - amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions to help combat the opioid crisis 18. S.3462 - Improving Coverage for Substance Use Disorder Recovery Expansion Act-amend title XIX of the Social Security Act to provide States with the option to provide medical assistance for substance use disorder treatment services to individuals between the ages of 21 and 64 with substance use disorders, and for other purposes 19. H.R. 3545/6082 - the Overdose Prevention and Patient Safety Act amends the Public Health Service Act to align federal privacy standards for substance use disorder (SUD) patient records more closely with standards under the Health Insurance Portability and Accountability Act (HIPAA). 20. Provided technical assistance on draft bills regarding grants for medication-assisted treatment/recovery programs for incarcerated individuals 21. Advocated for techinical changes to allow DATA waivered practitioners to treat hospitalized patients with OUD as a primary diagnosis with medications via hospital orders/controlled substance stock 22. Advocated for eligibility clarification to include addiction medicine physicians under current loan repayment/scholarship programs 23. Advocated for rapid healthcare response teams after clinics are shut down; DEA agent education around buprenorphine prescribing
Client expense: $60,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), Justice, Dept of (DOJ), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)
2018 · fourth_quarter · Alcohol and Drug Abuse
1.S. 2317/H.R. 3692 - Addiction Treatment Access Improvement Act - amend the Controlled Substances Act to provide for additional flexibility with respect to medication-assisted treatment for opioid use disorders, and for other purposes. 2.H.R. 6 - SUPPORT for Patients and Communities Act - provide for opioid use disorder prevention, recovery, and treatment, and for other purposes. 3.S. 2608 - Opioid Crisis Response Act - address the opioid crisis 4.H.R. 5605 - Advancing High Quality Treatment for Opioid Use Disorders in Medicare Act - provide for an opioid use disorder treatment demonstration program, and for other purposes 5.H.R. 5797 - Individuals in Medicaid Deserve Care that is Appropriate and Responsible in its Execution Act - provide under Medicaid services for certain individuals with opioid use disorders in institutions for mental diseases. 6.H.R. 5800 - the Medicaid IMD ADDITIONAL INFO Act - require the Medicaid and CHIP Payment and Access Commission to conduct an exploratory study and report on requirements applicable to and practices of institutions for mental diseases under the Medicaid program. 7.H.R. 5483 - Special Registration for Telemedicine Clarification Act - impose a deadline for the promulgation of interim final regulations in accordance with section 311(h) of the Controlled Substances Act (21 U.S.C. 831(h)) specifying the circumstances in which a special registration may be issued to a practitioner to engage in the practice of telemedicine, and for other purposes. 8.H.R. 5272 - a bill to ensure that programs and activities that are funded by a grant, cooperative agreement, loan, or loan guarantee from the Department of Health and Human Services, and whose purpose is to prevent or treat a mental health or substance use disorder, are evidence-based 9.S. 2524/H.R. 5102, Substance Use Disorder Workforce Loan Repayment Act - amend the Public Health Service Act to authorize a loan repayment program for substance use disorder treatment employees, and for other purposes 10.H.R. 4005 - the Medicaid Reentry Act - promote State innovations to ease transitions to the community for individuals who are inmates of a public institution and eligible for medical assistance under the Medicaid program. 11.S. 2253/H.R. 3192 - the CHIP Mental Health Parity Act - amend title XXI of the Social Security Act to ensure access to mental health services for children under the Childrens Health Insurance Program, and for other purposes 12.N/A 13.N/A 14.S. 2711, the Enhancing Access to Addiction Treatment Act - amend section 303 of the Controlled Substances Act to facilitate waivers of the separate registration requirement for physicians dispensing narcotic drugs to individuals for maintenance treatment or detoxification treatment 15.H.R. 5776 - Medicare and Opioid Safe Treatment Act - provide access to Medication-Assisted Treatment (MAT) in Medicare through bundled payments made to Opioid Treatment Programs for holistic service 16.S. 2875 - Comprehensive Opioid Management and Bundled Addiction Treatment Act of 2018 - amend title XVIII of the Social Security Act to provide for Medicare coverage of certain services furnished by opioid treatment programs, and for other purposes 17.S. 2843/H.R. 5818 - Opioid Workforce Act - amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions to help combat the opioid crisis 18. S.3462 - Improving Coverage for Substance Use Disorder Recovery Expansion Act-amend title XIX of the Social Security Act to provide States with the option to provide medical assistance for substance use disorder treatment services to individuals between the ages of 21 and 64 with substance use disorders, and for other purposes 19. H.R. 3545/6082 - the Overdose Prevention and Patient Safety Act amends the Public Health Service Act to align federal privacy standards for substance use disorder (SUD) patient records more closely with standards under the Health Insurance Portability and Accountability Act (HIPAA). 20. Provided technical assistance on draft bills regarding grants for medication-assisted treatment/recovery programs for incarcerated individuals 21. Advocated for techinical changes to allow DATA waivered practitioners to treat hospitalized patients with OUD as a primary diagnosis with medications via hospital orders/controlled substance stock 22. Advocated for eligibility clarification to include addiction medicine physicians under current loan repayment/scholarship programs 23. Advocated for rapid healthcare response teams after clinics are shut down; DEA agent education around buprenorphine prescribing
Client expense: $60,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), Justice, Dept of (DOJ), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)
2018 · fourth_quarter · Medical/Disease Research/Clinical Labs
1.S. 2317/H.R. 3692 - Addiction Treatment Access Improvement Act - amend the Controlled Substances Act to provide for additional flexibility with respect to medication-assisted treatment for opioid use disorders, and for other purposes. 2.H.R. 6 - SUPPORT for Patients and Communities Act - provide for opioid use disorder prevention, recovery, and treatment, and for other purposes. 3.S. 2608 - Opioid Crisis Response Act - address the opioid crisis 4.H.R. 5605 - Advancing High Quality Treatment for Opioid Use Disorders in Medicare Act - provide for an opioid use disorder treatment demonstration program, and for other purposes 5.H.R. 5797 - Individuals in Medicaid Deserve Care that is Appropriate and Responsible in its Execution Act - provide under Medicaid services for certain individuals with opioid use disorders in institutions for mental diseases. 6.H.R. 5800 - the Medicaid IMD ADDITIONAL INFO Act - require the Medicaid and CHIP Payment and Access Commission to conduct an exploratory study and report on requirements applicable to and practices of institutions for mental diseases under the Medicaid program. 7.H.R. 5483 - Special Registration for Telemedicine Clarification Act - impose a deadline for the promulgation of interim final regulations in accordance with section 311(h) of the Controlled Substances Act (21 U.S.C. 831(h)) specifying the circumstances in which a special registration may be issued to a practitioner to engage in the practice of telemedicine, and for other purposes. 8.H.R. 5272 - a bill to ensure that programs and activities that are funded by a grant, cooperative agreement, loan, or loan guarantee from the Department of Health and Human Services, and whose purpose is to prevent or treat a mental health or substance use disorder, are evidence-based 9.S. 2524/H.R. 5102, Substance Use Disorder Workforce Loan Repayment Act - amend the Public Health Service Act to authorize a loan repayment program for substance use disorder treatment employees, and for other purposes 10.H.R. 4005 - the Medicaid Reentry Act - promote State innovations to ease transitions to the community for individuals who are inmates of a public institution and eligible for medical assistance under the Medicaid program. 11.S. 2253/H.R. 3192 - the CHIP Mental Health Parity Act - amend title XXI of the Social Security Act to ensure access to mental health services for children under the Childrens Health Insurance Program, and for other purposes 12.N/A 13.N/A 14.S. 2711, the Enhancing Access to Addiction Treatment Act - amend section 303 of the Controlled Substances Act to facilitate waivers of the separate registration requirement for physicians dispensing narcotic drugs to individuals for maintenance treatment or detoxification treatment 15.H.R. 5776 - Medicare and Opioid Safe Treatment Act - provide access to Medication-Assisted Treatment (MAT) in Medicare through bundled payments made to Opioid Treatment Programs for holistic service 16.S. 2875 - Comprehensive Opioid Management and Bundled Addiction Treatment Act of 2018 - amend title XVIII of the Social Security Act to provide for Medicare coverage of certain services furnished by opioid treatment programs, and for other purposes 17.S. 2843/H.R. 5818 - Opioid Workforce Act - amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions to help combat the opioid crisis 18. S.3462 - Improving Coverage for Substance Use Disorder Recovery Expansion Act-amend title XIX of the Social Security Act to provide States with the option to provide medical assistance for substance use disorder treatment services to individuals between the ages of 21 and 64 with substance use disorders, and for other purposes 19. H.R. 3545/6082 - the Overdose Prevention and Patient Safety Act amends the Public Health Service Act to align federal privacy standards for substance use disorder (SUD) patient records more closely with standards under the Health Insurance Portability and Accountability Act (HIPAA). 20. Provided technical assistance on draft bills regarding grants for medication-assisted treatment/recovery programs for incarcerated individuals 21. Advocated for techinical changes to allow DATA waivered practitioners to treat hospitalized patients with OUD as a primary diagnosis with medications via hospital orders/controlled substance stock 22. Advocated for eligibility clarification to include addiction medicine physicians under current loan repayment/scholarship programs 23. Advocated for rapid healthcare response teams after clinics are shut down; DEA agent education around buprenorphine prescribing
Client expense: $60,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), Justice, Dept of (DOJ), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)
2018 · fourth_quarter · Insurance
Federal government relations services regarding payment policies and legislation impacting Sheppard Pratt Health System; HR 5795, Overdose Prevention and Patient Safety Act- Section 2; HR 5797, IMD Care Act- Section 2; HR 5800, Medicaid IMD ADDITIONAL INFO Act- Section 2; HR 6, SUPPORT for Patients and Communities Act; Reform of privacy regulation found in 42 CFR Part 2
Client expense: Not reported · Firm income: $30,000
Government targets: HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), SENATE
2018 · fourth_quarter · Health Issues
Federal government relations services regarding payment policies and legislation impacting Sheppard Pratt Health System; HR 5795, Overdose Prevention and Patient Safety Act- Section 2; HR 5797, IMD Care Act- Section 2; HR 5800, Medicaid IMD ADDITIONAL INFO Act- Section 2; HR 6, SUPPORT for Patients and Communities Act; Reform of privacy regulation found in 42 CFR Part 2
Client expense: Not reported · Firm income: $30,000
Government targets: HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), SENATE
2018 · fourth_quarter · Medicare/Medicaid
Federal government relations services regarding payment policies and legislation impacting Sheppard Pratt Health System; HR 5795, Overdose Prevention and Patient Safety Act- Section 2; HR 5797, IMD Care Act- Section 2; HR 5800, Medicaid IMD ADDITIONAL INFO Act- Section 2; HR 6, SUPPORT for Patients and Communities Act
Client expense: Not reported · Firm income: $30,000
Government targets: HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), SENATE
2018 · fourth_quarter · Health Issues
HCR: HCR: Implementation of health care reform law as it relates to substance abuse treatment and prevention, Medicaid - IMD exclusion; parity for SUD treatment; S. 524, access to treatment under Medicaid and Essential health benefits the Comprehensive Addiction & Recovery Act, specifically provisions that relate to SUD Treatment. S.1169 Medcaid Coverage for Addiction Recovery Expansion (Medicaid CARE) act , H.R. 2938 Road to Recovery Act, H.R. 2687 Medicaid Coverage for Addiction Recovery Expansion (Medicaid CARE) Act; monitoring policies and regulations related to the Presidents declaration of the opioid crisis as a public health emergency under the Public Health Service Act; H.R. 5797 Legislation to reform IMD exclusion; Provisions related to IMD exclusion in HR 6 and enacted into law as the SUPPORT for Patients and Communities Act, designated Public Law 115-271. Patient privacy provisions in H.R. 6082, the Overdose Prevention and Patient Safety Act
Client expense: Not reported · Firm income: $10,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)
2018 · fourth_quarter · Medicare/Medicaid
IMD exclusion; H.R. 5797 legislation related to reforming the IMD exclusion
Client expense: Not reported · Firm income: $10,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2018 · fourth_quarter · Health Issues
HCR: Implementation of health care reform law as it relates to substance abuse treatment and prevention, Medicaid - IMD exclusion; parity for SUD treatment;S.524 access to treatment under Medicaid and Essential Health benefits, the Comprehensive Addiction & Recovery Act, specifically provisions that relate to SUD Treatment. S.1169 Medcaid Coverage for Addiction Recovery Expansion (Medicaid CARE) act , H.R. 2938 Road to Recovery Act, H.R. 2687 Medicaid Coverage for Addiction Recovery Expansion (Medicaid CARE) Act; monitor policies and regulations related to the President's declaration of the opioid crisis as a public health emergency under the Public Health Service Act; H.R. 5797 Legislation to reform the IMD exclusion; Provisions related to IMD exclusion in HR 6 Opioid Crisis Response Act and enacted into law as the SUPPORT for Patients and Communities Act, designated Public Law 115-271
Client expense: Not reported · Firm income: $20,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2018 · fourth_quarter · Medicare/Medicaid
H.R. 5603, Access to Telehealth Services for Substance Use Disorders Act, all provisions; H.R. 5797, Individuals in Medicaid Deserve Care that is Appropriate and Responsible in its Execution Act, all provisions; Site-Neutral Payment Reductions; Stark Law; Federal Medicaid funding; Elimination of the statutory prohibition on Medicare paying for telehealth services if the patient is located in an urban area or at home; CMS heightened scrutiny process for Medicaid home and community-based services (HCBS) waivers
Client expense: $40,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2018 · fourth_quarter · Health Issues
340B; H.R. 5603, Access to Telehealth Services for Substance Use Disorders Act, all provisions; H.R. 5797, Individuals in Medicaid Deserve Care that is Appropriate and Responsible in its Execution Act, all provisions; H.R. 6082, Overdose Prevention & Patient Safety Act, all provisions; Site-Neutral Payment Reductions; Stark Law; Federal Medicaid funding; Elimination of the statutory prohibition on Medicare paying for telehealth services if the patient is located in an urban area or at home; CMS heightened scrutiny process for Medicaid home and community-based services (HCBS) waivers
Client expense: $40,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2018 · fourth_quarter · Medicare/Medicaid
Issues related to the improvements in the treatment of the United States territories under the Medicare and Medicaid programs - no specific legislation. Issues related to health insurance provider fees, extending funding for the Children's Health Insurance Program, Medicare and Medicaid issues - no specific legislation.. H.R. 6, the SUPPORT for Patients and Communities Act - entire bill. H.R. 5797, the IMD CARE Act - entire bill. H.R. 6082, the Overdose Prevention and Patient Safety Act - entire bill. H.R. 5801, the Medicaid PARTNERSHIP Act - entire bill. H.R. 5963, To delay the reimposition of the annual fee on health insurance providers until after 2020 - entire bill. S. 3063, Health Insurance Tax Relief Act of 2018 - entire bill. H.R. 246 - To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act - entire bill. H.R. 6042, to amend title XIX of the Social Security Act to delay the reduction in federal medical assistance percentage for Medicaid personal care services furnished without an electronic visit verification system, and for other purposes- entire bill. H.R. 3325 - ACE Kids Act - Entire bill.
Client expense: Not reported · Firm income: $80,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2018 · fourth_quarter · Medicare/Medicaid
Issues related to the improvements in the treatment of the United States territories under the Medicare and Medicaid programs - no specific legislation. Issues related to health insurance provider fees, extending funding for the Children's Health Insurance Program, Medicare and Medicaid issues - no specific legislation. H.R. 6, the SUPPORT for Patients and Communities Act - entire bill. H.R. 5797, the IMD CARE Act - entire bill. H.R. 6082, the Overdose Prevention and Patient Safety Act - entire bill. H.R. 5801, the Medicaid PARTNERSHIP Act - entire bill.
Client expense: Not reported · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2018 · fourth_quarter · Medicare/Medicaid
Issues related to the improvements in the treatment of the United States territories under the Medicare and Medicaid programs - no specific legislation. Issues related to health insurance provider fees, extending funding for the Children's Health Insurance Program, Medicare and Medicaid issues - no specific legislation. H.R. 6, the SUPPORT for Patients and Communities Act - entire bill. H.R. 5797, the IMD CARE Act - entire bill. H.R. 6082, the Overdose Prevention and Patient Safety Act - entire bill. H.R. 5801, the Medicaid PARTNERSHIP Act - entire bill. H.R. 5963, To delay the reimposition of the annual fee on health insurance providers until after 2020 - entire bill. S. 3063, Health Insurance Tax Relief Act of 2018 - entire bill. H.R. 246 - To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act - entire bill. H.R. 6042, to amend title XIX of the Social Security Act to delay the reduction in federal medical assistance percentage for Medicaid personal care services furnished without an electronic visit verification system, and for other purposes- entire bill. H.R. 3325 - ACE Kids Act - Entire bill.
Client expense: $320,000 · 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
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 · Health Issues
H.R. 6: SUPPORT for Patients and Communities Act - To provide for opioid use disorder prevention, recovery, and treatment, and for other purposes H.R. 449: Synthetic Drug Awareness Act: Provisions related to synthetic drug report H.R. 749: Lower Drug Costs through Competition Act - Provisions related to generic drug approvals H.R. 878: Right to Try Act of 2017 - Provisions related to use of unapproved medical products by patients with a terminal illness H.R. 1245: Affordable and Safe Prescription Drug Importation Act - Provisions related to importation H.R. 1480: Safe and Affordable Drugs from Canada Act of 2017 - Provisions related to importation H.R. 1628: American Health Care Act of 2017 - Provisions related to the biopharmaceutical industry including repeal of brand pharmaceutical manufacturer fee and individual and employer mandates, insurance affordability provisions, and Medicaid reforms H.R. 1776: Improving Access to Affordable Prescription Drugs Act - Provisions related to drug pricing H.R. 2025: Abuse-Deterrent Opioids Plan for Tomorrow Act of 2017 - Provisions related to labeling information describing abuse-deterrent properties H.R. 2051: FAST Generics Act of 2017 - Provisions related to REMS and limited distribution systems H.R. 2063: Opioid Preventing Abuse through Continuing Education (PACE) Act of 2017 - Provisions related to prescriber training H.R. 2212: CREATES Act of 2017 - Provisions related to Risk Evaluation and Mitigation Strategies (REMS) and limited distribution systems H.R. 4710: 340B Protecting Access for the Underserved and Safety-net Entities Act or PAUSE Act - Provisions related to the 340B program H.R. 4482: Opioid Abuse Deterrence, Research, and Recovery Act of 2017 - Provisions related to prescriber requirements H.R. 5041: The Safe Disposal of Unused Medication Act - Provisions related to drug disposal H.R. 5202: Ensuring Patient Access to Substance Use Disorder Treatments Act of 2018 - Provisions related to drug delivery H.R. 5228: SCREEN Act - Provisions related to drug recall authority H.R. 5311: CARA 2.0 Act of 2018 - Provisions to reauthorize and expand the Comprehensive Addiction and Recovery Act H.R. 5582: Abuse Deterrent Access Act of 2018 H.R. 5598: 340B Optimization Act - Provisions related to transparency in the 340B program H.R. 5687: SOUND Disposal and Packaging Act - Provisions related to packaging and disposal methods with respect to certain drugs H.R. 5752: Stop Illicit Importation Act of 2018 - Provisions related to importation H.R. 5788: Synthetics Trafficking and Overdose Prevention Act of 2018 or STOP Act of 2018 H.R. 5803: SAFETY Act of 2018 - Provisions related to drug approval H.R. 6143: Patient Right to Know Drug Prices Act - Provisions related to drug pricing H. Res. 949: Providing for consideration of the bill (H.R. 6) to provide for opioid use disorder prevention, recovery, and treatment, and for other purposes; providing for consideration of the bill (H.R. 5797) to amend title XIX of the Social Security Act to allow States to provide under Medicaid services for certain individuals with opioid use disorders in institutions for mental diseases; and providing for consideration of the bill (H.R. 6082) to amend the Public Health Service Act to protect the confidentiality of substance use disorder patient records S. 64: Safe and Affordable Drugs from Canada Act of 2017 - Provisions related to importation S. 92: Safe and Affordable Drugs from Canada Act of 2017 - Provisions related to importation S. 469: Affordable and Safe Prescription Drug Importation Act - Provisions related to importation S. 771: Improving Access to Affordable Prescription Drugs Act - Provisions related to drug pricing S. 974: CREATES Act of 2017 - Provisions related to Risk Evaluation and Mitigation Strategies (REMS) and limited distribution systems S. 1131: Fair Accountability and Innovative Research Drug Pricing Act of 2017 - Provisions related to drug pricing S. 1327: SITSA Act - Provisions related to controlled substances S. 2157: Drug-Price Transparency in Communications Act S. 2312: HELP Act - Provisions related to 340B program S. 2453: Ensuring the Value of the 340B Program Act of 2018 - Provisions to increase transparency in the 340B program S. 2553: Know the Lowest Price Act of 2018 - Provisions related to drug pricing S. 2554: Patient Right to Know Drug Prices Act - To ensure that health insurance issuers and group health plans do not prohibit pharmacy providers from providing certain information to enrollees S. 2665: A bill to require guidance on how the Food and Drug Administration will consider claims of opioid sparing and on the conditions under which the Food and Drug Administration will consider misuse and abuse of drugs in making certain determinations of safety S. 3519: A bill to establish a process for the Food and Drug Administration to determine whether to modify the labeling of drugs whose labeling may be outdated, including drugs with accepted uses that are not reflected in the approved labeling Drug cost and pricing policy issues Transparency policy issues Drug importation and counterfeiting policy issues Prescription drug take back and secure disposal policy issues Policy issues related to prescription drug abuse and opioids Expanded access policy issues Generic drug approval process policy issues High deductible health plans/HSA policy issues Sharing of truthful and non-misleading information about medicines with healthcare professionals and payors Risk Evaluation and Mitigation Strategy (REMS) policy issues FDA modernization policy issues PDUFA implementation policy issues 340B drug discount program policy issues Bipartisan Budget Act of 2018 (Public Law 115-123) - Part D provisions Patient assistance program policy issues Biosimilar approval and reimbursement policy issues Drug compounding policy issues including federal oversight of compounded drugs Cancer drug vial size policy issues TRICARE pharmacy pilot program Drug shortages policy issues Reauthorization of the Pandemic and All-Hazards Preparedness Act Request for Information: HHS Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs (RIN 0991-ZA49) HR6, SUPPORT for Patients and Communities Act, Provisions related to BBA technical correction (Part D) HR 394/S 85 - Restoring Access to Medication Act of 2017Vaccine manufacturing practices HR 4297/S2103, Protecting Seniors Through Immunization Act; HR4993/S3253, Vaccine Access Improvement Act; HR 5333 - Over-the-Counter Monograph Safety, Innovation, and Reform Act of 2018Durbin/Grassley Amendment HR 6199 - Restoring Access to Medication and Modernizing Health Savings Accounts Act of 2018 H.R.6378 To reauthorize certain programs under the Pandemic and All-Hazards Preparedness Reauthorization Act S 2315 - Over-the-Counter Drug Safety, Innovation, and Reform Act' S.2852 Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018
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 · Health Issues
H.R. 6, the SUPPORT for Patients and Communities Act; S. 2680, the Opioid Crisis Response Act of 2018; H.R. 6082 / H.R. 3545 / H.R. 5795, the Overdose Prevention and Patient Safety Act, and issues related to 42 CFR Part 2. Monitored issues related to health care consolidation. H.R. 5797, Individuals in Medicaid Deserve Care that is Appropriate and Responsible in its Execution Act; H.R. 5385, the Children's Hospital GME Support Reauthorization Act of 2018; H.R. 5804, the Post-Surgical Injections as an Opioid Alternative Act; issues related to hospital rape kits.
Client expense: Not reported · Firm income: $93,000
Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, 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 · Health Issues
H.R. 6: SUPPORT for Patients and Communities Act - To provide for opioid use disorder prevention, recovery, and treatment, and for other purposes H.R. 449: Synthetic Drug Awareness Act: Provisions related to synthetic drug report H.R. 749: Lower Drug Costs through Competition Act - Provisions related to generic drug approvals H.R. 1245: Affordable and Safe Prescription Drug Importation Act - Provisions related to importation H.R. 1480: Safe and Affordable Drugs from Canada Act of 2017 - Provisions related to importation H.R. 1628: American Health Care Act of 2017 - Provisions related to the biopharmaceutical industry including repeal of brand pharmaceutical manufacturer fee and individual and employer mandates, insurance affordability provisions, and Medicaid reforms H.R. 1776: Improving Access to Affordable Prescription Drugs Act - Provisions related to drug pricing H.R. 2025: Abuse-Deterrent Opioids Plan for Tomorrow Act of 2017 - Provisions related to labeling information describing abuse-deterrent properties H.R. 2051: FAST Generics Act of 2017 - Provisions related to REMS and limited distribution systems H.R. 2063: Opioid Preventing Abuse through Continuing Education (PACE) Act of 2017 - Provisions related to prescriber training H.R. 2212: CREATES Act of 2017 - Provisions related to Risk Evaluation and Mitigation Strategies (REMS) and limited distribution systems H.R. 2851: Stop Importation and Trafficking of Synthetic Analogues (SITSA) Act - Provisions related to controlled substances H.R. 3545: Overdose Prevention and Patient Safety Act - Provisions related to substance use disorder records H.R. 3692: Addiction Treatment Access Improvement Act of 2017 - Provisions related to medication assisted treatment (MAT) access H.R. 4275: Empowering Pharmacists in the Fight Against Opioid Abuse Act - Provisions related to pharmacist education H.R. 4284: Indexing Narcotics, Fentanyl, and Opioids (INFO) Act of 2018 - Provisions related to substance use disorder information H.R. 4710: 340B Protecting Access for the Underserved and Safety-net Entities Act or PAUSE Act - Provisions related to the 340B program H.R. 4482: Opioid Abuse Deterrence, Research, and Recovery Act of 2017 - Provisions related to prescriber requirements H.R. 5002: Advancing Cutting Edge Research Act - Provisions related to non-addiction pain medication H.R. 5009: Jessies Law - Provisions related to patient information H.R. 5041: The Safe Disposal of Unused Medication Act - Provisions related to drug disposal H.R. 5102: Substance Use Disorder Workforce Loan Repayment Act of 2018 - Provisions related to loan repayment program H.R. 5202: Ensuring Patient Access to Substance Use Disorder Treatments Act of 2018 - Provisions related to drug delivery H.R. 5228: SCREEN Act - Provisions related to drug recall authority H.R. 5311: CARA 2.0 Act of 2018 - Provisions to reauthorize and expand the Comprehensive Addiction and Recovery Act H.R. 5327: Comprehensive Opioid Recovery Centers Act of 2018 - Provisions related to opioid recovery center grants H.R. 5329: Poison Center Network Enhancement Act of 2018 - Provisions related to national poison center funding and other prevention funding H.R. 5582: Abuse Deterrent Access Act of 2018 H.R. 5598: 340B Optimization Act - Provisions related to transparency in the 340B program H.R. 5687: SOUND Disposal and Packaging Act - Provisions related to packaging and disposal methods with respect to certain drugs H.R. 5752: Stop Illicit Importation Act of 2018 - Provisions related to importation H.R. 5762: Joint Task Force to Combat Opioid Trafficking Act of 2018 - To authorize a Joint Task Force to enhance integration of the Department of Homeland Securitys border security operations to detect, interdict, disrupt, and prevent narcotics, such as fentanyl and other synthetic opioids, from entering the United States H.R. 5788: Synthetics Trafficking and Overdose Prevention Act of 2018 or STOP Act of 2018 H.R. 5803: SAFETY Act of 2018 - Provisions related to drug approval H.R. 5811: Long-Term Opioid Efficacy Act of 2018 - Postapproval study requirements H.R. 6143: Patient Right to Know Drug Prices Act - Provisions related to drug pricing H. Res. 949: Providing for consideration of the bill (H.R. 6) to provide for opioid use disorder prevention, recovery, and treatment, and for other purposes; providing for consideration of the bill (H.R. 5797) to amend title XIX of the Social Security Act to allow States to provide under Medicaid services for certain individuals with opioid use disorders in institutions for mental diseases; and providing for consideration of the bill (H.R. 6082) to amend the Public Health Service Act to protect the confidentiality of substance use disorder patient records S. 64: Safe and Affordable Drugs from Canada Act of 2017 - Provisions related to importation S. 92: Safe and Affordable Drugs from Canada Act of 2017 - Provisions related to importation S. 469: Affordable and Safe Prescription Drug Importation Act - Provisions related to importation S. 771: Improving Access to Affordable Prescription Drugs Act - Provisions related to drug pricing S. 974: CREATES Act of 2017 - Provisions related to Risk Evaluation and Mitigation Strategies (REMS) and limited distribution systems S. 1131: Fair Accountability and Innovative Research Drug Pricing Act of 2017 - Provisions related to drug pricing S. 1327: SITSA Act - Provisions related to controlled substances S. 2157: Drug-Price Transparency in Communications Act S. 2312: HELP Act - Provisions related to 340B program S. 2453: Ensuring the Value of the 340B Program Act of 2018 - Provisions to increase transparency in the 340B program S. 2553: Know the Lowest Price Act of 2018 - Provisions related to drug pricing S. 2554: Patient Right to Know Drug Prices Act - To ensure that health insurance issuers and group health plans do not prohibit pharmacy providers from providing certain information to enrollees S. 2665: A bill to require guidance on how the Food and Drug Administration will consider claims of opioid sparing and on the conditions under which the Food and Drug Administration will consider misuse and abuse of drugs in making certain determinations of safety S. 2680: Opioid Crisis Response Act of 2018 - Provisions related to opioids S. 3428: Lessening Addiction by Enhancing Labeling Opiods Act of 2018 S. 3519: A bill to establish a process for the Food and Drug Administration to determine whether to modify the labeling of drugs whose labeling may be outdated, including drugs with accepted uses that are not reflected in the approved labeling Drug cost and pricing policy issues Transparency policy issues Drug importation and counterfeiting policy issues Prescription drug take back and secure disposal policy issues Policy issues related to prescription drug abuse and opioids Expanded access policy issues Generic drug approval process policy issues High deductible health plans/HSA policy issues Sharing of truthful and non-misleading information about medicines with healthcare professionals and payors Risk Evaluation and Mitigation Strategy (REMS) policy issues FDA modernization policy issues PDUFA implementation policy issues 340B drug discount program policy issues Bipartisan Budget Act of 2018 (Public Law 115-123) - Part D provisions Patient assistance program policy issues Biosimilar approval and reimbursement policy issues Drug compounding policy issues including federal oversight of compounded drugs Cancer drug vial size policy issues TRICARE pharmacy pilot program Drug shortages policy issues Reauthorization of the Pandemic and All-Hazards Preparedness Act Request for Information: HHS Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs (RIN 0991-ZA49)
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 · Health Issues
Insurance market policies (Bipartisan Health Care Stabilization Act; Short-term, Limited Duration Health Insurance rule; Association Health Plans rule) Risk adjustment payments Cost sharing reduction payments Insurance navigator funding 340B Drug Pricing Program (H.R. 4392; H.R. 4710, 340B PAUSE Act; S. 2453, Ensuring the Value of the 340B Program Act; H.R. 6071, Stretching Entity Resources for Vulnerable Communities Act; H.R. 2889, Closing Loopholes for Orphan Drugs Act; H.R. 5598, 340B Optimization Act; H.R. 6240, Drug Discount Accountability Act; H.R. 6273, Creating Access to Rape Kit Exams (CARE) for Survivors Act) Opioid issues (S. 2680, the Opioid Crisis Response Act of 2018; H.R. 5176, Preventing Overdoses While in Emergency Rooms (POWER) Act; H.R. 5197, Alternatives to Opioids (ALTO) in the Emergency Department Act; H.R. 5009, Jessies Law; H.R. 5818 / S. 2843, the Opioid Workforce Act; H.R. 5797, the IMD CARE Act; H.R. 6082/H.R. 5795, the Overdose Prevention and Patient Safety Act; S. 2905, Strengthening Partnerships to Prevent Opioid Abuse Act; S. 2460, Every Prescription Conveyed Securely Act; S. 2920, Commit to Opioid Medical Prescriber Accountability and Safety for Seniors Act; H.R. 5582, the Abuse Deterrent Access Act; H.R. 5685, the Medicare Opioid Safety Education Act; Helping to End Addiction and Lessen (HEAL) Substance Use Disorders Act of 2018; H.R. 6, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act; S. 2899, Caring Recovery for Infants and Babies Act; S. 2898, Medication-Assisted Treatment Improvement Act; S.2911, Enhancing Patient Access to Non-Opioid Treatment Options) IV and medication shortages Drug prices (American Patients First, Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs; S. 2554 / H.R. 6143, Patient Right to Know Drug Prices Act; S. 2553, Know the Lowest Price Act; H.R. 6733, Know the Cost Act) Draft Protecting Patients from Surprise Medical Bills Act HIPAA policy in mental and behavioral health information sharing 21st Century Cures Act implementation Pandemic and All Hazards Preparedness Reauthorization, including Hospital Preparedness Program (S. 2852, the Pandemic and All-Hazards Preparedness and Advancing Innovation Act (PAHPAI) of 2018) S.781/ HR 1876. Good Samaritan Health Professional Act of 2017 Health workforce reauthorizations (H.R. 959, the Title VIII Nursing Workforce Reauthorization Act; H.R. 3728, the Educating Medical Professionals and Optimizing Workforce Efficiency Readiness (EMPOWER) Act; H.R. 1676, the Palliative Care and Hospice Education and Training Act Consumer Directed Health Plans Legislation (H.R. 6311 would modify the definition of a qualified health plan and allow individuals purchasing health insurance in the individual market to purchase a "copper" plan or use the premium tax credit to buy off-marketplace coverage; H.R. 6301 to allow CDHPs to provide coverage for services like telehealth, chronic disease management, or primary care visits below the minimum deductible; H.R. 6317 to allow coverage of direct primary care service arrangements; H.R. 6305 to permit use of CDHPs to receive certain employment-related health services like onsite clinics; H.R. 6309 to allow individuals only enrolled in Medicare Part A to contribute to health savings accounts; H.R. 6199 to include certain over-the-counter medical products as qualified medical expenses; H.R. 6306 to increase the current contribution limits for HSAs; H.R. 6312, Personal Health Investment Today (PHIT) Act to count sports equipment and exercise costs toward medical expenses; H.R. 6313 to allow carry-forward of flexible spending account balances each year; H.R. 6314 to allow bronze and catastrophic plans in connection with health savings accounts, allowing plans categorized as catastrophic and bronze in the individual and small group markets to qualify for HSA contributions) H.R. 4616 to delay the implementation of the excise tax on high cost employer-sponsored health coverage; and place a moratorium on the employer mandate Liver allocation policy
Client expense: $70,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, 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 · second_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 Draft Medicare Long-Term Care Services and Supports Act (Pallone) - Long-Term Services and Supports Program H.R. 195, Extension of Continuing Appropriations Act - CHIP funding extension for 2018-2023 and related provisions 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. 1892, Bipartisan Budget Act (Larson) - permanent authorization of Medicare Advantage Special Needs Plans; MA chronic care reforms: telehealth, supplemental benefits, value-based insurance design, star ratings; changes to Medicare Part D coverage gap and related discounts; CHIP funding extension for 2024-2027; funding for Puerto Ricos Medicaid program 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) - coordinated care for children with complex medical conditions H.R. 3360, Telehealth Enhancement Act (Harper) - telehealth in Medicare H.R. 3727, Increasing Telehealth Access in Medicare Act (Black) - telehealth in MA plans H.R. 3921, HEALTHY KIDS Act (Burgess) - CHIP funding H.R. 4952, Improving Seniors Access to Quality Benefits Act (Kelly) - MA benchmark cap study 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 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.
Client expense: $1,410,000 · 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), Internal Revenue Service (IRS), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE, Treasury, Dept of, White House Office
2018 · third_quarter · Medicare/Medicaid
Federal government relations services regarding payment policies and legislation impacting Sheppard Pratt Health System; HR 5795, Overdose Prevention and Patient Safety Act- Section 2; HR 5797, IMD Care Act- Section 2; HR 5800, Medicaid IMD ADDITIONAL INFO Act- Section 2; HR 6, SUPPORT for Patients and Communities Act
Client expense: Not reported · Firm income: $30,000
Government targets: HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), SENATE
2018 · third_quarter · Health Issues
Federal government relations services regarding payment policies and legislation impacting Sheppard Pratt Health System; HR 5795, Overdose Prevention and Patient Safety Act- Section 2; HR 5797, IMD Care Act- Section 2; HR 5800, Medicaid IMD ADDITIONAL INFO Act- Section 2; HR 6, SUPPORT for Patients and Communities Act
Client expense: Not reported · Firm income: $30,000
Government targets: HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), SENATE
2018 · third_quarter · Insurance
Federal government relations services regarding payment policies and legislation impacting Sheppard Pratt Health System; HR 5795, Overdose Prevention and Patient Safety Act- Section 2; HR 5797, IMD Care Act- Section 2; HR 5800, Medicaid IMD ADDITIONAL INFO Act- Section 2; HR 6, SUPPORT for Patients and Communities Act
Client expense: Not reported · Firm income: $30,000
Government targets: HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), SENATE
2018 · third_quarter · Medicare/Medicaid
Individuals in Medicaid Deserve Care that is Appropriate and Responsible in its Execution Act (H.R. 5797) - Supported greater access to the full continuum of care in treating substance use disorders. Access to Telehealth Services for Opioid Use Disorder Act (H.R. 5603) - Urged Congress to support waiving telehealth requirements for Medicare beneficiaries receiving substance use disorder treatment. CHIP Mental Health Parity Act (H.R. 3192) - Supported equal access and classification of mental health and physical health services under the Children's Health Insurance Program. CRIB Act (S. 2899) - Supported pediatric population access to Neonatal Abstinence Syndrome treatment at residential pediatric recovery centers. Help for Moms and Babies Act (S. 2922) - Supported greater access for pregnant and postpartum women to substance use disorder treatment. Medication-Assisted Treatment Improvement Act (S. 2898) - Urged Congress to eliminate the lifetime caps on medication-assisted treatment services for substance use disorders. Medicaid Substance Use Disorder Treatment via Telehealth Act (S. 2904) - Supported greater access to substance use disorder telehealth treatment for Medicaid beneficiaries. TeleCAST Act (S. 2910) - Supported greater pediatric population access to telehealth services. eTREAT Act (S. 2901) - Supported greater substance use disorder telehealth treatment access for Medicare beneficiaries. Support for Patients and Communities Act (H.R. 6) - Supported the expansion and availability of substance use disorder treatment to recipients in the Medicaid, Medicare, and Children's Health Insurance Program as well as the inclusion of an IMD exception.
Client expense: $170,000 · Firm income: Not reported
Government targets: 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), Homeland Security, Dept of (DHS), President of the U.S., SENATE
2018 · third_quarter · Alcohol and Drug Abuse
Public Law 110-343, Emergency Economic Stabilization Act of 2008, Regulations implementation, Mental health and addiction parity Prescription Drug abuse issues Public Law 114-255, 21st Century Cures Act H.R.3692/S.2317, Addiction Treatment Access Improvement Act of 2017 S.2711, Enhancing Access to Addiction Treatment Act H.R.5102/S.2524, Substance Use Disorder Workforce Loan Repayment Act H.R.5272, RESULTS Act H.R.5327/S.2589, Comprehensive Opioid Recovery Centers Act H.R.5261, TEACH to Combat Addiction Act of 2018 H.R.5797, Individuals in Medicaid Deserve Care that is Appropriate and Responsible in its Execution (IMD CARE) Act H.R.6, SUPPORT for Patients and Communities Act H.R.5606, Advancing High Quality Treatment for Opioid Use Disorders in Medicare Act H.R.6082, Overdose Prevention and Patient Safety Act S.2680, Opioid Crisis Response Act of 2018 S.3120, HEAL Act of 2018
Client expense: Not reported · Firm income: $30,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2018 · third_quarter · Medicare/Medicaid
H.R.6505 - Medicare Negotiation and Competitive Licensing Act - require the Secretary of Health and Human Services to negotiate prices of prescription drugs furnished under part D of the Medicare program H.R.6823 - Supporting Positive Outcomes After Release Act - suspend, rather than terminate, an individuals eligibility for medical assistance under the State Medicaid plan while such individual is an inmate of a public institution S.3330 - Medicare and Medicaid Protection Act of 2018 - prevent legislation privatizing Medicare, limiting federal funding for Medicaid, or decreasing benefits in Medicare or Medicare in reconciliation legislation H.R. 6 - Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act - Section 5021, 5022 - H.R. 3192, the CHIP Mental Health Parity Act; Section 5031, 5032 - H.R. 4005, the Medicaid Reentry Act; S.3462 - Improving Coverage for Substance Use Disorder Recovery Expansion Act - provide States with the option to provide medical assistance for substance use disorder treatment services to individuals; modification of IMD exclusion H.R. 5797 - Individuals in Medicaid Deserve Care that is Appropriate and Responsible in its Execution Act - partial removal of IMD exclusion H.R. 3891 -clarifying the authority of State Medicaid fraud and abuse control units to investigate and prosecute cases of Medicaid patient abuse and neglect in any setting Oral health -Medicare dental benefit; Medicare coverage of medically necessary oral health care
Client expense: $30,000 · 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
IMD exclusion; H.R. 5797 legislation related to reforming the IMD exclusion
Client expense: Not reported · Firm income: $10,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2018 · third_quarter · Medicare/Medicaid
Support for Graduate Medical Education (GME) funding including the Resident Physician Shortage Reduction Act (S. 1301/H.R. 2267) and the Opioid Workforce Act of 2018 (H.R. 5818/S. 2843) Support for legislation to address opioid epidemic (SUPPORT for Patients and Communities Act (H.R. 6)) including bills to modify to institute of mental disease exclusion (H.R. 5797) and to align 42 CFR Part 2 with the Health Insurance Portability and Accountability Act (H.R. 6082) and policies to expand ability to prescribe buprenorphine treatment Support for full protection of Critical Access Hospital payments Support for REMC Act of 2018 (H.R. 5678) Support for Fairness in Liver Allocation Act (H.R. 6517) Support for changes to Medicare Volume Decrease Adjustment calculation Support for correction of erroneous reductions of GME residency positions Opposition to 340B program reductions in Centers for Medicare and Medicaid Services (CMS) 2018 Outpatient Prospective Payment System (OPPS) proposed rule [CMS-1678-P] and support for legislation (H.R. 4392, H.R. 6071) to halt these payment cut Opposition to changes to 340B program (H.R. 4710, H.R. 6240) Opposition to site-neutral payment reductions to hospital outpatient departments proposed in CMS 2019 OPPS proposed rule [CMS-1695-P] Support for policies to preserve Medicare Disproportionate Share Hospital funding as part of CMS 2019 Inpatient Prospective Payment System proposed rule [CMS-1694-P]
Client expense: $140,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2018 · third_quarter · Health Issues
HCR: Implementation of health care reform law as it relates to substance abuse treatment and prevention, Medicaid - IMD exclusion; parity for SUD treatment;S.524 access to treatment under Medicaid and Essential Health benefits, the Comprehensive Addiction & Recovery Act, specifically provisions that relate to SUD Treatment. S.1169 Medcaid Coverage for Addiction Recovery Expansion (Medicaid CARE) act , H.R. 2938 Road to Recovery Act, H.R. 2687 Medicaid Coverage for Addiction Recovery Expansion (Medicaid CARE) Act; monitor policies and regulations related to the President's declaration of the opioid crisis as a public health emergency under the Public Health Service Act; H.R. 5797 Legislation to reform the IMD exclusion; Provisions related to IMD exclusion in HR 6 Opioid Crisis Response Act
Client expense: Not reported · Firm income: $20,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2018 · third_quarter · Medicare/Medicaid
Excellence in Mental Health and Addiction Treatment Expansion Act (S. 1905/ H.R.3931), all provisions related to expanding and extending the Certified Community Behavioral Health Clinic demonstration program. Medicaid Coverage for Addiction Recovery Expansion Act (S. 1169/H.R. 2687), all provisions related to expanding the number of residential substance use treatment facilities through Medicaid. Mental Health Access Improvement Act (S. 1879/H.R. 3032), all provisions related to allowing marriage and family therapists and mental health counselors to directly bill Medicare for their services. Opioid Emergency Response Act (H.R. 5531), all provisions related to expanding the Medicare eligible workforce to include marriage and family therapists and mental health counselors. Medicaid Reentry Act (H.R. 4005), all provisions related to allowing states the flexibility to restart Medicaid coverage for incarcerated individuals up to 30 days prior to their release. The IMD CARE Act (H.R. 5797), all provisions related to changing the restriction of Medicaid payment for residential substance use disorder treatment in certain facilities. Graham-Cassidy Bill (Senate Amendment 1030), all provisions related to the repeal of coverage expansions and consumer protections established in the Affordable Care Act.
Client expense: $116,648 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2018 · third_quarter · Health Issues
Monitor and advocate on legislative and regulatory issues regarding healthcare. H.R. 6, SUPPORT for Patients and Communities Act. H.R. 541, Improving Oversight and Accountability in Medicaid Non-DSH Supplemental Payments Act. H.R. 1038, Improving Transparency and Accuracy in Medicare Part D Spending Act. H.R. 2038, Budgeting for Opioid Addiction Treatment Act. H.R. 2843, Medicaid and CHIP Quality Improvement Act of 2017. H.R. 5795, Overdose Prevention and Patient Safety Act. H.R. 5797, Individuals in Medicaid Deserve Care that is Appropriate and Responsible in its Execution Act. H.R. 6071, SERV Communities Act. H.R. 6082, Overdose Prevention and Patient Safety Act. H.R. 6157, Department of Defense and Labor, Health and Human Services, and Education Appropriations Act, 2019 and Continuing Appropriations Act, 2019 H.R. 6470, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2019. H.R. 6733, Know the Cost Act of 2018. S.413, Improving Transparency and Accuracy in Medicare Part D Spending Act. S. 523, Budgeting for Opioid Addiction Treatment Act. S. 1079, Protecting Americans from Dangerous Opioids Act. S. 1123, Office of National Drug Control Policy Reauthorization Act of 2017. S. 2553, Know the Lowest Price Act of 2018. S. 2554, Patient Right to Know Drug Prices Act. S. 2680, Opioid Crisis Response Act of 2018. S. 3120, HEAL Act of 2018.
Client expense: Not reported · Firm income: $30,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2018 · third_quarter · Health Issues
Expressed support for opioid abuse prevention legislation - HR 6, HR 6082, HR 5797 Discussed regulation of marijuana research Expresses support for reauthorization of the Patient Centered Outcomes Research Institute (PCORI) Expressed opposition to CMS Physician Fee Schedule proposed cuts to reimbursement for evaluation and management clinic visits Expressed opposition to CMS Outpatient Prospective Payment System proposed cuts to reimbursement for evaluation and management clinic visits at hospital outpatient departments Expressed support for reforms of privacy regulations for substance abuse disorder Discussed NIH Clinical Trials Definition
Client expense: $152,165 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2018 · third_quarter · Insurance
The Childrens Health Insurance Program, including the reauthorization of the program in the January 2018 continuing resolution to fund the Federal government (support) (H.R. 195) and the extension of the program in the Bipartisan Budget Act of 2018 (support) (H.R. 1892). Support legislation to repeal the Medicaid IMD exclusion, the Individuals in Medicaid Deserve Care that is Appropriate and Responsible in its Execution Act (support) (H.R. 5797), and support the inclusion of the legislation in the SUPPORT for Patients and Communities Act (support) (H.R. 6) and the Opioid Crisis Response Act of 2018 (support) (S. 2680).
Client expense: $600,000 · Firm income: Not reported
Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Office of Management & Budget (OMB), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), White House Office
2018 · third_quarter · Health Issues
Hospital and Medicaid issues related to repeal and replace of the Affordable Care Act (ACA), including opposition to The American Health Care Act (House), the Better Care Reconciliation Act (Senate) (H.R. 1628), the Graham-Cassidy-Heller-Johnson bill, and the Trump Administration's FY 2019 budget proposal. Organ donation issues, including the liver transplant allocation system and in support of new proposed UNOS system. Discussions with HHS and DHS regarding cybersecurity issues. Advocated for individual marketplace stabilization measures, including the funding of ACA cost sharing reduction payments in standalone legislation and in FY 2018 funding legislation. Graduate Medical Education (GME) issues, including the Resident Physician Shortage Reduction Act of 2017 (support) (H.R. 2267/S. 1301), the Opioid Workforce Act of 2018 (support) (H.R. 5818/S. 2843), and the cuts and changes to Medicare and Medicaid GME programs in President Trumps FY 2019 budget proposal (oppose). Support the inclusion of legislation to increase GME funding, the Opioid Workforce Act of 2018 (support) (H.R. 5818/S. 2843), in the SUPPORT for Patients and Communities Act (support) (H.R. 6) and the Opioid Crisis Response Act of 2018 (support) (S. 2680). Support legislation to repeal the Medicaid IMD exclusion, the Individuals in Medicaid Deserve Care that is Appropriate and Responsible in its Execution Act (support) (H.R. 5797), and support the inclusion of the legislation in the SUPPORT for Patients and Communities Act (support) (H.R. 6) and the Opioid Crisis Response Act of 2018 (support) (S. 2680). Support legislation to align 42 CFR Part 2 regulations with the Health Insurance Portability and Accountability Act (HIPAA), The Overdose Prevention and Patient Safety Act (support) (H.R. 6082), and support the inclusion of the legislation in the SUPPORT for Patients and Communities Act (support) (H.R. 6) and the Opioid Crisis Response Act of 2018 (support) (S. 2680). Support the SUPPORT for Patients and Communities Act (support) (H.R. 6). Support the Opioid Crisis Response Act of 2018 (support) (S. 2680). Lobby HHS, HRSA, OPTN and UNOS on liver allocation reforms. Support liver allocation reforms, including the Fairness in Liver Allocation Act (support) (H.R. 6517). Oppose legislation to amend the National Organ Transplant Act, the National Organ Transplant Act Amendments of 2018 (oppose) (H.R. 6458), and the inclusion of language that would amend the National Organ Transplant Act in the Labor-HHS appropriations bill (H.R. 6157). Oppose 340B provisions and site-neutral provisions in the CMS OPPS proposed rule for 2019.
Client expense: $600,000 · Firm income: Not reported
Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Office of Management & Budget (OMB), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), White House Office