Independence at Home Demonstration Act of 2019

P.L. 111-375 National Alzheimer's Project Act, All Sections P.L. 115-119 Recognize, Assist, Include, Support and Engage (RAISE) Family Caregivers Act P.L. 115-406 Building Our Largest Dementia (BOLD) Infrastructure for Alzheimer's Act P.L. 116-131 Supporting Older Americans Act of 2020 S.591 Guardianship Accountability Act S.299 Geriatrics Workforce Improvement Act S.548/H.R.1342 EMPOWER Care Act H.R.1343 Protecting Married Seniors from Impoverishment Act S.740 Alzheimer's Caregiver Support Act H.R. 1955 Understanding Appropriate Alzheimer's Care Act of 2019 S.880/H.R.1873 Improving HOPE for Alzheimer's Act S.2080/H.R.647 Palliative Care and Hospice Education and Training Act S.1250/H.R.2401 American Cures Act S.1017 Supporting America's Caregivers and Families Act S.995/H.R.2035 Lifespan Respite Care Reauthorization Act of 2019 S.1126/H.R.2283 Concentrating on High-Value Alzheimer's Needs to Get to an End (CHANGE) Act of 2019 S.1361/H.R.2584 Preventive Health Savings Act of 2019 S.1628 Paid Family Leave Pilot Extension Act S.1618 Expanding Capacity for Health Outcomes (ECHO) Act of 2019 S.1202 Independence at Home Act of 2019 H.R.3644 Independence at Home Demonstration Act of 2019 H.R.3436 Improving Chronic Care Management Act H.R.3107 Improving Seniors' Timely Access to Care Act S.2469/H.R.4386 Stop the Wait Act H.R.2781 Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness (EMPOWER) for Health Act of 2019 S.2521/H.R.4397 Direct CARE Opportunity Act S.2677 Older Americans and Social Isolation and Loneliness Act H.R.4859 Protecting Older Americans from Social Isolation Act of 2019 H.Res.821 to establish a permanent select Committee in Aging in the House of Representatives H.R.6379 Families First Coronavirus Response Act S.3548/H.R.748 Coronavirus Aid, Relief, and Economic Security (CARES) Act; including provisions that would impact individuals living with Alzheimer's and other dementia and their caregivers. H.R.4334 Supporting Older Americans Act of 2020 S.3544/H.R.6305 Coronavirus Relief for Seniors and People with Disabilities Act S.3768 /H.R.6972 Nursing Home COVID-19 Protection and Prevention Act of 2020 H.R.7048 Nursing Home Pandemic Protection Act S.3644/H.R.6698 Quality Care for Nursing Home Residents and Workers During COVID-19 Act H.R.6638 Reducing COVID-19 Disparities by Investing in Public Health H.R.7158 Health Enterprise Zones Act H.R.6800 Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act S.3517/H.R.6487 ACCESS Act S.3740/H.R.6951 COVID-19 Recovery for Seniors and People with Disabilities Act H.R.8169 Elder Abuse Protection Act S.4182 Emergency Support for Nursing Homes and Elder Justice Reform Act of 2020 H.R.5958 Senior Health Planning Account Act S.4184/H.R.7463 Assisted Living Facility Coronavirus Reporting Act S.4682/H.R.8511 Care Corp Demonstration Act of 2020 H.R. 2477 Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act In forthcoming COVID-19 relief packages, the Alzheimer's Association is advocating for inclusion of policies that would impact those in the Alzheimer's and dementia community including: - Improving HOPE for Alzheimer's Act (S.880/H.R.1873) - Extension of the Independence at Home demonstration model - Promoting Alzheimer's Awareness to Prevent Elder Abuse Act, including Elder Justice Initiative training for professionals through the Department of Justice - Emergency Preparedness in long-term and community-based care settings - Expanding Capacity for Health Outcomes (Project ECHO) - Project VITAL: Virtual Inclusive Technology for ALL

Client expense: $360,000 · Firm income: Not reported

Government targets: Administration on Aging, Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Indian Health Service, Interior, Dept of (DOI), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Natl Institutes of Health (NIH), SENATE, Social Security Administration (SSA), Veterans Affairs, Dept of (VA)

S.1443/H.R.2730 Credit for Caring Act S.110/H.R.2073 Medical Expense Savings Act H.R.2878 Homecare for Seniors Act H.R.6379 Families First Coronavirus Response Act S.3548/H.R.748 Coronavirus Aid, Relief, and Economic Security (CARES) Act; including provisions related to all nonprofits S.3544/H.R.6305 Coronavirus Relief for Seniors and People with Disabilities Act H.R.6408 Save the Organizations that Serve (SOS) America Act H.R.6800 Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act H.R.5958 Senior Health Planning Account Act H.R.3644 Independence at Home Demonstration Act of 2019 Issues related to strengthening charitable giving incentives including the universal charitable deduction (S. 4032/H.R. 7324) and Legacy IRA Act (S.1327/H.R. 3832) In forthcoming COVID-19 relief packages the Alzheimer's Association has advocated for policies which will impact charitable nonprofits including: - Expanded Nonprofit Access to Credit: To establish an exclusive fund to support nonprofit employers with between 500 and 10,000 employees, including loan forgiveness. - Expand Charitable Giving Incentives - Allow larger charitable nonprofits to be eligible to receive funds under the Paycheck Protection Program - Clarify that charitable nonprofits of all sizes are able to participate in the emergency Small Business Loan Program by using the tax-law definition of charitable organizations (Sec. 501(c)(3) public charities) and removing the language that excludes nonprofits that are eligible to receive Medicaid reimbursements.

Client expense: $360,000 · Firm income: Not reported

H.R. 925, The Heroes Act, including provisions related to House Amendment to the Senate Amendments updated Heroes Act; specifically provisions related to provisions related to access to healthcare including FMAP, testing, protections for public health workers, and benefits to children and families impacted by the coronavirus, Federal Medical Assistance Percentages (FMAP) H.R. 2062, Overdose Prevention and Patient Safety Act, including provisions relating to 42 CFR Part 2 issues H.R. 3644/S. 1202, Independence at Home Act of 2019, including provisions relating to improve and provide for a permanent Independence at Home medical practice program under the Medicare program H.R. 4996, Helping Medicaid Offer Maternity Services (MOMS) Act H.R. 7659, Ensuring Parity in MA for Audio-Only Telehealth Act of 2020, including provisions relating to (MA audio-only visits are currently not included in risk adjustment calculations H.R. 6800, Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act including provisions relating to Medicaid, Medicare issues H.R. 8337, Continuing Appropriations Act, 2021 and Other Extensions Act, including provisions included in the section titled, Money Follows the Person, Medicaid Spousal Impoverishment Protections S. 2012, Protecting Jessica Grubb's Legacy Act, including provisions relating to 42 CFR Part 2 issues S. 3013, Encouraging Innovative Benefit Design to Lower Costs for Seniors Act, including provisions relating to prescription drug plans under Medicare Part D (allows for additional drug plan offerings) Potential legislation titled Health, Education Assistance, Liability Protections, Schools Act (HEALS Act) including provisions relating to Medicaid Medicare issues Issues relating to, Medicaid Fiscal Accountability Regulation; Medicare Part D Issues; Medicare Advantage

Client expense: $1,100,000 · Firm income: Not reported

P.L. 111-375 National Alzheimer's Project Act, All Sections P.L. 115-119 Recognize, Assist, Include, Support and Engage (RAISE) Family Caregivers Act P.L. 115-406 Building Our Largest Dementia (BOLD) Infrastructure for Alzheimer's Act S.591 Guardianship Accountability Act S.299 Geriatrics Workforce Improvement Act S.548/H.R.1342 EMPOWER Care Act H.R.1343 Protecting Married Seniors from Impoverishment Act S.740 Alzheimer's Caregiver Support Act H.R. 1955 Understanding Appropriate Alzheimer's Care Act of 2019 S.880/H.R.1873 Improving HOPE for Alzheimer's Act H.R.1903/S.901 Younger-Onset Alzheimer's Disease Act of 2019 S.2080/H.R.647 Palliative Care and Hospice Education and Training Act S.1250/H.R.2401 American Cures Act S.1017 Supporting America's Caregivers and Families Act S.995/H.R.2035 Lifespan Respite Care Reauthorization Act of 2019 S.1126/H.R.2283 Concentrating on High-Value Alzheimer's Needs to Get to an End (CHANGE) Act of 2019 S.1361/H.R.2584 Preventive Health Savings Act of 2019 S.1628 Paid Family Leave Pilot Extension Act S.1618 Expanding Capacity for Health Outcomes (ECHO) Act of 2019 S.1202 Independence at Home Act of 2019 H.R.3644 Independence at Home Demonstration Act of 2019 H.R.3436 Improving Chronic Care Management Act H.R.3107 Improving Seniors' Timely Access to Care Act H.R.4334 Dignity in Aging Act of 2019 S.2469/H.R.4386 Stop the Wait Act H.R.2781 Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness (EMPOWER) for Health Act of 2019 S.2521/H.R.4397 Direct CARE Opportunity Act S.3057 Modernization of the Older Americans Act Amendments S.2677 Older Americans and Social Isolation and Loneliness Act H.R.4859 Protecting Older Americans from Social Isolation Act of 2019 H.Res.821 to establish a permanent select Committee in Aging in the House of Representatives H.R.6379 Families First Coronavirus Response Act S.3548/H.R.748 Coronavirus Aid, Relief, and Economic Security (CARES) Act; including provisions that would impact individuals living with Alzheimer's and other dementia and their caregivers. H.R.4334 Supporting Older Americans Act of 2020 S.3544/H.R.6305 Coronavirus Relief for Seniors and People with Disabilities Act S.3768 /H.R.6972 Nursing Home COVID-19 Protection and Prevention Act of 2020 H.R.7048 Nursing Home Pandemic Protection Act S.3644/H.R.6698 Quality Care for Nursing Home Residents and Workers During COVID-19 Act H.R.6638 Reducing COVID-19 Disparities by Investing in Public Health H.R.7158 Health Enterprise Zones Act H.R.6800 Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act S.3517/H.R.6487 ACCESS Act S.3740/H.R.6951 COVID-19 Recovery for Seniors and People with Disabilities Act In forthcoming COVID-19 relief packages, the Alzheimer's Association is advocating for inclusion of policies that would impact those in the Alzheimer's and dementia community including: - Improving HOPE for Alzheimer's Act (S.880/H.R.1873) - Extension of the Independence at Home demonstration model - Promoting Alzheimer's Awareness to Prevent Elder Abuse Act, including Elder Justice Initiative training for professionals through the Department of Justice - Emergency Preparedness in long-term and community-based care settings - Expanding Capacity for Health Outcomes (Project ECHO) - Project VITAL: Virtual Inclusive Technology for ALL

H.R. 3107, Improving Seniors Timely Access to Care Act of 2019 - provisions related to prior authorization for Medicare Advantage Plans; S. 3013, Encouraging Innovative Benefit Design to Lower Costs for Seniors Act - provisions related to prescription drug plans under Medicare Part D; S. 2543, Prescription Drug Pricing Reduction Act (PDRPA) of 2019 - provisions addressing prescription drug pricing; S. 1202, Independence at Home Act of 2019 - provisions to improve and provide for a permanent Independence at Home medical practice program under the Medicare program; H.R. 3644, Independence at Home Act of 2019 - provisions to improve and extend the Independence at Home medical practice demonstration program under the Medicare program; H.R. 748, Coronavirus Aid, Relief, and Economic Security (CARES) Act - healthcare provisions related to access and support for providers and states and access to PPE; S. 3559, Immediate Relief for Rural Facilities and Providers Act - provisions related to emergency financial assistance to rural health care facilities and providers impacted by the COVID-19 emergency; H.R. 6201, Families First Coronavirus Response Act (stimulus 2) - provisions related to access to healthcare including FMAP, testing, protections for public health workers, and benefits to children and families impacted by the coronavirus; S. 1790 - National Defense Authorization Act for Fiscal Year 2020 - provisions related to telehealth; Issues related to point of sale rebate Issues related to allowing for audio only effective date alignment between Health Defense Agency and CMS Issues related to COVID-19 package 4

Client expense: $510,000 · Firm income: Not reported

P.L. 111-375 National Alzheimer's Project Act, All Sections P.L. 115-119 Recognize, Assist, Include, Support and Engage (RAISE) Family Caregivers Act P.L. 115-406 Building Our Largest Dementia (BOLD) Infrastructure for Alzheimer's Act S.591 Guardianship Accountability Act S.299 Geriatrics Workforce Improvement Act S.548/H.R.1342 EMPOWER Care Act H.R.1343 Protecting Married Seniors from Impoverishment Act S.740 Alzheimer's Caregiver Support Act H.R. 1955 Understanding Appropriate Alzheimer's Care Act of 2019 S.880/H.R.1873 Improving HOPE for Alzheimer's Act H.R.1903/S.901 Younger-Onset Alzheimer's Disease Act of 2019 S.2080/H.R.647 Palliative Care and Hospice Education and Training Act S.1250/H.R.2401 American Cures Act S.1017 Supporting America's Caregivers and Families Act S.995/H.R.2035 Lifespan Respite Care Reauthorization Act of 2019 S.1126/H.R.2283 Concentrating on High-Value Alzheimer's Needs to Get to an End (CHANGE) Act of 2019 S.1361/H.R.2584 Preventive Health Savings Act of 2019 S.1628 Paid Family Leave Pilot Extension Act S.1618 Expanding Capacity for Health Outcomes (ECHO) Act of 2019 S.1202 Independence at Home Act of 2019 H.R.3644 Independence at Home Demonstration Act of 2019 H.R.3436 Improving Chronic Care Management Act H.R.3107 Improving Seniors' Timely Access to Care Act H.R.4334 Dignity in Aging Act of 2019 S.2469/H.R.4386 Stop the Wait Act H.R.2781 Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness (EMPOWER) for Health Act of 2019 S.2521/H.R.4397 Direct CARE Opportunity Act S.3057 Modernization of the Older Americans Act Amendments S.2677 Older Americans and Social Isolation and Loneliness Act H.R.4859 Protecting Older Americans from Social Isolation Act of 2019 H.Res.821 to establish a permanent select Committee in Aging in the House of Representatives H.R.6379 Families First Coronavirus Response Act S.3548/H.R.748 Coronavirus Aid, Relief, and Economic Security (CARES) Act; including provisions that would impact individuals living with Alzheimer's and other dementia and their caregivers. H.R.4334 Supporting Older Americans Act of 2020 S.3544/H.R.6305 Coronavirus Relief for Seniors and People with Disabilities Act In forthcoming COVID-19 relief packages, the Alzheimer's Association is advocating for inclusion of policies that would impact those in the Alzheimer's and dementia community including: - Improving HOPE for Alzheimer's Act (S.880/H.R.1873) - Extension of the Independence at Home demonstration model - Promoting Alzheimer's Awareness to Prevent Elder Abuse Act, including Elder Justice Initiative training for professionals through the Department of Justice - Emergency Preparedness in long-term and community-based care settings - Expanding Capacity for Health Outcomes (Project ECHO) - Project VITAL: Virtual Inclusive Technology for ALL

H.R. 3107, Improving Seniors Timely Access to Care Act of 2019 - provisions related to prior authorization for Medicare Advantage Plans; S. 3013, Encouraging Innovative Benefit Design to Lower Costs for Seniors Act - provisions related to prescription drug plans under Medicare Part D S. 2543, Prescription Drug Pricing Reduction Act (PDRPA) of 2019 - provisions addressing prescription drug pricing; H.R. 4004/S. 2986, Social Determinants Accelerator Act of 2019 - provisions addressing social determinants of health; S. 1202, Independence at Home Act of 2019 - provisions to improve and provide for a permanent Independence at Home medical practice program under the Medicare program H.R. 3644, Independence at Home Act of 2019 - provisions to improve and extend the Independence at Home medical practice demonstration program under the Medicare program H.R. 748, Coronavirus Aid, Relief, and Economic Security (CARES) Act - healthcare provisions related to access and support for providers and states and access to PPE S. 3559, Immediate Relief for Rural Facilities and Providers Act - provisions related to emergency financial assistance to rural health care facilities and providers impacted by the COVID-19 emergency H.R. 6201, Families First Coronavirus Response Act (stimulus 2) - provisions related to access to healthcare including FMAP, testing, protections for public health workers, and benefits to children and families impacted by the coronavirus

Client expense: $690,000 · Firm income: Not reported

P.L. 111-375 National Alzheimer's Project Act, All Sections P.L. 115-119 Recognize, Assist, Include, Support and Engage (RAISE) Family Caregivers Act P.L. 115-406 Building Our Largest Dementia (BOLD) Infrastructure for Alzheimer's Act S.591 Guardianship Accountability Act S.299 Geriatrics Workforce Improvement Act S.548/H.R.1342 EMPOWER Care Act H.R.1343 Protecting Married Seniors from Impoverishment Act S.740 Alzheimer's Caregiver Support Act H.R. 1955 Understanding Appropriate Alzheimer's Care Act of 2019 S.880/H.R.1873 Improving HOPE for Alzheimer's Act H.R.1903/S.901 Younger-Onset Alzheimer's Disease Act of 2019 S.2080/H.R.647 Palliative Care and Hospice Education and Training Act S.1250/H.R.2401 American Cures Act S.1017 Supporting America's Caregivers and Families Act S.995/H.R.2035 Lifespan Respite Care Reauthorization Act of 2019 S.1126/H.R.2283 Concentrating on High-Value Alzheimer's Needs to Get to an End (CHANGE) Act of 2019 S.1361/H.R.2584 Preventive Health Savings Act of 2019 S.1628 Paid Family Leave Pilot Extension Act S.1618 Expanding Capacity for Health Outcomes (ECHO) Act of 2019 S.1202 Independence at Home Act of 2019 H.R.3644 Independence at Home Demonstration Act of 2019 H.R.3436 Improving Chronic Care Management Act H.R.3107 Improving Seniors' Timely Access to Care Act H.R.4334 Dignity in Aging Act of 2019 S.2469/H.R.4386 Stop the Wait Act H.R.2781 Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness (EMPOWER) for Health Act of 2019 S.2521/H.R.4397 Direct CARE Opportunity Act S.3057 Modernization of the Older Americans Act Amendments S.2677 Older Americans and Social Isolation and Loneliness Act H.R.4859 Protecting Older Americans from Social Isolation Act of 2019

Client expense: $400,000 · Firm income: Not reported

S. 62, Empowering Medicare Seniors to Negotiate Drug Prices Act (Klobuchar) - Part D price negotiations S. 99, Medicare Drug Price Negotiation Act (Sanders) - Part D price negotiations, formulary changes S. 205, Right Rebate Act (Wyden) - Medicaid drug rebate program S. 317, ACE Kids Act (Grassley) - health homes for children with medically complex conditions S. 377, Medicare Negotiation and Competitive Licensing Act (Brown) - Part D price negotiation S. 470, Medicare at 50 Act (Stabenow) - Medicare buy-in option S. 475, RxCAP Act (Wyden) - Part D cost-sharing S. 489, State Public Option Act (Schatz) - Medicaid buy-in option S. 516, Prescription Drug Monitoring Act (Klobuchar) - required use of PDMPs S. 548, EMPOWER Care Act (Portman) - MFP demonstration S. 640, Phair Pricing Act (Kennedy) -- Part D rebates at the point of sale S. 691, Medicare Extra Rx HELP Act (Casey) - Part D assistance for low-income seniors S. 709, Prescription Drug Pricing Dashboard Act (Casey) - interactive dashboard with drug price and utilization data for federal programs S. 773, Telehealth Innovation and Improvement Act (Gardner) - testing expanded coverage of telehealth services in Medicare S. 988, Improving Transparency and Accuracy in Medicare Part D Spending Act (Capito) - payments on clean claims S. 1114, Medicare Advantage Quality Payment Relief Act (Daines-King) - MA benchmark cap S. 2081, Stop Drug Companies from Overcharging Seniors in Medicare Part B Act of 2019 (Peters)- drugs in Part B S. 2252, Empowering States to Address Drug Costs Act (Van Hollen)- drug pricing S. 2446, Medicare Audiologist Access and Services Act of 2019 (Warren)-Medicare coverage of audiologist services S. 2650 - Medicare Prescription Drug Savings and Choice Act of 2019 (Durbin) - lowering prescription drug costs S. 2807, Hospice Care Improvement Act of 2019 (Portman) - Medicare hospice programs S. 2846, Protecting Patients Transportation to Care Act (Isakson) - Medicaid coverage of transportation S. 2911, Seniors Prescription Drug Relief Act of 2019 (Cassidy) - Part D smoothing S. 3000, Patient Shared Savings Act (Cassidy) - prescription drug plans S. 3001, Permanent Relief for Seniors and Medicare, Medicaid, Human Services Extension Act of 2019 (Toomey) - extensions S. 3029, Territories Medicare Prescription Drug Assistance Equity Act of 2019 (Menendez) - Territories, low-income Medicare part D beneficiaries S. 3078, Audit & Appeals Fairness, Integrity, and Reforms in Medicare Act of 2019 (Grassley) - Medicare appeals process S. 3129, Lower Costs, More Cures Act of 2019 (Crapo) - drug pricing H.R. 19, Lower Costs, More Cures Act of 2019 (Walden) - drug pricing H.R. 259, Medicaid Extenders Act (Pallone) - MFP demonstration, spousal impoverishment protections H.R. 448, Medicare Drug Price Negotiation Act (Cummings) - Part D price negotiations, formulary changes H.R. 789, Improving Transparency and Accuracy in Medicare Part D Spending Act (Welch) - payments on clean claims H.R. 937, Right Rebate Act (Schrader) - Medicaid drug rebate program H.R. 1034, Phair Pricing Act (Collins) - Part D rebates at the point of sale H.R. 1035, Prescription Drug Price Transparency Act (Collins) - Medicare PBM standards H.R. 1046, Medicare Negotiation and Competitive Licensing Act (Doggett) - Part D price negotiation H.R. 1226, ACE Kids Act (Castor) - health homes for children with medically complex conditions H.R. 1277, State Public Option Act (Lujan) - Medicaid buy-in option H.R. 1301, Mental Health Telemedicine Expansion Act (DelBene) - Medicare coverage of mental health telehealth services H.R. 1342, EMPOWER Care Act (Dingell) - MFP demonstration H.R. 1343, Protecting Married Seniors from Impoverishment Act (Dingell) - spousal impoverishment protections H.R. 1346, Medicare Buy-In and Health Care Stabilization Act (Higgins) - Medicare buy-in option H.R. 1375, PAID Act (Kind) - transparency of Medicare secondary payer information H.R. 1394, Medigap Consumer Protection Act (Doggett) - Medicare supplemental consumer protections H.R. 1551, Quality Care for Moms and Babies Act (Engel) - quality measures in Medicaid and CHIP H.R. 1781, Payment Commission Data Act (Carter) - MedPAC and MACPAC access to drug pricing and rebate data in Medicare and Medicaid H.R. 1839, Medicaid Services Investment and Accountability Act (Ruiz) - MFP demonstration, spousal impoverishment protections, ACE Kids Act, Medicaid drug rebate program, health homes for children with medically complex conditions H.R. 2131, Medicare Advantage Quality Payment Relief Act (Kind-Kelly) - MA benchmark cap H.R. 2757, Creating Lower Cost Alternatives for Your Prescription Drugs Act (Cunningham) - eliminate copay for generic drugs in Medicare Part D H.R. 3107, Improving Seniors' Timely Access to Care Act (DelBene) - Medicare Advantage prior authorization H.R. 3253, Empowering Beneficiaries, Ensuring Access, and Strengthening Accountability Act (Dingell) - MFP demonstration, spousal impoverishment protections, Medicaid drug rebate program H.R. 3417, Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act (Neal) - funding for quality measurement initiatives, Medicare coverage of mental health telehealth services, real-time benefit tools in Medicare Part D, Medicare eligibility and enrollment notices H.R. 3461, Community-Based Independence for Seniors Act (Sanchez-Kelly) - Community-Based Institutional Special Needs Plan H.R. 3613, State Accountability, Flexibility, and Equity for Hospitals Act of 2019 (Bilirakis) -Medicaid DSH payments H.R. 3631, Territories Health Care Improvement Act (Soto) -Medicaid funding H.R. 3644, Independence at Home Demonstration Act of 2019 (Burgess)-Medicare demonstration program H.R. 3925, Reducing Barriers to Substance Use Treatment Act (Tonko)- Opioids H.R. 3935, Protecting Patients Transportation to Care Act (Carter)-Medicaid coverage for transportation H.R. 4378, Continuing Appropriations Act, 2020, and Health Extenders Act of 2019 (Lowey)-Health extenders H.R. 4453, Protecting Seniors from Health Care Fraud Act of 2019 (Ruiz)-Distributing information to Medicare beneficiaries to prevent fraud H.R. 4527, Expanding Health Care Options for Early Retirees Act (Malinowski)-Option for first responders to buy-in to Medicare H.R. 4529, Promoting Access to Broadband Act of 2019 (Maloney)-Medicaid H.R. 4583, Medicare Extra Rx Higher Eligibility Limits in Part D Act of 2019 (Schneider) - prescription drug affordability H.R. 4597, Acting to Cancel Copays and Ensure Substantial Savings for Biosimilars Act of 2019 (Peters) - biosimilars, Part B H.R. 4618, Medicare Hearing Act of 2019 (McBath) - coverage for certain hearing items and services under part B H.R. 4619, Pharmaceutical Rebates for Excessive Pricing Above Inflation Act (Schakowsky) - drug rebates, Part D H.R. 4620, More Help for Seniors Act of 2019 (Rose) - expand eligibility for low-income subsidies under Part D of the Medicare program H.R. 4621, Collecting and Analyzing Resources Integral and Necessary for Guidance for Social Determinants Act of 2019 (Blunt Rochester) - best practices re social determinants of health H.R. 4628, Better Tools to Lower Costs Act of 2019 (Scanlon) - resource requirements H.R. 4629, Star Rating for Biosimilars Act (Tonko) - biosimilars H.R. 4632, Better Transparency in Information for Medicare Beneficiaries Act of 2019 (Kind) - provides consumers information regarding premiums under LIS benchmark plans H.R. 4649, Capping Drug Costs for Seniors Act of 2019 (Horsford) - cap on beneficiary liability under part D of the Medicare program H.R. 4650, Medicare Dental Act of 2019 (Kelly) - Medicare dental coverage H.R. 4655, Enhancing Retirement Security for Medicare Beneficiaries Act of 2019 (Lee) - eligibility of individuals for premium and cost-sharing subsidies under part D H.R. 4661, Advancing Enrollment and Reducing Drug Costs Act of 2019 (Pappas) - Medicaid in territories H.R. 4663, Freedom from Price Gouging Act (Porter) - drug rebates, Part B H.R. 4665, Medicare Vision Act of 2019 (Schrier) - vision items and services under part B H.R. 4666, To amend title XVIII of the Social Security Act to provide certain low-income territorial residents with automatic eligibility for premium and cost-sharing subsidies under the Medicare program, and for other purposes (Shalala) - Medicare in territories H.R. 4669, Maximizing Drug Coverage for Low-Income Seniors Act of 2019 (Stevens) - auto enrollment and intelligent assignment H.R. 4671, Helping Seniors Afford Health Care Act (Kim) - Medicare affordability and low income beneficiaries H.R. 4676, Protecting Medicare Beneficiaries with Pre-Existing Conditions Act (Schneider) - Medigap H.R. 4699, To amend title XIX of the Social Security Act to remove the matching requirement for a territory to use specially allocated Federal funds for Medicare covered part D drugs for low-income individuals (Gonzales-Colon) - Part D, territories H.R. 4769, Medicare Prescription Drug Savings and Choice Act of 2019 (Schakowsky) - lowering prescription drug costs H.R. 4946, Ensuring Seniors Access to Local Pharmacies Act of 2019 (Welch) - equal access of Medicare beneficiaries to community pharmacies in underserved areas H.R. 4996, Helping Medicaid Offer Maternity Services Act of 2019 (Kelly) - State extension of Medicaid H.R. 5006, Expanding Access to Inpatient Mental Health Act (Emmer) - Medicaid coverage for SUD/mental health for institutionalized H.R. 5039, Life Sustaining Prescription Drug Price Relief Act of 2019 (Lipinski) - part D H.R. 5057, Pass- Through Technical Corrections Act (Tonko) - drug pass-through status under Medicare outpatient payment H.R. 5201, Telemental Health Expansion Act of 2019 (Matsui) - Medicare coverage of mental telehealth H.R. 5232, Road to Recovery Act (Fitzpatrick) - Medicaid and CHIP SUD treatment H.R. 5281, Drug Price Transparency in Medicaid Act of 2019 (Carter) - transparency and spread pricing affordability Discussion Draft, Medicare Part D Reform (Neal-Pallone-Brady-Walden) - maximum out-of-pocket limit, federal reinsurance payments 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 risk adjustment data validation (RADV) audit issues including proposed RADV regulation for MA; 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 2021 policy and technical regulation for MA and Part D; MA and Part D proposed rule on drug pricing changes for 2020; Part D reform, out of pocket limits; issues related to Medicare for All, Medicare buy-in and public option; CMSs price transparency proposal for direct-to-consumer advertisements; issues relating to 2021 Rate Notice and Call Letter; issues related to MLTSS; issues related to proposed changes to removal of safe harbor protection for rebates (proposed rule); in-home health risk assessments; Medicare Medical Loss Ratio issues; implementation of sequestration under the Medicare Advantage and Part D programs; implications of the health insurer fee for MA and Part D plans; application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, enrollment rules, requirements for notice and denial forms, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible SNPs; Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, Part D coverage gap discount program, including employer group waiver plan (EGWP) issues, and other operational issues; issues raised by Part D coverage of new specialty drugs, the Part D non-interference policy and related issues (e.g., preferred pharmacy and any willing pharmacy requirements, standards for network pharmacy reimbursement, and policies regarding sponsor negotiation of pharmacy price concessions); issues related to the international price index; issues related to child and maternal health; issues related to Medicaid supplemental and disproportionate share hospital (DSH) funding; issues related to Medicaid funding for territories; issues related to medical management; issues relating to MA supplemental benefits; 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; issues related to health homes for children with medically complex conditions; socioeconomic status impacts on star ratings related to MA and Part D programs; and other issues relating to health care reform implementation.

P.L. 111-375 National Alzheimer's Project Act, All Sections P.L. 115-119 Recognize, Assist, Include, Support and Engage (RAISE) Family Caregivers Act P.L. 115-406 Building Our Largest Dementia (BOLD) Infrastructure for Alzheimer's Act S.591 Guardianship Accountability Act S.299 Geriatrics Workforce Improvement Act S.548/H.R.1342 EMPOWER Care Act H.R.1343 Protecting Married Seniors from Impoverishment Act S.740 Alzheimer's Caregiver Support Act H.R. 1955 Study on Use of Anti-Psychotics in Non-nursing Homes S.880/H.R.1873 Improving HOPE for Alzheimer's Act H.R.1903/S.901 Younger-Onset Alzheimer's Disease Act of 2019 S.2080/H.R.647 Palliative Care and Hospice Education and Training Act S.1250/H.R.2401 American Cures Act S.1017 Supporting America's Caregivers and Families Act S.995/H.R.2035 Lifespan Respite Care Reauthorization Act of 2019 S.1126/H.R.2283 Concentrating on High-Value Alzheimer's Needs to Get to an End (CHANGE) Act of 2019 S.1361/H.R.2584 Preventive Health Savings Act of 2019 S.1628 Paid Family Leave Pilot Extension Act H.R.2878 Homecare for Seniors Act S.1618 Expanding Capacity for Health Outcomes (ECHO) Act of 2019 S.1202 Independence at Home Act of 2019 H.R.3644 Independence at Home Demonstration Act of 2019 H.R.3436 Improving Chronic Care Management Act H.R.3107 Improving Seniors' Timely Access to Care Act H.R.4334 Dignity in Aging Act of 2019 S.2469/H.R.4386 Stop the Wait Act

Client expense: $500,000 · Firm income: Not reported

S. 62, Empowering Medicare Seniors to Negotiate Drug Prices Act (Klobuchar) - Part D price negotiations S. 99, Medicare Drug Price Negotiation Act (Sanders) - Part D price negotiations, formulary changes S. 205, Right Rebate Act (Wyden) - Medicaid drug rebate program S. 317, ACE Kids Act (Grassley) - health homes for children with medically complex conditions S. 377, Medicare Negotiation and Competitive Licensing Act (Brown) - Part D price negotiation S. 470, Medicare at 50 Act (Stabenow) - Medicare buy-in option S. 475, RxCAP Act (Wyden) - Part D cost-sharing S. 489, State Public Option Act (Schatz) - Medicaid buy-in option S. 516, Prescription Drug Monitoring Act (Klobuchar) - required use of PDMPs S. 548, EMPOWER Care Act (Portman) - MFP demonstration S. 640, Phair Pricing Act (Kennedy) -- Part D rebates at the point of sale S. 691, Medicare Extra Rx HELP Act (Casey) - Part D assistance for low-income seniors S. 709, Prescription Drug Pricing Dashboard Act (Casey) - interactive dashboard with drug price and utilization data for federal programs S. 773, Telehealth Innovation and Improvement Act (Gardner) - testing expanded coverage of telehealth services in Medicare S. 988, Improving Transparency and Accuracy in Medicare Part D Spending Act (Capito) - payments on clean claims S. 1114, Medicare Advantage Quality Payment Relief Act (Daines-King) - MA benchmark cap S. 2081, Stop Drug Companies from Overcharging Seniors in Medicare Part B Act of 2019 (Peters)- drugs in Part B S. 2252, Empowering States to Address Drug Costs Act (Van Hollen)- drug pricing S. 2446, Medicare Audiologist Access and Services Act of 2019 (Warren)-Medicare coverage of audiologist services H.R. 259, Medicaid Extenders Act (Pallone) - MFP demonstration, spousal impoverishment protections H.R. 448, Medicare Drug Price Negotiation Act (Cummings) - Part D price negotiations, formulary changes H.R. 789, Improving Transparency and Accuracy in Medicare Part D Spending Act (Welch) - payments on clean claims H.R. 937, Right Rebate Act (Schrader) - Medicaid drug rebate program H.R. 1034, Phair Pricing Act (Collins) - Part D rebates at the point of sale H.R. 1035, Prescription Drug Price Transparency Act (Collins) - Medicare PBM standards H.R. 1046, Medicare Negotiation and Competitive Licensing Act (Doggett) - Part D price negotiation H.R. 1226, ACE Kids Act (Castor) - health homes for children with medically complex conditions H.R. 1277, State Public Option Act (Lujan) - Medicaid buy-in option H.R. 1301, Mental Health Telemedicine Expansion Act (DelBene) - Medicare coverage of mental health telehealth services H.R. 1342, EMPOWER Care Act (Dingell) - MFP demonstration H.R. 1343, Protecting Married Seniors from Impoverishment Act (Dingell) - spousal impoverishment protections H.R. 1346, Medicare Buy-In and Health Care Stabilization Act (Higgins) - Medicare buy-in option H.R. 1375, PAID Act (Kind) - transparency of Medicare secondary payer information H.R. 1394, Medigap Consumer Protection Act (Doggett) - Medicare supplemental consumer protections H.R. 1551, Quality Care for Moms and Babies Act (Engel) - quality measures in Medicaid and CHIP H.R. 1781, Payment Commission Data Act (Carter) - MedPAC and MACPAC access to drug pricing and rebate data in Medicare and Medicaid H.R. 1839, Medicaid Services Investment and Accountability Act (Ruiz) - MFP demonstration, spousal impoverishment protections, ACE Kids Act, Medicaid drug rebate program, health homes for children with medically complex conditions H.R. 2131, Medicare Advantage Quality Payment Relief Act (Kind-Kelly) - MA benchmark cap H.R. 2757, Creating Lower Cost Alternatives for Your Prescription Drugs Act (Cunningham) - eliminate copay for generic drugs in Medicare Part D H.R. 3107, Improving Seniors' Timely Access to Care Act (DelBene) - Medicare Advantage prior authorization H.R. 3253, Empowering Beneficiaries, Ensuring Access, and Strengthening Accountability Act (Dingell) - MFP demonstration, spousal impoverishment protections, Medicaid drug rebate program H.R. 3417, Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act (Neal) - funding for quality measurement initiatives, Medicare coverage of mental health telehealth services, real-time benefit tools in Medicare Part D, Medicare eligibility and enrollment notices H.R. 3461, Community-Based Independence for Seniors Act (Sanchez-Kelly) - Community-Based Institutional Special Needs Plan Discussion Draft, Medicare Part D Reform (Neal-Pallone-Brady-Walden) - maximum out-of-pocket limit, federal reinsurance payments H.R. 3613, State Accountability, Flexibility, and Equity for Hospitals Act of 2019 (Bilirakis) -Medicaid DSH payments H.R. 3631, Territories Health Care Improvement Act (Soto) -Medicaid funding H.R. 3644, Independence at Home Demonstration Act of 2019 (Burgess)-Medicare demonstration program H.R. 3925, Reducing Barriers to Substance Use Treatment Act (Tonko)- Opioids H.R. 3935, Protecting Patients Transportation to Care Act (Carter)-Medicaid coverage for transportation H.R. 4378, Continuing Appropriations Act, 2020, and Health Extenders Act of 2019 (Lowey)-Health extenders H.R. 4453, Protecting Seniors from Health Care Fraud Act of 2019 (Ruiz)-Distributing information to Medicare beneficiaries to prevent fraud H.R. 4527, Expanding Health Care Options for Early Retirees Act (Malinowski)-Option for first responders to buy-in to Medicare H.R. 4529, Promoting Access to Broadband Act of 2019 (Maloney)-Medicaid 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 risk adjustment data validation (RADV) 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; Part D reform, out of pocket limits; issues related to Medicare for All, Medicare buy-in and public option; CMSs price transparency proposal for direct-to-consumer advertisements; issues relating to 2020 Rate Notice and Call Letter; issues related to proposed changes to removal of safe harbor protection for rebates (proposed rule); in-home health risk assessments; Medicare Medical Loss Ratio issues; implementation of sequestration under the Medicare Advantage and Part D programs; implications of the health insurer fee for MA and Part D plans; application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, enrollment rules, requirements for notice and denial forms, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible SNPs; Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, Part D coverage gap discount program, including employer group waiver plan (EGWP) issues, and other operational issues; issues raised by Part D coverage of new specialty drugs, the Part D non-interference policy and related issues (e.g., preferred pharmacy and any willing pharmacy requirements, standards for network pharmacy reimbursement, and policies regarding sponsor negotiation of pharmacy price concessions); issues related to the international price index; issues related to child and maternal health; issues related to Medicaid supplemental and disproportionate share hospital (DSH) funding; issues related to Medicaid funding for territories; issues related to medical management; issues relating to MA supplemental benefits; 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; issues related to health homes for children with medically complex conditions; socioeconomic status impacts on star ratings related to MA and Part D programs; and other issues relating to health care reform implementation.

H.R. 3644, Independence at Home Act

Client expense: $32,255 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE