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Increasing Hospital Capacity to Fight the Coronavirus Act of 2020
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Increasing Hospital Capacity to Fight the Coronavirus Act of 2020 This bill allows unapproved capital expenses that are made by health care facilities during the public health emergency declared on January 31, 2020, relating to COVID-19 (i.e., coronavirus disease 2019) to be included in federal payment determinations under Medicare and Medicaid.
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Referred to the Subcommittee on Health.
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Introduced in House
Congress.gov source codes: 1000, Intro-H
Bills with similar content found using semantic analysis.
Sources: Congress.gov
2020 · fourth_quarter · Health Issues
H.R 856 - Physicians Pro Bono Care Act - charitable deduction for pro-bono health services H.R. 3796 - Health Savings for Seniors Act - This bill permits a Medicare beneficiary to participate in and contribute to health savings accounts. S. 1227 - Prescription Pricing for the People Act of 2019 - Thisbill requiresthe Federal Trade Commission (FTC) to report about anticompetitive practicesand other trendswithin the pharmaceuticalsupply chain that may impact the cost of prescriptionsdrugs. H.R. 5198 - Patients' Right to Know Their Medication Act of 2019 - Creates FDA approved standard method of sharing consumer information. S. 2441 - Health Savings Account Expansion Act of 2019 - Thisbill permitsindividualswho are not enrolled in a high deductible health plan to participate in healthsavingsaccounts. S. 2440 - Qualified Health Savings Account Distribution Act of 2019 - This bill amends the Internal Revenue Code, with respect to the requirements for tax-preferred health accounts, to modify the rules for using a conversion or termination of a flexible spending account or a health reimbursement arrangement to establish a health savings account. H.R. 603 - Health Savings Account Expansion Act of 2019 - This bill modifies the requirements for health savings accounts (HSAs) to: increase the maximum contribution amounts, permit the use of HSAs to pay health insurance premiums and for direct primary care service arrangements, repeal the restriction on using HSAs for over-the-counter medications, eliminate the requirement that a participant in an HSA be enrolled in a high deductible health care plan, and decrease the additional tax for HSA distributions not used for qualified medical expenses. H.R. 5596, S. 3112 - Personalized Care Act of 2020 - This bill revises provisions relating to health savings accounts (HSAs) H.R. 5566 - Patient Fairness Act of 2020 - This bill revises requirements for health savings accounts (HSAs) H.R. 5076 - Protecting Seniors Through Immunization Act of 2019 - Seeks to eliminate out-of-pocket expenses for everyone covered by Medicare and spares seniors the decision to delay or not seek vaccines due to their share of the cost. S. 3537 - Protecting Our Pharmaceutical Supply Chain from China Act of 2020 - Requires Health and Human Services to maintain a list of the country of origin of all drugs marketed in the United States. S. 3432 - Securing America's Medicine Cabinet Act of 2020 - This bipartisan legislation would reduce American reliance on foreign manufacturing of active pharmaceutical ingredients (APIs). H.R. 6286 - Health Savings Act of 2020 - This bill revises requirements for health savings accounts (HSAs) H.R. 6336 - Increasing Hospital Capacity to Fight the Coronavirus Act of 2020 - This bill allows unapproved capital expenses that are made by health care facilities during the public health emergency declared on January 31, 2020, relating to COVID-19 (i.e., coronavirus disease 2019) to be included in federal payment determinations under Medicare and Medicaid. H.R. 3502 - Protecting People From Surprise Medical Bills Act - This bill makes a series of changes relating to health care costs and billing practices. S. 2543 - Prescription Drug Pricing Reduction Act of 2019 - Seeks to lower drug costs by establishing rebate programs for brandname drugs and biologics used for Part B and Part D with prices that increase faster than the rate of inflation. H.R.6663 - Truth in Healthcare Marketing - Strives to reduce confusion over professional licensure, education level, training, degrees obtained, and clinical expertise and makes it unlawful for providers to misrepresent these credentials. H.R. 6813, S. 3703 - Promoting Alzheimer's Awareness to Prevent Elder Abuse Act - Works toward providing this protection by requiring the development of training materials for anyone who responds, investigates, or prosecutes cases of elder abuse involving seniors afflicted with dementias H.R. 7233, S. 4216 - Knowing the Efficiency and Efficacy of Permanent (KEEP) Telehealth Options Act - The expansion of telehealth would provide a convenient, cost-effective tool that complements traditional in-office medical visits. S. 4106 - Healthcare PRICE Transparency Act - Codifies two healthcare price transparency rules requiring hospitals and insurers to disclose their discounted cash rates and negotiated rates to consumers before they receive medical care. S. 3993 - Equal Access to Care Act - Expands access to telemedicine during the coronavirus emergency by allowing licensed health care providers to treat patients over the phone and online wherever the patient is located. H.R. 6930 - Manufacturing API, Drugs, and Excipients (MADE) in America Act - Addresses our drug supply chains dependence on foreign countries like China and works to mitigate drug shortages while incentivizing the domestic manufacturing of drugs, active pharmaceutical ingredients (API), personal protective equipment (PPE), and diagnostics. S. 4134 - Increasing Access to Biosimilars Act - TheIncreasing Access to Biosimilars Actwould direct the Department of Health and Human Services to create a shared savings demonstration program for biosimilar drugs in the Medicare program, which will help increase competition and expand access to biosimilars. H.R. 7008 - Family Savings Flexibility Act - This bill (1) increases to $2,750 the maximum amount of unused benefits or contributions remaining in a health flexible or dependent care spending arrangement that may be carried over from the 2020 to the 2021 plan year, (2) increases the maximum contribution amount for health savings accounts, and (3) increases the exclusion from employee gross income of employer-paid dependent care assistance. S. 3872 - Promising Pathway Act - Requires the US Food and Drug Administration to establish a rolling, real-time, priority review pathway to evaluate provisional approval applications for drugs intended to treat, prevent, or diagnose serious or life-threatening diseases or conditions, including those that pose a threat of epidemic or pandemic. S. 4185 - End Surprise Medical Bills for Air Ambulances Act of 2020 - A bill to establish an independent dispute resolution process for surprise air ambulance bills, and for other purposes. S. 4198 - Affordable Coronavirus Testing Act - This bill requires health insurance plans to cover through 2021 without cost sharing COVID-19 (i.e., coronavirus disease 2019) serology testing, which looks for the presence of antibodies made in response to an infection. S. 4158 - PPE Supply Chain Transparency Act of 2020 - This bill requires the Federal Emergency Management Agency (FEMA) to issue, within 90 days, a public report on the security and resilience of the supply chain for personal protective equipment during the COVID-19 (i.e., coronavirus disease 2019) pandemic. S. 4151 & H.R. 4838 - The Sustaining Outpatient Services (SOS) Act - Prevents certain off-campus hospital outpatient services from receiving significant Medicare reimbursement cuts. S. 4367 and H.R. 8032 - Health Savings Accounts for All Act - Qualified medical expenses would include expenses incurred during the prior or current tax year before establishing the HSA and fees paid for personal patient care. H.R.5741 - Strengthening Innovation in Medicare and Medicaid Act - Recognizes the important work done by CMMI and incorporates protections into the processes including, limiting the scope of models to only the size needed to realize a statistically valid sample; encouraging feedback from beneficiaries in developing CMMI models; and limiting the testing of new payment and delivery models to five years to shield beneficiaries from being subjected to potentially harmful models. H.R. 5741 also provides for key Congressional oversight for CMMI demonstrations that will improve transparency and patient safety. S. 4866 - updating standards for oversight of nursing homes S. 4796 & H.R. 7617 - proposing free market reforms to healthcare S. 4367 and H.R. 8032 - Expansion of health savings accounts.
Client expense: Not reported · Firm income: $15,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2020 · fourth_quarter · Medicare/Medicaid
H.R. 3107 - Improving Seniors' Timely Access to Care Act of 2019 - DelBene - prior authorization in Medicare Advantage 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. 4453 - Protecting Seniors from Health Care Fraud Act of 2019 - Ruiz -Distributing information to Medicare beneficiaries to prevent fraud 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. 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. 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. 4671 - Helping Seniors Afford Health Care Act - Kim - Medicare affordability and low income beneficiaries H.R. 4996 - Helping Medicaid Offer Maternity Services Act of 2020 - Kelly - extend Medicaid coverage post-partum H.R. 5006 - Expanding Access to Inpatient Mental Health Act - Emmer - Medicaid coverage for SUD/mental health for institutionalized 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. 5693 - Primary Health Services Enhancement Act - Kind - Medicare rural health H.R. 5808 - Save Rural Communities Act of 2020 - Arrington - rural emergency medical access services under Medicare H.R. 5833 - To amend title XVIII of the Social Security Act to permit the use of certain psychological evaluation via telehealth for Medicare coverage of neurostimulation services for the treatment of chronic pain - Latta - Medicare coverage in telehealth H.R. 5882 - GENE Therapy Payment Act - Schrader - value based care H.R. 6098 - To amend title XXI of the Social Security Act to allow States to expand income eligibility standards under the Children's Health Insurance Program -Barragan - CHIP eligibility H.R. 6151 - CARING for Kids Act - Fineknauer - CHIP H.R. 6179 - Increasing Access to Biosimilars Act of 2020 - Cardenas - payments to providers of biosimilars under Medicare H.R. 6209 - Reducing Unnecessary Senior Hospitalizations Act of 2020 or the RUSH Act of 2020 -Kuster - Medicare coverage for certain services in hospital emergency departments H.R. 6244 - To amend titles XVIII and XIX to provide for coverage at no cost sharing of COVID-19 testing under the Medicaid program and Children's Health Insurance Program - Kelly - Medicaid coverage of COVID-19 related visits and testing H.R. 6263 - To amend title XVIII of the Social Security Act to waive cost sharing under the Medicare program for certain visits relating to testing for COVID-19 -Sarbanes - Medicare coverage of COVID-19 related visits and testing H.R. 6273 - Protecting Vulnerable Americans in Times of Crisis Act of 2020 - Butterfield - FMAP H.R. 6311 - Care for COVID-19 Act - Ruiz - COVID-19 cost sharing H.R. 6336 - Increasing Hospital Capacity to Fight the Coronavirus Act of 2020 - Bishop - Medicare and Medicaid payments during COVID-19 emergency H.R. 6462 - Emergency Medicaid for Coronavirus Treatment Act - Gallego - Medicaid coverage H.R. 6511 - Ensuring Vaccination and Treatment Affordability Act - Pappas - COVID H.R. 6521 - To prohibit the Secretary of Health and Human Services from taking certain actions with respect to Medicaid supplemental payments reporting requirements, and for other purposes - Diaz Barragan - Medicaid, delays implementation of MFAR H.R. 6538 - Modernized Medicine Act - Kennedy - Medicaid, Telehealth H.R. 6539 - Coronavirus Medicaid Response Act - Lee - FMAP H.R. 6572 - To direct the Secretary of Health and Human Services, acting through the Director of the Centers for Disease Control and Prevention, to carry out a national campaign to increase awareness and knowledge of COVID-19. -Bilirakis - COVID H.R. 6583 - To amend title XVIII of the Social Security Act to establish a risk corridor program for Medicare Advantage plans during the COVID-19 emergency, and for other purposes. - Houlahan - COVID H.R. 6616 - Stronger Medicaid Response to the COVID-19 Pandemic Act -Cardenas - COVID H.R. 6640 - Medicare Advantage COVID Treatment Act - Mucarsel-Powell - COVID H.R. 6658 - Insular Area Medicaid Coronavirus Recovery Act - Sablan - FMAP H.R. 6727 - To hold Medicare beneficiaries harmless for specified COVID-19 treatment services furnished under part A or part B of the Medicare program - Schrier - COVID H.R. 6744 - Computer and Internet Equity Act - Davis - internet access for Lifeline program H.R. 6753 - Save Rural Hospitals Act of 2020 - Finkenauer - Medicare hospital payments H.R. 6792 - Improving Telehealth for Underserved Communities Act of 2020 - Smith - telehealth H.R. 6797 - CHIPPER Act - Wild - CHIP, COVID H.R. 6837 - Medicare Accelerated and Advance Payments Improvement Act of 2020 -Schneider - COVID H.R. 7154 - Outpatient Therapy Modernization and Stabilization Act -Boyle - outpatient therapy services H.R. 7187 - HEALTH Act of 2020 -Thompson -Smith - telehealth H.R. 7292 - To amend title XVIII of the Social Security Act to provide for forgiveness of certain accelerated and advance payments under parts A and B of the Medicare program. - Kaptur - advance payments H.R. 7338 - To amend title XVIII of the Social Security Act to permit the Secretary of Health and Human Services to waive requirements relating to the furnishing of telehealth services under the Medicare program, and for other purposes. - Cheney - Telehealth H.R. 7391 - To amend title XVIII of the Social Security Act to remove certain geographic and originating site restrictions on the furnishing of telehealth services under the Medicare program - Sherrill- Telehealth H.R. 7606 - MFAR Transparency Act - Williams - report on impact of MFAR to Congress H.R. 7627 - MORE Savings Act - Dean - Medicare access to opioid treatment and MAT H.R. 7663 - Protecting Access to Post-COVID-19 Telehealth Act of 2020 - Thompson - waive or modify application of Medicare requirements with respect to telehealth during PHE H.R. 7791 - Value in Health Care Act of 2020 - Welch - Medicare shared savings program and alternative payment arrangements H.R. 7877 - Lowering Drug Costs for Seniors Act of 2020 - Katko - Medicare Part D costs H.R. 7892 - Medicaid Expansion During Crisis Act - Coleman - extend eligibility period for Medicaid enrollment application H.R. 8177 - Renal Anemia Innovation Support and Expansion Act - OHalleran - Medicare prescription drug coverage for chronic kidney disease H.R. 8218 - Rural Ambulance Reimbursement Fairness Act - Gianforte - Medicare payment for rural ambulance services H.R. 8254 - Bringing Enhanced Treatments and Therapies to ESRD Recipients Kidney Care Act - Blumenauer - integrated care for Medicare beneficiaries with ESRD H.R. 8427 - To provide for certain reports on enrollment in the Lifeline program, and for other purposes - Luria - Lifeline program H.R. 8476 - TIKES Act -Blunt Rochester - telehealth coverage in Medicaid H.R. 8505 - To amend title XVIII of the Social Security Act to provide for a one-year waiver of budget neutrality adjustments under the Medicare physician fee schedule - Burgess - Medicare physician fee schedule H.R. 8525 - Expanded Genetic Screening Act of 2020 - Speier - Medicaid coverage of non-invasive prenatal genetic screening H.R. 8529 - Protecting Access to Affordable Medicines Act of 2020 - Butterfield - rebates under the Medicaid program for certain noninnovator multiple source drugs H.R. 8546 - Fair Drug Prices for Kids Act -Wild - Medicaid drug rebate program in CHIP H.R. 8558 - Comprehensive Breast Reconstruction Act of 2020 - Hastings - extends coverage of certain breast reconstructive services following mastectomy under the Medicare and Medicaid programs H.R. 8561 - Restoring Fairness to Medicaid Reimbursement Act of 2020 - Johnson - FMAP H.R. 8574 - PROTECT Long Term Care Facilities Act -Sherrill - long term care in COVID-19 H.R. 8586 - Medicaid Coverage for Addiction Recovery Expansion Act -Foster - Substance Use Disorder H.R. 8623 - SAVE for Seniors Act - Spanberger - Medicare coverage of COVID-19 vaccines H.R. 8624 - Protecting Access to Innovation During COVID-19 Act - Wenstrup - extension of pass-through status under the Medicare program H.R. 8702 - Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020 -Bera - part B Medicare payments during COVID H.R. 8725 - HAPI Act - Soto - Medicaid Coverage of adult vaccines H.R. 8727 - Telehealth Modernization Act - Carter - Medicare telehealth payments H.R. 8755 - Expanded Telehealth Access Act -Sherrill - Medicare telehealth coverage H.R. 8756 - COVID Health Care Provider Assurance Act of 2020 - Riggleman - Medicare Part B payments during COVID-19 H.R. 8826 - The Resetting the Impact Act (TRIA) of 2020 - Sewell - amends the IMPACT Act of 2014 H.R. 8840 - Medicare Sequester COVID Moratorium Act - Schneider - extend temporary Medicare sequestration H.R. 8871 - COVID HCBS Relief Act of 2020 - Dingell - funding for state Medicaid programs HCBS H.R. 8934 - Community Integration Act of 2020 - Cartwright - Medicaid HCBS H.R. 8958 - Supporting Best Practices for Healthy Moms Act - Kelly - guidance for state Medicaid programs on maternal health H.R. 9002 - To amend title XIX of the Social Security Act to provide States an option to cover a children's program of all-inclusive coordinated care (ChiPACC) under Medicaid program - DeGette - Childrens health under Medicaid H.R. 9006 - To amend title XIX of the Social Security Act to provide for coverage under the Medicaid program under such title of routine patient costs associated with participation in certain clinical trials - Garcia - Medicaid coverage of clinical trials H.R. 9035 - Permanency for Audio-Only Telehealth Act - Smith - Audio only telehealth in Medicare 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. 3013 - Encouraging Innovative Benefit Design to Lower Costs for Seniors Act - Crapo - offer additional prescription drugs under Part D S. 3220 - Ensuring Access to Direct Support Professionals Act - Portman - Medicaid coverage in acute care hospitals S. 3238 - Preventive Home Visit Act - King - preventative home visits S. 3277 - HCBS Infrastructure Improvement Act - Casey - access to community based services S. 3353 - Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act of 2020 - Cassidy - Medicare coverage of kidney transplant services S. 3384 - Lowering Prescription Drug Prices for America's Seniors and Families Act of 2020 - McSally - Medicare Part D drug pricing negotiation S. 3399 - FCHIP Extension Act - Tester - rural health S. 3442 - Care for COVID-19 Act - Booker - COVID-19 cost sharing S. 3443 - Improving Coverage and Care for Mothers Act - Casey - Medicaid coverage for all pregnant and postpartum women S. 3447 - RUSH Act of 2020 - Thune - Medicare coverage for certain services in hospital emergency departments S. 3466 - ACCESS for Biosimilars Act of 2020 - McSally - eliminates cost sharing for biosimilar biological products furnished under part B of the Medicare program S. 3615 - Rural Community Hospital Demonstration Extension Act of 2020 - Murkowski - rural community hospital demonstration program S. 3665 - Save Rural Hospitals Act of 2020 - Alexander - Medicare hospital payments S. 3750 - Medicare Accelerated and Advance Payments Improvement Act of 2020 - Shaheen - COVID S. 3881 - CHIPPER Act - Casey - CHIP, COVID S. 3998 - HEALTH Act of 2020 - Hyde-Smith - telehealth S. 3999 - Mental and Behavioral Health Connectivity Act - King - Mental Health S. 4108 - A bill to amend title XIX of the Social Security Act to increase Federal support to State Medicaid programs during economic downturns - Casey - FMAP S. 4151 - SOS: Sustaining Outpatient Services Act - Hoeven - Medicare OPPS coverage S. 4230 - Telehealth Expansion Act of 2020 - Wyden - Telehealth mental health services in Medicare S. 4274 - Legalizing Drug Discounts for Seniors Act of 2020 - Paul - exclude discounts for covered part D drugs from the anti-kickback prohibition S. 4295 - Public Health Emergency Pass-Through Payment Fairness Act of 2020 - Paul - access to drugs and devices under Medicare S. 4358 - Stronger Medicaid Response to the COVID-19 Pandemic Act - Bennet - Medicaid coverage for vaccines and treatment for COVID-19 for uninsured without cost-sharing S. 4375 - Telehealth Modernization Act - Alexander - make permanent Medicare telehealth flexibilities S. 4423 - COVID-19 Hospice Respite Care Relief Act of 2020 - Brown - Medicare hospice care S. 4448- Fair Drug Prices for Kids Act - Warner - extend Medicaid drug rebate program to CHIP S. 4574 - Bringing Enhanced Treatments and Therapies to ESRD Recipients Kidney Care Act - Young - integrated care for Medicare beneficiaries with ESRD S. 4690 - Maternal Immunization Enhancement Act - Hassan - Medicaid and maternal health S. 4705 - Maternal Immunization Coverage Act - Cassidy - Medicaid coverage S. 4717 - Accelerating Kids Access to Care Act - Grassley - Medicaid enrollment S. 4742 - CLINICAL TREATMENT Act - Burr - Medicaid coverage S. 4825 - Ensuring Access to COVID-19 Vaccines for Seniors Act - Reed - Medicare coverage of COVID-19 vaccines S. 4840 - Ensuring Parity in MA for Audio-Only Telehealth Act of 2020 -Roberts - audio-only risk adjustment in Medicare Advantage S. 4859 - Connected MOM Act - Cassidy - expanded coverage of remote physiologic devices and related services under Medicaid S. 4864 - HAPI Act - Brown - Medicaid coverage of adult vaccines S. 4944 - Equality in Medicare and Medicaid Treatment Act of 2020 - Booker - CMMI models for SDOH in Medicare/Medicaid S. 4949 - Supporting Best Practices for Healthy Moms Act - Toomey - guidance for state Medicaid programs on maternal health S. 4957 - COVID HCBS Relief Act of 2020 - Casey - funding for state Medicaid programs HCBS S. 5007 - Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020 - Boozman - increase in Medicare part B payment S. 5044 - Bill to amend title XVIII of the SSA to establish requirement with respect to the use of prior authorization under the Medicare Advantage plans - Brown - Prior authorization S. 5077 - A bill to amend title XIX of the Social Security Act to adjust the limitations on Medicaid disproportionate share hospital payments - Cornyn - Medicaid DSH 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 2022 Rate Notice; Executive Orders relating to international pricing, Part D rebates, insulin costs, and importation; issues related to MLTSS; issues related to removal of safe harbor protection for rebates; issues relating to COVID-19, including testing; issues related to audio-only telehealth; issues related to addressing the social determinants of health, including housing, transportation, nutrition, and educational opportunities; issues related to Medicaid presumptive eligibility and continuous eligibility; issues relating to Medicaid best price; in-home health risk assessments; Medicare Medical Loss Ratio issues; issues related to changes to prior authorization regulations, electronic documentation, and related issues; issues relating to sequestration under the Medicare Advantage and Part D programs; issues related to health insurance tax for MA and Part D plans; implications of physician fee schedule on MA; 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 health plan models; 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.
Client expense: $2,400,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Council of Economic Advisers (CEA), Executive Office of the President (EOP), Food & Drug Administration (FDA), Government Accountability Office (GAO), 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), Office of the Vice President of the United States, SENATE, Treasury, Dept of, White House Office
2020 · third_quarter · Health Issues
H.R 856 - Physicians Pro Bono Care Act - charitable deduction for pro-bono health services H.R. 3796 - Health Savings for Seniors Act - This bill permits a Medicare beneficiary to participate in and contribute to health savings accounts. S. 1227 - Prescription Pricing for the People Act of 2019 - Thisbill requiresthe Federal Trade Commission (FTC) to report about anticompetitive practicesand other trendswithin the pharmaceuticalsupply chain that may impact the cost of prescriptionsdrugs. H.R. 5198 - Patients' Right to Know Their Medication Act of 2019 - Creates FDA approved standard method of sharing consumer information. S. 2441 - Health Savings Account Expansion Act of 2019 - Thisbill permitsindividualswho are not enrolled in a high deductible health plan to participate in healthsavingsaccounts. S. 2440 - Qualified Health Savings Account Distribution Act of 2019 - This bill amends the Internal Revenue Code, with respect to the requirements for tax-preferred health accounts, to modify the rules for using a conversion or termination of a flexible spending account or a health reimbursement arrangement to establish a health savings account. H.R. 603 - Health Savings Account Expansion Act of 2019 - This bill modifies the requirements for health savings accounts (HSAs) to: increase the maximum contribution amounts, permit the use of HSAs to pay health insurance premiums and for direct primary care service arrangements, repeal the restriction on using HSAs for over-the-counter medications, eliminate the requirement that a participant in an HSA be enrolled in a high deductible health care plan, and decrease the additional tax for HSA distributions not used for qualified medical expenses. H.R. 5596, S. 3112 - Personalized Care Act of 2020 - This bill revises provisions relating to health savings accounts (HSAs) H.R. 5566 - Patient Fairness Act of 2020 - This bill revises requirements for health savings accounts (HSAs) H.R. 5076 - Protecting Seniors Through Immunization Act of 2019 - Seeks to eliminate out-of-pocket expenses for everyone covered by Medicare and spares seniors the decision to delay or not seek vaccines due to their share of the cost. S. 3537 - Protecting Our Pharmaceutical Supply Chain from China Act of 2020 - Requires Health and Human Services to maintain a list of the country of origin of all drugs marketed in the United States. S. 3432 - Securing America's Medicine Cabinet Act of 2020 - This bipartisan legislation would reduce American reliance on foreign manufacturing of active pharmaceutical ingredients (APIs). H.R. 6286 - Health Savings Act of 2020 - This bill revises requirements for health savings accounts (HSAs) H.R. 6336 - Increasing Hospital Capacity to Fight the Coronavirus Act of 2020 - This bill allows unapproved capital expenses that are made by health care facilities during the public health emergency declared on January 31, 2020, relating to COVID-19 (i.e., coronavirus disease 2019) to be included in federal payment determinations under Medicare and Medicaid. H.R. 3502 - Protecting People From Surprise Medical Bills Act - This bill makes a series of changes relating to health care costs and billing practices. S. 2543 - Prescription Drug Pricing Reduction Act of 2019 - Seeks to lower drug costs by establishing rebate programs for brandname drugs and biologics used for Part B and Part D with prices that increase faster than the rate of inflation. H.R.6663 - Truth in Healthcare Marketing - Strives to reduce confusion over professional licensure, education level, training, degrees obtained, and clinical expertise and makes it unlawful for providers to misrepresent these credentials. H.R. 6813, S. 3703 - Promoting Alzheimer's Awareness to Prevent Elder Abuse Act - Works toward providing this protection by requiring the development of training materials for anyone who responds, investigates, or prosecutes cases of elder abuse involving seniors afflicted with dementias H.R. 7233, S. 4216 - Knowing the Efficiency and Efficacy of Permanent (KEEP) Telehealth Options Act - The expansion of telehealth would provide a convenient, cost-effective tool that complements traditional in-office medical visits. S. 4106 - Healthcare PRICE Transparency Act - Codifies two healthcare price transparency rules requiring hospitals and insurers to disclose their discounted cash rates and negotiated rates to consumers before they receive medical care. S. 3993 - Equal Access to Care Act - Expands access to telemedicine during the coronavirus emergency by allowing licensed health care providers to treat patients over the phone and online wherever the patient is located. H.R. 6930 - Manufacturing API, Drugs, and Excipients (MADE) in America Act - Addresses our drug supply chains dependence on foreign countries like China and works to mitigate drug shortages while incentivizing the domestic manufacturing of drugs, active pharmaceutical ingredients (API), personal protective equipment (PPE), and diagnostics. S. 4134 - Increasing Access to Biosimilars Act - TheIncreasing Access to Biosimilars Actwould direct the Department of Health and Human Services to create a shared savings demonstration program for biosimilar drugs in the Medicare program, which will help increase competition and expand access to biosimilars. H.R. 7008 - Family Savings Flexibility Act - This bill (1) increases to $2,750 the maximum amount of unused benefits or contributions remaining in a health flexible or dependent care spending arrangement that may be carried over from the 2020 to the 2021 plan year, (2) increases the maximum contribution amount for health savings accounts, and (3) increases the exclusion from employee gross income of employer-paid dependent care assistance. S. 3872 - Promising Pathway Act - Requires the US Food and Drug Administration to establish a rolling, real-time, priority review pathway to evaluate provisional approval applications for drugs intended to treat, prevent, or diagnose serious or life-threatening diseases or conditions, including those that pose a threat of epidemic or pandemic. S. 4185 - End Surprise Medical Bills for Air Ambulances Act of 2020 - A bill to establish an independent dispute resolution process for surprise air ambulance bills, and for other purposes. S. 4198 - Affordable Coronavirus Testing Act - This bill requires health insurance plans to cover through 2021 without cost sharing COVID-19 (i.e., coronavirus disease 2019) serology testing, which looks for the presence of antibodies made in response to an infection. S. 4158 - PPE Supply Chain Transparency Act of 2020 - This bill requires the Federal Emergency Management Agency (FEMA) to issue, within 90 days, a public report on the security and resilience of the supply chain for personal protective equipment during the COVID-19 (i.e., coronavirus disease 2019) pandemic. S. 4151 & H.R. 4838 - The Sustaining Outpatient Services (SOS) Act - Prevents certain off-campus hospital outpatient services from receiving significant Medicare reimbursement cuts. S. 4367 and H.R. 8032 - Health Savings Accounts for All Act - Qualified medical expenses would include expenses incurred during the prior or current tax year before establishing the HSA and fees paid for personal patient care. H.R.5741 - Strengthening Innovation in Medicare and Medicaid Act - Recognizes the important work done by CMMI and incorporates protections into the processes including, limiting the scope of models to only the size needed to realize a statistically valid sample; encouraging feedback from beneficiaries in developing CMMI models; and limiting the testing of new payment and delivery models to five years to shield beneficiaries from being subjected to potentially harmful models. H.R. 5741 also provides for key Congressional oversight for CMMI demonstrations that will improve transparency and patient safety.
Client expense: Not reported · Firm income: $15,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2020 · second_quarter · Health Issues
H.R 856 - Physicians Pro Bono Care Act - charitable deduction for pro-bono health services H.R. 3796 - Health Savings for Seniors Act - This bill permits a Medicare beneficiary to participate in and contribute to health savings accounts. S. 1227 - Prescription Pricing for the People Act of 2019 - Thisbill requiresthe Federal Trade Commission (FTC) to report about anticompetitive practicesand other trendswithin the pharmaceuticalsupply chain that may impact the cost of prescriptionsdrugs. H.R. 5198 - Patients' Right to Know Their Medication Act of 2019 - Creates FDA approved standard method of sharing consumer information. S. 2441 - Health Savings Account Expansion Act of 2019 - Thisbill permitsindividualswho are not enrolled in a high deductible health plan to participate in healthsavingsaccounts. S. 2440 - Qualified Health Savings Account Distribution Act of 2019 - This bill amends the Internal Revenue Code, with respect to the requirements for tax-preferred health accounts, to modify the rules for using a conversion or termination of a flexible spending account or a health reimbursement arrangement to establish a health savings account. H.R. 603 - Health Savings Account Expansion Act of 2019 - This bill modifies the requirements for health savings accounts (HSAs) to: increase the maximum contribution amounts, permit the use of HSAs to pay health insurance premiums and for direct primary care service arrangements, repeal the restriction on using HSAs for over-the-counter medications, eliminate the requirement that a participant in an HSA be enrolled in a high deductible health care plan, and decrease the additional tax for HSA distributions not used for qualified medical expenses. H.R. 5596, S. 3112 - Personalized Care Act of 2020 - This bill revises provisions relating to health savings accounts (HSAs) H.R. 5566 - Patient Fairness Act of 2020 - This bill revises requirements for health savings accounts (HSAs) H.R. 5076 - Protecting Seniors Through Immunization Act of 2019 - Seeks to eliminate out-of-pocket expenses for everyone covered by Medicare and spares seniors the decision to delay or not seek vaccines due to their share of the cost. S. 3537 - Protecting Our Pharmaceutical Supply Chain from China Act of 2020 - Requires Health and Human Services to maintain a list of the country of origin of all drugs marketed in the United States. S. 3432 - Securing America's Medicine Cabinet Act of 2020 - This bipartisan legislation would reduce American reliance on foreign manufacturing of active pharmaceutical ingredients (APIs). H.R. 6286 - Health Savings Act of 2020 - This bill revises requirements for health savings accounts (HSAs) H.R. 6336 - Increasing Hospital Capacity to Fight the Coronavirus Act of 2020 - This bill allows unapproved capital expenses that are made by health care facilities during the public health emergency declared on January 31, 2020, relating to COVID-19 (i.e., coronavirus disease 2019) to be included in federal payment determinations under Medicare and Medicaid. H.R. 3502 - Protecting People From Surprise Medical Bills Act - This bill makes a series of changes relating to health care costs and billing practices. S. 2543 - Prescription Drug Pricing Reduction Act of 2019 - Seeks to lower drug costs by establishing rebate programs for brandname drugs and biologics used for Part B and Part D with prices that increase faster than the rate of inflation. H.R.6663 - Truth in Healthcare Marketing - Strives to reduce confusion over professional licensure, education level, training, degrees obtained, and clinical expertise and makes it unlawful for providers to misrepresent these credentials. H.R. 6813, S. 3703 - Promoting Alzheimer's Awareness to Prevent Elder Abuse Act - Works toward providing this protection by requiring the development of training materials for anyone who responds, investigates, or prosecutes cases of elder abuse involving seniors afflicted with dementias H.R. 7233 - Knowing the Efficiency and Efficacy of Permanent (KEEP) Telehealth Options Act - The expansion of telehealth would provide a convenient, cost-effective tool that complements traditional in-office medical visits.
Client expense: Not reported · Firm income: $15,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2020 · third_quarter · Medicare/Medicaid
H.R. 3107 - Improving Seniors' Timely Access to Care Act of 2019 - DelBene - prior authorization in Medicare Advantage 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. 4453 - Protecting Seniors from Health Care Fraud Act of 2019 - Ruiz -Distributing information to Medicare beneficiaries to prevent fraud 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. 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. 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. 4671 - Helping Seniors Afford Health Care Act - Kim - Medicare affordability and low income beneficiaries H.R. 4996 - Helping Medicaid Offer Maternity Services Act of 2020 - Kelly - extend Medicaid coverage post-partum H.R. 5006 - Expanding Access to Inpatient Mental Health Act - Emmer - Medicaid coverage for SUD/mental health for institutionalized 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. 5693 - Primary Health Services Enhancement Act - Kind - Medicare rural health H.R. 5808 - Save Rural Communities Act of 2020 - Arrington - rural emergency medical access services under Medicare H.R. 5833 - To amend title XVIII of the Social Security Act to permit the use of certain psychological evaluation via telehealth for Medicare coverage of neurostimulation services for the treatment of chronic pain - Latta - Medicare coverage in telehealth H.R. 5882 - GENE Therapy Payment Act - Schrader - value based care H.R. 6098 - To amend title XXI of the Social Security Act to allow States to expand income eligibility standards under the Children's Health Insurance Program -Barragan - CHIP eligibility H.R. 6151 - CARING for Kids Act - Fineknauer - CHIP H.R. 6179 - Increasing Access to Biosimilars Act of 2020 - Cardenas - payments to providers of biosimilars under Medicare H.R. 6209 - Reducing Unnecessary Senior Hospitalizations Act of 2020 or the RUSH Act of 2020 -Kuster - Medicare coverage for certain services in hospital emergency departments H.R. 6244 - To amend titles XVIII and XIX to provide for coverage at no cost sharing of COVID-19 testing under the Medicaid program and Children's Health Insurance Program - Kelly - Medicaid coverage of COVID-19 related visits and testing H.R. 6263 - To amend title XVIII of the Social Security Act to waive cost sharing under the Medicare program for certain visits relating to testing for COVID-19 -Sarbanes - Medicare coverage of COVID-19 related visits and testing H.R. 6273 - Protecting Vulnerable Americans in Times of Crisis Act of 2020 - Butterfield - FMAP H.R. 6311 - Care for COVID-19 Act - Ruiz - COVID-19 cost sharing H.R. 6336 - Increasing Hospital Capacity to Fight the Coronavirus Act of 2020 - Bishop - Medicare and Medicaid payments during COVID-19 emergency H.R. 6462 - Emergency Medicaid for Coronavirus Treatment Act - Gallego - Medicaid coverage H.R. 6511 - Ensuring Vaccination and Treatment Affordability Act - Pappas - COVID H.R. 6521 - To prohibit the Secretary of Health and Human Services from taking certain actions with respect to Medicaid supplemental payments reporting requirements, and for other purposes - Diaz Barragan - Medicaid, delays implementation of MFAR H.R. 6538 - Modernized Medicine Act - Kennedy - Medicaid, Telehealth H.R. 6539 - Coronavirus Medicaid Response Act - Lee - FMAP H.R. 6572 - To direct the Secretary of Health and Human Services, acting through the Director of the Centers for Disease Control and Prevention, to carry out a national campaign to increase awareness and knowledge of COVID-19. -Bilirakis - COVID H.R. 6583 - To amend title XVIII of the Social Security Act to establish a risk corridor program for Medicare Advantage plans during the COVID-19 emergency, and for other purposes. - Houlahan - COVID H.R. 6616 - Stronger Medicaid Response to the COVID-19 Pandemic Act -Cardenas - COVID H.R. 6640 - Medicare Advantage COVID Treatment Act - Mucarsel-Powell - COVID H.R. 6658 - Insular Area Medicaid Coronavirus Recovery Act - Sablan - FMAP H.R. 6727 - To hold Medicare beneficiaries harmless for specified COVID-19 treatment services furnished under part A or part B of the Medicare program - Schrier - COVID H.R. 6744 - Computer and Internet Equity Act - Davis - internet access for Lifeline program H.R. 6753 - Save Rural Hospitals Act of 2020 - Finkenauer - Medicare hospital payments H.R. 6792 - Improving Telehealth for Underserved Communities Act of 2020 - Smith - telehealth H.R. 6797 - CHIPPER Act - Wild - CHIP, COVID H.R. 6837 - Medicare Accelerated and Advance Payments Improvement Act of 2020 -Schneider - COVID H.R. 7154 - Outpatient Therapy Modernization and Stabilization Act -Boyle - outpatient therapy services H.R. 7187 - HEALTH Act of 2020 -Thompson -Smith - telehealth H.R. 7292 - To amend title XVIII of the Social Security Act to provide for forgiveness of certain accelerated and advance payments under parts A and B of the Medicare program. - Kaptur - advance payments H.R. 7338 - To amend title XVIII of the Social Security Act to permit the Secretary of Health and Human Services to waive requirements relating to the furnishing of telehealth services under the Medicare program, and for other purposes. - Cheney - Telehealth H.R. 7391 - To amend title XVIII of the Social Security Act to remove certain geographic and originating site restrictions on the furnishing of telehealth services under the Medicare program - Sherrill- Telehealth H.R. 7606 - MFAR Transparency Act - Williams - report on impact of MFAR to Congress H.R. 7627 - MORE Savings Act - Dean - Medicare access to opioid treatment and MAT H.R. 7663 - Protecting Access to Post-COVID-19 Telehealth Act of 2020 - Thompson - waive or modify application of Medicare requirements with respect to telehealth during PHE H.R. 7791 - Value in Health Care Act of 2020 - Welch - Medicare shared savings program and alternative payment arrangements H.R. 7877 - Lowering Drug Costs for Seniors Act of 2020 - Katko - Medicare Part D costs H.R. 7892 - Medicaid Expansion During Crisis Act - Coleman - extend eligibility period for Medicaid enrollment application H.R. 8177 - Renal Anemia Innovation Support and Expansion Act - OHalleran - Medicare prescription drug coverage for chronic kidney disease H.R. 8218 - Rural Ambulance Reimbursement Fairness Act - Gianforte - Medicare payment for rural ambulance services H.R. 8254 - Bringing Enhanced Treatments and Therapies to ESRD Recipients Kidney Care Act - Blumenauer - integrated care for Medicare beneficiaries with ESRD H.R. 8427 - To provide for certain reports on enrollment in the Lifeline program, and for other purposes - Luria - Lifeline program 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. 3013 - Encouraging Innovative Benefit Design to Lower Costs for Seniors Act - Crapo - offer additional prescription drugs under Part D S. 3220 - Ensuring Access to Direct Support Professionals Act - Portman - Medicaid coverage in acute care hospitals S. 3238 - Preventive Home Visit Act - King - preventative home visits S. 3277 - HCBS Infrastructure Improvement Act - Casey - access to community based services S. 3353 - Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act of 2020 - Cassidy - Medicare coverage of kidney transplant services S. 3384 - Lowering Prescription Drug Prices for America's Seniors and Families Act of 2020 - McSally - Medicare Part D drug pricing negotiation S. 3399 - FCHIP Extension Act - Tester - rural health S. 3442 - Care for COVID-19 Act - Booker - COVID-19 cost sharing S. 3443 - Improving Coverage and Care for Mothers Act - Casey - Medicaid coverage for all pregnant and postpartum women S. 3447 - RUSH Act of 2020 - Thune - Medicare coverage for certain services in hospital emergency departments S. 3466 - ACCESS for Biosimilars Act of 2020 - McSally - eliminates cost sharing for biosimilar biological products furnished under part B of the Medicare program S. 3615 - Rural Community Hospital Demonstration Extension Act of 2020 - Murkowski - rural community hospital demonstration program S. 3665 - Save Rural Hospitals Act of 2020 - Alexander - Medicare hospital payments S. 3750 - Medicare Accelerated and Advance Payments Improvement Act of 2020 - Shaheen - COVID S. 3881 - CHIPPER Act - Casey - CHIP, COVID S. 3998 - HEALTH Act of 2020 - Hyde-Smith - telehealth S. 3999 - Mental and Behavioral Health Connectivity Act - King - Mental Health S. 4108 - A bill to amend title XIX of the Social Security Act to increase Federal support to State Medicaid programs during economic downturns - Casey - FMAP S. 4151 - SOS: Sustaining Outpatient Services Act - Hoeven - Medicare OPPS coverage S. 4230 - Telehealth Expansion Act of 2020 - Wyden - Telehealth mental health services in Medicare S. 4274 - Legalizing Drug Discounts for Seniors Act of 2020 - Paul - exclude discounts for covered part D drugs from the anti-kickback prohibition S. 4295 - Public Health Emergency Pass-Through Payment Fairness Act of 2020 - Paul - access to drugs and devices under Medicare S. 4358 - Stronger Medicaid Response to the COVID-19 Pandemic Act - Bennet - Medicaid coverage for vaccines and treatment for COVID-19 for uninsured without cost-sharing S. 4375 - Telehealth Modernization Act - Alexander - make permanent Medicare telehealth flexibilities S. 4423 - COVID-19 Hospice Respite Care Relief Act of 2020 - Brown - Medicare hospice care S. 4448 - Fair Drug Prices for Kids Act - Warner - extend Medicaid drug rebate program to CHIP S. 4574 - Bringing Enhanced Treatments and Therapies to ESRD Recipients Kidney Care Act - Young - integrated care for Medicare beneficiaries with ESRD S. 4690 - A bill to increase vaccination rates among pregnant women enrolled in Medicaid or CHIP, and for other purposes - Hassan - Medicaid and maternal health S. 4705 - A bill to amend title XIX requiring coverage under Medicaid of vaccines for pregnant women - Cassidy - Medicaid coverage S. 4717 - A bill to amend title XIX of the Social Security Act to streamline enrollment of certain Medicaid providers across State lines, and for other purposes - Grassley - Medicaid enrollment S. 4742 - A bill to amend title XIX of the Social Security Act to promote access to life-saving therapies for Medicaid enrollees by ensuring coverage of routine patient costs for items and services furnished in connection with participation in qualifying clinical trials, and for other purposes - Burr - Medicaid coverage 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 2022 Rate Notice; Executive Orders relating to international pricing, Part D rebates, insulin costs, and importation; issues related to MLTSS; issues related to proposed changes to removal of safe harbor protection for rebates (proposed rule); issues relating to COVID-19, including testing; issues related to audio-only telehealth; issues related to addressing the social determinants of health, including housing, transportation, nutrition, and educational opportunities; issues related to Medicaid presumptive eligibility and continuous eligibility; issues relating to Medicaid best price; 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.
Client expense: $2,230,000 · Firm income: Not reported
Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE, Treasury, Dept of, White House Office
2020 · third_quarter · Health Issues
EO 13951 - An America-First Healthcare Plan H.R. 6336 - Increasing Hospital Capacity to Fight the Coronavirus ActFull bill H.R. 6338 - Pandemic Healthcare Access ActFull bill H.R. 7676 - Health Care PRICE Transparency ActFull bill Issues related to organ procurement organizations S. 3546 - Pandemic Healthcare Access ActFull bill
Client expense: $220,000 · Firm income: Not reported
Government targets: Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, SENATE, White House Office
2020 · second_quarter · Health Issues
Affordable Care Act (ACA); ACA Regulations; ACA Stabilization; Health Care Reform; Rural Healthcare; Risk Adjustment; CSRs; Opioids; Marketplace Stability; Individual Market Reform; Association Health Plans (AHPs); Value-Based Reimbursement; Health Care Costs; Mental Health; Reinsurance; Transparency; Silverloading; Interoperability; Health IT; Surprise Billing; Small Business; Prior Authorization; Provider Directories; Health Reimbursement Arrangements (HRAs); Education and Enrollment; Consumer-facing app disclosures; Negotiated Rate Disclosure; Medicare for All; Medicare Buy-In, Social determinants of health, Community Health, Cybersecurity, NBPP(Notice Benefit and Payment Parameters);Provider directories; Maternal Health; Senior's health care; COVID-19 Response/Relief Packages; Healthcare access/privacy; Risk Corridors; COBRA; Telehealth; SEPs; CDC Guidance Testing; Safe Harbor; Prior Authorizations; COVID-19 Test Without Cost-Sharing. H.R. 1384 - 116th Congress (2019-2020) Medicare for All Act of 2019 Sponsor: Rep. Jayapal, Pramila [D-WA-7](Introduced 2/27/19) S. 1895 - 116th Congress (2019-2020) Lower Health Care Costs Act Sponsor: Sen. Alexander, Lamar [R-TN](Introduced 6/19/2019) H.R.3630 - 116th Congress (2019-2020) No Surprises Act Sponsor: Rep. Pallone, Frank, Jr [D-NJ-6](Introduced 07/09/2019) H.R.3439 - 116th Congress (2019-2020) PATIENT Act Sponsor: Rep. Beyer, Donald S.,Jr. [D-VA-8](Introduced 06/24/2019) S. 2546 - 116th Congress (2019-2020) Safe Step Act Sponsor: Sen. Lisa Murkowshi (R-Ark) H.R.5826 - 116th Congress (2019-2020) Consumer Protections Against Surprise Medical Bills Act of 2020 Sponsor: Rep. Neal, Richard [D-MA-1] (Introduced 02/10/2020) S.3548 - 116th Congress (2019-2020) Coronavirus Aid, Relief, and Economic Security Act Sponsor: Sen. McConnell, Mitch [R-KY](Introduced 03/19/2020) H.R.5754 - 116th Congress (2019-2020) Rural ER Access Act Sponsor: Rep. Green, Mark [R-TN-7](Introduced 02/04/2020) H.R. 5763 - 116th Congress - Second Session National Telehealth Strategy and Data Advancement Act Sponsor: Rep. Greg Gianforte (R-MT At-Large) H.R.5800 - 116th Congress (2019-2020) Ban Surprise Billing Act Sponsor: Rep. Scott, Robert [D-VA-3](Introduced 02/07/2020) H.R.5916 - 116th Congress (2019-2020) Transparent Health Care PRicing Act of 2020 Sponsor: Rep. Mike Gallagher (R-WI-08) Public Law 116-127 (H.R.6201) - 116th Congress - Second Session First Coronavirus Response Act Sponsor: Rep. Nita Lowey (D-NY-17) H.R. 6336 - 116th congress - Second Session To amend title XI of the Social Security Act to provide for a waiver of payment reductions under the Medicare and Medicaid programs for certain nonapproved capital expenditures undertaken by health care facilities during the COVID-19 emergency. Sponsor: Rep. Dan Bishop (R-NC_09) H.R. 6311 - 116th Congress - Second Session Care for COVID-19 Act Sponsor: Rep. Raul Ruiz (D-CA-36) H.R. 6299 - 116th COngress - Second Session Rapid COverage of COVID-19 Vaccine Act of 2020 H.R. 5816 - 116th Congress - Second Session Continuing Care for Patients Act of 2020 Sponsor: Rep. Gwen Moore (D-WI-04) H.R. 5826 - 116th Congress Second Session Consumer Protections Against Surprise Medical Bills Act of 2020 Sponsor: Rep. Richard Neal (D-MA-01) H.R. 5924 - 116th Congress Second Session To amend the Public Health Service Act to authorize a loan repayment program to encourage specialty medicine physicians to serve in rural communities experiencing a shortage of specialty medicine physicians, and for other purposes. Sponsor: Rep. David McKinley (R-WV-01) H.R. 6004 - 116th Congress - Second Session Transparency and Accountability in Health Care Costs and Prices Act of 2020 Sponsor: Rep. Dan Lipinski (D-IL-03) H.R. 6173 - 116th Congress - Second Session Covering Coronavirus Test Act of 2020 Sponsor: Rep. Diana DeGette (D-CO-01) H.R. 6213 - 116th Congress - Second Session No Cost for COVID-19 Testing Act Sponsor: Rep. Frederica Wilson (D-FL-24) H.R. 6222 - 116th Congress - Second Session Ensuring Affordable COVID-19 Preventative Care Act of 2020 Sponsor: Rep. Jan Schakowsky (D-IL-09) H.R. 6232 - 116th Congress - Second Session To require the SEcretary of Health and Human Services, through the National Desaster Medicdal System, to provide for certain laboratory reimbursement for diagnostic testing for COVID-19 in uninsured individuals. Sponsor: Rep Tony Cardenas (D-CA-29) H.R. 6231 - 116th Congress - Second Session Ensuring Access to COVID-19 Preventative Care Act of 2020 Sponsor: Rep. Larry Bucshon (R-IN-08) H.R. 6263 - 116th Congress - Second Session To amend title XVIII of the Social Security Acto to waive cost sharing under the Medicare program for certain visits relating to testing for COVID-19. Sponsor: Rep. John Sarbanes (D-MD-03) H.R. 6810 - 116th Congress - Second Session Health Care Protection Act Sponsor: Rep. Rodney Davis (R-IL-13) Public Law 116-123 (H.R. 6074) - 116th Congress - Second Session Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 Sponsor: Rep. Nita Lowey (D-NY-17) H.R. 6800 - 116th Congress - Second Session HEROES Act Sponsor: Rep. Nita Lowey (D-NY-17) H.R. 6338 - 116th Congress - Second Session Pandemic Healthcare Access Act Sponsor: Rep. Ted Budd (R-NC-13) H.R. 5808 - 116th Congress - Second Session Save Rural Communities Act of 2020 Sponsor: Rep. Jodey Arrington (R-TX-19) H.R. 7391 - 116th Congress - Second Session To amend title XVIII of the Social Security Act to remove certain geographic and originating site restrictions on the furnishing of telehealth services under the Medicare program. H.R. 5763 - 116th Congress - Second Session National Telehealth Strategy and Data Advancement Act Sponsor: Greg Gianforte (R-MT At-Large) H.R. 6792 - 116th Congress - Second Session Improving Telehealth for Underserved Communities Act of 2020 Sponsor: Rep. Adrian Smith (R-NE-03) H.R. 6918 - 116th Congress - Second Session Paycheck Recovery Act of 2020 Sponsor: Rep. Pramila Jayapal (D-WA-07) Public Law - 116-136 (H.R.748) - 116th Congress - First Session Third Coronavirus Stimulus Package Sponsor: Rep. Joe Courtney (D-CT-02) H.R. 3107 - 116th Congress Improving Senior's Timely Access to Care Act of 2019 Sponsor: Rep. Suzan DelBene (D-WA), Rep. Mike Kelly (R-PA), Rep. Roger Marshal (R-KS0 and Ami Bera (D-CA)
2020 · second_quarter · Medicare/Medicaid
H.R. 3107 - Improving Seniors' Timely Access to Care Act of 2019 - DelBene - prior authorization in Medicare Advantage 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. 4453 - Protecting Seniors from Health Care Fraud Act of 2019 - Ruiz -Distributing information to Medicare beneficiaries to prevent fraud 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. 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. 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. 4671 - Helping Seniors Afford Health Care Act - Kim - Medicare affordability and low income beneficiaries H.R. 5006 - Expanding Access to Inpatient Mental Health Act - Emmer - Medicaid coverage for SUD/mental health for institutionalized 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. 5693 - Primary Health Services Enhancement Act - Kind - Medicare rural health H.R. 5808 - Save Rural Communities Act of 2020 - Jodey Arrington - rural emergency medical access services under Medicare H.R. 5833 - To amend title XVIII of the Social Security Act to permit the use of certain psychological evaluation via telehealth for Medicare coverage of neurostimulation services for the treatment of chronic pain - Latta - Medicare coverage in telehealth H.R. 5882 - GENE Therapy Payment Act - Schrader - value based care H.R. 6098 - To amend title XXI of the Social Security Act to allow States to expand income eligibility standards under the Children's Health Insurance Program - Barragan - CHIP eligibility H.R. 6151 - CARING for Kids Act - Abby Fineknauer - CHIP H.R. 6179 - Increasing Access to Biosimilars Act of 2020 - Cardenas - payments to providers of biosimilars under Medicare H.R. 6209 - Reducing Unnecessary Senior Hospitalizations Act of 2020 or the RUSH Act of 2020 -Kuster - Medicare coverage for certain services in hospital emergency departments H.R. 6244 - To amend titles XVIII and XIX to provide for coverage at no cost sharing of COVID-19 testing under the Medicaid program and Children's Health Insurance Program - Kelly - Medicaid coverage of COVID-19 related visits and testing H.R. 6263 - To amend title XVIII of the Social Security Act to waive cost sharing under the Medicare program for certain visits relating to testing for COVID-19 -Sarbanes - Medicare coverage of COVID-19 related visits and testing H.R. 6273 - Protecting Vulnerable Americans in Times of Crisis Act of 2020 - Butterfield - FMAP H.R. 6311 - Care for COVID-19 Act - Ruiz - COVID-19 cost sharing H.R. 6336 - Increasing Hospital Capacity to Fight the Coronavirus Act of 2020 - Bishop - Medicare and Medicaid payments during COVID-19 emergency H.R. 6462 - Emergency Medicaid for Coronavirus Treatment Act - Gallego - Medicaid coverage H.R. 6511 - Ensuring Vaccination and Treatment Affordability Act - Pappas - COVID H.R. 6521 - To prohibit the Secretary of Health and Human Services from taking certain actions with respect to Medicaid supplemental payments reporting requirements, and for other purposes - Diaz Barragan H.R. 6538 - Modernized Medicine Act - Kennedy - Medicaid, Telehealth H.R. 6539 - Coronavirus Medicaid Response Act - Lee - FMAP H.R. 6572 - To direct the Secretary of Health and Human Services, acting through the Director of the Centers for Disease Control and Prevention, to carry out a national campaign to increase awareness and knowledge of COVID-19. - Bilirakis - COVID H.R. 6583 - To amend title XVIII of the Social Security Act to establish a risk corridor program for Medicare Advantage plans during the COVID-19 emergency, and for other purposes. - Houlahan - COVID H.R. 6616 - Stronger Medicaid Response to the COVID-19 Pandemic Act - Cardenas - COVID H.R. 6640 - Medicare Advantage COVID Treatment Act - Mucarsel-Powell - COVID H.R. 6658 - Insular Area Medicaid Coronavirus Recovery Act - Sablan - FMAP H.R. 6727 - To hold Medicare beneficiaries harmless for specified COVID-19 treatment services furnished under part A or part B of the Medicare program - Schrier - COVID H.R. 6744 - Computer and Internet Equity Act - Davis - internet access for Lifeline program H.R. 6753 - Save Rural Hospitals Act of 2020 - Finkenauer - Medicare hospital payments H.R. 6792 - Improving Telehealth for Underserved Communities Act of 2020 - Smith - telehealth H.R. 6797 - CHIPPER Act - Wild - CHIP, COVID H.R. 6837 - Medicare Accelerated and Advance Payments Improvement Act of 2020 - Schneider - COVID H.R. 7154 - Outpatient Therapy Modernization and Stabilization Act - Boyle - outpatient therapy services H.R. 7187 - HEALTH Act of 2020 -Thompson -Smith - telehealth H.R. 7297 - To amend title XVIII of the Social Security Act to provide for forgiveness of certain accelerated and advance payments under parts A and B of the Medicare program. - Kaptur H.R. 7338 - To amend title XVIII of the Social Security Act to permit the Secretary of Health and Human Services to waive requirements relating to the furnishing of telehealth services under the Medicare program, and for other purposes. - Cheney - Telehealth H.R. 7391 - To amend title XVIII of the Social Security Act to remove certain geographic and originating site restrictions on the furnishing of telehealth services under the Medicare program - Sherrill - Telehealth 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. 3220 - Ensuring Access to Direct Support Professionals Act - Portman - Medicaid coverage in acute care hospitals S. 3238 - Preventive Home Visit Act - King - preventative home visits S. 3277 - HCBS Infrastructure Improvement Act - Casey - access to community based services S. 3353 - Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act of 2020 - Cassidy - Medicare coverage of kidney transplant services S. 3384 - Lowering Prescription Drug Prices for America's Seniors and Families Act of 2020 - McSally - Medicare Part D drug pricing negotiation S. 3399 - FCHIP Extension Act - Tester - rural health S. 3442 - Care for COVID-19 Act - Booker - COVID-19 cost sharing S. 3443 - Improving Coverage and Care for Mothers Act - Casey - Medicaid coverage for all pregnant and postpartum women S. 3447 - RUSH Act of 2020 - Thune - Medicare coverage for certain services in hospital emergency departments S. 3466 - ACCESS for Biosimilars Act of 2020 - McSally - eliminates cost sharing for biosimilar biological products furnished under part B of the Medicare program S. 3615 - Rural Community Hospital Demonstration Extension Act of 2020 - Murkowski - rural community hospital demonstration program S. 3665 - Save Rural Hospitals Act of 2020 - Alexander - Medicare hospital payments S. 3750 - Medicare Accelerated and Advance Payments Improvement Act of 2020 - Shaheen - COVID S. 3881 - CHIPPER Act - Casey - CHIP, COVID S. 3998 - HEALTH Act of 2020 - Hyde-Smith - telehealth S. 3999 - Mental and Behavioral Health Connectivity Act - King - Mental Health S. 4108 - A bill to amend title XIX of the Social Security Act to increase Federal support to State Medicaid programs during economic downturns - Casey - FMAP 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); issues relating to COVID-19; issues related to audio-only telehealth; issues related to addressing the social determinants of health, including housing, transportation, nutrition, and educational opportunities; issues related to Medicaid presumptive eligibility and continuous eligibility; issues relating to Medicaid best price; 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.
2020 · second_quarter · Health Issues
Affordable Care Act (ACA); ACA Regulations; ACA Stabilization; Health Reform; Risk Adjustment; Opioids; Individual Market Reform; Health Care Costs; Mental Health; CSRs; Transparency; Surprise billing, Transparency, Prior Authorization; All payer claims database; Negotiated rate disclosure; Medicare for All; Maternal health; Senior's health care; Community health; NBPP (Notice Benefit and Payment Parameters), COVID-19 Response/Relief Packages, Healthcare access/privacy; Risk Corridors; COBRA; Telehealth; SEPs; CDC Guidance Testing; Safe Harbor; COVID-19; Postal Reform; Single Employer Pensions; H.R.1384 - 116th Congress (2019-2020) Medicare for All Act of 2019 Sponsor: Rep. Jayapal, Pramila [D-WA-7] (Introduced 02/27/2019) H.R.2003 - 116th Congress (2019-2020) Ensuring FEHBP Coverage During Shutdowns Act Sponsor: Rep. Cummings, Elijah E. [D-MD-7] (Introduced 04/01/2019) H.R.2004 - 116th Congress (2019-2020) Ensuring FEDVIP and FLTCIP Coverage During Shutdowns Act Sponsor: Rep. Cummings, Elijah E. [D-MD-7] (Introduced 04/01/2019) S.973 - 116th Congress (2019-2020) Ensuring FEDVIP and FLTCIP Coverage During Shutdowns Act Sponsor: Sen. Smith, Tina [D-MN] (Introduced 04/01/2019) S.971 - 116th Congress (2019-2020) Ensuring FEHBP Coverage During Shutdowns Act Sponsor: Sen. Smith, Tina [D-MN] (Introduced 04/01/2019) H.R.1520 - 116th Congress (2019-2020) Purple Book Continuity Act of 2019 Sponsor: Rep. Eshoo, Anna G. [D-CA-18] (Introduced 03/05/2019) S.1895 - 116th Congress (2019-2020) Lower Health Care Costs Act Sponsor: Sen. Alexander, Lamar [R-TN] (Introduced 06/19/2019) H.R.1046 - 116th Congress (2019-2020) Medicare Negotiation and Competitive Licensing Act of 2019 Sponsor: Rep. Doggett, Lloyd [D-TX-35] H.R.3630 - 116th Congress (2019-2020) No Surprises Act Sponsor: Rep. Pallone, Frank, Jr. [D-NJ-6] H.R.3439 - 116th Congress (2019-2020) PATIENT Act Sponsor: Rep. Beyer, Donald S., Jr. [D-VA-8] H.R.3107 - 116th Congress (2019-2020) Improving Seniors' Timely Access to Care Act of 2019 Sponsor: Rep. DelBene, Suzan K. [D-WA-1] H.R.2279 - 116th Congress (2019-2020) Safe Step Act Sponsor: Rep. Ruiz, Raul [D-CA-36] S.1895 - 116th Congress (2019-2020) Lower Health Care Costs Act Sponsor: Sen. Alexander, Lamar [R-TN] S. 2546 - 116th Congress (2019-2020) Safe Step Act Sponsor: Sen. Lisa Murkowski (R-AK) S. 2004 - 116th Congress (2019-2020) Ensuring FEDVIP and FLTCIP Coverage During Shutdowns Act Sponsor: Rep. Elijah Cummings (D-MD-07) H.R. 2774 - 116th Congress (2019-2020) Primary Care Patient Protection Act of 2019 Sponsor: Rep. Brad Schneider (D-IL-10) H.R. 5826 - 116th Congress - Second Session Consumer Protections Against Surprise Medical Bills Act of 2020 Sponsor: Rep. Richard Neal(D-MA-01) S. 3548 - 116th Congress - Second Session Coronavirus Aid, Relief, and Economic Security Act Sponsor: Sen. Mitch McConnell (R-KY) H.R. 5551 - 116th Congress - Second Session Ensuring Child Health Coverage Compensation in Divorce Act of 2020 Sponsor: Del. Eleanor Holmes Norton (D-DC At-Large) H.R. 5575 - 116th Congress - Second Session Primary and Behavioral Health Care Access Act of 2020 Sponsor: Rep. Lauren Underwood (D-IL-14) H.R. 5688 - 116th Congress - Second Session Reducing Administrative Costs and Burdens in Health Care Act of 2020 Sponsor: Rep. Cindy Axne (D-IA-03) H.R. 5754 - 116th Congress - Second Session Rural ER Access Act Sponsor: Rep. Mark Green (R-TN-07) H.R. 5763 - 116th Congress - Second Session National Telehealth Strategy and Data Advancement Act Sponsor: Rep. Greg Gianforte (R-MT At-Large) H.R. 5800 - 116th Congress - Second Session Ban Surprise Billing Act Sponsor: Rep. Bobby Scott (D-VA-03) H.R. 5807 - 116th Congress - Second Session Know Your Provider Act of 2020 Sponsor: Rep. John Larson (D-CT-01) H.R. 5916 - 116th Congress - Second Session Transparent Health Care Pricing Act of 2020 Sponsor: Rep. Mike Gallagher (R-WI-08) Public Law 116-127 (H.R. 6201) - 116th Congress - Second Session First Coronavirus Response Act Sponsor: Rep. Nita Lowey (D-NY-17) H.R. 6336 - 116th Congress - Second Session To amend title XI of the Social Security Act to provide for a waiver of payment reductions under the Medicare and Medicaid programs for certain nonapproved capital expenditures undertaken by health care facilities during the COVID-19 emergency. Sponsor: Rep. Dan Bishop (R-NC-09) H.R. 6311 - 116th Congress - Second Session Care for COVID-19 Act Sponsor: Rep. Raul Ruiz (D-CA-36) H.R. 6299 - 116th Congress - Second Session Rapid Coverage of COVID-19 Vaccine Act of 2020 H.R. 5817 - 116th Congress - Second Session Fair and Honest Advance Cost Estimate for Patients Act of 2020 Sponsor: Rep. Devin Nunes (R-CA-22) H.R. 5816 - 116th Congress - Second Session Continuing Care for Patients Act of 2020 Sponsor: Rep. Gwen Moore (D-WI-04) HR. 5809 - 116th Congress - Second Session Better Information Act of 2020 Sponsor: Rep. Don Beyer (D-VA-08) H.R. 5826 -116th Congress - Second Session Consumer Protections Against Surprise Medical Bills Act of 2020 Sponsor: Rep. Richard Neal (D-MA-01) H.R. 5924 - 116th Congress - Second Session To amend the Public Health Service Act to authorize a loan repayment program to encourage specialty medicine physicians to serve in rural communities experiencing a shortage of specialty medicine physicians, and for other purposes. Sponsor: Rep. David McKinley (R-WV-01) H.R. 6004 - 116th Congress - Second Session Transparency and Accountability in Health Care Costs and Prices Act of 2020 Sponsor: Rep. Dan Lipinski (D-IL-03) H.R. 6005 - 116th Congress - Second Session Know the Price Act Sponsor: Rep. Tom Malinowski (D-NJ-07) H.R. 6132 - 116th Congress - Second Session Social Determinants for Moms Act of 2020 Sponsor: Rep. Lucy McBath (D-GA-06) H.R. 6135 - 116th Congress - Second Session No More Narrow Networks Act of 2020 Sponsor: Rep. Jan Schakowsky (D-IL-09) H.R. 6136 - 116th Congress - Second Session Protecting Consumers from Unreasonable Rates Act of 2020 Sponsor: Rep. Jan Schakowsky (D-IL-09) H.R. 6137 - 116th Congress - Second Session Innovative Maternal Payment And Coverage To Save Moms Act Sponsor: Rep. Jan Schakowsky (D-IL-09) H.R. 6138 - 116th Congress - Second Session Tech to Save Moms Act Sponsor: Rep. Eddie Bernice Johnson (D-TX-30) H.R. 6149 - 116th Congress - Second Session Medicaid Report on Expansion of Access to Coverage for Health Act Sponsor: Rep. Joe Cunningham (D-SC-01) H.R. 6151 - 116th Congress - Second Session CARING for Kids Act Sponsor: Rep. Abby Finkenauer (D-IA-01) H.R. 6173 - 116th Congress - Second Session Covering Coronavirus Test Act of 2020 Sponsor: Rep. Diana DeGette (D-CO-01) H.R. 6213 - 116th Congress - Second Session No Cost for COVID-19 Testing Act Sponsor: Rep. Frederica Wilson (D-FL-24) H.R. 6222 - 116th Congress - Second Session Ensuring Affordable COVID-19 Preventive Care Act of 2020 Sponsor: Rep. Jan Schakowsky (D-IL-09) H.R. 6232 - 116th Congress - Second Session To require the Secretary of Health and Human Services, through the National Disaster Medical System, to provide for certain laboratory reimbursement for diagnostic testing for COVID-19 in uninsured individuals. Sponsor: Rep. Tony Cardenas (D-CA-29) H.R. 6231 - 116th Congress - Second Session Ensuring Access to COVID-19 Preventive Care Act of 2020 Sponsor: Rep. Larry Bucshon (R-IN-08) H.R. 6244 - 116th Congress - Second Session To amend titles XVIII and XIX to provide for coverage at no cost sharing of COVID-19 testing under the Medicaid program and Children's Health Insurance Program. Sponsor: Rep. Robin Kelly (D-IL-02) H.R. 6263 - 116th Congress - Second Session To amend title XVIII of the Social Security Act to waive cost sharing under the Medicare program for certain visits relating to testing for COVID-19. Sponsor: Rep. John Sarbanes (D-MD-03) H.R. 6282 - 116th Congress - Second Session Commission on America's Medical Security Act Sponsor: Rep. Raul Ruiz (D-CA-36) H.R. 6283 - 116th Congress - Second Session Good Samaritan Health Professionals Act of 2020 Sponsor: Rep. Raul Ruiz (D-CA-36) H.R. 1379 - 116th Congress - First Session Ensuring Lasting Smiles Act Rep. Collin Peterson (D-MN-07) H.R. 6810 - 116th Congress - Second Session Health Care Protection Act Sponsor: Rep. Rodney Davis (R-IL-13) H.R. 6808 - 116th Congress - Second Session Health Force and Resilience Force Act of 2020 Sponsor: Rep. Jason Crow (D-CO-06) S. 3606 - 116th Congress - Second Session Health Force and Resilience Force Act of 2020 Sponsor: Sen. Kirsten Gillibrand (D-NY) H.R. 6130 - 116th Congress - Second Session Improving Awareness of Health Coverage Options Act Sponsor: Rep. Josh Harder (D-CA-10) Public Law 116-123 (H.R.6074) - 116th Congress - Second Session Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 Sponsor: Rep. Nita Lowey (D-NY-17) H.R. 6379 - 116th Congress - Second Session Take Responsibility for Workers and Families Act Sponsor: Rep. Nita Lowey (D-NY-17) H.R. 6800 - 116th Congress - Second Session HEROES Act Sponsor: Rep. Nita Lowey (D-NY-17) H.R. 6426 - 116th Congress - Second Session To direct the Secretary of Health and Human Services to establish a program under which loans shall be made to certain health care organizations to assist such organizations with anticipated revenue loss or higher operating costs as a result of the COVID-19 emergency, and for other purposes Sponsor: Rep. Max Rose (D-NY-11) H.R. 6455 - 116th Congress - Second Session National Commission Regarding the 2019 Novel Coronavirus (COVID-19) Pandemic Act Sponsor: Rep. Bennie Thompson (D-MS-02) H.R. 6409 - 116th Congress - Second Session Assistance for Businesses and Local Economies Act Sponsor: Rep. Ilhan Omar (D-MN-05) Public Law 116-139 (H.R. 266) - 116th Congress - First Session Vehicle for Covid-19 Small Business, Hospital and Testing Funds Sponsor: Rep. Betty McCollum (D-MN-04) H.R. 5566 - 116th Congress - Second Session Patient Fairness Act of 2020 Sponsor: Rep. Warren Davidson (R-OH-08) H.R. 5596 - 116th Congress - Second Session Personalized Care Act of 2020 Sponsor: Rep. Chip Roy(R-TX-21) H.R. 6338 - 116th Congress - Second Session Pandemic Healthcare Access Act Sponsor: Rep. Ted Budd (R-NC-13) H.R. 5808 - 116th Congress - Second Session Save Rural Communities Act of 2020 Sponsor: Rep. Jodey Arrington (R-TX-19) H.R. 7391 - 116th Congress - Second Session To amend title XVIII of the Social Security Act to remove certain geographic and originating site restrictions on the furnishing of telehealth services under the Medicare program. H.R. 5763 - 116th Congress - Second Session National Telehealth Strategy and Data Advancement Act Sponsor: Rep. Greg Gianforte (R-MT At-Large) H.R. 6487 - 116th Congress - Second Session Advancing Connectivity during the Coronavirus to Ensure Support for Seniors Act Sponsor: Rep. Jan Schakowsky (D-IL-09) H.R. 6514 - 116th Congress - Second Session Worker Health Coverage Protection Act Sponsor: Rep. Bobby Scott (D-VA-03) H.R. 6712 - 116th Congress - Second Session American Healthshare Plans Act of 2020 Sponsor: Rep. John Curtis(R-UT-03) H.R. 6746 - 116th Congress - Second Session To require the Secretary of Labor to establish a program for providing portable benefits to eligible workers, and for other purposes Sponsor: Rep. Suzan DelBene (D-WA-01) H.R. 6833 - 116th Congress - Second Session Utilizing and Supporting Evacuated Peace Corps Volunteers Act Sponsor: Rep. Dean Phillips (D-MN-03) H.R. 6411 - 116th Congress - Second Session Emergency Advance Refill Notification Act of 2020 Sponsor: Rep. Lucy McBath (D-GA-06) H.R. 6511 - 116th Congress - Second Session Ensuring Vaccination and Treatment Affordability Act Sponsor: Rep. Chris Pappas (D-NH-01) H.R. 6518 - 116th Congress - Second Session Stop Health Premium Spikes Act of 2020 H.R. 6561 - 116th Congress - Second Session Improving Social Determinants of Health Act of 2020 Sponsor: Rep. Nanette Barragan (D-CA-44) H.R. 6568 - 116th Congress - Second Session Coverage for COVID-19 Treatment Act of 2020 Sponsor: Rep. Lisa Blunt Rochester (D-DE At-Large) H.R. 6634 - 116th Congress - Second Session Emergency COVID Telehealth Response Act Sponsor: Rep. Cindy Axne (D-IA-03) H.R. 6638 - 116th Congress - Second Session Reducing COVID-19 Disparities by Investing in Public Health Act Cosponsor: Rep. Jahana Hayes (D-CT-05) H.R. 6644 - 116th Congress - Second Session To require group health plans and health insurance issuers offering group or individual health insurance coverage to provide coverage for services furnished via telehealth if such services would be covered if furnished in-person during the COVID-19 emergency. Sponsor: Kim Schrier (D-WA-08) H.R. 6645 - 116th Congress - Second Session To direct the Secretary of Health and Human Services, acting through the Director of the National Institute of Mental Health, to conduct or support research on the mental health consequences of SARS-CoV-2 or COVID-19, and for other purposes. H.R. 6654 - 116th Congress - Second Session Emergency COVID Telehealth Response Act Sponsor: Rep. Cindy Axne (D-IA-03) H.R. 6663 - 116th Congress - Second Session Truth in Healthcare Marketing Act of 2020 Sponsor: Rep. Larry Buschon (R-IN-08) H.R. 6742 - 116th Congress - Second Session Protecting Life in Crisis Act Sponsor: Rep. Mike Conaway (R-TX-11) H.R. 6763 - 116th Congress - Second Session COVID-19 Racial and Ethnic Disparities Task Force Act of 2020 Sponsor: Rep. Robin Kelly (D-IL-02) H.R. 6792 - 116th Congress - Second Session Improving Telehealth for Underserved Communities Act of 2020 Sponsor: Rep. Adrian Smith (R-NE-03) H.R. 6797 - 116th Congress - Second Session Children's Health Insurance Program Pandemic Enhancement and Relief Act Sponsor: Rep. Susan Wild (D-PA-07) H.R. 6866 - 116th Congress - Second Session Public Health Emergency Privacy Act Sponsor: Rep. Anna Eshoo (D-CA-18) H.R. 6906 - 116th Congress - Second Session Health Care Emergency Guarantee Act Sponsor: Pramila Jayapal (D-WA-07) H.R. 6918 - 116th Congress - Second Session Paycheck Recovery Act of 2020 Sponsor: Rep. Pramila Jayapal(D-WA-07) H.R. 6925 - 116th Congress - Second Session Medical Innovation Acceleration Act of 2020 Sponsor: Rep. Andy Biggs (R-AZ-05) H.R. 6926 - 116th Congress - Second Session Meeting IMD Needs with Direction Act Sponsor: Rep. Brendan Boyle (D-PA-02) H.R. 6930 - 116th Congress - Second Session Manufacturing API, Drugs, and Excipients in America Act of 2020 Sponsor: Rep. Buddy Carter (R-GA-01) H.R. 6971 - 116th Congress - Second Session Medical Nutrition Therapy Act of 2020 Sponsor: Rep. Eliot Engel (D-NY-16) H.R. 6999 - 116th Congress - Second Session Coronavirus Mental Health and Addiction Assistance Act of 2020 Sponsor: Rep. Tim Ryan (D-OH-13) H.R. 7017 - 116th Congress - Second Session Right to Test Act Sponsor: Rep. Patrick McHenry (R-NC-10) H.R. 7077 - 116th Congress - Second Session Community Solutions for COVID-19 Act Sponsor: Rep. Robin Kelly (D-IL-02) H.R. 7078 - 116th Congress - Second Session Evaluating Disparities and Outcomes of Telehealth During the COVID-19 Emergency Act of 2020 Sponsor: Rep. Robin Kelly (D-IL-02) H.R. 7123 - 116th Congress - Second Session Katherine's Lung Cancer Early Detection and Survival Act of 2020 Sponsor: Rep. Brendan Boyle (D-PA-02) H.R. 7158 - 116th Congress - Second Session Health Enterprise Zones Act of 2020 Sponsor: Anthony Brown (D-MD-04) H.R. 7168 - 116th Congress - Second Session Creating Capacity for Communities in Need Act Sponsor: Vicente Gonzalez (D-TX-15) H.R. 7187 - 116th Congress - Second Session Helping Ensure Access to Local TeleHealth Act of 2020 Sponsor: Rep Glenn Thompson (R-PA-15) H.R. 7190 - 116th Congress - Second Session Increasing Rural Health Access During the COVID-19 Public Health Emergency Act of 2020 Sponsor: Rep. Xochitl Torres Small (D-NM-02) H.R. 7286 - 116th Congress - Second Session Quit Because of COVID-19 Act Sponsor: Rep. Lisa Blunt Rochester (D-DE-At-Large) H.R. 5958 - 116th Congress - Second Session Official Short Title: Senior Health Planning Account Act Sponsor: Rep. Brian Higgins (D-NY-26) H.R. 6209 - 116th Congress - Second Session Reducing Unnecessary Senior Hospitalizations Act of 2020 Sponsor: Rep. Ann Kuster (D-NH-02) H.R. 6436 - 116th Congress - Second Session Police and Fire Health Care Protection Act of 2020 Sponsor: Rep. Steve Chabot (R-OH-01) H.R. 6545 - 116th Congress - Second Session Health Insurance Marketplace Affordability Act of 2020 Sponsor: Rep. Stephanie Murphy (D-FL-07) H.R. 6698 - 116th Congress - Second Session Quality Care for Nursing Home Residents and Workers During COVID-19 Act of 2020 Sponsor: Rep. Jan Schakowsky (D-IL-09) H.R. 6753 - 116th Congress - Second Session Rural Community Hospital Demonstration Extension Act of 2020 Sponsor: Rep. Abby Finkenauer (D-IA-01) H.R. 6781 - 116th Congress - Second Session Paycheck Protection Program Improved Coordination Act of 2020 Cosponsor: Rep. Chris Pappas (D-NH-01) H.R. 6824 - 116th Congress - Second Session To amend the Internal Revenue Code of 1986 to provide for the carryover of the remaining 2020 balance in health flexible spending arrangements. Sponsor: Rep. Derek Kilmer (D-WA-06) H.R. 6855 - 116th Congress - Second Session Facilitating Virtual Visitation for Nursing Home Residents Act of 2020 Sponsor: Rep. Linda Sanchez (D-CA-38) H.R. 6857 - 116th Congress - Second Session COVID-19-Only Homes Organized for Resident Treatment Act of 2020 Sponsor: Rep. Tom Suozzi (D-NY-03) H.R. 6920 - 116th Congress - Second Session Keep Employees' Earnings Protected Act of 2020 Sponsor: Rep. Ross Spano (R-FL-15) H.R. 7008 - 116th Congress - Second Session Family Savings Flexibility Act Sponsor: Rep. Brad Wenstrup (R-OH-02) H.R. 7149 - 116th Congress - Second Session To amend the Internal Revenue Code of 1986 to provide special disposition rules for unused benefits in flexible spending arrangements of individuals for calendar year 2020. Sponsor: Rep. Gary Palmer (R-AL-06) H.R. 7233 - 116th Congress - Second Session Knowing the Efficiency and Efficacy of Permanent Telehealth Options Act of 2020 Sponsor: Rep. Troy Balderson (R-OH-12) H.R. 7242 - 116th Congress - Second Session To amend the Internal Revenue Code of 1986 to permit expenditures from health savings accounts for gym memberships and costs of home gym equipment, to repeal the requirement that health plan be high deductible, and for other purposes. Sponsor: Rep. John Curtis (R-UT-03) H.R. 7267 - 116th Congress - Second Session Patients Before Profits Act of 2020 Sponsor: Rep. Katie Porter (D-CA-45) Public Law 116-136(H.R. 748) - 116th Congress - First Session Third Coronavirus Stimulus Package Sponsor: Rep. Joe Courtney (D-CT-02)
2020 · second_quarter · Health Issues
H.R. 1425. Patient Protection and Affordable Care Enhancement Act: Full bill H.R. 6336. Increasing Hospital Capacity to Fight the Coronavirus Act: Full bill H.R. 6712. American Healthshare Plans Act: Full bill Issues related to healthcare, generally Issues related to the allocation of federal dollars for long-term care facilities, generally S. 3599. Healthcare Workforce Resilience Act: Full bill S. 3610. American Healthshare Plans Act: Full bill H.R. 266, Paycheck Protection Program and Health Care Enhancement Act, Full Bill; H.R. 6396, Responsible Relief for Americans Act, Full Bill
Client expense: $550,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), SENATE, White House Office
2020 · second_quarter · Medicare/Medicaid
Medicare Advantage; Medicaid Expansion; Medicaid; Medicare Data Sharing; Privacy; Medicare Prescription Drug Prices; CMS; Generic Drugs (CREATES Act); Drug Approval; HELP Cost Reduction Package; CHIP, MACRA; Provider Funding; Medicaid FMAP Increase; Coronavirus Medicaid Response; Rate Notice and Call Letter HR 3107 (116th Congress), Improving Seniors Timely Access to Care Act of 2019, by Rep. Suzan DelBene (D-WA). Establish requirements with respect to the use of prior authorization under Medicare Advantage plans. HR 5534 (116th Congress), Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act of 2019, by Rep. Ron Kind (D-WI). Provide for extended months of Medicare coverage of immunosuppressive drugs for kidney transplant patients. HR 5582 (116th Congress), Parental Accessibility Rights for Emergency and Negligent Treatment Act, by Rep. Gregory Murphy (R-NC). Expands the scope of advance directive policies and related disclosures for providers under Medicaid and the Children's Health Insurance Program (CHIP). HR 5693 (116th Congress), Primary Health Services Enhancement Act, by Rep. Ron Kind (D-WI). Expand Medicare Rural Health Clinic Services and Federally Qualified Health Center Services to include physical therapy services. HR 5741 (116th Congress), Strengthening Innovation in Medicare and Medicaid Act, by Rep. Terri Sewell (D-AL). Clarify parameters for model testing and add accountability to model expansion under the Center for Medicare and Medicaid Innovation. HR 5833 (116th Congress), by Rep. Bob Latta (R-OH). Permit the use of certain psychological evaluation via telehealth for Medicare coverage of neurostimulation services for the treatment of chronic pain. HR 5882 (116th Congress), GENE Therapy Payment Act, by Rep. Kurt Schrader (D-OR). Provide States with the option under the Medicaid program to pay for covered outpatient drugs through risk-sharing value-based agreements. HR 5897 (116th Congress), Preventing Abuse and Neglect of Vulnerable Americans Act of 2020, by Rep. Ruben Gallego (D-AZ). Requires the Centers for Medicare & Medicaid Services (CMS) to publish specified information on its website relating to deficiencies of Medicaid intermediate care facilities for individuals with intellectual disabilities, including information regarding inspections, complaints, and administrative actions. HR 5900 (116th Congress), Accelerating Kids' Access to Care Act, by Rep. Joseph Kennedy (D-MA). Requires state Medicaid programs to establish a process through which qualifying out-of-state providers may enroll as participating providers without undergoing additional screening requirements. HR 6098 (116th Congress), by Rep. Nanette Diaz Barragan (D-CA). Allow States to expand income eligibility standards under the Childrens Health Insurance Program. HR 6147 (116th Congress), Help Extend Auditory Relief (HEAR) Act of 2020, by Rep. Matt Cartwright (D-PA). Provide coverage under the Medicare program of hearing aids and related hearing services. HR 6159 (116th Congress), Kids Access to Primary Care Act of 2020, by Rep. Kim Schrier (D-WA). Renew the application of the Medicare payment rate floor to primary care services furnished under the Medicaid program. HR 6179 (116th Congress), Increasing Access to Biosimilars Act of 2020, by Rep. Tony Cardenas (D-CA). Require the Secretary of Health and Human Services to establish a demonstration project to increase access to biosimilar biological products under the Medicare program. HR 6214 (116th Congress), by Rep. Ron Kind (D-WI). Provide for coverage of testing for COVID-19 at no cost sharing under the Medicare Advantage program. HR 6218 (116th Congress), Preserving Patient Access to Home Infusion Act, by Rep. Eliot Engel (D-NY). Clarify congressional intent and preserve patient access to home infusion therapy under the Medicare program. HR 6263 (116th Congress), by Rep. John Sarbanes (D-MD). Waive cost sharing under the Medicare program for certain visits relating to testing for COVID-19. HR 6273 (116th Congress), Protecting Vulnerable Americans in Times of Crisis Act of 2020, by Rep. G. K. Butterfield (D-NC). Increase allotments under the Medicaid program for territories of the United States, to provide for a temporary increase in the Federal medical assistance percentage for States under the Medicaid program. HR 6281 (116th Congress), Medicare Wage Index Parity Act of 2020, by Rep. Bill Pascrell (D-NJ). Provides statutory authority for, and extends, a specified methodology used to calculate the minimum Medicare hospital wage index for all-urban states. HR 6282 (116th Congress), Commission on America's Medical Security Act, by Rep. Raul Ruiz (D-CA). Establish a commission to assess, evaluate, and address the dependence of the United States on medications, devices, and medical equipment from foreign countries. HR 6336 (116th Congress), Increasing Hospital Capacity to Fight the Coronavirus Act of 2020, by Rep. Dan Bishop (R-NC). Provide a waiver of payment reductions under the Medicare and Medicaid programs for certain nonapproved capital expenditures undertaken by health care facilities during the COVID-19 emergency. HR 6486 (116th Congress), Care for COVID-19 Act 2.0, by Rep. Raul Ruiz (D-CA). Require the Secretary of Health and Human Services to establish a special enrollment period during the COVID-19 emergency period, to require the Secretary to carry out outreach and educational activities for such special enrollment period, to require group health plans and health insurance issuers offering group or individual health insurance coverage to provide coverage without any cost sharing for certain items and services furnished during any portion of such emergency period. HR 6487 (116th Congress), Advancing Connectivity during the Coronavirus to Ensure Support for Seniors Act, by Rep. Jan Schakowsky (D-IL). Increase the ability of nursing facilities to access telehealth services and obtain technologies to allow virtual visits during the public health emergency relating to an outbreak of coronavirus disease 2019 (COVID-19). HR 6583 (116th Congress), by Rep. Chrissy Houlahan (D-PA). Establish a risk corridor program for Medicare Advantage plans during the COVID-19 emergency. HR 6616 (116th Congress), Stronger Medicaid Response to the COVID-19 Pandemic Act, by Rep. Tony Cardenas (D-CA). Allows COVID-19 vaccines and treatment, as well as treatment for conditions that may complicate COVID-19 treatment, for uninsured individuals to be covered under Medicaid during the public health emergency. HR 6640 (116th Congress), Medicare Advantage COVID Treatment Act, by Rep. Debbie Mucarsel-Powell (D-FL). Requires Medicare Advantage (MA) plans to cover specified treatment services relating to COVID-19 without cost-sharing during the public health emergency. HR 6649 (116th Congress), Lower Drug Costs for Seniors During COVID-19 Act of 2020, by Rep. Janice Schakowsky (D-IL). Requires the Centers for Medicare & Medicaid Services to establish a process for prescription drug plans under Medicare and Medicare Advantage to allow enrollees to make coinsurance payments in periodic installments, if the enrollee chooses to obtain the entire prescribed supply of a covered drug in a single fill. HR 6674 (116th Congress), Medicare Crisis Program Act of 2020, by Rep. Pramila Jayapal (D-WA). Ensure access to affordable, comprehensive health insurance benefits for certain uninsured individuals during the COVID-19 emergency, and to ensure adequate coverage of treatments for COVID-19 under the Medicare and Medicaid programs and under group health plans and group or individual health insurance coverage. HR 6698 (116th Congress), Quality Care for Nursing Home Residents and Workers During COVID-19 Act of 2020, by Rep. Jan Schakowsky (D-IL). Improve the quality of care in skilled nursing facilities under the Medicare program and nursing facilities under the Medicare program during the COVID-19 emergency period. HR 6739 (116th Congress), Ensuring Seniors' Access to COVID Treatments Act, by Rep. Sean Casten (D-IL). Requires prescription drug plans under Medicare and Medicare Advantage to cover drugs that are approved to treat COVID-19 without cost-sharing during the public health emergency. HR 6753 (116th Congress), Rural Community Hospital Demonstration Extension Act of 2020, by Rep. Abby Finkenauer (D-IA). Amend the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to extend the rural community hospital demonstration program. HR 6837 (116th Congress), Medicare Accelerated and Advance Payments Improvement Act of 2020, by Rep. Bradley Scott Schneider (D-IL). Modify the accelerated and advance payment programs under parts A and B of the Medicare program during the COVID-19 emergency. HR 6971 (116th Congress), Medical Nutrition Therapy Act of 2020, by Rep. Eliot Engel (D-NY). Expand the availability of medical nutrition therapy services under the Medicare program. HR 7062 (116th Congress), Affordable Insulin for the COVID-19 Emergency Act, by Rep. Maxine Waters (D-CA). Eliminate cost-sharing with respect to coverage of insulin as a covered part D drug and associated medical supplies and to provide mail order access to insulin and such supplies under the Medicare program during the COVID-19 emergency period. HR 7127 (116th Congress), by Rep. G. K. Butterfield (D-NC). Makes technical amendments to the separate payment under the Medicare program for disposable negative pressure wound therapy devices. HR 7154 (116th Congress), Outpatient Therapy Modernization and Stabilization Act, by Rep. Brendan Boyle (D-PA). Improve and ensure ongoing Medicare beneficiary access to outpatient therapy services. HR 7292 (116th Congress), COVID-19 Hospital and Health Provider Loan Forgiveness Act of 2020, by Rep. Marcy Kaptur (D-OH). Provide for forgiveness of certain accelerated and advance payments under parts A and B of the Medicare program. HR 7323 (116th Congress), Medicare Mental Health Inpatient Equity Act of 2019, by Rep. Paul Tonko (D-NY). Eliminate the 190-day lifetime limit on inpatient psychiatric hospital services under the Medicare Program. HR 7338 (116th Congress), by Rep. Liz Cheney (R-WY). Permit the Secretary of Health and Human Services to waive requirements relating to the furnishing of telehealth services under the Medicare program. HR 7391 (116th Congress), by Rep. Mikie Sherrill (D-NJ). Remove certain geographic and originating site restrictions on the furnishing of telehealth services under the Medicare program.
2020 · second_quarter · Medicare/Medicaid
Medicare Advantage; Medicaid Expansion; Medicaid; Medicare Data Sharing; Privacy; Medicare Prescription Drug Prices; CMS; Generic Drugs (CREATES Act); Drug Approval; HELP Cost Reduction Package; CHIP, MACRA; Provider Funding; Medicaid FMAP Increase; Coronavirus Medicaid Response; Rate Notice and Call Letter HR 3107 (116th Congress), Improving Seniors Timely Access to Care Act of 2019, by Rep. Suzan DelBene (D-WA). Establish requirements with respect to the use of prior authorization under Medicare Advantage plans. HR 5534 (116th Congress), Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act of 2019, by Rep. Ron Kind (D-WI). Provide for extended months of Medicare coverage of immunosuppressive drugs for kidney transplant patients. HR 5582 (116th Congress), Parental Accessibility Rights for Emergency and Negligent Treatment Act, by Rep. Gregory Murphy (R-NC). Expands the scope of advance directive policies and related disclosures for providers under Medicaid and the Children's Health Insurance Program (CHIP). HR 5693 (116th Congress), Primary Health Services Enhancement Act, by Rep. Ron Kind (D-WI). Expand Medicare Rural Health Clinic Services and Federally Qualified Health Center Services to include physical therapy services. HR 5741 (116th Congress), Strengthening Innovation in Medicare and Medicaid Act, by Rep. Terri Sewell (D-AL). Clarify parameters for model testing and add accountability to model expansion under the Center for Medicare and Medicaid Innovation. HR 5833 (116th Congress), by Rep. Bob Latta (R-OH). Permit the use of certain psychological evaluation via telehealth for Medicare coverage of neurostimulation services for the treatment of chronic pain. HR 5882 (116th Congress), GENE Therapy Payment Act, by Rep. Kurt Schrader (D-OR). Provide States with the option under the Medicaid program to pay for covered outpatient drugs through risk-sharing value-based agreements. HR 5897 (116th Congress), Preventing Abuse and Neglect of Vulnerable Americans Act of 2020, by Rep. Ruben Gallego (D-AZ). Requires the Centers for Medicare & Medicaid Services (CMS) to publish specified information on its website relating to deficiencies of Medicaid intermediate care facilities for individuals with intellectual disabilities, including information regarding inspections, complaints, and administrative actions. HR 5900 (116th Congress), Accelerating Kids' Access to Care Act, by Rep. Joseph Kennedy (D-MA). Requires state Medicaid programs to establish a process through which qualifying out-of-state providers may enroll as participating providers without undergoing additional screening requirements. HR 6098 (116th Congress), by Rep. Nanette Diaz Barragan (D-CA). Allow States to expand income eligibility standards under the Childrens Health Insurance Program. HR 6147 (116th Congress), Help Extend Auditory Relief (HEAR) Act of 2020, by Rep. Matt Cartwright (D-PA). Provide coverage under the Medicare program of hearing aids and related hearing services. HR 6159 (116th Congress), Kids Access to Primary Care Act of 2020, by Rep. Kim Schrier (D-WA). Renew the application of the Medicare payment rate floor to primary care services furnished under the Medicaid program. HR 6179 (116th Congress), Increasing Access to Biosimilars Act of 2020, by Rep. Tony Cardenas (D-CA). Require the Secretary of Health and Human Services to establish a demonstration project to increase access to biosimilar biological products under the Medicare program. HR 6214 (116th Congress), by Rep. Ron Kind (D-WI). Provide for coverage of testing for COVID-19 at no cost sharing under the Medicare Advantage program. HR 6218 (116th Congress), Preserving Patient Access to Home Infusion Act, by Rep. Eliot Engel (D-NY). Clarify congressional intent and preserve patient access to home infusion therapy under the Medicare program. HR 6263 (116th Congress), by Rep. John Sarbanes (D-MD). Waive cost sharing under the Medicare program for certain visits relating to testing for COVID-19. HR 6273 (116th Congress), Protecting Vulnerable Americans in Times of Crisis Act of 2020, by Rep. G. K. Butterfield (D-NC). Increase allotments under the Medicaid program for territories of the United States, to provide for a temporary increase in the Federal medical assistance percentage for States under the Medicaid program. HR 6281 (116th Congress), Medicare Wage Index Parity Act of 2020, by Rep. Bill Pascrell (D-NJ). Provides statutory authority for, and extends, a specified methodology used to calculate the minimum Medicare hospital wage index for all-urban states. HR 6282 (116th Congress), Commission on America's Medical Security Act, by Rep. Raul Ruiz (D-CA). Establish a commission to assess, evaluate, and address the dependence of the United States on medications, devices, and medical equipment from foreign countries. HR 6336 (116th Congress), Increasing Hospital Capacity to Fight the Coronavirus Act of 2020, by Rep. Dan Bishop (R-NC). Provide a waiver of payment reductions under the Medicare and Medicaid programs for certain nonapproved capital expenditures undertaken by health care facilities during the COVID-19 emergency. HR 6486 (116th Congress), Care for COVID-19 Act 2.0, by Rep. Raul Ruiz (D-CA). Require the Secretary of Health and Human Services to establish a special enrollment period during the COVID-19 emergency period, to require the Secretary to carry out outreach and educational activities for such special enrollment period, to require group health plans and health insurance issuers offering group or individual health insurance coverage to provide coverage without any cost sharing for certain items and services furnished during any portion of such emergency period. HR 6487 (116th Congress), Advancing Connectivity during the Coronavirus to Ensure Support for Seniors Act, by Rep. Jan Schakowsky (D-IL). Increase the ability of nursing facilities to access telehealth services and obtain technologies to allow virtual visits during the public health emergency relating to an outbreak of coronavirus disease 2019 (COVID-19). HR 6583 (116th Congress), by Rep. Chrissy Houlahan (D-PA). Establish a risk corridor program for Medicare Advantage plans during the COVID-19 emergency. HR 6616 (116th Congress), Stronger Medicaid Response to the COVID-19 Pandemic Act, by Rep. Tony Cardenas (D-CA). Allows COVID-19 vaccines and treatment, as well as treatment for conditions that may complicate COVID-19 treatment, for uninsured individuals to be covered under Medicaid during the public health emergency. HR 6640 (116th Congress), Medicare Advantage COVID Treatment Act, by Rep. Debbie Mucarsel-Powell (D-FL). Requires Medicare Advantage (MA) plans to cover specified treatment services relating to COVID-19 without cost-sharing during the public health emergency. HR 6649 (116th Congress), Lower Drug Costs for Seniors During COVID-19 Act of 2020, by Rep. Janice Schakowsky (D-IL). Requires the Centers for Medicare & Medicaid Services to establish a process for prescription drug plans under Medicare and Medicare Advantage to allow enrollees to make coinsurance payments in periodic installments, if the enrollee chooses to obtain the entire prescribed supply of a covered drug in a single fill. HR 6674 (116th Congress), Medicare Crisis Program Act of 2020, by Rep. Pramila Jayapal (D-WA). Ensure access to affordable, comprehensive health insurance benefits for certain uninsured individuals during the COVID-19 emergency, and to ensure adequate coverage of treatments for COVID-19 under the Medicare and Medicaid programs and under group health plans and group or individual health insurance coverage. HR 6698 (116th Congress), Quality Care for Nursing Home Residents and Workers During COVID-19 Act of 2020, by Rep. Jan Schakowsky (D-IL). Improve the quality of care in skilled nursing facilities under the Medicare program and nursing facilities under the Medicare program during the COVID-19 emergency period. HR 6739 (116th Congress), Ensuring Seniors' Access to COVID Treatments Act, by Rep. Sean Casten (D-IL). Requires prescription drug plans under Medicare and Medicare Advantage to cover drugs that are approved to treat COVID-19 without cost-sharing during the public health emergency. HR 6753 (116th Congress), Rural Community Hospital Demonstration Extension Act of 2020, by Rep. Abby Finkenauer (D-IA). Amend the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to extend the rural community hospital demonstration program. HR 6837 (116th Congress), Medicare Accelerated and Advance Payments Improvement Act of 2020, by Rep. Bradley Scott Schneider (D-IL). Modify the accelerated and advance payment programs under parts A and B of the Medicare program during the COVID-19 emergency. HR 6971 (116th Congress), Medical Nutrition Therapy Act of 2020, by Rep. Eliot Engel (D-NY). Expand the availability of medical nutrition therapy services under the Medicare program. HR 7062 (116th Congress), Affordable Insulin for the COVID-19 Emergency Act, by Rep. Maxine Waters (D-CA). Eliminate cost-sharing with respect to coverage of insulin as a covered part D drug and associated medical supplies and to provide mail order access to insulin and such supplies under the Medicare program during the COVID-19 emergency period. HR 7127 (116th Congress), by Rep. G. K. Butterfield (D-NC). Makes technical amendments to the separate payment under the Medicare program for disposable negative pressure wound therapy devices. HR 7154 (116th Congress), Outpatient Therapy Modernization and Stabilization Act, by Rep. Brendan Boyle (D-PA). Improve and ensure ongoing Medicare beneficiary access to outpatient therapy services. HR 7292 (116th Congress), COVID-19 Hospital and Health Provider Loan Forgiveness Act of 2020, by Rep. Marcy Kaptur (D-OH). Provide for forgiveness of certain accelerated and advance payments under parts A and B of the Medicare program. HR 7323 (116th Congress), Medicare Mental Health Inpatient Equity Act of 2019, by Rep. Paul Tonko (D-NY). Eliminate the 190-day lifetime limit on inpatient psychiatric hospital services under the Medicare Program. HR 7338 (116th Congress), by Rep. Liz Cheney (R-WY). Permit the Secretary of Health and Human Services to waive requirements relating to the furnishing of telehealth services under the Medicare program. HR 7391 (116th Congress), by Rep. Mikie Sherrill (D-NJ). Remove certain geographic and originating site restrictions on the furnishing of telehealth services under the Medicare program.
2020 · second_quarter · Health Issues
Affordable Care Act (ACA); ACA Regulations; ACA Stabilization; Health Reform; Risk Adjustment; Opioids; Individual Market Reform; Health Care Costs; Mental Health; Cost Sharing Reductions (CSRs); Transparency; Surprise Billing; Prior Authorization; All Payer Claims Database (APCD); Negotiated Rate Disclosure; Medicare for All; Maternal Health; Seniors Health Care; Community Health; 2021 Notice of Benefit and Payment Parameters (NBPP); COVID-19 Response/Relief Packages; Health Care Access/Privacy; Risk Corridors; COBRA; Telehealth; SEPs; CDC Guidance Testing HR 266 (116th Congress), Paycheck Protection Program and Health Care Enhancement Act, by Rep. Betty McCollum (D-MN). Responds to the COVID-19 outbreak by providing additional funding for small business loans, health care providers, and COVID-19 testing. HR 748 (116th Congress), Coronavirus Aid, Relief, and Economic Security (CARES) Act, by Rep. Joe Courtney (D-CT). Responds to the COVID-19 outbreak and its impact on the economy, public health, state and local governments, individuals, and businesses. HR 1384 (116th Congress), Medicare for All Act of 2019, by Rep. Pramila Jayapal (D-WA). Establish an improved Medicare for All national health insurance program. HR 2274 (116th Congress), Primary Care Patient Protection Act of 2019, by Rep. Brad Schneider (D-IL). Require coverage without a deductible of certain primary care services by high deductible health plans. HR 2279 (116th Congress), Safe Step Act, by Rep. Raul Ruiz (D-CA). Require a group health plan (or health insurance coverage offered in connection with such a plan) to provide an exceptions process for any medication step therapy protocol. HR 3630 (116th Congress), No Surprises Act, by Rep. Frank Pallone, Jr. (D-NJ). Protect health care consumers from surprise billing practices. HR 5566 (116th Congress), Patient Fairness Act of 2020, by Rep. Warren Davidson (R-OH). Allow all individuals to contribute to health savings accounts. HR 5575 (116th Congress), Primary and Behavioral Health Care Access Act of 2020, by Rep. Lauren Underwood (D-IL). Require group health plans and health insurance issuers offering group or individual health insurance coverage to provide for 3 primary care visits and 3 behavioral health care visits without application of any cost-sharing requirement. HR 5596 (116th Congress), Personalized Care Act of 2020, by Rep. Chip Roy (R-TX). Expand and improve health savings accounts. HR 5688 (116th Congress), Reducing Administrative Costs and Burdens in Health Care Act of 2020, by Rep. Cindy Axne (D-IA). Provide grants to enable States to carry out activities to reduce administrative costs and burdens in health care. HR 5763 (116th Congress), National Telehealth Strategy and Data Advancement Act, by Rep. Greg Gianforte (R-MT). Advance telehealth by developing a plan for adoption and coordination by Federal agencies. HR 5800 (116th Congress), Ban Surprise Billing Act, by Rep. Bobby Scott (D-VA). End surprise medical billing and increase transparency in health coverage. HR 5807 (116th Congress), Know Your Provider Act of 2020, by Rep. John Larson (D-CT). Improve the availability and accuracy of provider directory information made available by group health plans and health insurance issuers offering group or individuals health insurance coverage. HR 5809 (116th Congress), Better Information Act of 2020, by Rep. Don Beyer (D-VA). Require group health plans and health insurance issuers to include certain information on any health insurance membership card issued by such plan or issuer. HR 5816 (116th Congress), Continuing Care for Patients Act of 2020, by Rep. Gwen Moore (D-WI). Require group health plans and health insurance issuers to provide for certain coverage in the case of a change in a providers network status. HR 5817 (116th Congress), Fair and Honest Advance Cost Estimate for Patients Act of 2020, by Rep. Devin Nunes (R-CA). Require health plans to provide to participants, beneficiaries, and enrollees an advanced explanation of benefits with respect to items and services scheduled to be received from providers and facilities, and require health care providers and health care facilities to provide good faith estimates of the expected charges for furnishing such items and services. HR 5826 (116th Congress), Consumer Protections Against Surprise Medical Bills Act of 2020, by Rep. Richard Neal (D-MA). Prevent certain cases of out-of-network surprise medical bills, strengthen health care consumer protections, and improve health care information transparency. HR 5916 (116th Congress), Transparent Health Care Pricing Act of 2020, by Rep. Mike Gallagher (R-WI). Require providers of health care products and services to publicly disclose point-of-sale cash prices. HR 5924 (116th Congress), by Rep. David McKinley (R-WV). Authorize a loan repayment program to encourage specialty medicine physicians to serve in rural communities experiencing a shortage of specialty medicine physicians. HR 6004 (116th Congress), Transparency and Accountability in Health Care Costs and Prices Act of 2020, by Rep. Dan Lipinski (D-IL). Require the Secretary of Health and Human Services to establish a grant program for purposes of facilitating State efforts to establish or maintain all-payer claims databases. HR 6005 (116th Congress), Know the Price Act, by Rep. Tom Malinowski (D-NJ). Increase transparency of group health plans and health insurance issuers offering group or individual health insurance coverage by removing gag clauses on price and quality information. HR 6074 (116th Congress), Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020, by Rep. Nita Lowey (D-NY). Provides $8.3 billion in emergency funding for federal agencies to respond to the coronavirus outbreak. HR 6130 (116th Congress), Improving Awareness of Health Coverage Options Act, by Rep. Josh Harder (D-CA). Require the Secretary of Labor to update the model COBRA continuation coverage general notice and the model COBRA continuation coverage election notice. HR 6132 (116th Congress), Social Determinants for Moms Act of 2020, by Rep. Tom Malinowski (D-NJ). Address social determinants of health for women in the prenatal and postpartum periods. HR 6135 (116th Congress), No More Narrow Networks Act of 2020, by Rep. Jan Schakowsky (D-IL). Require Affordable Care Act (ACA) Exchanges to establish network adequacy standards for qualified health plans. HR 6136 (116th Congress), Protecting Consumers from Unreasonable Rates Act of 2020, by Rep. Jan Schakowsky (D-IL). Provide protections for consumers against excessive, unjustified, or unfairly discriminatory increases in premium rates. HR 6137 (116th Congress), Innovative Maternal Payment and Coverage to Save Moms Act, by Rep. Jan Schakowsky (D-IL). Require the Secretary of Health and Human Services to establish and implement a Perinatal Care Alternative Payment Model Demonstration Project. HR 6138 (116th Congress), Tech to Save Moms Act, by Rep. Eddie Bernice Johnson (D-TX). Improve maternal health outcomes, especially for underserved populations, through investments in technology. HR 6151 (116th Congress), CARING for Kids Act, by Rep. Abby Finkenauer (D-IA). Permanently extend the Childrens Health Insurance Program. HR 6173 (116th Congress), Covering Coronavirus Test Act of 2020, by Rep. Diana DeGette (D-CO). Require group health plans and health insurance issuers offering group or individual health insurance coverage to cover COVID-19 testing without cost sharing. HR 6201 (116th Congress), First Coronavirus Response Act, by Rep. Nita Lowey (D-NY). Makes emergency supplemental appropriations for the fiscal year ending September 30, 2020. HR 6213 (116th Congress), No Cost for COVID-19 Testing Act, by Rep. Frederica Wilson (D-FL). Provide for coverage (without cost sharing or utilization management requirements) under group health plans and individual and group health insurance coverage of testing for COVID-19. HR 6222 (116th Congress), Ensuring Affordable COVID-19 Preventive Care Act of 2020, by Rep. Jan Schakowsky (D-IL). Provide for coverage of items, services, and immunizations relating to the diagnosis or treatment of COVID-19 under group health plans and health insurance coverage within 15 days of the issuance of a recommendation from the United States Preventive Services Task Force or the Advisory Committee on Immunization Practices. HR 6231 (116th Congress), Ensuring Affordable COVID-19 Preventive Care Act of 2020, by Rep. Larry Bucshon (R-IN). Ensure affordable coverage of certain vaccines and testing services under group health plans and group and individual health insurance coverage during the COVID-19 public health emergency. HR 6232 (116th Congress), by Rep. Tony Cardenas (D-CA). Require the Secretary of Health and Human Services, through the National Disaster Medical System, to provide for certain laboratory reimbursement for diagnostic testing for COVID-19 in uninsured individuals. HR 6244 (116th Congress), by Rep. Robin Kelly (D-IL). Provide for coverage at no cost sharing of COVID-19 testing under the Medicaid program and Childrens Health Insurance Program. HR 6263 (116th Congress), by Rep. John Sarbanes (D-MD). Waive cost sharing under the Medicare program for certain visits relating to testing for COVID-19. HR 6282 (116th Congress), Commission on Americas Medical Security Act, by Rep. Raul Ruiz (D-CA). Establish a commission to assess, evaluate, and address the dependence of the United States on medications, devices, and medical equipment from foreign countries. HR 6283 (116th Congress), Good Samaritan Health Professionals Act of 2020, by Rep. Raul Ruiz (D-CA). Limit the liability of health care professionals who volunteer to provide health care services in response to a disaster. HR 6299 (116th Congress), Rapid Coverage of COVID-19 Vaccine Act of 2020, by Rep. Joe Courtney (D-CT). Provide for the rapid coverage of preventive services and vaccines for COVID-19. HR 6311 (116th Congress), Care for COVID-19 Act, by Rep. Raul Ruiz (D-CA). Require private health insurers to cover care related to COVID-19 without cost-sharing and to provide for special enrollment periods for individuals diagnosed with COVID-19. HR 6336 (116th Congress), Increasing Hospital Capacity to Fight the Coronavirus Act of 2020, by Rep. Dan Bishop (R-NC). Provide for a waiver of payment reductions under the Medicare and Medicaid programs for certain nonapproved capital expenditures undertaken by health care facilities during the COVID-19 emergency. HR 6338 (116th Congress), Pandemic Healthcare Access Act, by Rep. Ted Budd (R-NC). Waive high deductible health plan requirements for health savings accounts. HR 6379 (116th Congress), Take Responsibility for Workers and Families Act, by Rep. Nita Lowey (D-NY). Provides FY2020 supplemental appropriations for federal agencies to respond to the COVID-19 outbreak. HR 6409 (116th Congress), Assistance for Businesses and Local Economies Act, by Rep. Ilhan Omar (D-MN). Establish the Emergency Social Insurance Program in the Social Security Administration and Small Business Administration in order to address the injury concerns of certain small businesses and idle workers disproportionally affected by the COVID-19 crisis. HR 6411 (116th Congress), Emergency Advance Refill Notification Act of 2020, by Rep. Lucy McBath (D-GA). Require group health plans and health insurance issuers offering group or individual health insurance coverage to provide notices relating to prescription drug refills to individuals covered under such plans or coverage who reside in emergency areas during emergency periods. HR 6426 (116th Congress), by Rep. Max Rose (D-NY). Directs the Secretary of Health and Human Services to establish a program under which loans shall be made to certain health care organizations to assist such organizations with anticipated revenue loss or higher operating costs as a result of the COVID-19 emergency. HR 6436 (116th Congress), Police and Fire Health Care Protection Act of 2020, by Rep. Steve Chabot (R-OH). Repeal the direct payment requirement on the exclusion from gross income of distributions from governmental plans for health and long-term care insurance. HR 6455 (116th Congress), National Commission Regarding the 2019 Novel Coronavirus (COVID-19) Pandemic Act, by Rep. Bennie Thompson (D-MS). Establish the National Commission Regarding the 2019 Novel Coronavirus COVID-19 Pandemic. HR 6511 (116th Congress), Ensuring Vaccination and Treatment Affordability Act, by Rep. Chris Pappas (D-NH). Require coverage under the Medicaid program and Childrens Health Insurance Program for vaccines and treatment for COVID-19 without the imposition of cost sharing requirements. HR 6514 (116th Congress), Worker Health Coverage Protection Act, by Rep. Bobby Scott (D-VA). Provide premium assistance for COBRA continuation coverage and furloughed continuation coverage for individuals and their families during the COVID-19 emergency period and 180-days thereafter. HR 6518 (116th Congress), Stop Health Premium Spikes Act of 2020, by Rep. Scott Peters (D-CA). Directs the Secretary of Health and Human Services to establish a program of risk corridors for health insurance issuers offering health insurance coverage in the individual or small group market for certain plan years. HR 6545 (116th Congress), Health Insurance Marketplace Affordability Act of 2020, by Rep. Stephanie Murphy (D-FL). Provide an age rating adjustment to the applicable percentage used to determine the credit for coverage under qualified health plans. HR 6561 (116th Congress), Improving Social Determinants of Health Act of 2020, by Rep. Nanette Barragan. Authorize the Director of the Centers for Disease Control and Prevention to carry out a Social Determinants of Health Program. HR 6568 (116th Congress), Coverage for COVID-19 Treatment Act of 2020, by Rep. Lisa Blunt Rochester (D-DE). Require group health plans and health insurance issuers offering group or individual health insurance coverage to provide coverage without imposing any cost sharing requirements for certain items and services furnished during any portion of the COVID-19 emergency period. HR 6634 (116th Congress), Emergency COVID Telehealth Response Act, by Rep. Cindy Axne (D-IA). Ensure the extension of the telehealth waiver authority of the Secretary of Health and Human Services to physical therapists, occupational therapists, speech language-pathologists, and certain other providers. HR 6644 (116th Congress), by Rep. Kim Schrier (D-WA). Require group health plans and health insurance issuers offering group or individual health insurance coverage to provide coverage for services furnished via telehealth if such services would be covered if furnished in-person during the COVID-19 emergency. HR 6645 (116th Congress), by Rep. Paul Tonko (D-NY). Directs the Secretary of Health and Human Services, acting through the Director of the National Institute of Mental Health, to conduct or support research on the mental health consequences of SARS-CoV-2 or COVID-19. HR 6654 (116th Congress), Emergency COVID Telehealth Response Act, by Rep. Cindy Axne (D-IA). Ensure the extension of the telehealth waiver authority of the Secretary of Health and Human Services to physical therapists, occupational therapists, speech language-pathologists, and certain other providers. HR 6663 (116th Congress), Truth in Healthcare Marketing Act of 2020, by Rep. Larry Buschon (R-IN). Ensure that patients receive accurate health care information by prohibiting misleading and deceptive advertising or representation in the provision of health care services, to require the identification of the license of health care professionals. HR 6712 (116th Congress), American Healthshare Plans Act of 2020, by Rep. John Curtis (R-UT). Allow health share pools to be deemed an employer for purposes of offering a group health plan or group health insurance coverage. HR 6742 (116th Congress), Protecting Life in Crisis Act, by Rep. Mike Conaway (R-TX). Prohibit the expenditure for an abortion of Federal funds authorized or appropriated for preventing, preparing for, or responding to the COVID-19 pandemic. HR 6746 (116th Congress), by Rep. Suzan DelBene (D-WA). Require the Secretary of Labor to establish a program for providing portable benefits to eligible workers. HR 6763 (116th Congress), COVID-19 Racial and Ethnic Disparities Task Force Act of 2020, by Rep. Robin Kelly (D-IL). Establish a COVID-19 Racial and Ethnic Disparities Task Force to gather data about disproportionately affected communities and provide recommendations to combat the racial and ethnic disparities in the COVID-19 response. HR 6781 (116th Congress), Paycheck Protection Program Improved Coordination Act of 2020, by Rep. Chris Pappas (D-NH). Provide for improved coordination between the paycheck protection program and the employee retention tax credit. HR 6800 (116th Congress), HEROES Act, by Rep. Nita Lowey (D-NY). Responds to the COVID-19 outbreak and its impact on the economy, public health, state and local governments, individuals, and businesses. HR 6808 (116th Congress), Health Force and Resilience Force Act of 2020, by Rep. Jason Crow (D-CO). Provide for the establishment of a Health Force and a Resilience Force to respond to public health emergencies and meet public health needs. HR 6810 (116th Congress), Health Care Protection Act, by Rep. Rodney Davis (R-IL). Establish a Health Care Protection Program Fund to provide grants to employers to ensure continuity of coverage under a group health plan through the COVID-19 pandemic, to provide for premium assistance for COBRA benefits. HR 6824 (116th Congress), by Rep. Derek Kilmer (D-WA). Provide for the carryover of the remaining 2020 balance in health flexible spending arrangements. HR 6855 (116th Congress), Facilitating Virtual Visitation for Nursing Home Residents Act of 2020, by Rep. Linda Sanchez (D-CA). Ensure communications accessibility for residents of skilled nursing facilities during the COVID-19 emergency period. HR 6857 (116th Congress), COVID-19 Only Homes Organized for Resident Treatment Act of 2020, by Rep. Tom Suozzi (D-NY). Establish a COVID-19 skilled nursing facility payment incentive program. HR 6866 (116th Congress), Public Health Emergency Guarantee Act, by Rep. Pramila Jayapal (D-WA). Protect the privacy of health information during a national health emergency. HR 6906 (116th Congress), Health Care Emergency Guarantee Act, by Rep. Pramila Jayapal (D-WA). Provide reimbursements for certain costs of health care items and services, including prescription drugs, furnished during the public health emergency declared with respect to COVID-19. HR 6918 (116th Congress), Paycheck Recovery Act of 2020, by Rep. Pramila Jayapal (D-WA). Establish a grant program for employers adversely affected by COVID-19. HR 6920 (116th Congress), Keep Employees Earnings Protected Act of 2020, by Rep. Ross Spano (R-FL). Temporarily suspend payroll taxes during the emergency relating to COVID-19. HR 6925 (116th Congress), Medical Innovation Acceleration Act of 2020, by Rep. Andy Biggs (R-AZ). Exempt non-invasive diagnostic devices from regulation. HR 6926 (116th Congress), Meeting IMD Needs with Direction Act, by Rep. Brendan Boyle (D-PA). Provide coverage and payment for services furnished to individuals who are patients in institutions for mental diseases during the COVID-19 emergency period and 180-days thereafter. HR 6930 (116th Congress), Manufacturing API, Drugs, and Excipients in America Act of 2020, by Rep. Buddy Carter (R-GA). Mitigate drug shortages and provide incentives for maintaining, expanding, and relocating the manufacturing of active pharmaceutical ingredients, excipients, medical diagnostic devices, pharmaceuticals, and personal protective equipment in the United States. HR 6999 (116th Congress), Coronavirus Mental Health and Addiction Assistance Act of 2020, by Rep. Tim Ryan. Establish the Coronavirus Mental Health and Addiction Assistance Network. HR 7008 (116th Congress), Family Savings Flexibility Act, By Rep. Brad Wenstrup (R-OH). Provide flexibility for families with health flexible spending arrangements and dependent care flexible spending arrangements. HR 7017 (116th Congress), Right to Test Act, by Rep. Patrick McHenry (R-NC). Allow States to approve the use of diagnostic tests during a public health emergency. HR 7077 (116th Congress), Community Solutions for COVID-19 Act, by Rep. Robin Kelly (D-IL). Establish or expand programs to improve health equity regarding COVID-19 and reduce or eliminate inequities in the prevalence and health outcomes of COVID-19. HR 7078 (116th Congress), Evaluating Disparities and Outcomes of Telehealth During the COVID-19 Emergency Act of 2020, by Rep. Robin Kelly (D-IL). Study the effects of changes to telehealth under the Medicare and Medicaid programs during the COVID-19 emergency. HR 7123 (116th Congress), Katherines Lung Cancer Early Detection and Survival Act of 2020, by Rep. Brendan Boyle (D-PA). Require group health plans and health insurance issuers offering group or individual health insurance coverage to provide benefits for lung cancer screenings for certain individuals without the imposition of cost sharing. HR 7149 (116th Congress), by Rep. Gary Palmer (R-AL). Provide special disposition rules for unused benefits in flexible spending arrangements of individuals for calendar year 2020. HR 7158 (116th Congress), Health Enterprise Zones Act of 2020, by Rep. Anthony Brown (D-MD). Provide for the designation of areas as Health Enterprise Zones to reduce health disparities and improve health outcomes in such areas. HR 7168 (116th Congress), Creating Capacity for Communities in Need Act, by Rep. Vicente Gonzalez (D-TX). Waive limitations on expansion of facility capacity under rural provider and hospital exception to ownership or investment prohibition during coronavirus 2020 emergency period. HR 7187 (116th Congress), Helping Ensure Access to Local TeleHealth Act of 2020, by Rep. Glenn Thompson (R-PA). Provide for permanent payments for telehealth services furnished by Federally qualified health centers and rural health clinics under the Medicare program. HR 7190 (116th Congress), Increasing Rural Health Access During the COVID-19 Public Health Emergency Act of 2020, by Rep. Xochiti Torres Small (D-NM). Provide for the establishment of a virtual health pilot program to facilitate utilization of remote patient monitoring technology to maintain or expand access to health care services for individuals in rural areas during the COVID-19 emergency period. HR 7233 (116th Congress), Knowing the Efficiency and Efficacy of Permanent Telehealth Options Act of 2020, by Rep. Troy Balderson (R-OH). Conduct studies and report to Congress on actions taken to expand access to telehealth services under the Medicare, Medicaid, and Childrens Health Insurance programs during the COVID-19 emergency. HR 7242 (116th Congress), by Rep. John Curtis (R-UT). Permit expenditures from health savings accounts to be used for gym memberships and costs of home gym equipment, to repeal the requirement that health plan be a high deductible plan. HR 7267 (116th Congress), Patients Before Profits Act of 2020, by Rep. Katie Porter (D-CA). Prohibit a group health plan and a health insurance issuer offering group or individual health insurance coverage from reducing contracted rates, or terminating contracts, with health care providers during a public health emergency. HR 7286 (116th Congress), Quit Because of COVID-19 Act, by Rep. Lisa Blunt Rochester (D-DE). Provide coverage of comprehensive tobacco cessation services. S 1895 (116th Congress), Lower Health Care Costs Act, by Sen. Lamar Alexander (R-TN). To lower health care costs through a variety of changes relating to health care coverage, costs, and services. S 2546 (116th Congress), Safe Step Act, by Sen. Lisa Murkowski (R-AK). Amend the Employee Retirement Income Security Act of 1974 to require a group health plan or health insurance coverage offered in connection with such a plan to provide an exceptions process for any medication step therapy protocol. S 3548 (116th Congress), Coronavirus Aid, Relief, and Economic Security (CARES) Act, by Sen. Mitch McConnell (R-KY). Provide emergency assistance and health care response for individuals, families, and businesses affected by the 2020 coronavirus pandemic. S 3606 (116th Congress), Health Force and Resilience Force Act of 2020, by Sen. Kirsten Gillibrand (D-NY). Provide for the establishment of a Health Force and a Resilience Force to respond to public health emergencies and meet public health needs.
2020 · first_quarter · Medicare/Medicaid
H.R. 3107 - Improving Seniors' Timely Access to Care Act of 2019 - DelBene - prior authorization in Medicare Advantage 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. 4453 - Protecting Seniors from Health Care Fraud Act of 2019 - Ruiz -Distributing information to Medicare beneficiaries to prevent fraud 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. 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. 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. 4671 - Helping Seniors Afford Health Care Act - Kim - Medicare affordability and low income beneficiaries H.R. 5006 - Expanding Access to Inpatient Mental Health Act - Emmer - Medicaid coverage for SUD/mental health for institutionalized 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. 5693 - Primary Health Services Enhancement Act - Kind - Medicare rural health H.R. 5808 - Save Rural Communities Act of 2020 - Jodey Arrington - rural emergency medical access services under Medicare H.R. 5833 - To amend title XVIII of the Social Security Act to permit the use of certain psychological evaluation via telehealth for Medicare coverage of neurostimulation services for the treatment of chronic pain - Latta - Medicare coverage in telehealth H.R. 5882 - GENE Therapy Payment Act - Schrader - value based care H.R. 6098 - To amend title XXI of the Social Security Act to allow States to expand income eligibility standards under the Children's Health Insurance Program -Barragan - CHIP eligibility H.R. 6151 - CARING for Kids Act - Abby Fineknauer - CHIP H.R. 6179 - Increasing Access to Biosimilars Act of 2020 - Cardenas - payments to providers of biosimilars under Medicare H.R. 6209 - Reducing Unnecessary Senior Hospitalizations Act of 2020 or the RUSH Act of 2020 -Kuster - Medicare coverage for certain services in hospital emergency departments H.R. 6244 - To amend titles XVIII and XIX to provide for coverage at no cost sharing of COVID-19 testing under the Medicaid program and Children's Health Insurance Program - Kelly - Medicaid coverage of COVID-19 related visits and testing H.R. 6263 - To amend title XVIII of the Social Security Act to waive cost sharing under the Medicare program for certain visits relating to testing for COVID-19 -Sarbanes - Medicare coverage of COVID-19 related visits and testing H.R. 6273 - Protecting Vulnerable Americans in Times of Crisis Act of 2020 - Butterfield - FMAP H.R. 6311 - Care for COVID-19 Act - Ruiz - COVID-19 cost sharing H.R. 6336 - To amend title XI of the Social Security Act to provide for a waiver of payment reductions under the Medicare and Medicaid programs for certain nonapproved capital expenditures undertaken by health care facilities during the COVID-19 emergency - Bishop - Medicare and Medicaid payments during COVID-19 emergency 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. 3220 - Ensuring Access to Direct Support Professionals Act - Portman - Medicaid coverage in acute care hospitals S. 3238 - Preventive Home Visit Act - King - preventative home visits S. 3277 - HCBS Infrastructure Improvement Act - Casey - access to community based services S. 3353 - Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act of 2020 - Cassidy - Medicare coverage of kidney transplant services S. 3384 - Lowering Prescription Drug Prices for America's Seniors and Families Act of 2020 - McSally - Medicare Part D drug pricing negotiation S. 3399 - FCHIP Extension Act - Tester - rural health S. 3442 - Care for COVID-19 Act - Booker - COVID-19 cost sharing S. 3443 - Improving Coverage and Care for Mothers Act - Casey - Medicaid coverage for all pregnant and postpartum women S. 3447 - RUSH Act of 2020 - Thune - Medicare coverage for certain services in hospital emergency departments S. 3466 - ACCESS for Biosimilars Act of 2020 - McSally - eliminates cost sharing for biosimilar biological products furnished under part B of the Medicare program 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); issues relating to COVID-19; issues related to addressing the social determinants of health, including housing, transportation, nutrition, and educational opportunities; 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.
2020 · first_quarter · Health Issues
Affordable Care Act (ACA), Affordability, ACA Regulations; ACA Stabilization; Health Reform, Risk Adjustment; opioids; Marketplace stability; Individual Market Reform; Health Care Costs; Mental Health; Small Business Plans, CRSs; SNPs; 42 CFR Part 2; Transparency; Silverloading; Health IT; Surprise billing; Transparency; Small Business; State Felxibility; Education and Enrollment; Prior Authorization; All payer claims database; Negotiated rate disclosure; Consumer facing App, disclosures; Provider directories; Medicare for All, Medicare Buy-in; Maternal Health; Senior's health care; Community Health NBPP (Notice Benefit and Payment Parameters); COVID-19 Response/Relief Packages; Healthcare Access/Privacy. H.R.1384 - 116th Congress (2019-2020) Medicare for All Act of 2019 Sponsor: Rep. Jayapal, Pramila [D-WA-7] (Introduced 02/27/2019) H.R.1520 - 116th Congress (2019-2020) Purple Book Continuity Act of 2019 Sponsor: Rep. Eshoo, Anna G. [D-CA-18] (Introduced 03/05/2019) S.1895 - 116th Congress (2019-2020) Lower Health Care Costs Act Sponsor: Sen. Alexander, Lamar [R-TN] (Introduced 06/19/2019) H.R.1046 - 116th Congress (2019-2020) Medicare Negotiation and Competitive Licensing Act of 2019 Sponsor: Rep. Doggett, Lloyd [D-TX-35] H.R. 3630 - 116th Congress (2019-2020) No Surprises Act Rep. Frank Pallone Jr. (D-NJ-6) H.R. 3439 - 116th Congress (2019-2020) PATIENT Act Rep. Donald S. Beyer, Jr. (D-VA-8) H.R. 3107 - 116th Congress (2019-2020) Improving Seniors Timely Access to Care Act of 2019 Rep. Suzane K. DelBene (D-WA-1) H.R. 2279 - 116th Congress (2019-2020) Safe Step Act Rep. Raul Ruiz (D-CA-36) S. 1895- 116th Congress (2019-2020) Lower Health Care Costs Act Sen. Lamar Alexander (R-TN) S. 2456 - 116th Congress (2019-2020) Safe Step Act Sen. Lisa Murkowski (R-AK) S. 2004 - 116th Congress (2019-2020) Ensuring FEDVIP and FLTCIP Coverage During Shutdown Act Rep. Elijah Cummings (D-MD-07) H.R. 2774 - 116th Congress (2019-2020) Primary Care Patient Protection Act of 2019 Rep. Brad Schneider (D-IL-10) H.R. 5826 - 116th Congress (2019-2020) Consumer Protection Against Surpirse Medical Bills Act of 2020 Rep. Richard Neal (D-MA-01) S. 3548 - 116th Congress Second Session Coronavirus Aid, Relief and Economic Security Act Sen. Mitch McConnell (R-KY) H.R. 5575 - 116th Congress Second Session Primary and Behavioral Health Care Access Act of 2020 Rep. Lauren Underwood (D-IL-14) H.R. 5688 - 116th Congress Second Session Reducing Administrative Costs and Burden in Health Care Act of 2020 Rep. Cindy Axne (D-IA-03) HR 5763 - 116th Congress Second Session National Telehealth Strategy and Data Advancement Act Rep. Greg Gianforte (R-MT-At Large) HR 5800 - 116th Congress Second Session Ban Surprise Billing Act Rep. Bobby Scott (D-VA-03) HR 5807 - 116th Congress Second Session Know Your Provider Act Rep. John Larson (D-CT-01) HR 5916 - 116th Congress Second Session Transparent Health Care Pricing Act of 2020 Rep. Mike Gallagher (R-WI-08) HR 6201 - 116th Congress Second Session First Coronavirus Response Act Rep. Nita Lowey (D-NY-17) HR 6336 - 116th Congress Second Session To amend title XI of the Social Security Act to provide for a waiver of payment reductions under the Medicare and Medicaid programs for certain nonapproved capital expenditures undertaken by health care facilities during the COVID-19 Emergency. HR 6336 - 116th Congress Second Session Care for COVID-19 Act Rep. Paul Ruiz (D-CA-36) HR 6299 - 116th Congress Second Session Rapid Coverage of COVID-19 Vaccine Act of 2020 HR 5817 - 116th Congress Second Session Fair and Honest Advance Cost Estimate for Patients Act of 2020 Rep. David Nunes (R-CA-22) HR 5816 - 116th Congress Second Session Continuing Care for Patients Act of 2020 Rep. Gwen Moore - (D-WI-4) HR 5089 - 116th Congress Second Session Better Information Act of 2020 Rep. Don Byer (D-VA-08) HR 5826 - 116th Congress Second Session Consumer Protections Against Surprise Medical Bills Act of 2020 Rep. Richard Neal (D-MA-01) HR 6004 - 116th Congress Second Session Transparency and Accountability in Health Care Costs and Prices Act of 2020 Rep. Dan Lipinski (D-IL-03) HR 6005 - 116th Congress Second Session Know the Price Act Rep. Tom Malinowski (D-NJ-07) HR 6132 - 116th Congress Second Session Social Determinants for Moms Act of 2020 Rep. Lucy McBath (D-GA-06) HR 6149 - 116th Congress Second Session Medicaid Report on Expansion of Access to coverage for Health Act REp. Joe Cunningham (D-SC-01) HR 6151 - 116th Congress Second Session CARING for Kids Act Rep. Abby Finkenauer (D-IA-01) HR 6173- 116th Congress Second Session Covering Coronavirus Test Act of 2020 Rep. Diana DeGette (D-CO-01) HR 6213 -116th Congress second Session No Cost for COVID-19 testing Act Rep. Fredrica Wilson (D-FL-24) HR 6222 - 116th Congress Second Session Ensuring Affordable COVID-19 Preventative Care Act of 2020 Rep. Jan Schakowsky (D-IL-09) HR 6232 - 116th Congress Second Session To Require the Secretary of Health and Human Services through the National Disaster Medical System, to provide for certain laboraty reimbursement for diagnostic testing for COVID-19 in uninsured individuals. Rep. Tony Cardenas (D-CA-29) HR 6231 - 116th Congress Second Session Ensuring Access to COVID-19 Preventative Care Act of 2020 Rep. Larry Buschon (R-In-08) HR 6244 - 116th Congress Second Session To amend titles XVIII and XIX to provide for coverage at no cost sharing of COVID-19 testing under the Medicaid program and Children's Health Insurance Program. Rep. Robin Kelly (D=IL-02) HR 6263 - 116th Congress Second Session To amend title XVII of the Social Security Act to Waive cost sharing under the Medicare program for certain visits relating to testing for COVID-19 Rep. John Sarbanes (D-MD-03)
2020 · first_quarter · Health Issues
Affordable Care Act (ACA); Affordability, ACA Regulations; ACA Stabilization; Health Reform; Risk Adjustment; Opioids; Marketplace Stability; Individual Market Reform; Health Care Costs; Mental Health; Small Business Plans; CSRs; SNPs; 42 CFR Part 2; Transparency; Silverloading; Health IT; Surprise billing, Transparency, Small Business, State Flexibility; Education,and Enrollment; Prior Authorization; All payer claims database; Negotiated rate disclosure; Consumer-facing app disclosures; Provider directories; Medicare for All; Medicare Buy-in; Maternal health; Senior's health care; Community health; NBPP (Notice Benefit and Payment Parameters), COVID-19 Response/Relief Packages, Healthcare access/privacy H.R.1384 - 116th Congress (2019-2020) Medicare for All Act of 2019 Sponsor: Rep. Jayapal, Pramila [D-WA-7] (Introduced 02/27/2019) H.R.2003 - 116th Congress (2019-2020) Ensuring FEHBP Coverage During Shutdowns Act Sponsor: Rep. Cummings, Elijah E. [D-MD-7] (Introduced 04/01/2019) H.R.2004 - 116th Congress (2019-2020) Ensuring FEDVIP and FLTCIP Coverage During Shutdowns Act Sponsor: Rep. Cummings, Elijah E. [D-MD-7] (Introduced 04/01/2019) S.973 - 116th Congress (2019-2020) Ensuring FEDVIP and FLTCIP Coverage During Shutdowns Act Sponsor: Sen. Smith, Tina [D-MN] (Introduced 04/01/2019) S.971 - 116th Congress (2019-2020) Ensuring FEHBP Coverage During Shutdowns Act Sponsor: Sen. Smith, Tina [D-MN] (Introduced 04/01/2019) H.R.1520 - 116th Congress (2019-2020) Purple Book Continuity Act of 2019 Sponsor: Rep. Eshoo, Anna G. [D-CA-18] (Introduced 03/05/2019) S.1895 - 116th Congress (2019-2020) Lower Health Care Costs Act Sponsor: Sen. Alexander, Lamar [R-TN] (Introduced 06/19/2019) H.R.1046 - 116th Congress (2019-2020) Medicare Negotiation and Competitive Licensing Act of 2019 Sponsor: Rep. Doggett, Lloyd [D-TX-35] H.R.3630 - 116th Congress (2019-2020) No Surprises Act Sponsor: Rep. Pallone, Frank, Jr. [D-NJ-6] H.R.3439 - 116th Congress (2019-2020) PATIENT Act Sponsor: Rep. Beyer, Donald S., Jr. [D-VA-8] H.R.3107 - 116th Congress (2019-2020) Improving Seniors' Timely Access to Care Act of 2019 Sponsor: Rep. DelBene, Suzan K. [D-WA-1] H.R.2279 - 116th Congress (2019-2020) Safe Step Act Sponsor: Rep. Ruiz, Raul [D-CA-36] S.1895 - 116th Congress (2019-2020) Lower Health Care Costs Act Sponsor: Sen. Alexander, Lamar [R-TN] S. 2546 - 116th Congress (2019-2020) Safe Step Act Sponsor: Sen. Lisa Murkowski (R-AK) S. 2004 - 116th Congress (2019-2020) Ensuring FEDVIP and FLTCIP Coverage During Shutdowns Act Sponsor: Rep. Elijah Cummings (D-MD-07) H.R. 2774 - 116th Congress (2019-2020) Primary Care Patient Protection Act of 2019 Sponsor: Rep. Brad Schneider (D-IL-10) H.R. 5826 - 116th Congress - Second Session Consumer Protections Against Surprise Medical Bills Act of 2020 Sponsor: Rep. Richard Neal(D-MA-01) S. 3548 - 116th Congress - Second Session Coronavirus Aid, Relief, and Economic Security Act Sponsor: Sen. Mitch McConnell (R-KY) H.R. 5551 - 116th Congress - Second Session Ensuring Child Health Coverage Compensation in Divorce Act of 2020 Sponsor: Del. Eleanor Holmes Norton (D-DC At-Large) H.R. 5575 - 116th Congress - Second Session Primary and Behavioral Health Care Access Act of 2020 Sponsor: Rep. Lauren Underwood (D-IL-14) H.R. 5688 - 116th Congress - Second Session Reducing Administrative Costs and Burdens in Health Care Act of 2020 Sponsor: Rep. Cindy Axne (D-IA-03) H.R. 5754 - 116th Congress - Second Session Rural ER Access Act Sponsor: Rep. Mark Green (R-TN-07) H.R. 5763 - 116th Congress - Second Session National Telehealth Strategy and Data Advancement Act Sponsor: Rep. Greg Gianforte (R-MT At-Large) H.R. 5800 - 116th Congress - Second Session Ban Surprise Billing Act Sponsor: Rep. Bobby Scott (D-VA-03) H.R. 5807 - 116th Congress - Second Session Know Your Provider Act of 2020 Sponsor: Rep. John Larson (D-CT-01) H.R. 5916 - 116th Congress - Second Session Transparent Health Care Pricing Act of 2020 Sponsor: Rep. Mike Gallagher (R-WI-08) H.R. 6201 - 116th Congress - Second Session First Coronavirus Response Act Sponsor: Rep. Nita Lowey (D-NY-17) H.R. 6336 - 116th Congress - Second Session To amend title XI of the Social Security Act to provide for a waiver of payment reductions under the Medicare and Medicaid programs for certain nonapproved capital expenditures undertaken by health care facilities during the COVID-19 emergency. Sponsor: Rep. Dan Bishop (R-NC-09) H.R. 6311 - 116th Congress - Second Session Care for COVID-19 Act Sponsor: Rep. Raul Ruiz (D-CA-36) H.R. 6299 - 116th Congress - Second Session Rapid Coverage of COVID-19 Vaccine Act of 2020 H.R. 5817 - 116th Congress - Second Session Fair and Honest Advance Cost Estimate for Patients Act of 2020 Sponsor: Rep. Devin Nunes (R-CA-22) H.R. 5816 - 116th Congress - Second Session Continuing Care for Patients Act of 2020 Sponsor: Rep. Gwen Moore (D-WI-04) HR. 5809 - 116th Congress - Second Session Better Information Act of 2020 Sponsor: Rep. Don Beyer (D-VA-08) H.R. 5826 -116th Congress - Second Session Consumer Protections Against Surprise Medical Bills Act of 2020 Sponsor: Rep. Richard Neal (D-MA-01) H.R. 5924 - 116th Congress - Second Session To amend the Public Health Service Act to authorize a loan repayment program to encourage specialty medicine physicians to serve in rural communities experiencing a shortage of specialty medicine physicians, and for other purposes. Sponsor: Rep. David McKinley (R-WV-01) H.R. 6004 - 116th Congress - Second Session Transparency and Accountability in Health Care Costs and Prices Act of 2020 Sponsor: Rep. Dan Lipinski (D-IL-03) H.R. 6005 - 116th Congress - Second Session Know the Price Act Sponsor: Rep. Tom Malinowski (D-NJ-07) H.R. 6132 - 116th Congress - Second Session Social Determinants for Moms Act of 2020 Sponsor: Rep. Lucy McBath (D-GA-06) H.R. 6135 - 116th Congress - Second Session No More Narrow Networks Act of 2020 Sponsor: Rep. Jan Schakowsky (D-IL-09) H.R. 6136 - 116th Congress - Second Session Protecting Consumers from Unreasonable Rates Act of 2020 Sponsor: Rep. Jan Schakowsky (D-IL-09) H.R. 6137 - 116th Congress - Second Session Innovative Maternal Payment And Coverage To Save Moms Act Sponsor: Rep. Jan Schakowsky (D-IL-09) H.R. 6138 - 116th Congress - Second Session Tech to Save Moms Act Sponsor: Rep. Eddie Bernice Johnson (D-TX-30) H.R. 6149 - 116th Congress - Second Session Medicaid Report on Expansion of Access to Coverage for Health Act Sponsor: Rep. Joe Cunningham (D-SC-01) H.R. 6151 - 116th Congress - Second Session CARING for Kids Act Sponsor: Rep. Abby Finkenauer (D-IA-01) H.R. 6173 - 116th Congress - Second Session Covering Coronavirus Test Act of 2020 Sponsor: Rep. Diana DeGette (D-CO-01) H.R. 6213 - 116th Congress - Second Session No Cost for COVID-19 Testing Act Sponsor: Rep. Frederica Wilson (D-FL-24) H.R. 6222 - 116th Congress - Second Session Ensuring Affordable COVID-19 Preventive Care Act of 2020 Sponsor: Rep. Jan Schakowsky (D-IL-09) H.R. 6232 - 116th Congress - Second Session To require the Secretary of Health and Human Services, through the National Disaster Medical System, to provide for certain laboratory reimbursement for diagnostic testing for COVID-19 in uninsured individuals. Sponsor: Rep. Tony Cardenas (D-CA-29) H.R. 6231 - 116th Congress - Second Session Ensuring Access to COVID-19 Preventive Care Act of 2020 Sponsor: Rep. Larry Bucshon (R-IN-08) H.R. 6244 - 116th Congress - Second Session To amend titles XVIII and XIX to provide for coverage at no cost sharing of COVID-19 testing under the Medicaid program and Children's Health Insurance Program. Sponsor: Rep. Robin Kelly (D-IL-02) H.R. 6263 - 116th Congress - Second Session To amend title XVIII of the Social Security Act to waive cost sharing under the Medicare program for certain visits relating to testing for COVID-19. Sponsor: Rep. John Sarbanes (D-MD-03) H.R. 6282 - 116th Congress - Second Session Commission on America's Medical Security Act Sponsor: Rep. Raul Ruiz (D-CA-36) H.R. 6283 - 116th Congress - Second Session Good Samaritan Health Professionals Act of 2020 Sponsor: Rep. Raul Ruiz (D-CA-36) H.R. 1379 - 116th Congress - First Session Ensuring Lasting Smiles Act Rep. Collin Peterson (D-MN-07)
2020 · first_quarter · Medicare/Medicaid
Medicare Advantage; Medicare Prior Authorization; Medicaid Rebates; Medicaid Expansion; Rate Notice and Call Letter; Medicare Part D; Part D Prescription Drug Rebates; Medicare Data Sharing; Privacy; Medicare Prescription Drug Prices; CMS Program Integrity Rule; Generic Drugs (CREATES Act) HR 3 (116th Congress), Lower Drug Costs Now Act of 2019, by Rep. Frank Pallone, Jr. (D-NJ). To establish a fair price negotiation program, protect the Medicare program from excessive price increases, and establish an out-of-pocket maximum for Medicare part D enrollees, and for other purposes. HR 275 (116th Congress), Medicare Prescription Drug Price Negotiation Act of 2019, by Rep. Peter Welch (D-VT). To amend part D of title XVIII of the Social Security Act to require the Secretary of Health and Human Services to negotiate covered part D drug prices on behalf of Medicare beneficiaries. HR 448 (116th Congress), Medicare Drug Price Negotiation Act, by Rep. Elijah Cummings (D-MD). To amend title XVIII of the Social Security Act to provide for the negotiation of lower covered part D drug prices on behalf of Medicare beneficiaries and the establishment and application of a formulary by the Secretary of Health and Human Services under Medicare part D, and for other purposes. HR 1046 (116th Congress), Medicare Negotiation and Competitive Licensing Act of 2019, by Rep. Lloyd Doggett (D-TX). To amend title XVIII of the Social Security Act to require the Secretary of Health and Human Services to negotiate prices of prescription drugs furnished under part D of the Medicare program. HR 1781 (116th Congress), Payment Commission Data Act of 2019, by Rep. Earl Carter (D-GA). To amend titles XVIII and XIX of the Social Security Act to provide the Medicare Payment Advisory Commission and the Medicaid and CHIP Payment and Access Commission with access to certain drug payment information, including certain rebate information. HR 3107 (116th Congress), Improving Seniors Timely Access to Care Act of 2019, by Rep. Suzan DelBene (D-WA). To amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans, and for other purposes. HR 4629 (116th Congress), Star Rating for Biosimilars Act, by Rep. Paul Tonko (D-NY). To amend title XVIII of the Social Security Act to require the Secretary of Health and Human Services to add a new set of measures to the 5-star rating system under the Medicare Advantage program in order to encourage increased access to biosimilar biological products. HR 5534 (116th Congress), Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act of 2019, by Rep. Ron Kind (D-WI). To amend title XVIII of the Social Security Act to provide for extended months of Medicare coverage of immunosuppressive drugs for kidney transplant patients, and for other purposes. HR 5693 (116th Congress), Primary Health Services Enhancement Act, by Rep. Ron Kind (D-WI). To amend title XVIII of the Social Security Act to expand Medicare Rural Health Clinic Services and Federally Qualified Health Center Services to include physical therapy services. HR 5741 (116th Congress), Strengthening Innovation in Medicare and Medicaid Act, by Rep. Terri Sewell (D-AL). To amend title XI of the Social Security Act to clarify parameters for model testing and add accountability to model expansion under the Center for Medicare and Medicaid Innovation, and for other purposes. HR 5833 (116th Congress), by Rep. Bob Latta (R-OH). To amend title XVIII of the Social Security Act to permit the use of certain psychological evaluation via telehealth for Medicare coverage of neurostimulation services for the treatment of chronic pain. HR 6147 (116th Congress), Help Extend Auditory Relief (HEAR) Act of 2020, by Rep. Matt Cartwright (D-PA). To amend title XVIII of the Social Security Act to provide for coverage under the Medicare program of hearing aids and related hearing services. HR 6179 (116th Congress), Increasing Access to Biosimilars Act of 2020, by Rep. Tony Cardenas (D-CA). To require the Secretary of Health and Human Services to establish a demonstration project to increase access to biosimilar biological products under the Medicare program. HR 6218 (116th Congress), Preserving Patient Access to Home Infusion Act, by Rep. Eliot Engel (D-NY). To amend title XVIII of the Social Security Act to clarify congressional intent and preserve patient access to home infusion therapy under the Medicare program, and for other purposes. HR 6263 (116th Congress), by Rep. John Sarbanes (D-MD). To amend title XVIII of the Social Security Act to waive cost sharing under the Medicare program for certain visits relating to testing for COVID-19. HR 6273 (116th Congress), Protecting Vulnerable Americans in Times of Crisis Act of 2020, by Rep. G. K. Butterfield (D-NC). To amend title XI of the Social Security Act to increase allotments under the Medicaid program for territories of the United States, to provide for a temporary increase in the Federal medical assistance percentage for States under the Medicaid program, and for other purposes. HR 6336 (116th Congress), Increasing Hospital Capacity to Fight the Coronavirus Act of 2020, by Rep. Dan Bishop (R-NC). To amend title XI of the Social Security Act to provide for a waiver of payment reductions under the Medicare and Medicaid programs for certain nonapproved capital expenditures undertaken by health care facilities during the COVID-19 emergency.
2020 · first_quarter · Health Issues
Affordable Care Act (ACA); Affordability; ACA Regulations; ACA Stabilization; Health Reform; Risk Adjustment; Opioids; Marketplace Stability; Individual Market Reform; Health Care Costs; Mental Health; Small Business Plans; Cost Sharing Reductions (CSRs); Transparency; Silver Loading; Health IT; Surprise Billing; State Flexibility; Prior Authorization; All Payer Claims Database (APCD); Negotiated Rate Disclosure; Provider Directories; Medicare for All; Medicare Buy-in; Outreach, Education, and Enrollment; 2021 Notice of Benefit and Payment Parameters (NBPP); COVID-19 Response/Relief Packages HR 1384 (116th Congress), Medicare for All Act of 2019, by Rep. Pramila Jayapal (D-WA). To establish an improved Medicare for All national health insurance program. HR 2274 (116th Congress), Primary Care Patient Protection Act of 2019, by Rep. Brad Schneider (D-IL). To amend the Internal Revenue Code of 1986 to require coverage without a deductible of certain primary care services by high deductible health plans. HR 2279 (116th Congress), Safe Step Act, by Rep. Raul Ruiz (D-CA). To amend the Employee Retirement Income Security Act of 1974 to require a group health plan (or health insurance coverage offered in connection with such a plan) to provide an exceptions process for any medication step therapy protocol, and for other purposes. HR 3630 (116th Congress), No Surprises Act, by Rep. Frank Pallone, Jr. (D-NJ). To amend title XXVII of the Public Health Service Act to protect health care consumers from surprise billing practices, and for other purposes. HR 5551 (116th Congress), Ensuring Child Health Coverage Compensation in Divorce Act of 2020, by Del. Eleanor Holmes Norton (D-DC). To amend title XXVII of the Public Health Service Act and title 5, United States Code, to require group health plans, health insurance issuers offering group or individual health insurance coverage, and Federal Employees Health Benefits Program health benefits plans to meet certain requirements with respect to medical child support orders, and for other purposes. HR 5575 (116th Congress), Primary and Behavioral Health Care Access Act of 2020, by Rep. Lauren Underwood (D-IL). To amend the Employee Retirement Income Security Act of 1974, title XXVII of the Public Health Service Act, and the Internal Revenue Code of 1986 to require group health plans and health insurance issuers offering group or individual health insurance coverage to provide for 3 primary care visits and 3 behavioral health care visits without application of any cost-sharing requirement. HR 5688 (116th Congress), Reducing Administrative Costs and Burdens in Health Care Act of 2020, by Rep. Cindy Axne (D-IA). To amend the Public Health Service Act to provide for grants to enable States to carry out activities to reduce administrative costs and burdens in health care. HR 5754 (116th Congress), Rural ER Access Act, by Rep. Mark Green (R-TN). To direct the Secretary of Health and Human Services to revise regulations to remove the requirement under the Medicare program that an off-campus facility or organization shall be located within a 35-mile radius of a hospital or critical access hospital, and for other purposes. HR 5800 (116th Congress), Ban Surprise Billing Act, by Rep. Bobby Scott (D-VA). To end surprise medical billing and increase transparency in health coverage. HR 5809 (116th Congress), Better Information Act of 2020, by Rep. Don Beyer (D-VA). To amend title XXVII of the Public Health Service Act, the Internal Revenue Code of 1986, and the Employee Retirement Income Security Act of 1974 to require group health plans and health insurance issuers to include certain information on any health insurance membership card issued by such plan or issuer. HR 5816 (116th Congress), Continuing Care for Patients Act of 2020, by Rep. Gwen Moore (D-WI). To amend title XXVII of the Public Health Service Act, the Internal Revenue Code of 1986, the Employee Retirement Income Security Act of 1974, and title XI of the Social Security Act to require group health plans and health insurance issuers to provide for certain coverage in the case of a change in a providers network status, and for other purposes. HR 5817 (116th Congress), Fair and Honest Advance Cost Estimate for Patients Act of 2020, by Rep. Devin Nunes (R-CA). To amend title XXVII of the Public Health Service Act, the Internal Revenue Code of 1986, and the Employee Retirement Income Security Act of 1974 to require health plans to provide to participants, beneficiaries, and enrollees an advanced explanation of benefits with respect to items and services scheduled to be received from providers and facilities and to amend title XI of the Social Security Act to require health care providers and health care facilities to provide good faith estimates of the expected charges for furnishing such items and services. HR 5826 (116th Congress), Consumer Protections Against Surprise Medical Bills Act of 2020, by Rep. Richard Neal (D-MA). To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, the Internal Revenue Code of 1986, and title XI of the Social Security Act to prevent certain cases of out-of-network surprise medical bills, strengthen health care consumer protections, and improve health care information transparency, and for other purposes. HR 5916 (116th Congress), Transparent Health Care Pricing Act of 2020, by Rep. Mike Gallagher (R-WI). To require providers of health care products and services to publicly disclose point-of-sale cash prices. HR 6004 (116th Congress), Transparency and Accountability in Health Care Costs and Prices Act of 2020, by Rep. Dan Lipinski (D-IL). To amend title XXVII of the Public Health Service Act to require the Secretary of Health and Human Services to establish a grant program for purposes of facilitating State efforts to establish or maintain all-payer claims databases, and for other purposes. HR 6005 (116th Congress), Know the Price Act, by Rep. Tom Malinowski (D-NJ). To amend title XXVII of the Public Health Service Act to increase transparency of group health plans and health insurance issuers offering group or individual health insurance coverage by removing gag clauses on price and quality information, and for other purposes. HR 6135 (116th Congress), No More Narrow Networks Act of 2020, by Rep. Jan Schakowsky (D-IL). To amend the Patient Protection and Affordable Care Act to require Exchanges to establish network adequacy standards for qualified health plans. HR 6136 (116th Congress), Protecting Consumers from Unreasonable Rates Act of 2020, by Rep. Jan Schakowsky (D-IL). To amend the Public Health Service Act to provide protections for consumers against excessive, unjustified, or unfairly discriminatory increases in premium rates. HR 6173 (116th Congress), Covering Coronavirus Test Act of 2020, by Rep. Diana DeGette (D-CO). To amend title XXVII of the Public Health Service Act to require group health plans and health insurance issuers offering group or individual health insurance coverage to cover COVID-19 testing without cost sharing. HR 6201 (116th Congress), First Coronavirus Response Act, by Rep. Nita Lowey (D-NY). Making emergency supplemental appropriations for the fiscal year ending September 30, 2020, and for other purposes. HR 6213 (116th Congress), No Cost for COVID-19 Testing Act, by Rep. Frederica Wilson (D-FL). To provide for coverage (without cost sharing or utilization management requirements) under group health plans and individual and group health insurance coverage of testing for COVID-19. HR 6222 (116th Congress), Ensuring Affordable COVID-19 Preventive Care Act of 2020, by Rep. Jan Schakowsky (D-IL). To amend title XXVII of the Public Health Service Act to provide for coverage of items, services, and immunizations relating to the diagnosis or treatment of COVID-19 under group health plans and health insurance coverage within 15 days of the issuance of a recommendation from the United States Preventive Services Task Force or the Advisory Committee on Immunization Practices. HR 6231 (116th Congress), Ensuring Affordable COVID-19 Preventive Care Act of 2020, by Rep. Larry Bucshon (R-IN). To ensure affordable coverage of certain vaccines and testing services under group health plans and group and individual health insurance coverage during the COVID-19 public health emergency. HR 6244 (116th Congress), by Rep. Robin Kelly (D-IL). To amend titles XVIII and XIX to provide for coverage at no cost sharing of COVID-19 testing under the Medicaid program and Childrens Health Insurance Program. HR 6299 (116th Congress), Rapid Coverage of COVID-19 Vaccine Act of 2020, by Rep. Joe Courtney (D-CT). To provide for the rapid coverage of preventive services and vaccines for COVID-19. HR 6311 (116th Congress), Care for COVID-19 Act, by Rep. Raul Ruiz (D-CA). To require private health insurers to cover care related to COVID-19 without cost-sharing and to provide for special enrollment periods for individuals diagnosed with COVID-19. HR 6336 (116th Congress), Increasing Hospital Capacity to Fight the Coronavirus Act of 2020, by Rep. Dan Bishop (R-NC). To amend title XI of the Social Security Act to provide for a waiver of payment reductions under the Medicare and Medicaid programs for certain nonapproved capital expenditures undertaken by health care facilities during the COVID-19 emergency. S 1895 (116th Congress), Lower Health Care Costs Act, by Sen. Lamar Alexander (R-TN). To lower health care costs. S 2546 (116th Congress), Safe Step Act, by Sen. Lisa Murkowski (R-AK). To amend the Employee Retirement Income Security Act of 1974 to require a group health plan or health insurance coverage offered in connection with such a plan to provide an exceptions process for any medication step therapy protocol, and for other purposes. S 3548 (116th Congress), Coronavirus Aid, Relief, and Economic Security (CARES) Act, by Sen. Mitch McConnell (R-KY). To provide emergency assistance and health care response for individuals, families, and businesses affected by the 2020 coronavirus pandemic.
2020 · first_quarter · Medicare/Medicaid
Medicare Advantage; Medicare Prior Authorization; Medicaid Rebates; Medicaid Expansion; Rate Notice and Call Letter; Medicare Part D; Part D Prescription Drug Rebates; Medicare Data Sharing; Privacy; Medicare Prescription Drug Prices; CMS Program Integrity Rule; Generic Drugs (CREATES Act) HR 3 (116th Congress), Lower Drug Costs Now Act of 2019, by Rep. Frank Pallone, Jr. (D-NJ). To establish a fair price negotiation program, protect the Medicare program from excessive price increases, and establish an out-of-pocket maximum for Medicare part D enrollees, and for other purposes. HR 275 (116th Congress), Medicare Prescription Drug Price Negotiation Act of 2019, by Rep. Peter Welch (D-VT). To amend part D of title XVIII of the Social Security Act to require the Secretary of Health and Human Services to negotiate covered part D drug prices on behalf of Medicare beneficiaries. HR 448 (116th Congress), Medicare Drug Price Negotiation Act, by Rep. Elijah Cummings (D-MD). To amend title XVIII of the Social Security Act to provide for the negotiation of lower covered part D drug prices on behalf of Medicare beneficiaries and the establishment and application of a formulary by the Secretary of Health and Human Services under Medicare part D, and for other purposes. HR 1046 (116th Congress), Medicare Negotiation and Competitive Licensing Act of 2019, by Rep. Lloyd Doggett (D-TX). To amend title XVIII of the Social Security Act to require the Secretary of Health and Human Services to negotiate prices of prescription drugs furnished under part D of the Medicare program. HR 1781 (116th Congress), Payment Commission Data Act of 2019, by Rep. Earl Carter (D-GA). To amend titles XVIII and XIX of the Social Security Act to provide the Medicare Payment Advisory Commission and the Medicaid and CHIP Payment and Access Commission with access to certain drug payment information, including certain rebate information. HR 3107 (116th Congress), Improving Seniors Timely Access to Care Act of 2019, by Rep. Suzan DelBene (D-WA). To amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans, and for other purposes. HR 4629 (116th Congress), Star Rating for Biosimilars Act, by Rep. Paul Tonko (D-NY). To amend title XVIII of the Social Security Act to require the Secretary of Health and Human Services to add a new set of measures to the 5-star rating system under the Medicare Advantage program in order to encourage increased access to biosimilar biological products. HR 5534 (116th Congress), Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act of 2019, by Rep. Ron Kind (D-WI). To amend title XVIII of the Social Security Act to provide for extended months of Medicare coverage of immunosuppressive drugs for kidney transplant patients, and for other purposes. HR 5693 (116th Congress), Primary Health Services Enhancement Act, by Rep. Ron Kind (D-WI). To amend title XVIII of the Social Security Act to expand Medicare Rural Health Clinic Services and Federally Qualified Health Center Services to include physical therapy services. HR 5741 (116th Congress), Strengthening Innovation in Medicare and Medicaid Act, by Rep. Terri Sewell (D-AL). To amend title XI of the Social Security Act to clarify parameters for model testing and add accountability to model expansion under the Center for Medicare and Medicaid Innovation, and for other purposes. HR 5833 (116th Congress), by Rep. Bob Latta (R-OH). To amend title XVIII of the Social Security Act to permit the use of certain psychological evaluation via telehealth for Medicare coverage of neurostimulation services for the treatment of chronic pain. HR 6147 (116th Congress), Help Extend Auditory Relief (HEAR) Act of 2020, by Rep. Matt Cartwright (D-PA). To amend title XVIII of the Social Security Act to provide for coverage under the Medicare program of hearing aids and related hearing services. HR 6179 (116th Congress), Increasing Access to Biosimilars Act of 2020, by Rep. Tony Cardenas (D-CA). To require the Secretary of Health and Human Services to establish a demonstration project to increase access to biosimilar biological products under the Medicare program. HR 6218 (116th Congress), Preserving Patient Access to Home Infusion Act, by Rep. Eliot Engel (D-NY). To amend title XVIII of the Social Security Act to clarify congressional intent and preserve patient access to home infusion therapy under the Medicare program, and for other purposes. HR 6263 (116th Congress), by Rep. John Sarbanes (D-MD). To amend title XVIII of the Social Security Act to waive cost sharing under the Medicare program for certain visits relating to testing for COVID-19. HR 6273 (116th Congress), Protecting Vulnerable Americans in Times of Crisis Act of 2020, by Rep. G. K. Butterfield (D-NC). To amend title XI of the Social Security Act to increase allotments under the Medicaid program for territories of the United States, to provide for a temporary increase in the Federal medical assistance percentage for States under the Medicaid program, and for other purposes. HR 6336 (116th Congress), Increasing Hospital Capacity to Fight the Coronavirus Act of 2020, by Rep. Dan Bishop (R-NC). To amend title XI of the Social Security Act to provide for a waiver of payment reductions under the Medicare and Medicaid programs for certain nonapproved capital expenditures undertaken by health care facilities during the COVID-19 emergency.
| Republican |
| NC |
| Jim Banks | Republican | IN |
| Mike Johnson | Republican | LA |
| Mo Brooks | Republican | AL |
| Ralph Norman | Republican | SC |
| Randy K. Weber, Sr. | Republican | TX |
| Ross Spano | Republican | FL |
| Scott Perry | Republican | PA |
| Ted Budd | Republican | NC |
| Ted S. Yoho | Republican | FL |
Client expense: Not reported · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE
Client expense: $2,250,000 · Firm income: Not reported
Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), Federal Trade Commission (FTC), 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, White House Office
Client expense: $1,690,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, White House Office
Client expense: Not reported · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE
Client expense: $350,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, White House Office
Client expense: $350,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, White House Office
Client expense: $3,630,000 · 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), Office of the Vice President of the United States, SENATE, Treasury, Dept of, White House Office
Client expense: $102,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
Client expense: $1,880,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, White House Office
Client expense: $20,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE
Client expense: $230,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, White House Office
Client expense: $230,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, White House Office