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Coronavirus Medicaid Response Act
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Coronavirus Medicaid Response Act This bill increases the Medicaid Federal Medical Assistance Percentage (FMAP) for states and U.S. territories that experience economic downturns (i.e., high unemployment) beginning on or after January 1, 2020, in accordance with specified requirements and limitations. The bill's increase is in addition to previously enacted FMAP increases relating to COVID-19 (i.e., coronavirus disease 2019) but may not result in an FMAP greater than 95%.
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Filing registrants (5)
2021 · fourth_quarter · Medicare/Medicaid
Referred to the House Committee on Energy and Commerce.
Introduced in House
Congress.gov source codes: 1000, Intro-H
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Sources: Congress.gov
Urged Congress to address an extension of the moratorium on Medicare sequester cuts, as well as preventing the Statutory Pay-As-You-Go (PAYGO) sequester from taking effect by the end of the year. Urged Congress to permanently authorize CHIP and the bipartisan proposal to provide one year of continuous eligibility for children covered by Medicaid and CHIP. (H.R. 5376) Build Back Better Act of 2021 - Urged Congress to remove the reductions to the Medicaid disproportionate share hospital (DSH) program and uncompensated care pools from the Build Back Better Act. (H.R. 5376) Build Back Better Act of 2021 - Expressed support for the inclusion of a mandatory, permanent extension of Medicaid coverage from 60 days to one full year postpartum and provisions of the Black Maternal Health Momnibus in the Build Back Better Act. (S. 2210/H.R. 4131) Better Care Better Jobs Act of 2021- Expressed support for the inclusion of the bicameral Better Care Better Jobs Act to expand and improve access to Medicaid-funded home-and community-based services (HCBS), a chronically under-resourced sector. Urged Congress to continue to prioritize maternal health in the reconciliation legislation by requiring Medicaid to cover a full year postpartum. Urged Congress to maintain Medicare telehealth coverage for two years following the end of the PHE. (S. 834/H.R. 2256) The Resident Physician Shortage Reduction Act of 2021 - Urged Congress and President of the United States to support the Resident Physician Shortage Reduction Act of 2021. This legislation would alleviate the physician shortage by gradually providing 14,000 new Medicare-supported GME positions and further invest in the physician workforce by increasing the number of Medicare-support GME positions. (S. 2986/H.R. 2503) The Social Determinants Accelerator Act of 2021 - Expressed support for the Social Determinants Accelerator Act of 2021. This legislation would continue to provide needed resources that would address the social determinants of health affecting the Medicaid population and improve health outcomes. Opposed additional cuts to the Medicare program and repurposing unused COVID-19 relief funds as financing mechanisms in the Bipartisan Infrastructure Framework. Medicare funds should not be used to pay for roads or bridges. Expressed support the Consolidated Appropriations Act of 2021 and asked to work with CMS to implement the Medicaid supplemental payment reporting system by offering technical expertise and context. (S. 4108/H.R. 6539) Coronavirus Medicaid Response Act - Expressed support for the Coronavirus Medicaid Response Act. This legislation would provide an automatic federal medical assistance percentage (FMAP) increase to state Medicaid programs during an economic downturn. (S. 748/H.R. 1868) Medicare Sequester Relief Act - Expressed support for the Medicare Sequester Relief Act. This legislation would extend the 2% Medicare sequester moratorium for the duration of the COVID-19 Public Health Emergency (PHE) and prevent a projected 4% Medicare spending cut scheduled to begin next year. (H.R. 265) Insular Area Medicaid Parity Act - Expressed support for the Insular Area Medicaid Parity Act. This legislation will provide a long-term solution for Medicaid beneficiaries residing in the U.S. Territories, while ensuring that territorial governments are given fiscal relief to stabilize the health and economic security of their jurisdictions. Urged the House to add an increase to the FMAP of at least 12% in the COVID-19 relief and budget reconciliation legislation. This additional funding is essential for states to ensure that beneficiaries have continuous coverage during this public health emergency. (H.R. 4996) Helping Medicaid Offer Maternity Services Act - Expressed support for including the Helping Medicaid Offer Maternity Services Act in the next COVID -19 relief package and increase funding for maternal home visiting programs to improve the health and wellbeing of mothers and infants. (S. 2080/H.R. 647) Palliative Care and Hospice Education and Training Act - Urged Congress to increase support and access to palliative care by including the Palliative Care and Hospice Education and Training Act in the next COVID - 19 relief package.
Client expense: $172,206 · Firm income: Not reported
Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Occupational Safety & Health Administration (OSHA), Office of Management & Budget (OMB), Office of Personnel Management (OPM), President of the U.S., SENATE, Treasury, Dept of
2021 · third_quarter · Medicare/Medicaid
Urged Congress to continue to prioritize maternal health in the reconciliation legislation by requiring Medicaid to cover a full year postpartum. Urged Congress to maintain Medicare telehealth coverage for two years following the end of the PHE. (S. 834/H.R. 2256) The Resident Physician Shortage Reduction Act of 2021 - Urged Congress and President of the United States to support the Resident Physician Shortage Reduction Act of 2021. This legislation would alleviate the physician shortage by gradually providing 14,000 new Medicare-supported GME positions and further invest in the physician workforce by increasing the number of Medicare-support GME positions. (S. 2986/H.R. 2503) The Social Determinants Accelerator Act of 2021 - Expressed support for the Social Determinants Accelerator Act of 2021. This legislation would continue to provide needed resources that would address the social determinants of health affecting the Medicaid population and improve health outcomes. Opposed additional cuts to the Medicare program and repurposing unused COVID-19 relief funds as financing mechanisms in the Bipartisan Infrastructure Framework. Medicare funds should not be used to pay for roads or bridges. Expressed support the Consolidated Appropriations Act of 2021 and asked to work with CMS to implement the Medicaid supplemental payment reporting system by offering technical expertise and context. (S. 4108/H.R. 6539) Coronavirus Medicaid Response Act - Expressed support for the Coronavirus Medicaid Response Act. This legislation would provide an automatic federal medical assistance percentage (FMAP) increase to state Medicaid programs during an economic downturn. (S. 748/H.R. 1868) Medicare Sequester Relief Act - Expressed support for the Medicare Sequester Relief Act. This legislation would extend the 2% Medicare sequester moratorium for the duration of the COVID-19 Public Health Emergency (PHE) and prevent a projected 4% Medicare spending cut scheduled to begin next year. (H.R. 265) Insular Area Medicaid Parity Act - Expressed support for the Insular Area Medicaid Parity Act. This legislation will provide a long-term solution for Medicaid beneficiaries residing in the U.S. Territories, while ensuring that territorial governments are given fiscal relief to stabilize the health and economic security of their jurisdictions. Urged the House to add an increase to the FMAP of at least 12% in the COVID-19 relief and budget reconciliation legislation. This additional funding is essential for states to ensure that beneficiaries have continuous coverage during this public health emergency. (H.R. 4996) Helping Medicaid Offer Maternity Services Act - Expressed support for including the Helping Medicaid Offer Maternity Services Act in the next COVID -19 relief package and increase funding for maternal home visiting programs to improve the health and wellbeing of mothers and infants. (S. 2080/H.R. 647) Palliative Care and Hospice Education and Training Act - Urged Congress to increase support and access to palliative care by including the Palliative Care and Hospice Education and Training Act in the next COVID - 19 relief package.
Client expense: $174,878 · Firm income: Not reported
Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Occupational Safety & Health Administration (OSHA), President of the U.S., SENATE
2021 · second_quarter · Medicare/Medicaid
(S. 834/H.R. 2256) The Resident Physician Shortage Reduction Act of 2021 - Urged Congress and President of the United States to support the Resident Physician Shortage Reduction Act of 2021. This legislation would alleviate the physician shortage by gradually providing 14,000 new Medicare-supported GME positions and further invest in the physician workforce by increasing the number of Medicare-support GME positions. (S. 2986/H.R. 2503) The Social Determinants Accelerator Act of 2021 - Expressed support for the Social Determinants Accelerator Act of 2021. This legislation would continue to provide needed resources that would address the social determinants of health affecting the Medicaid population and improve health outcomes. Opposed additional cuts to the Medicare program and repurposing unused COVID-19 relief funds as financing mechanisms in the Bipartisan Infrastructure Framework. Medicare funds should not be used to pay for roads or bridges. Expressed support the Consolidated Appropriations Act of 2021 and asked to work with CMS to implement the Medicaid supplemental payment reporting system by offering technical expertise and context. (S. 4108/H.R. 6539) Coronavirus Medicaid Response Act - Expressed support for the Coronavirus Medicaid Response Act. This legislation would provide an automatic federal medical assistance percentage (FMAP) increase to state Medicaid programs during an economic downturn. (S. 748/H.R. 1868) Medicare Sequester Relief Act - Expressed support for the Medicare Sequester Relief Act. This legislation would extend the 2% Medicare sequester moratorium for the duration of the COVID-19 Public Health Emergency (PHE) and prevent a projected 4% Medicare spending cut scheduled to begin next year. (H.R. 265) Insular Area Medicaid Parity Act - Expressed support for the Insular Area Medicaid Parity Act. This legislation will provide a long-term solution for Medicaid beneficiaries residing in the U.S. Territories, while ensuring that territorial governments are given fiscal relief to stabilize the health and economic security of their jurisdictions. Urged the House to add an increase to the FMAP of at least 12% in the COVID-19 relief and budget reconciliation legislation. This additional funding is essential for states to ensure that beneficiaries have continuous coverage during this public health emergency. (H.R. 4996) Helping Medicaid Offer Maternity Services Act - Expressed support for including the Helping Medicaid Offer Maternity Services Act in the next COVID -19 relief package and increase funding for maternal home visiting programs to improve the health and wellbeing of mothers and infants. (S. 2080/H.R. 647) Palliative Care and Hospice Education and Training Act - Urged Congress to increase support and access to palliative care by including the Palliative Care and Hospice Education and Training Act in the next COVID - 19 relief package.
Client expense: $220,151 · Firm income: Not reported
Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Occupational Safety & Health Administration (OSHA), President of the U.S., SENATE
2021 · first_quarter · Medicare/Medicaid
(S. 4108/H.R. 6539) Coronavirus Medicaid Response Act - Expressed support for the Coronavirus Medicaid Response Act. This legislation would provide an automatic federal medical assistance percentage (FMAP) increase to state Medicaid programs during an economic downturn. (S. 748/H.R. 1868) Medicare Sequester Relief Act - Expressed support for the Medicare Sequester Relief Act. This legislation would extend the 2% Medicare sequester moratorium for the duration of the COVID-19 Public Health Emergency (PHE) and prevent a projected 4% Medicare spending cut scheduled to begin next year. (H.R. 265) Insular Area Medicaid Parity Act - Expressed support for the Insular Area Medicaid Parity Act. This legislation will provide a long-term solution for Medicaid beneficiaries residing in the U.S. Territories, while ensuring that territorial governments are given fiscal relief to stabilize the health and economic security of their jurisdictions. Urged the House to add an increase to the FMAP of at least 12% in the COVID-19 relief and budget reconciliation legislation. This additional funding is essential for states to ensure that beneficiaries have continuous coverage during this public health emergency. (H.R. 4996) Helping Medicaid Offer Maternity Services Act - Expressed support for including the Helping Medicaid Offer Maternity Services Act in the next COVID -19 relief package and increase funding for maternal home visiting programs to improve the health and wellbeing of mothers and infants. (S. 2080/H.R. 647) Palliative Care and Hospice Education and Training Act - Urged Congress to increase support and access to palliative care by including the Palliative Care and Hospice Education and Training Act in the next COVID - 19 relief package.
Client expense: $191,078 · Firm income: Not reported
Government targets: Centers For Disease Control & Prevention (CDC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), President of the U.S., SENATE
2020 · third_quarter · Medicare/Medicaid
Public Health Contact Tracing Workforce HR 6800- Health and Economic Recovery Omnibus Emergency Solutions (Heroes) Act State and Local Aid, including increasing the federal Medicaid match HR 6539, S 4108- Coronavirus Medicaid Response Act Implementation of Electronic Visit Verification
Client expense: $590,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2020 · third_quarter · Budget/Appropriations
Public Health Contact Tracing Workforce Funding for public health operations and rebuilding infrastructure HR 6800- Health and Economic Recovery Omnibus Emergency Solutions (Heroes) Act State and Local Aid, including increasing the federal Medicaid match HR 6539, S 4108- Coronavirus Medicaid Response Act HR 8337- Continuing Appropriations Act, 2021 HR 8406- Heroes 2.0 HR 925- Motion to concur in the Senate amendments with an amendment (Heroes 2.0) Delivering Immediate Relief Act (McConnell Relief Plan) Budget- general COVID-19 Emergency Funding S 1624- Health, Economic Assistance, Liability Protection and Schools (HEALS) Act S 3671- State and Local Emergency Stabilization Fund S 3752, HR 6954- State Municipal Assistance for Recovery and Transition (SMART) Fund Education State Stabilization Fund
Client expense: $590,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2020 · third_quarter · Urban Development/Municipalities
Public Health Contact Tracing Workforce Funding for public health operations and rebuilding infrastructure HR 6800- Health and Economic Recovery Omnibus Emergency Solutions (Heroes) Act State and Local Aid, including increasing the federal Medicaid match HR 6539, S 4108- Coronavirus Medicaid Response Act
Client expense: $590,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2020 · third_quarter · Disaster Planning/Emergencies
Public Health Contact Tracing Workforce Funding for public health operations and rebuilding infrastructure HR 6800- Health and Economic Recovery Omnibus Emergency Solutions (Heroes) Act State and Local Aid, including increasing the federal Medicaid match HR 6539, S 4108- Coronavirus Medicaid Response Act HR 1646- Helping Emergency Responders Overcome (HERO) Act
Client expense: $590,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2020 · third_quarter · Health Issues
Public Health Contact Tracing Workforce Funding for public health operations and rebuilding infrastructure HR 6800- Health and Economic Recovery Omnibus Emergency Solutions (Heroes) Act State and Local Aid, including increasing the federal Medicaid match HR 6539, S 4108- Coronavirus Medicaid Response Act Implementation of Electronic Visit Verification HR 1646- Helping Emergency Responders Overcome (HERO) Act HR 986- Protecting Americans With Preexisting Conditions Act HR 1633- Quality Care for Nursing Homes Act HR 6414- COBRA Coverage in Pandemic Federal income tax exclusion for employer sponsored health care benefits Medicaid Federal Medical Assistance Percentage (FMAP) COBRA subsidy
Client expense: $590,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2020 · third_quarter · Economics/Economic Development
Public Health Contact Tracing Workforce Funding for public health operations and rebuilding infrastructure HR 6800- Health and Economic Recovery Omnibus Emergency Solutions (Heroes) Act State and Local Aid, including increasing the federal Medicaid match HR 6539, S 4108- Coronavirus Medicaid Response Act
Client expense: $590,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2020 · fourth_quarter · Health Issues
Public Health Contact Tracing Workforce Funding for public health operations and rebuilding infrastructure HR 133- Consolidated Appropriations Act, 2021 State and Local aid, including increasing the federal Medicaid match Protecting workers at high risk of COVID-19 exposure Implementation of Electronic Visit Verification of Home Care Workers Special COVID-19 immunity for corporations and employers Continuation of funding for Certified Community Behavioral Health Clinics S 4957- COVID Home and Community Based Services (HCBS) Relief of 2020 S 4714, HR 6514- Worker Health Coverage Protection Act S 4108, HR 6539- Coronavirus Medicaid Response Act HR 3- Lowering Prescription Drug Prices Expanding Mental Health Parity HR 6414- COBRA Coverage in Pandemic Federal income tax exclusion for employer sponsored health care benefits Medicaid Federal Medical Assistance Percentage COBRA subsidy
Client expense: $530,000 · Firm income: Not reported
2020 · fourth_quarter · Economics/Economic Development
Public Health Contact Tracing Workforce Funding for public health operations and rebuilding infrastructure HR 133- Consolidated Appropriations Act, 2021 State and Local Aid, including increasing the federal Medicaid match Special COVID-19 immunity for corporations and employers S 4714, HR 6514- Worker Health Coverage Protection Act S 4108, HR 6539- Coronavirus Medicaid Response Act
Client expense: $530,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2020 · fourth_quarter · Disaster Planning/Emergencies
Public Health Contact Tracing Workforce Funding for public health operations and rebuilding infrastructure HR 133- Consolidated Appropriations Act, 2021 State and Local aid, including increasing the federal Medicaid match Protecting workers at high risk of COVID-19 exposure Special COVID-19 immunity for corporations and employers S 4957- COVID Home and Community Based Services (HCBS) Relief of 2020 S 4714, HR 6514- Worker Health Coverage Protection Act S 4108, HR 6539- Coronavirus Medicaid Response Act
Client expense: $530,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2020 · fourth_quarter · Medicare/Medicaid
Public Health Contact Tracing Workforce HR 133- Consolidated Appropriations Act, 2021 State and Local Aid, including increasing the federal Medicaid match Implementation of Electronic Visit Verification of Home Care Workers Continuation of Funding for Certified Community Behavioral Health Clinics S 4957- COVID Home and Community Based Services (HCBS) Relief Act of 2020 S 4108, HR 6539- Coronavirus Medicaid Response Act HR 3- Lowering Prescription Drug Prices
Client expense: $530,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2020 · fourth_quarter · Medicare/Medicaid
Additional Coronavirus Health Care Relief. S. 178, H.R. 925, S. 4108, H.R. 6539 and H.R. 6800: Proposals to increase the Medicaid federal medical assistance percentage (FMAP), expand Medicare coverage for COVID related services, increase FMAP funding specifically for Medicaid home and community-based services; improve nursing home oversight, provide funding for COVID testing; ensure tele-visitation for nursing home residents, and eliminate cost sharing for COVID treatment. COVID Drug Database. H.R. 7288 and S. 4539, the Taxpayer Research and Coronavirus Knowledge Act of 2020: Proposals to require a single user-friendly database of federal biomedical investments in COVID-19 vaccines, drugs, therapies, medical devices, or other products. COVID Drug Pricing. H.R. 7296, the Make Medications Affordable by Preventing Pandemic Price-gouging Act: Proposals to prohibit pharmaceutical companies from exclusive licensing of drugs used to treat or prevent COVID-19. Health Care Extenders. H.R. 8337, the Continuing Appropriations Act, 2021: Proposals to extend the Medicaid Money Follows the Person Program which provides states money to keep seniors in their homes; and extend spousal impoverishment protections in Medicaid to long term care services provided in the home. Infection Control in Nursing Homes. H.R. 6698 and S. 3644, the Quality Care for Nursing Home Residents and Workers During COVID-19 Act: Proposal to authorize $500 million for states to establish expert strike teams for resident and worker safety to be deployed within 72 hours of 3+ confirmed or suspected COVID-19 cases in a facility. Medicare Coverage of Vaccines. H.R. 5076 and S. 1872, the Protecting Seniors Through Immunization Act of 2019: Proposals to expand Medicare to cover all adult vaccines recommended by the Advisory Committee on Immunization Practices without any cost-sharing for Part D. Medicare Enrollment. H.R. 2477, the BENES Act of 2020, changes the Medicare general enrollment period to October 15-December 31, and requires coverage to begin on the first day of the month following enrollment. (The general enrollment period has been January 1-March 31, and coverage begins July 1.) Medicare Enrollment. H.R. 2564, Medicare Enrollment Protection Act: Proposal to bill creates a special Medicare enrollment period for individuals enrolled in, or transitioning out of, continuation coverage under the Consolidated Omnibus Budget Reconciliation Act (COBRA) -a federal law that allows an individual to maintain health coverage following loss of coverage due to termination of employment or another qualifying event. Medicare Enrollment. The Consolidated Appropriations Act of 2021 (P.L. 116-260): Proposal to extending funding for enrollment assistance to help low-income seniors access the Medicare Prescription Drug Program Part D Low-Income Subsidy. Medicare Telehealth. Proposal to support efforts at Center for Medicare and Medicaid Services to continue access to telehealth during the COVID pandemic. Nursing Home Telehealth Visitation. H.R. 6487 and S. 3517, the ACCESS Act: Proposal requiring that residents have access to telehealth visitation during the pandemic. Medical Expense Deduction. The Consolidated Appropriations Act of 2021 (P.L. 116-260): Proposal to include a permanent extension of the 7.5 percent threshold for the medical expense deduction. Medicare Structure. Letter to Biden Transition team. Proposals to modify Medicare including changing to premium support model, lowering the eligibility age, furthering privatization of the program, adding hearing dental and vision coverage. Medicare Prescription Drugs: Letter to Biden transition team. Proposals to allow Medicare to negotiate prices with drug makers, cap prices at inflation in Part B and D, cap beneficiary out-of-pocket costs in Part D. Drug Pricing. Letter to Biden transition team. Proposals to allow generics to come to market earlier by limiting brand manufacturers ability to pay generics to delay entering the market. Short Term Care Coverage. H.R. 1682, Improving Access to Medicare Coverage Act of 2019: Proposal to amend title XVIII of the Social Security Act to count a period of receipt of outpatient observation services in a hospital toward satisfying the 3-day inpatient hospital stay requirement for coverage of skilled nursing facility services under Medicare, and for other purposes.
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.
2020 · fourth_quarter · Medicare/Medicaid
Additional Coronavirus Health Care Relief. S. 178, H.R. 925, S. 4108, H.R. 6539 and H.R. 6800: Proposals to increase the Medicaid federal medical assistance percentage (FMAP), expand Medicare coverage for COVID related services, increase FMAP funding specifically for Medicaid home and community-based services; improve nursing home oversight, provide funding for COVID testing; ensure tele-visitation for nursing home residents, and eliminate cost sharing for COVID treatment. COVID Drug Database. H.R. 7288 and S. 4539, the Taxpayer Research and Coronavirus Knowledge Act of 2020: Proposals to require a single user-friendly database of federal biomedical investments in COVID-19 vaccines, drugs, therapies, medical devices, or other products. COVID Drug Pricing. H.R. 7296, the Make Medications Affordable by Preventing Pandemic Price-gouging Act: Proposals to prohibit pharmaceutical companies from exclusive licensing of drugs used to treat or prevent COVID-19. Health Care Extenders. H.R. 8337, the Continuing Appropriations Act, 2021: Proposals to extend the Medicaid Money Follows the Person Program which provides states money to keep seniors in their homes; and extend spousal impoverishment protections in Medicaid to long term care services provided in the home. Infection Control in Nursing Homes. H.R. 6698 and S. 3644, the Quality Care for Nursing Home Residents and Workers During COVID-19 Act: Proposal to authorize $500 million for states to establish expert strike teams for resident and worker safety to be deployed within 72 hours of 3+ confirmed or suspected COVID-19 cases in a facility. Medicare Coverage of Vaccines. H.R. 5076 and S. 1872, the Protecting Seniors Through Immunization Act of 2019: Proposals to expand Medicare to cover all adult vaccines recommended by the Advisory Committee on Immunization Practices without any cost-sharing for Part D. Medicare Enrollment. H.R. 2477, the BENES Act of 2020, changes the Medicare general enrollment period to October 15-December 31, and requires coverage to begin on the first day of the month following enrollment. (The general enrollment period has been January 1-March 31, and coverage begins July 1.) Medicare Enrollment. H.R. 2564, Medicare Enrollment Protection Act: Proposal to bill creates a special Medicare enrollment period for individuals enrolled in, or transitioning out of, continuation coverage under the Consolidated Omnibus Budget Reconciliation Act (COBRA) -a federal law that allows an individual to maintain health coverage following loss of coverage due to termination of employment or another qualifying event. Medicare Enrollment. The Consolidated Appropriations Act of 2021 (P.L. 116-260): Proposal to extending funding for enrollment assistance to help low-income seniors access the Medicare Prescription Drug Program Part D Low-Income Subsidy. Medicare Telehealth. Proposal to support efforts at Center for Medicare and Medicaid Services to continue access to telehealth during the COVID pandemic. Nursing Home Telehealth Visitation. H.R. 6487 and S. 3517, the ACCESS Act: Proposal requiring that residents have access to telehealth visitation during the pandemic. Medical Expense Deduction. The Consolidated Appropriations Act of 2021 (P.L. 116-260): Proposal to include a permanent extension of the 7.5 percent threshold for the medical expense deduction. Medicare Structure. Letter to Biden Transition team. Proposals to modify Medicare including changing to premium support model, lowering the eligibility age, furthering privatization of the program, adding hearing dental and vision coverage. Medicare Prescription Drugs: Letter to Biden transition team. Proposals to allow Medicare to negotiate prices with drug makers, cap prices at inflation in Part B and D, cap beneficiary out-of-pocket costs in Part D. Drug Pricing. Letter to Biden transition team. Proposals to allow generics to come to market earlier by limiting brand manufacturers ability to pay generics to delay entering the market. Short Term Care Coverage. H.R. 1682, Improving Access to Medicare Coverage Act of 2019: Proposal to amend title XVIII of the Social Security Act to count a period of receipt of outpatient observation services in a hospital toward satisfying the 3-day inpatient hospital stay requirement for coverage of skilled nursing facility services under Medicare, and for other purposes.
2020 · third_quarter · Medicare/Medicaid
Additional Coronavirus Health Care Relief. S. 178, H.R 925, S. 4108, H.R. 6539 and H.R. 6800: Proposals to increase the federal medical assistance percentage (FMAP), expand Medicare coverage for COVID related services, increase FMAP funding specifically for home and community based services; improve nursing home oversight, provide funding for COVID testing; ensure tele visitation for nursing home residents, and eliminate cost sharing for COVID treatment. COVID Drug Database. H.R. 7288 and S. 4539, the Taxpayer Research and Coronavirus Knowledge Act of 2020: Proposals to require a single user-friendly database of federal biomedical investments in COVID-19 vaccines, drugs, therapies, medical devices, or other products. COVID Drug Pricing. H.R. 7296, the Make Medications Affordable by Preventing Pandemic Price-gouging Act: Proposals to prohibit pharmaceutical companies from exclusive licensing of drugs used to treat or prevent COVID-19. Health care extenders. H.R. 8337, the Continuing Appropriations Act, 2021: Proposals to extend Money Follows the Person Program which provides states money to keep seniors in their homes; extend spousal impoverishment protections in Medicaid to long term care services provided in the home. Infection Control in Nursing Homes. H.R. 6698 and S. 3644, the Quality Care for Nursing Home Residents and Workers During COVID-19 Act: Proposal to authorize $500 million for states to establish expert strike teams for resident and worker safety to be deployed within 72 hours of 3+ confirmed or suspected COVID-19 cases in a facility. Medicare Coverage of Vaccines. H.R. 5076 and S. 1872, the Protecting Seniors Through Immunization Act of 2019: Proposals to expand Medicare to cover all adult vaccines recommended by the Advisory Committee on Immunization Practices without any cost-sharing for Part D. Medicare Part B premiums. The Continuing Appropriations Act, 2021 and Other Extensions Act (P.L. 116-159). Proposal to freeze the Medicare Part B standard monthly premium to a fee equal to 25% percent of the difference between the 2020 amount and the preliminary monthly actuarial rate for 2021. Medicare Telehealth. Proposal to support efforts at Center for Medicare and Medicaid Services to continue access to telehealth during the COVID pandemic. Nursing Home Telehealth Visitation. H.R. 6487 and S. 3517, the ACCESS Act: Proposal requiring that residents have access to telehealth visitation during the pandemic.
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.
2020 · third_quarter · Medicare/Medicaid
Public Health Contact Tracing Workforce HR 6800- Health and Economic Recovery Omnibus Emergency Solutions (Heroes) Act State and Local Aid, including increasing the federal Medicaid match HR 6539, S 4108- Coronavirus Medicaid Response Act Implementation of Electronic Visit Verification
Client expense: $590,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2020 · third_quarter · Health Issues
Public Health Contact Tracing Workforce Funding for public health operations and rebuilding infrastructure HR 6800- Health and Economic Recovery Omnibus Emergency Solutions (Heroes) Act State and Local Aid, including increasing the federal Medicaid match HR 6539, S 4108- Coronavirus Medicaid Response Act Implementation of Electronic Visit Verification HR 1646- Helping Emergency Responders Overcome (HERO) Act HR 986- Protecting Americans With Preexisting Conditions Act HR 1633- Quality Care for Nursing Homes Act HR 6414- COBRA Coverage in Pandemic Federal income tax exclusion for employer sponsored health care benefits Medicaid Federal Medical Assistance Percentage (FMAP) COBRA subsidy
Client expense: $590,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2020 · third_quarter · Economics/Economic Development
Public Health Contact Tracing Workforce Funding for public health operations and rebuilding infrastructure HR 6800- Health and Economic Recovery Omnibus Emergency Solutions (Heroes) Act State and Local Aid, including increasing the federal Medicaid match HR 6539, S 4108- Coronavirus Medicaid Response Act
Client expense: $590,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2020 · third_quarter · Disaster Planning/Emergencies
Public Health Contact Tracing Workforce Funding for public health operations and rebuilding infrastructure HR 6800- Health and Economic Recovery Omnibus Emergency Solutions (Heroes) Act State and Local Aid, including increasing the federal Medicaid match HR 6539, S 4108- Coronavirus Medicaid Response Act HR 1646- Helping Emergency Responders Overcome (HERO) Act
Client expense: $590,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2020 · third_quarter · Budget/Appropriations
Public Health Contact Tracing Workforce Funding for public health operations and rebuilding infrastructure HR 6800- Health and Economic Recovery Omnibus Emergency Solutions (Heroes) Act State and Local Aid, including increasing the federal Medicaid match HR 6539, S 4108- Coronavirus Medicaid Response Act HR 8337- Continuing Appropriations Act, 2021 HR 8406- Heroes 2.0 HR 925- Motion to concur in the Senate amendments with an amendment (Heroes 2.0) Delivering Immediate Relief Act (McConnell Relief Plan) Budget- general COVID-19 Emergency Funding S 1624- Health, Economic Assistance, Liability Protection and Schools (HEALS) Act S 3671- State and Local Emergency Stabilization Fund S 3752, HR 6954- State Municipal Assistance for Recovery and Transition (SMART) Fund Education State Stabilization Fund
Client expense: $590,000 · Firm income: Not reported
2020 · third_quarter · Urban Development/Municipalities
Public Health Contact Tracing Workforce Funding for public health operations and rebuilding infrastructure HR 6800- Health and Economic Recovery Omnibus Emergency Solutions (Heroes) Act State and Local Aid, including increasing the federal Medicaid match HR 6539, S 4108- Coronavirus Medicaid Response Act
Client expense: $590,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
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 · Medicare/Medicaid
Coronavirus Medicaid Response Act (H.R. 6539/S. 4108)
Client expense: $486,869 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
| HR 6379 |
116th |
| Related bill |
Government targets: HOUSE OF REPRESENTATIVES, SENATE
Client expense: $180,000 · Firm income: Not reported
Government targets: Administration on Aging, Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Social Security Administration (SSA), Treasury, Dept of, U.S. Postal Service (USPS)
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
Client expense: $170,000 · Firm income: Not reported
Government targets: Administration on Aging, Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Social Security Administration (SSA), Treasury, Dept of, U.S. Postal Service (USPS)
Client expense: $200,000 · Firm income: Not reported
Government targets: Administration on Aging, Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Social Security Administration (SSA), Treasury, Dept of, U.S. Postal Service (USPS)
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
Government targets: 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