Ensuring Parity in MA for Audio-Only Telehealth Act of 2020

Medicaid Maternal Health; Medicare Advantage Audio Only; Medicare; Medicare Advantage Reform; Medicaid; Part D Reform; S. 150 - Ensuring Parity in MA for Audio-Only Telehealth Act of 2021 Sponsor: Sen. Catherine Cortez Masto (D-NV) Public Law 117-7 (H.R. 1868) - To prevent across-the-board direct spending cuts, and for other purposes. Sponsor: Rep. John Yarmuth (D-KY-03) S. 4840 - Ensuring Parity in MA for Audio-Only Telehealth Act of 2020 Sponsor: Sen. Pat Roberts (R-KS) H.R. 7659 - Ensuring Parity in MA for Audio-Only Telehealth Act of 2020 Sponsor: Rep. Terri Sewell (D-AL-07) H.R. 2166 - To amend title XVIII of the Social Security Act to require the inclusion of certain audio-only diagnoses in the determination of risk adjustment for Medicare Advantage plans and PACE programs, and for other purposes. Sponsor: Rep. Terri Sewell (D-AL-07) H.R. 2170 - HAPI Act Sponsor: Rep. Darren Soto (D-FL-09) H.R. 2815 - BIOSIM Act Sponsor: Rep. Kurt Schrader H.R. 2846 - Ensuring Access to Lower-Cost Medicines for Seniors Act of 2021 Sponsor: Rep. David McKinley (R-WV-01) H.R. 2166 - Ensuring Parity in MA and PACE for Audio-Only Telehealth Act of 2021 Sponsor: Rep. Terri Sewell (D-AL-07)

Client expense: $1,650,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, White House Office

Surprise billing; pharmacy costs; health care access and subsidies; provider support; Medicare Advantage H.R. 6800 - 116th Congress - Second Session HEROES Act H.R. 6545 - 116th Congress - Second Session Health Insurance Marketplace Affordability Act of 2020 HR 7659 116th Congress - Second Session - Ensuring Parity in MA for Audio-Only Telehealth Act of 2020

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to Medicare Advantage and Part D prescription drug programs; Issues related to Prescription Drug Rebates; Issues related to Dual Eligible and Medicare Advantage Special Needs Plans; Issues related to Social Determinants of Health (SDOH)/Health Equity; and Issues related to Telehealth. 117th Congress COVID-19 American Rescue Plan American Jobs Plan Medicare Sequester COVID Moratorium Act (H.R. 315) Delay of the Prescription Drug Rebate Rule Ensuring Parity in MA for Audio-Only Telehealth Act of 2021 (S. 150) The Ensuring Parity in MA and PACE for Audio-Only Telehealth Act (HR 2166) Previous Congresses H.R. 3461, Community-Based Independence for Seniors Act H.R. 3877, Bipartisan Budget Act H.R. 19, Lower Costs, More Cures Act of 2019 S. 3013, Encouraging Innovative Benefit Design to Lower Costs for Seniors Act H.R. 6074, Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 H.R. 6201, Families First Coronavirus Response Act H.R. 748, CARES Act H.R. 6800, HEROES Act H.R. 7659, Ensuring Parity in MA for Audio-Only Telehealth Act of 2020 S. 4318, American Workers, Families and Employers Assistance Act S. 4199, Prescription Drug Pricing Reduction Act of 2020 S.4840, Ensuring Parity in MA for Audio-Only Telehealth Act of 2020 Bipartisan Coronavirus Relief and Omnibus Funding Bill H.R. 4074, Addressing Social Determinants in Medicare Advantage PL 115-123: H.R. 1892, The bipartisan Budget Act of 2018; H.R. 3168, To amend title XVIII of the Social Security Act to provide continued access to specialized Medicare Advantage plans for special needs individuals, and for other purposes; S. 870, CHRONIC Care Bill PL 115-271: H.R. 6, SUPPORT for Patients and Communities Act

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Medicaid Maternal Health; Medicaid; Medicare Advantage Audio Only; Medicare; Medicare Advantage Reform; Part D Reform HR 7659 (116th Congress), Ensuring Parity in MA for Audio-Only Telehealth Act of 2020, by Rep. Terri Sewell (D-AL). Requires the inclusion of certain audio-only diagnoses in the determination of risk adjustment for Medicare Advantage plans. HR 1868 (117th Congress), by Rep. John Yarmuth (D-KY). Makes several budgetary and technical changes to provisions under Medicare and Medicaid, including continuing to exempt Medicare from sequestration until December 31, 2021. HR 2166 (117th Congress), by Rep. Terri Sewell (D-AL). Amends title XVIII of the Social Security Act to require the inclusion of certain audio-only diagnoses in the determination of risk adjustment for Medicare Advantage plans and PACE programs, and for other purposes. HR 2170 (117th Congress), HAPI Act, by Rep. Darren Soto (D-FL). Amends title XIX of the Social Security Act to improve access to adult vaccines under Medicaid. HR 2815 (117th Congress), BIOSIM Act, by Rep. Kurt Schrader (D-OR). Amends title XVIII of the Social Security Act to provide for a temporary payment increase under the Medicare program for certain biosimilar biological products to encourage the development and use of such products. HR 2846 (117th Congress), Ensuring Access to Lower Cost Medicines for Seniors Act of 2021, by Rep. David McKinley (R-WV). Amends title XVIII of the Social Security Act to require PDP sponsors of a prescription drug plan under part D of the Medicare program that use a formulary to include certain generic drugs and biosimilar biological products on such formulary. S 4840 (116th Congress), Ensuring Parity in MA for Audio-Only Telehealth Act of 2020, by Sen. Pat Roberts (R-KS). Allows audio-only diagnoses made via telehealth to be used for purposes of determining risk adjustments to payments under Medicare Advantage, and requires payments for Medicare telehealth services furnished during the public health emergency relating to COVID-19 to be made in the same amounts as those for in-person services. S 150 (117th Congress), Ensuring Parity in MA for Audio-Only Telehealth Act of 2021, by Sen. Catherine Cortez Masto (D-NV). Amends title XVIII of the Social Security Act to require the inclusion of certain audio-only diagnoses in the determination of risk adjustment for Medicare Advantage plans, and for other purposes.

Client expense: Not reported · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, White House Office

Medicaid Maternal Health; Medicaid; Medicare Advantage Audio Only; Medicare; Medicare Advantage Reform; Part D Reform HR 7659 (116th Congress), Ensuring Parity in MA for Audio-Only Telehealth Act of 2020, by Rep. Terri Sewell (D-AL). Requires the inclusion of certain audio-only diagnoses in the determination of risk adjustment for Medicare Advantage plans. HR 1868 (117th Congress), by Rep. John Yarmuth (D-KY). Makes several budgetary and technical changes to provisions under Medicare and Medicaid, including continuing to exempt Medicare from sequestration until December 31, 2021. HR 2166 (117th Congress), by Rep. Terri Sewell (D-AL). Amends title XVIII of the Social Security Act to require the inclusion of certain audio-only diagnoses in the determination of risk adjustment for Medicare Advantage plans and PACE programs, and for other purposes. HR 2170 (117th Congress), HAPI Act, by Rep. Darren Soto (D-FL). Amends title XIX of the Social Security Act to improve access to adult vaccines under Medicaid. HR 2815 (117th Congress), BIOSIM Act, by Rep. Kurt Schrader (D-OR). Amends title XVIII of the Social Security Act to provide for a temporary payment increase under the Medicare program for certain biosimilar biological products to encourage the development and use of such products. HR 2846 (117th Congress), Ensuring Access to Lower Cost Medicines for Seniors Act of 2021, by Rep. David McKinley (R-WV). Amends title XVIII of the Social Security Act to require PDP sponsors of a prescription drug plan under part D of the Medicare program that use a formulary to include certain generic drugs and biosimilar biological products on such formulary. S 4840 (116th Congress), Ensuring Parity in MA for Audio-Only Telehealth Act of 2020, by Sen. Pat Roberts (R-KS). Allows audio-only diagnoses made via telehealth to be used for purposes of determining risk adjustments to payments under Medicare Advantage, and requires payments for Medicare telehealth services furnished during the public health emergency relating to COVID-19 to be made in the same amounts as those for in-person services. S 150 (117th Congress), Ensuring Parity in MA for Audio-Only Telehealth Act of 2021, by Sen. Catherine Cortez Masto (D-NV). Amends title XVIII of the Social Security Act to require the inclusion of certain audio-only diagnoses in the determination of risk adjustment for Medicare Advantage plans, and for other purposes.

Client expense: $150,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, White House Office

Medicaid Maternal Health; Medicare Advantage Audio Only; Medicare; Medicare Advantage Reform; Medicaid; Part D Reform; S. 150 - Ensuring Parity in MA for Audio-Only Telehealth Act of 2021 Sponsor: Sen. Catherine Cortez Masto (D-NV) Public Law 117-7 (H.R. 1868) To prevent across-the-board direct spending cuts, and for other purposes Sponsor: Rep. John Yarmuth (D-KY-03) S. 4840Ensuring Parity in MA for Audio-Only Telehealth Act of 2020 Sponsor: Sen. Pat Roberts (R-KS) H.R. 7659 - Ensuring Parity in MA for Audio-Only Telehealth Act of 2020 Sponsor: Rep. Terri Sewell (D-AL-07) H.R. 2166 - To amend title XVIII of the Social Security Act to require the inclusion of certain audio-only diagnoses in the determination of risk adjustment for Medicare Advantage plans and PACE programs, and for other purposes. Sponsor: Rep. Terri Sewell (D-AL-07) H.R. 2815 - Biosim Act Sponsor: Rep. Kurt Schrader H.R. 2846 - Ensuring access to Lower-Cost Medicines for Seniors Act of 2021 Sponsor: Rep. David McKinley (R-WV-01) H.R. 2166 - Ensuring Parity in MA and PACE for Audio-Only Telehealth Act of 2021 Sponsor: Rep. Terri Sewell (D-AL-07)

Client expense: $10,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

Medicaid Maternal Health; Medicare Advantage Audio Only; Medicaid FMAP; Medicare; Medicare Advantage; S. 748 - Medicare Sequester Relief Act Sponsor: Sen. Jeanne Shaheen (D-NH) S. 150 - Ensuring Parity in MA for Audio-Only Telehealth Act of 2021 Sponsor: Sen. Catherine Cortez Masto (D-NV) H.R. 4996 - Helping MOMS Act of 2020 Rep. Robin Kelly (D-IL-02) S. 4840 - Ensuring Parity in MA for Audio-Only Telehealth Act of 2020 Sponsor: Sen. Pat Roberts (R-KS) H.R. 7659 - Ensuring Parity in MA for Audio-Only Telehealth Act of 2020 Sponsor: Rep. Terri Sewell (D-AL-07) H.R. 2166 - To amend title XVIII of the Social Security Act to require the inclusion of certain audio-only diagnoses in the determination of risk adjustment for Medicare Advantage plans and PACE programs, and for other purposes. Sponsor: Rep. Terri Sewell (D-AL-07)

Client expense: $1,400,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, White House Office

Medicaid Maternal Health; Medicare Advantage Audio Only; Medicaid FMAP; Medicare; Medicare Advantage; S. 748 - Medicare Sequester Relief Act Sponsor: Sen. Jeanne Shaheen (D-NH) S. 150 - Ensuring Parity in MA for Audio-Only Telehealth Act of 2021 Sponsor: Sen. Catherine Cortez Masto (D-NV) H.R. 4996 - Helping MOMS Act of 2020 Rep. Robin Kelly (D-IL-02) S. 4840 - Ensuring Parity in MA for Audio-Only Telehealth Act of 2020 Sponsor: Sen. Pat Roberts (R-KS) H.R. 7659 - Ensuring Parity in MA for Audio-Only Telehealth Act of 2020 Sponsor: Rep. Terri Sewell (D-AL-07) H.R. 2166 - To amend title XVIII of the Social Security Act to require the inclusion of certain audio-only diagnoses in the determination of risk adjustment for Medicare Advantage plans and PACE programs, and for other purposes. Sponsor: Rep. Terri Sewell (D-AL-07)

Client expense: $114,300 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicaid Maternal Coverage; Medicare Advantage Audio Only; Medicaid FMAP; Medicare; Medicare Advantage HR 7659 (116th Congress), Ensuring Parity in MA for Audio-Only Telehealth Act of 2020, by Rep. Terri Sewell (D-AL). Require the inclusion of certain audio-only diagnoses in the determination of risk adjustment for Medicare Advantage plans. HR 2166 (117th Congress), by Rep. Terri Sewell (D-AL). Amends title XVIII of the Social Security Act to require the inclusion of certain audio-only diagnoses in the determination of risk adjustment for Medicare Advantage plans and PACE programs, and for other purposes. S 4840 (116th Congress), Ensuring Parity in MA for Audio-Only Telehealth Act of 2020, by Sen. Pat Roberts (R-KS). Allows audio-only diagnoses made via telehealth to be used for purposes of determining risk adjustments to payments under Medicare Advantage, and requires payments for Medicare telehealth services furnished during the public health emergency relating to COVID-19 to be made in the same amounts as those for in-person services. S 150 (117th Congress), Ensuring Parity in MA for Audio-Only Telehealth Act of 2021, by Sen. Catherine Cortez Masto (D-NV). Amends title XVIII of the Social Security Act to require the inclusion of certain audio-only diagnoses in the determination of risk adjustment for Medicare Advantage plans, and for other purposes. S 748 (117th Congress), Medicare Sequester Relief Act, by Rep. Jeanne Shaheen (D-NH). Provides for an extension of the temporary suspension of Medicare sequestration during the COVID-19 public health emergency.

Client expense: Not reported · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, White House Office

Medicaid Maternal Coverage; Medicare Advantage Audio Only; Medicaid FMAP; Medicare; Medicare Advantage HR 7659 (116th Congress), Ensuring Parity in MA for Audio-Only Telehealth Act of 2020, by Rep. Terri Sewell (D-AL). Require the inclusion of certain audio-only diagnoses in the determination of risk adjustment for Medicare Advantage plans. HR 2166 (117th Congress), by Rep. Terri Sewell (D-AL). Amends title XVIII of the Social Security Act to require the inclusion of certain audio-only diagnoses in the determination of risk adjustment for Medicare Advantage plans and PACE programs, and for other purposes. S 4840 (116th Congress), Ensuring Parity in MA for Audio-Only Telehealth Act of 2020, by Sen. Pat Roberts (R-KS). Allows audio-only diagnoses made via telehealth to be used for purposes of determining risk adjustments to payments under Medicare Advantage, and requires payments for Medicare telehealth services furnished during the public health emergency relating to COVID-19 to be made in the same amounts as those for in-person services. S 150 (117th Congress), Ensuring Parity in MA for Audio-Only Telehealth Act of 2021, by Sen. Catherine Cortez Masto (D-NV). Amends title XVIII of the Social Security Act to require the inclusion of certain audio-only diagnoses in the determination of risk adjustment for Medicare Advantage plans, and for other purposes. S 748 (117th Congress), Medicare Sequester Relief Act, by Rep. Jeanne Shaheen (D-NH). Provides for an extension of the temporary suspension of Medicare sequestration during the COVID-19 public health emergency.

Client expense: $250,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, White House Office

Issues related to Medicare Advantage and Part D prescription drug programs; Issues related to Prescription Drug Rebates; Issues related to Dual Eligible and Medicare Advantage Special Needs Plans; Issues related to Social Determinants of Health (SDOH)/Health Equity; and Issues related to Telehealth. 117th Congress COVID-19 American Rescue Plan American Jobs Plan Medicare Sequester COVID Moratorium Act (H.R. 315). Delay of the Prescription Drug Rebate Rule Ensuring Parity in MA for Audio-Only Telehealth Act of 2021 (S. 150) The Ensuring Parity in MA and PACE for Audio-Only Telehealth Act (HR 2166) Previous Congresses H.R. 3461, Community-Based Independence for Seniors Act H.R. 3877, Bipartisan Budget Act H.R. 19, Lower Costs, More Cures Act of 2019 S. 3013, Encouraging Innovative Benefit Design to Lower Costs for Seniors Act H.R. 6074, Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 H.R. 6201, Families First Coronavirus Response Act H.R. 748, CARES Act H.R. 6800, HEROES Act H.R. 7659, Ensuring Parity in MA for Audio-Only Telehealth Act of 2020 S. 4318, American Workers, Families and Employers Assistance Act S. 4199, Prescription Drug Pricing Reduction Act of 2020 S.4840, Ensuring Parity in MA for Audio-Only Telehealth Act of 2020 Bipartisan Coronavirus Relief and Omnibus Funding Bill PL 115-123: H.R. 1892, The bipartisan Budget Act of 2018; H.R. 3168, To amend title XVIII of the Social Security Act to provide continued access to specialized Medicare Advantage plans for special needs individuals, and for other purposes; S. 870, CHRONIC Care Bill PL 115-271: H.R. 6, SUPPORT for Patients and Communities Act

Client expense: $270,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Issues related to the Medicare Part D, Medicare Advantage, Medicaid (including increasing Medicaid funding to states), and the ESRD program. Issues related to CMS Medicare Advantage Advance Rate Notice and Draft Call Letter for 2020. Issues related to reimbursement levels for COVID testing and vaccination. H.R. 3, The Lower Drug Costs Now Act of 2019 H.R. 6800, The Health and Economic Recovery Omnibus Emergency Solutions Act of 2020 H.R. 7659, The Ensuring Parity for MA in Audio-only Telehealth Act of 2020 H.R. 8245/S. 4574, The Bringing Enhanced Treatments and Therapies to ESRD Recipients Kidney Care Act of 2020 S. 1895, The Lower Health Care Costs Act of 2019 S.2543, The Prescription Drug Pricing Reduction Act of 2019 S. 3013, The Encouraging Innovative Benefit Design to Lower Costs for Seniors Act of 2019 S. 3129, The Lower Costs, More Cures Act of 2019

Client expense: $2,300,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

-Proposals that impact Medicare Part D such as formulary requirements, pharmacy benefit manager (PBM) disclosure provisions, closing the Part D coverage gap and direct negotiation of prescription drug prices. -Pharmacy Direct and Indirect Remuneration (DIR) H.R. 1034, the Phair Pricing Act of 2019; S.640, the Phair Pricing Act of 2019; H.R. 803, the Improving Transparency and Accuracy in Medicare Part D Spending Act; H.R. 1035, the Improving Transparency and Accuracy in Medicare Part D Spending Act. -Policies that impact public programs payments for high cost drugs including gene therapies. -H.R.7659/S. 4840, Ensuring Parity in MA for Audio-Only Telehealth Act of 2020, to amend title XVIII of the Social Security Act to require the inclusion of certain audio-only diagnoses in the determination of risk adjustment for Medicare Advantage plans, and for other purposes. -Issues related to prior authorization and utilization management, H.R. 3107, the Improving Seniors' Timely Access to Care Act of 2019. -Issues related to H.R. 133 / PL 116-260 - FY2021 Omnibus and COVID Relief and Response Act.

Client expense: $1,520,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H.R. 748 - CARES Act -Courtney - COVID-19 coverage H.R. 1418 - Competitive Health Insurance Reform Act of 2020 - DeFazio - antitrust laws, health insurance, McCarran-Ferguson H.R. 3630 - No Surprises Act - Pallone - surprise medical billing H.R. 3784 - Air Ambulance Affordability Act of 2019 - Neguse - air ambulances H.R. 4223 - Protecting Patients from Surprise Medical Bills Act - Spano - surprise medical billing H.R. 5121 - Healthcare Cost Transparency Act - Beyer - provider price comparison tool H.R. 5239 - Prescription Drug Price Reporting Act - Joyce - reporting on drug expenditures and price changes under group health plans H.R. 5575 - Primary and Behavioral Health Care Access Act of 2020 -Underwood - coverage of primary care and behavioral health visits H.R. 6005 - Know the Price Act - Malinowski - health plan transparency H.R. 6173 - Covering Coronavirus Test Act of 2020 - DeGette - COVID-19 testing coverage H.R. 6193 - Medication Access in Emergencies Act of 2020 - Pappas - coverage of prescription drugs during emergency periods H.R. 6201 - Families First Coronavirus Response Act - Lowey - includes several provisions related to COVID-19 testing coverage H.R. 6213 - No Cost for COVID-19 Testing Act - Wilson - COVID-19 testing coverage H.R. 6214 - To amend title XVIII of the Social Security Act to provide for coverage of testing for COVID-19 at no cost sharing under the Medicare Advantage program - Kind - Medicare Advantage coverage of COVID-19 related visits and testing H.R. 6222 - Ensuring Affordable COVID-19 Preventive Care Act of 2020 - Schakowsky - coverage of certain new preventative services related to COVID-19 H.R. 6231 - Ensuring Access to COVID-19 Preventive Care Act of 2020 - Bucshon - coverage of certain vaccines and testing services during the COVID-19 emergency H.R. 6299 - Rapid Coverage of COVID-19 Vaccine Act of 2020 - Courtney - COVID-19 coverage H.R. 6317 - To provide for special enrollment periods during public health emergencies, coverage of services related to public health emergencies, and for other purposes - Doggett - special enrollment periods in public health emergency H.R. 6338 - To waive high deductible health plan requirements for health savings accounts -Budd - HDHP coverage during COVID H.R. 6486- Care for COVID-19 Act 2.0 -Ruiz - COVID H.R. 6514 - Worker Health Coverage Protection Act - Scott - COVID H.R. 6518 - Stop Health Premium Spikes Act of 2020 - Peters - risk corridors H.R. 6532 - COVID Special Enrollment Act of 2020 - Doggett - COVID H.R. 6568 - Coverage for COVID-19 Treatment Act of 2020 - Rochester - COVID H.R. 6644 - To require group health plans and health insurance issuers offering group or individual health insurance coverage to provide coverage for services furnished via telehealth if such services would be covered if furnished in-person during the COVID-19 emergency. -Schrier - COVID H.R. 6674 - Medicare Crisis Program Act of 2020 -Jayapal - COVID H.R. 6712 - American Healthshare Plans Act of 2020 - Curtis - health share pools H.R. 6810 - Health Care Protection Act -Davis - COVID H.R. 7006 - Improving Care in Home Health Agencies Act - Velazquez - home health services H.R. 7267 - To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to prohibit a group health plan and a health insurance issuer offering group or individual health insurance coverage from reducing contracted rates, or terminating contracts, with health care providers during a public health emergency. - Porter - ERISA H.R. 7475 - Ensuring FEHBP Coverage During Pandemic Act - Vela - special enrollment period H.R. 7539 - Strengthening Behavioral Health Parity Act - Kennedy - strengthen mental health and SUD benefits H.R. 7647 - To provide for a COVID-19-related delay regarding annual limitation on cost-sharing for group health plans and individual and small group health insurance coverage - McEachin - drug manufacturer support applied to patient out-of-pocket limit H.R. 7659 - Ensuring Parity in MA for Audio-Only Telehealth Act of 2020 - Sewell - inclusion of certain audio-only diagnoses in the determination of risk adjustment for MA plans H.R. 7676 - Health Care Prices Revealed and Information to Consumers Explained Transparency Act - Flores - hospital and insurer price transparency H.R. 7722 - Matts Act - Fortenberry - limit price of insulin drugs accessible for those enrolled in group or indiv. health insurance coverage, group health plans, uninsured H.R. 7921 - Connecting Communities to Grant Opportunities Act of 2020 - Velazquez - navigator programs H.R. 7942 - Public Health Emergency COBRA Extension Act -Sanchez - COBRA extension H.R. 8060 - Tele-Mental Health Improvement Act - Trone - parity in mental health and SUD service under private insurance H.R. 8181 - Jack Reynolds Memory MediGap Expansion - Axne - Medigap coverage for Medicare ESRD H.R. 8308 - Telehealth Coverage and Payment Parity Act - Phillips - coverage for services furnished through telehealth H.R. 8330 - No Surprise Bills for New Moms Act - Porter - health coverage of newborns H.R. 8527 - Fair Care Act of 2020 - Westerman - health care costs and coverage H.R. 8573 - Helping Families Access Pediatric Care Act of 2020 - Schrier - deductibles and outpatient pediatric services H.R. 8615 - ARC Act of 2020 -Payne, Jr. - coverage of peripheral artery disease screening tests H.R. 8875 - Health Insurance Lemon Law Act - Kennedy - special enrollment period for non-compliant health plans S. 350 - Competitive Health Insurance Reform Act of 2019 - Daines - McCarran-Ferguson Act S. 1531 - STOP Surprise Medical Bills Act - Cassidy-Bennet - surprise medical billing S. 1948 - Chronic Disease Management Act - Thune - pre-deductible coverage of chronic disease prevention services S. 2546 - Safe Step Act - Murkowski - Step therapy exceptions S. 3200 - Chronic Disease Management Act of 2020 - Thune - coverage of chronic disease prevention services S. 3383 - Continuing Coverage for Preexisting Conditions Act of 2020 -Kennedy - preexisting conditions S. 3499 - A bill to amend coverage requirements to ensure that no person incurs cost sharing when receiving a test to confirm a COVID-19 infection - Smith - COVID-19 cost -sharing S. 3505 - A bill to require private health insurance to rapidly cover preventive services and vaccines related to the coronavirus - Jones - rapid COVID-19 coverage S. 3536 - A bill to provide for special enrollment periods during public health emergencies, coverage of services related to public health emergencies, and for other purposes - Casey - COVID-19 coverage S. 3610 - American Healthshare Plans Act of 2020 - Paul - health share pools S. 3631 - Relief for Rural Providers During Emergencies Act - Sasse - COVID S. 3741 - Health Care at Home Act of 2020 - Smith - COVID S. 3792 - Tele-Mental Health Improvement Act - Smith - parity S. 3821 - Affordable Health Care Options Act of 2020 - Loeffler - affordability S. 3991 - Coronavirus 2019 Special Enrollment Period Act - Duckworth - SEP S. 4106 - A bill to amend the Public Health Service Act to provide for hospital and insurer price transparency - Braun - price transparency S. 4185 - End Surprise Medical Bills for Air Ambulances Act of 2020 - Wicker - establish an IDR for air ambulance S. 4198 - Affordable Coronavirus Testing Act - Scott - coverage for COVID serology testing S. 4255 - Katherines Lung Cancer Early Detection and Survival Act of 2020 - Smith - group health plans, group and indiv coverage benefits for lung cancer screenings S. 4329 - Continuous Health Coverage for Workers Act - McSally - COBRA continuation coverage S. 4469 - COVID-19 Treatment Coverage Act - Smith - COVID treatment Medicaid/MA/Private/Medicare coverage S. 4506 - Pre-Existing Conditions Protection Act of 2020 - Gardner - coverage of pre-ex conditions under private insurance S. 4521 - Health Care Improvement Act of 2020 - Warner - expand ACA coverage S. 4557 - COVid Enrollment Response Act - Baldwin - assistance enrolling in health care coverage S. 4609 - Vaccine And Coverage Certainty Act - Wyden - coverage of COVID vaccine under Medicare/Medicaid, CHIP S. 4653 - A bill to prevent efforts of the Department of Justice to advocate courts to strike down the Patient Protection and Affordable Care Act - Schumer - ACA S. 4761 - Primary and Behavioral Health Care Access Act of 2020 - King - coverage and cost-sharing S. 4796 - Fair Care Act of 2020 - Braun - health care costs and coverage S. 4820 - Long-Term Care Affordability Act - Pat Toomey - long term care insurance S. 4894 - DOC Access Act of 2019 - Manchin - vision and dental insurance S. 4959 - A bill to increase transparency and access to group health plan and health insurance issuer reporting - Braun - Transparency on pharmacy benefits and drug costs S. 5084 - A bill to increase transparency and access to group health plan and health insurance issuer reporting - Braun - Transparency Regulatory Issues: Insurance regulatory reform; issues related to the coordination of private and public disability income benefits; disability risk management; disability income insurance enrollment and awareness; issues related to COBRA continuation coverage; issues related to behavioral health benefits; issues related to encouraging impaired workers to stay in/return to the workforce; issues related to expanding long-term care insurance coverage; issues relating to COVID-19, including testing, vaccines and therapeutics; issues related to addressing the social determinants of health, including housing, transportation, nutrition, and educational opportunities; issues related to changes to prior authorization regulations, electronic documentation, and related issues; issues relating to Medicaid best price; issues relating to the coordination of benefits between private health insurance plans and Medicaid; Medigap claims processing and crossover fees; Medigap cross-over claim issues, Medigap coverage, implementation of Medigap standardized plan offerings; Medigap carrier recoveries related to CMS fraud and abuse enforcement activities, and issues related to Medigap educational materials, and other Medigap issues; fraud and abuse issues affecting public and private insurance coverage; issues relating to antitrust; implementation of the Mental Health Parity Act requirements; implementation of the 21st Century Cures Act requirements; summary of benefits and coverage disclosures; prior authorization; accountable care organizations; coverage of preventive services; preexisting condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; health reimbursement accounts; dependent coverage; treatment of expatriate plans; issues related to surprise medical bills; issues related to all payor claims databases; issues related to association health plans; issues related to substance abuse and provider treatment records (42 CFR Part 2); issues related to medical management; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations, non-discriminatory wellness programs; issues related to supplemental products; issues relating to dental coverage; issues relating to proposals for single-payer and Medicare/Medicaid buy-in options; issues related to implementation of the Telephone Consumer Protection Act; issues relating to third party payment of premiums; issues related to cost-sharing reductions (CSRs); issues related to interoperability and price transparency; issues related to the employer market; issues relating to the individual market; and other issues relating to health care reform implementation.

Client expense: $2,400,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Council of Economic Advisers (CEA), Executive Office of the President (EOP), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of the Vice President of the United States, SENATE, Treasury, Dept of, White House Office

Medicare and Medicaid dual eligible integration; Performance evaluation/quality oversight; SES (socio-economic status) issues related to SNP payment rates and quality measures; H.R. 3461, Community-Based Independence for Seniors Act of 2019; Public Law 116-136, CARES Act; telehealth issues related to COVID-19, particularly audio-only flexibilities; H.R. 925, The Heroes Act; H.R. 8337, Continuing Appropriations Act, 2021 and Other Extensions Act (Public Law 116-159); H.R. 7659, Ensuring Parity in MA for Audio-Only Telehealth Act of 2020; Extension of the Medicare Sequester; H.R. 133, Consolidated Appropriations Act, 2021 (Public Law 116-260)

Client expense: Not reported · Firm income: $50,000

Medicare Advantage Audio Only; Medicaid Maternal Coverage; MOMS Act; H.R. 7659 - 116th Congress Ensuring Parity in MA for Audio-Only Telehealth Act of 2020 Sponsor: Rep. Terri Sewell (D-AL-07) S. 4840 - 116th Congress Ensuring Parity in MA for Audio-Only Telehealth Act of 2020 Sponsor: Sen. Pat Roberts (R-KS)

Client expense: $104,240 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Monitor H.R. 7659 / S. 4840, the Ensuring Parity in MA for Audio-Only Telehealth Act of 2020, to amend title XVIII of the Social Security Act to require the inclusion of certain audio-only diagnoses in the determination of risk adjustment for Medicare Advantage plans, and for other purposes; issues related to prior authorization and utilization management, H.R. 3107, the Improving Seniors' Timely Access to Care Act of 2019; issues related to Pharmacy Direct and Indirect Remuneration (DIR); H.R. 1034, the Phair Pricing Act of 2019; S.640, the Phair Pricing Act of 2019; H.R. 803, the Improving Transparency and Accuracy in Medicare Part D Spending Act; H.R. 1035, the Improving Transparency and Accuracy in Medicare Part D Spending Act; proposals that impact Medicare Part D such as formulary requirements, pharmacy benefit manager (PBM) disclosure provisions, closing the Part D coverage gap and direct negotiation of prescription drug prices; issues related to H.R. 133 / PL 116-260 - FY2021 Omnibus and COVID Relief and Response Act.

Client expense: Not reported · Firm income: $90,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 6800, The Heroes Act, provisions related to Medicare Advantage and health coverage. S. 1895, Lower Health Care Costs Act, provisions related to surprise billing. H.R. 7659, Ensuring Parity in MA for Audio-Only Telehealth Act of 2020, provisions related to Medicare Advantage risk adjustment. S. 4840, Ensuring Parity in MA for Audio-Only Telehealth Act of 2021,provisions related to Medicare Advantage risk adjustment. H.R. 3630, No Surprises Act, provisions related to surprise billing. H.R. 133, Consolidated Appropriations Act of 2021, various health related provisions.

Client expense: $490,000 · Firm income: Not reported

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H.R. 133, Consolidated Appropriations Act of 2021, including provisions relating to the No Surprises Act, COVID-19 provisions (FMAP) and health extenders (Money Follows the Person, Medicaid spousal impoverishment protections, IAH) H.R. 925, The Heroes Act, including provisions related to House Amendment to the Senate Amendments updated Heroes Act; specifically provisions related to provisions related to access to healthcare including FMAP, testing, protections for public health workers, and benefits to children and families impacted by the coronavirus, Federal Medical Assistance Percentages (FMAP) H.R. 3644/S. 1202, Independence at Home Act of 2019, including provisions relating to improve and provide for a permanent Independence at Home medical practice program under the Medicare program H.R. 4996, Helping Medicaid Offer Maternity Services (MOMS) Act H.R. 7659/S. 4840, Ensuring Parity in MA for Audio-Only Telehealth Act of 2020, including provisions relating to (MA audio-only visits are currently not included in risk adjustment calculations H.R. 6800, Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act including provisions relating to Medicaid, Medicare issues H.R. 8337, Continuing Appropriations Act, 2021 and Other Extensions Act, including provisions included in the section titled, Money Follows the Person, Medicaid Spousal Impoverishment Protections H.R. 8834, Independence at Home Demonstration Improvement Act of 2020, including provisions relating to title XVII of the Social Security Act to extend and improve the Independence at Home Medical Practice Demonstration Program under the Medicare program S. 3013, Encouraging Innovative Benefit Design to Lower Costs for Seniors Act, including provisions relating to prescription drug plans under Medicare Part D (allows for additional drug plan offerings) Potential legislation titled Health, Education Assistance, Liability Protections, Schools Act (HEALS Act) including provisions relating to Medicaid Medicare issues Issues relating to, Medicaid Fiscal Accountability Regulation; Medicare Part D Issues; Medicare Advantage

Client expense: $910,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to Medicare Advantage and Part D prescription drug programs; Issues related to Prescription Drug Rebates; Issues related to Dual Eligible and Medicare Advantage Special Needs Plans; Issues related to Social Determinants of Health (SDOH); Issues related to Telehealth; H.R. 3461, Community-Based Independence for Seniors Act H.R. 3877, Bipartisan Budget Act H.R. 19, Lower Costs, More Cures Act of 2019 S. 3013, Encouraging Innovative Benefit Design to Lower Costs for Seniors Act H.R. 6074, Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 H.R. 6201, Families First Coronavirus Response Act H.R. 748, CARES Act H.R. 6800, HEROES Act H.R. 7659, Ensuring Parity in MA for Audio-Only Telehealth Act of 2020 S. 4318, American Workers, Families and Employers Assistance Act S. 4199, Prescription Drug Pricing Reduction Act of 2020 S.4840, Ensuring Parity in MA for Audio-Only Telehealth Act of 2020 Bipartisan Coronavirus Relief and Omnibus Funding Bill PL 115-123: H.R. 1892, The bipartisan Budget Act of 2018; H.R. 3168, To amend title XVIII of the Social Security Act to provide continued access to specialized Medicare Advantage plans for special needs individuals, and for other purposes; S. 870, CHRONIC Care Bill PL 115-271: H.R. 6, SUPPORT for Patients and Communities Act

Client expense: $190,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Advocated for amending testing language in Section 3201 of the CARES Act to clarify responsibility for diagnostic testing related to COVID-19. Medicare Advantage (Part C) and Prescription Drug (Part D) programs including: quality measures and star ratings; quality bonus payments; prescription drug costs; and program integrity audits. Medicare Advantage Quality Payments, including H.R.2131 the "Medicare Advantage Quality Payment Relief Act," corresponding Senate bill is S.1114. Legislation related to the COVID-19 Public Health Emergency - Issues included risk corridors for Medicare Advantage, maintaining payment parity between Medicare Advantage and traditional fee-for-service Medicare, establishing a Medicaid Stabilization Fund. Advocated for making telehealth regulatory flexibilities during the COVID-19 Public Health Emergency permanent. Advocated to allow audio-only telehealth services for risk adjustment in Medicare Advantage plans, including support for H.R. 7659, the "Ensuring Parity in MA for Audio-Only Telehealth Act of 2020." Advocated for suspending the Medicare sequester for Rural Hospitals, other providers, and health plans. Advocated for access to CDCs data lake to determine whether a patient has received a COVID-19 vaccination, which vaccine they received, and when they will need to receive a second dose. Advocated for allowing MA organizations to use a 24-month look-back period to supplement 2020 data for the calculation of 2021 risk scores.

Client expense: $480,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE

Medicare Sequestration COVID-19 Response Medicare Advantage Policy and Reimbursement 2021 Medicare Advantage Advance Rate Notice S. 1280/H.R. 2477, BENES Act CMS-4180-P - Modernizing Part D and Medicare Advantage to Lower Drug Prices and Reduce Medicaid and Dual Eligible Issues CMS 4190-P, 2021 and 2022 Policy and Technical Changes for Medicare Advantage, Part D, Medicaid, and PACE Proposed Rule Medicare Part D Issues CMS 4185-P Policy and Technical Changes in Medicare Advantage Program for 2020/2021 Medicaid and Dual Eligible Issues Pharmacy Reimbursement Issues Medicare Home Health Issues H.R. 6800, Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act Health, Economic Assistance, Liability Protection and Schools (HEALS) Act Delivering Immediate Relief to America's Families, Schools and Small Business Act (Senate Amendment No. 2652 to the House Amendment S. 178) Rebate Rule H.R. 133, Consolidated Appropriations Act, 2021 S. 4840/H.R. 7659, Ensuring Parity in MA for Audio Only Telehealth Act of 2020

Client expense: $1,070,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, Treasury, Dept of, White House Office

Medicare Advantage Audio Only; Medicaid Maternal Coverage; MOMS Act; H.R. 7659 - 116th Congress Ensuring Parity in MA for Audio-Only Telehealth Act of 2020 Sponsor: Rep. Terri Sewell (D-AL-07) S. 4840 - 116th Congress Ensuring Parity in MA for Audio-Only Telehealth Act of 2020 Sponsor: Sen. Pat Roberts (R-KS) H.R. 4996 - 116th Congress Helping MOMS Act of 2020 Sponsor: Rep. Robin Kelly (D-IL-02)

Client expense: $1,480,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, White House Office

HR 7659 Re: ensuring parity for Audio Only Telehealth (Sewell) S. 3001 Toomey, regarding Medicare and Medicaid program extensions HR 4932, Thompson regarding telehealth in the Medicare program S. 2741 Schatz, regarding telehealth in the Medicare program HR 1839, the Medicaid Services Investment and Accountability Act HR 3253, The Empowering Beneficiaries, Ensuring Access and Strengthening Accountability Act (regarding Medicaid) HR 2131 and S. 1114, regarding the Medicare Advantage benchmark cap HR 3107, regarding the use of preauthorization in the Medicare Advantage program HR 3417 the Beneficiary Education Tools, Telehealth and Extenders Reauthorization Act (regarding Medicare) Legislation and regulation regarding the Medicare Advantage program HR 1839, regarding multiple Medicaid program changes, including the Medicaid Drug Rebate program. HR 1046 and S. 377, regarding Medicare Part D and requirements for HHS to negotiate drug prices HR 1781 Regarding MedPAC and MACPAC access to drug pricing and rebate data.

Client expense: $160,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Medicare Advantage Audio Only; Medicaid Maternal Coverage; Medicaid FMAP Increase; Coronavirus Medicaid Response. H.R. 7659- 116th Congress Ensuring Parity in MA for Audio-Only Telehealth Act of 2020 To amend Title XVIII of the Social Security Act to require the inclusion of certain audio-only diagnoses in the determination of risk adjustment for Medicare Advantage plans, and for other purposes. Sponsor: Rep. Sewell, Terri [D-AL-07] (Introduced 07/16/2020) S. 4840- 116th Congress Ensuring Parity in MA for Audio-Only Telehealth Act of 2020 Sponsor: Sen. Roberts, Pat [R-KS] (Introduced 10/21/2020)

Client expense: $50,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

-Surprise billing; pharmacy costs; health care access and subsidies; provider support; Medicare Advantage -H.R. 6800 - 116th Congress - Second Session -HEROES Act -H.R. 6545 - 116th Congress - Second Session -Health Insurance Marketplace Affordability Act of 2020 -HR 7659 116th Congress - Second Session - Ensuring Parity in MA for Audio-Only Telehealth Act of 2020

Client expense: $65,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Advantage Audio-Only Telehealth; Prior Authorization H.R.3107 - 116th Congress (2019-2020) Improving Seniors' Timely Access to Care Act of 2019 Sponsor: Rep. DelBene, Suzan K. [D-WA-1] H.R. 7659 - 116th Congress Ensuring Parity in MA for Audio-Only Telehealth Act of 2020 Sponsor: Rep. Terri Sewell (D-AL-07) S. 4840 - 116th Congress Ensuring Parity in MA for Audio-Only Telehealth Act of 2020 Sponsor: Sen. Pat Roberts (R-KS)

Client expense: $270,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Discussions regarding healthcare and Medicare H.R.7659, Ensuring Parity in MA for Audio-Only Telehealth Act Surprise balance billing issues

Client expense: Not reported · Firm income: $20,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Advantage Audio Only; MOMS Act H.R. 7659 - 116th Congress Ensuring Parity in MA for Audio-Only Telehealth Act of 2020 To amend title XVIII of the Social Security Act to require the inclusion of certain audio-only diagnosis in the determination of risk adjustment for Medicare Advantage plans, and for other purposes. Sponsor: Rep. Terri Sewell (D-AL-07) S. 4840 - 116th Congress Ensuring Parity in MA for Audio-Only Telehealth Act of 2020 Sponsor: Sen. Pat Roberts (R-KS) H.R. 4996 - 116th Congress Helping MOMS Act of 2020 Sponsor: Rep. Robin Kelly (D-IL-02)

Client expense: Not reported · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

Medicare Advantage data and quality improvement. Telehealth coverage under Medicare Advantage Program; Issues related to systems improvement for STARS rating H.R. 600 - Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act Health, Economic Assistance, Liability Protection and Schools (HEALS) Act Delivering Immediate Relief to America's Families, Schools and Small Business Act (Senate Amendment No. 2652 to the House Amendment S. 178) H.R. 7659 - Ensuring Parity in Medicare Advantage for Audio Only Telehealth H.R. 133 - Consolidated Appropriations Act, 2021.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, White House Office

Proposals that impact Medicare Part D. Ongoing implementation of payment and regulatory issues for the Medicare Advantage program. Issues related to H.R. 7839 Continuing Access to In Home IVIG Act. H.R. 7659/S. 4840, Ensuring Parity in MA for Audio-Only Telehealth Act of 2020, to amend title XVIII of the Social Security Act to require the inclusion of certain audio-only diagnoses in the determination of risk adjustment for Medicare Advantage plans, and for other purposes. Issues related to H.R. 133 / PL 116-260 - FY2021 Omnibus and COVID Relief and Response Act.

Client expense: Not reported · Firm income: $80,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

Medicare Advantage Audio Only; Medicaid Maternal Coverage HR 7659 (116th Congress), Ensuring Parity in MA for Audio-Only Telehealth Act of 2020, by Rep. Terri Sewell (D-AL). Require the inclusion of certain audio-only diagnoses in the determination of risk adjustment for Medicare Advantage plans. S 4840 (116th Congress), Ensuring Parity in MA for Audio-Only Telehealth Act of 2020, by Sen. Pat Roberts (R-KS). Allows audio-only diagnoses made via telehealth to be used for purposes of determining risk adjustments to payments under Medicare Advantage, and requires payments for Medicare telehealth services furnished during the public health emergency relating to COVID-19 to be made in the same amounts as those for in-person services.

Client expense: Not reported · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, White House Office

Medicare Advantage Audio Only; Medicaid Maternal Coverage HR 7659 (116th Congress), Ensuring Parity in MA for Audio-Only Telehealth Act of 2020, by Rep. Terri Sewell (D-AL). Require the inclusion of certain audio-only diagnoses in the determination of risk adjustment for Medicare Advantage plans. S 4840 (116th Congress), Ensuring Parity in MA for Audio-Only Telehealth Act of 2020, by Sen. Pat Roberts (R-KS). Allows audio-only diagnoses made via telehealth to be used for purposes of determining risk adjustments to payments under Medicare Advantage, and requires payments for Medicare telehealth services furnished during the public health emergency relating to COVID-19 to be made in the same amounts as those for in-person services.

Client expense: $270,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, White House Office

PACE regulations and PACE demonstration. Medicaid and Medicare reimbursement. Medicare Part D reform. H.R. 600 - Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act Health, Economic Assistance, Liability Protection and Schools (HEALS) Act Delivering Immediate Relief to America's Families, Schools and Small Business Act (Senate Amendment No. 2652 to the House Amendment S. 178) H.R. 7659, Ensuring Parity in Medicare Advantage for audio-only telehealth H.R. 133 - Consolidated Appropriations Act, 2021 COVID provider relief fund, access to COVID treatments and vaccines

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE

Medicare Advantage (MLR, risk adjustment, 2022 star ratings), Medicare Prior Authorization (HR 3107), MA Quality Payments (H.R. 2131, S. 1114), Interoperability, Prescription Drug Rebates, Medicare Part D and Part D restructuring (S. 2543, H.R. 3, H.R. 19, S. 3129), Telehealth, Federal Coronavirus Response (H.R. 6074, H.R. 6201, H.R. 748, H.R. 266, H.R. 6800, H.R. 7010); Parity for Audio-Only Risk Adjustment (H.R. 7659, S. 4840).

Client expense: $450,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

-Surprise billing; pharmacy costs; health care access and subsidies; provider support; Medicare Advantage -H.R. 6800 - 116th Congress - Second Session -HEROES Act -H.R. 6545 - 116th Congress - Second Session -Health Insurance Marketplace Affordability Act of 2020 -HR 7659 116th Congress - Second Session - Ensuring Parity in MA for Audio-Only Telehealth Act of 2020

Client expense: $65,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

PACE regulations and PACE demonstration. Medicaid and Medicare reimbursement. Medicare Part D reform. S. 2543 - Prescription Drug Pricing Reduction Act of 2019. H.R. 3 - Elijah E. Cummings Lower Drug Costs Now Act H.R. 6074, the Coronavirus Preparedness and Response Supplemental Appropriations Act - Public Law No: 116-123 H.R. 6201, the Families First Coronavirus Response Act - Public Law No: 116-127 H.R. 748, the Coronavirus Aid, Relief, and Economic Security (CARES) Act - Public Law No: 116-136 H.R. 266, Paycheck Protection Program and Health Care Enhancement Act H.R. 6800, HEROES Act H.R. 600 - Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act Health, Economic Assistance, Liability Protection and Schools (HEALS) Act Delivering Immediate Relief to America's Families, Schools and Small Business Act (Senate Amendment No. 2652 to the House Amendment S. 178) H.R. 7659, Ensuring Parity in Medicare Advantage for audio-only telehealth

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE

Medicare Advantage; Medicaid Expansion; Medicaid General; Privacy; Medicare Prescription Drug Pricing; CMS; CHIP; MACRA; Provider funding; Rate Notice and Call Letter. H.R. 3107 - 116th Congress (2019-2020) Improving Seniors' Timely Access to Care Act of 2019 Sponsor: Rep. Suzan DelBene (D-WA) H.R. 7659 - 116th Congress - Second Session Ensuring Parity in MA for Audio-Only Telehealth Act of 2020 To amend title XVIII of the Social Security Act to require the inclusion of certain audio-only diagnosis in the determination of risk adjustment for Medicare Advantage plans, and for other purposes. Sponsor: Rep. Terri Sewell (D-AL-07)

Client expense: $5,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Issues related to the Medicare Part D, Medicare Advantage, Medicaid (including increasing Medicaid funding to states), and the ESRD program. Issues related to CMS Medicare Advantage Advance Rate Notice and Draft Call Letter for 2020. H.R. 3, The Lower Drug Costs Now Act of 2019 H.R. 6800, The Health and Economic Recovery Omnibus Emergency Solutions Act of 2020 H.R. 7659, The Ensuring Parity for MA in Audio-only Telehealth Act of 2020 H.R. 8245/S. 4574, The Bringing Enhanced Treatments and Therapies to ESRD Recipients Kidney Care Act of 2020 S. 1895, The Lower Health Care Costs Act of 2019 S.2543, The Prescription Drug Pricing Reduction Act of 2019 S. 3013, The Encouraging Innovative Benefit Design to Lower Costs for Seniors Act of 2019 S. 3129, The Lower Costs, More Cures Act of 2019

Client expense: $2,260,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

H.R. 6800, The Heroes Act, Provisions related to Medicare Advantage and health coverage S. 1895, Lower Health Care Costs Act, Provisions related to surprise billing S. 1624, HEALS Act, Provisions related to Medicare Advantage and health coverage H.R. 7659, Ensuring Parity in MA for Audio-Only Telehealth Act of 2020, Provisions related to Medicare Advantage risk adjustment

Client expense: $200,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

-Proposals that impact Medicare Part D such as formulary requirements, pharmacy benefit manager (PBM) disclosure provisions, closing the Part D coverage gap and direct negotiation of prescription drug prices. -Pharmacy Direct and Indirect Remuneration (DIR) H.R. 1034, the Phair Pricing Act of 2019; S.640, the Phair Pricing Act of 2019; H.R. 803, the Improving Transparency and Accuracy in Medicare Part D Spending Act; H.R. 1035, the Improving Transparency and Accuracy in Medicare Part D Spending Act. -Policies that impact public programs payments for high cost drugs including gene therapies. -H.R.7659, Ensuring Parity in MA for Audio-Only Telehealth Act of 2020, to amend title XVIII of the Social Security Act to require the inclusion of certain audio-only diagnoses in the determination of risk adjustment for Medicare Advantage plans, and for other purposes.

Client expense: $1,690,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Treasury, Dept of

Medicare Advantage; Medicare Prior Authorization; Medicaid Rebates; Medicaid Expansion; Medicaid General; Provider funding; Medicaid FMAP Increase; Coronavirus Medicaid Response. H.R. 3107 - 116th Congress (2019-2020) Improving Seniors Timely Access to Care Act of 2019 Rep. DelBene, Suzan [D-WA-01] (Introduced 06/05/2019) H.R. 7659- 116th Congress (2019-2020) Ensuring Parity in MA for Audio-Only Telehealth Act of 2020 To amend Title XVIII of the Social Security Act to require the inclusion of certain audio-only diagnoses in the determination of risk adjustment for Medicare Advantage plans, and for other purposes. Sponsor: Rep. Sewell, Terri [D-AL-07] (Introduced 07/16/2020)

Client expense: $50,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Advantage; Medicaid Expansion; Medicaid General; Privacy; Medicare prescription drug prices, CMS; CHIP; MACRA; Provider funding; Medicaid FMAP Increase; Coronavirus Medicaid Response; Rate Notice and Call Letter; Star Ratings; H.R.3107 - 116th Congress (2019-2020) Improving Seniors' Timely Access to Care Act of 2019 Sponsor: Rep. Suzan DelBene (D-WA-01) H.R. 7659 - 116th Congress - Second Session Ensuring Parity in MA for Audio-Only Telehealth Act of 2020 To amend title XVIII of the Social Security Act to require the inclusion of certain audio-only diagnoses in the determination of risk adjustment for Medicare Advantage plans, and for other purposes. Sponsor: Rep. Terri Sewell (D-AL-07)

Client expense: $104,240 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Advantage; Medicaid Expansion; Medicaid General; Privacy; Medicare prescription drug prices, CMS; CHIP; MACRA; Provider funding; Medicaid FMAP Increase; Coronavirus Medicaid Response; Rate Notice and Call Letter; Star Ratings; H.R.3107 - 116th Congress (2019-2020) Improving Seniors' Timely Access to Care Act of 2019 Sponsor: Rep. Suzan DelBene (D-WA-01) H.R. 7659 - 116th Congress - Second Session Ensuring Parity in MA for Audio-Only Telehealth Act of 2020 To amend title XVIII of the Social Security Act to require the inclusion of certain audio-only diagnoses in the determination of risk adjustment for Medicare Advantage plans, and for other purposes. Sponsor: Rep. Terri Sewell (D-AL-07)

Client expense: $1,360,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, White House Office

Medicare Advantage (Part C) and Prescription Drug (Part D) programs including: quality measures and star ratings; quality bonus payments; prescription drug costs; and program integrity audits. Medicare Advantage Quality Payments, including H.R.2131 the "Medicare Advantage Quality Payment Relief Act," corresponding Senate bill is S.1114. Legislation related to the COVID-19 Public Health Emergency - Issues included risk corridors for Medicare Advantage, maintaining payment parity between Medicare Advantage and traditional fee-for-service Medicare, establishing a Medicaid Stabilization Fund. Advocated for making telehealth regulatory flexibilities during the COVID-19 Public Health Emergency permanent. Advocated for additional guidance about financial responsibility for COVID-19 testing and additional public funding for COVID-19 testing. Advocated to allow audio-only telehealth services for risk adjustment in Medicare Advantage plans, including support for H.R. 7659, the "Ensuring Parity in MA for Audio-Only Telehealth Act of 2020." Advocated for rural health issues including suspending the Medicare sequester for Rural Hospitals, other providers, and health plans for 5 years.

Client expense: $480,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE