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Medicare Sequester COVID Moratorium Act
Legislative Progress
Introduced
December 2, 2020
Latest Action
December 2, 2020
Primary Sponsor
Bradley Scott SchneiderDemocratic(IL)
Momentum (last 30 days)
0
score
0 actions · 0 new cosponsors · 0 votes
Speed vs cohort
0pct
0d open
vs 9,062 other HR bills in the 116th — cohort avg 39d
Medicare Sequester COVID Moratorium Act This bill continues to exempt Medicare from budget sequestration orders until the end of the public health emergency relating to COVID-19 (i.e., coronavirus disease 2019).
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Filing registrants (14)
Referred to the House Committee on the Budget.
Introduced in House
Congress.gov source codes: 1000, Intro-H
Bills with similar content found using semantic analysis.
Sources: Congress.gov
2020 · fourth_quarter · Health Issues
Engaged with both legislative chambers and CMS in order to prevent CMS proposed steep cuts to Medicare in 2021 (projected 9% cut for physical therapy) by providing a one-time exemption from the currently mandated Medicare Physician Fee Schedule budget neutrality rules triggered by the re-weighting of the office/outpatient Evaluation & Management (E/M) Codes or other policy options to drastically reduce the cut to Medicare reimbursement. This was achieved by writing letters to Congress as well as supporting client's efforts to endorse and advocate for The Outpatient Therapy Modernization and Stabilization Act (H.R. 7154) would allow PT, OT, and SLP professionals, and facilities that provide outpatient therapy to bill Medicare for outpatient therapy services furnished via telehealth, modify the plan of care certification requirement in order to reduce administrative burden and delays in care; and prevent CMS proposed steep cuts to Medicare in 2021 by providing a one-time exemption from the currently mandated Medicare Physician Fee Schedule budget neutrality rules triggered by the re-weighting of the office/outpatient Evaluation & Management (E/M) Codes. Summarized impact of CMS 2021 Medicare Physician Fee Schedule final rule upon PPS members. Engaged with lawmakers and their staff as well as CMS in order to achieve Medicare coverage of PT provided via telehealth. Advised clients on the impacts of COVID-19 related legislation such as FFCRA, CARES (the PPP and other features), PPPFA, Consolidated Appropriations Act, etc. Successfully lobbied Congressional to clarify that forgiven PPP expenses also be tax deductible. Sent letter to Congressional leadership asking that Provider Relief Fund payments be tax free. Successfully advocated for the inclusion of language from S.4117/H.R.7777 in order to facilitate a one-page form EZ PPP loan forgiveness process for PPP loans of $150,000 or less in the Consolidated Appropriations Act. Advocated successfully for the delay of the reinstatement of the 2% Medicare sequester cut (a derivative of H.R.8840 which called for a delay for the duration of the public health emergency)
Client expense: Not reported · Firm income: $30,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE
2020 · fourth_quarter · Medicare/Medicaid
H.R. 8840, Medicare Sequester COVID Moratorium Act, all provisions H.R. 8702, Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020, all provisions S. 5007, Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020, all provisions H.R. 7154, Outpatient Therapy Modernization and Stabilization Act, all provisions H.R. 3107, Improving Seniors Timely Access to Care Act of 2019, all provisions S. 5044, Improving Seniors Timely Access to Care Act of 2020y, all provisions H.R. 8727, Telehealth Modernization Act, all provisions S. 4375, Telehealth Modernization Act, all provisions H.R. 7663, Protecting Access to Post-COVID-19 Telehealth Act of 2020, all provisions H.R. 7391, Protect Telehealth Access Act of 2020, all provisions H.R. 1301, Mental Health Telemedicine Expansion Act, all provisions H.R. 3417, Beneficiary Education Tools, Telehealth, and Extenders Reauthorization (BETTER) Act of 2019, all provisions H.R. 5201, Telemental Health Expansion Act of 2020, provisions relating to 1834(m) of the Social Security Act; geographic and originating sites H.R. 7233, Knowing the Efficiency and Efficacy of Permanent (KEEP) Telehealth Options Act of 2020, all provisions H.R. 5172, Non-Opioids Prevent Addiction In the Nation (NOPAIN) Act, All provisions S. 3067, Non-Opioids Prevent Addiction In the Nation (NOPAIN) Act, All provisions H.R. 3414, Opioid Workforce Act of 2019, all provisions H.R. 7791, Value in Health Care Act of 2020, provisions relating to qualifying APM physician thresholds H.R. 6837, Medicare Accelerated and Advance Payments Improvement Act of 2020, all provisions S. 3750, Medicare Accelerated and Advance Payments Improvement Act, all provisions 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, and for other purposes, all provisions H.R. 884, Medicare Mental Health Access Act, all provisions H.R. 945, Mental Health Access Improvement Act of 2019, all provisions H.R. 6744, Medically Tailored Home-Delivered Meals Demonstration Pilot Act of 2020, all provisions H.R. 4004, Social Determinants Accelerator Act of 2019, all provisions H.R. 4932, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019, all provisions S. 2741, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019, all provisions H.R. 5534, Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act of 2020, all provisions S. 3353, Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act of 2020, all provisions H.R. 3, Elijah E. Cummings Lower Drug Costs Now Act, provisions related to PBM and prescription drug price transparency H.R. 19, Lower Costs, More Cures Act of 2019, provisions related to PBM and prescription drug price transparency H.R. 4996, Helping Medicaid Offer Maternity Services (MOMS) Act of 2020, all provisions H.R. 6090, Physician Shortage GME Cap Flex Act of 2020, all provisions H.R. 6142, Black Maternal Health Momnibus Act of 2020, all provisions Medicare program: P.L. 114-10 Medicare Access and CHIP Reauthorization Act (MACRA) implementation/Accountable Care Organizations/APM thresholds Medicare program: Patient Protection and Affordable Care Act (PPACA)/Prior authorization provider and patient burdens/patient electronic access to health information Medicare program: P.L. 113-93 Protecting Access to Medicare Act (PAMA)/Imaging appropriate use criteria/Radiation Oncology APM Medicare program: FY 2021 Inpatient Rehab Facility Prospective Payment System (IRF PPS)/scope of practice issues Medicare program: CY 2021 physician fee schedule/E&M services/Budget neutrality/Part B/Sequester Medicare program: Alternative payment models (APMs) Medicare program: Merit-based Incentive Payment System (MIPS)/cost/quality/interoperability/hardship exemption Medicare program: Regulatory relief/Advanced APMs, prior authorization, and utilization management Medicare program: Shared Savings Program Medicare program: Quality Payment Program/prior authorization/electronic funds transfer Medicare program: Surprise medical billing Medicare program: Medicare-For-All Medicare program: Electronic Health Records (EHR) Certification Medicare program: 21st Century Cures Act Medicare program: Quality payment program/physician burdens Medicare program: National Coverage determination/validated home blood pressure monitors Medicare program: Health IT/physician burden Medicare program: Drug pricing Medicare program: Most favored nation drug pricing Medicare program: Provider compliance/regulatory relief Medicare program: Provider Enrollment, Chain and Ownership (PECOS) enrollment/revalidation Medicare and Medicaid programs: 21st Century Cures Act/health data and privacy Medicaid program: CMS proposed regulation Medicaid Program Medicaid program: FMAP increases Medicaid program: Interoperability
2020 · fourth_quarter · Medicare/Medicaid
Advocate for adequate and accurate network coverage for dermatologic care within Medicare Advantage. Advocate for increased funding and reforms to Graduate Medical Education. Lobby members of Congress regarding improvements to Health Information Technology implementation. Advocate for expansion of telemedicine services under Medicare and increased reimbursement for such services. Advocate for improving disease management and care coordination for patients with chronic diseases. Support preservation of the In-Offices Ancillary Services Exemption (IOASE) under Stark Law regarding physician self-referral and oppose repeal of the in-office ancillary and physician services exception. Oppose H.R. 2143, Promoting Integrity in Medicare Act (PIMA) of 2019. Advocate regarding possible changes to IOASE and Stark Law relative to implementation of Medicare Access and CHIP Reauthorization Act (MACRA P.L. 114-110) Support H.R. 2282/S.966 Medicare Care Coordination Improvement Act of 2019 Advocate for relief from Medicare regulations under Medicare Access and CHIP Reauthorization Act (MACRA P.L. 114-110), including the Quality Payment Program (QPP) and specifically the development of advanced alternative payment models (APMs) and implementation of the Merit-Based Incentive Payment System (MIPS). Advocate for relief for from prior authorization requirements under Medicare Advantage and Medicare Part D plans. Support H.R. 3107, Improving Seniors Timely Access to Care Act Advocate against a Medicare physician payment freeze beginning in January 2020 that was created under MACRA (P.L. 114-110) and the creation of the Quality Payment Program. Advocate expanding the period for reporting and returning overpayments beyond the 60 days statutorily required under audits by Recovery Audit Contractors (RACs). Lobby Congress to urge CMS to strengthen Qualified Clinical Data Registries (QCDRs) by removing barriers that restrict access to data from EHRs. Support H.R. 3302, Keep Physicians Serving Patients Act. Support the Creating Opportunities Now for Necessary and Effect Care Technologies (CONNECT) for Health Act of 2019 (S. 2741/H.R. 4932), which would increase access to telehealth services Request relief from Medicare payment sequester and relief from penalties in Merit-based Incentive Payment System (MIPS) under MACRA in the CARES Act (H.R. 748, S. 3548, H.R. 133) Extend moratorium of the Medicare sequester included in the CARES Act until end of COVID-19 public health emergency in H.R. 133, Consolidated Appropriations Act, 2021. Support H.R. 8840, the Medicare Sequester COVID Moratorium Act, which would extend relief from the Medicare sequester through end of the COVID 19 public health emergency (PHE). Support the Knowing the Efficiency and Efficacy of Permanent (KEEP) Telehealth Options Act (H.R. 7233) Advocate for congressional action to hold health care professionals harmless from any cuts related to CMS Evaluation and Management Code proposals in any forthcoming legislative package. Support H.R. 8702/S. 5007, Holding Providers Harmless from Medicare Cuts During COVID-19 Act Support S. 8505, a bill to provide a one-year waiver of budget neutrality adjustment under the Medicare Physician Fee Schedule Oppose H.R 884/S. 2772 the Medicare Mental Health Access Act.
2020 · fourth_quarter · Medicare/Medicaid
Advocate for adequate and accurate network coverage for dermatologic care within Medicare Advantage. Advocate for increased funding and reforms to Graduate Medical Education. Lobby members of Congress regarding improvements to Health Information Technology implementation. Advocate for expansion of telemedicine services under Medicare and increased reimbursement for such services. Advocate for improving disease management and care coordination for patients with chronic diseases. Support preservation of the In-Offices Ancillary Services Exemption (IOASE) under Stark Law regarding physician self-referral and oppose repeal of the in-office ancillary and physician services exception. Oppose H.R. 2143, Promoting Integrity in Medicare Act (PIMA) of 2019. Advocate regarding possible changes to IOASE and Stark Law relative to implementation of Medicare Access and CHIP Reauthorization Act (MACRA P.L. 114-110) Support H.R. 2282/S.966 Medicare Care Coordination Improvement Act of 2019 Advocate for relief from Medicare regulations under Medicare Access and CHIP Reauthorization Act (MACRA P.L. 114-110), including the Quality Payment Program (QPP) and specifically the development of advanced alternative payment models (APMs) and implementation of the Merit-Based Incentive Payment System (MIPS). Advocate for relief for from prior authorization requirements under Medicare Advantage and Medicare Part D plans. Support H.R. 3107, Improving Seniors Timely Access to Care Act Advocate against a Medicare physician payment freeze beginning in January 2020 that was created under MACRA (P.L. 114-110) and the creation of the Quality Payment Program. Advocate expanding the period for reporting and returning overpayments beyond the 60 days statutorily required under audits by Recovery Audit Contractors (RACs). Lobby Congress to urge CMS to strengthen Qualified Clinical Data Registries (QCDRs) by removing barriers that restrict access to data from EHRs. Support H.R. 3302, Keep Physicians Serving Patients Act. Support the Creating Opportunities Now for Necessary and Effect Care Technologies (CONNECT) for Health Act of 2019 (S. 2741/H.R. 4932), which would increase access to telehealth services Request relief from Medicare payment sequester and relief from penalties in Merit-based Incentive Payment System (MIPS) under MACRA in the CARES Act (H.R. 748, S. 3548, H.R. 133) Extend moratorium of the Medicare sequester included in the CARES Act until end of COVID-19 public health emergency in H.R. 133, Consolidated Appropriations Act, 2021. Support H.R. 8840, the Medicare Sequester COVID Moratorium Act, which would extend relief from the Medicare sequester through end of the COVID 19 public health emergency (PHE). Support the Knowing the Efficiency and Efficacy of Permanent (KEEP) Telehealth Options Act (H.R. 7233) Advocate for congressional action to hold health care professionals harmless from any cuts related to CMS Evaluation and Management Code proposals in any forthcoming legislative package. Support H.R. 8702/S. 5007, Holding Providers Harmless from Medicare Cuts During COVID-19 Act Support S. 8505, a bill to provide a one-year waiver of budget neutrality adjustment under the Medicare Physician Fee Schedule Oppose H.R 884/S. 2772 the Medicare Mental Health Access Act.
2020 · fourth_quarter · Medicare/Medicaid
S. 237/H.R. 808 - Promoting Access to Diabetic Shoes Act CONNECT for Health Act of 2019 (S. 2741, H.R. 4932) S.4541 - Nurse Overtime and Patient Safety Act of 2020 H.R. 8840 - Medicare Sequester COVID Moratorium Act
Client expense: $315,487 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE, White House Office
| Republican |
| PA |
| Cynthia Axne | Democratic | IA |
| David B. McKinley | Republican | WV |
| John B. Larson | Democratic | CT |
| Judy Chu | Democratic | CA |
| Kim Schrier | Democratic | WA |
| Thomas R. Suozzi | Democratic | NY |
Client expense: $3,870,000 · Firm income: Not reported
Government targets: Agriculture, Dept of (USDA), Bureau of Citizenship & Immigration Services (BCIS), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), SENATE, Veterans Affairs, Dept of (VA), White House Office
Client expense: $310,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
Client expense: $310,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2020 · fourth_quarter · Medicare/Medicaid
Issue: Support repeal or a delay in the implementation of the Medicaid disproportionate share hospital (DSH) cuts Issue: Educate Congress on concerns related to potentially burdensome Medicaid supplemental payment reporting proposals Issue: Educate Congress on the negative impact of the proposed Medicaid Fiscal Accountability Regulation (MFAR) and urge the administration to withdraw or delay the proposal Issue: ACA Medicaid expansion. Maintain commitment to match State spending on medical care for Medicaid beneficiaries without limits, caps, or block grants. Maintain and enforce network adequacy requirements and mandate sufficient payments to providers. S. 1343, Maximizing Outcomes for Moms through Medicaid Improvement and Enhancement of Services (MOMMIES) Act Issue: Support expansion of Medicaid and CHIP coverage for postpartum women from current 90 days to 1 year. S. 585, States Achieve Medicaid Expansion (SAME) Act of 2019 Issue: Support legislation to allow states that expanded Medicaid after 2014 to receive the same full federal matching funds as states that previously expanded Medicaid under the Affordable Care Act H.R. 1763 / S. 348, Resident Physician Shortage Reduction Act of 2019 Issue: Support additional Medicare funding for graduate medical education H.R. 3414 / H.R. 2439, Opioid Workforce Act Issue: Support additional Medicare funding for graduate medical education for addiction medicine, addiction psychiatry, and pain medicine residency programs S. 289, Rural Physician Workforce Production Act of 2019 Issue: Oppose legislation redesigning Medicare GME payment formulas that reduce current DGME/IME payments to teaching hospitals H.R. 8892, Rural-Urban Physician Workforce Act of 2020 Issue: Support improvements to Rural Training Track programs. H.R.1358, Advancing Medical Resident Training in Community Hospitals Act of 2019 H.R. 3417, Beneficiary Education Tools, Telehealth, and Extenders Reauthorization (BETTER) Act Issue: Support Medicare Graduate Medical Education (GME) per resident amount and cap-setting technical corrections and administrative relief. Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments Issue: Oppose reduction of Medicare GME/IME payments Issue: Oppose redesign of Medicare Indirect Medical Education financing and redistribution. Issue: Oppose reduction in Medicare hospital outpatient department reimbursement. Issue: Oppose Medicare hospital cuts Issue: Oppose overly burdensome Medicaid GME transparency language. Issue: Support technical correction to increase access to physician services in rural communities by allowing teaching hospitals to count resident time spent in critical access hospitals for purposes of Medicare GME payments. H.R. 5432, Medical Education for a Diverse America Act Issue: Ensure that time medical residents spend in unconscious bias training is counted toward the determination of FTE for Medicare GME Issue: Educate Congress on role of academic medicine as it relates to price transparency or disclosure initiatives H.R. 3107, Improving Seniors Timely Access to Care Act of 2019 Issue: Support protecting patients from delays in care by streamlining and standardizing prior authorization under the Medicare Advantage program and providing program oversight and transparency Issue: Modify CMS Hospital Compare Star Ratings to allow stakeholders time to work together to address concerns with methodology. Support inclusion of sociodemographic status as part of quality programs HHS Rebate Rule Medicare Part D benefit re-design Issue: Support policies to reduce prescription drug prices Issue: Support implementation of the 21st Century Cures Act (Cures) interoperability and health data sharing provisions. Issue: Support changes and improvements to the Medicare Shared Savings Program. Issue: Support necessary changes and improvements to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) S. 1343, Maximizing Outcomes for Moms through Medicaid Improvement and Enhancements of Services (MOMMIES) Act H.R. 4996, Helping Medicaid Offer Maternity Services (MOMS) Act of 2020 Issue: Support expansion of Medicaid coverage for postpartum women. H.R. 8702 Holding Providers Harmless from Medicare Cuts During COVID-19 Act of 2020 Issue: Support relief for providers from pending evaluation and management cuts included in the CY 2021 Physician Fee Schedule (PSF) rule. H.R. 8840 Medicare Sequester COVID Moratorium Act Issue: Support extension of Medicare sequester. Issue: Oppose efforts by states to impose work or other community engagement activities as a requirement for continued Medicaid eligibility or coverage for certain Medicaid beneficiaries. Issue: Support making permanent the CMS policy allowing teaching physicians to provide supervision via real-time, interactive audio/video technology to meet resident supervision requirements. Issue: Support making permanent the interim final rule that allows hospitals that unknowingly trigger their Medicare GME caps and per resident amounts to not have that happen and instead retain the ability to build a new resident cap / PRA so long as the cap / PRA is not above a minimum amount. Issue: Support CMS introducing new regulations to make permanent the interim final rule that ensures teaching hospitals that increased their number of inpatient beds to accommodate the surge in patients during the public health emergency to not have their Indirect Medical Education (IME) payments reduced by CMS. Issue: Oppose CMS hospital price transparency rule. Issue: Oppose site-neutral expansion to excepted off-campus provider-based departments (PBDs). Issue: Support waiving budget neutrality requirements associated with the E/M code changes or temporarily holding harmless physicians and other health care professionals. Issue: Oppose Hospital co-location draft guidance. Issue: Oppose finalizing proposed rule for Medicare Coverage of Innovative Technology (MCIT) and definition of reasonable and necessary. Issue: Oppose enforcement of linking Medicare Conditions of Participation (CoP) compliance with requiring that hospitals report 38 COVID-19 related measures. Issue: Support continuation of the 3-Day Skilled Nursing Facility (SNF) Stay waiver after the conclusion of the COVID-19 public health emergency. Issue: Oppose finalizing prior authorization policy in CY 2020 for certain HOPD services and in CY 2021 to include new service categories. Issue: Oppose efforts to remove five exclusion criteria that would allow over 270 new procedures to be performed in ASC settings in CY 2021. Issue: Oppose the elimination of the Inpatient Only List over a three-year period Issue: Oppose policy of incorporating revenue distinctions into the Medicare Shared Savings Program.
Client expense: $1,035,000 · Firm income: Not reported
Government targets: Agency for Healthcare Research & Quality (AHRQ), Bureau of Citizenship & Immigration Services (BCIS), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Executive Office of the President (EOP), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Internal Revenue Service (IRS), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Natl Science Foundation (NSF), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), Office of Science & Technology Policy (OSTP), Office of the Vice President of the United States, SENATE, State, Dept of (DOS), Substance Abuse & Mental Health Services Administration (SAMHSA), Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office
2020 · fourth_quarter · Medicare/Medicaid
H.R. 3107 - Improving Seniors' Timely Access to Care Act of 2019 - DelBene - prior authorization in Medicare Advantage H.R. 3925 - Reducing Barriers to Substance Use Treatment Act - Tonko - Opioids H.R. 3935 - Protecting Patients Transportation to Care Act - Carter - Medicaid coverage for transportation H.R. 4453 - Protecting Seniors from Health Care Fraud Act of 2019 - Ruiz -Distributing information to Medicare beneficiaries to prevent fraud H.R. 4529 - Promoting Access to Broadband Act of 2019 - Maloney - Medicaid H.R. 4583 - Medicare Extra Rx Higher Eligibility Limits in Part D Act of 2019 - Schneider - prescription drug affordability H.R. 4620 - More Help for Seniors Act of 2019 - Rose - expand eligibility for low-income subsidies under part D of the Medicare program H.R. 4621 - Collecting and Analyzing Resources Integral and Necessary for Guidance for Social Determinants Act of 2019 - Blunt Rochester - best practices re social determinants of health H.R. 4629 - Star Rating for Biosimilars Act - Tonko - biosimilars H.R. 4632 - Better Transparency in Information for Medicare Beneficiaries Act of 2019 - Kind - provides consumers information regarding premiums under LIS benchmark plans H.R. 4671 - Helping Seniors Afford Health Care Act - Kim - Medicare affordability and low income beneficiaries H.R. 4996 - Helping Medicaid Offer Maternity Services Act of 2020 - Kelly - extend Medicaid coverage post-partum H.R. 5006 - Expanding Access to Inpatient Mental Health Act - Emmer - Medicaid coverage for SUD/mental health for institutionalized H.R. 5201 - Telemental Health Expansion Act of 2019 - Matsui - Medicare coverage of mental telehealth H.R. 5232 - Road to Recovery Act - Fitzpatrick - Medicaid and CHIP SUD treatment H.R. 5693 - Primary Health Services Enhancement Act - Kind - Medicare rural health H.R. 5808 - Save Rural Communities Act of 2020 - Arrington - rural emergency medical access services under Medicare H.R. 5833 - To amend title XVIII of the Social Security Act to permit the use of certain psychological evaluation via telehealth for Medicare coverage of neurostimulation services for the treatment of chronic pain - Latta - Medicare coverage in telehealth H.R. 5882 - GENE Therapy Payment Act - Schrader - value based care H.R. 6098 - To amend title XXI of the Social Security Act to allow States to expand income eligibility standards under the Children's Health Insurance Program -Barragan - CHIP eligibility H.R. 6151 - CARING for Kids Act - Fineknauer - CHIP H.R. 6179 - Increasing Access to Biosimilars Act of 2020 - Cardenas - payments to providers of biosimilars under Medicare H.R. 6209 - Reducing Unnecessary Senior Hospitalizations Act of 2020 or the RUSH Act of 2020 -Kuster - Medicare coverage for certain services in hospital emergency departments H.R. 6244 - To amend titles XVIII and XIX to provide for coverage at no cost sharing of COVID-19 testing under the Medicaid program and Children's Health Insurance Program - Kelly - Medicaid coverage of COVID-19 related visits and testing H.R. 6263 - To amend title XVIII of the Social Security Act to waive cost sharing under the Medicare program for certain visits relating to testing for COVID-19 -Sarbanes - Medicare coverage of COVID-19 related visits and testing H.R. 6273 - Protecting Vulnerable Americans in Times of Crisis Act of 2020 - Butterfield - FMAP H.R. 6311 - Care for COVID-19 Act - Ruiz - COVID-19 cost sharing H.R. 6336 - Increasing Hospital Capacity to Fight the Coronavirus Act of 2020 - Bishop - Medicare and Medicaid payments during COVID-19 emergency H.R. 6462 - Emergency Medicaid for Coronavirus Treatment Act - Gallego - Medicaid coverage H.R. 6511 - Ensuring Vaccination and Treatment Affordability Act - Pappas - COVID H.R. 6521 - To prohibit the Secretary of Health and Human Services from taking certain actions with respect to Medicaid supplemental payments reporting requirements, and for other purposes - Diaz Barragan - Medicaid, delays implementation of MFAR H.R. 6538 - Modernized Medicine Act - Kennedy - Medicaid, Telehealth H.R. 6539 - Coronavirus Medicaid Response Act - Lee - FMAP H.R. 6572 - To direct the Secretary of Health and Human Services, acting through the Director of the Centers for Disease Control and Prevention, to carry out a national campaign to increase awareness and knowledge of COVID-19. -Bilirakis - COVID H.R. 6583 - To amend title XVIII of the Social Security Act to establish a risk corridor program for Medicare Advantage plans during the COVID-19 emergency, and for other purposes. - Houlahan - COVID H.R. 6616 - Stronger Medicaid Response to the COVID-19 Pandemic Act -Cardenas - COVID H.R. 6640 - Medicare Advantage COVID Treatment Act - Mucarsel-Powell - COVID H.R. 6658 - Insular Area Medicaid Coronavirus Recovery Act - Sablan - FMAP H.R. 6727 - To hold Medicare beneficiaries harmless for specified COVID-19 treatment services furnished under part A or part B of the Medicare program - Schrier - COVID H.R. 6744 - Computer and Internet Equity Act - Davis - internet access for Lifeline program H.R. 6753 - Save Rural Hospitals Act of 2020 - Finkenauer - Medicare hospital payments H.R. 6792 - Improving Telehealth for Underserved Communities Act of 2020 - Smith - telehealth H.R. 6797 - CHIPPER Act - Wild - CHIP, COVID H.R. 6837 - Medicare Accelerated and Advance Payments Improvement Act of 2020 -Schneider - COVID H.R. 7154 - Outpatient Therapy Modernization and Stabilization Act -Boyle - outpatient therapy services H.R. 7187 - HEALTH Act of 2020 -Thompson -Smith - telehealth H.R. 7292 - To amend title XVIII of the Social Security Act to provide for forgiveness of certain accelerated and advance payments under parts A and B of the Medicare program. - Kaptur - advance payments H.R. 7338 - To amend title XVIII of the Social Security Act to permit the Secretary of Health and Human Services to waive requirements relating to the furnishing of telehealth services under the Medicare program, and for other purposes. - Cheney - Telehealth H.R. 7391 - To amend title XVIII of the Social Security Act to remove certain geographic and originating site restrictions on the furnishing of telehealth services under the Medicare program - Sherrill- Telehealth H.R. 7606 - MFAR Transparency Act - Williams - report on impact of MFAR to Congress H.R. 7627 - MORE Savings Act - Dean - Medicare access to opioid treatment and MAT H.R. 7663 - Protecting Access to Post-COVID-19 Telehealth Act of 2020 - Thompson - waive or modify application of Medicare requirements with respect to telehealth during PHE H.R. 7791 - Value in Health Care Act of 2020 - Welch - Medicare shared savings program and alternative payment arrangements H.R. 7877 - Lowering Drug Costs for Seniors Act of 2020 - Katko - Medicare Part D costs H.R. 7892 - Medicaid Expansion During Crisis Act - Coleman - extend eligibility period for Medicaid enrollment application H.R. 8177 - Renal Anemia Innovation Support and Expansion Act - OHalleran - Medicare prescription drug coverage for chronic kidney disease H.R. 8218 - Rural Ambulance Reimbursement Fairness Act - Gianforte - Medicare payment for rural ambulance services H.R. 8254 - Bringing Enhanced Treatments and Therapies to ESRD Recipients Kidney Care Act - Blumenauer - integrated care for Medicare beneficiaries with ESRD H.R. 8427 - To provide for certain reports on enrollment in the Lifeline program, and for other purposes - Luria - Lifeline program H.R. 8476 - TIKES Act -Blunt Rochester - telehealth coverage in Medicaid H.R. 8505 - To amend title XVIII of the Social Security Act to provide for a one-year waiver of budget neutrality adjustments under the Medicare physician fee schedule - Burgess - Medicare physician fee schedule H.R. 8525 - Expanded Genetic Screening Act of 2020 - Speier - Medicaid coverage of non-invasive prenatal genetic screening H.R. 8529 - Protecting Access to Affordable Medicines Act of 2020 - Butterfield - rebates under the Medicaid program for certain noninnovator multiple source drugs H.R. 8546 - Fair Drug Prices for Kids Act -Wild - Medicaid drug rebate program in CHIP H.R. 8558 - Comprehensive Breast Reconstruction Act of 2020 - Hastings - extends coverage of certain breast reconstructive services following mastectomy under the Medicare and Medicaid programs H.R. 8561 - Restoring Fairness to Medicaid Reimbursement Act of 2020 - Johnson - FMAP H.R. 8574 - PROTECT Long Term Care Facilities Act -Sherrill - long term care in COVID-19 H.R. 8586 - Medicaid Coverage for Addiction Recovery Expansion Act -Foster - Substance Use Disorder H.R. 8623 - SAVE for Seniors Act - Spanberger - Medicare coverage of COVID-19 vaccines H.R. 8624 - Protecting Access to Innovation During COVID-19 Act - Wenstrup - extension of pass-through status under the Medicare program H.R. 8702 - Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020 -Bera - part B Medicare payments during COVID H.R. 8725 - HAPI Act - Soto - Medicaid Coverage of adult vaccines H.R. 8727 - Telehealth Modernization Act - Carter - Medicare telehealth payments H.R. 8755 - Expanded Telehealth Access Act -Sherrill - Medicare telehealth coverage H.R. 8756 - COVID Health Care Provider Assurance Act of 2020 - Riggleman - Medicare Part B payments during COVID-19 H.R. 8826 - The Resetting the Impact Act (TRIA) of 2020 - Sewell - amends the IMPACT Act of 2014 H.R. 8840 - Medicare Sequester COVID Moratorium Act - Schneider - extend temporary Medicare sequestration H.R. 8871 - COVID HCBS Relief Act of 2020 - Dingell - funding for state Medicaid programs HCBS H.R. 8934 - Community Integration Act of 2020 - Cartwright - Medicaid HCBS H.R. 8958 - Supporting Best Practices for Healthy Moms Act - Kelly - guidance for state Medicaid programs on maternal health H.R. 9002 - To amend title XIX of the Social Security Act to provide States an option to cover a children's program of all-inclusive coordinated care (ChiPACC) under Medicaid program - DeGette - Childrens health under Medicaid H.R. 9006 - To amend title XIX of the Social Security Act to provide for coverage under the Medicaid program under such title of routine patient costs associated with participation in certain clinical trials - Garcia - Medicaid coverage of clinical trials H.R. 9035 - Permanency for Audio-Only Telehealth Act - Smith - Audio only telehealth in Medicare S. 2846 - Protecting Patients Transportation to Care Act - Isakson - Medicaid coverage of transportation S. 2911 - Seniors Prescription Drug Relief Act of 2019 - Cassidy - Part D smoothing S. 3013 - Encouraging Innovative Benefit Design to Lower Costs for Seniors Act - Crapo - offer additional prescription drugs under Part D S. 3220 - Ensuring Access to Direct Support Professionals Act - Portman - Medicaid coverage in acute care hospitals S. 3238 - Preventive Home Visit Act - King - preventative home visits S. 3277 - HCBS Infrastructure Improvement Act - Casey - access to community based services S. 3353 - Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act of 2020 - Cassidy - Medicare coverage of kidney transplant services S. 3384 - Lowering Prescription Drug Prices for America's Seniors and Families Act of 2020 - McSally - Medicare Part D drug pricing negotiation S. 3399 - FCHIP Extension Act - Tester - rural health S. 3442 - Care for COVID-19 Act - Booker - COVID-19 cost sharing S. 3443 - Improving Coverage and Care for Mothers Act - Casey - Medicaid coverage for all pregnant and postpartum women S. 3447 - RUSH Act of 2020 - Thune - Medicare coverage for certain services in hospital emergency departments S. 3466 - ACCESS for Biosimilars Act of 2020 - McSally - eliminates cost sharing for biosimilar biological products furnished under part B of the Medicare program S. 3615 - Rural Community Hospital Demonstration Extension Act of 2020 - Murkowski - rural community hospital demonstration program S. 3665 - Save Rural Hospitals Act of 2020 - Alexander - Medicare hospital payments S. 3750 - Medicare Accelerated and Advance Payments Improvement Act of 2020 - Shaheen - COVID S. 3881 - CHIPPER Act - Casey - CHIP, COVID S. 3998 - HEALTH Act of 2020 - Hyde-Smith - telehealth S. 3999 - Mental and Behavioral Health Connectivity Act - King - Mental Health S. 4108 - A bill to amend title XIX of the Social Security Act to increase Federal support to State Medicaid programs during economic downturns - Casey - FMAP S. 4151 - SOS: Sustaining Outpatient Services Act - Hoeven - Medicare OPPS coverage S. 4230 - Telehealth Expansion Act of 2020 - Wyden - Telehealth mental health services in Medicare S. 4274 - Legalizing Drug Discounts for Seniors Act of 2020 - Paul - exclude discounts for covered part D drugs from the anti-kickback prohibition S. 4295 - Public Health Emergency Pass-Through Payment Fairness Act of 2020 - Paul - access to drugs and devices under Medicare S. 4358 - Stronger Medicaid Response to the COVID-19 Pandemic Act - Bennet - Medicaid coverage for vaccines and treatment for COVID-19 for uninsured without cost-sharing S. 4375 - Telehealth Modernization Act - Alexander - make permanent Medicare telehealth flexibilities S. 4423 - COVID-19 Hospice Respite Care Relief Act of 2020 - Brown - Medicare hospice care S. 4448- Fair Drug Prices for Kids Act - Warner - extend Medicaid drug rebate program to CHIP S. 4574 - Bringing Enhanced Treatments and Therapies to ESRD Recipients Kidney Care Act - Young - integrated care for Medicare beneficiaries with ESRD S. 4690 - Maternal Immunization Enhancement Act - Hassan - Medicaid and maternal health S. 4705 - Maternal Immunization Coverage Act - Cassidy - Medicaid coverage S. 4717 - Accelerating Kids Access to Care Act - Grassley - Medicaid enrollment S. 4742 - CLINICAL TREATMENT Act - Burr - Medicaid coverage S. 4825 - Ensuring Access to COVID-19 Vaccines for Seniors Act - Reed - Medicare coverage of COVID-19 vaccines S. 4840 - Ensuring Parity in MA for Audio-Only Telehealth Act of 2020 -Roberts - audio-only risk adjustment in Medicare Advantage S. 4859 - Connected MOM Act - Cassidy - expanded coverage of remote physiologic devices and related services under Medicaid S. 4864 - HAPI Act - Brown - Medicaid coverage of adult vaccines S. 4944 - Equality in Medicare and Medicaid Treatment Act of 2020 - Booker - CMMI models for SDOH in Medicare/Medicaid S. 4949 - Supporting Best Practices for Healthy Moms Act - Toomey - guidance for state Medicaid programs on maternal health S. 4957 - COVID HCBS Relief Act of 2020 - Casey - funding for state Medicaid programs HCBS S. 5007 - Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020 - Boozman - increase in Medicare part B payment S. 5044 - Bill to amend title XVIII of the SSA to establish requirement with respect to the use of prior authorization under the Medicare Advantage plans - Brown - Prior authorization S. 5077 - A bill to amend title XIX of the Social Security Act to adjust the limitations on Medicaid disproportionate share hospital payments - Cornyn - Medicaid DSH payments Regulatory Issues: Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, network adequacy and provider directories, encounter data and other data-related issues, and risk adjustment data validation (RADV) audit issues including proposed RADV regulation for MA; bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, Part D direct and indirect remuneration (DIR), and audits); calendar year 2021 policy and technical regulation for MA and Part D; MA and Part D proposed rule on drug pricing changes for 2020; Part D reform, out of pocket limits; issues related to Medicare for All, Medicare buy-in and public option; CMSs price transparency proposal for direct-to-consumer advertisements; issues relating to 2022 Rate Notice; Executive Orders relating to international pricing, Part D rebates, insulin costs, and importation; issues related to MLTSS; issues related to removal of safe harbor protection for rebates; issues relating to COVID-19, including testing; issues related to audio-only telehealth; issues related to addressing the social determinants of health, including housing, transportation, nutrition, and educational opportunities; issues related to Medicaid presumptive eligibility and continuous eligibility; issues relating to Medicaid best price; in-home health risk assessments; Medicare Medical Loss Ratio issues; issues related to changes to prior authorization regulations, electronic documentation, and related issues; issues relating to sequestration under the Medicare Advantage and Part D programs; issues related to health insurance tax for MA and Part D plans; implications of physician fee schedule on MA; application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, enrollment rules, requirements for notice and denial forms, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible SNPs; Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, Part D coverage gap discount program, including employer group waiver plan (EGWP) issues, and other operational issues; issues raised by Part D coverage of new specialty drugs, the Part D non-interference policy and related issues (e.g., preferred pharmacy and any willing pharmacy requirements, standards for network pharmacy reimbursement, and policies regarding sponsor negotiation of pharmacy price concessions); issues related to the international price index; issues related to child and maternal health; issues related to Medicaid supplemental and disproportionate share hospital (DSH) funding; issues related to Medicaid funding for territories; issues related to medical management; issues relating to MA supplemental benefits; Medication Therapy Management Program requirements and the Center for Medicare and Medicaid Innovation (CMMI) Demonstration; MA EGWP issues; CMMI's health plan models; Part D requirements for offering basic and enhanced alternative plans; MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; issues relating to MA and Part D Star Rating system including measures, the methodology for calculating ratings, and the role of the ratings for payment purposes; implementation of the Affordable Care Act (ACA) and the Bipartisan Budget Act of 2018 changes to the Part D coverage gap; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education Program; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; new payment system for physicians under MACRA, including implications for MA and Part D plans; Medicare clinical trials; Medicare/Medicaid integration for dual eligibles, including implementation of the Capitated Financial Alignment Demonstration and related issues (e.g., quality ratings); Medicaid managed care regulations and policies, including CMS's substantial revisions to the managed care regulations, mental health parity rules, the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, fraud and abuse compliance, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including block grants, the calculation of the federal medical assistance (federal matching) percentage (FMAP), and intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost issues affecting Medicaid health plans including issues raised by Medicaid coverage of new specialty drugs; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues and CHIP reauthorization; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including Medicaid managed care organization provider tax issues; standards for electronic prescribing; implementation of Medicaid changes of interest to Medicaid health plans made in the ACA including Medicaid expansion, the managed care organization (MCO) prescription drug rebate provisions, minimum payments to primary care providers (PCPs), interactions between the Medicaid program and health insurance exchanges, and Medicaid and CHIP maintenance of effort (MOE) requirements; implications of the health insurer fee for Medicaid health plans; issues related to Medicaid Managed long-term care including home and community-based waiver services (HCBS); expanding the availability of Medicare Advantage and Medicaid health plan telemedicine programs; implications of the new non-discrimination rules for health plans participating in public programs; issues related to Medigap coverage; issues related to business continuity in relation to pandemics or natural events (e.g., hurricane, tornado, etc.); cybersecurity; provider directories; value-based insurance design models; issues relating to prescription drug price blueprint; Part D prescriber enrollment requirements; Part D recovery audit contractor programs; issues relating to enrollment of beneficiaries with ESRD into MA plans; issues related to health homes for children with medically complex conditions; socioeconomic status impacts on star ratings related to MA and Part D programs; and other issues relating to health care reform implementation.
Client expense: $2,400,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Council of Economic Advisers (CEA), Executive Office of the President (EOP), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of the Vice President of the United States, SENATE, Treasury, Dept of, White House Office
2020 · fourth_quarter · Medicare/Medicaid
Advocate for adequate and accurate network coverage for dermatologic care within Medicare Advantage. Advocate for increased funding and reforms to Graduate Medical Education. Lobby members of Congress regarding improvements to Health Information Technology implementation. Advocate for expansion of telemedicine services under Medicare and increased reimbursement for such services. Advocate for improving disease management and care coordination for patients with chronic diseases. Support preservation of the In-Offices Ancillary Services Exemption (IOASE) under Stark Law regarding physician self-referral and oppose repeal of the in-office ancillary and physician services exception. Oppose H.R. 2143, Promoting Integrity in Medicare Act (PIMA) of 2019. Advocate regarding possible changes to IOASE and Stark Law relative to implementation of Medicare Access and CHIP Reauthorization Act (MACRA P.L. 114-110) Support H.R. 2282/S.966 Medicare Care Coordination Improvement Act of 2019 Advocate for relief from Medicare regulations under Medicare Access and CHIP Reauthorization Act (MACRA P.L. 114-110), including the Quality Payment Program (QPP) and specifically the development of advanced alternative payment models (APMs) and implementation of the Merit-Based Incentive Payment System (MIPS). Advocate for relief for from prior authorization requirements under Medicare Advantage and Medicare Part D plans. Support H.R. 3107, Improving Seniors Timely Access to Care Act Advocate against a Medicare physician payment freeze beginning in January 2020 that was created under MACRA (P.L. 114-110) and the creation of the Quality Payment Program. Advocate expanding the period for reporting and returning overpayments beyond the 60 days statutorily required under audits by Recovery Audit Contractors (RACs). Lobby Congress to urge CMS to strengthen Qualified Clinical Data Registries (QCDRs) by removing barriers that restrict access to data from EHRs. Support H.R. 3302, Keep Physicians Serving Patients Act. Support the Creating Opportunities Now for Necessary and Effect Care Technologies (CONNECT) for Health Act of 2019 (S. 2741/H.R. 4932), which would increase access to telehealth services Request relief from Medicare payment sequester and relief from penalties in Merit-based Incentive Payment System (MIPS) under MACRA in the CARES Act (H.R. 748, S. 3548, H.R. 133) Extend moratorium of the Medicare sequester included in the CARES Act until end of COVID-19 public health emergency in H.R. 133, Consolidated Appropriations Act, 2021. Support H.R. 8840, the Medicare Sequester COVID Moratorium Act, which would extend relief from the Medicare sequester through end of the COVID 19 public health emergency (PHE). Support the Knowing the Efficiency and Efficacy of Permanent (KEEP) Telehealth Options Act (H.R. 7233) Advocate for congressional action to hold health care professionals harmless from any cuts related to CMS Evaluation and Management Code proposals in any forthcoming legislative package. Support H.R. 8702/S. 5007, Holding Providers Harmless from Medicare Cuts During COVID-19 Act Support S. 8505, a bill to provide a one-year waiver of budget neutrality adjustment under the Medicare Physician Fee Schedule Oppose H.R 884/S. 2772 the Medicare Mental Health Access Act.
Client expense: $310,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2020 · fourth_quarter · Medicare/Medicaid
Advocate for adequate and accurate network coverage for dermatologic care within Medicare Advantage. Advocate for increased funding and reforms to Graduate Medical Education. Lobby members of Congress regarding improvements to Health Information Technology implementation. Advocate for expansion of telemedicine services under Medicare and increased reimbursement for such services. Advocate for improving disease management and care coordination for patients with chronic diseases. Support preservation of the In-Offices Ancillary Services Exemption (IOASE) under Stark Law regarding physician self-referral and oppose repeal of the in-office ancillary and physician services exception. Oppose H.R. 2143, Promoting Integrity in Medicare Act (PIMA) of 2019. Advocate regarding possible changes to IOASE and Stark Law relative to implementation of Medicare Access and CHIP Reauthorization Act (MACRA P.L. 114-110) Support H.R. 2282/S.966 Medicare Care Coordination Improvement Act of 2019 Advocate for relief from Medicare regulations under Medicare Access and CHIP Reauthorization Act (MACRA P.L. 114-110), including the Quality Payment Program (QPP) and specifically the development of advanced alternative payment models (APMs) and implementation of the Merit-Based Incentive Payment System (MIPS). Advocate for relief for from prior authorization requirements under Medicare Advantage and Medicare Part D plans. Support H.R. 3107, Improving Seniors Timely Access to Care Act Advocate against a Medicare physician payment freeze beginning in January 2020 that was created under MACRA (P.L. 114-110) and the creation of the Quality Payment Program. Advocate expanding the period for reporting and returning overpayments beyond the 60 days statutorily required under audits by Recovery Audit Contractors (RACs). Lobby Congress to urge CMS to strengthen Qualified Clinical Data Registries (QCDRs) by removing barriers that restrict access to data from EHRs. Support H.R. 3302, Keep Physicians Serving Patients Act. Support the Creating Opportunities Now for Necessary and Effect Care Technologies (CONNECT) for Health Act of 2019 (S. 2741/H.R. 4932), which would increase access to telehealth services Request relief from Medicare payment sequester and relief from penalties in Merit-based Incentive Payment System (MIPS) under MACRA in the CARES Act (H.R. 748, S. 3548, H.R. 133) Extend moratorium of the Medicare sequester included in the CARES Act until end of COVID-19 public health emergency in H.R. 133, Consolidated Appropriations Act, 2021. Support H.R. 8840, the Medicare Sequester COVID Moratorium Act, which would extend relief from the Medicare sequester through end of the COVID 19 public health emergency (PHE). Support the Knowing the Efficiency and Efficacy of Permanent (KEEP) Telehealth Options Act (H.R. 7233) Advocate for congressional action to hold health care professionals harmless from any cuts related to CMS Evaluation and Management Code proposals in any forthcoming legislative package. Support H.R. 8702/S. 5007, Holding Providers Harmless from Medicare Cuts During COVID-19 Act Support S. 8505, a bill to provide a one-year waiver of budget neutrality adjustment under the Medicare Physician Fee Schedule Oppose H.R 884/S. 2772 the Medicare Mental Health Access Act.
Client expense: $310,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2020 · fourth_quarter · Medicare/Medicaid
Issues pertaining to Medicaid reform, block grant proposals, per capita caps Medicare and Medicaid Graduate Medical Education Medicare bad debt payments Medicaid waivers Medicaid Expansion Issues Medicaid Disproportionate Share Hospital Payments Medicare Disproportionate Share Hospital Payments Legislation related to chronic care treatment Medicaid supplemental payments to hospitals Medicare site neutral payments for hospitals outpatient departments Legislation related to healthcare disparities Medicaid State Flexibility Medicaid 1115 & 1332 Waivers Upper Payment Limit payments State Financing of Medicaid Medicare Part B Cuts-OPPS proposed rule to 340B covered entities Hospital Price Transparency National Quality Forum Funding Medicaid & CHIP Coverage Medicaid Funding for Certified Community Behavioral Health Centers Medicaid Funding for Community-Based long-term care H.R.2328 - REACH Act H.R.3414 - Opioid Workforce Act of 2019 S.1699 - Prescription Drug Cost Reduction Act H.R.3 - Lower Drug Costs Now Act of 2019 S.348 - Resident Physician Shortage Reduction Act of 2019 H.R.1763 - Resident Physician Shortage Reduction Act of 2019 S.2648 - The Rural ACO Improvement Act H.R.4496 - Helping Medicaid Offer Maternity Services Act of 2019 S.2741 - Creating Opportunities Now for Necessary and Efficient Care Technologies for Health Act of 2019 Medicaid Fiscal Accountability Regulation H.R 748, Coronavirus Aid, Relief, and Economic Security (CARES) Act H.R. 6201, Families First Coronavirus Response Act H.R. 6074, Coronavirus Preparedness and Response Supplemental Appropriations Act H.R. 6379, Take Responsibility for Workers and Families Act H.R. 3, Elijah Cummings Lower Drug Costs Now Act H.R. 19, Lower Costs, More Cures Act S. 2543, Drug Pricing Reduction Act Social Determinants for Moms Act (H.R. 6132) IMPACT to Save Moms Act (H.R. 6137) Moms MATTER Act (H.R. 6143) Perinatal Workforce Act (H.R. 6164) Black Maternal Health Momnibus Act (S. 3424) Data to Save Moms Act (H.R. 6165) Social determinants of health HEROES Act Coronavirus Medicaid Response Act Federal Medical Assistance Percentage Telehealth Medicare Accelerated and Advance Payment Program H.R. 7663 - Protecting Access to Post-COVID-19 Telehealth Act of 2020 H.R.7791 - Value in Health Care Act of 2020 HR 4996, Helping MOMS Act Medicare Sequester COVID Moratorium Act (H.R. 8840) Utilizing National Data, Effectively Reforming Standards and Tools, to Address Negative Determinates of Health Act (S. 1323) Supporting Best Practices for Healthy Moms Act (H.R. 8958/S.4949) Consolidated Appropriations Act, 2021 (H.R. 133) Medicare physician payment
Client expense: $370,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE, White House Office
2020 · fourth_quarter · Medicare/Medicaid
H.R. 8840, Medicare Sequester COVID Moratorium Act, all provisions H.R. 8702, Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020, all provisions S. 5007, Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020, all provisions H.R. 7154, Outpatient Therapy Modernization and Stabilization Act, all provisions H.R. 3107, Improving Seniors Timely Access to Care Act of 2019, all provisions S. 5044, Improving Seniors Timely Access to Care Act of 2020y, all provisions H.R. 8727, Telehealth Modernization Act, all provisions S. 4375, Telehealth Modernization Act, all provisions H.R. 7663, Protecting Access to Post-COVID-19 Telehealth Act of 2020, all provisions H.R. 7391, Protect Telehealth Access Act of 2020, all provisions H.R. 1301, Mental Health Telemedicine Expansion Act, all provisions H.R. 3417, Beneficiary Education Tools, Telehealth, and Extenders Reauthorization (BETTER) Act of 2019, all provisions H.R. 5201, Telemental Health Expansion Act of 2020, provisions relating to 1834(m) of the Social Security Act; geographic and originating sites H.R. 7233, Knowing the Efficiency and Efficacy of Permanent (KEEP) Telehealth Options Act of 2020, all provisions H.R. 5172, Non-Opioids Prevent Addiction In the Nation (NOPAIN) Act, All provisions S. 3067, Non-Opioids Prevent Addiction In the Nation (NOPAIN) Act, All provisions H.R. 3414, Opioid Workforce Act of 2019, all provisions H.R. 7791, Value in Health Care Act of 2020, provisions relating to qualifying APM physician thresholds H.R. 6837, Medicare Accelerated and Advance Payments Improvement Act of 2020, all provisions S. 3750, Medicare Accelerated and Advance Payments Improvement Act, all provisions 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, and for other purposes, all provisions H.R. 884, Medicare Mental Health Access Act, all provisions H.R. 945, Mental Health Access Improvement Act of 2019, all provisions H.R. 6744, Medically Tailored Home-Delivered Meals Demonstration Pilot Act of 2020, all provisions H.R. 4004, Social Determinants Accelerator Act of 2019, all provisions H.R. 4932, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019, all provisions S. 2741, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019, all provisions H.R. 5534, Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act of 2020, all provisions S. 3353, Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act of 2020, all provisions H.R. 3, Elijah E. Cummings Lower Drug Costs Now Act, provisions related to PBM and prescription drug price transparency H.R. 19, Lower Costs, More Cures Act of 2019, provisions related to PBM and prescription drug price transparency H.R. 4996, Helping Medicaid Offer Maternity Services (MOMS) Act of 2020, all provisions H.R. 6090, Physician Shortage GME Cap Flex Act of 2020, all provisions H.R. 6142, Black Maternal Health Momnibus Act of 2020, all provisions Medicare program: P.L. 114-10 Medicare Access and CHIP Reauthorization Act (MACRA) implementation/Accountable Care Organizations/APM thresholds Medicare program: Patient Protection and Affordable Care Act (PPACA)/Prior authorization provider and patient burdens/patient electronic access to health information Medicare program: P.L. 113-93 Protecting Access to Medicare Act (PAMA)/Imaging appropriate use criteria/Radiation Oncology APM Medicare program: FY 2021 Inpatient Rehab Facility Prospective Payment System (IRF PPS)/scope of practice issues Medicare program: CY 2021 physician fee schedule/E&M services/Budget neutrality/Part B/Sequester Medicare program: Alternative payment models (APMs) Medicare program: Merit-based Incentive Payment System (MIPS)/cost/quality/interoperability/hardship exemption Medicare program: Regulatory relief/Advanced APMs, prior authorization, and utilization management Medicare program: Shared Savings Program Medicare program: Quality Payment Program/prior authorization/electronic funds transfer Medicare program: Surprise medical billing Medicare program: Medicare-For-All Medicare program: Electronic Health Records (EHR) Certification Medicare program: 21st Century Cures Act Medicare program: Quality payment program/physician burdens Medicare program: National Coverage determination/validated home blood pressure monitors Medicare program: Health IT/physician burden Medicare program: Drug pricing Medicare program: Most favored nation drug pricing Medicare program: Provider compliance/regulatory relief Medicare program: Provider Enrollment, Chain and Ownership (PECOS) enrollment/revalidation Medicare and Medicaid programs: 21st Century Cures Act/health data and privacy Medicaid program: CMS proposed regulation Medicaid Program Medicaid program: FMAP increases Medicaid program: Interoperability
Client expense: $4,170,000 · Firm income: Not reported
Government targets: Agriculture, Dept of (USDA), Bureau of Citizenship & Immigration Services (BCIS), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), SENATE, Veterans Affairs, Dept of (VA), White House Office
2020 · fourth_quarter · Health Issues
Issues concerning the Medicare Hospice Benefit and children's hospice issues. Issues concerning hospice payment and alternative payment models. Issues related to advanced care illness management. Issues involving inpatient respite care, bereavement funding, palliative care and a community-based palliative care demonstration. Issues related to COVID-19 emergency funding, extension of the public health emergency, testing, vaccines, and COVID-19 related legislation. Issues concerning hospice sequestration relief. Issues related to telehealth flexibilities and regulatory flexibilities granted under the public health emergency. Issues involving hospice providers and tax treatment and reporting requirements of the CARES Act Public Health and Social Services Emergency Fund. Issues concerning hospice program integrity. Issues concerning Medicare Advantage Value-Based Insurance Design. Issues pertaining to the hospice election statement and election statement addendum. Consolidated Appropriations Act, 2021 (H.R.133); ChiPACC Act of 2020 (H.R.9002); Medicare Sequester COVID Moratorium Act (H.R.8840); Compassionate Care Act (S.4945); HOSPICE Act (H.R. 5821); Hospice Care Improvement Act of 2019 (S.2807); Rural Access to Hospice Act (H.R.2594/S.1190); COVID-19 Hospice Respite Care Relief Act of 2020 (S.4423/H.R.8322); CONNECT Act (S. 2741/H.R. 4932); Palliative Care and Hospice Education and Training Act (H.R.647/S.2080); Provider Training in Palliative Care Act (S. 1921); Strengthening Innovation in Medicare and Medicaid Act (H.R.5741); Eliminating the Provider Relief Fund Tax Penalties Act of 2020 (H.R.7819); National Hospice and Palliative Care Month Proclamation Request and Senate Resolution
Client expense: $240,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office
2020 · fourth_quarter · Medicare/Medicaid
Issues concerning the Medicare Hospice Benefit and children's hospice issues. Issues concerning hospice payment and alternative payment models. Issues related to advanced care illness management. Issues involving inpatient respite care, bereavement funding, palliative care and a community-based palliative care demonstration. Issues related to COVID-19 emergency funding, extension of the public health emergency, testing, vaccines, and COVID-19 related legislation. Issues concerning hospice sequestration relief. Issues related to telehealth flexibilities and regulatory flexibilities granted under the public health emergency. Issues involving hospice providers and tax treatment and reporting requirements of the CARES Act Public Health and Social Services Emergency Fund. Issues concerning hospice program integrity. Issues concerning Medicare Advantage Value-Based Insurance Design. Issues pertaining to the hospice election statement and election statement addendum. Consolidated Appropriations Act, 2021 (H.R.133); ChiPACC Act of 2020 (H.R.9002); Medicare Sequester COVID Moratorium Act (H.R.8840); Compassionate Care Act (S.4945); HOSPICE Act (H.R. 5821); Hospice Care Improvement Act of 2019 (S.2807); Rural Access to Hospice Act (H.R.2594/S.1190); COVID-19 Hospice Respite Care Relief Act of 2020 (S.4423/H.R.8322); CONNECT Act (S. 2741/H.R. 4932); Palliative Care and Hospice Education and Training Act (H.R.647/S.2080); Provider Training in Palliative Care Act (S. 1921); Strengthening Innovation in Medicare and Medicaid Act (H.R.5741); Eliminating the Provider Relief Fund Tax Penalties Act of 2020 (H.R.7819); National Hospice and Palliative Care Month Proclamation Request and Senate Resolution
Client expense: $240,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office
2020 · fourth_quarter · Health Issues
S.1531, Stopping the Outrageous Practice of Surprise Medical Bills Act of 2019; S.1895, Lower Health Care Costs Act; H.R. 3630, No Surprises Act (issues related to Medicare, Medicaid, regulatory flexibility, and hospital funding); H.R. 3502, Protecting People from Surprise Medical Bills Act (issues related to Medicare, Medicaid, regulatory flexibility, and hospital funding); S 2741, CONNECT for Health Care Act (issues related to Medicare); HR 133 Consolidated Appropriations Act, 2021 (issues related to hospital policy); HR 5826, Consumer Protections Against Surprise Medical Bills Act of 2020 (entire bill); HR 8840, Medicare Sequester COVID Moratorium Act (entire bill)
Client expense: $710,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2020 · fourth_quarter · Budget/Appropriations
FY2021 Omnibus and COVID Relief and Response Act H.R. 133, H. Rept. 116-453, S. Rept. _____ FY21 Defense Appropriations Bill - funding and clarification language for military sexual trauma pilot program and advanced trauma training. FY2021 Omnibus and COVID Relief and Response Act H.R. 133, H. Rept. 116-450, S. Rept. _____ FY21 Labor, HHS & Education Appropriations Bill - funding for Geriatric Workforce Enhancement Program, no-cost extensions for expiring FY21 RF1/UF1 grants. FY2021 Omnibus and COVID Relief and Response Act H.R. 133 - Additional funding for the Provider Relief Fund (PRF); changes to PRF reporting requirements; suspension of Medicare sequestration;limited liability protections for hospitals and health care professionals during the COVID-19 emergency; permanent expansion of telehealth; no-cost extensions for expiring RF1/UF1 grants; revision of loan terms for the Medicare Accelerated Payment Program; elimination of cuts to the Medicaid disproportionate share hospital (DSH) program; surprise medical billing. Medicare Sequester COVID Moratorium Act (H.R. 8840) Clarification on HHS methodology and formula for Phase III of the Provider Relief Fund distribution.
Client expense: Not reported · Firm income: $20,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2020 · fourth_quarter · Health Issues
FY2021 Omnibus and COVID Relief and Response Act H.R. 133 - Additional funding for the Provider Relief Fund (PRF); changes to PRF reporting requirements; suspension of Medicare sequestration;limited liability protections for hospitals and health care professionals during the COVID-19 emergency; permanent expansion of telehealth; no-cost extensions for expiring RF1/UF1 grants; revision of loan terms for the Medicare Accelerated Payment Program; elimination of cuts to the Medicaid disproportionate share hospital (DSH) program; surprise medical billing. Medicare Sequester COVID Moratorium Act (H.R. 8840) Clarification on HHS methodology and formula for Phase III of the Provider Relief Fund distribution.
Client expense: Not reported · Firm income: $20,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2020 · fourth_quarter · Medicare/Medicaid
Support for H.R.4350/S. 3085, The Ambulatory Surgical Center Quality and Access Act of 2019, and legislation to tie ambulatory surgery center payment updates to the hospital market basket. H.R. 3429, the HEARTS and Rural Relief Act of 2019. Increase patient access to procedures in ASCs. Discontinuance of ASC relative weight scalar. Extension of Medicare out-of-pocket cap in HOPD to ASC setting. Extension of Medicare sequester delay in division N sec. 102 of H.R. 133 - Consolidated Appropriations Act, 2021 and H.R. 8840 - Medicare Sequester COVID Moratorium Act.
Client expense: Not reported · Firm income: $60,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2020 · fourth_quarter · Medicare/Medicaid
S. 2772, H.R. 884: Medicare Mental Health Access Act. H.R. 1301: The Mental Health Telemedicine Expansion Act H.R.1839: Medicaid Services Investment and Accountability Act of 2019 H.R. 1530, S. 595: Treat & Reduce Obesity H.R. 1329: Medicaid Reentry Act H.R. 3417: Beneficiary Education Tools Telehealth Extender Reauthorization Act of 2019 H.R. 5575: Primary Care and Behavioral Health Access Act H/S bill is under HCR S.3999: Mental and Behavioral Health Connectivity Act H.R. 6644, S. 3741: Health Care at Home Act H.R. 5201: Telemental Health Expansion Act H.R. 7663: Protecting Access to Post Covid-19 Telehealth Act H.R.4996: Helping MOMS Act of 2020 SF H.R.7539: Strengthening Behavioral Health Parity Act H.R. 9035: Permanency for Audio-Only Telehealth Act H,R, 8702, S. 5007: Holding Providers Harmless From Medicare Cuts During COVID-19 Act H.R. 8840: Medicare Sequester COVID Moratorium Act S. 4013, H.R. 7593: TREATS Act
Client expense: $216,000 · Firm income: Not reported
Government targets: Defense, Dept of (DOD), Education, Dept of, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), Natl Science Foundation (NSF), SENATE
2020 · fourth_quarter · Medicare/Medicaid
H.R. 3062/S. 2860 - "Patient Access to Higher Quality Health Care Act of 2019" - Oppose efforts to repeal certain provisions relating to the Medicare exception to the prohibition on certain physician referrals for hospitals. Support access to affordable prescription drugs. H.R. 3107 - "Improving Seniors' Timely Access to Care Act" - Support legislation that streamlines and standardizes prior authorization under the Medicare Advantage program. Sought moratorium on proposed Medicaid Fiscal Accountability Regulation H.R. 6800 Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act - Support Division C, Health Provisions for Medicare and Medicaid that support health care providers and patients Post-Acute Care - Refresh the unified PAC PPS timeline and process under the IMPACT Act, Sought Congressional support for an IMPACT Act implementation/ unified payment timeline reset Qualifying APM Professional Threshold - Support request of House Leadership to address impending MACRA changes that could derail the movement to value-based health care and alternative payment models H.R. 7663 - "Protecting Access to Post-COVID-19 Telehealth Act of 2020" - Support broader access to Medicare telehealth services H.R. 133 - "Consolidated Appropriations Act, 2021" - Advocated in support of health care extenders, E&M, GME, sequester moratorium. Support continued government funding and other provisions. H.R. 8337 - "Continuing Appropriations Act, 2021 and Other Extensions Act" - Support passage of continuing resolution, including language to improve repayment terms of Medicare Accelerated and Advanced Payment Programs. H.R. 8840 - "Medicare Sequester COVID Moratorium Act" - Support extending the temporary suspension of Medicare sequestration.
Client expense: $600,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office
2020 · fourth_quarter · Medicare/Medicaid
Support for H.R. 2282 / S. 966 - Medicare Care Coordination Improvement Act of 2019. Support site neutrality proposals. Reform to Stark Law and Anti-Kickback statute Medicare Program; Modernizing and Clarifying the Physician Self-Referral Regulations (84 FR 55766) and Medicare and State Healthcare Programs: Fraud and Abuse; Revisions to Safe Harbors Under the Anti-Kickback Statute, and Civil Monetary Penalty Rules Regarding Beneficiary Inducement (84 FR 55694). Implementation of Public Law 116-136. Most Favored Nation (MFN) Model, (CMS-5528-IFC). Extension to Medicare sequester delay in Division N Sec. 102 of H.R. 133 - Consolidated Appropriations Act, 2020 and H.R. 8840 - Medicare Sequester COVID Moratorium Act. Delay of implementation of the Radiation Oncology Model in Division CC Sec. 133 of H.R. 133.
Client expense: Not reported · Firm income: $90,000
Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2020 · fourth_quarter · Budget/Appropriations
FY 20201 Omnibus and COVID Relief and Response Act H.R. 133, H. Rept. 116-453, S. Rept. _____, FY21 Defense Appropriations Bill - funding and clarification language for military sexual trauma pilot program and advanced trauma training FY20201 Omnibus and COVID Relief Response Act H.R. 133, H. Rept. 116-450, S. Rept. ____, FY21 Labor, HHS & Education Appropriations Bill - funding for Geriatric Workforce Enhancement Program, no-cost extensions for expiring FY21 RF1/UF1 grants FY21 Omnibus and COVID Relief and Response Act H.R 133 - Additional funding for the Provider Relief Fund (PRF); changes to PRF reporting requirements; suspension of Medicare sequestration; limited liability protections for hospitals and health care professionals during COVID-19 emergency; permanent expansion of telehealth; no-cost extensions for expiring RF1/UF1 grants; revision of loan terms for the Medicare Accelerated Payment Program; elimination of cuts to the Medicaid disproportionate share hospital (DSH) program; surprise medical billing. Medicare Sequester COVID Moratorium Act (H.R. 8840) Clarification of HHS methodology and formula for Phase III of the Provider Relief Fund distribution.
Client expense: Not reported · Firm income: $50,000
Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE