Jack Reynolds Memory Medigap Expansion Act

Issues related to End Stage Renal Disease Perspective Payment System HR 7878/S 4307, Kidney Health Connect Act (all provisions) Issues related to supply chain Issues related to end stage renal disease calcimimetics utilization Issues related to Transitional Add-on Payment Adjustment for New and Innovative Equipment and Supplies (TPNIES) Issues related to Transitional Drug Add-on Payment Adjustment (TDAPA) Issues related to nursing shortages H.R. 4942/S. 2649, Bringing Enhanced Treatments and Therapies to ESRD Recipients Kidney Care Act H.R. 1676, The Jack Reynolds Memorial Medigap Expansion Act H.R. 5426, Improving Access to Home Dialysis Act of 2021 H.R. 8594/S. 4750, Restore Protections for Dialysis Patients Act H.R. 8063, Repair Abuses of MSP Payments Act CMS regulations pertaining to reimbursement rates for ESRD-related services CMS regulations pertaining to the Medicare Advantage program Protection of third party premium assistance for coverage under the Patient Protection and Affordable Care Act Issues related to chronic kidney disease (CKD) and prevention Issues related to home dialysis Issues related to access to kidney transplantation for ESRD patients ESRD Treatment Choices (ETC) mandatory demonstration Kidney Care Choices (KCC) Model and the Comprehensive Kidney Care Contracting (CKCC) voluntary payment options Emergency response related to COVID-19 MedPAC CY22 report to Congress, Medicare end-stage renal disease perspective payment system base rate recommendation S. 1971/ H.R. 4065 Chronic Kidney Disease Improvement in Research and Treatment Act, all provisions ESRD facilities serving as originating sites for telehealth services under the Medicare program H.R. 8295 Fiscal Year 2023 Labor, Health and Human Services, Education, and Related Agencies (LHHS) Appropriations bill, provision relating to KidneyX funding H.R. 6000, CURES 2.0 Act, provisions related to dialysis

Client expense: $960,000 · Firm income: Not reported

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

H.R. 66 - CARING for Kids Act - Rep. Buchanan, Vern - CHIP H.R. 265 - Insular Area Medicaid Parity Act - Rep. Sablan, Gregorio Kilili Camacho - Medicaid funding H.R. 315 - Medicare Sequester COVID Moratorium Act - Rep. Schneider, Bradley Scott - Medicare sequestration H.R.340 - Incentivizing Medicaid Expansion Act of 2021 - Rep. Veasey, Marc - Medicaid expansion H.R. 432 - Mental Health Access Improvement Act of 2021 - Rep. Thompson, Mike -Medicare coverage of marriage and family therapist services and mental health counselor H.R. 502 - Medicare Dental Benefit Act of 2021 - Rep. Barragan, Nanette Diaz - Medicare coverage of dental and oral health services H.R. 525 - COVID HCBS Relief Act of 2021 - Rep. Dingell, Debbie - increased FMAP for HCBS H.R. 871 - Expand Medicaid Now Act - Rep. Fletcher, Lizzie - FMAP H.R. 918 - Stronger Medicaid Response to the COVID-19 Pandemic Act - Rep. Cardenas, Tony - COVID-19 coverage for the uninsured via Medicaid H.R. 955 - Medicaid Reentry Act of 2021 - Rep. Tonko, Paul -Medicaid coverage for incarcerated individuals H.R. 1167 - Advancing Enrollment and Reducing Drug Costs Act of 2021 - Rep. Pappas, Chris - Medicaid eligibility for low-income subsidies H.R. 1227 - Medicare-X Choice Act of 2021 - Rep. Delgado, Antonio - Medicare public option H.R. 1332 - Telehealth Modernization Act - Rep. Carter, Earl - telehealth services under Medicare H.R. 1349 - The COVID-19 Hospital and Health Provider Loan Conversion Act of 2021- Rep. Kaptur, Marcy - advance payments under parts A and B of Medicare H.R. 1353 - Coronavirus Medicaid Response Act - Rep. Lee, Susie - FMAP H.R. 1390 - CHIPPER Act - Rep. Wild, Susan - CHIP funding H.R. 1397 - TIKES Act - Rep. Blunt Rochester, Lisa - telehealth under Medicaid and CHIP H.R. 1609 - Treatment in Place Act - Rep. Axne, Cynthia - Medicare coverage of ambulance services H.R. 1676 - Jack Reynolds Memory Medigap Expansion Act - Rep. Axne, Cynthia - Medigap coverage for ESRD H.R. 1677 - KEEP Telehealth Options Act of 2021 - Rep. Balderson, Troy - telehealth expansion H.R. 1717 - Protecting Married Seniors from Impoverishment Act of 2021 - Rep. Upton, Fred - permanent protections against spousal impoverishment H.R. 1722 - Puerto Rico Health Care Fairness, Accountability, and Beneficiary Access Act of 2021 - Rep. Velazquez, Nydia - Medicaid in Puerto Rico H.R. 1738 - Stabilize Medicaid and CHIP Coverage Act - Rep. Dingell, Debbie - Medicaid and CHIP continuous enrollment H.R. 1784 - Medicaid REACH Act - Rep. Doggett, Lloyd - requirements for non-expansion H.R. 1791 - CHIPP Act - Rep. Barragan, Nanette Diaz - extending CHIP H.R. 1792 - Ensuring Kids Have Access to Medically Necessary Dental Care Act - Rep. Barragan, Nanette Diaz - dental coverage under CHIP H.R. 1793 - Immediate Coverage for Former Foster Youth Act - Rep. Bass, Karen - Medicaid coverage for foster youth H.R. 1794 - Foster Youth Dental Act of 2021 - Rep. Bass, Karen - Medicaid dental coverage for foster youth H.R. 1823 - To amend title XIX of the Social Security Act to remove the matching requirement for a territory to use specially allocated Federal funds for Medicare covered part D drugs for low-income individuals - Resident Commissioner Gonzalez-Colon, Jenniffer - Medicare covered part D H.R. 1825 - Territories Medicare Prescription Drug Assistance Equality Act of 2021 - Resident Commissioner Gonzalez-Colon, Jenniffer - Medicare Part D premium and cost-sharing subsidies H.R. 1826 - Fairness in Medicare Part B Enrollment Act of 2021 - Resident Commissioner Gonzalez-Colon, Jenniffer - late enrollment penalties under part B of the Medicare program H.R. 1880 - To amend the Deficit Reduction Act of 2005 to make permanent the Money Follows the Person Rebalancing Demonstration - Rep. Dingell, Debbie - Money Follows the Person Rebalancing Demonstration H.R. 1885 - RUSH Protection Act of 2021 - Rep. Kind, Ron - Medicare rural health clinic payments H.R. 1887 - Rural Hospital Support Act - Rep. Reed, Tom - Medicare payments for hospitals H.R. 1890 - Health Insurance Consumer Protection Act - Rep. Schakowsky, Janice D. - network adequacy standards and premium rates H.R. 1914 - CAHOOTS Act - Rep. DeFazio, Peter A. - Medicaid mobile crisis intervention services H.R. 1969 - Medicare Advantage Integrity Act - Resident Commissioner Gonzalez-Colon, Jenniffer - disparity in MA benchmark rates H.R. 2035 - Improving Access to Mental Health Act of 2021 - Rep. Lee, Barbara - mental health services under Medicare H.R. 2080 - SAVE Act - Rep. Bishop, Sanford D., Jr. - Medicare coverage of transportation services H.R. 2166 - Ensuring Parity in MA and PACE for Audio-Only Telehealth Act of 2021 - Rep. Sewell, Terri - Medicare Advantage payments for audio-only diagnoses H.R. 2168 - Expanded Telehealth Access Act - Rep. Sherrill, Mikie - Medicare payment for telehealth services H.R. 2170 - HAPI Act - Rep. Soto, Darren - access to vaccines and Medicaid H.R. 2179 - Affordable Insulin for the COVID-19 Emergency Act - Rep. Waters, Maxine - cost-sharing regarding insulin coverage H.R. 2217 - Territory Federal Matching Requirement Equity Act of 2021 - Resident Commissioner Gonzalez-Colon, Jenniffer - Medicaid FMAP for Territories H.R. 2228 - Rural Behavioral Health Access Act of 2021 - Rep. Kildee, Daniel - Medicare coverage of outpatient telehealth services H.R. 4074 - Addressing Social Determinants in Medicare Advantage Act of 2021 - Rep. Bilirakis, Gus M. - Medicare Advantage supplemental benefits H.R. 4640 - Close the Medigap Act of 2021 - Rep. Doggett, Lloyd - Medigap policies H.R. 6833 - Affordable Insulin Now Act - Rep. Craig, Angie - Insulin prices and cost sharing S. 150 - Ensuring Parity in MA for Audio-Only Telehealth Act of 2021 - Sen. Cortez-Masto, Catherine - coverage of audio-only telehealth services in MA S. 151 - COVID HCBS Relief Act of 2021 - Sen. Casey, Robert - FMAP and HCBS S. 245 - SAME Act of 2021 - Sen. Warner, Mark - Medicaid expansion S. 274 - Stronger Medicaid Response to the COVID-19 Pandemic Act - Sen. Bennet, Michael - COVID-19 coverage for the uninsured via Medicaid S. 285 - Medicaid Reentry Act of 2021 - Sen. Baldwin, Tammy - Medicaid coverage for incarcerated individuals S. 368 - Telehealth Modernization Act - Sen. Scott, Tim - coverage of telehealth services under Medicare S. 386 - Medicare-X Choice Act of 2021 - Sen. Bennet, Michael - Medicare public option S. 439 - Coronavirus Medicaid Response Act - Sen. Casey, Robert - increases FMAP S. 440 - Continued Funding for Senior Services During COVID-19 Act - Sen. Casey, Robert - funding for services under the Older Americans Act of 1965 S. 453 - CHIPPER Act - Sen. Casey, Robert - CHIP funding S. 581 - HAPI Act -Sen. Brown, Sherrod - vaccines under Medicaid S. 620 - KEEP Telehealth Options Act of 2021 - Sen. Fischer, Deb - telehealth expansion S. 644 - Rural Hospital Closure Relief Act of 2021 - Sen. Durbin, Richard - Medicare coverage for critical access hospitals S. 646 - Stabilize Medicaid and CHIP Coverage Act of 2021 - Sen. Brown, Sherrod - Medicaid and CHIP enrollment S. 653 - COMP Act - Sen. Portman, Rob - Medicare secondary payer rules S. 712 - Dosha Joi Immediate Coverage for Former Foster Youth Act - Sen. Casey, Robert P., Jr. - Medicaid coverage for foster youth S. 748 - Medicare Sequester Relief Act - Sen. Shaheen, Jeanne - Medicare payment sequestration S. 764 - CAHOOTS Act - Sen. Wyden, Ron - Medicaid mobile crisis intervention services S. 826 - Medicare Patient Empowerment Act of 2021 - Sen. Paul, Rand - Medicaid payment options S. 870 - Improving Access to Mental Health Act of 2021 - Sen. Stabenow, Debbie - mental health services in Medicare S. 999 - Save Rural Hospitals Act of 2021 - Sen. Warner, Mark - Medicare hospital 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); issues related to Medicare for All, Medicare buy-in, reduced Medicare eligibility age, and public option; issues relating to 2024 Rate Notice; issues related to the expiration of Medicaid continuous eligibility and transitions in coverage; issues related to coverage of EUA drugs under Medicare Part D; issues related to coverage in non-Medicaid Expansion States (e.g., Gap Population); issues related to expanded Medicare fee for service benefits (dental, hearing and vision); issues related to Medicaid coverage gap; issues related to specialty infant formula; issues related to the Inflation Reduction Act passage and implementation; contraceptive coverage and reproductive health; Medicare NCD relating to monoclonal antibodies for treatment of Alzheimers disease; issues related to Managed Long Term Services and Supports (MLTSS); issues related to removal of safe harbor protection for rebates; issues relating to COVID-19, including testing, vaccines and therapeutics; issues related to the end of the public health emergency; telehealth; issues related to the cost of insulin, including price, copays, rebates, and medical management tools; issues related to health equity; issues related to vaccination; issues related to audio-only telehealth; issues related to addressing the social determinants of health, including housing, transportation, nutrition, educational opportunities, and MA supplemental benefits; 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 or legislation, electronic documentation, and related issues; issues relating to sequestration under the Medicare Advantage and Part D programs; 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 value based payment 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; 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; issues relating to MACRA, including implications for MA and Part D plans; Medicare/Medicaid integration for dual eligibles, including implementation of the Capitated Financial Alignment Demonstration and related issues (e.g., quality ratings); issues relating to potential Medicare mental health parity requirements; 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 Affordable Care Act (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; 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; 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: $2,470,000 · 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), SENATE, White House Office

H.R. 3, Elijah E. Cummings Lower Drug Costs Now Act H.R. 1676, Jack Reynolds Memorial Medigap Extension Act H.R. 1255/S. 377, The Living Donor Protection Act of 2021 H.R. 2617, Consolidated Appropriations Act, 2023, issues related to health care H.R. 4065, The Chronic Kidney Disease Improvement in Research and Treatment Act H.R. 5376, Build Back Better Act, provisions relating to health care H.R. 5585, Advanced Research Project Agency Health Act H.R. 6000, Cures 2.0 Act S. 1971, Chronic Kidney Disease Improvement in Research and Treatment Act of 2021 Implementation of Executive Order 13879, Advancing American Kidney Health.

Client expense: $310,000 · Firm income: Not reported

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

H.R. 3, Elijah E. Cummings Lower Drug Costs Now Act H.R. 1676, Jack Reynolds Memorial Medigap Extension Act H.R. 2934, Renal Anemia Innovation Support and Expansion (RAISE) Act S. 4011, Capping Drug Costs for Seniors Act of 2022 H.R. 4065, The Chronic Kidney Disease Improvement in Research and Treatment Act H.R. 4417, Capping Drug Costs for Seniors Act of 2021 H.R. 5260, Reduced Costs and Continued Cures Act H.R. 6973, Enhanced Access to Affordable Medicines Act of 2022 H.R. 7634, Protecting Health Care for All Patients Act of 2022 S. 1971, Chronic Kidney Disease Improvement in Research and Treatment Act of 2021 S. 2317, Seniors Prescription Drug Relief Act Issues related to Medicare Part D coverage for drugs indicated to treat patients with chronic kidney disease; Quality Improvement Program (QIP) in the End Stage Renal Disease (ESRD) prospective payment system; CY 2022 Medicare End Stage Renal Disease (ESRD) Prospective Payment System (PPS) and Quality Improvement Program (QIP) rule making; CY 2022 policy and technical issues changes to the Medicare Advantage Program and Medicare Prescription Drug Benefit Program; Centers for Medicare and Medicaid Innovation (CMMI) ESRD Treatment Choices (ETC) model; Implementation of expanded Medicare immunosuppressive drug coverage for kidney transplant patients; Implementation of Executive Order 13879, Advancing American Kidney Health; Telehealth flexibilities for nephrologists and kidney patients on dialysis.

Client expense: $310,000 · Firm income: Not reported

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

Issues relating to End Stage Renal Disease (ESRD) and Chronic Kidney Disease (CKD); S. 1971, Chronic Kidney Disease Improvement in Research and Treatment Act of 2021; H.R. 4065, To improve the understanding of, and promote access to treatment for, chronic kidney disease, and for other purposes; End-Stage Renal Disease (ESRD) payment reform and quality metrics; S. 377/H.R. 1255, Living Donor Protection Act; H.R. 1676, Jack Reynolds Memorial Medigap Expansion Act H.R. 3893, Coordination, Accountability, Research and Equity for All Kidneys Act of 2021 (CARE for All Kidneys Act); H.R. 2934, Renal Anemia Innovation Support and Expansion (RAISE) Act; End Stage Renal Disease (ESRD) Prospective Payment System (PPS) and utilization of calcimimetic drugs; Medicare Secondary Payer; H.R. 7878/S. 4307 Kidney Health Connect Act of 2022; Calendar Year 2023 End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) Final Rule (CMS-1768-F); H.R. 8594/S. 4750, Restore Protections for Dialysis Patients Act

Client expense: Not reported · Firm income: $70,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE, White House Office

Activities to address access and utilization of home dialysis, including H.R. 5426, the "Improving Access to Home Dialysis Act of 2021" to authorize Medicare reimbursement for staff-assisted home dialysis and for other purposes. H.R. 8594 and S. 4750, "Restore Protections for Dialysis Patients Act," to provide Medicare access to kidney dialysis. Letter to HHS regarding Final Rule for the Medicare Part B-ID benefit to extend eligibility of coverage of immunosuppressive drugs for kidney transplant recipients for Medicare ESRD beneficiaries. Support for Protected Classes under Medicare Part D program. S. 4873, Improving Access to Advance Care Planning Act for Medicare advanced care planning. H.R. 1676, provide access to Medigap coverage for Medicare end-stage kidney disease patients under age 65. These Medicare beneficiaries do not have a guaranteed opportunity to purchase a Medigap policy. S. 1536, H.R. 3108, Medicare Medical Nutrition Therapy Act. Legislation would expand coverage of nutrition therapy services to additional diseases and conditions and expand the types of medical providers for such services. S. 2203, H.R. 5804, Medicare Diabetes Self-Management Training Act. Expands coverage of diabetes outpatient self-management training. S. 2173, H.R. 2807, PREVENT DIABETES Act. Requires Medicare to offer its Diabetes Prevention Program in a virtual or online format. Support for Kidney Health Evaluation (KED) for patients with diabetes. S. 1512 and H.R. 2903, "CONNECT for Health Act." Expands coverage of telehealth services under Medicare. S. 596 and H.R. 1577, the "Treat and Reduce Obesity Act," to expand the types of health professionals permitted to provide weight loss management and counseling services under Medicare Part B and to include coverage of weight loss management drugs under Medicare Part D. Support for COVID-19 patients (telehealth, home dialysis, copayment waivers, regulatory waivers). Participated in health community effort to urge HHS to expand Medicare coverage to include medically necessary dental treatments for solid organ transplant recipients and other vulnerable individuals.

Client expense: $110,000 · Firm income: Not reported

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

Assist the Administration during Covid-19 epidemic on how to help and protect dialysis patients; Urge Congress to provide access to Medigap for all ESRD patients under 65 years of age - (H.R. 1676) - The Jack Reynolds Memorial Medigap Expansion Bill; Protect organ donors by urging passage of the Living Donor Protection Act of 2021 (H.R. 1255/S. 377); Protect dialysis patient access to charitable premium assistance; Ensure ESRD patients retain access to private insurance; Support ESRD care coordination - The BETTER Kidney Care Bill (H.R. 4942/S. 2649); Encourage support for improved kidney research and treatment; Support increased oversight of Organ Procurement Organizations; Support the Chronic Kidney Disease Improvement in Research and Treatment Act (H.R. 4065/S. 1971); Assist the Administration about Prioritizing Prevention, Home Dialysis; and Urge Congress to protect access to private insurance H.R. 8594/S. 4750 - The Restore Protections for Dialysis Patients Act.

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), Labor, Dept of (DOL), SENATE, White House Office

Medicare reform for dialysis patients; H.R.1676 - Jack Reynolds Memory Medigap Act; H.R.4942 - The BETTER Kidney Care Act; H.R.8594 - Restore Protections for Dialysis Patients Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare reform for dialysis patients; H.R.1676 - Jack Reynolds Memory Medigap Act; H.R.4942 - The BETTER Kidney Care Act; H.R.8594 - Restore Protections for Dialysis Patients Act

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

Government targets: HOUSE OF REPRESENTATIVES

Education Funding, Appropriations (ESSA Titles I, II, IV), Higher Education Act Reauthorization, Arts Education for all Act (H.R. 5581), Advancing Equity Through the Arts and Humanities Act (H.R. 7627), Reopen and Rebuild America's Schools Act (S.96) (H.R. 604), House and Senate Resolutions Recognizing June as African American Music Appreciation Month (H.Res.1215 and S.Res.693), House and Senate Resolutions Recognizing Hispanic Heritage Month (H.Res.1353) (S.Res.782), Expand Education Deduction for Teachers Act (H.R. 7071), Guarantee Access to Music and The Arts Act (H.R. 1676), Loan Forgiveness for Educators Act (H.R.8856) (S.4867), EDUCATORS for America Act (S.3360) (H.R. 6205)

Client expense: Not reported · Firm income: Not reported

Government targets: Education, Dept of, HOUSE OF REPRESENTATIVES, SENATE

Issues related to End-Stage Renal Disease, dialysis treatment and coordinated care. Issues related to H.R. 1676, Jack Reynold's Memorial MediGap Expansion Act. Issues related to H.R. 4942/S.2649, BETTER Kidney Care Act. Discussions related to Medicare coverage of End-Stage Renal Disease care, including S. 4750, Restore Protections for Dialysis Patients Act.

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

Government targets: SENATE

1. Patient Protection and Affordable Health Care Act, implementation of provisions regarding Medicare Part D coverage gap assistance, preventive care services, and dual eligible Medicare and Medicare beneficiaries 2. Proposals to create a premium support or voucher program under Medicare 3. Proposals to "means test" Medicare premiums and benefits 4. Proposals to change federal and state Medicaid cost sharing 5. Proposals to raise the Medicare eligibility age 6. Proposals regarding prescription drug costs for low income Medicare beneficiaries 7. Expansion of Medicare benefits to include hearing, vision, and dental benefits 8. Medicare Observation Status Regulations 9. Proposals to streamline Medicare enrollment during the COVID-19 pandemic 10. Proposals to permit Medicare prescription drug pricing negotiations 10. S. 245, States Achieve Medicaid Expansion Act of 2021 or the SAME Act of 2021, entire bill 11. H.R. 1868, To prevent across-the-board direct spending cuts, and for other purposes, entire bill 12. S. 782, Nursing Home Reform Modernization Act of 2021, entire bill 13. H.R. 4131, To amend title XIX of the Social Security Act to expand access to home and community-based services (HCBS) under Medicaid, entire bill 14. Demonstration projects for expanding home and community based services under Medicare and Medicaid 15. H.R. 4311, Medicare Dental, Vision, and Hearing Act of 2021, entire bill 16. H.R. 4811, Medicare Negotiation and Competitive Licensing Act of 2021, entire bill 17. H.R. 5260, Reduced Costs and Continued Cures Act, entire bill 18. H.R. 1676, Jack Reynolds Memory Medigap Expansion Act, entire bill 19. Proposals to adjust 2022 Medicare Part B premiums 20. H.R. 3650, Improving Access to Medicare Coverage Act of 2021, entire bill 21. Medicare Direct Contracting Entity (DCE)program 22. Medicare ACO Realizing Equity, Access, and Community Health (REACH) program 23. H.R. 6698, Stop Unfair Medicaid Recoveries Act of 2022, entire bill 24. Medicare regulations under the No Surprises Act 25. Administration of ACO REACH program 26. Administration of Medicare telephone help lines 27. H.R. 5376, Inflation Reduction Act of 2022, provisions relating to Medicare drug negotiations, vaccine access and pricing, insulin pricing, out of pocket annual caps, catastrophic drug out of pocket costs 28. Expansion of Medicare coverage for medically necessary dental services

Client expense: $70,000 · 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), SENATE

Assist the Administration during Covid-19 epidemic on how to help and protect dialysis patients; Urge Congress to provide access to Medigap for all ESRD patients under 65 years of age - (H.R. 1676) - The Jack Reynolds Memorial Medigap Expansion Bill; Protect organ donors by urging passage of the Living Donor Protection Act of 2021 (H.R. 1255/S. 377); Protect dialysis patient access to charitable premium assistance; Ensure ESRD patients retain access to private insurance; Support ESRD care coordination - The BETTER Kidney Care Bill (H.R. 4942/S. 2649); Encourage support for improved kidney research and treatment; Support increased oversight of Organ Procurement Organizations; Support the Chronic Kidney Disease Improvement in Research and Treatment Act (H.R. 4065/S. 1971); Assist the Administration about Prioritizing Prevention, Home Dialysis; and Urge Congress to protect access to private insurance H.R. 8594/S. 4750 - The Restore Protections for Dialysis Patients Act.

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

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

FY23 Congressional appropriations: -Increase NIH funds, including $632 million increase for NIDDK to support kidney research and prioritizing research to improve the diagnosis of kidney diseases and health equity interventions -Provide $25 million to KidneyX to continue development of an artificial kidney and other innovations innovative kidney therapeutics and technologies -Support CDC Chronic Kidney Disease Initiative at $15 million Other: -Enact the Living Donor Protection Act (HR1255 S377) -Enact the Restore Protections for Dialysis Patients Act (HR8594/S4750) -Enact the Jack Reyonlds Medigap Expansion Act (HR1676) -Enact the Improving Access to Home Dialysis Act of (HR5426) -Enact the Medical Nutrition Therapy Act (HR3108 S1536) -Enact the Health Equity and Accountability Act (HR7585) -Increase transparency and accountability in the US transplant system -Address Clinical Labor Cuts impacting vascular access in FY 23 Medicare Physician Fee Schedule

Client expense: $70,000 · Firm income: Not reported

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

Issues relating to ESRD policies and reimbursement. H.R. 4942 - The BETTER Kidney Act S. 2649 - The BETTER Kidney Act H.R. 8594 - Restore Protections for Dialysis Patients Act S. 4750 - Restore Protections for Dialysis Patients Act H.R. 1676 - The Jack Reynolds Memorial Medigap Expansion Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Covid-19 recovery and response efforts for ESRD patients. HR 1676 - The Jack Reynolds Memorial Medigap Expansion Act HR 1255 - Living Donor Protection Act of 2021 S. 377 - Living Donor Protection Act of 2021 HR 3893 - CARE for All Kidneys Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3, Elijah E. Cummings Lower Drug Costs Now Act H.R. 1676, Jack Reynolds Memorial Medigap Extension Act H.R. 2934, Renal Anemia Innovation Support and Expansion (RAISE) Act S. 4011, Capping Drug Costs for Seniors Act of 2022 H.R. 4065, The Chronic Kidney Disease Improvement in Research and Treatment Act H.R. 4417, Capping Drug Costs for Seniors Act of 2021 H.R. 5260, Reduced Costs and Continued Cures Act H.R. 6973, Enhanced Access to Affordable Medicines Act of 2022 H.R. 7634, Protecting Health Care for All Patients Act of 2022 S. 1971, Chronic Kidney Disease Improvement in Research and Treatment Act of 2021 S. 2317, Seniors Prescription Drug Relief Act Issues related to Medicare Part D coverage for drugs indicated to treat patients with chronic kidney disease; Quality Improvement Program (QIP) in the End Stage Renal Disease (ESRD) prospective payment system; CY 2022 Medicare End Stage Renal Disease (ESRD) Prospective Payment System (PPS) and Quality Improvement Program (QIP) rule making; CY 2022 policy and technical issues changes to the Medicare Advantage Program and Medicare Prescription Drug Benefit Program; Centers for Medicare and Medicaid Innovation (CMMI) ESRD Treatment Choices (ETC) model; Implementation of expanded Medicare immunosuppressive drug coverage for kidney transplant patients; Implementation of Executive Order 13879, Advancing American Kidney Health; Telehealth flexibilities for nephrologists and kidney patients on dialysis.

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

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

H.R. 3, Elijah E. Cummings Lower Drug Costs Now Act H.R. 1676, Jack Reynolds Memorial Medigap Extension Act H.R. 1255/S. 377, The Living Donor Protection Act of 2021 H.R. 4065, The Chronic Kidney Disease Improvement in Research and Treatment Act H.R. 5376, Build Back Better Act, provisions relating to health care H.R. 5585, Advanced Research Project Agency Health Act H.R. 6000, Cures 2.0 Act S. 1971, Chronic Kidney Disease Improvement in Research and Treatment Act of 2021 Implementation of Executive Order 13879, Advancing American Kidney Health.

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

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

H.R. 66 - CARING for Kids Act - Rep. Buchanan, Vern - CHIP H.R. 265 - Insular Area Medicaid Parity Act - Rep. Sablan, Gregorio Kilili Camacho - Medicaid funding H.R. 315 - Medicare Sequester COVID Moratorium Act - Rep. Schneider, Bradley Scott - Medicare sequestration H.R. 340 - Incentivizing Medicaid Expansion Act of 2021 - Rep. Veasey, Marc - Medicaid expansion H.R. 432 - Mental Health Access Improvement Act of 2021 - Rep. Thompson, Mike -Medicare coverage of marriage and family therapist services and mental health counselor H.R. 502 - Medicare Dental Benefit Act of 2021 - Rep. Barragan, Nanette Diaz - Medicare coverage of dental and oral health services H.R. 525 - COVID HCBS Relief Act of 2021 - Rep. Dingell, Debbie - increased FMAP for HCBS H.R. 871 - Expand Medicaid Now Act - Rep. Fletcher, Lizzie - FMAP H.R. 918 - Stronger Medicaid Response to the COVID-19 Pandemic Act - Rep. Cardenas, Tony - COVID-19 coverage for the uninsured via Medicaid H.R. 955 - Medicaid Reentry Act of 2021 - Rep. Tonko, Paul -Medicaid coverage for incarcerated individuals H.R. 1167 - Advancing Enrollment and Reducing Drug Costs Act of 2021 - Rep. Pappas, Chris - Medicaid eligibility for low-income subsidies H.R. 1227 - Medicare-X Choice Act of 2021 - Rep. Delgado, Antonio - Medicare public option H.R. 1332 - Telehealth Modernization Act - Rep. Carter, Earl - telehealth services under Medicare H.R. 1349 - The COVID-19 Hospital and Health Provider Loan Conversion Act of 2021- Rep. Kaptur, Marcy - advance payments under parts A and B of Medicare H.R. 1353 - Coronavirus Medicaid Response Act - Rep. Lee, Susie - FMAP H.R. 1390 - CHIPPER Act - Rep. Wild, Susan - CHIP funding H.R. 1397 - TIKES Act - Rep. Blunt Rochester, Lisa - telehealth under Medicaid and CHIP H.R. 1609 - Treatment in Place Act - Rep. Axne, Cynthia - Medicare coverage of ambulance services H.R. 1676 - Jack Reynolds Memory Medigap Expansion Act - Rep. Axne, Cynthia - Medigap coverage for ESRD H.R. 1677 - KEEP Telehealth Options Act of 2021 - Rep. Balderson, Troy - telehealth expansion H.R. 1717 - Protecting Married Seniors from Impoverishment Act of 2021 - Rep. Upton, Fred - permanent protections against spousal impoverishment H.R. 1722 - Puerto Rico Health Care Fairness, Accountability, and Beneficiary Access Act of 2021 - Rep. Velazquez, Nydia - Medicaid in Puerto Rico H.R. 1738 - Stabilize Medicaid and CHIP Coverage Act - Rep. Dingell, Debbie - Medicaid and CHIP continuous enrollment H.R. 1784 - Medicaid REACH Act - Rep. Doggett, Lloyd - requirements for non-expansion H.R. 1791 - CHIPP Act - Rep. Barragan, Nanette Diaz - extending CHIP H.R. 1792 - Ensuring Kids Have Access to Medically Necessary Dental Care Act - Rep. Barragan, Nanette Diaz - dental coverage under CHIP H.R. 1793 - Immediate Coverage for Former Foster Youth Act - Rep. Bass, Karen - Medicaid coverage for foster youth H.R. 1794 - Foster Youth Dental Act of 2021 - Rep. Bass, Karen - Medicaid dental coverage for foster youth H.R. 1823 - To amend title XIX of the Social Security Act to remove the matching requirement for a territory to use specially allocated Federal funds for Medicare covered part D drugs for low-income individuals - Resident Commissioner Gonzalez-Colon, Jenniffer - Medicare covered part D H.R. 1825 - Territories Medicare Prescription Drug Assistance Equality Act of 2021 - Resident Commissioner Gonzalez-Colon, Jenniffer - Medicare Part D premium and cost-sharing subsidies H.R. 1826 - Fairness in Medicare Part B Enrollment Act of 2021 - Resident Commissioner Gonzalez-Colon, Jenniffer - late enrollment penalties under part B of the Medicare program H.R. 1880 - To amend the Deficit Reduction Act of 2005 to make permanent the Money Follows the Person Rebalancing Demonstration - Rep. Dingell, Debbie - Money Follows the Person Rebalancing Demonstration H.R. 1885 - RUSH Protection Act of 2021 - Rep. Kind, Ron - Medicare rural health clinic payments H.R. 1887 - Rural Hospital Support Act - Rep. Reed, Tom - Medicare payments for hospitals H.R. 1890 - Health Insurance Consumer Protection Act - Rep. Schakowsky, Janice D. - network adequacy standards and premium rates H.R. 1914 - CAHOOTS Act - Rep. DeFazio, Peter A. - Medicaid mobile crisis intervention services H.R. 1969 - Medicare Advantage Integrity Act - Resident Commissioner Gonzalez-Colon, Jenniffer - disparity in MA benchmark rates H.R. 2035 - Improving Access to Mental Health Act of 2021 - Rep. Lee, Barbara - mental health services under Medicare H.R. 2080 - SAVE Act - Rep. Bishop, Sanford D., Jr. - Medicare coverage of transportation services H.R. 2166 - Ensuring Parity in MA and PACE for Audio-Only Telehealth Act of 2021 - Rep. Sewell, Terri - Medicare Advantage payments for audio-only diagnoses H.R. 2168 - Expanded Telehealth Access Act - Rep. Sherrill, Mikie - Medicare payment for telehealth services H.R. 2170 - HAPI Act - Rep. Soto, Darren - access to vaccines and Medicaid H.R. 2179 - Affordable Insulin for the COVID-19 Emergency Act - Rep. Waters, Maxine - cost-sharing regarding insulin coverage H.R. 2217 - Territory Federal Matching Requirement Equity Act of 2021 - Resident Commissioner Gonzalez-Colon, Jenniffer - Medicaid FMAP for Territories H.R. 2228 - Rural Behavioral Health Access Act of 2021 - Rep. Kildee, Daniel - Medicare coverage of outpatient telehealth services H.R. 4074 - Addressing Social Determinants in Medicare Advantage Act of 2021 - Rep. Bilirakis, Gus M. - Medicare Advantage supplemental benefits H.R. 4640 - Close the Medigap Act of 2021 - Rep. Doggett, Lloyd - Medigap policies H.R. 6833 - Affordable Insulin Now Act - Rep. Craig, Angie - Insulin prices and cost sharing S. 150 - Ensuring Parity in MA for Audio-Only Telehealth Act of 2021 - Sen. Cortez-Masto, Catherine - coverage of audio-only telehealth services in MA S. 151 - COVID HCBS Relief Act of 2021 - Sen. Casey, Robert - FMAP and HCBS S. 245 - SAME Act of 2021 - Sen. Warner, Mark - Medicaid expansion S. 274 - Stronger Medicaid Response to the COVID-19 Pandemic Act - Sen. Bennet, Michael - COVID-19 coverage for the uninsured via Medicaid S. 285 - Medicaid Reentry Act of 2021 - Sen. Baldwin, Tammy - Medicaid coverage for incarcerated individuals S. 368 - Telehealth Modernization Act - Sen. Scott, Tim - coverage of telehealth services under Medicare S. 386 - Medicare-X Choice Act of 2021 - Sen. Bennet, Michael - Medicare public option S. 439 - Coronavirus Medicaid Response Act - Sen. Casey, Robert - increases FMAP S. 440 - Continued Funding for Senior Services During COVID-19 Act - Sen. Casey, Robert - funding for services under the Older Americans Act of 1965 S. 453 - CHIPPER Act - Sen. Casey, Robert - CHIP funding S. 581 - HAPI Act -Sen. Brown, Sherrod - vaccines under Medicaid S. 620 - KEEP Telehealth Options Act of 2021 - Sen. Fischer, Deb - telehealth expansion S. 644 - Rural Hospital Closure Relief Act of 2021 - Sen. Durbin, Richard - Medicare coverage for critical access hospitals S. 646 - Stabilize Medicaid and CHIP Coverage Act of 2021 - Sen. Brown, Sherrod - Medicaid and CHIP enrollment S. 653 - COMP Act - Sen. Portman, Rob - Medicare secondary payer rules S. 712 - Dosha Joi Immediate Coverage for Former Foster Youth Act - Sen. Casey, Robert P., Jr. - Medicaid coverage for foster youth S. 748 - Medicare Sequester Relief Act - Sen. Shaheen, Jeanne - Medicare payment sequestration S. 764 - CAHOOTS Act - Sen. Wyden, Ron - Medicaid mobile crisis intervention services S. 826 - Medicare Patient Empowerment Act of 2021 - Sen. Paul, Rand - Medicaid payment options S. 870 - Improving Access to Mental Health Act of 2021 - Sen. Stabenow, Debbie - mental health services in Medicare S. 999 - Save Rural Hospitals Act of 2021 - Sen. Warner, Mark - Medicare hospital 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 2023 policy and technical regulation for MA and Part D; issues related to Medicare for All, Medicare buy-in, reduced Medicare eligibility age, and public option; issues relating to 2023 Rate Notice; issues related to coverage in non-Medicaid Expansion States (e.g., Gap Population); issues related to expanded Medicare fee for service benefits (dental, hearing and vision); issues related to Medicaid coverage gap; issues related to specialty infant formula; issues related to the Inflation Reduction Act passage and implementation; contraceptive coverage and reproductive health; Medicare NCD relating to monoclonal antibodies for treatment of Alzheimers disease; issues related to Managed Long Term Services and Supports (MLTSS); issues related to removal of safe harbor protection for rebates; issues relating to COVID-19, including testing, vaccines and therapeutics; issues related to the end of the public health emergency; telehealth; issues related to the cost of insulin, including price, copays, rebates, and medical management tools; issues related to health equity; issues related to vaccination; issues related to audio-only telehealth; issues related to addressing the social determinants of health, including housing, transportation, nutrition, educational opportunities, and MA supplemental benefits; 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 or legislation, electronic documentation, and related issues; issues relating to sequestration under the Medicare Advantage and Part D programs; 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 value based payment 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; 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; issues relating to MACRA, including implications for MA and Part D plans; Medicare/Medicaid integration for dual eligibles, including implementation of the Capitated Financial Alignment Demonstration and related issues (e.g., quality ratings); issues relating to potential Medicare mental health parity requirements; 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 Affordable Care Act (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; 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; 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. *Add MACPAC to Agency List.

Client expense: $3,230,000 · Firm income: Not reported

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

H.R. 8594/S. 4750, the Restore Protections for Dialysis Patients Act H.R. 7845/ the NIH Clinical Trial Diversity Act H.R. 1255/S. 377, the Living Donor Protection Act H.R. 1676, the Jack Reynold Medigap Expansion Act H.R. 526, Ensuring Coverage in Public Health Emergencies Act of 2021 Health disparities S. 1002, the Junk Plan Accountability and Disclosure Act of 2021 H.R. 4065/S. 1971, the Chronic Kidney Disease Improvement in Research and Treatment Act of 2021. H.R. 3893, the CARE for All Kidneys Act FY 2023, Labor-HHS-Education Appropriations Act H.R. 7585, the Health Equity and Accountability Act of 2022 (HEAA) H.R. 5801, the Help Ensure Lower Patient (HELP) Copays Act H.R. 7667, the Food and Drug Amendments of 2022 H.R. 7506, the New Era for Preventing End-Stage Kidney Disease Act of 2022 Medicare Program; Implementing Certain Provisions of the Consolidated Appropriations Act, 2021 and Other Revisions to Medicare Enrollment and Eligibility Rules Diversity Plans To Improve Enrollment of Participants From Underrepresented Racial and Ethnic Populations in Clinical Trials; Draft Guidance for Industry Request for Information on ways to strengthen and improve the Organ Procurement and Transplantation Network

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

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

Activities to address access and utilization of home dialysis, including H.R. 5426, the "Improving Access to Home Dialysis Act of 2021" to authorize Medicare reimbursement for staff-assisted home dialysis and for other purposes. Submitted comments on Proposed Rules for the ESRD Prospective Payment System, ESRD Quality Incentive Program, and ESRD Treatment Choices Model. Submitted comments on Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System. Submitted comments on Proposed 2023 Payment Policies under the Physician Fee Schedule. Responded to RFI on Medicare Advantage. H.R. 8594 and S. 4750, "Restore Protections for Dialysis Patients Act," to provide Medicare access to kidney dialysis. Support for Protected Classes under Medicare Part D program. H.R. 1676, provide access to Medigap coverage for Medicare end-stage kidney disease patients under age 65. These Medicare beneficiaries do not have a guaranteed opportunity to purchase a Medigap policy. S. 1536, H.R. 3108, Medicare Medical Nutrition Therapy Act. Legislation would expand coverage of nutrition therapy services to additional diseases and conditions and expand the types of medical providers for such services. S. 2203, H.R. 5804, Medicare Diabetes Self-Management Training Act. Expands coverage of diabetes outpatient self-management training. S. 2173, H.R. 2807, PREVENT DIABETES Act. Requires Medicare to offer its Diabetes Prevention Program in a virtual or online format. Support for Kidney Health Evaluation (KED) for patients with diabetes. S. 1512 and H.R. 2903, "CONNECT for Health Act." Expands coverage of telehealth services under Medicare. S. 596 and H.R. 1577, the "Treat and Reduce Obesity Act," to expand the types of health professionals permitted to provide weight loss management and counseling services under Medicare Part B and to include coverage of weight loss management drugs under Medicare Part D. Support for COVID-19 patients (telehealth, home dialysis, copayment waivers, regulatory waivers). Participated in health community effort to urge HHS to expand Medicare coverage to include medically necessary dental treatments for solid organ transplant recipients and other vulnerable individuals.

Client expense: $100,000 · 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 End Stage Renal Disease Perspective Payment System HR 7878/S 4307, Kidney Health Connect Act (all provisions) Issues related to supply chain Issues related to end stage renal disease calcimimetics utilization Issues related to Transitional Add-on Payment Adjustment for New and Innovative Equipment and Supplies (TPNIES) Issues related to Transitional Drug Add-on Payment Adjustment (TDAPA) Issues related to nursing shortages H.R. 4942/S. 2649, Bringing Enhanced Treatments and Therapies to ESRD Recipients Kidney Care Act H.R. 1676, The Jack Reynolds Memorial Medigap Expansion Act H.R. 5426, Improving Access to Home Dialysis Act of 2021 H.R. 8594/S. 4750, Restore Protections for Dialysis Patients Act H.R. 8063, Repair Abuses of MSP Payments Act CMS regulations pertaining to reimbursement rates for ESRD-related services CMS regulations pertaining to the Medicare Advantage program Protection of third party premium assistance for coverage under the Patient Protection and Affordable Care Act Issues related to home dialysis Issues related to chronic kidney disease (CKD) and prevention Issues related to access to kidney transplantation for ESRD patients ESRD Treatment Choices (ETC) mandatory demonstration Kidney Care Choices (KCC) Model and the Comprehensive Kidney Care Contracting (CKCC) voluntary payment options Emergency response related to COVID-19 S. 368, Telehealth Modernization Act, all provisions MedPAC CY22 report to Congress, Medicare end-stage renal disease perspective payment system base rate recommendation S. 1971/ H.R. 4065 Chronic Kidney Disease Improvement in Research and Treatment Act, all provisions ESRD facilities serving as originating sites for telehealth services under the Medicare program H.R. 8295 Fiscal Year 2023 Labor, Health and Human Services, Education, and Related Agencies (LHHS) Appropriations bill, provision relating to KidneyX funding H.R. 6000, CURES 2.0 Act, provisions related to dialysis

Client expense: $950,000 · Firm income: Not reported

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

Issues related to End Stage Renal Disease Perspective Payment System HR 7878/S 4307, Kidney Health Connect Act (all provisions) Issues related to supply chain Issues related to end stage renal disease calcimimetics utilization Issues related to Transitional Add-on Payment Adjustment for New and Innovative Equipment and Supplies (TPNIES) Issues related to Transitional Drug Add-on Payment Adjustment (TDAPA) Issues related to nursing shortages H.R. 4942/S. 2649, Bringing Enhanced Treatments and Therapies to ESRD Recipients Kidney Care Act H.R. 1676, The Jack Reynolds Memorial Medigap Expansion Act H.R. 5426, Improving Access to Home Dialysis Act of 2021 H.R. 8594/S. 4750, Restore Protections for Dialysis Patients Act H.R. 8063, Repair Abuses of MSP Payments Act CMS regulations pertaining to reimbursement rates for ESRD-related services CMS regulations pertaining to the Medicare Advantage program Protection of third party premium assistance for coverage under the Patient Protection and Affordable Care Act Issues related to chronic kidney disease (CKD) and prevention Issues related to home dialysis Issues related to access to kidney transplantation for ESRD patients ESRD Treatment Choices (ETC) mandatory demonstration Kidney Care Choices (KCC) Model and the Comprehensive Kidney Care Contracting (CKCC) voluntary payment options Emergency response related to COVID-19 MedPAC CY22 report to Congress, Medicare end-stage renal disease perspective payment system base rate recommendation S. 1971/ H.R. 4065 Chronic Kidney Disease Improvement in Research and Treatment Act, all provisions ESRD facilities serving as originating sites for telehealth services under the Medicare program H.R. 8295 Fiscal Year 2023 Labor, Health and Human Services, Education, and Related Agencies (LHHS) Appropriations bill, provision relating to KidneyX funding H.R. 6000, CURES 2.0 Act, provisions related to dialysis

Client expense: $950,000 · Firm income: Not reported

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

Issues relating to End Stage Renal Disease (ESRD) and Chronic Kidney Disease (CKD); S. 1971, Chronic Kidney Disease Improvement in Research and Treatment Act of 2021; H.R. 4065, To improve the understanding of, and promote access to treatment for, chronic kidney disease, and for other purposes; End-Stage Renal Disease (ESRD) payment reform and quality metrics; S. 377/H.R. 1255, Living Donor Protection Act; H.R. 1676, Jack Reynolds Memorial Medigap Expansion Act H.R. 3893, Coordination, Accountability, Research and Equity for All Kidneys Act of 2021 (CARE for All Kidneys Act); H.R. 2934, Renal Anemia Innovation Support and Expansion (RAISE) Act; End Stage Renal Disease (ESRD) Prospective Payment System (PPS) and utilization of calcimimetic drugs; Medicare Secondary Payer; H.R. 7878/S. 4307 Kidney Health Connect Act of 2022; Calendar Year 2023 End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) Proposed Rule, issued 6/21/22; H.R. 8594/S. 4750, Restore Protections for Dialysis Patients Act

Client expense: Not reported · Firm income: $70,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

1. Patient Protection and Affordable Health Care Act, implementation of provisions regarding Medicare Part D coverage gap assistance, preventive care services, and dual eligible Medicare and Medicare beneficiaries 2. Proposals to create a premium support or voucher program under Medicare 3. Proposals to "means test" Medicare premiums and benefits 4. Proposals to change federal and state Medicaid cost sharing 5. Proposals to raise the Medicare eligibility age 6. Proposals regarding prescription drug costs for low income Medicare beneficiaries 7. Expansion of Medicare benefits to include hearing, vision, and dental benefits 8. Medicare Observation Status Regulations 9. Proposals to streamline Medicare enrollment during the COVID-19 pandemic 10. Proposals to permit Medicare prescription drug pricing negotiations 10. S. 245, States Achieve Medicaid Expansion Act of 2021 or the SAME Act of 2021, entire bill 11. H.R. 1868, To prevent across-the-board direct spending cuts, and for other purposes, entire bill 12. S. 782, Nursing Home Reform Modernization Act of 2021, entire bill 13. H.R. 4131, To amend title XIX of the Social Security Act to expand access to home and community-based services (HCBS) under Medicaid, entire bill 14. Demonstration projects for expanding home and community based services under Medicare and Medicaid 15. H.R. 4311, Medicare Dental, Vision, and Hearing Act of 2021, entire bill 16. H.R. 4811, Medicare Negotiation and Competitive Licensing Act of 2021, entire bill 17. H.R. 5260, Reduced Costs and Continued Cures Act, entire bill 18. H.R. 1676, Jack Reynolds Memory Medigap Expansion Act, entire bill 19. Proposals to adjust 2022 Medicare Part B premiums 20. H.R. 3650, Improving Access to Medicare Coverage Act of 2021, entire bill 21. Medicare Direct Contracting Entity (DCE)program 22. Medicare ACO Realizing Equity, Access, and Community Health (REACH) program 23. H.R. 6698, Stop Unfair Medicaid Recoveries Act of 2022, entire bill 24. Medicare regulations under the No Surprises Act 25. Administration of ACO REACH program 26. Administration of Medicare telephone help lines 27. H.R. 5376, Inflation Reduction Act of 2022, provisions relating to Medicare drug negotiations, vaccine access and pricing, insulin pricing, out of pocket annual caps, catastrophic drug out of pocket costs 28. Expansion of Medicare coverage for medically necessary dental services

Client expense: $70,000 · 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), SENATE

Medicare reform for dialysis patients; H.R.1676 - Jack Reynolds Memory Medigap Act; H.R.4942 - The BETTER Kidney Care Act; H.R.8590 - Restore Protections for Dialysis Patients Act

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

Government targets: HOUSE OF REPRESENTATIVES

Medicare reform for dialysis patients; H.R.1676 - Jack Reynolds Memory Medigap Act; H.R.4942 - The BETTER Kidney Care Act; H.R.8590 - Restore Protections for Dialysis Patients Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to End-Stage Renal Disease, dialysis treatment and coordinated care. Issues related to H.R. 1676, Jack Reynold's Memorial MediGap Expansion Act. Issues related to H.R. 4942/S.2649, BETTER Kidney Care Act. Discussions related to Medicare coverage of End-Stage Renal Disease care, including S. 4750, Restore Protections for Dialysis Patients Act.

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

Government targets: SENATE

Issues relating to ESRD policies and reimbursement. H.R. 4942 - The BETTER Kidney Act S. 2649 - The BETTER Kidney Act H.R. 1676 - The Jack Reynolds Memorial Medigap Expansion Act Issues related to the Medicare Secondary Payer Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Covid-19 recovery and response efforts for ESRD patients. HR 1676 - The Jack Reynolds Memorial Medigap Expansion Act HR 1255 - Living Donor Protection Act of 2021 S. 377 - Living Donor Protection Act of 2021 HR 3893 - CARE for All Kidneys Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE, White House Office

H.R. 1255/S. 377, the Living Donor Protection Act H.R. 1676, the Jack Reynold Medigap Expansion Act H.R. 526, Ensuring Coverage in Public Health Emergencies Act of 2021 Health disparities S. 1002, the Junk Plan Accountability and Disclosure Act of 2021 H.R. 4065/S. 1971, the Chronic Kidney Disease Improvement in Research and Treatment Act of 2021. H.R. 3893, the CARE for All Kidneys Act FY 2023, Labor-HHS-Education Appropriations Act H.R. 7585, the Health Equity and Accountability Act of 2022 (HEAA) H.R. 5801, the Help Ensure Lower Patient (HELP) Copays Act H.R. 7845, NIH Clinical Trial Diversity Act of 2022 H.R. 7667, the Food and Drug Amendments of 2022 H.R. 7506, the New Era for Preventing End-Stage Kidney Disease Act of 2022 Medicare Program; Implementing Certain Provisions of the Consolidated Appropriations Act, 2021 and Other Revisions to Medicare Enrollment and Eligibility Rules Diversity Plans To Improve Enrollment of Participants From Underrepresented Racial and Ethnic Populations in Clinical Trials; Draft Guidance for Industry Request for Information on ways to strengthen and improve the Organ Procurement and Transplantation Network

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, White House Office

FY23 Congressional appropriations: -Increase NIH funds, including $632 million increase for NIDDK to support kidney research and prioritizing research to improve the diagnosis of kidney diseases and health equity interventions -Provide $25 million to KidneyX to continue development of an artificial kidney and other innovations innovative kidney therapeutics and technologies -Support CDC Chronic Kidney Disease Initiative at $15 million Other: -Enact the Living Donor Protection Act (HR1255 S377) -Enact the Jack Reyonlds Medigap Expansion Act (HR1676) -Enact the Improving Access to Home Dialysis Act of (HR5426) -Enact the Medical Nutrition Therapy Act (HR3108 S1536) -Enact the Health Equity and Accountability Act (HR7585) -Address Clinical Labor Cuts impacting vascular access in FY 23 Medicare Physician Fee Schedule

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

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

FY22 Congressional appropriations: -Increase NIH funds, supporting $6.5 billion for NIH in general including $2.2 billion for kidney research at NIDDK -Provide $25 million to KidneyX to continue development of an artificial kidney and other innovative kidney therapeutics and technologies -Support CDC Chronic Kidney Disease Initiative at $5 million FY23 Congressional appropriations: -Increase NIH funds, including $632 million increase for NIDDK to support kidney research -Provide $25 million to KidneyX to continue development of an artificial kidney and other innovations innovative kidney therapeutics and technologies -Support CDC Chronic Kidney Disease Initiative at $15 million Other: -Enact the Living Donor Protection Act (HR1255 S377) -Enact the Jack Reyonlds Medigap Expansion Act (HR1676) -Enact the Improving Access to Home Dialysis Act of (HR5426)

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

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

Issues relating to End Stage Renal Disease (ESRD) and Chronic Kidney Disease (CKD); S. 1971, Chronic Kidney Disease Improvement in Research and Treatment Act of 2021; H.R. 4065, To improve the understanding of, and promote access to treatment for, chronic kidney disease, and for other purposes; End-Stage Renal Disease (ESRD) payment reform and quality metrics; S.377/H.R. 1255, Living Donor Protection Act; H.R. 1676, Jack Reynolds Memorial Medigap Expansion Act H.R. 3893, Coordination, Accountability, Research and Equity for All Kidneys Act of 2021 (CARE for All Kidneys Act); H.R. 2934, Renal Anemia Innovation Support and Expansion (RAISE) Act; End Stage Renal Disease (ESRD) Prospective Payment System (PPS) and utilization of calcimimetic drugs; Medicare Secondary Payer; H.R. 7878/S. 4307 Kidney Health Connect Act of 2022; Calendar Year 2023 End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) Proposed Rule, issued 6/21/22

Client expense: Not reported · Firm income: $70,000

Government targets: HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), SENATE

Medicare reform for dialysis patients; H.R.1676 - Jack Reynolds Memory Medigap Act; H.R.4942 - The BETTER Kidney Care Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare reform for dialysis patients; H.R.1676 - Jack Reynolds Memory Medigap Act; H.R.4942 - The BETTER Kidney Care Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Assist the Administration during Covid-19 epidemic on how to help and protect dialysis patients; Urge Congress to provide access to Medigap for all ESRD patients under 65 years of age - (H.R. 1676) - The Jack Reynolds Memorial Medigap Expansion Bill; Protect organ donors by urging passage of the Living Donor Protection Act of 2021 (H.R. 1255/S. 377); Protect dialysis patient access to charitable premium assistance; Ensure ESRD patients retain access to private insurance; Support ESRD care coordination - The BETTER Kidney Care Bill (H.R. 4942/S. 2649); Encourage support for improved kidney research and treatment; Support increased oversight of Organ Procurement Organizations; Support the Chronic Kidney Disease Improvement in Research and Treatment Act (H.R. 4065/S. 1971); and Assist the Administration about Prioritizing Prevention, Home Dialysis.

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

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

Issues related to End Stage Renal Disease Perspective Payment System (no legislation introduced) HR 7878/S 4307, Kidney Health Connect Act (all provisions) Issues related to supply chain Issues related to end stage renal disease calcimimetics utilization Issues related to Transitional Add-on Payment Adjustment for New and Innovative Equipment and Supplies (TPNIES) Issues related to Transitional Drug Add-on Payment Adjustment (TDAPA) Issues related to nursing shortages H.R. 4942/S. 2649, Bringing Enhanced Treatments and Therapies to ESRD Recipients Kidney Care Act H.R. 1676, The Jack Reynolds Memorial Medigap Expansion Act H.R. 5426, Improving Access to Home Dialysis Act of 2021 Issues related to the Medicare Secondary Payor (MSP) Act CMS regulations pertaining to reimbursement rates for ESRD-related services CMS regulations pertaining to the Medicare Advantage program Protection of third party premium assistance for coverage under the Patient Protection and Affordable Care Act Issues related to home dialysis Issues related to chronic kidney disease (CKD) and prevention Issues related to access to kidney transplantation for ESRD patients ESRD Treatment Choices (ETC) mandatory demonstration Kidney Care Choices (KCC) Model and the Comprehensive Kidney Care Contracting (CKCC) voluntary payment options Emergency response related to COVID-19 S. 368, Telehealth Modernization Act, all provisions MedPAC CY22 report to Congress, Medicare end-stage renal disease perspective payment system base rate recommendation S. 1971/ H.R. 4065 Chronic Kidney Disease Improvement in Research and Treatment Act, all provisions ESRD facilities serving as originating sites for telehealth services under the Medicare program H.R. 8295 Fiscal Year 2023 Labor, Health and Human Services, Education, and Related Agencies (LHHS) Appropriations bill, provision relating to KidneyX funding H.R. 6000, CURES 2.0 Act, provisions related to dialysis

Client expense: $850,000 · Firm income: Not reported

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

Issues related to End Stage Renal Disease Perspective Payment System (no legislation introduced) HR 7878/S 4307, Kidney Health Connect Act (all provisions) Issues related to supply chain Issues related to end stage renal disease calcimimetics utilization Issues related to Transitional Add-on Payment Adjustment for New and Innovative Equipment and Supplies (TPNIES) Issues related to Transitional Drug Add-on Payment Adjustment (TDAPA) Issues related to nursing shortages H.R. 4942/S. 2649, Bringing Enhanced Treatments and Therapies to ESRD Recipients Kidney Care Act H.R. 1676, The Jack Reynolds Memorial Medigap Expansion Act H.R. 5426, Improving Access to Home Dialysis Act of 2021 Issues related to the Medicare Secondary Payor (MSP) Act CMS regulations pertaining to reimbursement rates for ESRD-related services CMS regulations pertaining to the Medicare Advantage program Protection of third party premium assistance for coverage under the Patient Protection and Affordable Care Act Issues related to chronic kidney disease (CKD) and prevention Issues related to home dialysis Issues related to access to kidney transplantation for ESRD patients ESRD Treatment Choices (ETC) mandatory demonstration Kidney Care Choices (KCC) Model and the Comprehensive Kidney Care Contracting (CKCC) voluntary payment options Emergency response related to COVID-19 MedPAC CY22 report to Congress, Medicare end-stage renal disease perspective payment system base rate recommendation S. 1971/ H.R. 4065 Chronic Kidney Disease Improvement in Research and Treatment Act, all provisions ESRD facilities serving as originating sites for telehealth services under the Medicare program H.R. 8295 Fiscal Year 2023 Labor, Health and Human Services, Education, and Related Agencies (LHHS) Appropriations bill, provision relating to KidneyX funding H.R. 6000, CURES 2.0 Act, provisions related to dialysis

Client expense: $850,000 · Firm income: Not reported

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

H.R. 3, Elijah E. Cummings Lower Drug Costs Now Act H.R. 1676, Jack Reynolds Memorial Medigap Extension Act H.R. 1255/S. 377, The Living Donor Protection Act of 2021 H.R. 4065, The Chronic Kidney Disease Improvement in Research and Treatment Act H.R. 5376, Build Back Better Act, provisions relating to health care H.R. 5585, Advanced Research Project Agency Health Act H.R. 6000, Cures 2.0 Act S. 1971, Chronic Kidney Disease Improvement in Research and Treatment Act of 2021 Implementation of Executive Order 13879, Advancing American Kidney Health.

Client expense: $320,000 · Firm income: Not reported

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

H.R. 3, Elijah E. Cummings Lower Drug Costs Now Act H.R. 1676, Jack Reynolds Memorial Medigap Extension Act H.R. 2934, Renal Anemia Innovation Support and Expansion (RAISE) Act S. 4011, Capping Drug Costs for Seniors Act of 2022 H.R. 4065, The Chronic Kidney Disease Improvement in Research and Treatment Act H.R. 4417, Capping Drug Costs for Seniors Act of 2021 H.R. 5260, Reduced Costs and Continued Cures Act H.R. 6973, Enhanced Access to Affordable Medicines Act of 2022 H.R. 7634, Protecting Health Care for All Patients Act of 2022 S. 1971, Chronic Kidney Disease Improvement in Research and Treatment Act of 2021 S. 2317, Seniors Prescription Drug Relief Act Issues related to Medicare Part D coverage for drugs indicated to treat patients with chronic kidney disease; Quality Improvement Program (QIP) in the End Stage Renal Disease (ESRD) prospective payment system; CY 2022 Medicare End Stage Renal Disease (ESRD) Prospective Payment System (PPS) and Quality Improvement Program (QIP) rule making; CY 2022 policy and technical issues changes to the Medicare Advantage Program and Medicare Prescription Drug Benefit Program; Centers for Medicare and Medicaid Innovation (CMMI) ESRD Treatment Choices (ETC) model; Implementation of expanded Medicare immunosuppressive drug coverage for kidney transplant patients; Implementation of Executive Order 13879, Advancing American Kidney Health; Telehealth flexibilities for nephrologists and kidney patients on dialysis.

Client expense: $320,000 · Firm income: Not reported

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

H.R. 66 - CARING for Kids Act - Rep. Buchanan, Vern - CHIP H.R. 265 - Insular Area Medicaid Parity Act - Rep. Sablan, Gregorio Kilili Camacho - Medicaid funding H.R. 315 - Medicare Sequester COVID Moratorium Act - Rep. Schneider, Bradley Scott - Medicare sequestration H.R. 340 - Incentivizing Medicaid Expansion Act of 2021 - Rep. Veasey, Marc - Medicaid expansion H.R. 432 - Mental Health Access Improvement Act of 2021 - Rep. Thompson, Mike -Medicare coverage of marriage and family therapist services and mental health counselor H.R. 502 - Medicare Dental Benefit Act of 2021 - Rep. Barragan, Nanette Diaz - Medicare coverage of dental and oral health services H.R. 525 - COVID HCBS Relief Act of 2021 - Rep. Dingell, Debbie - increased FMAP for HCBS H.R. 871 - Expand Medicaid Now Act - Rep. Fletcher, Lizzie - FMAP H.R. 918 - Stronger Medicaid Response to the COVID-19 Pandemic Act - Rep. Cardenas, Tony - COVID-19 coverage for the uninsured via Medicaid H.R. 955 - Medicaid Reentry Act of 2021 - Rep. Tonko, Paul -Medicaid coverage for incarcerated individuals H.R. 1167 - Advancing Enrollment and Reducing Drug Costs Act of 2021 - Rep. Pappas, Chris - Medicaid eligibility for low-income subsidies H.R. 1227 - Medicare-X Choice Act of 2021 - Rep. Delgado, Antonio - Medicare public option H.R. 1332 - Telehealth Modernization Act - Rep. Carter, Earl - telehealth services under Medicare H.R. 1349 - The COVID-19 Hospital and Health Provider Loan Conversion Act of 2021- Rep. Kaptur, Marcy - advance payments under parts A and B of Medicare H.R. 1353 - Coronavirus Medicaid Response Act - Rep. Lee, Susie - FMAP H.R. 1390 - CHIPPER Act - Rep. Wild, Susan - CHIP funding H.R. 1397 - TIKES Act - Rep. Blunt Rochester, Lisa - telehealth under Medicaid and CHIP H.R. 1609 - Treatment in Place Act - Rep. Axne, Cynthia - Medicare coverage of ambulance services H.R. 1676 - Jack Reynolds Memory Medigap Expansion Act - Rep. Axne, Cynthia - Medigap coverage for ESRD H.R. 1677 - KEEP Telehealth Options Act of 2021 - Rep. Balderson, Troy - telehealth expansion H.R. 1717 - Protecting Married Seniors from Impoverishment Act of 2021 - Rep. Upton, Fred - permanent protections against spousal impoverishment H.R. 1722 - Puerto Rico Health Care Fairness, Accountability, and Beneficiary Access Act of 2021 - Rep. Velazquez, Nydia - Medicaid in Puerto Rico H.R. 1738 - Stabilize Medicaid and CHIP Coverage Act - Rep. Dingell, Debbie - Medicaid and CHIP continuous enrollment H.R. 1784 - Medicaid REACH Act - Rep. Doggett, Lloyd - requirements for non-expansion H.R. 1791 - CHIPP Act - Rep. Barragan, Nanette Diaz - extending CHIP H.R. 1792 - Ensuring Kids Have Access to Medically Necessary Dental Care Act - Rep. Barragan, Nanette Diaz - dental coverage under CHIP H.R. 1793 - Immediate Coverage for Former Foster Youth Act - Rep. Bass, Karen - Medicaid coverage for foster youth H.R. 1794 - Foster Youth Dental Act of 2021 - Rep. Bass, Karen - Medicaid dental coverage for foster youth H.R. 1823 - To amend title XIX of the Social Security Act to remove the matching requirement for a territory to use specially allocated Federal funds for Medicare covered part D drugs for low-income individuals - Resident Commissioner Gonzalez-Colon, Jenniffer - Medicare covered part D H.R. 1825 - Territories Medicare Prescription Drug Assistance Equality Act of 2021 - Resident Commissioner Gonzalez-Colon, Jenniffer - Medicare Part D premium and cost-sharing subsidies H.R. 1826 - Fairness in Medicare Part B Enrollment Act of 2021 - Resident Commissioner Gonzalez-Colon, Jenniffer - late enrollment penalties under part B of the Medicare program H.R. 1880 - To amend the Deficit Reduction Act of 2005 to make permanent the Money Follows the Person Rebalancing Demonstration - Rep. Dingell, Debbie - Money Follows the Person Rebalancing Demonstration H.R. 1885 - RUSH Protection Act of 2021 - Rep. Kind, Ron - Medicare rural health clinic payments H.R. 1887 - Rural Hospital Support Act - Rep. Reed, Tom - Medicare payments for hospitals H.R. 1890 - Health Insurance Consumer Protection Act - Rep. Schakowsky, Janice D. - network adequacy standards and premium rates H.R. 1914 - CAHOOTS Act - Rep. DeFazio, Peter A. - Medicaid mobile crisis intervention services H.R. 1969 - Medicare Advantage Integrity Act - Resident Commissioner Gonzalez-Colon, Jenniffer - disparity in MA benchmark rates H.R. 2035 - Improving Access to Mental Health Act of 2021 - Rep. Lee, Barbara - mental health services under Medicare H.R. 2080 - SAVE Act - Rep. Bishop, Sanford D., Jr. - Medicare coverage of transportation services H.R. 2166 - Ensuring Parity in MA and PACE for Audio-Only Telehealth Act of 2021 - Rep. Sewell, Terri - Medicare Advantage payments for audio-only diagnoses H.R. 2168 - Expanded Telehealth Access Act - Rep. Sherrill, Mikie - Medicare payment for telehealth services H.R. 2170 - HAPI Act - Rep. Soto, Darren - access to vaccines and Medicaid H.R. 2179 - Affordable Insulin for the COVID-19 Emergency Act - Rep. Waters, Maxine - cost-sharing regarding insulin coverage H.R. 2217 - Territory Federal Matching Requirement Equity Act of 2021 - Resident Commissioner Gonzalez-Colon, Jenniffer - Medicaid FMAP for Territories H.R. 2228 - Rural Behavioral Health Access Act of 2021 - Rep. Kildee, Daniel - Medicare coverage of outpatient telehealth services H.R. 4074 - Addressing Social Determinants in Medicare Advantage Act of 2021 - Rep. Bilirakis, Gus M. - Medicare Advantage supplemental benefits H.R. 4640 - Close the Medigap Act of 2021 - Rep. Doggett, Lloyd - Medigap policies H.R. 6833 - Affordable Insulin Now Act - Rep. Craig, Angie - Insulin prices and cost sharing S. 150 - Ensuring Parity in MA for Audio-Only Telehealth Act of 2021 - Sen. Cortez-Masto, Catherine - coverage of audio-only telehealth services in MA S. 151 - COVID HCBS Relief Act of 2021 - Sen. Casey, Robert - FMAP and HCBS S. 245 - SAME Act of 2021 - Sen. Warner, Mark - Medicaid expansion S. 274 - Stronger Medicaid Response to the COVID-19 Pandemic Act - Sen. Bennet, Michael - COVID-19 coverage for the uninsured via Medicaid S. 285 - Medicaid Reentry Act of 2021 - Sen. Baldwin, Tammy - Medicaid coverage for incarcerated individuals S. 368 - Telehealth Modernization Act - Sen. Scott, Tim - coverage of telehealth services under Medicare S. 386 - Medicare-X Choice Act of 2021 - Sen. Bennet, Michael - Medicare public option S. 439 - Coronavirus Medicaid Response Act - Sen. Casey, Robert - increases FMAP S. 440 - Continued Funding for Senior Services During COVID-19 Act - Sen. Casey, Robert - funding for services under the Older Americans Act of 1965 S. 453 - CHIPPER Act - Sen. Casey, Robert - CHIP funding S. 581 - HAPI Act -Sen. Brown, Sherrod - vaccines under Medicaid S. 620 - KEEP Telehealth Options Act of 2021 - Sen. Fischer, Deb - telehealth expansion S. 644 - Rural Hospital Closure Relief Act of 2021 - Sen. Durbin, Richard - Medicare coverage for critical access hospitals S. 646 - Stabilize Medicaid and CHIP Coverage Act of 2021 - Sen. Brown, Sherrod - Medicaid and CHIP enrollment S. 653 - COMP Act - Sen. Portman, Rob - Medicare secondary payer rules S. 712 - Dosha Joi Immediate Coverage for Former Foster Youth Act - Sen. Casey, Robert P., Jr. - Medicaid coverage for foster youth S. 748 - Medicare Sequester Relief Act - Sen. Shaheen, Jeanne - Medicare payment sequestration S. 764 - CAHOOTS Act - Sen. Wyden, Ron - Medicaid mobile crisis intervention services S. 826 - Medicare Patient Empowerment Act of 2021 - Sen. Paul, Rand - Medicaid payment options S. 870 - Improving Access to Mental Health Act of 2021 - Sen. Stabenow, Debbie - mental health services in Medicare S. 999 - Save Rural Hospitals Act of 2021 - Sen. Warner, Mark - Medicare hospital 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 2023 policy and technical regulation for MA and Part D; Part D reform, out of pocket limits; issues related to Medicare for All, Medicare buy-in, reduced Medicare eligibility age, and public option; issues relating to 2023 Rate Notice; issues related to coverage in non-Medicaid Expansion States (e.g., Gap Population); issues related to expanded Medicare fee for service benefits (dental, hearing and vision); issues related to Medicaid coverage gap; contraceptive coverage and reproductive health; Medicare NCD relating to monoclonal antibodies for treatment of Alzheimers disease; 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, vaccines and therapeutics; issues related to the end of the public health emergency; telehealth; issues related to the cost of insulin, including price, copays, rebates, and medical management tools; issues related to health equity; issues related to vaccination; issues related to audio-only telehealth; issues related to addressing the social determinants of health, including housing, transportation, nutrition, educational opportunities, and MA supplemental benefits; 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 or legislation, electronic documentation, and related issues; issues relating to sequestration under the Medicare Advantage and Part D programs; 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 value based payment 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; 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; issues relating to MACRA, including implications for MA and Part D plans; Medicare/Medicaid integration for dual eligibles, including implementation of the Capitated Financial Alignment Demonstration and related issues (e.g., quality ratings); issues relating to potential Medicare mental health parity requirements; 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 Affordable Care Act (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; 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: $2,890,000 · 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), SENATE, White House Office

1. Patient Protection and Affordable Health Care Act, implementation of provisions regarding Medicare Part D coverage gap assistance, preventive care services, and dual eligible Medicare and Medicare beneficiaries 2. Proposals to create a premium support or voucher program under Medicare 3. Proposals to "means test" Medicare premiums and benefits 4. Proposals to change federal and state Medicaid cost sharing 5. Proposals to raise the Medicare eligibility age 6. Proposals regarding prescription drug costs for low income Medicare beneficiaries 7. Expansion of Medicare benefits to include hearing, vision, and dental benefits 8. Medicare Observation Status Regulations 9. Proposals to streamline Medicare enrollment during the COVID-19 pandemic 10. Proposals to permit Medicare prescription drug pricing negotiations 10. S. 245, States Achieve Medicaid Expansion Act of 2021 or the SAME Act of 2021, entire bill 11. H.R. 1868, To prevent across-the-board direct spending cuts, and for other purposes, entire bill 12. S. 782, Nursing Home Reform Modernization Act of 2021, entire bill 13. H.R. 4131, To amend title XIX of the Social Security Act to expand access to home and community-based services (HCBS) under Medicaid, entire bill 14. Demonstration projects for expanding home and community based services under Medicare and Medicaid 15. H.R. 4311, Medicare Dental, Vision, and Hearing Act of 2021, entire bill 16. H.R. 4811, Medicare Negotiation and Competitive Licensing Act of 2021, entire bill 17. H.R. 5260, Reduced Costs and Continued Cures Act, entire bill 18. H.R. 1676, Jack Reynolds Memory Medigap Expansion Act, entire bill 19. Proposals to adjust 2022 Medicare Part B premiums 20. H.R. 3650, Improving Access to Medicare Coverage Act of 2021, entire bill 21. Medicare Direct Contracting Entity (DCE)program 22. Medicare ACO Realizing Equity, Access, and Community Health (REACH) program 23. H.R. 6698, Stop Unfair Medicaid Recoveries Act of 2022, entire bill 24. Medicare regulations under the No Surprises Act 25. Proposals to cap insulin costs under Medicare

Client expense: $80,000 · 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 End-Stage Renal Disease, dialysis treatment and coordinated care. Issues related to H.R. 1676, Jack Reynold's Memorial MediGap Expansion Act. Issues related to H.R. 4942/S.2649, BETTER Kidney Care Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1255/S. 377, the Living Donor Protection Act H.R. 1676, the Jack Reynold Medigap Expansion Act H.R. 526, Ensuring Coverage in Public Health Emergencies Act of 2021 Increasing FMAP (Federal Medicare Assistance Percentage) Health disparities S. 1002, the Junk Plan Accountability and Disclosure Act of 2021 Organ Procurement Organizations Conditions for Coverage: Revisions to the Outcome Measure Requirements for Organ Procurement Organizations Part D Payment Modernization (PDM) Model for plan year 2022 Charitable Premium Assistance H.R. 3912/S. 1971, the Chronic Kidney Disease Improvement in Research and Treatment Act of 2021. H.R. 3893, the CARE for All Kidneys Act FY 2022, Labor-HHS-Education Appropriations 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, White House Office