KEEP Telehealth Options Act of 2021

Lobby members of Congress regarding issues related to telemedicine. Advocate for increased transparency regarding drug pricing. Advocate for reducing barriers to entry of generic drugs into the marketplace. Advocate for transparency on the part of pharmaceutical benefit managers. Advocate for patient access to compounded medications. Advocate for reducing the burdens of utilization management tools, including step therapy and prior authorization for pharmaceuticals and services. Advocate for a stable supply of medications and mitigate drug shortages. Lobby members of the House to join the Congressional Skin Cancer Caucus. Advocate for adequate and accurate network coverage for dermatologic care within health insurance exchange networks. Support H. Res 436, sense of the House supporting state, local and community initiatives to curb incidences of skin cancer beginning with childhood skin cancer. Support H. Res 718, designating October 17, 2021 as National Vitiligo Awareness Day Support H.R. 2163/S. 464, Safe Step Act. Support S. 989, Ensuring Childrens Access to Specialty Care Act Support H.R. 153, Protecting Consumer Access to Generic Drugs Act Support S. 898, Fair Accountability & Innovative Research (FAIR) Drug Pricing Act Support H.R. 3662, Patient Access to Urgent-Use Pharmacy Compounding Act Support H.R. 1916/S. 754, Ensuring Lasting Smiles Act Advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans. Advocate for the continued and increased funding of Community Health Centers. Advocate for implementation of surprise medical billing legislation (enacted as part of P.L. 116-260, Consolidated Appropriations Act, 2021, H.R. 133) as intended by Congress. Support H.R. 1677/S. 620, the KEEP Telehealth Options Act. Support H.R. 2903/S. 1512 the CONNECT for Health Act of 2021 Support the Dr. Lorna Breen Health Care Provider Protection Act (S. 610/H.R. 1667). Support H.R. 3173/S. 3018, Improving Seniors Timely Access to Care Act of 2021 Support H.R. 8437, the Improving Seniors Timely Access to Care Act of 2022 Support H.R. 4122/S. 3645, Resident Education Deferred Interest Act or the REDI Act Support the Resident Physician Shortage Reduction Act (S. 834/H.R. 2256) Advocate for the FDA to implement the 2015 rule, General and Plastic Surgery Devices: Restricted Sale, Distribution, and Use of Sunlamp Products; and the Sunlamp Products Proposed; Amendment to Performance Standard, which would ban minors under the age of 18 from using tanning beds. Support H.R. 5054, Keep Physicians Serving Patients Act Support H.R. 5394, the Meaningful Access to Federal Health Plan Claims Data Act Advocate for legislative solution to access problems to iPLEDGE/REMS program for isotretinoin (H.R. 7667, Food and Drug Amendments of 2022/S. 4348 FDASLA Act of 2022, H.R. 2617, Consolidated Appropriations Act). Support H.R. 7649, a bill to direct the Secretary of Health and Human Services to open a public docket for the submission of public comments regarding factors that should be taken into consideration when reviewing a proposed modification to an approved risk evaluation and mitigation strategy, and for other purposes. Support H.R. 5030/S. 2706, the Diversifying Investigations and Equitable Research Studies for Everyone (DIVERSE) Trials Act Support H.R. 7995, GOLD CARD Act of 2022 Advocate to provide relief from the 2% Medicare sequester, replace scheduled and anticipated cuts in payments with positive, inflationary-based updates, eliminate the nearly 4.5% conversion factor cut in the CMS proposed rule for the 2023 Medicare Physician Fee Schedule (MPFS) associated with budget neutrality adjustments tied to Evaluation & Management (E/M) Code MPFS policy changes, and waive the 4% PAYGO sequester to Medicare physician payment reimbursement due to enactment of H.R. 1319, American Recovery Act, P.L. 117-2 (H.R. 2617, Consolidated Appropriations Act). Support H.R. 8800, Supporting Medicare Providers Act of 2022 Advocate against H.R 6708, Improving Access to Workers Compensation for Injured Federal Workers Act, which expands the role of nurse practitioners and physician assistants in providing services to injured federal workers under the federal workers' compensation program. Oppose H.R. 8812, the Improving Care & Access to Nurses Act (I CAN Act)

Client expense: $410,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.2999 A bill to prohibit the Secretary of Health and Human Services, any officer or employee of the Department of Health and Human Services, and States from requiring COVID-19 vaccination as a condition of eligibility for benefits or assistance under the Medicare, Medicaid, or CHIP program; S.J.Res.32 A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Centers for Medicare & Medicaid Services relating to Medicare and Medicaid Programs; Omnibus COVID-19 Health Care Staff Vaccination; H.R.1677 - KEEP Telehealth Options Act of 2021 To direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission, and the Medicaid and CHIP Payment and Access Commission to conduct studies and report to Congress on actions taken to expand access to telehealth services under the Medicare, Medicaid, and Children's Health Insurance programs during the COVID-19 emergency; S.620 KEEP Telehealth Options Act of 2021; S104 HR379 Improving Social Determinants of Health Act of 2021; H.R.1227, S386 Medicare-X Choice Act of 2021; HR 3322-S826 Medicare Patient Empowerment Act of 2021; HR2410 Medicare & You Handbook Improvement Act of 2021; S1180 Choose Medicare Act' S748 Medicare Sequester Relief Act; HR 315 Medicare Sequester COVID Moratorium Act; HR599 Protecting Medicare Beneficiaries with Pre-Existing Conditions Act; S.2146 Improving Medicare Beneficiary Access to Innovative Diabetes Technologies Act of 2021; S.4067 A bill to amend title XI of the Social Security Act to improve access to care for all Medicare and Medicaid beneficiaries through models tested under the Center for Medicare and Medicaid Innovation, and for other purposes; H.R.3755 Women's Health Protection Act of 2022; . S.J.Res.32 - A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Centers for Medicare & Medicaid Services relating to "Medicare and Medicaid Programs; Omnibus COVID-19 Health Care Staff Vaccination"; H.J.Res.79 - Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Department of the Treasury and the Centers for Medicare & Medicaid Services relating to "Patient Protection and Affordable Care Act; Updating Payment Parameters, Section 1332 Waiver Implementing Regulations, and Improving Health Insurance Markets for 2022 and Beyond".

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.

HR 5- Equality Act HR 366- Protecting Access to Post-COVID-19 Telehealth Act of 2021 HR 1319- American Rescue Act of 2021 HR 1677- To Direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission... S 620 Keep Telehealth Options Act of 2021 HR 4502- Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act... S. 1544- Accelerating Kids' Access to Care Act HR 3089- Accelerating Kids' Access to Care Act HR 4943- The Children's Mental Health Infrastructure Act of 2021 HR 4944- The Helping Kids Cope Act of 2021 HR 4390- The PROTECT 340B Act HR 1916- Lasting Smiles Act HR 1397- The Telehealth Improvement for Kids' Essential Services HR 3783- Medical Nutrition Equity Act S 2013- Medical Nutrition Equity Act S 2691- Strengthening the Vaccines for Children Program Act of 2021 HR 2347- Strengthening the Vaccines for Children Program Act of 2021 HR 7236 Strengthen Kids' Mental Health Now Act HR 8295 Labor HHS FY23 Appropriations HR 6833 Continuing Appropriations Act of 2023 S 4747 Investing in Kids Mental Health Now Act S 4472 Health Care Capacity for Pediatric Mental Health General issues regarding mental health, physical health, Medicaid, CHIP, and DSH.

Client expense: $37,000 · Firm income: Not reported

HR 5- Equality Act HR 366- Protecting Access to Post-COVID-19 Telehealth Act of 2021 HR 1319- American Rescue Act of 2021 HR 1677- To Direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission... S 620 Keep Telehealth Options Act of 2021 HR 4502- Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act... S. 1544- Accelerating Kids' Access to Care Act HR 3089- Accelerating Kids' Access to Care Act HR 4943- The Children's Mental Health Infrastructure Act of 2021 HR 4944- The Helping Kids Cope Act of 2021 HR 4390- The PROTECT 340B Act HR 1916- Lasting Smiles Act HR 1397- The Telehealth Improvement for Kids' Essential Services HR 3783- Medical Nutrition Equity Act S 2013- Medical Nutrition Equity Act S 2691- Strengthening the Vaccines for Children Program Act of 2021 HR 2347- Strengthening the Vaccines for Children Program Act of 2021 HR 7236 Strengthen Kids' Mental Health Now Act HR 8295 Labor HHS FY23 Appropriations HR 6833 Continuing Appropriations Act of 2023 S 4747 Investing in Kids Mental Health Now Act S 4472 Health Care Capacity for Pediatric Mental Health General issues regarding mental health, physical health, Medicaid, CHIP, and DSH.

Client expense: $37,000 · Firm income: Not reported

Advocate for adequate and accurate network coverage for dermatologic care within Medicare Advantage. Advocate for increased funding and reforms to Graduate Medical Education. Lobby members of Congress regarding improvements to Health Information Technology implementation. Advocate for expansion of telemedicine services under Medicare and increased reimbursement for such services. Advocate for improving disease management and care coordination for patients with chronic diseases. Support preservation of the In-Offices Ancillary Services Exemption (IOASE) under Stark Law regarding physician self-referral and oppose repeal of the in-office ancillary and physician services exception. Advocate for relief from Medicare regulations under Medicare Access and CHIP Reauthorization Act (MACRA P.L. 114-110), including the Quality Payment Program (QPP) and specifically the development of advanced alternative payment models (APMs) and implementation of the Merit-Based Incentive Payment System (MIPS). Advocate for relief for from prior authorization requirements under Medicare Advantage and Medicare Part D plans. Lobby Congress to urge CMS to strengthen Qualified Clinical Data Registries (QCDRs) by removing barriers that restrict access to data from EHRs. (H.R. 6000) Advocate for congressional action to hold health care professionals harmless from any cuts related to CMS Evaluation and Management Code proposals in any forthcoming legislative package. Support the Knowing the Efficiency and Efficacy of Permanent (KEEP) Telehealth Options Act (H.R. 1677/S. 620). Support H.R.8437, the Improving Seniors Timely Access to Care Act of 2022 Support H.R. 3173/S. 3018, Improving Seniors Timely Access to Care Act of 2021 Support H.R. 2903/S. 1512 the CONNECT for Health Act of 2021 Support H.R. 5054, Keep Physicians Serving Patients Act Advocate to support extension of moratorium on 2% Medicare sequester, replace scheduled and anticipated cuts in payments with positive, inflationary-based updates, eliminate the nearly 4.5% conversion factor cut in the CMS proposed rule for the 2023 Medicare Physician Fee Schedule (MPFS) associated with budget neutrality adjustments tied to Evaluation & Management (E/M) Code MPFS policy changes, and waive the 4% PAYGO sequester to Medicare physician payment reimbursement due to enactment of H.R. 1319, American Recovery Act, P.L. 117-2. Support H.R. 8800, the Supporting Medicare Providers Act of 2022 Support H.R. 5394, the Meaningful Access to Federal Health Plan Claims Data Act Support H.R. 7995, GOLD CARD Act of 2022

Lobby members of Congress regarding issues related to telemedicine. Advocate for increased transparency regarding drug pricing. Advocate for reducing barriers to entry of generic drugs into the marketplace. Advocate for transparency on the part of pharmaceutical benefit managers. Advocate for patient access to compounded medications. Advocate for reducing the burdens of utilization management tools, including step therapy and prior authorization for pharmaceuticals and services. Advocate for a stable supply of medications and mitigate drug shortages. Lobby members of the House to join the Congressional Skin Cancer Caucus. Advocate for adequate and accurate network coverage for dermatologic care within health insurance exchange networks. Support H. Res 436, sense of the House supporting state, local and community initiatives to curb incidences of skin cancer beginning with childhood skin cancer. Support H. Res 718, designating October 17, 2021 as National Vitiligo Awareness Day Support H.R. 2163/S. 464, Safe Step Act. Support S. 989, Ensuring Childrens Access to Specialty Care Act Support H.R. 153, Protecting Consumer Access to Generic Drugs Act Support S. 898, Fair Accountability & Innovative Research (FAIR) Drug Pricing Act Support H.R. 3662, Patient Access to Urgent-Use Pharmacy Compounding Act Support H.R. 1916/S. 754, Ensuring Lasting Smiles Act Advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans. Advocate for the continued and increased funding of Community Health Centers. Advocate for implementation of surprise medical billing legislation (enacted as part of P.L. 116-260, Consolidated Appropriations Act, 2021, H.R. 133) as intended by Congress. Advocate for congressional action to hold health care professionals harmless from any cuts related to CMS Evaluation and Management Code proposals in any forthcoming legislation. (S. 610) Support H.R. 1677/S. 620, the KEEP Telehealth Options Act. Support H.R. 2903/S. 1512 the CONNECT for Health Act of 2021 Support the Dr. Lorna Breen Health Care Provider Protection Act (S. 610/H.R. 1667). Support H.R. 3173/S. 3018, Improving Seniors Timely Access to Care Act of 2021 Support H.R. 8437, the Improving Seniors Timely Access to Care Act of 2022 Support H.R. 4122/S. 3645, Resident Education Deferred Interest Act or the REDI Act Support the Resident Physician Shortage Reduction Act (S. 834/H.R. 2256) Advocate for the FDA to implement the 2015 rule, General and Plastic Surgery Devices: Restricted Sale, Distribution, and Use of Sunlamp Products; and the Sunlamp Products Proposed; Amendment to Performance Standard, which would ban minors under the age of 18 from using tanning beds. Support H.R. 5054, Keep Physicians Serving Patients Act Advocate to support extension of moratorium on 2% Medicare sequester as well as waiving PAYGO and mitigating anticipated additional 4% cuts to Medicare physician payment reimbursement due to enactment of H.R. 1319, American Recovery Act, P.L. 117-2. Support H.R. 5394, the Meaningful Access to Federal Health Plan Claims Data Act Advocate for legislative solution to access problems to iPLEDGE/REMS program for isotretinoin (H.R. 7667, Food and Drug Amendments of 2022/S. 4348 FDASLA Act of 2022). Support H.R. 7649, a bill to direct the Secretary of Health and Human Services to open a public docket for the submission of public comments regarding factors that should be taken into consideration when reviewing a proposed modification to an approved risk evaluation and mitigation strategy, and for other purposes. Support H.R. 5030/S. 2706, the Diversifying Investigations and Equitable Research Studies for Everyone (DIVERSE) Trials Act Support H.R. 7995, GOLD CARD Act of 2022 Advocate to support extension of moratorium on 2% Medicare sequester, replace scheduled and anticipated cuts in payments with positive, inflationary-based updates, eliminate the nearly 4.5% conversion factor cut in the CMS proposed rule for the 2023 Medicare Physician Fee Schedule (MPFS) associated with budget neutrality adjustments tied to Evaluation & Management (E/M) Code MPFS policy changes, and waive the 4% PAYGO sequester to Medicare physician payment reimbursement due to enactment of H.R. 1319, American Recovery Act, P.L. 117-2. Support H.R. 8800, Supporting Medicare Providers Act of 2022 Advocate against H.R 6708, Improving Access to Workers Compensation for Injured Federal Workers Act, which expands the role of nurse practitioners and physician assistants in providing services to injured federal workers under the federal workers' compensation program.

Update and reforms to Medicare payments for physicians and implementation of related provisions of the Medicare Access and CHIP Reauthorization Act, including: maintain patient access to In-Office Ancillary Services; implementation of Electronic Health Records meaningful use requirements; CMS implementation of misvalued codes; and Medicare sequestration. Medicare beneficiary access to telehealth, including related provisions in H.R. 4040, the Advancing Telehealth Beyond COVID-19 Act of 2022, H.R. 1677/S. 620, the KEEP Telehealth Options Act and Discussion Draft of bipartisan Senate Finance Committee legislation, the Telemental Health Access to Care Act. Medicare Part B reimbursement for prescription drugs and related issues to enhance patient access to covered drugs and CMMI quality initiatives, including: use of step therapy in Medicare and health insurance coverage, including related provisions in S. 464/H.R. 2163, the Safe Step Act; and H.R. 5376, Inflation Reduction Act of 2022 (Public Law No: 117-169), including provisions regarding application of Maximum Fair Prices and conforming amendments to modify Medicare Part B reimbursement for selected drugs; and physician reimbursement issues related to CMMI Most Favored Nation demonstration. Medicare beneficiary access to drugs/advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans, including related provisions in S. 3018/ H.R. 3173, and H.R. 8487, the Improving Seniors Timely Access to Care Act, and H.R. 7995, the GOLD CARD Act, to exempt qualifying physicians from prior authorization requirements under Medicare Advantage plans. Coronavirus response and support for health care providers and patients, including related provisions in S. 3799, the PREVENT Pandemics Act, and implementation of related provisions in H.R. 1319, the American Rescue Plan Act (P.L. 117-2).

S.2999 A bill to prohibit the Secretary of Health and Human Services, any officer or employee of the Department of Health and Human Services, and States from requiring COVID-19 vaccination as a condition of eligibility for benefits or assistance under the Medicare, Medicaid, or CHIP program; S.J.Res.32 A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Centers for Medicare & Medicaid Services relating to Medicare and Medicaid Programs; Omnibus COVID-19 Health Care Staff Vaccination; H.R.1677 - KEEP Telehealth Options Act of 2021 To direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission, and the Medicaid and CHIP Payment and Access Commission to conduct studies and report to Congress on actions taken to expand access to telehealth services under the Medicare, Medicaid, and Children's Health Insurance programs during the COVID-19 emergency; S.620 KEEP Telehealth Options Act of 2021; S104 HR379 Improving Social Determinants of Health Act of 2021; H.R.1227, S386 Medicare-X Choice Act of 2021; HR 3322-S826 Medicare Patient Empowerment Act of 2021; HR2410 Medicare & You Handbook Improvement Act of 2021; S1180 Choose Medicare Act' S748 Medicare Sequester Relief Act; HR 315 Medicare Sequester COVID Moratorium Act; HR599 Protecting Medicare Beneficiaries with Pre-Existing Conditions Act; S.2146 Improving Medicare Beneficiary Access to Innovative Diabetes Technologies Act of 2021; S.4067 A bill to amend title XI of the Social Security Act to improve access to care for all Medicare and Medicaid beneficiaries through models tested under the Center for Medicare and Medicaid Innovation, and for other purposes; H.R.3755 Women's Health Protection Act of 2022; . S.J.Res.32 - A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Centers for Medicare & Medicaid Services relating to "Medicare and Medicaid Programs; Omnibus COVID-19 Health Care Staff Vaccination"; H.J.Res.79 - Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Department of the Treasury and the Centers for Medicare & Medicaid Services relating to "Patient Protection and Affordable Care Act; Updating Payment Parameters, Section 1332 Waiver Implementing Regulations, and Improving Health Insurance Markets for 2022 and Beyond".

Advocate for adequate and accurate network coverage for dermatologic care within Medicare Advantage. Advocate for increased funding and reforms to Graduate Medical Education. Lobby members of Congress regarding improvements to Health Information Technology implementation. Advocate for expansion of telemedicine services under Medicare and increased reimbursement for such services. Advocate for improving disease management and care coordination for patients with chronic diseases. Support preservation of the In-Offices Ancillary Services Exemption (IOASE) under Stark Law regarding physician self-referral and oppose repeal of the in-office ancillary and physician services exception. Advocate for relief from Medicare regulations under Medicare Access and CHIP Reauthorization Act (MACRA P.L. 114-110), including the Quality Payment Program (QPP) and specifically the development of advanced alternative payment models (APMs) and implementation of the Merit-Based Incentive Payment System (MIPS). Advocate for relief for from prior authorization requirements under Medicare Advantage and Medicare Part D plans. Lobby Congress to urge CMS to strengthen Qualified Clinical Data Registries (QCDRs) by removing barriers that restrict access to data from EHRs. (H.R. 6000) Advocate for congressional action to hold health care professionals harmless from any cuts related to CMS Evaluation and Management Code proposals in any forthcoming legislative package. Support the Knowing the Efficiency and Efficacy of Permanent (KEEP) Telehealth Options Act (H.R. 1677/S. 620). Support H.R. 3173/S. 3018, Improving Seniors Timely Access to Care Act Support H.R. 2903/S. 1512 the CONNECT for Health Act of 2021 Support H.R. 5054, Keep Physicians Serving Patients Act Advocate to support extension of moratorium on 2% Medicare sequester, replace scheduled and anticipated cuts in payments with positive, inflationary-based updates, extend the congressionally-enacted 3% temporary increase in the Medicare Physician Fee Schedule (MPFS) conversion factor to avoid cuts associated with budget neutrality adjustments tied to Evalution & Management (E/M) Code MPFS policy changes, and waive the 4% PAYGO sequester to Medicare physician payment reimbursement due to enactment of H.R. 1319, American Recovery Act, P.L. 117-2. Support H.R. 6020, the Supporting Medicare Providers Act Support H.R. 5394, the Meaningful Access to Federal Health Plan Claims Data Act Support H.R. 7995, GOLD CARD Act of 2022

Lobby members of Congress regarding issues related to telemedicine. Advocate for increased transparency regarding drug pricing. Advocate for reducing barriers to entry of generic drugs into the marketplace. Advocate for transparency on the part of pharmaceutical benefit managers. Advocate for patient access to compounded medications. Advocate for reducing the burdens of utilization management tools, including step therapy and prior authorization for pharmaceuticals and services. Advocate for a stable supply of medications and mitigate drug shortages. Lobby members of the House to join the Congressional Skin Cancer Caucus. Advocate for adequate and accurate network coverage for dermatologic care within health insurance exchange networks. Support H. Res 436, sense of the House supporting state, local and community initiatives to curb incidences of skin cancer beginning with childhood skin cancer. Support H. Res 718, designating October 17, 2021 as National Vitiligo Awareness Day Support H.R. 2163/S. 464, Safe Step Act. Support S. 989, Ensuring Childrens Access to Specialty Care Act Support H.R. 153, Protecting Consumer Access to Generic Drugs Act Support S. 898, Fair Accountability & Innovative Research (FAIR) Drug Pricing Act Support H.R. 3662, Patient Access to Urgent-Use Pharmacy Compounding Act Support H.R. 1916/S. 754, Ensuring Lasting Smiles Act Advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans. Advocate for the continued and increased funding of Community Health Centers. Advocate for implementation of surprise medical billing legislation (enacted as part of P.L. 116-260, Consolidated Appropriations Act, 2021, H.R. 133) as intended by Congress. Advocate for congressional action to hold health care professionals harmless from any cuts related to CMS Evaluation and Management Code proposals in any forthcoming legislation. (S. 610) Support H.R. 1677/S. 620, the KEEP Telehealth Options Act. Support H.R. 2903/S. 1512 the CONNECT for Health Act of 2021 Support the Dr. Lorna Breen Health Care Provider Protection Act (S. 610/H.R. 1667). Support H.R. 3173/S. 3018, Improving Seniors Timely Access to Care Act Support H.R. 4122/S. 3645, Resident Education Deferred Interest Act or the REDI Act Support the Resident Physician Shortage Reduction Act (S. 834/H.R. 2256) Advocate for the FDA to implement the 2015 rule, General and Plastic Surgery Devices: Restricted Sale, Distribution, and Use of Sunlamp Products; and the Sunlamp Products Proposed; Amendment to Performance Standard, which would ban minors under the age of 18 from using tanning beds. Support H.R. 5054, Keep Physicians Serving Patients Act Advocate to support extension of moratorium on 2% Medicare sequester as well as waiving PAYGO and mitigating anticipated additional 4% cuts to Medicare physician payment reimbursement due to enactment of H.R. 1319, American Recovery Act, P.L. 117-2. Support H.R. 6020, the Supporting Medicare Providers Act Support H.R. 5394, the Meaningful Access to Federal Health Plan Claims Data Act Advocate for legislative solution to access problems to iPLEDGE/REMS program for isotretinoin (H.R. 7667, Food and Drug Amendments of 2022/S. 4348 FDASLA Act of 2022). Support H.R. 7649, a bill to direct the Secretary of Health and Human Services to open a public docket for the submission of public comments regarding factors that should be taken into consideration when reviewing a proposed modification to an approved risk evaluation and mitigation strategy, and for other purposes. Support H.R. 5030/S. 2706, the Diversifying Investigations and Equitable Research Studies for Everyone (DIVERSE) Trials Act Support H.R. 7995, GOLD CARD Act of 2022 Advocate to support extension of moratorium on 2% Medicare sequester, replace scheduled and anticipated cuts in payments with positive, inflationary-based updates, extend the congressionally-enacted 3% temporary increase in the Medicare Physician Fee Schedule (MPFS) conversion factor to avoid cuts associated with budget neutrality adjustments tied to Evaluation & Management (E/M) Code MPFS policy changes, and waive the 4% PAYGO sequester to Medicare physician payment reimbursement due to enactment of H.R. 1319, American Recovery Act, P.L. 117-2. Advocate against H.R 6708, Improving Access to Workers Compensation for Injured Federal Workers Act, which expands the role of nurse practitioners and physician assistants in providing services to injured federal workers under the federal workers' compensation program.

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.

Update and reforms to Medicare payments for physicians and implementation of related provisions of the Medicare Access and CHIP Reauthorization Act, including: maintain patient access to In-Office Ancillary Services; implementation of Electronic Health Records meaningful use requirements; CMS implementation of misvalued codes; and Medicare sequestration. Medicare beneficiary access to telehealth, including related provisions in H.R. 2471, the Consolidated Appropriations Act, 2022, P.L. 117-103, Division P, Title III, Subtitle A Telehealth Flexibility Extension; H.R. 1677/S. 620, the KEEP Telehealth Options Act, and Discussion Draft of bipartisan Senate Finance Committee legislation, the Telemental Health Access to Care Act. Medicare Part B reimbursement for prescription drugs and related issues to enhance patient access to covered drugs and CMMI quality initiatives, including: use of step therapy in Medicare and health insurance coverage, including related provisions in S. 464/H.R. 2163, the Safe Step Act; and in H.R. 5376, the Build Back Better Act - including Section 139001, Lowering Prices Through Drug Price Negotiation, and provisions regarding application of Maximum Fair Prices and Confirming Amendments to modify Medicare Part B reimbursement for selected drugs; and physician reimbursement issues related to CMMI Most Favored Nation demonstration. Medicare beneficiary access to drugs/advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans, including related provisions in S. 3018/H.R. 3173, the Improving Seniors Timely Access to Care Act, and H.R. 7995, the GOLD CARD Act, to exempt qualifying physicians from prior authorization requirements under Medicare Advantage plans. Coronavirus response and support for health care providers and patients, including related provisions in S. 3799, the PREVENT Pandemics Act, and implementation of related provisions in H.R. 1319, the American Rescue Plan Act (P.L. 117-2). Monitor Medicare vision coverage provisions in H.R. 5376, the Build Back Better Act.

HR 5- Equality Act HR 366- Protecting Access to Post-COVID-19 Telehealth Act of 2021 HR 1319- American Rescue Act of 2021 HR 1677- To Direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission... S 620 Keep Telehealth Options Act of 2021 HR 4502- Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act... S. 1544- Accelerating Kids' Access to Care Act HR 3089- Accelerating Kids' Access to Care Act HR 4943- The Children's Mental Health Infrastructure Act of 2021 HR 4944- The Helping Kids Cope Act of 2021 HR 4390- The PROTECT 340B Act HR 1916- Lasting Smiles Act HR 1397- The Telehealth Improvement for Kids' Essential Services HR 3783- Medical Nutrition Equity Act S 2013- Medical Nutrition Equity Act S 2691- Strengthening the Vaccines for Children Program Act of 2021 HR 2347- Strengthening the Vaccines for Children Program Act of 2021 HR 7236 Strengthen Kids' Mental Health Now Act HR 8295 Labor HHS FY23 Appropriations General issues regarding mental health, physical health, Medicaid, CHIP, and DSH.

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

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

HR 5- Equality Act HR 366- Protecting Access to Post-COVID-19 Telehealth Act of 2021 HR 1319- American Rescue Act of 2021 HR 1677- To Direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission... S 620 Keep Telehealth Options Act of 2021 HR 4502- Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act... S. 1544- Accelerating Kids' Access to Care Act HR 3089- Accelerating Kids' Access to Care Act HR 4943- The Children's Mental Health Infrastructure Act of 2021 HR 4944- The Helping Kids Cope Act of 2021 HR 4390- The PROTECT 340B Act HR 1916- Lasting Smiles Act HR 1397- The Telehealth Improvement for Kids' Essential Services HR 3783- Medical Nutrition Equity Act S 2013- Medical Nutrition Equity Act S 2691- Strengthening the Vaccines for Children Program Act of 2021 HR 2347- Strengthening the Vaccines for Children Program Act of 2021 HR 7236 Strengthen Kids' Mental Health Now Act HR 8295 Labor HHS FY23 Appropriations General issues regarding mental health, physical health, Medicaid, CHIP, and DSH.

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

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

S.2999 A bill to prohibit the Secretary of Health and Human Services, any officer or employee of the Department of Health and Human Services, and States from requiring COVID-19 vaccination as a condition of eligibility for benefits or assistance under the Medicare, Medicaid, or CHIP program; S.J.Res.32 A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Centers for Medicare & Medicaid Services relating to Medicare and Medicaid Programs; Omnibus COVID-19 Health Care Staff Vaccination; H.R.1677 - KEEP Telehealth Options Act of 2021 To direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission, and the Medicaid and CHIP Payment and Access Commission to conduct studies and report to Congress on actions taken to expand access to telehealth services under the Medicare, Medicaid, and Children's Health Insurance programs during the COVID-19 emergency; S.620 KEEP Telehealth Options Act of 2021; S104 HR379 Improving Social Determinants of Health Act of 2021; H.R.1227, S386 Medicare-X Choice Act of 2021; HR 3322-S826 Medicare Patient Empowerment Act of 2021; HR2410 Medicare & You Handbook Improvement Act of 2021; S1180 Choose Medicare Act' S748 Medicare Sequester Relief Act; HR 315 Medicare Sequester COVID Moratorium Act; HR599 Protecting Medicare Beneficiaries with Pre-Existing Conditions Act; S.2146 Improving Medicare Beneficiary Access to Innovative Diabetes Technologies Act of 2021; S.4067 A bill to amend title XI of the Social Security Act to improve access to care for all Medicare and Medicaid beneficiaries through models tested under the Center for Medicare and Medicaid Innovation, and for other purposes; H.R.3755 Women's Health Protection Act of 2022; . S.J.Res.32 - A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Centers for Medicare & Medicaid Services relating to "Medicare and Medicaid Programs; Omnibus COVID-19 Health Care Staff Vaccination"; H.J.Res.79 - Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Department of the Treasury and the Centers for Medicare & Medicaid Services relating to "Patient Protection and Affordable Care Act; Updating Payment Parameters, Section 1332 Waiver Implementing Regulations, and Improving Health Insurance Markets for 2022 and Beyond".

Update and reforms to Medicare payments for physicians and implementation of related provisions of the Medicare Access and CHIP Reauthorization Act, including: maintain patient access to In-Office Ancillary Services; implementation of Electronic Health Records meaningful use requirements; CMS implementation of misvalued codes; and Medicare sequestration. Medicare beneficiary access to telehealth, including related provisions in H.R. 2471, the Consolidated Appropriations Act, 2021, Division P, Title III, Subtitle A Telehealth Flexibility Extension; and H.R. 1677/S. 620, the KEEP Telehealth Options Act. Medicare Part B reimbursement for prescription drugs and related issues to enhance patient access to covered drugs and CMMI quality initiatives, including: use of step therapy in Medicare and health insurance coverage, including related provisions in S. 464/H.R. 2163, the Safe Step Act; and in H.R. 5376, the Build Back Better Act - including Section 139001, Lowering Prices Through Drug Price Negotiation, and provisions regarding application of Maximum Fair Prices and Confirming Amendments to modify Medicare Part B reimbursement for selected drugs; and physician reimbursement issues related to CMMI Most Favored Nation demonstration. Medicare beneficiary access to drugs/advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans, including related provisions in S. 3018/H.R. 3173, the Improving Seniors Timely Access to Care Act. Coronavirus response and support for health care providers and patients, including related provisions in S. 3799, the PREVENT Pandemics Act, and implementation of related provisions in H.R. 1319, the American Rescue Plan Act (P.L. 117-2). Monitor Medicare vision coverage provisions in H.R. 5376, the Build Back Better Act.

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

Outreach and monitoring regarding: -Telemedicine and telehealth flexibility, including interstate licensing. -Surprise billing and Medicare cuts. -H.R. 3684 (P.L. 117-58), Infrastructure Investment and Jobs Act. -H.R. 5376, Build Back Better Act. -H.R.1677, KEEP Telehealth Options Act of 2021. -H.R.1357 / S. 476, Pandemic Heroes Compensation Act of 2021. -H.R.3967, Honoring our PACT Act of 2021. -Draft, Foreign Medical School Accountability Act.

Client expense: $40,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, 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; 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, 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); 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.

HR 5- Equality Act HR 366- Protecting Access to Post-COVID-19 Telehealth Act of 2021 HR 1319- American Rescue Act of 2021 HR 1677- To Direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission... S 620 Keep Telehealth Options Act of 2021 HR 4502- Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act... S. 1544- Accelerating Kids' Access to Care Act HR 3089- Accelerating Kids' Access to Care Act HR 4943- The Children's Mental Health Infrastructure Act of 2021 HR 4944- The Helping Kids Cope Act of 2021 HR 4390- The PROTECT 340B Act HR 1916- Lasting Smiles Act HR 1397- The Telehealth Improvement for Kids' Essential Services HR 3783- Medical Nutrition Equity Act S 2013- Medical Nutrition Equity Act S 2691- Strengthening the Vaccines for Children Program Act of 2021 HR 2347- Strengthening the Vaccines for Children Program Act of 2021 HR 7236 Strengthen Kids' Mental Health Now Act General issues regarding mental health, physical health, Medicaid, CHIP, and DSH.

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

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

HR 5- Equality Act HR 366- Protecting Access to Post-COVID-19 Telehealth Act of 2021 HR 1319- American Rescue Act of 2021 HR 1677- To Direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission... S 620 Keep Telehealth Options Act of 2021 HR 4502- Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act... S. 1544- Accelerating Kids' Access to Care Act HR 3089- Accelerating Kids' Access to Care Act HR 4943- The Children's Mental Health Infrastructure Act of 2021 HR 4944- The Helping Kids Cope Act of 2021 HR 4390- The PROTECT 340B Act HR 1916- Lasting Smiles Act HR 1397- The Telehealth Improvement for Kids' Essential Services HR 3783- Medical Nutrition Equity Act S 2013- Medical Nutrition Equity Act S 2691- Strengthening the Vaccines for Children Program Act of 2021 HR 2347- Strengthening the Vaccines for Children Program Act of 2021 HR 7236 Strengthen Kids' Mental Health Now Act General issues regarding mental health, physical health, Medicaid, CHIP, and DSH.

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

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

Advocate for adequate and accurate network coverage for dermatologic care within Medicare Advantage. Advocate for increased funding and reforms to Graduate Medical Education. Lobby members of Congress regarding improvements to Health Information Technology implementation. Advocate for expansion of telemedicine services under Medicare and increased reimbursement for such services. Advocate for improving disease management and care coordination for patients with chronic diseases. Support preservation of the In-Offices Ancillary Services Exemption (IOASE) under Stark Law regarding physician self-referral and oppose repeal of the in-office ancillary and physician services exception. Advocate for relief from Medicare regulations under Medicare Access and CHIP Reauthorization Act (MACRA P.L. 114-110), including the Quality Payment Program (QPP) and specifically the development of advanced alternative payment models (APMs) and implementation of the Merit-Based Incentive Payment System (MIPS). Advocate for relief for from prior authorization requirements under Medicare Advantage and Medicare Part D plans. Lobby Congress to urge CMS to strengthen Qualified Clinical Data Registries (QCDRs) by removing barriers that restrict access to data from EHRs. (H.R. 6000) Advocate for congressional action to hold health care professionals harmless from any cuts related to CMS Evaluation and Management Code proposals in any forthcoming legislative package. Support the Knowing the Efficiency and Efficacy of Permanent (KEEP) Telehealth Options Act (H.R. 1677/S. 620). Support H.R. 3173, Improving Seniors Timely Access to Care Act Support H.R. 2903/S. 1512 the CONNECT for Health Act of 2021 Support H.R. 5054, Keep Physicians Serving Patients Act Advocate to support extension of moratorium on 2% Medicare sequester as well as waiving PAYGO and mitigating anticipated additional 4% cuts to Medicare physician payment reimbursement due to enactment of H.R. 1319, American Recovery Act, P.L. 117-2. Support H.R. 6020, the Supporting Medicare Providers Act Support H.R. 5394, the Meaningful Access to Federal Health Plan Claims Data Act

Lobby members of Congress regarding issues related to telemedicine. Advocate for increased transparency regarding drug pricing. Advocate for reducing barriers to entry of generic drugs into the marketplace. Advocate for transparency on the part of pharmaceutical benefit managers. Advocate for patient access to compounded medications. Advocate for reducing the burdens of utilization management tools, including step therapy and prior authorization for pharmaceuticals and services. Advocate for a stable supply of medications and mitigate drug shortages. Lobby members of the House to join the Congressional Skin Cancer Caucus. Advocate for adequate and accurate network coverage for dermatologic care within health insurance exchange networks. Support H. Res 436, sense of the House supporting state, local and community initiatives to curb incidences of skin cancer beginning with childhood skin cancer. Support H. Res 718, designating October 17, 2021 as National Vitiligo Awareness Day Support H.R. 2163/S. 464, Safe Step Act. Support S. 989, Ensuring Childrens Access to Specialty Care Act Support H.R. 153, Protecting Consumer Access to Generic Drugs Act Support S. 898, Fair Accountability & Innovative Research (FAIR) Drug Pricing Act Support H.R. 3662, Patient Access to Urgent-Use Pharmacy Compounding Act Support H.R. 1916/S. 754, Ensuring Lasting Smiles Act Advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans. Advocate for the continued and increased funding of Community Health Centers. Advocate for implementation of surprise medical billing legislation (enacted as part of P.L. 116-260, Consolidated Appropriations Act, 2021, H.R. 133) as intended by Congress. Advocate for congressional action to hold health care professionals harmless from any cuts related to CMS Evaluation and Management Code proposals in any forthcoming legislation. (S. 610) Support H.R. 1677/S. 620, the KEEP Telehealth Options Act. Support H.R. 2903/S. 1512 the CONNECT for Health Act of 2021 Support the Dr. Lorna Breen Health Care Provider Protection Act (S. 610/H.R. 1667). Support H.R. 3173, Improving Seniors Timely Access to Care Act Support H.R. 4122/S. 3645, Resident Education Deferred Interest Act or the REDI Act Support the Resident Physician Shortage Reduction Act (S. 834/H.R. 2256) Advocate for a study on skin cancer in minority populations and communities to be included in the FY2022 Labor, Health and Human Services, Education and Related Agencies Appropriations bill and FY2022 Omnibus (H.R. 4502/H.R. 2471) Advocate for the FDA to implement the 2015 rule, General and Plastic Surgery Devices: Restricted Sale, Distribution, and Use of Sunlamp Products; and the Sunlamp Products Proposed; Amendment to Performance Standard, which would ban minors under the age of 18 from using tanning beds. Support H.R. 5054, Keep Physicians Serving Patients Act Advocate to support extension of moratorium on 2% Medicare sequester as well as waiving PAYGO and mitigating anticipated additional 4% cuts to Medicare physician payment reimbursement due to enactment of H.R. 1319, American Recovery Act, P.L. 117-2. Support H.R. 6020, the Supporting Medicare Providers Act Support H.R. 5394, the Meaningful Access to Federal Health Plan Claims Data Act Advocate for legislative solution to access problems to iPLEDGE/REMS program for isotretinoin. Support H.R. 5030/S. 2706, the Diversifying Investigations and Equitable Research Studies for Everyone (DIVERSE) Trials Act

S.2999 A bill to prohibit the Secretary of Health and Human Services, any officer or employee of the Department of Health and Human Services, and States from requiring COVID-19 vaccination as a condition of eligibility for benefits or assistance under the Medicare, Medicaid, or CHIP program; S.J.Res.32 A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Centers for Medicare & Medicaid Services relating to "Medicare and Medicaid Programs; Omnibus COVID-19 Health Care Staff Vaccination";H.R.1677 To direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission, and the Medicaid and CHIP Payment and Access Commission to conduct studies and report to Congress on actions taken to expand access to telehealth services under the Medicare, Medicaid, and Children's Health Insurance programs during the COVID-19 emergency; . S.620 KEEP Telehealth Options Act of 2021; S104 HR379 Improving Social Determinants of Health Act of 2021; H.R.2517, S1125 To recommend that the Center for Medicare and Medicaid Innovation test the effect of a dementia care management model, and for other purposes; H.R.1227, S386 Medicare-X Choice Act of 2021; HR 3322-S826 Medicare Patient Empowerment Act of 2021; HR2410 Medicare & You Handbook Improvement Act of 2021; S1180 Choose Medicare Act' S748 Medicare Sequester Relief Act; HR 315 Medicare Sequester COVID Moratorium Act; HR599 Protecting Medicare Beneficiaries with Pre-Existing Conditions Act; S.2146 Improving Medicare Beneficiary Access to Innovative Diabetes Technologies Act of 2021; S.4067 A bill to amend title XI of the Social Security Act to improve access to care for all Medicare and Medicaid beneficiaries through models tested under the Center for Medicare and Medicaid Innovation, and for other purposes.

Update and reforms to Medicare payments for physicians and implementation of related provisions of the Medicare Access and CHIP Reauthorization Act, including: maintain patient access to In-Office Ancillary Services; implementation of Electronic Health Records meaningful use requirements; CMS implementation of misvalued codes; and Medicare sequestration, including related provisions affecting Medicare physician payments in S. 610, the Protecting Medicare and American Farmers from Sequestration Cuts Act. Medicare beneficiary access to telehealth, including related provisions in H.R. 1677/S. 620, the KEEP Telehealth Options Act. Medicare Part B reimbursement for prescription drugs and related issues to enhance patient access to covered drugs and CMMI quality initiatives, including: use of step therapy in Medicare and health insurance coverage, including related provisions in S. 464/H.R. 2163, the Safe Step Act; and in H.R. 5376, the Build Back Better Act - including Section 139001, Lowering Prices Through Drug Price Negotiation, and provisions regarding application of Maximum Fair Prices and Confirming Amendments to modify Medicare Part B reimbursement for selected drugs; and physician reimbursement issues related to CMMI Most Favored Nation demonstration. Medicare beneficiary access to drugs/advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans, including related provisions in H.R. 3173, the Improving Seniors Timely Access to Care Act. Coronavirus response efforts, including support for health care providers, patients and implementation of related provisions in H.R. 1319, the American Rescue Plan Act (P.L. 117-2). Monitor Medicare vision coverage provisions in H.R. 5376, the Build Back Better Act, Section 30901, Medicare coverage of hearing services, and related amendments to H.R. 5376 posted by the Senate Finance Committee.

Lobby members of Congress regarding issues related to telemedicine. Advocate for increased transparency regarding drug pricing. Advocate for reducing barriers to entry of generic drugs into the marketplace. Advocate for transparency on the part of pharmaceutical benefit managers. Advocate for patient access to compounded medications. Advocate for reducing the burdens of utilization management tools, including step therapy and prior authorization for pharmaceuticals and services. Advocate for a stable supply of medications and mitigate drug shortages. Lobby members of the House to join the Congressional Skin Cancer Caucus. Advocate for adequate and accurate network coverage for dermatologic care within health insurance exchange networks. Support H. Res 436, sense of the House supporting state, local and community initiatives to curb incidences of skin cancer beginning with childhood skin cancer. Support H. Res 718, designating October 17, 2021 as National Vitiligo Awareness Day Support H.R. 2163/S. 464, Safe Step Act. Support S. 989, Ensuring Childrens Access to Specialty Care Act. Support H.R. 153, Protecting Consumer Access to Generic Drugs Act Support S. 898, Fair Accountability & Innovative Research (FAIR) Drug Pricing Act Support H.R. 3662, Patient Access to Urgent-Use Pharmacy Compounding Act Support H.R. 1916/S. 754, Ensuring Lasting Smiles Act. Advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans. Advocate for the continued and increased funding of Community Health Centers. Advocate for implementation of surprise medical billing legislation (enacted as part of P.L. 116-260, Consolidated Appropriations Act, 2021, H.R. 133) as intended by Congress. Advocate for congressional action to hold health care professionals harmless from any cuts related to CMS Evaluation and Management Code proposals in any forthcoming legislation. (S. 610) Support H.R. 1677/S. 620, the KEEP Telehealth Options Act. Support H.R. 2903/S. 1512 the CONNECT for Health Act of 2021 Support the Dr. Lorna Breen Health Care Provider Protection Act (S. 610/H.R. 1667). Support H.R. 3173, Improving Seniors Timely Access to Care Act Support H.R. 1554, Resident Education Deferred Interest Act or the REDI Act Support the Resident Physician Shortage Reduction Act (S. 834/H.R. 2256) Advocate for a study on skin cancer in minority populations and communities to be included in the FY2022 Labor, Health and Human Services, Education and Related Agencies Appropriations bill (H.R. 4502) Advocate for the FDA to implement the 2015 rule, General and Plastic Surgery Devices: Restricted Sale, Distribution, and Use of Sunlamp Products; and the Sunlamp Products Proposed; Amendment to Performance Standard, which would ban minors under the age of 18 from using tanning beds. Support H.R. 5054, Keep Physicians Serving Patients Act Advocate to support extension of moratorium on 2% Medicare sequester as well as waiving PAYGO and mitigating anticipated additional 4% cuts to Medicare physician payment reimbursement due to enactment of H.R. 1319, American Recovery Act, P.L. 117-2. Support H.R. 6020, the Supporting Medicare Providers Act Support H.R. 5394, the Meaningful Access to Federal Health Plan Claims Data Act Lobby regarding access problems to iPLEDGE/REMS program for isotretinoin.

Advocate for adequate and accurate network coverage for dermatologic care within Medicare Advantage. Advocate for increased funding and reforms to Graduate Medical Education. Lobby members of Congress regarding improvements to Health Information Technology implementation. Advocate for expansion of telemedicine services under Medicare and increased reimbursement for such services. Advocate for improving disease management and care coordination for patients with chronic diseases. Support preservation of the In-Offices Ancillary Services Exemption (IOASE) under Stark Law regarding physician self-referral and oppose repeal of the in-office ancillary and physician services exception. Advocate for relief from Medicare regulations under Medicare Access and CHIP Reauthorization Act (MACRA P.L. 114-110), including the Quality Payment Program (QPP) and specifically the development of advanced alternative payment models (APMs) and implementation of the Merit-Based Incentive Payment System (MIPS). Advocate for relief for from prior authorization requirements under Medicare Advantage and Medicare Part D plans. Lobby Congress to urge CMS to strengthen Qualified Clinical Data Registries (QCDRs) by removing barriers that restrict access to data from EHRs. (H.R. 6000) Advocate for congressional action to hold health care professionals harmless from any cuts related to CMS Evaluation and Management Code proposals in any forthcoming legislative package. Support the Knowing the Efficiency and Efficacy of Permanent (KEEP) Telehealth Options Act (H.R. 1677/S. 620). Support H.R. 3173, Improving Seniors Timely Access to Care Act Support H.R. 2903/S. 1512 the CONNECT for Health Act of 2021 Support H.R. 5054, Keep Physicians Serving Patients Act Advocate to support extension of moratorium on 2% Medicare sequester as well as waiving PAYGO and mitigating anticipated additional 4% cuts to Medicare physician payment reimbursement due to enactment of H.R. 1319, American Recovery Act, P.L. 117-2. Support H.R. 6020, the Supporting Medicare Providers Act Support H.R. 5394, the Meaningful Access to Federal Health Plan Claims Data Act.

HR 5- Equality Act HR 366- Protecting Access to Post-COVID-19 Telehealth Act of 2021 HR 1319- American Rescue Act of 2021 HR 1677- To Direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission... S 620 Keep Telehealth Options Act of 2021 HR 4502- Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act... S. 1544- Accelerating Kids' Access to Care Act HR 3089- Accelerating Kids' Access to Care Act HR 4943- The Children's Mental Health Infrastructure Act of 2021 HR 4944- The Helping Kids Cope Act of 2021 HR 4390- The PROTECT 340B Act HR 1916- Lasting Smiles Act HR 1397- The Telehealth Improvement for Kids' Essential Services HR 3783- Medical Nutrition Equity Act S 2013- Medical Nutrition Equity Act General issues regarding mental health, physical health, Medicaid, CHIP, and DSH.P, and DSH.

Client expense: $40,000 · Firm income: Not reported

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

HR 5- Equality Act HR 366- Protecting Access to Post-COVID-19 Telehealth Act of 2021 HR 1319- American Rescue Act of 2021 HR 1677- To Direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission... S 620 Keep Telehealth Options Act of 2021 HR 4502- Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act... S. 1544- Accelerating Kids' Access to Care Act HR 3089- Accelerating Kids' Access to Care Act HR 4943- The Children's Mental Health Infrastructure Act of 2021 HR 4944- The Helping Kids Cope Act of 2021 HR 4390- The PROTECT 340B Act HR 1916- Lasting Smiles Act HR 1397- The Telehealth Improvement for Kids' Essential Services HR 3783- Medical Nutrition Equity Act S 2013- Medical Nutrition Equity Act General issues regarding mental health, physical health, Medicaid, CHIP, and DSH.

Client expense: $40,000 · Firm income: Not reported

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

S.2999 A bill to prohibit the Secretary of Health and Human Services, any officer or employee of the Department of Health and Human Services, and States from requiring COVID-19 vaccination as a condition of eligibility for benefits or assistance under the Medicare, Medicaid, or CHIP program; S.J.Res.32 A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Centers for Medicare & Medicaid Services relating to "Medicare and Medicaid Programs; Omnibus COVID-19 Health Care Staff Vaccination";H.R.1677 To direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission, and the Medicaid and CHIP Payment and Access Commission to conduct studies and report to Congress on actions taken to expand access to telehealth services under the Medicare, Medicaid, and Children's Health Insurance programs during the COVID-19 emergency; . S.620 KEEP Telehealth Options Act of 2021; S104 HR379 Improving Social Determinants of Health Act of 2021; H.R.2517, S1125 To recommend that the Center for Medicare and Medicaid Innovation test the effect of a dementia care management model, and for other purposes; H.R.1227, S386 Medicare-X Choice Act of 2021; HR 3322-S826 Medicare Patient Empowerment Act of 2021; HR2410 Medicare & You Handbook Improvement Act of 2021; S1180 Choose Medicare Act' S748 Medicare Sequester Relief Act; HR 315 Medicare Sequester COVID Moratorium Act; HR599 Protecting Medicare Beneficiaries with Pre-Existing Conditions Act; S.2146 Improving Medicare Beneficiary Access to Innovative Diabetes Technologies Act of 2021.

Client expense: Not reported · Firm income: $11,000

Advocate for adequate and accurate network coverage for dermatologic care within Medicare Advantage. Advocate for increased funding and reforms to Graduate Medical Education. Lobby members of Congress regarding improvements to Health Information Technology implementation. Advocate for expansion of telemedicine services under Medicare and increased reimbursement for such services. Advocate for improving disease management and care coordination for patients with chronic diseases. Support preservation of the In-Offices Ancillary Services Exemption (IOASE) under Stark Law regarding physician self-referral and oppose repeal of the in-office ancillary and physician services exception. Advocate for relief from Medicare regulations under Medicare Access and CHIP Reauthorization Act (MACRA P.L. 114-110), including the Quality Payment Program (QPP) and specifically the development of advanced alternative payment models (APMs) and implementation of the Merit-Based Incentive Payment System (MIPS). Advocate for relief for from prior authorization requirements under Medicare Advantage and Medicare Part D plans. Lobby Congress to urge CMS to strengthen Qualified Clinical Data Registries (QCDRs) by removing barriers that restrict access to data from EHRs. Advocate for congressional action to hold health care professionals harmless from any cuts related to CMS Evaluation and Management Code proposals in any forthcoming legislative package. Support the Knowing the Efficiency and Efficacy of Permanent (KEEP) Telehealth Options Act (H.R. 1677/S. 620). Support H.R. 3173, Improving Seniors Timely Access to Care Act Support H.R. 2903/S. 1512 the CONNECT for Health Act of 2021 Support H.R. 5054, Keep Physicians Serving Patients Act Advocate to support extension of moratorium on 2% Medicare sequester as well as waiving PAYGO and mitigating anticipated additional 4% cuts to Medicare physician payment reimbursement due to enactment of H.R. 1319, American Recovery Act, P.L. 117-2.

Lobby members of Congress regarding issues related to telemedicine. Advocate for increased transparency regarding drug pricing. Advocate for reducing barriers to entry of generic drugs into the marketplace. Advocate for transparency on the part of pharmaceutical benefit managers. Advocate for patient access to compounded medications. Advocate for reducing the burdens of utilization management tools, including step therapy and prior authorization for pharmaceuticals and services. Advocate for a stable supply of medications and mitigate drug shortages. Lobby members of the House to join the Congressional Skin Cancer Caucus. Advocate for adequate and accurate network coverage for dermatologic care within health insurance exchange networks. Support H.R. 2163/S. 464, Safe Step Act. Support S. 989, Ensuring Childrens Access to Specialty Care Act. Support H.R. 153, Protecting Consumer Access to Generic Drugs Act Support S. 898, Fair Accountability & Innovative Research (FAIR) Drug Pricing Act Support H.R. 3662, Patient Access to Urgent-Use Pharmacy Compounding Act Support H.R. 1916/S. 754, Ensuring Lasting Smiles Act. Advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans. Advocate for the continued and increased funding of Community Health Centers. Advocate for implementation of surprise medical billing legislation (enacted as part of P.L. 116-260, Consolidated Appropriations Act, 2021, H.R. 133) as intended by Congress. Advocate for congressional action to hold health care professionals harmless from any cuts related to CMS Evaluation and Management Code proposals in any forthcoming legislation. Support H.R. 1677/S. 620, the KEEP Telehealth Options Act. Support H.R. 2903/S. 1512 the CONNECT for Health Act of 2021 Support the Dr. Lorna Breen Health Care Provider Protection Act (S. 610/H.R. 1667). Support H.R. 3173, Improving Seniors Timely Access to Care Act Support H.R. 1554, Resident Education Deferred Interest Act or the REDI Act Support the Resident Physician Shortage Reduction Act (S. 834/H.R. 2256) Advocate for a study on skin cancer in minority populations and communities to be included in the FY2022 Labor, Health and Human Services, Education and Related Agencies Appropriations bill (H.R. 4502) Advocate for the FDA to implement the 2015 rule, General and Plastic Surgery Devices: Restricted Sale, Distribution, and Use of Sunlamp Products; and the Sunlamp Products Proposed; Amendment to Performance Standard, which would ban minors under the age of 18 from using tanning beds. Support H.R. 5054, Keep Physicians Serving Patients Act Advocate to support extension of moratorium on 2% Medicare sequester as well as waiving PAYGO and mitigating anticipated additional 4% cuts to Medicare physician payment reimbursement due to enactment of H.R. 1319, American Recovery Act, P.L. 117-2.

Update and reforms to Medicare payments for physicians and implementation of related provisions of the Medicare Access and CHIP Reauthorization Act, including: maintain patient access to In-Office Ancillary Services; implementation of Electronic Health Records meaningful use requirements; CMS implementation of misvalued codes; and Medicare sequestration, including related provisions in S. 748, the Medicare Sequester Relief Act, and H.R. 315, the Medicare Sequester COVID Moratorium Act. Medicare beneficiary access to telehealth, including related provisions in H.R. 1677/S. 620, the KEEP Telehealth Options Act. Medicare Part B reimbursement for prescription drugs and related issues to enhance patient access to covered drugs and CMMI quality initiatives, including: use of step therapy in Medicare and health insurance coverage, including related provisions in S. 464/H.R. 2163, the Safe Step Act; and physician reimbursement issues related to CMMI Most Favored Nation demonstration. Medicare beneficiary access to drugs/advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans, including related provisions in H.R. 3173, the Improving Seniors Timely Access to Care Act. Coronavirus response efforts, including support for health care providers, patients and implementation of related provisions in H.R. 1319, the American Rescue Plan Act (P.L. 117-2). Monitor Medicare vision coverage provisions in the Build Back Better Act, including Budget Reconciliation Legislative Recommendations Relating to Medicare, provisions regarding coverage for vision care under the Medicare Program - Subtitle I, Energy and Commerce, and Subtitle E, Part 4, Ways and Means.

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

HR 5- Equality Act HR 366- Protecting Access to Post-COVID-19 Telehealth Act of 2021 HR 1319- American Rescue Act of 2021 HR 1677- To Direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission... S 620 Keep Telehealth Options Act of 2021 HR 4502- Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act... S. 1544- Accelerating Kids' Access to Care Act HR 3089- Accelerating Kids' Access to Care Act HR 4943- The Children's Mental Health Infrastructure Act of 2021 HR 4944- The Helping Kids Cope Act of 2021 HR 4390- The PROTECT 340B Act General issues regarding mental health, physical health, Medicaid, CHIP, and DSH.

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

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

HR 5- Equality Act HR 366- Protecting Access to Post-COVID-19 Telehealth Act of 2021 HR 1319- American Rescue Act of 2021 HR 1677- To Direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission... S 620 Keep Telehealth Options Act of 2021 HR 4502- Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act... S. 1544- Accelerating Kids' Access to Care Act HR 3089- Accelerating Kids' Access to Care Act HR 4943- The Children's Mental Health Infrastructure Act of 2021 HR 4944- The Helping Kids Cope Act of 2021 HR 4390- The PROTECT 340B Act General issues regarding mental health, physical health, Medicaid, CHIP, and DSH.

Client expense: $50,000 · 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.1677 To direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission, and the Medicaid and CHIP Payment and Access Commission to conduct studies and report to Congress on actions taken to expand access to telehealth services under the Medicare, Medicaid, and Children's Health Insurance programs during the COVID-19 emergency; . S.620 KEEP Telehealth Options Act of 2021; S104 HR379 Improving Social Determinants of Health Act of 2021; H.R.2517, S1125 To recommend that the Center for Medicare and Medicaid Innovation test the effect of a dementia care management model, and for other purposes; H.R.1227, S386 Medicare-X Choice Act of 2021; HR 3322-S826 Medicare Patient Empowerment Act of 2021; HR2410 Medicare & You Handbook Improvement Act of 2021; S1180 Choose Medicare Act' S748 Medicare Sequester Relief Act; HR 315 Medicare Sequester COVID Moratorium Act; HR599 Protecting Medicare Beneficiaries with Pre-Existing Conditions Act; S.2146 Improving Medicare Beneficiary Access to Innovative Diabetes Technologies Act of 2021.

Client expense: Not reported · Firm income: $11,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Update and reforms to Medicare payments for physicians and implementation of related provisions of the Medicare Access and CHIP Reauthorization Act, including: maintain patient access to In-Office Ancillary Services; implementation of Electronic Health Records meaningful use requirements; CMS implementation of misvalued codes; and Medicare sequestration, including related provisions in S. 748, the Medicare Sequester Relief Act, and H.R. 315, the Medicare Sequester COVID Moratorium Act. Medicare beneficiary access to telehealth, including related provisions in H.R. 1677/S. 620, the KEEP Telehealth Options Act. Medicare Part B reimbursement for prescription drugs and related issues to enhance patient access to covered drugs and CMMI quality initiatives, including: use of step therapy in Medicare and health insurance coverage, including related provisions in S. 464/H.R. 2163, the Safe Step Act; and physician reimbursement issues related to CMMI Most Favored Nation demonstration. Medicare beneficiary access to drugs/advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans, including related provisions in H.R. 3173, the Improving Seniors Timely Access to Care Act. Coronavirus response efforts, including support for health care providers, patients and implementation of related provisions in H.R. 1319, the American Rescue Plan Act (P.L. 117-2).

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

HR 5- Equality Act HR 366- Protecting Access to Post-COVID-19 Telehealth Act of 2021 HR 1319- American Rescue Act of 2021 HR 1677- To Direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission... S 620 Keep Telehealth Options Act of 2021 HR 4502- Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act... S. 1544- Accelerating Kids' Access to Care Act HR 3089- Accelerating Kids' Access to Care Act General issues regarding mental health, physical health, Medicaid, CHIP, and DSH.

Client expense: $40,000 · Firm income: Not reported

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

HR 5- Equality Act HR 366- Protecting Access to Post-COVID-19 Telehealth Act of 2021 HR 1319- American Rescue Act of 2021 HR 1677- To Direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission... S 620 Keep Telehealth Options Act of 2021 HR 4502- Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act... S. 1544- Accelerating Kids' Access to Care Act HR 3089- Accelerating Kids' Access to Care Act General issues regarding mental health, physical health, Medicaid, CHIP, and DSH.

Client expense: $40,000 · Firm income: Not reported

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

Advocate for adequate and accurate network coverage for dermatologic care within Medicare Advantage. Advocate for increased funding and reforms to Graduate Medical Education. Lobby members of Congress regarding improvements to Health Information Technology implementation. Advocate for expansion of telemedicine services under Medicare and increased reimbursement for such services. Advocate for improving disease management and care coordination for patients with chronic diseases. Support preservation of the In-Offices Ancillary Services Exemption (IOASE) under Stark Law regarding physician self-referral and oppose repeal of the in-office ancillary and physician services exception. Advocate for relief from Medicare regulations under Medicare Access and CHIP Reauthorization Act (MACRA P.L. 114-110), including the Quality Payment Program (QPP) and specifically the development of advanced alternative payment models (APMs) and implementation of the Merit-Based Incentive Payment System (MIPS). Advocate for relief for from prior authorization requirements under Medicare Advantage and Medicare Part D plans. Lobby Congress to urge CMS to strengthen Qualified Clinical Data Registries (QCDRs) by removing barriers that restrict access to data from EHRs. Advocate to mitigate anticipated 4% cuts to Medicare physician payment reimbursement due to enactment of H.R. 1319, American Recovery Act, P.L. 117-2 (H.R. 1868). Advocate to support extension of moratorium on 2% Medicare sequester as well as waiving PAYGO for H.R. 1319, The American Rescue Plan Act(H.R. 315, S. 748, H.R. 1868). Advocate for congressional action to hold health care professionals harmless from any cuts related to CMS Evaluation and Management Code proposals in any forthcoming legislative package. Support the Knowing the Efficiency and Efficacy of Permanent (KEEP) Telehealth Options Act (H.R. 1677/S. 620). Support H.R. 3173, Improving Seniors Timely Access to Care Act.

Lobby members of Congress regarding issues related to telemedicine. Advocate for increased transparency regarding drug pricing. Advocate for reducing barriers to entry of generic drugs into the marketplace. Advocate for transparency on the part of pharmaceutical benefit managers. Advocate for patient access to compounded medications. Advocate for reducing the burdens of utilization management tools, including step therapy and prior authorization for pharmaceuticals and services. Advocate for a stable supply of medications and mitigate drug shortages. Lobby members of the House to join the Congressional Skin Cancer Caucus. Advocate for adequate and accurate network coverage for dermatologic care within health insurance exchange networks. Support H.R. 2163/S. 464, Safe Step Act. Support S. 989, Ensuring Childrens Access to Specialty Care Act. Support H.R. 153, Protecting Consumer Access to Generic Drugs Act Support S. 898, Fair Accountability & Innovative Research (FAIR) Drug Pricing Act Support H.R. 3662, Patient Access to Urgent-Use Pharmacy Compounding Act Support H.R. 1916/S. 754, Ensuring Lasting Smiles Act. Advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans. Advocate for the continued and increased funding of Community Health Centers. Advocate for implementation of surprise medical billing legislation (enacted as part of P.L. 116-260, Consolidated Appropriations Act, 2021, H.R. 133) as intended by Congress. Advocate to mitigate anticipated 4% cuts to Medicare physician payment reimbursement due to enactment of H.R. 1319, American Recovery Act, P.L. 117-2 (H.R. 1868). Advocate to support extension of moratorium on 2% Medicare sequester (H.R. 315, S. 748, H.R. 1868). Advocate for congressional action to hold health care professionals harmless from any cuts related to CMS Evaluation and Management Code proposals in any forthcoming legislation. Support H.R. 1677/S. 620, the KEEP Telehealth Options Act. Support the Dr. Lorna Breen Health Care Provider Protection Act (S. 610/H.R. 1667). Support H.R. 3173, Improving Seniors Timely Access to Care Act Support H.R. 1554, Resident Education Deferred Interest Act or the REDI Act Support the Resident Physician Shortage Reduction Act (S. 834/H.R. 2256) Advocate for a study on skin cancer in minority populations and communities to be included in the FY2022 Labor, Health and Human Services, Education and Related Agencies Appropriations bill. Advocate for the FDA to implement the 2015 rule, General and Plastic Surgery Devices: Restricted Sale, Distribution, and Use of Sunlamp Products; and the Sunlamp Products Proposed; Amendment to Performance Standard, which would ban minors under the age of 18 from using tanning beds.

H.R.1677 To direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission, and the Medicaid and CHIP Payment and Access Commission to conduct studies and report to Congress on actions taken to expand access to telehealth services under the Medicare, Medicaid, and Children's Health Insurance programs during the COVID-19 emergency; . S.620 KEEP Telehealth Options Act of 2021; S104 HR379 Improving Social Determinants of Health Act of 2021; H.R.2517, S1125 To recommend that the Center for Medicare and Medicaid Innovation test the effect of a dementia care management model, and for other purposes; H.R.1227, S386 Medicare-X Choice Act of 2021; HR 3322-S826 Medicare Patient Empowerment Act of 2021; HR2410 Medicare & You Handbook Improvement Act of 2021; S1180 Choose Medicare Act' S748 Medicare Sequester Relief Act; HR 315 Medicare Sequester COVID Moratorium Act; HR599 Protecting Medicare Beneficiaries with Pre-Existing Conditions Act.

Client expense: Not reported · Firm income: $11,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Lobby members of Congress regarding issues related to telemedicine. Advocate for increased transparency regarding drug pricing. Advocate for reducing barriers to entry of generic drugs into the marketplace. Advocate for transparency on the part of pharmaceutical benefit managers. Advocate for patient access to compounded medications. Advocate for reducing the burdens of utilization management tools, including step therapy and prior authorization for pharmaceuticals and services. Advocate for a stable supply of medications and mitigate drug shortages. Lobby members of the House to join the Congressional Skin Cancer Caucus. Advocate for adequate and accurate network coverage for dermatologic care within health insurance exchange networks. Support H.R. 2163/S. 464, Safe Step Act. Support S. 989, Ensuring Childrens Access to Specialty Care Act. Support H.R. 153, Protecting Consumer Access to Generic Drugs Act Support S. 898, Fair Accountability & Innovative Research (FAIR) Drug Pricing Act Support H.R. 1916/S. 754, Ensuring Lasting Smiles Act. Advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans. Advocate for the continued and increased funding of Community Health Centers. Advocate for implementation of surprise medical billing legislation (enacted as part of P.L. 116-260, Consolidated Appropriations Act, 2021, H.R. 133) as intended by Congress. Advocate to mitigate anticipated 4% cuts to Medicare physician payment reimbursement due to enactment of H.R. 1319, American Recovery Act, P.L. 117-2 (H.R. 1868). Advocate to support extension of moratorium on 2% Medicare sequester (H.R. 315, S. 748, H.R. 1868). Advocate for congressional action to hold health care professionals harmless from any cuts related to CMS Evaluation and Management Code proposals in any forthcoming legislation. Support H.R. 1677/S. 620, the KEEP Telehealth Options Act. Support the Dr. Lorna Breen Health Care Provider Protection Act (S. 610/H.R. 1667).

Advocate for adequate and accurate network coverage for dermatologic care within Medicare Advantage. Advocate for increased funding and reforms to Graduate Medical Education. Lobby members of Congress regarding improvements to Health Information Technology implementation. Advocate for expansion of telemedicine services under Medicare and increased reimbursement for such services. Advocate for improving disease management and care coordination for patients with chronic diseases. Support preservation of the In-Offices Ancillary Services Exemption (IOASE) under Stark Law regarding physician self-referral and oppose repeal of the in-office ancillary and physician services exception. Advocate for relief from Medicare regulations under Medicare Access and CHIP Reauthorization Act (MACRA P.L. 114-110), including the Quality Payment Program (QPP) and specifically the development of advanced alternative payment models (APMs) and implementation of the Merit-Based Incentive Payment System (MIPS). Advocate for relief for from prior authorization requirements under Medicare Advantage and Medicare Part D plans. Lobby Congress to urge CMS to strengthen Qualified Clinical Data Registries (QCDRs) by removing barriers that restrict access to data from EHRs. Advocate to mitigate anticipated 4% cuts to Medicare physician payment reimbursement due to enactment of H.R. 1319, American Recovery Act, P.L. 117-2 (H.R. 1868). Advocate to support extension of moratorium on 2% Medicare sequester (H.R. 315, S. 748, H.R. 1868). Advocate for congressional action to hold health care professionals harmless from any cuts related to CMS Evaluation and Management Code proposals in any forthcoming legislative package. Support the Knowing the Efficiency and Efficacy of Permanent (KEEP) Telehealth Options Act (H.R. 1677/S. 620).

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 - To amend title XVIII of the Social Security Act to provide for the conversion of certain accelerated and advance payments to grants under parts A and B of the Medicare program - 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 - To amend title XI of the Social Security Act to provide Secretarial authority to temporarily waive or modify application of certain Medicare requirements with respect to ambulance services furnished during certain emergency periods - Rep. Axne, Cynthia - Medicare coverage of ambulance services H.R. 1676 - To amend title XVIII to provide for certain Medigap coverage for Medicare beneficiaries with end-stage renal disease, and for other purposes - Rep. Axne, Cynthia - Medigap coverage for ESRD H.R. 1677 - To direct the Secretary of HHS, the Medicare Payment Advisory Commission, and the Medicaid and CHIP Payment and Access Commission to conduct studies and report to Congress on actions taken to expand access to telehealth services under the Medicare, Medicaid, and Children's Health Insurance programs during the COVID-19 emergency - Rep. Balderson, Troy - telehealth expansion H.R. 1717 - To amend title XIX of the Social Security Act to make permanent the protections under Medicaid for recipients of home and community-based services against spousal impoverishment - Rep. Upton, Fred - permanent protections against spousal impoverishment H.R. 1722 - To amend titles XI and XIX of the Social Security Act to stabilize the Medicaid program in Puerto Rico - Rep. Velazquez, Nydia - Medicaid in Puerto Rico H.R. 1738 - To amend titles XIX and XXI of the Social Security Act to provide for 12-month continuous enrollment of individuals under the Medicaid program and CHIP- Rep. Dingell, Debbie - Medicaid and CHIP enrollment H.R. 1784 - To amend title XIX of the Social Security Act to enhance reporting requirements for nonexpansion States, and for other purposes - Rep. Doggett, Lloyd - nonexpansion H.R. 1791 - To amend title XXI of the Social Security Act to permanently extend the Children's Health Insurance Program, and for other purposes - Rep. Barragan, Nanette Diaz - extending CHIP H.R. 1792 - To amend title XXI of the Social Security Act to prohibit lifetime or annual limits on dental coverage under CHIP, and to require wraparound coverage of dental services for certain children under such program - Rep. Barragan, Nanette Diaz - dental coverage under CHIP H.R. 1793 - To amend the SUPPORT for Patients and Communities Act to provide for immediate eligibility for former foster youth under Medicaid - Rep. Bass, Karen - Medicaid coverage for foster youth H.R. 1794 - To amend title XIX of the Social Security Act to strengthen coverage under the Medicaid program for certain foster youth individuals - Rep. Bass, Karen - Medicaid 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 - To amend titles XVIII and XIX of the Social Security Act to make premium and cost-sharing subsidies available to low-income Medicare part D beneficiaries who reside in Puerto Rico or another territory of the United States - Resident Commissioner Gonzalez-Colon, Jenniffer - premium and cost-sharing subsidies H.R. 1826 - To amend title XVIII of the Social Security Act to eliminate late enrollment penalties under part B of the Medicare program for individuals residing in Puerto Rico if such individuals enroll within 5 years of becoming entitled to benefits under part A of such program - 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 - To amend title XVIII of the Social Security Act to adjust certain rural health clinic payments under the Medicare program - Rep. Kind, Ron - Medicare rural health clinic payments H.R. 1887 - To amend title XVIII of the Social Security Act to rebase the calculation of payments for sole community hospitals and Medicare-dependent hospitals, and for other purposes - Rep. Reed, Tom - Medicare payments for hospitals H.R. 1890 - To amend the Patient Protection and ACA to require Exchanges to establish network adequacy standards for qualified health plans and amend the Public Health Service Act to provide protections for consumers against excessive, unjustified, or unfairly discriminatory increases in premium rates - Rep. Schakowsky, Janice D. - network adequacy standards and premium rates H.R. 1914 - To amend title XIX of the Social Security Act to encourage State Medicaid programs to provide community-based mobile crisis intervention services, and for other purposes - Rep. DeFazio, Peter A. - Medicaid mobile crisis intervention services H.R. 1969 - To amend title XVIII of the Social Security Act to address disparity in Medicare Advantage benchmark rates for regions with low Medicare fee-for-service penetration - Resident Commissioner Gonzalez-Colon, Jenniffer - disparity in MA benchmark rates H.R. 2035 - To amend title XVIII of the Social Security Act to improve access to mental health services under the Medicare program - Rep. Lee, Barbara - mental health services under Medicare H.R. 2080 - To amend title XVIII of the Social Security Act to provide for temporary coverage of certain transportation services for certain individuals under the Medicare program, and for other purposes - Rep. Bishop, Sanford D., Jr. - Medicare coverage of transportation services H.R. 2166 - To amend title XVIII of the Social Security Act to require the inclusion of certain audio-only diagnoses in the determination of risk adjustment for Medicare Advantage plans and PACE programs, and for other purposes - Rep. Sewell, Terri - audio-only diagnoses in MA H.R. 2168 - To amend title XVIII of the Social Security Act to expand the scope of practitioners eligible for payment for telehealth services under the Medicare program, and for other purposes - Rep. Sherrill, Mikie - payment for telehealth services H.R. 2170 - To amend title XIX of the Social Security Act to improve access to adult vaccines under Medicaid - Rep. Soto, Darren - access to vaccines and Medicaid H.R. 2179 - To amend title XVIII of the Social Security Act to eliminate cost-sharing with respect to coverage of insulin as a covered part D drug and associated medical supplies and to provide mail order access to insulin and such supplies under the Medicare program during the COVID-19 emergency period - Rep. Waters, Maxine - cost-sharing regarding insulin coverage H.R. 2217 - To amend title XIX of the Social Security Act to treat each territory as one of the 50 States for purposes of calculating the Federal medical assistance percentage under the Medicaid program - Resident Commissioner Gonzalez-Colon, Jenniffer - FMAP H.R. 2228 - To allow for payment of outpatient critical access hospital services furnished through telehealth under the Medicare program - Rep. Kildee, Daniel - Medicare coverage of outpatient telehealth services 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 - A bill to amend title XIX of the Social Security Act to improve access to adult vaccines under Medicaid - Sen. Brown, Sherrod - vaccines under Medicaid S. 620 - A bill to direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission, and the Medicaid and CHIP Payment and Access Commission to conduct studies and report to Congress on actions taken to expand access to telehealth services under the Medicare, Medicaid, and CHIP programs during the COVID-19 emergency - Sen. Fischer, Deb - telehealth expansion S. 644 - A bill to amend title XVIII of the Social Security Act to restore State authority to waive for certain facilities the 35-mile rule for designating critical access hospitals under the Medicare program, and for other purposes - Sen. Durbin, Richard - Medicare coverage for critical access hospitals S. 646 - A bill to amend titles XIX and XXI of the Social Security Act to provide for 12-month continuous enrollment under Medicaid and CHIP - Sen. Brown, Sherrod - Medicaid and CHIP enrollment S. 653 - A bill to amend title XVIII of the Social Security Act to provide for the application of Medicare secondary payer rules to certain workers' compensation settlement agreements and qualified Medicare set-aside provisions - Sen. Portman, Rob - Medicare secondary payer rules S. 712 - A bill to amend the SUPPORT for Patients and Communities Act to provide for immediate eligibility for former foster youth under Medicaid - Sen. Casey, Robert P., Jr. - Medicaid coverage for foster youth S. 748 - A bill to provide for an extension of the temporary suspension of Medicare sequestration during the COVID-19 public health emergency - Sen. Shaheen, Jeanne - Medicare sequestration S. 764 - A bill to amend title XIX of the Social Security Act to encourage State Medicaid programs to provide community-based mobile crisis intervention services, and for other purposes - Sen. Wyden, Ron - Medicaid mobile crisis intervention services S. 826 - A bill to amend title XVIII of the Social Security Act to establish a Medicare payment option for patients and eligible professionals to freely contract, without penalty, for Medicare fee-for-service items and services, while allowing Medicare beneficiaries to use their Medicare benefits - Sen. Paul, Rand - Medicaid payment options S. 870 - A bill to amend title XVIII of the Social Security Act to improve access to mental health services under the Medicare program - Sen. Stabenow, Debbie - mental health services in Medicare S. 999 - A bill to amend the title XVIII of the Social Security Act to preserve access to rural health care by ensuring fairness in Medicare hospital payments - 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 2021 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 and public option; issues relating to 2022 Rate Notice; Executive Orders relating to international pricing, Part D rebates, insulin costs, and importation; issues related to MLTSS; issues related to removal of safe harbor protection for rebates; issues relating to COVID-19, including testing and vaccines; 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, and educational opportunities; issues related to Medicaid presumptive eligibility and continuous eligibility; issues relating to Medicaid best price; in-home health risk assessments; Medicare Medical Loss Ratio issues; issues related to changes to prior authorization regulations, electronic documentation, and related issues; issues relating to sequestration under the Medicare Advantage and Part D programs; 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); 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.

H.R.1677 To direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission, and the Medicaid and CHIP Payment and Access Commission to conduct studies and report to Congress on actions taken to expand access to telehealth services under the Medicare, Medicaid, and Children's Health Insurance programs during the COVID-19 emergency; . S.620 KEEP Telehealth Options Act of 2021; S104 HR379 Improving Social Determinants of Health Act of 2021; H.R.2517, S1125 To recommend that the Center for Medicare and Medicaid Innovation test the effect of a dementia care management model, and for other purposes; H.R.1227, S386 Medicare-X Choice Act of 2021

Client expense: Not reported · Firm income: $11,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE