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Legislative Progress
Momentum (last 30 days)
0
score
0 actions · 0 new cosponsors · 0 votes
Speed vs cohort
43pct
1d open
vs 9,698 other HR bills in the 117th — cohort avg 63d
Expanded Telehealth Access Act This bill permanently allows audiologists, physical therapists, occupational therapists, speech-language pathologists, and other providers designated by the Centers for Medicare & Medicaid Services (CMS) to provide telehealth services under Medicare. Currently, the CMS is authorized to waive requirements for Medicare telehealth services during the public health emergency relating to COVID-19, and it has done so to allow all providers that are otherwise eligible to furnish in-person services under Medicare to also furnish telehealth services.
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Filing registrants (19)
Referred to the Subcommittee on Health.
Referred to the Subcommittee on Health.
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Introduced in House
Congress.gov source codes: 1000, Intro-H
Bills with similar content found using semantic analysis.
Sources: Congress.gov
2023 · first_quarter · Medicare/Medicaid
Issues pertaining to durable medical equipment including: competitive bidding, power wheelchairs, oxygen, non-invasive ventilators, diabetic supplies, negative pressure wound therapy, Medicare audits, sequestration; Medicare sequestration paygo relief legislation (H.R. 1868 - To prevent across-the-board direct spending cuts, and for other purposes); Issues related the non-application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs manual accessories, titanium/carbon upgrade legislation, and Medicare coverage of seat elevation and standing features; Issues related to Medicare reimbursement cuts in DME noncompetitive bidding areas; H.R. 2168 - Expanded Telehealth Access Act, and for other purposes; Issues related to the COVID-19 public health emergency; H.R. 2079 - To provide that CARES Act Provider Relief Fund payments are not includible in gross income, and for other purposes; Issues related to the 2020 DME proposed rule; H.R. 6641 - DMEPOS Relief Act of 2022 and H.R. 2356/S. 2363 - Better Wound Care at Home Act of 2021.
Client expense: Not reported · Firm income: $60,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2023 · first_quarter · Medicare/Medicaid
Issues pertaining to durable medical equipment including: competitive bidding, power wheelchairs, oxygen, non-invasive ventilators, diabetic supplies, negative pressure wound therapy, Medicare audits, sequestration; Medicare sequestration paygo relief legislation (H.R. 1868 - To prevent across-the-board direct spending cuts, and for other purposes); Issues related the non-application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs manual accessories, titanium/carbon upgrade legislation, and Medicare coverage of seat elevation and standing features; Issues related to Medicare reimbursement cuts in DME noncompetitive bidding areas; H.R. 2168 - Expanded Telehealth Access Act, and for other purposes; Issues related to the COVID-19 public health emergency; H.R. 2079 - To provide that CARES Act Provider Relief Fund payments are not includible in gross income, and for other purposes; Issues related to the 2020 DME proposed rule; H.R. 6641 - DMEPOS Relief Act of 2022 and H.R. 2356/S. 2363 - Better Wound Care at Home Act of 2021.
Client expense: $290,000 · Firm income: Not reported
2022 · second_quarter · Medicare/Medicaid
Payment of EMG services under Medicare Medicare sequestration moratorium Medicaid coverage and reimbursement Medicare wound care coverage National Correct Coding Initiative Edits Protection of programs related to physical therapy in deficit reduction Medicare Advantage Essential Health Benefits Medicare improvement standards Inclusion of physical therapists in quality programs Medicare Self-referral Coverage of telehealth under Medicare, Medicare Advantage, and Medicaid H.R. 2168/S. 3193 Expanded Telehealth Access Act APTA PT Outcomes Registry/Qualified Clinical Data Registries Medicare Quality Programs Accelerating Innovation in Medicine Act Improving Medicare Post-Acute Care Transformation Act Chronic Care Management Orthotics and Prosthetics Medicare Private Contracting H.R. 3322/S. 826 Medicare Patient Empowerment Act Skilled Nursing Facility 3-Day rule H.R. 5536 Stabilizing Medicare Access to Rehabilitation and Therapy (SMART) Act PTA Differential in Medicare Prior Authorization in Medicare Advantage Plans Alternative payment models Pelvic Health/Pelvic Health Awareness Health information technology: Electronic health records, health IT incentives for physical therapists, certification of EHRs interoperability, and information blocking durable medical equipment prosthetics orthotics and supplies competitive bidding H.R. 3630/S. 1315 Lymphedema Treatment Act Medicare enrollment Skilled Nursing Facility payment Home Health payment Medical review (Medicare) Reducing Health Care costs REAADI & DRMA Acts Home Health Payment Innovation Act H.R. 3173/S. 3018 Improving Seniors Timely Access to Care Act H.R. 3650/S. 2048 Improving Access to Medicare Coverage Act Critical Access Hospital Relief Act Medicare Fee Schedule Unified post-acute care prospective payment system Inpatient rehabilitation facilities / long term care hospital payment HIPAA proposed rule HR 6020 - Support Medicare Providers Act S. 3799 PREVENT Pandemics Act H.R. 5365 Primary Health Services Enhancement Act H.R. 8181 Optimizing Postpartum Outcomes Act
2022 · third_quarter · Medicare/Medicaid
HR 8344: Electrodiagnostic Medicine Patient Protection and Fraud Elimination Act of 2022 Medicare sequestration moratorium Medicaid coverage and reimbursement Medicare wound care coverage National Correct Coding Initiative Edits Protection of programs related to physical therapy in deficit reduction Medicare Advantage Essential Health Benefits Medicare improvement standards Inclusion of physical therapists in quality programs Medicare Self-referral Coverage of telehealth under Medicare, Medicare Advantage, and Medicaid H.R. 2168/S. 3193 Expanded Telehealth Access Act APTA PT Outcomes Registry/Qualified Clinical Data Registries Medicare Quality Programs Accelerating Innovation in Medicine Act Improving Medicare Post-Acute Care Transformation Act Chronic Care Management Orthotics and Prosthetics H.R. 1990/S. 2556: Medicare Orthotics and Prosthetics Patient-Centered Care Act Medicare Private Contracting H.R. 3322/S. 826 Medicare Patient Empowerment Act Skilled Nursing Facility 3-Day rule H.R. 5536 Stabilizing Medicare Access to Rehabilitation and Therapy (SMART) Act PTA Differential in Medicare Prior Authorization in Medicare Advantage Plans Alternative payment models Health information technology: Electronic health records, health IT incentives for physical therapists, certification of EHRs interoperability, and information blocking durable medical equipment prosthetics orthotics and supplies competitive bidding H.R. 3630/S. 1315 Lymphedema Treatment Act Medicare enrollment Skilled Nursing Facility payment Home Health payment Medical review (Medicare) Reducing Health Care costs REAADI & DRMA Acts Home Health Payment Innovation Act H.R. 3173/S. 3018 Improving Seniors Timely Access to Care Act H.R. 3650/S. 2048 Improving Access to Medicare Coverage Act Critical Access Hospital Relief Act Medicare Fee Schedule Unified post-acute care prospective payment system Inpatient rehabilitation facilities / long term care hospital payment HIPAA proposed rule HR 6020 - Support Medicare Providers Act S. 3799 PREVENT Pandemics Act H.R. 5365 Primary Health Services Enhancement Act H.R. 8181 Optimizing Postpartum Outcomes Act H.R 8800 Supporting Medicare Providers Act of 2022
2022 · second_quarter · Medicare/Medicaid
Payment of EMG services under Medicare Medicare sequestration moratorium Medicaid coverage and reimbursement Medicare wound care coverage National Correct Coding Initiative Edits Protection of programs related to physical therapy in deficit reduction Medicare Advantage Essential Health Benefits Medicare improvement standards Inclusion of physical therapists in quality programs Medicare Self-referral Coverage of telehealth under Medicare, Medicare Advantage, and Medicaid H.R. 2168/S. 3193 Expanded Telehealth Access Act APTA PT Outcomes Registry/Qualified Clinical Data Registries Medicare Quality Programs Accelerating Innovation in Medicine Act Improving Medicare Post-Acute Care Transformation Act Chronic Care Management Orthotics and Prosthetics Medicare Private Contracting H.R. 3322/S. 826 Medicare Patient Empowerment Act Skilled Nursing Facility 3-Day rule H.R. 5536 Stabilizing Medicare Access to Rehabilitation and Therapy (SMART) Act PTA Differential in Medicare Prior Authorization in Medicare Advantage Plans Alternative payment models Pelvic Health/Pelvic Health Awareness Health information technology: Electronic health records, health IT incentives for physical therapists, certification of EHRs interoperability, and information blocking durable medical equipment prosthetics orthotics and supplies competitive bidding H.R. 3630/S. 1315 Lymphedema Treatment Act Medicare enrollment Skilled Nursing Facility payment Home Health payment Medical review (Medicare) Reducing Health Care costs REAADI & DRMA Acts Home Health Payment Innovation Act H.R. 3173/S. 3018 Improving Seniors Timely Access to Care Act H.R. 3650/S. 2048 Improving Access to Medicare Coverage Act Critical Access Hospital Relief Act Medicare Fee Schedule Unified post-acute care prospective payment system Inpatient rehabilitation facilities / long term care hospital payment HIPAA proposed rule HR 6020 - Support Medicare Providers Act S. 3799 PREVENT Pandemics Act H.R. 5365 Primary Health Services Enhancement Act H.R. 8181 Optimizing Postpartum Outcomes Act
| Democratic |
| AZ |
| Anthony Gonzalez | Republican | OH |
| Barbara Lee | Democratic | CA |
| Betty McCollum | Democratic | MN |
| Bobby L. Rush | Democratic | IL |
| Brian K. Fitzpatrick | Republican | PA |
| Burgess Owens | Republican | UT |
| Carolyn B. Maloney | Democratic | NY |
| Chellie Pingree | Democratic | ME |
| Claudia Tenney | Republican | NY |
| Cynthia Axne | Democratic | IA |
| David B. McKinley | Republican | WV |
| David G. Valadao | Republican | CA |
| David J. Trone | Democratic | MD |
| Dean Phillips | Democratic | MN |
| Deborah K. Ross | Democratic | NC |
| Derek Kilmer | Democratic | WA |
| Diana Harshbarger | Republican | TN |
| Don Bacon | Republican | NE |
| Don Young | Republican | AK |
| Dwight Evans | Democratic | PA |
| Ed Case | Democratic | HI |
| Eleanor Holmes Norton | Democratic | DC |
| Elise M. Stefanik | Republican | NY |
| G. K. Butterfield | Democratic | NC |
| Glenn Thompson | Republican | PA |
| Greg Stanton | Democratic | AZ |
| Jaime Herrera Beutler | Republican | WA |
| James Comer | Republican | KY |
| James R. Baird | Republican | IN |
| Janice D. Schakowsky | Democratic | IL |
| Jefferson Van Drew | Republican | NJ |
| Jim Banks | Republican | IN |
| Joe Neguse | Democratic | CO |
| John H. Rutherford | Republican | FL |
| Joseph D. Morelle | Democratic | NY |
| Josh Gottheimer | Democratic | NJ |
| Joyce Beatty | Democratic | OH |
| Kaiali’i Kahele | Democratic | HI |
| Kathleen M. Rice | Democratic | NY |
| Kathy E. Manning | Democratic | NC |
| Lisa Blunt Rochester | Democratic | DE |
| Madeleine Dean | Democratic | PA |
| Madison Cawthorn | Republican | NC |
| Marc A. Veasey | Democratic | TX |
| Mark E. Amodei | Republican | NV |
| Mark Pocan | Democratic | WI |
| Mike Bost | Republican | IL |
| Nanette Diaz Barragán | Democratic | CA |
| Paul Tonko | Democratic | NY |
| Pete Aguilar | Democratic | CA |
| Pramila Jayapal | Democratic | WA |
| Rodney Davis | Republican | IL |
| Salud O. Carbajal | Democratic | CA |
| Sanford D. Bishop, Jr. | Democratic | GA |
| Stephen F. Lynch | Democratic | MA |
| Steve Cohen | Democratic | TN |
| Steven M. Palazzo | Republican | MS |
| Susan Wild | Democratic | PA |
| Ted Lieu | Democratic | CA |
| Thomas R. Suozzi | Democratic | NY |
| Tom O’Halleran | Democratic | AZ |
| Tony Cárdenas | Democratic | CA |
| Tracey Mann | Republican | KS |
| Val Butler Demings | Democratic | FL |
| Vicky Hartzler | Republican | MO |
| William R. Timmons IV | Republican | SC |
| Young Kim | Republican | CA |
Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE
Client expense: $195,457 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE, Small Business Administration (SBA), Veterans Affairs, Dept of (VA), White House Office
Client expense: $194,970 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE, Small Business Administration (SBA), Veterans Affairs, Dept of (VA), White House Office
Client expense: $195,457 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE, Small Business Administration (SBA), Veterans Affairs, Dept of (VA), White House Office
2022 · fourth_quarter · Insurance
Support reforming prior authorization procedures to be more seamless, automated and transparent for physicians: HR 3173/ S.3018, Improving Seniors Timely Access to Care Act of 2021. Support extending and expanding telehealth: HR 1332 and S 368, The Telehealth Modernization Act; HR 2903 and S 1512, The Connect for Health Act; HR 4480 The Telehealth Coverage and Payment Parity Act and HR 2168 The Expanded Telehealth Access Act. Oppose H.R. 6087, Improving Access to Workers Compensation for Injured Federal Workers Act. Would inappropriately permit nurse practitioners and physician assistants to diagnose, prescribe, treat and certify an injury for federal workers compensation claims. Ensure relevant traveling physicians can appropriately treat their patients by supporting HR7259 the Medical Controlled Substances Transportation Act of 2022.
Client expense: $326,542 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · fourth_quarter · Medicare/Medicaid
H.R. 66 - CARING for Kids Act - Rep. Buchanan, Vern - CHIP H.R. 265 - Insular Area Medicaid Parity Act - Rep. Sablan, Gregorio Kilili Camacho - Medicaid funding H.R. 315 - Medicare Sequester COVID Moratorium Act - Rep. Schneider, Bradley Scott - Medicare sequestration H.R.340 - Incentivizing Medicaid Expansion Act of 2021 - Rep. Veasey, Marc - Medicaid expansion H.R. 432 - Mental Health Access Improvement Act of 2021 - Rep. Thompson, Mike -Medicare coverage of marriage and family therapist services and mental health counselor H.R. 502 - Medicare Dental Benefit Act of 2021 - Rep. Barragan, Nanette Diaz - Medicare coverage of dental and oral health services H.R. 525 - COVID HCBS Relief Act of 2021 - Rep. Dingell, Debbie - increased FMAP for HCBS H.R. 871 - Expand Medicaid Now Act - Rep. Fletcher, Lizzie - FMAP H.R. 918 - Stronger Medicaid Response to the COVID-19 Pandemic Act - Rep. Cardenas, Tony - COVID-19 coverage for the uninsured via Medicaid H.R. 955 - Medicaid Reentry Act of 2021 - Rep. Tonko, Paul -Medicaid coverage for incarcerated individuals H.R. 1167 - Advancing Enrollment and Reducing Drug Costs Act of 2021 - Rep. Pappas, Chris - Medicaid eligibility for low-income subsidies H.R. 1227 - Medicare-X Choice Act of 2021 - Rep. Delgado, Antonio - Medicare public option H.R. 1332 - Telehealth Modernization Act - Rep. Carter, Earl - telehealth services under Medicare H.R. 1349 - The COVID-19 Hospital and Health Provider Loan Conversion Act of 2021- Rep. Kaptur, Marcy - advance payments under parts A and B of Medicare H.R. 1353 - Coronavirus Medicaid Response Act - Rep. Lee, Susie - FMAP H.R. 1390 - CHIPPER Act - Rep. Wild, Susan - CHIP funding H.R. 1397 - TIKES Act - Rep. Blunt Rochester, Lisa - telehealth under Medicaid and CHIP H.R. 1609 - Treatment in Place Act - Rep. Axne, Cynthia - Medicare coverage of ambulance services H.R. 1676 - Jack Reynolds Memory Medigap Expansion Act - Rep. Axne, Cynthia - Medigap coverage for ESRD H.R. 1677 - KEEP Telehealth Options Act of 2021 - Rep. Balderson, Troy - telehealth expansion H.R. 1717 - Protecting Married Seniors from Impoverishment Act of 2021 - Rep. Upton, Fred - permanent protections against spousal impoverishment H.R. 1722 - Puerto Rico Health Care Fairness, Accountability, and Beneficiary Access Act of 2021 - Rep. Velazquez, Nydia - Medicaid in Puerto Rico H.R. 1738 - Stabilize Medicaid and CHIP Coverage Act - Rep. Dingell, Debbie - Medicaid and CHIP continuous enrollment H.R. 1784 - Medicaid REACH Act - Rep. Doggett, Lloyd - requirements for non-expansion H.R. 1791 - CHIPP Act - Rep. Barragan, Nanette Diaz - extending CHIP H.R. 1792 - Ensuring Kids Have Access to Medically Necessary Dental Care Act - Rep. Barragan, Nanette Diaz - dental coverage under CHIP H.R. 1793 - Immediate Coverage for Former Foster Youth Act - Rep. Bass, Karen - Medicaid coverage for foster youth H.R. 1794 - Foster Youth Dental Act of 2021 - Rep. Bass, Karen - Medicaid dental coverage for foster youth H.R. 1823 - To amend title XIX of the Social Security Act to remove the matching requirement for a territory to use specially allocated Federal funds for Medicare covered part D drugs for low-income individuals - Resident Commissioner Gonzalez-Colon, Jenniffer - Medicare covered part D H.R. 1825 - Territories Medicare Prescription Drug Assistance Equality Act of 2021 - Resident Commissioner Gonzalez-Colon, Jenniffer - Medicare Part D premium and cost-sharing subsidies H.R. 1826 - Fairness in Medicare Part B Enrollment Act of 2021 - Resident Commissioner Gonzalez-Colon, Jenniffer - late enrollment penalties under part B of the Medicare program H.R. 1880 - To amend the Deficit Reduction Act of 2005 to make permanent the Money Follows the Person Rebalancing Demonstration - Rep. Dingell, Debbie - Money Follows the Person Rebalancing Demonstration H.R. 1885 - RUSH Protection Act of 2021 - Rep. Kind, Ron - Medicare rural health clinic payments H.R. 1887 - Rural Hospital Support Act - Rep. Reed, Tom - Medicare payments for hospitals H.R. 1890 - Health Insurance Consumer Protection Act - Rep. Schakowsky, Janice D. - network adequacy standards and premium rates H.R. 1914 - CAHOOTS Act - Rep. DeFazio, Peter A. - Medicaid mobile crisis intervention services H.R. 1969 - Medicare Advantage Integrity Act - Resident Commissioner Gonzalez-Colon, Jenniffer - disparity in MA benchmark rates H.R. 2035 - Improving Access to Mental Health Act of 2021 - Rep. Lee, Barbara - mental health services under Medicare H.R. 2080 - SAVE Act - Rep. Bishop, Sanford D., Jr. - Medicare coverage of transportation services H.R. 2166 - Ensuring Parity in MA and PACE for Audio-Only Telehealth Act of 2021 - Rep. Sewell, Terri - Medicare Advantage payments for audio-only diagnoses H.R. 2168 - Expanded Telehealth Access Act - Rep. Sherrill, Mikie - Medicare payment for telehealth services H.R. 2170 - HAPI Act - Rep. Soto, Darren - access to vaccines and Medicaid H.R. 2179 - Affordable Insulin for the COVID-19 Emergency Act - Rep. Waters, Maxine - cost-sharing regarding insulin coverage H.R. 2217 - Territory Federal Matching Requirement Equity Act of 2021 - Resident Commissioner Gonzalez-Colon, Jenniffer - Medicaid FMAP for Territories H.R. 2228 - Rural Behavioral Health Access Act of 2021 - Rep. Kildee, Daniel - Medicare coverage of outpatient telehealth services H.R. 4074 - Addressing Social Determinants in Medicare Advantage Act of 2021 - Rep. Bilirakis, Gus M. - Medicare Advantage supplemental benefits H.R. 4640 - Close the Medigap Act of 2021 - Rep. Doggett, Lloyd - Medigap policies H.R. 6833 - Affordable Insulin Now Act - Rep. Craig, Angie - Insulin prices and cost sharing S. 150 - Ensuring Parity in MA for Audio-Only Telehealth Act of 2021 - Sen. Cortez-Masto, Catherine - coverage of audio-only telehealth services in MA S. 151 - COVID HCBS Relief Act of 2021 - Sen. Casey, Robert - FMAP and HCBS S. 245 - SAME Act of 2021 - Sen. Warner, Mark - Medicaid expansion S. 274 - Stronger Medicaid Response to the COVID-19 Pandemic Act - Sen. Bennet, Michael - COVID-19 coverage for the uninsured via Medicaid S. 285 - Medicaid Reentry Act of 2021 - Sen. Baldwin, Tammy - Medicaid coverage for incarcerated individuals S. 368 - Telehealth Modernization Act - Sen. Scott, Tim - coverage of telehealth services under Medicare S. 386 - Medicare-X Choice Act of 2021 - Sen. Bennet, Michael - Medicare public option S. 439 - Coronavirus Medicaid Response Act - Sen. Casey, Robert - increases FMAP S. 440 - Continued Funding for Senior Services During COVID-19 Act - Sen. Casey, Robert - funding for services under the Older Americans Act of 1965 S. 453 - CHIPPER Act - Sen. Casey, Robert - CHIP funding S. 581 - HAPI Act -Sen. Brown, Sherrod - vaccines under Medicaid S. 620 - KEEP Telehealth Options Act of 2021 - Sen. Fischer, Deb - telehealth expansion S. 644 - Rural Hospital Closure Relief Act of 2021 - Sen. Durbin, Richard - Medicare coverage for critical access hospitals S. 646 - Stabilize Medicaid and CHIP Coverage Act of 2021 - Sen. Brown, Sherrod - Medicaid and CHIP enrollment S. 653 - COMP Act - Sen. Portman, Rob - Medicare secondary payer rules S. 712 - Dosha Joi Immediate Coverage for Former Foster Youth Act - Sen. Casey, Robert P., Jr. - Medicaid coverage for foster youth S. 748 - Medicare Sequester Relief Act - Sen. Shaheen, Jeanne - Medicare payment sequestration S. 764 - CAHOOTS Act - Sen. Wyden, Ron - Medicaid mobile crisis intervention services S. 826 - Medicare Patient Empowerment Act of 2021 - Sen. Paul, Rand - Medicaid payment options S. 870 - Improving Access to Mental Health Act of 2021 - Sen. Stabenow, Debbie - mental health services in Medicare S. 999 - Save Rural Hospitals Act of 2021 - Sen. Warner, Mark - Medicare hospital payments Regulatory Issues: Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, network adequacy and provider directories, encounter data and other data-related issues, and risk adjustment data validation (RADV) audit issues including proposed RADV regulation for MA; bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, Part D direct and indirect remuneration (DIR), and audits); issues related to Medicare for All, Medicare buy-in, reduced Medicare eligibility age, and public option; issues relating to 2024 Rate Notice; issues related to the expiration of Medicaid continuous eligibility and transitions in coverage; issues related to coverage of EUA drugs under Medicare Part D; issues related to coverage in non-Medicaid Expansion States (e.g., Gap Population); issues related to expanded Medicare fee for service benefits (dental, hearing and vision); issues related to Medicaid coverage gap; issues related to specialty infant formula; issues related to the Inflation Reduction Act passage and implementation; contraceptive coverage and reproductive health; Medicare NCD relating to monoclonal antibodies for treatment of Alzheimers disease; issues related to Managed Long Term Services and Supports (MLTSS); issues related to removal of safe harbor protection for rebates; issues relating to COVID-19, including testing, vaccines and therapeutics; issues related to the end of the public health emergency; telehealth; issues related to the cost of insulin, including price, copays, rebates, and medical management tools; issues related to health equity; issues related to vaccination; issues related to audio-only telehealth; issues related to addressing the social determinants of health, including housing, transportation, nutrition, educational opportunities, and MA supplemental benefits; issues related to Medicaid presumptive eligibility and continuous eligibility; issues relating to Medicaid best price; in-home health risk assessments; Medicare Medical Loss Ratio issues; issues related to changes to prior authorization regulations or legislation, electronic documentation, and related issues; issues relating to sequestration under the Medicare Advantage and Part D programs; implications of physician fee schedule on MA; application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, enrollment rules, requirements for notice and denial forms, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible SNPs; Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, Part D coverage gap discount program, including employer group waiver plan (EGWP) issues, and other operational issues; issues raised by Part D coverage of new specialty drugs, the Part D non-interference policy and related issues (e.g., preferred pharmacy and any willing pharmacy requirements, standards for network pharmacy reimbursement, and policies regarding sponsor negotiation of pharmacy price concessions); issues related to the international price index; issues related to child and maternal health; issues related to Medicaid supplemental and disproportionate share hospital (DSH) funding; issues related to Medicaid funding for territories; issues related to medical management; issues relating to MA supplemental benefits; Medication Therapy Management Program requirements and the Center for Medicare and Medicaid Innovation (CMMI) Demonstration; MA EGWP issues; CMMI's value based payment models; Part D requirements for offering basic and enhanced alternative plans; MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; issues relating to MA and Part D Star Rating system including measures, the methodology for calculating ratings, and the role of the ratings for payment purposes; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education Program; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; issues relating to MACRA, including implications for MA and Part D plans; Medicare/Medicaid integration for dual eligibles, including implementation of the Capitated Financial Alignment Demonstration and related issues (e.g., quality ratings); issues relating to potential Medicare mental health parity requirements; Medicaid managed care regulations and policies, including CMS's substantial revisions to the managed care regulations, mental health parity rules, the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, fraud and abuse compliance, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including block grants, the calculation of the federal medical assistance (federal matching) percentage (FMAP), and intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost issues affecting Medicaid health plans including issues raised by Medicaid coverage of new specialty drugs; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues and CHIP reauthorization; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including Medicaid managed care organization provider tax issues; standards for electronic prescribing; implementation of Medicaid changes of interest to Medicaid health plans made in the Affordable Care Act (ACA) including Medicaid expansion, the managed care organization (MCO) prescription drug rebate provisions, minimum payments to primary care providers (PCPs), interactions between the Medicaid program and health insurance exchanges, and Medicaid and CHIP maintenance of effort (MOE) requirements; issues related to Medicaid Managed long-term care including home and community-based waiver services (HCBS); expanding the availability of Medicare Advantage and Medicaid health plan telemedicine programs; implications of the new non-discrimination rules for health plans participating in public programs; issues related to Medigap coverage; issues related to business continuity in relation to pandemics or natural events (e.g., hurricane, tornado, etc.); cybersecurity; provider directories; value-based insurance design models; Part D prescriber enrollment requirements; Part D recovery audit contractor programs; issues relating to enrollment of beneficiaries with ESRD into MA plans; issues related to health homes for children with medically complex conditions; socioeconomic status impacts on star ratings related to MA and Part D programs; and other issues relating to health care reform implementation.
Client expense: $2,470,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office
2022 · fourth_quarter · Insurance
Support reforming prior authorization procedures to be more seamless, automated and transparent for physicians: HR 3173/ S.3018, Improving Seniors Timely Access to Care Act of 2021. Support extending and expanding telehealth: HR 1332 and S 368, The Telehealth Modernization Act; HR 2903 and S 1512, The Connect for Health Act; HR 4480 The Telehealth Coverage and Payment Parity Act and HR 2168 The Expanded Telehealth Access Act. Oppose H.R. 6087, Improving Access to Workers Compensation for Injured Federal Workers Act. Would inappropriately permit nurse practitioners and physician assistants to diagnose, prescribe, treat and certify an injury for federal workers compensation claims. Ensure relevant traveling physicians can appropriately treat their patients by supporting HR7259 the Medical Controlled Substances Transportation Act of 2022.
Client expense: $326,542 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · fourth_quarter · Medicare/Medicaid
Access and reimbursement of Part B drugs in Medicare. Continued expansion of Telehealth services including in H.R. 2168 - Expanded Telehealth Access Act and S. 368/H.R. 1332 - Telehealth Modernization Act. Provisions included in Title I-Subtitle B of P.L. 117-169/H.R. 5376 - Inflation Reduction Act of 2022. Support for site neutrality policies. Issues related to payments cuts to the Medicare Physician Fee Schedule including in H.R.8800 - Supporting Medicare Providers Act of 2022 and Sec.4112 of H.R. 2617 - Consolidated Appropriations Act of 2023 (P.L. No: 117-328). Support for Sec. 4113 - Advancing Telehealth Beyond COVID-19 included in H.R. 2617 - Consolidated Appropriations Act of 2023 (P.L. No: 117-328).
Client expense: Not reported · Firm income: $90,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · fourth_quarter · Health Issues
Continued expansion of Telehealth services including in H.R. 2168 - Expanded Telehealth Access Act and S. 368/H.R. 1332 - Telehealth Modernization Act. Policies to remove barriers to physician prescribing decisions including in H.R. 2163/S.464 - Safe Step Act of 2021. Support inclusion of Sec. 102 - Department of Veterans Affairs treatment and research of prostate cancer in Title I Subtitle A of H.R. 2617 - Consolidated Appropriations Act of 2023 (P.L. No: 117-328).
Client expense: Not reported · Firm income: $90,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · fourth_quarter · Medicare/Medicaid
Access and reimbursement of Part B Drugs in Medicare. Continued expansion of Telehealth services including in H.R. 2168 - Expanded Telehealth Access Act and S. 368/H.R. 1332 - Telehealth Modernization Act. Support for site neutrality policies. Provisions included in Title I - Subtitle B of Public Law No: 117-169/H.R. 5376 - Inflation Reduction Act of 2022. Issues related to payments cuts to the Medicare Physician Fee Schedule including in H.R.8800 - Supporting Medicare Providers Act of 2022 and Sec. 4112 of H.R. 2617 - Consolidated Appropriations Act of 2023 (P.L. No: 117-328). Support for Sec. 4113 - Advancing Telehealth Beyond COVID-19 included in H.R. 2617 - Consolidated Appropriations Act of 2023 (P.L. No: 117-328).
Client expense: Not reported · Firm income: $70,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · fourth_quarter · Health Issues
Continued expansion of Telehealth services including in H.R. 2168 - Expanded Telehealth Access Act and S. 368/H.R. 1332 - Telehealth Modernization Act. Policies to remove barriers to physician prescribing decisions including in H.R. 2163/S. 464 - Safe Step Act of 2021.
Client expense: Not reported · Firm income: $70,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · fourth_quarter · Medicare/Medicaid
Continued access to occupational therapy services including in H.R. 5536 - Stabilizing Medicare Access to Rehabilitation and Therapy (SMART) Act. Continued expansion of Telehealth services in H.R. 2168 - Expanded Telehealth Access Act and S. 368/H.R. 1332 - Telehealth Modernization Act. Support introduction of S. 4712 - Occupational Therapy Mental Health Parity Act. Provisions related to payments cuts to the Medicare Physician Fee Schedule included in Sec. 4112 of H.R. 2617 - Consolidated Appropriations Act of 2023 (P.L. No: 117-328).
Client expense: Not reported · Firm income: $40,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · fourth_quarter · Health Issues
Continued expansion of Telehealth services in H.R. 2168 - Expanded Telehealth Access Act and S. 368/H.R. 1332 - Telehealth Modernization Act.
Client expense: Not reported · Firm income: $40,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · fourth_quarter · Medicare/Medicaid
HR 8344: Electrodiagnostic Medicine Patient Protection and Fraud Elimination Act of 2022 Medicare sequestration moratorium Medicaid coverage and reimbursement Medicare wound care coverage National Correct Coding Initiative Edits Protection of programs related to physical therapy in deficit reduction Medicare Advantage Essential Health Benefits Medicare improvement standards Inclusion of physical therapists in quality programs Medicare Self-referral Coverage of telehealth under Medicare, Medicare Advantage, and Medicaid H.R. 2168/S. 3193 Expanded Telehealth Access Act APTA PT Outcomes Registry/Qualified Clinical Data Registries Medicare Quality Programs Accelerating Innovation in Medicine Act Improving Medicare Post-Acute Care Transformation Act Chronic Care Management Orthotics and Prosthetics H.R. 1990/S. 2556: Medicare Orthotics and Prosthetics Patient-Centered Care Act Medicare Private Contracting H.R. 3322/S. 826 Medicare Patient Empowerment Act Skilled Nursing Facility 3-Day rule H.R. 5536 Stabilizing Medicare Access to Rehabilitation and Therapy (SMART) Act PTA Differential in Medicare Prior Authorization in Medicare Advantage Plans Alternative payment models Health information technology: Electronic health records, health IT incentives for physical therapists, certification of EHRs interoperability, and information blocking durable medical equipment prosthetics orthotics and supplies competitive bidding H.R. 3630/S. 1315 Lymphedema Treatment Act Medicare enrollment Skilled Nursing Facility payment Home Health payment Medical review (Medicare) Reducing Health Care costs REAADI & DRMA Acts Home Health Payment Innovation Act H.R. 3173/S. 3018 Improving Seniors Timely Access to Care Act H.R. 3650/S. 2048 Improving Access to Medicare Coverage Act Critical Access Hospital Relief Act Medicare Fee Schedule Unified post-acute care prospective payment system Inpatient rehabilitation facilities / long term care hospital payment HIPAA proposed rule HR 6020 - Support Medicare Providers Act S. 3799 PREVENT Pandemics Act H.R. 5365 Primary Health Services Enhancement Act H.R. 8181 Optimizing Postpartum Outcomes Act H.R 8800 Supporting Medicare Providers Act of 2022 S. 5 PTA/OTA Supervision
Client expense: $202,662 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE, Small Business Administration (SBA), Veterans Affairs, Dept of (VA), White House Office
2022 · fourth_quarter · Health Issues
Public Health Emergency, Telehealth, and Physician Virtual Supervision issues. H.R.2168/S.3193 - Expanded Telehealth Access Act, H.R.2903/S.1512- CONNECT for Health Act, H.R. 6202 - Telehealth Expansion Act, H.R.1332/S.368 - Telehealth Modernization Act, H.R.7573/S.3593 - Telehealth Extension and Evaluation Act; H.R.9247 - The Sustainable Cardiopulmonary Rehabilitation Services in the Home Act
Client expense: Not reported · Firm income: $20,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · fourth_quarter · Medicare/Medicaid
DMEPOS payment and coverage Extension of telehealth flexibilities S. 3193/H.R.2168 - Expanded Telehealth Access Act S. 2556/H.R.1990 - Medicare Orthotics and Prosthetics Patient-Centered Care Act Issues surrounding local coverage determinations, local coverage articles, and carrier advisory committees Issues surrounding Medicare reimbursement H.R. 4040 - Advancing Telehealth Beyond COVID-19 Act HR 8800 - Supporting Medicare Providers Act of 2022 H.R.2617 - Consolidated Appropriations Act, 2023
Client expense: Not reported · Firm income: $20,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · fourth_quarter · Medicare/Medicaid
Expanded Telehealth Access Act (H.R.2168) Improving Access to Medicare Coverage Act of 2021 (H.R.3650/S.2048) Creating Opportunities Now and Effective Care Technologies (CONNECT) for Health Act of 2021 (S.1512/H.R.2903) Stabilizing Medicare Access to Rehabilitation and Therapy (SMART) Act of 2021 (H.R.5536) Telehealth Extension Act (H.R.6202) Protecting Medicare and American Farmers from Sequester Cuts Act (S.610) Improving Seniors' Timely Access to Care Act (H.R.3173/S.3018) Saving Access to Laboratory Services Act (H.R.8188/S.4449) Advancing Telehealth Beyond COVID-19 Act of 2021 (H.R.4040) Supporting Medicare Providers Act of 2022 (H.R.8800) H.Res 1177 - Expressing the sense of the House of Representatives regarding the Centers for Medicare & Medicaid Services developing a mobility metric to guide providers in preventing mobility loss among hospitalized older adults.
Client expense: $39,516 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2022 · fourth_quarter · Medicare/Medicaid
Issues relating to durable medical equipment (DME) including Medicare reimbursement, sequestration and "PAYGO" relief, extending DME non-Competitive Bidding area relief included in the "CARES" Act of 2020 (Pub. Law 116-136); issues related to the COVID-19 public health emergency including for home respiratory therapy coverage and documentation; DMEPOS Relief Act of 2022 (H.R. 6641); Expanded Telehealth Access Act (H.R. 2168); Consolidated Appropriations Act, 2023 (Pub. Law 117-328).
Client expense: $300,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · fourth_quarter · Medicare/Medicaid
Issues pertaining to durable medical equipment including: competitive bidding, power wheelchairs, oxygen, non-invasive ventilators, diabetic supplies, negative pressure wound therapy, Medicare audits, sequestration; Medicare sequestration paygo relief legislation (H.R. 1868 - To prevent across-the-board direct spending cuts, and for other purposes); Issues related the non-application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs manual accessories, titanium/carbon upgrade legislation, and Medicare coverage of seat elevation and standing features; Issues related to Medicare reimbursement cuts in DME noncompetitive bidding areas; H.R. 2168 - Expanded Telehealth Access Act, and for other purposes; Issues related to the COVID-19 public health emergency; H.R. 2079 - To provide that CARES Act Provider Relief Fund payments are not includible in gross income, and for other purposes; Issues related to the 2020 DME proposed rule; H.R. 6641 - DMEPOS Relief Act of 2022 and H.R. 2356/S. 2363 - Better Wound Care at Home Act of 2021.
Client expense: $250,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE
2022 · fourth_quarter · Medicare/Medicaid
S 1315/HR 3630 - The Lymphedema Treatment At: Support passage. HR 5536 - Stabilizing Medicare Access to Rehabilitation and Therapy (SMART) Act: Advocated for passage of SMART Act and related S5 (To amend title XVIII of the Social Security Act to ensure appropriate supervision requirements for outpatient physical therapy and outpatient occupational therapy), which contained provision of SMART Act that revised supervision rules for Occupational Therapy Assistants. HR 2168/S3193 - Expanded Telehealth Access Act: Advocated for passage. S. 368/HR 1332 - Telehealth Modernization Act: Advocated for passage. HR 1990/S 2556 - Medicare Orthotics and Prosthetics Patient-Centered Care Act: Lobbied for changes to the bills to ensure the legislation does not disrupt the ability of occupational therapy practitioners to provide and bill for orthotics and prosthetics and related services under Medicare. S.4712-OT Mental Health Parity Act: Support Passage of bill to direct CMS to put forward guidance clarifying that occupational therapy services can be provided to a person with a mental or behavioral health diagnosis under Medicare and Medicaid. HR3173/S3018-Improving Seniors' Timely Access to Care Act: Support passage. HR 6202 - Telehealth Extension Act: Endorsed S.3593 - Telehealth Extension & Evaluation Act: Endorsed HR 6770-PACE Plus Act and S 3626 PACE Expanded Act: Support passage HR 8800 - Supporting Medicare Providers Act of 2022: Advocate for passage HR 4040, Advancing Telehealth Beond COVID-19 Act of 2021 - Support Senate adoption to extend telehealth waivers through the end of 2024. Provision adopted as part of the year-end Omnibus. H.R. 2617 - Consolidated Appropriations Act of 2023: Support inclusion of all above provisions in end of year Omnibus bill. No bill: Supported efforts to include occupational therapy in new school-based Medicaid guidelines, where appropriate. No bill number: Support for passage of legislative provisions to clarify providers who are exempt from competitive bidding when providing orthotics and prosthetics, and reducing fraud in the provision of orthotics and prosthetics.
Client expense: $180,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · fourth_quarter · Medicare/Medicaid
Issues pertaining to durable medical equipment including: competitive bidding, power wheelchairs, oxygen, non-invasive ventilators, diabetic supplies, negative pressure wound therapy, Medicare audits, sequestration; Medicare sequestration paygo relief legislation (H.R. 1868 - To prevent across-the-board direct spending cuts, and for other purposes); Issues related the non-application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs manual accessories, titanium/carbon upgrade legislation, and Medicare coverage of seat elevation and standing features; Issues related to Medicare reimbursement cuts in DME noncompetitive bidding areas; H.R. 2168 - Expanded Telehealth Access Act, and for other purposes; Issues related to the COVID-19 public health emergency; H.R. 2079 - To provide that CARES Act Provider Relief Fund payments are not includible in gross income, and for other purposes; Issues related to the 2020 DME proposed rule; - H.R. 6641 - DMEPOS Relief Act of 2022 and H.R. 2356/S. 2363 - Better Wound Care at Home Act of 2021.
Client expense: Not reported · Firm income: $60,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2022 · fourth_quarter · Medicare/Medicaid
H.R. 1587/S. 1731, the Medicare Audiologist Access and Services Act of 2021 H.R. 2168/S. 3193, the Expanded Telehealth Access Act H.R. 4040, the Advancing Telehealth Beyond COVID-19 Act of 2021 H.R. 4311, the Medicare Dental, Vision, and Hearing Benefit Act H.R. 6202, the Telehealth Extension Act H.R. 6020/S. 3314, the Supporting Medicare Providers Act of 2021 H.R. 7876, the Connecting Rural Telehealth to the Future Act H.R. 2471, the Consolidated Appropriations Act, 2022 (Public Law 117-103) Implementation of S. 610, the Protecting Medicare and American Farmers from Sequester Cuts Act Implementation of H.R. 1319, American Rescue Plan Act of 2021 (Public Law 117-2) Issues related to enhanced Federal Medical Assistance Percentage in Medicaid Various issues related to CMS Actions surrounding: Medicare supervision requirements audits of medical records and claims for Part A and B services code development and reimbursement of personal protective equipment Quality reporting under MIPS Implementation of the IMPACT Act Medicare physician fee schedule Prospective payments systems Demonstration projects/episodic payment models Accountable Care Organizations Federally-facilitated marketplace Medicare Advantage Reimbursement of telehealth services COVID-19 emergency telepractice coverage of Medicare, Medicare Advantage and Medicaid Medicare telehealth coverage under Part A and B Essential and Non-essential personnel designation Implementation of CARES Act (P.L. 116-136) Provision and payment for Part A therapy Various issues related to implementation of ACA Various issues related to Medicaid in schools Advocated for Medicaid Federal Medical Assistance Percentage (FMAP) Sequestration H.R. 3173/S. 3018, the Improving Seniors Timely Access to Care Act Issues related to extension of COVID-19 public health emergency H.R. 8800, the Supporting Medicare Providers Act of 2022 Issues related to coverage of augmentative and alternative communication devices and systems and their role in integration of individuals with disabilities in work and community settings Issues related to Medicare beneficiaries accessing services provided by audiologists without a physician order H.R.6833 - Continuing Appropriations and Ukraine Supplemental Appropriations Act, 2023 H.R. 2617, Consolidated Appropriations Act, 2023
Client expense: $270,000 · Firm income: Not reported
Government targets: Administration on Aging, Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE
2022 · fourth_quarter · Health Issues
1. The Prevent Interruptions in Physical Therapy Act (H.R.1611/S.2612)to allow ALL private practice physical therapists-regardless of where their clinic is located-to use a locum tenens to provide their Medicare patients continued care when they need to be out of the clinic. 2. The Expanded Telehealth Access Act (H.R.2168/S.3193) to permanently add physical therapists, physical therapist assistants, and other rehabilitation therapists to the list of providers that Medicare pays for telehealth. 3. The Medicare Patient Empowerment Act (S.826/H.R.3322)to allow a Medicare beneficiary to enter into a direct contract with an eligible professional (regardless of whether that person was a participating or non-participating physician or practitioner) for any item or service covered by Medicare. 4. The SMART Act (H.R.5536) to delay implementation of the PTA/OTA differential by one year, exempt therapy assistants in rural and medically underserved areas from the differential, and to change the supervision requirement for PTAs in private practice settings to that which state law requires. 5. S.5, a bill to change the supervision requirement for PTAs in private practice settings to that which state law requires. 6. The Improving Seniors Timely Access to Care Act (H.R.3173/S.3108) to reduce administrative burden by requiring a streamed and standardized way Medicare Advantage (MA) plans use prior authorization as well as increasing oversight and transparency around prior authorization.
Client expense: Not reported · Firm income: $30,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE
2022 · third_quarter · Health Issues
1. The Prevent Interruptions in Physical Therapy Act (H.R.1611/S.2612)to allow ALL private practice physical therapists-regardless of where their clinic is located-to use a locum tenens to provide their Medicare patients continued care when they need to be out of the clinic. 2. The Expanded Telehealth Access Act (H.R.2168/S.3193) to permanently add physical therapists, physical therapist assistants, and other rehabilitation therapists to the list of providers that Medicare pays for telehealth. 3. The Medicare Patient Empowerment Act (S.826/H.R.3322)to allow a Medicare beneficiary to enter into a direct contract with an eligible professional (regardless of whether that person was a participating or non-participating physician or practitioner) for any item or service covered by Medicare. 4. The SMART Act (H.R.5536) to delay implementation of the PTA/OTA differential by one year, exempt therapy assistants in rural and medically underserved areas from the differential, and to change the supervision requirement for PTAs in private practice settings to that which state law requires. 5. S.5, a bill to change the supervision requirement for PTAs in private practice settings to that which state law requires. 6. The Improving Seniors Timely Access to Care Act (H.R.3173/S.3108) to reduce administrative burden by requiring a streamed and standardized way Medicare Advantage (MA) plans use prior authorization as well as increasing oversight and transparency around prior authorization.
Client expense: Not reported · Firm income: $30,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE
2022 · third_quarter · Medicare/Medicaid
Expanded Telehealth Access Act (H.R.2168) Improving Access to Medicare Coverage Act of 2021 (H.R.3650/S.2048) Creating Opportunities Now and Effective Care Technologies (CONNECT) for Health Act of 2021 (S.1512/H.R.2903) Stabilizing Medicare Access to Rehabilitation and Therapy (SMART) Act of 2021 (H.R.5536) Telehealth Extension Act (H.R.6202) Protecting Medicare and American Farmers from Sequester Cuts Act (S.610) Improving Seniors' Timely Access to Care Act (H.R.3173/S.3018) Saving Access to Laboratory Services Act (H.R.8188/S.4449) Advancing Telehealth Beyond COVID-19 Act of 2021 (H.R.4040) Supporting Medicare Providers Act of 2022 (H.R.8800) H.Res 1177 - Expressing the sense of the House of Representatives regarding the Centers for Medicare & Medicaid Services developing a mobility metric to guide providers in preventing mobility loss among hospitalized older adults.
Client expense: $39,516 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2022 · third_quarter · Medicare/Medicaid
H.R. 66 - CARING for Kids Act - Rep. Buchanan, Vern - CHIP H.R. 265 - Insular Area Medicaid Parity Act - Rep. Sablan, Gregorio Kilili Camacho - Medicaid funding H.R. 315 - Medicare Sequester COVID Moratorium Act - Rep. Schneider, Bradley Scott - Medicare sequestration H.R. 340 - Incentivizing Medicaid Expansion Act of 2021 - Rep. Veasey, Marc - Medicaid expansion H.R. 432 - Mental Health Access Improvement Act of 2021 - Rep. Thompson, Mike -Medicare coverage of marriage and family therapist services and mental health counselor H.R. 502 - Medicare Dental Benefit Act of 2021 - Rep. Barragan, Nanette Diaz - Medicare coverage of dental and oral health services H.R. 525 - COVID HCBS Relief Act of 2021 - Rep. Dingell, Debbie - increased FMAP for HCBS H.R. 871 - Expand Medicaid Now Act - Rep. Fletcher, Lizzie - FMAP H.R. 918 - Stronger Medicaid Response to the COVID-19 Pandemic Act - Rep. Cardenas, Tony - COVID-19 coverage for the uninsured via Medicaid H.R. 955 - Medicaid Reentry Act of 2021 - Rep. Tonko, Paul -Medicaid coverage for incarcerated individuals H.R. 1167 - Advancing Enrollment and Reducing Drug Costs Act of 2021 - Rep. Pappas, Chris - Medicaid eligibility for low-income subsidies H.R. 1227 - Medicare-X Choice Act of 2021 - Rep. Delgado, Antonio - Medicare public option H.R. 1332 - Telehealth Modernization Act - Rep. Carter, Earl - telehealth services under Medicare H.R. 1349 - The COVID-19 Hospital and Health Provider Loan Conversion Act of 2021- Rep. Kaptur, Marcy - advance payments under parts A and B of Medicare H.R. 1353 - Coronavirus Medicaid Response Act - Rep. Lee, Susie - FMAP H.R. 1390 - CHIPPER Act - Rep. Wild, Susan - CHIP funding H.R. 1397 - TIKES Act - Rep. Blunt Rochester, Lisa - telehealth under Medicaid and CHIP H.R. 1609 - Treatment in Place Act - Rep. Axne, Cynthia - Medicare coverage of ambulance services H.R. 1676 - Jack Reynolds Memory Medigap Expansion Act - Rep. Axne, Cynthia - Medigap coverage for ESRD H.R. 1677 - KEEP Telehealth Options Act of 2021 - Rep. Balderson, Troy - telehealth expansion H.R. 1717 - Protecting Married Seniors from Impoverishment Act of 2021 - Rep. Upton, Fred - permanent protections against spousal impoverishment H.R. 1722 - Puerto Rico Health Care Fairness, Accountability, and Beneficiary Access Act of 2021 - Rep. Velazquez, Nydia - Medicaid in Puerto Rico H.R. 1738 - Stabilize Medicaid and CHIP Coverage Act - Rep. Dingell, Debbie - Medicaid and CHIP continuous enrollment H.R. 1784 - Medicaid REACH Act - Rep. Doggett, Lloyd - requirements for non-expansion H.R. 1791 - CHIPP Act - Rep. Barragan, Nanette Diaz - extending CHIP H.R. 1792 - Ensuring Kids Have Access to Medically Necessary Dental Care Act - Rep. Barragan, Nanette Diaz - dental coverage under CHIP H.R. 1793 - Immediate Coverage for Former Foster Youth Act - Rep. Bass, Karen - Medicaid coverage for foster youth H.R. 1794 - Foster Youth Dental Act of 2021 - Rep. Bass, Karen - Medicaid dental coverage for foster youth H.R. 1823 - To amend title XIX of the Social Security Act to remove the matching requirement for a territory to use specially allocated Federal funds for Medicare covered part D drugs for low-income individuals - Resident Commissioner Gonzalez-Colon, Jenniffer - Medicare covered part D H.R. 1825 - Territories Medicare Prescription Drug Assistance Equality Act of 2021 - Resident Commissioner Gonzalez-Colon, Jenniffer - Medicare Part D premium and cost-sharing subsidies H.R. 1826 - Fairness in Medicare Part B Enrollment Act of 2021 - Resident Commissioner Gonzalez-Colon, Jenniffer - late enrollment penalties under part B of the Medicare program H.R. 1880 - To amend the Deficit Reduction Act of 2005 to make permanent the Money Follows the Person Rebalancing Demonstration - Rep. Dingell, Debbie - Money Follows the Person Rebalancing Demonstration H.R. 1885 - RUSH Protection Act of 2021 - Rep. Kind, Ron - Medicare rural health clinic payments H.R. 1887 - Rural Hospital Support Act - Rep. Reed, Tom - Medicare payments for hospitals H.R. 1890 - Health Insurance Consumer Protection Act - Rep. Schakowsky, Janice D. - network adequacy standards and premium rates H.R. 1914 - CAHOOTS Act - Rep. DeFazio, Peter A. - Medicaid mobile crisis intervention services H.R. 1969 - Medicare Advantage Integrity Act - Resident Commissioner Gonzalez-Colon, Jenniffer - disparity in MA benchmark rates H.R. 2035 - Improving Access to Mental Health Act of 2021 - Rep. Lee, Barbara - mental health services under Medicare H.R. 2080 - SAVE Act - Rep. Bishop, Sanford D., Jr. - Medicare coverage of transportation services H.R. 2166 - Ensuring Parity in MA and PACE for Audio-Only Telehealth Act of 2021 - Rep. Sewell, Terri - Medicare Advantage payments for audio-only diagnoses H.R. 2168 - Expanded Telehealth Access Act - Rep. Sherrill, Mikie - Medicare payment for telehealth services H.R. 2170 - HAPI Act - Rep. Soto, Darren - access to vaccines and Medicaid H.R. 2179 - Affordable Insulin for the COVID-19 Emergency Act - Rep. Waters, Maxine - cost-sharing regarding insulin coverage H.R. 2217 - Territory Federal Matching Requirement Equity Act of 2021 - Resident Commissioner Gonzalez-Colon, Jenniffer - Medicaid FMAP for Territories H.R. 2228 - Rural Behavioral Health Access Act of 2021 - Rep. Kildee, Daniel - Medicare coverage of outpatient telehealth services H.R. 4074 - Addressing Social Determinants in Medicare Advantage Act of 2021 - Rep. Bilirakis, Gus M. - Medicare Advantage supplemental benefits H.R. 4640 - Close the Medigap Act of 2021 - Rep. Doggett, Lloyd - Medigap policies H.R. 6833 - Affordable Insulin Now Act - Rep. Craig, Angie - Insulin prices and cost sharing S. 150 - Ensuring Parity in MA for Audio-Only Telehealth Act of 2021 - Sen. Cortez-Masto, Catherine - coverage of audio-only telehealth services in MA S. 151 - COVID HCBS Relief Act of 2021 - Sen. Casey, Robert - FMAP and HCBS S. 245 - SAME Act of 2021 - Sen. Warner, Mark - Medicaid expansion S. 274 - Stronger Medicaid Response to the COVID-19 Pandemic Act - Sen. Bennet, Michael - COVID-19 coverage for the uninsured via Medicaid S. 285 - Medicaid Reentry Act of 2021 - Sen. Baldwin, Tammy - Medicaid coverage for incarcerated individuals S. 368 - Telehealth Modernization Act - Sen. Scott, Tim - coverage of telehealth services under Medicare S. 386 - Medicare-X Choice Act of 2021 - Sen. Bennet, Michael - Medicare public option S. 439 - Coronavirus Medicaid Response Act - Sen. Casey, Robert - increases FMAP S. 440 - Continued Funding for Senior Services During COVID-19 Act - Sen. Casey, Robert - funding for services under the Older Americans Act of 1965 S. 453 - CHIPPER Act - Sen. Casey, Robert - CHIP funding S. 581 - HAPI Act -Sen. Brown, Sherrod - vaccines under Medicaid S. 620 - KEEP Telehealth Options Act of 2021 - Sen. Fischer, Deb - telehealth expansion S. 644 - Rural Hospital Closure Relief Act of 2021 - Sen. Durbin, Richard - Medicare coverage for critical access hospitals S. 646 - Stabilize Medicaid and CHIP Coverage Act of 2021 - Sen. Brown, Sherrod - Medicaid and CHIP enrollment S. 653 - COMP Act - Sen. Portman, Rob - Medicare secondary payer rules S. 712 - Dosha Joi Immediate Coverage for Former Foster Youth Act - Sen. Casey, Robert P., Jr. - Medicaid coverage for foster youth S. 748 - Medicare Sequester Relief Act - Sen. Shaheen, Jeanne - Medicare payment sequestration S. 764 - CAHOOTS Act - Sen. Wyden, Ron - Medicaid mobile crisis intervention services S. 826 - Medicare Patient Empowerment Act of 2021 - Sen. Paul, Rand - Medicaid payment options S. 870 - Improving Access to Mental Health Act of 2021 - Sen. Stabenow, Debbie - mental health services in Medicare S. 999 - Save Rural Hospitals Act of 2021 - Sen. Warner, Mark - Medicare hospital payments Regulatory Issues: Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, network adequacy and provider directories, encounter data and other data-related issues, and risk adjustment data validation (RADV) audit issues including proposed RADV regulation for MA; bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, Part D direct and indirect remuneration (DIR), and audits); calendar year 2023 policy and technical regulation for MA and Part D; issues related to Medicare for All, Medicare buy-in, reduced Medicare eligibility age, and public option; issues relating to 2023 Rate Notice; issues related to coverage in non-Medicaid Expansion States (e.g., Gap Population); issues related to expanded Medicare fee for service benefits (dental, hearing and vision); issues related to Medicaid coverage gap; issues related to specialty infant formula; issues related to the Inflation Reduction Act passage and implementation; contraceptive coverage and reproductive health; Medicare NCD relating to monoclonal antibodies for treatment of Alzheimers disease; issues related to Managed Long Term Services and Supports (MLTSS); issues related to removal of safe harbor protection for rebates; issues relating to COVID-19, including testing, vaccines and therapeutics; issues related to the end of the public health emergency; telehealth; issues related to the cost of insulin, including price, copays, rebates, and medical management tools; issues related to health equity; issues related to vaccination; issues related to audio-only telehealth; issues related to addressing the social determinants of health, including housing, transportation, nutrition, educational opportunities, and MA supplemental benefits; issues related to Medicaid presumptive eligibility and continuous eligibility; issues relating to Medicaid best price; in-home health risk assessments; Medicare Medical Loss Ratio issues; issues related to changes to prior authorization regulations or legislation, electronic documentation, and related issues; issues relating to sequestration under the Medicare Advantage and Part D programs; implications of physician fee schedule on MA; application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, enrollment rules, requirements for notice and denial forms, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible SNPs; Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, Part D coverage gap discount program, including employer group waiver plan (EGWP) issues, and other operational issues; issues raised by Part D coverage of new specialty drugs, the Part D non-interference policy and related issues (e.g., preferred pharmacy and any willing pharmacy requirements, standards for network pharmacy reimbursement, and policies regarding sponsor negotiation of pharmacy price concessions); issues related to the international price index; issues related to child and maternal health; issues related to Medicaid supplemental and disproportionate share hospital (DSH) funding; issues related to Medicaid funding for territories; issues related to medical management; issues relating to MA supplemental benefits; Medication Therapy Management Program requirements and the Center for Medicare and Medicaid Innovation (CMMI) Demonstration; MA EGWP issues; CMMI's value based payment models; Part D requirements for offering basic and enhanced alternative plans; MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; issues relating to MA and Part D Star Rating system including measures, the methodology for calculating ratings, and the role of the ratings for payment purposes; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education Program; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; issues relating to MACRA, including implications for MA and Part D plans; Medicare/Medicaid integration for dual eligibles, including implementation of the Capitated Financial Alignment Demonstration and related issues (e.g., quality ratings); issues relating to potential Medicare mental health parity requirements; Medicaid managed care regulations and policies, including CMS's substantial revisions to the managed care regulations, mental health parity rules, the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, fraud and abuse compliance, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including block grants, the calculation of the federal medical assistance (federal matching) percentage (FMAP), and intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost issues affecting Medicaid health plans including issues raised by Medicaid coverage of new specialty drugs; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues and CHIP reauthorization; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including Medicaid managed care organization provider tax issues; standards for electronic prescribing; implementation of Medicaid changes of interest to Medicaid health plans made in the Affordable Care Act (ACA) including Medicaid expansion, the managed care organization (MCO) prescription drug rebate provisions, minimum payments to primary care providers (PCPs), interactions between the Medicaid program and health insurance exchanges, and Medicaid and CHIP maintenance of effort (MOE) requirements; issues related to Medicaid Managed long-term care including home and community-based waiver services (HCBS); expanding the availability of Medicare Advantage and Medicaid health plan telemedicine programs; implications of the new non-discrimination rules for health plans participating in public programs; issues related to Medigap coverage; issues related to business continuity in relation to pandemics or natural events (e.g., hurricane, tornado, etc.); cybersecurity; provider directories; value-based insurance design models; Part D prescriber enrollment requirements; Part D recovery audit contractor programs; issues relating to enrollment of beneficiaries with ESRD into MA plans; issues related to health homes for children with medically complex conditions; socioeconomic status impacts on star ratings related to MA and Part D programs; and other issues relating to health care reform implementation. *Add MACPAC to Agency List.
Client expense: $3,230,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office
2022 · third_quarter · Health Issues
Continued expansion of Telehealth services including in H.R. 2168 - Expanded Telehealth Access Act and S. 368/H.R. 1332 - Telehealth Modernization Act. Policies to remove barriers to physician prescribing decisions including in H.R. 2163/S.464 - Safe Step Act of 2021.
Client expense: Not reported · Firm income: $90,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · third_quarter · Medicare/Medicaid
Access and reimbursement of Part B drugs in Medicare. Continued expansion of Telehealth services including in H.R. 2168 - Expanded Telehealth Access Act and S. 368/H.R. 1332 - Telehealth Modernization Act. Provisions included in Title I-Subtitle B of P.L. 117-169/H.R. 5376 - Inflation Reduction Act of 2022. Support for site neutrality policies. Issues related to physician payments included in H.R. 8800 - Supporting Medicare Providers Act of 2022.
Client expense: Not reported · Firm income: $90,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · third_quarter · Health Issues
Continued expansion of Telehealth services including in H.R. 2168 - Expanded Telehealth Access Act and S. 368/H.R. 1332 - Telehealth Modernization Act. Policies to remove barriers to physician prescribing decisions including in H.R. 2163/S. 464 - Safe Step Act of 2021.
Client expense: Not reported · Firm income: $70,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · third_quarter · Medicare/Medicaid
Access and reimbursement of Part B Drugs in Medicare. Continued expansion of Telehealth services including in H.R. 2168 - Expanded Telehealth Access Act and S. 368/H.R. 1332 - Telehealth Modernization Act. Support for site neutrality policies. Provisions included in Title I - Subtitle B of Public Law No: 117-169/H.R. 5376 - Inflation Reduction Act of 2022. Issues related to physician payments including in H.R.8800 - Supporting Medicare Providers Act of 2022.
Client expense: Not reported · Firm income: $70,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · third_quarter · Medicare/Medicaid
Continued access to occupational therapy services including in H.R. 5536 - Stabilizing Medicare Access to Rehabilitation and Therapy (SMART) Act. Continued expansion of Telehealth services in H.R. 2168 - Expanded Telehealth Access Act and S. 368/H.R. 1332 - Telehealth Modernization Act. Support introduction of S. 4712 - Occupational Therapy Mental Health Parity Act.
Client expense: Not reported · Firm income: $40,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · third_quarter · Health Issues
Continued expansion of Telehealth services in H.R. 2168 - Expanded Telehealth Access Act and S. 368/H.R. 1332 - Telehealth Modernization Act.
Client expense: Not reported · Firm income: $40,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · third_quarter · Insurance
Support reforming prior authorization procedures to be more seamless, automated and transparent for physicians: HR 3173/ S.3018, Improving Seniors Timely Access to Care Act of 2021. Support extending and expanding telehealth: HR 1332 and S 368, The Telehealth Modernization Act; HR 2903 and S 1512, The Connect for Health Act; HR 4480 The Telehealth Coverage and Payment Parity Act and HR 2168 The Expanded Telehealth Access Act. Oppose H.R. 6087, Improving Access to Workers Compensation for Injured Federal Workers Act. Would inappropriately permit nurse practitioners and physician assistants to diagnose, prescribe, treat and certify an injury for federal workers compensation claims. Ensure relevant traveling physicians can appropriately treat their patients by supporting H.R. 7259 the Medical Controlled Substances Transportation Act of 2022
Client expense: $319,516 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · third_quarter · Medicare/Medicaid
Issues pertaining to durable medical equipment including: competitive bidding, power wheelchairs, oxygen, non-invasive ventilators, diabetic supplies, negative pressure wound therapy, Medicare audits, sequestration; Medicare sequestration relief legislation (H.R. 1868 - To prevent across-the-board direct spending cuts, and for other purposes); Issues related the non-application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs manual accessories, titanium/carbon upgrade legislation, and Medicare coverage of seat elevation and standing features; Issues related to Medicare reimbursement cuts in DME noncompetitive bidding areas; H.R. 2168 - Expanded Telehealth Access Act, and for other purposes; Issues related to the COVID-19 public health emergency; H.R. 2079 - To provide that CARES Act Provider Relief Fund payments are not includible in gross income, and for other purposes; Issues related to the 2020 DME proposed rule; - H.R. 6641 - DMEPOS Relief Act of 2022 and H.R. 2356/S. 2363 - Better Wound Care at Home Act of 2021.
Client expense: $250,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE
2022 · third_quarter · Medicare/Medicaid
DMEPOS payment and coverage Extension of telehealth flexibilities S. 3193/H.R.2168 - Expanded Telehealth Access Act S. 2556/H.R.1990 - Medicare Orthotics and Prosthetics Patient-Centered Care Act Issues surrounding local coverage determinations, local coverage articles, and carrier advisory committees Issues surrounding Medicare reimbursement H.R. 4040 - Advancing Telehealth Beyond COVID-19 Act HR 8800 - Supporting Medicare Providers Act of 2022
Client expense: Not reported · Firm income: $20,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · third_quarter · Medicare/Medicaid
S 1315/HR 3630 - The Lymphedema Treatment At: Support passage. HR 5536 - Stabilizing Medicare Access to Rehabilitation and Therapy (SMART) Act: Advocated for passage and support introduction of similar legislation in the Senate. HR 2168/S3193 - Expanded Telehealth Access Act: Advocated for passage. S. 368/HR 1332 - Telehealth Modernization Act: Advocated for passage. HR 1990/S 2556 - Medicare Orthotics and Prosthetics Patient-Centered Care Act: Lobbied for changes to the bills to ensure the legislation does not disrupt the ability of occupational therapy practitioners to provide and bill for orthotics and prosthetics and related services under Medicare. S.4712-OT Mental Health Parity Act: Support Passage of bill to direct CMS to put forward guidance clarifying that occupational therapy services can be provided to a person with a mental or behavioral health diagnosis under Medicare and Medicaid. HR3173/S3018-Improving Seniors' Timely Access to Care Act: Support passage. HR 6202 - Telehealth Extension Act: Endorsed S.3593 - Telehealth Extension & Evaluation Act: Endorsed HR 6770-PACE Plus Act and S 3626 PACE Expanded Act: Support passage HR 8201: Promoting Health Care Quality Act of 2002 - support passage. No bill: Supported efforts to include occupational therapy in new school-based Medicaid guidelines, where appropriate. HR 8800 - Supporting Medicare Providers Act of 2022: Advocate for passage
Client expense: $120,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · third_quarter · Medicare/Medicaid
HR 8344: Electrodiagnostic Medicine Patient Protection and Fraud Elimination Act of 2022 Medicare sequestration moratorium Medicaid coverage and reimbursement Medicare wound care coverage National Correct Coding Initiative Edits Protection of programs related to physical therapy in deficit reduction Medicare Advantage Essential Health Benefits Medicare improvement standards Inclusion of physical therapists in quality programs Medicare Self-referral Coverage of telehealth under Medicare, Medicare Advantage, and Medicaid H.R. 2168/S. 3193 Expanded Telehealth Access Act APTA PT Outcomes Registry/Qualified Clinical Data Registries Medicare Quality Programs Accelerating Innovation in Medicine Act Improving Medicare Post-Acute Care Transformation Act Chronic Care Management Orthotics and Prosthetics H.R. 1990/S. 2556: Medicare Orthotics and Prosthetics Patient-Centered Care Act Medicare Private Contracting H.R. 3322/S. 826 Medicare Patient Empowerment Act Skilled Nursing Facility 3-Day rule H.R. 5536 Stabilizing Medicare Access to Rehabilitation and Therapy (SMART) Act PTA Differential in Medicare Prior Authorization in Medicare Advantage Plans Alternative payment models Health information technology: Electronic health records, health IT incentives for physical therapists, certification of EHRs interoperability, and information blocking durable medical equipment prosthetics orthotics and supplies competitive bidding H.R. 3630/S. 1315 Lymphedema Treatment Act Medicare enrollment Skilled Nursing Facility payment Home Health payment Medical review (Medicare) Reducing Health Care costs REAADI & DRMA Acts Home Health Payment Innovation Act H.R. 3173/S. 3018 Improving Seniors Timely Access to Care Act H.R. 3650/S. 2048 Improving Access to Medicare Coverage Act Critical Access Hospital Relief Act Medicare Fee Schedule Unified post-acute care prospective payment system Inpatient rehabilitation facilities / long term care hospital payment HIPAA proposed rule HR 6020 - Support Medicare Providers Act S. 3799 PREVENT Pandemics Act H.R. 5365 Primary Health Services Enhancement Act H.R. 8181 Optimizing Postpartum Outcomes Act H.R 8800 Supporting Medicare Providers Act of 2022
Client expense: $194,970 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE, Small Business Administration (SBA), Veterans Affairs, Dept of (VA), White House Office
2022 · third_quarter · Medicare/Medicaid
H.R. 1587/S. 1731, the Medicare Audiologist Access and Services Act of 2021 H.R. 2168/S. 3193, the Expanded Telehealth Access Act H.R. 4040, the Advancing Telehealth Beyond COVID-19 Act of 2021 H.R. 4311, the Medicare Dental, Vision, and Hearing Benefit Act H.R. 6202, the Telehealth Extension Act H.R. 6020/S. 3314, the Supporting Medicare Providers Act of 2021 H.R. 7876, the Connecting Rural Telehealth to the Future Act H.R. 2471, the Consolidated Appropriations Act, 2022 (Public Law 117-103) Implementation of S. 610, the Protecting Medicare and American Farmers from Sequester Cuts Act Implementation of H.R. 1319, American Rescue Plan Act of 2021 (Public Law 117-2) Issues related to enhanced Federal Medical Assistance Percentage in Medicaid Various issues related to CMS Actions surrounding: Medicare supervision requirements audits of medical records and claims for Part A and B services code development and reimbursement of personal protective equipment Quality reporting under MIPS Implementation of the IMPACT Act Medicare physician fee schedule Prospective payments systems Demonstration projects/episodic payment models Accountable Care Organizations Federally-facilitated marketplace Medicare Advantage Reimbursement of telehealth services COVID-19 emergency telepractice coverage of Medicare, Medicare Advantage and Medicaid Medicare telehealth coverage under Part A and B Essential and Non-essential personnel designation Implementation of CARES Act (P.L. 116-136) Provision and payment for Part A therapy Various issues related to implementation of ACA Various issues related to Medicaid in schools Advocated for Medicaid Federal Medical Assistance Percentage (FMAP) Sequestration H.R. 3173/S. 3018, the Improving Seniors Timely Access to Care Act Issues related to extension of COVID-19 public health emergency H.R. 8800, the Supporting Medicare Providers Act of 2022 Issues related to coverage of augmentative and alternative communication devices and systems and their role in integration of individuals with disabilities in work and community settings Issues related to Medicare beneficiaries accessing services provided by audiologists without a physician order
Client expense: $240,000 · Firm income: Not reported
Government targets: Administration on Aging, Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE
2022 · third_quarter · Health Issues
Public Health Emergency, Telehealth, and Physician Virtual Supervision issues. H.R.2168/S.3193 - Expanded Telehealth Access Act, H.R.2903/S.1512- CONNECT for Health Act, H.R. 6202 - Telehealth Expansion Act, H.R.1332/S.368 - Telehealth Modernization Act, H.R.7573/S.3593 - Telehealth Extension and Evaluation Act
Client expense: Not reported · Firm income: $20,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · third_quarter · Medicare/Medicaid
Issues pertaining to durable medical equipment including: competitive bidding, power wheelchairs, oxygen, non-invasive ventilators, diabetic supplies, negative pressure wound therapy, Medicare audits, sequestration; Medicare sequestration relief legislation (H.R. 1868 - To prevent across-the-board direct spending cuts, and for other purposes); Issues related the non-application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs manual accessories, titanium/carbon upgrade legislation, and Medicare coverage of seat elevation and standing features; Issues related to Medicare reimbursement cuts in DME noncompetitive bidding areas; H.R. 2168 - Expanded Telehealth Access Act, and for other purposes; Issues related to the COVID-19 public health emergency; H.R. 2079 - To provide that CARES Act Provider Relief Fund payments are not includible in gross income, and for other purposes; Issues related to the 2020 DME proposed rule; - H.R. 6641 - DMEPOS Relief Act of 2022 and H.R. 2356/S. 2363 - Better Wound Care at Home Act of 2021.
Client expense: Not reported · Firm income: $60,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2022 · second_quarter · Health Issues
1. The Prevent Interruptions in Physical Therapy Act (H.R.1611/S.2612)and potential Senate companion bill, to allow ALL private practice physical therapists-regardless of where their clinic is located-to use a locum tenens to provide their Medicare patients continued care when they need to be out of the clinic. 2. The Expanded Telehealth Access Act (H.R.2168/S.3193) and potential Senate companion bill, to permanently add physical therapists, physical therapist assistants, and other rehabilitation therapists to the list of providers that Medicare pays for telehealth. 3. The Medicare Patient Empowerment Act (S.826/H.R.3322)to allow a Medicare beneficiary to enter into a direct contract with an eligible professional (regardless of whether that person was a participating or non-participating physician or practitioner) for any item or service covered by Medicare. 4. The SMART Act (H.R.5536) to delay implementation of the PTA/OTA differential by one year, exempt therapy assistants in rural and medically underserved areas from the differential, and to change the supervision requirement for PTAs in private practice settings to that which state law requires. 5. The Improving Seniors Timely Access to Care Act (H.R.3173/S.3108) to reduce administrative burden by requiring a streamed and standardized way Medicare Advantage (MA) plans use prior authorization as well as increasing oversight and transparency around prior authorization. 6. The bipartisan Primary Health Services Enhancement Act (H.R.5365) would allow CHCs to offer physical therapy services which will be provided by a physical therapist.
Client expense: Not reported · Firm income: $50,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE
2022 · first_quarter · Health Issues
1. The Prevent Interruptions in Physical Therapy Act (H.R.1611/S.2612)and potential Senate companion bill, to allow ALL private practice physical therapists-regardless of where their clinic is located-to use a locum tenens to provide their Medicare patients continued care when they need to be out of the clinic. 2. The Expanded Telehealth Access Act (H.R.2168/S.3193) and potential Senate companion bill, to permanently add physical therapists, physical therapist assistants, and other rehabilitation therapists to the list of providers that Medicare pays for telehealth. 3. The Medicare Patient Empowerment Act (S.826/H.R.3322)to allow a Medicare beneficiary to enter into a direct contract with an eligible professional (regardless of whether that person was a participating or non-participating physician or practitioner) for any item or service covered by Medicare. 4. The SMART Act (H.R.5536) to delay implementation of the PTA/OTA differential by one year, exempt therapy assistants in rural and medically underserved areas from the differential, and to change the supervision requirement for PTAs in private practice settings to that which state law requires. 5. The Improving Seniors Timely Access to Care Act (H.R.3173/S.3108) to reduce administrative burden by requiring a streamed and standardized way Medicare Advantage (MA) plans use prior authorization as well as increasing oversight and transparency around prior authorization.
Client expense: Not reported · Firm income: $50,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE
2022 · second_quarter · Medicare/Medicaid
HR 1868 - A bill to prevent across-the-board direct spending cuts and for other purposes: Support for delaying Medicare Sequester and passage of bill. S 1315/HR 3630 - The Lymphedema Treatment At: Support passage. HR 5536 - Stabilizing Medicare Access to Rehabilitation and Therapy (SMART) Act: Advocated for passage HR 2168/S3193 - Expanded Telehealth Access Act: Advocated for passage. S. 368/HR 1332 - Telehealth Modernization Act: Advocated for passage. HR 1990/S 2556 - Medicare Orthotics and Prosthetics Patient-Centered Care Act: Lobbied for changes to the bills to ensure the legislation does not disrupt the ability of occupational therapy practitioners to provide and bill for orthotics and prosthetics and related services under Medicare. No bill number: advocated for inclusion of language in Senate mental health legislation, directing CMS to put forward guidance clarifying that occupational therapy services can be provided to a person with a mental or behavioral health diagnosis under Medicare and Medicaid. No bill number: advocated for inclusion of language in Senate mental health legislation requiring an occupational therapy evaluation for anyone with dementia who lives in a skilled nursing or long-term care facility, or who is newly diagnosed with schizophrenia. HR3173/S3018-Improving Seniors' Timely Access to Care Act: Support passage. HR 6202 - Telehealth Extension Act: Endorsed S.3593 - Telehealth Extension & Evaluation Act: Endorsed HR 6770-PACE Plus Act and S 3626 PACE Expanded Act: Support passage S 2938 - Bipartisan Safer Communities Act: Support passage. No bill: Advocated for occupational therapy's role in long COVID treatment and recovery.
Client expense: $150,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · second_quarter · Health Issues
Public Health Emergency, Telehealth, and Physician Virtual Supervision issues. H.R.2168/S.3193 - Expanded Telehealth Access Act, H.R.2903/S.1512- CONNECT for Health Act, H.R. 6202 - Telehealth Expansion Act, H.R.1332/S.368 - Telehealth Modernization Act, H.R.7573/S.3593 - Telehealth Extension and Evaluation Act
Client expense: Not reported · Firm income: $30,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · second_quarter · Health Issues
Public Health Emergency, Telehealth, and Physician Virtual Supervision issues. H.R.2168/S.3193 - Expanded Telehealth Access Act, H.R.2903/S.1512- CONNECT for Health Act, H.R. 6202 - Telehealth Expansion Act, H.R.1332/S.368 - Telehealth Modernization Act, H.R.7573/S.3593 - Telehealth Extension and Evaluation Act
Client expense: Not reported · Firm income: $30,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · second_quarter · Medicare/Medicaid
H.R. 66 - CARING for Kids Act - Rep. Buchanan, Vern - CHIP H.R. 265 - Insular Area Medicaid Parity Act - Rep. Sablan, Gregorio Kilili Camacho - Medicaid funding H.R. 315 - Medicare Sequester COVID Moratorium Act - Rep. Schneider, Bradley Scott - Medicare sequestration H.R. 340 - Incentivizing Medicaid Expansion Act of 2021 - Rep. Veasey, Marc - Medicaid expansion H.R. 432 - Mental Health Access Improvement Act of 2021 - Rep. Thompson, Mike -Medicare coverage of marriage and family therapist services and mental health counselor H.R. 502 - Medicare Dental Benefit Act of 2021 - Rep. Barragan, Nanette Diaz - Medicare coverage of dental and oral health services H.R. 525 - COVID HCBS Relief Act of 2021 - Rep. Dingell, Debbie - increased FMAP for HCBS H.R. 871 - Expand Medicaid Now Act - Rep. Fletcher, Lizzie - FMAP H.R. 918 - Stronger Medicaid Response to the COVID-19 Pandemic Act - Rep. Cardenas, Tony - COVID-19 coverage for the uninsured via Medicaid H.R. 955 - Medicaid Reentry Act of 2021 - Rep. Tonko, Paul -Medicaid coverage for incarcerated individuals H.R. 1167 - Advancing Enrollment and Reducing Drug Costs Act of 2021 - Rep. Pappas, Chris - Medicaid eligibility for low-income subsidies H.R. 1227 - Medicare-X Choice Act of 2021 - Rep. Delgado, Antonio - Medicare public option H.R. 1332 - Telehealth Modernization Act - Rep. Carter, Earl - telehealth services under Medicare H.R. 1349 - The COVID-19 Hospital and Health Provider Loan Conversion Act of 2021- Rep. Kaptur, Marcy - advance payments under parts A and B of Medicare H.R. 1353 - Coronavirus Medicaid Response Act - Rep. Lee, Susie - FMAP H.R. 1390 - CHIPPER Act - Rep. Wild, Susan - CHIP funding H.R. 1397 - TIKES Act - Rep. Blunt Rochester, Lisa - telehealth under Medicaid and CHIP H.R. 1609 - Treatment in Place Act - Rep. Axne, Cynthia - Medicare coverage of ambulance services H.R. 1676 - Jack Reynolds Memory Medigap Expansion Act - Rep. Axne, Cynthia - Medigap coverage for ESRD H.R. 1677 - KEEP Telehealth Options Act of 2021 - Rep. Balderson, Troy - telehealth expansion H.R. 1717 - Protecting Married Seniors from Impoverishment Act of 2021 - Rep. Upton, Fred - permanent protections against spousal impoverishment H.R. 1722 - Puerto Rico Health Care Fairness, Accountability, and Beneficiary Access Act of 2021 - Rep. Velazquez, Nydia - Medicaid in Puerto Rico H.R. 1738 - Stabilize Medicaid and CHIP Coverage Act - Rep. Dingell, Debbie - Medicaid and CHIP continuous enrollment H.R. 1784 - Medicaid REACH Act - Rep. Doggett, Lloyd - requirements for non-expansion H.R. 1791 - CHIPP Act - Rep. Barragan, Nanette Diaz - extending CHIP H.R. 1792 - Ensuring Kids Have Access to Medically Necessary Dental Care Act - Rep. Barragan, Nanette Diaz - dental coverage under CHIP H.R. 1793 - Immediate Coverage for Former Foster Youth Act - Rep. Bass, Karen - Medicaid coverage for foster youth H.R. 1794 - Foster Youth Dental Act of 2021 - Rep. Bass, Karen - Medicaid dental coverage for foster youth H.R. 1823 - To amend title XIX of the Social Security Act to remove the matching requirement for a territory to use specially allocated Federal funds for Medicare covered part D drugs for low-income individuals - Resident Commissioner Gonzalez-Colon, Jenniffer - Medicare covered part D H.R. 1825 - Territories Medicare Prescription Drug Assistance Equality Act of 2021 - Resident Commissioner Gonzalez-Colon, Jenniffer - Medicare Part D premium and cost-sharing subsidies H.R. 1826 - Fairness in Medicare Part B Enrollment Act of 2021 - Resident Commissioner Gonzalez-Colon, Jenniffer - late enrollment penalties under part B of the Medicare program H.R. 1880 - To amend the Deficit Reduction Act of 2005 to make permanent the Money Follows the Person Rebalancing Demonstration - Rep. Dingell, Debbie - Money Follows the Person Rebalancing Demonstration H.R. 1885 - RUSH Protection Act of 2021 - Rep. Kind, Ron - Medicare rural health clinic payments H.R. 1887 - Rural Hospital Support Act - Rep. Reed, Tom - Medicare payments for hospitals H.R. 1890 - Health Insurance Consumer Protection Act - Rep. Schakowsky, Janice D. - network adequacy standards and premium rates H.R. 1914 - CAHOOTS Act - Rep. DeFazio, Peter A. - Medicaid mobile crisis intervention services H.R. 1969 - Medicare Advantage Integrity Act - Resident Commissioner Gonzalez-Colon, Jenniffer - disparity in MA benchmark rates H.R. 2035 - Improving Access to Mental Health Act of 2021 - Rep. Lee, Barbara - mental health services under Medicare H.R. 2080 - SAVE Act - Rep. Bishop, Sanford D., Jr. - Medicare coverage of transportation services H.R. 2166 - Ensuring Parity in MA and PACE for Audio-Only Telehealth Act of 2021 - Rep. Sewell, Terri - Medicare Advantage payments for audio-only diagnoses H.R. 2168 - Expanded Telehealth Access Act - Rep. Sherrill, Mikie - Medicare payment for telehealth services H.R. 2170 - HAPI Act - Rep. Soto, Darren - access to vaccines and Medicaid H.R. 2179 - Affordable Insulin for the COVID-19 Emergency Act - Rep. Waters, Maxine - cost-sharing regarding insulin coverage H.R. 2217 - Territory Federal Matching Requirement Equity Act of 2021 - Resident Commissioner Gonzalez-Colon, Jenniffer - Medicaid FMAP for Territories H.R. 2228 - Rural Behavioral Health Access Act of 2021 - Rep. Kildee, Daniel - Medicare coverage of outpatient telehealth services H.R. 4074 - Addressing Social Determinants in Medicare Advantage Act of 2021 - Rep. Bilirakis, Gus M. - Medicare Advantage supplemental benefits H.R. 4640 - Close the Medigap Act of 2021 - Rep. Doggett, Lloyd - Medigap policies H.R. 6833 - Affordable Insulin Now Act - Rep. Craig, Angie - Insulin prices and cost sharing S. 150 - Ensuring Parity in MA for Audio-Only Telehealth Act of 2021 - Sen. Cortez-Masto, Catherine - coverage of audio-only telehealth services in MA S. 151 - COVID HCBS Relief Act of 2021 - Sen. Casey, Robert - FMAP and HCBS S. 245 - SAME Act of 2021 - Sen. Warner, Mark - Medicaid expansion S. 274 - Stronger Medicaid Response to the COVID-19 Pandemic Act - Sen. Bennet, Michael - COVID-19 coverage for the uninsured via Medicaid S. 285 - Medicaid Reentry Act of 2021 - Sen. Baldwin, Tammy - Medicaid coverage for incarcerated individuals S. 368 - Telehealth Modernization Act - Sen. Scott, Tim - coverage of telehealth services under Medicare S. 386 - Medicare-X Choice Act of 2021 - Sen. Bennet, Michael - Medicare public option S. 439 - Coronavirus Medicaid Response Act - Sen. Casey, Robert - increases FMAP S. 440 - Continued Funding for Senior Services During COVID-19 Act - Sen. Casey, Robert - funding for services under the Older Americans Act of 1965 S. 453 - CHIPPER Act - Sen. Casey, Robert - CHIP funding S. 581 - HAPI Act -Sen. Brown, Sherrod - vaccines under Medicaid S. 620 - KEEP Telehealth Options Act of 2021 - Sen. Fischer, Deb - telehealth expansion S. 644 - Rural Hospital Closure Relief Act of 2021 - Sen. Durbin, Richard - Medicare coverage for critical access hospitals S. 646 - Stabilize Medicaid and CHIP Coverage Act of 2021 - Sen. Brown, Sherrod - Medicaid and CHIP enrollment S. 653 - COMP Act - Sen. Portman, Rob - Medicare secondary payer rules S. 712 - Dosha Joi Immediate Coverage for Former Foster Youth Act - Sen. Casey, Robert P., Jr. - Medicaid coverage for foster youth S. 748 - Medicare Sequester Relief Act - Sen. Shaheen, Jeanne - Medicare payment sequestration S. 764 - CAHOOTS Act - Sen. Wyden, Ron - Medicaid mobile crisis intervention services S. 826 - Medicare Patient Empowerment Act of 2021 - Sen. Paul, Rand - Medicaid payment options S. 870 - Improving Access to Mental Health Act of 2021 - Sen. Stabenow, Debbie - mental health services in Medicare S. 999 - Save Rural Hospitals Act of 2021 - Sen. Warner, Mark - Medicare hospital payments Regulatory Issues: Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, network adequacy and provider directories, encounter data and other data-related issues, and risk adjustment data validation (RADV) audit issues including proposed RADV regulation for MA; bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, Part D direct and indirect remuneration (DIR), and audits); calendar year 2023 policy and technical regulation for MA and Part D; Part D reform, out of pocket limits; issues related to Medicare for All, Medicare buy-in, reduced Medicare eligibility age, and public option; issues relating to 2023 Rate Notice; issues related to coverage in non-Medicaid Expansion States (e.g., Gap Population); issues related to expanded Medicare fee for service benefits (dental, hearing and vision); issues related to Medicaid coverage gap; contraceptive coverage and reproductive health; Medicare NCD relating to monoclonal antibodies for treatment of Alzheimers disease; Executive Orders relating to international pricing, Part D rebates, insulin costs, and importation; issues related to MLTSS; issues related to removal of safe harbor protection for rebates; issues relating to COVID-19, including testing, vaccines and therapeutics; issues related to the end of the public health emergency; telehealth; issues related to the cost of insulin, including price, copays, rebates, and medical management tools; issues related to health equity; issues related to vaccination; issues related to audio-only telehealth; issues related to addressing the social determinants of health, including housing, transportation, nutrition, educational opportunities, and MA supplemental benefits; issues related to Medicaid presumptive eligibility and continuous eligibility; issues relating to Medicaid best price; in-home health risk assessments; Medicare Medical Loss Ratio issues; issues related to changes to prior authorization regulations or legislation, electronic documentation, and related issues; issues relating to sequestration under the Medicare Advantage and Part D programs; implications of physician fee schedule on MA; application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, enrollment rules, requirements for notice and denial forms, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible SNPs; Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, Part D coverage gap discount program, including employer group waiver plan (EGWP) issues, and other operational issues; issues raised by Part D coverage of new specialty drugs, the Part D non-interference policy and related issues (e.g., preferred pharmacy and any willing pharmacy requirements, standards for network pharmacy reimbursement, and policies regarding sponsor negotiation of pharmacy price concessions); issues related to the international price index; issues related to child and maternal health; issues related to Medicaid supplemental and disproportionate share hospital (DSH) funding; issues related to Medicaid funding for territories; issues related to medical management; issues relating to MA supplemental benefits; Medication Therapy Management Program requirements and the Center for Medicare and Medicaid Innovation (CMMI) Demonstration; MA EGWP issues; CMMI's value based payment models; Part D requirements for offering basic and enhanced alternative plans; MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; issues relating to MA and Part D Star Rating system including measures, the methodology for calculating ratings, and the role of the ratings for payment purposes; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education Program; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; issues relating to MACRA, including implications for MA and Part D plans; Medicare/Medicaid integration for dual eligibles, including implementation of the Capitated Financial Alignment Demonstration and related issues (e.g., quality ratings); issues relating to potential Medicare mental health parity requirements; Medicaid managed care regulations and policies, including CMS's substantial revisions to the managed care regulations, mental health parity rules, the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, fraud and abuse compliance, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including block grants, the calculation of the federal medical assistance (federal matching) percentage (FMAP), and intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost issues affecting Medicaid health plans including issues raised by Medicaid coverage of new specialty drugs; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues and CHIP reauthorization; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including Medicaid managed care organization provider tax issues; standards for electronic prescribing; implementation of Medicaid changes of interest to Medicaid health plans made in the Affordable Care Act (ACA) including Medicaid expansion, the managed care organization (MCO) prescription drug rebate provisions, minimum payments to primary care providers (PCPs), interactions between the Medicaid program and health insurance exchanges, and Medicaid and CHIP maintenance of effort (MOE) requirements; implications of the health insurer fee for Medicaid health plans; issues related to Medicaid Managed long-term care including home and community-based waiver services (HCBS); expanding the availability of Medicare Advantage and Medicaid health plan telemedicine programs; implications of the new non-discrimination rules for health plans participating in public programs; issues related to Medigap coverage; issues related to business continuity in relation to pandemics or natural events (e.g., hurricane, tornado, etc.); cybersecurity; provider directories; value-based insurance design models; Part D prescriber enrollment requirements; Part D recovery audit contractor programs; issues relating to enrollment of beneficiaries with ESRD into MA plans; issues related to health homes for children with medically complex conditions; socioeconomic status impacts on star ratings related to MA and Part D programs; and other issues relating to health care reform implementation.
Client expense: $2,890,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office
2022 · second_quarter · Health Issues
Continued expansion of Telehealth services including in H.R. 2168 - Expanded Telehealth Access Act and S. 368/H.R. 1332 - Telehealth Modernization Act. Policies to remove barriers to physician prescribing decisions including in H.R. 2163/S.464 - Safe Step Act of 2021.
Client expense: Not reported · Firm income: $90,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · second_quarter · Health Issues
Continued expansion of Telehealth services including in H.R. 2168 - Expanded Telehealth Access Act and S. 368/H.R. 1332 - Telehealth Modernization Act. Policies to remove barriers to physician prescribing decisions including in H.R. 2163/S. 464 - Safe Step Act of 2021.
Client expense: Not reported · Firm income: $70,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · second_quarter · Health Issues
Continued expansion of Telehealth services in H.R. 2168 - Expanded Telehealth Access Act and S. 368/H.R. 1332 - Telehealth Modernization Act. Issues related to mental health legislation.
Client expense: Not reported · Firm income: $40,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE