Taxpayers Support Life Act

Recovery audit contractor reform. Medicare regulatory reform, including Medicare physician fee schedule and sequestration relief and payment reforms, including Medicare physician payment provisions in: (1) S. 3430, the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act, Sec. 403 to extend work geographic index floor under Medicare; Sec. 404 to extend incentive payments for participation in eligible alternative payment models; and Sec. 407 to increase support for physicians and other professionals in adjusting to Medicare payment changes; (2) H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; (3) H.R. 4366, the Consolidated Appropriations Act, 2024, P.L. 118-42: Sec. 304, Extending Incentive Payments for Participation in Eligible Alternative Payment Models; and Sec. 305, Temporary Payment Increase under the Medicare Physician Fee Schedule to Account for Exceptional Circumstances and Atypical Timing of Enactment; and (4) HR ____ Further Continuing Appropriations and Disaster Relief Supplemental Appropriations Act, 2025-related to physician payment adjustment of 2.5%. Network adequacy oversight, including Medicare Advantage plan provider directory accuracy issues, including provisions in S. 3430, the Better Mental Health Care, Lower Cost Drugs, and Extenders Act of 2023, in Sec. 109, to require MA plans to maintain accurate provider directories on a public website. Medicare accountable care organizations. Electronic health record interoperability and vendor accountability. Medicare Parts C and D prior authorization reforms, including related provisions in: H.R. 4968, the GOLD Card Act; H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Physician-led hospital barriers, including related provisions in H.R. 977/S. 470, the Patient Access to Higher Quality Care Act, and H.R. 9001, the Physician Led and Rural Access to Quality Care Act, to revise certain physician self-referral exemptions relating to physician-owned hospitals in rural areas. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor: (1) implementation of provisions in the Inflation Reduction Act of 2022 (P.L. 117-169), Subtitle B, Part 1, sec. (b), to modify Medicare Part B reimbursement by application of Maximum Fair Prices and Conforming Amendments, to selected Medicare Part B covered drugs; and (2) CMMI Medicare Part B drug demonstrations, including the Most Favored Nation demonstration.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Recovery audit contractor reform. Medicare regulatory reform, including Medicare physician fee schedule and sequestration relief and payment reforms, including Medicare physician payment provisions in: (1) S. 3430, the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act, Sec. 403 to extend work geographic index floor under Medicare; Sec. 404 to extend incentive payments for participation in eligible alternative payment models; and Sec. 407 to increase support for physicians and other professionals in adjusting to Medicare payment changes; (2) H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; and (3) H.R. 4366, the Consolidated Appropriations Act, 2024, P.L. 118-42: Sec. 304, Extending Incentive Payments for Participation in Eligible Alternative Payment Models; and Sec. 305, Temporary Payment Increase under the Medicare Physician Fee Schedule to Account for Exceptional Circumstances and Atypical Timing of Enactment. Network adequacy oversight, including Medicare Advantage plan provider directory accuracy issues, including provisions in S. 3430, the Better Mental Health Care, Lower Cost Drugs, and Extenders Act of 2023, in Sec. 109, to require MA plans to maintain accurate provider directories on a public website. Medicare accountable care organizations. Electronic health record interoperability and vendor accountability. Medicare Parts C and D prior authorization reforms, including related provisions in: H.R. 4968, the GOLD Card Act; H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Physician-led hospital barriers, including related provisions in H.R. 977/S. 470, the Patient Access to Higher Quality Care Act, and H.R. 9001, the Physician Led and Rural Access to Quality Care Act, to revise certain physician self-referral exemptions relating to physician-owned hospitals in rural areas. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor: (1) implementation of provisions in the Inflation Reduction Act of 2022 (P.L. 117-169), Subtitle B, Part 1, sec. (b), to modify Medicare Part B reimbursement by application of Maximum Fair Prices and Conforming Amendments, to selected Medicare Part B covered drugs; and (2) CMMI Medicare Part B drug demonstrations, including the Most Favored Nation demonstration.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Recovery audit contractor reform. Medicare regulatory reform, including physician payment reforms, including Medicare physician payment provisions in: (1) S. 3430, the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act, Sec. 403 to extend work geographic index floor under Medicare; Sec. 404 to extend incentive payments for participation in eligible alternative payment models; and Sec. 407 to increase support for physicians and other professionals in adjusting to Medicare payment changes; (2) H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; and (3) H.R. 4366, the Consolidated Appropriations Act, 2024, P.L. 118-42: Sec. 304, Extending Incentive Payments for Participation in Eligible Alternative Payment Models; and Sec. 305, Temporary Payment Increase under the Medicare Physician Fee Schedule to Account for Exceptional Circumstances and Atypical Timing of Enactment. Network adequacy oversight, including Medicare Advantage plan provider directory accuracy issues, including provisions in S. 3430, the Better Mental Health Care, Lower Cost Drugs, and Extenders Act of 2023, in Sec. 109, to require MA plans to maintain accurate provider directories on a public website. Medicare accountable care organizations. Electronic health record interoperability and vendor accountability. Medicare Parts C and D prior authorization reforms, including related provisions in: H.R. 4968, the GOLD Card Act; H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Physician-led hospital barriers, including related provisions in H.R. 977/S. 470, the Patient Access to Higher Quality Care Act. Medicare physician fee schedule and sequestration relief, and Draft Legislation by Rep. Burgess to amend title XVIII of the Social Security Act to revise certain physician self-referral exemptions relating to physician-owned hospitals in rural areas. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor: (1) implementation of provisions in the Inflation Reduction Act of 2022 (P.L. 117-169), Subtitle B, Part 1, sec. (b), to modify Medicare Part B reimbursement by application of Maximum Fair Prices and Conforming Amendments, to selected Medicare Part B covered drugs; and (2) CMMI Medicare Part B drug demonstrations, including the Most Favored Nation demonstration.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE