Coverage Determination Clarity Act of 2023

Medicare Advantage Supplemental Benefits In-Home Health Risk Assessments Coverage Determination Clarity Act of 2023 (H.R. 5396) Puerto Rico Medicaid Program Funding - Federal Matching Assistance Percentage (FMAP) Fairness in Medicare Part B Enrollment Act of 2023 (H.R. 4027) Fairness in Medicare Savings Program Act of 2023 (H.R. 4410) Medicare Advantage Integrity Act of 2023 (H.R. 4411) Medicare Advantage & Medicare Part D Prescription Drug Program Medicaid Managed Care Medicaid Eligibility and Redetermination Medicare Site Neutrality Medicare & Medicaid Social Determinants of Health (SDOH)

Client expense: $1,210,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), SENATE

Medicare Advantage Supplemental Benefits In-Home Health Risk Assessments Coverage Determination Clarity Act of 2023 (H.R. 5396) Puerto Rico Medicaid Program Funding - Federal Matching Assistance Percentage (FMAP) Fairness in Medicare Part B Enrollment Act of 2023 (H.R. 4027) Fairness in Medicare Savings Program Act of 2023 (H.R. 4410) Medicare Advantage Integrity Act of 2023 (H.R. 4411) Medicare Advantage & Medicare Part D Prescription Drug Program Medicaid Managed Care Medicaid Eligibility and Redetermination Medicare Site Neutrality Medicare & Medicaid Social Determinants of Health (SDOH)

Client expense: $1,110,000 · Firm income: Not reported

Medicare Advantage Supplemental Benefits In-Home Health Risk Assessments Coverage Determination Clarity Act of 2023 (H.R. 5396) Puerto Rico Medicaid Program Funding - Federal Matching Assistance Percentage (FMAP) Fairness in Medicare Part B Enrollment Act of 2023 (H.R. 4027) Fairness in Medicare Savings Program Act of 2023 (H.R. 4410) Medicare Advantage Integrity Act of 2023 (H.R. 4411) Medicare Advantage & Medicare Part D Prescription Drug Program Medicaid Managed Care Medicaid Eligibility and Redetermination Medicare Site Neutrality Medicare & Medicaid Social Determinants of Health (SDOH)

Client expense: $1,220,000 · Firm income: Not reported

Medicare Advantage Supplemental Benefits Local Coverage Determinations - Coverage Determination Clarity Act of 2023 (H.R. 5396) Puerto Rico Medicaid Program Funding - Federal Matching Assistance Percentage (FMAP) Fairness in Medicare Part B Enrollment Act of 2023 (H.R. 4027) Fairness in Medicare Savings Program Act of 2023 (H.R. 4410) Medicare Advantage Integrity Act of 2023 (H.R. 4411) Medicare Advantage & Medicare Part D Prescription Drug Program Territories Medicare Prescription Drug Assistance Equality Act of 2021 (H.R. 1825) Medicaid Managed Care Medicaid Eligibility and Redetermination Medicare Site Neutrality Medicare & Medicaid Social Determinants of Health (SDOH)

Client expense: $2,350,000 · Firm income: Not reported

Provider Directories; Medicaid Redeterminations & renewals; Same-day billing restrictions in Medicaid; Medicare Advantage Health Equity Index; Star Ratings in Medicare Advantage; Payment under the Informal Dispute Resolution (IDR) process; Medicare Advantage; Transitional Coverage of Emerging Technologies (TCET); Site Neutral Payments and Payment Accuracy; MA RADV Rule; Medicare Advantage Advance Rate Notice; H.R.5746 - Addressing Whole Health in Medicare Advantage Act To amend title XVIII of the Social Security Act to expand the availability of supplemental benefits to certain Medicare Advantage enrollees. Sponsor: Rep. Bilirakis, Gus M. [R-FL-12] H.R.5386 - Cutting Copays Act To amend title XVIII of the Social Security Act to provide for adjustments to the Medicare part D cost-sharing reductions for low-income individuals. Sponsor: Rep. McGarvey, Morgan [D-KY-3] H.R.5380 - To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage. To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage. Sponsor: Rep. Sarbanes, John P. [D-MD-3] H.R.2880 - Protecting Patients Against PBM Abuses Act To amend title XVIII of the Social Security Act to establish certain requirements for pharmacy benefit managers under part D of the Medicare program. Sponsor: Rep. Carter, Earl L. "Buddy" [R-GA-1] H.R.5385 - Medicare PBM Accountability Act To amend title XVIII of the Social Security Act to establish pharmacy benefit manager reporting requirements with respect to prescription drug plans and MA-PD plans under Medicare part D. Sponsor:Rep. Landsman, Greg [D-OH-1] S.2556 - Improving CARE for Youth Act To amend title XIX of the Social Security Act to ensure Medicaid coverage of mental health services and primary care services furnished on the same day. Sponsor: Sen. Carper, Thomas R. [D-DE] S.1002 - No UPCODE Act To amend title XVIII of the Social Security Act to improve risk adjustment under Medicare Advantage. Sponsor: Sen. Cassidy, Bill [R-LA] H.R.5388 - Supporting Innovation for Seniors Act To amend title XVIII of the Social Security Act to provide coverage of certain technologies and medical devices under the Medicare program. Sponsor: Rep. Balderson, Troy [R-OH-12] H.R.5393 - To amend title XVIII of the Social Security Act to ensure fair assessment of pharmacy performance and quality under Medicare part D, and for other purposes. To amend title XVIII of the Social Security Act to ensure fair assessment of pharmacy performance and quality under Medicare part D, and for other purposes. Sponsor: Rep. Griffith, H. Morgan [R-VA-9] H.R.4881 - To amend title XVIII of the Social Security Act to limit cost sharing for drugs under the Medicare program. To amend title XVIII of the Social Security Act to limit cost sharing for drugs under the Medicare program. Sponsor: Rep. Malliotakis, Nicole [R-NY-11] H.R.5396 - Coverage Determination Clarity Act of 2023 To amend title XVIII of the Social Security Act to prohibit Medicare local coverage determinations from restricting access to care, and for other purposes. Sponsor: Rep. Bucshon, Larry [R-IN-8] H.R.6364 - Medicare Telehealth Privacy Act of 2023 To amend title XVIII of the Social Security Act to maintain certain telehealth flexibilities relating to provider privacy under the Medicare program. Sponsor: Rep. Balderson, Troy [R-OH-12] S.2973 - Modernizing and Ensuring PBM Accountability Act To amend titles XVIII and XIX of the Social Security Act to establish requirements relating to pharmacy benefit managers under the Medicare and Medicaid programs, and for other purposes. Sponsor: Sen. Wyden, Ron [D-OR]

Medicare Advantage Supplemental Benefits Telehealth Expansion Act (H.R. 1843) Local Coverage Determinations - Coverage Determination Clarity Act of 2023 (H.R. 5396) Puerto Rico Medicaid Program Funding - Federal Matching Assistance Percentage (FMAP) Territory Federal Matching Requirement Equity Act of 2021 Medicare Savings Program (MSP) Fairness in Medicare Part B Enrollment Act of 2023 (H.R. 4027) Medicare Advantage Integrity Act of 2023 (H.R. 4411) Medicare Advantage & Medicare Part D Prescription Drug Program Medicaid Managed Care Medicaid Eligibility and Redetermination Medicare Site Neutrality Medicare & Medicaid Social Determinants of Health (SDOH)

Client expense: $1,460,000 · Firm income: Not reported

Provider Directories; Medicaid Redeterminations; Draft Duals Legislation; IRA Copay Smoothing; MA Health Equity Index HR 2880 (118th Congress), Protecting Patients Against PBM Abuses Act, by Rep. Earl Carter (R-GA). To amend title XVIII of the Social Security Act to establish certain requirements for pharmacy benefit managers under Part D of the Medicare program. HR 4881 (118th Congress), by Rep. Nicole Malliotakis (R-NY). To amend title XVIII of the Social Security Act to limit cost sharing for drugs under the Medicare program. HR 5380 (118th Congress), by Rep. John Sarbanes (D-MD). To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage. HR 5385 (118th Congress), Medicare PBM Accountability Act, by Rep. Greg Landsman (D-OH). To amend title XVIII of the Social Security Act to establish pharmacy benefit manager reporting requirements with respect to prescription drug plans and MA-PD plans under Medicare Part D. HR 5386 (118th Congress), Cutting Copays Act, by Rep. Morgan McGarvey (D-KY). To amend title XVIII of the Social Security Act to provide for adjustments to the Medicare Part D cost-sharing reductions for low-income individuals. HR 5388 (118th Congress), Supporting Innovation for Seniors Act, by Rep. Troy Balderson (R-OH). To amend title XVIII of the Social Security Act to provide coverage of certain technologies and medical devices under the Medicare program. HR 5393 (118th Congress), by Rep. Morgan Griffith (R-VA). To amend title XVIII of the Social Security Act to ensure fair assessment of pharmacy performance and quality under Medicare Part D. HR 5396 (118th Congress), Coverage Determination Clarity Act of 2023, by Rep. Larry Bucshon (R-IN). To amend title XVIII of the Social Security Act to prohibit Medicare local coverage determinations from restricting access to care. H.R.5746 (118th Congress), Addressing Whole Health in Medicare Advantage Act, by Rep. Gus Bilirakis (R-FL). To amend title XVIII of the Social Security Act to expand the availability of supplemental benefits to certain Medicare Advantage enrollees. HR 6364 (118th Congress), Medicare Telehealth Privacy Act of 2023, by Rep. Troy Balderson (R-OH). To amend title XVIII of the Social Security Act to maintain certain telehealth flexibilities relating to provider privacy under the Medicare program. S 1002 (118th Congress), No UPCODE Act, by Sen. Bill Cassidy (R-LA). To amend title XVIII of the Social Security Act to improve risk adjustment under Medicare Advantage. S 2973 (118th Congress), Modernizing and Ensuring PBM Accountability Act, by Sen. Ron Wyden (D-OR). To amend titles XVIII and XIX of the Social Security Act to establish requirements relating to pharmacy benefit managers under the Medicare and Medicaid programs.

Provider Directories; Medicaid Redeterminations and Renewals; MA Health Equity Index; MA Star Ratings; Site Neutral Payments and Payment Accuracy; MA RADV Rule, MA Advance Rate Notice HR 2880 (118th Congress), Protecting Patients Against PBM Abuses Act, by Rep. Earl Carter (R-GA). To amend title XVIII of the Social Security Act to establish certain requirements for pharmacy benefit managers under Part D of the Medicare program. HR 4881 (118th Congress), by Rep. Nicole Malliotakis (R-NY). To amend title XVIII of the Social Security Act to limit cost sharing for drugs under the Medicare program. HR 5380 (118th Congress), by Rep. John Sarbanes (D-MD). To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage. HR 5385 (118th Congress), Medicare PBM Accountability Act, by Rep. Greg Landsman (D-OH). To amend title XVIII of the Social Security Act to establish pharmacy benefit manager reporting requirements with respect to prescription drug plans and MA-PD plans under Medicare Part D. HR 5386 (118th Congress), Cutting Copays Act, by Rep. Morgan McGarvey (D-KY). To amend title XVIII of the Social Security Act to provide for adjustments to the Medicare Part D cost-sharing reductions for low-income individuals. HR 5388 (118th Congress), Supporting Innovation for Seniors Act, by Rep. Troy Balderson (R-OH). To amend title XVIII of the Social Security Act to provide coverage of certain technologies and medical devices under the Medicare program. HR 5393 (118th Congress), by Rep. Morgan Griffith (R-VA). To amend title XVIII of the Social Security Act to ensure fair assessment of pharmacy performance and quality under Medicare Part D. HR 5396 (118th Congress), Coverage Determination Clarity Act of 2023, by Rep. Larry Bucshon (R-IN). To amend title XVIII of the Social Security Act to prohibit Medicare local coverage determinations from restricting access to care. H.R.5746 (118th Congress), Addressing Whole Health in Medicare Advantage Act, by Rep. Gus Bilirakis (R-FL). To amend title XVIII of the Social Security Act to expand the availability of supplemental benefits to certain Medicare Advantage enrollees. HR 6364 (118th Congress), Medicare Telehealth Privacy Act of 2023, by Rep. Troy Balderson (R-OH). To amend title XVIII of the Social Security Act to maintain certain telehealth flexibilities relating to provider privacy under the Medicare program. S 1002 (118th Congress), No UPCODE Act, by Sen. Bill Cassidy (R-LA). To amend title XVIII of the Social Security Act to improve risk adjustment under Medicare Advantage. S 2973 (118th Congress), Modernizing and Ensuring PBM Accountability Act, by Sen. Ron Wyden (D-OR). To amend titles XVIII and XIX of the Social Security Act to establish requirements relating to pharmacy benefit managers under the Medicare and Medicaid programs.