Sickle Cell Disease Comprehensive Care Act

Coverage of blood transfusions under Medicare Hospice Benefit Issues related to CAR-T/cellular and gene therapies Implementation of the Medicare Access and CHIP Reauthorization Act pf 2015 (P.L. 114-10) Implementation of the Patient Protection and Affordable Care Act (P.L. 111-148) CMS national coverage determinations Medicaid coverage for sickle cell disease Issues related to telemedicine/telehealth Sickle cell disease/trait issues, including coverage for cell and gene therapies Prior authorization Implementation of the Inflation Reduction Act of 2022 (P.L. 117-169) Strengthening Medicare for Patients and Providers Act (H.R. 2474) Resident Physician Shortage Reduction Act (S. 1302) CONNECT for Health Act (S. 2016/ H.R. 4189) Improving Access to Transfusion Care for Hospice Patients Act (S. 2186) Provider Reimbursement Stability Act of 2023 (H.R. 6371) Telehealth Modernization Act (H.R. 7623 / S. 3967) Sickle Cell Disease Comprehensive Care Act (H.R. 7432/S. 5097) dental coverage for Medicare beneficiaries CMS FY 2025 Hospice proposed rule and payment mechanisms for high intensity palliative care services, including blood transfusions Improving Seniors' Timely Access to Care Act (S. 4518/S. 4532/H.R. 8702) Senate Finance Committee Request for Information (RFI) on Medicare physician payment National Coverage Decision for hematopoietic stem cell transplantation (HSCT) for MDS Local Coverage Decisions for hematopoietic stem cell transplantation (HSCT) for lymphoma Duffy-null ICD-10 coding Local Coverage Decisions for next generation sequencing Sickle cell disease quality measures Issues impacting drug shortages Senate draft Pay PCPs Act CY 2025 Hospital Outpatient Prospective Payment System (HOPPS) proposed rule CY 2025 Physician Fee Schedule proposed rule

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

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

Womens Health Protection Act Mental Health Workforce Shortages Federal policies affecting access to contingency management services for substance use disorders S. 4246 Advancing Menopause Care and Mid-Life Womens Health Act General Menopause health policy H. R. 498 / S.1493, 9-8-8 Lifeline Cybersecurity Responsibility Act H.R. 501 Block, Report, And Suspend Suspicious Shipments Act H.R. 773/S. 3165, Homelessness and Behavioral Health Care Coordination Act of 2023 H.R. 1359/S. 644 Modernizing Opioid Treatment Access Act H.R. 1423 911 Community Crisis Responders Act of 2023 H.R. 1502 Comprehensive Opioid Recovery Centers Reauthorization Act of 2023 H.R. 2474 - The Strengthening Medicare for Patients and Providers Act H.R.2577/S.1137,DHS Suicide Prevention and Resiliency for Law Enforcement Act H.R. 3074/S. 971 The Due Process Continuity of Care Act HR 3305 Black Maternal Health Momnibus Act H.R. 3375 STOP Fentanyl Overdoses Act H.R. 3752 Parity Enforcement Act of 2023 H.R.4310/S.2233, Youth Poisoning Protection Act H.R. 4531 / S. 2433, SUPPORT for Patients and Communities Reauthorization Act of 2023 H.R. 4851, 9-8-8 Implementation Act of 2023 H.R. 4884 /S. 2476 Mental Health for Latinos Act of 2023 H.R.4974, Local 988 Response Act H.R. 5866, Substance Use Disorder and Family Engagement (SAFE) in Recovery Act H.R. 6284/S. 3260 Improving Measurements for Loneliness and Isolation Act of 2023 H.R. 6475 Health Disparity Zones Act of 2023 H.R.6928 CONNECT Act of 2024 H.R. 7153/S. 3679 Dr. Lorna Breen Health Care Provider Protection Reauthorization Act H.R. 7301 Certified Community Behavioral Health Clinic Expansion Act of 2024 H.R. 8390 Mental Health and MAMA Act of 2024 H.R. 8503 Integrated Care for Dual Eligibles H.R. 9577 STOP Suicide Act H.R. 10073 Medicare Patient Access and Practice Stabilization Act of 2024 S.669/H.R. 8458 Increasing Mental Health Options Act of 2023 S. 923 Better Mental Health Care for Americans Act S. 1378/ H.R 5819 COMPLETE Care Act S.2350, National Strategy for Social Connection Act Reintroduction of The Behavioral Health Coverage Transparency Act Reintroduction of The Parity Enforcement Act of 2023 H.R. 5804, The Mental Health Infrastructure Improvement Act Reintroduction of The Comprehensive Addiction Resources Emergency Act Reintroduction of The Stop Online Suicide Assistance Forums Act S.2511, the ADAPT Act S. 2733, PEER Support Act H.R. 7808, EARLY Minds Act S.3364, Kids Providing Resources for Optimal Outcomes Against Fatalities Act of 2024 (KID Proof Act) S.3085, Preventing Adverse Childhood Experiences Act (PACE Act) S. 3393 SUPPORT for Patients and Communities Reauthorization Act S.3498 Promoting Effective and Empowering Recovery Services in Medicare Act of 2023 S. 3557 Public Health Impact of Opioid Drugs S. 3769, Alternative Pathways to Child Abuse Prevention Act S. 4312 United States Senate Commission on Mental Health Act of 2024 S. 4338 Pay PCPs Act of 2024 Reauthorization of the Older Americans Act Caregiving for older adults Title IV-B of the Social Security Act Mental Health Parity Final Rule Meeting with the Tri-Departments (DOL, HHS and Treasury) H.R 3312, S. 1602, Moms Matter Act S.4811, Prevention Services for Youth Act S.4812, Strengthening Supports for Youth Act H.R.9875, Child Safety and Well-Being Act Response to RFI regarding regulation of cannabis and hemp products Research regarding the safety and efficacy of psychedelic-assisted therapy Meeting with CMS on eligibility of postdoctoral training programs for Nursing/Allied Health Reimbursement   Flexibility to prescribe certain controlled medications via telehealth for the treatment of mental health and substance use disorders Support of the proposed rule on georouting solutions for the 988 Suicide & Crisis Lifeline (988 Lifeline) Medicare coverage policies regarding mental health and substance use disorder services Sickle Cell Disease Comprehensive Care Act (H.R. 7432 / S. 5097)

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

Government targets: Agriculture, Dept of (USDA), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Treasury, Dept of, White House Office

Draft, Medicare Compare Website (no bill number) - Rep. Guthrie, Brett - improvements to CMS Medicare compare website H.R. 35 - Close the Medigap Act of 2023 - Rep. Doggett, Lloyd - Medigap policies H.R. 3746 - Fiscal Responsibility Act of 2023 - Rep. McHenry, Patrick - work requirements for federal programs H.R. 3875 - Expanded Telehealth Access Act - Rep. Sherrill, Mikie - Medicare payment for telehealth services H.R. 4411 - Medicare Advantage Integrity Act - Resident Commissioner Gonzalez-Colon, Jenniffer - disparity in MA benchmark rates H.R. 4818 - Treat and Reduce Obesity Act of 2023 - Rep. Wenstrup, Brad -Medicare Coverage of weight loss treatment H.R. 5526 - Seniors' Access to Critical Medications Act of 2023 - Rep. Harshbarger, Diana - exception for physician self-referral H.R. 5584 - Medicaid Third Party Liability Act - Rep. Burgess, Michael - amends Medicaid Third Party liability requirements H.R. 5746 - Addressing Whole Health in Medicare Advantage Act - Rep. Bilirakis, Gus - Medicare Advantage supplemental benefits H.R. 5854 - Medicare Advantage Consumer Protection and Transparency Act - Rep. Porter, Katie - Medicare Advantage organization reporting H.R. 6364 - Medicare Telehealth Privacy Act of 2023 - Rep. Balderson, Troy - Provider privacy provisions for telehealth under Medicare H.R. 6400 - To amend title XVIII of the Social Security Act to extend eligibility for certain payment increases for biosimilar biological products under the Medicare program - Rep. Cardenas, Tony - Medicare payment increase for biosimilars H.R. 6445 - Medicare Audiology Access Improvement Act of 2023 - Rep. Bilirakis, Gus - Medicare Audiology Coverage H.R. 7147 - Medicare Transaction Fraud Prevention Act - Rep. Schweikert, David - oversight of payments for medical equipment & clinical DLTs under Medicare H.R. 7148 - Medicare Home Health Accessibility Act - Rep. Smucker, Lloyd - occupational therapy eligibility for home health coverage under Medicare H.R. 7254 - Hearing Device Coverage Clarification Act - Rep. Fischbach, Michelle - excludes fully implanted active middle ear hearing devices from the hearing aid coverage exclusion under Medicare H.R. 7274 - Connecting Caregivers to Medicare Act of 2024 - Rep. Carey, Mike - outreach, education, and simplify information for family caregivers on Medicare benefits H.R. 7432 - Sickle Cell Disease Comprehensive Care Act - Rep. Burgess, Michael - enables State Medicaid programs to provide coordinated care through health home to individuals with sickle cell disease H.R. 7512 - Real-Time Benefit Tool Implementation Act - Rep. Arrington, Jodey - implementation of real-time benefit tools under part D of under Medicare H.R. 7573 - Stop Unfair Medicaid Recoveries Act - Rep. Schakowsky, Janice - Medicaid Estate Recovery Program H.R. 7619 - Expand the Behavioral Health Workforce Now Act - Rep. Neguse, Joe - education, training, recruitment, and retention of mental health and substance use disorder providers under Medicaid and CHIP H.R. 7623 - Telehealth Modernization Act of 2024 - Rep. Carter, Earl L. Buddy - makes certain telehealth flexibilities permanent under Medicare and adds requirements for Part D plan contracts with PBMs including reporting and delinking provisions H.R. 7856 - Promoting Responsible and Effective Virtual Experiences through Novel Technology to Deliver Improved Access and Better Engagement with Tested and Evidence-based Strategies Act (PREVENT DIABETES Act)- Rep. DeGette, Diana - Medicare, coverage, preventive care, chronic care H.R. 7863 - To require the Secretary of Health and Human Services to issue guidance on furnishing behavioral health services via telehealth to individuals with limited English proficiency under Medicare program. - Rep. Steel, Michelle - Medicare, behavioral health, telehealth, accessibility H.R. 7939 - Patient Access to Innovative New Technologies Act of 2024 - Rep. Carey, Mike - Medicare, quality, medical devices, coverage H.R. 7996 - Improving CARE for Youth Act - Rep. Dunn, Neal - allows for same-day billing for mental health services for youth Medicaid beneficiaries who are being seen for a primary care service H.R. 8018 - Alleviating Barriers for Caregivers Act- Rep. Cammack, Kat - review and simplify caregiver paperwork, CHIP, Medicare, Medicaid H.R. 8064 - Help Extend Auditory Relief Act of 2024- Rep. Cartwright, Matt - Medicare coverage of hearing aids H.R. 8075 - Improving Access to Home Dialysis Act of 2024- Rep. Miller, Carol - Medicare coverage of home dialysis H.R. 8115 - To amend title XIX of the Social Security Act to allow for the deferral or disallowance of portions of payments for certain managed care violations under Medicaid- Rep. Sarbanes, John - Medicaid managed care payment deferral H.R. 8261 - Preserving Telehealth, Hospital, and Ambulance Access Act- Rep. Schweikert, David - extend flexibilities and payment for Medicare H.R. 8702 - Improving Seniors Timely Access to Care Act - Rep. Mike Kelly - prior authorization, transparency, MA S. 838 - Improving Access to Mental Health Act - Sen. Stabenow, Debbie - mental health services in Medicare S. 948 - Healthy Moms and Babies Act - Sen. Grassley, Chuck - establishes programs and requirements to support maternal health services under Medicaid and CHIP S. 1002 - No UPCODE Act - Sen. Cassidy, Bill - modifies certain factors that are used to determine Medicare Advantage (MA) payments, particularly relating to health status and related data S. 2880 - Expanded Telehealth Access Act - Sen. Daines, Steve - Medicare payment for telehealth services S. 3573 - Medicare Advantage Supplemental Benefits Transparency Act- Sen. Warner, Mike - MA, data transparency, supplemental benefits S. 3578 - Protect Medicaid Act - Sen. Cassidy, Bill - prohibits federal payments under Medicaid for noncitizens, requires reporting to HHS of states that provide such health benefits S. 3630 - Medicare Transaction Fraud Prevention Act- Sen. Braun, Mike- pilot program for predictive risk-scoring algorithm, oversight, Medicare S. 3651 - Telemental Health Care Access Act of 2024- Sen. Cassidy, Bill - Medicare, mental health services, telehealth S. 3766 - Connecting Caregivers to Medicare Act of 2024- Sen. Tillis, Thomas - Medicare, outreach and education, caregivers S. 3882 - Helping States Integrate Medicare and Medicaid Act- Sen. Casey, Robert - dual eligibles, quality measures, access, enrollment S. 3934 - Increasing Access to Biosimilars Act of 2023- Sen. Cornyn, John - Medicare drug access S. 3950 - Delivering Unified Access to Lifesaving Services Act of 2024 - Sen. Cassidy, Bill - reforming Integrated Medicare/Medicaid Care Programs for Dually Eligible Individuals S. 4094 - PREVENT DIABETES Act - Sen. Scott, Tim - Medicare, coverage, preventive care, chronic care S. 4532 - Improving Seniors Timely Access to Care Act - Sen. Marshall, Roger - prior authorization, transparency, MA S. 4767 - Insurance Fraud Accountability Act - Sen. Wyden, Ron - reduces fraudulent enrollments in qualified health plans Issues related to mental health and Medicare; Medicare and Medicaid funding; Medicaid expansion; State innovation waivers; Medicaid and CHIP; Medicaid FMAP; Medicare Supplement Coverage; Medicare Transparency in Coverage; Medicaid Access Final Rule; Medicaid Redeterminations; Medicaid rate actuarial soundness; value of Medicaid Managed Care; Medicare Advantage Health Risk Assessment and chart reviews; Medicare Advantage supplemental benefits and Social Determinants of health; coverage of weight loss drugs; and Inflation Reduction Act implementation.

Client expense: $2,560,000 · 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

Implementation of the Patient Protection and Affordable Care Act (P.L. 111-148) Hematology/oncology drug research and approval issues Implementation of the Food and Drug Administration Safety and Innovation Act (FDASIA) (P.L. 112-144) Clinical trials regulations and coverage Issues impacting coverage for hematologic diseases and conditions Issues related to CAR-T/cellular and gene therapies Issues impacting blood supply shortages/safety Issues related to diversity, equity, and inclusion (DEI) in hematology research, practice, and training Implementation of No Surprises Act (P.L. 116-260) Sickle cell disease/trait issues Issues related to maternal health care and abortion access Issues related to healthcare workforce Sickle Cell Care Expansion Act (S. 1423/H.R. 3100) Life Saving Leave Act (H.R. 3024) Cancer Drug Parity Act (S. 2039/H.R. 6301) Sickle Cell Disease and Other Heritable Blood Disorders Research, Surveillance, Prevention, and Treatment Act (S. 1852/H.R. 3884) Issues impacting drug shortages Sickle cell disease quality measures House discussion draft of Stop Drug Shortages Act Let Doctors Provide Reproductive Health Care Act (H.R. 2907/S. 1297) Iron Deficiency Education and Awareness (IDEA) Act (H.R. 6746) Sickle Cell Disease Treatment Centers Act (H.R. 9872/S. 5226) Sickle Cell Disease Comprehensive Care Act (H.R. 7432/S. 5097)

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), SENATE

Coverage of blood transfusions under Medicare Hospice Benefit Issues related to CAR-T/cellular and gene therapies Implementation of the Medicare Access and CHIP Reauthorization Act pf 2015 (P.L. 114-10) Implementation of the Patient Protection and Affordable Care Act (P.L. 111-148) CMS national coverage determinations Medicaid coverage for sickle cell disease Issues related to telemedicine/telehealth Sickle cell disease/trait issues, including coverage for cell and gene therapies Prior authorization Implementation of the Inflation Reduction Act of 2022 (P.L. 117-169) Strengthening Medicare for Patients and Providers Act (H.R. 2474) Resident Physician Shortage Reduction Act (S. 1302) CONNECT for Health Act (S. 2016/ H.R. 4189) Improving Access to Transfusion Care for Hospice Patients Act (S. 2186) Provider Reimbursement Stability Act of 2023 (H.R. 6371) Telehealth Modernization Act (H.R. 7623 / S. 3967) Sickle Cell Disease Comprehensive Care Act (H.R. 7432/S. 5097) dental coverage for Medicare beneficiaries CMS FY 2025 Hospice proposed rule and payment mechanisms for high intensity palliative care services, including blood transfusions Improving Seniors' Timely Access to Care Act (S. 4518/S. 4532/H.R. 8702) Senate Finance Committee Request for Information (RFI) on Medicare physician payment National Coverage Decision for hematopoietic stem cell transplantation (HSCT) for MDS Local Coverage Decisions for hematopoietic stem cell transplantation (HSCT) for lymphoma Duffy-null ICD-10 coding Local Coverage Decisions for next generation sequencing Sickle cell disease quality measures Issues impacting drug shortages Senate draft Pay PCPs Act CY 2025 Hospital Outpatient Prospective Payment System (HOPPS) proposed rule CY 2025 Physician Fee Schedule proposed rule

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

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

H.R.7384/S.4583, the Creating Hope Reauthorization Act of 2024 H.Res.1307 - Expressing support for the designation of June 20, 2024, as "World FSHD Day". H.R. 7432, Sickle Cell Disease Comprehensive Care Act S. 1852, Sickle Cell Disease and Other Heritable Blood Disorders Research, Surveillance, Prevention, and Treatment Act of 2023 H.R. 5539, ORPHAN Cures Act H.R. 4408/S.1644, Promising Pathway Act S.4426,Promising Pathway Act 2.0 H.R. 3100, Sickle Cell Care Expansion Act of 2023

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Physician payment reform Counting observation stays as satisfying Medicare three-day inpatient stay prerequisite for skilled nursing facility (SNF) coverage Eliminating prior authorization requirements in Medicare Advantage H.R. 1128-Rural Health Care Access Act of 2023, to eliminate the 35-mile requirement to qualify as a critical access hospital H.R. 1129-Rural ER Access Act, to require the Centers for Medicare and Medicaid Services to repeal the 35-mile requirement for off-campus facilities H.R. 2474-Strengthening Medicare for Patients and Providers Act, to add an inflationary adjustment to physician payments under the Medicare Physician Fee Schedule H.R. 4189-CONNECT for Health Act, to expand access to telehealth services H.R.4366-Consolidated Appropriations Act, to provide appropriations for several federal departments and agencies and to provide an increase for the calendar year 2024 physician fee schedule conversion factor H.R. 4968-GOLD CARD Act of 2023, to improve prior authorization processes under Medicare Advantage for physicians with high approval rates H.R. 5213-Reducing Medically Unnecessary Delays in Care Act of 2023, to ensure that prior authorization medical decisions under Medicare are determined by physicians H.R. 6371-Provider Reimbursement Stability Act, to reform the Medicare budget neutrality process H.R. 6545-Physician Fee Schedule Update and Improvements Act, to provide a 1.25 percent adjustment to the 2024 Medicare Physician Fee Schedule conversion factor and update the budget neutrality threshold H.R. 6683-Preserving Seniors Access to Physicians Act of 2023, to fully eliminate the 3.37 percent conversion factor adjustment for calendar year 2024 H.R. 7432-Sickle Cell Comprehensive Care Act, to allow Medicaid programs to cover home health services for those with sickle cell disease H.R. 8702-Improving Seniors Timely Access to Care Act, to improve and streamline prior authorization under Medicare Advantage Plans H.R.---- -Fewer Burdens for Better Care Act of 2023, to provide for multi-stakeholder input on removal of quality and efficiency measures in Medicare reporting S. 996- H.R. 7432-Sickle Cell Comprehensive Care Act, to allow Medicaid programs to cover home health services for those with sickle cell disease S.2016-CONNECT for Health Act, to expand access to telehealth services S. 3430-Better Mental Health Care, Lower-Cost Drugs and Extenders Act, to provide a 1.25 percent adjustment to the 2024 Medicare Physician Fee Schedule conversion factor, and other provisions H.R. 4532-Improving Seniors Timely Access to Care Act, to improve and streamline prior authorization under Medicare Advantage Plans

Client expense: $428,634 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Advocating for federal health care policies based on the National Academies 2020 report that will improve the lives of patients living with Sickle Cell Disease; H.R.7432, Sickle Cell Disease Comprehensive Care Act.

Client expense: Not reported · Firm income: $20,000

Government targets: HOUSE OF REPRESENTATIVES

Engagement with the Center for Medicare and Medicaid Innovation on the Cell & Gene Therapy Access Model Sickle Cell Disease Comprehensive Care Act (H.R. 7432/S. 5097) Accelerating Kids Access to Care Act (H.R. 4758/S. 2372)

Client expense: Not reported · Firm income: $20,000

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

HR7432, Sickle Cell Disease Comprehensive Care Act; Social Security Disability Insurance Reform; Sickle Cell Disease - comprehensive care and cell and gene therapy model

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Draft, Broker Accountability Act (no bill number) - ACA Agent/Broker accountability H.R. 35 - Close the Medigap Act of 2023 - Rep. Doggett, Lloyd - Medigap policies H.R. 3746 - Fiscal Responsibility Act of 2023 - Rep. McHenry, Patrick - work requirements for federal programs H.R. 3875 - Expanded Telehealth Access Act - Rep. Sherrill, Mikie - Medicare payment for telehealth services H.R. 4411 - Medicare Advantage Integrity Act - Resident Commissioner Gonzalez-Colon, Jenniffer - disparity in MA benchmark rates H.R. 4818 - Treat and Reduce Obesity Act of 2023 - Rep. Wenstrup, Brad -Medicare Coverage of weight loss treatment H.R. 5526 - Seniors' Access to Critical Medications Act of 2023 - Rep. Harshbarger, Diana - exception for physician self-referral H.R. 5584 - Medicaid Third Party Liability Act - Rep. Burgess, Michael - amends Medicaid Third Party liability requirements H.R. 5746 - Addressing Whole Health in Medicare Advantage Act - Rep. Bilirakis, Gus - Medicare Advantage supplemental benefits H.R. 5854 - Medicare Advantage Consumer Protection and Transparency Act - Rep. Porter, Katie - Medicare Advantage organization reporting H.R. 6364 - Medicare Telehealth Privacy Act of 2023 - Rep. Balderson, Troy - Provider privacy provisions for telehealth under Medicare H.R. 6400 - To amend title XVIII of the Social Security Act to extend eligibility for certain payment increases for biosimilar biological products under the Medicare program - Rep. Cardenas, Tony - Medicare payment increase for biosimilars H.R. 6445 - Medicare Audiology Access Improvement Act of 2023 - Rep. Bilirakis, Gus - Medicare Audiology Coverage H.R. 7147 - Medicare Transaction Fraud Prevention Act - Rep. Schweikert, David - oversight of payments for medical equipment & clinical DLTs under Medicare H.R. 7148 - Medicare Home Health Accessibility Act - Rep. Smucker, Lloyd - occupational therapy eligibility for home health coverage under Medicare H.R. 7254 - Hearing Device Coverage Clarification Act - Rep. Fischbach, Michelle - excludes fully implanted active middle ear hearing devices from the hearing aid coverage exclusion under Medicare H.R. 7274 - Connecting Caregivers to Medicare Act of 2024 - Rep. Carey, Mike - outreach, education, and simplify information for family caregivers on Medicare benefits H.R. 7432 - Sickle Cell Disease Comprehensive Care Act - Rep. Burgess, Michael - enables State Medicaid programs to provide coordinated care through health home to individuals with sickle cell disease H.R. 7512 - Real-Time Benefit Tool Implementation Act - Rep. Arrington, Jodey - implementation of real-time benefit tools under part D of under Medicare H.R. 7573 - Stop Unfair Medicaid Recoveries Act - Rep. Schakowsky, Janice - Medicaid Estate Recovery Program H.R. 7619 - Expand the Behavioral Health Workforce Now Act - Rep. Neguse, Joe - education, training, recruitment, and retention of mental health and substance use disorder providers under Medicaid and CHIP H.R. 7623 - Telehealth Modernization Act of 2024 - Rep. Carter, Earl L. Buddy - makes certain telehealth flexibilities permanent under Medicare H.R. 7856 - Promoting Responsible and Effective Virtual Experiences through Novel Technology to Deliver Improved Access and Better Engagement with Tested and Evidence-based Strategies Act (PREVENT DIABETES Act)- Rep. DeGette, Diana - Medicare, coverage, preventive care, chronic care H.R. 7863 - To require the Secretary of Health and Human Services to issue guidance on furnishing behavioral health services via telehealth to individuals with limited English proficiency under Medicare program. - Rep. Steel, Michelle - Medicare, behavioral health, telehealth, accessibility H.R. 7939 - Patient Access to Innovative New Technologies Act of 2024 - Rep. Carey, Mike - Medicare, quality, medical devices, coverage H.R. 8018 - Alleviating Barriers for Caregivers Act- Rep. Cammack, Kat - review and simplify caregiver paperwork, CHIP, Medicare, Medicaid H.R. 8064 - Help Extend Auditory Relief Act of 2024- Rep. Cartwright, Matt - Medicare coverage of hearing aids H.R. 8075 - Improving Access to Home Dialysis Act of 2024- Rep. Miller, Carol - Medicare coverage of home dialysis H.R. 8115 - To amend title XIX of the Social Security Act to allow for the deferral or disallowance of portions of payments for certain managed care violations under Medicaid- Rep. Sarbanes, John - Medicaid managed care payment deferral H.R. 8261 - Preserving Telehealth, Hospital, and Ambulance Access Act- Rep. Schweikert, David - extend flexibilities and payment for Medicare H.R. 8702 - Improving Seniors Timely Access to Care Act - Rep. Mike Kelly - prior authorization, transparency, MA S. 838 - Improving Access to Mental Health Act - Sen. Stabenow, Debbie - mental health services in Medicare S. 2880 - Expanded Telehealth Access Act - Sen. Daines, Steve - Medicare payment for telehealth services S. 3573 - Medicare Advantage Supplemental Benefits Transparency Act- Sen. Warner, Mike - MA, data transparency, supplemental benefits S. 3578 - Protect Medicaid Act - Sen. Cassidy, Bill - prohibits federal payments under Medicaid for noncitizens, requires reporting to HHS of states that provide such health benefits S. 3630 - Medicare Transaction Fraud Prevention Act- Sen. Braun, Mike- pilot program for predictive risk-scoring algorithm, oversight, Medicare S. 3651 - Telemental Health Care Access Act of 2024- Sen. Cassidy, Bill - Medicare, mental health services, telehealth S. 3766 - Connecting Caregivers to Medicare Act of 2024- Sen. Tillis, Thomas - Medicare, outreach and education, caregivers S. 3882 - Helping States Integrate Medicare and Medicaid Act- Sen. Casey, Robert - dual eligibles, quality measures, access, enrollment S. 3934 - Increasing Access to Biosimilars Act of 2023- Sen. Cornyn, John - Medicare drug access S. 3950 - Delivering Unified Access to Lifesaving Services Act of 2024 - Sen. Cassidy, Bill - reforming Integrated Medicare/Medicaid Care Programs for Dually Eligible Individuals S. 4094 - PREVENT DIABETES Act - Sen. Scott, Tim - Medicare, coverage, preventive care, chronic care S. 4532 - Improving Seniors Timely Access to Care Act - Sen. Marshall, Roger - prior authorization, transparency, MA Issues related to mental health and Medicare; Medicare and Medicaid funding; Medicaid expansion; State innovation waivers; Medicaid and CHIP; Medicaid FMAP; Medicare Supplement Coverage; Medicaid Access Final Rule; Medicaid Redeterminations; value of Medicaid Managed Care; Medicare Advantage Health Risk Assessment; coverage of weight loss drugs; and Inflation Reduction Act implementation.

Client expense: $2,390,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, SENATE

Engagement with the Center for Medicare and Medicaid Innovation on the Cell & Gene Therapy Access Model Sickle Cell Disease Comprehensive Care Act (H.R. 7432) CMSs Office of Minority Health Sickle Cell Disease Action Plan

Client expense: Not reported · Firm income: $20,000

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

HR7432 Sickle Cell Disease Comprehensive Care Act; Social Security Disability Insurance Reform; Sickle Cell Disease - comprehensive care and cell and gene therapy model

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

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

Coverage of blood transfusions under Medicare Hospice Benefit Issues related to CAR-T/cellular and gene therapies Implementation of the Medicare Access and CHIP Reauthorization Act pf 2015 (P.L. 114-10) Implementation of the Patient Protection and Affordable Care Act (P.L. 111-148) CMS national coverage determinations Medicaid coverage for sickle cell disease Issues impacting opioid access/use for patients with hematologic disease and disorders Issues related to telemedicine/telehealth Sickle cell disease/trait issues, including coverage for cell and gene therapies Sickle Cell Disease Comprehensive Care Act (H.R. 1672/S. 996) Prior authorization Implementation of the Inflation Reduction Act of 2022 (P.L. 117-169) Strengthening Medicare for Patients and Providers Act (H.R. 2474) Resident Physician Shortage Reduction Act (S. 1302) CONNECT for Health Act (S. 2016/ H.R. 4189) Improving Access to Transfusion Care for Hospice Patients Act (S. 2186) Provider Reimbursement Stability Act of 2023 (H.R. 6371) Telehealth Modernization Act (H.R. 7623 / S. 3967) Sickle Cell Disease Comprehensive Care Act (H.R. 7432) dental coverage for Medicare beneficiaries Centers for Medicare & Medicaid Services (CMS) FY 2025 Hospice proposed rule request for information on payment mechanisms for high intensity palliative care services, including blood transfusions Improving Seniors' Timely Access to Care Act (S. 4518/S. 4532/H.R. 8702) Senate Finance Committee Request for Information (RFI) on Medicare Graduate Medical Education (GME) and physician workforce shortages Senate Finance Committee Request for Information (RFI) on Medicare physician payment National Coverage Decision for hematopoietic stem cell transplantation (HSCT) for MDS Local Coverage Decisions for hematopoietic stem cell transplantation (HSCT) for lymphoma Duffy-null ICD-10 coding Issues impacting drug shortages

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

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

Implementation of the Patient Protection and Affordable Care Act (P.L. 111-148) Hematology/oncology drug research and approval issues Implementation of the Food and Drug Administration Safety and Innovation Act (FDASIA) (P.L. 112-144) Clinical trials regulations and coverage Issues impacting coverage for hematologic diseases and conditions Issues related to CAR-T/cellular and gene therapies Issues impacting opioid access/use for patients with hematologic disease and disorders Issues impacting blood supply shortages/safety Issues related to diversity, equity, and inclusion (DEI) in hematology research, practice, and training Implementation of No Surprises Act (P.L. 116-260) Sickle cell disease/trait issues Sickle Cell Disease Comprehensive Care Act (H.R. 1672/S. 996) Issues related to maternal health care and abortion access Issues related to healthcare workforce Sickle Cell Care Expansion Act (S. 1423/H.R. 3100) Life Saving Leave Act (H.R. 3024) Cancer Drug Parity Act (S. 2039/H.R. 6301) Sickle Cell Disease and Other Heritable Blood Disorders Research, Surveillance, Prevention, and Treatment Act (S. 1852/H.R. 3884) Issues impacting drug shortages House discussion Draft of Stop Drug Shortages Act Let Doctors Provide Reproductive Health Care Act (H.R. 2907/S. 1297) Iron Deficiency Education and Awareness (IDEA) Act (H.R. 6746) Sickle Cell Disease Comprehensive Care Act (H.R. 7432) H.Res. 1180, re: diversity, equity and inclusion in medical education

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), SENATE

Advocating for federal health care policies based on the National Academies 2020 report that will improve the lives of patients living with Sickle Cell Disease; H.R.7432, Sickle Cell Disease Comprehensive Care Act.

Client expense: Not reported · Firm income: $20,000

Government targets: HOUSE OF REPRESENTATIVES

Physician payment reform Counting observation stays as satisfying Medicare three-day inpatient stay prerequisite for skilled nursing facility (SNF) coverage Eliminating prior authorization requirements in Medicare Advantage H.R. 1128-Rural Health Care Access Act of 2023, to eliminate the 35-mile requirement to qualify as a critical access hospital H.R. 1129-Rural ER Access Act, to require the Centers for Medicare and Medicaid Services to repeal the 35-mile requirement for off-campus facilities H.R. 2474-Strengthening Medicare for Patients and Providers Act, to add an inflationary adjustment to physician payments under the Medicare Physician Fee Schedule H.R. 4189-CONNECT for Health Act, to expand access to telehealth services H.R.4366-Consolidated Appropriations Act, to provide appropriations for several federal departments and agencies and to provide an increase for the calendar year 2024 physician fee schedule conversion factor H.R. 4968-GOLD CARD Act of 2023, to improve prior authorization processes under Medicare Advantage for physicians with high approval rates H.R. 5213-Reducing Medically Unnecessary Delays in Care Act of 2023, to ensure that prior authorization medical decisions under Medicare are determined by physicians H.R. 6371-Provider Reimbursement Stability Act, to reform the Medicare budget neutrality process H.R. 6545-Physician Fee Schedule Update and Improvements Act, to provide a 1.25 percent adjustment to the 2024 Medicare Physician Fee Schedule conversion factor and update the budget neutrality threshold H.R. 6683-Preserving Seniors Access to Physicians Act of 2023, to fully eliminate the 3.37 percent conversion factor adjustment for calendar year 2024 H.R. 7432-Sickle Cell Comprehensive Care Act, to allow Medicaid programs to cover home health services for those with sickle cell disease H.R. 8702-Improving Seniors Timely Access to Care Act, to improve and streamline prior authorization under Medicare Advantage Plans H.R.---- -Fewer Burdens for Better Care Act of 2023, to provide for multi-stakeholder input on removal of quality and efficiency measures in Medicare reporting S. 996- H.R. 7432-Sickle Cell Comprehensive Care Act, to allow Medicaid programs to cover home health services for those with sickle cell disease S.2016-CONNECT for Health Act, to expand access to telehealth services S. 3430-Better Mental Health Care, Lower-Cost Drugs and Extenders Act, to provide a 1.25 percent adjustment to the 2024 Medicare Physician Fee Schedule conversion factor, and other provisions H.R. 4532-Improving Seniors Timely Access to Care Act, to improve and streamline prior authorization under Medicare Advantage Plans

Client expense: $509,774 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.6664 - Innovation in Pediatric Drugs Act of 2023 H.R.7384 - Creating Hope Reauthorization Act of 2024 H.Res.1307 - Expressing support for the designation of June 20, 2024, as "World FSHD Day". H.R. 7432, Sickle Cell Disease Comprehensive Care Act H.R. 7384, Creating Hope Reauthorization Act of 2024 S. 652, Safe Step Act H.R.1092, Better Empowerment Now to Enhance Framework and Improve Treatments Act of 2023 S. 1852, Sickle Cell Disease and Other Heritable Blood Disorders Research, Surveillance, Prevention, and Treatment Act of 2023 H.R. 830/S. 1375, HELP Copays Act H.R. 883/S. 320, Stop the Wait Act of 2023 H.R. 4758/S.2372, Accelerating Kids Access to Care Act H.R. 6094, Providing Realistic Opportunity To Equal and Comparable Treatment for (PROTECT) Rare Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Abortion access (general); Access to mifepristone (general); Contraception (general); Maternal mortality and morbidity (general); H.R. 1117, Advancing Safe Medications for Moms and Babies Act; Obstetric and gynecologic care in rural and underserved areas (general); impact of closures of ob-gyn units in rural hospitals on patient access to care and maternal morbidity and mortality; Impact of abortion restrictions on patient outcomes and the ob-gyn workforce (general); H.R. 3305/S. 1606, Black Maternal Health Momnibus Act; H.R. 1202/S. 704, Resident Education Deferred Interest (REDI) Act; H.R. 2389/S. 1302, Resident Physician Shortage Reduction Act of 2023; H.R. 2569, Doctors of Community (DOC) Act; Teaching Health Center Graduate Medication Education (general); H.R. 3838/S. 2415, Preventing Maternal Deaths Reauthorization Act of 2023; H.R. 3226/S. 1573, PREEMIE Reauthorization Act of 2023; Inclusion of pregnant and lactating individuals in research (general); Telemedicine (general); H.R. 5012/S. 2647, SHINE for Autumn Act; H.R. 4581/S. 2231, Maternal and Child Health Stillbirth Prevention Act; H.R. 7056/S. 3612, Access to Family Building Act; H.R. 7153/S. 3679, Dr. Lorna Breen Health Care Provider Protection Act; S.___, Supporting Healthy Moms and Babies Act; S. 712/H.R. 8532, Connected MOM Act; S. 4079/H.R. 8383, Rural Obstetrics Readiness Act; H.R.___, PRAMS for Dads Act; S. 4223, Access to Birth Control Act; H.Res.1248, National Menstrual Health Awareness Month Resolution; Diversity, Equity, and Inclusion in medicine (general); H.R 8715, NEST Act; S.___, Keep Obstetrics Local Act; H.R. 7855, Rural Residency Planning and Development Act; H.R.___, Diane Powis Ovarian Cancer Testing Access Act; H.R. 8247, Uterine Fibroids Intervention and Gynecological Health Treatment Act (UFIGHT); H.R. 4933/S. 462, Mental Health Professionals Workforce Shortage Loan Repayment Act; H.R. 7432, Sickle Cell Disease Comprehensive Care Act of 2024; S. 4445, Right to IVF Act; Implementation of P.L. 117-328, Pregnant Workers Fairness Act; H.R. 834/S. 230, Rural Physician Workforce Production Act; Rural Residency Planning and Development Program (general); National Health Service Corps (general); H.R. 3523/S. 1710, Perinatal Workforce Act; H.R. 3086, Find it Early Act; H.R. 8796/S. 4619, Stop Comstock Act; Health Insurance Portability and Accountability Act (general); Patient-physician relationship (general); Menopause research, training, and education (general); Alliance for Innovation on Maternal Health; Residency programs in obstetrics and gynecology (general); Abortion training in obstetrics and gynecology residency programs (general); Obstetrician-gynecologist workforce (general); Reproductive health data privacy (general); Substance use disorder during pregnancy (general); Physician burnout (general); Maternal mental health (general); Artificial intelligence in health care (general); Coverage for infertility (general); Protections for in vitro fertilization (general); Restrictions on menthol cigarettes and flavored cigars (general); Nicotine limits in cigarettes (general); White House Initiative on Womens Health Research (general); Pediatric Subspecialty Loan Repayment Program; Over-the-counter contraception (general); HPV vaccination (general); Cancer Moonshot Initiative; Remote patient monitoring (general); Fertility preservation services for sickle cell patients treated with cell and gene therapies; Prenatal screening (general);Prenatal supplements (general); Crisis pregnancy centers (general); Care for pregnant and postpartum incarcerated individuals (general); Congenital syphilis (general); Gun violence as a public health issue (general); Obstetric hemorrhage managements at the Indian Health Service (general); H.Res. 1180, Recognizing the importance of diversity, equity, and inclusion efforts in medical education.

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, White House Office

-Access to Therapeutic Apheresis, generally. -Sickle Cell Disease issues, generally; S.1852, Sickle Cell Disease and Other Heritable Blood Disorders Research, Surveillance, Prevention, and Treatment Act of 2023. -Blood collection issues, generally. -Medical device sterilization. -ARPA-H, cell collections issues, generally. -H.R.7432, The Sickle Cell Disease Comprehensive Care Act.

Client expense: $130,000 · Firm income: Not reported

Government targets: Environmental Protection Agency (EPA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

Womens Health Protection Act Mental Health Workforce Shortages Meeting with various administrative agencies on expanding access to mental health care in rural areas Forthcoming House bill on capital investments in rural mental health Federal policies affecting access to contingency management services for substance use disorders H. R. 498 / S.1493, 9-8-8 Lifeline Cybersecurity Responsibility Act H.R. 501 Block, Report, And Suspend Suspicious Shipments Act H.R. 773/S. 3165, Homelessness and Behavioral Health Care Coordination Act of 2023 H.R. 1359/S. 644 Modernizing Opioid Treatment Access Act H.R. 1423 911 Community Crisis Responders Act of 2023 H.R. 1502 Comprehensive Opioid Recovery Centers Reauthorization Act of 2023 H.R. 2400 The Reentry Act H.R. 2474 - The Strengthening Medicare for Patients and Providers Act H.R.2577/S.1137,DHS Suicide Prevention and Resiliency for Law Enforcement Act H.R. 3074/S. 971 The Due Process Continuity of Care Act HR 3305 Black Maternal Health Momnibus Act H.R. 3375 STOP Fentanyl Overdoses Act H.R. 3548 Pursuing Equity in Mental Health Act H.R. 3752 Parity Enforcement Act of 2023 H.R. 3759 Barriers to Suicide Act of 2023 H.R. 3850/S.3949 Pride in Mental Health Act H.R.4310/S.2233, Youth Poisoning Protection Act H.R. 4531 / S. 2433, SUPPORT for Patients and Communities Reauthorization Act of 2023 H.R. 4851, 9-8-8 Implementation Act of 2023 H.R. 4884 /S. 2476 Mental Health for Latinos Act of 2023 H.R.4974, Local 988 Response Act H.R. 5866, Substance Use Disorder and Family Engagement (SAFE) in Recovery Act H.R. 6284/S. 3260 Improving Measurements for Loneliness and Isolation Act of 2023 H.R. 6475 Health Disparity Zones Act of 2023 H.R.6928 CONNECT Act of 2024 H.R. 7301 Certified Community Behavioral Health Clinic Expansion Act of 2024 H.R. 8390 Mental Health and MAMA Act of 2024 H.R. 8503 Integrated Care for Dual Eligibles S.669/H.R. 8458 Increasing Mental Health Options Act of 2023 S. 923 Better Mental Health Care for Americans Act S. 1378/ H.R 5819 COMPLETE Care Act S. 1426/H.R. 4541 Rise from Trauma Act S.2350, National Strategy for Social Connection Act Reintroduction of The Behavioral Health Coverage Transparency Act Reintroduction of The Parity Enforcement Act of 2023 H.R. 5804, The Mental Health Infrastructure Improvement Act Reintroduction of The Comprehensive Addiction Resources Emergency Act Reintroduction of The Stop Online Suicide Assistance Forums Act S.2511, the ADAPT Act S. 2688 / H.R. 5116, the Behavioral Health IT Coordination Act S. 2733, PEER Support Act Response to Senator Bill Cassidy Request for Information re: patient data privacy Federal policies affecting the use of contingency management services for the treatment of stimulant use disorders H.R. 7808, EARLY Minds Act H.R. 6407 / S. 3297, Medical Nutrition Therapy Act S.3364, Kids Providing Resources for Optimal Outcomes Against Fatalities Act of 2024 (KID Proof Act) S.3085, Preventing Adverse Childhood Experiences Act (PACE Act) S. 3393 SUPPORT for Patients and Communities Reauthorization Act S.3430 Better Mental Health Care, Lower-Cost Drugs, and Extenders Act of 2023 S.3498 Promoting Effective and Empowering Recovery Services in Medicare Act of 2023S. 3557 Public Health Impact of Opioid Drugs S. 3769, Alternative Pathways to Child Abuse Prevention Act S. 4312 United States Senate Commission on Mental Health Act of 2024 S. 4338 Pay PCPs Act of 2024 Dear Colleague letter to CMS re: coverage of digital therapeutics Reauthorization of the Older Americans Act Elder Justice Act Title IV-B of the Social Security Act H.R. 7432, Sickle Cell Comprehensive Care Act H.R. 3432/S. 3651, Telemental Health Care Access Act Congressional briefing on telehealth and H.R. 3432 Congressional briefing on caregiving and mental health Congressional Briefing on A Population Health Approach to Youth Substance Use Disorder Prevention Congressional Briefing on Caucus on the Commission on the Social Status of Black Men and Boys Mental Health Parity Final Rule Meeting with the Tri-Departments (DOL, HHS and Treasury) H.R. 2412, Helping Kids Cope Act H.R 3312, S. 1602, Moms Matter Act

Client expense: $500,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Faith-Based & Community Initiatives, Office of Management & Budget (OMB), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Treasury, Dept of

Engagement with the Center for Medicare and Medicaid Innovation on the Cell & Gene Therapy Access Model Sickle Cell Disease Comprehensive Care Act (H.R. 1672/S.996) Sickle Cell Disease Comprehensive Care Act (H.R. 7432) CMSs Office of Minority Health Sickle Cell Disease Action Plan

Client expense: Not reported · Firm income: $20,000

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

H.R. 35 - Close the Medigap Act of 2023 - Rep. Doggett, Lloyd - Medigap policies H.R. 3746 - Fiscal Responsibility Act of 2023 - Rep. McHenry, Patrick - work requirements for federal programs H.R. 3875 - Expanded Telehealth Access Act - Rep. Sherrill, Mikie - Medicare payment for telehealth services H.R. 4411 - Medicare Advantage Integrity Act - Resident Commissioner Gonzalez-Colon, Jenniffer - disparity in MA benchmark rates H.R. 5526 - Seniors' Access to Critical Medications Act of 2023 - Rep. Harshbarger, Diana - exception for physician self-referral H.R. 5584 - Medicaid Third Party Liability Act - Rep. Burgess, Michael - amends Medicaid Third Party liability requirements H.R. 5746 - Addressing Whole Health in Medicare Advantage Act - Rep. Bilirakis, Gus - Medicare Advantage supplemental benefits H.R. 5854 - Medicare Advantage Consumer Protection and Transparency Act - Rep. Porter, Katie - Medicare Advantage organization reporting H.R. 6364 - Medicare Telehealth Privacy Act of 2023 - Rep. Balderson, Troy - Provider privacy provisions for telehealth under Medicare H.R. 6400 - To amend title XVIII of the Social Security Act to extend eligibility for certain payment increases for biosimilar biological products under the Medicare program - Rep. Cardenas, Tony - Medicare payment increase for biosimilars H.R. 6445 - Medicare Audiology Access Improvement Act of 2023 - Rep. Bilirakis, Gus - Medicare Audiology Coverage H.R. 7147 - Medicare Transaction Fraud Prevention Act - Rep. Schweikert, David - oversight of payments for medical equipment & clinical DLTs under Medicare H.R. 7274 - Connecting Caregivers to Medicare Act of 2024 - Rep. Carey, Mike - outreach, education, and simplify information for family caregivers on Medicare benefits H.R. 7432 - Sickle Cell Disease Comprehensive Care Act - Rep. Burgess, Michael - enables State Medicaid programs to provide coordinated care through health home to individuals with sickle cell disease H.R. 7512 - Real-Time Benefit Tool Implementation Act - Rep. Arrington, Jodey - implementation of real-time benefit tools under part D of under Medicare H.R. 7573 - Stop Unfair Medicaid Recoveries Act - Rep. Schakowsky, Janice - Medicaid Estate Recovery Program H.R. 7619 - Expand the Behavioral Health Workforce Now Act - Rep. Neguse, Joe - education, training, recruitment, and retention of mental health and substance use disorder providers under Medicaid and CHIP H.R. 7623 - Telehealth Modernization Act of 2024 - Rep. Carter, Earl L. - makes certain telehealth flexibilities permanent under Medicare S. 838 - Improving Access to Mental Health Act - Sen. Stabenow, Debbie - mental health services in Medicare S. 2880 - Expanded Telehealth Access Act - Sen. Daines, Steve - Medicare payment for telehealth services S. 3573- Medicare Advantage Supplemental Benefits Transparency Act- Sen. Warner, Mike - MA, data transparency, supplemental benefits S. 3578- Protect Medicaid Act - Sen. Cassidy, Bill - prohibits federal payments under Medicaid for noncitizens, requires reporting to HHS of states that provide such health benefits S. 3630- Medicare Transaction Fraud Prevention Act- Sen. Braun. Mike- pilot program for predictive risk-scoring algorithm, oversight, Medicare S. 3651- Telemental Health Care Access Act of 2024- Sen. Cassidy, Bill - Medicare, mental health services, telehealth S. 3766- Connecting Caregivers to Medicare Act of 2024- Sen. Tillis, Thomas - Medicare, outreach and education, caregivers S. 3882- Helping States Integrate Medicare and Medicaid Act- Sen. Casey, Robert - dual eligibles, quality measures, access, enrollment S. 3934- Increasing Access to Biosimilars Act of 2023- Sen. Cornyn, John - Medicare drug access S. 3950 - Delivering Unified Access to Lifesaving Services Act of 2024 - Sen. Cassidy, Bill - reforming Integrated Medicare/Medicaid Care Programs for Dually Eligible Individuals Issues related to mental health and Medicare; Medicare and Medicaid funding; Medicaid expansion; State innovation waivers; Medicaid and CHIP; Medicaid FMAP; issues related to Medicare Advantage payment, including Medicare Payment Advisory Commission analyses and the 2025 Advance Rate Notice for MA and Part D; MedPAC analysis of MA payments, MA CY 2025 rate notice; MA risk adjustment; prior authorization in Medicare and Medicaid; MA coverage in rural areas; and issues related to implementation of the Inflation Reduction Act, including reform of the Medicare Part D program. 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 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 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 specialty infant formula; issues related to the Inflation Reduction Act 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 relating to COVID-19, including testing, vaccines and therapeutics; issues related to the end of the public health emergency, including the Medicaid unwinding; telehealth; issues related to the cost of insulin, including price, copays, rebates, and medical management tools; issues related to health equity; issues related to artificial intelligence; 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 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; 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 related to health homes for children with medically complex conditions; socioeconomic status impacts on star ratings related to MA and Part D programs; issues related to private equity ownership transparency; and other issues relating to health care reform implementation.

Client expense: $4,210,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE, White House Office

HR7432 Sickle Cell Disease Comprehensive Care Act; Social Security Disability Insurance Reform; Sickle Cell Disease - comprehensive care and cell and gene therapy model

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

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

Coverage of blood transfusions under Medicare Hospice Benefit Issues related to CAR-T/cellular and gene therapies Implementation of the Medicare Access and CHIP Reauthorization Act pf 2015 (P.L. 114-10) Implementation of the Patient Protection and Affordable Care Act (P.L. 111-148) CMS national coverage determinations Medicaid coverage for sickle cell disease Issues impacting opioid access/use for patients with hematologic disease and disorders Issues related to telemedicine/telehealth Sickle cell disease/trait issues, including coverage for cell and gene therapies Sickle Cell Disease Comprehensive Care Act (H.R. 1672/S. 996) Prior authorization Implementation of the Inflation Reduction Act of 2022 (P.L. 117-169) Strengthening Medicare for Patients and Providers Act (H.R. 2474) Resident Physician Shortage Reduction Act (S. 1302) CONNECT for Health Act (S. 2016/ H.R. 4189) Improving Access to Transfusion Care for Hospice Patients Act (S. 2186) Provider Reimbursement Stability Act of 2023 (H.R. 6371) Telehealth Modernization Act (H.R. 7623 / S. 3967) Sickle Cell Disease Comprehensive Care Act (H.R. 7432) National Coverage Decision for hematopoietic stem cell transplantation (HSCT) for MDS dental coverage for Medicare beneficiaries

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

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

Implementation of the Patient Protection and Affordable Care Act (P.L. 111-148) Hematology/oncology drug research and approval issues Implementation of the Food and Drug Administration Safety and Innovation Act (FDASIA) (P.L. 112-144) Clinical trials regulations and coverage Issues impacting coverage for hematologic diseases and conditions Issues related to CAR-T/cellular and gene therapies Issues impacting opioid access/use for patients with hematologic disease and disorders Issues impacting blood supply shortages/safety Issues related to diversity, equity, and inclusion (DEI) in hematology research, practice, and training Implementation of No Surprises Act (P.L. 116-260) Sickle cell disease/trait issues Sickle Cell Disease Comprehensive Care Act (H.R. 1672/S. 996) Issues related to maternal health care and abortion access Issues related to healthcare workforce Sickle Cell Care Expansion Act (S. 1423/H.R. 3100) Life Saving Leave Act (H.R. 3024) Cancer Drug Parity Act (S. 2039/H.R. 6301) Sickle Cell Disease and Other Heritable Blood Disorders Research, Surveillance, Prevention, and Treatment Act (S. 1852/H.R. 3884) Issues impacting drug shortages House discussion Draft of Stop Drug Shortages Act Let Doctors Provide Reproductive Health Care Act (H.R. 2907/S. 1297) Iron Deficiency Education and Awareness (IDEA) Act (H.R. 6746) Sickle Cell Disease Comprehensive Care Act (H.R. 7432)

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), SENATE

HR7432 Sickle Cell Disease Comprehensive Care Act; Social Security Disability Insurance Reform; Sickle Cell Disease - comprehensive care and cell and gene therapy model

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

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