Access to Claims Data Act

Medicare Physician Payments; H.R. 2474, the Strengthening Medicare for Patients and Providers Act, creates a single conversion factor for all physicians for physician payments through Medicare and increased payments based on the Medicare Economic Index every year. Submitted extensive comments to CMS regarding the Physician Fee Schedule. CMS has proposed a 2.8% cut to cardiothoracic surgery reimbursement, problematic updates to the globals, and is prematurely transitioning away from MIPS. Submitted comments to representatives Dianne DeGette and Larry Bucshon regarding their request for information on the 21st Century Cures Act. Data Sharing; H.R. 9805, the Access to Claims Data Act, would allow surgeons and other providers comprehensive access to federal claims data. This would help identify trends, improve treatment protocols, and ultimately ensure better patient outcomes. H.R. 6371, the Provider Reimbursement Stability Act, provides certain adjustments to the Medicare Physician Fee Schedule. Support for a national coverage determination for Transcatheter Tricuspid Valve Replacement (TTVR) therapy. Lung Cancer Screening; H.R. 4286, the Increasing Access to Lung Cancer Screening Act, provides for coverage without prior authorization requirements of annual lung cancer screenings under Medicaid and expands coverage of counseling and pharmaceuticals for tobacco cessation. Access to Care: H.R. 4758 / S. 2372, the Accelerating Kid's Access to Care Act would establish a voluntary pathway for qualified providers providing specialized care to children that is not available locally to enroll in other states' Medicaid of CHIP programs without delay.

Client expense: $157,711 · Firm income: Not reported

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

S.470/H.R.977, Patient Access to Higher Quality Health Care Act: To repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals. S.4532/H.R. 8702), Improving Seniors Timely Access to Care Act: To streamline prior authorization in the Medicare Advantage program. H.R.2389, Resident Physician Shortage Reduction Act: To provide for the distribution of additional residency positions H.R. 2474, Strengthening Medicare for Patients and Providers Act: To provide an update to a single conversion factor under the Medicare physician fee schedule that is based on the Medicare economic index. H.R. 4968, the GOLD CARD Act of 2023: Prior authorization reform in Medicare Advantage H.R. 9001, Physician Led and Rural Access to Quality Care Act: To amend title XVIII of the Social Security Act to revise certain physician self-referral exemptions relating to physician-owned hospitals and allow physician ownership of rural hospitals H.R.9805, Access to Claims Data Act: To require the Secretary of Health and Human Services to establish a process to expand access to claims data under certain Federal health plans in order to facilitate research and quality improvement. No bill: Graduate medical education policy reform ideas. No bill: Medicare physician payment reform policy ideas, need for legislation to prevent Medicare physician payment cuts and adopt an inflation-based payment update for 2025, modifications to Medicare's budget neutrality rules, increasing surgical global codes to incorporate increased RVUs for follow-up care w/in the global period, and improvements to value-based care payment models

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

S.470/H.R.977, Patient Access to Higher Quality Health Care Act: To repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals. S.4532/H.R. 8702), Improving Seniors Timely Access to Care Act: To streamline prior authorization in the Medicare Advantage program. H.R.2389, Resident Physician Shortage Reduction Act: To provide for the distribution of additional residency positions H.R. 2474, Strengthening Medicare for Patients and Providers Act: To provide an update to a single conversion factor under the Medicare physician fee schedule that is based on the Medicare economic index. H.R. 4968, the GOLD CARD Act of 2023: Prior authorization reform in Medicare Advantage H.R. 9001, Physician Led and Rural Access to Quality Care Act: To amend title XVIII of the Social Security Act to revise certain physician self-referral exemptions relating to physician-owned hospitals and allow physician ownership of rural hospitals H.R.9805, Access to Claims Data Act: To require the Secretary of Health and Human Services to establish a process to expand access to claims data under certain Federal health plans in order to facilitate research and quality improvement. No bill: Graduate medical education policy reform ideas. No bill: Medicare physician payment reform policy ideas, need for legislation to prevent Medicare physician payment cuts and adopt an inflation-based payment update for 2025, modifications to Medicare's budget neutrality rules, increasing surgical global codes to incorporate increased RVUs for follow-up care w/in the global period, and improvements to value-based care payment models

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

Medicare physician payment; new/alternative payment models; Medicare coverage, hospital payment of cardiovascular services; access to Medicare claims data; physician and hospital quality; Quality Payment Program; clinical data registries; health care quality; medical imaging and prior authorization; the Stark Law and the in-office ancillary services exception; Medicare Access and CHIP Reauthorization Act implementation and oversight; Bipartisan Budget Act of 2015 and Medicare site of service policy; graduate medical education policy including the Resident Physician Shortage Reduction Act of 2023 (HR 2389/S. 1302); oversight and implementation of the Protecting Access to Medicare Act of 2014, including Appropriate Use Criteria; physician-owned hospital policy including the Physician Led Rural Access to Quality Care Act (HR 9001); COVID-19 public health emergency and the implementation of the Coronavirus Preparedness and Response Supplemental Appropriations Act, the Families First Coronavirus Response Act, the Coronavirus Aid, Relief, and Economic Security Act; implementation of the Protecting Medicare and American Farmers from Sequester Cuts Act (S. 610); implementation of the Consolidated Appropriations Act of 2022; Increasing Access to Quality Cardiac Rehabilitation Care Act of 2023 (H.R. 2583/S. 3481); Sustainable Cardiopulmonary Rehabilitation Services in the Home At (H.R. 1406/S. 3021); Strengthening Medicare for Patients and Providers (H.R. 2474); site-neutrality; Providing Relief and Stability for Medicare Patients Act (H.R. 3674); Connected Maternal Online Monitoring Act (Connected Mom) (S. 712); Charles Rochester Blood Clot Prevention and Treatment Act (H.R. 5699) Preserving Seniors Access to Physicians Act (H.R. 6683); Provider Reimbursement Stability Act (H.R. 6371); FY2024 Further Consolidated Appropriations Act (H.R. 2882); The Improving Seniors Timely Access to Care Act of 2024 (H.R. 8702/S. 4532); The Pay PCPs Act (S. 4338); the Electronic Prior Authorization for Prescription Drugs Act (S. 4349); FY 25 Labor-HHS Appropriations (H.R. 9029/S. 4942); The Physician Fee Stabilization Act (S. 4935); GOLD CARD Act (H.R. 4968); Access to Claims Data Act (H.R. 9805)