Health Care Efficiency Through Flexibility Act
Legislative Progress
Momentum (last 30 days)
0
score
0 actions · 0 new cosponsors · 0 votes
Speed vs cohort
96pct
301d open
vs 10,940 other HR bills in the 119th — cohort avg 30d
Health Care Efficiency Through Flexibility Act This bill delays certain requirements relating to the reporting of quality measures by accountable care organizations (ACOs) under the Medicare Shared Savings Program. It also requires the Centers for Medicare & Medicaid Services (CMS) to establish a pilot program that tests alternative digital reporting methods for ACOs. The Medicare Shared Savings Program enables ACOs to receive payments for savings stemming from care coordination and management. In 2024, the CMS issued a rule requiring ACOs to report on quality measures using a certain electronic system beginning in 2025. The bill allows ACOs to continue to use prior methods of reporting quality measures through 2029. Additionally, the CMS must establish a pilot program to test other digital reporting methods from 2028-2032; ACOs that participate in the pilot program are exempt from using other methods. The CMS must publicly post an analysis of the program and any related recommendations for using the tested methods.
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Filing registrants (4)
2026 · third_quarter · Medicare/Medicaid
H.R. 5347: Health Care Efficiency Through Flexibility Act H.R. 786/ S. 1460: Preserving Patient Access to Accountable Care Act S. 1816/ 3514: Improving Seniors Timely Access to Care Act S. 1105: No UPCODE Act S. 2561/ H.R. 5768: Skin Substitute Access and Payment Reform Act H.R. 4773/ S.3350: ACO Assignment Improvement Act H.R. 8129: To amend title XVIII of the Social Security Act to establish a full risk ACO program H.R. 6852: Advanced Wound Care and Regenerative Medicine Access and Reform Act H.R. 8163: Provider Reimbursement Stability Act H.R. 8622: Medicare Physician Data Driven Performance Payment System H.R. 9693: Patients First Act S.5269: Pay PCPs Act Issues related to Medicare payments, Medicare Shared Savings Program, ACO REACH, Medicare Advantage, alternative payment model incentives, telehealth, and fraud, waste, abuse.
Received in the Senate and Read twice and referred to the Committee on Finance.
Motion to reconsider laid on the table Agreed to without objection.
On motion to suspend the rules and pass the bill, as amended Agreed to by voice vote. (text: CR H4272)
Passed/agreed to in House: On motion to suspend the rules and pass the bill, as amended Agreed to by voice vote. (text: CR H4272)
DEBATE - The House proceeded with forty minutes of debate on H.R. 5347.
Considered under suspension of the rules. (consideration: CR H4272-4273)
Mr. Smith (MO) moved to suspend the rules and pass the bill, as amended.
Ordered to be Reported by the Yeas and Nays: 44 - 0.
Committee Consideration and Mark-up Session Held
Forwarded by Subcommittee to Full Committee (Amended) by Voice Vote.
Bills with similar content found using semantic analysis.
Sources: Congress.gov
Client expense: $177,310 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2026 · third_quarter · Medicare/Medicaid
H.R. 4093 - Apples to Apples Comparison Act of 2025, all provisions H.R. 483 - Health Care Efficiency Through Flexibility Act, all provisions H.R. 6728 - Linking Seniors to Needed Legal Services Act of 2025, all provisions H.R. 9393 - Lower Costs, More Transparency Act, all provisions H.R. 9397 - Premium Transparency Act, all provisions H.R. 9468 - Saving Today's Ascute-Care Resouces (STAR) act, all provisions H.R. 9693 - The Patients First Act of 2026 - all provisions H.R.1 - An act to provide for reconciliation pursuant to title II of H. Con. Res. 14 (PL 119-21), provisions related to Medicare payment reform, Medicaid reforms, Alternative Payment Models (APMs) H.R.1317 - I CAN Act, all provisions H.R.1614 - To amend title XVIII of the Social Security Act to expand practitioners eligible to furnish telehealth services under the Medicare program, all provisions H.R.2 - Medicare Access and CHIP Reauthorization Act of 2015 (PL 114-10) H.R.2120 - ROCR Value Based Program Act, all provisions H.R.2433 - Reducing Medically Unnecessary Delays in Care Act of 2025, all provisions H.R.2757 - Medicare Audiology Access Improvement Act of 2025, all provisions H.R.2902 - SOAR Act of 2025, all provisions H.R.3069 - Medicare for All Act, all provisions H.R.3108 - RPM Access Act, all provisions, all provisions H.R.3514 - Improving Seniors Timely Access to Care Act of 2025, all provisions H.R.3878 - RNs for Rural Health Act of 2025, all provisions H.R.4002 - Patient Access to Higher Quality Health Care Act of 2025, all provisions H.R.4206 - CONNECT for Health Act of 2025, all provisions H.R.483 - Health Care Efficiency Through Flexibility Act, all provisions H.R.4977 - Connected MOM Act, all provisions H.R.5081 - Telehealth Modernization Act, all provisions H.R.5178 - Sickle Cell Disease Comprehensive Care Act, all provisions H.R.5243 - To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage. H.R.5347 - Health Care Efficiency Through Flexibility Act, all provisions H.R.539 - Chiropractic Medicare Coverage Modernization Act of 2025, all provisions H.R.5467 - PAAT Act, all provisions H.R.5940 - Seniors Deserve SMARTER Care Act of 2025, all provisions H.R.6160 - Strengthening Medicare for Patients and Providers Act, all provisions H.R.6280 - Access to Genetic Counselor Services Act of 2025, all provisions H.R.7520 - Efficiency Adjustment Delay Act, all provisions H.R.786 - Preserving Patient Access to Accountable Care Act, all provisions H.R.7905 - Diabetes Foot Health Access and Modernization Act of 2026, all provisions H.R.8129 - To amend title XVIII of the Social Security Act to establish a full risk ACO program, all provisions H.R.8163 - Provider Reimbursement Stability Act of 2026, all provisions H.R.8261 - Chronic Care Management Improvement Act of 2026, all provisions H.R.8375 - Medicare Advantage Improvement Act of 2026, all provisions H.R.8500 - Timely Access to Coverage Decisions Act of 2026, all provisions H.R.8622 - Medicare Physician Data-driven Performance Payment System Act of 2026, all provisions H.R.879 - Medicare Patient Access and Practice Stabilization Act of 2025, all provisions H.R.9392 - Medicare Advantage Cost Transparency Act, all provisions H.R.9644 - Medicare Advantage MLR Transparency Act, all provisions S.1031 - ROCR Value Based Program Act, all provisions S.106 - Chiropractic Medicare Coverage Modernization Act of 2025, all provisions S.1105 - No UPCODE Act, all provisions S.1261 - CONNECT for Health Act of 2025, all provisions S.1399 - Health Tech Investment Act, all provisions S.141 - Connected MOM Act, all provisions S.1460 - Preserving Patient Access to Accountable Care Act, all provisions S.1535 - Rural Patient Monitoring (RPM) Access Act, all provisions S.1640 - Medicare Patient Access and Practice Stabilization Act of 2025, all provisions S.1816 - Improving Seniors Timely Access to Care Act of 2025, all provisions S.1996 - Medicare Audiology Access Improvement Act of 2025, all provisions S.2709 - Telehealth Modernization Act, all provisions S.3480 - Seniors Deserve SMARTER Care Act of 2025, all provisions S.3607 - Access to Genetic Counselor Services Act of 2026, all provisions S.5168 - Provider Reimbursement Stability Act of 2026, all provisions S.5180 - Provider Reimbursement Stability Act, all provisions S.665 - Fatal Overdose Reduction Act of 2025, all provisions S.721 - Sickle Cell Disease Comprehensive Care Act, all provisions S.891 - Bipartisan Health Care Act, all provisions Comment Letter: [CMS 0057 F] 2024 CMS Interoperability and Prior Authorization final rule Comment Letter: [CMS-0062-P] Medicare and Medicaid Programs; Patient Protection and Affordable Care Act; Interoperability Standards and Prior Authorization for Drugs for Medicare Advantage Organizations, Medicaid Managed Care Plans, State Medicaid Agencies, Children's Health Insurance Program (CHIP) Agencies and CHIP Managed Care Entities, and Issuers of Qualified Health Plans on the Federally-Facilitated Exchanges Comment Letter: [CMS-1844-P] CY 2027 Home Health Prospective Payment System proposed rule Comment Letter: [CMS-1848-P] Medicare Physician Fee Schedule, including conversion factors, Modifier -25 payment reduction, efficiency adjustment, RPM/RTM, Maternity Care Services codes, CPT request for information, MIPS/MVP transition, Medicare Shared Savings Program, and Qualifying APM Participant determinations Comment Letter: [CMS-1850-P] Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems; and Quality Reporting Programs; Including the Hospital Outpatient Quality Reporting Program and Ambulatory Surgical Center Quality Program; Request for Information on Strengthening the Standardization and Comparability of Hospital Price Transparency (HPT) Data; Prior Authorization; Accrediting Organization (AO) Deeming for Emergency Medical Treatment and Labor Act (EMTALA); and Notices of Closure of Teaching Hospitals and Opportunities To Apply for Available Slots Comment Letter: [CMS-2452-P] Medicaid Program; Amending the Indirect Hold Harmless Threshold of Health Care-Related Taxes Comment Letter: [CMS-2454-IFC] Medicaid Program; Community Engagement Requirement for Certain Individuals Comment Letter: [CMS-3847-NC] Regulatory Alignment for Predictable and Immediate Device (RAPID) coverage pathway Comment Letter: [CMS-9874-NC] Request for Information; Comprehensive Review of the Essential Health Benefits Framework and Typical Employer Plan Standard Comment Letter: [HHS-OS-2026-0332] Request for Information: Categories Used in Federal Vaccine Recommendations and the Role of Shared Clinical Decision-Making Comment Letter: Request for Information (RFI) Strengthening the Medicare Physician Payment System Statement for the Record: Examining Legislative Proposals to Reform Medicare Provider Payment and Bolster Health Care Cybersecurity Medicare program: ACO (Accountable Care Organization) REACH Model Medicare program: ACO/APM flexibilities Medicare program: Advanced APM reporting Medicare program: AI chatbots/Medicare Advantage preventive screens Medicare program: AI services/payment Medicare program: Aligned Networks and interoperability Medicare program: Alternative Payment Models (APMs) Medicare program: Certified electronic health record and PI Medicare program: Coding Medicare program: Data privacy/cybersecurity Medicare program: Data-Driven Performance Payment System Medicare program: Digital quality measures Medicare program: G2211 Inherent Complexity Code Medicare program: Health Information Technology/physician burdens Medicare program: Indirect practice expense Medicare program: Informed decision-making among beneficiaries Medicare program: Medicare Advantage provider networks/physician experience Medicare program: Medicare Diabetes Prevention Program Medicare program: Medicare Economic Index (MEI)/inflationary updates Medicare program: Medicare Part D issues Medicare program: Medicare physician payment/budget neutrality Medicare program: Merit-based Incentive Payment System (MIPS)/reforms and penalties Medicare program: MIPS Promoting Interoperability Medicare program: MIPS quality and cost measures Medicare program: MIPS Value Pathways (MVPs) reform Medicare program: Organ transplantation access Medicare program: Prior authorization/Medical billing transition Medicare program: Promoting Interoperability (PI) Program Medicare program: Provider directories Medicare program: Public Health Reporting and Data Exchange Medicare program: Quality Payment Program Medicare program: Review Choice Demonstration (RCD)/Inpatient Rehabilitation Facility (IRF) Medicare program: RVS Update Committee (RUC) and Current Procedural Terminology (CPT) issues Medicare program: Shared Savings Program Medicare program: Site Neutral Payment Medicare program: Traditional Medicare/Medicare Advantage enrollment difficulties Medicare program: Wasteful and Inappropriate Service Reduction (WISeR) and Ambulatory Specialty Model Medicaid program: Changes in Children's Health Insurance Program (CHIP) and Affordable Care Act insurance marketplaces Medicaid program: Community engagement/medical frailty exemption Medicaid program: Practice of Medicine Medicaid program: State directed payments Medicaid program: Work requirements, per capita caps, provider taxes, Federal Medical Assistance Percentage (FMAP) changes Medicare and Medicaid programs: ACO REACH (Realizing Equity, Access, and Community Health) Model Reform Medicare and Medicaid programs: Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) Model reform. Medicare and Medicaid programs: Center for Medicare and Medicaid Innovation (CMMI) reforms Medicare and Medicaid programs: CMMI reform/Physician AI use Medicare and Medicaid programs: Evaluation and Management (E/M) codes Medicare and Medicaid programs: High-cost disposable supplies/billing codes Medicare and Medicaid programs: Indirect Practice Expense Relative Value Updates (RVU) changes Medicare and Medicaid programs: Interoperability Medicare and Medicaid programs: LEAD (Long-term Enhanced ACO Design) Model Reform Medicare and Medicaid programs: MACRA/physician burdens Medicare and Medicaid programs: Medicare Access and CHIP Reauthorization Act (MACRA)/broad reform Medicare and Medicaid programs: Prior authorization Medicare and Medicaid programs: TEAM (Transforming Episode Accountability Model) changes Medicare and Medicaid programs: Telehealth and Digital Health Draft: Artificial intelligence in prior authorization denials by Medicare Advantage organizations Draft: GOLD CARD Act Draft: MACRA/MIPS program reform Draft: Transparency in Downcoding Model Act Draft: Value in Health Care Act Matters related to downcoding by Insurace plans Matters related to drug price negotiations Matters related to expiring Medicare Physician payment rates Matters related to Modifier-25/Multiple Procedure Payment Reductions
Client expense: $4,540,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE
2026 · third_quarter · Medicare/Medicaid
H.R.1, One Big Beautiful Bill Act H.R. 3164/S. 2426, Main Street Pharmacy Access Act H.R. 3514/S. 1816, Improving Seniors Timely Access to Care Act H.R. 4093/S. 3848, Apples to Apples Comparison Act H.R. 4731/S. 2439, Resident Physician Shortage Reduction Act H.R. 5269/S. 2761, Reforming and Enhancing Sustainable Updates to Laboratory Services Act H.R. 5347, Health care Efficiency Through Flexibility Act U.S Department of Health and Human Services, Centers for Medicare & Medicaid Services Medicaid Program; Community Engagement Requirement for Certain Individuals Interim Final Rule with Comment Period (CMS-2454-IFC) U.S Department of Health and Human Services, Centers for Medicare & Medicaid Services Medicare and Medicaid Programs; CY 2027 Payment Policies under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; and Medicare Prescription Drug Inflation Rebate Program (CMS-1848-P)
Client expense: $150,000 · 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
2026 · second_quarter · Medicare/Medicaid
H.R. 5347: Health Care Efficiency Through Flexibility Act H.R. 786/ S. 1460: Preserving Patient Access to Accountable Care Act S. 1816/ 3514: Improving Seniors Timely Access to Care Act S. 1105: No UPCODE Act S. 2561/ H.R. 5768: Skin Substitute Access and Payment Reform Act H.R. 4773/ S.3350: ACO Assignment Improvement Act H.R. 4313/ S.2237: Hospital Inpatient Services Modernization Act H.R. 8129: To amend title XVIII of the Social Security Act to establish a full risk ACO program H.R. 6852: Advanced Wound Care and Regenerative Medicine Access and Reform Act H.R. 8375/ S.4384: Medicare Advantage Improvement Act H.R. 8163: Provider Reimbursement Stability Act H.R. 8622: Medicare Physician Data Driven Performance Payment System H.J. Res 187/ S.J. Res 192: Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Centers for Medicare & Medicaid Services of the Department of Health and Human Services relating to Medicare Program; Implementation of Prior Authorization for Select Services for the Wasteful and Inappropriate Services Reduction (WISeR) Model. Issues related to Medicare payments, Medicare Shared Savings Program, ACO REACH, Medicare Advantage, alternative payment model incentives, telehealth, and fraud, waste, abuse.
Client expense: $142,230 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2026 · second_quarter · Medicare/Medicaid
H.R. 5347, Health Care Efficiency Through Flexibility Act, including provisions relating to Medicare physician fee schedule Medicare advantage Medicare physician fee schedule Medicare advantage, medicare physician fee schedule Center for Medicare and Medicaid Innovation
Client expense: $110,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), SENATE
2026 · second_quarter · Medicare/Medicaid
H.R.1 - An act to provide for reconciliation pursuant to title II of H. Con. Res. 14 (PL 119-21), provisions related to Medicare payment reform, Medicaid reforms, Alternative Payment Models (APMs) H.R.1317 - I CAN Act, all provisions H.R.1614 - To amend title XVIII of the Social Security Act to expand practitioners eligible to furnish telehealth services under the Medicare program, all provisions H.R.2 - Medicare Access and CHIP Reauthorization Act of 2015 (PL 114-10) H.R.2120 - ROCR Value Based Program Act, all provisions H.R.2433 - Reducing Medically Unnecessary Delays in Care Act of 2025, all provisions H.R.2757 - Medicare Audiology Access Improvement Act of 2025, all provisions H.R.2757 - Medicare Audiology Access Improvement Act of 2025, all provisions H.R.2902 - SOAR Act of 2025, all provisions H.R.3069 - Medicare for All Act, all provisions H.R.3108 - RPM Access Act, all provisions, all provisions H.R.3514 - Improving Seniors Timely Access to Care Act of 2025, all provisions H.R.3878 - RNs for Rural Health Act of 2025, all provisions H.R.4002 - Patient Access to Higher Quality Health Care Act of 2025, all provisions H.R.4074 - Optimizing Postpartum Outcomes Act of 2025, all provisions H.R.4206 - CONNECT for Health Act of 2025, all provisions H.R.483 - Health Care Efficiency Through Flexibility Act, all provisions H.R.483 - Health Care Efficiency Through Flexibility Act, all provisions H.R.4977 - Connected MOM Act, all provisions H.R.5081 - Telehealth Modernization Act, all provisions H.R.5178 - Sickle Cell Disease Comprehensive Care Act, all provisions H.R.5281 - REAL Health Providers Act, all provisions H.R.5347 - Health Care Efficiency Through Flexibility Act, all provisions H.R.539 - Chiropractic Medicare Coverage Modernization Act of 2025, all provisions H.R.5467 - PAAT Act, all provisions H.R.5940 - Seniors Deserve SMARTER Care Act of 2025, all provisions H.R.6160 - Strengthening Medicare for Patients and Providers Act, all provisions H.R.6280 - Access to Genetic Counselor Services Act of 2025, all provisions H.R.7520 - Efficiency Adjustment Delay Act, all provisions H.R.786 - Preserving Patient Access to Accountable Care Act, all provisions H.R.786 - Preserving Patient Access to Accountable Care Act, all provisions H.R.7905 - Diabetes Foot Health Access and Modernization Act of 2026, all provisions H.R.8129 - To amend title XVIII of the Social Security Act to establish a full risk ACO program, all provisions H.R.8163 - Provider Reimbursement Stability Act of 2026, all provisions H.R.8261 - Chronic Care Management Improvement Act of 2026, all provisions H.R.8375 - Medicare Advantage Improvement Act of 2026, all provisions H.R.8487 - Ensuring Excellence in Mental Health Act, all provisions H.R.8500 - Timely Access to Coverage Decisions Act of 2026, all provisions H.R.8622 - Medicare Physician Data-driven Performance Payment System Act of 2026, all provisions H.R.879 - Medicare Patient Access and Practice Stabilization Act of 2025, all provisions S.1031 - ROCR Value Based Program Act, all provisions S.106 - Chiropractic Medicare Coverage Modernization Act of 2025, all provisions S.1105 - No UPCODE Act, all provisions S.1261 - CONNECT for Health Act of 2025, all provisions S.1399 - Health Tech Investment Act, all provisions S.141 - Connected MOM Act, all provisions S.1460 - Preserving Patient Access to Accountable Care Act, all provisions S.1535 - Rural Patient Monitoring (RPM) Access Act, all provisions S.1640 - Medicare Patient Access and Practice Stabilization Act of 2025, all provisions S.1816 - Improving Seniors Timely Access to Care Act of 2025, all provisions S.1996 - Medicare Audiology Access Improvement Act of 202, all provisions S.1996 - Medicare Audiology Access Improvement Act of 2025, all provisions S.2709 - Telehealth Modernization Act, all provisions S.3480 - Seniors Deserve SMARTER Care Act of 2025, all provisions S.3607 - Access to Genetic Counselor Services Act of 2026, all provisions S.3750 - REAL Health Providers Act, all provisions S.3762 - Prior Authorization Relief Act, all provisions S.4070 - Diabetes Foot Health Access and Modernization Act of 2026, all provisions S.4384 - Medicare Advantage Improvement Act of 2026, all provisions S.665 - Fatal Overdose Reduction Act of 2025, all provisions S.721 - Sickle Cell Disease Comprehensive Care Act, all provisions S.891 - Bipartisan Health Care Act, all provisions Comment Letter: [CMS 0057 F] 2024 CMS Interoperability and Prior Authorization final rule Comment Letter: [CMS-0062-P] Medicare and Medicaid Programs; Patient Protection and Affordable Care Act; Interoperability Standards and Prior Authorization for Drugs for Medicare Advantage Organizations, Medicaid Managed Care Plans, State Medicaid Agencies, Children's Health Insurance Program (CHIP) Agencies and CHIP Managed Care Entities, and Issuers of Qualified Health Plans on the Federally-Facilitated Exchanges Comment Letter: [CMS-1849-P] Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals (IPPS) and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year (FY) 2027 Rates; Requirements for Quality Programs; and Other Policy Changes Comment Letter: [CMS-9874-NC] Request for Information; Comprehensive Review of the Essential Health Benefits Framework and Typical Employer Plan Standard Statement for the Record: Examining the Medicare Physician Fee Schedule, MACRA, and Opportunities for Payment Reforms Draft: Artificial intelligence in prior authorization denials by Medicare Advantage organizations Draft: GOLD CARD Act Draft: MACRA/MIPS program reform Draft: Medicare bonus payment for alternative payment model (APM) participation Draft: Medicare Budget Neutrality and MIPS reform Medicaid program: Changes in Children's Health Insurance Program (CHIP) and Affordable Care Act insurance marketplaces Medicaid program: Community engagement/medical frailty exemption Medicaid program: Practice of Medicine Medicaid program: Work requirements, per capita caps, provider taxes, Federal Medical Assistance Percentage (FMAP) changes Medicare and Medicaid programs: LEAD (Long-term Enhanced ACO Design) Model Reform Medicare and Medicaid programs: ACO REACH (Realizing Equity, Access, and Community Health) Model Reform Medicare and Medicaid programs: Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) Model reform. Medicare and Medicaid programs: Center for Medicare and Medicaid Innovation (CMMI) reforms Medicare and Medicaid programs: CMMI reform/Physician AI use Medicare and Medicaid programs: Evaluation and Management (E/M) codes Medicare and Medicaid programs: High-cost disposable supplies/billing codes Medicare and Medicaid programs: Indirect Practice Expense Relative Value Updates (RVU) changes Medicare and Medicaid programs: Interoperability Medicare and Medicaid programs: MACRA/physician burdens Medicare and Medicaid programs: Medicare Access and CHIP Reauthorization Act (MACRA)/broad reform Medicare and Medicaid programs: Prior authorization Medicare and Medicaid programs: TEAM (Transforming Episode Accountability Model) changes Medicare and Medicaid programs: Telehealth Medicare and Medicaid programs: Telehealth and Digital Health Medicare program: ACO (Accountable Care Organization) REACH Model Medicare program: ACO/APM flexibilities Medicare program: Advanced APM reporting Medicare program: AI chatbots/Medicare Advantage preventive screens Medicare program: AI services/payment Medicare program: Aligned Networks and interoperability Medicare program: Alternative Payment Models (APMs) Medicare program: Certified electronic health record and PI Medicare program: CJR-X (Comprehensive Care for Joint Replacement Expanded) Model Medicare program: Coding Medicare program: Data privacy/cybersecurity Medicare program: Data-Driven Performance Payment System Medicare program: Digital quality measures Medicare program: G2211 Inherent Complexity Code Medicare program: Health Information Technology/physician burdens Medicare program: Indirect practice expense Medicare program: Long-term Enhanced ACO Design (LEAD) Model Medicare program: Medicare Advantage provider networks/physician experience Medicare program: Medicare Diabetes Prevention Program Medicare program: Medicare Economic Index (MEI)/inflationary updates Medicare program: Medicare Part D issues Medicare program: Medicare physician payment/budget neutrality Medicare program: MEI Update Medicare program: Merit-based Incentive Payment System (MIPS)/reforms and penalties Medicare program: MIPS quality and cost measures Medicare program: MIPS Value Pathways (MVPs) reform Medicare program: Organ transplantation access Medicare program: Prior authorization/Medical billing transition Medicare program: Promoting Interoperability (PI) Program Medicare program: Provider directories Medicare program: Public Health Reporting and Data Exchange Medicare program: Quality Payment Program Medicare program: Review Choice Demonstration (RCD)/Inpatient Rehabilitation Facility (IRF) Medicare program: RVS Update Committee (RUC) and Current Procedural Terminology (CPT) issues Medicare program: Shared Savings Program Medicare program: Site Neutral Payment Medicare program: Traditional Medicare/Medicare Advantage enrollment difficulties Medicare program: Wasteful and Inappropriate Service Reduction (WISeR) and Ambulatory Specialty Model
2026 · second_quarter · Medicare/Medicaid
H.R.1 - An act to provide for reconciliation pursuant to title II of H. Con. Res. 14 (PL 119-21), provisions related to Medicare payment reform, Medicaid reforms, Alternative Payment Models (APMs) H.R.1317 - I CAN Act, all provisions H.R.1614 - To amend title XVIII of the Social Security Act to expand practitioners eligible to furnish telehealth services under the Medicare program, all provisions H.R.2 - Medicare Access and CHIP Reauthorization Act of 2015 (PL 114-10) H.R.2120 - ROCR Value Based Program Act, all provisions H.R.2433 - Reducing Medically Unnecessary Delays in Care Act of 2025, all provisions H.R.2757 - Medicare Audiology Access Improvement Act of 2025, all provisions H.R.2757 - Medicare Audiology Access Improvement Act of 2025, all provisions H.R.2902 - SOAR Act of 2025, all provisions H.R.3069 - Medicare for All Act, all provisions H.R.3108 - RPM Access Act, all provisions, all provisions H.R.3514 - Improving Seniors Timely Access to Care Act of 2025, all provisions H.R.3878 - RNs for Rural Health Act of 2025, all provisions H.R.4002 - Patient Access to Higher Quality Health Care Act of 2025, all provisions H.R.4074 - Optimizing Postpartum Outcomes Act of 2025, all provisions H.R.4206 - CONNECT for Health Act of 2025, all provisions H.R.483 - Health Care Efficiency Through Flexibility Act, all provisions H.R.483 - Health Care Efficiency Through Flexibility Act, all provisions H.R.4977 - Connected MOM Act, all provisions H.R.5081 - Telehealth Modernization Act, all provisions H.R.5178 - Sickle Cell Disease Comprehensive Care Act, all provisions H.R.5281 - REAL Health Providers Act, all provisions H.R.5347 - Health Care Efficiency Through Flexibility Act, all provisions H.R.539 - Chiropractic Medicare Coverage Modernization Act of 2025, all provisions H.R.5467 - PAAT Act, all provisions H.R.5940 - Seniors Deserve SMARTER Care Act of 2025, all provisions H.R.6160 - Strengthening Medicare for Patients and Providers Act, all provisions H.R.6280 - Access to Genetic Counselor Services Act of 2025, all provisions H.R.7520 - Efficiency Adjustment Delay Act, all provisions H.R.786 - Preserving Patient Access to Accountable Care Act, all provisions H.R.786 - Preserving Patient Access to Accountable Care Act, all provisions H.R.7905 - Diabetes Foot Health Access and Modernization Act of 2026, all provisions H.R.8129 - To amend title XVIII of the Social Security Act to establish a full risk ACO program, all provisions H.R.8163 - Provider Reimbursement Stability Act of 2026, all provisions H.R.8261 - Chronic Care Management Improvement Act of 2026, all provisions H.R.8375 - Medicare Advantage Improvement Act of 2026, all provisions H.R.8487 - Ensuring Excellence in Mental Health Act, all provisions H.R.8500 - Timely Access to Coverage Decisions Act of 2026, all provisions H.R.8622 - Medicare Physician Data-driven Performance Payment System Act of 2026, all provisions H.R.879 - Medicare Patient Access and Practice Stabilization Act of 2025, all provisions S.1031 - ROCR Value Based Program Act, all provisions S.106 - Chiropractic Medicare Coverage Modernization Act of 2025, all provisions S.1105 - No UPCODE Act, all provisions S.1261 - CONNECT for Health Act of 2025, all provisions S.1399 - Health Tech Investment Act, all provisions S.141 - Connected MOM Act, all provisions S.1460 - Preserving Patient Access to Accountable Care Act, all provisions S.1535 - Rural Patient Monitoring (RPM) Access Act, all provisions S.1640 - Medicare Patient Access and Practice Stabilization Act of 2025, all provisions S.1816 - Improving Seniors Timely Access to Care Act of 2025, all provisions S.1996 - Medicare Audiology Access Improvement Act of 202, all provisions S.1996 - Medicare Audiology Access Improvement Act of 2025, all provisions S.2709 - Telehealth Modernization Act, all provisions S.3480 - Seniors Deserve SMARTER Care Act of 2025, all provisions S.3607 - Access to Genetic Counselor Services Act of 2026, all provisions S.3750 - REAL Health Providers Act, all provisions S.3762 - Prior Authorization Relief Act, all provisions S.4070 - Diabetes Foot Health Access and Modernization Act of 2026, all provisions S.4384 - Medicare Advantage Improvement Act of 2026, all provisions S.665 - Fatal Overdose Reduction Act of 2025, all provisions S.721 - Sickle Cell Disease Comprehensive Care Act, all provisions S.891 - Bipartisan Health Care Act, all provisions Comment Letter: [CMS 0057 F] 2024 CMS Interoperability and Prior Authorization final rule Comment Letter: [CMS-0062-P] Medicare and Medicaid Programs; Patient Protection and Affordable Care Act; Interoperability Standards and Prior Authorization for Drugs for Medicare Advantage Organizations, Medicaid Managed Care Plans, State Medicaid Agencies, Children's Health Insurance Program (CHIP) Agencies and CHIP Managed Care Entities, and Issuers of Qualified Health Plans on the Federally-Facilitated Exchanges Comment Letter: [CMS-1849-P] Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals (IPPS) and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year (FY) 2027 Rates; Requirements for Quality Programs; and Other Policy Changes Comment Letter: [CMS-9874-NC] Request for Information; Comprehensive Review of the Essential Health Benefits Framework and Typical Employer Plan Standard Statement for the Record: Examining the Medicare Physician Fee Schedule, MACRA, and Opportunities for Payment Reforms Draft: Artificial intelligence in prior authorization denials by Medicare Advantage organizations Draft: GOLD CARD Act Draft: MACRA/MIPS program reform Draft: Medicare bonus payment for alternative payment model (APM) participation Draft: Medicare Budget Neutrality and MIPS reform Medicaid program: Changes in Children's Health Insurance Program (CHIP) and Affordable Care Act insurance marketplaces Medicaid program: Community engagement/medical frailty exemption Medicaid program: Practice of Medicine Medicaid program: Work requirements, per capita caps, provider taxes, Federal Medical Assistance Percentage (FMAP) changes Medicare and Medicaid programs: LEAD (Long-term Enhanced ACO Design) Model Reform Medicare and Medicaid programs: ACO REACH (Realizing Equity, Access, and Community Health) Model Reform Medicare and Medicaid programs: Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) Model reform. Medicare and Medicaid programs: Center for Medicare and Medicaid Innovation (CMMI) reforms Medicare and Medicaid programs: CMMI reform/Physician AI use Medicare and Medicaid programs: Evaluation and Management (E/M) codes Medicare and Medicaid programs: High-cost disposable supplies/billing codes Medicare and Medicaid programs: Indirect Practice Expense Relative Value Updates (RVU) changes Medicare and Medicaid programs: Interoperability Medicare and Medicaid programs: MACRA/physician burdens Medicare and Medicaid programs: Medicare Access and CHIP Reauthorization Act (MACRA)/broad reform Medicare and Medicaid programs: Prior authorization Medicare and Medicaid programs: TEAM (Transforming Episode Accountability Model) changes Medicare and Medicaid programs: Telehealth Medicare and Medicaid programs: Telehealth and Digital Health Medicare program: ACO (Accountable Care Organization) REACH Model Medicare program: ACO/APM flexibilities Medicare program: Advanced APM reporting Medicare program: AI chatbots/Medicare Advantage preventive screens Medicare program: AI services/payment Medicare program: Aligned Networks and interoperability Medicare program: Alternative Payment Models (APMs) Medicare program: Certified electronic health record and PI Medicare program: CJR-X (Comprehensive Care for Joint Replacement Expanded) Model Medicare program: Coding Medicare program: Data privacy/cybersecurity Medicare program: Data-Driven Performance Payment System Medicare program: Digital quality measures Medicare program: G2211 Inherent Complexity Code Medicare program: Health Information Technology/physician burdens Medicare program: Indirect practice expense Medicare program: Long-term Enhanced ACO Design (LEAD) Model Medicare program: Medicare Advantage provider networks/physician experience Medicare program: Medicare Diabetes Prevention Program Medicare program: Medicare Economic Index (MEI)/inflationary updates Medicare program: Medicare Part D issues Medicare program: Medicare physician payment/budget neutrality Medicare program: MEI Update Medicare program: Merit-based Incentive Payment System (MIPS)/reforms and penalties Medicare program: MIPS quality and cost measures Medicare program: MIPS Value Pathways (MVPs) reform Medicare program: Organ transplantation access Medicare program: Prior authorization/Medical billing transition Medicare program: Promoting Interoperability (PI) Program Medicare program: Provider directories Medicare program: Public Health Reporting and Data Exchange Medicare program: Quality Payment Program Medicare program: Review Choice Demonstration (RCD)/Inpatient Rehabilitation Facility (IRF) Medicare program: RVS Update Committee (RUC) and Current Procedural Terminology (CPT) issues Medicare program: Shared Savings Program Medicare program: Site Neutral Payment Medicare program: Traditional Medicare/Medicare Advantage enrollment difficulties Medicare program: Wasteful and Inappropriate Service Reduction (WISeR) and Ambulatory Specialty Model
2026 · first_quarter · Medicare/Medicaid
H.R. 879, Medicare Patient Access and Practice Stabilization Act of 2025, all provisions S. 1640, Medicare Patient Access and Practice Stabilization Act of 2025, all provisions S, 891, Bipartisan Health Care Act, all provisions H.R. 786, Preserving Patient Access to Accountable Care Act, all provisions S. 1460, Preserving Patient Access to Accountable Care Act, all provisions H.R. 539, Chiropractic Medicare Coverage Modernization Act of 2025, all provisions S. 106, Chiropractic Medicare Coverage Modernization Act of 2025, all provisions H.R. 1317, Improving Care and Access to Nurses (I CAN) Act, all provisions H.R. 2191, Physician Led and Rural Access to Quality Care Act, all provisions S. 1390, Physician Led and Rural Access to Quality Care Act, all provisions S. 665, Fatal Overdose Reduction Act of 2025, all provisions H.R, 4977, Connected MOM Act, all provisions S. 141, Connected MOM Act, all provisions H.R. 3514, Improving Seniors Timely Access to Care Act of 2025, all provisions S. 1816, Improving Seniors Timely Access to Care Act of 2025, all provisions S. 1105, No UPCODE Act, all provisions H.R. 5081, Telehealth Modernization Act, all provisions S. 2709, Telehealth Modernization Act, all provisions H.R. 2483, SUPPORT for Patients and Communities Reauthorization Act of 2025, all provisions H.R. 1, One Big Beautiful Bill Act, provisions related to Medicare payment reform, Medicaid reforms, Alternative Payment Models (APMs) H.R. 6160, Strengthening Medicare for Patients and Providers Act, all provisions H.R. 7520, Efficiency Adjustment Delay Act, all provisions H.R. 7148, Consolidated Appropriations Act, 2026, provisions related to APM bonus extension/incentive payments/qualifying provider revenue thresholds freeze H.R. 1968, Full-Year Continuing Appropriations and Extensions Act, 2025, provisions related to APMs H.R. 8163, To amend title XVIII of the Social Security Act to ensure stability for provider payments under the Medicare program, all provisions H.R. 2120, Radiation Oncology Case Rate (ROCR) Value Based Program Act of 2025, all provisions S. 1031, Radiation Oncology Case Rate (ROCR) Value Based Program Act of 2025, all provisions H.R. 483, Health Care Efficiency Through Flexibility Act, all provisions H.R. 5347, Health Care Efficiency Through Flexibility Act, all provisions H.R. 8129, To amend title XVIII of the Social Security Act to establish a full risk ACO program, all provisions H.R. 1614, To amend title XVIII of the Social Security Act to expand practitioners eligible to furnish telehealth services under the Medicare program, all provisions H.R. 3108, Rural Patient Monitoring (RPM) Access Act, all provisions S. 1535, Rural Patient Monitoring (RPM) Access Act, all provisions H.R. 3164, Ensuring Community Access to Pharmacist Services Act, all provisions H.R. 2725, Affordable Housing Credit Improvement Act of 2025, all provisions H.R. 2757, Medicare Audiology Access Improvement Act of 2025, all provisions S. 1996, Medicare Audiology Access Improvement Act of 2025, all provisions H.R. 3878, RNs for Rural Health Act of 2025, all provisions H.R. 5199, Modernizing Rural Physician Assistant and Nurse Practitioner Utilization Act of 2025, all provisions H.R. 2433, Reducing Medically Unnecessary Delays in Care Act of 2025, all provisions H.R. 5467, Patient Access to Autoimmune Treatments (PAAT) Act, all provisions H.R. 5940, Seniors Deserve Streamlined Medical Approvals for Timely, Efficient Recovery (SMARTER) Care Act of 2025, all provisions S. 3480, Seniors Deserve Streamlined Medical Approvals for Timely, Efficient Recovery (SMARTER) Care Act of 2025, all provisions H.R. 4002, Patient Access to Higher Quality Health Care Act of 2025, all provisions H.R. 3022, Restoring Rights of Physicians to Own Hospitals Act, all provisions S. 1399, Health Tech Investment Act, all provisions S. 3386, Health Care Freedom for Patients Act of 2025, provisions related to the ACA H.R. 498, Do No Harm in Medicaid Act, all provisions H.R. 4710, No Surprises Act Enforcement Act, all provisions S. 2420, No Surprises Act Enforcement Act, all provisions S. 1692, Radiology Outpatient Ordering Transmission (ROOT) Act, provisions related to imaging appropriate use criteria H.R. 5737, Radiology Outpatient Ordering Transmission (ROOT) Act, provisions related to imaging appropriate use criteria H.R. 3164, Equitable Community Access to Pharmacist Services Act, all provisions S. 2426, Equitable Community Access to Pharmacist Services Act, all provisions S. 3934, Medical Nutrition Therapy Act of 2026, all provisions H.R. 4206, CONNECT for Health Act of 2025, all provisions No Fees for EFTs Act, all provisions Drafts/Chronic Care Management Improvement Act Drafts/Access to Genetic Counselor Services Act Drafts/GOLD CARD Act Drafts/Medicare Advantage Improvement Act Draft/Value in Health Care Act Draft/Medicare Budget Neutrality and MIPS reform Draft/MACRA/MIPS program reform Medicare program: Medicare Economic Index (MEI)/inflationary updates Medicare program: Medicare physician payment/budget neutrality Medicare program: Merit-based Incentive Payment System (MIPS)/reforms and penalties Medicare program: MIPS Value Pathways (MVPs) reform Medicare program: MIPS quality and cost measures Medicare program: G2211 Inherent Complexity Code Medicare program: Alternative Payment Models (APMs) Medicare program: ACO (Accountable Care Organization) REACH Model Medicare program: Long-term Enhanced ACO Design (LEAD) Model Medicare program: ACO/APM flexibilities Medicare program: Prior authorization Medicare program: Wasteful and Inappropriate Service Reduction (WISeR) and Ambulatory Specialty Model Medicare program: Site Neutral Payment Medicare program: AI chatbots/Medicare Advantage preventive screens Medicare program: Coding Medicare program: MEI Update Medicare program: AI services/payment Medicare program: Indirect practice expense Medicare program: Telehealth and Digital Health Medicare program: Medicare Advantage provider networks/physician experience Medicare program: Shared Savings Program Medicare program: Medicare Diabetes Prevention Program Medicare program: Data-Driven Performance Payment System Medicare program: Promoting Interoperability (PI) Program Medicare program: Quality Payment Program Medicare program: Certified electronic health record and PI Medicare program: Advanced APM reporting Medicare program: Public Health Reporting and Data Exchange Medicare program: Provider directories Medicare program: Digital quality measures Medicare program: Aligned Networks and interoperability Medicare program: Health Information Technology/physician burdens Medicare program: Data privacy/cybersecurity Medicare program: Review Choice Demonstration (RCD)/Inpatient Rehabilitation Facility (IRF) Medicare program: Organ transplantation access Medicare program: Prior authorization/Medical billing transition Medicare program: Traditional Medicare/Medicare Advantage enrollment difficulties Medicare and Medicaid programs: Medicare Access and CHIP Reauthorization Act (MACRA)/broad reform Medicare and Medicaid programs: MACRA/physician burdens Medicare and Medicaid programs: Telehealth Medicare and Medicaid programs: Center for Medicare and Medicaid Innovation (CMMI) reforms Medicare and Medicaid programs: CMMI reform/Physician AI use Medicare and Medicaid programs: High-cost disposable supplies/billing codes Medicaid program: Gender affirming care Medicaid program: Work requirements, per capita caps, provider taxes, FMAP changes Medicaid program: Community engagement/medical frailty exemption
2026 · first_quarter · Medicare/Medicaid
H.R. 879, Medicare Patient Access and Practice Stabilization Act of 2025, all provisions S. 1640, Medicare Patient Access and Practice Stabilization Act of 2025, all provisions S, 891, Bipartisan Health Care Act, all provisions H.R. 786, Preserving Patient Access to Accountable Care Act, all provisions S. 1460, Preserving Patient Access to Accountable Care Act, all provisions H.R. 539, Chiropractic Medicare Coverage Modernization Act of 2025, all provisions S. 106, Chiropractic Medicare Coverage Modernization Act of 2025, all provisions H.R. 1317, Improving Care and Access to Nurses (I CAN) Act, all provisions H.R. 2191, Physician Led and Rural Access to Quality Care Act, all provisions S. 1390, Physician Led and Rural Access to Quality Care Act, all provisions S. 665, Fatal Overdose Reduction Act of 2025, all provisions H.R, 4977, Connected MOM Act, all provisions S. 141, Connected MOM Act, all provisions H.R. 3514, Improving Seniors Timely Access to Care Act of 2025, all provisions S. 1816, Improving Seniors Timely Access to Care Act of 2025, all provisions S. 1105, No UPCODE Act, all provisions H.R. 5081, Telehealth Modernization Act, all provisions S. 2709, Telehealth Modernization Act, all provisions H.R. 2483, SUPPORT for Patients and Communities Reauthorization Act of 2025, all provisions H.R. 1, One Big Beautiful Bill Act, provisions related to Medicare payment reform, Medicaid reforms, Alternative Payment Models (APMs) H.R. 6160, Strengthening Medicare for Patients and Providers Act, all provisions H.R. 7520, Efficiency Adjustment Delay Act, all provisions H.R. 7148, Consolidated Appropriations Act, 2026, provisions related to APM bonus extension/incentive payments/qualifying provider revenue thresholds freeze H.R. 1968, Full-Year Continuing Appropriations and Extensions Act, 2025, provisions related to APMs H.R. 8163, To amend title XVIII of the Social Security Act to ensure stability for provider payments under the Medicare program, all provisions H.R. 2120, Radiation Oncology Case Rate (ROCR) Value Based Program Act of 2025, all provisions S. 1031, Radiation Oncology Case Rate (ROCR) Value Based Program Act of 2025, all provisions H.R. 483, Health Care Efficiency Through Flexibility Act, all provisions H.R. 5347, Health Care Efficiency Through Flexibility Act, all provisions H.R. 8129, To amend title XVIII of the Social Security Act to establish a full risk ACO program, all provisions H.R. 1614, To amend title XVIII of the Social Security Act to expand practitioners eligible to furnish telehealth services under the Medicare program, all provisions H.R. 3108, Rural Patient Monitoring (RPM) Access Act, all provisions S. 1535, Rural Patient Monitoring (RPM) Access Act, all provisions H.R. 3164, Ensuring Community Access to Pharmacist Services Act, all provisions H.R. 2725, Affordable Housing Credit Improvement Act of 2025, all provisions H.R. 2757, Medicare Audiology Access Improvement Act of 2025, all provisions S. 1996, Medicare Audiology Access Improvement Act of 2025, all provisions H.R. 3878, RNs for Rural Health Act of 2025, all provisions H.R. 5199, Modernizing Rural Physician Assistant and Nurse Practitioner Utilization Act of 2025, all provisions H.R. 2433, Reducing Medically Unnecessary Delays in Care Act of 2025, all provisions H.R. 5467, Patient Access to Autoimmune Treatments (PAAT) Act, all provisions H.R. 5940, Seniors Deserve Streamlined Medical Approvals for Timely, Efficient Recovery (SMARTER) Care Act of 2025, all provisions S. 3480, Seniors Deserve Streamlined Medical Approvals for Timely, Efficient Recovery (SMARTER) Care Act of 2025, all provisions H.R. 4002, Patient Access to Higher Quality Health Care Act of 2025, all provisions H.R. 3022, Restoring Rights of Physicians to Own Hospitals Act, all provisions S. 1399, Health Tech Investment Act, all provisions S. 3386, Health Care Freedom for Patients Act of 2025, provisions related to the ACA H.R. 498, Do No Harm in Medicaid Act, all provisions H.R. 4710, No Surprises Act Enforcement Act, all provisions S. 2420, No Surprises Act Enforcement Act, all provisions S. 1692, Radiology Outpatient Ordering Transmission (ROOT) Act, provisions related to imaging appropriate use criteria H.R. 5737, Radiology Outpatient Ordering Transmission (ROOT) Act, provisions related to imaging appropriate use criteria H.R. 3164, Equitable Community Access to Pharmacist Services Act, all provisions S. 2426, Equitable Community Access to Pharmacist Services Act, all provisions S. 3934, Medical Nutrition Therapy Act of 2026, all provisions H.R. 4206, CONNECT for Health Act of 2025, all provisions No Fees for EFTs Act, all provisions Drafts/Chronic Care Management Improvement Act Drafts/Access to Genetic Counselor Services Act Drafts/GOLD CARD Act Drafts/Medicare Advantage Improvement Act Draft/Value in Health Care Act Draft/Medicare Budget Neutrality and MIPS reform Draft/MACRA/MIPS program reform Medicare program: Medicare Economic Index (MEI)/inflationary updates Medicare program: Medicare physician payment/budget neutrality Medicare program: Merit-based Incentive Payment System (MIPS)/reforms and penalties Medicare program: MIPS Value Pathways (MVPs) reform Medicare program: MIPS quality and cost measures Medicare program: G2211 Inherent Complexity Code Medicare program: Alternative Payment Models (APMs) Medicare program: ACO (Accountable Care Organization) REACH Model Medicare program: Long-term Enhanced ACO Design (LEAD) Model Medicare program: ACO/APM flexibilities Medicare program: Prior authorization Medicare program: Wasteful and Inappropriate Service Reduction (WISeR) and Ambulatory Specialty Model Medicare program: Site Neutral Payment Medicare program: AI chatbots/Medicare Advantage preventive screens Medicare program: Coding Medicare program: MEI Update Medicare program: AI services/payment Medicare program: Indirect practice expense Medicare program: Telehealth and Digital Health Medicare program: Medicare Advantage provider networks/physician experience Medicare program: Shared Savings Program Medicare program: Medicare Diabetes Prevention Program Medicare program: Data-Driven Performance Payment System Medicare program: Promoting Interoperability (PI) Program Medicare program: Quality Payment Program Medicare program: Certified electronic health record and PI Medicare program: Advanced APM reporting Medicare program: Public Health Reporting and Data Exchange Medicare program: Provider directories Medicare program: Digital quality measures Medicare program: Aligned Networks and interoperability Medicare program: Health Information Technology/physician burdens Medicare program: Data privacy/cybersecurity Medicare program: Review Choice Demonstration (RCD)/Inpatient Rehabilitation Facility (IRF) Medicare program: Organ transplantation access Medicare program: Prior authorization/Medical billing transition Medicare program: Traditional Medicare/Medicare Advantage enrollment difficulties Medicare and Medicaid programs: Medicare Access and CHIP Reauthorization Act (MACRA)/broad reform Medicare and Medicaid programs: MACRA/physician burdens Medicare and Medicaid programs: Telehealth Medicare and Medicaid programs: Center for Medicare and Medicaid Innovation (CMMI) reforms Medicare and Medicaid programs: CMMI reform/Physician AI use Medicare and Medicaid programs: High-cost disposable supplies/billing codes Medicaid program: Gender affirming care Medicaid program: Work requirements, per capita caps, provider taxes, FMAP changes Medicaid program: Community engagement/medical frailty exemption
2026 · first_quarter · Medicare/Medicaid
H.R. 483: Health Care Efficiency Through Flexibility Act H.R. 5347: Health Care Efficiency Through Flexibility Act H.R. 786/ S. 1460: Preserving Patient Access to Accountable Care Act S.891: Bipartisan Health Care Act H.R. 1768: Lower Costs for Everyday Americans Act S. 1816/ 3514: Improving Seniors Timely Access to Care Act S. 1105: No UPCODE Act S. 2561/ H.R. 5768: Skin Substitute Access and Payment Reform Act H.R. 4773/ S. 3350: ACO Assignment Improvement Act H.R. 4313/ S.2237: Hospital Inpatient Services Modernization Act H.R. 8129: To amend title XVIII of the Social Security Act to establish a full risk ACO program H.R. 6852: Advanced Wound Care and Regenerative Medicine Access and Reform Act Issues related to Medicare payments, Medicare Shared Savings Program, ACO REACH, Medicare Advantage, alternative payment model incentives, telehealth, and fraud, waste, abuse
Client expense: $183,336 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2025 · fourth_quarter · Medicare/Medicaid
H.R. 539, Chiropractic Medicare Coverage Modernization Act of 2025, all provisions S. 106, Chiropractic Medicare Coverage Modernization Act of 2025, all provisions H.R. 1317, Improving Care and Access to Nurses (I CAN) Act, all provisions H.R. 1521, Dental and Optometric Care (DOC) Access Act of 2025, all provisions H.R. 2191, Physician Led and Rural Access to Quality Care Act, all provisions S. 1390, Physician Led and Rural Access to Quality Care Act, all provisions S. 665, Fatal Overdose Reduction Act of 2025, all provisions H.R. 4977, Connected MOM Act, all provisions H.R. 1, One Big Beautiful Bill Act (PL 119-21), provisions relating to Graduate Medical Education, Medicare Physician Payment Reform, Medicaid Reform (work requirements, per capita caps, provider taxes, and FMAP changes), Alternative Payment Models (APMs), Artificial Intelligence (AI), and Medicaid biannual redetermination requirements S. 141, Connected MOM Act, all provisions H.R. 3514, Improving Seniors Timely Access to Care Act of 2025, all provisions S. 1816, Improving Seniors Timely Access to Care Act of 2025, all provisions S. 1105, No Unreasonable Payments, Coding, Or Diagnoses for the Elderly (No UPCODE) Act, all provisions H.R. 5081, Telehealth Modernization Act, all provisions S. 2709, Telehealth Modernization Act, all provisions H.R. 879, Medicare Patient Access and Practice Stabilization Act of 2025, all provisions S. 1640, Medicare Patient Access and Practice Stabilization Act of 2025, all provisions H.R. 6160, Strengthening Medicare for Patients and Providers Act, all provisions H.R. 786, Preserving Patient Access to Accountable Care Act, all provisions S. 1460, Preserving Patient Access to Accountable Care Act, all provisions H.R. 2120, Radiation Oncology Case Rate (ROCR) Value Based Program Act of 2025, all provisions S. 1031, Radiation Oncology Case Rate (ROCR) Value Based Program Act of 2025, all provisions H.R. 1968, Full-Year Continuing Appropriations and Extensions Act, 2025, provisions relating to APMs H.R. 483, Health Care Efficiency Through Flexibility Act, provisions relating to APMs H.R. 3890, Resident Physician Shortage Reduction Act of 2025, all provisions S. 2439, Resident Physician Shortage Reduction Act of 2025, all provisions H.R. 4731, Resident Physician Shortage Reduction Act of 2025, all provisions H.R. 4206, CONNECT for Health Act of 2025, all provisions S. 1261, CONNECT for Health Act of 2025, all provisions H.R. 1614, To amend title XVIII of the Social Security Act to expand practitioners eligible to furnish telehealth services under the Medicare program, all provisions H.R. 3108, Rural Patient Monitoring (RPM) Access Act, all provisions S. 1535, Rural Patient Monitoring (RPM) Access Act, all provisions H.R. 3164, Ensuring Community Access to Pharmacist Services (ECAPS) Act, all provisions S. 2426, Equitable Community Access to Pharmacist Services (ECAPS) Act, all provisions H.R. 2757, Medicare Audiology Access Improvement Act of 2025, all provisions S. 1996, Medicare Audiology Access Improvement Act of 2025, all provisions H.R. 3878, RNs for Rural Health Act of 2025, all provisions H.R. 5199, Modernizing Rural Physician Assistant and Nurse Practitioner Utilization Act of 2025, all provisions H.R. 2433, Reducing Medically Unnecessary Delays in Care Act of 2025, all provisions H.R. 5467, Patient Access to Autoimmune Treatments (PAAT) Act, all provisions H.R. 5940, Seniors Deserve SMARTER Care Act of 2025, all provisions S. 3480, Seniors Deserve SMARTER Care Act of 2025, all provisions H.R. 4002, Patient Access to Higher Quality Health Care Act of 2025, all provisions H.R. 3022, Restoring Rights of Physicians to Own Hospitals Act, all provisions S. 1399, Health Tech Investment Act, all provisions H.R. 4710, No Surprises Act Enforcement Act, all provisions S. 2420, No Surprises Act Enforcement Act, all provisions S. 2882, Continuing Appropriations and Extensions and Other Matters Act, 2026, provisions relating to ACA premium tax credit S.J.Res.84, A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Centers for Medicare & Medicaid Services relating to "Patient Protection and Affordable Care Act; Market Integrity and Affordability,/Congressional Review Act repeal effort S. 3386, Health Care Freedom for Patients Act of 2025, provisions related to ACA premium tax credit H.R. 6575, CommonGround for Affordable Health Care Act, provisions related to ACA premium tax credit H.R. 6501, Bipartisan Health Insurance Affordability Act, provisions related to ACA premium tax credit H.R. 5737, Radiology Outpatient Ordering Transmission (ROOT) Act, all provisions S. 1692, Radiology Outpatient Ordering Transmission (ROOT) Act, all provisions H.R. 5813, Womens Health and Cancer Rights Modernization Act of 2025, all provisions H.R. 5347, Health Care Efficiency Through Flexibility Act, all provisions H.R. 5269, Reforming and Enhancing Sustainable Updates to Laboratory Testing Services (RESULTS) Act of 2025, all provisions S. 2761, Reforming and Enhancing Sustainable Updates to Laboratory Testing Services (RESULTS) Act of 2025, all provisions Access to Genetic Counselor Services Act/draft GOLD CARD Act/drafts Medicare Access to Radiology Care (MARCA) Act/drafts Data-Driven Payment Performance System (DPPS) Act/draft Value in Health Care Act/draft Legislation to reform the MACRA and MIPS Programs/draft Medicare program: Medicare Economic Index (MEI)/Physician inflationary updates Medicare program: Medicare Physician Payment System/Budget Neutrality reforms Medicare program: MEDPAC/physician practice 2027 payment update/full MEI update recommendation Medicare program: Merit-Based Incentive Payment System (MIPS)/reforms/penalties/replacement proposal Medicare program: CY 2026 Medicare Physician Fee Schedule/implementation phase-in/indirect practice expense Medicare program: APMs/bonuses/incentive payments Medicare program: G2211 Inherent Complexity Code Medicare program: Private practice physician issues/benchmark survey Medicare program: Center for Medicare & Medicaid Innovation (CMMI) reforms Medicare program: Payer and EHR developers/proprietary technology and electronic prior authorizations Medicare program: Prior Authorization/AI Medicare program: Medicare Advantage/prior authorization Medicare program: Site neutral payment Medicare program: Coding Medicare program: Medicare Advantage/preventive screens/AI Chatbots Medicare program: AI services/payment Medicare program: Diabetes Prevention Program Medicare program: Promoting Interoperability (PI) Program Medicare program: Quality Payment Program Medicare program: HIPAA/Electronic health records Medicare program: Certified electronic health record technology and PI Medicare program: Medicare Shared Savings Program/Advanced APM reporting Medicare program: Public Health Reporting and Data Exchange Medicare program: Value-based care delivery Medicare program: Telehealth/digital health/budget neutrality Medicare program: Medicare Telehealth waiver extension Medicare program: Wasteful and Inappropriate Service Reduction (WISER) payment model Medicare program: Modifier 25/appropriate use Medicare program: Provider directories Medicare program: ACO/MIPS/skin substitutes/clinicians increased spending Medicare program: ACO/APM flexibilities Medicare program: Local Coverage Determination/peripheral nerve blocks/chronic pain procedures Medicare program: Data privacy/cybersecurity Medicare program: ACA/Enhanced tax credit extension Medicare program: Digital health and wearables Medicare and Medicaid programs: Medicare Access and CHIP Reauthorization Act (MACRA)/broad reform Medicare and Medicaid programs: MACRA/physician burdens Medicare and Medicaid programs: Health IT/physician burdens
2025 · fourth_quarter · Medicare/Medicaid
H.R. 483: Health Care Efficiency Through Flexibility Act H.R. 5347: Health Care Efficiency Through Flexibility Act H.R. 786/ S. 1460: Preserving Patient Access to Accountable Care Act S.891: Bipartisan Health Care Act H.R. 1768: Lower Costs for Everyday Americans Act S. 1816/ 3514: Improving Seniors Timely Access to Care Act S. 1650: Medicare Patient Access and Practice Stabilization Act S. 1105: No UPCODE Act H.R. 4559: Prompt and Fair Pay Act H.R. 5454: Medicare Advantage Prompt Pay Act S. 2561/ H.R. 5768: Skin Substitute Access and Payment Reform Act H.R. 4773/ S. 3350: ACO Assignment Improvement Act H.R. 4313/ S.2237: Hospital Inpatient Services Modernization Act Issues related to Medicare payments, Medicare Shared Savings Program, ACO REACH, Medicare Advantage, alternative payment model incentives, telehealth, and fraud, waste, abuse.
Client expense: $134,639 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2025 · third_quarter · Medicare/Medicaid
H.R. 879, Medicare Patient Access and Practice Stabilization Act of 2025, all provisions S. 1640, Medicare Patient Access and Practice Stabilization Act of 2025, all provisions S. 891, Bipartisan Health Care Act, provisions related to Medicare and Medicaid H.R. 786, Preserving Patient Access to Accountable Care Act, all provisions S. 1460, Preserving Patient Access to Accountable Care Act, all provisions H.R. 539, Chiropractic Medicare Coverage Modernization Act of 2025, all provisions S. 106, Chiropractic Medicare Coverage Modernization Act of 2025, all provisions H.R. 1317, Improving Care and Access to Nurses (I CAN) Act, all provisions H.R. 2191, Physician Led and Rural Access to Quality Care Act, all provisions S. 665, Fatal Overdose Reduction Act of 2025, all provisions H.R. 4977, Connected MOM Act, all provisions S. 141, Connected MOM Act, all provisions H.R. 3514, Improving Seniors Timely Access to Care Act of 2025, all provisions S. 1816, Improving Seniors Timely Access to Care Act of 2025, all provisions S. 1105, No Unreasonable Payments, Coding, Or Diagnoses for the Elderly (No UPCODE) Act, all provisions H.R. 5081, Telehealth Modernization Act, all provisions S. 2709, Telehealth Modernization Act, all provisions H.R. 1, One Big Beautiful Bill Act, provisions relating to Medicare and Medicaid physician payments, work requirements, per capita taxes, provider taxes, APMs, FMAP changes, PBM transparency H.R. 5347, Health Care Efficiency Through Flexibility Act, all provisions H.R. 2120, Radiation Oncology Case Rate (ROCR) Value Based Program Act of 2025, all provisions S. 1031, Radiation Oncology Case Rate (ROCR) Value Based Program Act of 2025, all provisions H.R. 2314, Fair Access In Residency (FAIR) Act, all provisions S. 2715, Fair Access In Residency (FAIR) Act of 2025, all provisions H.R. 1968, Full-Year Continuing Appropriations and Extensions Act, 2025, provisions relating to APMs H.R. 4206, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2025, all provisions S. 1261, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2025, all provisions H.R. 1614, To amend title XVIII of the Social Security Act to expand practitioners eligible to furnish telehealth services under the Medicare program, all provisions H.R. 3108, Rural Patient Monitoring (RPM) Access Act, all provisions S. 1535, Rural Patient Monitoring (RPM) Access Act, all provisions H.R. 3164, Ensuring Community Access to Pharmacist Services (ECAPS) Act, all provisions S. 2426, Equitable Community Access to Pharmacist Services (ECAPS) Act, all provisions H.R. 2757, Medicare Audiology Access Improvement Act of 2025, all provisions S. 1996, Medicare Audiology Access Improvement Act of 2025, all provisions H.R. 3878, RNs for Rural Health Act of 2025, all provisions H.R. 5199, Modernizing Rural Physician Assistant and Nurse Practitioner Utilization Act of 2025, al provisions H.R. 2433, Reducing Medically Unnecessary Delays in Care Act of 2025, all provisions H.R. 5467, Patient Access to Autoimmune Treatments (PAAT) Act, all provisions H.R. 4002, Patient Access to Higher Quality Health Care Act of 2025, all provisions H.R. 3022, Restoring Rights of Physicians to Own Hospitals Act, all provisions H.R. 2191, Physician Led and Rural Access to Quality Care Act, all provisions S. 1390, Physician Led and Rural Access to Quality Care Act, all provisions S. 1399, Health Tech Investment Act, all provisions H.R. 4559, Prompt and Fair Pay Act, all provisions H.R. 5454, Medicare Advantage Prompt Pay Act, all provisions S. 2879, Medicare Advantage Prompt Pay Act, all provisions H.R. 4313, Hospital Inpatient Services Modernization Act, all provisions S. 2237, Hospital Inpatient Services Modernization Act, all provisions H.R. 4752, Reducing Hereditary Cancer Act, all provisions S. 2760, Reducing Hereditary Cancer Act, all provisions S. 2882, Continuing Appropriations and Extensions and Other Matters Act, 2026, provisions relating to Medicaid S.J.Res.8, A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Centers for Medicare & Medicaid Services relating to "Patient Protection and Affordable Care Act; Market Integrity and Affordability," all provisions H.R. 5343, Ensuring Patient Access to Critical Breakthrough Products Act, all provisions S. 1717, Ensuring Patient Access to Critical Breakthrough Products Act of 2025, all provisions H.R. 842, Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage Act, all provisions S. 1692, Radiology Outpatient Ordering Transmission (ROOT) Act, all provisions H.R. 3890, Resident Physician Shortage Reduction Act of 2025, all provisions H.R. 4731, Resident Physician Shortage Reduction Act of 2025, all provisions S. 2439, Resident Physician Shortage Reduction Act of 2025, all provisions H.R. 4464, Preventive Health Savings Act, all provisions H.R. 2509, Connecting Our Medical Providers with Links to Expand Tailored and Effective (COMPLETE) Care Act, all provisions S. 931, Connecting Our Medical Providers with Links to Expand Tailored and Effective (COMPLETE) Care Act, all provisions Draft legislation to reform the MACRA/MIPS program Value in Health Care Act/draft GOLD CARD Act/drafts Medicare program: 21st Century Cures Act/implementation Medicare program: Medicare Economic Index (MEI) inflationary updates Medicare program: Merit-based Incentive Payment System (MIPS)/cost, quality, improvement activities, and interoperability Medicare program: MIPS Value Pathways (MVPs) reforms Medicare program: Medicare Physician Fee Schedule/efficiency adjustment, and indirect practice-expense Medicare program: Physician payment/budget neutrality Medicare program: Physician payment reform Medicare program: Kidney care models Medicare program: Coding Medicare program: G2211 Inherent Complexity Code Medicare program: Prior authorization Medicare program: Site neutral payment Medicare program: Accountable Care Organizations (ACOs)/Alternative Payment Model (APM) flexibilities Medicare program: APMs/Wasteful and Inappropriate Service Reduction (WISeR) Medicare program: APMs/Ambulatory Specialty Model (ASM) Medicare program: APM Bonus Extension Medicare program: Medicare acceptance rates, private practice issues/benchmark survey Medicare program: Relative Value Scale Update Committee (RUC) processes Medicare program: Wearables Medicare program: Local and National Coverage Determination processes Medicare program: Value-based care Medicare program: Postoperative visits Medicare program: Medicare Advantage (MA)/utilization management Medicare program: MA/prior authorization Medicare program: Promoting Interoperability (PI) Program Medicare program: Health IT/physician burdens Medicare program: Data privacy and cybersecurity Medicare program: HIPAA/electronic records Medicare and Medicaid programs: Medicare Access and CHIP Reauthorization Act (MACRA)/broad reform Medicare and Medicaid programs: MACRA/physician burdens Medicare and Medicaid programs: Center for Medicare & Medicaid Innovation (CMMI) reforms Medicare and Medicaid programs: Telehealth flexibilities Medicaid: Access to care/advance premium tax credit
2025 · third_quarter · Medicare/Medicaid
H.R. 483: Health Care Efficiency Through Flexibility Act H.R. 5347: Health Care Efficiency Through Flexibility Act H.R. 786/ S. 1460: Preserving Patient Access to Accountable Care Act S.891: Bipartisan Health Care Act H.R. 1768: Lower Costs for Everyday Americans Act S. 1816/ 3514: Improving Seniors Timely Access to Care Act S. 1650: Medicare Patient Access and Practice Stabilization Act S. 1105: No UPCODE Act H.R. 4559: Prompt and Fair Pay Act H.R. 5454: Medicare Advantage Prompt Pay Act S. 2561: Skin Substitute Access and Payment Reform Act H.R. 4773: ACO Assignment Improvement Act Issues related to Medicare payments, Medicare Shared Savings Program, ACO REACH, Medicare Advantage, alternative payment model incentives, telehealth, and fraud, waste, abuse.
Client expense: $167,316 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2025 · third_quarter · Medicare/Medicaid
H.R. 1, One Big Beautiful Bill Act H.R. 1492/S. 832, Ensuring Pathways to Innovative Cures ACT (EPIC) H.R. 1672, Maintaining Investments in New Innovation Act (MINI) H.R. 3164/S. 2426, the Ensuring Community Access to Pharmacist Services Act (ECAPS) H.R. 3514/S. 1816, Improving Seniors Timely Access to Care Act H.R. 4206/S. 1261, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act H.R. 4313/S. 2237, Hospital Inpatient Services Modernization Act H.R. 4731/S. 2439, Resident Physician Shortage Reduction Act H.R. 5081, Telehealth Modernization Act H.R. 5347, Health Care Efficiency Through Flexibility Act Implementation of H.R. 1 Provisions Anticipated to Have an Impact on Health Insurance Coverage
Client expense: $200,000 · Firm income: Not reported
Subcommittee Consideration and Mark-up Session Held
Ordered to be Reported in the Nature of a Substitute (Amended) by the Yeas and Nays: 43 - 0.
Committee Consideration and Mark-up Session Held
Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Subcommittee on Health.
Introduced in House
Congress.gov source codes: 1000, Intro-H
| Referred To |
| September 15, 2025 |
| Ways and Means Committee | House | Referred To | September 15, 2025 |
| Republican |
| NY |
Client expense: $5,130,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE
Client expense: $513,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE
Client expense: $7,970,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Medicare Payment Advisory Commission (MedPAC), SENATE
Client expense: $7,970,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Medicare Payment Advisory Commission (MedPAC), SENATE
Client expense: $5,480,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Medicare Payment Advisory Commission (MedPAC), SENATE
Client expense: $4,620,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Technology Policy (OTP), SENATE
Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE