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Medicaid VBPs for Patients Act or the MVP Act This bill provides statutory authority for regulations that allow for the use of varying best price points under value-based purchasing arrangements for purposes of the Medicaid Drug Rebate Program. ( Value-based purchasing arrangements refer to arrangements in which the price of a drug is linked to clinical outcomes; such arrangements are particularly used for new high-cost treatments, such as gene therapies.) The Government Accountability Office must study the impact of value-based purchasing arrangements on federal health care programs, including with respect to the bill's changes. Additionally, the bill (1) exempts sales of drugs that are made under value-based purchasing arrangements from calculations of the manufacturer average sales price for purposes of payments under Medicare medical services, if the manufacturer reports multiple best prices under Medicaid in accordance with the bill's changes; and (2) requires the Centers for Medicare & Medicaid Services to issue guidance on how state Medicaid programs may cover drugs in inpatient settings via value-based purchasing arrangements.
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Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, 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.
Introduced in House
Congress.gov source codes: 1000, Intro-H
Bills with similar content found using semantic analysis.
Sources: Congress.gov
2026 · third_quarter · Medicare/Medicaid
FY 2026 Appropriations for Specific Issues ---Alternative Funding Programs ---Antimicrobial Resistance (General) ---CMMI: GLOBE and GUARD Models ---Drug Pricing ---Pandemic Preparedness - R&D Funding for Medical Countermeasures ---Vaccines and Infectious Diseases 340B Drug Discount Program ---H.R.5256: 340B ACCESS Act ---H.R.9504: Tax Exempt Hospital Transparency Act ---H.R.9599: SECURE 340B Act ---S.5244: SUSTAIN 340B Act ---Program Implementation & Oversight ---Rebate Models Accelerated Approval Artificial Intelligence (AI) Alternative Funding Programs Biosimilars ---H.R.10628/S.5571: Biosimilars Access and Affordability Act ---S.1954: Biosimilars Red Tape Elimination Act ---Interchangeability and Pharmacy Substitution Cell & Gene Therapy ---H.R.1672: Maintaining Investments and New Innovation (MINI) Act ---H.R.7871/S.1637: MVP Act Clinical Trial Data in China Data Privacy ---H.R.8413: SECURE Data Act Diversity & Inclusion ---Decentralized Clinical Trials Drug Evaluation and Review ---FDA Hiring Flexibility Drug Importation Drug Manufacturing, Quality & Distribution ---Advanced Manufacturing ---Compounded Medicines ---Drug Shortages ---Supply Chain Integrity and Traceability Drug Patenting ---S.43/H.R.6485: Skinny Labels, Big Savings Act ---S.527: Prescription Pricing for the People Act ---S.1095: Stop STALLING Act ---S.1096: Preserve Access to Affordable Generics and Biosimilars Act ---S.1097: Interagency Patent Coordination and Improvement Act ---Patent Thickets ---Restrictions on Intellectual Property Rights Drug Pricing ---H.R.946: ORPHAN Cures Act ---H.R.1492/S.832: Ensuring Pathways to Innovative Cures (EPIC) Act ---H.R.1672: Maintaining Investments and New Innovation (MINI) Act ---H.R.6166: Lowering Drug Costs for American Families Act ---S.526: Pharmacy Benefit Manager Transparency Act ---S.527: Prescription Pricing for the People Act ---S.1096: Preserve Access to Affordable Generics and Biosimilars Act ---CMMI Authority ---Implementation of the Inflation Reduction Act (IRA) of 2022 ---Most Favored Nation Drug Pricing Proposals ---Patient Cost-Sharing and Implementation ---PBM Reform Foreign Drug Data Protection Laws ---Regulatory Harmonization Medicaid ---S.526: Pharmacy Benefit Manager Transparency Act ---Alternative Payment Arrangements for Gene Therapies ---CMMI (GENEROUS Model) ---Drug Benefit Design ---Medicaid Drug Rebate Program ---Most Favored Nation in Medicaid ---Pricing and Rebates ---Value-Based Purchasing (VBP) Rule Opioid Crisis ---Coverage and Reimbursement Orphan Drug Issues ---H.R.1414: Cameron's Law ---H.R.6166: Lowering Drug Costs for American Families Act ---H.R.10359: Priority for Pediatric Cures Act ---Implementation of the Inflation Reduction Act (IRA) of 2022 ---Orphan Drug Tax Credit Pandemic Preparedness ---Drug Supply Chain Management ---Medical Countermeasure Priority Review Voucher Reauthorization ---Monoclonal Antibody Coverage and Utilization ---R&D Funding for Medical Countermeasures ---WHO Pandemic Preparedness Accord Reimbursement and Coverage of Innovative Products ---H.R.6166: Lowering Drug Costs for American Families Act ---S.864/H.R.6423: HELP Copays Act ---CMMI Authority ---Medicare Part B Physician-Administered Products ---National Coverage Determination ---Patient Cost-Sharing and Smoothing ---Protected Classes ---Support of Patient Premiums and Cost-Sharing Obligations Vaccines and Infectious Diseases ---Adult Immunization ---Countermeasures Injury Compensation Program ---Maternal Immunization ---MCM Manufacturing & Capacity ---Medical Countermeasure Priority Review Voucher Reauthorization ---Vaccine Injury Compensation Program ---Vaccine Safety and Quality ---Vaccine Safety Net and Vaccine Infrastructure ---Value of Vaccines and Vaccine Confidence
Client expense: $2,560,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Patent & Trademark Office (PTO), SENATE
2026 · third_quarter · Medicare/Medicaid
Draft, Medicare Compare Website (no bill number) - Rep. Guthrie, Brett - improvements to CMS' Medicare compare website Draft, HELP STATES Act (no bill number) - Rep. Kean, Tom - Medicaid fraud and program integrity H.R. 1 - One Big Beautiful Bill Act - Rep. Arrington, Jodey - Medicaid eligibility and state financing, Marketplace coverage and enrollment, Health Savings Account expansion, Pharmacy Benefit Manager financing and regulation H.R. 497 - Medicaid Third Party Liability Act - Rep. Crenshaw, Dan - Medicaid liable third-party exceptions H.R. 584 - No Medicaid for Illegal Immigrants Act - Rep. Kiley, Kevin - Medicaid eligibility requirements H.R. 610 - Close the Medigap Act - Rep. Doggett, Lloyd - Medigap plan reform H.R. 879 - Medicare Patient Access and Practice Stabilization Act - Rep. Murphy, Gregory - Medicare physician reimbursement H.R. 1019 - Medicaid Program Improvement Act - Rep. Miller-Meeks, Mariannette - Medicaid management care reporting H.R. 1059 - Jobs and Opportunities for Medicaid Act - Rep. Crenshaw, Dan - Medicaid eligibility requirements H.R. 1162 - Medicaid Primary Care Improvement Act - Rep. Crenshaw, Dan - Medicaid direct primary care arrangements H.R. 1195 - Protect Medicaid Act - Rep. Hudson, Richard - Medicaid eligibility requirements H.R. 1279 - To amend title XIX of the Social Security Act to establish a community engagement requirement for certain individuals under the Medicaid program. - Rep. Bean, Aaron - Medicaid eligibility requirements H.R. 1403 - LIVE Beneficiaries Act - Rep. Bilirakis, Gus - Medicaid registration audits H.R. 1598 - Ensuring Access to Medicaid Buy-in Programs Act - Rep. Ciscomani, Juan - Medicaid eligibility requirements H.R. 1924 - Securing Access to Care for Seniors in Critical Condition Act - Rep. Hern, Kevin - Medicare site-neutral payments for LTC hospitals H.R. 2045 - Medicare Dental, Vision, and Hearing Benefit Act - Rep. Doggett, Lloyd - Medicare dental, vision, and hearing coverage H.R. 2263 - Telehealth Coverage Act - Rep. Khanna, Ro - Telehealth flexibilities in Medicare H.R. 2309 - Medicare and Medicaid Fraud Prevention Act - Rep. Peters, Scott - provider screening for Federal programs H.R. 2433 - Reducing Medically Unnecessary Delays in Care Act - Rep. Green, Mark - Medicare Advantage prior authorization H.R. 2586 - Reentry Act - Rep. Tonko, Paul - Medicaid coverage for incarcerated population H.R. 2610 - Protecting Options for Seniors Act - Rep. Tenney, Claudia - MA wage index reclassification H.R. 3023 - Preventing Hospital Overbilling of Medicare Act - Rep. Spartz, Victoria - Site-neutral payment reform H.R. 3069 - Medicare for All Act - Rep. Jayapal, Pramila - New national health insurance program H.R. 3222 - SMART Health Care Act - Rep. Spartz, Victoria - MA risk adjustment H.R. 3321 - Ending Medicaid Discrimination Against the Most Vulnerable Act - Rep. Roy, Chip - Enhance FMAP phase out H.R. 3415 - Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act - Rep. Schakowsky, Janice - Nurse staffing ratio requirements H.R. 3467 - To amend title XVIII to reform the Medicare Advantage program - Rep. Schweikert, David - MA reforms H.R. 3808 - Expanding Seniors Access to Mental Health Services Act - Rep. Fitzpatrick, Brian - Medicare mental health services H.R. 4093 - Apples to Apples Comparison Act - Rep. Bean, Aaron - Medicare and Medicare Advantage spending reports H.R. 4139 - Cutting Copays Act - Rep. McGarvey, Morgan - Medicare cost-sharing for generic drugs H.R. 4313 - Hospital Inpatient Services Modernization Act - Rep. Buchanan, Vern - Acute hospital care at home waiver H.R. 4559 - Prompt and Fair Pay Act - Rep. Doggett, Lloyd - Payment parity for MA and FFS; MA reimbursement requirements H.R. 4641 - Keep Kids Covered Act - Rep. Castor, Kathy - Continuous eligibility for children in Medicaid/CHIP H.R. 4807 - Protect Our Hospitals Act - Rep. Landsman, Greg - Medicaid provider tax repeal H.R. 5243 - To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage. - Rep. McClellan, Jennifer - MA supplemental benefits data reporting H.R. 5281 - REAL Health Providers Act - Rep. Panetta, Jimmy - MA provider directory requirements H.R. 5584 - Medicaid Third Party Liability Act - Rep. Burgess, Michael - Impact of Third Party Liability on MCOs H.R. 6109 - To amend title XVIII of the Social Security Act to establish certain requirements with respect to rates of reversed prior authorization coverage determinations under Medicare Advantage plans. - Rep. Pocan, Mark - prior authorization under Medicare Advantage H.R. 6110 - To amend title XVIII of the Social Security Act to require Medicare Advantage plans to automatically reconsider determinations denying coverage. - Rep. Pocan, Mark - reconsider denials under Medicare Advantage H.R. 6111 - To amend title XVIII of the Social Security Act to require any advertisement of a Medicare Advantage plan to include information related to the rates of prior authorization denials under such plan. - Rep. Pocan, Mark - advertise rates of prior authorization denials under Medicare Advantage H.R. 6112 - To amend title XVIII of the Social Security Act to establish certain requirements with respect to the average monthly cost to provide coverage to an enrollee under Medicare Advantage plans. - Rep. Pocan, Mark - require monthly coverage cost to enrollees under Medicare Advantage H.R. 6113 - To amend title XVIII of the Social Security Act to impose limitations on contracts with Medicare Advantage organizations offering multiple Medicare Advantage plans under the Medicare program. - Rep. Pocan, Mark - limit multiple Medicare Advantage plans H.R. 6114 - To prohibit funds made available to the Department of Health and Human Services by previous Appropriations Acts from being used for any activity that makes Medicare Advantage the default under the Medicare program. - Rep. Pocan, Mark - prohibit Medicare Advantage from becoming the default H.R. 6254 - Medicaid Staffing Flexibility and Protection Act of 2025 - Rep. Carter, Earl - extend eligibility determinations and redeterminations for Medicaid H.R. 6361 - Ban AI Denials in Medicare Act - Rep. Landsman, Greg - limit WISeR model H.R. 6951 - Stop Unfair Medicaid Recoveries Act - Rep. Schakowsky, Janice - State Medicaid cost recoupment H.R. 6974 - Improving MA SNP Act of 2026 - Rep. Arrington, Jodey - MA SNP beneficiary approval H.R. 7803 - Save Medicare Act - Rep. Pocan, Mark - Renames Medicare Advantage H.R. 7871 - MVP Act - Rep. Guthrie, Brett - Value-based purchasing arrangements in Medicaid H.R. 8375 - Medicare Advantage Improvement Act - Rep. Joyce, John - MA programmatic reforms H.R. 8377 - Stop Deadly Denials Act - Rep. Khanna, Ro - MA prior authorization prohibition H.R. 8875 - Improving Home Dialysis Act - Rep. Miller, Carol - Home dialysis coverage under Medicare H.R. 9542 - Protecting Health Care and Lowering Costs Act - Rep. Boyle, Brendan - Medicaid reforms H.R. 9544 - Save MEDICARE Act - Rep. Doggett, Lloyd - MA risk adjustment and requirements H.R. 9644 - Medicare Advantage MLR Transparency Act - Rep. Moran, Nathaniel - MA plan revenue and benefits reporting H.R. 9693 - Patients First Act - Rep. Joyce, John - Medicare physician fee schedule reform H.R. 10374 - Affordable Premiums for Seniors Act - Rep. Sewell, Terri - Part D premium stabilization demo H.R. 10521 - MA STARS Act - Rep. Kelly, Mike - MA star ratings reform S. 523 - Protect Medicaid Act - Sen. Cassidy, Bill - Medicaid eligibility requirements S. 678 - LIVE Beneficiaries Act - Sen. Scott, Rick - Medicaid enrollment audits S. 717 - Increasing Access to Quality Cardiac Rehabilitation Care Act - Sen. Capito, Shelley Moore - Expanding cardiac care coverage in Medicare S. 752 - Accelerating Kids' Access to Care Act - Sen. Grassley, Chuck - Out-of-state provider access for Medicaid S. 939 - Medicare Dental, Hearing, and Vision Expansion Act - Sen. Sanders, Bernard - Medicare coverage requirements S. 1082 - Safeguarding Medicaid Act - Sen. Barrasso, John - Medicaid enrollee asset verification S. 1105 - No UPCODE Act - Sen. Cassidy, Bill - MA risk adjustment S. 1399 - Health Tech Investment Act - Sen. Rounds, Mike - Medicare coverage for algorithm-based services S. 1506 - Medicare for All Act - Sen. Sanders, Bernard - New national health insurance program S. 1629 - Same Care, Lower Cost Act - Sen. Kennedy, John - Medicare site-neutral payment reform S. 1637 - MVP Act - Sen. Mullin, Markwayne - Medicaid value-based purchasing agreements S. 1816 - Improving Seniors' Timely Access to Care Act - Sen. Marshall, Roger - MA prior authorization S. 1903 - A bill to prohibit changes to Medicare and Medicaid in reconciliation - Sen. Reed, Jack - Medicare and Medicaid safeguards against reconciliation cuts S. 2237 - Hospital Inpatient Services Modernization Act - Sen. Scott, Tim - Acute hospital care at home waiver S. 2279 - Protect Medicaid and Rural Hospitals Act - Sen. Hawley, Josh - Medicaid provider tax and State directed payments S. 2289 - Healthy Moms and Babies Act - Sen. Grassley, Chuck - Medicaid/CHIP maternal health coverage improvements S. 2496 - Keep Kids Covered Act - Sen. Bennet, Michael - Continuous eligibility for children in Medicaid/CHIP S. 2497 - Fair Billing Act - Sen. Hassan, Maggie - Medicare site-neutral transparency and identification requirements S. 2556 - Protecting Healthcare and Lowering Costs Act - Sen. Schumer, Charles - repeal of Medicaid provisions in the One Big Beautiful Bill Act S. 2793 - Ensuring Access to Essential Providers Act - Sen. Cassidy, Bill - Essential community provider coverage requirements for MA S. 3642 - WALZ Act - Sen. Marshall, Roger - Medicaid payment investigation and audits S. 3690 - Ensuring Access to Medicaid Buy-in Programs - Sen. Blackburn, Marsha - Medicaid eligibility parameters S. 3729 - PBM Reporting Transparency Act - Sen. Warner, Mark - MedPAC reports on PBMs S. 3750 - REAL Health Providers Act - Sen. Bennet, Michael - MA provider directory accuracy S. 3762 - Prior Authorization Relief Act - Sen. Whitehouse, Sheldon - MA prior authorization restrictions S. 3848 - Apples to Apples Comparison Act - Sen. Scott, Tim - Medicare and Medicare Advantage spending reports S. 3886 - Nurses Belong in Nursing Homes Act - Sen. Wyden, Ron - Nursing home staffing hours S. 4384 - Medicare Advantage Improvement Act - Sen. Marshall, Roger - MA programmatic reforms S. 5034 - Medicare Advantage Supplemental Benefits Transparency Act - Sen. Warner, Mark - MA supplemental benefits reporting requirements S. 5037 - MediKids Act - Sen. Kim, Andy - Universal Medicaid eligibility for youth 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; Waste Fraud and Abuse; Medicaid Access Final Rule; Medicaid Redeterminations; Medicaid rate actuarial soundness; value of Medicaid Managed Care; value of Medicare Advantage; Affordability; public option; Dental, Hearing, Vision benchmarks; HCBS; Home Health FFS Coverage; Medicare Advantage Health Risk Assessment and chart reviews; Medicare Advantage supplemental benefits and Social Determinants of health; CBO estimates of MA and FFS costs; coverage of weight loss drugs; Inflation Reduction Act implementation; Medicare Advantage Rate Notice; Part D Payment Issues; Part D VBID Issues; RADV; MA payment issues; Part D issues; prior authorization; MA prompt pay; agent/broker issues; MA reporting requirements; MA provider networks and network adequacy; nursing home staffing requirements; implementation of the One Big Beautiful Bill Act; Medicaid provider taxes; MA Star Ratings; Medicaid community engagement requirements; and VA's community care program.
Client expense: $3,010,000 · 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
Monitor and engage on legislative and administrative action related to Medicare and Medicaid policy. Monitor the implementation of the Inflation Reduction Act of 2022 (P.L. 117-169). Monitor and engage on legislative and administrative action related to Medicare inpatient reimbursement for cell and gene therapies. H.R. 1492, Ensuring Pathways to Innovative Cures (EPIC) Act of 2025. H.R. 7871, Medicaid VBPs for Patients Act (MVP Act). S. 832, Ensuring Pathways to Innovative Cures (EPIC) Act of 2025.
Client expense: $1,710,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2026 · third_quarter · Health Issues
S.1637/H.R 7871; Medicaid VBPs for Patients Act S. 4323/ H.R. 8143; Ensuring Access to Lower-Cost Medicines for Seniors Act of 2026 S. 2355/H.R. 5582; Patients Deserve Price Tags Act S. 2426/H.R. 3164; Ensuring Community Access to Pharmacist Services Act S.4509/ H.R. 8779; Patients Before Monopolies Act S.2276/ H.R. 3269; Eliminating Thickets to Improve Competition Act S. 526; Pharmacy Benefit Manager Transparency Act S. 882; Patients Before Middlemen Act S. 927; Protecting Pharmacies in Medicaid Act S. 1041; Affordable Prescriptions for Patients Act S. 1095; Stop Significant and Time-wasting Abuse Limiting Legitimate Innovation of New Generics Act S. 1096; Preserve Access to Affordable Generics and Biosimilars Act S. 1097; Interagency Patent Coordination and Improvements Act of 2025 S. 1414; Expedited Access to Biosimilars Act S. 2617; Reducing Drug Prices for Seniors Act S. 2800; Pharmacy and Medically Underserved Areas Enhancement Act S. 3345; PBM Price Transparency and Accountability Act S. 3349; PBM Disclosure Act S. 3549; PBM Fiduciary, Accountability, Integrity, and Reform Act S. 3822; Break Up Big Medicine Act S. 4189; INSLUN Act of 2026 S. 5586; Ensuring Accurate Payments to Specialty Pharmacies Act H.R. 1244; Reducing Drug Prices for Seniors Act H.R. 2214; Delinking Revenue from Unfair Gouging Act H.R. 4317; PBM Reform Act H.R. 4409; Fair Pharmacies for Federal Employees Act H.R. 4570; Interagency Patent Coordination and Improvements Act of 2025 H.R. 6609; Pharmacists Fight Back Act in Medicare and Medicaid H.R. 6610; Pharmacists Fight Back Act in the Federal Employees Health Benefits Program H.R. 6837; To amend the Employee Retirement Income Security Act of 1974 to ensure that pharmacy benefit managers are considered fiduciaries, and for other purposes. H.R. 7148; Consolidated Appropriations Act of 2026 oSec. 6233- Any Willing Pharmacy oSec 6224- Medicare Delinking oSec. 6701- Oversight of PBM Services oSec. 6702- Full Rebate Pass Through to Plans H.R. 7895; PBM Kickback Prohibition Act H.R. 8324; Great American Healthcare Plan H.R. 9228; Health Data Access, Transparency, and Affordability Act of 2026 H.R. 9486; Health Data Access, Transparency and Affordability Act H.R. 9117; Clear Healthcare Expense Cost Knowledge Act H.R. 9393; Lower Cost, More Transparency Act of 2026 H.R. 9645; Health Care Price Certainty for All Americans Act H.R. 10369; Net Effective Cost Transparency and Prescription Drug Affordability Act of 2026 Implementation of the Inflation Reduction Act of 2022, P.L. 169- Provisions on Medicare Part D modernization and drug price negotiation, and the implementation of the Consolidated Appropriations Act of 2026 (P.L. 119-75)
Client expense: $3,203,049 · 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), Labor, Dept of (DOL), SENATE, Small Business Administration (SBA)
2026 · third_quarter · Medicare/Medicaid
S.1637/H.R 7871; Medicaid VBPs for Patients Act S. 2426/H.R. 3164; Ensuring Community Access to Pharmacist Services Act S. 2617/H.R. 1244; Reducing Drug Prices for Seniors Act S. 882; Patients Before Middlemen Act S. 927; Protecting Pharmacies in Medicaid Act S. 1041; Affordable Prescriptions for Patients Act S. 2800; Pharmacy and Medically Underserved Areas Enhancement Act S. 3345; PBM Price Transparency and Accountability Act S.4323/ H.R. 8143; Ensuring Access to Lower-Cost Medicines for Seniors Act of 2026 S. 5586; Ensuring Accurate Payments to Specialty Pharmacies Act H.R. 4317; PBM Reform Act H.R. 6609; Pharmacists Fight Back Act in Medicare and Medicaid H.R. 7148; Consolidated Appropriations Act of 2026 oSec. 6233- Any Willing Pharmacy oSec 6224- Medicare Delinking oSec. 6701- Oversight of PBM Services H.R. 9393; Lower Costs, More Transparency Act H.R. 9645; Health Care Price Certainty for All Americans Act H.R. 10369; Net Effective Cost Transparency and Prescription Drug Affordability Act of 2026 Implementation of the Inflation Reduction Act of 2022, P.L. 169- Provisions on Medicare Part D modernization and drug price negotiation, and the implementation of the Consolidated Appropriations Act of 2026 (P.L. 119-75)
Client expense: $3,203,049 · 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), Labor, Dept of (DOL), SENATE
2026 · third_quarter · Health Issues
H.R. 7681, the HSAs for All Act. H.R. 5463, the CHOICE Act. H.R. 6703, the Lower Health Care Premiums for All Americans Act. H.R. 6538, the More Affordable Care Act. H.R. 5582, the Patients Deserve Price Tags Act. H.R. 6248, the Healthy Competition for Better Care Act. H.R. 8270, the Every Dollar Counts Act. H.R. 7871, the Medicaid VBPs for Patients (MVP) Act
Client expense: Not reported · Firm income: $30,000
Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE
2026 · third_quarter · Health Issues
Issues related to patient access to innovative therapies, H.R. 7871 - MVP Act, H.R. 5187 - Sickle Cell Disease, H.R. 7837 - Most Favored Nation Drug Pricing
Client expense: Not reported · Firm income: $10,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2026 · third_quarter · Medicare/Medicaid
S.1637/H.R. 7871: Medicaid Value-Based Payments for Patients (MVP) Act CMS Policies to Support Expedited Implementation of Accelerating Kids' Access to Care Act (AKATCA) and States' Awareness of VBAs
Client expense: $240,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE
2026 · third_quarter · Health Issues
Issues related to managed care pharmacists, including access to digital therapeutics and value-based care in Medicaid; Issues related to H.R. 3288/S. 1702 - Access to Prescription Digital Therapeutics Act of 2025; Issues related to H.R. 7871/S. 1637 - MVP Act; Issues related to S. 2426 - Equitable Community Access to Pharmacist Services Act; Issues related to H.R. 3164 - Ensuring Community Access to Pharmacist Services Act.
Client expense: Not reported · Firm income: $80,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2026 · second_quarter · Medicare/Medicaid
Draft, Medicare Compare Website (no bill number) - Rep. Guthrie, Brett - improvements to CMS' Medicare compare website H.R. 1 - One Big Beautiful Bill Act - Rep. Arrington, Jodey - Medicaid eligibility and state financing, Marketplace coverage and enrollment, Health Savings Account expansion, Pharmacy Benefit Manager financing and regulation H.R. 497 - Medicaid Third Party Liability Act - Rep. Crenshaw, Dan - Medicaid liable third-party exceptions H.R. 538 - Critical Access Hospital Relief Act - Rep. Smith, Adrian - Medicare physician certification requirement H.R. 584 - No Medicaid for Illegal Immigrants Act - Rep. Kiley, Kevin - Medicaid eligibility requirements H.R. 608 - COVER Now Act - Rep. Doggett, Lloyd - Medicaid expansion demo H.R. 610 - Close the Medigap Act - Rep. Doggett, Lloyd - Medigap plan reform H.R. 879 - Medicare Patient Access and Practice Stabilization Act - Rep. Murphy, Gregory - Medicare physician reimbursement H.R. 936 - Medicaid Improvement and State Flexibility Act - Rep. Green, Mark - Medicaid demonstration programs H.R. 1019 - Medicaid Program Improvement Act - Rep. Miller-Meeks, Mariannette - Medicaid management care reporting H.R. 1059 - Jobs and Opportunities for Medicaid Act - Rep. Crenshaw, Dan - Medicaid eligibility requirements H.R. 1162 - Medicaid Primary Care Improvement Act - Rep. Crenshaw, Dan - Medicaid direct primary care arrangements H.R. 1191 - Supporting Access to Rural Community Hospitals Act - Rep. Flood, Mike - Medicare critical access hospitals definition H.R. 1195 - Protect Medicaid Act - Rep. Hudson, Richard - Medicaid eligibility requirements H.R. 1279 - To amend title XIX of the Social Security Act to establish a community engagement requirement for certain individuals under the Medicaid program. - Rep. Bean, Aaron - Medicaid eligibility requirements H.R. 1403 - LIVE Beneficiaries Act - Rep. Bilirakis, Gus - Medicaid registration audits H.R. 1598 - Ensuring Access to Medicaid Buy-in Programs Act - Rep. Ciscomani, Juan - Medicaid eligibility requirements H.R. 1683 - Protecting Rural Seniors' Access to Care Act - Rep. Fischbach, Michelle - Minimum nursing home staffing H.R. 1775 - Second Chances for Rural Hospitals Act - Rep. Arrington, Jodey -Definition of rural emergency hospitals H.R. 1805 - ARCH Act - Rep. Miller, Carol - Extend Medicare-dependent and low-value hospitals payments H.R. 1924 - Securing Access to Care for Seniors in Critical Condition Act - Rep. Hern, Kevin - Medicare site-neutral payments for LTC hospitals H.R. 2045 - Medicare Dental, Vision, and Hearing Benefit Act - Rep. Doggett, Lloyd - Medicare dental, vision, and hearing coverage H.R. 2263 - Telehealth Coverage Act - Rep. Khanna, Ro - Telehealth flexibilities in Medicare H.R. 2309 - Medicare and Medicaid Fraud Prevention Act - Rep. Peters, Scott - provider screening for Federal programs H.R. 2433 - Reducing Medically Unnecessary Delays in Care Act - Rep. Green, Mark - Medicare Advantage prior authorization H.R. 2533 - EASE Act - Rep. Arrington, Jodey - CMS model for virtual technology H.R. 2586 - Reentry Act - Rep. Tonko, Paul - Medicaid coverage for incarcerated population H.R. 2590 - Mental and Physical Health Care Comorbidities Act - Rep. Boyle, Brendan - CMS demonstration to treat comorbidities H.R. 2610 - Protecting Options for Seniors Act - Rep. Tenney, Claudia - MA wage index reclassification H.R. 3023 - Preventing Hospital Overbilling of Medicare Act - Rep. Spartz, Victoria - Site-neutral payment reform H.R. 3069 - Medicare for All Act - Rep. Jayapal, Pramila - New national health insurance program H.R. 3222 - SMART Health Care Act - Rep. Spartz, Victoria - MA risk adjustment H.R. 3263 - PATCH Act - Rep. Tokuda, Jill - Medicare geographic practice cost indices H.R. 3321 - Ending Medicaid Discrimination Against the Most Vulnerable Act - Rep. Roy, Chip - Enhance FMAP phase out H.R. 3415 - Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act - Rep. Schakowsky, Janice - Nurse staffing ratio requirements H.R. 3467 - To amend title XVIII to reform the Medicare Advantage program - Rep. Schweikert, David - MA reforms H.R. 3808 - Expanding Seniors Access to Mental Health Services Act - Rep. Fitzpatrick, Brian - Medicare mental health services H.R. 4093 - Apples to Apples Comparison Act - Rep. Bean, Aaron - Medicare and Medicare Advantage spending reports H.R. 4139 - Cutting Copays Act - Rep. McGarvey, Morgan - Medicare cost-sharing for generic drugs H.R. 4277 - Rural Emergency Hospital Financial Stability Act - Rep. Davis, Donald - Medicaid treatment of rural emergency hospitals H.R. 4313 - Hospital Inpatient Services Modernization Act - Rep. Buchanan, Vern - Acute hospital care at home waiver H.R. 4559 - Prompt and Fair Pay Act - Rep. Doggett, Lloyd - Payment parity for MA and FFS; MA reimbursement requirements H.R. 4641 - Keep Kids Covered Act - Rep. Castor, Kathy - Continuous eligibility for children in Medicaid/CHIP H.R. 4807 - Protect Our Hospitals Act - Rep. Landsman, Greg - Medicaid provider tax repeal H.R. 5243 - To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage. - Rep. McClellan, Jennifer - MA supplemental benefits data reporting H.R. 5281 - REAL Health Providers Act - Rep. Panetta, Jimmy - MA provider directory requirements H.R. 5584 - Medicaid Third Party Liability Act - Rep. Burgess, Michael - Impact of Third Party Liability on MCOs H.R. 6109 - To amend title XVIII of the Social Security Act to establish certain requirements with respect to rates of reversed prior authorization coverage determinations under Medicare Advantage plans. - Rep. Pocan, Mark - prior authorization under Medicare Advantage H.R. 6110 - To amend title XVIII of the Social Security Act to require Medicare Advantage plans to automatically reconsider determinations denying coverage. - Rep. Pocan, Mark - reconsider denials under Medicare Advantage H.R. 6111 - To amend title XVIII of the Social Security Act to require any advertisement of a Medicare Advantage plan to include information related to the rates of prior authorization denials under such plan. - Rep. Pocan, Mark - advertise rates of prior authorization denials under Medicare Advantage H.R. 6112 - To amend title XVIII of the Social Security Act to establish certain requirements with respect to the average monthly cost to provide coverage to an enrollee under Medicare Advantage plans. - Rep. Pocan, Mark - require monthly coverage cost to enrollees under Medicare Advantage H.R. 6113 - To amend title XVIII of the Social Security Act to impose limitations on contracts with Medicare Advantage organizations offering multiple Medicare Advantage plans under the Medicare program. - Rep. Pocan, Mark - limit multiple Medicare Advantage plans H.R. 6114 - To prohibit funds made available to the Department of Health and Human Services by previous Appropriations Acts from being used for any activity that makes Medicare Advantage the default under the Medicare program. - Rep. Pocan, Mark - prohibit Medicare Advantage from becoming the default H.R. 6254 - Medicaid Staffing Flexibility and Protection Act of 2025 - Rep. Carter, Earl - extend eligibility determinations and redeterminations for Medicaid H.R. 6361 - Ban AI Denials in Medicare Act - Rep. Landsman, Greg - limit WISeR model H.R. 6951 - Stop Unfair Medicaid Recoveries Act - Rep. Schakowsky, Janice - State Medicaid cost recoupment H.R. 6974 - Improving MA SNP Act of 2026 - Rep. Arrington, Jodey - MA SNP beneficiary approval H.R. 7189 - PrEP Access Act - Rep. Pocan, Mark - HIV prevention services under Medicare H.R. 7409 - Defend Rural Health Act - Rep. Taylor, Dave - Medicare definition of rural hospital H.R. 7727 - Sustaining Rural Healthcare Act - Rep. Alford, Mark - Medicare CAH designation H.R. 7778 - Medicaid PNA Modernization Act - Rep. Subramanyam, Suhas - Medicaid minimum monthly personal needs allowance H.R. 7803 - Save Medicare Act - Rep. Pocan, Mark - Renames Medicare Advantage H.R. 7871 - MVP Act - Rep. Guthrie, Brett - Value-based purchasing arrangements in Medicaid H.R. 8375 - Medicare Advantage Improvement Act - Rep. Joyce, John - MA programmatic reforms H.R. 8377 - Stop Deadly Denials Act - Rep. Khanna, Ro - MA prior authorization prohibition H.R. 8875 - Improving Home Dialysis Act - Rep. Miller, Carol - Home dialysis coverage under Medicare S. 523 - Protect Medicaid Act - Sen. Cassidy, Bill - Medicaid eligibility requirements S. 678 - LIVE Beneficiaries Act - Sen. Scott, Rick - Medicaid enrollment audits S. 717 - Increasing Access to Quality Cardiac Rehabilitation Care Act - Sen. Capito, Shelley Moore - Expanding cardiac care coverage in Medicare S. 750 - Protecting Rural Seniors' Access to Care Act - Sen. Fischer, Deb - Medicaid nursing home staff requirements S. 752 - Accelerating Kids' Access to Care Act - Sen. Grassley, Chuck - Out-of-state provider access for Medicaid S. 939 - Medicare Dental, Hearing, and Vision Expansion Act - Sen. Sanders, Bernard - Medicare coverage requirements S. 1082 - Safeguarding Medicaid Act - Sen. Barrasso, John - Medicaid enrollee asset verification S. 1105 - No UPCODE Act - Sen. Cassidy, Bill - MA risk adjustment S. 1264 - Mental and Physical Health Care Comorbidities Act - Sen. Bennet, Michael - CMS demonstration to treat comorbidities S. 1399 - Health Tech Investment Act - Sen. Rounds, Mike - Medicare coverage for algorithm-based services S. 1506 - Medicare for All Act - Sen. Sanders, Bernard - New national health insurance program S. 1624 - PATCH Act - Sen. Schatz, Brian - Medicare geographic practice cost indices S. 1629 - Same Care, Lower Cost Act - Sen. Kennedy, John - Medicare site-neutral payment reform S. 1637 - MVP Act - Sen. Mullin, Markwayne - Medicaid value-based purchasing agreements S. 1709 - Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act - Sen. Padilla, Alex - Nurse staffing ratio requirements S. 1816 - Improving Seniors' Timely Access to Care Act - Sen. Marshall, Roger - MA prior authorization S. 1903 - A bill to prohibit changes to Medicare and Medicaid in reconciliation - Sen. Reed, Jack - Medicare and Medicaid safeguards against reconciliation cuts S. 2237 - Hospital Inpatient Services Modernization Act - Sen. Scott, Tim - Acute hospital care at home waiver S. 2279 - Protect Medicaid and Rural Hospitals Act - Sen. Hawley, Josh - Medicaid provider tax and State directed payments S. 2289 - Healthy Moms and Babies Act - Sen. Grassley, Chuck - Medicaid/CHIP maternal health coverage improvements S. 2496 - Keep Kids Covered Act - Sen. Bennet, Michael - Continuous eligibility for children in Medicaid/CHIP S. 2497 - Fair Billing Act - Sen. Hassan, Maggie - Medicare site-neutral transparency and identification requirements S. 2556 - Protecting Healthcare and Lowering Costs Act - Sen. Schumer, Charles - repeal of Medicaid provisions in the One Big Beautiful Bill Act S. 2793 - Ensuring Access to Essential Providers Act - Sen. Cassidy, Bill - Essential community provider coverage requirements for MA S. 3642 - WALZ Act - Sen. Marshall, Roger - Medicaid payment investigation and audits S. 3690 - Ensuring Access to Medicaid Buy-in Programs - Sen. Blackburn, Marsha - Medicaid eligibility parameters S. 3727 - Putting an N to Learing about Fraud Act - Sen. Ernst, Joni - Federal program fraud prevention S. 3729 - PBM Reporting Transparency Act - Sen. Warner, Mark - MedPAC reports on PBMs S. 3750 - REAL Health Providers Act - Sen. Bennet, Michael - MA provider directory accuracy S. 3762 - Prior Authorization Relief Act - Sen. Whitehouse, Sheldon - MA prior authorization restrictions S. 3848 - Apples to Apples Comparison Act - Sen. Scott, Tim - Medicare and Medicare Advantage spending reports S. 3886 - Nurses Belong in Nursing Homes Act - Sen. Wyden, Ron - Nursing home staffing hours S. 4384 - Medicare Advantage Improvement Act - Sen. Marshall, Roger - MA programmatic reforms 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; Waste Fraud and Abuse; Medicaid Access Final Rule; Medicaid Redeterminations; Medicaid rate actuarial soundness; value of Medicaid Managed Care; value of Medicare Advantage; Medicare Advantage Health Risk Assessment and chart reviews; Medicare Advantage supplemental benefits and Social Determinants of health; CBO estimates of MA and FFS costs; coverage of weight loss drugs; Inflation Reduction Act implementation; Medicare Advantage Rate Notice; Part D Payment Issues; Part D VBID Issues; RADV; MA payment issues; Part D issues; prior authorization; MA prompt pay; agent/broker issues; MA reporting requirements; MA provider networks and network adequacy; implementation of the One Big Beautiful Bill Act; Medicaid provider taxes; Medicaid community engagement requirements; and VA's community care program.
2026 · second_quarter · Medicare/Medicaid
S.1637/H.R 7871; Medicaid VBPs for Patients Act S. 2426/H.R. 3164; Ensuring Community Access to Pharmacist Services Act S. 2617/H.R. 1244; Reducing Drug Prices for Seniors Act S. 882; Patients Before Middlemen Act S. 927; Protecting Pharmacies in Medicaid Act S. 1041; Affordable Prescriptions for Patients Act S. 2800; Pharmacy and Medically Underserved Areas Enhancement Act S. 3345; PBM Price Transparency and Accountability Act H.R. 4317; PBM Reform Act H.R. 6609; Pharmacists Fight Back Act in Medicare and Medicaid H.R. 7148; Consolidated Appropriations Act of 2026 oSec. 6233- Any Willing Pharmacy oSec 6224- Medicare Delinking oSec. 6701- Oversight of PBM Services S.4323/ H.R. 8143; Ensuring Access to Lower-Cost Medicines for Seniors Act of 2026 Implementation of the Inflation Reduction Act of 2022, P.L. 169- Provisions on Medicare Part D modernization and drug price negotiation, and the implementation of the Consolidated Appropriations Act of 2026 (P.L. 119-75)
Client expense: $3,282,990 · Firm income: Not reported
2026 · second_quarter · Health Issues
S.1637/H.R 7871; Medicaid VBPs for Patients Act S. 4323/ H.R. 8143; Ensuring Access to Lower-Cost Medicines for Seniors Act of 2026 S. 2355/H.R. 5582; Patients Deserve Price Tags Act S. 2426/H.R. 3164; Ensuring Community Access to Pharmacist Services Act S.4509/ H.R. 8779; Patients Before Monopolies Act S. 526; Pharmacy Benefit Manager Transparency Act S. 882; Patients Before Middlemen Act S. 927; Protecting Pharmacies in Medicaid Act S. 1041; Affordable Prescriptions for Patients Act S. 1095; Stop Significant and Time-wasting Abuse Limiting Legitimate Innovation of New Generics Act S. 1096; Preserve Access to Affordable Generics and Biosimilars Act S. 1097; Interagency Patent Coordination and Improvements Act of 2025 S. 1414; Expedited Access to Biosimilars Act S. 2617; Reducing Drug Prices for Seniors Act S. 2800; Pharmacy and Medically Underserved Areas Enhancement Act S. 3345; PBM Price Transparency and Accountability Act S. 3349; PBM Disclosure Act S. 3549; PBM Fiduciary, Accountability, Integrity, and Reform Act S. 3822; Break Up Big Medicine Act S. 4189; INSLUN Act of 2026 H.R. 1244; Reducing Drug Prices for Seniors Act H.R. 2214; Delinking Revenue from Unfair Gouging Act H.R. 4317; PBM Reform Act H.R. 4409; Fair Pharmacies for Federal Employees Act H.R. 4570; Interagency Patent Coordination and Improvements Act of 2025 H.R. 6609; Pharmacists Fight Back Act in Medicare and Medicaid H.R. 6610; Pharmacists Fight Back Act in the Federal Employees Health Benefits Program H.R. 6837; To amend the Employee Retirement Income Security Act of 1974 to ensure that pharmacy benefit managers are considered fiduciaries, and for other purposes. H.R. 7148; Consolidated Appropriations Act of 2026 oSec. 6233- Any Willing Pharmacy oSec 6224- Medicare Delinking oSec. 6701- Oversight of PBM Services oSec. 6702- Full Rebate Pass Through to Plans H.R. 7895; PBM Kickback Prohibition Act H.R. 8324; Great American Healthcare Plan H.R. 9228; Health Data Access, Transparency, and Affordability Act of 2026 H.R. 9486; Health Data Access, Transparency and Affordability Act H.R. 9117; Clear Healthcare Expense Cost Knowledge Act H.R. 9393; Lower Cost, More Transparency Act of 2026 Implementation of the Inflation Reduction Act of 2022, P.L. 169- Provisions on Medicare Part D modernization and drug price negotiation, and the implementation of the Consolidated Appropriations Act of 2026 (P.L. 119-75)
2026 · second_quarter · Health Issues
H.R. 7681, the HSAs for All Act. H.R. 5463, the CHOICE Act. H.R. 6703, the Lower Health Care Premiums for All Americans Act. H.R. 6538, the More Affordable Care Act. H.R. 5582, the Patients Deserve Price Tags Act. H.R. 6248, the Healthy Competition for Better Care Act. H.R. 8270, the Every Dollar Counts Act. H.R. 7871, the Medicaid VBPs for Patients (MVP) Act
Client expense: Not reported · Firm income: $30,000
Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE
2026 · second_quarter · Health Issues
Issues related to managed care pharmacists, including access to digital therapeutics and value-based care in Medicaid; Issues related to H.R. 3288/S. 1702 - Access to Prescription Digital Therapeutics Act of 2025; Issues related to H.R. 7871/S. 1637 - MVP Act; Issues related to S. 2426 - Equitable Community Access to Pharmacist Services Act; Issues related to H.R. 3164 - Ensuring Community Access to Pharmacist Services Act.
Client expense: Not reported · Firm income: $80,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2026 · second_quarter · Medicare/Medicaid
S.1637/H.R. 7871: Medicaid Value-Based Payments for Patients (MVP) Act CMS Policies to Support Expedited Implementation of Accelerating Kids' Access to Care Act (AKATCA) and States' Awareness of VBAs
Client expense: $190,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE
2026 · second_quarter · Health Issues
Issues related to patient access to innovative therapies, H.R. 7871 - MVP Act, H.R. 5187 - Sickle Cell Disease, H.R. 7837 - Most Favored Nation Drug Pricing
Client expense: Not reported · Firm income: $10,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2026 · first_quarter · Medicare/Medicaid
H.R. 7871: Medicaid Value-Based Payments for Patients (MVP) Act AKATCA and states' awareness of VBA's
Client expense: $470,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE
2026 · first_quarter · Medicare/Medicaid
S.1637/H.R 7871; Medicaid VBPs for Patients Act S. 2426/H.R. 3164; Ensuring Community Access to Pharmacist Services Act S. 2617/H.R. 1244; Reducing Drug Prices for Seniors Act S. 882; Patients Before Middlemen Act S. 927; Protecting Pharmacies in Medicaid Act S. 1041; Affordable Prescriptions for Patients Act S. 2800; Pharmacy and Medically Underserved Areas Enhancement Act S. 3345; PBM Price Transparency and Accountability Act H.R. 4317; PBM Reform Act H.R. 6609; Pharmacists Fight Back Act in Medicare and Medicaid H.R. 7148; Consolidated Appropriations Act of 2026 oSec. 6233- Any Willing Pharmacy oSec 6224- Medicare Delinking oSec. 6701- Oversight of PBM Services H.R. 8143; Ensuring Access to Lower-Cost Medicines for Seniors Act of 2026 Implementation of the Inflation Reduction Act of 2022, P.L. 169- Provisions on Medicare Part D modernization and drug price negotiation, and the implementation of the Consolidated Appropriations Act of 2026 (P.L. 119-75)
Client expense: $2,996,995 · Firm income: Not reported
2026 · first_quarter · Health Issues
S.1637/H.R 7871; Medicaid VBPs for Patients Act S. 2355/H.R. 5582; Patients Deserve Price Tags Act S. 2426/H.R. 3164; Ensuring Community Access to Pharmacist Services Act S. 526; Pharmacy Benefit Manager Transparency Act S. 882; Patients Before Middlemen Act S. 927; Protecting Pharmacies in Medicaid Act S. 1041; Affordable Prescriptions for Patients Act S. 1095; Stop Significant and Time-wasting Abuse Limiting Legitimate Innovation of New Generics Act S. 1096; Preserve Access to Affordable Generics and Biosimilars Act S. 1097; Interagency Patent Coordination and Improvements Act of 2025 S. 1414; Expedited Access to Biosimilars Act S. 2617; Reducing Drug Prices for Seniors Act S. 2800; Pharmacy and Medically Underserved Areas Enhancement Act S. 3345; PBM Price Transparency and Accountability Act S. 3349; PBM Disclosure Act S. 3549; PBM Fiduciary, Accountability, Integrity, and Reform Act S. 3822; Break Up Big Medicine Act H.R. 1244; Reducing Drug Prices for Seniors Act H.R. 2214; Delinking Revenue from Unfair Gouging Act H.R. 3164; Ensuring Community Access to Pharmacist Service Act H.R. 4317; PBM Reform Act H.R. 4409; Fair Pharmacies for Federal Employees Act H.R. 4570; Interagency Patent Coordination and Improvements Act of 2025 H.R. 6609; Pharmacists Fight Back Act in Medicare and Medicaid H.R. 6610; Pharmacists Fight Back Act in the Federal Employees Health Benefits Program H.R. 6837; To amend the Employee Retirement Income Security Act of 1974 to ensure that pharmacy benefit managers are considered fiduciaries, and for other purposes. H.R. 7148; Consolidated Appropriations Act of 2026 oSec. 6233- Any Willing Pharmacy oSec 6224- Medicare Delinking oSec. 6701- Oversight of PBM Services oSec. 6702- Full Rebate Pass Through to Plans H.R. 7895; PBM Kickback Prohibition Act H.R. 8143; Ensuring Access to Lower-Cost Medicines for Seniors Act of 2026 Implementation of the Inflation Reduction Act of 2022, P.L. 169- Provisions on Medicare Part D modernization and drug price negotiation, and the implementation of the Consolidated Appropriations Act of 2026 (P.L. 119-75)
2026 · first_quarter · Medicare/Medicaid
Draft, Medicare Compare Website (no bill number) - Rep. Guthrie, Brett - improvements to CMS Medicare compare website H.R. 1 - One Big Beautiful Bill Act - Rep. Arrington, Jodey - Medicaid eligibility and state financing, Marketplace coverage and enrollment, Health Savings Account expansion, Pharmacy Benefit Manager financing and regulation H.R. 497 - Medicaid Third Party Liability Act - Rep. Crenshaw, Dan - Medicaid liable third-party exceptions H.R. 538 - Critical Access Hospital Relief Act - Rep. Smith, Adrian - Medicare physician certification requirement H.R. 584 - No Medicaid for Illegal Immigrants Act - Rep. Kiley, Kevin - Medicaid eligibility requirements H.R. 608 - COVER Now Act - Rep. Doggett, Lloyd - Medicaid expansion demo H.R. 610 - Close the Medigap Act - Rep. Doggett, Lloyd - Medigap plan reform H.R. 879 - Medicare Patient Access and Practice Stabilization Act - Rep. Murphy, Gregory - Medicare physician reimbursement H.R. 936 - Medicaid Improvement and State Flexibility Act - Rep. Green, Mark - Medicaid demonstration programs H.R. 1019 - Medicaid Program Improvement Act - Rep. Miller-Meeks, Mariannette - Medicaid management care reporting H.R. 1059 - Jobs and Opportunities for Medicaid Act - Rep. Crenshaw, Dan - Medicaid eligibility requirements H.R. 1162 - Medicaid Primary Care Improvement Act - Rep. Crenshaw, Dan - Medicaid direct primary care arrangements H.R. 1191 - Supporting Access to Rural Community Hospitals Act - Rep. Flood, Mike - Medicare critical access hospitals definition H.R. 1195 - Protect Medicaid Act - Rep. Hudson, Richard - Medicaid eligibility requirements H.R. 1279 - To amend title XIX of the Social Security Act to establish a community engagement requirement for certain individuals under the Medicaid program. - Rep. Bean, Aaron - Medicaid eligibility requirements H.R. 1403 - LIVE Beneficiaries Act - Rep. Bilirakis, Gus - Medicaid registration audits H.R. 1598 - Ensuring Access to Medicaid Buy-in Programs Act - Rep. Ciscomani, Juan - Medicaid eligibility requirements H.R. 1683 - Protecting Rural Seniors Access to Care Act - Rep. Fischbach, Michelle - Minimum nursing home staffing H.R. 1775 - Second Chances for Rural Hospitals Act - Rep. Arrington, Jodey -Definition of rural emergency hospitals H.R. 1805 - ARCH Act - Rep. Miller, Carol - Extend Medicare-dependent and low-value hospitals payments H.R. 1924 - Securing Access to Care for Seniors in Critical Condition Act - Rep. Hern, Kevin - Medicare site-neutral payments for LTC hospitals H.R. 2045 - Medicare Dental, Vision, and Hearing Benefit Act - Rep. Doggett, Lloyd - Medicare dental, vision, and hearing coverage H.R. 2263 - Telehealth Coverage Act - Rep. Khanna, Ro - Telehealth flexibilities in Medicare H.R. 2309 - Medicare and Medicaid Fraud Prevention Act - Rep. Peters, Scott - provider screening for Federal programs H.R. 2433 - Reducing Medically Unnecessary Delays in Care Act - Rep. Green, Mark - Medicare Advantage prior authorization H.R. 2533 - EASE Act - Rep. Arrington, Jodey - CMS model for virtual technology H.R. 2586 - Reentry Act - Rep. Tonko, Paul - Medicaid coverage for incarcerated population H.R. 2590 - Mental and Physical Health Care Comorbidities Act - Rep. Boyle, Brendan - CMS demonstration to treat comorbidities H.R. 2610 - Protecting Options for Seniors Act - Rep. Tenney, Claudia - MA wage index reclassification H.R. 3023 - Preventing Hospital Overbilling of Medicare Act - Rep. Spartz, Victoria - Site-neutral payment reform H.R. 3069 - Medicare for All Act - Rep. Jayapal, Pramila - New national health insurance program H.R. 3222 - SMART Health Care Act - Rep. Spartz, Victoria - MA risk adjustment H.R. 3263 - PATCH Act - Rep. Tokuda, Jill - Medicare geographic practice cost indices H.R. 3321 - Ending Medicaid Discrimination Against the Most Vulnerable Act - Rep. Roy, Chip - Enhance FMAP phase out H.R. 3415 - Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act - Rep. Schakowsky, Janice - Nurse staffing ratio requirements H.R. 3467 - To amend title XVIII to reform the Medicare Advantage program - Rep. Schweikert, David - MA reforms H.R. 3808 - Expanding Seniors Access to Mental Health Services Act - Rep. Fitzpatrick, Brian - Medicare mental health services H.R. 4093 - Apples to Apples Comparison Act - Rep. Bean, Aaron - Medicare and Medicare Advantage spending reports H.R. 4139 - Cutting Copays Act - Rep. McGarvey, Morgan - Medicare cost-sharing for generic drugs H.R. 4277 - Rural Emergency Hospital Financial Stability Act - Rep. Davis, Donald - Medicaid treatment of rural emergency hospitals H.R. 4313 - Hospital Inpatient Services Modernization Act - Rep. Buchanan, Vern - Acute hospital care at home waiver H.R. 4559 - Prompt and Fair Pay Act - Rep. Doggett, Lloyd - Payment parity for MA and FFS; MA reimbursement requirements H.R. 4641 - Keep Kids Covered Act - Rep. Castor, Kathy - Continuous eligibility for children in Medicaid/CHIP H.R. 4807 - Protect Our Hospitals Act - Rep. Landsman, Greg - Medicaid provider tax repeal H.R. 5243 - To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage. - Rep. McClellan, Jennifer - MA supplemental benefits data reporting H.R. 5281 - REAL Health Providers Act - Rep. Panetta, Jimmy - MA provider directory requirements H.R. 5584 - Medicaid Third Party Liability Act - Rep. Burgess, Michael - Impact of Third Party Liability on MCOs H.R. 6109 - To amend title XVIII of the Social Security Act to establish certain requirements with respect to rates of reversed prior authorization coverage determinations under Medicare Advantage plans. - Rep. Pocan, Mark -prior authorization under Medicare Advantage H.R. 6110 -To amend title XVIII of the Social Security Act to require Medicare Advantage plans to automatically reconsider determinations denying coverage. - Rep. Pocan, Mark - reconsider denials under Medicare Advantage H.R. 6111 - To amend title XVIII of the Social Security Act to require any advertisement of a Medicare Advantage plan to include information related to the rates of prior authorization denials under such plan. - Rep. Pocan, Mark - advertise rates of prior authorization denials under Medicare Advantage H.R. 6112 - To amend title XVIII of the Social Security Act to establish certain requirements with respect to the average monthly cost to provide coverage to an enrollee under Medicare Advantage plans. - Rep. Pocan, Mark - require monthly coverage cost to enrollees under Medicare Advantage H.R. 6113 - To amend title XVIII of the Social Security Act to impose limitations on contracts with Medicare Advantage organizations offering multiple Medicare Advantage plans under the Medicare program. - Rep. Pocan, Mark - limit multiple Medicare Advantage plans H.R. 6114 - To prohibit funds made available to the Department of Health and Human Services by previous Appropriations Acts from being used for any activity that makes Medicare Advantage the default under the Medicare program. - Rep. Pocan, Mark - prohibit Medicare Advantage from becoming the default H.R. 6254 - Medicaid Staffing Flexibility and Protection Act of 2025 - Rep. Carter, Earl - extend eligibility determinations and redeterminations for Medicaid H.R. 6361 - Ban AI Denials in Medicare Act - Rep. Landsman, Greg - limit WISeR model H.R. 6951 - Stop Unfair Medicaid Recoveries Act - Rep. Schakowsky, Janice - State Medicaid cost recoupment H.R. 6974 - Improving MA SNP Act of 2026 - Rep. Arrington, Jodey - MA SNP beneficiary approval H.R. 7189 - PrEP Access Act - Rep. Pocan, Mark - HIV prevention services under Medicare H.R. 7409 - Defend Rural Health Act - Rep. Taylor, Dave - Medicare definition of rural hospital H.R. 7727 - Sustaining Rural Healthcare Act - Rep. Alford, Mark - Medicare CAH designation H.R. 7778 - Medicaid PNA Modernization Act - Rep. Subramanyam, Suhas - Medicaid minimum monthly personal needs allowance H.R. 7803 - Save Medicare Act - Rep. Pocan, Mark - Renames Medicare Advantage H.R. 7871 - MVP Act - Rep. Guthrie, Brett - Value-based purchasing arrangements in Medicaid S. 523 - Protect Medicaid Act - Sen. Cassidy, Bill - Medicaid eligibility requirements S. 678 - LIVE Beneficiaries Act - Sen. Scott, Rick - Medicaid enrollment audits S. 717 - Increasing Access to Quality Cardiac Rehabilitation Care Act - Sen. Capito, Shelley Moore - Expanding cardiac care coverage in Medicare S. 750 - Protecting Rural Seniors Access to Care Act - Sen. Fischer, Deb - Medicaid nursing home staff requirements S. 752 - Accelerating Kids Access to Care Act - Sen. Grassley, Chuck - Out-of-state provider access for Medicaid S. 939 - Medicare Dental, Hearing, and Vision Expansion Act - Sen. Sanders, Bernard - Medicare coverage requirements S. 1082 - Safeguarding Medicaid Act - Sen. Barrasso, John - Medicaid enrollee asset verification S. 1105 - No UPCODE Act - Sen. Cassidy, Bill - MA risk adjustment S. 1264 - Mental and Physical Health Care Comorbidities Act - Sen. Bennet, Michael - CMS demonstration to treat comorbidities S. 1399 - Health Tech Investment Act - Sen. Rounds, Mike - Medicare coverage for algorithm-based services S. 1506 - Medicare for All Act - Sen. Sanders, Bernard - New national health insurance program S. 1624 - PATCH Act - Sen. Schatz, Brian - Medicare geographic practice cost indices S. 1629 - Same Care, Lower Cost Act - Sen. Kennedy, John - Medicare site-neutral payment reform S. 1637 - MVP Act - Sen. Mullin, Markwayne - Medicaid value-based purchasing agreements S. 1709 - Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act - Sen. Padilla, Alex - Nurse staffing ratio requirements S. 1816 - Improving Seniors Timely Access to Care Act - Sen. Marshall, Roger - MA prior authorization S. 1903 - A bill to prohibit changes to Medicare and Medicaid in reconciliation - Sen. Reed, Jack - Medicare and Medicaid safeguards against reconciliation cuts S. 2237 - Hospital Inpatient Services Modernization Act - Sen. Scott, Tim - Acute hospital care at home waiver S. 2279 - Protect Medicaid and Rural Hospitals Act - Sen. Hawley, Josh - Medicaid provider tax and State directed payments S. 2289 - Healthy Moms and Babies Act - Sen. Grassley, Chuck - Medicaid/CHIP maternal health coverage improvements S. 2496 - Keep Kids Covered Act - Sen. Bennet, Michael - Continuous eligibility for children in Medicaid/CHIP S. 2497 - Fair Billing Act - Sen. Hassan, Maggie - Medicare site-neutral transparency and identification requirements S. 2556 - Protecting Healthcare and Lowering Costs Act - Sen. Schumer, Charles - repeal of Medicaid provisions in the One Big Beautiful Bill Act S. 2793 - Ensuring Access to Essential Providers Act - Sen. Cassidy, Bill - Essential community provider coverage requirements for MA S. 3642 - WALZ Act - Sen. Marshall, Roger - Medicaid payment investigation and audits S. 3690 - Ensuring Access to Medicaid Buy-in Programs - Sen. Blackburn, Marsha - Medicaid eligibility parameters S. 3727 - Putting an N to Learing about Fraud Act - Sen. Ernst, Joni - Federal program fraud prevention S. 3729 - PBM Reporting Transparency Act - Sen. Warner, Mark - MedPAC reports on PBMs S. 3750 - REAL Health Providers Act - Sen. Bennet, Michael - MA provider directory accuracy S. 3762 - Prior Authorization Relief Act - Sen. Whitehouse, Sheldon - MA prior authorization restrictions S. 3848 - Apples to Apples Comparison Act - Sen. Scott, Tim - Medicare and Medicare Advantage spending reports S. 3886 - Nurses Belong in Nursing Homes Act - Sen. Wyden, Ron - Nursing home staffing hours 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; value of Medicare Advantage; Medicare Advantage Health Risk Assessment and chart reviews; Medicare Advantage supplemental benefits and Social Determinants of health; CBO estimates of MA and FFS costs; coverage of weight loss drugs; Inflation Reduction Act implementation; Medicare Advantage Rate Notice; Part D Payment Issues; Part D VBID Issues; RADV; MA payment issues; Part D issues; prior authorization; MA prompt pay; agent/broker issues; implementation of the One Big Beautiful Bill Act; provider taxes; Medicaid community engagement requirements; and VAs community care program.
2026 · first_quarter · Medicare/Medicaid
S.1637/H.R 7871; Medicaid VBPs for Patients Act S. 2426/H.R. 3164; Ensuring Community Access to Pharmacist Services Act S. 2617/H.R. 1244; Reducing Drug Prices for Seniors Act S. 882; Patients Before Middlemen Act S. 927; Protecting Pharmacies in Medicaid Act S. 1041; Affordable Prescriptions for Patients Act S. 2800; Pharmacy and Medically Underserved Areas Enhancement Act S. 3345; PBM Price Transparency and Accountability Act H.R. 4317; PBM Reform Act H.R. 6609; Pharmacists Fight Back Act in Medicare and Medicaid H.R. 7148; Consolidated Appropriations Act of 2026 oSec. 6233- Any Willing Pharmacy oSec 6224- Medicare Delinking oSec. 6701- Oversight of PBM Services H.R. 8143; Ensuring Access to Lower-Cost Medicines for Seniors Act of 2026 Implementation of the Inflation Reduction Act of 2022, P.L. 169- Provisions on Medicare Part D modernization and drug price negotiation, and the implementation of the Consolidated Appropriations Act of 2026 (P.L. 119-75)
Client expense: $299,699 · Firm income: Not reported
2026 · first_quarter · Health Issues
S.1637/H.R 7871; Medicaid VBPs for Patients Act S. 2355/H.R. 5582; Patients Deserve Price Tags Act S. 2426/H.R. 3164; Ensuring Community Access to Pharmacist Services Act S. 526; Pharmacy Benefit Manager Transparency Act S. 882; Patients Before Middlemen Act S. 927; Protecting Pharmacies in Medicaid Act S. 1041; Affordable Prescriptions for Patients Act S. 1095; Stop Significant and Time-wasting Abuse Limiting Legitimate Innovation of New Generics Act S. 1096; Preserve Access to Affordable Generics and Biosimilars Act S. 1097; Interagency Patent Coordination and Improvements Act of 2025 S. 1414; Expedited Access to Biosimilars Act S. 2617; Reducing Drug Prices for Seniors Act S. 2800; Pharmacy and Medically Underserved Areas Enhancement Act S. 3345; PBM Price Transparency and Accountability Act S. 3349; PBM Disclosure Act S. 3549; PBM Fiduciary, Accountability, Integrity, and Reform Act S. 3822; Break Up Big Medicine Act H.R. 1244; Reducing Drug Prices for Seniors Act H.R. 2214; Delinking Revenue from Unfair Gouging Act H.R. 3164; Ensuring Community Access to Pharmacist Service Act H.R. 4317; PBM Reform Act H.R. 4409; Fair Pharmacies for Federal Employees Act H.R. 4570; Interagency Patent Coordination and Improvements Act of 2025 H.R. 6609; Pharmacists Fight Back Act in Medicare and Medicaid H.R. 6610; Pharmacists Fight Back Act in the Federal Employees Health Benefits Program H.R. 6837; To amend the Employee Retirement Income Security Act of 1974 to ensure that pharmacy benefit managers are considered fiduciaries, and for other purposes. H.R. 7148; Consolidated Appropriations Act of 2026 oSec. 6233- Any Willing Pharmacy oSec 6224- Medicare Delinking oSec. 6701- Oversight of PBM Services oSec. 6702- Full Rebate Pass Through to Plans H.R. 7895; PBM Kickback Prohibition Act H.R. 8143; Ensuring Access to Lower-Cost Medicines for Seniors Act of 2026 Implementation of the Inflation Reduction Act of 2022, P.L. 169- Provisions on Medicare Part D modernization and drug price negotiation, and the implementation of the Consolidated Appropriations Act of 2026 (P.L. 119-75)
2026 · first_quarter · Health Issues
Issues related to managed care pharmacists, including access to digital therapeutics and value-based care in Medicaid; Issues related to H.R. 3288/S. 1702 - Access to Prescription Digital Therapeutics Act of 2025. Issues related to H.R. 7871/S. 1637 - MVP Act.
Client expense: Not reported · Firm income: $80,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2026 · first_quarter · Medicare/Medicaid
H.R. 7871: Medicaid Value-Based Payments for Patients (MVP) Act AKATCA and states' awareness of VBA's
Client expense: $350,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE
| Republican |
| GA |
| Glenn Ivey | Democratic | MD |
| Gus M. Bilirakis | Republican | FL |
| Jake Auchincloss | Democratic | MA |
| Joe Wilson | Republican | SC |
| John Joyce | Republican | PA |
| Kat Cammack | Republican | FL |
| Kevin Mullin | Democratic | CA |
| Mariannette Miller-Meeks | Republican | IA |
| Mike Kelly | Republican | PA |
| Neal P. Dunn | Republican | FL |
| Scott H. Peters | Democratic | CA |
| Ted Lieu | Democratic | CA |
| Troy Balderson | Republican | OH |
Client expense: $3,010,000 · 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), SENATE
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
Client expense: $3,282,990 · 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), Labor, Dept of (DOL), SENATE, Small Business Administration (SBA)
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
Client expense: $2,996,995 · 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), Labor, Dept of (DOL), SENATE, Small Business Administration (SBA)
Client expense: $5,320,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
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
Client expense: $299,699 · 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), Labor, Dept of (DOL), SENATE, Small Business Administration (SBA)