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Fiscal Sustainability Act of 2013
Legislative Progress
Momentum (last 30 days)
0
score
0 actions · 0 new cosponsors · 0 votes
Speed vs cohort
0pct
0d open
vs 3,002 other S bills in the 113th — cohort avg 39d
No CRS summary is available for this bill yet. The source title, actions, sponsors, and text versions below come from Congress.gov.
These links require the bill number to appear in the filing's source-reported specific issue text. Client expenses and lobbying-firm income are separate disclosure fields.
Filing registrants (6)
2015 · second_quarter · Insurance
Bills with similar content found using semantic analysis.
Sources: Congress.gov
Antitrust: -Issues related to the McCarran Ferguson antitrust exemption for insurers: impact to employer-provided benefits, and supplemental and voluntary benefits insurance industry -H.R.99 Health Insurance Industry Antitrust Enforcement Act 2013: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry ERISA: -Issues related to regulation of employee benefits under the Employee Retirement Income Security Act and legislation impacting ERISA plans -Clarification of permissibility of default enrollment arrangements for group income protection insurance under ERISA and/or the Fair Labor Standards Act Federal Debt Limit: -Debt Limit Increase: impact on employer-sponsored financial protection benefits industry -S.11 Fiscal Sustainability Act of 2013: impact on employer-sponsored financial protection benefits industry -American Taxpayer Relief Act of 2012, fiscal cliff: impact on employer-sponsored financial protection benefits industry Financial Services Regulation: -Dodd-Frank Wall Street Reform and Consumer Protection Act implementation: impact on employer-sponsored financial protection benefits industry -Consumer Financial Protection Bureau Interim Final Rule of Records and Information: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Criteria and process for designating nonbank financial companies: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -FY 2014 budget proposals: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Terrorism Risk Insurance Act, specifically provisions related to the proposed National Association of Registered Agents and Brokers (NARAB) Health Care: -Implementation of the Patient Protection and Affordable Care Act, including HHS FAQ regarding fixed indemnity products and other provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Loss ratios: issues related to employer-provided benefits, and supplemental and voluntary benefits insurance industry -The Health Information Technology for Economic and Clinical Health Act (HITECH) Act: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Issues related to wellness programs Labor: -Labor issues impacting large employers, including worker classification and amendments to the Fair Labor Standards Act -S.534 National Association of Registered Agents and Brokers Reform Act of 2013: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -H.R.1155 National Association of Registered Agents and Brokers Reform Act of 2013: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Disability insurance auto enrollment: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry Long-term Care: -Issues related to public and private programs providing long-term care services and insurance, including LTC Commission and repeal of the CLASS Act Privacy: -Privacy and Data breach, cyber security, and SSN protection -H.R.749 - Eliminate Privacy Notice Confusion Act of 2013 -S.676 - Identity Theft and Tax Fraud Prevention Act of 2013 (Death Master File): impact on employer-sponsored financial protection benefits industry -H.R.466 - Social Security Death Master File Privacy Act of 2013: impact on employer-sponsored financial protection benefits industry -H.R. 624 - Cyber Intelligence Sharing and Protection Act of 2013 -H.R.1468 - SECURE IT Act of 2013 SSDI Reform: -H.R.1374 - Social Security Enhancement and Protection Act of 2013: impact on employer-sponsored financial protection benefits industry -Short-term Disability for Federal Workers Bill: impact on employer-sponsored financial protection benefits industry -Increasing employment for people with disabilities Tax Reform: -Corporate tax issues -Deficit reduction -Taxation of Employer Provided Benefits: impact to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Tax Extender Package -Taxation and entitlement reform issues related to the budget agreement reached in December, 2013: impact to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Chairman Dave Camps tax reform discussion draft
Client expense: $120,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE, Social Security Administration (SSA), Treasury, Dept of, White House Office
2015 · first_quarter · Insurance
Antitrust: -Issues related to the McCarran Ferguson antitrust exemption for insurers: impact to employer-provided benefits, and supplemental and voluntary benefits insurance industry -H.R.99 Health Insurance Industry Antitrust Enforcement Act 2013: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry ERISA: -Issues related to regulation of employee benefits under the Employee Retirement Income Security Act and legislation impacting ERISA plans -Clarification of permissibility of default enrollment arrangements for group income protection insurance under ERISA and/or the Fair Labor Standards Act Federal Debt Limit: -Debt Limit Increase: impact on employer-sponsored financial protection benefits industry -S.11 Fiscal Sustainability Act of 2013: impact on employer-sponsored financial protection benefits industry -American Taxpayer Relief Act of 2012, fiscal cliff: impact on employer-sponsored financial protection benefits industry Financial Services Regulation: -Dodd-Frank Wall Street Reform and Consumer Protection Act implementation: impact on employer-sponsored financial protection benefits industry -Consumer Financial Protection Bureau Interim Final Rule of Records and Information: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Criteria and process for designating nonbank financial companies: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -FY 2014 budget proposals: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Terrorism Risk Insurance Act, specifically provisions related to the proposed National Association of Registered Agents and Brokers (NARAB Health Care: -Implementation of the Patient Protection and Affordable Care Act, including HHS FAQ regarding fixed indemnity products and other provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Loss ratios: issues related to employer-provided benefits, and supplemental and voluntary benefits insurance industry -The Health Information Technology for Economic and Clinical Health Act (HITECH) Act: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Issues related to wellness programs Labor: -Labor issues impacting large employers, including worker classification and amendments to the Fair Labor Standards Act -S.534 National Association of Registered Agents and Brokers Reform Act of 2013: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -H.R.1155 National Association of Registered Agents and Brokers Reform Act of 2013: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Disability insurance auto enrollment: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry Long-term Care: -Issues related to public and private programs providing long-term care services and insurance, including LTC Commission and repeal of the CLASS Act Privacy: -Privacy and Data breach, cyber security, and SSN protection -H.R.749 - Eliminate Privacy Notice Confusion Act of 2013 -S.676 - Identity Theft and Tax Fraud Prevention Act of 2013 (Death Master File): impact on employer-sponsored financial protection benefits industry -H.R.466 - Social Security Death Master File Privacy Act of 2013: impact on employer-sponsored financial protection benefits industry -H.R. 624 - Cyber Intelligence Sharing and Protection Act of 2013 -H.R.1468 - SECURE IT Act of 2013 SSDI Reform: -H.R.1374 - Social Security Enhancement and Protection Act of 2013: impact on employer-sponsored financial protection benefits industry -Short-term Disability for Federal Workers Bill: impact on employer-sponsored financial protection benefits industry -Increasing employment for people with disabilities Tax Reform: -Corporate tax issues -Deficit reduction -Taxation of Employer Provided Benefits: impact to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Tax Extender Package -Taxation and entitlement reform issues related to the budget agreement reached in December, 2013: impact to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Chairman Dave Camps tax reform discussion draft
Client expense: $360,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE, Social Security Administration (SSA), Treasury, Dept of, White House Office
2014 · third_quarter · Medicare/Medicaid
H.R. 162, Medicaid Integrity Act (Bachmann) - Medicaid health plan audits H.R. 670, Puerto Rico Medicare Part B Equity Act (Pierluisi) H.R. 928, Medicare Prescription Drug Savings and Choice Act (Schakowsky) - Medicare Part D changes H.R. 1179, Improving Access to Medicare Coverage Act (Courtney) - Medicare coverage of skilled nursing care H.R. 1102, Medicare Prescription Drug Price Negotiation Act (Welch) - Medicare Part D price negotiations H.R. 1853, Medicaid Accountability and Care Act (Cassidy) -federal financing of state Medicaid programs H.R. 2305, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Roskam-Carney) - fighting fraud and abuse H.R. 2453, Medicare Beneficiary Preservation of Choice Act (Rothfus-Schrader) - MA enrollment rules H.R. 2524, Medicare Better Health Rewards Program Act (Paulsen-Kind) - wellness incentives H.R. 2753, Securing Care for Seniors Act (Black) - MA payment and enrollment issues, wellness incentives H.R, 2960, Medicare Prescription Drug Integrity Act of 2013 (Pallone) - Part D drug utilization review H.R. 3512, Seniors' Health Care Choice Act (Heck) - MA open enrollment period H.R. 3890, Better Care, Lower Cost Act (Paulsen-Welch) - delivery models for Medicare beneficiaries with chronic conditions H.R. 4015, SGR Repeal and Medicare Provider Payment Modernization Act (Burgess) - SGR repeal, quality- and value-based payment reforms, ACA individual mandate delay H.R. 4160, Keep the Promise to Seniors Act (Ellmers) - blocking Medicare Part D proposed rule H.R. 4302, Protecting Access to Medicare Act (Pitts) - 12-month Medicare SGR patch, Medicare Advantage Special Needs Plans, Appropriate Use Criteria for Advanced Diagnostic Imaging, Medicare sequestration cuts, Other Medicare-Medicaid Extenders H.R. 4484, Strengthening Healthcare Options for Vulnerable Populations Act (Sinema) - MA special needs plans H.R. 4998, MA Participant Bill of Rights Act (DeLauro) - MA plan provider networks H.R. 5113, Protecting Seniors' Medicare Choices from Obamacare Act (Coffman) - MA stabilization program H.R. 5183, Value Based Insurance Design for Better Care Act (Black) - MA demonstration to test VBID methodologies H.R. 5364, CHIP Extension and Improvement Act (Pallone) - federal CHIP funding Draft Bill, Protecting the Integrity of Medicare Act (Brady) - preventing fraud in Medicare and Medicaid S. 11, Fiscal Sustainability Act (Corker) - Medicare, Medigap, Medicaid issues S. 25 (Hatch) - extension of Medicare sequestration cuts S. 117, Medicare Prescription Drug Price Negotiation Act (Klobuchar) - Medicare Part D price negotiations S. 324, Puerto Rico Medicare Part B Equity Act (Schumer) S. 408, Medicare Prescription Drug Savings and Choice Act (Durbin) - Medicare Part D changes S. 569, Improving Access to Medicare Coverage Act (Brown) - Medicare coverage of skilled nursing care S. 1123, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Carper-Coburn) - fighting fraud and abuse S. 1228, Medicare Better Health Rewards Program Act (Wyden-Portman) - wellness incentives S. 1787, Medicaid Managed Care Responsibility and Equity Act (Rockefeller) - medical loss ratio requirement for Medicaid managed care organizations S. 1871, SGR Repeal and Medicare Beneficiary Access Act (Senate Finance Committee) - SGR repeal, quality- and value-based payment reforms, MA Special Needs Plans, Cost Plans, QI and TMA programs S. 1932, Better Care, Lower Cost Act (Wyden-Isakson) - delivery models for Medicare beneficiaries with chronic conditions S. 1980, Medicaid and CHIP Continuous Quality Act (Rockefeller) - 12 month continuous enrollment S. 2000, SGR Repeal and Medicare Provider Payment Modernization Act (Senate Finance Committee) - SGR repeal, quality- and value-based payment reforms S. 2110, SGR Repeal and Medicare Provider Payment Modernization Act (Wyden) - SGR repeal, quality- and value-based payment reforms, Medicare and Medicaid extenders S. 2122, Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act (Hatch) - SGR repeal, quality- and value-based payment reforms, ACA individual mandate repeal S. 2361, Stop SCAMS Act (Nelson-Collins) - reducing Medicare fraud S. 2461, CHIP Extension Act (Rockefeller) --- federal CHIP funding S. 2552, MA Participant Bill of Rights Act (Brown-Blumenthal) - MA plan provider networks S. 2783, Value Based Insurance Design for Better Care Act (Thune) - MA demonstration to test VBID methodologies Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, encounter data and other data-related issues, and audit issues; bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, and audits); in-home health risk assessments; Medicare Medical Loss Ratio issues; implementation of sequestration under the Medicare Advantage and Part D programs; implications of the health insurer fee for MA and Part D plans; application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, SSA and CMS premium withhold processing issues, enrollment rules, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible Special Needs Plans (SNPs); Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, Part D coverage gap discount program, including employer group waiver plan (EGWP) issues, and other operational issues; issues raised by Part D coverage of new specialty drugs, the Part D non-interference policy and related issues (e.g., preferred pharmacy and any willing pharmacy requirements, standards for network pharmacy reimbursement, and policies regarding sponsor negotiation of pharmacy price concessions); Medication Therapy Management Program requirements; Part D requirements for offering basic and enhanced alternative plans; MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; issues relating to MA and Part D Star Rating system including measures, the methodology for calculating ratings, and the role of the ratings for payment purposes; implementation of the Affordable Care Act (ACA) changes to the Part D coverage gap; ongoing implementation issues for the Medicare cost plan program including enrollment, marketing materials review and approval and other operational issues; Medicare creditable drug coverage reporting requirements; implementation issues for the Medicare Retiree Drug Subsidy program; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education Program; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; Medicare clinical trials; Medicare/Medicaid integration for dual eligibles, including the Capitated Financial Alignment Demonstration; Medicaid managed care regulations and policies, including the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, fraud and abuse compliance, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including block grants, the calculation of the federal medical assistance (federal matching) percentage (FMAP), and intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost issues affecting Medicaid health plans including issues raised by Medicaid coverage of new specialty drugs; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues and CHIP reauthorization; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including Medicaid managed care organization provider tax issues; standards for electronic prescribing; implementation of Medicaid changes of interest to Medicaid health plans made in the ACA including Medicaid expansion, the managed care organization (MCO) prescription drug rebate provisions, minimum payments to primary care providers (PCPs), interactions between the Medicaid program and health insurance exchanges, and Medicaid and CHIP maintenance of effort (MOE) requirements; implications of the health insurer fee for Medicaid health plans ; issues related to Medigap coverage; issues relating to "meaningful use" requirements for health information technology; and other issues relating to health care reform implementation.
Client expense: $2,010,000 · Firm income: Not reported
Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Federal Bureau of Investigation (FBI), Federal Trade Commission (FTC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of Personnel Management (OPM), SENATE, Social Security Administration (SSA), Treasury, Dept of, White House Office
2014 · fourth_quarter · Medicare/Medicaid
H.R. 162, Medicaid Integrity Act (Bachmann) - Medicaid health plan audits H.R. 670, Puerto Rico Medicare Part B Equity Act (Pierluisi) H.R. 928, Medicare Prescription Drug Savings and Choice Act (Schakowsky) - Medicare Part D changes H.R. 1024, Medication Therapy Management Empowerment Act (McMorris Rodgers) - medication therapy management programs H.R. 1179, Improving Access to Medicare Coverage Act (Courtney) - Medicare coverage of skilled nursing care H.R. 1102, Medicare Prescription Drug Price Negotiation Act (Welch) - Medicare Part D price negotiations H.R. 1853, Medicaid Accountability and Care Act (Cassidy) -federal financing of state Medicaid programs H.R. 2305, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Roskam-Carney) - fighting fraud and abuse H.R. 2453, Medicare Beneficiary Preservation of Choice Act (Rothfus-Schrader) - MA enrollment rules H.R. 2524, Medicare Better Health Rewards Program Act (Paulsen-Kind) - wellness incentives H.R. 2753, Securing Care for Seniors Act (Black) - MA payment and enrollment issues, wellness incentives H.R, 2960, Medicare Prescription Drug Integrity Act of 2013 (Pallone) - Part D drug utilization review H.R. 3512, Seniors' Health Care Choice Act (Heck) - MA open enrollment period H.R. 3890, Better Care, Lower Cost Act (Paulsen-Welch) - delivery models for Medicare beneficiaries with chronic conditions H.R. 4015, SGR Repeal and Medicare Provider Payment Modernization Act (Burgess) - SGR repeal, quality- and value-based payment reforms, ACA individual mandate delay H.R. 4160, Keep the Promise to Seniors Act (Ellmers) - blocking Medicare Part D proposed rule H.R. 4302, Protecting Access to Medicare Act (Pitts) - 12-month Medicare SGR patch, Medicare Advantage Special Needs Plans, Appropriate Use Criteria for Advanced Diagnostic Imaging, Medicare sequestration cuts, Other Medicare-Medicaid Extenders H.R. 4484, Strengthening Healthcare Options for Vulnerable Populations Act (Sinema) - MA special needs plans H.R. 4998, MA Participant Bill of Rights Act (DeLauro) - MA plan provider networks H.R. 5113, Protecting Seniors' Medicare Choices from Obamacare Act (Coffman) - MA stabilization program H.R. 5183, Value Based Insurance Design for Better Care Act (Black) - MA demonstration to test VBID methodologies H.R. 5364, CHIP Extension and Improvement Act (Pallone) - federal CHIP funding Draft Bill, Protecting the Integrity of Medicare Act (Brady) - preventing fraud in Medicare and Medicaid S. 11, Fiscal Sustainability Act (Corker) - Medicare, Medigap, Medicaid issues S. 25 (Hatch) - extension of Medicare sequestration cuts S. 117, Medicare Prescription Drug Price Negotiation Act (Klobuchar) - Medicare Part D price negotiations S. 324, Puerto Rico Medicare Part B Equity Act (Schumer) S. 408, Medicare Prescription Drug Savings and Choice Act (Durbin) - Medicare Part D changes S. 569, Improving Access to Medicare Coverage Act (Brown) - Medicare coverage of skilled nursing care S. 1123, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Carper-Coburn) - fighting fraud and abuse S. 1228, Medicare Better Health Rewards Program Act (Wyden-Portman) - wellness incentives S. 1787, Medicaid Managed Care Responsibility and Equity Act (Rockefeller) - medical loss ratio requirement for Medicaid managed care organizations S. 1871, SGR Repeal and Medicare Beneficiary Access Act (Senate Finance Committee) - SGR repeal, quality- and value-based payment reforms, MA Special Needs Plans, Cost Plans, QI and TMA programs S. 1932, Better Care, Lower Cost Act (Wyden-Isakson) - delivery models for Medicare beneficiaries with chronic conditions S. 1980, Medicaid and CHIP Continuous Quality Act (Rockefeller) - 12 month continuous enrollment S. 2000, SGR Repeal and Medicare Provider Payment Modernization Act (Senate Finance Committee) - SGR repeal, quality- and value-based payment reforms S. 2110, SGR Repeal and Medicare Provider Payment Modernization Act (Wyden) - SGR repeal, quality- and value-based payment reforms, Medicare and Medicaid extenders S. 2122, Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act (Hatch) - SGR repeal, quality- and value-based payment reforms, ACA individual mandate repeal S. 2361, Stop SCAMS Act (Nelson-Collins) - reducing Medicare fraud S. 2461, CHIP Extension Act (Rockefeller) --- federal CHIP funding S. 2552, MA Participant Bill of Rights Act (Brown-Blumenthal) - MA plan provider networks S. 2783, Value Based Insurance Design for Better Care Act (Thune) - MA demonstration to test VBID methodologies Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, encounter data and other data-related issues, and audit issues; bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, and audits); in-home health risk assessments; Medicare Medical Loss Ratio issues; implementation of sequestration under the Medicare Advantage and Part D programs; implications of the health insurer fee for MA and Part D plans; application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, SSA and CMS premium withhold processing issues, enrollment rules, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible Special Needs Plans (SNPs); Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, Part D coverage gap discount program, including employer group waiver plan (EGWP) issues, and other operational issues; issues raised by Part D coverage of new specialty drugs, the Part D non-interference policy and related issues (e.g., preferred pharmacy and any willing pharmacy requirements, standards for network pharmacy reimbursement, and policies regarding sponsor negotiation of pharmacy price concessions); Medication Therapy Management Program requirements; Part D requirements for offering basic and enhanced alternative plans; MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; issues relating to MA and Part D Star Rating system including measures, the methodology for calculating ratings, and the role of the ratings for payment purposes; implementation of the Affordable Care Act (ACA) changes to the Part D coverage gap; ongoing implementation issues for the Medicare cost plan program including enrollment, marketing materials review and approval and other operational issues;implementation issues for the Medicare Retiree Drug Subsidy program; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education Program; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; Medicare clinical trials; Medicare/Medicaid integration for dual eligibles, including the Capitated Financial Alignment Demonstration; Medicaid managed care regulations and policies, including the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, fraud and abuse compliance, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including block grants, the calculation of the federal medical assistance (federal matching) percentage (FMAP), and intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost issues affecting Medicaid health plans including issues raised by Medicaid coverage of new specialty drugs; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues and CHIP reauthorization; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including Medicaid managed care organization provider tax issues; standards for electronic prescribing; implementation of Medicaid changes of interest to Medicaid health plans made in the ACA including Medicaid expansion, the managed care organization (MCO) prescription drug rebate provisions, minimum payments to primary care providers (PCPs), interactions between the Medicaid program and health insurance exchanges, and Medicaid and CHIP maintenance of effort (MOE) requirements; implications of the health insurer fee for Medicaid health plans ; issues related to Medigap coverage financing for infectious disease such as Ebola; and other issues relating to health care reform implementation. *AddMACPACtoAgencyList
Client expense: $2,230,000 · Firm income: Not reported
Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Pension & Welfare Benefits Administration, SENATE, Treasury, Dept of, White House Office
2014 · fourth_quarter · Medicare/Medicaid
H.R. 162, Medicaid Integrity Act (Bachmann) - Medicaid health plan audits. H.R. 670, Puerto Rico Medicare Part B Equity Act (Pierluisi). H.R. 928, Medicare Prescription Drug Savings and Choice Act (Schakowsky) - Medicare Part D changes. H.R. 1024, Medication Therapy Management Empowerment Act (McMorris Rodgers) - medication therapy management programs. H.R. 1179, Improving Access to Medicare Coverage Act (Courtney) - Medicare coverage of skilled nursing care. H.R. 1102, Medicare Prescription Drug Price Negotiation Act (Welch) - Medicare Part D price negotiations. H.R. 1853, Medicaid Accountability and Care Act (Cassidy) -federal financing of state Medicaid programs. H.R. 2305, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Roskam-Carney) - fighting fraud and abuse. H.R. 2453, Medicare Beneficiary Preservation of Choice Act (Rothfus-Schrader) - MA enrollment rules. H.R. 2524, Medicare Better Health Rewards Program Act (Paulsen-Kind) - wellness incentives. H.R. 2753, Securing Care for Seniors Act (Black) - MA payment and enrollment issues, wellness incentives. H.R, 2960, Medicare Prescription Drug Integrity Act of 2013 (Pallone) - Part D drug utilization review. H.R. 3512, Seniors' Health Care Choice Act (Heck) - MA open enrollment period. H.R. 3890, Better Care, Lower Cost Act (Paulsen-Welch) - delivery models for Medicare beneficiaries with chronic conditions. H.R. 4015, SGR Repeal and Medicare Provider Payment Modernization Act (Burgess) - SGR repeal, quality- and value-based payment reforms, ACA individual mandate delay. H.R. 4160, Keep the Promise to Seniors Act (Ellmers) - blocking Medicare Part D proposed rule. H.R. 4302, Protecting Access to Medicare Act (Pitts) - 12-month Medicare SGR patch, Medicare Advantage Special Needs Plans, Appropriate Use Criteria for Advanced Diagnostic Imaging, Medicare sequestration cuts, Other Medicare-Medicaid Extenders . H.R. 4484, Strengthening Healthcare Options for Vulnerable Populations Act (Sinema) - MA special needs plans. H.R. 4998, MA Participant Bill of Rights Act (DeLauro) - MA plan provider networks. H.R. 5113, Protecting Seniors' Medicare Choices from Obamacare Act (Coffman) - MA stabilization program. H.R. 5183, Value Based Insurance Design for Better Care Act (Black) - MA demonstration to test VBID methodologies. H.R. 5364, CHIP Extension and Improvement Act (Pallone) - federal CHIP funding. Draft Bill, Protecting the Integrity of Medicare Act (Brady) - preventing fraud in Medicare and Medicaid. S. 11, Fiscal Sustainability Act (Corker) - Medicare, Medigap, Medicaid issues. S. 25 (Hatch) - extension of Medicare sequestration cuts. S. 117, Medicare Prescription Drug Price Negotiation Act (Klobuchar) - Medicare Part D price negotiations. S. 324, Puerto Rico Medicare Part B Equity Act (Schumer). S. 408, Medicare Prescription Drug Savings and Choice Act (Durbin) - Medicare Part D changes. S. 569, Improving Access to Medicare Coverage Act (Brown) - Medicare coverage of skilled nursing care. S. 1123, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Carper-Coburn) - fighting fraud and abuse. S. 1228, Medicare Better Health Rewards Program Act (Wyden-Portman) - wellness incentives. S. 1787, Medicaid Managed Care Responsibility and Equity Act (Rockefeller) - medical loss ratio requirement for Medicaid managed care organizations. S. 1871, SGR Repeal and Medicare Beneficiary Access Act (Senate Finance Committee) - SGR repeal, quality- and value-based payment reforms, MA Special Needs Plans, Cost Plans, QI and TMA programs. S. 1932, Better Care, Lower Cost Act (Wyden-Isakson) - delivery models for Medicare beneficiaries with chronic conditions. S. 1980, Medicaid and CHIP Continuous Quality Act (Rockefeller) - 12 month continuous enrollment. S. 2000, SGR Repeal and Medicare Provider Payment Modernization Act (Senate Finance Committee) - SGR repeal, quality- and value-based payment reforms. S. 2110, SGR Repeal and Medicare Provider Payment Modernization Act (Wyden) - SGR repeal, quality- and value-based payment reforms, Medicare and Medicaid extenders. S. 2122, Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act (Hatch) - SGR repeal, quality- and value-based payment reforms, ACA individual mandate repeal. S. 2361, Stop SCAMS Act (Nelson-Collins) - reducing Medicare fraud. S. 2461, CHIP Extension Act (Rockefeller) --- federal CHIP funding. S. 2552, MA Participant Bill of Rights Act (Brown-Blumenthal) - MA plan provider networks. S. 2783, Value Based Insurance Design for Better Care Act (Thune) - MA demonstration to test VBID methodologies.
Client expense: Not reported · Firm income: $20,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2014 · fourth_quarter · Insurance
Antitrust: -Issues related to the McCarran Ferguson antitrust exemption for insurers: impact to employer-provided benefits, and supplemental and voluntary benefits insurance industry -H.R.99 Health Insurance Industry Antitrust Enforcement Act 2013: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry ERISA: -Issues related to regulation of employee benefits under the Employee Retirement Income Security Act and legislation impacting ERISA plans -Clarification of permissibility of default enrollment arrangements for group income protection insurance under ERISA and /or the Fair Labor Standards Act Federal Debt Limit: -Debt Limit Increase: impact on employer-sponsored financial protection benefits industry -S.11 Fiscal Sustainability Act of 2013: impact on employer-sponsored financial protection benefits industry -American Taxpayer Relief Act of 2012, fiscal cliff: impact on employer-sponsored financial protection benefits industry Financial Services Regulation: -Dodd-Frank Wall Street Reform and Consumer Protection Act implementation: impact on employer-sponsored financial protection benefits industry -Consumer Financial Protection Bureau Interim Final Rule of Records and Information: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Criteria and process for designating nonbank financial companies: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -FY 2014 budget proposals: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Terrorism Risk Insurance Act, specifically provisions related to the proposed National Association of Registered Agents and Brokers (NARAB) Health Care: -Implementation of the Patient Protection and Affordable Care Act, including HHS FAQ regarding fixed indemnity products and other provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Loss ratios: issues related to employer-provided benefits, and supplemental and voluntary benefits insurance industry -The Health Information Technology for Economic and Clinical Health Act (HITECH) Act: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Issues related to wellness programs Labor: -Labor issues impacting large employers, including worker classification and amendments to the Fair Labor Standards Act -S.534 National Association of Registered Agents and Brokers Reform Act of 2013: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -H.R.1155 National Association of Registered Agents and Brokers Reform Act of 2013: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Disability insurance auto enrollment: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry Long-term Care: -Issues related to public and private programs providing long-term care services and insurance, including LTC Commission and repeal of the CLASS Act Privacy: -Privacy and Data breach, cyber security, and SSN protection -H.R.749 - Eliminate Privacy Notice Confusion Act of 2013 -S.676 - Identity Theft and Tax Fraud Prevention Act of 2013 (Death Master File): impact on employer-sponsored financial protection benefits industry -H.R.466 - Social Security Death Master File Privacy Act of 2013: impact on employer-sponsored financial protection benefits industry -H.R. 624 - Cyber Intelligence Sharing and Protection Act of 2013 -H.R.1468 - SECURE IT Act of 2013 SSDI Reform: -H.R.1374 - Social Security Enhancement and Protection Act of 2013: impact on employer-sponsored financial protection benefits industry -Short-term Disability for Federal Workers Bill: impact on employer-sponsored financial protection benefits industry -Increasing employment for people with disabilities Tax Reform: -Corporate tax issues -Deficit reduction -Taxation of Employer Provided Benefits: impact to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Tax Extender Package -Taxation and entitlement reform issues related to the budget agreement reached in December, 2013: impact to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Chairman Dave Camps tax reform discussion draft
2014 · third_quarter · Insurance
Antitrust: -Issues related to the McCarran Ferguson antitrust exemption for insurers: impact to employer-provided benefits, and supplemental and voluntary benefits insurance industry -H.R.99 Health Insurance Industry Antitrust Enforcement Act 2013: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry ERISA: -Issues related to regulation of employee benefits under the Employee Retirement Income Security Act and legislation impacting ERISA plans -Clarification of permissibility of default enrollment arrangements for group income protection insurance under ERISA and /or the Fair Labor Standards Act Federal Debt Limit: -Debt Limit Increase: impact on employer-sponsored financial protection benefits industry -S.11 Fiscal Sustainability Act of 2013: impact on employer-sponsored financial protection benefits industry -American Taxpayer Relief Act of 2012, fiscal cliff: impact on employer-sponsored financial protection benefits industry Financial Services Regulation: -Dodd-Frank Wall Street Reform and Consumer Protection Act implementation: impact on employer-sponsored financial protection benefits industry -Consumer Financial Protection Bureau Interim Final Rule of Records and Information: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Criteria and process for designating nonbank financial companies: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -FY 2014 budget proposals: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Terrorism Risk Insurance Act, specifically provisions related to the proposed National Association of Registered Agents and Brokers (NARAB) Health Care: -Implementation of the Patient Protection and Affordable Care Act, including HHS FAQ regarding fixed indemnity products and other provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Loss ratios: issues related to employer-provided benefits, and supplemental and voluntary benefits insurance industry -The Health Information Technology for Economic and Clinical Health Act (HITECH) Act: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Issues related to wellness programs Labor: -Labor issues impacting large employers, including worker classification and amendments to the Fair Labor Standards Act -S.534 National Association of Registered Agents and Brokers Reform Act of 2013: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -H.R.1155 National Association of Registered Agents and Brokers Reform Act of 2013: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Disability insurance auto enrollment: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry Long-term Care: -Issues related to public and private programs providing long-term care services and insurance, including LTC Commission and repeal of the CLASS Act Privacy: -Privacy and Data breach, cyber security, and SSN protection -H.R.749 - Eliminate Privacy Notice Confusion Act of 2013 -S.676 - Identity Theft and Tax Fraud Prevention Act of 2013 (Death Master File): impact on employer-sponsored financial protection benefits industry -H.R.466 - Social Security Death Master File Privacy Act of 2013: impact on employer-sponsored financial protection benefits industry -H.R. 624 - Cyber Intelligence Sharing and Protection Act of 2013 -H.R.1468 - SECURE IT Act of 2013 SSDI Reform: -H.R.1374 - Social Security Enhancement and Protection Act of 2013: impact on employer-sponsored financial protection benefits industry -Short-term Disability for Federal Workers Bill: impact on employer-sponsored financial protection benefits industry -Increasing employment for people with disabilities Tax Reform: -Corporate tax issues -Deficit reduction -Taxation of Employer Provided Benefits: impact to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Tax Extender Package -Taxation and entitlement reform issues related to the budget agreement reached in December, 2013: impact to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Chairman Dave Camps tax reform discussion draft
2014 · first_quarter · Insurance
Antitrust: -Issues related to the McCarran Ferguson antitrust exemption for insurers: impact to employer-provided benefits, and supplemental and voluntary benefits insurance industry -H.R.99 Health Insurance Industry Antitrust Enforcement Act 2013: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry ERISA: -Issues related to regulation of employee benefits under the Employee Retirement Income Security Act and legislation impacting ERISA plans -Clarification of permissibility of default enrollment arrangements for group income protection insurance under ERISA and /or the Fair Labor Standards Act Federal Debt Limit: -Debt Limit Increase: impact on employer-sponsored financial protection benefits industry -S.11 Fiscal Sustainability Act of 2013: impact on employer-sponsored financial protection benefits industry -American Taxpayer Relief Act of 2012, fiscal cliff: impact on employer-sponsored financial protection benefits industry Financial Regulation: -Dodd-Frank Wall Street Reform and Consumer Protection Act implementation: impact on employer-sponsored financial protection benefits industry -Consumer Financial Protection Bureau Interim Final Rule of Records and Information: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Criteria and process for designating nonbank financial companies: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -FY 2014 budget proposals: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry Health Care: -Implementation of the Patient Protection and Affordable Care Act, including HHS FAQ regarding fixed indemnity products and other provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Loss ratios: issues related to employer-provided benefits, and supplemental and voluntary benefits insurance industry -The Health Information Technology for Economic and Clinical Health Act (HITECH) Act: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Issues related to wellness programs Labor: -Labor issues impacting large employers, including worker classification and amendments to the Fair Labor Standards Act -S.534 National Association of Registered Agents and Brokers Reform Act of 2013: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -H.R.1155 National Association of Registered Agents and Brokers Reform Act of 2013: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry Long-term Care: -Issues related to public and private programs providing long-term care services and insurance, including LTC Commission and repeal of the CLASS Act Privacy: -Privacy and Data breach, cyber security, and SSN protection -H.R.749 - Eliminate Privacy Notice Confusion Act of 2013 -S.676 - Identity Theft and Tax Fraud Prevention Act of 2013 (Death Master File): impact on employer-sponsored financial protection benefits industry -H.R.466 - Social Security Death Master File Privacy Act of 2013: impact on employer-sponsored financial protection benefits industry -H.R. 624 - Cyber Intelligence Sharing and Protection Act of 2013 -H.R.1468 - SECURE IT Act of 2013 SSDI Reform: -H.R.1374 - Social Security Enhancement and Protection Act of 2013: impact on employer-sponsored financial protection benefits industry -Short-term Disability for Federal Workers Bill: impact on employer-sponsored financial protection benefits industry -Increasing employment for people with disabilities Tax Reform: -Corporate tax issues -Deficit reduction -Taxation of Employer Provided Benefits: impact to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Tax Extender Package -Taxation and entitlement reform issues related to the budget agreement reached in December, 2013: impact to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Chairman Dave Camps tax reform discussion draft
2014 · fourth_quarter · Medicare/Medicaid
Federal Coordinated Health Care Office (Medicare-Medicaid Coordination Office). (No bill.) Proposals related to the activities of the Federal Coordinated Health Care Office intended to improve the quality of care for recipients receiving benefits from both Medicare and Medicaid, i.e., dual-eligibles. Medicare Advantage. S. 2552, H.R.4998, Medicare Advantage Participant Bill of Rights Act of 2014: provisions to establish necessary protections for seniors enrolled in Medicare Advantage plans. Medicare Benefit Redesign. S. 11, Fiscal Sustainability Act of 2013: provisions pertaining to Parts A and B deductibles; premiums, including means-testing; a catastrophic cap on out-of-pocket spending; the eligibility age; and proposals to privatize Medicare. Medicare Drug Savings. S. 740, H.R. 1588, Medicare Drug Savings Act of 2013: provisions to extend the application of Medicaid drug rebates to prescription drugs paid for by Medicare and used by people eligible for both Medicare and Medicaid (dual-eligibles), and by people receiving the Medicare Part D Low-Income Subsidy. Medicare Home Health Benefits. (No bill.) Proposals pertaining to copayments for beneficiaries receiving the Medicare home health benefit. Medicare Part D Negotiation of Drug Prices. S. 408, H.R. 928, Medicare Prescription Drug Savings and Choice Act of 2013: proposals to create a Medicare-operated prescription drug plan, allowing or requiring the Secretary of the Department of Health and Human Services to negotiate price concessions from pharmaceutical manufacturers for drugs purchased under the Part D program. Medicare Physician Fees and Extenders. H.R. 4015, SGR Repeal and Medicare Provider Payment Modernization Act of 2014; S. 2157, Commonsense Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014: provisions relating to a permanent fix of the sustainable growth rate (SGR) formula used to determine physician fees under Part B; the extension of the Qualified Individual (QI) program; and the therapy caps. Medicare Supplemental Health Insurance. (No bill.) Proposals to increase costs for Medicare beneficiaries who purchase Medigap insurance. Medicare Observation Status. S. 569, H.R. 1179, Improving Access to Medicare Coverage Act of 2013: legislation to count days in the hospital in observation status toward meeting the three-day prior hospitalization requirement for skilled nursing facility (SNF) care eligibility. Nursing Home Staffing. H.R. 5373, Put A Registered Nurse in the Nursing Home Act of 2014: legislation to require nursing homes and skilled nursing facilities that receive Medicare and/or Medicaid reimbursement to have at least one direct care registered nurse on duty at all times. Comprehensive Health Care Reform. P.L. 111-148, Patient Protection and Affordable Care Act; P.L. 111-152, Health Care and Education Reconciliation Act of 2010: implementation of provisions reducing Medicare Advantage plan payments; requiring higher income Medicare beneficiaries to pay an increased share of Medicare Parts B and D premium costs; expanding benefits for low-income beneficiaries under the Medicare Savings Programs and the Part D Low-Income Subsidy (LIS); expanding coverage of prevention services; testing payment and delivery system reforms; and providing expanded Medicaid coverage.
2014 · third_quarter · Insurance
Antitrust: -Issues related to the McCarran Ferguson antitrust exemption for insurers: impact to employer-provided benefits, and supplemental and voluntary benefits insurance industry -H.R.99 Health Insurance Industry Antitrust Enforcement Act 2013: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry ERISA: -Issues related to regulation of employee benefits under the Employee Retirement Income Security Act and legislation impacting ERISA plans -Clarification of permissibility of default enrollment arrangements for group income protection insurance under ERISA and /or the Fair Labor Standards Act Federal Debt Limit: -Debt Limit Increase: impact on employer-sponsored financial protection benefits industry -S.11 Fiscal Sustainability Act of 2013: impact on employer-sponsored financial protection benefits industry -American Taxpayer Relief Act of 2012, fiscal cliff: impact on employer-sponsored financial protection benefits industry Financial Services Regulation: -Dodd-Frank Wall Street Reform and Consumer Protection Act implementation: impact on employer-sponsored financial protection benefits industry -Consumer Financial Protection Bureau Interim Final Rule of Records and Information: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Criteria and process for designating nonbank financial companies: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -FY 2014 budget proposals: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Terrorism Risk Insurance Act, specifically provisions related to the proposed National Association of Registered Agents and Brokers (NARAB) Health Care: -Implementation of the Patient Protection and Affordable Care Act, including HHS FAQ regarding fixed indemnity products and other provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Loss ratios: issues related to employer-provided benefits, and supplemental and voluntary benefits insurance industry -The Health Information Technology for Economic and Clinical Health Act (HITECH) Act: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Issues related to wellness programs Labor: -Labor issues impacting large employers, including worker classification and amendments to the Fair Labor Standards Act -S.534 National Association of Registered Agents and Brokers Reform Act of 2013: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -H.R.1155 National Association of Registered Agents and Brokers Reform Act of 2013: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Disability insurance auto enrollment: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry Long-term Care: -Issues related to public and private programs providing long-term care services and insurance, including LTC Commission and repeal of the CLASS Act Privacy: -Privacy and Data breach, cyber security, and SSN protection -H.R.749 - Eliminate Privacy Notice Confusion Act of 2013 -S.676 - Identity Theft and Tax Fraud Prevention Act of 2013 (Death Master File): impact on employer-sponsored financial protection benefits industry -H.R.466 - Social Security Death Master File Privacy Act of 2013: impact on employer-sponsored financial protection benefits industry -H.R. 624 - Cyber Intelligence Sharing and Protection Act of 2013 -H.R.1468 - SECURE IT Act of 2013 SSDI Reform: -H.R.1374 - Social Security Enhancement and Protection Act of 2013: impact on employer-sponsored financial protection benefits industry -Short-term Disability for Federal Workers Bill: impact on employer-sponsored financial protection benefits industry -Increasing employment for people with disabilities Tax Reform: -Corporate tax issues -Deficit reduction -Taxation of Employer Provided Benefits: impact to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Tax Extender Package -Taxation and entitlement reform issues related to the budget agreement reached in December, 2013: impact to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Chairman Dave Camps tax reform discussion draft
2014 · third_quarter · Medicare/Medicaid
H.R. 162, Medicaid Integrity Act (Bachmann) - Medicaid health plan audits H.R. 670, Puerto Rico Medicare Part B Equity Act (Pierluisi) H.R. 928, Medicare Prescription Drug Savings and Choice Act (Schakowsky) - Medicare Part D changes H.R. 1179, Improving Access to Medicare Coverage Act (Courtney) - Medicare coverage of skilled nursing care H.R. 1102, Medicare Prescription Drug Price Negotiation Act (Welch) - Medicare Part D price negotiations H.R. 1853, Medicaid Accountability and Care Act (Cassidy) -federal financing of state Medicaid programs H.R. 2305, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Roskam-Carney) - fighting fraud and abuse H.R. 2453, Medicare Beneficiary Preservation of Choice Act (Rothfus-Schrader) - MA enrollment rules H.R. 2524, Medicare Better Health Rewards Program Act (Paulsen-Kind) - wellness incentives H.R. 2753, Securing Care for Seniors Act (Black) - MA payment and enrollment issues, wellness incentives H.R, 2960, Medicare Prescription Drug Integrity Act of 2013 (Pallone) - Part D drug utilization review H.R. 3512, Seniors' Health Care Choice Act (Heck) - MA open enrollment period H.R. 3890, Better Care, Lower Cost Act (Paulsen-Welch) - delivery models for Medicare beneficiaries with chronic conditions H.R. 4015, SGR Repeal and Medicare Provider Payment Modernization Act (Burgess) - SGR repeal, quality- and value-based payment reforms, ACA individual mandate delay H.R. 4160, Keep the Promise to Seniors Act (Ellmers) - blocking Medicare Part D proposed rule H.R. 4302, Protecting Access to Medicare Act (Pitts) - 12-month Medicare SGR patch, Medicare Advantage Special Needs Plans, Appropriate Use Criteria for Advanced Diagnostic Imaging, Medicare sequestration cuts, Other Medicare-Medicaid Extenders H.R. 4484, Strengthening Healthcare Options for Vulnerable Populations Act (Sinema) - MA special needs plans H.R. 4998, MA Participant Bill of Rights Act (DeLauro) - MA plan provider networks H.R. 5113, Protecting Seniors' Medicare Choices from Obamacare Act (Coffman) - MA stabilization program H.R. 5183, Value Based Insurance Design for Better Care Act (Black) - MA demonstration to test VBID methodologies H.R. 5364, CHIP Extension and Improvement Act (Pallone) - federal CHIP funding Draft Bill, Protecting the Integrity of Medicare Act (Brady) - preventing fraud in Medicare and Medicaid S. 11, Fiscal Sustainability Act (Corker) - Medicare, Medigap, Medicaid issues S. 25 (Hatch) - extension of Medicare sequestration cuts S. 117, Medicare Prescription Drug Price Negotiation Act (Klobuchar) - Medicare Part D price negotiations S. 324, Puerto Rico Medicare Part B Equity Act (Schumer) S. 408, Medicare Prescription Drug Savings and Choice Act (Durbin) - Medicare Part D changes S. 569, Improving Access to Medicare Coverage Act (Brown) - Medicare coverage of skilled nursing care S. 1123, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Carper-Coburn) - fighting fraud and abuse S. 1228, Medicare Better Health Rewards Program Act (Wyden-Portman) - wellness incentives S. 1787, Medicaid Managed Care Responsibility and Equity Act (Rockefeller) - medical loss ratio requirement for Medicaid managed care organizations S. 1871, SGR Repeal and Medicare Beneficiary Access Act (Senate Finance Committee) - SGR repeal, quality- and value-based payment reforms, MA Special Needs Plans, Cost Plans, QI and TMA programs S. 1932, Better Care, Lower Cost Act (Wyden-Isakson) - delivery models for Medicare beneficiaries with chronic conditions S. 1980, Medicaid and CHIP Continuous Quality Act (Rockefeller) - 12 month continuous enrollment S. 2000, SGR Repeal and Medicare Provider Payment Modernization Act (Senate Finance Committee) - SGR repeal, quality- and value-based payment reforms S. 2110, SGR Repeal and Medicare Provider Payment Modernization Act (Wyden) - SGR repeal, quality- and value-based payment reforms, Medicare and Medicaid extenders S. 2122, Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act (Hatch) - SGR repeal, quality- and value-based payment reforms, ACA individual mandate repeal S. 2361, Stop SCAMS Act (Nelson-Collins) - reducing Medicare fraud S. 2461, CHIP Extension Act (Rockefeller) --- federal CHIP funding S. 2552, MA Participant Bill of Rights Act (Brown-Blumenthal) - MA plan provider networks S. 2783, Value Based Insurance Design for Better Care Act (Thune) - MA demonstration to test VBID methodologies Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, encounter data and other data-related issues, and audit issues; bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, and audits); in-home health risk assessments; Medicare Medical Loss Ratio issues; implementation of sequestration under the Medicare Advantage and Part D programs; implications of the health insurer fee for MA and Part D plans; application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, SSA and CMS premium withhold processing issues, enrollment rules, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible Special Needs Plans (SNPs); Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, Part D coverage gap discount program, including employer group waiver plan (EGWP) issues, and other operational issues; issues raised by Part D coverage of new specialty drugs, the Part D non-interference policy and related issues (e.g., preferred pharmacy and any willing pharmacy requirements, standards for network pharmacy reimbursement, and policies regarding sponsor negotiation of pharmacy price concessions); Medication Therapy Management Program requirements; Part D requirements for offering basic and enhanced alternative plans; MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; issues relating to MA and Part D Star Rating system including measures, the methodology for calculating ratings, and the role of the ratings for payment purposes; implementation of the Affordable Care Act (ACA) changes to the Part D coverage gap; ongoing implementation issues for the Medicare cost plan program including enrollment, marketing materials review and approval and other operational issues; Medicare creditable drug coverage reporting requirements; implementation issues for the Medicare Retiree Drug Subsidy program; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education Program; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; Medicare clinical trials; Medicare/Medicaid integration for dual eligibles, including the Capitated Financial Alignment Demonstration; Medicaid managed care regulations and policies, including the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, fraud and abuse compliance, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including block grants, the calculation of the federal medical assistance (federal matching) percentage (FMAP), and intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost issues affecting Medicaid health plans including issues raised by Medicaid coverage of new specialty drugs; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues and CHIP reauthorization; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including Medicaid managed care organization provider tax issues; standards for electronic prescribing; implementation of Medicaid changes of interest to Medicaid health plans made in the ACA including Medicaid expansion, the managed care organization (MCO) prescription drug rebate provisions, minimum payments to primary care providers (PCPs), interactions between the Medicaid program and health insurance exchanges, and Medicaid and CHIP maintenance of effort (MOE) requirements; implications of the health insurer fee for Medicaid health plans ; issues related to Medigap coverage; issues relating to "meaningful use" requirements for health information technology; and other issues relating to health care reform implementation.
2014 · third_quarter · Medicare/Medicaid
H.R. 162, Medicaid Integrity Act (Bachmann) - Medicaid health plan audits. H.R. 670, Puerto Rico Medicare Part B Equity Act (Pierluisi). H.R. 928, Medicare Prescription Drug Savings and Choice Act (Schakowsky) - Medicare Part D changes. H.R. 1179, Improving Access to Medicare Coverage Act (Courtney) - Medicare coverage of skilled nursing care. H.R. 1102, Medicare Prescription Drug Price Negotiation Act (Welch) - Medicare Part D price negotiations. H.R. 1853, Medicaid Accountability and Care Act (Cassidy) -federal financing of state Medicaid programs. H.R. 2305, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Roskam-Carney) - fighting fraud and abuse. H.R. 2453, Medicare Beneficiary Preservation of Choice Act (Rothfus-Schrader) - MA enrollment rules. H.R. 2524, Medicare Better Health Rewards Program Act (Paulsen-Kind) - wellness incentives. H.R. 2753, Securing Care for Seniors Act (Black) - MA payment and enrollment issues, wellness incentives. H.R, 2960, Medicare Prescription Drug Integrity Act of 2013 (Pallone) - Part D drug utilization review. H.R. 3512, Seniors' Health Care Choice Act (Heck) - MA open enrollment period. H.R. 3890, Better Care, Lower Cost Act (Paulsen-Welch) - delivery models for Medicare beneficiaries with chronic conditions. H.R. 4015, SGR Repeal and Medicare Provider Payment Modernization Act (Burgess) - SGR repeal, quality- and value-based payment reforms, ACA individual mandate delay. H.R. 4160, Keep the Promise to Seniors Act (Ellmers) - blocking Medicare Part D proposed rule. H.R. 4302, Protecting Access to Medicare Act (Pitts) - 12-month Medicare SGR patch, Medicare Advantage Special Needs Plans, Appropriate Use Criteria for Advanced Diagnostic Imaging, Medicare sequestration cuts, Other Medicare-Medicaid Extenders. H.R. 4484, Strengthening Healthcare Options for Vulnerable Populations Act (Sinema) - MA special needs plans. H.R. 4998, MA Participant Bill of Rights Act (DeLauro) - MA plan provider networks. H.R. 5113, Protecting Seniors' Medicare Choices from Obamacare Act (Coffman) - MA stabilization program. H.R. 5183, Value Based Insurance Design for Better Care Act (Black) - MA demonstration to test VBID methodologies. H.R. 5364, CHIP Extension and Improvement Act (Pallone) - federal CHIP funding. Draft Bill, Protecting the Integrity of Medicare Act (Brady) - preventing fraud in Medicare and Medicaid. S. 11, Fiscal Sustainability Act (Corker) - Medicare, Medigap, Medicaid issues. S. 25 (Hatch) - extension of Medicare sequestration cuts. S. 117, Medicare Prescription Drug Price Negotiation Act (Klobuchar) - Medicare Part D price negotiations. S. 324, Puerto Rico Medicare Part B Equity Act (Schumer). S. 408, Medicare Prescription Drug Savings and Choice Act (Durbin) - Medicare Part D changes. S. 569, Improving Access to Medicare Coverage Act (Brown) - Medicare coverage of skilled nursing care. S. 1123, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Carper-Coburn) - fighting fraud and abuse. S. 1228, Medicare Better Health Rewards Program Act (Wyden-Portman) - wellness incentives. S. 1787, Medicaid Managed Care Responsibility and Equity Act (Rockefeller) - medical loss ratio requirement for Medicaid managed care organizations. S. 1871, SGR Repeal and Medicare Beneficiary Access Act (Senate Finance Committee) - SGR repeal, quality- and value-based payment reforms, MA Special Needs Plans, Cost Plans, QI and TMA programs. S. 1932, Better Care, Lower Cost Act (Wyden-Isakson) - delivery models for Medicare beneficiaries with chronic conditions. S. 1980, Medicaid and CHIP Continuous Quality Act (Rockefeller) - 12 month continuous enrollment. S. 2000, SGR Repeal and Medicare Provider Payment Modernization Act (Senate Finance Committee) - SGR repeal, quality- and value-based payment reforms. S. 2110, SGR Repeal and Medicare Provider Payment Modernization Act (Wyden) - SGR repeal, quality- and value-based payment reforms, Medicare and Medicaid extenders. S. 2122, Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act (Hatch) - SGR repeal, quality- and value-based payment reforms, ACA individual mandate repeal. S. 2361, Stop SCAMS Act (Nelson-Collins) - reducing Medicare fraud. S. 2461, CHIP Extension Act (Rockefeller) --- federal CHIP funding. S. 2552, MA Participant Bill of Rights Act (Brown-Blumenthal) - MA plan provider networks. S. 2783, Value Based Insurance Design for Better Care Act (Thune) - MA demonstration to test VBID methodologies.
2014 · second_quarter · Medicare/Medicaid
H.R. 162, Medicaid Integrity Act (Bachmann) Medicaid health plan audits16. Specific Lobbying Issues (continued): H.R. 670, Puerto Rico Medicare Part B Equity Act (Pierluisi) H.R. 928, Medicare Prescription Drug Savings and Choice Act (Schakowsky) Medicare Part D changes H.R. 1179, Improving Access to Medicare Coverage Act (Courtney) Medicare coverage of skilled nursing care H.R. 1102, Medicare Prescription Drug Price Negotiation Act (Welch) Medicare Part D price negotiations H.R. 1853, Medicaid Accountability and Care Act (Cassidy) federal financing of state Medicaid programs H.R. 2305, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Roskam-Carney) fighting fraud and abuse H.R. 2453, Medicare Beneficiary Preservation of Choice Act (Rothfus-Schrader) MA enrollment rules H.R. 2524, Medicare Better Health Rewards Program Act (Paulsen-Kind) wellness incentives H.R. 2753, Securing Care for Seniors Act (Black) MA payment and enrollment issues, wellness incentives H.R. 2810, Medicare Patient Access and Quality Improvement Act (Burgess/Camp) SGR repeal, quality- and value-based payment reforms H.R, 2960, Medicare Prescription Drug Integrity Act of 2013 (Pallone) Part D drug utilization review H.R. 3512, Seniors' Health Care Choice Act (Heck) MA open enrollment period H.R. 3890, Better Care, Lower Cost Act (Paulsen-Welch) delivery models for Medicare beneficiaries with chronic conditions H.R. 4015, SGR Repeal and Medicare Provider Payment Modernization Act (Burgess) SGR repeal, quality- and value-based payment reforms, ACA individual mandate delay H.R. 4160, Keep the Promise to Seniors Act (Ellmers) blocking Medicare Part D proposed rule H.R. 4302, Protecting Access to Medicare Act (Pitts) 12-month Medicare SGR patch, Medicare Advantage Special Needs Plans, Appropriate Use Criteria for Advanced Diagnostic Imaging, Medicare sequestration cuts, Other Medicare-Medicaid Extenders H.R. 4484, Strengthening Healthcare Options for Vulnerable Populations Act (Sinema) MA special needs plans H.R. 4998, MA Participant Bill of Rights Act (DeLauro) MA plan provider networks H.Con.Res. 96, Budget Resolution (Ryan) Medicare, Medigap, Medicaid, ACA issues S. 11, Fiscal Sustainability Act (Corker) Medicare, Medigap, Medicaid issues S. 25 (Hatch) extension of Medicare sequestration cuts S. 117, Medicare Prescription Drug Price Negotiation Act (Klobuchar) Medicare Part D price negotiations S. 324, Puerto Rico Medicare Part B Equity Act (Schumer) S. 408, Medicare Prescription Drug Savings and Choice Act (Durbin) Medicare Part D changes S. 569, Improving Access to Medicare Coverage Act (Brown) Medicare coverage of skilled nursing care S. 1123, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Carper-Coburn) fighting fraud and abuse S. 1228, Medicare Better Health Rewards Program Act (Wyden-Portman) wellness incentives S. 1787, Medicaid Managed Care Responsibility and Equity Act (Rockefeller) medical loss ratio requirement for Medicaid managed care organizations S. 1871, SGR Repeal and Medicare Beneficiary Access Act (Senate Finance Committee) SGR repeal, quality- and value-based payment reforms, MA Special Needs Plans, Cost Plans, QI and TMA programs S. 1932, Better Care, Lower Cost Act (Wyden-Isakson) delivery models for Medicare beneficiaries with chronic conditions S. 1980, Medicaid and CHIP Continuous Quality Act (Rockefeller) 12 month continuous enrollment S. 2000, SGR Repeal and Medicare Provider Payment Modernization Act (Senate Finance Committee) SGR repeal, quality- and value-based payment reforms S. 2110, SGR Repeal and Medicare Provider Payment Modernization Act (Wyden) SGR repeal, quality- and value-based payment reforms, Medicare and Medicaid extenders S. 2122, Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act (Hatch) SGR repeal, quality- and value-based payment reforms, ACA individual mandate repeal S. 2361, Stop SCAMS Act (Nelson-Collins) reducing Medicare fraud S. 2461, CHIP Extension Act (Rockefeller) --- CHIP reauthorization S. 2552, MA Participant Bill of Rights Act (Brown-Blumenthal) MA plan provider networks16. Specific Lobbying Issues (continued): Regulatory Issues: Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, encounter data and other data-related issues, and audit issues; bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, and audits); Medicare Medical Loss Ratio issues; implementation of sequestration under the Medicare Advantage and Part D programs; implications of the health insurer fee for MA and Part D plans; application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, SSA and CMS premium withhold processing issues, enrollment rules, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible Special Needs Plans (SNPs); Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, Part D coverage gap discount program, including employer group waiver plan (EGWP) issues, and other operational issues; issues raised by Part D coverage of new specialty drugs, the Part D non-interference policy and related issues (e.g., preferred pharmacy and any willing pharmacy requirements, standards for network pharmacy reimbursement, and policies regarding sponsor negotiation of pharmacy price concessions); Medication Therapy Management Program requirements; Part D requirements for offering basic and enhanced alternative plans; MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; issues relating to MA Star Rating system including measures, the methodology for calculating ratings, and the role of the ratings for payment purposes; implementation of the Affordable Care Act (ACA) changes to the Part D coverage gap; ongoing implementation issues for the Medicare cost plan program including enrollment, marketing materials review and approval and other operational issues; Medicare creditable drug coverage reporting requirements; implementation issues for the Medicare Retiree Drug Subsidy program; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education Program; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; Medicare clinical trials; Medicare/Medicaid integration for dual eligibles, including the Capitated Financial Alignment Demonstration; Medicaid managed care regulations and policies, including the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, fraud and abuse compliance, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including block grants, the calculation of the federal medical assistance (federal matching) percentage (FMAP), and intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost issues affecting Medicaid health plans including issues raised by Medicaid coverage of new specialty drugs; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues and CHIP reauthorization; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including Medicaid managed care organization provider tax issues; standards for electronic prescribing; implementation of Medicaid changes of interest to Medicaid health plans made in the ACA including Medicaid expansion, the managed care organization (MCO) prescription drug rebate provisions, minimum payments to primary care providers (PCPs), interactions between the Medicaid program and health insurance exchanges, and Medicaid and CHIP maintenance of effort (MOE) requirements; implications of the health insurer fee for Medicaid health plans ; issues related to Medigap coverage; issues relating to "meaningful use" requirements for health information technology; and other issues relating to health care reform implementation. 17. Houses of Congress and Federal Agencies (continued): Medicaid and CHIP Payment and Access Commission (MACPAC)
2014 · second_quarter · Insurance
Antitrust: -Issues related to the McCarran Ferguson antitrust exemption for insurers: impact to employer-provided benefits, and supplemental and voluntary benefits insurance industry -H.R.99 Health Insurance Industry Antitrust Enforcement Act 2013: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry ERISA: -Issues related to regulation of employee benefits under the Employee Retirement Income Security Act and legislation impacting ERISA plans -Clarification of permissibility of default enrollment arrangements for group income protection insurance under ERISA and /or the Fair Labor Standards Act Federal Debt Limit: -Debt Limit Increase: impact on employer-sponsored financial protection benefits industry -S.11 Fiscal Sustainability Act of 2013: impact on employer-sponsored financial protection benefits industry -American Taxpayer Relief Act of 2012, fiscal cliff: impact on employer-sponsored financial protection benefits industry -Terrorism Risk Insurance Act, specifically provisions related to the proposed National Association of Registered Agents and Brokers (NARAB) Financial Services Regulation: -Dodd-Frank Wall Street Reform and Consumer Protection Act implementation: impact on employer-sponsored financial protection benefits industry -Consumer Financial Protection Bureau Interim Final Rule of Records and Information: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Criteria and process for designating nonbank financial companies: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -FY 2014 budget proposals: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Terrorism Risk Insurance Act, specifically provisions related to the proposed National Association of Registered Agents and Brokers (NARAB) Health Care: -Implementation of the Patient Protection and Affordable Care Act, including HHS FAQ regarding fixed indemnity products and other provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Loss ratios: issues related to employer-provided benefits, and supplemental and voluntary benefits insurance industry -The Health Information Technology for Economic and Clinical Health Act (HITECH) Act: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Issues related to wellness programs Labor: -Labor issues impacting large employers, including worker classification and amendments to the Fair Labor Standards Act -S.534 National Association of Registered Agents and Brokers Reform Act of 2013: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -H.R.1155 National Association of Registered Agents and Brokers Reform Act of 2013: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry Long-term Care: -Issues related to public and private programs providing long-term care services and insurance, including LTC Commission and repeal of the CLASS Act Privacy: -Privacy and Data breach, cyber security, and SSN protection -H.R.749 - Eliminate Privacy Notice Confusion Act of 2013 -S.676 - Identity Theft and Tax Fraud Prevention Act of 2013 (Death Master File): impact on employer-sponsored financial protection benefits industry -H.R.466 - Social Security Death Master File Privacy Act of 2013: impact on employer-sponsored financial protection benefits industry -H.R. 624 - Cyber Intelligence Sharing and Protection Act of 2013 -H.R.1468 - SECURE IT Act of 2013 SSDI Reform: -H.R.1374 - Social Security Enhancement and Protection Act of 2013: impact on employer-sponsored financial protection benefits industry -Short-term Disability for Federal Workers Bill: impact on employer-sponsored financial protection benefits industry -Increasing employment for people with disabilities Tax Reform: -Corporate tax issues -Deficit reduction -Taxation of Employer Provided Benefits: impact to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Tax Extender Package -Taxation and entitlement reform issues related to the budget agreement reached in December, 2013: impact to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Chairman Dave Camps tax reform discussion draft
2014 · second_quarter · Insurance
Antitrust: -Issues related to the McCarran Ferguson antitrust exemption for insurers: impact to employer-provided benefits, and supplemental and voluntary benefits insurance industry -H.R.99 Health Insurance Industry Antitrust Enforcement Act 2013: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry ERISA: -Issues related to regulation of employee benefits under the Employee Retirement Income Security Act and legislation impacting ERISA plans -Clarification of permissibility of default enrollment arrangements for group income protection insurance under ERISA and /or the Fair Labor Standards Act Federal Debt Limit: -Debt Limit Increase: impact on employer-sponsored financial protection benefits industry -S.11 Fiscal Sustainability Act of 2013: impact on employer-sponsored financial protection benefits industry -American Taxpayer Relief Act of 2012, fiscal cliff: impact on employer-sponsored financial protection benefits industry -Terrorism Risk Insurance Act, specifically provisions related to the proposed National Association of Registered Agents and Brokers (NARAB) Financial Services Regulation: -Dodd-Frank Wall Street Reform and Consumer Protection Act implementation: impact on employer-sponsored financial protection benefits industry -Consumer Financial Protection Bureau Interim Final Rule of Records and Information: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Criteria and process for designating nonbank financial companies: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -FY 2014 budget proposals: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry Health Care: -Implementation of the Patient Protection and Affordable Care Act, including HHS FAQ regarding fixed indemnity products and other provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Loss ratios: issues related to employer-provided benefits, and supplemental and voluntary benefits insurance industry -The Health Information Technology for Economic and Clinical Health Act (HITECH) Act: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Issues related to wellness programs Labor: -Labor issues impacting large employers, including worker classification and amendments to the Fair Labor Standards Act -S.534 National Association of Registered Agents and Brokers Reform Act of 2013: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -H.R.1155 National Association of Registered Agents and Brokers Reform Act of 2013: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry Long-term Care: -Issues related to public and private programs providing long-term care services and insurance, including LTC Commission and repeal of the CLASS Act Privacy: -Privacy and Data breach, cyber security, and SSN protection -H.R.749 - Eliminate Privacy Notice Confusion Act of 2013 -S.676 - Identity Theft and Tax Fraud Prevention Act of 2013 (Death Master File): impact on employer-sponsored financial protection benefits industry -H.R.466 - Social Security Death Master File Privacy Act of 2013: impact on employer-sponsored financial protection benefits industry -H.R. 624 - Cyber Intelligence Sharing and Protection Act of 2013 -H.R.1468 - SECURE IT Act of 2013 SSDI Reform: -H.R.1374 - Social Security Enhancement and Protection Act of 2013: impact on employer-sponsored financial protection benefits industry -Short-term Disability for Federal Workers Bill: impact on employer-sponsored financial protection benefits industry -Increasing employment for people with disabilities Tax Reform: -Corporate tax issues -Deficit reduction -Taxation of Employer Provided Benefits: impact to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Tax Extender Package -Taxation and entitlement reform issues related to the budget agreement reached in December, 2013: impact to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Chairman Dave Camps tax reform discussion draft
2014 · second_quarter · Insurance
Antitrust: -Issues related to the McCarran Ferguson antitrust exemption for insurers: impact to employer-provided benefits, and supplemental and voluntary benefits insurance industry -H.R.99 Health Insurance Industry Antitrust Enforcement Act 2013: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry ERISA: -Issues related to regulation of employee benefits under the Employee Retirement Income Security Act and legislation impacting ERISA plans -Clarification of permissibility of default enrollment arrangements for group income protection insurance under ERISA and /or the Fair Labor Standards Act Federal Debt Limit: -Debt Limit Increase: impact on employer-sponsored financial protection benefits industry -S.11 Fiscal Sustainability Act of 2013: impact on employer-sponsored financial protection benefits industry -American Taxpayer Relief Act of 2012, fiscal cliff: impact on employer-sponsored financial protection benefits industry -Terrorism Risk Insurance Act, specifically provisions related to the proposed National Association of Registered Agents and Brokers (NARAB) Financial Services Regulation: -Dodd-Frank Wall Street Reform and Consumer Protection Act implementation: impact on employer-sponsored financial protection benefits industry -Consumer Financial Protection Bureau Interim Final Rule of Records and Information: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Criteria and process for designating nonbank financial companies: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -FY 2014 budget proposals: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry Health Care: -Implementation of the Patient Protection and Affordable Care Act, including HHS FAQ regarding fixed indemnity products and other provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Loss ratios: issues related to employer-provided benefits, and supplemental and voluntary benefits insurance industry -The Health Information Technology for Economic and Clinical Health Act (HITECH) Act: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Issues related to wellness programs Labor: -Labor issues impacting large employers, including worker classification and amendments to the Fair Labor Standards Act -S.534 National Association of Registered Agents and Brokers Reform Act of 2013: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -H.R.1155 National Association of Registered Agents and Brokers Reform Act of 2013: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry Long-term Care: -Issues related to public and private programs providing long-term care services and insurance, including LTC Commission and repeal of the CLASS Act
2014 · second_quarter · Medicare/Medicaid
H.R. 162, Medicaid Integrity Act (Bachmann) - Medicaid health plan audits. H.R. 670, Puerto Rico Medicare Part B Equity Act (Pierluisi). H.R. 928, Medicare Prescription Drug Savings and Choice Act (Schakowsky) - Medicare Part D changes. H.R. 1179, Improving Access to Medicare Coverage Act (Courtney) - Medicare coverage of skilled nursing care. H.R. 1102, Medicare Prescription Drug Price Negotiation Act (Welch) - Medicare Part D price negotiations. H.R. 1853, Medicaid Accountability and Care Act (Cassidy) -federal financing of state Medicaid programs. H.R. 2305, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Roskam-Carney) - fighting fraud and abuse. H.R. 2453, Medicare Beneficiary Preservation of Choice Act (Rothfus-Schrader) - MA enrollment rules. H.R. 2524, Medicare Better Health Rewards Program Act (Paulsen-Kind) - wellness incentives. H.R. 2753, Securing Care for Seniors Act (Black) - MA payment and enrollment issues, wellness incentives. H.R. 2810, Medicare Patient Access and Quality Improvement Act (Burgess/Camp) - SGR repeal, quality- and value-based payment reforms. H.R, 2960, Medicare Prescription Drug Integrity Act of 2013 (Pallone) - Part D drug utilization review. H.R. 3512, Seniors' Health Care Choice Act (Heck) - MA open enrollment period. H.R. 3890, Better Care, Lower Cost Act (Paulsen-Welch) - delivery models for Medicare beneficiaries with chronic conditions. H.R. 4015, SGR Repeal and Medicare Provider Payment Modernization Act (Burgess) - SGR repeal, quality- and value-based payment reforms, ACA individual mandate delay H.R. 4160, Keep the Promise to Seniors Act (Ellmers) - blocking Medicare Part D proposed rule. H.R. 4302, Protecting Access to Medicare Act (Pitts) - 12-month Medicare SGR patch, Medicare Advantage Special Needs Plans, Appropriate Use Criteria for Advanced Diagnostic Imaging, Medicare sequestration cuts, Other Medicare-Medicaid Extenders." H.R. 4484, Strengthening Healthcare Options for Vulnerable Populations Act (Sinema) - MA special needs plans. H.R. 4998, MA Participant Bill of Rights Act (DeLauro) - MA plan provider networks. H.Con.Res. 96, Budget Resolution (Ryan) - Medicare, Medigap, Medicaid, ACA issues. S. 11, Fiscal Sustainability Act (Corker) - Medicare, Medigap, Medicaid issues. S. 25 (Hatch) - extension of Medicare sequestration cuts. S. 117, Medicare Prescription Drug Price Negotiation Act (Klobuchar) - Medicare Part D price negotiations. S. 324, Puerto Rico Medicare Part B Equity Act (Schumer) S. 408, Medicare Prescription Drug Savings and Choice Act (Durbin) - Medicare Part D changes. S. 569, Improving Access to Medicare Coverage Act (Brown) - Medicare coverage of skilled nursing care. S. 1123, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Carper-Coburn) - fighting fraud and abuse. S. 1228, Medicare Better Health Rewards Program Act (Wyden-Portman) - wellness incentives. S. 1787, Medicaid Managed Care Responsibility and Equity Act (Rockefeller) - medical loss ratio requirement for Medicaid managed care organizations. S. 1871, SGR Repeal and Medicare Beneficiary Access Act (Senate Finance Committee) - SGR repeal, quality- and value-based payment reforms, MA Special Needs Plans, Cost Plans, QI and TMA programs. S. 1932, Better Care, Lower Cost Act (Wyden-Isakson) - delivery models for Medicare beneficiaries with chronic conditions. S. 1980, Medicaid and CHIP Continuous Quality Act (Rockefeller) - 12 month continuous enrollment. S. 2000, SGR Repeal and Medicare Provider Payment Modernization Act (Senate Finance Committee) - SGR repeal, quality- and value-based payment reforms. S. 2110, SGR Repeal and Medicare Provider Payment Modernization Act (Wyden) - SGR repeal, quality- and value-based payment reforms, Medicare and Medicaid extenders." S. 2122, Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act (Hatch) - SGR repeal, quality- and value-based payment reforms, ACA individual mandate repeal. S. 2361, Stop SCAMS Act (Nelson-Collins) - reducing Medicare fraud S. 2461, CHIP Extension Act (Rockefeller) --- CHIP reauthorization. S. 2552, MA Participant Bill of Rights Act (Brown-Blumenthal) - MA plan provider networks.
2014 · first_quarter · Insurance
Antitrust: -Issues related to the McCarran Ferguson antitrust exemption for insurers: impact to employer-provided benefits, and supplemental and voluntary benefits insurance industryAntitrust (continued): -H.R.99 Health Insurance Industry Antitrust Enforcement Act 2013: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry ERISA: -Issues related to regulation of employee benefits under the Employee Retirement Income Security Act and legislation impacting ERISA plans -Clarification of permissibility of default enrollment arrangements for group income protection insurance under ERISA and /or the Fair Labor Standards Act Federal Debt Limit: -Debt Limit Increase: impact on employer-sponsored financial protection benefits industry -S.11 Fiscal Sustainability Act of 2013: impact on employer-sponsored financial protection benefits industry -American Taxpayer Relief Act of 2012, fiscal cliff: impact on employer-sponsored financial protection benefits industry Financial Regulation: -DoddFrank Wall Street Reform and Consumer Protection Act implementation: impact on employer-sponsored financial protection benefits industry -Consumer Financial Protection Bureau Interim Final Rule of Records and Information: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Criteria and process for designating nonbank financial companies: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -FY 2014 budget proposals: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry Health Care: -Implementation of the Patient Protection and Affordable Care Act, including HHS FAQ regarding fixed indemnity products and other provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Loss ratios: issues related to employer-provided benefits, and supplemental and voluntary benefits insurance industry -The Health Information Technology for Economic and Clinical Health Act (HITECH) Act: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Issues related to wellness programs Labor: -Labor issues impacting large employers, including worker classification and amendments to the Fair Labor Standards Act -S.534 National Association of Registered Agents and Brokers Reform Act of 2013: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -H.R.1155 National Association of Registered Agents and Brokers Reform Act of 2013: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry Long-term Care: -Issues related to public and private programs providing long-term care services and insurance, including LTC Commission and repeal of the CLASS ActPrivacy: -Privacy and Data breach, cyber security, and SSN protection -H.R.749 - Eliminate Privacy Notice Confusion Act of 2013 -S.676 Identity Theft and Tax Fraud Prevention Act of 2013 (Death Master File): impact on employer-sponsored financial protection benefits industry -H.R.466 Social Security Death Master File Privacy Act of 2013: impact on employer-sponsored financial protection benefits industry -H.R. 624 Cyber Intelligence Sharing and Protection Act of 2013 -H.R.1468 SECURE IT Act of 2013 SSDI Reform: -H.R.1374 - Social Security Enhancement and Protection Act of 2013: impact on employer-sponsored financial protection benefits industry -Short-term Disability for Federal Workers Bill: impact on employer-sponsored financial protection benefits industry -Increasing employment for people with disabilities Tax Reform: -Corporate tax issues -Deficit reduction -Taxation of Employer Provided Benefits: impact to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Tax Extender Package -Taxation and entitlement reform issues related to the budget agreement reached in December, 2013: impact to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Chairman Dave Camps tax reform discussion draft
2014 · first_quarter · Medicare/Medicaid
H.R. 162, Medicaid Integrity Act (Bachmann) Medicaid health plan audits16. Specific Lobbying Issues (continued): H.R. 670, Puerto Rico Medicare Part B Equity Act (Pierluisi) H.R. 928, Medicare Prescription Drug Savings and Choice Act (Schakowsky) Medicare Part D changes H.R. 1179, Improving Access to Medicare Coverage Act (Courtney) Medicare coverage of skilled nursing care H.R. 1102, Medicare Prescription Drug Price Negotiation Act (Welch) Medicare Part D price negotiations H.R. 1853, Medicaid Accountability and Care Act (Cassidy) federal financing of state Medicaid programs H.R. 2305, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Roskam-Carney) fighting fraud and abuse H.R. 2453, Medicare Beneficiary Preservation of Choice Act (Rothfus-Schrader) MA enrollment rules H.R. 2524, Medicare Better Health Rewards Program Act (Paulsen-Kind) wellness incentives H.R. 2753, Securing Care for Seniors Act (Black) MA payment and enrollment issues, wellness incentives H.R. 2810, Medicare Patient Access and Quality Improvement Act (Burgess/Camp) SGR repeal, quality- and value- based payment reforms H.R, 2960, Medicare Prescription Drug Integrity Act of 2013 (Pallone) Part D drug utilization review H.R. 3512, Seniors' Health Care Choice Act (Heck) MA open enrollment period H.R. 3890, Better Care, Lower Cost Act (Paulsen-Welch) delivery models for Medicare beneficiaries with chronic conditions H.R. 4015, SGR Repeal and Medicare Provider Payment Modernization Act (Burgess) SGR repeal, quality- and value-based payment reforms, ACA individual mandate delay H.R. 4160, Keep the Promise to Seniors Act (Ellmers) blocking Medicare Part D proposed rule H.R. 4302, Protecting Access to Medicare Act (Pitts) 12-month Medicare SGR patch, Medicare Advantage Special Needs Plans, Appropriate Use Criteria for Advanced Diagnostic Imaging, Medicare sequestration cuts, Other Medicare-Medicaid Extenders H.J.Res. 59, Bipartisan Budget Act (Rogers) MA Special Needs Plans, Cost Plans, Medicare physician payment, QI and TMA programs S. 11, Fiscal Sustainability Act (Corker) Medicare, Medigap, Medicaid issues S. 25 (Hatch) extension of Medicare sequestration cuts S. 117, Medicare Prescription Drug Price Negotiation Act (Klobuchar) Medicare Part D price negotiations S. 324, Puerto Rico Medicare Part B Equity Act (Schumer) S. 408, Medicare Prescription Drug Savings and Choice Act (Durbin) Medicare Part D changes S. 569, Improving Access to Medicare Coverage Act (Brown) Medicare coverage of skilled nursing care S. 1123, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Carper-Coburn) fighting fraud and abuse S. 1228, Medicare Better Health Rewards Program Act (Wyden-Portman) wellness incentives S. 1787, Medicaid Managed Care Responsibility and Equity Act (Rockefeller) medical loss ratio requirement for Medicaid managed care organizations S. 1871, SGR Repeal and Medicare Beneficiary Access Act (Baucus) SGR repeal, quality- and value-based payment reforms, MA Special Needs Plans, Cost Plans, QI and TMA programs S. 1932, Better Care, Lower Cost Act (Wyden-Isakson) delivery models for Medicare beneficiaries with chronic conditions S. 1980, Medicaid and CHIP Continuous Quality Act (Rockefeller) 12 month continuous enrollment S. 2000, SGR Repeal and Medicare Provider Payment Modernization Act (Baucus) SGR repeal, quality- and value-based payment reforms S. 2110, SGR Repeal and Medicare Provider Payment Modernization Act (Wyden) SGR repeal, quality- and value-based payment reforms, Medicare and Medicaid extenders S. 2122, Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act (Hatch) SGR repeal, quality- and value-based payment reforms, ACA individual mandate repeal U.S. Senate Special Committee on Aging Draft of Stop SCAMS Act (not yet introduced) - anti-fraud activities, including coding, Healthcare Fraud Prevention Partnership, and MEDPAC report16. Regulatory Issues (continued): Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, encounter data and other data-related issues, and audit issues; bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, and audits); Medicare Medical Loss Ratio issues; implementation of sequestration under the Medicare Advantage and Part D programs; implications of the health insurer fee for MA and Part D plans; application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, SSA and CMS premium withhold processing issues, enrollment rules, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible Special Needs Plans (SNPs); Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, Part D coverage gap discount program, including employer group waiver plan (EGWP) issues, and other operational issues; issues raised by Part D coverage of new specialty drugs, the Part D non-interference policy and related issues (e.g., preferred pharmacy and any willing pharmacy requirements, standards for network pharmacy reimbursement, and policies regarding sponsor negotiation of pharmacy price concessions); Medication Therapy Management Program requirements; Part D requirements for offering basic and enhanced alternative plans; MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; issues relating to MA Star Rating system including measures, the methodology for calculating ratings, and the role of the ratings for payment purposes; implementation of the Affordable Care Act (ACA) changes to the Part D coverage gap; ongoing implementation issues for the Medicare cost plan program including enrollment, marketing materials review and approval and other operational issues; Medicare creditable drug coverage reporting requirements; implementation issues for the Medicare Retiree Drug Subsidy program; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education Program; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; Medicare clinical trials; Medicare/Medicaid integration for dual eligibles, including the Capitated Financial Alignment Demonstration; Medicaid managed care regulations and policies, including the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, fraud and abuse compliance, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including block grants, the calculation of the federal medical assistance (federal matching) percentage (FMAP), and intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost issues affecting Medicaid health plans; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including Medicaid managed care organization provider tax issues; standards for electronic prescribing; implementation of Medicaid changes of interest to Medicaid health plans made in the ACA including Medicaid expansion, the managed care organization (MCO) prescription drug rebate provisions, minimum payments to primary care providers (PCPs), interactions between the Medicaid program and health insurance exchanges, and Medicaid and CHIP maintenance of effort (MOE) requirements; implications of the health insurer fee for Medicaid health plans ; issues related to Medigap coverage; issues relating to "meaningful use" requirements for health information technology; and other issues relating to health care reform implementation. 17. Houses of Congress and Federal Agencies (continued): Medicaid and CHIP Payment and Access Commission (MACPAC) 18. Name of Lobbyists (con't): C. Lawrence: Assistant, Legislative Director for Rep. Bill Cassidy (LA-6); May 2008-July 200: Staff Assistant, Legislative Correspondent for Rep. Tom Price (GA-6)
2014 · first_quarter · Medicare/Medicaid
H.R. 162, Medicaid Integrity Act (Bachmann) - Medicaid health plan audits; H.R. 670, Puerto Rico Medicare Part B Equity Act (Pierluisi); H.R. 928, Medicare Prescription Drug Savings and Choice Act (Schakowsky) - Medicare Part D changes; H.R. 1179, Improving Access to Medicare Coverage Act (Courtney) - Medicare coverage of skilled nursing care; H.R. 1102, Medicare Prescription Drug Price Negotiation Act (Welch) - Medicare Part D price negotiations; H.R. 1853, Medicaid Accountability and Care Act (Cassidy) -federal financing of state Medicaid programs; H.R. 2305, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Roskam-Carney) - fighting fraud and abuse; H.R. 2453, Medicare Beneficiary Preservation of Choice Act (Rothfus-Schrader) - MA enrollment rules; H.R. 2524, Medicare Better Health Rewards Program Act (Paulsen-Kind) - wellness incentives; H.R. 2753, Securing Care for Seniors Act (Black) - MA payment and enrollment issues, wellness incentives; H.R. 2810, Medicare Patient Access and Quality Improvement Act (Burgess/Camp) - SGR repeal, quality- and value-based payment reforms; H.R, 2960, Medicare Prescription Drug Integrity Act of 2013 (Pallone) - Part D drug utilization review; H.R. 3512, Seniors' Health Care Choice Act (Heck) - MA open enrollment period; H.R. 3890, Better Care, Lower Cost Act (Paulsen-Welch) - delivery models for Medicare beneficiaries with chronic conditions; H.R. 4015, SGR Repeal and Medicare Provider Payment Modernization Act (Burgess) - SGR repeal, quality- and value-based payment reforms, ACA individual mandate delay; H.R. 4160, Keep the Promise to Seniors Act (Ellmers) - blocking Medicare Part D proposed rule; H.R. 4302, Protecting Access to Medicare Act (Pitts) - 12-month Medicare SGR patch, Medicare Advantage Special Needs Plans, Appropriate Use Criteria for Advanced Diagnostic Imaging, Medicare sequestration cuts, Other Medicare-Medicaid Extenders; H.J.Res. 59, Bipartisan Budget Act (Rogers) - MA Special Needs Plans, Cost Plans, Medicare physician payment, QI and TMA programs; S. 11, Fiscal Sustainability Act (Corker) - Medicare, Medigap, Medicaid issues; S. 25 (Hatch) - extension of Medicare sequestration cuts; S. 117, Medicare Prescription Drug Price Negotiation Act (Klobuchar) - Medicare Part D price negotiations; S. 324, Puerto Rico Medicare Part B Equity Act (Schumer); S. 408, Medicare Prescription Drug Savings and Choice Act (Durbin) - Medicare Part D changes; S. 569, Improving Access to Medicare Coverage Act (Brown) - Medicare coverage of skilled nursing care; S. 1123, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Carper-Coburn) - fighting fraud and abuse; S. 1228, Medicare Better Health Rewards Program Act (Wyden-Portman) - wellness incentives; S. 1787, Medicaid Managed Care Responsibility and Equity Act (Rockefeller) - medical loss ratio requirement for Medicaid managed care organizations; S. 1871, SGR Repeal and Medicare Beneficiary Access Act (Baucus) - SGR repeal, quality- and value-based payment reforms, MA Special Needs Plans, Cost Plans, QI and TMA programs; S. 1932, Better Care, Lower Cost Act (Wyden-Isakson) - delivery models for Medicare beneficiaries with chronic conditions; S. 1980, Medicaid and CHIP Continuous Quality Act (Rockefeller) - 12 month continuous enrollment; S. 2000, SGR Repeal and Medicare Provider Payment Modernization Act (Baucus) - SGR repeal, quality- and value-based payment reform; S. 2110, SGR Repeal and Medicare Provider Payment Modernization Act (Wyden) - SGR repeal, quality- and value-based payment reforms, Medicare and Medicaid extenders; S. 2122, Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act (Hatch) - SGR repeal, quality- and value-based payment reforms, ACA individual mandate repeal.
2013 · fourth_quarter · Medicare/Medicaid
H.Con.Res. 25, House Budget Resolution (Ryan) public program issues, deficit reduction proposals16. Specific Lobbying Issues (continued): S.Con.Res. 8, Senate Budget Resolution (Murray) public program issues, deficit reduction proposals H.R. 162, Medicaid Integrity Act (Bachmann) Medicaid health plan audits H.R. 670, Puerto Rico Medicare Part B Equity Act (Pierluisi) H.R. 928, Medicare Prescription Drug Savings and Choice Act (Schakowsky) Medicare Part D changes H.R. 1179, Improving Access to Medicare Coverage Act (Courtney) Medicare coverage of skilled nursing care H.R. 1102, Medicare Prescription Drug Price Negotiation Act (Welch) Medicare Part D price negotiations H.R. 1853, Medicaid Accountability and Care Act (Cassidy) federal financing of state Medicaid programs H.R. 2305, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Roskam-Carney) fighting fraud and abuse H.R. 2453, Medicare Beneficiary Preservation of Choice Act (Rothfus-Schrader) MA enrollment rules H.R. 2524, Medicare Better Health Rewards Program Act (Paulsen-Kind) wellness incentives H.R. 2753, Securing Care for Seniors Act (Black) MA payment and enrollment issues, wellness incentives H.R. 2810, Medicare Patient Access and Quality Improvement Act (Burgess/Camp) SGR repeal, quality- and value-based payment reforms H.R, 2960, Medicare Prescription Drug Integrity Act of 2013 (Pallone) Part D drug utilization review H.R. 3512, Seniors' Health Care Choice Act (Heck) MA open enrollment period H.J.Res. 59, Bipartisan Budget Act (Rogers) MA Special Needs Plans, Cost Plans, Medicare physician payment, QI and TMA programs S. 11, Fiscal Sustainability Act (Corker) Medicare, Medigap, Medicaid issues S. 117, Medicare Prescription Drug Price Negotiation Act (Klobuchar) Medicare Part D price negotiations S. 324, Puerto Rico Medicare Part B Equity Act (Schumer) S. 408, Medicare Prescription Drug Savings and Choice Act (Durbin) Medicare Part D changes S. 569, Improving Access to Medicare Coverage Act (Brown) Medicare coverage of skilled nursing care S. 1123, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Carper-Coburn) fighting fraud and abuse S. 1228, Medicare Better Health Rewards Program Act (Wyden-Portman) wellness incentives S. 1787, Medicaid Managed Care Responsibility and Equity Act (Rockefeller) medical loss ratio requirement for Medicaid managed care organizations S. 1871, SGR Repeal and Medicare Beneficiary Access Act (Baucus) SGR repeal, quality- and value-based payment reforms, MA Special Needs Plans, Cost Plans, QI and TMA programs Regulatory Issues: Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, encounter data and other data-related issues, and audit issues; bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, and audits); Medicare Medical Loss Ratio issues; implementation of sequestration under the Medicare Advantage and Part D programs; implications of the health insurer fee for MA and Part D plans; application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, SSA and CMS premium withhold processing issues, enrollment rules, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible Special Needs Plans (SNPs); Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, Part D coverage gap discount program, including employer group waiver plan (EGWP) issues, and other operational issues; MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; issues relating to MA Star Rating system including measures, the methodology for calculating ratings, and the role of the ratings for payment purposes; implementation of the Affordable Care Act (ACA) changes to the Part D coverage gap; ongoing implementation issues for the Medicare cost plan program including enrollment, marketing materials review and approval and other operational issues; Medicare creditable drug coverage reporting requirements; implementation issues for the Medicare Retiree Drug Subsidy program; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education Program; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative;Regulatory Issues (con't): issues relating to Medicare coverage policy and national coverage decisions; Medicare clinical trials; Medicare/Medicaid integration for dual eligibles, including the Capitated Financial Alignment Demonstration; Medicaid managed care regulations and policies, including the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, fraud and abuse compliance, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including block grants, the calculation of the federal medical assistance (federal matching) percentage (FMAP), and intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost issues affecting Medicaid health plans; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including Medicaid managed care organization provider tax issues; standards for electronic prescribing; implementation of Medicaid changes of interest to Medicaid health plans made in the ACA including Medicaid expansion, the managed care organization (MCO) prescription drug rebate provisions, minimum payments to primary care providers (PCPs), interactions between the Medicaid program and health insurance exchanges, and Medicaid and CHIP maintenance of effort (MOE) requirements; implications of the health insurer fee for Medicaid health plans ; issues related to Medigap coverage; issues relating to "meaningful use" requirements for health information technology; and other issues relating to health care reform implementation. 17. Houses of Congress and Federal Agencies (con't): Medicaid and CHIP Payment and Access Commission (MACPAC)
2013 · fourth_quarter · Insurance
Antitrust: -Issues related to the McCarran Ferguson antitrust exemption for insurers: impact to employer-provided benefits, and supplemental and voluntary benefits insurance industryAntitrust (continued): -H.R.99 Health Insurance Industry Antitrust Enforcement Act 2013: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry ERISA: -Issues related to regulation of employee benefits under the Employee Retirement Income Security Act and legislation impacting ERISA plans Federal Debt Limit: -Debt Limit Increase: impact on employer-sponsored financial protection benefits industry -S.11 Fiscal Sustainability Act of 2013: impact on employer-sponsored financial protection benefits industry -American Taxpayer Relief Act of 2012, fiscal cliff: impact on employer-sponsored financial protection benefits industry Financial Regulation: -DoddFrank Wall Street Reform and Consumer Protection Act implementation: impact on employer-sponsored financial protection benefits industry -Consumer Financial Protection Bureau Interim Final Rule of Records and Information: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Criteria and process for designating nonbank financial companies: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -FY 2014 budget proposals: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry Health Care: -Implementation of the Patient Protection and Affordable Care Act, including HHS FAQ regarding fixed indemnity products and other provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Loss ratios: issues related to employer-provided benefits, and supplemental and voluntary benefits insurance industry -The Health Information Technology for Economic and Clinical Health Act (HITECH) Act: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Issues related to wellness programs Labor: -Labor issues impacting large employers, including worker classification and amendments to the Fair Labor Standards Act -S.534 National Association of Registered Agents and Brokers Reform Act of 2013: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry -H.R.1155 National Association of Registered Agents and Brokers Reform Act of 2013: provisions relating to employer-provided benefits, and supplemental and voluntary benefits insurance industry Long-term Care: -Issues related to public and private programs providing long-term care services and insurance, including LTC Commission and repeal of the CLASS ActPrivacy: -Privacy and Data breach, cyber security, and SSN protection -H.R.749 - Eliminate Privacy Notice Confusion Act of 2013 -S.676 Identity Theft and Tax Fraud Prevention Act of 2013 (Death Master File): impact on employer-sponsored financial protection benefits industry -H.R.466 Social Security Death Master File Privacy Act of 2013: impact on employer-sponsored financial protection benefits industry -H.R. 624 Cyber Intelligence Sharing and Protection Act of 2013 -H.R.1468 SECURE IT Act of 2013 SSDI Reform: -H.R.1374 - Social Security Enhancement and Protection Act of 2013: impact on employer-sponsored financial protection benefits industry -Short-term Disability for Federal Workers Bill: impact on employer-sponsored financial protection benefits industry -Increasing employment for people with disabilities Tax Reform: -Corporate tax issues -Deficit reduction -Taxation of Employer Provided Benefits: impact to employer-provided benefits, and supplemental and voluntary benefits insurance industry -Tax Extender Package -Taxation and entitlement reform issues related to the budget agreement reached in December, 2013: impact to employer-provided benefits, and supplemental and voluntary benefits insurance industry
2013 · fourth_quarter · Medicare/Medicaid
H.Con.Res. 25, House Budget Resolution (Ryan) - public program issues, deficit reduction proposals. S.Con.Res. 8, Senate Budget Resolution (Murray) - public program issues, deficit reduction proposals. H.R. 162, Medicaid Integrity Act (Bachmann) - Medicaid health plan audits. H.R. 670, Puerto Rico Medicare Part B Equity Act (Pierluisi). H.R. 928, Medicare Prescription Drug Savings and Choice Act (Schakowsky) - Medicare Part D changes. H.R. 1179, Improving Access to Medicare Coverage Act (Courtney) - Medicare coverage of skilled nursing care. H.R. 1102, Medicare Prescription Drug Price Negotiation Act (Welch) - Medicare Part D price negotiations. H.R. 1853, Medicaid Accountability and Care Act (Cassidy) -federal financing of state Medicaid programs. H.R. 2305, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Roskam-Carney) - fighting fraud and abuse. H.R. 2453, Medicare Beneficiary Preservation of Choice Act (Rothfus-Schrader) - MA enrollment rules. H.R. 2524, Medicare Better Health Rewards Program Act (Paulsen-Kind) - wellness incentives. H.R. 2753, Securing Care for Seniors Act (Black) - MA payment and enrollment issues, wellness incentives. H.R. 2810, Medicare Patient Access and Quality Improvement Act (Burgess/Camp) - SGR repeal, quality- and value-based payment reforms. H.R, 2960, Medicare Prescription Drug Integrity Act of 2013 (Pallone) - Part D drug utilization review. H.R. 3512, Seniors' Health Care Choice Act (Heck) - MA open enrollment period. H.J.Res. 59, Bipartisan Budget Act (Rogers) - MA Special Needs Plans, Cost Plans, Medicare physician payment, QI and TMA programs. S. 11, Fiscal Sustainability Act (Corker) - Medicare, Medigap, Medicaid issues. S. 117, Medicare Prescription Drug Price Negotiation Act (Klobuchar) - Medicare Part D price negotiations. S. 324, Puerto Rico Medicare Part B Equity Act (Schumer). S. 408, Medicare Prescription Drug Savings and Choice Act (Durbin) - Medicare Part D changes. S. 569, Improving Access to Medicare Coverage Act (Brown) - Medicare coverage of skilled nursing care. S. 1123, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Carper-Coburn) - fighting fraud and abuse. S. 1228, Medicare Better Health Rewards Program Act (Wyden-Portman) - wellness incentives. S. 1787, Medicaid Managed Care Responsibility and Equity Act (Rockefeller) - medical loss ratio requirement for Medicaid managed care organizations. S. 1871, SGR Repeal and Medicare Beneficiary Access Act (Baucus) - SGR repeal, quality- and value-based payment reforms, MA Special Needs Plans, Cost Plans, QI and TMA programs.
2013 · third_quarter · Medicare/Medicaid
H.R. 162, Medicaid Integrity Act (Bachmann) - Medicaid health plan audits. H.R. 670, Puerto Rico Medicare Part B Equity Act (Pierluisi). H.R. 928, Medicare Prescription Drug Savings and Choice Act (Schakowsky) - Medicare Part D changes. H.R. 1179, Improving Access to Medicare Coverage Act (Courtney) - Medicare coverage of skilled nursing care. H.R. 1102, Medicare Prescription Drug Price Negotiation Act (Welch) - Medicare Part D price negotiations. H.R. 1853, Medicaid Accountability and Care Act (Cassidy) -federal financing of state Medicaid programs. H.R. 2305, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Roskam-Carney) - fighting fraud and abuse. H.R. 2453, Medicare Beneficiary Preservation of Choice Act (Rothfus-Schrader) - MA enrollment rules. H.R. 2524, Medicare Better Health Rewards Program Act (Paulsen-Kind) - wellness incentives. H.R. 2753, Securing Care for Seniors Act (Black) - MA payment and enrollment issues, wellness incentives. H.R. 2810, Medicare Patient Access and Quality Improvement Act (Burgess) - SGR repeal, quality- and value-based payment reforms. House Ways and Means Committee Discussion Draft of Medicare Physician Payment Reform (not yet introduced) - SGR repeal, quality- and value-based payment reforms. House Ways and Means Committee Draft Medicare Reforms. S. 11, Fiscal Sustainability Act (Corker) - Medicare, Medigap, Medicaid issues. S. 117, Medicare Prescription Drug Price Negotiation Act (Klobuchar) - Medicare Part D price negotiations. S. 324, Puerto Rico Medicare Part B Equity Act (Schumer). S. 408, Medicare Prescription Drug Savings and Choice Act (Durbin) - Medicare Part D changes. S. 569, Improving Access to Medicare Coverage Act (Brown) - Medicare coverage of skilled nursing care. S. 1123, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Carper-Coburn) - fighting fraud and abuse. S. 1228, Medicare Better Health Rewards Program Act (Wyden-Portman) - wellness incentives. Senate Finance Committee Discussion Draft of Medicare Physician Payment Reform (not yet introduced) - SGR repeal, quality- and value-based payment reforms. H.R, 2960, Medicare Prescription Drug Integrity Act of 2013 (Pallone) - Part D drug utilization review.
2013 · third_quarter · Insurance
Antitrust Issues related to the McCarran Ferguson antitrust exemption for insurers: H.R.99 - Health Insurance Industry Antitrust Enforcement Act 2013: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry.ERISA: Issues related to regulation of employee benefits under the Employee Retirement Income Security Act and legislation impacting ERISA plans. Federal Debt Limit: Debt Limit Increase: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; S.11 - Fiscal Sustainability Act of 2013: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; American Taxpayer Relief Act of 2012, fiscal cliff; impact on employer-sponsored financial protection benefits industry; Financial Regulation: DoddFrank Wall Street Reform and Consumer Protection Act implementation: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; Consumer Financial Protection Bureau Interim Final Rule of Records and Information: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; Criteria and process for designating nonbank financial companies: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; FY 2014 budget proposals; impact on employer-sponsored financial protection benefits industry. Health Care Issues: Implementation of the Patient Protection and Affordable Care Act: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; Loss ratios: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; HHS FAQ regarding fixed indemnity products: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; The Health Information Technology for Economic and Clinical Health Act (HITECH) Act: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; Issues related to wellness programs. Labor: Labor issues impacting large employers, including worker classification; S.534 National Association of Registered Agents and Brokers Reform Act of 2013: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; H.R.1155 National Association of Registered Agents and Brokers Reform Act of 2013: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry. Long-Term Care: Issues related to public and private programs providing long-term care services and insurance, including LTC Commission and repeal of the CLASS Act.Privacy: Privacy and Data breach, cyber security, and SSN protection: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; H.R.749 - Eliminate Privacy Notice Confusion Act of 2013: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; S.676 Identity Theft and Tax Fraud Prevention Act of 2013 (Death Master File): provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; H.R.466 Social Security Death Master File Privacy Act of 2013: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; H.R. 624 Cyber Intelligence Sharing and Protection Act of 2013: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; H.R.1468 SECURE IT Act of 2013; provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry. Social Security Disability Insurance Reform: H.R.1374 - Social Security Enhancement and Protection Act of 2013: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; Short-term Disability for Federal Workers Bill: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; Increasing employment for people with disabilities: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry. Tax Reform: Corporate tax issues: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry Deficit reduction: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; Taxation of Employer Provided Benefits: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; Tax Extender Package: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry.
2013 · third_quarter · Medicare/Medicaid
H.R. 162, Medicaid Integrity Act (Bachmann) Medicaid health plan audits16. Specific Lobbying Issues (continued): H.R. 670, Puerto Rico Medicare Part B Equity Act (Pierluisi) H.R. 928, Medicare Prescription Drug Savings and Choice Act (Schakowsky) Medicare Part D changes H.R. 1179, Improving Access to Medicare Coverage Act (Courtney) Medicare coverage of skilled nursing care H.R. 1102, Medicare Prescription Drug Price Negotiation Act (Welch) Medicare Part D price negotiations H.R. 1853, Medicaid Accountability and Care Act (Cassidy) federal financing of state Medicaid programs H.R. 2305, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Roskam-Carney) fighting fraud and abuse H.R. 2453, Medicare Beneficiary Preservation of Choice Act (Rothfus-Schrader) MA enrollment rules H.R. 2524, Medicare Better Health Rewards Program Act (Paulsen-Kind) wellness incentives H.R. 2753, Securing Care for Seniors Act (Black) MA payment and enrollment issues, wellness incentives H.R. 2810, Medicare Patient Access and Quality Improvement Act (Burgess) SGR repeal, quality- and value-based payment reforms House Ways and Means Committee Discussion Draft of Medicare Physician Payment Reform (not yet introduced) SGR repeal, quality- and value-based payment reforms House Ways and Means Committee Draft Medicare Reforms S. 11, Fiscal Sustainability Act (Corker) Medicare, Medigap, Medicaid issues S. 117, Medicare Prescription Drug Price Negotiation Act (Klobuchar) Medicare Part D price negotiations S. 324, Puerto Rico Medicare Part B Equity Act (Schumer) S. 408, Medicare Prescription Drug Savings and Choice Act (Durbin) Medicare Part D changes S. 569, Improving Access to Medicare Coverage Act (Brown) Medicare coverage of skilled nursing care S. 1123, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Carper-Coburn) fighting fraud and abuse S. 1228, Medicare Better Health Rewards Program Act (Wyden-Portman) wellness incentives Senate Finance Committee Discussion Draft of Medicare Physician Payment Reform (not yet introduced) SGR repeal, quality- and value-based payment reforms H.R, 2960, Medicare Prescription Drug Integrity Act of 2013 (Pallone) Part D drug utilization review Regulatory Issues: Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, encounter data and other data-related issues, and audit issues; bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, and audits); Medicare Medical Loss Ratio issues; implementation of sequestration under the Medicare Advantage and Part D programs; implications of the health insurer fee for MA and Part D plans; application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, SSA and CMS premium withhold processing issues, enrollment rules, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); SNP reauthorization; quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible SNPs; Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, Part D coverage gap discount program, including employer group waiver plan (EGWP) issues, and other operational issues; MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; issues relating to MA Star Rating system including measures, the methodology for calculating ratings, and the role of the ratings for payment purposes; implementation of the Affordable Care Act (ACA) changes to the Part D coverage gap; ongoing implementation issues for the Medicare cost plan program including enrollment, marketing materials review and approval and other operational issues; Medicare creditable drug coverage reporting requirements; implementation issues for the Medicare Retiree Drug Subsidy program; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education Program;16. Regulatory Issues (con't): Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; Medicare clinical trials; Medicare/Medicaid integration for dual eligibles, including the Capitated Financial Alignment Demonstration; Medicaid managed care regulations and policies, including the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, fraud and abuse compliance, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including block grants, the calculation of the federal medical assistance (federal matching) percentage (FMAP), and intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost issues affecting Medicaid health plans; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including Medicaid managed care organization provider tax issues; standards for electronic prescribing; implementation of Medicaid changes of interest to Medicaid health plans made in the ACA including Medicaid expansion, the managed care organization (MCO) prescription drug rebate provisions, minimum payments to primary care providers (PCPs), interactions between the Medicaid program and health insurance exchanges, and Medicaid and CHIP maintenance of effort (MOE) requirements; implications of the health insurer fee for Medicaid health plans ; issues related to Medigap coverage; issues relating to "meaningful use" requirements for health information technology; and other issues relating to health care reform implementation. 17. Selected Agencies (con't): Medicaid and CHIP Payment and Access Commission (MACPAC)
2013 · second_quarter · Medicare/Medicaid
H.Con.Res. 25, House Budget Resolution (Ryan) - public program issues, deficit reduction proposals. S.Con.Res. 8, Senate Budget Resolution (Murray) - public program issues, deficit reduction proposals. H.R. 162, Medicaid Integrity Act (Bachmann) - Medicaid health plan audits. H.R. 670, Puerto Rico Medicare Part B Equity Act (Pierluisi). H.R. 928, Medicare Prescription Drug Savings and Choice Act (Schakowsky) - Medicare Part D changes. H.R. 1179, Improving Access to Medicare Coverage Act (Courtney) - Medicare coverage of skilled nursing care. H.R. 1102, Medicare Prescription Drug Price Negotiation Act (Welch) - Medicare Part D price negotiations. H.R. 1853, Medicaid Accountability and Care Act (Cassidy) -federal financing of state Medicaid programs. H.R. 2305, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Roskam-Carney) - fighting fraud and abuse. H.R. 2453, Medicare Beneficiary Preservation of Choice Act (Rothfus-Schrader) - MA enrollment rules. H.R. 2524, Medicare Better Health Rewards Program Act (Paulsen-Kind) - wellness incentives. S. 11, Fiscal Sustainability Act (Corker) - Medicare, Medigap, Medicaid issues. S. 117, Medicare Prescription Drug Price Negotiation Act (Klobuchar) - Medicare Part D price negotiations. S. 324, Puerto Rico Medicare Part B Equity Act (Schumer). S. 408, Medicare Prescription Drug Savings and Choice Act (Durbin) - Medicare Part D changes. S. 569, Improving Access to Medicare Coverage Act (Brown) - Medicare coverage of skilled nursing care. S. 1123, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Carper-Coburn) - fighting fraud and abuse. S. 1228, Medicare Better Health Rewards Program Act (Wyden-Portman) - wellness incentives.
Client expense: Not reported · Firm income: $60,000
2013 · second_quarter · Insurance
Antitrust Issues related to the McCarran Ferguson antitrust exemption for insurers: H.R.99 - Health Insurance Industry Antitrust Enforcement Act 2013: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry.ERISA: Issues related to regulation of employee benefits under the Employee Retirement Income Security Act and legislation impacting ERISA plans. Federal Debt Limit: Debt Limit Increase: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; S.11 - Fiscal Sustainability Act of 2013: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry. Financial Regulation: DoddFrank Wall Street Reform and Consumer Protection Act implementation: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; Consumer Financial Protection Bureau Interim Final Rule of Records and Information: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; Criteria and process for designating nonbank financial companies: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry. Health Care Issues: Implementation of the Patient Protection and Affordable Care Act: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; Loss ratios: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; HHS FAQ regarding fixed indemnity products: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; The Health Information Technology for Economic and Clinical Health Act (HITECH) Act: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; Issues related to wellness programs. Labor: Labor issues impacting large employers, including worker classification. Long Term Care: Issues related to public and private programs providing long term care services and insurance. Privacy: Privacy and Data breach, cyber security, and SSN protection: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; H.R.749 - Eliminate Privacy Notice Confusion Act of 2013: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; S.676 Identity Theft and Tax Fraud Prevention Act of 2013: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry. Social Security Disability Insurance Reform: H.R.1374 - Social Security Enhancement and Protection Act of 2013: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; Short-term Disability for Federal Workers Bill: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; Increasing employment for people with disabilities: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry.Tax Reform: Corporate tax issues; Provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; Taxation of Employer Provided Benefits: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; Tax Extender Package: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry.
2013 · second_quarter · Medicare/Medicaid
H.Con.Res. 25, House Budget Resolution (Ryan) public program issues, deficit reduction proposals16. Specific Lobbying Issues (continued): S.Con.Res. 8, Senate Budget Resolution (Murray) public program issues, deficit reduction proposals H.R. 162, Medicaid Integrity Act (Bachmann) Medicaid health plan audits H.R. 670, Puerto Rico Medicare Part B Equity Act (Pierluisi) H.R. 928, Medicare Prescription Drug Savings and Choice Act (Schakowsky) Medicare Part D changes H.R. 1179, Improving Access to Medicare Coverage Act (Courtney) Medicare coverage of skilled nursing care H.R. 1102, Medicare Prescription Drug Price Negotiation Act (Welch) Medicare Part D price negotiations H.R. 1853, Medicaid Accountability and Care Act (Cassidy) federal financing of state Medicaid programs H.R. 2305, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Roskam-Carney) fighting fraud and abuse H.R. 2453, Medicare Beneficiary Preservation of Choice Act (Rothfus-Schrader) MA enrollment rules H.R. 2524, Medicare Better Health Rewards Program Act (Paulsen-Kind) wellness incentives S. 11, Fiscal Sustainability Act (Corker) Medicare, Medigap, Medicaid issues S. 117, Medicare Prescription Drug Price Negotiation Act (Klobuchar) Medicare Part D price negotiations S. 324, Puerto Rico Medicare Part B Equity Act (Schumer) S. 408, Medicare Prescription Drug Savings and Choice Act (Durbin) Medicare Part D changes S. 569, Improving Access to Medicare Coverage Act (Brown) Medicare coverage of skilled nursing care S. 1123, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Carper-Coburn) fighting fraud and abuse S. 1228, Medicare Better Health Rewards Program Act (Wyden-Portman) wellness incentives Discussion Drafts of Medicare Physician Payment Reform Bills (not yet introduced) SGR repeal, quality- and value-based payment reforms Regulatory Issues: Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, encounter data and other data-related issues, and audit issues; bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, and audits); Medicare Medical Loss Ratio issues; implementation of sequestration under the Medicare Advantage and Part D programs; implications of the health insurer fee for MA and Part D plans; application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, SSA and CMS premium withhold processing issues, enrollment rules, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible Special Needs Plans (SNPs); Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, Part D coverage gap discount program, including employer group waiver plan (EGWP) issues, and other operational issues; MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; issues relating to MA Star Rating system including measures, the methodology for calculating ratings, and the role of the ratings for payment purposes; implementation of the Affordable Care Act (ACA) changes to the Part D coverage gap; ongoing implementation issues for the Medicare cost plan program including enrollment, marketing materials review and approval and other operational issues; Medicare creditable drug coverage reporting requirements; implementation issues for the Medicare Retiree Drug Subsidy program; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education Program; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; Medicare clinical trials; Medicare/Medicaid integration for dual eligibles, including the Capitated Financial Alignment Demonstration; Medicaid managed care regulations and policies, including the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, fraud and abuse compliance, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including block grants, the calculation of the federal medical assistance (federal matching) percentage (FMAP), and intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs;Medicaid prescription drug cost issues affecting Medicaid health plans; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including Medicaid managed care organization provider tax issues; standards for electronic prescribing; implementation of Medicaid changes of interest to Medicaid health plans made in the ACA including Medicaid expansion, the managed care organization (MCO) prescription drug rebate provisions, minimum payments to primary care providers (PCPs), interactions between the Medicaid program and health insurance exchanges, and Medicaid and CHIP maintenance of effort (MOE) requirements; implications of the health insurer fee for Medicaid health plans ; issues related to Medigap coverage; issues relating to "meaningful use" requirements for health information technology; and other issues relating to health care reform implementation.
2013 · second_quarter · Medicare/Medicaid
H.Con.Res. 25, House Budget Resolution (Ryan) public program issues, deficit reduction proposals16. Specific Lobbying Issues (continued): S.Con.Res. 8, Senate Budget Resolution (Murray) public program issues, deficit reduction proposals H.R. 162, Medicaid Integrity Act (Bachmann) Medicaid health plan audits H.R. 670, Puerto Rico Medicare Part B Equity Act (Pierluisi) H.R. 928, Medicare Prescription Drug Savings and Choice Act (Schakowsky) Medicare Part D changes H.R. 1179, Improving Access to Medicare Coverage Act (Courtney) Medicare coverage of skilled nursing care H.R. 1102, Medicare Prescription Drug Price Negotiation Act (Welch) Medicare Part D price negotiations H.R. 1853, Medicaid Accountability and Care Act (Cassidy) federal financing of state Medicaid programs H.R. 2305, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Roskam-Carney) fighting fraud and abuse H.R. 2453, Medicare Beneficiary Preservation of Choice Act (Rothfus-Schrader) MA enrollment rules H.R. 2524, Medicare Better Health Rewards Program Act (Paulsen-Kind) wellness incentives S. 11, Fiscal Sustainability Act (Corker) Medicare, Medigap, Medicaid issues S. 117, Medicare Prescription Drug Price Negotiation Act (Klobuchar) Medicare Part D price negotiations S. 324, Puerto Rico Medicare Part B Equity Act (Schumer) S. 408, Medicare Prescription Drug Savings and Choice Act (Durbin) Medicare Part D changes S. 569, Improving Access to Medicare Coverage Act (Brown) Medicare coverage of skilled nursing care S. 1123, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Carper-Coburn) fighting fraud and abuse S. 1228, Medicare Better Health Rewards Program Act (Wyden-Portman) wellness incentives Discussion Drafts of Medicare Physician Payment Reform Bills (not yet introduced) SGR repeal, quality- and value-based payment reforms Regulatory Issues: Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, encounter data and other data-related issues, and audit issues; bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, and audits); Medicare Medical Loss Ratio issues; implementation of sequestration under the Medicare Advantage and Part D programs; implications of the health insurer fee for MA and Part D plans; application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, SSA and CMS premium withhold processing issues, enrollment rules, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible Special Needs Plans (SNPs); Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, Part D coverage gap discount program, including employer group waiver plan (EGWP) issues, and other operational issues; MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; issues relating to MA Star Rating system including measures, the methodology for calculating ratings, and the role of the ratings for payment purposes; implementation of the Affordable Care Act (ACA) changes to the Part D coverage gap; ongoing implementation issues for the Medicare cost plan program including enrollment, marketing materials review and approval and other operational issues; Medicare creditable drug coverage reporting requirements; implementation issues for the Medicare Retiree Drug Subsidy program; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education Program; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; Medicare clinical trials; Medicare/Medicaid integration for dual eligibles, including the Capitated Financial Alignment Demonstration; Medicaid managed care regulations and policies, including the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, fraud and abuse compliance, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including block grants, the calculation of the federal medical assistance (federal matching) percentage (FMAP), and intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs;Medicaid prescription drug cost issues affecting Medicaid health plans; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including Medicaid managed care organization provider tax issues; standards for electronic prescribing; implementation of Medicaid changes of interest to Medicaid health plans made in the ACA including Medicaid expansion, the managed care organization (MCO) prescription drug rebate provisions, minimum payments to primary care providers (PCPs), interactions between the Medicaid program and health insurance exchanges, and Medicaid and CHIP maintenance of effort (MOE) requirements; implications of the health insurer fee for Medicaid health plans ; issues related to Medigap coverage; issues relating to "meaningful use" requirements for health information technology; and other issues relating to health care reform implementation.
2013 · first_quarter · Insurance
S.11 - Fiscal Sustainability Act of 2013: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; H.R.1374 - Social Security Enhancement and Protection Act of 2013: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry;H.R.749 - Elimnate Privacy Notice Confusion Act of 2013: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; H.R.99 - Health Insurance Industry Antitrust Enforcement Act 2013: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; DoddFrank Wall Street Reform and Consumer Protection Act: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; Short-term Disability for Federal Workers Bill; provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; Patient Protection and Affordable Care Act: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; Tax Reform: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; Consumer Financial Protection Bureau Interim Final Rule of Records and Information: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; Privacy and Data breach, Cybersecurity, and SSN protection: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; Loss ratios: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; Criteria and process for designating nonbank financial companies: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; The Health Information Technology for Economic and Clinical Health Act (HITECH) Act: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; Taxation of Employer Provided Benefits: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; Debt Limit Increase: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; Tax Extender Package: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; Safety Net/Employer Provided Benefits Protection: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; Increasing employment for people with disabilities: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; HHS FAQ regarding fixed indemnity products: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry
2013 · first_quarter · Medicare/Medicaid
H.Con.Res. 25, House Budget Resolution (Ryan) - public program issues, deficit reduction proposals. S.Con.Res. 8, Senate Budget Resolution (Murray) - public program issues, deficit reduction proposals. H.R. 8, American Taxpayer Relief Act (Camp) - Medicare Advantage, Special Needs Plans, Medicare physician payment, Medicaid and long-term care issues. H.R. 162, Medicaid Integrity Act (Bachmann) - Medicaid health plan audits. H.R. 670, Puerto Rico Medicare Part B Equity Act (Pierluisi). H.R. 928, Medicare Prescription Drug Savings and Choice Act (Schakowsky) - Medicare Part D changes. H.R. 1179, Improving Access to Medicare Coverage Act (Courtney) - Medicare coverage of skilled nursing care. H.R. 1102, Medicare Prescription Drug Price Negotiation Act (Welch) - Medicare Part D price negotiations. S. 11, Fiscal Sustainability Act (Corker) - Medicare, Medigap, Medicaid issues. S. 117, Medicare Prescription Drug Price Negotiation Act (Klobuchar) - Medicare Part D price negotiations. S. 324, Puerto Rico Medicare Part B Equity Act (Schumer) S. 408, Medicare Prescription Drug Savings and Choice Act (Durbin) - Medicare Part D changes. S. 569, Improving Access to Medicare Coverage Act (Brown) - Medicare coverage of skilled nursing care.
Client expense: Not reported · Firm income: $10,000
2013 · first_quarter · Insurance
S.11 - Fiscal Sustainability Act of 2013: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; H.R.1374 - Social Security Enhancement and Protection Act of 2013: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry;H.R.749 - Elimnate Privacy Notice Confusion Act of 2013: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; H.R.99 - Health Insurance Industry Antitrust Enforcement Act 2013: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; DoddFrank Wall Street Reform and Consumer Protection Act: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; Short-term Disability for Federal Workers Bill; provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; Patient Protection and Affordable Care Act: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; Tax Reform: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; Consumer Financial Protection Bureau Interim Final Rule of Records and Information: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; Privacy and Data breach, Cybersecurity, and SSN protection: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; Loss ratios: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; Criteria and process for designating nonbank financial companies: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; The Health Information Technology for Economic and Clinical Health Act (HITECH) Act: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; Taxation of Employer Provided Benefits: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; Debt Limit Increase: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; Tax Extender Package: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; Safety Net/Employer Provided Benefits Protection: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; Increasing employment for people with disabilities: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry; HHS FAQ regarding fixed indemnity products: provisions relating to employer-provided benefits and supplemental and voluntary benefits insurance industry
2013 · first_quarter · Health Issues
Discussions involving Group Purchasing Organizations HR 351 Protecting Seniors' Access to Medicare Act of 2013 (all sections of full text) Discussions pertinent to CMS Geographic Practice Index (GPCI) server locality payments S 11 Fiscal Sustainability Act of 2013 (See 2405 Reduction of Bad Debt treated as an allowable cost) S. Con. Res. 8 Fiscal Year 14 Budget (all sections of full text) Monitor discussions regarding regulation of compounding pharmacies Discussions involving implementation of spending sequester under P.L. 112-25 Discussions involving the Veterans Administration's health care facility realignment in Denver, Colorado known as "Project Eagle"
Client expense: Not reported · Firm income: $40,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2013 · first_quarter · Medicare/Medicaid
H.Con.Res. 25, House Budget Resolution (Ryan) - public program issues, deficit reduction proposals. S.Con.Res. 8, Senate Budget Resolution (Murray) - public program issues, deficit reduction proposals. H.R. 8, American Taxpayer Relief Act (Camp) - Medicare Advantage, Special Needs Plans, Medicare physician payment, Medicaid and long-term care issues. H.R. 162, Medicaid Integrity Act (Bachmann) - Medicaid health plan audits. H.R. 670, Puerto Rico Medicare Part B Equity Act (Pierluisi). H.R. 928, Medicare Prescription Drug Savings and Choice Act (Schakowsky) - Medicare Part D changes. H.R. 1179, Improving Access to Medicare Coverage Act (Courtney) - Medicare coverage of skilled nursing care. H.R. 1102, Medicare Prescription Drug Price Negotiation Act (Welch) - Medicare Part D price negotiations. S. 11, Fiscal Sustainability Act (Corker) - Medicare, Medigap, Medicaid issues. S. 117, Medicare Prescription Drug Price Negotiation Act (Klobuchar) - Medicare Part D price negotiations. S. 324, Puerto Rico Medicare Part B Equity Act (Schumer) S. 408, Medicare Prescription Drug Savings and Choice Act (Durbin) - Medicare Part D changes. S. 569, Improving Access to Medicare Coverage Act (Brown) - Medicare coverage of skilled nursing care.
Client expense: Not reported · Firm income: $50,000
2013 · first_quarter · Medicare/Medicaid
H.Con.Res. 25, House Budget Resolution (Ryan) public program issues, deficit reduction proposals16. Specific Lobbying Issues (continued): S.Con.Res. 8, Senate Budget Resolution (Murray) public program issues, deficit reduction proposals H.R. 8, American Taxpayer Relief Act (Camp) Medicare Advantage, Special Needs Plans, Medicare physician payment, Medicaid and long-term care issues H.R. 162, Medicaid Integrity Act (Bachmann) Medicaid health plan audits H.R. 670, Puerto Rico Medicare Part B Equity Act (Pierluisi) H.R. 928, Medicare Prescription Drug Savings and Choice Act (Schakowsky) Medicare Part D changes H.R. 1179, Improving Access to Medicare Coverage Act (Courtney) Medicare coverage of skilled nursing care H.R. 1102, Medicare Prescription Drug Price Negotiation Act (Welch) Medicare Part D price negotiations S. 11, Fiscal Sustainability Act (Corker) Medicare, Medigap, Medicaid issues S. 117, Medicare Prescription Drug Price Negotiation Act (Klobuchar) Medicare Part D price negotiations S. 324, Puerto Rico Medicare Part B Equity Act (Schumer) S. 408, Medicare Prescription Drug Savings and Choice Act (Durbin) Medicare Part D changes S. 569, Improving Access to Medicare Coverage Act (Brown) Medicare coverage of skilled nursing care Regulatory Issues: Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, encounter data and other data-related issues, and audit issues; bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, and audits); Medicare Medical Loss Ratio issues; implementation of sequestration under the Medicare Advantage and Part D programs; implications of the health insurer fee for MA and Part D plans; application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, SSA and CMS premium withhold processing issues, enrollment rules, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible Special Needs Plans (SNPs); Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, Part D coverage gap discount program, including employer group waiver plan (EGWP) issues, and other operational issues; MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; issues relating to MA Star Rating system including measures, the methodology for calculating ratings, and the role of the ratings for payment purposes; implementation of the Affordable Care Act (ACA) changes to the Part D coverage gap; ongoing implementation issues for the Medicare cost plan program including enrollment, marketing materials review and approval and other operational issues; Medicare creditable drug coverage reporting requirements; implementation issues for the Medicare Retiree Drug Subsidy program; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education Program; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; Medicare clinical trials; Medicare/Medicaid integration for dual eligibles, including the Capitated Financial Alignment Demonstration; Medicaid managed care regulations and policies, including the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, fraud and abuse compliance, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including block grants, the calculation of the federal medical assistance (federal matching) percentage (FMAP), and intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost issues affecting Medicaid health plans; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including Medicaid managed care organization provider tax issues; standards for electronic prescribing; implementation of Medicaid changes of interest to Medicaid health plans made in the ACA including Medicaid expansion, the managed care organization (MCO) prescription drug rebate provisions, minimum payments to primary care providers (PCPs), interactions between the Medicaid program and health insurance exchanges, and Medicaid and CHIP maintenance of effort (MOE) requirements; implications of the health insurer fee for Medicaid health plans; issues related to Medigap coverage; issues relating to "meaningful use" requirements for health information technology; and other issues relating to health care reform implementation. 17. Federal Agencies (continued) Medicaid and CHIP Payment and Access Commission (MACPAC)
Client expense: $120,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE, Treasury, Dept of, White House Office
Client expense: $200,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE, Treasury, Dept of, White House Office
Client expense: $360,000 · Firm income: Not reported
Government targets: Administration for Children & Families (ACF), SENATE, Social Security Administration (SSA), Treasury, Dept of
Client expense: $230,000 · Firm income: Not reported
Government targets: Administration on Aging, Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Natl Economic Council (NEC), Office of Management & Budget (OMB), President of the U.S., SENATE, Social Security Administration (SSA), Treasury, Dept of, Vice President of the U.S.
Client expense: $170,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE, Treasury, Dept of, White House Office
Client expense: $2,010,000 · Firm income: Not reported
Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Federal Bureau of Investigation (FBI), Federal Trade Commission (FTC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of Personnel Management (OPM), SENATE, Social Security Administration (SSA), Treasury, Dept of, White House Office
Client expense: Not reported · Firm income: $30,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
Client expense: $2,530,000 · Firm income: Not reported
Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Pension & Welfare Benefits Administration, SENATE, Social Security Administration (SSA), Treasury, Dept of, White House Office
Client expense: $120,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE, Treasury, Dept of, White House Office
Client expense: $120,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
Client expense: $120,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
Client expense: Not reported · Firm income: $30,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
Client expense: $320,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE, Social Security Administration (SSA), Treasury, Dept of
Client expense: $2,430,000 · Firm income: Not reported
Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Pension & Welfare Benefits Administration, SENATE, Treasury, Dept of, White House Office
Client expense: Not reported · Firm income: $30,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
Client expense: $3,630,000 · Firm income: Not reported
Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Federal Bureau of Investigation (FBI), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Pension & Welfare Benefits Administration, SENATE, Treasury, Dept of, White House Office
Client expense: $120,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
Client expense: Not reported · Firm income: $60,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
Client expense: Not reported · Firm income: $60,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
Client expense: $180,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), SENATE
Client expense: $2,210,000 · Firm income: Not reported
Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Federal Bureau of Investigation (FBI), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Pension & Welfare Benefits Administration, SENATE, Treasury, Dept of, White House Office
Government targets: HOUSE OF REPRESENTATIVES, SENATE
Client expense: $130,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE
Client expense: $2,090,000 · Firm income: Not reported
Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Federal Bureau of Investigation (FBI), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Pension & Welfare Benefits Administration, SENATE, Treasury, Dept of, White House Office
Client expense: $2,090,000 · Firm income: Not reported
Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Federal Bureau of Investigation (FBI), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Pension & Welfare Benefits Administration, SENATE, Treasury, Dept of, White House Office
Client expense: $380,000 · Firm income: Not reported
Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), SENATE
Government targets: HOUSE OF REPRESENTATIVES, SENATE
Client expense: $370,000 · Firm income: Not reported
Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), SENATE
Government targets: HOUSE OF REPRESENTATIVES, SENATE
Client expense: $2,490,000 · Firm income: Not reported
Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Federal Bureau of Investigation (FBI), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Pension & Welfare Benefits Administration, SENATE, Treasury, Dept of, White House Office