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Medicare Better Health Rewards Program Act of 2013
Legislative Progress
Momentum (last 30 days)
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0 actions · 0 new cosponsors · 0 votes
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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.
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Bills with similar content found using semantic analysis.
Sources: Congress.gov
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 · Health Issues
Budget and appropriations for disease and injury prevention, including obesity and related diseases; pandemic influenza and emerging infectious diseases; physical activity; public health bioterrorism preparedness; food safety, environmental health; paid sick days; womens and childrens health; community-based public health interventions and prescription drug abuse. 1.Implementation of the Patient Protection and Affordable Care Act (Public Law 111-148) 2.Implementation of the FDA Food Safety Modernization Act (Public Law 111-353) 3.Implementation of Pandemic and All-Hazards Preparedness Reauthorization Act (Public Law 113-5) 4.Implementation of Healthy, Hunger-Free Kids Act of 2010 (Public Law 111-296) 5.Implementation of the Budget Control Act of 2011 (Public Law 112-25) 6.Delivering Antimicrobial Transparency in Animals Act of 2013 (H.R. 820) 7.Animal Drug and Animal Generic Drug User Fee Act (Public Law 113-14) 8.Healthier Lifestyles and Prevention America Act (S. 39) 9.Promoting Health as Youth Skills in Classrooms and Life Act (S. 392/H.R. 2160) 10.Medicare Diabetes Prevention Act (S. 452/H.R. 962) 11.Personal Health Investment Today Act (H.R. 956) 12.A bill to provide for a sequester replacement (S. 16/S. 799) 13.American Family Economic Protection Act of 2013 (S. 388) 14.Consolidated and Further Continuing Appropriations Act, 2013 (H.R. 933/Public Law 113-6) 15.Pandemic and All-Hazards Preparedness Reauthorization Act of 2013 (Public Law 113-5) 16.National Diabetes Clinical Care Commission Act (H.R. 1074/S. 539) 17.Physical Activity Guidelines for Americans Act (S. 531/H.R. 2179) 18.Firearm Safety and Public Health Research Act (H.R. 321) 19.Energy Consumers Relief Act (S. 1363/H.R. 1582) 20.Common Sense Nutrition Disclosure Act (H.R. 1249/S. 1756) 21.Improve Nutrition Program Integrity and Deficit Reduction Act (S. 458/H.R. 1510) 22.A bill to amend the Food and Nutrition Act of 2008 to improve the supplemental nutrition assistance program (S. 762/H.R. 1657) 23.Agriculture Reform, Food, and Jobs Act (S. 954/H.R. 2498) 24.Federal Agriculture Reform and Risk Management Act (H.R. 1947) 25.FIT Kids Act (S. 1033/H.R. 2178) 26.Strengthening Americas Schools Act (S. 1094) 27.Access to Quality Diabetes Education Act (S. 945/H.R. 1274) 28.Fit to Serve Act (S. 976) 29.Climate Change Health Protection and Promotion Act (H.R. 2023/S. 2864) 30.Treat and Reduce Obesity Act (S. 1184 / H.R. 2415) 31.Student Success Act (H.R. 5) 32.To repeal the Patient Protection and Affordable Care Act and health care-related provisions in the Health Care and Education Reconciliation Act (H.R. 45) 33.Medicare Better Health Rewards Program Act (S. 1228/H.R. 2524) 34.Senate FY14 Labor, Health and Human Services, and Education Bill (S. 1284) 35.House of Representatives FY14 Labor, Health and Human Services, and Education Bill 36.Pharmacy Compounding Quality and Accountability Act (S. 959) 37.Safeguarding Americas Pharmaceuticals Act (H.R. 1919) 38.Implementation of Drug Supply Chain Security Act (P.L. 113-54) 39.Preservation of Antibiotics for Medical Treatment Act (H.R. 1150)/Preventing Antibiotic Resistance Act of 2013 (S. 1256) 40.Healthy Families Act (H.R. 1286/S. 631) 41.FY2014 Continuing Resolution (H.J. Res. 59) 42.Pharmaceutical Quality, Security and Accountability Act (S. 959) 43.Energy Consumers Relief Act (S. 1363/H.R. 1582) 44.Increasing the Safety of Prescription Drug Use Act (S. 1657) 45.National Energy Tax Repeal Act (S. 1324) 46.Saving Coal Jobs Act of 2013 (S. 1514/H.R. 5077) 47.Community Parks Revitalization Act (H.R. 2424) 48.A bill to amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings (S. 1422/H.R. 2663) 49.School-based Health Centers Program Reauthorization Act of 2013 (H.R. 2632) 50.Nutrition Reform and Work Opportunity Act (H.R. 3102) 51.Health Equity and Accountability Act (H.R. 5294) 52.Secure America for Education (SAFE) in Our Schools Act of 2013 (H.R. 3158) 53.Continuing Appropriations Resolution, 2014 (H.J. Res 59) 54.Continuing Resolution FY 2014 (HR 2775, PL 113-46) 55.A bill to amend title 23, United States Code, with respect to the establishment of performance measures for the highway safety improvement program, and for other purposes. (H.R. 3493/S. 1708) 56.The Farm Bill (S. (S. 954/H.R. 2498; H.R. 1947, and H.R. 3102, Public Law 113-79) 57.Better Care, Lower Cost Act (S. 1932/H.R. 3890) 58.Antibiotic Development to Advance Patient Treatment Act of 2013 (ADAPT Act) (H.R. 3742) 59.The Consolidated Appropriations Act of 2014 (H.R. 3547/Public Law 113-76 60.Strategies to Address Antimicrobial Resistance (STAAR) Act (S. 2236/H.R. 2285) 61.New Opportunities for Bicycling and Pedestrian Infrastructure Financing Act of 2014 (H.R. 3978) 62.Eliminating Disparities in Diabetes Prevention, Access, and Care Act (H.R. 3322) 63.Electricity Security and Affordability Act (S. 1905/H.R. 3826) 64.Stop Overdose Stat Act (HR 4169) 65.Overdose Prevention Act (S 2755) 66.Opioid Overdose Reduction Act (S. 2092/H.R. 4288) 67.Developing an Innovative Strategy for Antimicrobial Resistant Microorganisms Act of 2014 (DISARM Act) (H.R. 4187) 68.Child Care and Development Block Grant Act of 2014 (S. 1086) 69.Departments of Labor, Health and Human Services and Education And Related Agencies Fiscal Year 2015 Appropriations Bill (including H.R. 5464) 70.Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, 2015 (S. 2389 / H.R. 4800) 71.Department of the Interior, Environment, and Related Agencies appropriations legislation, 2015 (including H.R. 5171) 72.MAP-21 Reauthorization Act (S. 2322) 73.Stop Subsidizing Childhood Obesity Act (S. 2342/H.R. 2831) 74.ENRICH Act (H.R. 4427) 75.Healthy Kids Outdoors Act of 2014 (S. 2367/H.R. 4706) 76.Summer Meals Act of 2014 (S. 2527/HR. 5012) 77.Long-Term SCORE Act (H.R. 4444) 78.American Cures Act (S. 2115/H.R. 4384) 79.A joint resolution to disapprove a rule of the Environmental Protection Agency relating to greenhouse gas emissions from electric utility generating units. (S.J. Res 30) 80.Fit for Life Act of 2014 (H.R.4765) 81.School Food Modernization Act (S. 2210/H.R. 1783) 82.Protecting Children from Electronic Cigarette Advertising Act of 2014 (S. 2014/H.R. 4325) 83.Pedestrian Safety Act of 2014 (S. 2284) 84.Safe Streets Act of 2014 (S. 2004/H.R. 2468) 85.Time for Recovery Enhancement for Addiction Treatment Act (S. 2645) 86.FY 2015 Financial Services and General Government Appropriations bill, in support of an appropriation for the National Alliance for Model State Drug Laws (including H.R. 5016) 87.Vector-Borne Disease Research Accountability and Transparency Act (H.R. 4701) 88.Highway and Transportation Funding Act of 2014 (H.R. 5021/Public Law 113-159) 89.Full-Service Community Schools Act of 2014 (H.R. 5168) 90.PREPARE Act of 2014 (H.R. 5314) 91.Waters of the United States Regulatory Overreach Protection Act of 2014 (S. 2496/H.R. 5078) 92.American Energy Solutions for Lower Costs and More American Jobs Act (H.R. 2) 93.FY2015 Omnibus; Consolidated and Further Continuing Appropriations Act (H.R. 83/Public Law 113-234) 94.Promise for Antibiotics and Therapeutics for Health Act (PATH Act, S. 2996) 95.Infectious Disease Hospital Hubs Act (S. 2942)
Client expense: $39,000 · Firm income: Not reported
Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Environmental Protection Agency (EPA), Executive Office of the President (EOP), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Office of Management & Budget (OMB), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Transportation, Dept of (DOT)
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 · third_quarter · Health Issues
Budget and appropriations for disease and injury prevention, including obesity and related diseases; pandemic influenza and emerging infectious diseases; physical activity; public health bioterrorism preparedness; food safety, environmental health; paid sick days; womens and childrens health; and community-based public health interventions and prescription drug abuse. 1. Implementation of the Patient Protection and Affordable Care Act (Public Law 111-148)2.Implementation of the FDA Food Safety Modernization Act (Public Law 111-353) 3.Implementation of Pandemic and All-Hazards Preparedness Reauthorization Act (Public Law 113-5) 4.Implementation of Healthy, Hunger-Free Kids Act of 2010 (Public Law 111-296) 5.Implementation of the Budget Control Act of 2011 (Public Law 112-25) 6.Delivering Antimicrobial Transparency in Animals Act of 2013 (H.R. 820) 7.Animal Drug and Animal Generic Drug User Fee Act (Public Law 113-14) 8.Healthier Lifestyles and Prevention America Act (S. 39) 9.Promoting Health as Youth Skills in Classrooms and Life Act (S. 392/H.R. 2160) 10.Medicare Diabetes Prevention Act (S. 452/H.R. 962) 11.Personal Health Investment Today Act (H.R. 956) 12.A bill to provide for a sequester replacement (S. 16/S. 799) 13.American Family Economic Protection Act of 2013 (S. 388) 14.Consolidated and Further Continuing Appropriations Act, 2013 (H.R. 933/Public Law 113-6) 15.Pandemic and All-Hazards Preparedness Reauthorization Act of 2013 (Public Law 113-5) 16.National Diabetes Clinical Care Commission Act (H.R. 1074/S. 539) 17.Physical Activity Guidelines for Americans Act (S. 531/H.R. 2179) 18.Firearm Safety and Public Health Research Act (H.R. 321) 19.Energy Consumers Relief Act (S. 1363/H.R. 1582) 20.Common Sense Nutrition Disclosure Act (H.R. 1249/S. 1756) 21.Improve Nutrition Program Integrity and Deficit Reduction Act (S. 458/H.R. 1510) 22.A bill to amend the Food and Nutrition Act of 2008 to improve the supplemental nutrition assistance program (S. 762/H.R. 1657) 23.Agriculture Reform, Food, and Jobs Act (S. 954/H.R. 2498) 24.Federal Agriculture Reform and Risk Management Act (H.R. 1947) 25.FIT Kids Act (S. 1033/H.R. 2178) 26.Strengthening Americas Schools Act (S. 1094) 27.Access to Quality Diabetes Education Act (S. 945/H.R. 1274) 28.Fit to Serve Act (S. 976) 29.Climate Change Health Protection and Promotion Act (H.R. 2023/S. 2864) 30.Treat and Reduce Obesity Act (S. 1184 / H.R. 2415) 31.Student Success Act (H.R. 5) 32.To repeal the Patient Protection and Affordable Care Act and health care-related provisions in the Health Care and Education Reconciliation Act (H.R. 45) 33.Medicare Better Health Rewards Program Act (S. 1228/H.R. 2524) 34.Senate FY14 Labor, Health and Human Services, and Education Bill (S. 1284) 35.House of Representatives FY14 Labor, Health and Human Services, and Education Bill 36.Pharmacy Compounding Quality and Accountability Act (S. 959) 37.Safeguarding Americas Pharmaceuticals Act (H.R. 1919) 38.Implementation of Drug Supply Chain Security Act (P.L. 113-54) 39.Preservation of Antibiotics for Medical Treatment Act (H.R. 1150)/Preventing Antibiotic Resistance Act of 2013 (S. 1256) 40.Healthy Families Act (H.R. 1286/S. 631) 41.FY2014 Continuing Resolution (H.J. Res. 59) 42.Pharmaceutical Quality, Security and Accountability Act (S. 959) 43.Energy Consumers Relief Act (S. 1363/H.R. 1582) 44.Increasing the Safety of Prescription Drug Use Act (S. 1657) 45.National Energy Tax Repeal Act (S. 1324) 46.Saving Coal Jobs Act of 2013 (S. 1514/H.R. 5077) 47.Community Parks Revitalization Act (H.R. 2424) 48.A bill to amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings (S. 1422/H.R. 2663) 49.School-based Health Centers Program Reauthorization Act of 2013 (H.R. 2632) 50.Nutrition Reform and Work Opportunity Act (H.R. 3102) 51.Health Equity and Accountability Act (H.R. 5294) 52.Secure America for Education (SAFE) in Our Schools Act of 2013 (H.R. 3158) 53.Continuing Appropriations Resolution, 2014 (H.J. Res 59) 54.Continuing Resolution FY 2014 (HR 2775, PL 113-46) 55.A bill to amend title 23, United States Code, with respect to the establishment of performance measures for the highway safety improvement program, and for other purposes. (H.R. 3493/S. 1708) 56.The Farm Bill (S. (S. 954/H.R. 2498; H.R. 1947, and H.R. 3102, Public Law 113-79) 57.Better Care, Lower Cost Act (S. 1932/H.R. 3890) 58.Antibiotic Development to Advance Patient Treatment Act of 2013 (ADAPT Act) (H.R. 3742) 59.The Consolidated Appropriations Act of 2014 (H.R. 3547/Public Law 113-76 60.Strategies to Address Antimicrobial Resistance (STAAR) Act (S. 2236/H.R. 2285) 61.New Opportunities for Bicycling and Pedestrian Infrastructure Financing Act of 2014 (H.R. 3978) 62.Eliminating Disparities in Diabetes Prevention, Access, and Care Act (H.R. 3322) 63.Electricity Security and Affordability Act (S. 1905/H.R. 3826) 64.Stop Overdose Stat Act (HR 4169) 65.Overdose Prevention Act (S 2755) 66.Opioid Overdose Reduction Act (S. 2092/H.R. 4288) 67.Developing an Innovative Strategy for Antimicrobial Resistant Microorganisms Act of 2014 (DISARM Act) (H.R. 4187) 68.Child Care and Development Block Grant Act of 2014 (S. 1086) 69.Departments of Labor, Health and Human Services and Education And Related Agencies Fiscal Year 2015 Appropriations Bill (including H.R. 5464) 70.Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, 2015 (S. 2389 / H.R. 4800) 71.Department of the Interior, Environment, and Related Agencies appropriations legislation, 2015 (including H.R. 5171) 72.MAP-21 Reauthorization Act (S. 2322) 73.Stop Subsidizing Childhood Obesity Act (S. 2342/H.R. 2831) 74.ENRICH Act (H.R. 4427) 75.Healthy Kids Outdoors Act of 2014 (S. 2367/H.R. 4706) 76.Summer Meals Act of 2014 (S. 2527/HR. 5012) 77.Long-Term SCORE Act (H.R. 4444) 78.American Cures Act (S. 2115/H.R. 4384) 79.A joint resolution to disapprove a rule of the Environmental Protection Agency relating to greenhouse gas emissions from electric utility generating units. (S.J. Res 30) 80.Fit for Life Act of 2014 (H.R.4765) 81.School Food Modernization Act (S. 2210/H.R. 1783) 82.Protecting Children from Electronic Cigarette Advertising Act of 2014 (S. 2014/H.R. 4325) 83.Pedestrian Safety Act of 2014 (S. 2284) 84.Safe Streets Act of 2014 (S. 2004/H.R. 2468) 85.The Recovery Enhancement for Addiction Treatment Act (S. 2645) 86.FY 2015 Financial Services and General Government Appropriations bill, in support of an appropriation for the National Alliance for Model State Drug Laws (including H.R. 5016) 87.Vector-Borne Disease Research Accountability and Transparency Act (H.R. 4701) 88.Highway and Transportation Funding Act of 2014 (H.R. 5021/Public Law 113-520) 89.Full-Service Community Schools Act of 2014 (H.R. 5168) 90.PREPARE Act of 2014 (H.R. 5314) 91.Waters of the United States Regulatory Overreach Protection Act of 2014 (S. 2496/H.R. 5078) 92.American Energy Solutions for Lower Costs and More American Jobs Act (H.R.
Client expense: $38,000 · Firm income: Not reported
Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Environmental Protection Agency (EPA), Executive Office of the President (EOP), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Office of Management & Budget (OMB), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Transportation, Dept of (DOT)
2014 · third_quarter · Medicare/Medicaid
Issues concerning cancer prospective payment system exemptions. Medicare Better Health Rewards Program Act (S. 1228/H.R. 1250); issues related to employee health. The Medicare Audit Improvement Act (S. 1012/H.R. 1250; issues related to health information technology and transparency. The IMPACT Act of 2014 (H.R. 4994); general reimbursement issues.
Client expense: $150,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, Office of Natl Drug Control Policy (NDCP), SENATE
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 · third_quarter · Medicare/Medicaid
Issues concerning new GME residency programs and cancer pps-exempt hospitals; S. 1228/H.R. 2524, Medicare Better Health Rewards Act. S. 1012/H.R. 1250, The Medicare Audit Improvement Act; Issues related to health information technology and transparency. Issues related to hospital reimbursement. H.R. 4994, The IMPACT Act of 2014.
Client expense: Not reported · Firm income: $60,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2014 · second_quarter · Medicare/Medicaid
Issues concerning cancer prospective payment system exemptions. Issues related to individual nominations for the Medicare Payement Advisory Commission. Medicare Better Health Rewards Program Act (S. 1228/H.R. 1250); issues related to employee health. Strenghtening Medicare anti Fraud Measures Act of 2013 (H.R. 2925); issues related to health information technology and transparency. The Medicare Audit Improvement Act (S. 1012/H.R. 1250; provisions related to hospital reimbursement. TheBundled Payments for Care Improvement Initiative at Center for Medicare & Medicaid Innovation; issues related to hospital quality measures.
Client expense: $170,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE
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 · Health Issues
Budget and appropriations for disease and injury prevention, including obesity and related diseases; pandemic influenza and emerging infectious diseases; physical activity; public health bioterrorism preparedness; food safety, environmental health; paid sick days; womens and childrens health; and community-based public health interventions. 1. Implementation of the Patient Protection and Affordable Care Act (Public Law 111-148)1.Implementation of the Patient Protection and Affordable Care Act (Public Law 111-148) 2.Middle Class Tax Relief and Job Promotion Act (H.R. 3630) 3.Implementation of the FDA Food Safety Modernization Act (Public Law 111-353) 4.Implementation of Pandemic and All-Hazards Preparedness Act (Public Law 109-417) 5.Implementation of Healthy, Hunger-Free Kids Act of 2010 (Public Law 111-296) 6.Implementation of the Budget Control Act of 2011 (Public Law 112-25) 7.Delivering Antimicrobial Transparency in Animals Act of 2013 (H.R. 820) 8.Animal Drug and Animal Generic Drug User Fee Act (S. 622/H.R.___) 9.Healthier Lifestyles and Prevention America Act (S. 39) 10.Promoting Health as Youth Skills in Classrooms and Life Act (S. 392) 11.Medicare Diabetes Prevention Act (S. 452/H.R. 962) 12.Personal Health Investment Today Act (H.R. 956) 13.A bill to provide for a sequester replacement (S. 16) 14.American Family Economic Protection Act of 2013 (S. 388) 15.Consolidated and Further Continuing Appropriations Act, 2013 (H.R. 933) 16.Regulations From the Executive in Need of Scrutiny Act of 2013 (S. 15 / H.R. 367) 17.To repeal the Prevention and Public Health Fund (H.R. 1099) 18.Pandemic and All-Hazards Preparedness Reauthorization Act of 2013 (Public Law 113-5) 19.National Diabetes Clinical Care Commission Act (H.R. 1074/S. 539) 20.Physical Activity Guidelines for Americans Act (S. 531) 21.Firearm Safety and Public Health Research Act (H.R. 321) 22.Helping Sick Americans Now Act (H.R. 1549) 23.Energy Consumers Relief Act (H.R. 1582) 24.Common Sense Nutrition Disclosure Act (H.R. 1249) 25.Improve Nutrition Program Integrity and Deficit Reduction Act (S. 458/H.R. 1510) 26.A bill to amend the Food and Nutrition Act of 2008 to improve the supplemental nutrition assistance program (S. 762/H.R. 1657) 27.Agriculture Reform, Food, and Jobs Act (S. 954/H.R. 2498) 28.Federal Agriculture Reform and Risk Management Act (H.R. 1947) 29.FIT Kids Act (S. 1033/H.R. 2178) 30.Strengthening Americas Schools Act (S. 840) 31.Access to Quality Diabetes Education Act (S. 945/H.R. 1274) 32.Fit to Serve Act (S. 976) 33.Climate Change Health Protection and Promotion Act (H.R. 2023) 34.Treat and Reduce Obesity Act (S. 1184 / H.R. 2415) 35.Student Success Act (H.R. 5) 36.To repeal the Patient Protection and Affordable Care Act and health care-related provisions in the Health Care and Education Reconciliation Act (H.R. 45) 37.Medicare Better Health Rewards Program Act (S. 1228/H.R. 2524) 38.Senate FY14 Labor, Health and Human Services, and Education Bill 39.House of Representatives FY14 Labor, Health and Human Services, and Education Bill 40.Pharmacy Compounding Quality and Accountability Act (S. 959) 41.Safeguarding Americas Pharmaceuticals Act (H.R. 1919) 42.Drug Supply Chain Security Act (S. 957) 43.Preservation of Antibiotics for Medical Treatment Act (H.R. 1150)/Preventing Antibiotic Resistance Act of 2013 (S. 1256) 44.Healthy Families Act (H.R. 1286/S. 631) 45.FY2014 Continuing Resolution (H.J. Res. 59) 46.Drug Quality and Security Act (H.R. 3204) 47.Pharmaceutical Quality, Security and Accountability Act (S. 959) 48.Energy Consumers Relief Act (H.R. 1582) 49.Increasing the Safety of Prescription Drug User Act (not yet introduced proposed by Sen. Udall-NM) 50.National Energy Tax Repeal Act (S. 1324)51.Saving Coal Jobs Act of 2013 (S. 1514) 52.Community Parks Revitalization Act (H.R. 2424) 53.A bill to amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings (S. 1422/H.R. 2663) 54.School-based Health Centers Program Reauthorization Act of 2013 (H.R. 2632) 55.Nutrition Reform and Work Opportunity Act (H.R. 3102) 56.Health Equity and Accountability Act (not yet introduced) 57.Secure America for Education (SAFE) in Our Schools Act of 2013 (H.R. 3158) 58.Continuing Appropriations Resolution, 2014 (H.J. Res 59) 59.Continuing Resolution FY 2014 (HR 2775, PL 113-46) 60.A bill to amend title 23, United States Code, with respect to the establishment of performance measures for the highway safety improvement program, and for other purposes. (H.R. 3493/S. 1708) 61.The Farm Bill (S. (S. 954/H.R. 2498; H.R. 1947, and H.R. 3102) 62.Better Care, Lower Cost Act (S. 1932/H.R. 3890) 63.Antibiotic Development to Advance Patient Treatment Act of 2013 (ADAPT Act) (H.R. 3742) 64.Preventing Antibiotic Resistance Act (S. 1256) 65.The Consolidated Appropriations Act of 2014 66.Strategies to Address Antimicrobial Resistance (STAAR) Act 67.New Opportunities for Bicycling and Pedestrian Infrastructure Financing Act of 2014 (H.R. 3978) 68.Eliminating Disparities in Diabetes Prevention, Access, and Care Act (H.R. 3322) 69.Electricity Security and Affordability Act (HR 3826) 70.Stop Overdose Stat Act (HR 4169) and Senate companion bill soon to be introduced by Senator Reed 71.Opioid Overdose Reduction Act (S. 2092/H.R. 4288) 72.Developing an Innovative Strategy for Antimicrobial Resistant Microorganisms Act of 2014 (DISARM Act) (H.R. 4186) 73.Child Care and Development Block Grant Act of 2014 (S. 1086) 74.Departments of Labor, Health and Human Services and Education And Related Agencies Fiscal Year 2015 Appropriations Bill 75.Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, 2015 (S. 2389 / H.R. 4800) 76.Department of the Interior, Environment, and Related Agencies appropriations legislation, 2015 77.MAP-21 Reauthorization Act (S. 2322) 78.Stop Subsidizing Childhood Obesity Act (S. 2342/H.R. 2831) 79.ENRICH Act (H.R. 4427) 80.Agricultural Act of 2014 (Public Law 113-79) 81.Healthy Kids Outdoors Act of 2014 (S. 2367/H.R. 4706) 82.A bill to amend the Richard B. Russell National School Lunch Act to improve the efficiency of summer meals (S. 2527) 83.Summer Meals Act of 2014 (HR. 5012) 84.Long-Term SCORE Act (H.R. 4444) 85.American Cures Act (S. 2115/H.R. 4384) 86.A joint resolution to disapprove a rule of the Environmental Protection Agency relating to greenhouse gas emissions from electric utility generating units. (S.J. Res 30) 87.Fit for Life Act of 2014 (H.R.4765) 88.School Food Modernization Act (S. 2210/H.R. 1783) 89.Protecting Children from Electronic Cigarette Advertising Act of 2014 (S. 2014/H.R. 4325) 90.Pedestrian Safety Act of 2014 (S. 2284) 91.Safe Streets Act of 2014 (S. 2004/H.R. 2468) 92.The Recovery Enhancement for Addiction Treatment Act (not yet introduced, by Senator Markey) 93.FY 2015 Financial Services and General Government Appropriations bill, in support of an appropriation for the National Alliance for Model State Drug Laws
2014 · second_quarter · Medicare/Medicaid
Issues concerning cancer pps-exempt hospitals; issues related to candidate nomination for MedPac; S. 1228 / H.R. 2524, Medicare Better Health Rewards Act. H.R. 2925, Strengthening Medicare Anti Fraud Measures Act of 2013 and S. 1012/H.R. 1250, The Medicare Audit Improvement Act; Issues related to health information technology and transparency.
Client expense: Not reported · Firm income: $60,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
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 · Medicare/Medicaid
Legislation and policies related to: Physician/nurse practitioner reimbursement Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Adoption of recommendations of the Institute of Medicine report, The Future of Nursing: Leading Change, Advancing HealthDraft legislation to repeal the Medicare sustainable growth rate and reform fee-for-service payment Delay of the scheduled implementation of Medicare durable medical equipment documentation requirements Medicare Shared Savings Program beneficiary assignment requirements Medicare hospice certification requirements Medicare skilled nursing facility conditions of participation Medicare-Medicaid hospital conditions of participation Draft legislation on admission of advanced practice registered nurses to hospital medical staff and granting of clinical privileges Provisions of the 2013 Medicare fee schedule final regulations Draft legislation to require states to recognize nurse practitioners as primary care case managers and as primary care providers in managed care plans Draft legislation to extend Medicaid incentives to adopt electronic health records to nurse-managed health clinics Evaluation of the Medicare Graduate Nurse Education demonstration Medicare-Medicaid Program Integrity policies Medicaid maintenance of effort requirements Medicaid eligibility expansion and state options Medicaid waiver application procedures Medicaid per capita cap policy options Medicare-Medicaid dual eligible coverage and demonstration H.R. 351/S. 351 Protecting Seniors Access to Medicare Act H.R. 574 Medicare Physician Payment Innovation Act H.R. 2524/S. 1228 Medicare Better Health Rewards Act H.R. 2810 Medicare Patient Access and Quality Improvement Act H.R. 2817 Protect Patient Access to Quality Health Professionals Act S.1758 Quality Data, Quality Healthcare Act
2014 · first_quarter · Health Issues
Budget and appropriations for disease and injury prevention, including obesity and related diseases; pandemic influenza and emerging infectious diseases; physical activity; public health bioterrorism preparedness; food safety, environmental health; paid sick days; womens and childrens health; and community-based public health interventions. 1. Implementation of the Patient Protection and Affordable Care Act (Public Law 111-148)1.Implementation of the Patient Protection and Affordable Care Act (Public Law 111-148) 2.Middle Class Tax Relief and Job Promotion Act (H.R. 3630) 3.Implementation of the FDA Food Safety Modernization Act (Public Law 111-353) 4.Implementation of Pandemic and All-Hazards Preparedness Act (Public Law 109-417) 5.Implementation of Healthy, Hunger-Free Kids Act of 2010 (Public Law 111-296) 6.Implementation of the Budget Control Act of 2011 (Public Law 112-25) 7.Delivering Antimicrobial Transparency in Animals Act of 2013 (H.R. 820) 8.Animal Drug and Animal Generic Drug User Fee Act (S. 622/H.R.___) 9.Healthier Lifestyles and Prevention America Act (S. 39) 10.Promoting Health as Youth Skills in Classrooms and Life Act (S. 392) 11.Medicare Diabetes Prevention Act (S. 452/H.R. 962) 12.Personal Health Investment Today Act (H.R. 956) 13.A bill to provide for a sequester replacement (S. 16) 14.American Family Economic Protection Act of 2013 (S. 388) 15.Consolidated and Further Continuing Appropriations Act, 2013 (H.R. 933) 16.Regulations From the Executive in Need of Scrutiny Act of 2013 (S. 15 / H.R. 367) 17.To repeal the Prevention and Public Health Fund (H.R. 1099) 18.Pandemic and All-Hazards Preparedness Reauthorization Act of 2013 (Public Law 113-5) 19.National Diabetes Clinical Care Commission Act (H.R. 1074/S. 539) 20.Physical Activity Guidelines for Americans Act (S. 531) 21.Firearm Safety and Public Health Research Act (H.R. 321) 22.Helping Sick Americans Now Act (H.R. 1549) 23.Energy Consumers Relief Act (H.R. 1582) 24.Common Sense Nutrition Disclosure Act (H.R. 1249) 25.Improve Nutrition Program Integrity and Deficit Reduction Act (S. 458/H.R. 1510) 26.A bill to amend the Food and Nutrition Act of 2008 to improve the supplemental nutrition assistance program (S. 762/H.R. 1657) 27.Agriculture Reform, Food, and Jobs Act (S. 954/H.R. 2498) 28.Federal Agriculture Reform and Risk Management Act (H.R. 1947) 29.FIT Kids Act (S. 1033/H.R. 2178) 30.Strengthening Americas Schools Act (S. 840) 31.Access to Quality Diabetes Education Act (S. 945/H.R. 1274) 32.Fit to Serve Act (S. 976) 33.Climate Change Health Protection and Promotion Act (H.R. 2023) 34.Treat and Reduce Obesity Act (S. 1184 / H.R. 2415) 35.Student Success Act (H.R. 5) 36.To repeal the Patient Protection and Affordable Care Act and health care-related provisions in the Health Care and Education Reconciliation Act (H.R. 45) 37.Medicare Better Health Rewards Program Act (S. 1228/H.R. 2524) 38.Senate FY14 Labor, Health and Human Services, and Education Bill 39.House of Representatives FY14 Labor, Health and Human Services, and Education Bill 40.Pharmacy Compounding Quality and Accountability Act (S. 959) 41.Safeguarding Americas Pharmaceuticals Act (H.R. 1919) 42.Drug Supply Chain Security Act (S. 957) 43.Preservation of Antibiotics for Medical Treatment Act (H.R. 1150)/Preventing Antibiotic Resistance Act of 2013 (S. 1256) 44.Healthy Families Act (H.R. 1286/S. 631) 45.FY2014 Continuing Resolution (H.J. Res. 59) 46.Drug Quality and Security Act (H.R. 3204) 47.Pharmaceutical Quality, Security and Accountability Act (S. 959) 48.Energy Consumers Relief Act (H.R. 1582) 49.Increasing the Safety of Prescription Drug User Act (not yet introduced proposed by Sen. Udall-NM) 50.National Energy Tax Repeal Act (S. 1324) 51.Saving Coal Jobs Act of 2013 (S. 1514) 52.Community Parks Revitalization Act (H.R. 2424) 53.A bill to amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings (S. 1422/H.R. 2663) 54.School-based Health Centers Program Reauthorization Act of 2013 (H.R. 2632) 55.Nutrition Reform and Work Opportunity Act (H.R. 3102) 56.Health Equity and Accountability Act (not yet introduced) 57.Secure America for Education (SAFE) in Our Schools Act of 2013 (H.R. 3158) 58.Continuing Appropriations Resolution, 2014 (H.J. Res 59) 59.Continuing Resolution FY 2014 (HR 2775, PL 113-46) 60.A bill to amend title 23, United States Code, with respect to the establishment of performance measures for the highway safety improvement program, and for other purposes. (H.R. 3493/S. 1708) 61.To provide direction to the Administrator of the Environmental Protection Agency regarding the establishment of standards for emissions of any greenhouse gas from fossil fuel-fired electric utility generating units, and for other purposes. (H.R. 3826) 62.Potential conference report for the Farm Bill (S. (S. 954/H.R. 2498; H.R. 1947, and H.R. 3102) 63.Senators Wyden and Isakson proposal on chronic disease care coordination in Medicare (not yet introduced) 64.Antibiotic Development to Advance Patient Treatment Act of 2013 (ADAPT Act) (H.R. 3742) 65.Preventing Antibiotic Resistance Act (S. 1256) 66.The Consolidated Appropriations Act of 2014 67.Strategies to Address Antimicrobial Resistance (STAAR) Act 68.New Opportunities for Bicycling and Pedestrian Infrastructure Financing Act of 2014 (H.R. 3978) 69.Eliminating Disparities in Diabetes Prevention, Access, and Care Act (H.R. 3322) 70.Electricity Security and Affordability Act (HR 3826) 71.Stop Overdose Stat Act (HR 4169) 72.Opioid Overdose Reduction Act (S. 2092/H.R. 4288)
2014 · first_quarter · Medical/Disease Research/Clinical Labs
H.R. 962 / S. 452 - Medicare Diabetes Prevention Act of 2013 H.R. 1074 / S. 539 - National Diabetes Clinical Care Commission Act H.R. 1257 - Preventing Diabetes in Medicare Act H.R. 1274 / S. 945 - Access to Quality Diabetes Education Act of 2013 S. 557 - Medication Therapy Management Empowerment Act H.R. 3322 - Eliminating Disparities in Diabetes Prevention, Access, and Care Act of 2013 H.R. 2845 / S. 1935 - Diabetic Testing Supply Access of 2013/14 H.R. 3591 - Minority Diabetes Initiative Act H.R. 2415 / S. 1184 - Treat and Reduce Obesity Act of 2013 S. 596 - Fostering Independence Through Technology Act of 2013 H.R. 2524 / S. 1228 - Medicare Better Health Rewards Program Act of 2013
Client expense: Not reported · Firm income: $10,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
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
Issues concerning cancer pps-exempt hospitals; issues related to candidate nomination for MedPac; S. 1228 / H.R. 2524, Medicare Better Health Rewards Act. H.R. 2925, Strengthening Medicare Anti Fraud Measures Act of 2013 and S. 1012/H.R. 1250, The Medicare Audit Improvement Act; S. 2000 / H.R. 4015, The SGR Repeal Act of 2014; H.R. 4302, Protecting Access to Medicare Act of 2014 and issues related to hospital reimbursement.
Client expense: Not reported · Firm income: $60,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
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.
2014 · first_quarter · Medicare/Medicaid
Legislation and policies related to: Physician/nurse practitioner reimbursement Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Adoption of recommendations of the Institute of Medicine report, The Future of Nursing: Leading Change, Advancing Health Delay of implementation of Medicare durable medical equipment documentation requirements Medicare Shared Savings Program beneficiary assignment requirements Medicare-Medicaid hospital conditions of participation Draft legislation on admission of advanced practice registered nurses to hospital medical staff and granting of clinical privileges Provisions of the 2013 and 2014 Medicare fee schedule final regulations Draft legislation to require states to recognize nurse practitioners as primary care case managers and as primary care providers in managed care plans Draft legislation to extend Medicaid incentives to adopt electronic health records to nurse-managed health clinics Evaluation of the Medicare Graduate Nurse Education demonstration Medicare-Medicaid Program Integrity policies Medicaid maintenance of effort requirements Medicaid eligibility expansion and state options Medicaid waiver application procedures Medicaid per capita cap policy options Medicare-Medicaid dual eligible coverage and demonstration H.R. 351/S. 351 - Protecting Seniors Access to Medicare Act H.R. 574 - Medicare Physician Payment Innovation Act H.R. 1698 - Stabilize Medicaid and CHIP Coverage Act H.R. 2504/S. 1332 - Home Health Care Planning Improvement Act H.R. 2524/S. 1228 - Medicare Better Health Rewards Act H.R. 2810 - Medicare Patient Access and Quality Improvement Act H.R. 2817 - Protect Patient Access to Quality Health Professionals Act H.R. 2986 - Protecting Access to Primary Care Act H.R. 3796 - Comprehensive Care Payment Innovation Act H.R. 3833 - To amend title XVIII of the Social Security Act to modify the Medicare durable medical equipment face-to-face encounter documentation requirement. H.R. 4015/S. 2000 - SGR Repeal and Medicare Provider Payment Modernization Act H.R. 4302 - Protecting Access to Medicare Act S. 1143/H.R. 2810 - Protecting Access to Rural Therapy Services (PARTS) Act S. 1871 - SGR Repeal and Medicare Beneficiary Access Act S. 1954/H.R. 4067 - To provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2014. S. 1980 - Medicaid and CHIP Continuous Quality Act S. 2110 - Medicare SGR Repeal and Beneficiary Access Improvement Act S. 2122 - Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act S. 2157 - Commonsense Medicare SGR Repeal and Beneficiary Access Improvement Act
2014 · first_quarter · Health Issues
S. 2157, the Commonsense Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 H.R. 2019 Gabriella Miller Kids First Research Act H.R. 1037 Occupational Therapy in Mental Health Act H.R. 1178 Creating Access to Residency Education Act of 2013H.R. 1180 Resident Physician Shortage Reduction Act of 2013 H.R. 1201 Training Tomorrow's Doctors Act H.R. 1252 Physical Therapist Workforce and Patient Access Act of 2013 H.R. 1274 Access to Quality Diabetes Education Act of 2013 H.R. 1326 Health Care Price Transparency Promotion Act of 2013 H.R. 1339 Palliative Care and Hospice Education and Training Act H.R. 1427 Truth in Healthcare Marketing Act of 2013 H.R. 1790 Health IT Modernization for Underserved Communities Act of 2013 H.R. 1814 Equitable Access to Care and Health (EACH) Act H.R. 1821 Registered Nurse Safe Staffing Act of 2013 H.R. 1827 Pediatric Subspecialty and Mental Health Workforce Reauthorization Act of 2013 H.R. 1838 Enhanced Access to Medicaid Services Act of 2013 H.R. 1874 Pro-Growth Budgeting Act H.R. 1907 Nurse Staffing Standards for Patient Safety and Quality Care Act of 2013 H.R. 1976 Access to Certified Professional Midwives Act of 2013 H.R. 2131 Supplying Knowledge-based Immigrants and Lifting Levels of STEM (SKILLS) Visas Act of 2013 H.R. 235 Veteran Emergency Medical Technician Support Act of 2013 H.R. 2415 Treat and Reduce Obesity Act H.R. 244 Physician Availability Act of 2013 H.R. 2453 Medicare Beneficiary Preservation of Choice Act of 2013 H.R. 2484 Conrad State 30 and Physician Access Act H.R. 2619 Medicare Repiratory Therapist Access Act of 2013 H.R. 2651 Critical Care Assessment and Improvement Act of 2013 H.R. 2663 Preventive Health Savings Act H.R. 2801 Protecting Access to Rural Therapy Services (PARTS) Act H.R. 2810 Medicare Patient Access and Quality Improvement Act of 2013 H.R. 2843/S. 1180 Medicare Data Access for Transparency and Accountability Act H.R. 2867 Medicare Hospice Care Access Act of 2013 H.R. 2969 Medicare Patient Access to Hospice Act of 2013 H.R. 297 Children's Hospital GME Support Reauthorization Act of 2013 H.R. 2986 Protecting Access to Primary Care Act H.R. 3077 TELEmedicine for MEDicare Act of 2013 or TELE-MED Act of 2013 H.R. 3120 Comprehensive Dental Reform Act of 2013 H.R. 3303 Sensible Oversight for Technology which Advances Regulatory Efficiency (SOFTWARE) Act H.R. 3306 Telehealth Enhancement Act of 2013 H.R. 3362, Exchange Information Disclosure Act H.R. 3392 Medicare Part D Patient Safety and Drug Abuse Prevention Act of 2013 H.R. 3474 Hire More Heroes Act of 2013 H.R. 3507 21st Century Care for Military and Veterans Act H.R. 3717, the Helping Families in Mental Health Crisis Act of 2013 H.R. 3811, Health Exchange Security and Transparency Act H.R. 3979 Protecting Volunteer Firefighters and Emergency Responders Act of 2014 H.R. 4106, Barr-Bera Saving Lives, Saving Costs Act H.R. 4118, The SIMPLE Fairness Act H.R. 4160 - the "Keep the Promise to Seniors Act of 2014." H.R. 4177: a bill to amend the Internal Revenue Code of 1986 to Allow Medicare beneficiaries participating in a Medicare Advantage MSA to contribute their own money to their MSA. H.R. 4180: a bill to amend the Internal Revenue Code of 1986 to permit rollovers from health savings accounts to Medicare Advantage MSAs H.R. 4196: Seniors' Fairness Act of 2014H.R. 4201: Seniors' Rights to Know Act H.R. 487 Primary Care Workforce Access Improvement Act of 2013 H.R. 574 Medicare Physician Payment Innovation Act of 2013 H.R. 7, No Taxpayer Funding for Abortion Act H.R. 794 To amend title XVIII of the Social Security Act to provide for treatment of clinical psychologists as physicians for purposes of furnishing clinical psychologist services under the Medicare Program. H.R. 962 Medicare Diabetes Prevention Act H.R. 2575, the "Save American Workers Act of 2014," H.R. 4064, FAIR ACT of 2014 H.R. 4302, the Protecting Access to Medicare Act of 2014 H.RES.356 A resolution recognizing that access to hospitals and other health care providers for patients in rural areas of the United States is essential to the survival and success of communities in the United States. H.R.1024 The Medication Therapy Management Empowerment Act IMPACT Act of 2014 (Improving Medicare Post-Acute Care Transformation Act of 2014) S. 1060 Veterans to Paramedics Transition Act S. 1061 Veterans Access to Care Act S. 1064 Medicare Mental Health Access Act S. 1143 Protecting Access to Rural Therapy Services (PARTS) Act S. 1152 Building a Health Care Workforce for the Future Act S. 1184 Treat and Reduce Obesity Act S. 1193 Data Security and Breach Notification Act of 2013 S. 1228 Medicare Better Health Rewards Program Act S. 1422 Preventive Health Savings Act S. 1439 Care Planning Act of 2013 S. 1444 Medicare Access to Rural Anesthesiology Act of 2013 S. 1445 National Health Service Corps Improvement Act of 2013 S. 1475 National Nurse Act of 2013 S. 1517 Behavioral Health Information Technology Act of 2013 S. 1522 Comprehensive Dental Reform Act of 2013 S. 1557 Children's Hospital GME Support Reauthorization Act of 2013 S. 1685 Behavioral Health Information Technology Coordination Act of 2013 S. 1729 - Expanded Consumer Choice Act S. 1758 Quality Data, Quality Healthcare Act of 2013 S. 1871, SGR Repeal and Medicare Beneficiary Improvement Act of 2013 S. 2000/H.R. 4015 SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S. 2007, Preventing Regulatory Overreach To Enhance Care Technology Act of 2014 (PROTECT Act) S. 2110, SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S. 2166 Treating Families Fairly Act S. 2168 amends the definition from 50 100 employees for the purposes of the employer mandate S. 2173 the CHOICE Act S. 2175 Enhancing Access to Agents and Brokers Act S. 2240 The Medicare Choices Empowerment and Protection Act S. 236 Medicare Patient Empowerment Act S. 328 Strengthening Rural Access to Emergency Services Act S. 382 A bill to amend title XVIII of the Social Security Act to allow physician assistants, nurse practitioners, and clinical nurse specialists to supervise cardiac, intensive cardiac, and pulmonary rehabilitation programs.S. 452 Medicare Diabetes Prevention Act S. 557 The Medication Therapy Management Empowerment Act S. 577 The Resident Physician Shortage Reduction Act of 2013 S. 602 Physical Therapist Workforce and Patient Access Act of 2013 S. 616 Conrad State 30 and Physician Access Act S. 641 Palliative Care and Hospice Education and Training Act S. 739 National Nursing Shortage Reform and Patient Advocacy Act S. 744 Border Security, Economic Opportunity, and Immigration Modernization Act S. 755 Enhanced Access to Medicaid Services Act of 2013 S. 945 Access to Quality Diabetes Education Act of 2013 S.1067 Innovation Inspiration School Grant Program Act S.1897 Personal Data Privacy and Security Act of 2014 S.1927 The Data Security Act of 2014 S.1932/H.R. 3890 The Better Care, Lower Cost Act S.1976 Data Security and Breach Notification Act of 2014 S.1995 Personal Data Protection and Breach Accountability Act S.2106, FAIR Act of 2014 S.236 / H.R. 1310 - Medicare Patient Empowerment Act of 2013 S.577 Resident Physician Shortage Reduction Act of 2013 S.RES.26 A resolution recognizing that access to hospitals and other health care providers for patients in rural areas of the United States is essential to the survival and success of communities in the United States.
2014 · first_quarter · Medicare/Medicaid
S.236 / H.R. 1310 - Medicare Patient Empowerment Act of 2013 S. 755 Enhanced Access to Medicaid Services Act of 2013 S. 641 Palliative Care and Hospice Education and Training Act S. 452 Medicare Diabetes Prevention ActS. 2240 The Medicare Choices Empowerment and Protection Act S. 236 Medicare Patient Empowerment Act S. 2110, SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S.1932/H.R. 3890 The Better Care, Lower Cost Act S. 2000/H.R. 4015 SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S. 1871, SGR Repeal and Medicare Beneficiary Improvement Act of 2013 S. 1439 Care Planning Act of 2013 S. 1444 Medicare Access to Rural Anesthesiology Act of 2013 S. 1228 Medicare Better Health Rewards Program Act S. 1064 Medicare Mental Health Access Act IMPACT Act of 2014 (Improving Medicare Post-Acute Care Transformation Act of 2014) H.R. 4302, the Protecting Access to Medicare Act of 2014 H.R. 962 Medicare Diabetes Prevention Act H.R. 574 Medicare Physician Payment Innovation Act of 2013 H.R. 4160 - the "Keep the Promise to Seniors Act of 2014." H.R. 3392 Medicare Part D Patient Safety and Drug Abuse Prevention Act of 2013 H.R. 3077 TELEmedicine for MEDicare Act of 2013 (TELE-MED Act of 2013) H.R. 2810 Medicare Patient Access and Quality Improvement Act of 2013 H.R. 2843/S. 1180 Medicare Data Access for Transparency and Accountability Act H.R. 2867 Medicare Hospice Care Access Act of 2013 H.R. 2969 Medicare Patient Access to Hospice Act of 2013 H.R. 2619 Medicare Repiratory Therapist Access Act of 2013 H.R. 1838 Enhanced Access to Medicaid Services Act of 2013 S. 2157, the Commonsense Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014
Client expense: $160,000 · Firm income: Not reported
2013 · fourth_quarter · Medicare/Medicaid
Legislation and policies related to: Physician/nurse practitioner reimbursement Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Adoption of recommendations of the Institute of Medicine report, The Future of Nursing: Leading Change, Advancing Health Draft legislation to repeal the Medicare sustainable growth rate and reform fee-for-service payment Delay of the scheduled implementation of Medicare durable medical equipment documentation requirements Medicare Shared Savings Program beneficiary assignment requirements Medicare hospice certification requirements Medicare skilled nursing facility conditions of participation Medicare-Medicaid hospital conditions of participation Draft legislation on admission of advanced practice registered nurses to hospital medical staff and granting of clinical privileges Provisions of the 2013 Medicare fee schedule final regulations Draft legislation to require states to recognize nurse practitioners as primary care case managers and as primary care providers in managed care plans Draft legislation to extend Medicaid incentives to adopt electronic health records to nurse-managed health clinics Evaluation of the Medicare Graduate Nurse Education demonstration Medicare-Medicaid Program Integrity policies Medicaid maintenance of effort requirements Medicaid eligibility expansion and state options Medicaid waiver application procedures Medicaid per capita cap policy options Medicare-Medicaid dual eligible coverage and demonstration H.R. 351/S. 351 Protecting Seniors Access to Medicare Act H.R. 574 Medicare Physician Payment Innovation Act H.R. 2504/S. 1332 Home Health Care Planning Improvement Act H.R. 2524/S. 1228 Medicare Better Health Rewards Act H.R. 2810 Medicare Patient Access and Quality Improvement Act H.R. 2817 Protect Patient Access to Quality Health Professionals Act H.R. 2986 Protecting Access to Primary Care Act S. 1143/H.R. 2810 Protecting Access to Rural Therapy Services (PARTS) Act S.1758 Quality Data, Quality Healthcare Act S. 1871 SGR Repeal and Medicare Beneficiary Access Act
2013 · fourth_quarter · Health Issues
Budget and appropriations for disease and injury prevention, including obesity and related diseases; pandemic influenza and emerging infectious diseases; physical activity; public health bioterrorism preparedness; food safety, environmental health; paid sick days; womens and childrens health; and community-based public health interventions. 1. Implementation of the Patient Protection and Affordable Care Act (Public Law 111-148)1.Implementation of the Patient Protection and Affordable Care Act (Public Law 111-148) 2.Middle Class Tax Relief and Job Promotion Act (H.R. 3630) 3.Implementation of the FDA Food Safety Modernization Act (Public Law 111-353) 4.Implementation of Pandemic and All-Hazards Preparedness Act (Public Law 109-417) 5.Implementation of Healthy, Hunger-Free Kids Act of 2010 (Public Law 111-296) 6.Implementation of the Budget Control Act of 2011 (Public Law 112-25) 7.Delivering Antimicrobial Transparency in Animals Act of 2013 (H.R. 820) 8.Animal Drug and Animal Generic Drug User Fee Act (S. 622/H.R.___) 9.Healthier Lifestyles and Prevention America Act (S. 39) 10.Promoting Health as Youth Skills in Classrooms and Life Act (S. 392) 11.Medicare Diabetes Prevention Act (S. 452/H.R. 962) 12.Personal Health Investment Today Act (H.R. 956) 13.A bill to provide for a sequester replacement (S. 16) 14.American Family Economic Protection Act of 2013 (S. 388) 15.Consolidated and Further Continuing Appropriations Act, 2013 (H.R. 933) 16.Regulations From the Executive in Need of Scrutiny Act of 2013 (S. 15 / H.R. 367) 17.To repeal the Prevention and Public Health Fund (H.R. 1099) 18.Pandemic and All-Hazards Preparedness Reauthorization Act of 2013 (Public Law 113-5) 19.National Diabetes Clinical Care Commission Act (H.R. 1074/S. 539) 20.Physical Activity Guidelines for Americans Act (S. 531) 21.Firearm Safety and Public Health Research Act (H.R. 321) 22.Helping Sick Americans Now Act (H.R. 1549) 23.Energy Consumers Relief Act (H.R. 1582) 24.Common Sense Nutrition Disclosure Act (H.R. 1249) 25.Improve Nutrition Program Integrity and Deficit Reduction Act (S. 458/H.R. 1510) 26.A bill to amend the Food and Nutrition Act of 2008 to improve the supplemental nutrition assistance program (S. 762/H.R. 1657) 27.Agriculture Reform, Food, and Jobs Act (S. 954/H.R. 2498) 28.Federal Agriculture Reform and Risk Management Act (H.R. 1947) 29.FIT Kids Act (S. 1033/H.R. 2178) 30.Strengthening Americas Schools Act (S. 840) 31.Access to Quality Diabetes Education Act (S. 945/H.R. 1274) 32.Fit to Serve Act (S. 976) 33.Climate Change Health Protection and Promotion Act (H.R. 2023) 34.Treat and Reduce Obesity Act (S. 1184 / H.R. 2415) 35.Student Success Act (H.R. 5) 36.To repeal the Patient Protection and Affordable Care Act and health care-related provisions in the Health Care and Education Reconciliation Act (H.R. 45) 37.Medicare Better Health Rewards Program Act (S. 1228/H.R. 2524) 38.Senate FY14 Labor, Health and Human Services, and Education Bill 39.House of Representatives FY14 Labor, Health and Human Services, and Education Bill 40.Pharmacy Compounding Quality and Accountability Act (S. 959) 41.Safeguarding Americas Pharmaceuticals Act (H.R. 1919) 42.Drug Supply Chain Security Act (S. 957) 43.Preservation of Antibiotics for Medical Treatment Act (H.R. 1150)/Preventing Antibiotic Resistance Act of 2013 (S. 1256) 44.Healthy Families Act (H.R. 1286/S. 631) 45.FY2014 Continuing Resolution (H.J. Res. 59) 46.Drug Quality and Security Act (H.R. 3204) 47.Pharmaceutical Quality, Security and Accountability Act (S. 959) 48.Energy Consumers Relief Act (H.R. 1582) 49.Increasing the Safety of Prescription Drug User Act (not yet introduced proposed by Sen. Udall-NM) 50.National Energy Tax Repeal Act (S. 1324) 51.Saving Coal Jobs Act of 2013 (S. 1514) 52.Community Parks Revitalization Act (H.R. 2424) 53.A bill to amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings (S. 1422/H.R. 2663) 54.School-based Health Centers Program Reauthorization Act of 2013 (H.R. 2632) 55.Nutrition Reform and Work Opportunity Act (H.R. 3102) 56.Health Equity and Accountability Act (not yet introduced) 57.Secure America for Education (SAFE) in Our Schools Act of 2013 (H.R. 3158) 58.Continuing Appropriations Resolution, 2014 (H.J. Res 59) 59.Continuing Resolution FY 2014 (HR 2775, PL 113-46) 60.A bill to amend title 23, United States Code, with respect to the establishment of performance measures for the highway safety improvement program, and for other purposes. (H.R. 3493/S. 1708) 61.To provide direction to the Administrator of the Environmental Protection Agency regarding the establishment of standards for emissions of any greenhouse gas from fossil fuel-fired electric utility generating units, and for other purposes. (H.R. 3826) 62.Potential conference report for the Farm Bill (S. (S. 954/H.R. 2498; H.R. 1947, and H.R. 3102) 63.Senators Wyden and Isakson proposal on chronic disease care coordination in Medicare (not yet introduced) 64.Antibiotic Development to Advance Patient Treatment Act of 2013 (ADAPT Act) (H.R. 3742) 65.Preventing Antibiotic Resistance Act (S. 1256) 66.The Consolidated Appropriations Act of 2014
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 · Medicare/Medicaid
Graduate Medical Education (GME) and Indirect Medical Education (IME), issues related to payment program. Issues related to Prospective Payment System exemptions. Issues related to MedPAC committee member nominations. The SGR Repeal and Medicare Beneficiary Access Act of 2013 (S.1871) and The Medicare Patient Access and quality Improvement Act of 2013 (H.R.2810), provisions related to hospital reimbursements. Medicare Better Health Rewards Act (S.1228/H.R.2524),Medicare Better Health Rewards Act (S.1228/H.R.2524), provisions related to wellness incentives. Strengthening Medicare Anti-Fraud Measures Act of 2013 (H.R. 2925), provisions related to hospital oversight. The Medicare Audit Improvement Act (S.1012/H.R.1250), provisions related to hospital audits.
Client expense: $100,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2013 · fourth_quarter · Medicare/Medicaid
Issues involving GME programs; issues concerning cancer pps-exempt hospitals; issues related to candidate nomination for MedPac; S. 1871, The SGR Repeal and Medicare Beneficiary Access Act of 2013 and H.R. 2810, The Medicare Patient Access and Quality Improvement Act of 2013; S. 1228 / H.R. 2524, Medicare Better Health Rewards Act. H.R. 2925, Strengthening Medicare Anti Fraud Measures Act of 2013 and S. 1012/H.R. 1250, The Medicare Audit Improvement Act.
Client expense: Not reported · Firm income: $45,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2013 · fourth_quarter · Medicare/Medicaid
Issues related to Medicare/Medicaid reimbursements; S. 1228, Medicare Better Health Records Program Act of 2013.
Client expense: Not reported · Firm income: $20,000
Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, SENATE
2013 · fourth_quarter · Health Issues
H.R.2775 Continuing Appropriations Act, 2014 H.J. Res 59 Bipartisan Budget Act of 2013 H.R. 2810 The Medicare Patient Access and Quality Improvement Act of 2013 H.R. 3077 TELE-MED Act of 2013H.R. 3303 Sensible Oversight for Technology which Advances Regulatory Efficiency (SOFTWARE) Act H.R. 2725 FDA Safety Over Sequestration Act H.R. 3204 Drug Quality and Security Act H.R. 2651 Critical Care Assessment and Improvement Act of 2013 S. 1439 Care Planning Act of 2013 S. 1193 Data Security and Breach Notification Act of 2013 S.1927 The Data Security Act of 2014 H.R. 3696 National Cybersecurity and Critical Infrastructure Protection Act of 2013 H.R. 3811 Healthcare Exchange Security and Transparency Act of 2014 S.1897 Personal Data Privacy and Security Act of 2014 H.R. 1326 Health Care Price Transparency Promotion Act of 2013 H.R. 2651 Critical Care Assessment and Improvement Act of 2013 H.R. 2843 Medicare Data Access for Transparency and Accountability Act S. 1180 Medicare Data Access for Transparency and Accountability Act S. 1758 Quality Data, Quality Healthcare Act of 2013 H.R.3367 To amend section 9010 of the Patient Protection and Affordable Care Act to delay the application of the health insurance provider annual fee until 2016 and to provide a process to return to consumers any amounts attributable to the expected application of the annual fee to 2014 or 2015 H.R. 1037 Occupational Therapy in Mental Health Act H.R. 3120 Comprehensive Dental Reform Act of 2013 H.R. 3306 Telehealth Enhancement Act of 2013 H.R. 3507 21st Century Care for Military and Veterans Act H.R. 487 Primary Care Workforce Access Improvement Act of 2013 H.R. 574 Medicare Physician Payment Innovation Act of 2013 H.R. 1180 Resident Physician Shortage Reduction Act of 2013 H.R. 1201 Training Tomorrow's Doctors Act H.R. 1252 Physical Therapist Workforce and Patient Access Act of 2013 H.R. 1274 Access to Quality Diabetes Education Act of 2013 H.R. 1339 Palliative Care and Hospice Education and Training Act H.R. 1427 Truth in Healthcare Marketing Act of 2013 H.R. 1790 Health IT Modernization for Underserved Communities Act of 2013 H.R. 1821 Registered Nurse Safe Staffing Act of 2013 H.R. 1827 Pediatric Subspecialty and Mental Health Workforce Reauthorization Act of 2013 H.R. 1838 Enhanced Access to Medicaid Services Act of 2013 H.R. 1907 Nurse Staffing Standards for Patient Safety and Quality Care Act of 2013 H.R. 1976 Access to Certified Professional Midwives Act of 2013 H.R. 2131 Supplying Knowledge-based Immigrants and Lifting Levels of STEM (SKILLS) Visas Act of 2013 H.R. 235 Veteran Emergency Medical Technician Support Act of 2013 H.R. 244 Physician Availability Act of 2013 H.R. 2484 Conrad State 30 and Physician Access Act H.R. 2619 Medicare Repiratory Therapist Access Act of 2013 H.R. 2801 Protecting Access to Rural Therapy Services (PARTS) Act H.R. 2867 Medicare Hospice Care Access Act of 2013 H.R. 2969 Medicare Patient Access to Hospice Act of 2013 H.R. 297 Children's Hospital GME Support Reauthorization Act of 2013 H.R. 2986 Protecting Access to Primary Care ActH.R. 794 To amend title XVIII of the Social Security Act to provide for treatment of clinical psychologists as physicians for purposes of furnishing clinical psychologist services under the Medicare Program. S. 1060 Veterans to Paramedics Transition Act S. 1061 Veterans Access to Care Act S. 1064 Medicare Mental Health Access Act S. 1143 Protecting Access to Rural Therapy Services (PARTS) Act S. 1152 Building a Health Care Workforce for the Future Act S. 1444 Medicare Access to Rural Anesthesiology Act of 2013 S. 1445 National Health Service Corps Improvement Act of 2013 S. 1475 National Nurse Act of 2013 S. 1517 Behavioral Health Information Technology Act of 2013 S. 1522 Comprehensive Dental Reform Act of 2013 S. 1557 Children's Hospital GME Support Reauthorization Act of 2013 S. 1685 Behavioral Health Information Technology Coordination Act of 2013 S. 236 Medicare Patient Empowerment Act S. 328 Strengthening Rural Access to Emergency Services Act S. 382 A bill to amend title XVIII of the Social Security Act to allow physician assistants, nurse practitioners, and clinical nurse specialists to supervise cardiac, intensive cardiac, and pulmonary rehabilitation programs. S. 602 Physical Therapist Workforce and Patient Access Act of 2013 S. 616 Conrad State 30 and Physician Access Act S. 641 Palliative Care and Hospice Education and Training Act S. 739 National Nursing Shortage Reform and Patient Advocacy Act S. 755 Enhanced Access to Medicaid Services Act of 2013 S. 945 Access to Quality Diabetes Education Act of 2013 S.577 Resident Physician Shortage Reduction Act of 2013 S. 744 Border Security, Economic Opportunity, and Immigration Modernization Act H.R. 2663 Preventive Health Savings Act S. 1422 Preventive Health Savings Act S. 1228 Medicare Better Health Rewards Program Act S. 1184 Treat and Reduce Obesity Act H.R. 2415 Treat and Reduce Obesity Act H.R. 2810 Medicare Patient Access and Quality Improvement Act H.R. 2642 Federal Agriculture Reform and Risk Management (FARRM) Act S. 954 Agriculture Reform, Food and Jobs Act
2013 · fourth_quarter · Medicare/Medicaid
H.R.2775 Continuing Appropriations Act, 2014 H.J. Res 59 Bipartisan Budget Act of 2013 H.R. 2810 The Medicare Patient Access and Quality Improvement Act of 2013 H.R. 2843 Medicare Data Access for Transparency and Accountability ActS. 1180 Medicare Data Access for Transparency and Accountability Act H.R. 1838 Enhanced Access to Medicaid Services Act of 2013 H.R. 2619 Medicare Repiratory Therapist Access Act of 2013 H.R. 2867 Medicare Hospice Care Access Act of 2013 H.R. 2969 Medicare Patient Access to Hospice Act of 2013 H.R. 3077 TELEmedicine for MEDicare Act of 2013 or TELE-MED Act of 2013 S. 1064 Medicare Mental Health Access Act S. 1444 Medicare Access to Rural Anesthesiology Act of 2013 S. 236 Medicare Patient Empowerment Act S. 755 Enhanced Access to Medicaid Services Act of 2013 S. 1228 Medicare Better Health Rewards Program Act
Client expense: $160,000 · Firm income: Not reported
2013 · fourth_quarter · Medicare/Medicaid
Legislation and policies related to: Physician/nurse practitioner reimbursement Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Adoption of recommendations of the Institute of Medicine report, The Future of Nursing: Leading Change, Advancing HealthDraft legislation to repeal the Medicare sustainable growth rate and reform fee-for-service payment Delay of the scheduled implementation of Medicare durable medical equipment documentation requirements Medicare Shared Savings Program beneficiary assignment requirements Medicare hospice certification requirements Medicare skilled nursing facility conditions of participation Medicare-Medicaid hospital conditions of participation Draft legislation on admission of advanced practice registered nurses to hospital medical staff and granting of clinical privileges Provisions of the 2013 Medicare fee schedule final regulations Draft legislation to require states to recognize nurse practitioners as primary care case managers and as primary care providers in managed care plans Draft legislation to extend Medicaid incentives to adopt electronic health records to nurse-managed health clinics Evaluation of the Medicare Graduate Nurse Education demonstration Medicare-Medicaid Program Integrity policies Medicaid maintenance of effort requirements Medicaid eligibility expansion and state options Medicaid waiver application procedures Medicaid per capita cap policy options Medicare-Medicaid dual eligible coverage and demonstration H.R. 351/S. 351 Protecting Seniors Access to Medicare Act H.R. 574 Medicare Physician Payment Innovation Act H.R. 2504/S. 1332 Home Health Care Planning Improvement Act H.R. 2524/S. 1228 Medicare Better Health Rewards Act H.R. 2810 Medicare Patient Access and Quality Improvement Act H.R. 2817 Protect Patient Access to Quality Health Professionals Act H.R. 2986 Protecting Access to Primary Care Act S. 1143/H.R. 2810 Protecting Access to Rural Therapy Services (PARTS) Act S.1758 Quality Data, Quality Healthcare Act S. 1871 SGR Repeal and Medicare Beneficiary Access Act
2013 · fourth_quarter · Medicare/Medicaid
Legislation and policies related to: Physician/nurse practitioner reimbursement Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Adoption of recommendations of the Institute of Medicine report, The Future of Nursing: Leading Change, Advancing Health Draft legislation to repeal the Medicare sustainable growth rate and reform fee-for-service payment Delay of the scheduled implementation of Medicare durable medical equipment documentation requirements Medicare Shared Savings Program beneficiary assignment requirements Medicare-Medicaid hospital conditions of participation Draft legislation on admission of advanced practice registered nurses to hospital medical staff and granting of clinical privileges Provisions of the 2013 Medicare fee schedule final regulations Draft legislation to require states to recognize nurse practitioners as primary care case managers and as primary care providers in managed care plans Draft legislation to extend Medicaid incentives to adopt electronic health records to nurse-managed health clinics Evaluation of the Medicare Graduate Nurse Education demonstration Medicare-Medicaid Program Integrity policies Medicaid maintenance of effort requirements Medicaid eligibility expansion and state options Medicaid waiver application procedures Medicaid per capita cap policy options Medicare-Medicaid dual eligible coverage and demonstration H.R. 351/S. 351 - Protecting Seniors Access to Medicare Act H.R. 574 - Medicare Physician Payment Innovation Act H.R. 1698 - Stabilize Medicaid and CHIP Coverage Act H.R. 2504/S. 1332 - Home Health Care Planning Improvement Act H.R. 2524/S. 1228 - Medicare Better Health Rewards Act H.R. 2810 - Medicare Patient Access and Quality Improvement Act H.R. 2817 - Protect Patient Access to Quality Health Professionals Act H.R. 2986 - Protecting Access to Primary Care Act S. 1143/H.R. 2810 - Protecting Access to Rural Therapy Services (PARTS) Act S. 1758 - Quality Data, Quality Healthcare Act S. 1871 - SGR Repeal and Medicare Beneficiary Access Act
2013 · fourth_quarter · Medicare/Medicaid
Legislation and policies related to: Physician/nurse practitioner reimbursement Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Adoption of recommendations of the Institute of Medicine report, The Future of Nursing: Leading Change, Advancing Health Draft legislation to repeal the Medicare sustainable growth rate and reform fee-for-service payment Delay of the scheduled implementation of Medicare durable medical equipment documentation requirements Medicare Shared Savings Program beneficiary assignment requirements Medicare hospice certification requirements Medicare skilled nursing facility conditions of participation Medicare-Medicaid hospital conditions of participation Draft legislation on admission of advanced practice registered nurses to hospital medical staff and granting of clinical privileges Provisions of the 2013 Medicare fee schedule final regulations Draft legislation to require states to recognize nurse practitioners as primary care case managers and as primary care providers in managed care plans Draft legislation to extend Medicaid incentives to adopt electronic health records to nurse-managed health clinics Evaluation of the Medicare Graduate Nurse Education demonstration Medicare-Medicaid Program Integrity policies Medicaid maintenance of effort requirements Medicaid eligibility expansion and state options Medicaid waiver application procedures Medicaid per capita cap policy options Medicare-Medicaid dual eligible coverage and demonstration H.R. 351/S. 351 - Protecting Seniors Access to Medicare Act H.R. 574 - Medicare Physician Payment Innovation Act H.R. 2504/S. 1332 - Home Health Care Planning Improvement Act H.R. 2524/S. 1228 - Medicare Better Health Rewards Act H.R. 2810 - Medicare Patient Access and Quality Improvement Act H.R. 2817 - Protect Patient Access to Quality Health Professionals Act H.R. 2986 - Protecting Access to Primary Care Act S. 1143/H.R. 2810 - Protecting Access to Rural Therapy Services (PARTS) Act S. 1758 - Quality Data, Quality Healthcare Act S. 1871 - SGR Repeal and Medicare Beneficiary Access Act
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
Issues related to Medicare/Medicaid reimbursements; S. 1228, Medicare Better Health Records Program Act of 2013.
Client expense: Not reported · Firm income: $10,000
Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, SENATE
2013 · third_quarter · Health Issues
Budget and appropriations for disease and injury prevention, including obesity and related diseases; pandemic influenza and emerging infectious diseases; physical activity; public health bioterrorism preparedness; food safety, environmental health; paid sick days; womens and childrens health; and community-based public health interventions. 1. Implementation of the Patient Protection and Affordable Care Act (Public Law 111-148)1.Implementation of the Patient Protection and Affordable Care Act (Public Law 111-148) 2.Middle Class Tax Relief and Job Promotion Act (H.R. 3630) 3.Implementation of the FDA Food Safety Modernization Act (Public Law 111-353) 4.Implementation of Pandemic and All-Hazards Preparedness Act (Public Law 109-417) 5.Implementation of Healthy, Hunger-Free Kids Act of 2010 (Public Law 111-296) 6.Implementation of the Budget Control Act of 2011 (Public Law 112-25) 7.Delivering Antimicrobial Transparency in Animals Act of 2013 (H.R. 820) 8.Animal Drug and Animal Generic Drug User Fee Act (S. 622/H.R.___) 9.Healthier Lifestyles and Prevention America Act (S. 39) 10.Promoting Health as Youth Skills in Classrooms and Life Act (S. 392) 11.Medicare Diabetes Prevention Act (S. 452/H.R. 962) 12.Personal Health Investment Today Act (H.R. 956) 13.A bill to provide for a sequester replacement (S. 16) 14.American Family Economic Protection Act of 2013 (S. 388) 15.Consolidated and Further Continuing Appropriations Act, 2013 (H.R. 933) 16.Regulations From the Executive in Need of Scrutiny Act of 2013 (S. 15 / H.R. 367) 17.To repeal the Prevention and Public Health Fund (H.R. 1099) 18.Pandemic and All-Hazards Preparedness Reauthorization Act of 2013 (Public Law 113-5) 19.National Diabetes Clinical Care Commission Act (H.R. 1074/S. 539) 20.Physical Activity Guidelines for Americans Act (S. 531) 21.Firearm Safety and Public Health Research Act (H.R. 321) 22.Helping Sick Americans Now Act (H.R. 1549) 23.Energy Consumers Relief Act (H.R. 1582) 24.Common Sense Nutrition Disclosure Act (H.R. 1249) 25.Improve Nutrition Program Integrity and Deficit Reduction Act (S. 458/H.R. 1510) 26.A bill to amend the Food and Nutrition Act of 2008 to improve the supplemental nutrition assistance program (S. 762/H.R. 1657) 27.Agriculture Reform, Food, and Jobs Act (S. 954/H.R. 2498) 28.Federal Agriculture Reform and Risk Management Act (H.R. 1947) 29.FIT Kids Act (S. 1033/H.R. 2178) 30.Strengthening Americas Schools Act (S. 840) 31.Access to Quality Diabetes Education Act (S. 945/H.R. 1274) 32.Fit to Serve Act (S. 976) 33.Climate Change Health Protection and Promotion Act (H.R. 2023) 34.Treat and Reduce Obesity Act (S. 1184 / H.R. 2415) 35.Student Success Act (H.R. 5) 36.To repeal the Patient Protection and Affordable Care Act and health care-related provisions in the Health Care and Education Reconciliation Act (H.R. 45) 37.Medicare Better Health Rewards Program Act (S. 1228/H.R. 2524) 38.Senate FY14 Labor, Health and Human Services, and Education Bill 39.House of Representatives FY14 Labor, Health and Human Services, and Education Bill 40.Pharmacy Compounding Quality and Accountability Act (S. 959) 41.Safeguarding Americas Pharmaceuticals Act (H.R. 1919) 42.Drug Supply Chain Security Act (S. 957) 43.Preservation of Antibiotics for Medical Treatment Act (H.R. 1150)/Preventing Antibiotic Resistance Act of 2013 (S. 1256) 44.Healthy Families Act (H.R. 1286/S. 631) 45.FY2014 Continuing Resolution (H.J. Res. 59) 46.Drug Quality and Security Act (H.R. 3204) 47.Pharmaceutical Quality, Security and Accountability Act (S. 959) 48.Energy Consumers Relief Act (H.R. 1582) 49.Increasing the Safety of Prescription Drug User Act (not yet introduced proposed by Sen. Udall-NM) 50.National Energy Tax Repeal Act (S. 1324) 51.Saving Coal Jobs Act of 2013 (S. 1514) 52.Community Parks Revitalization Act (H.R. 2424) 53.A bill to amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings (S. 1422/H.R. 2663) 54.School-based Health Centers Program Reauthorization Act of 2013 (H.R. 2632) 55.Nutrition Reform and Work Opportunity Act (H.R. 3102) 56.Health Equity and Accountability Act (not yet introduced) 57.Secure America for Education (SAFE) in Our Schools Act of 2013 (H.R. 3158)
2013 · third_quarter · Medicare/Medicaid
Issues involving new GME programs and cancer hospitals. Issues concerning Medicare audit practices. S. 1228 / H.R. 2524, Medicare Better Health Rewards Program Act, as it relates to providing wellness incentives to Medicare beneficiaries.
Client expense: Not reported · Firm income: $50,700
Government targets: HOUSE OF REPRESENTATIVES, SENATE
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 · Medicare/Medicaid
Legislation and policies related to: Physician/nurse practitioner reimbursement Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Adoption of recommendations of the Institute of Medicine report, The Future of Nursing: Leading Change, Advancing Health Draft legislation to repeal the Medicare sustainable growth rate and reform fee-for-service payment Delay of the scheduled implementation of Medicare durable medical equipment documentation requirements Medicare Shared Savings Program beneficiary assignment requirements Medicare-Medicaid hospital conditions of participation Draft legislation on admission of advanced practice registered nurses to hospital medical staff and granting of clinical privileges Provisions of the 2013 Medicare fee schedule final regulations Draft legislation to require states to recognize nurse practitioners as primary care case managers and as primary care providers in managed care plans Draft legislation to extend Medicaid incentives to adopt electronic health records to nurse-managed health clinics Regulations on Medicare and Medicaid regulatory reform Evaluation of the Medicare Graduate Nurse Education demonstration Medicare-Medicaid Program Integrity policies Medicaid maintenance of effort requirements Medicaid eligibility expansion and state options Medicaid waiver application procedures Medicaid per capita cap policy options Medicare-Medicaid dual eligible coverage and demonstration H.R. 351/S. 351 - Protecting Seniors Access to Medicare Act H.R. 574 - Medicare Physician Payment Innovation Act H.R. 1698 - Stabilize Medicaid and CHIP Coverage Act H.R. 2504/S. 1332 - Home Health Care Planning Improvement Act H.R. 2524/S. 1228 - Medicare Better Health Rewards Act H.R. 2810 - Medicare Patient Access and Quality Improvement Act H.R. 2817 - Protect Patient Access to Quality Health Professionals Act H.R. 2986 - Protecting Access to Primary Care Act S. 1143/H.R. 2810 - Protecting Access to Rural Therapy Services (PARTS) Act
2013 · third_quarter · Medicare/Medicaid
Legislation and policies related to: Physician/nurse practitioner reimbursement Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Adoption of recommendations of the Institute of Medicine report, The Future of Nursing: Leading Change, Advancing Health Draft legislation to repeal the Medicare sustainable growth rate and reform fee-for-service payment Delay of the scheduled implementation of Medicare durable medical equipment documentation requirements Medicare Shared Savings Program beneficiary assignment requirements Medicare hospice certification requirements Medicare skilled nursing facility conditions of participation Medicare-Medicaid hospital conditions of participation Draft legislation on admission of advanced practice registered nurses to hospital medical staff and granting of clinical privileges Provisions of the 2013 Medicare fee schedule final regulations Draft legislation to require states to recognize nurse practitioners as primary care case managers and as primary care providers in managed care plans Draft legislation to extend Medicaid incentives to adopt electronic health records to nurse-managed health clinics Regulations on Medicare and Medicaid regulatory reform Evaluation of the Medicare Graduate Nurse Education demonstration Medicare-Medicaid Program Integrity policies Medicaid maintenance of effort requirements Medicaid eligibility expansion and state options Medicaid waiver application procedures Medicaid per capita cap policy options Medicare-Medicaid dual eligible coverage and demonstration H.R. 351/S. 351 - Protecting Seniors Access to Medicare Act H.R. 574 - Medicare Physician Payment Innovation Act H.R. 2504/S. 1332 - Home Health Care Planning Improvement Act H.R. 2524/S. 1228 - Medicare Better Health Rewards Act H.R. 2810 - Medicare Patient Access and Quality Improvement Act H.R. 2817 - Protect Patient Access to Quality Health Professionals Act H.R. 2986 - Protecting Access to Primary Care Act S. 1143/H.R. 2810 - Protecting Access to Rural Therapy Services (PARTS) Act
2013 · third_quarter · Medicare/Medicaid
Legislation and policies related to: Physician/nurse practitioner reimbursement Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Adoption of recommendations of the Institute of Medicine report, "The Future of Nursing: Leading Change, Advancing Health"Draft legislation to repeal the Medicare sustainable growth rate and reform fee-for-service payment Delay of the scheduled implementation of Medicare durable medical equipment documentation requirements Medicare Shared Savings Program beneficiary assignment requirements Medicare hospice certification requirements Medicare skilled nursing facility conditions of participation Medicare-Medicaid hospital conditions of participation Draft legislation on admission of advanced practice registered nurses to hospital medical staff and granting of clinical privileges Provisions of the 2013 Medicare fee schedule final regulations Draft legislation to require states to recognize nurse practitioners as primary care case managers and as primary care providers in managed care plans Draft legislation to extend Medicaid incentives to adopt electronic health records to nurse-managed health clinics Regulations on Medicare and Medicaid regulatory reform Evaluation of the Medicare Graduate Nurse Education demonstration Medicare-Medicaid Program Integrity policies Medicaid maintenance of effort requirements Medicaid eligibility expansion and state options Medicaid waiver application procedures Medicaid per capita cap policy options Medicare-Medicaid dual eligible coverage and demonstration H.R. 351/S. 351 Protecting Seniors Access to Medicare Act H.R. 574 Medicare Physician Payment Innovation Act H.R. 2504/S. 1332 Home Health Care Planning Improvement Act H.R. 2524/S. 1228 Medicare Better Health Rewards Act H.R. 2810 Medicare Patient Access and Quality Improvement Act H.R. 2817 Protect Patient Access to Quality Health Professionals Act H.R. 2986 Protecting Access to Primary Care Act S. 1143/H.R. 2810 Protecting Access to Rural Therapy Services (PARTS) Act
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 · third_quarter · Medicare/Medicaid
H.R. 2843 Medicare Data Access for Transparency and Accountability Act H.R. 2524 Medicare Better Health Rewards Program Act of 2013 S. 1228 Medicare Better Health Rewards Program Act of 2013 S. 1180 Medicare Data Access for Transparency and Accountability ActS. 351 Protecting Seniors' Access to Medicare Act H.R. 351 Protecting Seniors' Access to Medicare Act H.R. 2810 The Medicare Patient Access and Quality Improvement Act of 2013
Client expense: $180,000 · Firm income: Not reported
Government targets: Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2013 · third_quarter · Health Issues
H.R. 2775 No Subsidies Without Verification Act H.R. 2009 Keep IRS Off Your Health Care Act of 2013 S. 851 Caregivers Expansion and Improvement Act of 2013 S. 1497 No exemption for Washington from Abamacare actH.R. 3093 Union Bailout Prevention Act of 2013 S. 1490 A bill to delay the application of the Patient Protection and Affordable Care Act H.R. 3076 James Madison Congressional Accountability Act H.R. 3077 TELE-MED Act of 2013 S. 1488 A bill to delay the application of the individual health insurance mandate, to delay the application of the employer health insurance mandate, and for other purposes. H.R. 3067 No Obamacare for Subsidies for Members of Congress Act of 2013 H.R. 3071 No Special Treatment for Congress Act H.R. 2995 Unneccesary Cap Act of 2013 S. 1469 The Congressional Health Care for Seniors Act H.R. 2843 Medicare Data Access for Transparency and Accountability Act H.R. 2837 To prohibit for a one-year period beginning September 30, 2013 the implementation, operation and coordination of a Federal Data Services Hub or any similar database system for determining or verifying eiligibility under the Patient Protection and Affordable Care Act H.R. 2668 Fairness for American Families Act H.R. 2667 Authority for Mandate Delay Act H.R. 2524 Medicare Better Health Rewards Program Act of 2013 S. 1228 Medicare Better Health Rewards Program Act of 2013 S. 1198 Medicare Fair Share Act of 2013 S. 1180 Medicare Data Access for Transparency and Accountability Act H.R. 1173 Personalize Your Care Act of 2013 H.R. 763 To repeal the annual fee on insurance providers enacted by the Patient Protection and Affordable Care Act H.R. 1634 Medical Flexible Spending Account Improvement Act H.R. 1326 Health Care Price Transparency Promotion Act of 2013 S. 351 Protecting Seniors' Access to Medicare Act H.R. 523 Protect Medical Innovation Act of 2013 H.R. 351Protecting Seniors' Access to Medicare Act H. R. 2810 The Medicare Patient Access and Quality Improvement Act of 2013 H.R. 3204 Drug Quality and Security Act S. 1422 A bill to amend the Congressional Budget Act of 1974 respecting the scorings of preventive health savings H.R. 2725 FDA Safety Over Sequestrian Act H.R. 2651 Critical Care Assessment and Improvement Act of 2013 H.R. 2663 To amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings H.R. 1919 Safeguarding America's Pharmaceutical Act of 2013 H.R. 2415 Treat and Reduce Obesity Act of 2013 S. 1193 Data Security and Breach Notification Act of 2013 S. 959 Pharmaceutical Quality, Security, and Accountability Act S. 1184 Treat and Reduce Obesity Act of 2013 H.R. 2179 Physical Activity Guidelines for Americans Act S. 957 Drug Supply Chain Security Act H.R. 1473 Standard of Care Protection Act of 2013 S. 616Conrad State 30 and Physician Access Act S. 531 Physical Activity Guidelines for Americans Act H.R. 5 Student Success Act H.R. 2426 The Educating Tomorrow's Engineers Act (ETEA) H.R. 2131 SKILLS Visa Act S. 744 Border Security, Economic Opportunity and Immigration Modernization Act S. 1178 The Educating Tomorrow's Engineers Act (ETEA) S. 1152 Building a Health Care Workforce for the Future Act H.R. 903 American Job Protection Act
2013 · second_quarter · Medicare/Medicaid
Issues related to Graduate Medical Education (GME) payment program. General issues related to proposed structural reforms of Medicare, including reimbursements and eligibility. Medicare Better Health Rewards Program Act of 2013 (S.1228), provisions related to incentivizing wellness bahaviors
Client expense: $130,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
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 · Medicare/Medicaid
Issues related to healthy lifestyles for Medicare beneficiaries. Issues involving new GME programs and cancer hospitals. H.Con.Res.25, House budget resolution and S.Con.Res.8, Senate budget resolution as they relate to Medicare and Medicaid payments for hospitals; issues concerning Health IT; issues concerning audit practices. S. 1228 / H.R. 2524, Medicare Better Health Rewards Program Act, as it relates to providing wellness incentives to Medicare beneficiaries.
Client expense: Not reported · Firm income: $53,550
Government targets: HOUSE OF REPRESENTATIVES, SENATE
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.
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: $38,000 · Firm income: Not reported
Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Environmental Protection Agency (EPA), Executive Office of the President (EOP), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Office of Management & Budget (OMB), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Transportation, Dept of (DOT)
Client expense: Not reported · Firm income: $30,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
Client expense: $117,584 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE, White House Office
Client expense: $33,000 · Firm income: Not reported
Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Environmental Protection Agency (EPA), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Office of Management & Budget (OMB), SENATE, Transportation, Dept of (DOT)
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: Not reported · Firm income: $23,450
Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, White House Office
Client expense: $160,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
Client expense: $101,617 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE, White House Office
Client expense: $37,000 · Firm income: Not reported
Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Environmental Protection Agency (EPA), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Office of Management & Budget (OMB), SENATE, Transportation, Dept of (DOT)
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: $160,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
Client expense: $101,618 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE, White House Office
Client expense: Not reported · Firm income: $23,450
Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, White House Office
Client expense: Not reported · Firm income: $15,625
Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE, White House Office
Client expense: Not reported · Firm income: $60,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
Client expense: $38,000 · Firm income: Not reported
Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Environmental Protection Agency (EPA), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Office of Management & Budget (OMB), SENATE, Transportation, Dept of (DOT)
Client expense: Not reported · Firm income: $60,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
Client expense: Not reported · Firm income: $23,450
Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE, White House Office
Client expense: Not reported · Firm income: $23,450
Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE, White House Office
Client expense: $84,089 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE, White House Office
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
Client expense: $180,000 · Firm income: Not reported
Government targets: Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
Government targets: HOUSE OF REPRESENTATIVES, 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