Part D Beneficiary Appeals Fairness Act

H.R. 2827/S. 1365 The Part D Beneficiary Appeals Fairness Act (all provisions)

Client expense: $210,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Support H.R. 351 and S.351 to repeal the Medicare Independent Payment Advisory Board mandated by the Affordable Care Act Oppose any reduction of Medicare Part B drug and biologic reimbursement payments that will harm patients. Support robust Part D formularies and continued coverage of the six protected classes. Support raising the Part D specialty tier cost-sharing threshold above the $600 minimum, and to at least index it to inflation.Support strong Part D oversight and improved transparency for consumers, as well as a better process for notice of non-coverage, for appeals, and exceptions to provide the best access to necessary, life-saving prescription medications. Support changes to the Part D Program that would address gaps in coverage, eliminate onerous cost-shifting through the use of specialty tiers and restrictive utilization management tools. Support any changes that improve the effectiveness of the program for those receiving low income subsidies. Support the most stringent safety requirements for any substitution of biosimilar drugs for any prescribed biologic, including notification of both the patient and the prescribing physician. Oppose any cuts to the Medicare Part D Program or any legislation requiring the Secretary of Health and Human Services to "negotiate" Part D prices or rebates that will forever limit access to the best drugs and biologics for Medicare beneficiaries. Support "Fight Fraud First" efforts (rather than Medicare benefit cuts or fee increases) to reduce overall Medicare spending. Oppose any changes to the Medicare Part D program that would shift additional costs to beneficiaries or create barriers to access, both of which actions would lead to cost increases in other parts of the Medicare program. Oppose all proposed cuts to Medicare reimbursements rates for critical home health services under the Home Health Prospective Payment System (HHPPS). Support the "Part D Beneficiary Appeals Fairness Act," H.R. 2827 and S. 1365. Opposed CMS efforts to institute a 700-page Medicare Part D Prescription Drug Plan "proposed rule" that included harmful changes to the critical "Six Protected Classes" of drugs and attempted to limit drug plan choices for patients. The proposed rule threatened destructive government interference in this successful program that could only result in fewer options and higher costs for beneficiaries. Support H.R. 4160, the Keep the Promise to Seniors Act. Support H.R. 3320, a measure to broaden coverage to include more Medicare beneficiaries who could benefit from the use of a ventricular assist device (VAD). Support "340B" Medicaid program reform to end widespread abuse of the drug discount program that ultimately harms patients. Supported the nomination of Kirsten Axelsen to the position of Commissioner on the Medicare Payment Advisory Commission (MedPAC). Support a "safety first" unique naming policy for any and all biosimilar drugs pending market approval. Urged the FTC and the FDA to place patient safety and consumer protection above all other considerations regarding biosimilar drugs. Urged changes to the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 that would allow telehealth to reach its full potential, including relaxed reimbursement restrictions, increased coverage, and removal of other barriers to use such as state licensure barriers. Support the Advisory Committee on Immunization Practices (ACIP) recommendations to the Centers for Medicare and Medicaid Services (CMS) related to the 13-valent pneumococcal conjugate vaccine (PCV13), including:1) Adults 65 years of age or older who have not previously received pneumococcal vaccine or whose previous vaccination history is unknown should receive a dose of PCV13 first, followed by a dose of PPSV23; 2) Adults 65 years of age or older who have not previously received PCV13 and who have previously received one or more doses of PPSV23 should receive a dose of PVC13; 3)The recommendations for routine PVC13 use among adults 65 years and older should be re-evaluated in 2018 and revised as needed. To protect at risk and high risk Medicare beneficiaries, the ACIP recommendations should be adopted and implemented without delay. Support MAPRx coalition December comments and principles regarding the Medicare Part D prescription Drug Program and the 21st Century Cures Initiative in a letter to the House Energy and Commerce Committee. Joined numerous other organizations in a letter urging the Medicare Payment Advisory Committee (MedPAC) to conduct a comprehensive analysis of the Medicare Part D exceptions and appeals process and to issue recommendations to improve it. Support H.R. 4302.

P.L. 111-375 National Alzheimer's Project Act, All sections S709/HR1507 Health Outcomes, Planning and Education for Alzheimer's Act, All sections S.1119 Positive Aging Act of 2013, All Sections S.1028 Older American's Act Amendments of 2013 S.219/H.R.4351 - Alzheimer's Accountability Act of 2014 P.L. 111-148/111-152 Patient Protection and Affordable Car Act - All Sections related to care coordination, transitional care, long term care services and supports access to affordable insurance, establishment of a national voluntary disability insurance program, provisions related to individuals with Alzheimer's disease and caregivers and provisions related to research including the Cures Acceleration Network. H.R. 2976 Missing Alzheimer's Disease Patient Alert Program Reauthorization All sections H.R. 2975 Alzheimer's Caregiver Support Act. All Sections S.1914 National Silver Alert Act of 2013 H. Res. 396 - A resolution supporting the goals of the National Alzheimer's Disease Awareness month S.1365/H.R. 2827 Part D Beneficiary appeals S. Res. 301 - A resolution recognizing and supporting the goals and implementation of the national Alzheimer's Project Act and the National Plan to Address Alzheimer's Disease. S. Res 303 - A resolution declaring that achieving the primary goal of the National Plan to Address Alzheimer's Disease of the Department of Health and Human Services to prevent and effectively treat Alzheimer's disease by 2025 is an urgent national priority H.R. 3836/S. 1910 Pat Summitt Congressional Gold Medal Act H. Res. 489 - A resolution expressing the need to facilitate a robust response to the looming global crisis of Alzheimer's and other forms of dementia. H.R. 4484 - Strengthening Healthcare Options for Vulnerable Populations Act. H.R.4543 - PACE Pilot Act of 2014 H.R. 647/S.313 - ABLE Act H.R. 4145 - Elder Care Tax Credit Act H.R. 5633/S.5633 - In Home Caregiver Assessment Reources and Education Act H.R. 5024 - Social Security Caregiver Credit Act H.R. 5214 - Olson Registry Bill

Urge Congress to support efforts that increase access to care for people with psoriasis and psoriatic arthritis by supporting the following efforts: -H.R.460: Patients' Access to Treatments Act of 2013: Support efforts to reduce impediments to treatment for individuals with moderate to severe psoriasis. The National Psoriasis Foundation supports the Patients' Access to Treatments Act of 2013 (introduced in the House as H.R. 460), which limits copayments, coinsurance, and other cost-sharing and out-of-pocket expenses for so-calledspecialty tier drugs. This bill will help ensure that people with psoriasis and other chronic conditions have access to the therapy that their health care provider determines is most appropriate for them. -S.1365/H.R. 2827: The Part D Beneficiary Appeals Fairness Act: Support efforts to reduce impediments to treatment for individuals with moderate to severe psoriasis. The National Psoriasis Foundation supports the Part D Beneficiary Appeals Fairness Act. The Act amends part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act, with respect to a prescription drug plan (PDP) that provides for any tiered cost-sharing within a formulary (including a structure that provides for different co-payment or coinsurance amounts for drugs in different tiers included within the formulary), to authorize a Medicare part D eligible individual enrolled in the plan to request an exception to the tiered cost-sharing structure. -Ensure that Medicare Advantage networks are providing patients with adequate and timely access to providers with appropriate training and specialty expertise by copsonsoring HR.4998/S.2552

Client expense: $80,000 · Firm income: Not reported

Support H.R. 351 and S.351 to repeal the Medicare Independent Payment Advisory Board mandated by the Affordable Care Act Oppose any reduction of Medicare Part B drug and biologic reimbursement payments that will harm patients. Support robust Part D formularies and continued coverage of the six protected classes. Support raising the Part D specialty tier cost-sharing threshold above the $600 minimum, and to at least index it to inflation.Support strong Part D oversight and improved transparency for consumers, as well as a better process for notice of non-coverage, for appeals, and exceptions to provide the best access to necessary, life-saving prescription medications. Support changes to the Part D Program that would address gaps in coverage, eliminate onerous cost-shifting through the use of specialty tiers and restrictive utilization management tools. Support any changes that improve the effectiveness of the program for those receiving low income subsidies. Support the most stringent safety requirements for any substitution of biosimilar drugs for any prescribed biologic, including notification of both the patient and the prescribing physician. Oppose any cuts to the Medicare Part D Program or any legislation requiring the Secretary of Health and Human Services to "negotiate" Part D prices or rebates that will forever limit access to the best drugs and biologics for Medicare beneficiaries. Support "Fight Fraud First" efforts (rather than Medicare benefit cuts or fee increases) to reduce overall Medicare spending. Oppose any changes to the Medicare Part D program that would shift additional costs to beneficiaries or create barriers to access, both of which actions would lead to cost increases in other parts of the Medicare program. Oppose all proposed cuts to Medicare reimbursements rates for critical home health services under the Home Health Prospective Payment System (HHPPS). Support the "Part D Beneficiary Appeals Fairness Act," H.R. 2827 and S. 1365. Opposed CMS efforts to institute a 700-page Medicare Part D Prescription Drug Plan "proposed rule" that included harmful changes to the critical "Six Protected Classes" of drugs and attempted to limit drug plan choices for patients. The proposed rule threatened destructive government interference in this successful program that could only result in fewer options and higher costs for beneficiaries. Support H.R. 4160, the Keep the Promise to Seniors Act. Support H.R. 3320, a measure to broaden coverage to include more Medicare beneficiaries who could benefit from the use of a ventricular assist device (VAD). Support "340B" Medicaid program reform to end widespread abuse of the drug discount program that ultimately harms patients. Supported the nomination of Kirsten Axelsen to the position of Commissioner on the Medicare Payment Advisory Commission (MedPAC). Support a "safety first" unique naming policy for any and all biosimilar drugs pending market approval. Urged the FTC and the FDA to place patient safety and consumer protection above all other considerations regarding biosimilar drugs. Urged changes to the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 that would allow telehealth to reach its full potential, including relaxed reimbursement restrictions, increased coverage, and removal of other barriers to use such as state licensure barriers. Support the Advisory Committee on Immunization Practices (ACIP) recommendations to the Centers for Medicare and Medicaid Services (CMS) related to the 13-valent pneumococcal conjugate vaccine (PCV13), including:1) Adults 65 years of age or older who have not previously received pneumococcal vaccine or whose previous vaccination history is unknown should receive a dose of PCV13 first, followed by a dose of PPSV23; 2) Adults 65 years of age or older who have not previously received PCV13 and who have previously received one or more doses of PPSV23 should receive a dose of PVC13; 3)The recommendations for routine PVC13 use among adults 65 years and older should be re-evaluated in 2018 and revised as needed. To protect at risk and high risk Medicare beneficiaries, the ACIP recommendations should be adopted and implemented without delay.

H.R. 351, Protecting Seniors Access to Medicare Act of 2013: Provisions related to the Independent Payment Advisory Board H.R. 460, Patients Access to Treatments Act: Provisions related to cost sharing in the specialty tier H.R. 928, Medicare Prescription Drug Savings and Choice Act of 2013: Provisions related to Part D issues H.R. 1024, Medication Therapy Management Empowerment Act of 2013: Provisions related to medication therapy management in Part D H.R. 1102, Medicare Prescription Drug Price Negotiation Act of 2013: Provisions related to Part D issues and non-interference H.R. 1588, Medicare Drug Savings Act of 2013: Provisions related to Part D issues H.R. 2753 Securing Care for Seniors Act: Provisions related to Value Based Insurance Design H.R. 2810, Medicare Patient Access and Quality Improvement Act: Provisions related to SGR reform H.R. 2827, To amend title XVIII of the Social Security Act to allow for fair application of the exceptions process for drugs in tiers in formularies in prescription drug plans under Medicare part D: Provisions related to Medicare Part D Drug Tier Formularies H.R. 2925, Strengthening Medicare Anti-Fraud Measures Act of 2013: Provisions related to fraud and abuse H.R. 3392, Medicare Part D Patient Safety and Drug Abuse Prevention Act of 2013: Provisions related to lock-in programs H.R. 3796, Comprehensive Care Payment Innovation Act: Provisions related to alternative payment models H.R. 3890 Better Care, Lower Cost Act: Provisions related to Part D, value-based insurance design, and chronic disease H.R. 4015, SGR Repeal and Medicare Provider Payment Modernization Act of 2014: Provisions related to sustainable growth rate (SGR) and Medicare provider payment reform H.R. 4160, Keep the Promise to Seniors Act of 2014: Provisions related to Part D issues H.R. 4302, Protecting Access to Medicare Act of 2014: Provisions related to the biopharmaceutical industry H.R. 4577, Ensuring Seniors Access to Local Pharmacies Act of 2014: Provisions related to Part D preferred pharmacy networks H.R. 5183, Value Based Insurance Design for Better Care Act of 2014: Provisions related to valued base insurance design demonstration program H.R. 5558 ACO Improvement Act: Provisions related to alternate payment models S. 117, Medicare Prescription Drug Price Negotiation Act of 2013: Provisions related to Part D issues and non-interference S. 351, Protecting Seniors Access to Medicare Act of 2013: Provisions related to Independent Payment Advisory Board S. 408, Medicare Prescription Drug Savings and Choice Act of 2013: Provision related to Part D issues S. 557, Medication Therapy Management Empowerment Act of 2013: Provisions related to Part D and medication therapy management S. 740, Medicare Drug Savings Act of 2013: Provisions related to Part D issues Deficit reduction policy issues S. 882, Stop Trafficking of Pills (STOP) Act: Provisions related to lock-in programs (112th Congress) S. 1365, Part D Beneficiary Appeals Fairness Act: Provisions related to the specialty tier in Part D S. 1871, SGR Repeal and Medicare Beneficiary Access Act of 2013: Provisions related to reforming Medicare physician payments S. 1932, Better Care, Lower Cost Act: Provisions related to Part D, value-based insurance design, and chronic disease S. 2000, SGR Repeal and Medicare Provider Payment Modernization Act of 2014: Provisions related to SGR reform S. 2110, Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014: Provisions related to SGR reform Medicare Prescription Drug Diversion and Abuse Prevention Act: Provisions related to diversion and abuse (no bill number) Contract Year 2015 Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefits Programs: Provisions related to Part D Proposals to increase co-payments for Part D beneficiaries receiving the low-income subsidy Medicaid Program, Covered Outpatient Drugs rulemaking Medicare sustainable growth rate policy issues Implementation issues relating to the Physician Payment Sunshine Act, including Medicare, Medicaid, Childrens Health Insurance Programs; Transparency Reports and Reporting of Physician Ownership or Investment Interests rulemaking Issues related to better use of medicine and adherence Protecting Integrity in Medicare Act of 2014 (no bill number): Provisions related to addressing fraud, prescription drug abuse, and other issues Lock-in concepts generally

H.R. 2827/S. 1365 The Part D Beneficiary Appeals Fairness Act (all provisions); Issues related to the reauthorization of the Medicaid State Children's Health Insurance Program (no specific bills)

Client expense: $280,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Support H.R. 351 and S.351 to repeal the Medicare Independent Payment Advisory Board mandated by the Affordable Care Act Oppose any reduction of Medicare Part B drug and biologic reimbursement payments that will harm patients. Support robust Part D formularies and continued coverage of the six protected classes. Support raising the Part D specialty tier cost-sharing threshold above the $600 minimum, and to at least index it to inflation.Support strong Part D oversight and improved transparency for consumers, as well as a better process for notice of non-coverage, for appeals, and exceptions to provide the best access to necessary, life-saving prescription medications. Support changes to the Part D Program that would address gaps in coverage, eliminate onerous cost-shifting through the use of specialty tiers and restrictive utilization management tools. Support any changes that improve the effectiveness of the program for those receiving low income subsidies. Support the most stringent safety requirements for any substitution of biosimilar drugs for any prescribed biologic, including notification of both the patient and the prescribing physician. Oppose any cuts to the Medicare Part D Program or any legislation requiring the Secretary of Health and Human Services to "negotiate" Part D prices or rebates that will forever limit access to the best drugs and biologics for Medicare beneficiaries. Support "Fight Fraud First" efforts (rather than Medicare benefit cuts or fee increases) to reduce overall Medicare spending. Oppose any changes to the Medicare Part D program that would shift additional costs to beneficiaries or create barriers to access, both of which actions would lead to cost increases in other parts of the Medicare program. Oppose all proposed cuts to Medicare reimbursements rates for critical home health services under the Home Health Prospective Payment System (HHPPS). Support the "Part D Beneficiary Appeals Fairness Act," H.R. 2827 and S. 1365. Opposed CMS efforts to institute a 700-page Medicare Part D Prescription Drug Plan "proposed rule" that included harmful changes to the critical "Six Protected Classes" of drugs and attempted to limit drug plan choices for patients. The proposed rule threatened destructive government interference in this successful program that could only result in fewer options and higher costs for beneficiaries. Support H.R. 4160, the Keep the Promise to Seniors Act. Support H.R. 3320, a measure to broaden coverage to include more Medicare beneficiaries who could benefit from the use of a ventricular assist device (VAD). Support "340B" Medicaid program reform to end widespread abuse of the drug discount program that ultimately harms patients. Supported the nomination of Kirsten Axelsen to the position of Commissioner on the Medicare Payment Advisory Commission (MedPAC). Support a "safety first" unique naming policy for any and all biosimilar drugs pending market approval. Urged the FTC and the FDA to place patient safety and consumer protection above all other considerations regarding biosimilar drugs. Urged changes to the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 that would allow telehealth to reach its full potential, including relaxed reimbursement restrictions, increased coverage, and removal of other barriers to use such as state licensure barriers. Support the Advisory Committee on Immunization Practices (ACIP) recommendations to the Centers for Medicare and Medicaid Services (CMS) related to the 13-valent pneumococcal conjugate vaccine (PCV13), including:1) Adults 65 years of age or older who have not previously received pneumococcal vaccine or whose previous vaccination history is unknown should receive a dose of PCV13 first, followed by a dose of PPSV23; 2) Adults 65 years of age or older who have not previously received PCV13 and who have previously received one or more doses of PPSV23 should receive a dose of PVC13; 3)The recommendations for routine PVC13 use among adults 65 years and older should be re-evaluated in 2018 and revised as needed. To protect at risk and high risk Medicare beneficiaries, the ACIP recommendations should be adopted and implemented without delay.

P.L. 111-375 National Alzheimer's Project Act, All sections S709/HR1507 Health Outcomes, Planning and Education for Alzheimer's Act, All sections S.1119 Positive Aging Act of 2013, All Sections S.1028 Older American's Act Amendments of 2013S.219/H.R.4351 - Alzheimer's Accountability Act of 2014 P.L. 111-148/111-152 Patient Protection and Affordable Car Act - All Sections related to care coordination, transitional care, long term care services and supports access to affordable insurance, establishment of a national voluntary disability insurance program, provisions related to individuals with Alzheimer's disease and caregivers and provisions related to research including the Cures Acceleration Network. H.R. 2976 Missing Alzheimer's Disease Patient Alert Program Reauthorization All sections H.R. 2975 Alzheimer's Caregiver Support Act. All Sections S.1914 National Silver Alert Act of 2013 H. Res. 396 - A resolution supporting the goals of the National Alzheimer's Disease Awareness month S.1365/H.R. 2827 Part D Beneficiary appeals S. Res. 301 - A resolution recognizing and supporting the goals and implementation of the national Alzheimer's Project Act and the National Plan to Address Alzheimer's Disease. S. Res 303 - A resolution declaring that achieving the primary goal of the National Plan to Address Alzheimer's Disease of the Department of Health and Human Services to prevent and effectively treat Alzheimer's disease by 2025 is an urgent national priority H.R. 3836/S. 1910 Pat Summitt Congressional Gold Medal Act H. Res. 489 - A resolution expressing the need to facilitate a robust response to the looming global crisis of Alzheimer's and other forms of dementia. H.R. 4484 - Strengthening Healthcare Options for Vulnerable Populations Act. H.R.4543 - PACE Pilot Act of 2014.

Client expense: $130,000 · Firm income: Not reported

Support H.R. 351 and S.351 to repeal the Medicare Independent Payment Advisory Board mandated by the Affordable Care Act Oppose any reduction of Medicare Part B drug and biologic reimbursement payments that will harm patients. Support robust Part D formularies and continued coverage of the six protected classes. Support raising the Part D specialty tier cost-sharing threshold above the $600 minimum, and to at least index it to inflation.Support strong Part D oversight and improved transparency for consumers, as well as a better process for notice of non-coverage, for appeals, and exceptions to provide the best access to necessary, life-saving prescription medications. Support changes to the Part D Program that would address gaps in coverage, eliminate onerous cost-shifting through the use of specialty tiers and restrictive utilization management tools. Support any changes that improve the effectiveness of the program for those receiving low income subsidies. Support the most stringent safety requirements for any substitution of biosimilar drugs for any prescribed biologic, including notification of both the patient and the prescribing physician. Oppose any cuts to the Medicare Part D Program or any legislation requiring the Secretary of Health and Human Services to "negotiate" Part D prices or rebates that will forever limit access to the best drugs and biologics for Medicare beneficiaries. Support "Fight Fraud First" efforts (rather than Medicare benefit cuts or fee increases) to reduce overall Medicare spending. Oppose any changes to the Medicare Part D program that would shift additional costs to beneficiaries or create barriers to access, both of which actions would lead to cost increases in other parts of the Medicare program. Oppose all proposed cuts to Medicare reimbursements rates for critical home health services under the Home Health Prospective Payment System (HHPPS). Support the "Part D Beneficiary Appeals Fairness Act," H.R. 2827 and S. 1365. Opposed CMS efforts to institute a 700-page Medicare Part D Prescription Drug Plan "proposed rule" that included harmful changes to the critical "Six Protected Classes" of drugs and attempted to limit drug plan choices for patients. The proposed rule threatened destructive government interference in this successful program that could only result in fewer options and higher costs for beneficiaries. Support H.R. 4160, the Keep the Promise to Seniors Act. Support H.R. 3320, a measure to broaden coverage to include more Medicare beneficiaries who could benefit from the use of a ventricular assist device (VAD). Support "340B" Medicaid program reform to end widespread abuse of the drug discount program that ultimately harms patients. Supported the nomination of Kirsten Axelsen to the position of Commissioner on the Medicare Payment Advisory Commission (MedPAC). Support a "safety first" unique naming policy for any and all biosimilar drugs pending market approval. Urged the FTC and the FDA to place patient safety and consumer protection above all other considerations regarding biosimilar drugs. Urged changes to the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 that would allow telehealth to reach its full potential, including relaxed reimbursement restrictions, increased coverage, and removal of other barriers to use such as state licensure barriers.

Access to care for people with psoriasis and psoriatic arthritis. -H.R.460: Patients' Access to Treatments Act of 2013: Support efforts to reduce impediments to treatment for individuals with moderate to severe psoriasis. The National Psoriasis Foudation supports the Patients' Access to Treatments Act of 2013 (introduced in the House as H.R. 460), which limits copayments, coinsurance, and other cost-sharing and out-of-pocket expenses for so-called specialty tier drugs. This bill will help ensure that people with psoriasis and other chronic conditions have access to the therapy that their health care provider determines is most appropriate for them. -S.1365/H.R. 2827: The Part D Beneficiary Appeals Fairness Act: Support efforts to reduce impediments to treatment for individuals with moderate to severe psoriasis. The National Psoriasis Foudation supports the Part D Beneficiary Appeals Fairness Act. The Act amends part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act, with respect to a prescription drug plan (PDP) that provides for any tiered cost-sharing within a formulary (including a structure that provides for different co-payment or coinsurance amounts for drugs in different tiers included within the formulary), to authorize a Medicare part D eligible individual enrolled in the plan to request an exception to the tiered cost-sharing structure.

Client expense: $130,000 · Firm income: Not reported

H.R. 2827/S. 1365 The Part D Beneficiary Appeals Fairness Act (all provisions).

Client expense: $480,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H.R. 351, Protecting Seniors Access to Medicare Act of 2013: Provisions related to the Independent Payment Advisory Board H.R. 460, Patients Access to Treatments Act: Provisions related to cost sharing in the specialty tier H.R. 928, Medicare Prescription Drug Savings and Choice Act of 2013: Provisions related to Part D issuesH.R. 1024, Medication Therapy Management Empowerment Act of 2013: Provisions related to medication therapy management in Part D H.R. 1102, Medicare Prescription Drug Price Negotiation Act of 2013: Provisions related to Part D issues and non-interference H.R. 1588, Medicare Drug Savings Act of 2013: Provisions related to Part D issues H.R. 2810, Medicare Patient Access and Quality Improvement Act: Provisions related to SGR reform H.R. 2827, To amend title XVIII of the Social Security Act to allow for fair application of the exceptions process for drugs in tiers in formularies in prescription drug plans under Medicare part D: Provisions related to Medicare Part D Drug Tier Formularies H.R. 2925, Strengthening Medicare Anti-Fraud Measures Act of 2013: Provisions related to fraud and abuse H.R. 3392, Medicare Part D Patient Safety and Drug Abuse Prevention Act of 2013: Provisions related to lock-in programs H.R. 3796, Comprehensive Care Payment Innovation Act: Provisions related to alternative payment models H.R. 4160, Keep the Promise to Seniors Act of 2014: Provisions related to Part D issues H.R. 4302, Protecting Access to Medicare Act of 2014: Provisions related to the biopharmaceutical industry S. 117, Medicare Prescription Drug Price Negotiation Act of 2013: Provisions related to Part D issues and non-interference S. 351, Protecting Seniors Access to Medicare Act of 2013: Provisions related to Independent Payment Advisory Board S. 408, Medicare Prescription Drug Savings and Choice Act of 2013: Provision related to Part D issues S. 740, Medicare Drug Savings Act of 2013: Provisions related to Part D issues Deficit reduction policy issues S. 882, Stop Trafficking of Pills (STOP) Act: Provisions related to lock-in programs (112th Congress) S. 1365, Part D Beneficiary Appeals Fairness Act: Provisions related to the specialty tier in Part D S. 1871, SGR Repeal and Medicare Beneficiary Access Act of 2013: Provisions related to reforming Medicare physician payments S. 1932, Better Care, Lower Cost Act: Provisions related to Part D, value-based insurance design, and chronic disease S. 2000, SGR Repeal and Medicare Provider Payment Modernization Act of 2014: Provisions related to SGR reform S. 2110, Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014: Provisions related to SGR reform Medicare Prescription Drug Diversion and Abuse Prevention Act: Provisions related to diversion and abuse (no bill number) Contract Year 2015 Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefits Programs: Provisions related to Part D Proposals to increase co-payments for Part D beneficiaries receiving the low-income subsidy Medicaid Program, Covered Outpatient Drugs rulemaking Medicare sustainable growth rate policy issues Implementation issues relating to the Physician Payment Sunshine Act, including Medicare, Medicaid, Childrens Health Insurance Programs; Transparency Reports and Reporting of Physician Ownership or Investment Interests rulemaking Issues related to better use of medicine and adherence

Support H.R. 351 and S.351 to repeal the Medicare Independent Payment Advisory Board mandated by the Affordable Care Act Oppose any reduction of Medicare Part B drug and biologic reimbursement payments that will harm patients. Support robust Part D formularies and continued coverage of the six protected classes. Support raising the Part D specialty tier cost-sharing threshold above the $600 minimum, and to at least index it to inflation.Support strong Part D oversight and improved transparency for consumers, as well as a better process for notice of non-coverage, for appeals, and exceptions to provide the best access to necessary, life-saving prescription medications. Support changes to the Part D Program that would address gaps in coverage, eliminate onerous cost-shifting through the use of specialty tiers and restrictive utilization management tools. Support any changes that improve the effectiveness of the program for those receiving low income subsidies. Support the most stringent safety requirements for any substitution of biosimilar drugs for any prescribed biologic, including notification of both the patient and the prescribing physician. Oppose any cuts to the Medicare Part D Program or any legislation requiring the Secretary of Health and Human Services to "negotiate" Part D prices or rebates that will forever limit access to the best drugs and biologics for Medicare beneficiaries. Support "Fight Fraud First" efforts (rather than Medicare benefit cuts or fee increases) to reduce overall Medicare spending. Oppose any changes to the Medicare Part D program that would shift additional costs to beneficiaries or create barriers to access, both of which actions would lead to cost increases in other parts of the Medicare program. Oppose all proposed cuts to Medicare reimbursements rates for critical home health services under the Home Health Prospective Payment System (HHPPS). Support the "Part D Beneficiary Appeals Fairness Act," H.R. 2827 and S. 1365. Opposed CMS efforts to institute a 700-page Medicare Part D Prescription Drug Plan "proposed rule" that included harmful changes to the critical "Six Protected Classes" of drugs and attempted to limit drug plan choices for patients. The proposed rule threatened destructive government interference in this successful program that could only result in fewer options and higher costs for beneficiaries. Support H.R. 4160, the Keep the Promise to Seniors Act. Support H.R. 3320, a measure to broaden coverage to include more Medicare beneficiaries who could benefit from the use of a ventricular assist device (VAD). Support "340B" Medicaid program reform to end widespread abuse of the drug discount program that ultimately harms patients. Supported the nomination of Kirsten Axelsen to the position of Commissioner on the Medicare Payment Advisory Commission (MedPAC). Support a "safety first" unique naming policy for any and all biosimilar drugs pending market approval. Urged the FTC and the FDA to place patient safety and consumer protection above all other considerations regarding biosimilar drugs. Urged changes to the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 that would allow telehealth to reach its full potential, including relaxed reimbursement restrictions, increased coverage, and removal of other barriers to use such as state licensure barriers.

P.L. 111-375 National Alzheimers Project Act, All sections S709/HR1507 Health Outcomes, Planning and Education for Alzheimer's Act, All sections S.1119 Positive Aging Act of 2013, All Sections S.1028 Older Americans Act Amendments of 2013S.219/H.R.4351 - Alzheimer's Accountability Act of 2014 P.L. 111-148/111-152 Patient Protection and Affordable Care Act - All Sections related to care coordination, transitional care, long term care services and supports access to affordable insurance, establishment of a national voluntary disability insurance program, provisions related to individuals with Alzheimer's disease and caregivers and provisions related to research including the Cures Acceleration Network. H.R. 2976 Missing Alzheimer's Disease Patient Alert Program Reauthorization All sections H.R. 2975 Alzheimer's Caregiver Support Act. All Sections S. 1914 National Silver Alert Act of 2013 H. Res. 396 - A resolution supporting the goals of National Alzheimer's Disease Awareness month S.1365/H.R. 2827 Part D Beneficiary appeals S. Res. 301 - A resolution recognizing and supporting the goals and implemenation of the national Alzheimer's Project Act and the National Plan to Address Alzheimer's Disease. S. Res 303 - A resolution declaring that achieving the primary goal of the National Plan to Address Alzheimer's Disease of the Department of Health and Human Services to prevent and effectively treat Alzheimer's disease by 2025 is an urgent national priority H.R. 3836/S. 1910 - Pat Summitt Congressional Gold Medal Act H.Res. 489 - A resolution expressing the need to faciliate a robust response to the looming global crisis of Alzheimer's and other forms of dementia

Client expense: $130,000 · Firm income: Not reported

Support H.R. 351 and S.351 to repeal the Medicare Independent Payment Advisory Board mandated by the Affordable Care Act Oppose any reduction of Medicare Part B drug and biologic reimbursement payments that will harm patients. Support robust Part D formularies and continued coverage of the six protected classes. Support raising the Part D specialty tier cost-sharing threshold above the $600 minimum, and to at least index it to inflation.Support strong Part D oversight and improved transparency for consumers, as well as a better process for notice of non-coverage, for appeals, and exceptions to provide the best access to necessary, life-saving prescription medications. Support changes to the Part D Program that would address gaps in coverage, eliminate onerous cost-shifting through the use of specialty tiers and restrictive utilization management tools. Support any changes that improve the effectiveness of the program for those receiving low income subsidies. Support the most stringent safety requirements for any substitution of biosimilar drugs for any prescribed biologic, including notification of both the patient and the prescribing physician. Oppose any cuts to the Medicare Part D Program or any legislation requiring the Secretary of Health and Human Services to "negotiate" Part D prices or rebates that will forever limit access to the best drugs and biologics for Medicare beneficiaries. Support "Fight Fraud First" efforts (rather than Medicare benefit cuts or fee increases) to reduce overall Medicare spending. Oppose any changes to the Medicare Part D program that would shift additional costs to beneficiaries or create barriers to access, both of which actions would lead to cost increases in other parts of the Medicare program. Oppose all proposed cuts to Medicare reimbursements rates for critical home health services under the Home Health Prospective Payment System (HHPPS). Support the "Part D Beneficiary Appeals Fairness Act," H.R. 2827 and S. 1365. Opposed CMS efforts to institute a 700-page Medicare Part D Prescription Drug Plan "proposed rule" that included harmful changes to the critical "Six Protected Classes" of drugs and attempted to limit drug plan choices for patients. The proposed rule threatened destructive government interference in this successful program that could only result in fewer options and higher costs for beneficiaries. Support H.R. 4160, the Keep the Promise to Seniors Act. Support H.R. 3320, a measure to broaden coverage to include more Medicare beneficiaries who could benefit from the use of a ventricular assist device (VAD). Support "340B" Medicaid program reform to end widespread abuse of the drug discount program that ultimately harms patients. Supported the nomination of Kirsten Axelsen to the position of Commissioner on the Medicare Payment Advisory Commission (MedPAC). Support a "safety first" unique naming policy for any and all biosimilar drugs pending market approval. Urged the FTC and the FDA to place patient safety and consumer protection above all other considerations regarding biosimilar drugs.

Issues pertaining to access to quality care for blood cancer patients [HR 460, the Patients Access to Treatments Act - all provisions]; [HR 1801, the Cancer Drug Coverage Parity Act - all provisions]; [S 1365/HR 2827, The Part D Beneficiary Appeals Fairness Act - all provisions]; [P.L. 111-148, the Patient Protection and Affordable Care - provisions specific to network adequacy and cost sharing]; [S. 2115, the American CURES Act - all provisions]; Energy & Commerce committee proposal re: FDA reform

Client expense: $150,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 2827/S. 1365 The Part D Beneficiary Appeals Fairness Act (all provisions)

Client expense: $190,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H.R. 351, Protecting Seniors Access to Medicare Act of 2013: Provisions related to the Independent Payment Advisory Board H.R. 928, Medicare Prescription Drug Savings and Choice Act of 2013: Provisions related to Part D issues H.R. 1024, Medication Therapy Management Empowerment Act of 2013: Provisions related to medication therapy management in Part DH.R. 1102, Medicare Prescription Drug Price Negotiation Act of 2013: Provisions related to Part D issues and non-interference H.R. 1588, Medicare Drug Savings Act of 2013: Provisions related to Part D issues H.R. 2810, Medicare Patient Access and Quality Improvement Act: Provisions related to SGR reform H.R. 2827, Part D Beneficiary Appeals Fairness Act: Provisions related to the specialty tier in Part D H.R. 2925, Strengthening Medicare Anti-Fraud Measures Act of 2013: Provisions related to fraud and abuse H.R. 3392, Medicare Part D Patient Safety and Drug Abuse Prevention Act of 2013: Provisions related to lock-in programs H.R. 3796, Comprehensive Care Payment Innovation Act: Provisions related to alternative payment models H.R. 4160, Keep the Promise to Seniors Act of 2014: Provisions related to Part D issues H.R. 4302, Protecting Access to Medicare Act of 2014: Provisions related to the biopharmaceutical industry S. 117, Medicare Prescription Drug Price Negotiation Act of 2013: Provisions related to Part D issues and non-interference S. 351, Protecting Seniors Access to Medicare Act of 2013: Provisions related to Independent Payment Advisory Board S. 408, Medicare Prescription Drug Savings and Choice Act of 2013: Provision related to Part D issues S. 740, Medicare Drug Savings Act of 2013: Provisions related to Part D issues Deficit reduction policy issues S. 882, Stop Trafficking of Pills (STOP) Act: Provisions related to lock-in programs (112th Congress) S. 1365, Part D Beneficiary Appeals Fairness Act: Provisions related to the specialty tier in Part D S. 1871, SGR Repeal and Medicare Beneficiary Access Act of 2013: Provisions related to reforming Medicare physician payments S. 1932, Better Care, Lower Cost Act: Provisions related to Part D, value-based insurance design, and chronic disease S. 2000, SGR Repeal and Medicare Provider Payment Modernization Act of 2014: Provisions related to SGR reform S. 2110, Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014: Provisions related to SGR reform Medicare Prescription Drug Diversion and Abuse Prevention Act: Provisions related to diversion and abuse (no bill number) Contract Year 2015 Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefits Programs: Provisions related to Part D Proposals to increase co-payments for Part D beneficiaries receiving the low-income subsidy Medicaid Program, Covered Outpatient Drugs rulemaking Medicare sustainable growth rate policy issues Implementation issues relating to the Physician Payment Sunshine Act, including Medicare, Medicaid, Childrens Health Insurance Programs; Transparency Reports and Reporting of Physician Ownership or Investment Interests rulemaking

Support H.R. 351 and S.351 to repeal the Medicare Independent Payment Advisory Board mandated by the Affordable Care Act Oppose any reduction of Medicare Part B drug and biologic reimbursement payments that will harm patients. Support robust Part D formularies and continued coverage of the six protected classes. Support raising the Part D specialty tier cost-sharing threshold above the $600 minimum, and to at least index it to inflation.Support strong Part D oversight and improved transparency for consumers, as well as a better process for notice of non-coverage, for appeals, and exceptions to provide the best access to necessary, life-saving prescription medications. Support changes to the Part D Program that would address gaps in coverage, eliminate onerous cost-shifting through the use of specialty tiers and restrictive utilization management tools. Support any changes that improve the effectiveness of the program for those receiving low income subsidies. Support the most stringent safety requirements for any substitution of biosimilar drugs for any prescribed biologic, including notification of both the patient and the prescribing physician. Oppose any cuts to the Medicare Part D Program or any legislation requiring the Secretary of Health and Human Services to "negotiate" Part D prices or rebates that will forever limit access to the best drugs and biologics for Medicare beneficiaries. Support "Fight Fraud First" efforts (rather than Medicare benefit cuts or fee increases) to reduce overall Medicare spending. Oppose any changes to the Medicare Part D program that would shift additional costs to beneficiaries or create barriers to access, both of which actions would lead to cost increases in other parts of the Medicare program. Oppose all proposed cuts to Medicare reimbursements rates for critical home health services under the Home Health Prospective Payment System (HHPPS). Support the "Part D Beneficiary Appeals Fairness Act," H.R. 2827 and S. 1365. Opposed CMS efforts to institute a 700-page Medicare Part D Prescription Drug Plan "proposed rule" that included harmful changes to the critical "Six Protected Classes" of drugs and attempted to limit drug plan choices for patients. The proposed rule threatened destructive government interference in this successful program that could only result in fewer options and higher costs for beneficiaries. Support H.R. 4160, the Keep the Promise to Seniors Act. Support H.R. 3320, a measure to broaden coverage to include more Medicare beneficiaries who could benefit from the use of a ventricular assist device (VAD). Support "340B" Medicaid program reform to end widespread abuse of the drug discount program that ultimately harms patients. Supported the nomination of Kirsten Axelsen to the position of Commissioner on the Medicare Payment Advisory Commission (MedPAC). Support a "safety first" unique naming policy for any and all biosimilar drugs pending market approval. Urged the FTC and the FDA to place patient safety and consumer protection above all other considerations regarding biosimilar drugs.

P.L. 111-375 National Alzheimers Project Act, All sections S709/HR1507 Health Outcomes, Planning and Education for Alzheimer's Act, All sections S.1119 Positive Aging Act of 2013, All Sections S.1562 Older Americans Act Amendments of 2013P.L. 111-148/111-152 Patient Protection and Affordable Care Act - All Sections related to care coordination, transitional care, long term care services and supports access to affordable insurance, establishment of a national voluntary disability insurance program, provisions related to individuals with Alzheimer's disease and caregivers and provisions related to research including the Cures Acceleration Network. H.R. 2976 Missing Alzheimer's Disease Patient Alert Program Reauthorization All sections H.R. 2975 Alzheimer's Caregiver Support Act. All Sections S. 1914 National Silver Alert Act of 2013 H. Res. 396 - A resolution supporting the goals of National Alzheimer's Disease Awareness month S.1365/H.R. 2827 Part D Beneficiary appeals S. Res. 301 - A resolution recognizing and supporting the goals and implemenation of the national Alzheimer's Project Act and the National Plan to Address Alzheimer's Disease. S. Res 303 - A resolution declaring that achieving the primary goal of the National Plan to Address Alzheimer's Disease of the Department of Health and Human Services to prevent and effectively treat Alzheimer's disease by 2025 is an urgent national priority.

Client expense: $130,000 · Firm income: Not reported

Support H.R. 351 and S.351 to repeal the Medicare Independent Payment Advisory Board mandated by the Affordable Care Act Oppose any reduction of Medicare Part B drug and biologic reimbursement payments that will harm patients. Support robust Part D formularies and continued coverage of the six protected classes. Support raising the Part D specialty tier cost-sharing threshold above the $600 minimum, and to at least index it to inflation.Support strong Part D oversight and improved transparency for consumers, as well as a better process for notice of non-coverage, for appeals, and exceptions to provide the best access to necessary, life-saving prescription medications. Support changes to the Part D Program that would address gaps in coverage, eliminate onerous cost-shifting through the use of specialty tiers and restrictive utilization management tools. Support any changes that improve the effectiveness of the program for those receiving low income subsidies. Support the most stringent safety requirements for any substitution of biosimilar drugs for any prescribed biologic, including notification of both the patient and the prescribing physician. Oppose any cuts to the Medicare Part D Program or any legislation requiring the Secretary of Health and Human Services to "negotiate" Part D prices or rebates that will forever limit access to the best drugs and biologics for Medicare beneficiaries. Support "Fight Fraud First" efforts (rather than Medicare benefit cuts or fee increases) to reduce overall Medicare spending. Oppose any changes to the Medicare Part D program that would shift additional costs to beneficiaries or create barriers to access, both of which actions would lead to cost increases in other parts of the Medicare program. Oppose all proposed cuts to Medicare reimbursements rates for critical home health services under the Home Health Prospective Payment System (HHPPS). Support the "Part D Beneficiary Appeals Fairness Act," H.R. 2827 and S. 1365.

H.R. 351, Protecting Seniors' Access to Medicare Act of 2013: Provisions related to the Independent Payment Advisory Board H.R. 460, Patients' Access to Treatments Act of 2013: Provisions related to capping specialty tier drugs and no cost-sharing above the non-preferred brand tier H.R. 928, Medicare Prescription Drug Savings and Choice Act of 2013: Provisions related to Part D issuesH.R. 1588, Medicare Drug Savings Act of 2013: Provisions related to Part D issues H.R. 2810, Medicare Patient Access and Quality Improvement Act: Provisions related to Sustainable Growth Rate (SGR) reform H.R. 2827, To amend title XVIII of the Social Security Act to allow for fair application of the exceptions process for drugs in tiers in formularies in prescription drug plans under Medicare part D: Provisions related to Medicare Part D Drug Tier Formularies H.R. 2925, Strengthening Medicare Anti-Fraud Measures Act of 2013: Provisions related to fraud and abuse H.R. 3392, Medicare Part D Patient Safety and Drug Abuse Prevention Act of 2013: Provisions related to lock-in programs H.R. 3796, Comprehensive Care Payment Innovation Act: Provisions related to alternative payment models S. 117, Medicare Prescription Drug Price Negotiation Act of 2013: Provisions related to Part D issues S. 351, Protecting Seniors Access to Medicare Act of 2013: Provisions related to Independent Payment Advisory Board S. 408, Medicare Prescription Drug Savings and Choice Act of 2013: Provision related to Part D issues S. 740, Medicare Drug Savings Act of 2013: Provisions related to Part D issues Deficit reduction policy issues S. 882, Stop Trafficking of Pills (STOP) Act: Provisions related to lock-in programs (112th Congress) S. 1365, Part D Beneficiary Appeals Fairness Act: Provisions related to the specialty tier in Part D S. 1871, SGR Repeal and Medicare Beneficiary Access Act of 2013: Provisions related to reforming Medicare physician payments Medicare Prescription Drug Diversion and Abuse Prevention Act: Provisions related to diversion and abuse (no bill number) Proposals to increase co-payments for Part D beneficiaries receiving the low-income subsidy Medicaid Program, Covered Outpatient Drugs rulemaking Medicare sustainable growth rate policy issues Implementation issues relating to the Physician Payment Sunshine Act, including Medicare, Medicaid, Childrens Health Insurance Programs; Transparency Reports and Reporting of Physician Ownership or Investment Interests rulemaking

H.R. 2827/S. 1365 The Part D Beneficiary Appeals Fairness Act (all provisions)

Client expense: $210,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Support H.R. 351 and S.351 to repeal the Medicare Independent Payment Advisory Board mandated by the Affordable Care Act Oppose any reduction of Medicare Part B drug and biologic reimbursement payments that will harm patients. Support robust Part D formularies and continued coverage of the six protected classes. Support raising the Part D specialty tier cost-sharing threshold above the $600 minimum, and to at least index it to inflation.Support strong Part D oversight and improved transparency for consumers, as well as a better process for notice of non-coverage, for appeals, and exceptions to provide the best access to necessary, life-saving prescription medications. Support changes to the Part D Program that would address gaps in coverage, eliminate onerous cost-shifting through the use of specialty tiers and restrictive utilization management tools. Support any changes that improve the effectiveness of the program for those receiving low income subsidies. Support the most stringent safety requirements for any substitution of biosimilar drugs for any prescribed biologic, including notification of both the patient and the prescribing physician. Oppose any cuts to the Medicare Part D Program or any legislation requiring the Secretary of Health and Human Services to "negotiate" Part D prices or rebates that will forever limit access to the best drugs and biologics for Medicare beneficiaries. Support "Fight Fraud First" efforts (rather than Medicare benefit cuts or fee increases) to reduce overall Medicare spending. Oppose any changes to the Medicare Part D program that would shift additional costs to beneficiaries or create barriers to access, both of which actions would lead to cost increases in other parts of the Medicare program. Oppose all proposed cuts to Medicare reimbursements rates for critical home health services under the Home Health Prospective Payment System (HHPPS). Support the "Part D Beneficiary Appeals Fairness Act," H.R. 2827 and S. 1365.

HR.672 Prescription Drug Abuse Prevention and Treatment Act of 2013 S. 348 Prescription Drug Abuse Prevention and Treatment Act of 2013 Prescription drug abuse S. 1365 Part D Beneficiary Appeals Fairness ActSpecialty drug costs

Client expense: $200,000 · Firm income: Not reported

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

HR.672 Prescription Drug Abuse Prevention and Treatment Act of 2013 S. 348 Prescription Drug Abuse Prevention and Treatment Act of 2013 Prescription drug abuse S. 1365 Part D Beneficiary Appeals Fairness Actspecialty drug costs

Client expense: $200,000 · Firm income: Not reported

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

HR.672 Prescription Drug Abuse Prevention and Treatment Act of 2013 S. 348 Prescription Drug Abuse Prevention and Treatment Act of 2013 Prescription drug abuse S. 1365 Part D Beneficiary Appeals Fairness Actspecialty drug costs

Client expense: $200,000 · Firm income: Not reported

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

H.R. 2827/S. 1365 The Part D Beneficiary Appeals Fairness Act (all provisions)

Client expense: $210,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Support H.R. 351 and S.351 to repeal the Medicare Independent Payment Advisory Board mandated by the Affordable Care Act Oppose any reduction of Medicare Part B drug and biologic reimbursement payments that will harm patients. Support robust Part D formularies and continued coverage of the six protected classes. Support raising the Part D specialty tier cost-sharing threshold above the $600 minimum, and to at least index it to inflation.Support strong Part D oversight and improved transparency for consumers, as well as a better process for notice of non-coverage, for appeals, and exceptions to provide the best access to necessary, life-saving prescription medications. Support changes to the Part D Program that would address gaps in coverage, eliminate onerous cost-shifting through the use of specialty tiers and restrictive utilization management tools. Support any changes that improve the effectiveness of the program for those receiving low income subsidies. Support the most stringent safety requirements for any substitution of biosimilar drugs for any prescribed biologic, including notification of both the patient and the prescribing physician. Oppose any cuts to the Medicare Part D Program or any legislation requiring the Secretary of Health and Human Services to "negotiate" Part D prices or rebates that will forever limit access to the best drugs and biologics for Medicare beneficiaries. Support "Fight Fraud First" efforts (rather than Medicare benefit cuts or fee increases) to reduce overall Medicare spending. Oppose any changes to the Medicare Part D program that would shift additional costs to beneficiaries or create barriers to access, both of which actions would lead to cost increases in other parts of the Medicare program. Oppose all proposed cuts to Medicare reimbursements rates for critical home health services under the Home Health Prospective Payment System (HHPPS). Support the "Part D Beneficiary Appeals Fairness Act," H.R. 2827 and S. 1365.

Discussed possible solutions for improving access to Medicaid for military families who have children with disabilities.Promote Congressional support of H.R. 942/S.948 - Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013. This legislation creates a separate benefit for complex rehab technology under Medicare for individuals with significant disabilities and functional limitations. United Spinal discussed concerns with the Centers for Medicare and Medicaid Services (CMS) regarding access to wheelchair repair under CMS' competitive acquisition program and outside of competitive acquisition areas across the country. United Spinal raised concerns with CMS regarding the Affordable Care Act healthcare marketplaces and navigator training to ensure consumer protections for enrollees. United Spinal discussed with the Department of Health and Human Services' Administration for Community Living access to the right type of wheelchair equipment, H.R. 942/S.948 - Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013 (described above) and related wheelchair coding issues, concerns with consumer protections under Medicaid, essential health benefits under the Affordable Care Act and respite care funding matters. In June 2012, Medicare issued an Advanced Notice of Proposed Rulemaking (ANPRM) that seeks to significantly expand Medicare Secondary Payer authority to require that current Medicare beneficiaries and non-beneficiaries project what their future medical needs may be related to the accident, injury or illness in question and then place settlement funds in trust to ensure future medical treatment is fully funded before the beneficiary can access any additional settlement funds. United Spinal raised our concerns regarding the need for consumer protections in this regulation and met with the White House, Congress and CMS. United Spinal signed on to a letter to the Director of the Medicare-Medicaid Coordination Office at the Centers for Medicare and Medicaid Services. The letter thanked the office for providing states with an opportunity to apply for funding to develop independent Demonstration Ombudsman Programs. United Spinal and a host of other organizations have been recommending that CMS require ombudsmen for dual demonstration projects. United Spinal submitted comments to the Centers for Medicare and Medicaid Services regarding their proposed policy of converting complex rehab technology (Medicare beneficiary customized purchase items) to capped rental items. United Spinal supports Part D Beneficiary Appeals Fairness Act, S. 1365/H.R. 2827 which permits Medicare Part D beneficiaries to request lower co-pays for high-cost specialty drugs used to treat chronic illnesses. Healthcare Coalition Protecting Dialysis Care United Spinal signed onto a letter to CMS Administrator Marilyn Tavenner opposing a proposed 9.4% cut to dialysis care. This significant cut is likely to result in restrictions in access or have other negative effects on patient care. United Spinal supports Medicare Access to Rehabilitation Services Act of 2013 (H.R 713/S. 367) and have raised our concerns with CMS and Congress. United Spinal raised concerns with the White House regarding recent companionship regulations and matters around institutionalization for the disability community as well as our support of improvements to the provision of home and community-based services. United Spinal supports the Medicare DMEPOS Market Pricing Program Act of 2013/H.R. 1717 which replaces CMS' current competitive acquisition program to allow for imporved choces of medical equipment providers for Medicare beneficiaries.

Support H.R. 351 and S.351 to repeal the Medicare Independent Payment Advisory Board mandated by the Affordable Care Act Oppose any reduction of Medicare Part B drug and biologic reimbursement payments that will harm patients. Support robust Part D formularies and continued coverage of the six protected classes. Support raising the Part D specialty tier cost-sharing threshold above the $600 minimum, and to at least index it to inflation.Support strong Part D oversight and improved transparency for consumers, as well as a better process for notice of non-coverage, for appeals, and exceptions to provide the best access to necessary, life-saving prescription medications. Support changes to the Part D Program that would address gaps in coverage, eliminate onerous cost-shifting through the use of specialty tiers and restrictive utilization management tools. Support any changes that improve the effectiveness of the program for those receiving low income subsidies. Support the most stringent safety requirements for any substitution of biosimilar drugs for any prescribed biologic, including notification of both the patient and the prescribing physician. Oppose any cuts to the Medicare Part D Program or any legislation requiring the Secretary of Health and Human Services to "negotiate" Part D prices or rebates that will forever limit access to the best drugs and biologics for Medicare beneficiaries. Support "Fight Fraud First" efforts (rather than Medicare benefit cuts or fee increases) to reduce overall Medicare spending. Oppose any changes to the Medicare Part D program that would shift additional costs to beneficiaries or create barriers to access, both of which actions would lead to cost increases in other parts of the Medicare program. Oppose all proposed cuts to Medicare reimbursements rates for critical home health services under the Home Health Prospective Payment System (HHPPS). Support the "Part D Beneficiary Appeals Fairness Act," H.R. 2827 and S. 1365.