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Part D Beneficiary Appeals Fairness Act
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Part D Beneficiary Appeals Fairness 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. States that in no case may the Secretary of Health and Human Services allow a PDP sponsor to make any element of the tiered cost-sharing structure (including a tier used for very high cost or unique items) ineligible for lower-cost sharing through an exception.
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Filing registrants (13)
Read twice and referred to the Committee on Finance.
Introduced in Senate
Bills with similar content found using semantic analysis.
Sources: Congress.gov
2016 · fourth_quarter · Medicare/Medicaid
RetireSafe worked as a leader, along with other patient advocate groups, to oppose any new cuts to the Medicare Advantage payment rates for 2016. RetireSafe worked with the Medicare Access for Patients Rx Coalition (MAPRx) to raise concerns regarding the Advance Notice of Methodological Changes for Calendar Year 2016 for Medicare Advantage Capitation Rates, Part C and Part D Payment Policies and 2016 Call Letter to express concerns related to: the Exceptions and Appeals Process, Star Ratings and the Dual-Eligibles, Formulary Oversight, Drug Utilization Review Controls, Tier Labeling and Composition, Specialty Tiers, and the Use of Multiple Tiers with Coinsurance Cost-Sharing Rates. RetireSafe joined with the Medicare Rights Center and other patient advocates to urge numerous changes to the Medicare Part D Program to make the Exceptions and Appeals Processes More Accessible for Beneficiaries. RetireSafe joined with the Healthcare Leadership Council and others to support the Protecting Seniors Access to Medicare Act, (H.R. 1190 and S. 141) to repeal the Independent Payment Advisory Board (IPAB), authorized under the Patient Protection and Affordable Care Act. Support H.R. 2624 and S. 1488, the Part D Beneficiary Appeals Fairness Act. Support the passage of H.R. 160 to repeal the 2.3% Medical Device Tax. Support the passage of H.R. 1190 to repeal the Independent Payment Advisory Board (IPAB). Joined with the MAPRx coalition to urge Congress to build on the success of Medicare Part D to ensure robust formularies, coverage for the six-protected classes, strong oversight, and transparency for consumers, as well as add improvements to the process for notice of non-coverage, appeals and exceptions. Also, urged Part D remedies to correct gaps in coverage, onerous cost-shifting created by specialty tiers, and restrictive utilization management tools that severely reduce patient benefits. Support "340B" Medicaid program reform to end widespread abuse of the drug discount program that ultimately harms patients. Joined with other patient advocate groups to comment on proposed rule: CMS-2390-P-Medicaid and Childrens Health Insurance Programs (CHIP); Medicaid Managed Care, CHIP Delivered in Managed Care, Medicaid and CHIP Comprehensive Quality Strategies, and Revisions Related to Third Party Liability. We supported the proposed rules intent to strengthen program integrity safeguards, and ensure beneficiary protections in areas of provider networks, coverage standards, and the treatment of appeals. We agree with the other groups that a modernized Medicaid managed care regulatory structure is essential to facilitate necessary system reform initiatives, and advance the delivery of health care for millions of people, and we supported rule changes to achieve those goals. RetireSafe joined with other patient advocates to comment on proposed rule: CMS-1631-P-Medicare Program; Revisions to Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY2016. In commenting we supported various measures for improving accuracy for primary care and care management services; providing appropriate advanced care planning services; providing better Medicare Tele-health services; providing better Chronic Care Management services for Rural Health Clinics and Qualified Health Centers; providing a useful Physicians Compare Website with data in proper context; and providing physician payment, efficiency, and quality improvements linked to a physician quality reporting system. RetireSafe joined with numerous patient groups to oppose a new CMS plan to cut the payment rate (from Average Sales Price plus 6%) for Medicare Part B Drugs administered by physicians in large parts of the U.S. because this Center for Medicare & Medicaid initiative focuses on costs rather than patients needs and health care quality. This new Part B Drug Plan will adversely impact Medicare patients with complex conditions such as cancer, macular degeneration, hypertension, rheumatoid arthritis, and primary immunodeficiency diseases. Along with many other patient advocates in the MAPRx Coalition, we strongly opposed a recent MedPAC effort to place Medicare cost savings ahead of the best interests of Medicare patients. Specifically, we urged MedPAC to reject proposals to make changes to true out-of-pocket costs (TrOOP); increase copays for low-income subsidy (LIS) beneficiaries; and eliminate any of the protected classes. RetireSafe joined with numerous patient groups to comment on the CMS Advance Notice and Draft Call Letter issued on February 19, 2016. The comments focused on better patient access to Medicare Part D Prescription Drugs and related specifically to: Specialty Tier Thresholds, Tier Labeling and Composition, Generic Tier $0 Copay Plans, Formulary Oversight, Drug Utilization Review Controls, Coverage Determination Timelines, and Access to Preferred Cost-sharing Pharmacies. RetireSafe has continued to work with a large number of patient groups (on several occasions) to strongly oppose the Centers for Medicare Services (CMS) Centers for Medicare and Medicaid Innovation (CMMI) March 8, 2016 proposed rule that would implement substantial changes to the Medicare Part B payment program. As we have stated in several joint letters to Members of Congress and to CMS, we believe the proposed changes which have been proposed as a demonstration project would impact some 75 percent of Medicare population and could limit access to the full range of available treatments under Part B to treat serious illnesses and medical treatments such as cancer, multiple sclerosis, primary immune deficiency, macular degeneration and schizophrenia. Unfortunately, the proposed program will be, in fact, mandatory for many physicians and their patients, and will cause patients to switch from the most appropriate treatment to less effective therapies or to forego treatment altogether because of transportation hurdles created by the new rule. RetireSafe also objects to the lack of sufficient stakeholder input from the beginning of this rule-making process, which has now created one-size-fits-all government payment policies that ignore patient differences and completely undermines the goal of patient-centered Medicare.
Client expense: $11,560 · Firm income: Not reported
Government targets: Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2016 · third_quarter · Medicare/Medicaid
RetireSafe worked as a leader, along with other patient advocate groups, to oppose any new cuts to the Medicare Advantage payment rates for 2016. RetireSafe worked with the Medicare Access for Patients Rx Coalition (MAPRx) to raise concerns regarding the Advance Notice of Methodological Changes for Calendar Year 2016 for Medicare Advantage Capitation Rates, Part C and Part D Payment Policies and 2016 Call Letter to express concerns related to: the Exceptions and Appeals Process, Star Ratings and the Dual-Eligibles, Formulary Oversight, Drug Utilization Review Controls, Tier Labeling and Composition, Specialty Tiers, and the Use of Multiple Tiers with Coinsurance Cost-Sharing Rates. RetireSafe joined with the Medicare Rights Center and other patient advocates to urge numerous changes to the Medicare Part D Program to make the Exceptions and Appeals Processes More Accessible for Beneficiaries. RetireSafe joined with the Healthcare Leadership Council and others to support the Protecting Seniors Access to Medicare Act, (H.R. 1190 and S. 141) to repeal the Independent Payment Advisory Board (IPAB), authorized under the Patient Protection and Affordable Care Act. Support H.R. 2624 and S. 1488, the Part D Beneficiary Appeals Fairness Act. Support the passage of H.R. 160 to repeal the 2.3% Medical Device Tax. Support the passage of H.R. 1190 to repeal the Independent Payment Advisory Board (IPAB). Joined with the MAPRx coalition to urge Congress to build on the success of Medicare Part D to ensure robust formularies, coverage for the six-protected classes, strong oversight, and transparency for consumers, as well as add improvements to the process for notice of non-coverage, appeals and exceptions. Also, urged Part D remedies to correct gaps in coverage, onerous cost-shifting created by specialty tiers, and restrictive utilization management tools that severely reduce patient benefits. Support "340B" Medicaid program reform to end widespread abuse of the drug discount program that ultimately harms patients. Joined with other patient advocate groups to comment on proposed rule: CMS-2390-P-Medicaid and Childrens Health Insurance Programs (CHIP); Medicaid Managed Care, CHIP Delivered in Managed Care, Medicaid and CHIP Comprehensive Quality Strategies, and Revisions Related to Third Party Liability. We supported the proposed rules intent to strengthen program integrity safeguards, and ensure beneficiary protections in areas of provider networks, coverage standards, and the treatment of appeals. We agree with the other groups that a modernized Medicaid managed care regulatory structure is essential to facilitate necessary system reform initiatives, and advance the delivery of health care for millions of people, and we supported rule changes to achieve those goals. RetireSafe joined with other patient advocates to comment on proposed rule: CMS-1631-P-Medicare Program; Revisions to Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY2016. In commenting we supported various measures for improving accuracy for primary care and care management services; providing appropriate advanced care planning services; providing better Medicare Tele-health services; providing better Chronic Care Management services for Rural Health Clinics and Qualified Health Centers; providing a useful Physicians Compare Website with data in proper context; and providing physician payment, efficiency, and quality improvements linked to a physician quality reporting system. RetireSafe joined with numerous patient groups to oppose a new CMS plan to cut the payment rate (from Average Sales Price plus 6%) for Medicare Part B Drugs administered by physicians in large parts of the U.S. because this Center for Medicare & Medicaid initiative focuses on costs rather than patients needs and health care quality. This new Part B Drug Plan will adversely impact Medicare patients with complex conditions such as cancer, macular degeneration, hypertension, rheumatoid arthritis, and primary immunodeficiency diseases. Along with many other patient advocates in the MAPRx Coalition, we strongly opposed a recent MedPAC effort to place Medicare cost savings ahead of the best interests of Medicare patients. Specifically, we urged MedPAC to reject proposals to make changes to true out-of-pocket costs (TrOOP); increase copays for low-income subsidy (LIS) beneficiaries; and eliminate any of the protected classes. RetireSafe joined with numerous patient groups to comment on the CMS Advance Notice and Draft Call Letter issued on February 19, 2016. The comments focused on better patient access to Medicare Part D Prescription Drugs and related specifically to: Specialty Tier Thresholds, Tier Labeling and Composition, Generic Tier $0 Copay Plans, Formulary Oversight, Drug Utilization Review Controls, Coverage Determination Timelines, and Access to Preferred Cost-sharing Pharmacies. RetireSafe has continued to work with a large number of patient groups (on several occasions) to strongly oppose the Centers for Medicare Services (CMS) Centers for Medicare and Medicaid Innovation (CMMI) March 8, 2016 proposed rule that would implement substantial changes to the Medicare Part B payment program. As we have stated in several joint letters to Members of Congress and to CMS, we believe the proposed changes which have been proposed as a demonstration project would impact some 75 percent of Medicare population and could limit access to the full range of available treatments under Part B to treat serious illnesses and medical treatments such as cancer, multiple sclerosis, primary immune deficiency, macular degeneration and schizophrenia. Unfortunately, the proposed program will be, in fact, mandatory for many physicians and their patients, and will cause patients to switch from the most appropriate treatment to less effective therapies or to forego treatment altogether because of transportation hurdles created by the new rule. RetireSafe also objects to the lack of sufficient stakeholder input from the beginning of this rule-making process, which has now created one-size-fits-all government payment policies that ignore patient differences and completely undermines the goal of patient-centered Medicare.
2016 · second_quarter · Medicare/Medicaid
RetireSafe worked as a leader, along with other patient advocate groups, to oppose any new cuts to the Medicare Advantage payment rates for 2016. RetireSafe worked with the Medicare Access for Patients Rx Coalition (MAPRx) to raise concerns regarding the Advance Notice of Methodological Changes for Calendar Year 2016 for Medicare Advantage Capitation Rates, Part C and Part D Payment Policies and 2016 Call Letter to express concerns related to: the Exceptions and Appeals Process, Star Ratings and the Dual-Eligibles, Formulary Oversight, Drug Utilization Review Controls, Tier Labeling and Composition, Specialty Tiers, and the Use of Multiple Tiers with Coinsurance Cost-Sharing Rates. RetireSafe joined with the Medicare Rights Center and other patient advocates to urge numerous changes to the Medicare Part D Program to make the Exceptions and Appeals Processes More Accessible for Beneficiaries. RetireSafe joined with the Healthcare Leadership Council and others to support the Protecting Seniors Access to Medicare Act, (H.R. 1190 and S. 141) to repeal the Independent Payment Advisory Board (IPAB), authorized under the Patient Protection and Affordable Care Act. Support H.R. 2624 and S. 1488, the Part D Beneficiary Appeals Fairness Act. Support the passage of H.R. 160 to repeal the 2.3% Medical Device Tax. Support the passage of H.R. 1190 to repeal the Independent Payment Advisory Board (IPAB). Joined with the MAPRx coalition to urge Congress to build on the success of Medicare Part D to ensure robust formularies, coverage for the six-protected classes, strong oversight, and transparency for consumers, as well as add improvements to the process for notice of non-coverage, appeals and exceptions. Also, urged Part D remedies to correct gaps in coverage, onerous cost-shifting created by specialty tiers, and restrictive utilization management tools that severely reduce patient benefits. Support "340B" Medicaid program reform to end widespread abuse of the drug discount program that ultimately harms patients. Joined with other patient advocate groups to comment on proposed rule: CMS-2390-P-Medicaid and Childrens Health Insurance Programs (CHIP); Medicaid Managed Care, CHIP Delivered in Managed Care, Medicaid and CHIP Comprehensive Quality Strategies, and Revisions Related to Third Party Liability. We supported the proposed rules intent to strengthen program integrity safeguards, and ensure beneficiary protections in areas of provider networks, coverage standards, and the treatment of appeals. We agree with the other groups that a modernized Medicaid managed care regulatory structure is essential to facilitate necessary system reform initiatives, and advance the delivery of health care for millions of people, and we supported rule changes to achieve those goals. RetireSafe joined with other patient advocates to comment on proposed rule: CMS-1631-P-Medicare Program; Revisions to Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY2016. In commenting we supported various measures for improving accuracy for primary care and care management services; providing appropriate advanced care planning services; providing better Medicare Tele-health services; providing better Chronic Care Management services for Rural Health Clinics and Qualified Health Centers; providing a useful Physicians Compare Website with data in proper context; and providing physician payment, efficiency, and quality improvements linked to a physician quality reporting system. RetireSafe joined with numerous patient groups to oppose a new CMS plan to cut the payment rate (from Average Sales Price plus 6%) for Medicare Part B Drugs administered by physicians in large parts of the U.S. because this Center for Medicare & Medicaid initiative focuses on costs rather than patients needs and health care quality. This new Part B Drug Plan will adversely impact Medicare patients with complex conditions such as cancer, macular degeneration, hypertension, rheumatoid arthritis, and primary immunodeficiency diseases. Along with many other patient advocates in the MAPRx Coalition, we strongly opposed a recent MedPAC effort to place Medicare cost savings ahead of the best interests of Medicare patients. Specifically, we urged MedPAC to reject proposals to make changes to true out-of-pocket costs (TrOOP); increase copays for low-income subsidy (LIS) beneficiaries; and eliminate any of the protected classes. RetireSafe joined with numerous patient groups to comment on the CMS Advance Notice and Draft Call Letter issued on February 19, 2016. The comments focused on better patient access to Medicare Part D Prescription Drugs and related specifically to: Specialty Tier Thresholds, Tier Labeling and Composition, Generic Tier $0 Copay Plans, Formulary Oversight, Drug Utilization Review Controls, Coverage Determination Timelines, and Access to Preferred Cost-sharing Pharmacies. RetireSafe has continued to work with a large number of patient groups (on several occasions) to strongly oppose the Centers for Medicare Services (CMS) Centers for Medicare and Medicaid Innovation (CMMI) March 8, 2016 proposed rule that would implement substantial changes to the Medicare Part B payment program. As we have stated in several joint letters to Members of Congress and to CMS, we believe the proposed changes which have been proposed as a demonstration project would impact some 75 percent of Medicare population and could limit access to the full range of available treatments under Part B to treat serious illnesses and medical treatments such as cancer, multiple sclerosis, primary immune deficiency, macular degeneration and schizophrenia. Unfortunately, the proposed program will be, in fact, mandatory for many physicians and their patients, and will cause patients to switch from the most appropriate treatment to less effective therapies or to forego treatment altogether because of transportation hurdles created by the new rule. RetireSafe also objects to the lack of sufficient stakeholder input from the beginning of this rule-making process, which has now created one-size-fits-all government payment policies that ignore patient differences and completely undermines the goal of patient-centered Medicare.
2016 · first_quarter · Medicare/Medicaid
RetireSafe worked as a leader, along with other patient advocate groups, to oppose any new cuts to the Medicare Advantage payment rates for 2016. RetireSafe worked with the Medicare Access for Patients Rx Coalition (MAPRx) to raise concerns regarding the Advance Notice of Methodological Changes for Calendar Year 2016 for Medicare Advantage Capitation Rates, Part C and Part D Payment Policies and 2016 Call Letter to express concerns related to: the Exceptions and Appeals Process, Star Ratings and the Dual-Eligibles, Formulary Oversight, Drug Utilization Review Controls, Tier Labeling and Composition, Specialty Tiers, and the Use of Multiple Tiers with Coinsurance Cost-Sharing Rates. RetireSafe joined with the Medicare Rights Center and other patient advocates to urge numerous changes to the Medicare Part D Program to make the Exceptions and Appeals Processes More Accessible for Beneficiaries. RetireSafe joined with the Healthcare Leadership Council and others to support the Protecting Seniors Access to Medicare Act, (H.R. 1190 and S. 141) to repeal the Independent Payment Advisory Board (IPAB), authorized under the Patient Protection and Affordable Care Act. Support H.R. 2624 and S. 1488, the Part D Beneficiary Appeals Fairness Act. Support the passage of H.R. 160 to repeal the 2.3% Medical Device Tax. Support the passage of H.R. 1190 to repeal the Independent Payment Advisory Board (IPAB). Joined with the MAPRx coalition to urge Congress to build on the success of Medicare Part D to ensure robust formularies, coverage for the six-protected classes, strong oversight, and transparency for consumers, as well as add improvements to the process for notice of non-coverage, appeals and exceptions. Also, urged Part D remedies to correct gaps in coverage, onerous cost-shifting created by specialty tiers, and restrictive utilization management tools that severely reduce patient benefits. Support "340B" Medicaid program reform to end widespread abuse of the drug discount program that ultimately harms patients. Joined with other patient advocate groups to comment on proposed rule: CMS-2390-P-Medicaid and Childrens Health Insurance Programs (CHIP); Medicaid Managed Care, CHIP Delivered in Managed Care, Medicaid and CHIP Comprehensive Quality Strategies, and Revisions Related to Third Party Liability. We supported the proposed rules intent to strengthen program integrity safeguards, and ensure beneficiary protections in areas of provider networks, coverage standards, and the treatment of appeals. We agree with the other groups that a modernized Medicaid managed care regulatory structure is essential to facilitate necessary system reform initiatives, and advance the delivery of health care for millions of people, and we supported rule changes to achieve those goals. RetireSafe joined with other patient advocates to comment on proposed rule: CMS-1631-P-Medicare Program; Revisions to Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY2016. In commenting we supported various measures for improving accuracy for primary care and care management services; providing appropriate advanced care planning services; providing better Medicare Tele-health services; providing better Chronic Care Management services for Rural Health Clinics and Qualified Health Centers; providing a useful Physicians Compare Website with data in proper context; and providing physician payment, efficiency, and quality improvements linked to a physician quality reporting system. RetireSafe joined with numerous patient groups to oppose a new CMS plan to cut the payment rate (from Average Sales Price plus 6%) for Medicare Part B Drugs administered by physicians in large parts of the U.S. because this Center for Medicare & Medicaid initiative focuses on costs rather than patients needs and health care quality. This new Part B Drug Plan will adversely impact Medicare patients with complex conditions such as cancer, macular degeneration, hypertension, rheumatoid arthritis, and primary immunodeficiency diseases. Along with many other patient advocates in the MAPRx Coalition, we strongly opposed a recent MedPAC effort to place Medicare cost savings ahead of the best interests of Medicare patients. Specifically, we urged MedPAC to reject proposals to make changes to true out-of-pocket costs (TrOOP); increase copays for low-income subsidy (LIS) beneficiaries; and eliminate any of the protected classes. RetireSafe joined with numerous patient groups to comment on the CMS Advance Notice and Draft Call Letter issued on February 19, 2016. The comments focused on better patient access to Medicare Part D Prescription Drugs and related specifically to: Specialty Tier Thresholds, Tier Labeling and Composition, Generic Tier $0 Copay Plans, Formulary Oversight, Drug Utilization Review Controls, Coverage Determination Timelines, and Access to Preferred Cost-sharing Pharmacies.
2016 · first_quarter · Medicare/Medicaid
"H.R. 775/S. 539, Medicare Access to Rehabilitation Services Act," all sections;"H.R. 3081/S.1778, The TELE-Med Act, all sections;"H.R. 2624/S. 1488, The Part D Beneficiary Fairness Appeals Act," all sections; "The Veterans E-Health and Telemedicine Support Act," (S. 2170); Medicare support for FDA breakthrough therapies (coalition sign-on support letter)
Client expense: $50,765 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
Client expense: Not reported · Firm income: $10,368
Government targets: Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
Client expense: $10,000 · Firm income: Not reported
Government targets: Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
Client expense: $16,214 · Firm income: Not reported
Government targets: Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2016 · fourth_quarter · Health Issues
P.L. 111-375 National Alzheimer's Project Act, All sections H.R. 9/S. 1137, the Innovation Act H.R. 1559/S. 857, the Health Outcomes, Planning, and Education (HOPE) for Alzheimer's Act of 2015 H.R. 1468, the Global Brain Health Act of 2015 H.R. 2624/S. 1488, the Part D Beneficiary Appeals Fairness Act H.R. 3090/S. 3113, the Alzheimer's Caregiver Support Act H.R. 3091, the Missing Alzheimer's Disease Patient Alert Program Reauthorization Act H.R. 3092, the Alzheimer's Disease Semipostal Stamp Act H.R. 3099/S. 1719, the RAISE Family Caregivers Act H.R. 3119/S. 2748, the Palliative Care and Hospice Education and Training Act H.R. 3243/S. 1362, the PACE Innovation Act H.R. 3660/S. 3126, the Preventive Health Savings Act H.R. 4708/S.2759, the Credit for Caring Act of 2016 H.R. 4919/S. 2614, Kevin and Avonte's Law of 2016 H.R. 5196/S. 879, the Americans Giving Care to Elders (AGE) Act of 2015 H.R. 5347, the Social Security Disability Fairness Act H.R. 5681/S. 3137, the Alzheimer's Beneficiary and Caregiver Support Act H. Res. 237/S. Res. 74, 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 S. 192, the Older Americans Act Reauthorization Act of 2015 S. 1549, the Care Planning Act of 2015 S. 2010, the Expedited Disability Insurance Payments for Terminally Ill Individuals Act S. 2961, the Compassionate Care Act S. 3130, the Independence at Home Act of 2016 S. 3270, the Elder Abuse Prevention and Prosecution Act
Client expense: $245,500 · 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), Natl Institutes of Health (NIH), SENATE, Veterans Affairs, Dept of (VA)
2016 · fourth_quarter · Health Issues
P.L. 111-375 National Alzheimer's Project Act, All sections H.R. 9/S. 1137, the Innovation Act H.R. 1559/S. 857, the Health Outcomes, Planning, and Education (HOPE) for Alzheimer's Act of 2015 H.R. 1468, the Global Brain Health Act of 2015 H.R. 2624/S. 1488, the Part D Beneficiary Appeals Fairness Act H.R. 3090/S. 3113, the Alzheimer's Caregiver Support Act H.R. 3091, the Missing Alzheimer's Disease Patient Alert Program Reauthorization Act H.R. 3092, the Alzheimer's Disease Semipostal Stamp Act H.R. 3099/S. 1719, the RAISE Family Caregivers Act H.R. 3119/S. 2748, the Palliative Care and Hospice Education and Training Act H.R. 3243/S. 1362, the PACE Innovation Act H.R. 3660/S. 3126, the Preventive Health Savings Act H.R. 4708/S.2759, the Credit for Caring Act of 2016 H.R. 4919/S. 2614, Kevin and Avonte's Law of 2016 H.R. 5196/S. 879, the Americans Giving Care to Elders (AGE) Act of 2015 H.R. 5347, the Social Security Disability Fairness Act H.R. 5681/S. 3137, the Alzheimer's Beneficiary and Caregiver Support Act H. Res. 237/S. Res. 74, 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 S. 192, the Older Americans Act Reauthorization Act of 2015 S. 1549, the Care Planning Act of 2015 S. 2010, the Expedited Disability Insurance Payments for Terminally Ill Individuals Act S. 2961, the Compassionate Care Act S. 3130, the Independence at Home Act of 2016 S. 3270, the Elder Abuse Prevention and Prosecution Act
Client expense: $245,500 · 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), Natl Institutes of Health (NIH), SENATE, Veterans Affairs, Dept of (VA)
2016 · second_quarter · Health Issues
1. Urge Congress to support efforts that increase access to care for people with psoriasis and psoriasis arthritis by supporting H.R.1600: Patients' Access to Treatments Act of 2015. This bill 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. 2. Support efforts to facilitate research efforts on psoriasis and psoriatic arthritis within institutes at the NIH. 3. Worked with CDC's Chronic Disease Prevention and Health Promotion on initiative that will develop public health self-management interventions for persons with psoriatic disease and advance knowledge of the links between psoriatic disease and other chronic conditions 4. Urge Congress to support HR 2624/S.1488 Medicare Part D Beneficiary Appeals Fairness Act. Allows a Medicare part D eligible individual enrolled in the plan to request an exception to the tiered cost-sharing structure 5.21st Century Cures Act - biomedical research bill 6. Crowdsourcing and Citizen Science Act of 2015 American Innovation Act
Client expense: $70,000 · Firm income: Not reported
Government targets: Centers For Disease Control & Prevention (CDC), HOUSE OF REPRESENTATIVES, Natl Institutes of Health (NIH), SENATE
2016 · fourth_quarter · Health Issues
1. Fiscal Year 2017 Labor, Health and Human Services, Education and Related Agencies Appropriations Act to help patients by urging Congress to implement a public health agenda through the Centers for Disease Control and Prevention by requesting $1.5 million to support a psoriatic disease initiative to better understand linkages between psoriatic disease and other life-threatening health conditions and to develop effective public health strategies to better equip patients to manage their health. 2. S. 1014, the Personal Care Products Safety Act, the bill strengthens FDA authority to regulate personal care products, addresses questions about the safety of certain ingredients (use by many psoriatic disease patients), creates guidance for manufacturers, and would set a national standard for cosmetics oversight. 3. S. 2113 Crowdsourcing and Citizen Science Act of 2015, the bill would encourage and increase the use of crowdsourcing and citizen science within the federal government. 4. Patients Access to Treatments Act (H.R. 1600), the bill limits cost sharing and out-of-pocket expenses for specialty tier drugs. 5. S.1488/ H.R. 2624 The Part D Beneficiary Appeals Fairness Act, the bill would allow Medicare Part D beneficiaries to request lower co-pays for high-cost specialty drugs used to treat chronic illnesses. 6. 21st Century Cures Act, set appropriated funds for biomedical research at NIH and reforms to the FDA to develop and implement a strategic plan for biomedical research
Client expense: $70,000 · Firm income: Not reported
Government targets: Centers For Disease Control & Prevention (CDC), HOUSE OF REPRESENTATIVES, SENATE
2016 · fourth_quarter · Medicare/Medicaid
RetireSafe worked as a leader, along with other patient advocate groups, to oppose any new cuts to the Medicare Advantage payment rates for 2016. RetireSafe worked with the Medicare Access for Patients Rx Coalition (MAPRx) to raise concerns regarding the Advance Notice of Methodological Changes for Calendar Year 2016 for Medicare Advantage Capitation Rates, Part C and Part D Payment Policies and 2016 Call Letter to express concerns related to: the Exceptions and Appeals Process, Star Ratings and the Dual-Eligibles, Formulary Oversight, Drug Utilization Review Controls, Tier Labeling and Composition, Specialty Tiers, and the Use of Multiple Tiers with Coinsurance Cost-Sharing Rates. RetireSafe joined with the Medicare Rights Center and other patient advocates to urge numerous changes to the Medicare Part D Program to make the Exceptions and Appeals Processes More Accessible for Beneficiaries. RetireSafe joined with the Healthcare Leadership Council and others to support the Protecting Seniors Access to Medicare Act, (H.R. 1190 and S. 141) to repeal the Independent Payment Advisory Board (IPAB), authorized under the Patient Protection and Affordable Care Act. Support H.R. 2624 and S. 1488, the Part D Beneficiary Appeals Fairness Act. Support the passage of H.R. 160 to repeal the 2.3% Medical Device Tax. Support the passage of H.R. 1190 to repeal the Independent Payment Advisory Board (IPAB). Joined with the MAPRx coalition to urge Congress to build on the success of Medicare Part D to ensure robust formularies, coverage for the six-protected classes, strong oversight, and transparency for consumers, as well as add improvements to the process for notice of non-coverage, appeals and exceptions. Also, urged Part D remedies to correct gaps in coverage, onerous cost-shifting created by specialty tiers, and restrictive utilization management tools that severely reduce patient benefits. Support "340B" Medicaid program reform to end widespread abuse of the drug discount program that ultimately harms patients. Joined with other patient advocate groups to comment on proposed rule: CMS-2390-P-Medicaid and Childrens Health Insurance Programs (CHIP); Medicaid Managed Care, CHIP Delivered in Managed Care, Medicaid and CHIP Comprehensive Quality Strategies, and Revisions Related to Third Party Liability. We supported the proposed rules intent to strengthen program integrity safeguards, and ensure beneficiary protections in areas of provider networks, coverage standards, and the treatment of appeals. We agree with the other groups that a modernized Medicaid managed care regulatory structure is essential to facilitate necessary system reform initiatives, and advance the delivery of health care for millions of people, and we supported rule changes to achieve those goals. RetireSafe joined with other patient advocates to comment on proposed rule: CMS-1631-P-Medicare Program; Revisions to Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY2016. In commenting we supported various measures for improving accuracy for primary care and care management services; providing appropriate advanced care planning services; providing better Medicare Tele-health services; providing better Chronic Care Management services for Rural Health Clinics and Qualified Health Centers; providing a useful Physicians Compare Website with data in proper context; and providing physician payment, efficiency, and quality improvements linked to a physician quality reporting system. RetireSafe joined with numerous patient groups to oppose a new CMS plan to cut the payment rate (from Average Sales Price plus 6%) for Medicare Part B Drugs administered by physicians in large parts of the U.S. because this Center for Medicare & Medicaid initiative focuses on costs rather than patients needs and health care quality. This new Part B Drug Plan will adversely impact Medicare patients with complex conditions such as cancer, macular degeneration, hypertension, rheumatoid arthritis, and primary immunodeficiency diseases. Along with many other patient advocates in the MAPRx Coalition, we strongly opposed a recent MedPAC effort to place Medicare cost savings ahead of the best interests of Medicare patients. Specifically, we urged MedPAC to reject proposals to make changes to true out-of-pocket costs (TrOOP); increase copays for low-income subsidy (LIS) beneficiaries; and eliminate any of the protected classes. RetireSafe joined with numerous patient groups to comment on the CMS Advance Notice and Draft Call Letter issued on February 19, 2016. The comments focused on better patient access to Medicare Part D Prescription Drugs and related specifically to: Specialty Tier Thresholds, Tier Labeling and Composition, Generic Tier $0 Copay Plans, Formulary Oversight, Drug Utilization Review Controls, Coverage Determination Timelines, and Access to Preferred Cost-sharing Pharmacies. RetireSafe has continued to work with a large number of patient groups (on several occasions) to strongly oppose the Centers for Medicare Services (CMS) Centers for Medicare and Medicaid Innovation (CMMI) March 8, 2016 proposed rule that would implement substantial changes to the Medicare Part B payment program. As we have stated in several joint letters to Members of Congress and to CMS, we believe the proposed changes which have been proposed as a demonstration project would impact some 75 percent of Medicare population and could limit access to the full range of available treatments under Part B to treat serious illnesses and medical treatments such as cancer, multiple sclerosis, primary immune deficiency, macular degeneration and schizophrenia. Unfortunately, the proposed program will be, in fact, mandatory for many physicians and their patients, and will cause patients to switch from the most appropriate treatment to less effective therapies or to forego treatment altogether because of transportation hurdles created by the new rule. RetireSafe also objects to the lack of sufficient stakeholder input from the beginning of this rule-making process, which has now created one-size-fits-all government payment policies that ignore patient differences and completely undermines the goal of patient-centered Medicare.
Client expense: Not reported · Firm income: $11,560
Government targets: Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2016 · fourth_quarter · Medicare/Medicaid
RetireSafe worked as a leader, along with other patient advocate groups, to oppose any new cuts to the Medicare Advantage payment rates for 2016. RetireSafe worked with the Medicare Access for Patients Rx Coalition (MAPRx) to raise concerns regarding the Advance Notice of Methodological Changes for Calendar Year 2016 for Medicare Advantage Capitation Rates, Part C and Part D Payment Policies and 2016 Call Letter to express concerns related to: the Exceptions and Appeals Process, Star Ratings and the Dual-Eligibles, Formulary Oversight, Drug Utilization Review Controls, Tier Labeling and Composition, Specialty Tiers, and the Use of Multiple Tiers with Coinsurance Cost-Sharing Rates. RetireSafe joined with the Medicare Rights Center and other patient advocates to urge numerous changes to the Medicare Part D Program to make the Exceptions and Appeals Processes More Accessible for Beneficiaries. RetireSafe joined with the Healthcare Leadership Council and others to support the Protecting Seniors Access to Medicare Act, (H.R. 1190 and S. 141) to repeal the Independent Payment Advisory Board (IPAB), authorized under the Patient Protection and Affordable Care Act. Support H.R. 2624 and S. 1488, the Part D Beneficiary Appeals Fairness Act. Support the passage of H.R. 160 to repeal the 2.3% Medical Device Tax. Support the passage of H.R. 1190 to repeal the Independent Payment Advisory Board (IPAB). Joined with the MAPRx coalition to urge Congress to build on the success of Medicare Part D to ensure robust formularies, coverage for the six-protected classes, strong oversight, and transparency for consumers, as well as add improvements to the process for notice of non-coverage, appeals and exceptions. Also, urged Part D remedies to correct gaps in coverage, onerous cost-shifting created by specialty tiers, and restrictive utilization management tools that severely reduce patient benefits. Support "340B" Medicaid program reform to end widespread abuse of the drug discount program that ultimately harms patients. Joined with other patient advocate groups to comment on proposed rule: CMS-2390-P-Medicaid and Childrens Health Insurance Programs (CHIP); Medicaid Managed Care, CHIP Delivered in Managed Care, Medicaid and CHIP Comprehensive Quality Strategies, and Revisions Related to Third Party Liability. We supported the proposed rules intent to strengthen program integrity safeguards, and ensure beneficiary protections in areas of provider networks, coverage standards, and the treatment of appeals. We agree with the other groups that a modernized Medicaid managed care regulatory structure is essential to facilitate necessary system reform initiatives, and advance the delivery of health care for millions of people, and we supported rule changes to achieve those goals. RetireSafe joined with other patient advocates to comment on proposed rule: CMS-1631-P-Medicare Program; Revisions to Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY2016. In commenting we supported various measures for improving accuracy for primary care and care management services; providing appropriate advanced care planning services; providing better Medicare Telehealth services; providing better Chronic Care Management services for Rural Health Clinics and Qualified Health Centers; providing a useful Physicians Compare Website with data in proper context; and providing physician payment, efficiency, and quality improvements linked to a physician quality reporting system. RetireSafe joined with numerous patient groups to oppose a new CMS plan to cut the payment rate (from Average Sales Price plus 6%) for Medicare Part B Drugs administered by physicians in large parts of the U.S. because this Center for Medicare & Medicaid initiative focuses on costs rather than patients needs and health care quality. This new Part B Drug Plan will adversely impact Medicare patients with complex conditions such as cancer, macular degeneration, hypertension, rheumatoid arthritis, and primary immunodeficiency diseases. Along with many other patient advocates in the MAPRx Coalition, we strongly opposed a recent MedPAC effort to place Medicare cost savings ahead of the best interests of Medicare patients. Specifically, we urged MedPAC to reject proposals to make changes to true out-of-pocket costs (TrOOP); increase copays for low-income subsidy (LIS) beneficiaries; and eliminate any of the protected classes. RetireSafe joined with numerous patient groups to comment on the CMS Advance Notice and Draft Call Letter issued on February 19, 2016. The comments focused on better patient access to Medicare Part D Prescription Drugs and related specifically to: Specialty Tier Thresholds, Tier Labeling and Composition, Generic Tier $0 Copay Plans, Formulary Oversight, Drug Utilization Review Controls, Coverage Determination Timelines, and Access to Preferred Cost-sharing Pharmacies. RetireSafe has continued to work with a large number of patient groups (on several occasions) to strongly oppose the Centers for Medicare Services (CMS) Centers for Medicare and Medicaid Innovation (CMMI) March 8, 2016 proposed rule that would implement substantial changes to the Medicare Part B payment program. As we have stated in several joint letters to Members of Congress and to CMS, we believe the proposed changes which have been proposed as a demonstration project would impact some 75 percent of Medicare population and could limit access to the full range of available treatments under Part B to treat serious illnesses and medical treatments such as cancer, multiple sclerosis, primary immune deficiency, macular degeneration and schizophrenia. Unfortunately, the proposed program will be, in fact, mandatory for many physicians and their patients, and will cause patients to switch from the most appropriate treatment to less effective therapies or to forego treatment altogether because of transportation hurdles created by the new rule. RetireSafe also objects to the lack of sufficient stakeholder input from the beginning of this rule-making process, which has now created one-size-fits-all government payment policies that ignore patient differences and completely undermines the goal of patient-centered Medicare.
Client expense: Not reported · 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), SENATE
2016 · fourth_quarter · Health Issues
Pub. Law No. 111-148, Patient Protection and Affordable Care Act, matters related to the implementation of breast health education, research and clinical trials; S.1566/H.R.2722, Cancer Drug Coverage Parity Act, advocate to require insurance companies cover iv-administered and orally-administered anti-cancer drugs at the same cost to patients; H.R.1600, Patients' Access to Treatment Act, support amending the Public Health Service Act to establish cost-sharing limits for health plans that cover prescription drugs and use a formulary or other tiered cost-sharing structure and prohibits such a health plan from imposing higher cost-sharing requirements, including co-payment and co-insurance, for specialty drugs than for other prescription drugs in a non-preferred brand drug tier; H.R.1608, Lymphedema Treatment Act, support Medicare coverage of certain lymphedema compression treatment items as durable medical equipment; S.370/H.R.716, Breast Density and Mammography Reporting Act, issues related to the information provided to women and doctors on breast density and the potential impact it has on the detection of breast cancer and require the FDA to utilize up to date medical information and direct HHS to focus research on the best screening methods for breast tissue; H.R.1925, Dr. Balazs "Ernie" Bodai Congressional Gold Medal, support the presentation of a congressional gold medal to Dr. Balaz "Ernie" Bodai in recognition of his many outstanding contributions to the nation, including a tireless commitment to breast cancer research; H.R.6, 21st Century Cures Act, issues related to cancer prevention and research funding; S.620/H.R.1189, Preserving Employee Wellness Programs Act, issues related to the Genetic Information Act of 2008 and workplace wellness programs; H.R.2846, Planning Actively for Cancer Treatments Act, support coverage of cancer care planning and coordination services; S.91/H.R.4112, Mobile Mammography Promotion Act, issues related to excluding mobile mammography vehicles from the motor fuel excise tax; H.R.3119, Palliative Care and Hospice Education and Training Act, support federal funding for research, training, education and awareness into palliative care; S.1488/H.R.2624, Part D Beneficiary Appeals Fairness Act, issues related to out-of-pocket costs for prescription drugs.
Client expense: $38,415 · Firm income: Not reported
Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), SENATE, White House Office
2016 · fourth_quarter · Medicare/Medicaid
Part D Beneficiary Appeals Fairness Act (HR 2624, S 1488)
Client expense: $70,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, Office of the Vice President of the United States, SENATE
2016 · fourth_quarter · Medicare/Medicaid
Issues related to Medicare Part D as related to blood cancer beneficiaries including H.R. 2624, S.1488, the Part D Beneficiary Appeals Fairness Act.
Client expense: Not reported · Firm income: $50,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2016 · fourth_quarter · Medicare/Medicaid
Medicare Part B and D Telemedicine Medicaid CHIP CHIP Re-authorization S.776 Medication Therapy Management Empowerment Act of 2015 HR 2624/S1488 Part D Beneficiary Appeals Fairness Act Part B proposal HR5122
Client expense: $75,000 · Firm income: Not reported
Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), SENATE, Veterans Affairs, Dept of (VA)
2016 · third_quarter · Health Issues
P.L. 111-375 National Alzheimer's Project Act, All sections H.R. 9/S. 1137, the Innovation Act H.R. 1559/S. 857, the Health Outcomes, Planning, and Education (HOPE) for Alzheimer's Act of 2015 H.R. 1468, the Global Brain Health Act of 2015 H.R. 2624/S. 1488, the Part D Beneficiary Appeals Fairness Act H.R. 3090/S. 3113, the Alzheimer's Caregiver Support Act H.R. 3091, the Missing Alzheimer's Disease Patient Alert Program Reauthorization Act H.R. 3092, the Alzheimer's Disease Semipostal Stamp Act H.R. 3099/S. 1719, the RAISE Family Caregivers Act H.R. 3119/S. 2748, the Palliative Care and Hospice Education and Training Act H.R. 3243/S. 1362, the PACE Innovation Act H.R. 3660/S. 3126, the Preventive Health Savings Act H.R. 4708/S.2759, the Credit for Caring Act of 2016 H.R. 4919/S. 2614, Kevin and Avonte's Law of 2016 H.R. 5196/S. 879, the Americans Giving Care to Elders (AGE) Act of 2015 H.R. 5347, the Social Security Disability Fairness Act H.R. 5681/S. 3137, the Alzheimer's Beneficiary and Caregiver Support Act H. Res. 237/S. Res. 74, 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 S. 192, the Older Americans Act Reauthorization Act of 2015 S. 1549, the Care Planning Act of 2015 S. 2010, the Expedited Disability Insurance Payments for Terminally Ill Individuals Act S. 2961, the Compassionate Care Act S. 3130, the Independence at Home Act of 2016 S. 3270, the Elder Abuse Prevention and Prosecution Act
Client expense: $220,000 · 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), Natl Institutes of Health (NIH), SENATE, Veterans Affairs, Dept of (VA)
2016 · third_quarter · Health Issues
H.R.927 - Keeping All Students Safe Act H.R.2646 - Helping Families in Mental Health Crisis Act H.R.2624/S. 1488 - Part D Beneficiary Appeals Fairness H.R.1211/S. 1588 - Mental Health in Schools Act of 2015 H.R.3060 - Stop Child Abuse in Residential Programs for Teens Act H.R.4977 - COVER Act H. 6 - 21st Century Cures Act H.R.1859/S. 2782 - Ensuring Children's Access to Specialty Care Act H.R.2555 - Veteran Wellness Act S. 473 - Saving Our Next Generation Act S. 841 - Prioritizing Veterans Access to Mental Health Care H.R.2632/S.1494 - Children's Recovery from Trauma Act H.R.938/S. 1299 - Garrett Lee Smith Memorial Act Reauthorization of 2015 H.R.5 - Student Success Act S.1177 - Every Child Achieves Act of 2015 S. 1893 - Mental Health Awareness & Improvement Act H.R. 670 - The Special Needs Trust Fairness Act S. 1865 - Anna Westin Act S. 524/H.R.953: Comprehensive Addiction and Recovery Act of 2015 H.R. 2994: Safer Communities Act of 2015 H.R.1006 - Building a Health Care Workforce for the Future Act H.R.3285 - Reducing Disparities Using Care Models and Education Act of 2015 H.R. 3020 - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2016 H.R.3640 - Mental Health Awareness Semipostal Stamp Act S.2012 - Energy Policy Modernization Act of 2015 - support an amendment funding lead poisoning research H.R.4276/S. 2647 - Behavioral Health Coverage Transparency Act of 2015 - support S.2680 - Mental Health Reform Act of 2016 - recommendations to improve coordination and children's health H.R.3660 - To amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings. - support S. 2685/H.R.4374 - Mental Health on Campus Improvement Act - support S. 2787S - States Achieve Medicaid Expansion Act of 2016 - Support H.R. 5234 - The Stop Mental Health Stigma in Our Communities Act of 2016 - Support S.3130 - Independence at Home Act of 2016 - Support S.2848 - Water Resources Development Act of 2016 - Support funding for lead exposure supports H.R. 5330: Peer-Support Specialist Act of 2016 - supported H.R.5100 - At-Risk Youth Medicaid Protection Act of 2016 - Supported S. 2691: Integrating Behavioral Health Through Technology Act of 2016 - Supported S.3130 - Independence at Home Act of 2016 - supported S.1604/H.R.5903 - Transition to Independence Act - supported
Client expense: $7,558 · Firm income: Not reported
Government targets: Administration for Children & Families (ACF), Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Justice, Dept of (DOJ), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)
2016 · third_quarter · Medicare/Medicaid
H.R.927 - Keeping All Students Safe Act - Support H.R.2646 - Helping Families in Mental Health Crisis Act - Support H.R.2624/S. 1488 - Part D Beneficiary Appeals Fairness - Support H.R.4435 - Comprehensive Behavioral Health Reform and Recovery Act of 2016 - Discuss why Medicaid reforms are important H.R. 670 - The Special Needs Trust Fairness Act - Support S. 1865 - Anna Westin Act - Support H.R.3285 - Reducing Disparities Using Care Models and Education Act of 2015 S. 2787S - States Achieve Medicaid Expansion Act of 2016 - Support H.R.5100 - At-Risk Youth Medicaid Protection Act of 2016 - Supported S. 2691: Integrating Behavioral Health Through Technology Act of 2016 - Supported S.3130 - Independence at Home Act of 2016 - Supported
Client expense: $7,558 · Firm income: Not reported
Government targets: Administration for Children & Families (ACF), Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Justice, Dept of (DOJ), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)
2016 · third_quarter · Medicare/Medicaid
RetireSafe worked as a leader, along with other patient advocate groups, to oppose any new cuts to the Medicare Advantage payment rates for 2016. RetireSafe worked with the Medicare Access for Patients Rx Coalition (MAPRx) to raise concerns regarding the Advance Notice of Methodological Changes for Calendar Year 2016 for Medicare Advantage Capitation Rates, Part C and Part D Payment Policies and 2016 Call Letter to express concerns related to: the Exceptions and Appeals Process, Star Ratings and the Dual-Eligibles, Formulary Oversight, Drug Utilization Review Controls, Tier Labeling and Composition, Specialty Tiers, and the Use of Multiple Tiers with Coinsurance Cost-Sharing Rates. RetireSafe joined with the Medicare Rights Center and other patient advocates to urge numerous changes to the Medicare Part D Program to make the Exceptions and Appeals Processes More Accessible for Beneficiaries. RetireSafe joined with the Healthcare Leadership Council and others to support the Protecting Seniors Access to Medicare Act, (H.R. 1190 and S. 141) to repeal the Independent Payment Advisory Board (IPAB), authorized under the Patient Protection and Affordable Care Act. Support H.R. 2624 and S. 1488, the Part D Beneficiary Appeals Fairness Act. Support the passage of H.R. 160 to repeal the 2.3% Medical Device Tax. Support the passage of H.R. 1190 to repeal the Independent Payment Advisory Board (IPAB). Joined with the MAPRx coalition to urge Congress to build on the success of Medicare Part D to ensure robust formularies, coverage for the six-protected classes, strong oversight, and transparency for consumers, as well as add improvements to the process for notice of non-coverage, appeals and exceptions. Also, urged Part D remedies to correct gaps in coverage, onerous cost-shifting created by specialty tiers, and restrictive utilization management tools that severely reduce patient benefits. Support "340B" Medicaid program reform to end widespread abuse of the drug discount program that ultimately harms patients. Joined with other patient advocate groups to comment on proposed rule: CMS-2390-P-Medicaid and Childrens Health Insurance Programs (CHIP); Medicaid Managed Care, CHIP Delivered in Managed Care, Medicaid and CHIP Comprehensive Quality Strategies, and Revisions Related to Third Party Liability. We supported the proposed rules intent to strengthen program integrity safeguards, and ensure beneficiary protections in areas of provider networks, coverage standards, and the treatment of appeals. We agree with the other groups that a modernized Medicaid managed care regulatory structure is essential to facilitate necessary system reform initiatives, and advance the delivery of health care for millions of people, and we supported rule changes to achieve those goals. RetireSafe joined with other patient advocates to comment on proposed rule: CMS-1631-P-Medicare Program; Revisions to Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY2016. In commenting we supported various measures for improving accuracy for primary care and care management services; providing appropriate advanced care planning services; providing better Medicare Tele-health services; providing better Chronic Care Management services for Rural Health Clinics and Qualified Health Centers; providing a useful Physicians Compare Website with data in proper context; and providing physician payment, efficiency, and quality improvements linked to a physician quality reporting system. RetireSafe joined with numerous patient groups to oppose a new CMS plan to cut the payment rate (from Average Sales Price plus 6%) for Medicare Part B Drugs administered by physicians in large parts of the U.S. because this Center for Medicare & Medicaid initiative focuses on costs rather than patients needs and health care quality. This new Part B Drug Plan will adversely impact Medicare patients with complex conditions such as cancer, macular degeneration, hypertension, rheumatoid arthritis, and primary immunodeficiency diseases. Along with many other patient advocates in the MAPRx Coalition, we strongly opposed a recent MedPAC effort to place Medicare cost savings ahead of the best interests of Medicare patients. Specifically, we urged MedPAC to reject proposals to make changes to true out-of-pocket costs (TrOOP); increase copays for low-income subsidy (LIS) beneficiaries; and eliminate any of the protected classes. RetireSafe joined with numerous patient groups to comment on the CMS Advance Notice and Draft Call Letter issued on February 19, 2016. The comments focused on better patient access to Medicare Part D Prescription Drugs and related specifically to: Specialty Tier Thresholds, Tier Labeling and Composition, Generic Tier $0 Copay Plans, Formulary Oversight, Drug Utilization Review Controls, Coverage Determination Timelines, and Access to Preferred Cost-sharing Pharmacies. RetireSafe has continued to work with a large number of patient groups (on several occasions) to strongly oppose the Centers for Medicare Services (CMS) Centers for Medicare and Medicaid Innovation (CMMI) March 8, 2016 proposed rule that would implement substantial changes to the Medicare Part B payment program. As we have stated in several joint letters to Members of Congress and to CMS, we believe the proposed changes which have been proposed as a demonstration project would impact some 75 percent of Medicare population and could limit access to the full range of available treatments under Part B to treat serious illnesses and medical treatments such as cancer, multiple sclerosis, primary immune deficiency, macular degeneration and schizophrenia. Unfortunately, the proposed program will be, in fact, mandatory for many physicians and their patients, and will cause patients to switch from the most appropriate treatment to less effective therapies or to forego treatment altogether because of transportation hurdles created by the new rule. RetireSafe also objects to the lack of sufficient stakeholder input from the beginning of this rule-making process, which has now created one-size-fits-all government payment policies that ignore patient differences and completely undermines the goal of patient-centered Medicare.
Client expense: Not reported · Firm income: $10,000
Government targets: Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
Discussed structural changes to Medicaid. Discussed health care quality and measurement. Discussed changes to the Medicare benefit design, such as copays, premiums and deductibles. S. 1083, H.R.2005 - Discussed legislation to require drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. S. 1488, H.R. 2624, Part D Beneficiary Appeals Fairness Act - Discussed bill that would allow seniors to appeal the placement of their medications on a Medicare Part D specialty tier. Discussed Medicare Part D fraud and abuse legislation including lock-in provisions for high risk enrollees. Discussed legislation to require the addition of unique device identifier (UDI) of medical devices in health insurance claim forms. S. 624, H.R.1220, Removing Barriers to Colorectal Cancer Screening Act - Discussed bill. S. 3040, H.R. 5926, H.R. 5325, Labor, Health and Human Services Appropriations bill, FY2017 - Lobbied in support of increased funding for CMS' state survey and certification program. Discussed the Medicare Part D prescription drug benefit program and changes needed to lower prescription drug costs and related agency proposed rule changes. H.R. 5122 - Discussed the Medicare Part B prescription drug demonstration proposal from the Centers for Medicare and Medicaid Services. Discussed potential benefit and coverage improvements under Medicare and Medicare Savings Programs. Discussed Section 1115 Medicaid expansion demonstration waivers (HHS, CMS). H.R. 2759, Mental Health Access Improvement Act - Discussed support of bill. Discussed MACRA implementation. Discussed Medicare enrollment and coverage issues such as: provider access, direct billing and penalties. Discussed DOJ investigation regarding Olmstead and ADA violations by South Dakota (DOJ, ACL) and related public events. Discussed Olmstead enforcement and older adults at roundtable discussion. S. 3096, Removing Barriers to Person-Centered Care Act of 2016 - Discussed and provided feedback. Discussed possible hearing witnesses. Responded to inquiry regarding MACRA rules and value modifier. H.R. 3298, Post Acute Care Value Based Purchasing Act - Discussed and provided feedback. Discussed arbitration provision in LTC facility requirements proposed rule (OMB, CMS, HHS). Responded to inquiry on Virtual Caregiving Fair. PL 111-148 - Discussed ACA Medicaid HCBS spousal impoverishment provisions. Responded to inquiry on state nursing home legislation. Discussed Medicaid assisted living, HCBS setting rule and follow-up (GAO). Discussed Medicare home health (CMS). Urged support for family caregivers in Medicare and Medicaid and testing modeling. Signed letter to CMS regarding arbitration in LTC facility requirements rule. Discussed family caregiver assessment guidance (CMS). Attended PPI home health roundtable with staff from HHS. Responded to a question about a scorecard and letters to CMS. Responded to an inquiry regarding an arbitration regulatory provision. Responded to an inquiry regarding personal needs allowances. Discussed Medicaid functional assessment tools, family caregiver assessment, and follow-up(GAO). Responded to inquiries regarding Medicaid managed long-term services and supports, best practices, and state ombuds programs. S. 3130, Independence at Home Act - Discussed and sent AARP endorsement letter for bill
Client expense: $2,290,000 · 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), Commerce, Dept of (DOC), Congressional Budget Office (CBO), Federal Transit Administration (FTA), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Social Security Administration (SSA), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Trade Representative (USTR), Veterans Affairs, Dept of (VA), White House Office
2016 · third_quarter · Medicare/Medicaid
Part D Beneficiary Appeals Fairness Act (HR 2624, S 1488)
Client expense: $120,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, Office of the Vice President of the United States, SENATE
2016 · third_quarter · Medicare/Medicaid
RetireSafe worked as a leader, along with other patient advocate groups, to oppose any new cuts to the Medicare Advantage payment rates for 2016. RetireSafe worked with the Medicare Access for Patients Rx Coalition (MAPRx) to raise concerns regarding the Advance Notice of Methodological Changes for Calendar Year 2016 for Medicare Advantage Capitation Rates, Part C and Part D Payment Policies and 2016 Call Letter to express concerns related to: the Exceptions and Appeals Process, Star Ratings and the Dual-Eligibles, Formulary Oversight, Drug Utilization Review Controls, Tier Labeling and Composition, Specialty Tiers, and the Use of Multiple Tiers with Coinsurance Cost-Sharing Rates. RetireSafe joined with the Medicare Rights Center and other patient advocates to urge numerous changes to the Medicare Part D Program to make the Exceptions and Appeals Processes More Accessible for Beneficiaries. RetireSafe joined with the Healthcare Leadership Council and others to support the Protecting Seniors Access to Medicare Act, (H.R. 1190 and S. 141) to repeal the Independent Payment Advisory Board (IPAB), authorized under the Patient Protection and Affordable Care Act. Support H.R. 2624 and S. 1488, the Part D Beneficiary Appeals Fairness Act. Support the passage of H.R. 160 to repeal the 2.3% Medical Device Tax. Support the passage of H.R. 1190 to repeal the Independent Payment Advisory Board (IPAB). Joined with the MAPRx coalition to urge Congress to build on the success of Medicare Part D to ensure robust formularies, coverage for the six-protected classes, strong oversight, and transparency for consumers, as well as add improvements to the process for notice of non-coverage, appeals and exceptions. Also, urged Part D remedies to correct gaps in coverage, onerous cost-shifting created by specialty tiers, and restrictive utilization management tools that severely reduce patient benefits. Support "340B" Medicaid program reform to end widespread abuse of the drug discount program that ultimately harms patients. Joined with other patient advocate groups to comment on proposed rule: CMS-2390-P-Medicaid and Childrens Health Insurance Programs (CHIP); Medicaid Managed Care, CHIP Delivered in Managed Care, Medicaid and CHIP Comprehensive Quality Strategies, and Revisions Related to Third Party Liability. We supported the proposed rules intent to strengthen program integrity safeguards, and ensure beneficiary protections in areas of provider networks, coverage standards, and the treatment of appeals. We agree with the other groups that a modernized Medicaid managed care regulatory structure is essential to facilitate necessary system reform initiatives, and advance the delivery of health care for millions of people, and we supported rule changes to achieve those goals. RetireSafe joined with other patient advocates to comment on proposed rule: CMS-1631-P-Medicare Program; Revisions to Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY2016. In commenting we supported various measures for improving accuracy for primary care and care management services; providing appropriate advanced care planning services; providing better Medicare Telehealth services; providing better Chronic Care Management services for Rural Health Clinics and Qualified Health Centers; providing a useful Physicians Compare Website with data in proper context; and providing physician payment, efficiency, and quality improvements linked to a physician quality reporting system. RetireSafe joined with numerous patient groups to oppose a new CMS plan to cut the payment rate (from Average Sales Price plus 6%) for Medicare Part B Drugs administered by physicians in large parts of the U.S. because this Center for Medicare & Medicaid initiative focuses on costs rather than patients needs and health care quality. This new Part B Drug Plan will adversely impact Medicare patients with complex conditions such as cancer, macular degeneration, hypertension, rheumatoid arthritis, and primary immunodeficiency diseases. Along with many other patient advocates in the MAPRx Coalition, we strongly opposed a recent MedPAC effort to place Medicare cost savings ahead of the best interests of Medicare patients. Specifically, we urged MedPAC to reject proposals to make changes to true out-of-pocket costs (TrOOP); increase copays for low-income subsidy (LIS) beneficiaries; and eliminate any of the protected classes. RetireSafe joined with numerous patient groups to comment on the CMS Advance Notice and Draft Call Letter issued on February 19, 2016. The comments focused on better patient access to Medicare Part D Prescription Drugs and related specifically to: Specialty Tier Thresholds, Tier Labeling and Composition, Generic Tier $0 Copay Plans, Formulary Oversight, Drug Utilization Review Controls, Coverage Determination Timelines, and Access to Preferred Cost-sharing Pharmacies. RetireSafe has continued to work with a large number of patient groups (on several occasions) to strongly oppose the Centers for Medicare Services (CMS) Centers for Medicare and Medicaid Innovation (CMMI) March 8, 2016 proposed rule that would implement substantial changes to the Medicare Part B payment program. As we have stated in several joint letters to Members of Congress and to CMS, we believe the proposed changes which have been proposed as a demonstration project would impact some 75 percent of Medicare population and could limit access to the full range of available treatments under Part B to treat serious illnesses and medical treatments such as cancer, multiple sclerosis, primary immune deficiency, macular degeneration and schizophrenia. Unfortunately, the proposed program will be, in fact, mandatory for many physicians and their patients, and will cause patients to switch from the most appropriate treatment to less effective therapies or to forego treatment altogether because of transportation hurdles created by the new rule. RetireSafe also objects to the lack of sufficient stakeholder input from the beginning of this rule-making process, which has now created one-size-fits-all government payment policies that ignore patient differences and completely undermines the goal of patient-centered Medicare.
Client expense: Not reported · 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), SENATE
2016 · third_quarter · Medicare/Medicaid
Issues related to Medicare Part D as related to blood cancer beneficiaries including H.R. 2624, S.1488, the Part D Beneficiary Appeals Fairness Act.
Client expense: Not reported · Firm income: $50,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2016 · third_quarter · Medicare/Medicaid
H.R.927 - Keeping All Students Safe Act - Support H.R.2646 - Helping Families in Mental Health Crisis Act - Support H.R.2624/S. 1488 - Part D Beneficiary Appeals Fairness - Support H.R.4435 - Comprehensive Behavioral Health Reform and Recovery Act of 2016 - Discuss why Medicaid reforms are important H.R. 670 - The Special Needs Trust Fairness Act - Support S. 1865 - Anna Westin Act - Support H.R.3285 - Reducing Disparities Using Care Models and Education Act of 2015 S. 2787S - States Achieve Medicaid Expansion Act of 2016 - Support H.R.5100 - At-Risk Youth Medicaid Protection Act of 2016 - Supported S. 2691: Integrating Behavioral Health Through Technology Act of 2016 - Supported S.3130 - Independence at Home Act of 2016 - Supported
Client expense: $7,558 · Firm income: Not reported
Government targets: Administration for Children & Families (ACF), Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Justice, Dept of (DOJ), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)
2016 · third_quarter · Health Issues
H.R.927 - Keeping All Students Safe Act H.R.2646 - Helping Families in Mental Health Crisis Act H.R.2624/S. 1488 - Part D Beneficiary Appeals Fairness H.R.1211/S. 1588 - Mental Health in Schools Act of 2015 H.R.3060 - Stop Child Abuse in Residential Programs for Teens Act H.R.4977 - COVER Act H. 6 - 21st Century Cures Act H.R.1859/S. 2782 - Ensuring Children's Access to Specialty Care Act H.R.2555 - Veteran Wellness Act S. 473 - Saving Our Next Generation Act S. 841 - Prioritizing Veterans Access to Mental Health Care H.R.2632/S.1494 - Children's Recovery from Trauma Act H.R.938/S. 1299 - Garrett Lee Smith Memorial Act Reauthorization of 2015 H.R.5 - Student Success Act S.1177 - Every Child Achieves Act of 2015 S. 1893 - Mental Health Awareness & Improvement Act H.R. 670 - The Special Needs Trust Fairness Act S. 1865 - Anna Westin Act S. 524/H.R.953: Comprehensive Addiction and Recovery Act of 2015 H.R. 2994: Safer Communities Act of 2015 H.R.1006 - Building a Health Care Workforce for the Future Act H.R.3285 - Reducing Disparities Using Care Models and Education Act of 2015 H.R. 3020 - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2016 H.R.3640 - Mental Health Awareness Semipostal Stamp Act S.2012 - Energy Policy Modernization Act of 2015 - support an amendment funding lead poisoning research H.R.4276/S. 2647 - Behavioral Health Coverage Transparency Act of 2015 - support S.2680 - Mental Health Reform Act of 2016 - recommendations to improve coordination and children's health H.R.3660 - To amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings. - support S. 2685/H.R.4374 - Mental Health on Campus Improvement Act - support S. 2787S - States Achieve Medicaid Expansion Act of 2016 - Support H.R. 5234 - The Stop Mental Health Stigma in Our Communities Act of 2016 - Support S.3130 - Independence at Home Act of 2016 - Support S.2848 - Water Resources Development Act of 2016 - Support funding for lead exposure supports H.R. 5330: Peer-Support Specialist Act of 2016 - supported H.R.5100 - At-Risk Youth Medicaid Protection Act of 2016 - Supported S. 2691: Integrating Behavioral Health Through Technology Act of 2016 - Supported S.3130 - Independence at Home Act of 2016 - supported S.1604/H.R.5903 - Transition to Independence Act - supported
Client expense: $7,558 · Firm income: Not reported
Government targets: Administration for Children & Families (ACF), Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Justice, Dept of (DOJ), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)
2016 · third_quarter · Health Issues
Pub. Law No. 111-148, Patient Protection and Affordable Care Act, matters related to the implementation of breast health education, research and clinical trials; S.1566/H.R.2722, Cancer Drug Coverage Parity Act, advocate to require insurance companies cover iv-administered and orally-administered anti-cancer drugs at the same cost to patients; H.R.1600, Patients' Access to Treatment Act, support amending the Public Health Service Act to establish cost-sharing limits for health plans that cover prescription drugs and use a formulary or other tiered cost-sharing structure and prohibits such a health plan from imposing higher cost-sharing requirements, including co-payment and co-insurance, for specialty drugs than for other prescription drugs in a non-preferred brand drug tier; H.R.1608, Lymphedema Treatment Act, support Medicare coverage of certain lymphedema compression treatment items as durable medical equipment; S.370/H.R.716, Breast Density and Mammography Reporting Act, issues related to the information provided to women and doctors on breast density and the potential impact it has on the detection of breast cancer and require the FDA to utilize up to date medical information and direct HHS to focus research on the best screening methods for breast tissue; H.R.1925, Dr. Balazs "Ernie" Bodai Congressional Gold Medal, support the presentation of a congressional gold medal to Dr. Balaz "Ernie" Bodai in recognition of his many outstanding contributions to the nation, including a tireless commitment to breast cancer research; H.R.6, 21st Century Cures Act, issues related to cancer prevention and research funding; S.620/H.R.1189, Preserving Employee Wellness Programs Act, issues related to the Genetic Information Act of 2008 and workplace wellness programs; H.R.2846, Planning Actively for Cancer Treatments Act, support coverage of cancer care planning and coordination services; S.91/H.R.4112, Mobile Mammography Promotion Act, issues related to excluding mobile mammography vehicles from the motor fuel excise tax; H.R.3119, Palliative Care and Hospice Education and Training Act, support federal funding for research, training, education and awareness into palliative care; S.1488/H.R.2624, Part D Beneficiary Appeals Fairness Act, issues related to out-of-pocket costs for prescription drugs.
Client expense: $39,585 · Firm income: Not reported
Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), SENATE, White House Office
2016 · third_quarter · Health Issues
1. Fiscal Year 2017 Labor, Health and Human Services, Education and Related Agencies Appropriations Act to help patients by urging Congress to implement a public health agenda through the Centers for Disease Control and Prevention by requesting $1.5 million to support a psoriatic disease initiative to better understand linkages between psoriatic disease and other life-threatening health conditions and to develop effective public health strategies to better equip patients to manage their health. 2. S. 1014, the Personal Care Products Safety Act, the bill strengthens FDA authority to regulate personal care products, addresses questions about the safety of certain ingredients (use by many psoriatic disease patients), creates guidance for manufacturers, and would set a national standard for cosmetics oversight. 3. S. 2113 Crowdsourcing and Citizen Science Act of 2015, the bill would encourage and increase the use of crowdsourcing and citizen science within the federal government. 4. Patients Access to Treatments Act (H.R. 1600), the bill limits cost sharing and out-of-pocket expenses for specialty tier drugs. 5. S.1488/ H.R. 2624 The Part D Beneficiary Appeals Fairness Act, the bill would allow Medicare Part D beneficiaries to request lower co-pays for high-cost specialty drugs used to treat chronic illnesses.
Client expense: $70,000 · Firm income: Not reported
Government targets: Centers For Disease Control & Prevention (CDC), HOUSE OF REPRESENTATIVES, SENATE
2016 · third_quarter · Medicare/Medicaid
Medicare Part B and D Telemedicine Medicaid CHIP CHIP Re-authorization S.776 Medication Therapy Management Empowerment Act of 2015 HR 2624/S1488 Part D Beneficiary Appeals Fairness Act Part B proposal HR5122
Client expense: $75,000 · Firm income: Not reported
Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), SENATE, Veterans Affairs, Dept of (VA)
2016 · second_quarter · Health Issues
P.L. 111-375 National Alzheimer's Project Act, All sections H.R. 9/S. 1137, the Innovation Act H.R. 1559/S. 857, the Health Outcomes, Planning, and Education (HOPE) for Alzheimer's Act of 2015 H.R. 1468, the Global Brain Health Act of 2015 H.R. 2624/S. 1488, the Part D Beneficiary Appeals Fairness Act H.R. 3090/S. 3113, the Alzheimer's Caregiver Support Act H.R. 3091, the Missing Alzheimer's Disease Patient Alert Program Reauthorization Act H.R. 3092, the Alzheimer's Disease Semipostal Stamp Act H.R. 3099/S. 1719, the RAISE Family Caregivers Act H.R. 3119/S. 2748, the Palliative Care and Hospice Education and Training Act H.R. 3243/S. 1362, the PACE Innovation Act H.R. 3660, the Preventive Health Savings Act H.R. 4708/S.2759, the Credit for Caring Act of 2016 H.R. 4919/S. 2614, Kevin and Avonte's Law of 2016 H.R. 5196/S. 879, the Americans Giving Care to Elders (AGE) Act of 2015 H. Res. 237/S. Res. 74, 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 S. 192, the Older Americans Act Reauthorization Act of 2015 S. 1549, the Care Planning Act of 2015 S. 2961, the Compassionate Care Act S. 3130, the Independence at Home Act of 2016
Client expense: $180,000 · 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), Natl Institutes of Health (NIH), SENATE, Veterans Affairs, Dept of (VA)
2016 · second_quarter · Medicare/Medicaid
RetireSafe worked as a leader, along with other patient advocate groups, to oppose any new cuts to the Medicare Advantage payment rates for 2016. RetireSafe worked with the Medicare Access for Patients Rx Coalition (MAPRx) to raise concerns regarding the Advance Notice of Methodological Changes for Calendar Year 2016 for Medicare Advantage Capitation Rates, Part C and Part D Payment Policies and 2016 Call Letter to express concerns related to: the Exceptions and Appeals Process, Star Ratings and the Dual-Eligibles, Formulary Oversight, Drug Utilization Review Controls, Tier Labeling and Composition, Specialty Tiers, and the Use of Multiple Tiers with Coinsurance Cost-Sharing Rates. RetireSafe joined with the Medicare Rights Center and other patient advocates to urge numerous changes to the Medicare Part D Program to make the Exceptions and Appeals Processes More Accessible for Beneficiaries. RetireSafe joined with the Healthcare Leadership Council and others to support the Protecting Seniors Access to Medicare Act, (H.R. 1190 and S. 141) to repeal the Independent Payment Advisory Board (IPAB), authorized under the Patient Protection and Affordable Care Act. Support H.R. 2624 and S. 1488, the Part D Beneficiary Appeals Fairness Act. Support the passage of H.R. 160 to repeal the 2.3% Medical Device Tax. Support the passage of H.R. 1190 to repeal the Independent Payment Advisory Board (IPAB). Joined with the MAPRx coalition to urge Congress to build on the success of Medicare Part D to ensure robust formularies, coverage for the six-protected classes, strong oversight, and transparency for consumers, as well as add improvements to the process for notice of non-coverage, appeals and exceptions. Also, urged Part D remedies to correct gaps in coverage, onerous cost-shifting created by specialty tiers, and restrictive utilization management tools that severely reduce patient benefits. Support "340B" Medicaid program reform to end widespread abuse of the drug discount program that ultimately harms patients. Joined with other patient advocate groups to comment on proposed rule: CMS-2390-P-Medicaid and Childrens Health Insurance Programs (CHIP); Medicaid Managed Care, CHIP Delivered in Managed Care, Medicaid and CHIP Comprehensive Quality Strategies, and Revisions Related to Third Party Liability. We supported the proposed rules intent to strengthen program integrity safeguards, and ensure beneficiary protections in areas of provider networks, coverage standards, and the treatment of appeals. We agree with the other groups that a modernized Medicaid managed care regulatory structure is essential to facilitate necessary system reform initiatives, and advance the delivery of health care for millions of people, and we supported rule changes to achieve those goals. RetireSafe joined with other patient advocates to comment on proposed rule: CMS-1631-P-Medicare Program; Revisions to Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY2016. In commenting we supported various measures for improving accuracy for primary care and care management services; providing appropriate advanced care planning services; providing better Medicare Tele-health services; providing better Chronic Care Management services for Rural Health Clinics and Qualified Health Centers; providing a useful Physicians Compare Website with data in proper context; and providing physician payment, efficiency, and quality improvements linked to a physician quality reporting system. RetireSafe joined with numerous patient groups to oppose a new CMS plan to cut the payment rate (from Average Sales Price plus 6%) for Medicare Part B Drugs administered by physicians in large parts of the U.S. because this Center for Medicare & Medicaid initiative focuses on costs rather than patients needs and health care quality. This new Part B Drug Plan will adversely impact Medicare patients with complex conditions such as cancer, macular degeneration, hypertension, rheumatoid arthritis, and primary immunodeficiency diseases. Along with many other patient advocates in the MAPRx Coalition, we strongly opposed a recent MedPAC effort to place Medicare cost savings ahead of the best interests of Medicare patients. Specifically, we urged MedPAC to reject proposals to make changes to true out-of-pocket costs (TrOOP); increase copays for low-income subsidy (LIS) beneficiaries; and eliminate any of the protected classes. RetireSafe joined with numerous patient groups to comment on the CMS Advance Notice and Draft Call Letter issued on February 19, 2016. The comments focused on better patient access to Medicare Part D Prescription Drugs and related specifically to: Specialty Tier Thresholds, Tier Labeling and Composition, Generic Tier $0 Copay Plans, Formulary Oversight, Drug Utilization Review Controls, Coverage Determination Timelines, and Access to Preferred Cost-sharing Pharmacies. RetireSafe has continued to work with a large number of patient groups (on several occasions) to strongly oppose the Centers for Medicare Services (CMS) Centers for Medicare and Medicaid Innovation (CMMI) March 8, 2016 proposed rule that would implement substantial changes to the Medicare Part B payment program. As we have stated in several joint letters to Members of Congress and to CMS, we believe the proposed changes which have been proposed as a demonstration project would impact some 75 percent of Medicare population and could limit access to the full range of available treatments under Part B to treat serious illnesses and medical treatments such as cancer, multiple sclerosis, primary immune deficiency, macular degeneration and schizophrenia. Unfortunately, the proposed program will be, in fact, mandatory for many physicians and their patients, and will cause patients to switch from the most appropriate treatment to less effective therapies or to forego treatment altogether because of transportation hurdles created by the new rule. RetireSafe also objects to the lack of sufficient stakeholder input from the beginning of this rule-making process, which has now created one-size-fits-all government payment policies that ignore patient differences and completely undermines the goal of patient-centered Medicare.
Client expense: Not reported · Firm income: $10,000
Government targets: Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2016 · second_quarter · Medicare/Medicaid
RetireSafe worked as a leader, along with other patient advocate groups, to oppose any new cuts to the Medicare Advantage payment rates for 2016. RetireSafe worked with the Medicare Access for Patients Rx Coalition (MAPRx) to raise concerns regarding the Advance Notice of Methodological Changes for Calendar Year 2016 for Medicare Advantage Capitation Rates, Part C and Part D Payment Policies and 2016 Call Letter to express concerns related to: the Exceptions and Appeals Process, Star Ratings and the Dual-Eligibles, Formulary Oversight, Drug Utilization Review Controls, Tier Labeling and Composition, Specialty Tiers, and the Use of Multiple Tiers with Coinsurance Cost-Sharing Rates. RetireSafe joined with the Medicare Rights Center and other patient advocates to urge numerous changes to the Medicare Part D Program to make the Exceptions and Appeals Processes More Accessible for Beneficiaries. RetireSafe joined with the Healthcare Leadership Council and others to support the Protecting Seniors Access to Medicare Act, (H.R. 1190 and S. 141) to repeal the Independent Payment Advisory Board (IPAB), authorized under the Patient Protection and Affordable Care Act. Support H.R. 2624 and S. 1488, the Part D Beneficiary Appeals Fairness Act. Support the passage of H.R. 160 to repeal the 2.3% Medical Device Tax. Support the passage of H.R. 1190 to repeal the Independent Payment Advisory Board (IPAB). Joined with the MAPRx coalition to urge Congress to build on the success of Medicare Part D to ensure robust formularies, coverage for the six-protected classes, strong oversight, and transparency for consumers, as well as add improvements to the process for notice of non-coverage, appeals and exceptions. Also, urged Part D remedies to correct gaps in coverage, onerous cost-shifting created by specialty tiers, and restrictive utilization management tools that severely reduce patient benefits. Support "340B" Medicaid program reform to end widespread abuse of the drug discount program that ultimately harms patients. Joined with other patient advocate groups to comment on proposed rule: CMS-2390-P-Medicaid and Childrens Health Insurance Programs (CHIP); Medicaid Managed Care, CHIP Delivered in Managed Care, Medicaid and CHIP Comprehensive Quality Strategies, and Revisions Related to Third Party Liability. We supported the proposed rules intent to strengthen program integrity safeguards, and ensure beneficiary protections in areas of provider networks, coverage standards, and the treatment of appeals. We agree with the other groups that a modernized Medicaid managed care regulatory structure is essential to facilitate necessary system reform initiatives, and advance the delivery of health care for millions of people, and we supported rule changes to achieve those goals. RetireSafe joined with other patient advocates to comment on proposed rule: CMS-1631-P-Medicare Program; Revisions to Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY2016. In commenting we supported various measures for improving accuracy for primary care and care management services; providing appropriate advanced care planning services; providing better Medicare Telehealth services; providing better Chronic Care Management services for Rural Health Clinics and Qualified Health Centers; providing a useful Physicians Compare Website with data in proper context; and providing physician payment, efficiency, and quality improvements linked to a physician quality reporting system. RetireSafe joined with numerous patient groups to oppose a new CMS plan to cut the payment rate (from Average Sales Price plus 6%) for Medicare Part B Drugs administered by physicians in large parts of the U.S. because this Center for Medicare & Medicaid initiative focuses on costs rather than patients needs and health care quality. This new Part B Drug Plan will adversely impact Medicare patients with complex conditions such as cancer, macular degeneration, hypertension, rheumatoid arthritis, and primary immunodeficiency diseases. Along with many other patient advocates in the MAPRx Coalition, we strongly opposed a recent MedPAC effort to place Medicare cost savings ahead of the best interests of Medicare patients. Specifically, we urged MedPAC to reject proposals to make changes to true out-of-pocket costs (TrOOP); increase copays for low-income subsidy (LIS) beneficiaries; and eliminate any of the protected classes. RetireSafe joined with numerous patient groups to comment on the CMS Advance Notice and Draft Call Letter issued on February 19, 2016. The comments focused on better patient access to Medicare Part D Prescription Drugs and related specifically to: Specialty Tier Thresholds, Tier Labeling and Composition, Generic Tier $0 Copay Plans, Formulary Oversight, Drug Utilization Review Controls, Coverage Determination Timelines, and Access to Preferred Cost-sharing Pharmacies. RetireSafe has continued to work with a large number of patient groups (on several occasions) to strongly oppose the Centers for Medicare Services (CMS) Centers for Medicare and Medicaid Innovation (CMMI) March 8, 2016 proposed rule that would implement substantial changes to the Medicare Part B payment program. As we have stated in several joint letters to Members of Congress and to CMS, we believe the proposed changes which have been proposed as a demonstration project would impact some 75 percent of Medicare population and could limit access to the full range of available treatments under Part B to treat serious illnesses and medical treatments such as cancer, multiple sclerosis, primary immune deficiency, macular degeneration and schizophrenia. Unfortunately, the proposed program will be, in fact, mandatory for many physicians and their patients, and will cause patients to switch from the most appropriate treatment to less effective therapies or to forego treatment altogether because of transportation hurdles created by the new rule. RetireSafe also objects to the lack of sufficient stakeholder input from the beginning of this rule-making process, which has now created one-size-fits-all government payment policies that ignore patient differences and completely undermines the goal of patient-centered Medicare.
Client expense: Not reported · 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), SENATE
Responded to inquiry regarding in-home supportive services programs. S. 1549, Care Planning Act - Discussed the bill and urged cosponsorship. Discussed structural changes to Medicaid. Discussed health care quality and measurement. Discussed changes to the Medicare benefit design, such as copays, premiums and deductibles. H.R.1571, Improving Access to Medicare Coverage Act - Discussed bill. S.578, Home Health Planning Improvement Act - Discussed bill and urged cosponsorship. Discussed the Medicare Part D prescription drug benefit program and changes needed to lower prescription drug costs and related agency proposed rule changes. S. 1083, H.R.2005 - Discussed legislation to require drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. S. 1488, H.R. 2624, Part D Beneficiary Appeals Fairness Act - Discussed bill that would allow seniors to appeal the placement of their medications on a Medicare Part D specialty tier. Discussed Medicare Part D fraud and abuse legislation including lock-in provisions for high risk enrollees. Discussed legislation to require the addition of unique device identifier (UDI) of medical devices in health insurance claim forms. Discussed the Medicare Part B prescription drug demonstration proposal from the Centers for Medicare and Medicaid Services. S. 624, H.R.1220,Removing Barriers to Colorectal Cancer Screening Act - Discussed bill. S. 3040, Labor, Health and Human Services,FY2017 - Lobbied in support of increased funding for CMS' state survey and certification program. S. 1549 - Discussed support of Care Planning Act. Discussed the Medicare Part B prescription drug benefit program and changes needed to lower prescription drug costs and related agency proposed rule changes. H.R. 5122 - Discussed the Medicare Part B prescription drug demonstration proposal. Discussed potential benefit and coverage improvements under Medicare and Medicaid Savings Programs. H.R. 2759, Mental Health Access Improvement Act - Discussed support of bill. Discussed MACRA implementation. Discussed Medicare enrollment and coverage issues such as: provider access, direct billing and penalties. S. 1719, H.R. 3099, RAISE Act - Discussed CMS' efforts regarding family caregiving. Provided feedback on advanced directive registry bill. (no bill #) Discussed independence at home legislation. S. 2961, Compassionate Care Act - Discussed our position and provided feedback. Discussed DOJ investigation regarding Olmstead and ADA violations by South Dakota and provided feedback (DOJ). Responded to inquiry regarding roundtable (ACL). S. 3096, Removing Barriers to Person-Centered Care Act of 2016 - Discussed and provided feedback. Discussed possible hearing witnesses. Discussed Medicaid HCBS spousal impoverishment bill. (no bill #) Responded to inquiry regarding MACRA rules and value modifier. Discussed Medicare's 180-day coverage of skilled nursing facility care. S. 2836, H.R. 5036, Protecting Families with Disabilities Act - Signed letter in support of bill.
Client expense: $2,060,000 · 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), Commerce, Dept of (DOC), Congressional Budget Office (CBO), Equal Employment Opportunity Commission (EEOC), Federal Transit Administration (FTA), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Social Security Administration (SSA), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Trade Representative (USTR), Veterans Affairs, Dept of (VA), White House Office
2016 · second_quarter · Medicare/Medicaid
Medicare Part B and D Telemedicine Medicaid CHIP CHIP Re-authorization S.776 Medication Therapy Management Empowerment Act of 2015 HR 2624/S1488 Part D Beneficiary Appeals Fairness Act Part B proposal HR5122
Client expense: $75,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2016 · second_quarter · Health Issues
H.R.927 - Keeping All Students Safe Act H.R.2646 - Helping Families in Mental Health Crisis Act H.R.2624/S. 1488 - Part D Beneficiary Appeals Fairness H.R.1211/S. 1588 - Mental Health in Schools Act of 2015 H.R.3060 - Stop Child Abuse in Residential Programs for Teens Act H.R.4977 - COVER Act H. 6 - 21st Century Cures Act H.R.1859/S. 2782 - Ensuring Children's Access to Specialty Care Act H.R.2555 - Veteran Wellness Act S. 473 - Saving Our Next Generation Act S. 841 - Prioritizing Veterans Access to Mental Health Care H.R.2632/S.1494 - Children's Recovery from Trauma Act H.R.938/S. 1299 - Garrett Lee Smith Memorial Act Reauthorization of 2015 H.R.5 - Student Success Act S.1177 - Every Child Achieves Act of 2015 S. 1893 - Mental Health Awareness & Improvement Act H.R. 670 - The Special Needs Trust Fairness Act S. 1865 - Anna Westin Act S. 524/H.R.953: Comprehensive Addiction and Recovery Act of 2015 H.R. 2994: Safer Communities Act of 2015 H.R.1006 - Building a Health Care Workforce for the Future Act H.R.3285 - Reducing Disparities Using Care Models and Education Act of 2015 H.R. 3020 - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2016 H.R.3640 - Mental Health Awareness Semipostal Stamp Act S.2012 - Energy Policy Modernization Act of 2015 - support an amendment funding lead poisoning research H.R.4276/S. 2647 - Behavioral Health Coverage Transparency Act of 2015 - support S.2680 - Mental Health Reform Act of 2016 - recommendations to improve coordination and children's health H.R.3660 - To amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings. - support S. 2685/H.R.4374 - Mental Health on Campus Improvement Act - support S. 2787S - States Achieve Medicaid Expansion Act of 2016 - Support H.R. 5234 - The Stop Mental Health Stigma in Our Communities Act of 2016 - Support S.3130 - Independence at Home Act of 2016 - Support S.2848 - Water Resources Development Act of 2016 - Support funding for lead exposure supports H.R. 5330: Peer-Support Specialist Act of 2016 - supported H.R.5100 - At-Risk Youth Medicaid Protection Act of 2016 - Supported S. 2691: Integrating Behavioral Health Through Technology Act of 2016 - Supported
Client expense: $6,916 · Firm income: Not reported
Government targets: Administration for Children & Families (ACF), Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Justice, Dept of (DOJ), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)
2016 · second_quarter · Medicare/Medicaid
H.R.927 - Keeping All Students Safe Act - Support H.R.2646 - Helping Families in Mental Health Crisis Act - Support H.R.2624/S. 1488 - Part D Beneficiary Appeals Fairness - Support H.R.4435 - Comprehensive Behavioral Health Reform and Recovery Act of 2016 - Discuss why Medicaid reforms are important H.R. 670 - The Special Needs Trust Fairness Act - Support S. 1865 - Anna Westin Act - Support H.R.3285 - Reducing Disparities Using Care Models and Education Act of 2015 S. 2787S - States Achieve Medicaid Expansion Act of 2016 - Support H.R.5100 - At-Risk Youth Medicaid Protection Act of 2016 - Supported S. 2691: Integrating Behavioral Health Through Technology Act of 2016 - Supported
Client expense: $6,916 · Firm income: Not reported
Government targets: Administration for Children & Families (ACF), Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Justice, Dept of (DOJ), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)
2016 · second_quarter · Medicare/Medicaid
Issues related to Medicare Part D as related to blood cancer beneficiaries including H.R. 2624, S.1488, the Part D Beneficiary Appeals Fairness Act.
Client expense: Not reported · Firm income: $50,000
Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of the Vice President of the United States, SENATE
2016 · second_quarter · Health Issues
Pub. Law No. 111-148, Patient Protection and Affordable Care Act, matters related to the implementation of breast health education, research and clinical trials; S.1566/H.R.2722, Cancer Drug Coverage Parity Act, advocate to require insurance companies cover iv-administered and orally-administered anti-cancer drugs at the same cost to patients; H.R.1600, Patients' Access to Treatment Act, support amending the Public Health Service Act to establish cost-sharing limits for health plans that cover prescription drugs and use a formulary or other tiered cost-sharing structure and prohibits such a health plan from imposing higher cost-sharing requirements, including co-payment and co-insurance, for specialty drugs than for other prescription drugs in a non-preferred brand drug tier; H.R.1608, Lymphedema Treatment Act, support Medicare coverage of certain lymphedema compression treatment items as durable medical equipment; S.370/H.R.716, Breast Density and Mammography Reporting Act, issues related to the information provided to women and doctors on breast density and the potential impact it has on the detection of breast cancer and require the FDA to utilize up to date medical information and direct HHS to focus research on the best screening methods for breast tissue; H.R.1925, Dr. Balazs "Ernie" Bodai Congressional Gold Medal, support the presentation of a congressional gold medal to Dr. Balaz "Ernie" Bodai in recognition of his many outstanding contributions to the nation, including a tireless commitment to breast cancer research; H.R.6, 21st Century Cures Act, issues related to cancer prevention and research funding; S.620/H.R.1189, Preserving Employee Wellness Programs Act, issues related to the Genetic Information Act of 2008 and workplace wellness programs; H.R.2846, Planning Actively for Cancer Treatments Act, support coverage of cancer care planning and coordination services; S.91/H.R.4112, Mobile Mammography Promotion Act, issues related to excluding mobile mammography vehicles from the motor fuel excise tax; H.R.3119, Palliative Care and Hospice Education and Training Act, support federal funding for research, training, education and awareness into palliative care; S.1488/H.R.2624, Part D Beneficiary Appeals Fairness Act, issues related to out-of-pocket costs for prescription drugs.
Client expense: $100,208 · Firm income: Not reported
Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), SENATE, White House Office
2016 · second_quarter · Medicare/Medicaid
Issues related to Medicare Part D as they are related to blood cancer patients including H.R. 2624, S.1488, the Part D Beneficiary Appeals Fairness Act.
Client expense: Not reported · Firm income: $50,000
Government targets: HOUSE OF REPRESENTATIVES, Office of the Vice President of the United States, SENATE
2016 · second_quarter · Medicare/Medicaid
Part D Beneficiary Appeals Fairness Act (HR 2624, S 1488)
Client expense: $150,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, Office of the Vice President of the United States, SENATE
2016 · first_quarter · Medicare/Medicaid
"H.R. 775/S. 539, Medicare Access to Rehabilitation Services Act," all sections;"H.R. 3081/S.1778, The TELE-Med Act, all sections;"H.R. 2624/S. 1488, The Part D Beneficiary Fairness Appeals Act," all sections; "The Veterans E-Health and Telemedicine Support Act," (S. 2170); Medicare support for FDA breakthrough therapies (coalition sign-on support letter)
Client expense: $50,765 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2016 · first_quarter · Health Issues
1. Urge Congress to support efforts that increase access to care for people with psoriasis and psoriasis arthritis by supporting H.R.1600: Patients' Access to Treatments Act of 2015. This bill 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. 2. Support efforts to facilitate research efforts on psoriasis and psoriatic arthritis within institutes at the NIH. 3. Worked with CDC's Chronic Disease Prevention and Health Promotion on initiative that will develop public health self-management interventions for persons with psoriatic disease and advance knowledge of the links between psoriatic disease and other chronic conditions 4. Urge Congress to support HR 2624/S.1488 Medicare Part D Beneficiary Appeals Fairness Act. Allows a Medicare part D eligible individual enrolled in the plan to request an exception to the tiered cost-sharing structure
Client expense: $83,000 · Firm income: Not reported
Government targets: Centers For Disease Control & Prevention (CDC), HOUSE OF REPRESENTATIVES, Natl Institutes of Health (NIH), SENATE
2016 · first_quarter · Medicare/Medicaid
Medicare Part B and D Telemedicine Medicaid CHIP CHIP Re-authorization S.776 Medication Therapy Management Empowerment Act of 2015 HR 2624/S1488 Part D Beneficiary Appeals Fairness Act FY 17 appropriations for HHS,CDC,NIH,DOD,FOA,VA H.R. 2029 FY16 omnibus Budget Control Act
Client expense: $308,850 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2016 · first_quarter · Medicare/Medicaid
RetireSafe worked as a leader, along with other patient advocate groups, to oppose any new cuts to the Medicare Advantage payment rates for 2016. RetireSafe worked with the Medicare Access for Patients Rx Coalition (MAPRx) to raise concerns regarding the Advance Notice of Methodological Changes for Calendar Year 2016 for Medicare Advantage Capitation Rates, Part C and Part D Payment Policies and 2016 Call Letter to express concerns related to: the Exceptions and Appeals Process, Star Ratings and the Dual-Eligibles, Formulary Oversight, Drug Utilization Review Controls, Tier Labeling and Composition, Specialty Tiers, and the Use of Multiple Tiers with Coinsurance Cost-Sharing Rates. RetireSafe joined with the Medicare Rights Center and other patient advocates to urge numerous changes to the Medicare Part D Program to make the Exceptions and Appeals Processes More Accessible for Beneficiaries. RetireSafe joined with the Healthcare Leadership Council and others to support the Protecting Seniors Access to Medicare Act, (H.R. 1190 and S. 141) to repeal the Independent Payment Advisory Board (IPAB), authorized under the Patient Protection and Affordable Care Act. Support H.R. 2624 and S. 1488, the Part D Beneficiary Appeals Fairness Act. Support the passage of H.R. 160 to repeal the 2.3% Medical Device Tax. Support the passage of H.R. 1190 to repeal the Independent Payment Advisory Board (IPAB). Joined with the MAPRx coalition to urge Congress to build on the success of Medicare Part D to ensure robust formularies, coverage for the six-protected classes, strong oversight, and transparency for consumers, as well as add improvements to the process for notice of non-coverage, appeals and exceptions. Also, urged Part D remedies to correct gaps in coverage, onerous cost-shifting created by specialty tiers, and restrictive utilization management tools that severely reduce patient benefits. Support "340B" Medicaid program reform to end widespread abuse of the drug discount program that ultimately harms patients. Joined with other patient advocate groups to comment on proposed rule: CMS-2390-P-Medicaid and Childrens Health Insurance Programs (CHIP); Medicaid Managed Care, CHIP Delivered in Managed Care, Medicaid and CHIP Comprehensive Quality Strategies, and Revisions Related to Third Party Liability. We supported the proposed rules intent to strengthen program integrity safeguards, and ensure beneficiary protections in areas of provider networks, coverage standards, and the treatment of appeals. We agree with the other groups that a modernized Medicaid managed care regulatory structure is essential to facilitate necessary system reform initiatives, and advance the delivery of health care for millions of people, and we supported rule changes to achieve those goals. RetireSafe joined with other patient advocates to comment on proposed rule: CMS-1631-P-Medicare Program; Revisions to Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY2016. In commenting we supported various measures for improving accuracy for primary care and care management services; providing appropriate advanced care planning services; providing better Medicare Tele-health services; providing better Chronic Care Management services for Rural Health Clinics and Qualified Health Centers; providing a useful Physicians Compare Website with data in proper context; and providing physician payment, efficiency, and quality improvements linked to a physician quality reporting system. RetireSafe joined with numerous patient groups to oppose a new CMS plan to cut the payment rate (from Average Sales Price plus 6%) for Medicare Part B Drugs administered by physicians in large parts of the U.S. because this Center for Medicare & Medicaid initiative focuses on costs rather than patients needs and health care quality. This new Part B Drug Plan will adversely impact Medicare patients with complex conditions such as cancer, macular degeneration, hypertension, rheumatoid arthritis, and primary immunodeficiency diseases. Along with many other patient advocates in the MAPRx Coalition, we strongly opposed a recent MedPAC effort to place Medicare cost savings ahead of the best interests of Medicare patients. Specifically, we urged MedPAC to reject proposals to make changes to true out-of-pocket costs (TrOOP); increase copays for low-income subsidy (LIS) beneficiaries; and eliminate any of the protected classes. RetireSafe joined with numerous patient groups to comment on the CMS Advance Notice and Draft Call Letter issued on February 19, 2016. The comments focused on better patient access to Medicare Part D Prescription Drugs and related specifically to: Specialty Tier Thresholds, Tier Labeling and Composition, Generic Tier $0 Copay Plans, Formulary Oversight, Drug Utilization Review Controls, Coverage Determination Timelines, and Access to Preferred Cost-sharing Pharmacies.
Client expense: Not reported · Firm income: $16,214
Government targets: Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2016 · first_quarter · Medicare/Medicaid
Part D Beneficiary Appeals Fairness Act (HR 2624, S 1488)
Client expense: $90,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, Office of the Vice President of the United States, SENATE
2016 · first_quarter · Health Issues
P.L. 111-375 National Alzheimer's Project Act, All sections H.R. 9/S. 1137, the Innovation Act H.R. 1559/S. 857, the Health Outcomes, Planning, and Education (HOPE) for Alzheimer's Act of 2015 H.R. 1468, the Global Brain Health Act of 2015 H.R. 2624/S. 1488, the Part D Beneficiary Appeals Fairness Act H.R. 3090, the Alzheimer's Caregiver Support Act H.R. 3091, the Missing Alzheimer's Disease Patient Alert Program Reauthorization Act H.R. 3092, the Alzheimer's Disease Semipostal Stamp Act H.R. 3099/S. 1719, the RAISE Family Caregivers Act H.R. 3119/S. 2748, the Palliative Care and Hospice Education and Training Act H.R. 3243/S. 1362, the PACE Innovation Act H.R. 3660, the Preventive Health Savings Act H.R. 4919/S. 2614, Kevin and Avonte's Law of 2016 H. Res. 237/S. Res. 74, 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 S. 192, the Older Americans Act Reauthorization Act of 2015 S. 1549, the Care Planning Act of 2015
Client expense: $190,000 · 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), Natl Institutes of Health (NIH), SENATE, Veterans Affairs, Dept of (VA)
2016 · first_quarter · Medicare/Medicaid
H.R.927 - Keeping All Students Safe Act - Support H.R.2646 - Helping Families in Mental Health Crisis Act H.R.2624/S. 1488 - Part D Beneficiary Appeals Fairness - Support H.R.4435 - Comprehensive Behavioral Health Reform and Recovery Act of 2016 - Discuss why Medicaid reforms are important H.R. 670 - The Special Needs Trust Fairness Act - Support S. 1865 - Anna Westin Act - Support H.R.3285 - Reducing Disparities Using Care Models and Education Act of 2015
Client expense: $5,352 · Firm income: Not reported
Government targets: Administration for Children & Families (ACF), Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Justice, Dept of (DOJ), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)
2016 · first_quarter · Health Issues
H.R.927 - Keeping All Students Safe Act H.R.2646 - Helping Families in Mental Health Crisis Act H.R.2624/S. 1488 - Part D Beneficiary Appeals Fairness H.R.1211/S. 1588 - Mental Health in Schools Act of 2015 H.R.3060 - Stop Child Abuse in Residential Programs for Teens Act H.R.4977 - COVER Act H. 6 - 21st Century Cures Act H.R.1859 - Ensuring Children's Access to Specialty Care Act H.R.2555 - Veteran Wellness Act S. 473 - Saving Our Next Generation Act S. 841 - Prioritizing Veterans Access to Mental Health Care H.R.2632/S.1494 - Children's Recovery from Trauma Act H.R.938/S. 1299 - Garrett Lee Smith Memorial Act Reauthorization of 2015 H.R.5 - Student Success Act S.1177 - Every Child Achieves Act of 2015 S. 1893 - Mental Health Awareness & Improvement Act H.R. 670 - The Special Needs Trust Fairness Act S. 1865 - Anna Westin Act S. 524/H.R.953: Comprehensive Addiction and Recovery Act of 2015 H.R. 2994: Safer Communities Act of 2015 H.R.1006 - Building a Health Care Workforce for the Future Act S.1945 - Mental Health Reform Act of 2015 H.R.3285 - Reducing Disparities Using Care Models and Education Act of 2015 H.R. 3020 - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2016 H.R.3640 - Mental Health Awareness Semipostal Stamp Act S.2012 - Energy Policy Modernization Act of 2015 - support an amendment funding lead poisoning research H.R.4276/S. 2647 - Behavioral Health Coverage Transparency Act of 2015 - support S.2680 - Mental Health Reform Act of 2016 - recommendations to improve coordination and children's health H.R.3660 - To amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings. - support S. 2685: Mental Health on Campus Improvement Act - support
Client expense: $5,352 · Firm income: Not reported
Government targets: Administration for Children & Families (ACF), Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Justice, Dept of (DOJ), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)
Responded to inquiry regarding in-home supportive services programs. (no bill #) S. 1549, Care Planning Act - Discussed the bill and urged cosponsorship. Discussed structural changes to Medicaid. (no bill #) Discussed health care quality and measurement. (no bill #) Discussed changes to the Medicare benefit design, such as copays, premiums and deductibles. (no bill #) Discussed Personalize Your Care Act and provided feedback. (no bill #) Discussed Money Follows the Person Rebalancing Demonstration. (no bill #) Made inquiry regarding DC Medicaid HCBS waiver. (no bill #) S. 1085, Military and Veteran Caregiver Services Improvement Act - Discussed bill. H.R. 4878, Better Care Lower Cost Act - Discussed bill. Discussed spousal impoverishment in Medicaid. (no bill #) H.R. 4059, S.2297, Medicare Choices Empowerment and Protection Act - Provided feedback on bill. H.R. 3298, Medicare Post-Acute Care Value-Based Purchasing Act - Discussed feedback and next steps. (no bill #) Inquired regarding final rule on discharge planning. (no bill #) H.R.1571, Improving Access to Medicare Coverage Act - Discussed bill. Discussed retroactive eligibility for Medicaid HCBS (no bill #) Discussed observations status issues. (no bill #) S.578, Home Health Planning Improvement Act - Discussed bill and urged cosponsorship. Discussed the Medicare Part D prescription drug benefit program and changes needed to lower prescription drug costs and related agency proposed rule changes. (no bill #) H.R.2005, S.1083 - Discussed legislation to require drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. H.R. 2624, S.1488, Part D Beneficiary Appeals Fairness Act- Discussed bill that would allow seniors to appeal the placement of their medications on a Medicare Part D specialty tier. Discussed Medicare Part D fraud and abuse legislation including lock-in provisions for high risk enrollees. (no bill #) Discussed legislation to require the addition of unique device identifier (UDI) of medical devices in health insurance claim forms. Discussed the Medicare Part B prescription drug demonstration proposal from the Centers for Medicare and Medicaid Services. H.R.1220, S.624, Removing Barriers to Colorectal Cancer Screening Act - Discussed bill. Discussed Medicare site of service payment policy. (no bill #) H.R. 4442,S.2484,CONNECT Act - Sent letter of endorsement. Discussed Medicare coverage and reimbursement of cataract surgery. Labor, Health and Human Services,FY2017 - Lobbied in support of increased funding for CMS' state survey and certification program. (no bill #)
Client expense: $1,830,000 · 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), Commerce, Dept of (DOC), Congressional Budget Office (CBO), Equal Employment Opportunity Commission (EEOC), Federal Transit Administration (FTA), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Social Security Administration (SSA), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Trade Representative (USTR), Veterans Affairs, Dept of (VA), White House Office
2016 · first_quarter · Health Issues
Pub. Law No. 111-148, Patient Protection and Affordable Care Act, matters related to the implementation of breast health education, research and clinical trials; S.1566/H.R.2722, Cancer Drug Coverage Parity Act, advocate to require insurance companies cover iv-administered and orally-administered anti-cancer drugs at the same cost to patients; H.R.1600, Patients' Access to Treatment Act, support amending the Public Health Service Act to establish cost-sharing limits for health plans that cover prescription drugs and use a formulary or other tiered cost-sharing structure and prohibits such a health plan from imposing higher cost-sharing requirements, including co-payment and co-insurance, for specialty drugs than for other prescription drugs in a non-preferred brand drug tier; H.R.1608, Lymphedema Treatment Act, support Medicare coverage of certain lymphedema compression treatment items as durable medical equipment; S.370/H.R.716, Breast Density and Mammography Reporting Act, issues related to the information provided to women and doctors on breast density and the potential impact it has on the detection of breast cancer and require the FDA to utilize up to date medical information and direct HHS to focus research on the best screening methods for breast tissue; H.R.1925, Dr. Balazs "Ernie" Bodai Congressional Gold Medal, support the presentation of a congressional gold medal to Dr. Balaz "Ernie" Bodai in recognition of his many outstanding contributions to the nation, including a tireless commitment to breast cancer research; S.1192/H.R.2540, Breast Cancer Patient Education Act, efforts to support creating an educational campaign to inform breast cancer patients anticipating surgery about the availability and coverage of breast reconstruction and prostheses; H.R.6, 21st Century Cures Act, issues related to cancer prevention and research funding; S.620/H.R.1189, Preserving Employee Wellness Programs Act, issues related to the Genetic Information Act of 2008 and workplace wellness programs; H.R.2846, Planning Actively for Cancer Treatments Act, support coverage of cancer care planning and coordination services; S.91/H.R.4112, Mobile Mammography Promotion Act, issues related to excluding mobile mammography vehicles from the motor fuel excise tax; H.R.3119, Palliative Care and Hospice Education and Training Act, support federal funding for research, training, education and awareness into palliative care; S.1488/H.R.2624, Part D Beneficiary Appeals Fairness Act, issues related to out-of-pocket costs for prescription drugs.
Client expense: $70,000 · Firm income: Not reported
Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), SENATE, White House Office
2016 · first_quarter · Medicare/Medicaid
RetireSafe worked as a leader, along with other patient advocate groups, to oppose any new cuts to the Medicare Advantage payment rates for 2016. RetireSafe worked with the Medicare Access for Patients Rx Coalition (MAPRx) to raise concerns regarding the Advance Notice of Methodological Changes for Calendar Year 2016 for Medicare Advantage Capitation Rates, Part C and Part D Payment Policies and 2016 Call Letter to express concerns related to: the Exceptions and Appeals Process, Star Ratings and the Dual-Eligibles, Formulary Oversight, Drug Utilization Review Controls, Tier Labeling and Composition, Specialty Tiers, and the Use of Multiple Tiers with Coinsurance Cost-Sharing Rates. RetireSafe joined with the Medicare Rights Center and other patient advocates to urge numerous changes to the Medicare Part D Program to make the Exceptions and Appeals Processes More Accessible for Beneficiaries. RetireSafe joined with the Healthcare Leadership Council and others to support the Protecting Seniors Access to Medicare Act, (H.R. 1190 and S. 141) to repeal the Independent Payment Advisory Board (IPAB), authorized under the Patient Protection and Affordable Care Act. Support H.R. 2624 and S. 1488, the Part D Beneficiary Appeals Fairness Act. Support the passage of H.R. 160 to repeal the 2.3% Medical Device Tax. Support the passage of H.R. 1190 to repeal the Independent Payment Advisory Board (IPAB). Joined with the MAPRx coalition to urge Congress to build on the success of Medicare Part D to ensure robust formularies, coverage for the six-protected classes, strong oversight, and transparency for consumers, as well as add improvements to the process for notice of non-coverage, appeals and exceptions. Also, urged Part D remedies to correct gaps in coverage, onerous cost-shifting created by specialty tiers, and restrictive utilization management tools that severely reduce patient benefits. Support "340B" Medicaid program reform to end widespread abuse of the drug discount program that ultimately harms patients. Joined with other patient advocate groups to comment on proposed rule: CMS-2390-P-Medicaid and Childrens Health Insurance Programs (CHIP); Medicaid Managed Care, CHIP Delivered in Managed Care, Medicaid and CHIP Comprehensive Quality Strategies, and Revisions Related to Third Party Liability. We supported the proposed rules intent to strengthen program integrity safeguards, and ensure beneficiary protections in areas of provider networks, coverage standards, and the treatment of appeals. We agree with the other groups that a modernized Medicaid managed care regulatory structure is essential to facilitate necessary system reform initiatives, and advance the delivery of health care for millions of people, and we supported rule changes to achieve those goals. RetireSafe joined with other patient advocates to comment on proposed rule: CMS-1631-P-Medicare Program; Revisions to Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY2016. In commenting we supported various measures for improving accuracy for primary care and care management services; providing appropriate advanced care planning services; providing better Medicare Telehealth services; providing better Chronic Care Management services for Rural Health Clinics and Qualified Health Centers; providing a useful Physicians Compare Website with data in proper context; and providing physician payment, efficiency, and quality improvements linked to a physician quality reporting system. RetireSafe joined with numerous patient groups to oppose a new CMS plan to cut the payment rate (from Average Sales Price plus 6%) for Medicare Part B Drugs administered by physicians in large parts of the U.S. because this Center for Medicare & Medicaid initiative focuses on costs rather than patients needs and health care quality. This new Part B Drug Plan will adversely impact Medicare patients with complex conditions such as cancer, macular degeneration, hypertension, rheumatoid arthritis, and primary immunodeficiency diseases. Along with many other patient advocates in the MAPRx Coalition, we strongly opposed a recent MedPAC effort to place Medicare cost savings ahead of the best interests of Medicare patients. Specifically, we urged MedPAC to reject proposals to make changes to true out-of-pocket costs (TrOOP); increase copays for low-income subsidy (LIS) beneficiaries; and eliminate any of the protected classes. RetireSafe joined with numerous patient groups to comment on the CMS Advance Notice and Draft Call Letter issued on February 19, 2016. The comments focused on better patient access to Medicare Part D Prescription Drugs and related specifically to: Specialty Tier Thresholds, Tier Labeling and Composition, Generic Tier $0 Copay Plans, Formulary Oversight, Drug Utilization Review Controls, Coverage Determination Timelines, and Access to Preferred Cost-sharing Pharmacies.
Client expense: Not reported · 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), SENATE