Protecting Medicare Beneficiaries Act of 2015

H.R.6 - 21st Century Cures Act H.R.3298 - Medicare Post-Acute Care Value-Based Purchasing Act of 2015 S.2148 - A bill to amend title XVIII of the Social Security Act to prevent an increase in the Medicare part B premium and deductible in 2016 H.R.3696 - Medicare Premium Fairness Act of 2015 P.L. 111-148: The Patient Protection and Affordable Care Act. H.R. 4302: Protecting Access to Medicare Act of 2014 (PL 113-93) on 4.1.2014 H.R. 1571: Improving Access to Medicare Coverage Act of 2015. S. 843: Improving Access to Medicare Coverage Act of 2015. S. 539 and H.R.775 The Medicare Access to Rehabilitation Services Act. H.R. 290: The Creating Access to Rehabilitation for Every Senior (CARES ACT). S. 1932: A bill to amend title XVIII of the Social Security Act to establish a Medicare Better Care Program. Protect and Preserve Medicaid Provider Assessment. Protect and Preserve Medicare Bad Debt Reimbursement Improving the CMS State Plan Amdt. Process. Sustainable Growth Rate (SGR) and other reform proposals. Reducing hospital readmissions from skilled nursing facility. The Veteran Access to Long Term Care and Health Services Act (S.2000) and VA Provider Agreement and Proposal MedPAC site neutral payment system for post acute care. CME proposed Rule for SNF Prospective Payment System (PPS). PL. 113-185 Impact Act of 2014 H.R. 952: To amend titles XVIII and XIX of the Social Security Act to establish a minimum direct care registered nurse staffing requirement at nursing facilities and skilled nursing facilities under Medicare and Medicaid and for other purposes. H.R. 2: Medicare Access & CHIP Reauthorization Act of 2015 H.R. 876: Notice Act (P.L. 114-42) S.1916: The Rural Health Care Connectivity Act of 2015 (Public Law No. 114-182) H.R.4111 Rural Health Care Connectivity Act of 2015 (Public Law No. 114-182) Skilled Nursing Episodic Payment Reform

Client expense: $950,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), SENATE, Veterans Affairs, Dept of (VA)

Support administrative action or legislation to prevent a disproportionate increase in Medicare Part B premiums for about 30 percent of beneficiaries, including hundreds of thousands of federal retirees. Support H.R. 3696, the Medicare Premium Fairness Act of 2015 & S. 2148, the Protecting Medicare Beneficiaries Act of 2015. Both bills would keep Medicare Part B premiums and deductibles at 2015 levels for all beneficiaries in 2016. Support H.R. 1314 for its provisions to lower 2016 Medicare Part B premiums for those individuals not held harmless from an increase.

Client expense: $70,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Personnel Management (OPM), SENATE, U.S. Postal Service (USPS)

H.R.6 - 21st Century Cures Act H.R.3298 - Medicare Post-Acute Care Value-Based Purchasing Act of 2015 S.2148 - A bill to amend title XVIII of the Social Security Act to prevent an increase in the Medicare part B premium and deductible in 2016 H.R.3696 - Medicare Premium Fairness Act of 2015 P.L. 111-148: The Patient Protection and Affordable Care Act. H.R. 4302: Protecting Access to Medicare Act of 2014 (PL 113-93) on 4.1.2014 H.R. 1571: Improving Access to Medicare Coverage Act of 2015. S. 843: Improving Access to Medicare Coverage Act of 2015. S. 539 and H.R.775 The Medicare Access to Rehabilitation Services Act. H.R. 290: The Creating Access to Rehabilitation for Every Senior (CARES ACT). S. 1932: A bill to amend title XVIII of the Social Security Act to establish a Medicare Better Care Program. Protect and Preserve Medicaid Provider Assessment. Protect and Preserve Medicare Bad Debt Reimbursement Improving the CMS State Plan Amdt. Process. Sustainable Growth Rate (SGR) and other reform proposals. Reducing hospital readmissions from skilled nursing facility. The Veteran Access to Long Term Care and Health Services Act (S.2000) and VA Provider Agreement and Proposal MedPAC site neutral payment system for post acute care. CME proposed Rule for SNF Prospective Payment System (PPS). PL. 113-185 Impact Act of 2014 H.R. 952: To amend titles XVIII and XIX of the Social Security Act to establish a minimum direct care registered nurse staffing requirement at nursing facilities and skilled nursing facilities under Medicare and Medicaid and for other purposes. H.R. 2: Medicare Access & CHIP Reauthorization Act of 2015 H.R. 876: Notice Act (P.L. 114-42) S.1916: The Rural Health Care Connectivity Act of 2015 H.R.4111 Rural Health Care Connectivity Act of 2015 Skilled Nursing Episodic Payment Reform

Support administrative action or legislation to prevent a disproportionate increase in Medicare Part B premiums for about 30 percent of beneficiaries, including hundreds of thousands of federal retirees. Support H.R. 3696, the Medicare Premium Fairness Act of 2015 & S. 2148, the Protecting Medicare Beneficiaries Act of 2015. Both bills would keep Medicare Part B premiums and deductibles at 2015 levels for all beneficiaries in 2016. Support H.R. 1314 for its provisions to lower 2016 Medicare Part B premiums for those individuals not held harmless from an increase.

Client expense: $70,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Personnel Management (OPM), SENATE, U.S. Postal Service (USPS)

H.R.6 - 21st Century Cures Act H.R.3298 - Medicare Post-Acute Care Value-Based Purchasing Act of 2015 S.2148 - A bill to amend title XVIII of the Social Security Act to prevent an increase in the Medicare part B premium and deductible in 2016 H.R.3696 - Medicare Premium Fairness Act of 2015 P.L. 111-148: The Patient Protection and Affordable Care Act. H.R. 4302: Protecting Access to Medicare Act of 2014 (PL 113-93) on 4.1.2014 H.R. 1571: Improving Access to Medicare Coverage Act of 2015. S. 843: Improving Access to Medicare Coverage Act of 2015. S. 539 and H.R.775 The Medicare Access to Rehabilitation Services Act. H.R. 290: The Creating Access to Rehabilitation for Every Senior (CARES ACT). S. 1932: A bill to amend title XVIII of the Social Security Act to establish a Medicare Better Care Program. Protect and Preserve Medicaid Provider Assessment. Protect and Preserve Medicare Bad Debt Reimbursement Improving the CMS State Plan Amdt. Process. Sustainable Growth Rate (SGR) and other reform proposals. Reducing hospital readmissions from skilled nursing facility. The Veteran Access to Long Term Care and Health Services Act (S.2000) and VA Provider Agreement and Proposal MedPAC site neutral payment system for post acute care. CME proposed Rule for SNF Prospective Payment System (PPS). PL. 113-185 Impact Act of 2014 H.R. 952: To amend titles XVIII and XIX of the Social Security Act to establish a minimum direct care registered nurse staffing requirement at nursing facilities and skilled nursing facilities under Medicare and Medicaid and for other purposes. H.R. 2: Medicare Access & CHIP Reauthorization Act of 2015 H.R. 876: Notice Act (P.L. 114-42) S.1916: The Rural Health Care Connectivity Act of 2015 H.R.4111 Rural Health Care Connectivity Act of 2015 Skilled Nursing Episodic Payment Reform

Medicare Privatization. (No bill.) Proposals to transform traditional Medicare to a private insurance carrier program. Medicare Benefit Redesign. (No bill.) Proposals pertaining to Parts A and B deductibles; premiums, including means-testing; a catastrophic cap on out-of-pocket spending; the eligibility age; and proposals to privatize Medicare. Medicare Eligibility Age. (No bill.) Proposals to raise the eligibility age for Medicare from 65 to 67. Medicare Drug Savings. S. 1083, H.R. 2005, the Medicare Drug Savings Act: proposals to extend the application of Medicaid drug rebates to prescription drugs paid for by Medicare and used by Medicare-Medicaid eligible beneficiaries (dual-eligibles), and by people receiving the Medicare Part D Low-Income Subsidy. Medicare Prescription Drug Price Negotiation. H.R. 3061, S. 31, the Medicare Prescription Drug Price Negotiation Act of 2015: proposals to authorize the Secretary of the Department of Health and Human Services to negotiate discounts, rebates, and other price concessions to lower the cost paid by Medicare to pharmaceutical manufacturers. Medicare Prescription Drug Price Negotiation. H.R. 4207, Medicare Fair Drug Pricing Act of 2015: proposal to allow the Secretary of HHS to negotiate prices with manufacturers where little or no competition exists for drugs. Medicare Prescription Drug Plan Option. H.R. 3261, S. 1884, the Medicare Prescription Drug Savings and Choice Act of 2015: proposals to create one or more Medicare-administered drug plans with uniform premiums, providing seniors with the opportunity to purchase drugs directly through the Medicare program; requires the federal government to use its purchasing power to negotiate lower prices on prescription drugs for beneficiaries who enroll in the Medicare-administered plan. Medicare Home Health Benefits. (No bill.) Proposals pertaining to copayments for beneficiaries receiving the Medicare home health benefit. Medicare Observation Status. S. 843, H.R. 1571, Improving Access to Medicare Coverage Act of 2015: proposal to count days in the hospital in observation status toward meeting the three-day prior hospitalization requirement for skilled nursing facility (SNF) care eligibility. Comprehensive Health Care Reform. P.L. 111-148, Patient Protection and Affordable Care Act; P.L. 111-152, Health Care and Education Reconciliation Act of 2010: implementation of provisions reducing Medicare Advantage plan payments; requiring higher income Medicare beneficiaries to pay an increased share of Medicare Parts B and D premium costs; expanding benefits for low-income beneficiaries under the Medicare Savings Programs and the Part D Low-Income Subsidy (LIS); expanding coverage of prevention services; testing payment and delivery system reforms; and providing expanded Medicaid coverage. Patent Reform. S. 1137, Patent Act; H.R. 9, Innovation Act: proposal to carve brand-named pharmaceutical manufacturers out of an expedited United States Patent and Trademark Office (USPTO) review process that allows generic companies to bypass costly litigation when challenging drug patents. Expanding Drug Monopolies. H.R. 6, 21st Century Cures Act: proposal to extend orphan drug market exclusivity for existing drugs to new indications. Reducing Prescription Drug Costs. S. 2023, H.R. 3513, Prescription Drug Affordability Act: proposals to allow Medicare to negotiate drug prices, to allow Medicare and Medicaid to receive additional rebates from brand and generic drugs, and to allow for the re-importation of drugs from Canada. Chronic Care Coordination. (No bill.) Proposals to facilitate the delivery of high-quality care for people with Medicare living with multiple chronic conditions. Medicare Vision, Dental and Hearing Coverage. H.R. 3308, Seniors Have Eyes, Ears and Teeth Act: proposal to provide Medicare coverage for vision, hearing and dental services. Medicare Hearing Coverage. H.R. 1653, the Medicare Hearing Aid Coverage Act of 2015: proposal to provide Medicare coverage for the cost of hearing aids and examinations. Medicare Dental Coverage. S. 570, H.R. 1055, the Comprehensive Dental Reform Act: proposal to extend comprehensive dental coverage to all Medicare, Medicaid, and VA beneficiaries. Medicare Part B Premium and Deductible Increase. S. 2148, Protecting Medicare Beneficiaries Act of 2015; H.R. 3696, Medicare Premium Fairness Act of 2015 and P.L. 114-74: proposals to prevent steep increases in Medicare Part B premiums and deductibles in 2016. Medicare Care Planning. S. 1549, the Care Planning Act of 2015: proposals to create a Medicare benefit for care planning, the coordination of services, to fill gaps in quality measurement in the advanced illness field, and to include advanced care planning information in the Medicare & You handbook. Medicare Private Plan Notification Improvements. (No bill.) Proposals to improve the annual notification Medicare private plans promulgate to Parts C and D enrollees pertaining to plan changes that will raise enrollee costs or limit access to products and services. Medicare Part B Payment Reforms. (No bill.) Proposals to change the way Medicare pays doctors for administering drugs to eliminate incentives to prescribe drugs based on their expense instead of clinical need. Medicare Advantage Payment Reforms. (No bill.) Proposals to eliminate discrepancies in how much Medicare pays for services for similarly situated individuals in traditional Medicare and in Medicare Advantage plans.

1. Patient Protection and Affordable Health Care Act, implementation of provisions regarding Medicare Part D coverage gap assistance, preventive care services, and dual eligible Medicare and Medicare beneficiaries 2. Proposals to create a premium support or voucher program under Medicare 3. Proposals to "means test" Medicare premiums and benefits 4. Proposals to change federal and state Medicaid cost sharing 5. Proposals to raise the Medicare eligibility age 6. Proposals regarding prescription drug costs for low income Medicare beneficiaries 7. S. 1083, Medicare Drug Savings Act, entire bill 8. Medicare Part B Premiums and Deductibles for 2016 9. Expansion of Medicare benefits to include hearing, vision, and dental benefits 10.H.R. 3696, Medicare Premium Fairness Act of 2015, entire bill 11. S. 2148, Medicare Beneficiaries Act of 2015, entire bill

Client expense: $50,000 · Firm income: Not reported

Government targets: Executive Office of the President (EOP), Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H.R.6 - 21st Century Cures Act H.R.3298 - Medicare Post-Acute Care Value-Based Purchasing Act of 2015 S.2148 - A bill to amend title XVIII of the Social Security Act to prevent an increase in the Medicare part B premium and deductible in 2016 H.R.3696 - Medicare Premium Fairness Act of 2015 P.L. 111-148: The Patient Protection and Affordable Care Act. H.R. 4302: Protecting Access to Medicare Act of 2014 (PL 113-93) on 4.1.2014 H.R. 1571: Improving Access to Medicare Coverage Act of 2015. S. 843: Improving Access to Medicare Coverage Act of 2015. S. 367: The Medicare Access to Rehabilitation Services Act. H.R. 290: The Creating Access to Rehabilitation for Every Senior (CARES ACT). S. 1932: A bill to amend title XVIII of the Social Security Act to establish a Medicare Better Care Program. Protect and Preserve Medicaid Provider Assessment. Protect and Preserve Medicare Bad Debt Reimbursement Improving the CMS State Plan Amdt. Process. Sustainable Growth Rate (SGR) and other reform proposals. Reducing hospital readmissions from skilled nursing facility. Improving Medicare Post-Acute Care Transformation Act (IMPACT) The Veteran Access to Long Term Care and Health Services Act (S.2000) and VA Provider Agreement and Proposal Repealing the Cap on Medicare Part B therapy services for seniors. MedPAC site neutral payment system for post acute care. CME proposed Rule for SNF Prospective Payment System (PPS). PL. 113-185 Impact Act of 2014 H.R. 952: To amend titles XVIII and XIX of the Social Security Act to establish a minimum direct care registered nurse staffing requirement at nursing facilities and skilled nursing facilities under Medicare and Medicaid and for other purposes. H.R. 2: Medicare Access & CHIP Reauthorization Act of 2015 H.R. 876: Notice Act (P.L. 114-42) S.1916: The Rural Health Care Connectivity Act of 2015 H.R.4111 Rural Health Care Connectivity Act of 2015 Skilled Nursing Episodic Payment Reform

Support administrative action or legislation to prevent a disproportionate increase in Medicare Part B premiums for about 30 percent of beneficiaries, including hundreds of thousands of federal retirees. Support H.R. 3696, the Medicare Premium Fairness Act of 2015 & S. 2148, the Protecting Medicare Beneficiaries Act of 2015. Both bills would keep Medicare Part B premiums and deductibles at 2015 levels for all beneficiaries in 2016. Support H.R. 1314 for its provisions to lower 2016 Medicare Part B premiums for those individuals not held harmless from an increase.

Client expense: $70,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Personnel Management (OPM), SENATE, U.S. Postal Service (USPS)

1. Patient Protection and Affordable Health Care Act, implementation of provisions regarding Medicare Part D coverage gap assistance, preventive care services, and dual eligible Medicare and Medicare beneficiaries 2. Proposals to create a premium support or voucher program under Medicare 3. Proposals to "means test" Medicare premiums and benefits 4. Proposals to change federal and state Medicaid cost sharing 5. Proposals to raise the Medicare eligibility age 6. Proposals regarding prescription drug costs for low income Medicare beneficiaries 7. S. 1083, Medicare Drug Savings Act, entire bill 8. Medicare Part B Premiums and Deductibles for 2016 9. Expansion of Medicare benefits to include hearing, vision, and dental benefits 10.H.R. 3696, Medicare Premium Fairness Act of 2015, entire bill 11. S. 2148, Medicare Beneficiaries Act of 2015, entire bill 12. H.R. 1314, Bipartisan Budget Act of 2015, provisions relating to Medicare premiums and deductibles

Client expense: $60,000 · Firm income: Not reported

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, U.S. Postal Service (USPS)

H.R. 588, Medicare Beneficiary Preservation of Choice Act (Rothfus-Schrader) - MA enrollment opportunities H.R. 818, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Roskam-Carney) - reducing fraud H.R. 1021, Protecting the Integrity of Medicare Act (Brady) - reducing fraud H.R. 1314, Bipartisan Budget Act - Medicare Part B premium and deductible, Medicare sequestration cuts H.R. 2488, Medicare Beneficiary Preservation of Choice Act (Rothfus-Schrader) - MA open enrollment period H.R. 2505, Increasing Access to Data in Medicare Advantage Act (Kelly) - annual reporting of MA enrollment data H.R. 2506, Preventing Unnecessary Plan Terminations Act (Buchanan) - preventing certain MA plan terminations H.R. 2507, Increasing Regulatory Fairness Act (Brady) - schedule for MA rates H.R. 2570, Strengthening Medicare Advantage through Innovation and Transparency for Seniors Act (Black) - Value-Based Insurance Design demonstration H.R. 2579, Securing Care for Seniors Act (Black) - MA risk adjustment model H.R. 2581, Preservation of Access for Seniors in Medicare Advantage Act (Brady) - Value-Based Insurance Design demonstration and MA open enrollment period H.R. 2582, Seniors Health Care Plan Protection Act (Buchanan) - preventing certain MA plan terminations, MA risk adjustment model H.R. 3696, Protecting Medicare Beneficiaries Act (Titus) - Medicare Part B premiums and deductibles H.R. 3718, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Roskam-Carney) - reducing fraud H.R. 3831, Securing Fairness in Regulatory Timing Act (Brady) - revised schedule for MA payment rates H.R. 4275, Medicare Advantage Quality Payment Relief Act (Kelly) - calculation of MA benchmark cap S. 861, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Carper-Enzi) - reducing fraud S. 1347, Electronic Health Fairness Act - preventing certain MA plan terminations, annual reporting of MA enrollment data S. 1396, Value-Based Insurance Design Seniors Copayment Reduction Act (Thune-Stabenow) - VBID demonstration S. 1549, Care Planning Act (Warner) - advanced illness care coordination for Medicare beneficiaries S. 2104, Preserving Medicare Advantage for all Medicare Beneficiaries Act (Portman-Casey) - preventing certain MA plan terminations, MA demonstration program S. 2148, Protecting Medicare Beneficiaries Act (Wyden) - Medicare Part B premiums and deductibles S. 2349, Medicare Advantage Coverage Transparency Act (Heller) - MA enrollment data S. 2351, Securing Fairness in Regulatory Timing Act (Isakson) - revised schedule for MA payment rates Regulatory Issues: Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, encounter data and other data-related issues, and audit issues; bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, and audits); in-home health risk assessments; Medicare Medical Loss Ratio issues; implementation of sequestration under the Medicare Advantage and Part D programs; implications of the health insurer fee for MA and Part D plans; application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, SSA and CMS premium withhold processing issues, enrollment rules, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible Special Needs Plans (SNPs); Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, Part D coverage gap discount program, including employer group waiver plan (EGWP) issues, and other operational issues; issues raised by Part D coverage of new specialty drugs, the Part D non-interference policy and related issues (e.g., preferred pharmacy and any willing pharmacy requirements, standards for network pharmacy reimbursement, and policies regarding sponsor negotiation of pharmacy price concessions); Medication Therapy Management Program requirements; Part D requirements for offering basic and enhanced alternative plans; MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; issues relating to MA and Part D Star Rating system including measures, the methodology for calculating ratings, and the role of the ratings for payment purposes; implementation of the Affordable Care Act (ACA) changes to the Part D coverage gap; implementation issues for the Medicare Retiree Drug Subsidy program; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education Program; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; Medicare clinical trials; Medicare/Medicaid integration for dual eligibles, including the Capitated Financial Alignment Demonstration; Medicaid managed care regulations and policies, including the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, fraud and abuse compliance, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including block grants, the calculation of the federal medical assistance (federal matching) percentage (FMAP), and intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost issues affecting Medicaid health plans including issues raised by Medicaid coverage of new specialty drugs; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues and CHIP reauthorization; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including Medicaid managed care organization provider tax issues; standards for electronic prescribing; implementation of Medicaid changes of interest to Medicaid health plans made in the ACA including Medicaid expansion, the managed care organization (MCO) prescription drug rebate provisions, minimum payments to primary care providers (PCPs), interactions between the Medicaid program and health insurance exchanges, and Medicaid and CHIP maintenance of effort (MOE) requirements; implications of the health insurer fee for Medicaid health plans; issues related to Medigap coverage; issues related to business continuity in relation to pandemics or natural events (e.g., hurricane, tornado, etc.); cybersecurity; provider directories; value-based insurance design models; Part D prescriber enrollment requirements; Part D recovery audit contractor programs; socioeconomic status impacts on star ratings related to MA and Part D programs; Center for Medicare and Medicaid Innovation demonstrations for MA and PDP plans; and other issues relating to health care reform implementation. *Add MACPAC to Agency List

H.R.6 - 21st Century Cures Act H.R.3298 - Medicare Post-Acute Care Value-Based Purchasing Act of 2015 S.2148 - A bill to amend title XVIII of the Social Security Act to prevent an increase in the Medicare part B premium and deductible in 2016 H.R.3696 - Medicare Premium Fairness Act of 2015 P.L. 111-148: The Patient Protection and Affordable Care Act. H.R. 4302: Protecting Access to Medicare Act of 2014 (PL 113-93) on 4.1.2014 H.R. 1571: Improving Access to Medicare Coverage Act of 2015. S. 843: Improving Access to Medicare Coverage Act of 2015. S. 367: The Medicare Access to Rehabilitation Services Act. H.R. 290: The Creating Access to Rehabilitation for Every Senior (CARES ACT). S. 1932: A bill to amend title XVIII of the Social Security Act to establish a Medicare Better Care Program. Protect and Preserve Medicaid Provider Assessment. Protect and Preserve Medicare Bad Debt Reimbursement Improving the CMS State Plan Amdt. Process. Sustainable Growth Rate (SGR) and other reform proposals. Reducing hospital readmissions from skilled nursing facility. Improving Medicare Post-Acute Care Transformation Act (IMPACT) The Veteran Access to Long Term Care and Health Services Act (S.2000) and VA Provider Agreement and Proposal Repealing the Cap on Medicare Part B therapy services for seniors. MedPAC site neutral payment system for post acute care. CME proposed Rule for SNF Prospective Payment System (PPS). PL. 113-185 Impact Act of 2014 H.R. 952: To amend titles XVIII and XIX of the Social Security Act to establish a minimum direct care registered nurse staffing requirement at nursing facilities and skilled nursing facilities under Medicare and Medicaid and for other purposes. H.R. 2: Medicare Access & CHIP Reauthorization Act of 2015 H.R. 876: Notice Act (P.L. 114-42) S.1916: The Rural Health Care Connectivity Act of 2015 H.R.4111 Rural Health Care Connectivity Act of 2015 Skilled Nursing Episodic Payment Reform

ACA reconciliation Affordable Care Act (ACA) ESEA, excise tax Excise Tax Excise Tax, Extenders H.R.1624: Protecting Affordable Coverage for Employees Act H.R.3696 H.R.3762 H.R.5, excise tax Medicare part b Medicare Part B sign on letter S.1099: PACE Act S.2148 Tax Extenders

Client expense: $677,000 · Firm income: Not reported

Government targets: Education, Dept of, Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, SENATE, White House Office

HR 2446- Electronic verification of home care services HR 3696- Medicare Premium Fairness Act of 2015 S 2148- Protecting Medicare Beneficiaries Act of 2015 HR 3762- Reconciliation bill to repeal health care reform S 599- Improving access to emergency inpatient psychiatric care Improving access to and quality of developmental health care services Safe Patient Handling Improving Access to Quality Home Care Services Medicaid funding and benefits Medicare funding, benefits, policy, eligibility age, means tests, equitable spending across jurisdictions

Client expense: $640,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), Natl Labor Relations Board (NLRB), SENATE, Treasury, Dept of, U.S. Trade Representative (USTR), White House Office

Additional FEHBP Health Plan Types (5 USC) H.R. 2, Medicare Access and CHIP Reauthorization Act of 2015 H.R. 138, Access to Insurance for All Americans Act S. 810, SGR Repeal and Medicare Provider Payment Modernization Act of 2015 H.R. 1786, James Zadroga 9/11 Health and Compensation Reauthorization Act H.R. 2050, Middle Class Health Benefits Tax Repeal Act of 2015 S. 2051, Postal Bill S. 2148, Protect Medicare Beneficiaries Act of 2015 H.R. 2175, FEHBP Prescription Drug Oversight and Cost Savings Act H.R. 3696, Medicare Premium Fairness Act of 2015

Client expense: $216,765 · Firm income: Not reported

Medicare Privatization. (No bill.) Proposals to transform traditional Medicare to a private insurance carrier program. Medicare Benefit Redesign. (No bill.) Proposals pertaining to Parts A and B deductibles; premiums, including means-testing; a catastrophic cap on out-of-pocket spending; the eligibility age; and proposals to privatize Medicare. Medicare Drug Savings. S. 1083, H.R. 2005, the Medicare Drug Savings Act: proposals to extend the application of Medicaid drug rebates to prescription drugs paid for by Medicare and used by Medicare-Medicaid eligible beneficiaries (dual-eligibles), and by people receiving the Medicare Part D Low-Income Subsidy. Medicare Prescription Drug Price Negotiation. H.R. 3061, S. 31, the Medicare Prescription Drug Price Negotiation Act of 2015: proposals to authorize the Secretary of the Department of Health and Human Services to negotiate discounts, rebates, and other price concessions to lower the cost paid by Medicare to pharmaceutical manufacturers. Medicare Prescription Drug Price Negotiation. H.R. 4207, Medicare Fair Drug Pricing Act of 2015: proposal to allow the Secretary of HHS to negotiate prices with manufacturers where little or no competition exists for drugs. Medicare Prescription Drug Plan Option. H.R. 3261, S. 1884, the Medicare Prescription Drug Savings and Choice Act of 2015: proposals to create one or more Medicare-administered drug plans with uniform premiums, providing seniors with the opportunity to purchase drugs directly through the Medicare program; requires the federal government to use its purchasing power to negotiate lower prices on prescription drugs for beneficiaries who enroll in the Medicare-administered plan. Medicare Home Health Benefits. (No bill.) Proposals pertaining to copayments for beneficiaries receiving the Medicare home health benefit. Medicare Observation Status. S. 843, H.R. 1571, Improving Access to Medicare Coverage Act of 2015: proposal to count days in the hospital in observation status toward meeting the three-day prior hospitalization requirement for skilled nursing facility (SNF) care eligibility. Comprehensive Health Care Reform. P.L. 111-148, Patient Protection and Affordable Care Act; P.L. 111-152, Health Care and Education Reconciliation Act of 2010: implementation of provisions reducing Medicare Advantage plan payments; requiring higher income Medicare beneficiaries to pay an increased share of Medicare Parts B and D premium costs; expanding benefits for low-income beneficiaries under the Medicare Savings Programs and the Part D Low-Income Subsidy (LIS); expanding coverage of prevention services; testing payment and delivery system reforms; and providing expanded Medicaid coverage. Patent Reform. S. 1137, Patent Act; H.R. 9, Innovation Act: proposal to carve brand-named pharmaceutical manufacturers out of an expedited United States Patent and Trademark Office (USPTO) review process that allows generic companies to bypass costly litigation when challenging drug patents. Expanding Drug Monopolies. H.R. 6, 21st Century Cures Act: proposal to extend orphan drug market exclusivity for existing drugs to new indications. Reducing Prescription Drug Costs. S. 2023, H.R. 3513, Prescription Drug Affordability Act: proposals to allow Medicare to negotiate drug prices, to allow Medicare and Medicaid to receive additional rebates from brand and generic drugs, and to allow for the re-importation of drugs from Canada. Chronic Care Coordination. (No bill.) Proposals to facilitate the delivery of high-quality care for people with Medicare living with multiple chronic conditions. Medicare Vision, Dental and Hearing Coverage. H.R. 3308, Seniors Have Eyes, Ears and Teeth Act: proposal to provide Medicare coverage for vision, hearing and dental services. Medicare Hearing Coverage. H.R. 1653, the Medicare Hearing Aid Coverage Act of 2015: proposal to provide Medicare coverage for the cost of hearing aids and examinations. Medicare Dental Coverage. S. 570, H.R. 1055, the Comprehensive Dental Reform Act: proposal to extend comprehensive dental coverage to all Medicare, Medicaid, and VA beneficiaries. Medicare Part B Premium and Deductible Increase. S. 2148, Protecting Medicare Beneficiaries Act of 2015; H.R. 3696, Medicare Premium Fairness Act of 2015 and P.L. 114-74: proposals to prevent steep increases in Medicare Part B premiums and deductibles in 2016. Medicare Care Planning. S. 1549, the Care Planning Act of 2015: proposals to create a Medicare benefit for care planning, the coordination of services, to fill gaps in quality measurement in the advanced illness field, and to include advanced care planning information in the Medicare & You handbook. Medicare Private Plan Notification Improvements. (No bill.) Proposals to improve the annual notification Medicare private plans promulgate to Parts C and D enrollees pertaining to plan changes that will raise enrollee costs or limit access to products and services.

H.R.6 - 21st Century Cures Act H.R.3298 - Medicare Post-Acute Care Value-Based Purchasing Act of 2015 S.2148 - A bill to amend title XVIII of the Social Security Act to prevent an increase in the Medicare part B premium and deductible in 2016 H.R.3696 - Medicare Premium Fairness Act of 2015 P.L. 111-148: The Patient Protection and Affordable Care Act. H.R. 4302: Protecting Access to Medicare Act of 2014 (PL 113-93) on 4.1.2014 H.R. 1571: Improving Access to Medicare Coverage Act of 2015. S. 843: Improving Access to Medicare Coverage Act of 2015. S. 367: The Medicare Access to Rehabilitation Services Act. H.R. 290: The Creating Access to Rehabilitation for Every Senior (CARES ACT). S. 1932: A bill to amend title XVIII of the Social Security Act to establish a Medicare Better Care Program. Protect and Preserve Medicaid Provider Assessment. Protect and Preserve Medicare Bad Debt Reimbursement Improving the CMS State Plan Amdt. Process. Sustainable Growth Rate (SGR) and other reform proposals. Reducing hospital readmissions from skilled nursing facility. Improving Medicare Post-Acute Care Transformation Act (IMPACT) The Veteran Access to Long Term Care and Health Services Act (S.2000) and VA Provider Agreement and Proposal Repealing the Cap on Medicare Part B therapy services for seniors. MedPAC site neutral payment system for post acute care. CME proposed Rule for SNF Prospective Payment System (PPS). PL. 113-185 Impact Act of 2014 H.R. 952: To amend titles XVIII and XIX of the Social Security Act to establish a minimum direct care registered nurse staffing requirement at nursing facilities and skilled nursing facilities under Medicare and Medicaid and for other purposes. H.R. 2: Medicare Access & CHIP Reauthorization Act of 2015 H.R. 876: Notice Act (P.L. 114-42) S.1916: The Rural Health Care Connectivity Act of 2015

H.R.2050, the Middle Class Health Benefits Tax Repeal Act H.R. 3696, the Medicare Premium Fairness Act of 2015 S. 2148, the Protecting Medicare Beneficiaries Act

Client expense: $358,847 · Firm income: Not reported

Government targets: Education, Dept of, Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

H.R. 3696, the Medicare Premium Fairness Act of 2015 S. 2148, the Protecting Medicare Beneficiaries Act

Client expense: $358,847 · Firm income: Not reported

Government targets: Education, Dept of, Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

Medicare Privatization. (No bill.) Proposals to transform traditional Medicare to a private insurance carrier program. Medicare Benefit Redesign. (No bill.) Proposals pertaining to Parts A and B deductibles; premiums, including means-testing; a catastrophic cap on out-of-pocket spending; the eligibility age; and proposals to privatize Medicare. Medicare Drug Savings. S. 1083, H.R. 2005, the Medicare Drug Savings Act: proposals to extend the application of Medicaid drug rebates to prescription drugs paid for by Medicare and used by Medicare-Medicaid eligible beneficiaries (dual-eligibles), and by people receiving the Medicare Part D Low-Income Subsidy. Medicare Prescription Drug Price Negotiation. H.R. 3061, S. 31, the Medicare Prescription Drug Price Negotiation Act of 2015: proposals to authorize the Secretary of the Department of Health and Human Services to negotiate discounts, rebates, and other price concessions to lower the cost paid by Medicare to pharmaceutical manufacturers. Medicare Prescription Drug Plan Option. H.R. 3261, S. 1884, the Medicare Prescription Drug Savings and Choice Act of 2015: proposals to create one or more Medicare-administered drug plans with uniform premiums, providing seniors with the opportunity to purchase drugs directly through the Medicare program; requires the federal government to use its purchasing power to negotiate lower prices on prescription drugs for beneficiaries who enroll in the Medicare-administered plan. Medicare Home Health Benefits. (No bill.) Proposals pertaining to copayments for beneficiaries receiving the Medicare home health benefit. Medicare Observation Status. S. 843, H.R. 1571, Improving Access to Medicare Coverage Act of 2015: proposal to count days in the hospital in observation status toward meeting the three-day prior hospitalization requirement for skilled nursing facility (SNF) care eligibility. Comprehensive Health Care Reform. P.L. 111-148, Patient Protection and Affordable Care Act; P.L. 111-152, Health Care and Education Reconciliation Act of 2010: implementation of provisions reducing Medicare Advantage plan payments; requiring higher income Medicare beneficiaries to pay an increased share of Medicare Parts B and D premium costs; expanding benefits for low-income beneficiaries under the Medicare Savings Programs and the Part D Low-Income Subsidy (LIS); expanding coverage of prevention services; testing payment and delivery system reforms; and providing expanded Medicaid coverage. Patent Reform. S. 1137, Patent Act; H.R.9, Innovation Act: proposals to omit brand manufacturers from the U.S. Patent Office expedited review process intended to allow generic manufacturers to bypass costly litigation when challenging drug patents. Expanding Drug Monopolies. H.R. 6, 21st Century Cures Act: proposal to extend orphan drug market exclusivity for existing drugs to new indications. Reducing Prescription Drug Costs. S. 2023, H.R. 3513, Prescription Drug Affordability Act: proposals to allow Medicare to negotiate drug prices, to allow Medicare and Medicaid to receive additional rebates from brand and generic drugs, and to allow for the re-importation of drugs from Canada. Chronic Care Coordination. (No bill.) Proposals to facilitate the delivery of high-quality care for people with Medicare living with multiple chronic conditions. Medicare Vision, Dental and Hearing Coverage. H.R. 3308, Seniors Have Eyes, Ears and Teeth Act: proposal to provide Medicare coverage for vision, hearing and dental services. Medicare Hearing Coverage. H.R. 1653, the Medicare Hearing Aid Coverage Act of 2015: proposal to provide Medicare coverage for the cost of hearing aids and examinations. Medicare Dental Coverage. S. 570, H.R. 1055, the Comprehensive Dental Reform Act: proposal to extend comprehensive dental coverage to all Medicare, Medicaid, and VA beneficiaries. Medicare Part B Premium and Deductible Increase. S. 2148, Protecting Medicare Beneficiaries Act of 2015; H.R. 3696, Medicare Premium Fairness Act of 2015: proposals to prevent steep increases in Medicare Part B premiums and deductibles in 2016.