States Achieve Medicaid Expansion (SAME) Act of 2016

Legislation and policies related to: Physician/nurse practitioner reimbursement Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Adoption of recommendations of the Institute of Medicine report, The Future of Nursing: Leading Change, Advancing Health Medicare Shared Savings Program beneficiary assignment requirements Medicare-Medicaid hospital conditions of participation Evaluation of the Medicare Graduate Nurse Education demonstration Medicare-Medicaid Program Integrity policies Medicaid maintenance of effort requirements Medicaid eligibility expansion and state options Medicaid waiver application procedures Medicaid per capita cap policy options Medicare-Medicaid dual eligible coverage and demonstration Draft Hospital Improvement for Payment (HIP) Act HHS study on the comparability of CHIP coverage and benefits with those of marketplace health plans Medicare provisions of H.R. 1892, the Trade Adjustment Assistance Act H.R. 2 - Medicare Access and CHIP Reauthorization Act H.R. 160/S. 149 - Protect Medical Innovation Act H.R. 546/S. 298 - Advancing Care for Exceptional Kids (ACE Kids) Act H.R. 700 - Stabilize Medicaid and CHIP Coverage Act H.R. 818/S. 861 - Preventing and Reducing Improper Medicare and Medicaid Expenditures (PRIME) Act H.R. 876 - Notice of Observation Treatment and Implication for Care Eligibility (NOTICE) Act H.R. 919 - CHIP Extension and Improvement Act H.R. 1021 - Protecting Integrity of Medicare Act (PIMA) H.R. 1190/S. 141 - Protecting Seniors Access to Medicare Act H.R. 1362 - Medicaid Requiring Expenditures for Public Objectives to be Reflective of Total Spending (Medicaid REPORTS) Act H.R. 1458 - Bundling and Coordinating Post-Acute Care (BACPAC) Act H.R. 1470 - SGR Repeal and Medicare Provider Payment Modernization Act H.R. 2339 - To amend title XIX of the Social Security Act to clarify the treatment of lottery winnings and other lump sum income for purposes of income eligibility under the Medicaid program H.R. 3014 - Medical Controlled Substances Transportation Act H.R. 3134 - Defund Planned Parenthood Act of 2015 H.R. 3292 - Medicare IME Pool Act H.R. 3298 - Medicare Post-Acute Care Value-Based Purchasing Act H.R. 3716 - Ensuring Terminated Providers Are Removed From Medicaid and CHIP Act H.R. 3821/S. 2618 - Medicaid Directory of Caregivers (Medicaid DOC) Act H.R. 4588 - Incentivizing Medicaid Expansion Act of 2016 H.R. 4725 - Common Sense Savings Act of 2016 H.R. 5164 - Rural Hospital Regulatory Relief Act H.R. 5122 - To prohibit further action on the proposed rule regarding testing of Medicare part B prescription drug models H.R. 5210/S. 2736 - Patient Access to Durable Medical Equipment Act H.R. 5273 - Helping Hospitals Improve Patient Care Act of 2016 H.R. 5613/S. 3129 - Continuing Access to Hospitals Act of 2016 S. 257/H.R. 1611 - Protecting Access to Rural Therapy Services Act S. 578/H.R. 1342 - Home Health Care Planning Improvement Act S. 737/H.R. 2253 - Ensuring Access to Primary Care for Women & Children Act S. 1349 - Notice of Observation Treatment and Implication for Care Eligibility (NOTICE) Act S. 1456 - Rural ACO Improvement Act S. 1461 - Extending a moratorium on enforcement of direct physician supervision of outpatient therapeutic services in critical access and small rural hospitals through 2015 S. 2425 - Patient Access and Medicare Protection Act S. 2787 - States Achieve Medicaid Expansion (SAME) Act S. 3130 - Independence at Home Act of 2016

Client expense: Not reported · Firm income: $23,450

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA), White House Office

Issues relating to health disparities, health care reform, childhood cancer, quality of life and palliative care, federal health care programs, genetic information, cancer, nutrition, tanning beds, skin cancer, and wellness, including: H.R.3119 & S.2748, the Palliative Care and Hospice Education and Training Act; H.R.716 & S.370, the Breast Density & Mammography Reporting Act; H.R.3381 & S.1883, Childhood Cancer STAR Act; and regulations relating to tanning beds. In addition, regulatory issues before the FDA relating to laboratory developed tests, and any legislation pertaining thereto, suncreens, colorectal cancer screening tests, electronic medical devices, H.R.2739/S.1566 - the Cancer Drug Coverage Parity Act, H.R.2846 - Planning Actively for Cancer Treatment Act, S.1014 - Personal Care Products Safety Act, H.R.1608 - Lymphedema Treatment Act, H.R.2191/S.1170 - the Breast Cancer Research Stamp Reauthorization Act, S.705 - Transportation Alternatives Act, S.540 - School Food Modernization Act, and H.R.644 - America Gives More Act, CDC opioid prescription guidelines, and legislation relating to opioid prescribing, addition and rehabilitation; H.R.5475, the Health Equity and Accountability Act; S.2787, the SAME Act and Senate Amendment 4369 to S.2943, the Senate Defense Authorization bill; and S.3136, H.R.5003 childhood nutrition bill; and H.R.2017 and S.2217, the Common Sense Nutrition Disclosure Act; and S.524 and H.R.953, the Comprehensive Addiction and Recovery Act, and related bills and amendments, S.3077, the Marijuana Effective Drug Studies Act of 2016.

Client expense: $1,620,000 · Firm income: Not reported

Issues relating to health disparities, health care reform, childhood cancer, quality of life and palliative care, federal health care programs, genetic information, cancer, nutrition, tanning beds, skin cancer, and wellness, including: H.R.3119 & S.2748, the Palliative Care and Hospice Education and Training Act; H.R.716 & S.370, the Breast Density & Mammography Reporting Act; H.R.3381 & S.1883, Childhood Cancer STAR Act; and regulations relating to tanning beds. In addition, regulatory issues before the FDA relating to laboratory developed tests, and any legislation pertaining thereto, suncreens, colorectal cancer screening tests, electronic medical devices, H.R.2739/S.1566 - the Cancer Drug Coverage Parity Act, H.R.2846 - Planning Actively for Cancer Treatment Act, S.1014 - Personal Care Products Safety Act, H.R.1608 - Lymphedema Treatment Act, H.R.2191/S.1170 - the Breast Cancer Research Stamp Reauthorization Act, S.705 - Transportation Alternatives Act, S.540 - School Food Modernization Act, and H.R.644 - America Gives More Act, CDC opioid prescription guidelines, and legislation relating to opioid prescribing, addition and rehabilitation; H.R.5475, the Health Equity and Accountability Act; S.2787, the SAME Act and Senate Amendment 4369 to S.2943, the Senate Defense Authorization bill; and S.3136, H.R.5003 childhood nutrition bill; and H.R.2017 and S.2217, the Common Sense Nutrition Disclosure Act; and S.524 and H.R.953, the Comprehensive Addiction and Recovery Act, and related bills and amendments, S.3077, the Marijuana Effective Drug Studies Act of 2016.

Client expense: $1,630,000 · Firm income: Not reported

Issues relating to health disparities, health care reform, childhood cancer, quality of life and palliative care, federal health care programs, genetic information, cancer, nutrition, tanning beds, skin cancer, and wellness, including: H.R.3119 & S.2748, the Palliative Care and Hospice Education and Training Act; H.R.716 & S.370, the Breast Density & Mammography Reporting Act; H.R.3381 & S.1883, Childhood Cancer STAR Act; and regulations relating to tanning beds. In addition, regulatory issues before the FDA relating to laboratory developed tests, and any legislation pertaining thereto, suncreens, colorectal cancer screening tests, electronic medical devices, H.R.2739/S.1566 - the Cancer Drug Coverage Parity Act, H.R.2846 - Planning Actively for Cancer Treatment Act, S.1014 - Personal Care Products Safety Act, H.R.1608 - Lymphedema Treatment Act, H.R.2191/S.1170 - the Breast Cancer Research Stamp Reauthorization Act, S.705 - Transportation Alternatives Act, S.540 - School Food Modernization Act, and H.R.644 - America Gives More Act, CDC opioid prescription guidelines, and legislation relating to opioid prescribing, addition and rehabilitation; H.R.5475, the Health Equity and Accountability Act; S.2787, the SAME Act and Senate Amendment 4369 to S.2943, the Senate Defense Authorization bill; and S.3136, H.R.5003 childhood nutrition bill; and H.R.2017 and S.2217, the Common Sense Nutrition Disclosure Act; and S.524 and H.R.953, the Comprehensive Addiction and Recovery Act, and related bills and amendments, S.3077, the Marijuana Effective Drug Studies Act of 2016.

Client expense: $1,200,000 · Firm income: Not reported

Legislation and policies related to: Physician/nurse practitioner reimbursement Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Adoption of recommendations of the Institute of Medicine report, The Future of Nursing: Leading Change, Advancing Health Medicare Shared Savings Program beneficiary assignment requirements Medicare-Medicaid hospital conditions of participation Evaluation of the Medicare Graduate Nurse Education demonstration Medicare-Medicaid Program Integrity policies Medicaid maintenance of effort requirements Medicaid eligibility expansion and state options Medicaid waiver application procedures Medicaid per capita cap policy options Medicare-Medicaid dual eligible coverage and demonstration Draft Hospital Improvement for Payment (HIP) Act HHS study on the comparability of CHIP coverage and benefits with those of marketplace health plans Medicare provisions of H.R. 1892, the Trade Adjustment Assistance Act H.R. 2 - Medicare Access and CHIP Reauthorization Act H.R. 160/S. 149 - Protect Medical Innovation Act H.R. 546/S. 298 - Advancing Care for Exceptional Kids (ACE Kids) Act H.R. 700 - Stabilize Medicaid and CHIP Coverage Act H.R. 818/S. 861 - Preventing and Reducing Improper Medicare and Medicaid Expenditures (PRIME) Act H.R. 876 - Notice of Observation Treatment and Implication for Care Eligibility (NOTICE) Act H.R. 919 - CHIP Extension and Improvement Act H.R. 1021 - Protecting Integrity of Medicare Act (PIMA) H.R. 1190/S. 141 - Protecting Seniors Access to Medicare Act H.R. 1362 - Medicaid Requiring Expenditures for Public Objectives to be Reflective of Total Spending (Medicaid REPORTS) Act H.R. 1458 - Bundling and Coordinating Post-Acute Care (BACPAC) Act H.R. 1470 - SGR Repeal and Medicare Provider Payment Modernization Act H.R. 2339 - To amend title XIX of the Social Security Act to clarify the treatment of lottery winnings and other lump sum income for purposes of income eligibility under the Medicaid program H.R. 3014 - Medical Controlled Substances Transportation Act H.R. 3134 - Defund Planned Parenthood Act of 2015 H.R. 3292 - Medicare IME Pool Act H.R. 3298 - Medicare Post-Acute Care Value-Based Purchasing Act H.R. 3716 - Ensuring Terminated Providers Are Removed From Medicaid and CHIP Act H.R. 3821/S. 2618 - Medicaid Directory of Caregivers (Medicaid DOC) Act H.R. 4588 - Incentivizing Medicaid Expansion Act of 2016 H.R. 4725 - Common Sense Savings Act of 2016 H.R. 5164 - Rural Hospital Regulatory Relief Act H.R. 5210/S. 2736 - Patient Access to Durable Medical Equipment Act H.R. 5273 - Helping Hospitals Improve Patient Care Act of 2016 H.R. 5613/S. 3129 - Continuing Access to Hospitals Act of 2016 S. 257/H.R. 1611 - Protecting Access to Rural Therapy Services Act S. 578/H.R. 1342 - Home Health Care Planning Improvement Act S. 737/H.R. 2253 - Ensuring Access to Primary Care for Women & Children Act S. 1349 - Notice of Observation Treatment and Implication for Care Eligibility (NOTICE) Act S. 1456 - Rural ACO Improvement Act S. 1461 - Extending a moratorium on enforcement of direct physician supervision of outpatient therapeutic services in critical access and small rural hospitals through 2015 S. 2425 - Patient Access and Medicare Protection Act S. 2787 - States Achieve Medicaid Expansion (SAME) Act S. 3130 - Independence at Home Act of 2016

H.R. 2124/S. 1148, Resident Physician Shortage Reduction Act of 2015 Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments H.R. 4774, The Training Tomorrows Doctors Today Act Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments. Increases transparency and accountability measures. Issue: Oppose reduction of Medicare GME/IME payments Issue: Oppose reduction in Medicare hospital outpatient department reimbursement. Issue: Oppose inclusion of Medicare add-on payments in Hospital-Acquired Condition (HAC) program. Issue: Oppose Medicare hospital cuts as offsets for physician payment reform Issue: Support delay of Enforcement of new Centers for Medicare and Medicaid Services inpatient criteria (e.g., "Two-Midnight" rule) in FY 2016 Inpatient Prospective Payment System (IPPS) final rule. H.R. 4732/S.2671, Advancing Medical Resident Training in Community Hospitals Act Issue: Support Medicare Graduate Medical Education (GME) per resident amount technical corrections and administrative relief. H.R. 5273, Helping Hospitals Improve Patient Care Act of 2016 Issue: Support incorporating sociodemographic status Hospital Readmissions Reduction Program and addressing mid-build, off-campus outpatient departments under development at the time of enactment of the Bipartisan Budget Act of 2015. H.R. 1343/S. 688, Establishing Beneficiary Equity in the Hospital Readmissions Program Act of 2015 Issue: Support inclusion of socioeconomic status as part of hospital readmissions program. H.R. 3288, Strengthening DSH and Medicare through Subsidy Recapture and Payment Reform Act of 2015 Issue: Alter DSH payment methodology and increase DSH spending in non-Medicaid expansion states S. 2787, the States Achieve Medicaid Expansion (SAME) Act Issue: Support legislation providing three full years of federal Medicaid matching funding to states that expand Medicaid H.R. 3292, Medicare IME Pool Act of 2015 Issue: Oppose redesign of Medicare Indirect Medical Education financing and redistribution. H.R. 3291, Medicare Crosswalk Hospital Code Development Act of 2015 Issue: Create a crosswalk between Medicare Part A and Part B payments P.L. 114-10, Medicare Access and CHIP Reauthorization Act of 2015. Issues: Support repeal of Medicare's sustainable growth rate (SGR) formula; Medicare physician payment reform; extension of the Childrens Health Insurance Program (CHIP); and extension of mandatory funding for the National Health Service Corps (NHSC). H.R. 1117, Creating Access to Residency Education Act of 2015 Issue: Create CMS grant program for new residency programs. Issue: Development and implementation of new Medicare Disproportionate Share Hospital (DSH) formula required under the ACA. Draft Hospital Improvements for Payment (HIP) Act of 2014 Issues: Support repeal of CMS Two-Midnights Rule, extending RAC audit moratorium for short stays, and permanent bundle program. Issue: Oppose further delays in the implementation of the ICD-10 system Issue: Support inclusion of socioeconomic status as part of hospital readmissions program including support for adoption of National Quality Forum (NQF) recommendations. Issue: Support allowing providers in new delivery models (e.g., ACOs, bundled payments, etc.) to access medical records with information on substance use disorders H.R. 6088, Hospital Quality Rating Transparency Act of 2016 Issue: delay release of CMS Hospital Compare Star Ratings to give stakeholders time to work together to address concerns with methodology. Submitted comments to: --CMS on the Medicaid DSH Payment Proposed Rule. --CMS on the CY 2017 Outpatient Prospective Payment System (OPPS) Proposed Rule. --CMS on revisions to payment policies under the Physician Fee Schedule and other revisions to Part B for CY 2017. --CMS regarding concerns with Hospital Compare Star Ratings.

Connect for Health Act (S.2484/ H.R. 4442) Furthering Access to Stroke Telemedicine Act (S.1465/H.R.2799) Medicare Access to Rehabilitation Services Act(H.R.775/S.539) Medicare Cardiac Rehab Supervision Bill(S.488/H.R.3355) Medicare Diabetes Prevention Act(H.R.2102/S.1131) Medicare-Strengthening Medicare Intensive Cardiac Rehabilitation Programs Act of 2015(S.2382) Medicare Telehealth Parity Act(H.R.2448) Senate Finance Chronic Care Bill States Achieve Medicaid Expansion(SAME)Act(S.2787) Independence at Home Act(S.3130)

Client expense: $166,728 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Education, Dept of, Environmental Protection Agency (EPA), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Transportation, Dept of (DOT), Treasury, Dept of, U.S. Trade Representative (USTR), White House Office

HR 2446- Electronic visit verification for personal care services Improving Access to Quality Long-Term Care Services HR 2646- Helping Families in Mental Health Crisis Act S 2680- Mental Health Reform Act of 2016 S 2787- States Achieve Medicaid Expansion (SAME) Act of 2016 HR 5396- Medicare Dental, Vision, and Hearing Benefit Act Medicaid Payments and Upper Payment Limits Improving Medicare benefits HR 5367- Seniors' Security Act of 2016 ACA and tax treatment of health care; alternatives to the ACA, tax exclusion for employer-provided health care, policies to rein in prescription drug costs S 2579- Funding for water infrastructure and other aid to address lead crisis in Flint, MI Medicaid funding and benefits Medicare funding, benefits, policy, eligibility age, means tests, spending equity across jurisdictions

Client expense: $660,000 · Firm income: Not reported

Legislation and policies related to: Physician/nurse practitioner reimbursement Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Adoption of recommendations of the Institute of Medicine report, The Future of Nursing: Leading Change, Advancing Health Medicare Shared Savings Program beneficiary assignment requirements Medicare-Medicaid hospital conditions of participation Evaluation of the Medicare Graduate Nurse Education demonstration Medicare-Medicaid Program Integrity policies Medicaid maintenance of effort requirements Medicaid eligibility expansion and state options Medicaid waiver application procedures Medicaid per capita cap policy options Medicare-Medicaid dual eligible coverage and demonstration Draft Hospital Improvement for Payment (HIP) Act HHS study on the comparability of CHIP coverage and benefits with those of marketplace health plans Medicare provisions of H.R. 1892, the Trade Adjustment Assistance Act H.R. 2 - Medicare Access and CHIP Reauthorization Act H.R. 160/S. 149 - Protect Medical Innovation Act H.R. 546/S. 298 - Advancing Care for Exceptional Kids (ACE Kids) Act H.R. 700 - Stabilize Medicaid and CHIP Coverage Act H.R. 818/S. 861 - Preventing and Reducing Improper Medicare and Medicaid Expenditures (PRIME) Act H.R. 876 - Notice of Observation Treatment and Implication for Care Eligibility (NOTICE) Act H.R. 919 - CHIP Extension and Improvement Act H.R. 1021 - Protecting Integrity of Medicare Act (PIMA) H.R. 1190/S. 141 - Protecting Seniors Access to Medicare Act H.R. 1362 - Medicaid Requiring Expenditures for Public Objectives to be Reflective of Total Spending (Medicaid REPORTS) Act H.R. 1458 - Bundling and Coordinating Post-Acute Care (BACPAC) Act H.R. 1470 - SGR Repeal and Medicare Provider Payment Modernization Act H.R. 2339 - To amend title XIX of the Social Security Act to clarify the treatment of lottery winnings and other lump sum income for purposes of income eligibility under the Medicaid program H.R. 3014 - Medical Controlled Substances Transportation Act H.R. 3134 - Defund Planned Parenthood Act of 2015 H.R. 3292 - Medicare IME Pool Act H.R. 3298 - Medicare Post-Acute Care Value-Based Purchasing Act H.R. 3716 - Ensuring Terminated Providers Are Removed From Medicaid and CHIP Act H.R. 3821/S. 2618 - Medicaid Directory of Caregivers (Medicaid DOC) Act H.R. 4588 - Incentivizing Medicaid Expansion Act of 2016 H.R. 4725 - Common Sense Savings Act of 2016 H.R. 5164 - Rural Hospital Regulatory Relief Act H.R. 5273 - Helping Hospitals Improve Patient Care Act of 2016 S. 257/H.R. 1611 - Protecting Access to Rural Therapy Services Act S. 578/H.R. 1342 - Home Health Care Planning Improvement Act S. 737/H.R. 2253 - Ensuring Access to Primary Care for Women & Children Act S. 1349 - Notice of Observation Treatment and Implication for Care Eligibility (NOTICE) Act S. 1456 - Rural ACO Improvement Act S. 1461 - Extending a moratorium on enforcement of direct physician supervision of outpatient therapeutic services in critical access and small rural hospitals through 2015 S. 2425 - Patient Access and Medicare Protection Act S. 2787 - States Achieve Medicaid Expansion (SAME) Act

Issues relating to health disparities, health care reform, childhood cancer, quality of life and palliative care, federal health care programs, genetic information, cancer, nutrition, tanning beds, skin cancer, and wellness, including: H.R.3119 & S.2748, the Palliative Care and Hospice Education and Training Act; H.R.716 & S.370, the Breast Density & Mammography Reporting Act; H.R.3381 & S.1883, Childhood Cancer STAR Act; and regulations relating to tanning beds. In addition, regulatory issues before the FDA relating to laboratory developed tests, and any legislation pertaining thereto, suncreens, colorectal cancer screening tests, electronic medical devices, H.R.2739/S.1566 - the Cancer Drug Coverage Parity Act, H.R.2846 - Planning Actively for Cancer Treatment Act, S.1014 - Personal Care Products Safety Act, H.R.1608 - Lymphedema Treatment Act, H.R.2191/S.1170 - the Breast Cancer Research Stamp Reauthorization Act, S.705 - Transportation Alternatives Act, S.540 - School Food Modernization Act, and H.R.644 - America Gives More Act, CDC opioid prescription guidelines, and legislation relating to opiod prescribing, addition and rehabilitation; H.R.5475, the Health Equity and Accountability Act; S.2787, the SAME Act and Senate Amendment 4369 to S.2943, the Senate Defense Authorization bill; and S.3136, H.R.5003 childhood nutrition bill; and H.R.2017 and S.2217, the Common Sense Nutrition Disclosure Act; and S.524 and H.R.953, the Comprehensive Addiction and Recovery Act, and related bills and amendments.

Client expense: $1,250,000 · Firm income: Not reported

Connect for Health Act (S.2484/ H.R. 4442) Furthering Access to Stroke Telemedicine Act (S.1465/H.R.2799) Medicare Access to Rehabilitation Services Act(H.R.775/S.539) Medicare Cardiac Rehab Supervision Bill(S.488/H.R.3355) Medicare Diabetes Prevention Act(H.R.2102/S.1131) Medicare-Strengthening Medicare Intensive Cardiac Rehabilitation Programs Act of 2015(S.2382) Medicare Telehealth Parity Act(H.R.2448) Meeting with CMMI-Mobile Stroke Units Senate Finance Chronic Care Bill States Achieve Medicaid Expansion(SAME)Act(S.2787)

Client expense: $159,620 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Education, Dept of, Environmental Protection Agency (EPA), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Transportation, Dept of (DOT), Treasury, Dept of, U.S. Trade Representative (USTR), White House Office

H.R. 2124/S. 1148, Resident Physician Shortage Reduction Act of 2015 Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments H.R. 4774, The Training Tomorrows Doctors Today Act Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments. Increases transparency and accountability measures. Issue: Oppose reduction of Medicare GME/IME payments Issue: Oppose reduction in Medicare hospital outpatient department reimbursement. Issue: Oppose inclusion of Medicare add-on payments in Hospital-Acquired Condition (HAC) program. Issue: Oppose Medicare hospital cuts as offsets for physician payment reform Issue: Support delay of Enforcement of new Centers for Medicare and Medicaid Services inpatient criteria (e.g., "Two-Midnight" rule) in FY 2016 Inpatient Prospective Payment System (IPPS) final rule. H.R. 4732/S.2671, Advancing Medical Resident Training in Community Hospitals Act Issue: Support Medicare Graduate Medical Education (GME) per resident amount technical corrections and administrative relief. H.R. 5273, Helping Hospitals Improve Patient Care Act of 2016 Issue: Support incorporating sociodemographic status Hospital Readmissions Reduction Program and addressing mid-build, off-campus outpatient departments under development at the time of enactment of the Bipartisan Budget Act of 2015. H.R. 1343/S. 688, Establishing Beneficiary Equity in the Hospital Readmissions Program Act of 2015 Issue: Support inclusion of socioeconomic status as part of hospital readmissions program. H.R. 3288, Strengthening DSH and Medicare through Subsidy Recapture and Payment Reform Act of 2015 Issue: Alter DSH payment methodology and increase DSH spending in non-Medicaid expansion states S. 2787, the States Achieve Medicaid Expansion (SAME) Act Issue: Support legislation providing three full years of federal Medicaid matching funding to states that expand Medicaid H.R. 3292, Medicare IME Pool Act of 2015 Issue: Oppose redesign of Medicare Indirect Medical Education financing and redistribution. H.R. 3291, Medicare Crosswalk Hospital Code Development Act of 2015 Issue: Create a crosswalk between Medicare Part A and Part B payments P.L. 114-10, Medicare Access and CHIP Reauthorization Act of 2015. Issues: Support repeal of Medicare's sustainable growth rate (SGR) formula; Medicare physician payment reform; extension of the Childrens Health Insurance Program (CHIP); and extension of mandatory funding for the National Health Service Corps (NHSC). H.R. 1117, Creating Access to Residency Education Act of 2015 Issue: Create CMS grant program for new residency programs. Issue: Development and implementation of new Medicare Disproportionate Share Hospital (DSH) formula required under the ACA. Draft Hospital Improvements for Payment (HIP) Act of 2014 Issues: Support repeal of CMS Two-Midnights Rule, extending RAC audit moratorium for short stays, and permanent bundle program. Issue: Oppose further delays in the implementation of the ICD-10 system Issue: Support inclusion of socioeconomic status as part of hospital readmissions program including support for adoption of National Quality Forum (NQF) recommendations. Issue: Support allowing providers in new delivery models (e.g., ACOs, bundled payments, etc.) to access medical records with information on substance use disorders Submitted comments to: --CMS on the Medicare Program; Merit-Based Incentive Payment Systems (MIPS) and Alternative Payment Model (APM) Incentive under the Physician Fee Schedule, and Criteria for Physician-Focused Payment Models proposed rule --CMS on the Medicare Access CHIP Reauthorization Act (MACRA) implementation --CMS on the FY 2017 Inpatient Prospective Payment System (IPPS) proposed rule Office of the National Coordinator for Health Information Technology (ONC) on Assessing Interoperability for MACRA --CMS on Medicare Part B Drug Payment Model proposed rule ONC on principles for interoperability among health information systems

HR 2446- Electronic visit verification for personal care services Improving Access to Quality Long-Term Care Services HR 2646- Helping Families in Mental Health Crisis Act S 2680- Mental Health Reform Act of 2016 S 2787- States Achieve Medicaid Expansion (SAME) Act of 2016 HR 5396- Medicare Dental, Vision, and Hearing Benefit Act Medicaid Payments and Upper Payment Limits Improving Medicare benefits HR 5367- Seniors' Security Act of 2016 ACA and tax treatment of health care; alternatives to the ACA, tax exclusion for employer-provided health care, policies to rein in prescription drug costs S 2579- Funding for water infrastructure and other aid to address lead crisis in Flint, MI Medicaid funding and benefits Medicare funding, benefits, policy, eligibility age, means tests, spending equity across jurisdictions

Client expense: $650,000 · 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 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. Reducing the cost of biologics. H.R. 5573, S. 3094, Price, Innovation and Competition for Essential Drugs (PRICED) Act: proposal to reduce the marketing exclusivity period for biologics from 12 to 7 years. Drug payment under Medicare Part B. H.R. 5122, to prohibit further action on the proposed rule regarding testing of Medicare Part B prescription drug models: proposal to prohibit implementation of a proposed demonstration testing new ways of paying physicians for drugs in order to eliminate incentives to unnecessarily prescribe high cost drugs. Medicare Fraud. H.R. 5340, Fighting Medicare Fraud Act: Legislation to close off a loophole allowing Medicare fraud offenders to evade enforcement authority when they move to a new company. Out-of-pocket drug costs. S.2864, RXCAP Act of 2016: proposal to cap out-of-pocket costs for Part D enrollees. 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; H.R. 5396, the Medicare Dental, Vision, and Hearing Benefit Act of 2016: proposals to provide Medicare coverage for vision, hearing and dental services. Medicare Hearing Coverage. H.R. 1653, the Medicare Hearing Aid Coverage Act of 2015; H.R. 2748, the Help Extend Auditory Relief (HEAR) Act of 2015: proposals to provide Medicare coverage for the cost of hearing aids and examinations, to amend Medicare to cover aural rehabilitation services, hearing aids, audiology rehabilitation services, and related hearing services. 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 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. 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. H.R. 5122: 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. Medicare Access and CHIP Reauthorization Act. (Public Law 114-10). Comments to CMS/HHS proposing ways the proposed rule can be strengthened to ensure the new Quality Payment Program delivers on the promise of health system transformation. Medicaid Expansion. H.R. 4588 and S. 2787: proposal to provide a higher level of federal Medicaid funding for states that did not choose to expand Medicaid when the Affordable Care Act (ACA) first launched Medicaid expansion in 2014.

Restoring Americans' Healthcare Freedom Reconciliation Act (H.R. 3762) States Achieve Medicaid Expansion Act (S. 2787)

Client expense: $49,129 · Firm income: Not reported

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), SENATE, State, Dept of (DOS), U.S. Agency for International Development (USAID)

Issues pertaining to Medicaid reform, block grant proposals, per capita caps Medicare and Medicaid Graduate Medical Education Medicaid provider taxes Medicare bad debt payments Medicare and Medicaid payment H.R.2 the Medicare Access and CHIP Reauthorization Act of 2015, all provisions H.R.1343/S.688 Establishing Equity in the Hospital Readmissions Program Act of 2015, all provisions Medicaid Waivers Medicaid Expansion Issues Medicaid disproportionate share hospital payments Medicare disproportionate share hospital payments Medicare hospital readmissions program Funding for the Children's Health Insurance Program Medicaid primary care payment parity Issues related to Medicaid reform including Medicaid block grants and per capita caps Medicare evaluation and management codes and other Medicare outpatient codes/ Medicare site neutral documents Meaningful Use stage 2 and 3 Medicare Shared Savings Program HR2151 Improving Oversight and Accountability in Medicaid Non-DSH Supplemental Payments Act HR1362 Medicaid Reports Act HR1400 Medicaid Tax Fairness Act HR1361 Medicaid Home Improvement HR2119 To amend title XI of the Social Security Act to require that state applications for state plan waivers under the Medicaid program be approved only if such applications are budget neutral, and for other purposes Legislation related to chronic care treatment H.R. 3292 Medicare IME Pool Act of 2015 H.R. 3288 Strengthening DSH and Medicare through Subsidy Recapture and Payment Reform Act H.R. 3291 Medicare Crosswalk Hospital Code Development Act Medicaid data and transparency Medicaid Managed Care Policies/ rulemaking Medicaid supplemental payments Medicare Site Neutral payments for hospital outpatient departments H.R.4442/S.2484 Connect for Health Act H.R.3309 Flex-It 2 Act H.R.4774 Training tomorrow's doctors today act H.R.4588 Incentivizing Medicaid expansion act S.2787 States achieve Medicaid expansion act