Patient Access To Integrated-care, Empowerment, Nephrologists and Treatment Demonstration Act of 2016

(1)Issues related to Public Law 111-148 - The Patient Protection and Affordable Care Act (provisions related to Medicaid and Medicare) (2)Issues related to Public Law 111-152 - Health Care and Education Reconciliation Act of 2010 (provisions related to Medicaid and Medicare) (3)Issues pertaining to entitlement reform, Medicare Advantage, Part D, Medicaid Dual Eligibles, the Children's Health Insurance Program (CHIP) and Medicare reimbursement and enrollment (4)Issues related to S. 2498 - Medicare Program Linking Uncoordinated Services (PLUS) Act (114th Congress) (5)Issues related to H.R.3244 - Providing Innovative Care for Complex Cases Demonstration Act of 2015 (114th Congress) (6)Issues related to CMS Advance Notice of Methodological Changes for Calendar Year (CY) 2018 for Medicare Advantage (MA) Capitation Rates, Part C and Part D Payment Policies and 2018 Call Letter (7)Issues related to CMS Advance Notice of Methodological Changes for Calendar Year (CY) 2019 for Medicare Advantage (MA) Capitation Rates, Part C and Part D Payment Policies and 2019 Call Letter (8) Issues related to H.R. 908, the Medicare Advantage Quality Payment Relief Act (9) Issues related to S.870, Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017 (10) Issues related to H.R. 3168, To amend title XVIII of the Social Security Act to provide continued access to specialized Medicare Advantage plans for special needs individuals, and for other purposes. (11) Issues related to S. 1827/H.R. 3921 - KIDS Act of 2017 & H.R.3922 - Championing Healthy Kids Act (12) Issues related to H.R.5942 / S. 3090 - Dialysis Patient Access To Integrated-care, Empowerment, Nephrologists, Treatment, and Services Demonstration Act of 2016

Client expense: $1,310,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE, Treasury, Dept of

H.R. 5942/S. 3090 Dialysis PATIENT Demonstration Act of 2016, all provisions (bill number for 114th Congress) CMS-3317-IFC, Conditions for Coverage for End-Stage Renal Disease Facilities-Third Party Payment CMS regulations pertaining to reimbursement rates for ESRD-related services CMS survey and certification of kidney dialysis centers S. 870, Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act, provisions related to end stage renal disease H.R. 2644, Chronic Kidney Disease Improvement in Research and Treatment Act, all provisions H.R. 2556 and S. 1016, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act, all provisions H.R. 3178, Medicare Part B Improvement Act, all provisions S. 1729, Dialysis Access Improvement Act of 2017, all provisions H.R. 3168, To amend title XVIII of the Social Security Act to provide continued access to specialized Medicare Advantage plans for special needs individuals, and for other purposes H.R. 3166, To amend title XVIII of the Social Security Act to provide under the Medicare program for independent accreditation for dialysis facilities and assurance of high quality surveys with respect to such facilities

Client expense: $730,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Veterans Affairs, Dept of (VA)

H.R. 5942/S. 3090, Dialysis PATIENT Demonstration Act of 2016, all provisions (bill number for 114th Congress) CMS-3317-IFC, Conditions for Coverage for End-Stage Renal Disease (ESRD) Facilities-Third Party Payment CMS regulations pertaining to reimbursement rates for ESRD-related services CMS/Medicare Advantage ESRD rate formulation S. 870, Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act, provisions related to end stage renal disease H.R. 2644, Chronic Kidney Disease Improvement in Research and Treatment Act, all provisions H.R. 2556 and S. 1016, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act, all provisions H.R. 3178, Medicare Part B Improvement Act, all provisions S. 1729, Dialysis Access Improvement Act of 2017, all provisions H.R. 3168, To amend title XVIII of the Social Security Act to provide continued access to specialized Medicare Advantage plans for special needs individuals, and for other purposes H.R. 3166, To amend title XVIII of the Social Security Act to provide under the Medicare program for independent accreditation for dialysis facilities and assurance of high quality surveys with respect to such facilities

Client expense: $730,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Veterans Affairs, Dept of (VA)

Issues related to H.R. 5942/S. 3090, the Dialysis Patient Access To Integrated-care, Empowerment, Nephrologists, Treatment, and Services Demonstration Act of 2016 (bill number from 114th Congress)

Client expense: Not reported · Firm income: $10,000

Government targets: HOUSE OF REPRESENTATIVES

H.R. 5942/S. 3090, Dialysis PATIENT Demonstration Act of 2016; all provisions (bill number for 114th Congress) CMS-3317-IFC, Conditions for Coverage for End-Stage Renal Disease (ESRD) Facilities-Third Party Payment H.R. 2507 The Increasing Regulatory Fairness Act; all provisions (bill number from 114th Congress) Comprehensive reforms to meaningful use; stage 3 meaningful use proposed rule CMS ESRD benchmark calculation CMS regulations pertaining to reimbursement rates for ESRD-related services CMS survey and certification of kidney dialysis centers CMS vascular care rate change proposal CMS/Medicare Advantage ESRD rate formulation S. 870, Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act H.R. 2644, Chronic Kidney Disease Improvement in Research and Treatment Act, all provisions H.R. 2556 and S. 1016, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act, all provisions H.R. 3178, Medicare Part B Improvement Act, sections 201 and 202 H.R. 3168, Legislation to reauthorize Special Needs Plans, all provisions

Client expense: $1,340,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Veterans Affairs, Dept of (VA)

H.R. 5942/S. 3090 Dialysis PATIENT Demonstration Act of 2016; all provisions (bill number for 114th Congress) CMS-3317-IFC, Conditions for Coverage for End-Stage Renal Disease Facilities-Third Party Payment H.R. 2507, The Increasing Regulatory Fairness Act; all provisions (bill number from 114th Congress) Comprehensive reforms to meaningful use; stage 3 meaningful use proposed rule CMS ESRD benchmark calculation CMS regulations pertaining to reimbursement rates for ESRD-related services CMS survey and certification of kidney dialysis centers CMS vascular care rate change proposal CMS/Medicare Advantage ESRD rate formulation S. 870, Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act H.R. 2644, Chronic Kidney Disease Improvement in Research and Treatment Act, all provisions H.R. 2556 and S. 1016, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act, all provisions H.R. 3178, Medicare Part B Improvement Act, sections 201 and 202 H.R. 3168, Legislation to reauthorize Special Needs Plans, all provisions

Client expense: $1,340,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Veterans Affairs, Dept of (VA)

Issues related to H.R. 5942/S. 3090, the Dialysis Patient Access To Integrated-care, Empowerment, Nephrologists, Treatment, and Services Demonstration Act of 2016 (bill number from 114th Congress)

Client expense: Not reported · Firm income: $10,000

Government targets: HOUSE OF REPRESENTATIVES

Issues related to H.R. 5942/S. 3090, the Dialysis Patient Access To Integrated-care, Empowerment, Nephrologists, Treatment, and Services Demonstration Act of 2016 (bill number from 114th Congress)

Client expense: Not reported · Firm income: Not reported

H.R. 5942/S. 3090 Dialysis PATIENT Demonstration Act of 2016; all provisions (bill number for 114th Congress) Conditions for Coverage for End-Stage Renal Disease (ESRD) Facilities-Third Party Payment (CMS-3317-IFC) H.R. 2507 The Increasing Regulatory Fairness Act; all provisions (bill number from 114th Congress) S. 2484 CONNECT for Health Act; all provisions (bill number from 114th Congress) Comprehensive reforms to meaningful use; stage 3 meaningful use proposed rule CMS ESRD benchmark calculation CMS regulations pertaining to reimbursement rates for ESRD-related services CMS survey and certification of kidney dialysis centers CMS vascular care rate change proposal CMS/Medicare Advantage ESRD rate formulation

Client expense: $1,050,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Veterans Affairs, Dept of (VA)

H.R. 5942/S. 3090 Dialysis PATIENT Demonstration Act of 2016; all provisions (bill number for 114th Congress) Conditions for Coverage for End-Stage Renal Disease Facilities-Third Party Payment (CMS-3317-IFC) H.R. 2507 The Increasing Regulatory Fairness Act; all provisions (bill number from 114th Congress) S. 2484 CONNECT for Health Act; all provisions (bill number from 114th Congress) Comprehensive reforms to meaningful use; stage 3 meaningful use proposed rule CMS ESRD benchmark calculation CMS regulations pertaining to reimbursement rates for ESRD-related services CMS survey and certification of kidney dialysis centers CMS vascular care rate change proposal CMS/Medicare Advantage ESRD rate formulation

Client expense: $1,050,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Veterans Affairs, Dept of (VA)

Healthcare reimbursement policy. H.R. 1130, Chronic Kidney Disease Improvement in Research and Treatment Act of 2015. H.R. 2579, Securing Care for Seniors Act of 2015. H.R. 5659, ESRD Choice Act of 2016 H.R. 5942/S. 3090, Dialysis Patient Access To Integrated-care, Empowerment, Nephrologists, Treatment, and Services Demonstration Act of 2016 H.R. 5506, Dialysis PATIENT Demonstration Act of 2016

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 34, 21st Century Cures Act (Upton) - Medicare Advantage and Medicaid issues H.R. 546, ACE Kids Act (Barton) - Medicaid Childrens Care Coordination Program 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. 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. 3718, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Roskam-Carney) - reducing fraud H.R. 3716, Ensuring Access to Quality Medicaid Providers Act (Bucshon) - oversight of terminated Medicaid providers H.R. 4275, Medicare Advantage Quality Payment Relief Act (Kelly) - calculation of MA benchmark cap H.R. 4442, CONNECT for Health Act (Black-Welch) - telehealth, remote patient monitoring services H.R. 4589, Excellence in Medicare Act (MacArthur) - MA payment cap H.R. 5273, Helping Hospitals Improve Patient Care Act (Tiberi) - MA issues, site-neutral payments H.R. 5506, Dialysis PATIENT Demonstration Act (Young) - demonstration program for Medicare beneficiaries with ESRD H.R. 5659, ESRD Choice Act (Smith) - option for ESRD patients to enroll in MA plans H.R. 5942, Dialysis PATIENTS Demonstration Act (Young) - demonstration program for Medicare beneficiaries with ESRD H.R. 6265, Medigap Reforms (McDermott) S. 298, ACE Kids Act (Grassley) - Medicaid Childrens Care Coordination Program S. 524, Comprehensive Addiction and Recovery Act (Whitehouse) - Medicare Part D lock-in programs 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. 1913, Stopping Medication Abuse and Protecting Seniors Act (Toomey) - Medicare Part D lock-in programs S. 2104, Preserving Medicare Advantage for all Medicare Beneficiaries Act (Portman-Casey) - preventing certain MA plan terminations, MA demonstration program S. 2349, Medicare Advantage Coverage Transparency Act (Heller) - MA enrollment data S. 2484, CONNECT for Health Act (Schatz-Wicker) - telehealth, remote patient monitoring services S. 2864, RxCAP Act (Wyden) - Medicare Part D cost-sharing S. 3090, Dialysis PATIENT Demonstration Act (Heller) - demonstration program for Medicare beneficiaries with ESRD S. 3504, Chronic Care Act (Hatch-Wyden-Isakson-Warner) - chronic care reforms, Medicare Advantage provisions Regulatory Issues: Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, network adequacy and provider directories, 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, Part D direct and indirect remuneration (DIR), 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, enrollment rules, requirements for notice and denial forms, 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 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); CMS's proposed Part B drug demonstration program; Medication Therapy Management Program requirements and the Center for Medicare and Medicaid Innovation (CMMI) Demonstration; MA EGWP issues; CMMI's value-based insurance design (VBID) demonstration; 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; 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; new payment system for physicians under MACRA, including implications for MA and Part D plans; Medicare clinical trials; Medicare/Medicaid integration for dual eligibles, including implementation of the Capitated Financial Alignment Demonstration and related issues (e.g., quality ratings); Medicaid managed care regulations and policies, including CMS' proposed substantial revisions to the managed care regulations, new mental health parity rules, 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 Medicaid Managed long-term care including home and community-based waiver services (HCBS); expanding the availability of Medicare Advantage and Medicaid health plan telemedicine programs; implications of the new non-discrimination rules for health plans participating in public programs; 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; issues relating to enrollment of beneficiaries with ESRD into MA plans; socioeconomic status impacts on star ratings related to MA and Part D programs; and other issues relating to health care reform implementation. *Add MACPAC to Agency List.

Client expense: $1,330,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of Personnel Management (OPM), SENATE, Treasury, Dept of, White House Office

H.R. 34 21st Century Cures Act (Provisions relating to ESRD Choice Act) H.R. 5506/ H.R. 5942/S. 3090 Dialysis PATIENT Demonstration Act of 2016 (All provisions) H.R. 5659 ESRD Choice Act of 2016 (All provisions) Conditions for Coverage for End-Stage Renal Disease Facilities-Third Party Payment (CMS-3317-IFC) H.R. 270 Flexibility in Health IT Reporting Act (All provisions) S. 598 Chronic Kidney Disease Improvement in Research and Treatment Act of 2015 (All provisions) H.R. 1130 Chronic Kidney Disease Improvement in Research and Treatment Act of 2015 (All provisions) S. 776 Medication Therapy Management Empowerment Act of 2015 (All provisions) H.R. 244 MAC Transparency Act (All provisions) H.R. 2507 The Increasing Regulatory Fairness Act (All provisions) S. 2484 CONNECT for Health Act (All provisions) Comprehensive reforms to meaningful use; stage 3 meaningful use proposed rule CMS regulations related to the treatment of Medicare Part C and Part D CMS regulations pertaining to reimbursement rates for ESRD-related services CMS survey and certification of kidney dialysis centers CMS vascular care rate change proposal CMS/Medicare Advantage ESRD rate formulation

Client expense: $720,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Veterans Affairs, Dept of (VA)

Issues regarding care for chronic diseases, including telehealth and remote monitoring of home dialysis patients. Issues concerning reimbursement for home hemodialysis. H.R. 5659, The ESRD Choice Act of 2016, H.R. 5942, Dialysis Patient Access To Integrated-care, Empowerment, Nephrologists, Treatment, and Services Demonstration Act of 2016; S. 3090, Patient Access To Integrated-care, Empowerment, Nephrologists and Treatment Demonstration Act of 2016.

Client expense: Not reported · Firm income: $45,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

The Protecting Access to Medicare Act of 2014 (Pub. L. 113-93); The Budget Control Act of 2011 (Pub. L. 112-25); The Patient Protection and Affordable Care Act (Pub. L. 111-148); The Health Care and Education Reconciliation Act of 2010 (Pub. L. 111-152); The American Taxpayer Relief Act of 2012 (Pub. L. 112-240); Medicare Program; End-Stage Renal Disease Prospective Payment System, Quality Incentive Program, and Durable Medical Equipment, Prosthetics, Orthotics, and Supplies; Proposed Rule [CMS-1614-P]; CMS Transmittal 171, CR 8271 Revisions to Medicare Benefit Policy Manual; Centers for Medicare & Medicaid Services, Letter to Issuers on Federally-facilitated Marketplace (Issues related to Marketplace Development); The Achieving a Better Life Experience Act of 2014 (ABLE Act of 2014); the Medicare Access and CHIP Reauthorization Act of 2015 (H.R.1458); HHS Notice of Benefit and Payment Parameters for 2017, Final 2017 Letter to Issuers in the Federally-facilitated Marketplaces; The Dialysis PATIENT Act (S. 3090, H.R. 5506); The End Stage Renal Disease Choice Act (H.R. 5659); CMS 3337-ATII Medicare Program: Conditions for Coverage for End Stage Renal Disease - Third Party Payment; 21st Century Cures Act (H.R.6).

Client expense: Not reported · Firm income: $100,000

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

The Protecting Access to Medicare Act of 2014 (Pub. L. 113-93); The Budget Control Act of 2011 (Pub. L. 112-25); The Patient Protection and Affordable Care Act (Pub. L. 111-148); The Health Care and Education Reconciliation Act of 2010 (Pub. L. 111-152); The American Taxpayer Relief Act of 2012 (Pub. L. 112-240); Medicare Program; End-Stage Renal Disease Prospective Payment System, Quality Incentive Program, and Durable Medical Equipment, Prosthetics, Orthotics, and Supplies; Proposed Rule [CMS-1614-P]; CMS Transmittal 171, CR 8271 Revisions to Medicare Benefit Policy Manual; Centers for Medicare & Medicaid Services, Letter to Issuers on Federally-facilitated Marketplace (Issues related to Marketplace Development); The Achieving a Better Life Experience Act of 2014 (ABLE Act of 2014); the Medicare Access and CHIP Reauthorization Act of 2015 (H.R.1458); HHS Notice of Benefit and Payment Parameters for 2017, Final 2017 Letter to Issuers in the Federally-facilitated Marketplaces; The Dialysis PATIENT Act (S. 3090, H.R. 5506); The End Stage Renal Disease Choice Act (H.R. 5659); CMS 3337-ATII Medicare Program: Conditions for Coverage for End Stage Renal Disease - Third Party Payment; 21st Century Cures Act (H.R.6).

Client expense: Not reported · Firm income: $100,000

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

The Protecting Access to Medicare Act of 2014 (Pub. L. 113-93); The Budget Control Act of 2011 (Pub. L. 112-25); The Patient Protection and Affordable Care Act (Pub. L. 111-148); The Health Care and Education Reconciliation Act of 2010 (Pub. L. 111-152); The American Taxpayer Relief Act of 2012 (Pub. L. 112-240); Medicare Program; End-Stage Renal Disease Prospective Payment System, Quality Incentive Program, and Durable Medical Equipment, Prosthetics, Orthotics, and Supplies; Proposed Rule [CMS-1614-P]; CMS Transmittal 171, CR 8271 Revisions to Medicare Benefit Policy Manual; Centers for Medicare & Medicaid Services, Letter to Issuers on Federally-facilitated Marketplace (Issues related to Marketplace Development); The Achieving a Better Life Experience Act of 2014 (ABLE Act of 2014); the Medicare Access and CHIP Reauthorization Act of 2015 (H.R.1458); HHS Notice of Benefit and Payment Parameters for 2017, Final 2017 Letter to Issuers in the Federally-facilitated Marketplaces; The Dialysis PATIENT Act (S. 3090, H.R. 5506); The End Stage Renal Disease Choice Act (H.R. 5659); CMS 3337-ATII Medicare Program: Conditions for Coverage for End Stage Renal Disease - Third Party Payment; 21st Century Cures Act (H.R.6).

Client expense: Not reported · Firm income: $40,000

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

Implementation of the Protecting Access to Medicare Act of 2014 (Pub. L. 113-93); The Budget Control Act of 2011 (Pub. L. 112-25); Implementation of the Patient Protection and Affordable Care Act (Pub. L. 111-148); The Health Care and Education Reconciliation Act of 2010 (Pub. L. 111-152); The American Taxpayer Relief Act of 2012 (Pub. L. 112-240); Medicare Program; End-Stage Renal Disease Prospective Payment System, Quality Incentive Program, and Durable Medical Equipment, Prosthetics, Orthotics, and Supplies; Proposed Rule [CMS-1614-P]; CMS Transmittal 171, CR 8271 Revisions to Medicare Benefit Policy Manual; Centers for Medicare & Medicaid Services, Letter to Issuers on federally-facilitated Marketplace (Issues related to Marketplace Development); The Achieving a Better Life Experience Act of 2014 (ABLE Act of 2014); The Medicare Access and CHIP Reauthorization Act of 2015 (H.R. 1458); HHS Notice of Benefit and Payment Parameters for 2017, Final 2017 Letter to Issuers in the Federally-facilitated Marketplaces; The Dialysis PATIENT Act (S. 3090, H.R. 5506); The ERSD Choice Act (H.R. 5659); Issues related to ERSD Program; S. 598 and H.R. 1130, the Chronic Kidney Disease Improvement in Research and Treatment Act of 2015; Medicare Advantage; Senate Finance Committee Chronic Care Working Group; Integrated care legislation; Access to coverage in Health Insurance Marketplaces for ESRD; Implementation of Pub. L. 114-27, the Trade Preferences Extension Act of 2015; OCR anti-discrimination proposed and final rules; ERSD quality programs; ERSD payment rules.

Client expense: $270,000 · Firm income: Not reported

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

Implementation of the Protecting Access to Medicare Act of 2014 (Pub. L. 113-93); The Budget Control Act of 2011 (Pub. L. 112-25); Implementation of the Patient Protection and Affordable Care Act (Pub. L. 111-148); The Health Care and Education Reconciliation Act of 2010 (Pub. L. 111-152); The American Taxpayer Relief Act of 2012 (Pub. L. 112-240); Medicare Program; End-Stage Renal Disease Prospective Payment System, Quality Incentive Program, and Durable Medical Equipment, Prosthetics, Orthotics, and Supplies; Proposed Rule [CMS-1614-P]; CMS Transmittal 171, CR 8271 Revisions to Medicare Benefit Policy Manual; Centers for Medicare & Medicaid Services, Letter to Issuers on federally-facilitated Marketplace (Issues related to Marketplace Development); The Achieving a Better Life Experience Act of 2014 (ABLE Act of 2014); The Medicare Access and CHIP Reauthorization Act of 2015 (H.R. 1458); HHS Notice of Benefit and Payment Parameters for 2017, Final 2017 Letter to Issuers in the Federally-facilitated Marketplaces; The Dialysis PATIENT Act (S. 3090, H.R. 5506); The ERSD Choice Act (H.R. 5659); Issues related to ERSD Program; S. 598 and H.R. 1130, the Chronic Kidney Disease Improvement in Research and Treatment Act of 2015; Medicare Advantage; Senate Finance Committee Chronic Care Working Group; Integrated care legislation; Access to coverage in Health Insurance Marketplaces for ESRD; Implementation of Pub. L. 114-27, the Trade Preferences Extension Act of 2015; OCR anti-discrimination proposed and final rules; ERSD quality programs; ERSD payment rules.

Client expense: $270,000 · Firm income: Not reported

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

- Medicare payment for End Stage Renal Disease (ESRD) and Medicare Advantage Issues - H.R. 5506/S. 3090, the Dialysis PATIENT Demo Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Survey and certification delays for dialysis facilities and policies related to Medicare payment, including H.R.5942/S.3090, the Dialysis PATIENT Demonstration Act and H.R.5659, the ESRD Choice Act of 2016, and policies related to third party payments.

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

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

Implementation of P.L. 114-10 (Medicare Access and CHIP Reauthorization Act of 2015) - provisions related to provider participation in MIPS and APM programs; all provisions related to Medicare Advantage participation. H.R. 34 (21st Century Cures Act) - all provisions relating to Medicare Advantage Star Ratings; mental health in Medicaid and Medicare; end stage renal disease (ESRD). House Republican Leadership Task Force Proposal on Medicare and Medicaid (A Better Way) - all provisions relating to Medicare and Medicaid. H.R. 2646 (Helping Families in Mental Health Crisis Act) - all provisions relating to Medicaid and Medicare. S. 2680 (Mental Health Reform Act) - all provisions relating to Medicaid and Medicare. H.R. 5506 and S. 3090 (Dialysis PATIENT Demonstration Act) - all provisions relating to establishing a demonstration project to provide integrated care for Medicare beneficiaries with end-stage renal disease. H.R. 5659 (ESRD Choice Act) - all provisions relating to expanding Medicare Advantage coverage for individuals with end-stage renal disease. Advocated for Medicaid Managed care in any effort to reform the Medicaid program.

Client expense: $260,000 · Firm income: Not reported

Government targets: Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, SENATE

Urge Congress to open Medicare Advantage to dialysis patients (HR 5659); Support ESRD care coordination legislation - the Dialysis PATIENTS Act (HR 5506/S 3090); Encourage support for to improve kidney disease research and treatment (HR 1130/S 598); Protect Medicare funding for dialysis patients; Improve access to home dialysis treatment; and Ensure ESRD patients retain access to commercial insurance.

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

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

End stage renal disease (ESRD) Medicare reimbursement and payment reform. ESRD Quality measurement. Improved policies for Chronic Kidney Disease (CKD). Transplant Initiatives. Dialysis PATIENT Demonstration Act (H.R. 5506/S. 3090/H.R. 5942) ESRD Choice Act (H.R. 5659) Medicare Third Party Payment

Client expense: Not reported · Firm income: $20,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

End stage renal disease (ESRD) rebasing, Medicare reimbursement and payment reform. CMS's Center for Medicare and Medicaid Innovation's comprehensive ESRD Care Initiative and improving overall ESRD patient health quality. Improved policies on chronic kidney disease. Chronic care management reform legislation. ESRD Integrated Care legislation. Transplant Initiatives. Implementation of the Medicare Access and CHIP Reauthorization Act. Living Donor Protection Act (H.R. 4616/S. 2584) ESRD Choice Act (H.R. 5659) Dialysis PATIENT Demonstration Act (H.R. 5506/S. 3090/H.R. 5942) Creating High-Quality Results & Outcomes Necessary to Improve Chronic (CHRONIC) Care Act (S. 3504) 21st Century Cures Act, provisions related to ESRD coverage in Medicare Advantage Medicare Third Party Payment

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), Natl Economic Council (NEC), Office of Science & Technology Policy (OSTP), SENATE

End stage renal disease (ESRD) rebasing, Medicare reimbursement and payment reform. CMS's Center for Medicare and Medicaid Innovation's comprehensive ESRD Care Initiative and improving overall patient health quality. Improved policies on chronic kidney disease. Chronic Care management reform legislation. ESRD Integrated Care Legislation. Transplant Initiatives. Living Donor Protection Act (H.R. 4616/S. 2584) ESRD Choice Act (H.R. 5659) Dialysis PATIENT Demonstration Act (H.R. 5506/S. 3090/H.R. 5942) Implementation of the Medicare Access and CHIP Reauthorization Act Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act(S. 3504) 21st Century Cures Act, provisions related to ESRD coverage in Medicare Advantage

Client expense: Not reported · Firm income: $20,000

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

S. 3090 and House draft of FY 2017 Labor, Health and Human Services and Education appropriations bill; H.R. 5293/S3000 FY 2017 Defense appropriations bill, issues related to malaria, infectious disease, public health research and development and scientific conference attendance; S 3117 and House draft of FY 2017 State and Foreign operations appropriations bill, issues related to malaria and global health programs; H.R. 2577 Military Construction and Veteran Affairs appropriations provisions related to Zika funding; Funding for Zika prevention and control; FY 2018 global health research and development funding.

Client expense: Not reported · Firm income: $30,000

Government targets: SENATE

S. 3090 and House draft of FY 2017 Labor, Health and Human Services and Education appropriations bill; H.R. 5293/S3000 FY 2017 Defense appropriations bill, issues related to malaria, infectious disease, public health research and development and scientific conference attendance; S 3117 and House draft of FY 2017 State and Foreign operations appropriations bill, issues related to malaria and global health programs; H.R. 2577 Military Construction and Veteran Affairs appropriations provisions related to Zika funding; Funding for Zika prevention and control; FY 2018 global health research and development funding.

Client expense: Not reported · Firm income: $30,000

Government targets: SENATE

S. 3504 - Creating High Quality Results and Outcome Necessary to Improve Chronic Care Act of 2016 - Issues related to ESRD, palliative care, telemedicine and other issues related to better serving Medicare beneficiaries with End Stage Renal Disease. H.R.1130/S.598 - Chronic Kidney Disease Improvement in Research and Treatment Act of 2015 - Issues related to giving ESRD patients greater choice in their Medicare coverage. H.R.5506/S. 3090 - Dialysis PATIENT Demonstration Act - legislation to create a comprehensive care model for individuals living with End Stage Renal Disease. Work on current and potential demonstration projects in Medicare to support better integration of care for ESRD patients with both CMS and Members of Congress. Issues focused on ESRD and Risk Adjustment for chronically ill patients and related work being conducted by the Senate Finance Committee. Legislative and Administrative actions related to factoring in Socio Economic Status into policies impacting all beneficiaries and their providers.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 3504 - Creating High Quality Results and Outcome Necessary to Improve Chronic Care Act of 2016 - Issues related to ESRD, palliative care, telemedicine and other issues related to better serving Medicare beneficiaries with End Stage Renal Disease. H.R.1130/S.598 - Chronic Kidney Disease Improvement in Research and Treatment Act of 2015 - Issues related to giving ESRD patients greater choice in their Medicare coverage. H.R.5506/S. 3090 - Dialysis PATIENT Demonstration Act - legislation to create a comprehensive care model for individuals living with End Stage Renal Disease. Work on current and potential demonstration projects in Medicare to support better integration of care for ESRD patients with both CMS and Members of Congress. Issues focused on ESRD and Risk Adjustment for chronically ill patients and related work being conducted by the Senate Finance Committee. CMS policies related to Medicare Advantage with specific focus on the formula asserted for the Medicare Advantage Risk Adjustment factor and its impact on beneficiaries, plans and providers who serve Medicare Beneficiaries who live with multiple chronic conditions. Legislative and Administrative actions related to factoring in SocioEconomic Status into policies impacting all beneficiaries and their providers.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 5506 and H.R. 5659, Medicare coverage of End-Stage Renal Disease (ESRD). The ESRD Seamless Care Organizations (ESCO), and Chronic Care and Integrated Kidney Care. S. 3090, The Patient Access To Integrated-care, Empowerment, Nephrologists and Treatment Demonstration Act of 2016. H.R. 5942, ERSD Patient Act.

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

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

Implementation of the Protecting Access to Medicare Act of 2014 (Pub. L. 113-93); The Budget Control Act of 2011 (Pub. L. 112-25); Implementation of the Patient Protection and Affordable Care Act (Pub. L. 111-148); The Health Care and Education Reconciliation Act of 2010 (Pub. L. 111-152); The American Taxpayer Relief Act of 2012 (Pub. L. 112-240); Medicare Program; End-Stage Renal Disease Prospective Payment System, Quality Incentive Program, and Durable Medical Equipment, Prosthetics, Orthotics, and Supplies; Proposed Rule [CMS-1614-P]; CMS Transmittal 171, CR 8271 Revisions to Medicare Benefit Policy Manual; Centers for Medicare & Medicaid Services, Letter to Issuers on federally-facilitated Marketplace (Issues related to Marketplace Development); The Achieving a Better Life Experience Act of 2014 (ABLE Act of 2014); The Medicare Access and CHIP Reauthorization Act of 2015 (H.R. 1458); HHS Notice of Benefit and Payment Parameters for 2017, Final 2017 Letter to Issuers in the Federally-facilitated Marketplaces; The Dialysis PATIENT Act (S. 3090, H.R. 5506); The ERSD Choice Act (H.R. 5659); Issues related to ERSD Program; S. 598 and H.R. 1130, the Chronic Kidney Disease Improvement in Research and Treatment Act of 2015; Medicare Advantage; Senate Finance Committee Chronic Care Working Group; Integrated care legislation; Access to coverage in Health Insurance Marketplaces for ESRD; Implementation of Pub. L. 114-27, the Trade Preferences Extension Act of 2015; OCR anti-discrimination proposed and final rules; ERSD quality programs; ERSD payment rules.

Client expense: $230,000 · Firm income: Not reported

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

Implementation of the Protecting Access to Medicare Act of 2014 (Pub. L. 113-93); The Budget Control Act of 2011 (Pub. L. 112-25); Implementation of the Patient Protection and Affordable Care Act (Pub. L. 111-148); The Health Care and Education Reconciliation Act of 2010 (Pub. L. 111-152); The American Taxpayer Relief Act of 2012 (Pub. L. 112-240); Medicare Program; End-Stage Renal Disease Prospective Payment System, Quality Incentive Program, and Durable Medical Equipment, Prosthetics, Orthotics, and Supplies; Proposed Rule [CMS-1614-P]; CMS Transmittal 171, CR 8271 Revisions to Medicare Benefit Policy Manual; Centers for Medicare & Medicaid Services, Letter to Issuers on federally-facilitated Marketplace (Issues related to Marketplace Development); The Achieving a Better Life Experience Act of 2014 (ABLE Act of 2014); The Medicare Access and CHIP Reauthorization Act of 2015 (H.R. 1458); HHS Notice of Benefit and Payment Parameters for 2017, Final 2017 Letter to Issuers in the Federally-facilitated Marketplaces; The Dialysis PATIENT Act (S. 3090, H.R. 5506); The ERSD Choice Act (H.R. 5659); Issues related to ERSD Program; S. 598 and H.R. 1130, the Chronic Kidney Disease Improvement in Research and Treatment Act of 2015; Medicare Advantage; Senate Finance Committee Chronic Care Working Group; Integrated care legislation; Access to coverage in Health Insurance Marketplaces for ESRD; Implementation of Pub. L. 114-27, the Trade Preferences Extension Act of 2015; OCR anti-discrimination proposed and final rules; ERSD quality programs; ERSD payment rules.

Client expense: $230,000 · Firm income: Not reported

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

H.R. 546, ACE Kids Act (Barton) - Medicaid Childrens Care Coordination Program 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. 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. 3718, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Roskam-Carney) - reducing fraud H.R. 3716, Ensuring Access to Quality Medicaid Providers Act (Bucshon) - oversight of terminated Medicaid providers H.R. 4275, Medicare Advantage Quality Payment Relief Act (Kelly) - calculation of MA benchmark cap H.R. 4442, CONNECT for Health Act (Black-Welch) - telehealth, remote patient monitoring services H.R. 4589, Excellence in Medicare Act (MacArthur) - MA payment cap H.R. 5273, Helping Hospitals Improve Patient Care Act (Tiberi) - MA issues, site-neutral payments H.R. 5506, Dialysis PATIENT Demonstration Act (Young) - demonstration program for Medicare beneficiaries with ESRD H.R. 5659, ESRD Choice Act (Smith) - option for ESRD patients to enroll in MA plans H.R. 5942, Dialysis PATIENTS Demonstration Act (Young) - demonstration program for Medicare beneficiaries with ESRD H.R. 6265, Medigap Reforms (McDermott) S. 298, ACE Kids Act (Grassley) - Medicaid Childrens Care Coordination Program S. 524, Comprehensive Addiction and Recovery Act (Whitehouse) - Medicare Part D lock-in programs 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. 1913, Stopping Medication Abuse and Protecting Seniors Act (Toomey) - Medicare Part D lock-in programs S. 2104, Preserving Medicare Advantage for all Medicare Beneficiaries Act (Portman-Casey) - preventing certain MA plan terminations, MA demonstration program S. 2349, Medicare Advantage Coverage Transparency Act (Heller) - MA enrollment data S. 2484, CONNECT for Health Act (Schatz-Wicker) - telehealth, remote patient monitoring services S. 2864, RxCAP Act (Wyden) - Medicare Part D cost-sharing S. 3090, Dialysis PATIENT Demonstration Act (Heller) - demonstration program for Medicare beneficiaries with ESRD Regulatory Issues: Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, network adequacy and provider directories, 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, Part D direct and indirect remuneration (DIR), 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, enrollment rules, requirements for notice and denial forms, 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 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); CMS's proposed Part B drug demonstration program; Medication Therapy Management Program requirements and the Center for Medicare and Medicaid Innovation (CMMI) Demonstration; MA EGWP issues; CMMI's value-based insurance design (VBID) demonstration; 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; 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; new payment system for physicians under MACRA, including implications for MA and Part D plans; Medicare clinical trials; Medicare/Medicaid integration for dual eligibles, including implementation of the Capitated Financial Alignment Demonstration and related issues (e.g., quality ratings); Medicaid managed care regulations and policies, including CMS' proposed substantial revisions to the managed care regulations, new mental health parity rules, 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 Medicaid Managed long-term care including home and community-based waiver services (HCBS); expanding the availability of Medicare Advantage and Medicaid health plan telemedicine programs; implications of the new non-discrimination rules for health plans participating in public programs; 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; issues relating to enrollment of beneficiaries with ESRD into MA plans; socioeconomic status impacts on star ratings related to MA and Part D programs; and other issues relating to health care reform implementation.

Client expense: $1,710,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE, Treasury, Dept of, White House Office

H.R. 546 and S. 298, ACE Kids Act, all provisions regarding care of children with complex medical needs. H.R. 2646, Helping Families in Mental Health Crisis Act, all provisions relating to Medicaid and Medicare. S. 2680, Mental Health Reform Act, all provisions relating to Medicaid and Medicare. H.R. 5506 and S. 3090, Dialysis PATIENT Demonstration Act, all provisions relating to establishing a demonstration project to provide integrated care for Medicare beneficiaries with end-stage renal disease. H.R. 5659, ESRD Choice Act, all provisions relating to expanding Medicare Advantage coverage for individuals with end-stage renal disease. Advocated for Medicaid Managed care in an effort to reform the Medicaid program. S. 524, Comprehensive Addiction and Recovery Act, all provisions relating to opioids in Medicare and Medicaid.

Client expense: $260,000 · Firm income: Not reported

Government targets: Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, SENATE

Survey and certification delays for dialysis facilities and policies related to Medicare payment, including H.R.5942/S.3090, the Dialysis PATIENT Demonstration Act and H.R.5659, the ESRD Choice Act of 2016.

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

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

Issues regarding care for chronic diseases, including telehealth and remote monitoring of home dialysis patients. Issues concerning reimbursement for home hemodialysis. H.R. 5659, The ESRD Choice Act of 2016, H.R. 5942, Dialysis Patient Access To Integrated-care, Empowerment, Nephrologists, Treatment, and Services Demonstration Act of 2016; S. 3090, Patient Access To Integrated-care, Empowerment, Nephrologists and Treatment Demonstration Act of 2016.

Client expense: Not reported · Firm income: $45,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

The Protecting Access to Medicare Act of 2014 (Pub. L. 113-93); The Budget Control Act of 2011 (Pub. L. 112-25); The Patient Protection and Affordable Care Act (Pub. L. 111-148); The Health Care and Education Reconciliation Act of 2010 (Pub. L. 111-152); The American Taxpayer Relief Act of 2012 (Pub. L. 112-240); Medicare Program; End-Stage Renal Disease Prospective Payment System, Quality Incentive Program, and Durable Medical Equipment, Prosthetics, Orthotics, and Supplies; Proposed Rule [CMS-1614-P]; CMS Transmittal 171, CR 8271 Revisions to Medicare Benefit Policy Manual; Centers for Medicare & Medicaid Services, Letter to Issuers on Federally-facilitated Marketplace (Issues related to Marketplace Development); The Achieving a Better Life Experience Act of 2014 (ABLE Act of 2014); the Medicare Access and CHIP Reauthorization Act of 2015 (H.R.1458); HHS Notice of Benefit and Payment Parameters for 2017, Final 2017 Letter to Issuers in the Federally-facilitated Marketplaces; The Dialysis PATIENT Act (S. 3090, H.R. 5506); The ESRD Choice Act (H.R. 5659).

Client expense: Not reported · Firm income: $90,000

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

The Protecting Access to Medicare Act of 2014 (Pub. L. 113-93); The Budget Control Act of 2011 (Pub. L. 112-25); The Patient Protection and Affordable Care Act (Pub. L. 111-148); The Health Care and Education Reconciliation Act of 2010 (Pub. L. 111-152); The American Taxpayer Relief Act of 2012 (Pub. L. 112-240); Medicare Program; End-Stage Renal Disease Prospective Payment System, Quality Incentive Program, and Durable Medical Equipment, Prosthetics, Orthotics, and Supplies; Proposed Rule [CMS-1614-P]; CMS Transmittal 171, CR 8271 Revisions to Medicare Benefit Policy Manual; Centers for Medicare & Medicaid Services, Letter to Issuers on Federally-facilitated Marketplace (Issues related to Marketplace Development); The Achieving a Better Life Experience Act of 2014 (ABLE Act of 2014); the Medicare Access and CHIP Reauthorization Act of 2015 (H.R.1458); HHS Notice of Benefit and Payment Parameters for 2017, Final 2017 Letter to Issuers in the Federally-facilitated Marketplaces; The Dialysis PATIENT Act (S. 3090, H.R. 5506); The ESRD Choice Act (H.R. 5659).

Client expense: Not reported · Firm income: $90,000

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

The Protecting Access to Medicare Act of 2014 (Pub. L. 113-93); The Budget Control Act of 2011 (Pub. L. 112-25); The Patient Protection and Affordable Care Act (Pub. L. 111-148); The Health Care and Education Reconciliation Act of 2010 (Pub. L. 111-152); The American Taxpayer Relief Act of 2012 (Pub. L. 112-240); Medicare Program; End-Stage Renal Disease Prospective Payment System, Quality Incentive Program, and Durable Medical Equipment, Prosthetics, Orthotics, and Supplies; Proposed Rule [CMS-1614-P]; CMS Transmittal 171, CR 8271 Revisions to Medicare Benefit Policy Manual; Centers for Medicare & Medicaid Services, Letter to Issuers on Federally-facilitated Marketplace (Issues related to Marketplace Development); The Achieving a Better Life Experience Act of 2014 (ABLE Act of 2014); the Medicare Access and CHIP Reauthorization Act of 2015 (H.R.1458); HHS Notice of Benefit and Payment Parameters for 2017, Final 2017 Letter to Issuers in the Federally-facilitated Marketplaces; The Dialysis PATIENT Act (S. 3090, H.R. 5506); The ESRD Choice Act (H.R. 5659).

Client expense: Not reported · Firm income: $40,000

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

H.R. 5506/ H.R. 5942/S. 3090 Dialysis PATIENT Demonstration Act of 2016 (All provisions) H.R. 5659 ESRD Choice Act of 2016 (All provisions) H.R. 270 Flexibility in Health IT Reporting Act (All provisions) S. 598 Chronic Kidney Disease Improvement in Research and Treatment Act of 2015 (All provisions) H.R. 1130 Chronic Kidney Disease Improvement in Research and Treatment Act of 2015 (All provisions) S. 776 Medication Therapy Management Empowerment Act of 2015 (All provisions) H.R. 244 MAC Transparency Act (All provisions) H.R. 2507 The Increasing Regulatory Fairness Act (All provisions) S. 2484 CONNECT for Health Act (All provisions) Comprehensive reforms to meaningful use; stage 3 meaningful use proposed rule CMS regulations related to the treatment of Medicare Part C and Part D CMS regulations pertaining to reimbursement rates for ESRD-related services CMS survey and certification of kidney dialysis centers CMS vascular care rate change proposal CMS/Medicare Advantage ESRD rate formulation

Client expense: $650,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Veterans Affairs, Dept of (VA)

H.R.1130/S.598 - Chronic Kidney Disease Improvement in Research and Treatment Act of 2015 - Issues related to giving ESRD patients greater choice in their Medicare coverage. H.R.5506/S. 3090 - Dialysis PATIENT Demonstration Act - legislation to create a comprehensive care model for individuals living with End Stage Renal Disease. Work on current and potential demonstration projects in Medicare to support better integration of care for ESRD patients with both CMS and Members of Congress. Issues focused on ESRD and Risk Adjustment for chronically ill patients and related work being conducted by the Senate Finance Committee. CMS policies related to Medicare Advantage with specific focus on the formula asserted for the Medicare Advantage Risk Adjustment factor and its impact on beneficiaries, plans and providers who serve Medicare Beneficiaries who live with multiple chronic conditions. Legislative and Administrative actions related to factoring in SocioEconomic Status into policies impacting all beneficiaries and their providers.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.1130/S.598 - Chronic Kidney Disease Improvement in Research and Treatment Act of 2015 - Issues related to giving ESRD patients greater choice in their Medicare coverage. H.R.5506/S. 3090 - Dialysis PATIENT Demonstration Act - legislation to create a comprehensive care model for individuals living with End Stage Renal Disease. Work on current and potential demonstration projects in Medicare to support better integration of care for ESRD patients with both CMS and Members of Congress. Issues focused on ESRD and Risk Adjustment for chronically ill patients and related work being conducted by the Senate Finance Committee. Legislative and Administrative actions related to factoring in Socio Economic Status into policies impacting all beneficiaries and their providers.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Urge Congress to open Medicare Advantage to dialysis patients (HR 5659); Support ESRD care coordination legislation - the Dialysis PATIENTS Act (HR 5506/S 3090); Encourage support for to improve kidney disease research and treatment (HR 1130/S 598); Protect Medicare funding for dialysis patients; Improve access to home dialysis treatment; and Ensure ESRD patients retain access to commercial insurance.

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

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

Discussed legislation concerning care delivery models for Medicare beneficiaries with kidney disease (including HR 5506/S 3090) Supported legislation to permit patients with ESRD enrolling in Medicare Advantage Plans (H.R. 5659) Discussed transplantation policy in general Implementation of 2015 TAA/TPA legislation related to AKI care Supported HR1130/S598 (comprehensive kidney care legislation)

Client expense: $20,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), SENATE, Veterans Affairs, Dept of (VA), White House Office