CONNECT for Health Act of 2017

The Improving Access to Medicare Coverage Act of 2019 (H.R. 1682/S. 753) National Defense Authorization Act of 2018 (H.R. 2810) S. AMDT. 621 (H.R. 2810)--Authorization of Physical Therapist Assistants and Occupational Therapy Assistants to Provide Services Under the TRICARE Program Trusted Exchange Framework and Common Agreement (TEFCA) CONNECT for Health Act of 2017 (H.R. 2556/S. 1016) The Laboratory Access for Beneficiaries (LAB) Act of 2019 (H.R. 3584) The Ensuring Access to Quality Complex Rehabilitation Technology Act of 2019 (H.R. 2408) The Protecting Access to Wheelchairs Act of 2019 (H.R. 2293) The Protecting Beneficiary Access to Complex Rehab Technology Act of 2019 (S. 1223) The Beneficiary Education Tools, Telehealth, and Extenders Reauthorization (BETTER) Act of 2019 (H.R.3417) The Creating Opportunities Now and Effective Care Technologies (CONNECT) Act of 2019 (S.2741) The Safeguarding Medicare Access to Respiratory Therapy (SMART) Act of 2019 (H.R.4945)

Client expense: $39,516 · Firm income: Not reported

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

The Improving Access to Medicare Coverage Act of 2019 (H.R. 1682/S. 753) National Defense Authorization Act of 2018 (H.R. 2810) S. AMDT. 621 (H.R. 2810)--Authorization of Physical Therapist Assistants and Occupational Therapy Assistants to Provide Services Under the TRICARE Program Trusted Exchange Framework and Common Agreement (TEFCA) CONNECT for Health Act of 2017 (H.R. 2556/S. 1016) The Laboratory Access for Beneficiaries (LAB) Act of 2019 (H.R. 3584) The Ensuring Access to Quality Complex Rehabilitation Technology Act of 2019 (H.R. 2408) The Protecting Access to Wheelchairs Act of 2019 (H.R. 2293) The Protecting Beneficiary Access to Complex Rehab Technology Act of 2019 (S. 1223)

Client expense: $39,516 · Firm income: Not reported

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

The Improving Access to Medicare Coverage Act of 2019 (H.R. 1682/S. 753) National Defense Authorization Act of 2018 (H.R. 2810) S. AMDT. 621 (H.R. 2810)--Authorization of Physical Therapist Assistants and Occupational Therapy Assistants to Provide Services Under the TRICARE Program Trusted Exchange Framework and Common Agreement (TEFCA) CONNECT for Health Act of 2017 (H.R. 2556/S. 1016 The Reducing Unnecessary Senior Hospitalizations (RUSH) Act of 2018 (H.R. 6502)

Client expense: $39,516 · Firm income: Not reported

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

Implementation/Expansion of CDC Falls Program Implementation of Affordable Care Act - provisions pertaining to Essential Health Benefits & Health Insurance Exchanges AHRQ provisions pertaining to PT Physician self-referra/Stark Law American Cures Act H.R. 930/S.497 Lymphadema Treatment Act Health Information Technology Nominations to PCORI Methodology Committees Medicaid Expansion HR. 1639/S.619 Physical Therapist Workforce & Patient Access Act Physician owned distributerships H.R. 302/S.808 Sports Medicine Licensure Clarity Act MACRA/MIPS APMS IMPACT/PAC reform Network adequacy Insurance Benefit parameters H.R. 1361/S.486 Ensuring Access to Quality CRT Medicare Telehealth Parity Act HR2550 American Healthcare Act of 2017/CONNECT - H.R. 2556/S1016 H.R. 1628 - American Health Care Action of 2017 Opioid Epidemic/Pain Management Better Care Reconciliation Act of 2017 H.R.2066 Promoting Integrity in Medicare H.R. 2063 Opioid Pace Act of 2017 H.R. 5261 Teach Act H.R. 5197 Alto Act H.R. 5686, Medicare Clear Health Options in Care for Enrollees Act H.R. 5773, Preventing Addiction for Susceptible Seniors Act H.R. 5774, Combating Opioid Abuse for Care in Hospitals Act H.R. 5718, Perioperative Reduction for Opioids Act H.R. 5719, Reduce Overprescribing Opioids in Treatment Act H.R. 5722, Dr. Todd Graham Pain Management Improvement Act H.R. 6, Substance-Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act S. 3120, the HEAL Act S. 2680, Opioid Crisis Response Act Association Retirement Plans State Relief and Empowerment Waivers D.O.L Information Collection Request Extensions Health Reimbursement Accounts HR 7217: Improve Act

Client expense: $252,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, Government Accountability Office (GAO), 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, Small Business Administration (SBA), Veterans Affairs, Dept of (VA), White House Office

S.1016-Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2017

Client expense: $549,617 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA)

Essential emergency medication shortages Mental health services for emergency psychiatric patients Price transparency, out-of-network reimbursement of emergency medical services H.Res.906-Congratulating the American College of Emergency Physicians on its 50th anniversary H.R.6-Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act H.R.372-Competetive Health Insurance Reform Act of 2017 H.R.548-Health Care Safety Net Enhancement Act of 2017 H.R.767-Stop, Observe, Ask, and Respond (SOAR) to Health and Wellness Act of 2017 H.R.817-End Surprise Billing Act of 2017 H.R.880-Military Injury Surgical Systems Integrated Operationally Nationwide to Achieve ZERO Preventable Deaths Act H.R.1057-Synthetics Trafficking and Overdose Prevention Act of 2017 H.R.1215-Protecting Access to Care Act of 2017 H.R.1323-Reducing Unnecessary Emergency Room Visits under Medicaid Act H.R.1492-Medical Controlled Substances Transportation Act of 2017 H.R.1565-Saving Lives, Saving Costs Act H.R.1822-Good Samaritan Health Professionals Act of 2017 H.R.1876-Good Samaritan Health Professionals Act of 2017 H.R.2200-Frederick Douglass Trafficking Victims Prevention and Protection Reauthorization Act of 2017 H.R.2410-Sickle Cell Disease Research, Surveillance, Prevention, and Treatment Act of 2017 H.R.2851-Stop the Importation and Trafficking of Synthetic Analogues (SITSA) Act of 2017 H.R.2957-Save Rural Hospitals Act H.R.3181-Medicare Choices Empowerment and Protection Act H.R.3258-Marketplace Certainty Act H.R.3545-Overdose Prevention and Patient Safety (OPPS) Act H.R.4922-Stopping Overdoses of Fentanyl Analogues Act H.R.5176-Preventing Overdoses While in Emergency Rooms Act of 2018 H.R.5197-Alternatives to Opioids (ALTO) in the Emergency Department Act H.R.5531-Opioid Emergency Response Act H.R.5558-Alternatives to Opioids Prescribing Act H.R.5678-Rural Emergency Medical Center Act of 2018 H.R.5734-Resident Education Deferred Interest Act H.R.6082-Overdose Prevention and Patient Safety (OPPS) Act H.R.6143-Patient Right to Know Drug Prices Act H.R.6144-Know the Lowest Price Act of 2018 H.R.6372-To require the Secretary of Health and Human Services issue regulations to ensure due process rights for physicians furnishing emergency medical services H.R.6502-Reducing Unnecessary Senior Hospitalizations Act of 2018 H.R.6615-Traumatic Brain Injury Program Reauthorization Act of 2018 H.R.6733-Know the Cost Act of 2018 H.R.6748-Emergency Medical Services for Children Program Reauthorization Act of 2018 H.R.7223-Right Rebate Act of 2018 Senate resolution congratulating the American College of Emergency Physicians on its 50th anniversary S.191-Patient Freedom Act of 2017 S.256-SOAR to Health and Wellness Act of 2017 S.284-End Surprise Billing Act of 2017 S.372- Synthetics Trafficking and Overdose Prevention Act of 2017 S.527-Health Care Safety Net Enhancement Act of 2017 S.568-Improving Access to Medicare Coverage Act of 2017 S.781-Good Samaritan Health Professionals Act of 2017 S.1016-Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2017 S.1022-Military Injury Surgical Systems Integrated Operationally Nationwide to Achieve ZERO Preventable Deaths Act S.1130-Rural Emergency Acute Care Hospital (REACH) Act S.1462-Marketplace Certainty Act S.1530- Medicare Choices Empowerment and Protection Act S.1553-Stopping Overdoses of Fentanyl Analogues Act S.1835-Lower Premiums Through Reinsurance Act of 2017 S.2465-Sickle Cell Disease Research, Surveillance, Prevention, and Treatment Act of 2018 S.2516-Alternatives to Opioids (ALTO) in the Emergency Department Act S.2544-Patient Right to Know Drug Prices Act S.2553-Know the Lowest Price Act of 2018 S.2609-Recovery Coaches Offer Addiction Counseling and Healing (COACH) Act S.2610-Preventing Overdoses While in Emergency Departments Act of 2018 S.2680-Opioid Crisis Response Act of 2018 S.3482-Emergency Medical Services for Children Program Reauthorization Act of 2018 S.3531-Emergency Care Improvement Act S.3657-Traumatic Brain Injury Program Reauthorization Act of 2018 S.3702-Right Rebate Act of 2018

Client expense: $549,617 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA)

S. 413, Improving Transparency and Accuracy in Medicare Part D Spending Act (Capito) - PDP/MA-PD payments on clean claims from pharmacies S. 428, ACE Kids Act (Grassley) - coordinated care for children with complex medical conditions S. 1016, CONNECT For Health Act (Schatz) - telehealth S. 1169, Medicaid CARE Act (Durbin-Portman) - changes to Medicaid IMD exclusion S. 1688, Empowering Medicare Seniors to Negotiate Drug Prices Act (Klobuchar) - Part D price negotiations S. 1804, Medicare for All Act (Sanders) - single payer health system S. 1890, Chronic Kidney Disease Improvement in Research and Treatment and Medigap Access (Cardin) - Medigap coverage for beneficiaries with end-stage renal disease S. 1909, BENES Act (Casey) - notifications of Medicare eligibility S. 2027, Medicaid Third Party Liability Act (Portman) - Medicaid third party liability S. 2051, Medicare Care Coordination Improvement Act of 2017 (Portman) - barriers to payment reform models S. 2227, EMPOWER Care Act (Portman-Cantwell) - Medicaid Money Follows the Person Demonstration S. 2707, Informing Seniors About Opioids Act (Nelson) - opioid issues S. 2901, Expanding Telehealth Response to Ensure Addiction Treatment Act (Thune) - opioid issues S. 2904, Medicaid Substance Use Disorder Treatment Via Telehealth Act (Carper) - opioid issues S. 2908, Electronic Prior Authorization in Medicare Part D Act (Roberts) - opioid issues S. 3327, SENIOR Communities Protection Act (Cortez Masto) - preventing fraudulent opioid prescriptions S. 3496, Improving Seniors Access to Quality Benefits Act (Daines-King) - study on MA benchmark cap S. 3497, Medicare Advantage Quality Payment Relief Act (Daines-King) - MA benchmark cap S. 3702, Right Rebate Act (Wyden-Grassley) - Medicaid drug rebate program Draft Bill: Medicare Long-Term Care Services and Supports Act (Pallone) - Long-Term Services and Supports Program H.R. 6, SUPPORT Patients and Families Act (Walden) - opioid initiatives, Medicare and Medicaid issues, budget offsets H.R. 695, Continuing Appropriations Act (Schiff) - Money Follows the Person demonstration, spousal impoverishment protections H.R. 849, Protecting Seniors Access to Medicare Act (Roe) - Independent Payment Advisory Board H.R. 908, Medicare Advantage Quality Payment Relief Act (Kelly) - MA payment cap H.R. 1038, Improving Transparency and Accuracy in Medicare Part D Spending Act (Griffith) - PDP/MA-PD payments on clean claims from pharmacies H.R. 1148, FAST Act (Griffith) - access to telehealth-eligible stroke services under Medicare H.R. 1316, Prescription Drug Price Transparency Act (Collins) - PBM standards for MA and PDP plans H.R. 1995, V-BID for Better Care Act (Black) - value-based insurance design in Medicare Advantage H.R. 2556, CONNECT For Health Act (Black) - telehealth H.R. 2575, BENES Act (Ruiz) - notifications of Medicare eligibility H.R. 2644, Chronic Kidney Disease Improvement in Research and Treatment and Medigap Access (Marino) - Medigap coverage for beneficiaries with end-stage renal disease H.R. 2687, Medicaid CARE Act (Foster-Fitzpatrick) - changes to Medicaid IMD exclusion H.R. 3044, Supplemental Benefits for Chronically Ill Medicare Advantage Enrollees (Meehan) H.R. 3263, Medicare Independence at Home Model of Care (Burgess) - demonstration program H.R. 3325, ACE Kids Act (Barton) - health homes for children with complex medical conditions H.R. 3360, Telehealth Enhancement Act (Harper) - telehealth in Medicare H.R. 3635, Local Coverage Determination Clarification Act (Jenkins) - procedures for Medicare administrative contractors H.R. 3727, Increasing Telehealth Access in Medicare Act (Black) - telehealth in MA plans H.R. 4143, Dialysis PATIENTS Demonstration Act (Smith) - alternative care delivery models and payment methodologies for patients with end-stage renal disease H.R. 4952, Improving Seniors Access to Quality Benefits Act (Kelly) - MA benchmark cap study H.R. 5306, EMPOWER Care Act (Guthrie) - extension of Money Follows the Person demonstration H.R. 5603, Access to Telehealth Services for Substance Use Disorders Act (Matsui) - opioid issues H.R. 5605, Advancing High Quality Treatment for Opioid Use Disorders in Medicare Act (Ruiz) - opioid issues H.R. 5675, drug management programs for at-risk Medicare beneficiaries (Bilirakis) - opioid issues H.R. 5676, SENIOR Communities Protection Act (MacArthur) - preventing fraudulent opioid prescriptions H.R. 5684, Protecting Seniors from Opioid Abuse Act (Kelly) - opioid issues H.R. 5685, Medicare Opioid Safety Education Act (Faso) - opioid issues H.R. 5686, Medicare Clear Health Options in Care for Enrollees Act (Paulsen) - opioid issues H.R. 5715, Strengthening Partnerships to Prevent Opioid Abuse Act (Renacci) - communication between Medicare plan sponsors and CMS H.R. 5773, Preventing Addiction for Susceptible Seniors Act (Roskam) - opioid issues H.R. 5797, IMD CARE Act (Walters) - Medicaid IMD exclusion H.R. 5798, Opioid Screening and Chronic Pain Management Alternatives for Seniors Act (Bucshon) - opioid issues H.R. 5799, Medicaid Drug Review, Utilization, Good Governance Improvement Act (Blackburn) - opioid issues H.R. 5800, Medicaid IMD ADDITIONAL INFO Act (Upton) - opioid issues H.R. 5804, Post-Surgical Injections as an Opioid Alternative Act (Shimkus) - opioid issues H.R. 5808, Medicaid Pharmaceutical Home Act (Bilirakis) - opioid issues H.R. 5809, Postoperative Opioid Prevention Act (Peters) - opioid issues H.R. 5810, Medicaid Health Homes for Opioid-Use-Disorder Medicaid Enrollees Encouraged Act (Lance) - opioid issues H.R. 5812, Improving Medicaid Data Timeliness Act (Griffith) - opioid issues H.R. 6431, Medigap Consumer Protection Act (Levin) - reforms to Medicare supplemental insurance H.R. 6561, Comprehensive Care for Seniors Act (Walorski) -- Program of All-Inclusive Care for the Elderly H.R. 6563, Lower Out-of-Pocket Costs for Seniors Act (Pallone-Neal) - Medicare Part D cliff H.R. 6662, Empowering Seniors Decision Enrollment Act (Paulsen) - special enrollment period for non-deemed Medicare Cost Plan enrollees H.R. 6690, Fighting Fraud to Protect Care for Seniors Act (Roskam) - Medicare pilot program for smart card technology H.R. 7122, Shared Accountability for Improved Patient Outcomes Act (Paulsen) - value-based payment and delivery arrangements H.R. 7217, IMPROVE Act (Barton) - Money Follows the Person demonstration, ACE Kids Act, Medicare drug rebate program, spousal impoverishment protections H.R. 7223, Right Rebate Act (Schrader-Welch) - Medicaid drug rebate program H.R. 7247, Incentivizing Shared Risk in Medicare Advantage Act (Brady) - MA prior authorization H.R. 7249, Better Prior Authorization Notification Act (Reed) - MA prior authorization H.R. 7250, Prior Authorization Improvement Act (Kelly) - MA prior authorization 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); calendar year 2020 policy and technical regulation for MA and Part D; MA and Part D proposed rule on drug pricing changes for 2020; CMSs price transparency proposal for direct-to-consumer advertisements; issues relating to 2019 Rate Notice and Call Letter; 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; Bipartisan Budget Act of 2018 changes to 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) and the Bipartisan Budget Act of 2018 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's substantial revisions to the managed care regulations, 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; issues relating to prescription drug price blueprint; 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: $1,550,000 · Firm income: Not reported

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

S. 260 / H.R. 849: Protecting Seniors Access to Medicare Act S. 431 / H.R. 1148: Furthering Access to Stroke Telemedicine (FAST) Act S. 870 / H.R. 4579: CHRONIC Care Act S. 1016 / H.R. 2556: CONNECT for Health Act Preservation of the in-office ancillary exception to the Stark law; appropriate use criteria for imaging services; Medicare coverage of oxygen therapy for cluster headaches; urging changes to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Advocating for funding to assist long-term and post-acute care providers with the cost of electronic health records and other applied technology. Urging Congress to include long-term and post-acute care settings in national health IT initiatives, including the development, adoption and use of interoperability standards, the certification of IT products, and the engagement of LTPAC providers in EHR incentive programs. Support S. 1016, the CONNECT for Health Act, to broaden Medicare reimbursement criteria for telehealth. Support S. 787, the Telehealth Innovation and Improvement Act, allowing CMS to test telehealth and other technologies to improve delivery of health services to beneficiaries with defined illnesses.

Client expense: $66,571 · Firm income: Not reported

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

S.1016-Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2017

Client expense: $402,721 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Essential emergency medication shortages Mental health services for emergency psychiatric patients Price transparency, out-of-network reimbursement of emergency medical services H.Res.906-Congratulating the American College of Emergency Physicians on its 50th anniversary H.R.6-Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act H.R.372-Competetive Health Insurance Reform Act of 2017 H.R.548-Health Care Safety Net Enhancement Act of 2017 H.R.767-Stop, Observe, Ask, and Respond (SOAR) to Health and Wellness Act of 2017 H.R.817-End Surprise Billing Act of 2017 H.R.880-Military Injury Surgical Systems Integrated Operationally Nationwide to Achieve ZERO Preventable Deaths Act H.R.1057-Synthetics Trafficking and Overdose Prevention Act of 2017 H.R.1215-Protecting Access to Care Act of 2017 H.R.1323-Reducing Unnecessary Emergency Room Visits under Medicaid Act H.R.1492-Medical Controlled Substances Transportation Act of 2017 H.R.1565-Saving Lives, Saving Costs Act H.R.1822-Good Samaritan Health Professionals Act of 2017 H.R.1876-Good Samaritan Health Professionals Act of 2017 H.R.2200-Frederick Douglass Trafficking Victims Prevention and Protection Reauthorization Act of 2017 H.R.2410-Sickle Cell Disease Research, Surveillance, Prevention, and Treatment Act of 2017 H.R.2851-Stop the Importation and Trafficking of Synthetic Analogues (SITSA) Act of 2017 H.R.2957-Save Rural Hospitals Act H.R.3181-Medicare Choices Empowerment and Protection Act H.R.3258-Marketplace Certainty Act H.R.3545-Overdose Prevention and Patient Safety (OPPS) Act H.R.4922-Stopping Overdoses of Fentanyl Analogues Act H.R.5176-Preventing Overdoses While in Emergency Rooms Act of 2018 H.R.5197-Alternatives to Opioids (ALTO) in the Emergency Department Act H.R.5531-Opioid Emergency Response Act H.R.5558-Alternatives to Opioids Prescribing Act H.R.5678-Rural Emergency Medical Center Act of 2018 H.R.5734-Resident Education Deferred Interest Act H.R.6082-Overdose Prevention and Patient Safety (OPPS) Act H.R.6143-Patient Right to Know Drug Prices Act H.R.6144-Know the Lowest Price Act of 2018 H.R.6372-To require the Secretary of Health and Human Services issue regulations to ensure due process rights for physicians furnishing emergency medical services H.R.6502-Reducing Unnecessary Senior Hospitalizations Act of 2018 H.R.6733-Know the Cost Act of 2018 Senate resolution congratulating the American College of Emergency Physicians on its 50th anniversary S.191-Patient Freedom Act of 2017 S.256-SOAR to Health and Wellness Act of 2017 S.284-End Surprise Billing Act of 2017 S.372- Synthetics Trafficking and Overdose Prevention Act of 2017 S.527-Health Care Safety Net Enhancement Act of 2017 S.568-Improving Access to Medicare Coverage Act of 2017 S.781-Good Samaritan Health Professionals Act of 2017 S.1016-Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2017 S.1022-Military Injury Surgical Systems Integrated Operationally Nationwide to Achieve ZERO Preventable Deaths Act S.1130-Rural Emergency Acute Care Hospital (REACH) Act S.1462-Marketplace Certainty Act S.1530- Medicare Choices Empowerment and Protection Act S.1553-Stopping Overdoses of Fentanyl Analogues Act S.1835-Lower Premiums Through Reinsurance Act of 2017 S.2465-Sickle Cell Disease Research, Surveillance, Prevention, and Treatment Act of 2018 S.2516-Alternatives to Opioids (ALTO) in the Emergency Department Act S.2544-Patient Right to Know Drug Prices Act S.2553-Know the Lowest Price Act of 2018 S.2609-Recovery Coaches Offer Addiction Counseling and Healing (COACH) Act S.2610-Preventing Overdoses While in Emergency Departments Act of 2018 S.2680-Opioid Crisis Response Act of 2018 S.3531-Emergency Care Improvement Act

Client expense: $402,721 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation and policies relating to: Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Reauthorization of funding for the Childrens Health Insurance Program Reauthorization of the Child Nutrition Act Section 2706 of the ACA regarding provider non-discrimination Policies related to health insurance market stabilization Policies affecting nurse practitioner education and workforce Definition, evaluation and enforcement of essential health benefits and provider network adequacy Health information technology and electronic health records Mental health services and violence prevention Human and child trafficking H.R. 315/S. 783 - Improving Access to Maternity Care Act H.R. 767/S. 256 - Stop, Observe, Ask, and Respond (SOAR) to Health and Wellness Act of 2017 H.R. 772/S. 261 - Common Sense Nutrition Disclosure Act H.R. 959/S. 1109 - Title VIII Nursing Workforce Reauthorization Act of 2017 H.R. 1168 - United States Cadet Nurse Corps Equity Act H.R. 1174/S. 1497 - Fairness For Breastfeeding Mothers Act of 2017 H.R. 1215 - Protecting Access to Care Act of 2017 H.R. 1318 - Preventing Maternal Deaths Act of 2017 H.R. 1865 - Allow States and Victims to Fight Online Sex Trafficking Act of 2017 H.R. 2742/S. 1257 - Modernizing the Interstate Placement of Children in Foster Care Act H.R. 2824 - Increasing Opportunity through Evidence-Based Home Visiting Act H.R. 2857 - Supporting Families in Substance Abuse Treatment Act H.R. 2834 - Partnership Grants to Strengthen Families Affected by Parental Substance Abuse Act H.R. 2866 - Reducing Barriers for Relative Foster Parents Act H.R. 2847 - Improving Services for Older Youth in Foster Care Act H.R. 3192 - CHIP Mental Health Parity Act H.R. 3291 - Alleviating Adverse Childhood Experiences (ACES) Act H.R. 3387 - Drinking Water System Improvement Act of 2017 H.R. 3525 - Home Visiting Works Act of 2017 H.R. 3728 - Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness (EMPOWER) Act of 2017 H.R. 3921 - Helping Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable (HEALTHY KIDS) Act H.R. 3922 - Continuing Community Health And Medical Professional Programs to Improve Our Nation, Increase National Gains, and Help Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable (CHAMPIONING HEALTHY KIDS) Act of 2017 H.R. 3928 - Truth in Healthcare Marketing Act of 2017 H.R. 4695 - Bipartisan Market Stabilization and Innovation Act of 2017 H.R. 4978/S. 2410 - Chronic Disease Management Act of 2018 H.R. 4998 - Health Insurance for Former Foster Youth Act H.R. 5385/S. 2597 - Childrens Hospital GME Support Reauthorization Act of 2018 H.R. 5425/S. 2647 - Food Labeling Modernization Act of 2018 H.R. 5977 - Mothers and Offspring Mortality and Morbidity Awareness (MOMMAs) Act H.R. 6199 - Restoring Access to Medication and Modernizing Health Savings Accounts Act of 2018 H.R. 6560 - ChiPACC Act of 2018 H.R. 7141 - Workplace Violence Prevention for Health Care and Social Service Workers Act S. 761/H.R. 1933 - Health Care Options Act of 2017 S. 920 - National Clinical Care Commission Act S. 1016/H.R. 2556 - Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2017 S. 1028 - Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act S. 1091/H.R. 3105 - Supporting Grandparents Raising Grandchildren Act S. 1112 - Maternal Health Accountability Act of 2017 S. 1268 - Child Protection and Family Support Act of 2017 S. 1377 - Reaching Underserved Rural Areas to Lead on Telehealth Act S. 1441/H.R. 3059 - Community Health Center and Primary Care Workforce Expansion Act of 2017 S. 1522/H.R. 3186 - Every Kid Outdoors Act S. 1630/H.R. 3381 - Child Poverty Reduction Act of 2017 S. 1693 - Stop Enabling Sex Traffickers Act of 2017 S. 1827 - Keeping Kids Insurance Dependable and Secure (KIDS) Act S. 1829 - Strong Families Act of 2017 S. 2415 - Accelerating Kids Access to Care Act S. 2582 - Consumer Health Insurance Protection Act of 2018 S. 2852/H.R. 3678 - Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018 S. 3029 - Prematurity Research Expansion and Education for Mothers who deliver Infants Early (PREEMIE) Reauthorization Act of 2018 S. 3074 - Focus on Children Act S. 3075 - Childrens Budget Act S. 3319 - Stopping Appealing Flavors in E-Cigarettes (SAFE) for Kids Act S. 3388 - Ensuring Coverage for Patients with Pre-Existing Conditions Act S. 3482/H.R. 6748 - Emergency Medical Services for Children Program Reauthorization Act of 2018 S. 3685 - Nursing Where It's Needed (Nurse WIN) Act S. 3729 - United States Cadet Nurse Corps Service Recognition Act of 2018 S. J. Res. 63 - A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Secretary of the Treasury, Secretary of Labor, and Secretary of Health and Human Services relating to Short-Term, Limited Duration Insurance

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

Government targets: Agriculture, Dept of (USDA), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Justice, Dept of (DOJ), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA)

Medicaid and Medicare payment for Health Centers; Medicaid quality reporting; Childrens Health Insurance Program (CHIP); Telehealth legislation; Connect for Health Act of 2017 (S.1016/H.R.2556); Rural Access to Hospice Act(H.R.1828); [Seniors] Mental Health Access Improvement Act (S.1879/H.R.3032).

Client expense: $120,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), Office of Management & Budget (OMB), SENATE, White House Office

H.R. 2550, "Medicare Telehealth Parity Act of 2017", regarding all provisions. Issues relating to Home Dialysis Expansion Legislation. H.R.1245/S. 469, "Affordable and Safe Prescription Drug Importation Act", regarding all provisions. S.1016, "CONNECT for Health Act of 2017", regarding all provisions. Issues related to ESRD Reimbursement for Hemodialysis. H.R.28, "Biological Implant Tracking and Veteran Safety Act of 2017", regarding all provisions. Implementation of the 21st Century Cures regulations. Issues relating to 340B Drug Pricing.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 6, Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act, all provisions H.R. 930, Lymphedema Treatment Act, all provisions S. 497, Lymphedema Treatment Act, all provisions H.R. 6836, CLINICAL TREATMENT Act, all provisions S. 3592, No More Surprise Medical Bills Act of 2018, all provisions H.R. 7122, Shared Accountability for Improved Patient Outcomes Act of 2018, all provisions H.R. 6, SUPPORT for Patients and Communities Act, all provisions S. 3120, HEAL Act of 2018, all provisions H.R.3528 - Every Prescription Conveyed Securely Act, all provisions S. 2460, Every Prescription Conveyed Securely Act, all provisions H.R. 2687, Medicaid Coverage for Addiction Recovery Expansion Act, all provisions S. 1169, Medicaid Coverage for Addiction Recovery Expansion Act, all provisions S. 1016, CONNECT for Health Act of 2017, provisions relating to telehealth Medicare program: Protecting Patients from Surprise Medical Bills Act Medicare program: Protecting Access to Medicare Act (PAMA)/physician office labs Medicare program: Medicare Access and Chip Reauthorization Act (MACRA) implementation Medicare program: Merit-based Incentive Payment System (MIPS) Medicare program: MIPS cost measures Medicare program: MIPS impact on Part B drugs and DME Medicare program: Physician-Focused Payment Model Technical Advisory Committee (PTAC) Medicare program: Diabetes Prevention Program/virtual coverage Medicare program: Evaluation and Management Codes/documentation Medicare program: Medicare physician fee schedule Medicare program: Medicare Advantage (MA) and Part D Medicare program: Quality Payment Program Medicare program: Shared Savings Program Medicare program: Health IT burdens Medicare program: Surprise billing Medicare program: Graduate Medical Education (GME) Medicare program: Alternative Payment Models (APMs) Medicare program: Appropriate Use Criteria Medicare program: Cybersecurity Medicare program: Interoperability Medicare program: Stark/Anti-kickback Medicare program: Privacy Medicare program: Regulatory relief Medicare program: Step therapy Medicare program: Residents/minor procedures Medicare program: Prior authorization and utilization management Medicare program: Medicare for all Medicare program: Open Payments Medicare program: PECOS/Medicare Enrollment/Revocations/Revalidations Medicare program: Pharmacy Benefit Manager (PBM)/drug price transparency Medicare program: Misvalued codes Medicare program: List price for drugs Medicare program: Drug pricing transparency

Client expense: $4,740,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Bureau of Citizenship & Immigration Services (BCIS), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Natl Drug Control Policy (NDCP), SENATE, U.S. Customs & Border Protection, U.S. Trade Representative (USTR), Veterans Affairs, Dept of (VA), White House Office

S. 413, Improving Transparency and Accuracy in Medicare Part D Spending Act (Capito) - PDP/MA-PD payments on clean claims from pharmacies S. 428, ACE Kids Act (Grassley) - coordinated care for children with complex medical conditions S. 1016, CONNECT For Health Act (Schatz) - telehealth S. 1169, Medicaid CARE Act (Durbin-Portman) - changes to Medicaid IMD exclusion S. 1688, Empowering Medicare Seniors to Negotiate Drug Prices Act (Klobuchar) - Part D price negotiations S. 1804, Medicare for All Act (Sanders) - single payer health system S. 1890, Chronic Kidney Disease Improvement in Research and Treatment and Medigap Access (Cardin) - Medigap coverage for beneficiaries with end-stage renal disease S. 1909, BENES Act (Casey) - notifications of Medicare eligibility S. 2027, Medicaid Third Party Liability Act (Portman) - Medicaid third party liability S. 2051, Medicare Care Coordination Improvement Act of 2017 (Portman) - barriers to payment reform models S. 2227, EMPOWER Care Act (Portman-Cantwell) - Medicaid Money Follows the Person Demonstration S. 2707, Informing Seniors About Opioids Act (Nelson) - opioid issues S. 2901, Expanding Telehealth Response to Ensure Addiction Treatment Act (Thune) - opioid issues S. 2904, Medicaid Substance Use Disorder Treatment Via Telehealth Act (Carper) - opioid issues S. 2908, Electronic Prior Authorization in Medicare Part D Act (Roberts) - opioid issues S. 3327, SENIOR Communities Protection Act (Cortez Masto) - preventing fraudulent opioid prescriptions S. 3496, Improving Seniors Access to Quality Benefits Act (Daines-King) - study on MA benchmark cap S. 3497, Medicare Advantage Quality Payment Relief Act (Daines-King) - MA benchmark cap S. 3702, Right Rebate Act (Wyden-Grassley) - Medicaid drug rebate program Draft Bill: Medicare Long-Term Care Services and Supports Act (Pallone) - Long-Term Services and Supports Program H.R. 6, SUPPORT Patients and Families Act (Walden) - opioid initiatives, Medicare and Medicaid issues, budget offsets H.R. 695, Continuing Appropriations Act (Schiff) - Money Follows the Person demonstration, spousal impoverishment protections H.R. 849, Protecting Seniors Access to Medicare Act (Roe) - Independent Payment Advisory Board H.R. 908, Medicare Advantage Quality Payment Relief Act (Kelly) - MA payment cap H.R. 1038, Improving Transparency and Accuracy in Medicare Part D Spending Act (Griffith) - PDP/MA-PD payments on clean claims from pharmacies H.R. 1148, FAST Act (Griffith) - access to telehealth-eligible stroke services under Medicare H.R. 1316, Prescription Drug Price Transparency Act (Collins) - PBM standards for MA and PDP plans H.R. 1995, V-BID for Better Care Act (Black) - value-based insurance design in Medicare Advantage H.R. 2556, CONNECT For Health Act (Black) - telehealth H.R. 2575, BENES Act (Ruiz) - notifications of Medicare eligibility H.R. 2644, Chronic Kidney Disease Improvement in Research and Treatment and Medigap Access (Marino) - Medigap coverage for beneficiaries with end-stage renal disease H.R. 2687, Medicaid CARE Act (Foster-Fitzpatrick) - changes to Medicaid IMD exclusion H.R. 3044, Supplemental Benefits for Chronically Ill Medicare Advantage Enrollees (Meehan) H.R. 3263, Medicare Independence at Home Model of Care (Burgess) - demonstration program H.R. 3325, ACE Kids Act (Barton) - health homes for children with complex medical conditions H.R. 3360, Telehealth Enhancement Act (Harper) - telehealth in Medicare H.R. 3635, Local Coverage Determination Clarification Act (Jenkins) - procedures for Medicare administrative contractors H.R. 3727, Increasing Telehealth Access in Medicare Act (Black) - telehealth in MA plans H.R. 4143, Dialysis PATIENTS Demonstration Act (Smith) - alternative care delivery models and payment methodologies for patients with end-stage renal disease H.R. 4952, Improving Seniors Access to Quality Benefits Act (Kelly) - MA benchmark cap study H.R. 5306, EMPOWER Care Act (Guthrie) - extension of Money Follows the Person demonstration H.R. 5603, Access to Telehealth Services for Substance Use Disorders Act (Matsui) - opioid issues H.R. 5605, Advancing High Quality Treatment for Opioid Use Disorders in Medicare Act (Ruiz) - opioid issues H.R. 5675, drug management programs for at-risk Medicare beneficiaries (Bilirakis) - opioid issues H.R. 5676, SENIOR Communities Protection Act (MacArthur) - preventing fraudulent opioid prescriptions H.R. 5684, Protecting Seniors from Opioid Abuse Act (Kelly) - opioid issues H.R. 5685, Medicare Opioid Safety Education Act (Faso) - opioid issues H.R. 5686, Medicare Clear Health Options in Care for Enrollees Act (Paulsen) - opioid issues H.R. 5715, Strengthening Partnerships to Prevent Opioid Abuse Act (Renacci) - communication between Medicare plan sponsors and CMS H.R. 5773, Preventing Addiction for Susceptible Seniors Act (Roskam) - opioid issues H.R. 5797, IMD CARE Act (Walters) - Medicaid IMD exclusion H.R. 5798, Opioid Screening and Chronic Pain Management Alternatives for Seniors Act (Bucshon) - opioid issues H.R. 5799, Medicaid Drug Review, Utilization, Good Governance Improvement Act (Blackburn) - opioid issues H.R. 5800, Medicaid IMD ADDITIONAL INFO Act (Upton) - opioid issues H.R. 5804, Post-Surgical Injections as an Opioid Alternative Act (Shimkus) - opioid issues H.R. 5808, Medicaid Pharmaceutical Home Act (Bilirakis) - opioid issues H.R. 5809, Postoperative Opioid Prevention Act (Peters) - opioid issues H.R. 5810, Medicaid Health Homes for Opioid-Use-Disorder Medicaid Enrollees Encouraged Act (Lance) - opioid issues H.R. 5812, Improving Medicaid Data Timeliness Act (Griffith) - opioid issues H.R. 6431, Medigap Consumer Protection Act (Levin) - reforms to Medicare supplemental insurance H.R. 6561, Comprehensive Care for Seniors Act (Walorski) -- Program of All-Inclusive Care for the Elderly H.R. 6563, Lower Out-of-Pocket Costs for Seniors Act (Pallone-Neal) - Medicare Part D cliff H.R. 6662, Empowering Seniors Decision Enrollment Act (Paulsen) - special enrollment period for non-deemed Medicare Cost Plan enrollees H.R. 6690, Fighting Fraud to Protect Care for Seniors Act (Roskam) - Medicare pilot program for smart card technology H.R. 7122, Shared Accountability for Improved Patient Outcomes Act (Paulsen) - value-based payment and delivery arrangements H.R. 7217, IMPROVE Act (Barton) - Money Follows the Person demonstration, ACE Kids Act, Medicare drug rebate program, spousal impoverishment protections H.R. 7223, Right Rebate Act (Schrader-Welch) - Medicaid drug rebate program H.R. 7247, Incentivizing Shared Risk in Medicare Advantage Act (Brady) - MA prior authorization H.R. 7249, Better Prior Authorization Notification Act (Reed) - MA prior authorization H.R. 7250, Prior Authorization Improvement Act (Kelly) - MA prior authorization 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); calendar year 2020 policy and technical regulation for MA and Part D; MA and Part D proposed rule on drug pricing changes for 2020; CMSs price transparency proposal for direct-to-consumer advertisements; issues relating to 2019 Rate Notice and Call Letter; 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; Bipartisan Budget Act of 2018 changes to 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) and the Bipartisan Budget Act of 2018 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's substantial revisions to the managed care regulations, 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; issues relating to prescription drug price blueprint; 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: $1,540,000 · Firm income: Not reported

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

HR 5041, Safe Disposal of Unused Medication Act. S. 2680, Opioid Crisis Response Act of 2018. H.R. 6, SUPPORT for Patients and Communities Act. S. 1016, CONNECT for Health Act. Hospice and Opioid Prescribing. Hospice Shortages of Controlled Substances. H.R. 6813, Homecare for Seniors Act. Reestablishment of the House of Representatives Select Committee on Aging. Time-limited Equitable Relief for Medicare Part B Beneficiaries.

Client expense: $120,000 · Firm income: Not reported

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

National Drug Abuse Crisis and related bills. Specifically H.R. 6, SUPPORT for Patients and Communities Act. 42 CFR Part 2 - advocating to align 42 CFR Part 2 (substance use privacy regulations) with HIPAA to allow appropriate access to patient information that is essential for providing whole-person care. Advocating for the passage of the Overdose Prevention and Patient Safety Act, H.R. 6082, or the Protecting Jessica Grubb's Legacy Act, S. 1850, in the Senate. Behavioral Health Information Technology, extending health information technology assistance eligibility to more mental health and substance use disorder professionals and facilities. Specifically H.R. 3331 and S. 1732, the Improving Access to Behavioral Health Information Technology Act. Telehealth, reforming barriers to Medicare reimbursement. Specifically, the CONNECT for Health Act, S. 1016/H.R. 2556. Medicare coverage of Mental Health Counselors and Marriage and Family Therapists - the Mental Health Access Improvement Act, H.R. 3032, and the Seniors Mental Health Access Improvement Act, S. 1879. Mental Health Parity Behavioral Health

Client expense: $37,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Treasury, Dept of, White House Office

National Drug Abuse Crisis and related bills. Specifically H.R. 6, SUPPORT for Patients and Communities Act. 42 CFR Part 2 - advocating to align 42 CFR Part 2 (substance use privacy regulations) with HIPAA to allow appropriate access to patient information that is essential for providing whole-person care. Advocating for the passage of the Overdose Prevention and Patient Safety Act, H.R. 6082, or the Protecting Jessica Grubb's Legacy Act, S. 1850, in the Senate. Behavioral Health Information Technology, extending health information technology assistance eligibility to more mental health and substance use disorder professionals and facilities. Specifically H.R. 3331 and S. 1732, the Improving Access to Behavioral Health Information Technology Act. Telehealth, reforming barriers to Medicare reimbursement. Specifically, the CONNECT for Health Act, S. 1016/H.R. 2556. Medicare coverage of Mental Health Counselors and Marriage and Family Therapists - the Mental Health Access Improvement Act, H.R. 3032, and the Seniors Mental Health Access Improvement Act, S. 1879. Mental Health Parity Behavioral Health

Client expense: $37,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Treasury, Dept of, White House Office

National Drug Abuse Crisis and related bills. Specifically H.R. 6, SUPPORT for Patients and Communities Act. 42 CFR Part 2 - advocating to align 42 CFR Part 2 (substance use privacy regulations) with HIPAA to allow appropriate access to patient information that is essential for providing whole-person care. Advocating for the passage of the Overdose Prevention and Patient Safety Act, H.R. 6082, or the Protecting Jessica Grubb's Legacy Act, S. 1850, in the Senate. Behavioral Health Information Technology, extending health information technology assistance eligibility to more mental health and substance use disorder professionals and facilities. Specifically H.R. 3331 and S. 1732, the Improving Access to Behavioral Health Information Technology Act. Telehealth, reforming barriers to Medicare reimbursement. Specifically, the CONNECT for Health Act, S. 1016/H.R. 2556. Medicare coverage of Mental Health Counselors and Marriage and Family Therapists - the Mental Health Access Improvement Act, H.R. 3032, and the Seniors Mental Health Access Improvement Act, S. 1879. Mental Health Parity Behavioral Health

Client expense: $37,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Treasury, Dept of, White House Office

340B Program rules; HR1628; S428; S1016 / HR2556; S870; S445 / HR1825; S1361; S1628;HConRes 71; HR4710; HR4392;OPPS CY2019 Proposed Rule;

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Update and reforms to Medicare payments for physicians and implementation of related provisions of the Medicare Access and CHIP Reauthorization Act (MACRA), including regulatory relief for physicians in the MACRA Quality Payment Program, evaluation and management codes, and qualified clinical data registries; maintain patient access to In-Office Ancillary Services; issues related to adequate network coverage for dermatologic care within Medicare Advantage plans; legislative issues regarding implementation of Meaningful Use of Electronic Health Records; Medicare reimbursement for telemedicine; including related provisions in H.R. 2556 and S. 1016, the CONNECT for Health Act; and Medicare RAC reform.

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

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

S. 1016: CONNECT for Health Act of 2017. A bill to amend title XVIII of the Social Security Act to expand access to telehealth services, and for other purposes H.R. 2336: Behavioral Health Care Integration Act of 2017 H.R. 3192: CHIP Mental Health Parity Act H.R. 3921: HEALTHY KIDS Act. To extend funding for the Children's Health Insurance Program, and for other purposes S. 1827: KIDS Act of 2017. A bill to extend funding for the Children's Health Insurance Program, and for other purposes H.R. 1625: FY18 Consolidated Appropriations Act S. 3796, H.R. 6597: Mental Health Professionals Workforce Shortage Loan Repayment Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to implementation of the 21st Century Cures Act (Public Law No: 114-255); in general H.R. 5311/S. 2456, the CARA 2.0 Act of 2018 H.R. 2556/S. 1016, the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act S. 1850, the Protecting Jessica Grubbs Legacy Act H.R. 3545, the Overdose Prevention and Patient Safety Act Docket ID: SAMHSA-4162-20, Confidentiality of Substance Use Disorder Patient Records Issues relating to the reauthorization of the Childrens Health Insurance Program H.R. 3192/S. 2253, the CHIP Mental Health Parity Act S. 774, the Trauma-Informed Care for Children and Families Act H.R. 4778/S. 2301, the Behavioral Health Coverage Transparency Act S. 2406/H.R. 5002, the Advancing Cutting-Edge (ACE) Research Act H.R. 5102/S. 2524, the Substance use Disorder Workforce Loan Repayment Act Issues relating to market stabilization for the Affordable Care Act Issues related to opioids. Issues related to gun violence and mental health, in general H.R. 2276/S. 2575, the Audiology Patient Choice Act H.R. 6, SUPPORT for Patients and Communities Act S. 2680, the Opioid Crisis Response Act H.R. 994, the Examining Opioid Treatment Infrastructure Act H.R. 1375, a bill to amend the Public Health Service Act to authorize the Secretary of Health of Human Services to award grants to States (or collaborations of States) to establish, expand, or maintain a comprehensive regional, State, or municipal system to provide training, education, consultation, and other resources to prescribers relating to patient pain, substance misuse, and substance abuse disorders, and for other purposes. S. 581/H.R. 5009, Jessie's Law H.R. 2077, theRestoring the Patient's Voice Act H.R. 2345, the National Suicide Hotline Improvement Act S. 1354, a bill to establish an Individual Market Reinsurance fund to provide funding for State individual market stabilization reinsurance programs. H.R. 3692, the Addiction Treatment Access Improvement Act H.R. 3931/S.1905, the Excellence in Mental Health and Addiction Treatment Expansion Act H.R. 4733/S. 2260, the Opioids and STOP Pain Initiative Act S. 2317, a bill to amend the Controlled Substances Act to provide for additional flexibility with respect to medication-assisted treatment for opioid use disorders, and for other purposes. H.R. 4903, Combating Opioid Misuse By Advancing Treatment (COMBAT) Act H.R. 5083, the Expanding Access to Evidence-Based Opioid Treatment for Seniors Act H.R. 5327, the Comprehensive Opioid Recovery Centers Act H.R. 5385/S. 2597, the Children's Hospital GME Support Reauthorization Act S. 2606, the Opioid ECHO Act H.R. 5795, the Overdose Prevention and Patient Safety Act H.R. 5483, the Special Registration for Telemedicine Clarification Act H.R. 6082, the Overdose Prevention and Patient Safety Act S.3337, the Mental Health Services for Students Act H.R.6597, the Mental Health Professionals Workforce Shortage Loan Repayment Act S. 2554, the Patient Right to Know Drug Prices Act H.R. 6143, the Patient Right to Know Drug Prices Act Issues relating to suicide prevention; in general Issues relating to the enforcement of mental health parity; in general

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Justice, Dept of (DOJ), Natl Institutes of Health (NIH), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), U.S. Immigration & Customs Enforcement (ICE), Veterans Affairs, Dept of (VA)

Telemedicine Issues related to Health Savings Accounts (HSA's) and telehealth. S. 1016 - Creating Opportunities Now for Necessary and Effective Care Technologies for Health Act (CONNECT Act). H.R. 3727 - Increasing Telehealth Access to Medicare Act.

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

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

HR 807 and S 253 - legislation regarding rehab therapy spending caps in Medicare; HR 2556 and S 1016 - the CONNECT for Health Act; HR 2550 - the Medicare Telehealth Parity Act; S 787 - the Telehealth Innovation and Improvement Act; and S 431 - the Furthering Access to Stroke Telemedicine Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Telemedicine Issues related to Health Savings Accounts (HSA's) and telehealth. S. 1016 - Creating Opportunities Now for Necessary and Effective Care Technologies for Health Act (CONNECT Act). H.R. 3727 - Increasing Telehealth Access to Medicare Act. CMS-Medicare Advantage proposed rule.

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

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

S. 1016 - Creating Opportunities Now for Necessary and Effective Care Technologies for Health Act (CONNECT Act). 340B Drug Pricing Program. Cyber-security related to Healthcare data.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), Office of Science & Technology Policy (OSTP), SENATE

S. 977/HR 3820 and HR 6225: Medicare Home Health Flexibility Act - Advocate for passage . HR 2550: Medicare Telehealth Parity Act of 2017 - Advocated for the inclusion of occupational therapy as part of telehealth legislation that would allow for reimbursement of certain telehealth services under Medicare. HR2556: Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act; S787: A bill to require the Center for Medicare and Medicaid Innovation to test the effect of including telehealth services in Medicare health care delivery reform models; HR3360: Telehealth Enhancement Act; HR3482: Evidence-Based Telehealth Expansion Act; S1016: Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act; and HR3727: A bill to amend title XVIII of the Social Security Act to include additional telehealth services for purposes of MA organization bids, and for other purposes. - Advocated for the inclusion of occupational therapy as part of telehealth legislation that would allow for reimbursement of certain telehealth services under Medicare. No bill# Red Tape Reduction Initiative from Ways and Means Committee: Submitted following priorities for occupational therapy red tape reduction - 1) Initiation of Home Health Therapy Services Under Medicare (S. 977/HR 3820 now HR 6225), 2) Recognition of Occupational Therapy as a Primary Rehab Service (no bill number), 3) Permanently Eliminate Outside Certification Requirement for Occupational Therapists to Fabricate Custom Orthotics and Prosthetic Items (no bill number), 4) Modify or Eliminate Claims-Based Data Collection of Functional Limitation Information for Therapy Services (no bill number), 5) Add Doctor-prescribed Compression Supplies to the Durable Medical Equipment category (S 497/HR 930), and 6) Medicare Opt-out Option (no bill number). No Bill: Discussed how Stark laws affect the ability of occupational therapy practitioners to provide coordinated care services, particularly as it relates to the management of chronic conditions. S. 497/HR 930: Lymphedema Treatment Act - Support passage. No bill: Advocate for role of skilled therapy in changing reimbursement under Medicare Part A and Part B. HR 6 SUPPORT for Patients and Communities Act (PL 115-271) and various bills on opioids HR 5722, HR 5774, HR 5776, HR 6110, S 3008 and S 3120: Educate Members of Congress about the role of occupational therapy in the non-pharmacological management of pain, and advocate for any legislation that includes studies or funding for these alternatives, includes occupational therapy. Discussed and examined the effect of changes to reimbursement for occupational therapy assistants included in the Bi-partisan Budget Act, and possibly requesting a report from the GAO. S. 2387/HR 4957 - Concentrating on High-value Alzheimer's Needs to Get to an End (CHANGE) Act of 2018: Support

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Implementation/Expansion of CDC Falls Program Implementation of Affordable Care Act - provisions pertaining to Essential Health Benefits & Health Insurance Exchanges AHRQ provisions pertaining to PT Physician self-referra/Stark Law American Cures Act H.R. 930/S.497 Lymphadema Treatment Act Health Information Technology Nominations to PCORI Methodology Committees Medicaid Expansion HR. 1639/S.619 Physical Therapist Workforce & Patient Access Act Physician owned distributerships H.R. 302/S.808 Sports Medicine Licensure Clarity Act MACRA/MIPS APMS IMPACT/PAC reform Network adequacy Insurance Benefit parameters H.R. 1361/S.486 Ensuring Access to Quality CRT Medicare Telehealth Parity Act HR2550 American Healthcare Act of 2017/CONNECT - H.R. 2556/S1016 H.R. 1628 - American Health Care Action of 2017 Opioid Epidemic/Pain Management Better Care Reconciliation Act of 2017 H.R.2066 Promoting Integrity in Medicare H.R. 2063 Opioid Pace Act of 2017 H.R. 5261 Teach Act H.R. 5197 Alto Act H.R. 5686, Medicare Clear Health Options in Care for Enrollees Act H.R. 5773, Preventing Addiction for Susceptible Seniors Act H.R. 5774, Combating Opioid Abuse for Care in Hospitals Act H.R. 5718, Perioperative Reduction for Opioids Act H.R. 5719, Reduce Overprescribing Opioids in Treatment Act H.R. 5722, Dr. Todd Graham Pain Management Improvement Act H.R. 6, Substance-Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act S. 3120, the HEAL Act S. 2680, Opioid Crisis Response Act Association Retirement Plans State Relief and Empowerment Waivers D.O.L Information Collection Request Extensions Health Reimbursement Accounts HR 7217: Improve Act

Client expense: $252,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, Government Accountability Office (GAO), 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, Small Business Administration (SBA), Veterans Affairs, Dept of (VA), White House Office

CONNECT Act HR 2556/S 1016 HEART Act of 2017, HR 2291 Telehealth Parity Act, HR 2550 Medicare telehealth pilot for COPD patient Medicare competitive bidding proposal

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1289 - Dorothy I. Height and Whitney M. Young, Jr., Social Work Reinvestment Act S. 1188/H.R.2535 - Lifespan Respite Care Reauthorization Act of 2017 H.R. 6 [P.L. No: 115-271] - SUPPORT for Patients and Communities Act S.2524/H.R. 5102 - Substance Use Disorder Workforce Loan Repayment Act of 2018 H.Res.1099 - Providing for the concurrence by the House in the Senate amendment to H.R. 6, with an amendment H.R.3331 - To amend title XI of the Social Security Act to promote testing of incentive payments for behavioral health providers for adoption and use of certified electronic health record technology. S.1732 - Improving Access to Behavioral Health Information Technology Act S. 1905/ H.R.3931 - Excellence in Mental Health and Addiction Treatment Expansion Act S.1016/H.R. 2556 - CONNECT for Health Act of 2017 S.2120/H.R. 5034 - International Violence Against Women Act of 2017 S.2164/H.R.2953 - To amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings. S.1334/H.R.2797 - Patient Choice and Quality Care Act of 2017 H.R.620 - ADA Education and Reform Act of 2017 S.Res.427 - A resolution supporting the goals and ideals of Social Work Month during March 2018 and World Social Work Day on March 20, 2018. H.Res.770 - Supporting the goals and ideals of Social Work Month during March 2018 and World Social Work Day on March 20, 2018. H.R.3713 - Geriatrics Workforce and Caregiver Enhancement Act S. 2456/H.R. 5311 - CARA 2.0 Act of 2018 S.2301/H.R. 4778- Behavioral Health Coverage Transparency Act of 2018 S. 1015/H.R.2345 [P.L. No: 115-233] - National Suicide Hotline Improvement Act of 2017 H.R.4704 - Nursing Home CARE Act S.2227/H.R. 5306 - EMPOWER Care Act S.2076/H.R. 4256 [P.L. No: 115-406] - BOLD Infrastructure for Alzheimer's Act S.2680 - Opioid Crisis Response Act of 2018 Improving Parity for Mental Health and Substance Use Disorder Coverage. H.R. 5942 - Health Equity and Accountability Act of 2018 Preserve ACA Essential Health Benefits, cost sharing subsidies, state waivers, and funding for navigators and assisters. Health care access Reduce Gun Violence: Comprehensive Legislative Solutions to firearm-related injuries and fatalities Opioid Epidemic 340B drug pricing issues Section 1115 waiver approval issues Medicare Part D program issues Medicaid non-emergency medical transportation (NEMT) issues H.R.6597 - Mental Health Professionals Workforce Shortage Loan Repayment Act of 2018 H.R.5202/S.916 - Ensuring Patient Access to Substance Use Disorder Treatments Act of 2018 S.1370/H.R.2913 - Mental Health in Schools Act of 2017 S.3337 - Mental Health Services for Students Act of 2018

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Education, Dept of, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

Mental Health Issues (incl 21st Century Cures implementation, mental health parity) General Health Care Issues (incl. Medicare/Medicaid, preexisting conditions coverage) Research, Medical and Scientific Issues HR 427/S. 1147 The Collaborative Academic Research Efforts (CARE) for Tourette Syndrome Act 21st Century Cures Act implementation Telemedicine/telehealth including S. 1016 - CONNECTf or Health Act Access to treatment (step therapy/fail first, prior authorizations, non-medical switching, CY2019 Physician fee issues)incl. HR 2077 the Restoring the Patient's Voice Act of 2017 Drug pricing

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

Government targets: Centers For Disease Control & Prevention (CDC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), SENATE

Telemedicine Issues related to Health Savings Accounts (HSA's) and telehealth. S. 1016 - Creating Opportunities Now for Necessary and Effective Care Technologies for Health Act (CONNECT Act). H.R. 3727 - Increasing Telehealth Access to Medicare Act.

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

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

S. 1016 - Creating Opportunities Now for Necessary and Effective Care Technologies for Health Act (CONNECT Act). 340B Drug Pricing Program. Cyber-security related to Healthcare data.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), Office of Science & Technology Policy (OSTP), SENATE

Advocating for funding to assist long-term and post-acute care providers with the cost of electronic health records and other applied technology. Urging Congress to include long-term and post-acute care settings in national health IT initiatives, including the development, adoption and use of interoperability standards, the certification of IT products, and the engagement of LTPAC providers in EHR incentive programs. Support S. 1016, the CONNECT for Health Act, to broaden Medicare reimbursement criteria for telehealth. Support S. 787, the Telehealth Innovation and Improvement Act, allowing CMS to test telehealth and other technologies to improve delivery of health services to beneficiaries with defined illnesses.

Client expense: $91,901 · Firm income: Not reported

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

Legislation and policies relating to: Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Reauthorization of funding for the Childrens Health Insurance Program Reauthorization of the Child Nutrition Act Section 2706 of the ACA regarding provider non-discrimination Policies related to health insurance market stabilization Policies affecting nurse practitioner education and workforce Definition, evaluation and enforcement of essential health benefits and provider network adequacy Health information technology and electronic health records Mental health services and violence prevention Human and child trafficking H.R. 315/S. 783 - Improving Access to Maternity Care Act H.R. 767/S. 256 - Stop, Observe, Ask, and Respond (SOAR) to Health and Wellness Act of 2017 H.R. 772/S. 261 - Common Sense Nutrition Disclosure Act H.R. 959/S. 1109 - Title VIII Nursing Workforce Reauthorization Act of 2017 H.R. 1174/S. 1497 - Fairness For Breastfeeding Mothers Act of 2017 H.R. 1215 - Protecting Access to Care Act of 2017 H.R. 1318 - Preventing Maternal Deaths Act of 2017 H.R. 1865 - Allow States and Victims to Fight Online Sex Trafficking Act of 2017 H.R. 2742/S. 1257 - Modernizing the Interstate Placement of Children in Foster Care Act H.R. 2824 - Increasing Opportunity through Evidence-Based Home Visiting Act H.R. 2857 - Supporting Families in Substance Abuse Treatment Act H.R. 2834 - Partnership Grants to Strengthen Families Affected by Parental Substance Abuse Act H.R. 2866 - Reducing Barriers for Relative Foster Parents Act H.R. 2847 - Improving Services for Older Youth in Foster Care Act H.R. 3192 - CHIP Mental Health Parity Act H.R. 3291 - Alleviating Adverse Childhood Experiences (ACES) Act H.R. 3387 - Drinking Water System Improvement Act of 2017 H.R. 3525 - Home Visiting Works Act of 2017 H.R. 3728 - Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness (EMPOWER) Act of 2017 H.R. 3921 - Helping Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable (HEALTHY KIDS) Act H.R. 3922 - Continuing Community Health And Medical Professional Programs to Improve Our Nation, Increase National Gains, and Help Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable (CHAMPIONING HEALTHY KIDS) Act of 2017 H.R. 3928 - Truth in Healthcare Marketing Act of 2017 H.R. 4695 - Bipartisan Market Stabilization and Innovation Act of 2017 H.R. 4978/S. 2410 - Chronic Disease Management Act of 2018 H.R. 4998 - Health Insurance for Former Foster Youth Act H.R. 5385/S. 2597 - Childrens Hospital GME Support Reauthorization Act of 2018 H.R. 5425/S. 2647 - Food Labeling Modernization Act of 2018 H.R. 5977 - Mothers and Offspring Mortality and Morbidity Awareness (MOMMAs) Act H.R. 6199 - Restoring Access to Medication and Modernizing Health Savings Accounts Act of 2018 H.R. 6560 - ChiPACC Act of 2018 S. 761/H.R. 1933 - Health Care Options Act of 2017 S. 920 - National Clinical Care Commission Act S. 1016/H.R. 2556 - Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2017 S. 1028 - Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act S. 1091/H.R. 3105 - Supporting Grandparents Raising Grandchildren Act S. 1112 - Maternal Health Accountability Act of 2017 S. 1268 - Child Protection and Family Support Act of 2017 S.1377 - Reaching Underserved Rural Areas to Lead on Telehealth Act S. 1441/H.R. 3059 - Community Health Center and Primary Care Workforce Expansion Act of 2017 S. 1693 - Stop Enabling Sex Traffickers Act of 2017 S. 1827 - Keeping Kids Insurance Dependable and Secure (KIDS) Act S. 1829 - Strong Families Act of 2017 S. 2415 - Accelerating Kids Access to Care Act S. 2852/H.R. 3678 - Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018 S. 3029 - Prematurity Research Expansion and Education for Mothers who deliver Infants Early (PREEMIE) Reauthorization Act of 2018 S. 3319 - Stopping Appealing Flavors in E-Cigarettes (SAFE) for Kids Act S. 3388 - Ensuring Coverage for Patients with Pre-Existing Conditions Act S. J. Res. 63 - A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Secretary of the Treasury, Secretary of Labor, and Secretary of Health and Human Services relating to Short-Term, Limited Duration Insurance"

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

Government targets: Agriculture, Dept of (USDA), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Justice, Dept of (DOJ), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA)

H.R., 5041 Safe Disposal of Unused Medication Act. S. 2680, Opioid Crisis Response Act of 2018. H.R. 6, SUPPORT for Patients and Communities Act. S. 1016, CONNECT for Health Act. Hospice and Opioid Prescribing. Hospice Shortages of Controlled Substances. H.R. 6813, Homecare for Seniors Act.

Client expense: $120,000 · Firm income: Not reported

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

National Drug Abuse Crisis and related bills. Specifically H.R. 6, SUPPORT for Patients and Communities Act. 42 CFR Part 2 - advocating to align 42 CFR Part 2 (substance use privacy regulations) with HIPAA to allow appropriate access to patient information that is essential for providing whole-person care. Advocating for the passage of the Overdose Prevention and Patient Safety Act, H.R. 6082, or the Protecting Jessica Grubb's Legacy Act, S. 1850, in the Senate. Behavioral Health Information Technology, extending health information technology assistance eligibility to more mental health and substance use disorder professionals and facilities. Specifically H.R. 3331 and S. 1732, the Improving Access to Behavioral Health Information Technology Act. Telehealth, reforming barriers to Medicare reimbursement. Specifically, the CONNECT for Health Act, S. 1016/H.R. 2556. Medicare coverage of Mental Health Counselors and Marriage and Family Therapists - the Mental Health Access Improvement Act, H.R. 3032, and the Seniors Mental Health Access Improvement Act, S. 1879. Mental Health Parity Behavioral Health

Client expense: $125,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Treasury, Dept of, White House Office

National Drug Abuse Crisis and related bills. Specifically H.R. 6, SUPPORT for Patients and Communities Act. 42 CFR Part 2 - advocating to align 42 CFR Part 2 (substance use privacy regulations) with HIPAA to allow appropriate access to patient information that is essential for providing whole-person care. Advocating for the passage of the Overdose Prevention and Patient Safety Act, H.R. 6082, or the Protecting Jessica Grubb's Legacy Act, S. 1850, in the Senate. Behavioral Health Information Technology, extending health information technology assistance eligibility to more mental health and substance use disorder professionals and facilities. Specifically H.R. 3331 and S. 1732, the Improving Access to Behavioral Health Information Technology Act. Telehealth, reforming barriers to Medicare reimbursement. Specifically, the CONNECT for Health Act, S. 1016/H.R. 2556. Medicare coverage of Mental Health Counselors and Marriage and Family Therapists - the Mental Health Access Improvement Act, H.R. 3032, and the Seniors Mental Health Access Improvement Act, S. 1879. Mental Health Parity Behavioral Health

Client expense: $125,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Treasury, Dept of, White House Office

National Drug Abuse Crisis and related bills. Specifically H.R. 6, SUPPORT for Patients and Communities Act. 42 CFR Part 2 - advocating to align 42 CFR Part 2 (substance use privacy regulations) with HIPAA to allow appropriate access to patient information that is essential for providing whole-person care. Advocating for the passage of the Overdose Prevention and Patient Safety Act, H.R. 6082, or the Protecting Jessica Grubb's Legacy Act, S. 1850, in the Senate. Behavioral Health Information Technology, extending health information technology assistance eligibility to more mental health and substance use disorder professionals and facilities. Specifically H.R. 3331 and S. 1732, the Improving Access to Behavioral Health Information Technology Act. Telehealth, reforming barriers to Medicare reimbursement. Specifically, the CONNECT for Health Act, S. 1016/H.R. 2556. Medicare coverage of Mental Health Counselors and Marriage and Family Therapists - the Mental Health Access Improvement Act, H.R. 3032, and the Seniors Mental Health Access Improvement Act, S. 1879. Mental Health Parity Behavioral Health

Client expense: $125,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Treasury, Dept of, White House Office

H.R. 2556/S. 1016 - Connect for Health Act of 2017. Support and education regarding remote patient monitoring.

Client expense: $2,110,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, SENATE, Transportation, Dept of (DOT), U.S. Trade Representative (USTR)

S. 413, Improving Transparency and Accuracy in Medicare Part D Spending Act (Capito) - PDP/MA-PD payments on clean claims from pharmacies S. 428, ACE Kids Act (Grassley) - coordinated care for children with complex medical conditions S. 1016, CONNECT For Health Act (Schatz) - telehealth S. 1169, Medicaid CARE Act (Durbin-Portman) - changes to Medicaid IMD exclusion S. 1688, Empowering Medicare Seniors to Negotiate Drug Prices Act (Klobuchar) - Part D price negotiations S. 1804, Medicare for All Act (Sanders) - single payer health system S. 1827, Keep Kids Insurance Dependable and Secure Act (Hatch-Wyden) - federal CHIP funding S. 1890, Chronic Kidney Disease Improvement in Research and Treatment and Medigap Access (Cardin) - Medigap coverage for beneficiaries with end-stage renal disease S. 2027, Medicaid Third Party Liability Act (Portman) - Medicaid third party liability S. 2227, EMPOWER Care Act (Portman-Cantwell) - Medicaid Money Follows the Person Demonstration S. 2707, Informing Seniors About Opioids Act (Nelson) - opioid issues S. 2901, Expanding Telehealth Response to Ensure Addiction Treatment Act (Thune) - opioid issues S. 2904, Medicaid Substance Use Disorder Treatment Via Telehealth Act (Carper) - opioid issues S. 2908, Electronic Prior Authorization in Medicare Part D Act (Roberts) - opioid issues S. 3327, SENIOR Communities Protection Act (Cortez Masto) - preventing fraudulent opioid prescriptions S. 3496, Improving Seniors Access to Quality Benefits Act (Daines-King) - study on MA benchmark cap S. 3497, Medicare Advantage Quality Payment Relief Act (Daines-King) - MA benchmark cap Draft Bill: Medicare Long-Term Care Services and Supports Act (Pallone) - Long-Term Services and Supports Program Draft Bills: Prior Authorization in Medicare Advantage (House Ways and Means Committee) - prior authorization notifications, report to Congress S. 2051: Medicare Care Coordination Improvement Act of 2017 (Portman) - barriers to payment reform models H.R. 849, Protecting Seniors Access to Medicare Act (Roe) - Independent Payment Advisory Board H.R. 908, Medicare Advantage Quality Payment Relief Act (Kelly) - MA payment cap H.R. 1038, Improving Transparency and Accuracy in Medicare Part D Spending Act (Griffith) - PDP/MA-PD payments on clean claims from pharmacies H.R. 1148, FAST Act (Griffith) - access to telehealth-eligible stroke services under Medicare H.R. 1316, Prescription Drug Price Transparency Act (Collins) - PBM standards for MA and PDP plans H.R. 1995, V-BID for Better Care Act (Black) - value-based insurance design in Medicare Advantage H.R. 2556, CONNECT For Health Act (Black) - telehealth H.R. 2644, Chronic Kidney Disease Improvement in Research and Treatment and Medigap Access (Marino) - Medigap coverage for beneficiaries with end-stage renal disease H.R. 2687, Medicaid CARE Act (Foster-Fitzpatrick) - changes to Medicaid IMD exclusion H.R. 3044, Supplemental Benefits for Chronically Ill Medicare Advantage Enrollees (Meehan) H.R. 3168, Special Needs Plans (Tiberi-Levin) - SNP reauthorization H.R. 3263, Medicare Independence at Home Model of Care (Burgess) - demonstration program H.R. 3325, ACE Kids Act (Barton) - health homes for children with complex medical conditions H.R. 3360, Telehealth Enhancement Act (Harper) - telehealth in Medicare H.R. 3635, Local Coverage Determination Clarification Act (Jenkins) - procedures for Medicare administrative contractors H.R. 3727, Increasing Telehealth Access in Medicare Act (Black) - telehealth in MA plans H.R. 4143, Dialysis PATIENTS Demonstration Act of 2017 (Smith) - alternative care delivery models and payment methodologies for patients with end-stage renal disease H.R. 4952, Improving Seniors Access to Quality Benefits Act (Kelly) - MA benchmark cap study H.R. 5306, EMPOWER Care Act (Guthrie) - extension of Money Follows the Person Act H.R. 5603, Access to Telehealth Services for Substance Use Disorders Act (Matsui) - opioid issues H.R. 5605, Advancing High Quality Treatment for Opioid Use Disorders in Medicare Act (Ruiz) - opioid issues H.R. 5675, drug management programs for at-risk Medicare beneficiaries (Bilirakis) - opioid issues H.R. 5676, SENIOR Communities Protection Act (MacArthur) - preventing fraudulent opioid prescriptions H.R. 5684, Protecting Seniors from Opioid Abuse Act (Kelly) - opioid issues H.R. 5685, Medicare Opioid Safety Education Act (Faso) - opioid issues H.R. 5686, Medicare Clear Health Options in Care for Enrollees Act (Paulsen) - opioid issues H.R. 5715, Strengthening Partnerships to Prevent Opioid Abuse Act (Renacci) - communication between Medicare plan sponsors and CMS H.R. 5773, Preventing Addiction for Susceptible Seniors Act (Roskam) - opioid issues H.R. 5797, IMD CARE Act (Walters) - Medicaid IMD exclusion H.R. 5798, Opioid Screening and Chronic Pain Management Alternatives for Seniors Act (Bucshon) - opioid issues H.R. 5799, Medicaid Drug Review, Utilization, Good Governance Improvement Act (Blackburn) - opioid issues H.R. 5800, Medicaid IMD ADDITIONAL INFO Act (Upton) - opioid issues H.R. 5804, Post-Surgical Injections as an Opioid Alternative Act (Shimkus) - opioid issues H.R. 5808, Medicaid Pharmaceutical Home Act (Bilirakis) - opioid issues H.R. 5809, Postoperative Opioid Prevention Act (Peters) - opioid issues H.R. 5810, Medicaid Health Homes for Opioid-Use-Disorder Medicaid Enrollees Encouraged Act (Lance) - opioid issues H.R. 5812, Improving Medicaid Data Timeliness Act (Griffith) - opioid issues H.R. 6431, Medigap Consumer Protection Act (Levin) - reforms to Medicare supplemental insurance H.R. 6561, Comprehensive Care for Seniors Act (Walorski) -- Program of All-Inclusive Care for the Elderly H.R. 6563, Lower Out-of-Pocket Costs for Seniors Act (Pallone-Neal) - Medicare Part D cliff H.R. 6662, Empowering Seniors Decision Enrollment Act (Paulsen) - special enrollment period for non-deemed Medicare Cost Plan enrollees H.R. 6690, Fighting Fraud to Protect Care for Seniors Act (Roskam) - Medicare pilot program for smart card technology 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); calendar year 2019 policy and technical regulation for MA and Part D; issues relating to 2019 Rate Notice and Call Letter; 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; Bipartisan Budget Act of 2018 changes to 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) and the Bipartisan Budget Act of 2018 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' substantial revisions to the managed care regulations, 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; issues relating to prescription drug price blueprint; 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: $1,500,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Treasury, Dept of

S. 413, Improving Transparency and Accuracy in Medicare Part D Spending Act (Capito) -PDP/MA-PD payments on clean claims from pharmacies S. 428, ACE Kids Act (Grassley) - coordinated care for children with complex medical conditions S. 1016, CONNECT For Health Act (Schatz) - telehealth S. 1169, Medicaid CARE Act (Durbin-Portman) - changes to Medicaid IMD exclusion S. 1688, Empowering Medicare Seniors to Negotiate Drug Prices Act (Klobuchar) - Part D price negotiations S. 1804, Medicare for All Act (Sanders) - single payer health system S. 1827, Keep Kids Insurance Dependable and Secure Act (Hatch-Wyden) - federal CHIP funding S. 1890, Chronic Kidney Disease Improvement in Research and Treatment and Medigap Access (Cardin) - Medigap coverage for beneficiaries with end-stage renal disease S. 2027, Medicaid Third Party Liability Act (Portman) - Medicaid third party liability S. 2227, EMPOWER Care Act (Portman-Cantwell) - Medicaid Money Follows the Person Demonstration S. 2707, Informing Seniors About Opioids Act (Nelson) - opioid issues S. 2901, Expanding Telehealth Response to Ensure Addiction Treatment Act (Thune) - opioid issues S. 2904, Medicaid Substance Use Disorder Treatment Via Telehealth Act (Carper) - opioid issues S. 2908, Electronic Prior Authorization in Medicare Part D Act (Roberts) - opioid issues Draft Medicare Long-Term Care Services and Supports Act (Pallone) - Long-Term Services and Supports Program H.R. 195, Extension of Continuing Appropriations Act - CHIP funding extension for 2018-2023 and related provisions H.R. 849, Protecting Seniors Access to Medicare Act (Roe) - Independent Payment Advisory Board H.R. 908, Medicare Advantage Quality Payment Relief Act (Kelly) - MA payment cap H.R. 1038, Improving Transparency and Accuracy in Medicare Part D Spending Act (Griffith) - PDP/MA-PD payments on clean claims from pharmacies H.R. 1148, FAST Act (Griffith) - access to telehealth-eligible stroke services under Medicare H.R. 1316, Prescription Drug Price Transparency Act (Collins) - PBM standards for MA and PDP plans H.R. 1892, Bipartisan Budget Act (Larson) - permanent authorization of Medicare Advantage Special Needs Plans; MA chronic care reforms: telehealth, supplemental benefits, value-based insurance design, star ratings; changes to Medicare Part D coverage gap and related discounts; CHIP funding extension for 2024-2027; funding for Puerto Ricos Medicaid program H.R. 1995, V-BID for Better Care Act (Black) - value-based insurance design in Medicare Advantage H.R. 2556, CONNECT For Health Act (Black) - telehealth H.R. 2644, Chronic Kidney Disease Improvement in Research and Treatment and Medigap Access (Marino) - Medigap coverage for beneficiaries with end-stage renal disease H.R. 2687, Medicaid CARE Act (Foster-Fitzpatrick) - changes to Medicaid IMD exclusion H.R. 3044, Supplemental Benefits for Chronically Ill Medicare Advantage Enrollees (Meehan) H.R. 3168, Special Needs Plans (Tiberi-Levin) - SNP reauthorization H.R. 3263, Medicare Independence at Home Model of Care (Burgess) - demonstration program H.R. 3325, ACE Kids Act (Barton) - coordinated care for children with complex medical conditions H.R. 3360, Telehealth Enhancement Act (Harper) - telehealth in Medicare H.R. 3727, Increasing Telehealth Access in Medicare Act (Black) - telehealth in MA plans H.R. 3921, HEALTHY KIDS Act (Burgess) - CHIP funding H.R. 4952, Improving Seniors Access to Quality Benefits Act (Kelly) - MA benchmark cap study H.R. 5603, Access to Telehealth Services for Substance Use Disorders Act (Matsui) - opioid issues H.R. 5605, Advancing High Quality Treatment for Opioid Use Disorders in Medicare Act (Ruiz) - opioid issues H.R. 5675, drug management programs for at-risk Medicare beneficiaries (Bilirakis) - opioid issues H.R. 5676, SENIOR Communities Protection Act (MacArthur) - preventing fraudulent opioid prescriptions H.R. 5684, Protecting Seniors from Opioid Abuse Act (Kelly) - opioid issues H.R. 5685, Medicare Opioid Safety Education Act (Faso) - opioid issues H.R. 5686, Medicare Clear Health Options in Care for Enrollees Act (Paulsen) - opioid issues H.R. 5715, Strengthening Partnerships to Prevent Opioid Abuse Act (Renacci) - communication between Medicare plan sponsors and CMS H.R. 5773, Preventing Addiction for Susceptible Seniors Act (Roskam) - opioid issues H.R. 5797, IMD CARE Act (Walters) - Medicaid IMD exclusion H.R. 5798, Opioid Screening and Chronic Pain Management Alternatives for Seniors Act (Bucshon) - opioid issues H.R. 5799, Medicaid Drug Review, Utilization, Good Governance Improvement Act (Blackburn) - opioid issues H.R. 5800, Medicaid IMD ADDITIONAL INFO Act (Upton) - opioid issues H.R. 5804, Post-Surgical Injections as an Opioid Alternative Act (Shimkus) - opioid issues H.R. 5808, Medicaid Pharmaceutical Home Act (Bilirakis) - opioid issues H.R. 5809, Postoperative Opioid Prevention Act (Peters) - opioid issues H.R. 5810, Medicaid Health Homes for Opioid-Use-Disorder Medicaid Enrollees Encouraged Act (Lance) - opioid issues H.R. 5812, Improving Medicaid Data Timeliness Act (Griffith) - opioid issues 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); calendar year 2019 policy and technical regulation for MA and Part D; issues relating to 2019 Rate Notice and Call Letter; 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; Bipartisan Budget Act of 2018 changes to 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) and the Bipartisan Budget Act of 2018 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' substantial revisions to the managed care regulations, 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; issues relating to prescription drug price blueprint; 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: $1,410,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Food & Drug Administration (FDA), 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. 2550, "Medicare Telehealth Parity Act of 2017", regarding all provisions. Issues relating to Home Dialysis Expansion Legislation. H.R.1245/S. 469, "Affordable and Safe Prescription Drug Importation Act", regarding all provisions. S.1016, "CONNECT for Health Act of 2017", regarding all provisions. Issues related to ESRD Reimbursement for Hemodialysis. H.R.28, "Biological Implant Tracking and Veteran Safety Act of 2017", regarding all provisions. Implementation of the 21st Century Cures regulations. Issues relating to 340B Drug Pricing.

Client expense: $470,000 · Firm income: Not reported

Government targets: Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), SENATE