Medicaid Coverage for Addiction Recovery Expansion Act

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

S. 448/H.R. 1173 Medicare Mental Health Access Act S. 874 At-Risk Youth Medicaid Protection Act S. 1905/H.R. 3931 Excellence in Mental Health and Addiction Treatment Expansion Act S. 1169/H.R. 2687 Medicaid Coverage for Addiction Recovery Expansion Act S. 1732/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 H.R. 6 Support for Patients and Communities Act H.R. 2337: To amend title XIX of the Social Security Act to provide for a State Medicaid option to enhance administrative matching funds to support statewide behavioral health access program activities for children under 21 years of age, and for other purposes H.R. 2509 Medicare Mental Health Inpatient Inequity Act H.R. 7217 IMPROVE Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE, White House Office

H.R. 1173: Medicare Mental Health Access Act. Legislation to amend Medicares Physician Definition, to provide for treatment of clinical psychologists as physicians for purposes of furnishing clinical psychologist services under the Medicare Program S. 448: Medicare Mental Health Access Act. Legislation to amend Medicares Physician Definition, to provide for treatment of clinical psychologists as physicians for purposes of furnishing clinical psychologist services under the Medicare Program H.R. 2509: Medicare Mental Health Inpatient Equity Act of 2017. Legislation To amend title XVIII of the Social Security Act to eliminate the 190-day lifetime limit on inpatient psychiatric hospital services under the Medicare Program S.1169: Medicaid Coverage for Addiction Recovery Expansion Act. A bill to amend title XIX of the Social Security Act to provide States with an option to provide medical assistance to individuals between the ages of 22 and 64 for inpatient services to treat substance use disorders at certain facilities, and for other purposes H.R. 1953: Treat and Reduce Obesity Act of 2017. To amend title XVIII of the Social Security Act to provide for the coordination of programs to prevent and treat obesity, and for other purposes S. 3797, H.R. 6781: Mental Health Telemedicine Expansion Act S. 830: Treat and Reduce Obesity Act of 2017. To amend title XVIII of the Social Security Act to provide for the coordination of programs to prevent and treat obesity, and for other purposes 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 H.R. 2337: To amend title XIX of the Social Security Act to provide for a State Medicaid option to enhance administrative matching funds to support statewide behavioral health access program activities for children under 21 years of age, and for other purposes S. 1905, HR 3931: Excellence in Mental Health and Addiction Treatment Expansion Act. To increase the number of States that may conduct Medicaid demonstration programs to improve access to community mental health services S. 1169, H.R. 2687: Medicaid Coverage for Addiction Recovery Expansion Act. A bill to amend title XIX of the Social Security Act to provide States with an option to provide medical assistance to individuals between the ages of 22 and 64 for inpatient services to treat substance use disorders at certain facilities, and for other purposes S. 3383, H.R. 5477: Rural DOCS Act. To provide incentives for state Medicaid expenditures related to the expansion of substance-use treatment and recovery services targeting provider capacity S. 428, H.R. 3325: Advancing Care for Exceptional Kids Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1173/S. 448, the Medicare Mental Health Access Act H.R. 849, the Protecting Seniors Access to Medicare Act S. 1301/H.R. 2267, the Resident Physician Shortage Reduction Act H.R. 2276/S. 2575, the Audiology Patient Choice Act H.R. 5594, the Improving Access to Remote Behavioral Health Treatment Act of 2018 S. 2680, the Opioid Crisis Response Act of 2018 H.R. 6, the SUPPORT for Patients and Communities Act H.R. 1925, the At-Risk Youth Medicaid Protection Act H.R. 2509, the Medicare Mental Health Inpatient Equity Act S. 1169, the Medicaid Coverage for Addiction Recovery Expansion Act H.R. 2687, the Medicaid Coverage for Addiction Recovery Expansion Act H.R. 4005, the Medicaid Reentry Act H.R. 4097, the Medicare Beneficiary Opioid Addiction Treatment Act S. 2843/H.R. 5818, the Opioid Workforce Act of 2018 Comments re: the Centers for Medicare & Medicaid Services (CMS) decision to suspend the risk adjustment payments to insurers participating in the individual and small-group marketplaces, as mandated by the Affordable Care Act Support for 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. Comments re: CMSs proposed rule, Revisions to Payment Policies under the Medicare Physician Fee Schedule, Quality Payment Program and Other Revisions to Part B for CY 2019. CMS-1693-P Comments re: CMSs proposed rule, Medicare Program; Medicare Shared Savings Program; Accountable Care Organizations-Pathways to Success. Comments re: CMSs proposed rule, Medicare Program; Medicare Shared Savings Program; Accountable Care Organizations-Pathways to Success Comment on the CY 2019 Proposed Rule for the Medicare and Medicaid Programs; Regulatory Provisions to Promote Program Efficiency, Transparency, and Burden Reduction. Issue 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)

HCR: HCR: Implementation of health care reform law as it relates to substance abuse treatment and prevention, Medicaid - IMD exclusion; parity for SUD treatment; S. 524, access to treatment under Medicaid and Essential health benefits the Comprehensive Addiction & Recovery Act, specifically provisions that relate to SUD Treatment. S.1169 Medcaid Coverage for Addiction Recovery Expansion (Medicaid CARE) act , H.R. 2938 Road to Recovery Act, H.R. 2687 Medicaid Coverage for Addiction Recovery Expansion (Medicaid CARE) Act; monitoring policies and regulations related to the Presidents declaration of the opioid crisis as a public health emergency under the Public Health Service Act; H.R. 5797 Legislation to reform IMD exclusion; Provisions related to IMD exclusion in HR 6 and enacted into law as the SUPPORT for Patients and Communities Act, designated Public Law 115-271. Patient privacy provisions in H.R. 6082, the Overdose Prevention and Patient Safety Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

HCR: Implementation of health care reform law as it relates to substance abuse treatment and prevention, Medicaid - IMD exclusion; parity for SUD treatment;S.524 access to treatment under Medicaid and Essential Health benefits, the Comprehensive Addiction & Recovery Act, specifically provisions that relate to SUD Treatment. S.1169 Medcaid Coverage for Addiction Recovery Expansion (Medicaid CARE) act , H.R. 2938 Road to Recovery Act, H.R. 2687 Medicaid Coverage for Addiction Recovery Expansion (Medicaid CARE) Act; monitor policies and regulations related to the President's declaration of the opioid crisis as a public health emergency under the Public Health Service Act; H.R. 5797 Legislation to reform the IMD exclusion; Provisions related to IMD exclusion in HR 6 Opioid Crisis Response Act and enacted into law as the SUPPORT for Patients and Communities Act, designated Public Law 115-271

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 5102, S. 2524 - Substance Use Disorder Workforce Loan Repayment Act H.R. 6 - SUPPORT for Patients and Communities Act (Public Law No: 115-271) S.2680: The Opioid Crisis Response Act of 2018 H.R. 6082, H.R. 5795, Overdose Prevention and Patient Safety Act H.R. 2938, The Road to Recovery Act S. 1169, The Medicaid Coverage for Addiction Recovery Expansion (Medicaid CARE) Act S.756, First Step Act (P.L. 115-391)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.2613/H.R. 1290 Improving Access to Mental Health Act of 2018 H.R.3922 - CHAMPIONING HEALTHY KIDS Act H.R.3921 - HEALTHY KIDS Act S.1827 - KIDS Act of 2017 H.R. 6 [P.L. No: 115-271] - SUPPORT for Patients and Communities Act H.Res.1099 - Providing for the concurrence by the House in the Senate amendment to H.R. 6, with an amendment S.2253/H.R.3192 - CHIP Mental Health Parity Act Practice and Reimbursement issues related to clinical social workers S.1169/ H.R. 2687 - Medicaid Coverage for Addiction Recovery Expansion (CARE) Act Medicare Part B program issues

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)

Support H.R. 741/ S. 243 Rural Hospital Regulatory Relief Act of 2017, a bill that amends title XVIII (Medicare) of the Social Security Act to permanently extend the application by the Centers for Medicare & Medicaid Services of an instruction against the enforcement of certain physician supervision requirements with respect to outpatient therapeutic services in critical access hospitals and small rural hospitals; Support H.R. 807/ S. 253 Medicare Access to Rehabilitation Services Act of 2017, a bill to amend title XVIII of the Social Security Act to repeal the Medicare outpatient rehabilitation therapy caps; Discussion about the Electronic Clinical Quality Measure Reporting: advocating for an extension of the reporting deadline to increase hospitals ability to meet requirements in the Hospital Inpatient Quality Reporting program and the Medicare EHR Incentive Program;Requested clarification from CMS about providing care to justice-involved individuals and receiving Medicaid/Medicare reimbursement for such care to Made efforts in support of clarifying that hospitals may have designated units to care for patients in the custody of law enforcement/correctional institutions and may receive Medicaid reimbursement for care provided in such units; Support S. 872/ HR 1955Rural Hospital Access Act of 2017, a bill to amend title XVIII of the Social Security Act to make permanent the extension of the Medicare-dependent hospital (MDH) program and the increased payments under the Medicare low-volume hospital program; Support S 1301/ HR 2267, Resident Physician Shortage Reduction Act of 2017, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; Oppose H.R. 1628 American Health Care Act / Better Care Reconciliation Act, a bill that would repeal and replace much of the Affordable Care Act, including repealing Medicaid expansion and the advanced premium tax credits for the purchase of coverage on the Health Insurance Marketplaces; Support S 1334/ HR 2797Patient Choices and Quality Care Act of 2017, a bill to provide for advanced illness care coordination services for Medicare beneficiaries; Urged the Administration to cancel Stage 3 of meaningful use by removing the 2018 start date from the regulation. The Administration also should institute a 90- day reporting period in every future year of the program, and gather input from stakeholders on ways to further reduce the burden of the meaningful use program from current requirements; Review S. 1169/ HR 2687, Medicaid Coverage for Addiction Recovery Expansion Act, a bill to amend title XIX of the Social Security Act to provide States with an option to provide medical assistance to individuals between the ages of 22 and 64 for inpatient services to treat substance use disorders at certain facilities; Review HR 2509 Medicare Mental Health Inpatient Equity Act, a bill to amend title XVIII of the Social Security Act to eliminate the 190-day lifetime limit on inpatient psychiatric hospital services under the Medicare Program; Urged CMS to rescind the 25% Rule and instead rely on the site-neutral payment policy to bring transformative change to the LTCH field; Discussion with CMS about direct supervision of outpatient therapeutic services; Support HR 3120, a bill to amend title XVIII of the Social Security Act to reduce the volume of future electronic health record-related significant hardship requests; Discussed with Congress potential offsets to pay for CHIP and other Medicare extender legislation; Support straight extensions of the Medicare-dependent hospital and enhanced low-volume adjustment program; Support eliminating the reductions to Medicaid payments for DSH in fiscal years 2018 and 2019; Urged CMS to eliminate a duplicative budget-neutrality adjustment (BNA) being applied to Medicare payments for LTCH site-neutral cases, an unwarranted 5.1 percent cut. Urged CMS to permanently eliminate the LTCH 25% Rule policy; support The Limited Repeal of the IMD Exclusion for Adult Medicaid Beneficiaries with Substance Use Disorder Act, which would improve access to needed substance use disorder (SUD)treatment services for millions of Americans.

Client expense: $5,220,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Office of Management & Budget (OMB), SENATE, 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. 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

HCR: Implementation of health care reform law as it relates to substance abuse treatment and prevention, Medicaid - IMD exclusion; parity for SUD treatment;S.524 access to treatment under Medicaid and Essential Health benefits, the Comprehensive Addiction & Recovery Act, specifically provisions that relate to SUD Treatment. S.1169 Medcaid Coverage for Addiction Recovery Expansion (Medicaid CARE) act , H.R. 2938 Road to Recovery Act, H.R. 2687 Medicaid Coverage for Addiction Recovery Expansion (Medicaid CARE) Act; monitor policies and regulations related to the President's declaration of the opioid crisis as a public health emergency under the Public Health Service Act; H.R. 5797 Legislation to reform the IMD exclusion; Provisions related to IMD exclusion in HR 6 Opioid Crisis Response Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1173/S. 448, the Medicare Mental Health Access Act H.R. 849, the Protecting Seniors Access to Medicare Act S. 1301/H.R. 2267, the Resident Physician Shortage Reduction Act H.R. 2276/S. 2575, the Audiology Patient Choice Act H.R. 5594, the Improving Access to Remote Behavioral Health Treatment Act of 2018 S. 2680, the Opioid Crisis Response Act of 2018 H.R. 6, the SUPPORT for Patients and Communities Act H.R. 1925, the At-Risk Youth Medicaid Protection Act H.R. 2509, the Medicare Mental Health Inpatient Equity Act S. 1169, the Medicaid Coverage for Addiction Recovery Expansion Act H.R. 2687, the Medicaid Coverage for Addiction Recovery Expansion Act H.R. 4005, the Medicaid Reentry Act H.R. 4097, the Medicare Beneficiary Opioid Addiction Treatment Act S. 2843/H.R. 5818, the Opioid Workforce Act of 2018 Comments re: the Centers for Medicare & Medicaid Services (CMS) decision to suspend the risk adjustment payments to insurers participating in the individual and small-group marketplaces, as mandated by the Affordable Care Act Support for 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. Comments re: CMSs proposed rule, Revisions to Payment Policies under the Medicare Physician Fee Schedule, Quality Payment Program and Other Revisions to Part B for CY 2019. CMS-1693-P Comments re: CMSs proposed rule, Medicare Program; Medicare Shared Savings Program; Accountable Care Organizations-Pathways to Success. Issue relating to suicide prevention; in general Issues relating to the enforcement of mental health parity; in general

Client expense: $260,000 · 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)

H.R. 6, Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act, all provisions H.R. 4143, Dialysis Patient Access To Integrated-care, Empowerment, Nephrologists, Treatment, and Services (PATIENTS) Demonstration Act of 2017, all provisions S. 2065, Dialysis Patient Access To Integrated-care, Empowerment, Nephrologists, Treatment, and Services (PATIENTS) Demonstration Act of 2017, all provisions H.R. 4554, Medicare Common Access Card Act of 2017, all provisions H.R. 6309, Allowing Working Seniors to Keep Their Health Savings Accounts Act of 2018, all provisions H.R. 6733, Know the Cost Act of 2018, all provisions S. 2553, Know the Lowest Price Act of 2018, all provisions S. 3120, Helping to End Addiction and Lessen (HEAL) Substance Use Disorders Act of 2018, provisions relating to Medicare and Medicaid S. 2904, Medicaid Substance Use Disorder Treatment via Telehealth Act, provision relating to telehealth definition S. 2910, Telehealth for Children's Access to Services and Treatment (TeleCAST) Act, provision relating to telehealth definition 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. 1291, Advancing Medical Resident Training in Community Hospitals Act of 2017, all provisions S. 1016, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2017, provisions relating to telehealth Medicare program: Medicare Access and Chip Reauthorization (MACRA) implementation Medicare program: Merit-based Incentive Payment System (MIPS) Medicare program: Regulatory Relief Medicare program: Quality Payment Program (QPP)/Interoperability Medicare program: QPP cost measures Medicare program: Protecting Access to Medicare Act (PAMA) clinical lab issues/physician office labs Medicare program: Part B drug reimbursement Medicare program: Outpatient Prospective Payment System (OPPS)/Ambulatory Surgical Center (ASC) Payment System Medicare program: Appropriate Use Criteria Medicare program: Health IT Medicare program: Office visit codes Medicare program: Alternative Payment Models (APMs) Medicare program: Accountable Care Organization (ACO)/Medicare Shared Savings Program (MSSP) Medicare program: Graduate Medical Education (GME) Medicare program: 2019 Medicare Physician Fee Schedule Medicare program: Drug pricing/Competitive Acquisition Program, Part B to Part D, Medicare Advantage Step Therapy Medicare program: Open Payments Medicare program: Clinical laboratory fee schedule cuts Medicare program: Evaluation & Management Codes Medicare program: Misvalued codes Medicare program: Outpatient Prospective Payment System (OPPS)/Ambulatory Surgical Centers (ASC) Payment System Medicare program: Prior Authorization Medicare program: Electronic Health Records (EHR) Medicare program: Inpatient Prospective Payment System Medicare program: Diabetes/payment Medicare program: Diabetes Prevention Program Medicare program: Opioids Medicare program: Smart Cards Medicare program: Value-based arrangements Medicare program: Evaluation and Management proposals Medicare program: Payment Model Technical Advisory Committee (PTAC)/model approval process Medicare program: Medicare Advantage Qualifying Payment Arrangement Incentive (MAQI) demonstration Medicare program: Pharmacy Benefit Managers (PBMs) Medicare and Medicaid programs: Appropriate Use Criteria Medicare and Medicaid programs: Cybersecurity Medicare and Medicaid programs: Stark/Anti-Kickback/Value-based arrangements Medicare and Medicaid programs: Electronic Health Records/certification Medicare and Medicaid programs: Provider Enrollment, Chain and Ownership System (PECOS)/Medicare Enrollment/Revocations/Revalidations Medicaid program: Marylands Medicaid Demonstration Waiver Amendment

Client expense: $4,120,000 · Firm income: Not reported

Government targets: Bureau of Citizenship & Immigration Services (BCIS), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), SENATE, Veterans Affairs, Dept of (VA), White House Office

Excellence in Mental Health and Addiction Treatment Expansion Act (S. 1905/ H.R.3931), all provisions related to expanding and extending the Certified Community Behavioral Health Clinic demonstration program. Medicaid Coverage for Addiction Recovery Expansion Act (S. 1169/H.R. 2687), all provisions related to expanding the number of residential substance use treatment facilities through Medicaid. Mental Health Access Improvement Act (S. 1879/H.R. 3032), all provisions related to allowing marriage and family therapists and mental health counselors to directly bill Medicare for their services. Opioid Emergency Response Act (H.R. 5531), all provisions related to expanding the Medicare eligible workforce to include marriage and family therapists and mental health counselors. Medicaid Reentry Act (H.R. 4005), all provisions related to allowing states the flexibility to restart Medicaid coverage for incarcerated individuals up to 30 days prior to their release. The IMD CARE Act (H.R. 5797), all provisions related to changing the restriction of Medicaid payment for residential substance use disorder treatment in certain facilities. Graham-Cassidy Bill (Senate Amendment 1030), all provisions related to the repeal of coverage expansions and consumer protections established in the Affordable Care Act.

Client expense: $116,648 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1173: Medicare Mental Health Access Act. Legislation to amend Medicares Physician Definition, to provide for treatment of clinical psychologists as physicians for purposes of furnishing clinical psychologist services under the Medicare Program. S. 448: Medicare Mental Health Access Act. Legislation to amend Medicares Physician Definition, to provide for treatment of clinical psychologists as physicians for purposes of furnishing clinical psychologist services under the Medicare Program. H.R. 2509: Medicare Mental Health Inpatient Equity Act of 2017. Legislation To amend title XVIII of the Social Security Act to eliminate the 190-day lifetime limit on inpatient psychiatric hospital services under the Medicare Program. S.1169: Medicaid Coverage for Addiction Recovery Expansion Act. A bill to amend title XIX of the Social Security Act to provide States with an option to provide medical assistance to individuals between the ages of 22 and 64 for inpatient services to treat substance use disorders at certain facilities, and for other purposes. H.R. 1953: Treat and Reduce Obesity Act of 2017. To amend title XVIII of the Social Security Act to provide for the coordination of programs to prevent and treat obesity, and for other purposes. S. 830: Treat and Reduce Obesity Act of 2017. To amend title XVIII of the Social Security Act to provide for the coordination of programs to prevent and treat obesity, and for other purposes. 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 H.R. 2337: To amend title XIX of the Social Security Act to provide for a State Medicaid option to enhance administrative matching funds to support statewide behavioral health access program activities for children under 21 years of age, and for other purposes. S. 1905, HR 3931: Excellence in Mental Health and Addiction Treatment Expansion Act. To increase the number of States that may conduct Medicaid demonstration programs to improve access to community mental health services. S. 1169, H.R. 2687: Medicaid Coverage for Addiction Recovery Expansion Act. A bill to amend title XIX of the Social Security Act to provide States with an option to provide medical assistance to individuals between the ages of 22 and 64 for inpatient services to treat substance use disorders at certain facilities, and for other purposes. S. 3383, H.R. 5477: Rural DOCS Act. To provide incentives for state Medicaid expenditures related to the expansion of substance-use treatment and recovery services targeting provider capacity.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 448/H.R. 1173 Medicare Mental Health Access Act S. 874 At-Risk Youth Medicaid Protection Act S. 1905/H.R. 3931 Excellence in Mental Health and Addiction Treatment Expansion Act S. 1169/H.R. 2687 Medicaid Coverage for Addiction Recovery Expansion Act S. 1732/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 H.R. 6 Support for Patients and Communities Act H.R. 2337: To amend title XIX of the Social Security Act to provide for a State Medicaid option to enhance administrative matching funds to support statewide behavioral health access program activities for children under 21 years of age, and for other purposes H.R. 2509 Medicare Mental Health Inpatient Inequity Act

Client expense: $160,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE, White House Office

H.R. 5102, S. 2524 - Substance Use Disorder Workforce Loan Repayment Act H.R. 6 - SUPPORT for Patients and Communities Act H.Res.1099 - Providing for the concurrence by the House in the Senate amendment to H.R. 6, with an amendment S.2680: The Opioid Crisis Response Act of 2018 H.R. 6082, H.R. 5795, Overdose Prevention and Patient Safety Act H.R. 2938, The Road to Recovery Act S. 1169, The Medicaid Coverage for Addiction Recovery Expansion (Medicaid CARE) Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.2613/H.R. 1290 Improving Access to Mental Health Act of 2018 H.R.3922 - CHAMPIONING HEALTHY KIDS Act H.R.3921 - HEALTHY KIDS Act S.1827 - KIDS Act of 2017 H.R. 6 - SUPPORT for Patients and Communities Act H.Res.1099 - Providing for the concurrence by the House in the Senate amendment to H.R. 6, with an amendment S.2253/H.R.3192 - CHIP Mental Health Parity Act Practice and Reimbursement issues related to clinical social workers S.1169/ H.R. 2687 - Medicaid Coverage for Addiction Recovery Expansion (CARE) Act

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), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

-Advocacy on behalf of broadening and improving opportunities for alternative payment model participation under MACRA, including population-based models, advanced primary care models, and episodic bundled payment models; -Advocacy on behalf of establishing a new advanced physician group practice model; and -Advocacy on behalf of HR 4006 a bill establishing a CBI-SNP demonstration. -Advocacy related to a potential legislative response to the opioid and substance abuse crisis, including but not limited to advocacy in support of S.1169/H.R.2687 the Medicaid Coverage for Addiction Recovery Expansion Act, S.2460/H.R. 3528 the Every Prescription Conveyed Securely Act, and S.2317/H.R.3692 the Addiction Treatment Access Improvement Act.

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

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

-Advocacy on behalf of expanding the preventive services safe harbor for Health Savings Account-eligible High-Deductible Health Plans to provide for better coverage of chronic care services -Advocacy related to a potential legislative response to the opioid and substance abuse crisis, including but not limited to advocacy in support of S.1169/H.R.2687 the Medicaid Coverage for Addiction Recovery Expansion Act, S.2460/H.R. 3528 the Every Prescription Conveyed Securely Act, and S.2317/H.R.3692 the Addiction Treatment Access Improvement Act.

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

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

-Advocacy on behalf of broadening and improving opportunities for alternative payment model participation under MACRA, including population-based models, advanced primary care models, and episodic bundled payment models; -Advocacy on behalf of establishing a new advanced physician group practice model; and -Advocacy on behalf of HR 4006 a bill establishing a CBI-SNP demonstration. -Advocacy related to a potential legislative response to the opioid and substance abuse crisis, including but not limited to advocacy in support of S.1169/H.R.2687 the Medicaid Coverage for Addiction Recovery Expansion Act, S.2460/H.R. 3528 the Every Prescription Conveyed Securely Act, and S.2317/H.R.3692 the Addiction Treatment Access Improvement Act.

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

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

-Advocacy on behalf of expanding the preventive services safe harbor for Health Savings Account-eligible High-Deductible Health Plans to provide for better coverage of chronic care services -Advocacy related to a potential legislative response to the opioid and substance abuse crisis, including but not limited to advocacy in support of S.1169/H.R.2687 the Medicaid Coverage for Addiction Recovery Expansion Act, S.2460/H.R. 3528 the Every Prescription Conveyed Securely Act, and S.2317/H.R.3692 the Addiction Treatment Access Improvement Act.

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

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

-Advocacy on behalf of expanding the preventive services safe harbor for Health Savings Account-eligible High-Deductible Health Plans to provide for better coverage of chronic care services -Advocacy related to a potential legislative response to the opioid and substance abuse crisis, including but not limited to advocacy in support of S.1169/H.R.2687 the Medicaid Coverage for Addiction Recovery Expansion Act, S.2460/H.R. 3528 the Every Prescription Conveyed Securely Act, and S.2317/H.R.3692 the Addiction Treatment Access Improvement Act.

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

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

-Advocacy on behalf of broadening and improving opportunities for alternative payment model participation under MACRA, including population-based models, advanced primary care models, and episodic bundled payment models; -Advocacy on behalf of establishing a new advanced physician group practice model; and -Advocacy on behalf of HR 4006 a bill establishing a CBI-SNP demonstration. -Advocacy related to a potential legislative response to the opioid and substance abuse crisis, including but not limited to advocacy in support of S.1169/H.R.2687 the Medicaid Coverage for Addiction Recovery Expansion Act, S.2460/H.R. 3528 the Every Prescription Conveyed Securely Act, and S.2317/H.R.3692 the Addiction Treatment Access Improvement Act.

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

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

Support H.R. 741/ S. 243 Rural Hospital Regulatory Relief Act of 2017, a bill that amends title XVIII (Medicare) of the Social Security Act to permanently extend the application by the Centers for Medicare & Medicaid Services of an instruction against the enforcement of certain physician supervision requirements with respect to outpatient therapeutic services in critical access hospitals and small rural hospitals; Support H.R. 807/ S. 253 Medicare Access to Rehabilitation Services Act of 2017, a bill to amend title XVIII of the Social Security Act to repeal the Medicare outpatient rehabilitation therapy caps; Discussion about the Electronic Clinical Quality Measure Reporting: advocating for an extension of the reporting deadline to increase hospitals ability to meet requirements in the Hospital Inpatient Quality Reporting program and the Medicare EHR Incentive Program;Requested clarification from CMS about providing care to justice-involved individuals and receiving Medicaid/Medicare reimbursement for such care to Made efforts in support of clarifying that hospitals may have designated units to care for patients in the custody of law enforcement/correctional institutions and may receive Medicaid reimbursement for care provided in such units; Support S. 872/ HR 1955Rural Hospital Access Act of 2017, a bill to amend title XVIII of the Social Security Act to make permanent the extension of the Medicare-dependent hospital (MDH) program and the increased payments under the Medicare low-volume hospital program; Support S 1301/ HR 2267, Resident Physician Shortage Reduction Act of 2017, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; Oppose H.R. 1628 American Health Care Act / Better Care Reconciliation Act, a bill that would repeal and replace much of the Affordable Care Act, including repealing Medicaid expansion and the advanced premium tax credits for the purchase of coverage on the Health Insurance Marketplaces; Support S 1334/ HR 2797Patient Choices and Quality Care Act of 2017, a bill to provide for advanced illness care coordination services for Medicare beneficiaries; Urged the Administration to cancel Stage 3 of meaningful use by removing the 2018 start date from the regulation. The Administration also should institute a 90- day reporting period in every future year of the program, and gather input from stakeholders on ways to further reduce the burden of the meaningful use program from current requirements; Review S. 1169/ HR 2687, Medicaid Coverage for Addiction Recovery Expansion Act, a bill to amend title XIX of the Social Security Act to provide States with an option to provide medical assistance to individuals between the ages of 22 and 64 for inpatient services to treat substance use disorders at certain facilities; Review HR 2509 Medicare Mental Health Inpatient Equity Act, a bill to amend title XVIII of the Social Security Act to eliminate the 190-day lifetime limit on inpatient psychiatric hospital services under the Medicare Program; Urged CMS to rescind the 25% Rule and instead rely on the site-neutral payment policy to bring transformative change to the LTCH field; Discussion with CMS about direct supervision of outpatient therapeutic services; Support HR 3120, a bill to amend title XVIII of the Social Security Act to reduce the volume of future electronic health record-related significant hardship requests; Discussed with Congress potential offsets to pay for CHIP and other Medicare extender legislation; Support straight extensions of the Medicare-dependent hospital and enhanced low-volume adjustment program; Support eliminating the reductions to Medicaid payments for DSH in fiscal years 2018 and 2019; Urged CMS to eliminate a duplicative budget-neutrality adjustment (BNA) being applied to Medicare payments for LTCH site-neutral cases, an unwarranted 5.1 percent cut. Urged CMS to permanently eliminate the LTCH 25% Rule policy; support The Limited Repeal of the IMD Exclusion for Adult Medicaid Beneficiaries with Substance Use Disorder Act, which would improve access to needed substance use disorder (SUD)treatment services for millions of Americans.

Client expense: $4,290,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA), White House Office

Implementation of health care reform law as it relates to substance abuse treatment and prevention, Medicaid - IMD exclusion; parity for SUD treatment;S. 524, ccess to treatment under Medicaid and Essential health benefits the Comprehensive Addiction & Recovery Act, specifically provisions that relate to SUD Treatment. S.1169 Medcaid Coverage for Addiction Recovery Expansion (Medicaid CARE) act , H.R. 2938 Road to Recovery Act, H.R. 2687 Medicaid Coverage for Addiction Recovery Expansion (Medicaid CARE) Act; monitoring policies and regulations related to the Presidents declaration of the opioid crisis as a public health emergency under the Public Health Service Act; H.R. 5797 Legislation to reform IMD exclusion

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

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

H.R. 1173/S. 448, the Medicare Mental Health Access Act H.R. 849, the Protecting Seniors Access to Medicare Act S. 1301/H.R. 2267, the Resident Physician Shortage Reduction Act H.R. 2276/S. 2575, the Audiology Patient Choice Act H.R. 5594, the Improving Access to Remote Behavioral Health Treatment Act of 2018 S. 2680, the Opioid Crisis Response Act of 2018 H.R. 6, the SUPPORT for Patients and Communities Act H.R. 1925, the At-Risk Youth Medicaid Protection Act H.R. 2509, the Medicare Mental Health Inpatient Equity Act S. 1169, the Medicaid Coverage for Addiction Recovery Expansion Act H.R. 2687, the Medicaid Coverage for Addiction Recovery Expansion Act H.R. 4005, the Medicaid Reentry Act H.R. 4097, the Medicare Beneficiary Opioid Addiction Treatment Act

Client expense: $260,000 · 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), 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)

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, all provisions S. 1732, Improving Access to Behavioral Health Information Technology Act, all provisions S. 2904, Medicaid Substance Use Disorder Treatment via Telehealth Act, all provisions S. 2910, Telehealth for Children's Access to Services and Treatment (TeleCAST) Act, all provisions S. 2707, Informing Seniors about Opioids Act of 2018, all provisions S. 2900, Comprehensive Screenings for Seniors Act of 201, all provisions H.R. 3528, Every Prescription Conveyed Securely Act, all provisions S. 2460, Every Prescription Conveyed Securely Act, all provisions S. 2908, A bill to amend title XVIII of the Social Security Act to provide for electronic prior authorization under Medicare part D for covered part D drugs, and for other purposes, all provisions S. 2920, Commit to Opioid Medical Prescriber Accountability and Safety for Seniors Act of 2018, all provisions H.R. 4552, Advancing Medical Resident Training in Community Hospitals Act of 2017, all provisions S. 1291, Advancing Medical Resident Training in Community Hospitals Act of 2017, all provisions H.R. 284, Advancing Medical Resident Training in Community Hospitals Act of 2017, all provisions H.R. 5605, Advancing High Quality Treatment for Opioid Use Disorders in Medicare Act, all provisions H.R. 5801, Medicaid Providers Are Required To Note Experiences in Record Systems to Help In-need Patients (PARTNERSHIP) Act, all provisions H.R. 5797, Individuals in Medicaid Deserve Care that is Appropriate and Responsible in its Execution (IMD CARE) Act, all provisions H.R. 5800, Medicaid Institutes for Mental Disease Are Decisive in Delivering Inpatient Treatment for Individuals but Opportunities for Needed Access are Limited without Information Needed about Facility Obligations (IMD ADDITIONAL INFO) Act, all provisions H.R. 5799, Medicaid Drug Review, Utilization, Good Governance (DRUG) Improvement Act, all provisions H.R. 4841, Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018, all provisions H.R. 5603, Access to Telehealth Services for Substance Use Disorders Act, all provisions H.R. 5808, Medicaid Pharmaceutical Home Act of 2018, all provisions H.R. 5685, Medicare Opioid Safety Education Act of 2018, all provisions H.R. 5675, To amend title XVIII of the Social Security Act to require prescription drug plan sponsors under the Medicare program to establish drug management programs for at-risk beneficiaries, all provisions H.R. 1925, At-Risk Youth Medicaid Protection Act of 2018, all provisions H.R. 3192, CHIP Mental Health Parity Act, all provisions H.R. 4005, Medicaid Reentry Act, all provisions H.R. 4998, Health Insurance for Former Foster Youth Act, all provisions H.R. 5477, Rural Development of Opioid Capacity Services (DOCS) Act, all provisions H.R. 5582, Abuse Deterrent Access Act of 2018, all provisions H.R. 5583, To amend title XI of the Social Security Act to require States to annually report on certain adult health quality measures, and for other purposes, all provisions H.R. 5684, Protecting Seniors From Opioid Abuse Act, all provisions H.R. 5776, Medicare and Opioid Safe Treatment (MOST) Act, all provisions H.R. 5789, To amend title XIX of the Social Security Act to provide for Medicaid coverage protections for pregnant and post-partum women while receiving inpatient treatment for a substance use disorder, and for other purposes, all provisions H.R. 5810, Medicaid Health Homes for Opioid-Use-Disorder Medicaid Enrollees Encouraged (HOME) Act, all provisions H.R. 5716, Commit to Opioid Medical Prescriber Accountability and Safety for Seniors (COMPASS) Act, all provisions H.R. 5773, Preventing Addiction for Susceptible Seniors (PASS) Act of 2018, all provisions H.R. 5775, Providing Reliable Options for Patients and Educational Resources (PROPER) Act of 2018, all provisions H.R. 5798, Opioid Screening and Chronic Pain Management Alternatives for Seniors Act, all provisions H.R. 5686, Medicare Clear Health Options in Care for Enrollees (CHOICE) Act of 2018, all provisions H.R. 6138, Ambulatory Surgical Center (ASC) Payment Transparency Act of 2018, all provisions H.R. 5774, Combating Opioid Abuse for Care in Hospitals (COACH) Act of 2018, all provisions H.R. 4206, Medicare Care Coordination Improvement Act of 2017, all provisions S. 2051, Medicare Care Coordination Improvement Act of 2017, all provisions H.R. 4143, Dialysis Patient Access To Integrated-care, Empowerment, Nephrologists, Treatment, and Services (PATIENTS) Demonstration Act of 2017, all provisions H.R. 4554, Medicare Common Access Card Act of 2017, all provisions H.R. 2788, Health Equity and Access under the Law (HEAL) for Immigrant Women and Families Act of 2017, 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. 1291, Advancing Medical Resident Training in Community Hospitals Act of 2017, all provisions Medicare program: Draft legislation relating to the prescribing of opioids for individuals eligible for Medicare Part A & B Medicare program: Creating Access to Residency Education Act (draft bill) Medicare program: Medicare Access and Chip Reauthorization (MACRA) implementation Medicare program: Quality Payment Program Medicare program: Merit-Based Incentive Payment System (MIPS)/quality, cost, interoperability, improvement activities Medicare program: MIPS quality measure reporting period Medicare program: Protecting Access to Medicare Act (PAMA)/clinical testing reimbursement Medicare program: Alternative Payment Models (APMs) Medicare program: APMs/PTAC Medicare program: Medicare Shared Savings Program Medicare program: Graduate Medical Education (GME) Medicare program: Electronic prescribing of controlled substances Medicare program: Regulatory Relief Medicare program: Self-referral Medicare program: Anti-kickback Medicare program: Program Integrity - Recovery Audit Contractors (RACs) Medicare program: Regulatory Relief - E & M Guidelines Medicare program: Virtual Diabetes Prevention Program (DPP)/Telehealth/remote patient monitoring Medicare program: Drug pricing transparency Medicare program: Coding Medicare program: Prior authorization Medicare program: Documentation errors Medicare program: Health Information Technology burdens Medicare program: Cybersecurity Medicare program: Interoperability Medicare program: Group Purchasing Organizations/Stark Laws Medicare program: Substance abuse disorder/quality, research Medicare program: Electronic payments Medicare program: Electronic clinical attachments Medicare program: Ambulatory blood pressure monitoring Medicare program: Physician billing/MACs Medicare program: Open Payments Medicare program: PECOS/Medicare Enrollment/Revocations/Revalidations Medicare program: Medicare Diabetes Prevention Program Medicare program: Misvalued codes Medicare program: Pharmacy Benefits Manager

Client expense: $4,300,000 · Firm income: Not reported

Government targets: Bureau of Citizenship & Immigration Services (BCIS), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Justice, Dept of (DOJ), Medicare Payment Advisory Commission (MedPAC), SENATE, Veterans Affairs, Dept of (VA), White House Office

Excellence in Mental Health and Addiction Treatment Expansion Act (S. 1905/ H.R.3931), all provisions related to expanding and extending the Certified Community Behavioral Health Clinic demonstration program. Medicaid CARE Act (S. 1169), all provisions related to expanding the number of residential substance use treatment facilities through Medicaid. Mental Health Access Improvement Act (S. 1879/H.R. 3032), all provisions related to allowing marriage and family therapists and mental health counselors to directly bill Medicare for their services.

Client expense: $119,574 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

HCR: Implementation of health care reform law as it relates to substance abuse treatment and prevention, Medicaid - IMD exclusion; parity for SUD treatment;S.524 access to treatment under Medicaid and Essential Health benefits, the Comprehensive Addiction & Recovery Act, specifically provisions that relate to SUD Treatment. S.1169 Medcaid Coverage for Addiction Recovery Expansion (Medicaid CARE) act , H.R. 2938 Road to Recovery Act, H.R. 2687 Medicaid Coverage for Addiction Recovery Expansion (Medicaid CARE) Act; monitor policies and regulations related to the President's declaration of the opioid crisis as a public health emergency under the Public Health Service Act; H.R. 5797 Legislation to reform the IMD exclusion

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

1.S. 2317/H.R. 3692 - Addiction Treatment Access Improvement Act - amend the Controlled Substances Act to provide for additional flexibility with respect to medication-assisted treatment for opioid use disorders, and for other purposes. 2.H.R. 6 - SUPPORT for Patients and Communities Act - provide for opioid use disorder prevention, recovery, and treatment, and for other purposes. 3.S. 2406/H.R. 5002 - Advancing Cutting Edge Research Act - expand the unique research initiatives authority of the National Institutes of Health 4.S. 2608 - Opioid Crisis Response Act - address the opioid crisis 5.H.R. 5605 - Advancing High Quality Treatment for Opioid Use Disorders in Medicare Act - provide for an opioid use disorder treatment demonstration program, and for other purposes 6.H.R. 5797 - Individuals in Medicaid Deserve Care that is Appropriate and Responsible in its Execution Act - provide under Medicaid services for certain individuals with opioid use disorders in institutions for mental diseases. 7.H.R. 5800 - the Medicaid IMD ADDITIONAL INFO Act - require the Medicaid and CHIP Payment and Access Commission to conduct an exploratory study and report on requirements applicable to and practices of institutions for mental diseases under the Medicaid program. 8.H.R. 5483 - Special Registration for Telemedicine Clarification Act - impose a deadline for the promulgation of interim final regulations in accordance with section 311(h) of the Controlled Substances Act (21 U.S.C. 831(h)) specifying the circumstances in which a special registration may be issued to a practitioner to engage in the practice of telemedicine, and for other purposes. 9.S. 2589/H.R. 5327 - Comprehensive Opioid Recovery Centers Act - amend title V of the Public Health Service Act to establish a grant program to create comprehensive opioid recovery centers, and for other purposes 10.H.R. 5272 - a bill to ensure that programs and activities that are funded by a grant, cooperative agreement, loan, or loan guarantee from the Department of Health and Human Services, and whose purpose is to prevent or treat a mental health or substance use disorder, are evidence-based 11.H.R. 5261 - TEACH to Combat Addiction Act - amend the Public Health Service Act to provide for regional centers of excellence in substance use disorder education, and for other purposes 12.S. 2610/H.R. 5176 - Preventing Overdoses While in Emergency Rooms (POWER) Act - require the Secretary of Health and Human Services to provide coordinated care to patients who have experienced a non-fatal overdose after emergency room discharge, and for other purposes 13.S. 2524/H.R. 5102, Substance Use Disorder Workforce Loan Repayment Act - amend the Public Health Service Act to authorize a loan repayment program for substance use disorder treatment employees, and for other purposes 14.H.R. 4005 - the Medicaid Reentry Act - promote State innovations to ease transitions to the community for individuals who are inmates of a public institution and eligible for medical assistance under the Medicaid program. 15.S. 2253/H.R. 3192 - the CHIP Mental Health Parity Act - amend title XXI of the Social Security Act to ensure access to mental health services for children under the Childrens Health Insurance Program, and for other purposes 16.S. 3158 - FY2019 Labor-HHS Appropriations Act - making appropriations for the Departments of Labor, Health and Human Services, and Education, and related agencies for the fiscal year ending September 30, 2019, and for other purposes 17.House FY 2019 Labor, Health and Human Services, and Related Agencies - making appropriations for the Departments of Labor, Health and Human Services, and Education, and related agencies for the fiscal year ending September 30, 2019, and for other purposes 18.S. 2711, the Enhancing Access to Addiction Treatment Act - amend section 303 of the Controlled Substances Act to facilitate waivers of the separate registration requirement for physicians dispensing narcotic drugs to individuals for maintenance treatment or detoxification treatment 19.H.R. 5776 - Medicare and Opioid Safe Treatment Act - provide access to Medication-Assisted Treatment (MAT) in Medicare through bundled payments made to Opioid Treatment Programs for holistic service 20.S. 2875 - Comprehensive Opioid Management and Bundled Addiction Treatment Act of 2018 - amend title XVIII of the Social Security Act to provide for Medicare coverage of certain services furnished by opioid treatment programs, and for other purposes 21.S. 2456/H.R. 5311 - CARA 2.0 Act - reauthorize and expand the Comprehensive Addiction and Recovery Act of 2016 22.S. 2700/ H.R. 5545 - Comprehensive Addiction Resources Emergency Act - provide emergency assistance to States, territories, Tribal nations, and local areas affected by the opioid epidemic and to make financial assistance available to States, territories, Tribal nations, local areas, and public or private nonprofit entities to provide for the development, organization, coordination, and operation of more effective and cost efficient systems for the delivery of essential services to individuals with substance use disorder and their families 23.S. 2843/H.R. 5818 - Opioid Workforce Act - amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions to help combat the opioid crisis 24.S. 1169 - Medicaid Coverage for Addiction Recovery Expansion Act - amend title XIX of the Social Security Act to provide States with an option to provide medical assistance to individuals between the ages of 22 and 64 for inpatient services to treat substance use disorders at certain facilities, and for other purposes 25.Commented on draft legislation to amend title XXVII of the Public Health Service Act and titles XVIII and XIX of the Social Security Act to prohibit the imposition of prior authorization requirements with respect to a certain supply of a prescription drug used for the treatment of a substance use disorder, and for other purposes 26.S. 1276 - Cannabidiol Research Expansion Act - require the Attorney General to make a determination as to whether cannabidiol should be a controlled substance and listed in a schedule under the Controlled Substances Act and to expand research on the potential medical benefits of cannabidiol and other marihuana components

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

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

1.S. 2317/H.R. 3692 - Addiction Treatment Access Improvement Act - amend the Controlled Substances Act to provide for additional flexibility with respect to medication-assisted treatment for opioid use disorders, and for other purposes. 2.H.R. 6 - SUPPORT for Patients and Communities Act - provide for opioid use disorder prevention, recovery, and treatment, and for other purposes. 3.S. 2406/H.R. 5002 - Advancing Cutting Edge Research Act - expand the unique research initiatives authority of the National Institutes of Health 4.S. 2608 - Opioid Crisis Response Act - address the opioid crisis 5.H.R. 5605 - Advancing High Quality Treatment for Opioid Use Disorders in Medicare Act - provide for an opioid use disorder treatment demonstration program, and for other purposes 6.H.R. 5797 - Individuals in Medicaid Deserve Care that is Appropriate and Responsible in its Execution Act - provide under Medicaid services for certain individuals with opioid use disorders in institutions for mental diseases. 7.H.R. 5800 - the Medicaid IMD ADDITIONAL INFO Act - require the Medicaid and CHIP Payment and Access Commission to conduct an exploratory study and report on requirements applicable to and practices of institutions for mental diseases under the Medicaid program. 8.H.R. 5483 - Special Registration for Telemedicine Clarification Act - impose a deadline for the promulgation of interim final regulations in accordance with section 311(h) of the Controlled Substances Act (21 U.S.C. 831(h)) specifying the circumstances in which a special registration may be issued to a practitioner to engage in the practice of telemedicine, and for other purposes. 9.S. 2589/H.R. 5327 - Comprehensive Opioid Recovery Centers Act - amend title V of the Public Health Service Act to establish a grant program to create comprehensive opioid recovery centers, and for other purposes 10.H.R. 5272 - a bill to ensure that programs and activities that are funded by a grant, cooperative agreement, loan, or loan guarantee from the Department of Health and Human Services, and whose purpose is to prevent or treat a mental health or substance use disorder, are evidence-based 11.H.R. 5261 - TEACH to Combat Addiction Act - amend the Public Health Service Act to provide for regional centers of excellence in substance use disorder education, and for other purposes 12.S. 2610/H.R. 5176 - Preventing Overdoses While in Emergency Rooms (POWER) Act - require the Secretary of Health and Human Services to provide coordinated care to patients who have experienced a non-fatal overdose after emergency room discharge, and for other purposes 13.S. 2524/H.R. 5102, Substance Use Disorder Workforce Loan Repayment Act - amend the Public Health Service Act to authorize a loan repayment program for substance use disorder treatment employees, and for other purposes 14.H.R. 4005 - the Medicaid Reentry Act - promote State innovations to ease transitions to the community for individuals who are inmates of a public institution and eligible for medical assistance under the Medicaid program. 15.S. 2253/H.R. 3192 - the CHIP Mental Health Parity Act - amend title XXI of the Social Security Act to ensure access to mental health services for children under the Childrens Health Insurance Program, and for other purposes 16.S. 3158 - FY2019 Labor-HHS Appropriations Act - making appropriations for the Departments of Labor, Health and Human Services, and Education, and related agencies for the fiscal year ending September 30, 2019, and for other purposes 17.House FY 2019 Labor, Health and Human Services, and Related Agencies - making appropriations for the Departments of Labor, Health and Human Services, and Education, and related agencies for the fiscal year ending September 30, 2019, and for other purposes 18.S. 2711, the Enhancing Access to Addiction Treatment Act - amend section 303 of the Controlled Substances Act to facilitate waivers of the separate registration requirement for physicians dispensing narcotic drugs to individuals for maintenance treatment or detoxification treatment 19.H.R. 5776 - Medicare and Opioid Safe Treatment Act - provide access to Medication-Assisted Treatment (MAT) in Medicare through bundled payments made to Opioid Treatment Programs for holistic service 20.S. 2875 - Comprehensive Opioid Management and Bundled Addiction Treatment Act of 2018 - amend title XVIII of the Social Security Act to provide for Medicare coverage of certain services furnished by opioid treatment programs, and for other purposes 21.S. 2456/H.R. 5311 - CARA 2.0 Act - reauthorize and expand the Comprehensive Addiction and Recovery Act of 2016 22.S. 2700/ H.R. 5545 - Comprehensive Addiction Resources Emergency Act - provide emergency assistance to States, territories, Tribal nations, and local areas affected by the opioid epidemic and to make financial assistance available to States, territories, Tribal nations, local areas, and public or private nonprofit entities to provide for the development, organization, coordination, and operation of more effective and cost efficient systems for the delivery of essential services to individuals with substance use disorder and their families 23.S. 2843/H.R. 5818 - Opioid Workforce Act - amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions to help combat the opioid crisis 24.S. 1169 - Medicaid Coverage for Addiction Recovery Expansion Act - amend title XIX of the Social Security Act to provide States with an option to provide medical assistance to individuals between the ages of 22 and 64 for inpatient services to treat substance use disorders at certain facilities, and for other purposes 25.Commented on draft legislation to amend title XXVII of the Public Health Service Act and titles XVIII and XIX of the Social Security Act to prohibit the imposition of prior authorization requirements with respect to a certain supply of a prescription drug used for the treatment of a substance use disorder, and for other purposes 26.S. 1276 - Cannabidiol Research Expansion Act - require the Attorney General to make a determination as to whether cannabidiol should be a controlled substance and listed in a schedule under the Controlled Substances Act and to expand research on the potential medical benefits of cannabidiol and other marihuana components

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

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

1.S. 2317/H.R. 3692 - Addiction Treatment Access Improvement Act - amend the Controlled Substances Act to provide for additional flexibility with respect to medication-assisted treatment for opioid use disorders, and for other purposes. 2.H.R. 6 - SUPPORT for Patients and Communities Act - provide for opioid use disorder prevention, recovery, and treatment, and for other purposes. 3.S. 2406/H.R. 5002 - Advancing Cutting Edge Research Act - expand the unique research initiatives authority of the National Institutes of Health 4.S. 2608 - Opioid Crisis Response Act - address the opioid crisis 5.H.R. 5605 - Advancing High Quality Treatment for Opioid Use Disorders in Medicare Act - provide for an opioid use disorder treatment demonstration program, and for other purposes 6.H.R. 5797 - Individuals in Medicaid Deserve Care that is Appropriate and Responsible in its Execution Act - provide under Medicaid services for certain individuals with opioid use disorders in institutions for mental diseases. 7.H.R. 5800 - the Medicaid IMD ADDITIONAL INFO Act - require the Medicaid and CHIP Payment and Access Commission to conduct an exploratory study and report on requirements applicable to and practices of institutions for mental diseases under the Medicaid program. 8.H.R. 5483 - Special Registration for Telemedicine Clarification Act - impose a deadline for the promulgation of interim final regulations in accordance with section 311(h) of the Controlled Substances Act (21 U.S.C. 831(h)) specifying the circumstances in which a special registration may be issued to a practitioner to engage in the practice of telemedicine, and for other purposes. 9.S. 2589/H.R. 5327 - Comprehensive Opioid Recovery Centers Act - amend title V of the Public Health Service Act to establish a grant program to create comprehensive opioid recovery centers, and for other purposes 10.H.R. 5272 - a bill to ensure that programs and activities that are funded by a grant, cooperative agreement, loan, or loan guarantee from the Department of Health and Human Services, and whose purpose is to prevent or treat a mental health or substance use disorder, are evidence-based 11.H.R. 5261 - TEACH to Combat Addiction Act - amend the Public Health Service Act to provide for regional centers of excellence in substance use disorder education, and for other purposes 12.S. 2610/H.R. 5176 - Preventing Overdoses While in Emergency Rooms (POWER) Act - require the Secretary of Health and Human Services to provide coordinated care to patients who have experienced a non-fatal overdose after emergency room discharge, and for other purposes 13.S. 2524/H.R. 5102, Substance Use Disorder Workforce Loan Repayment Act - amend the Public Health Service Act to authorize a loan repayment program for substance use disorder treatment employees, and for other purposes 14.H.R. 4005 - the Medicaid Reentry Act - promote State innovations to ease transitions to the community for individuals who are inmates of a public institution and eligible for medical assistance under the Medicaid program. 15.S. 2253/H.R. 3192 - the CHIP Mental Health Parity Act - amend title XXI of the Social Security Act to ensure access to mental health services for children under the Childrens Health Insurance Program, and for other purposes 16.S. 3158 - FY2019 Labor-HHS Appropriations Act - making appropriations for the Departments of Labor, Health and Human Services, and Education, and related agencies for the fiscal year ending September 30, 2019, and for other purposes 17.House FY 2019 Labor, Health and Human Services, and Related Agencies - making appropriations for the Departments of Labor, Health and Human Services, and Education, and related agencies for the fiscal year ending September 30, 2019, and for other purposes 18.S. 2711, the Enhancing Access to Addiction Treatment Act - amend section 303 of the Controlled Substances Act to facilitate waivers of the separate registration requirement for physicians dispensing narcotic drugs to individuals for maintenance treatment or detoxification treatment 19.H.R. 5776 - Medicare and Opioid Safe Treatment Act - provide access to Medication-Assisted Treatment (MAT) in Medicare through bundled payments made to Opioid Treatment Programs for holistic service 20.S. 2875 - Comprehensive Opioid Management and Bundled Addiction Treatment Act of 2018 - amend title XVIII of the Social Security Act to provide for Medicare coverage of certain services furnished by opioid treatment programs, and for other purposes 21.S. 2456/H.R. 5311 - CARA 2.0 Act - reauthorize and expand the Comprehensive Addiction and Recovery Act of 2016 22.S. 2700/ H.R. 5545 - Comprehensive Addiction Resources Emergency Act - provide emergency assistance to States, territories, Tribal nations, and local areas affected by the opioid epidemic and to make financial assistance available to States, territories, Tribal nations, local areas, and public or private nonprofit entities to provide for the development, organization, coordination, and operation of more effective and cost efficient systems for the delivery of essential services to individuals with substance use disorder and their families 23.S. 2843/H.R. 5818 - Opioid Workforce Act - amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions to help combat the opioid crisis 24.S. 1169 - Medicaid Coverage for Addiction Recovery Expansion Act - amend title XIX of the Social Security Act to provide States with an option to provide medical assistance to individuals between the ages of 22 and 64 for inpatient services to treat substance use disorders at certain facilities, and for other purposes 25.Commented on draft legislation to amend title XXVII of the Public Health Service Act and titles XVIII and XIX of the Social Security Act to prohibit the imposition of prior authorization requirements with respect to a certain supply of a prescription drug used for the treatment of a substance use disorder, and for other purposes 26.S. 1276 - Cannabidiol Research Expansion Act - require the Attorney General to make a determination as to whether cannabidiol should be a controlled substance and listed in a schedule under the Controlled Substances Act and to expand research on the potential medical benefits of cannabidiol and other marihuana components

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

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

1.S. 2317/H.R. 3692 - Addiction Treatment Access Improvement Act - amend the Controlled Substances Act to provide for additional flexibility with respect to medication-assisted treatment for opioid use disorders, and for other purposes. 2.H.R. 6 - SUPPORT for Patients and Communities Act - provide for opioid use disorder prevention, recovery, and treatment, and for other purposes. 3.S. 2406/H.R. 5002 - Advancing Cutting Edge Research Act - expand the unique research initiatives authority of the National Institutes of Health 4.S. 2608 - Opioid Crisis Response Act - address the opioid crisis 5.H.R. 5605 - Advancing High Quality Treatment for Opioid Use Disorders in Medicare Act - provide for an opioid use disorder treatment demonstration program, and for other purposes 6.H.R. 5797 - Individuals in Medicaid Deserve Care that is Appropriate and Responsible in its Execution Act - provide under Medicaid services for certain individuals with opioid use disorders in institutions for mental diseases. 7.H.R. 5800 - the Medicaid IMD ADDITIONAL INFO Act - require the Medicaid and CHIP Payment and Access Commission to conduct an exploratory study and report on requirements applicable to and practices of institutions for mental diseases under the Medicaid program. 8.H.R. 5483 - Special Registration for Telemedicine Clarification Act - impose a deadline for the promulgation of interim final regulations in accordance with section 311(h) of the Controlled Substances Act (21 U.S.C. 831(h)) specifying the circumstances in which a special registration may be issued to a practitioner to engage in the practice of telemedicine, and for other purposes. 9.S. 2589/H.R. 5327 - Comprehensive Opioid Recovery Centers Act - amend title V of the Public Health Service Act to establish a grant program to create comprehensive opioid recovery centers, and for other purposes 10.H.R. 5272 - a bill to ensure that programs and activities that are funded by a grant, cooperative agreement, loan, or loan guarantee from the Department of Health and Human Services, and whose purpose is to prevent or treat a mental health or substance use disorder, are evidence-based 11.H.R. 5261 - TEACH to Combat Addiction Act - amend the Public Health Service Act to provide for regional centers of excellence in substance use disorder education, and for other purposes 12.S. 2610/H.R. 5176 - Preventing Overdoses While in Emergency Rooms (POWER) Act - require the Secretary of Health and Human Services to provide coordinated care to patients who have experienced a non-fatal overdose after emergency room discharge, and for other purposes 13.S. 2524/H.R. 5102, Substance Use Disorder Workforce Loan Repayment Act - amend the Public Health Service Act to authorize a loan repayment program for substance use disorder treatment employees, and for other purposes 14.H.R. 4005 - the Medicaid Reentry Act - promote State innovations to ease transitions to the community for individuals who are inmates of a public institution and eligible for medical assistance under the Medicaid program. 15.S. 2253/H.R. 3192 - the CHIP Mental Health Parity Act - amend title XXI of the Social Security Act to ensure access to mental health services for children under the Childrens Health Insurance Program, and for other purposes 16.S. 3158 - FY2019 Labor-HHS Appropriations Act - making appropriations for the Departments of Labor, Health and Human Services, and Education, and related agencies for the fiscal year ending September 30, 2019, and for other purposes 17.House FY 2019 Labor, Health and Human Services, and Related Agencies - making appropriations for the Departments of Labor, Health and Human Services, and Education, and related agencies for the fiscal year ending September 30, 2019, and for other purposes 18.S. 2711, the Enhancing Access to Addiction Treatment Act - amend section 303 of the Controlled Substances Act to facilitate waivers of the separate registration requirement for physicians dispensing narcotic drugs to individuals for maintenance treatment or detoxification treatment 19.H.R. 5776 - Medicare and Opioid Safe Treatment Act - provide access to Medication-Assisted Treatment (MAT) in Medicare through bundled payments made to Opioid Treatment Programs for holistic service 20.S. 2875 - Comprehensive Opioid Management and Bundled Addiction Treatment Act of 2018 - amend title XVIII of the Social Security Act to provide for Medicare coverage of certain services furnished by opioid treatment programs, and for other purposes 21.S. 2456/H.R. 5311 - CARA 2.0 Act - reauthorize and expand the Comprehensive Addiction and Recovery Act of 2016 22.S. 2700/ H.R. 5545 - Comprehensive Addiction Resources Emergency Act - provide emergency assistance to States, territories, Tribal nations, and local areas affected by the opioid epidemic and to make financial assistance available to States, territories, Tribal nations, local areas, and public or private nonprofit entities to provide for the development, organization, coordination, and operation of more effective and cost efficient systems for the delivery of essential services to individuals with substance use disorder and their families 23.S. 2843/H.R. 5818 - Opioid Workforce Act - amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions to help combat the opioid crisis 24.S. 1169 - Medicaid Coverage for Addiction Recovery Expansion Act - amend title XIX of the Social Security Act to provide States with an option to provide medical assistance to individuals between the ages of 22 and 64 for inpatient services to treat substance use disorders at certain facilities, and for other purposes 25.Commented on draft legislation to amend title XXVII of the Public Health Service Act and titles XVIII and XIX of the Social Security Act to prohibit the imposition of prior authorization requirements with respect to a certain supply of a prescription drug used for the treatment of a substance use disorder, and for other purposes 26.S. 1276 - Cannabidiol Research Expansion Act - require the Attorney General to make a determination as to whether cannabidiol should be a controlled substance and listed in a schedule under the Controlled Substances Act and to expand research on the potential medical benefits of cannabidiol and other marihuana components

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

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

1.S. 2317/H.R. 3692 - Addiction Treatment Access Improvement Act - amend the Controlled Substances Act to provide for additional flexibility with respect to medication-assisted treatment for opioid use disorders, and for other purposes. 2.H.R. 6 - SUPPORT for Patients and Communities Act - provide for opioid use disorder prevention, recovery, and treatment, and for other purposes. 3.S. 2406/H.R. 5002 - Advancing Cutting Edge Research Act - expand the unique research initiatives authority of the National Institutes of Health 4.S. 2608 - Opioid Crisis Response Act - address the opioid crisis 5.H.R. 5605 - Advancing High Quality Treatment for Opioid Use Disorders in Medicare Act - provide for an opioid use disorder treatment demonstration program, and for other purposes 6.H.R. 5797 - Individuals in Medicaid Deserve Care that is Appropriate and Responsible in its Execution Act - provide under Medicaid services for certain individuals with opioid use disorders in institutions for mental diseases. 7.H.R. 5800 - the Medicaid IMD ADDITIONAL INFO Act - require the Medicaid and CHIP Payment and Access Commission to conduct an exploratory study and report on requirements applicable to and practices of institutions for mental diseases under the Medicaid program. 8.H.R. 5483 - Special Registration for Telemedicine Clarification Act - impose a deadline for the promulgation of interim final regulations in accordance with section 311(h) of the Controlled Substances Act (21 U.S.C. 831(h)) specifying the circumstances in which a special registration may be issued to a practitioner to engage in the practice of telemedicine, and for other purposes. 9.S. 2589/H.R. 5327 - Comprehensive Opioid Recovery Centers Act - amend title V of the Public Health Service Act to establish a grant program to create comprehensive opioid recovery centers, and for other purposes 10.H.R. 5272 - a bill to ensure that programs and activities that are funded by a grant, cooperative agreement, loan, or loan guarantee from the Department of Health and Human Services, and whose purpose is to prevent or treat a mental health or substance use disorder, are evidence-based 11.H.R. 5261 - TEACH to Combat Addiction Act - amend the Public Health Service Act to provide for regional centers of excellence in substance use disorder education, and for other purposes 12.S. 2610/H.R. 5176 - Preventing Overdoses While in Emergency Rooms (POWER) Act - require the Secretary of Health and Human Services to provide coordinated care to patients who have experienced a non-fatal overdose after emergency room discharge, and for other purposes 13.S. 2524/H.R. 5102, Substance Use Disorder Workforce Loan Repayment Act - amend the Public Health Service Act to authorize a loan repayment program for substance use disorder treatment employees, and for other purposes 14.H.R. 4005 - the Medicaid Reentry Act - promote State innovations to ease transitions to the community for individuals who are inmates of a public institution and eligible for medical assistance under the Medicaid program. 15.S. 2253/H.R. 3192 - the CHIP Mental Health Parity Act - amend title XXI of the Social Security Act to ensure access to mental health services for children under the Childrens Health Insurance Program, and for other purposes 16.S. 3158 - FY2019 Labor-HHS Appropriations Act - making appropriations for the Departments of Labor, Health and Human Services, and Education, and related agencies for the fiscal year ending September 30, 2019, and for other purposes 17.House FY 2019 Labor, Health and Human Services, and Related Agencies - making appropriations for the Departments of Labor, Health and Human Services, and Education, and related agencies for the fiscal year ending September 30, 2019, and for other purposes 18.S. 2711, the Enhancing Access to Addiction Treatment Act - amend section 303 of the Controlled Substances Act to facilitate waivers of the separate registration requirement for physicians dispensing narcotic drugs to individuals for maintenance treatment or detoxification treatment 19.H.R. 5776 - Medicare and Opioid Safe Treatment Act - provide access to Medication-Assisted Treatment (MAT) in Medicare through bundled payments made to Opioid Treatment Programs for holistic service 20.S. 2875 - Comprehensive Opioid Management and Bundled Addiction Treatment Act of 2018 - amend title XVIII of the Social Security Act to provide for Medicare coverage of certain services furnished by opioid treatment programs, and for other purposes 21.S. 2456/H.R. 5311 - CARA 2.0 Act - reauthorize and expand the Comprehensive Addiction and Recovery Act of 2016 22.S. 2700/ H.R. 5545 - Comprehensive Addiction Resources Emergency Act - provide emergency assistance to States, territories, Tribal nations, and local areas affected by the opioid epidemic and to make financial assistance available to States, territories, Tribal nations, local areas, and public or private nonprofit entities to provide for the development, organization, coordination, and operation of more effective and cost efficient systems for the delivery of essential services to individuals with substance use disorder and their families 23.S. 2843/H.R. 5818 - Opioid Workforce Act - amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions to help combat the opioid crisis 24.S. 1169 - Medicaid Coverage for Addiction Recovery Expansion Act - amend title XIX of the Social Security Act to provide States with an option to provide medical assistance to individuals between the ages of 22 and 64 for inpatient services to treat substance use disorders at certain facilities, and for other purposes 25.Commented on draft legislation to amend title XXVII of the Public Health Service Act and titles XVIII and XIX of the Social Security Act to prohibit the imposition of prior authorization requirements with respect to a certain supply of a prescription drug used for the treatment of a substance use disorder, and for other purposes 26.S. 1276 - Cannabidiol Research Expansion Act - require the Attorney General to make a determination as to whether cannabidiol should be a controlled substance and listed in a schedule under the Controlled Substances Act and to expand research on the potential medical benefits of cannabidiol and other marihuana components

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

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

Imputed Floor (FY 19 IPPS rule) 340B Drug Pricing Program Opioids SUD patient record sharing (H.R. 3545/S. 1850) 190-day limit on inpatient psychiatric care under Medicare (HR 2509) IMD exclusion (H.R. 2938/S. 1169) Veterans mental health and SUD at non-VA facilities (no specific bill) Observation status (H.R. 1421/S. 568) MISSION ZERO (H.R. 880/S. 1022) ALTO (H.R. 5197/S. 2516)

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

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

H.R. 1173: Medicare Mental Health Access Act. Legislation to amend Medicares Physician Definition, to provide for treatment of clinical psychologists as physicians for purposes of furnishing clinical psychologist services under the Medicare Program. S. 448: Medicare Mental Health Access Act. Legislation to amend Medicares Physician Definition, to provide for treatment of clinical psychologists as physicians for purposes of furnishing clinical psychologist services under the Medicare Program. H.R. 2509: Medicare Mental Health Inpatient Equity Act of 2017. Legislation To amend title XVIII of the Social Security Act to eliminate the 190-day lifetime limit on inpatient psychiatric hospital services under the Medicare Program. S.1169: Medicaid Coverage for Addiction Recovery Expansion Act. A bill to amend title XIX of the Social Security Act to provide States with an option to provide medical assistance to individuals between the ages of 22 and 64 for inpatient services to treat substance use disorders at certain facilities, and for other purposes. H.R. 1953: Treat and Reduce Obesity Act of 2017. To amend title XVIII of the Social Security Act to provide for the coordination of programs to prevent and treat obesity, and for other purposes. S. 830: Treat and Reduce Obesity Act of 2017. To amend title XVIII of the Social Security Act to provide for the coordination of programs to prevent and treat obesity, and for other purposes. 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 H.R. 2337: To amend title XIX of the Social Security Act to provide for a State Medicaid option to enhance administrative matching funds to support statewide behavioral health access program activities for children under 21 years of age, and for other purposes. S. 1905, HR 3931: Excellence in Mental Health and Addiction Treatment Expansion Act. To increase the number of States that may conduct Medicaid demonstration programs to improve access to community mental health services. S. 1169, H.R. 2687: Medicaid Coverage for Addiction Recovery Expansion Act. A bill to amend title XIX of the Social Security Act to provide States with an option to provide medical assistance to individuals between the ages of 22 and 64 for inpatient services to treat substance use disorders at certain facilities, and for other purposes. H.R. 5477: Rural DOCS Act. To provide incentives for state Medicaid expenditures related to the expansion of substance-use treatment and recovery services targeting provider capacity.

Client expense: $275,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 448/H.R. 1173 Medicare Mental Health Access Act S. 874 At-Risk Youth Medicaid Protection Act S. 1905/H.R. 3931 Excellence in Mental Health and Addiction Treatment Expansion Act S. 1169/H.R. 2687 Medicaid Coverage for Addiction Recovery Expansion Act S. 1732/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 H.R. 2337: To amend title XIX of the Social Security Act to provide for a State Medicaid option to enhance administrative matching funds to support statewide behavioral health access program activities for children under 21 years of age, and for other purposes H.R. 2509 Medicare Mental Health Inpatient Inequity Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE, White House Office

S.2613/H.R. 1290 Improving Access to Mental Health Act of 2018 H.R.3922 - CHAMPIONING HEALTHY KIDS Act H.R.3921 - HEALTHY KIDS Act S.1827 - KIDS Act of 2017 H.R. 6 - SUPPORT for Patients and Communities Act S.2253/H.R.3192 - CHIP Mental Health Parity Act Practice and Reimbursement issues related to clinical social workers S.1169/ H.R. 2687 - Medicaid Coverage for Addiction Recovery Expansion (CARE) Act

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

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

Imputed Floor (FY 19 IPPS rule), 340B Drug Pricing Program, Opioids: SUD patient record sharing (H.R. 3545/S. 1850), 190-day limit on inpatient psychiatric care under Medicare (HR 2509), IMD exclusion (H.R. 2938/S. 1169), Veterans mental health and SUD at non-VA facilities (no specific bill), Observation status (H.R. 1421/S. 568), MISSION ZERO (H.R. 880/S. 1022), ALTO (H.R. 5197/S. 2516)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 448/H.R. 1173 Medicare Mental Health Access Act S. 1905/H.R. 3931 Excellence in Mental Health and Addiction Treatment Expansion Act S. 1169/H.R. 2687 Medicaid Coverage for Addiction Recovery Expansion Act S. 1732/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 H.R. 2337: To amend title XIX of the Social Security Act to provide for a State Medicaid option to enhance administrative matching funds to support statewide behavioral health access program activities for children under 21 years of age, and for other purposes H.R. 2509 Medicare Mental Health Inpatient Inequity Act

Client expense: $140,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE, White House Office

Support H.R. 741/ S. 243 Rural Hospital Regulatory Relief Act of 2017, a bill that amends title XVIII (Medicare) of the Social Security Act to permanently extend the application by the Centers for Medicare & Medicaid Services of an instruction against the enforcement of certain physician supervision requirements with respect to outpatient therapeutic services in critical access hospitals and small rural hospitals; Support H.R. 807/ S. 253 Medicare Access to Rehabilitation Services Act of 2017, a bill to amend title XVIII of the Social Security Act to repeal the Medicare outpatient rehabilitation therapy caps; Discussion about the Electronic Clinical Quality Measure Reporting: advocating for an extension of the reporting deadline to increase hospitals ability to meet requirements in the Hospital Inpatient Quality Reporting program and the Medicare EHR Incentive Program;Requested clarification from CMS about providing care to justice-involved individuals and receiving Medicaid/Medicare reimbursement for such care to Made efforts in support of clarifying that hospitals may have designated units to care for patients in the custody of law enforcement/correctional institutions and may receive Medicaid reimbursement for care provided in such units; Support S. 872/ HR 1955Rural Hospital Access Act of 2017, a bill to amend title XVIII of the Social Security Act to make permanent the extension of the Medicare-dependent hospital (MDH) program and the increased payments under the Medicare low-volume hospital program; Support S 1301/ HR 2267, Resident Physician Shortage Reduction Act of 2017, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; Oppose H.R. 1628 American Health Care Act / Better Care Reconciliation Act, a bill that would repeal and replace much of the Affordable Care Act, including repealing Medicaid expansion and the advanced premium tax credits for the purchase of coverage on the Health Insurance Marketplaces; Support S 1334/ HR 2797Patient Choices and Quality Care Act of 2017, a bill to provide for advanced illness care coordination services for Medicare beneficiaries; Urged the Administration to cancel Stage 3 of meaningful use by removing the 2018 start date from the regulation. The Administration also should institute a 90- day reporting period in every future year of the program, and gather input from stakeholders on ways to further reduce the burden of the meaningful use program from current requirements; Review S. 1169/ HR 2687, Medicaid Coverage for Addiction Recovery Expansion Act, a bill to amend title XIX of the Social Security Act to provide States with an option to provide medical assistance to individuals between the ages of 22 and 64 for inpatient services to treat substance use disorders at certain facilities; Review HR 2509 Medicare Mental Health Inpatient Equity Act, a bill to amend title XVIII of the Social Security Act to eliminate the 190-day lifetime limit on inpatient psychiatric hospital services under the Medicare Program; Urged CMS to rescind the 25% Rule and instead rely on the site-neutral payment policy to bring transformative change to the LTCH field; Discussion with CMS about direct supervision of outpatient therapeutic services; Support HR 3120, a bill to amend title XVIII of the Social Security Act to reduce the volume of future electronic health record-related significant hardship requests; Discussed with Congress potential offsets to pay for CHIP and other Medicare extender legislation; Support straight extensions of the Medicare-dependent hospital and enhanced low-volume adjustment program; Support eliminating the reductions to Medicaid payments for DSH in fiscal years 2018 and 2019; Urged CMS to eliminate a duplicative budget-neutrality adjustment (BNA) being applied to Medicare payments for LTCH site-neutral cases, an unwarranted 5.1 percent cut. Urged CMS to permanently eliminate the LTCH 25% Rule policy.

Client expense: $4,960,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA), White House Office

S. 2059, EHR Regulatory Relief Act, all provisions H.R. 4580, ACO Improvement Act of 2017, all provisions H.R. 1892, Bipartisan Budget Act of 2018, provisions relating to Medicare H.R. 4206, Medicare Care Coordination Improvement Act of 2017, all provisions S. 2051, Medicare Care Coordination Improvement Act of 2017, all provisions H.R. 4841, Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018, all provisions H.R. 4613, Ensuring Patient Access to Healthcare Records Act of 2017, 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 (Medicaid CARE) Act, all provisions S. 1169, Medicaid Coverage for Addiction Recovery Expansion (Medicaid CARE) Act, all provisions S. 870, Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017, all provisions S. 1016, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2017, provisions relating to telehealth S. 479, Removing Barriers to Colorectal Cancer Screening Act of 2017, all provisions H.R. 4097, Medicare Beneficiary Opioid Addiction Treatment Act, all provisions H.R. 4005, Medicaid Reentry Act, all provisions H.R. 2938, Road to Recovery Act, all provisions Medicare program: Medicare Access and CHIP Reauthorization Act (MACRA) implementation Medicare program: Alternative Payment Models (APMs) Medicare program: MACRA technical amendments Medicare program: Independent Payment Advisory Board (IPAB) Repeal Medicare program: Protecting Access to Medicare Act (PAMA) Medicare program: Physician office lab testing Medicare program: Laboratory Developed Tests (LDTs) Medicare program: Creating Access to Residency Education Act, all provisions Medicare program: Graduate Medical Education (GME) Medicare program: Telemedicine Medicare program: Electronic Health Records (EHR) Medicare program: EHR Certification Medicare program: Misvalued Codes Medicare program: Electronic Prescribing of Controlled Substances Medicare program: Electronic payments Medicare program: Provider Price Transparency Medicare program: Pharmacy Benefit Manager (PBM) Medicare program: Prescription Drug Price Transparency Medicare program: Cybersecurity Medicare program: Health Insurance Portability and Accountability Act (HIPAA) Medicare program: Program Integrity/enrollment/audit process/prior authorization/clarity of payment policies Medicare program: eRx and Prior Authorizations Medicare program: Regulatory Relief Medicare program: Opioid Use Disorder Medicare program: Medicare Shared Savings Program (MSSP)/ACOs Medicare program: Merit-Based Incentive Payment System (MIPS)/scoring formula simplification/episode-based cost measures Medicare program: MIPS/Medicare physician payments redistribution proposal Medicare program: MIPS/Advancing Care Information (ACI)/Improvement Activities (IA) Medicare program: E & M Documentation Guidelines Medicare program: Quality & patient-generated health data Medicare program: Quality Information Organizations (QIOs) Medicare program: Open Payments Medicare program: Health IT burden Medicare program: PECOS/Medicare Enrollment/Revocations/Revalidations Medicare program: Medicare Diabetes Prevention Program Medicare program: Provider Compliance Medicare program: Physician Fee Schedule/Zismer Study Medicare program: Making Accountable Sustainable Oncology Networks (MASON) proposal Medicare program: CMS Hospital Readmissions Reduction Program/fee-for-service mortality Medicare program: Fee-for-service payment policies Medicaid program: Childrens Health Insurance Plan (CHIP) Reauthorization Medicaid program: Work requirements

Client expense: $6,590,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), SENATE, Veterans Affairs, Dept of (VA), White House Office