Independence at Home Act of 2019

H.R. 1319, American Rescue Plan Act of 2021, including provisions relating to Medicaid (FMAP incentive and enhancement provisions, postpartum coverage), state and local funding, provider relief fund H.R.1868, To prevent across-the-board direct spending cuts, and for other purposes, including provisions relating to Medicare sequester suspension extension H.R. 2166, Ensuring Parity in MA and PACE for Audio-Only Telehealth Act of 2021 S. 748, Medicare Sequester Relief Act S. 150, Ensuring Parity in MA for Audio-Only Telehealth Act of 2021 H.Res. 101, Providing for the adoption of the concurrent resolution (S. Con. Res. 5) setting forth the congressional budget for the United States Government for fiscal year 2021 and setting forth the appropriate budgetary levels for fiscal years 2022 through 2030, including provisions relating to Medicaid (FMAP incentive and enhancement provisions, postpartum coverage), state and local funding, provider relief fund S.Con.Res. 5, A concurrent resolution setting forth the congressional budget for the United States Government for fiscal year 2021 and setting forth the appropriate budgetary levels for fiscal years 2022 through 2030, including provisions relating to Medicaid (FMAP incentive and enhancement provisions, postpartum coverage), state and local funding, provider relief fund Potential legislation similar to H.R. 3644, Independence at Home Demonstration Act of 2019, including provisions to improve and extend the Independence at Home medical practice demonstration program under the Medicare program Potential legislation similar to H.R. 8834, Independence at Home Demonstration Improvement Act of 2020, including provisions to medical practice demonstration program under the Medicare program Potential legislation similar to S. 1202, Independence at Home Act of 2019, including provisions to improve and provide for a permanent Independence at Home medical practice program under the Medicare program Potential legislation regarding Medicare Part D Plan innovation proposal to require CMS to issue new guidance increasing the maximum number of plan options to at least for four in each region, allowing part D sponsors to offer two additional plans provided that at least of the two plans passes on at least 10% of aggregate rebates to consumers Issues related to, Budget reconciliation instructions from Ways and Means, Energy and Commerce, Education and Labor, Oversight and Reform Committees; COVID 19 - Sequestration, MLR, Audio only risk adjustment; Medicare Advantage Medical Loss Ratio issues (no bill number).

Client expense: $1,410,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Independence at Home. Primary Care, Direct Contracting. S.1202: Independence at Home Act of 2019. Public Law No: 116-136: Coronavirus Aid, Relief, and Economic Security (CARES) Act.

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

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

P.L. 111-375 National Alzheimer's Project Act, All Sections P.L. 115-119 Recognize, Assist, Include, Support and Engage (RAISE) Family Caregivers Act P.L. 115-406 Building Our Largest Dementia (BOLD) Infrastructure for Alzheimer's Act P.L. 116-131 Supporting Older Americans Act of 2020 S.591 Guardianship Accountability Act S.299 Geriatrics Workforce Improvement Act S.548/H.R.1342 EMPOWER Care Act H.R.1343 Protecting Married Seniors from Impoverishment Act S.740 Alzheimer's Caregiver Support Act H.R. 1955 Understanding Appropriate Alzheimer's Care Act of 2019 S.880/H.R.1873 Improving HOPE for Alzheimer's Act S.2080/H.R.647 Palliative Care and Hospice Education and Training Act S.1250/H.R.2401 American Cures Act S.1017 Supporting America's Caregivers and Families Act S.995/H.R.2035 Lifespan Respite Care Reauthorization Act of 2019 S.1126/H.R.2283 Concentrating on High-Value Alzheimer's Needs to Get to an End (CHANGE) Act of 2019 S.1361/H.R.2584 Preventive Health Savings Act of 2019 S.1628 Paid Family Leave Pilot Extension Act S.1618 Expanding Capacity for Health Outcomes (ECHO) Act of 2019 S.1202 Independence at Home Act of 2019 H.R.3644 Independence at Home Demonstration Act of 2019 H.R.3436 Improving Chronic Care Management Act H.R.3107 Improving Seniors' Timely Access to Care Act S.2469/H.R.4386 Stop the Wait Act H.R.2781 Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness (EMPOWER) for Health Act of 2019 S.2521/H.R.4397 Direct CARE Opportunity Act S.2677 Older Americans and Social Isolation and Loneliness Act H.R.4859 Protecting Older Americans from Social Isolation Act of 2019 H.Res.821 to establish a permanent select Committee in Aging in the House of Representatives H.R.6379 Families First Coronavirus Response Act S.3548/H.R.748 Coronavirus Aid, Relief, and Economic Security (CARES) Act; including provisions that would impact individuals living with Alzheimer's and other dementia and their caregivers. H.R.4334 Supporting Older Americans Act of 2020 S.3544/H.R.6305 Coronavirus Relief for Seniors and People with Disabilities Act S.3768 /H.R.6972 Nursing Home COVID-19 Protection and Prevention Act of 2020 H.R.7048 Nursing Home Pandemic Protection Act S.3644/H.R.6698 Quality Care for Nursing Home Residents and Workers During COVID-19 Act H.R.6638 Reducing COVID-19 Disparities by Investing in Public Health H.R.7158 Health Enterprise Zones Act H.R.6800 Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act S.3517/H.R.6487 ACCESS Act S.3740/H.R.6951 COVID-19 Recovery for Seniors and People with Disabilities Act H.R.8169 Elder Abuse Protection Act S.4182 Emergency Support for Nursing Homes and Elder Justice Reform Act of 2020 H.R.5958 Senior Health Planning Account Act S.4184/H.R.7463 Assisted Living Facility Coronavirus Reporting Act S.4682/H.R.8511 Care Corp Demonstration Act of 2020 H.R. 2477 Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act S.3703/H.R.6813 Promoting Alzheimer's Awareness to Prevent Elder Abuse Act, including Elder Justice Initiative training for professionals through the Department of Justice In forthcoming COVID-19 relief packages, the Alzheimer's Association is advocating for inclusion of policies that would impact those in the Alzheimer's and dementia community including: - Improving HOPE for Alzheimer's Act (S.880/H.R.1873) - Extension of the Independence at Home demonstration model - Emergency Preparedness in long-term and community-based care settings - Expanding Capacity for Health Outcomes (Project ECHO) - Project VITAL: Virtual Inclusive Technology for ALL

H.R. 133, Consolidated Appropriations Act of 2021, including provisions relating to the No Surprises Act, COVID-19 provisions (FMAP) and health extenders (Money Follows the Person, Medicaid spousal impoverishment protections, IAH) H.R. 925, The Heroes Act, including provisions related to House Amendment to the Senate Amendments updated Heroes Act; specifically provisions related to provisions related to access to healthcare including FMAP, testing, protections for public health workers, and benefits to children and families impacted by the coronavirus, Federal Medical Assistance Percentages (FMAP) H.R. 3644/S. 1202, Independence at Home Act of 2019, including provisions relating to improve and provide for a permanent Independence at Home medical practice program under the Medicare program H.R. 4996, Helping Medicaid Offer Maternity Services (MOMS) Act H.R. 7659/S. 4840, Ensuring Parity in MA for Audio-Only Telehealth Act of 2020, including provisions relating to (MA audio-only visits are currently not included in risk adjustment calculations H.R. 6800, Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act including provisions relating to Medicaid, Medicare issues H.R. 8337, Continuing Appropriations Act, 2021 and Other Extensions Act, including provisions included in the section titled, Money Follows the Person, Medicaid Spousal Impoverishment Protections H.R. 8834, Independence at Home Demonstration Improvement Act of 2020, including provisions relating to title XVII of the Social Security Act to extend and improve the Independence at Home Medical Practice Demonstration Program under the Medicare program S. 3013, Encouraging Innovative Benefit Design to Lower Costs for Seniors Act, including provisions relating to prescription drug plans under Medicare Part D (allows for additional drug plan offerings) Potential legislation titled Health, Education Assistance, Liability Protections, Schools Act (HEALS Act) including provisions relating to Medicaid Medicare issues Issues relating to, Medicaid Fiscal Accountability Regulation; Medicare Part D Issues; Medicare Advantage

No bill: Support inclusion of occupational therapy services via telehealth under Medicare Part B, Medicare Advantage and any demonstration programs such as telehealth within accountable care organizations. HR 3127/S 1725 - The Home Health Flexibility Act: Support the ability of occupational therapists to conduct the initial and comprehensive assessments for Medicare Home Health cases. No bill: Support for Congressional attention to the issue of falls related injuries and falls prevention. HR 4932/S 2741 - CONNECT for Health Act of 2019: Support expanded coverage for services provided to Medicare patients via telehealth, including occupational therapy and other therapy services. HR 1329 - Medicaid Reentry Act (mental health and Medicaid policy): Support passage S 1754/HR 3215 - The Disaster Relief Medicaid Act (DRMA): Support passage No bill: Support for Medicare payment for evidence-based programs, led by occupational therapists, that support caregivers for people with dementia. No bill: Support for Medicare payment for evidence-based programs, led by occupational therapists, to support aging in place. S 1202 - Independence At Home Act: support passage HR 7154 - Outpatient Therapy Modernization and Stabilization Act: Support passage. HR 6634 - Emergency COVID Telehealth Response Act: Support introduction and passage. S. 4375/HR 8727 - Telehealth Modernization Act: Advocate for provisions that would allow the Secretary of Health and Human Services to permanently add occupational therapy practitioners to the Medicare telehealth benefit. Support passage. Support various House and Senate proposals to extend and make permanent the Public Health Emergency provisions that enable occupational therapists to provide services to Medicare patients via telehealth. HR 8755-Expanded Telehealth Access Act: Support passage of bill that would allow occupational therapists and other therapists to provide services to Medicare Part B Patients via telehealth after public health emergency ends. S 4343/HR 8581-Triple A Study Bill: advocate to add occupational therapists to list of providers included in legislation mandating study of amputee healthcare. H.R. 133 - Consolidated Appropriations Act of 2021, Division CC Section 115: Advocate to permit occupational therapists to conduct the initial assessment visit and complete the comprehensive assessment with respect to certain rehabilitation services for home health agencies under the Medicare Part B program. HR 8702/S. 5007 - Holding Providers Harmless from Medicare Cuts During COVID-19 Act of 2020; Division CC Section 113 of HR 133-Consolidated Appropriations Act, 2021; and HR 8505-a bill to provide a one year waiver of budget neutrality under the Medicare physician fee schedule: Advocate for changes to evaluation and management coding redistribution in Revisions to Payment Policies under the Medicare Physician Fee Schedule, Quality Payment Program and Other Revisions to Part B for CY 2021 (CMS-1734-F). No bill: Advocated to pause Medicare sequestration for 2021.

Independence at Home. S.1202: Independence at Home Act of 2019. Public Law No: 116-136: Coronavirus Aid, Relief, and Economic Security (CARES) Act.

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

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

P.L. 111-375 National Alzheimer's Project Act, All Sections P.L. 115-119 Recognize, Assist, Include, Support and Engage (RAISE) Family Caregivers Act P.L. 115-406 Building Our Largest Dementia (BOLD) Infrastructure for Alzheimer's Act P.L. 116-131 Supporting Older Americans Act of 2020 S.591 Guardianship Accountability Act S.299 Geriatrics Workforce Improvement Act S.548/H.R.1342 EMPOWER Care Act H.R.1343 Protecting Married Seniors from Impoverishment Act S.740 Alzheimer's Caregiver Support Act H.R. 1955 Understanding Appropriate Alzheimer's Care Act of 2019 S.880/H.R.1873 Improving HOPE for Alzheimer's Act S.2080/H.R.647 Palliative Care and Hospice Education and Training Act S.1250/H.R.2401 American Cures Act S.1017 Supporting America's Caregivers and Families Act S.995/H.R.2035 Lifespan Respite Care Reauthorization Act of 2019 S.1126/H.R.2283 Concentrating on High-Value Alzheimer's Needs to Get to an End (CHANGE) Act of 2019 S.1361/H.R.2584 Preventive Health Savings Act of 2019 S.1628 Paid Family Leave Pilot Extension Act S.1618 Expanding Capacity for Health Outcomes (ECHO) Act of 2019 S.1202 Independence at Home Act of 2019 H.R.3644 Independence at Home Demonstration Act of 2019 H.R.3436 Improving Chronic Care Management Act H.R.3107 Improving Seniors' Timely Access to Care Act S.2469/H.R.4386 Stop the Wait Act H.R.2781 Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness (EMPOWER) for Health Act of 2019 S.2521/H.R.4397 Direct CARE Opportunity Act S.2677 Older Americans and Social Isolation and Loneliness Act H.R.4859 Protecting Older Americans from Social Isolation Act of 2019 H.Res.821 to establish a permanent select Committee in Aging in the House of Representatives H.R.6379 Families First Coronavirus Response Act S.3548/H.R.748 Coronavirus Aid, Relief, and Economic Security (CARES) Act; including provisions that would impact individuals living with Alzheimer's and other dementia and their caregivers. H.R.4334 Supporting Older Americans Act of 2020 S.3544/H.R.6305 Coronavirus Relief for Seniors and People with Disabilities Act S.3768 /H.R.6972 Nursing Home COVID-19 Protection and Prevention Act of 2020 H.R.7048 Nursing Home Pandemic Protection Act S.3644/H.R.6698 Quality Care for Nursing Home Residents and Workers During COVID-19 Act H.R.6638 Reducing COVID-19 Disparities by Investing in Public Health H.R.7158 Health Enterprise Zones Act H.R.6800 Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act S.3517/H.R.6487 ACCESS Act S.3740/H.R.6951 COVID-19 Recovery for Seniors and People with Disabilities Act H.R.8169 Elder Abuse Protection Act S.4182 Emergency Support for Nursing Homes and Elder Justice Reform Act of 2020 H.R.5958 Senior Health Planning Account Act S.4184/H.R.7463 Assisted Living Facility Coronavirus Reporting Act S.4682/H.R.8511 Care Corp Demonstration Act of 2020 H.R. 2477 Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act In forthcoming COVID-19 relief packages, the Alzheimer's Association is advocating for inclusion of policies that would impact those in the Alzheimer's and dementia community including: - Improving HOPE for Alzheimer's Act (S.880/H.R.1873) - Extension of the Independence at Home demonstration model - Promoting Alzheimer's Awareness to Prevent Elder Abuse Act, including Elder Justice Initiative training for professionals through the Department of Justice - Emergency Preparedness in long-term and community-based care settings - Expanding Capacity for Health Outcomes (Project ECHO) - Project VITAL: Virtual Inclusive Technology for ALL

H.R. 925, The Heroes Act, including provisions related to House Amendment to the Senate Amendments updated Heroes Act; specifically provisions related to provisions related to access to healthcare including FMAP, testing, protections for public health workers, and benefits to children and families impacted by the coronavirus, Federal Medical Assistance Percentages (FMAP) H.R. 2062, Overdose Prevention and Patient Safety Act, including provisions relating to 42 CFR Part 2 issues H.R. 3644/S. 1202, Independence at Home Act of 2019, including provisions relating to improve and provide for a permanent Independence at Home medical practice program under the Medicare program H.R. 4996, Helping Medicaid Offer Maternity Services (MOMS) Act H.R. 7659, Ensuring Parity in MA for Audio-Only Telehealth Act of 2020, including provisions relating to (MA audio-only visits are currently not included in risk adjustment calculations H.R. 6800, Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act including provisions relating to Medicaid, Medicare issues H.R. 8337, Continuing Appropriations Act, 2021 and Other Extensions Act, including provisions included in the section titled, Money Follows the Person, Medicaid Spousal Impoverishment Protections S. 2012, Protecting Jessica Grubb's Legacy Act, including provisions relating to 42 CFR Part 2 issues S. 3013, Encouraging Innovative Benefit Design to Lower Costs for Seniors Act, including provisions relating to prescription drug plans under Medicare Part D (allows for additional drug plan offerings) Potential legislation titled Health, Education Assistance, Liability Protections, Schools Act (HEALS Act) including provisions relating to Medicaid Medicare issues Issues relating to, Medicaid Fiscal Accountability Regulation; Medicare Part D Issues; Medicare Advantage

Client expense: $1,100,000 · Firm income: Not reported

No bill: Support inclusion of occupational therapy services via telehealth under Medicare Part B, Medicare Advantage and any demonstration programs such as telehealth within accountable care organizations. HR 3127/S 1725 - The Home Health Flexibility Act: Support the ability of occupational therapists to conduct the initial and comprehensive assessments for Medicare Home Health cases. S 518/HR 1948 - Lymphedema Treatment Act - Support passage. No bill: Advocate for Congressional oversight of new Medicare payment models - PDPM & PDGM. No bill: Support for Congressional attention to the issue of falls related injuries and falls prevention. No bill: Advocated to stop proposed cuts to therapy services in the 2021 Physician Fee Schedule. HR 4932/S 2741 - CONNECT for Health Act of 2019: Support expanded coverage for services provided to Medicare patients via telehealth, including occupational therapy and other therapy services. HR 1329 - Medicaid Reentry Act (mental health and Medicaid policy): Support passage S 1754/HR 3215 - The Disaster Relief Medicaid Act (DRMA): Support passage No bill: Support for Medicare payment for evidence-based programs, led by occupational therapists, that support caregivers for people with dementia. No bill: Support for Medicare payment for evidence-based programs, led by occupational therapists, to support aging in place. S 1202 - Independence At Home Act: support passage HR2408 - Ensuring Access to Complex Rehabilitation Technology Act of 2019: support passage HR 748, CARES Act: Advocated to include occupational therapy practitioners as eligible Medicare telehealth service providers for both the duration of the COVID-19 public health emergency and on a permanent basis. HR 7154 - Outpatient Therapy Modernization and Stabilization Act: Support passage. HR 6634 - Emergency COVID Telehealth Response Act: Support introduction and passage. No bill #: Support for waiving statutory budget neutrality requirements, or exempting certain provider specialties from the application of budget neutrality, for the implementation of new Evaluation and Management Codes in the 2021 Medicare Physician Fee Schedule, and inclusion of this waiver in any COVID-19 legislation. HR 6365/3559 -Immediate Relief for Rural Facilities and Providers Act of 2020: Support passage. CMS - Met with CMS to discuss Medicare Part B payment reductions to therapy provider payments proposed in the 2021 physician fee schedule: Participants included Demetrios Kouzoukas, Director of Medicare. S. 4375 - Telehealth Modernization Act: Support , particularly for provisions that would allow the Secretary of Health and Human Services to permanently add occupational therapy practitioners to the Medicare telehealth benefit. Support various House and Senate proposals to extend and make permanent the Public Health Emergency provisions that enable occupational therapists to provide services to Medicare patients via telehealth.

Independence at Home. S.1202: Independence at Home Act of 2019. Public Law No: 116-136: Coronavirus Aid, Relief, and Economic Security (CARES) Act.

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

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

P.L. 111-375 National Alzheimer's Project Act, All Sections P.L. 115-119 Recognize, Assist, Include, Support and Engage (RAISE) Family Caregivers Act P.L. 115-406 Building Our Largest Dementia (BOLD) Infrastructure for Alzheimer's Act S.591 Guardianship Accountability Act S.299 Geriatrics Workforce Improvement Act S.548/H.R.1342 EMPOWER Care Act H.R.1343 Protecting Married Seniors from Impoverishment Act S.740 Alzheimer's Caregiver Support Act H.R. 1955 Understanding Appropriate Alzheimer's Care Act of 2019 S.880/H.R.1873 Improving HOPE for Alzheimer's Act H.R.1903/S.901 Younger-Onset Alzheimer's Disease Act of 2019 S.2080/H.R.647 Palliative Care and Hospice Education and Training Act S.1250/H.R.2401 American Cures Act S.1017 Supporting America's Caregivers and Families Act S.995/H.R.2035 Lifespan Respite Care Reauthorization Act of 2019 S.1126/H.R.2283 Concentrating on High-Value Alzheimer's Needs to Get to an End (CHANGE) Act of 2019 S.1361/H.R.2584 Preventive Health Savings Act of 2019 S.1628 Paid Family Leave Pilot Extension Act S.1618 Expanding Capacity for Health Outcomes (ECHO) Act of 2019 S.1202 Independence at Home Act of 2019 H.R.3644 Independence at Home Demonstration Act of 2019 H.R.3436 Improving Chronic Care Management Act H.R.3107 Improving Seniors' Timely Access to Care Act H.R.4334 Dignity in Aging Act of 2019 S.2469/H.R.4386 Stop the Wait Act H.R.2781 Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness (EMPOWER) for Health Act of 2019 S.2521/H.R.4397 Direct CARE Opportunity Act S.3057 Modernization of the Older Americans Act Amendments S.2677 Older Americans and Social Isolation and Loneliness Act H.R.4859 Protecting Older Americans from Social Isolation Act of 2019 H.Res.821 to establish a permanent select Committee in Aging in the House of Representatives H.R.6379 Families First Coronavirus Response Act S.3548/H.R.748 Coronavirus Aid, Relief, and Economic Security (CARES) Act; including provisions that would impact individuals living with Alzheimer's and other dementia and their caregivers. H.R.4334 Supporting Older Americans Act of 2020 S.3544/H.R.6305 Coronavirus Relief for Seniors and People with Disabilities Act S.3768 /H.R.6972 Nursing Home COVID-19 Protection and Prevention Act of 2020 H.R.7048 Nursing Home Pandemic Protection Act S.3644/H.R.6698 Quality Care for Nursing Home Residents and Workers During COVID-19 Act H.R.6638 Reducing COVID-19 Disparities by Investing in Public Health H.R.7158 Health Enterprise Zones Act H.R.6800 Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act S.3517/H.R.6487 ACCESS Act S.3740/H.R.6951 COVID-19 Recovery for Seniors and People with Disabilities Act In forthcoming COVID-19 relief packages, the Alzheimer's Association is advocating for inclusion of policies that would impact those in the Alzheimer's and dementia community including: - Improving HOPE for Alzheimer's Act (S.880/H.R.1873) - Extension of the Independence at Home demonstration model - Promoting Alzheimer's Awareness to Prevent Elder Abuse Act, including Elder Justice Initiative training for professionals through the Department of Justice - Emergency Preparedness in long-term and community-based care settings - Expanding Capacity for Health Outcomes (Project ECHO) - Project VITAL: Virtual Inclusive Technology for ALL

No bill: Support inclusion of occupational therapy services via telehealth under Medicare Part B, Medicare Advantage and any demonstration programs such as telehealth within accountable care organizations. HR 3127/S 1725 - The Home Health Flexibility Act: Support the ability of occupational therapists to conduct the initial and comprehensive assessments for Medicare Home Health cases. S 518/HR 1948 - Lymphedema Treatment Act - Support passage. No bill: Advocate for Congressional oversight of new Medicare payment models - PDPM & PDGM. No bill: Support for Congressional attention to the issue of falls related injuries and falls prevention. No bill: Advocated to stop proposed cuts to therapy services in the 2021 Physician Fee Schedule. HR 4932/S 2741 - CONNECT for Health Act of 2019: Support expanded coverage for services provided to Medicare patients via telehealth, including occupational therapy and other therapy services. HR 1329 - Medicaid Reentry Act (mental health and Medicaid policy): Support passage S 1754/HR 3215 - The Disaster Relief Medicaid Act (DRMA): Support passage No bill: Support for Medicare payment for evidence-based programs, led by occupational therapists, that support caregivers for people with dementia. No bill: Support for Medicare payment for evidence-based programs, led by occupational therapists, to support aging in place. S 1202 - Independence At Home Act: support passage HR2408 - Ensuring Access to Complex Rehabilitation Technology Act of 2019: support passage HR 748, CARES Act: Advocated to include occupational therapy practitioners as eligible Medicare telehealth service providers for both the duration of the COVID-19 public health emergency and on a permanent basis. HR 7154 - Outpatient Therapy Modernization and Stabilization Act: Support introduction and passage. HR 6634 - Emergency COVID Telehealth Response Act: Support introduction and passage. No bill #: Support for waiving statutory budget neutrality requirements, or exempting certain provider specialties from the application of budget neutrality, for the implementation of new Evaluation and Management Codes in the 2021 Medicare Physician Fee Schedule, and inclusion of this waiver in any COVID-19 legislation. HR 6365/3559 -Immediate Relief for Rural Facilities and Providers Act of 2020: Support passage. Meeting with CMS officials from Division of Non-Institutional Quality Standards both Mary Rossi-Coajou, Senior Nurse Consultant and Maria Hammel, Director; from Division of Continuing and Acute Care Providers both James Cowher, Branch Manager and Tara Lemons, RDN,RN,MA,MSN; and from Division of Home Health, Hospice and HCPCS Kelly Vontran, Acting Deputy Director: Advocated making permanent the public health emergency provisions that enable occupational therapists to open Medicare home health therapy cases. CMS - Met with Demetrios Kouzoukas, Director of Medicare, Ing-Jyu Cheng, Acting Director of Hospital and Ambulatory Policy Group, and Gift Tee, Director of the Division of Practitioner Services: Discussed Medicare Part B payment reductions to therapy provider payments proposed for the 2021 physician fee schedule in 84 FR 62568. GAO - Met with officials from the Office of Management and Budget and official from the Office of Information and Regulatory Affairs: Discussed Medicare Part B payment reductions to therapy provider payments proposed for the 2021 physician fee schedule in 84 FR 62568

H.R. 3107, Improving Seniors Timely Access to Care Act of 2019 - provisions related to prior authorization for Medicare Advantage Plans; S. 3013, Encouraging Innovative Benefit Design to Lower Costs for Seniors Act - provisions related to prescription drug plans under Medicare Part D; S. 2543, Prescription Drug Pricing Reduction Act (PDRPA) of 2019 - provisions addressing prescription drug pricing; S. 1202, Independence at Home Act of 2019 - provisions to improve and provide for a permanent Independence at Home medical practice program under the Medicare program; H.R. 3644, Independence at Home Act of 2019 - provisions to improve and extend the Independence at Home medical practice demonstration program under the Medicare program; H.R. 748, Coronavirus Aid, Relief, and Economic Security (CARES) Act - healthcare provisions related to access and support for providers and states and access to PPE; S. 3559, Immediate Relief for Rural Facilities and Providers Act - provisions related to emergency financial assistance to rural health care facilities and providers impacted by the COVID-19 emergency; H.R. 6201, Families First Coronavirus Response Act (stimulus 2) - provisions related to access to healthcare including FMAP, testing, protections for public health workers, and benefits to children and families impacted by the coronavirus; S. 1790 - National Defense Authorization Act for Fiscal Year 2020 - provisions related to telehealth; Issues related to point of sale rebate Issues related to allowing for audio only effective date alignment between Health Defense Agency and CMS Issues related to COVID-19 package 4

Client expense: $510,000 · Firm income: Not reported

Independence at Home. S.1202: Independence at Home Act of 2019. Public Law No: 116-136: Coronavirus Aid, Relief, and Economic Security (CARES) Act.

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

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

P.L. 111-375 National Alzheimer's Project Act, All Sections P.L. 115-119 Recognize, Assist, Include, Support and Engage (RAISE) Family Caregivers Act P.L. 115-406 Building Our Largest Dementia (BOLD) Infrastructure for Alzheimer's Act S.591 Guardianship Accountability Act S.299 Geriatrics Workforce Improvement Act S.548/H.R.1342 EMPOWER Care Act H.R.1343 Protecting Married Seniors from Impoverishment Act S.740 Alzheimer's Caregiver Support Act H.R. 1955 Understanding Appropriate Alzheimer's Care Act of 2019 S.880/H.R.1873 Improving HOPE for Alzheimer's Act H.R.1903/S.901 Younger-Onset Alzheimer's Disease Act of 2019 S.2080/H.R.647 Palliative Care and Hospice Education and Training Act S.1250/H.R.2401 American Cures Act S.1017 Supporting America's Caregivers and Families Act S.995/H.R.2035 Lifespan Respite Care Reauthorization Act of 2019 S.1126/H.R.2283 Concentrating on High-Value Alzheimer's Needs to Get to an End (CHANGE) Act of 2019 S.1361/H.R.2584 Preventive Health Savings Act of 2019 S.1628 Paid Family Leave Pilot Extension Act S.1618 Expanding Capacity for Health Outcomes (ECHO) Act of 2019 S.1202 Independence at Home Act of 2019 H.R.3644 Independence at Home Demonstration Act of 2019 H.R.3436 Improving Chronic Care Management Act H.R.3107 Improving Seniors' Timely Access to Care Act H.R.4334 Dignity in Aging Act of 2019 S.2469/H.R.4386 Stop the Wait Act H.R.2781 Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness (EMPOWER) for Health Act of 2019 S.2521/H.R.4397 Direct CARE Opportunity Act S.3057 Modernization of the Older Americans Act Amendments S.2677 Older Americans and Social Isolation and Loneliness Act H.R.4859 Protecting Older Americans from Social Isolation Act of 2019 H.Res.821 to establish a permanent select Committee in Aging in the House of Representatives H.R.6379 Families First Coronavirus Response Act S.3548/H.R.748 Coronavirus Aid, Relief, and Economic Security (CARES) Act; including provisions that would impact individuals living with Alzheimer's and other dementia and their caregivers. H.R.4334 Supporting Older Americans Act of 2020 S.3544/H.R.6305 Coronavirus Relief for Seniors and People with Disabilities Act In forthcoming COVID-19 relief packages, the Alzheimer's Association is advocating for inclusion of policies that would impact those in the Alzheimer's and dementia community including: - Improving HOPE for Alzheimer's Act (S.880/H.R.1873) - Extension of the Independence at Home demonstration model - Promoting Alzheimer's Awareness to Prevent Elder Abuse Act, including Elder Justice Initiative training for professionals through the Department of Justice - Emergency Preparedness in long-term and community-based care settings - Expanding Capacity for Health Outcomes (Project ECHO) - Project VITAL: Virtual Inclusive Technology for ALL

H.R. 3107, Improving Seniors Timely Access to Care Act of 2019 - provisions related to prior authorization for Medicare Advantage Plans; S. 3013, Encouraging Innovative Benefit Design to Lower Costs for Seniors Act - provisions related to prescription drug plans under Medicare Part D S. 2543, Prescription Drug Pricing Reduction Act (PDRPA) of 2019 - provisions addressing prescription drug pricing; H.R. 4004/S. 2986, Social Determinants Accelerator Act of 2019 - provisions addressing social determinants of health; S. 1202, Independence at Home Act of 2019 - provisions to improve and provide for a permanent Independence at Home medical practice program under the Medicare program H.R. 3644, Independence at Home Act of 2019 - provisions to improve and extend the Independence at Home medical practice demonstration program under the Medicare program H.R. 748, Coronavirus Aid, Relief, and Economic Security (CARES) Act - healthcare provisions related to access and support for providers and states and access to PPE S. 3559, Immediate Relief for Rural Facilities and Providers Act - provisions related to emergency financial assistance to rural health care facilities and providers impacted by the COVID-19 emergency H.R. 6201, Families First Coronavirus Response Act (stimulus 2) - provisions related to access to healthcare including FMAP, testing, protections for public health workers, and benefits to children and families impacted by the coronavirus

Client expense: $690,000 · Firm income: Not reported

No bill: Support inclusion of occupational therapy services via telehealth under Medicare Part B, Medicare Advantage and any demonstration programs such as telehealth within accountable care organizations. HR 3127/S 1725 - The Home Health Flexibility Act: Support the ability of occupational therapists to conduct the initial and comprehensive assessments for Medicare Home Health cases. S 518/HR 1948 - Lymphedema Treatment Act - Support passage. No bill: Advocate for Congressional oversight of new Medicare payment models - PDPM & PDGM. No bill: Support for Congressional attention to the issue of falls related injuries and falls prevention. No bill: Advocated to stop proposed cuts to therapy services in the 2021 Physician Fee Schedule. HR 4932/S 2741 - CONNECT for Health Act of 2019: Support expanded coverage for services provided to Medicare patients via telehealth, including occupational therapy and other therapy services. HR 1329 - Medicaid Reentry Act (mental health and Medicaid policy): Support passage S 1754/HR 3215 - The Disaster Relief Medicaid Act (DRMA): Support passage No bill: Support for Medicare payment for evidence-based programs, led by occupational therapists, that support caregivers for people with dementia. No bill: Support for Medicare payment for evidence-based programs, led by occupational therapists, to support aging in place. HR 1109 - Mental Health Services for Students Act: Support passage HR 4564 - Suicide Prevention Lifeline Improvement Act: Support passage HR 1767 - Excellence in Mental Health and Addiction Treatment Expansion Act: Support passage HR 4861 - Effective Suicide Screening and Assessment in the Emergency Department Act: Support passage HR 4309 - Barriers to Suicide Act: Support passage S 995 - Lifespan Respite Care Reauthorization Act: Support passage S 1202 - Independence At Home Act: support passage HR2408 - Ensuring Access to Complex Rehabilitation Technology Act of 2019: support passage HR 748, CARES Act: Asked that occupational therapy practitioners and other therapy providers be made eligible to provide Medicare telehealth services under emergency waivers. CMS - Met with Gift Tee, Director of the Division of Practitioner Services; Kathy Bryant; and Pam West: Discussed Medicare Part B payment reductions to therapy provider payments proposed for the 2021 physician fee schedule. We discussed proposals that would allow the changes to evaluation and management (E&M) codes to proceed without adversely affecting specialties that do not bill E&M codes. HR 6365/3559 -Immediate Relief for Rural Facilities and Providers Act of 2020: Support passage.

Independence at Home. S.1202: Independence at Home Act of 2019.

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

Government targets: Administration on Aging, Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE, White House Office

P.L. 111-375 National Alzheimer's Project Act, All Sections P.L. 115-119 Recognize, Assist, Include, Support and Engage (RAISE) Family Caregivers Act P.L. 115-406 Building Our Largest Dementia (BOLD) Infrastructure for Alzheimer's Act S.591 Guardianship Accountability Act S.299 Geriatrics Workforce Improvement Act S.548/H.R.1342 EMPOWER Care Act H.R.1343 Protecting Married Seniors from Impoverishment Act S.740 Alzheimer's Caregiver Support Act H.R. 1955 Understanding Appropriate Alzheimer's Care Act of 2019 S.880/H.R.1873 Improving HOPE for Alzheimer's Act H.R.1903/S.901 Younger-Onset Alzheimer's Disease Act of 2019 S.2080/H.R.647 Palliative Care and Hospice Education and Training Act S.1250/H.R.2401 American Cures Act S.1017 Supporting America's Caregivers and Families Act S.995/H.R.2035 Lifespan Respite Care Reauthorization Act of 2019 S.1126/H.R.2283 Concentrating on High-Value Alzheimer's Needs to Get to an End (CHANGE) Act of 2019 S.1361/H.R.2584 Preventive Health Savings Act of 2019 S.1628 Paid Family Leave Pilot Extension Act S.1618 Expanding Capacity for Health Outcomes (ECHO) Act of 2019 S.1202 Independence at Home Act of 2019 H.R.3644 Independence at Home Demonstration Act of 2019 H.R.3436 Improving Chronic Care Management Act H.R.3107 Improving Seniors' Timely Access to Care Act H.R.4334 Dignity in Aging Act of 2019 S.2469/H.R.4386 Stop the Wait Act H.R.2781 Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness (EMPOWER) for Health Act of 2019 S.2521/H.R.4397 Direct CARE Opportunity Act S.3057 Modernization of the Older Americans Act Amendments S.2677 Older Americans and Social Isolation and Loneliness Act H.R.4859 Protecting Older Americans from Social Isolation Act of 2019

Client expense: $400,000 · Firm income: Not reported

Independence at Home. S.1202: Independence at Home Act of 2019.

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

Government targets: Administration on Aging, Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE, White House Office

P.L. 111-375 National Alzheimer's Project Act, All Sections P.L. 115-119 Recognize, Assist, Include, Support and Engage (RAISE) Family Caregivers Act P.L. 115-406 Building Our Largest Dementia (BOLD) Infrastructure for Alzheimer's Act S.591 Guardianship Accountability Act S.299 Geriatrics Workforce Improvement Act S.548/H.R.1342 EMPOWER Care Act H.R.1343 Protecting Married Seniors from Impoverishment Act S.740 Alzheimer's Caregiver Support Act H.R. 1955 Study on Use of Anti-Psychotics in Non-nursing Homes S.880/H.R.1873 Improving HOPE for Alzheimer's Act H.R.1903/S.901 Younger-Onset Alzheimer's Disease Act of 2019 S.2080/H.R.647 Palliative Care and Hospice Education and Training Act S.1250/H.R.2401 American Cures Act S.1017 Supporting America's Caregivers and Families Act S.995/H.R.2035 Lifespan Respite Care Reauthorization Act of 2019 S.1126/H.R.2283 Concentrating on High-Value Alzheimer's Needs to Get to an End (CHANGE) Act of 2019 S.1361/H.R.2584 Preventive Health Savings Act of 2019 S.1628 Paid Family Leave Pilot Extension Act H.R.2878 Homecare for Seniors Act S.1618 Expanding Capacity for Health Outcomes (ECHO) Act of 2019 S.1202 Independence at Home Act of 2019 H.R.3644 Independence at Home Demonstration Act of 2019 H.R.3436 Improving Chronic Care Management Act H.R.3107 Improving Seniors' Timely Access to Care Act H.R.4334 Dignity in Aging Act of 2019 S.2469/H.R.4386 Stop the Wait Act

Client expense: $500,000 · Firm income: Not reported

Independence at Home. S.1202: Independence at Home Act of 2019.

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

Government targets: Administration on Aging, Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE, White House Office

P.L. 111-375 National Alzheimer's Project Act, All Sections P.L. 115-119 Recognize, Assist, Include, Support and Engage (RAISE) Family Caregivers Act P.L. 115-406 Building Our Largest Dementia (BOLD) Infrastructure for Alzheimer's Act S.591 Guardianship Accountability Act S.299 Geriatrics Workforce Improvement Act S.548/H.R.1342 EMPOWER Care Act H.R.1343 Protecting Married Seniors from Impoverishment Act S.740 Alzheimer's Caregiver Support Act H.R. 1955 Study on Use of Anti-Psychotics in Non-nursing Homes S.880/H.R.1873 Improving HOPE for Alzheimer's Act H.R.1903/S.901 Younger-Onset Alzheimer's Disease Act of 2019 H.R.647 Palliative Care and Hospice Education and Training Act S.1250/H.R.2401 American Cures Act S.1017 Supporting America's Caregivers and Families Act S.995/H.R.2035 Lifespan Respite Care Reauthorization Act of 2019 S.1126/H.R.2283 Concentrating on High-Value Alzheimer's Needs to Get to an End (CHANGE) Act of 2019 S.1361/H.R.2584 Preventive Health Savings Act of 2019 S.1628 Paid Family Leave Pilot Extension Act H.R.2878 Homecare for Seniors Act S.1618 Expanding Capacity for Health Outcomes (ECHO) Act of 2019 S.1202 Independence at Home Act of 2019 H.R.3436 Improving Chronic Care Management Act

Client expense: $871,000 · Firm income: Not reported

Independence at Home, S. 1202 - A bill to amend title XVIII of the Social Security Act to provide for a permanent Independence at Home medical practice program under the Medicare program, Primary Care Reimbursement for Medicare, Medicare Advantage

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

Government targets: Administration on Aging, Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), Government Accountability Office (GAO), 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 Personnel Management (OPM), SENATE, White House Office

Independence at Home, S. 1202 - A bill to amend title XVIII of the Social Security Act to provide for a permanent Independence at Home medical practice program under the Medicare program, Primary Care Reimbursement for Medicare, Medicare Advantage

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

Government targets: Administration on Aging, Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), Government Accountability Office (GAO), 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 Personnel Management (OPM), SENATE, White House Office

Medicaid block grant/per capita caps; H.R. 1342, EMPOWER Care Act; S. 548, EMPOWER Care Act; S. 1202, Independence Home Act; reauthorization of the Independence at Home Medicare Demonstration, generally.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 2740 Labor-HHS Appropriations bill, FY 2020 - lobbied in support of increased funding for CMS' state survey and certification program and opposition to hostile policy riders re Patient Protection and Affordable Care Act. Discussed civil money penalties for enforcement in nursing homes. Lobbied CMS. Discussed nursing home quality and enforcement issues and shared relevant information. Discussed draft nursing home bill. Submitted and shared statement for the record for Senate Finance Committee nursing home hearing. Discussed nursing homes, including the Special Focus Facility Program (no bill number). Discussed emergency preparedness regulations for nursing homes. S. 117/H.R. 555, Disability Integration Act -discussed bill language, support for, and introduction of the bill. No bill number - discussed Money Follows the Person Rebalancing Demonstration Program and Medicaid home and community-based services (HCBS) spousal impoverishment protections and extending them. S. 753/H.R. 1682 - Improving Access to Medicare Coverage Act - shared AARP support letters for the legislation, discussed the bill, and shared related information. P.L. 114-42, NOTICE Act - discussed transparency/surprise medical billing, including observation issues and related prior legislation. S. 548/H.R. 1342, EMPOWER Care Act - discussed and shared AARPs support for the bill. H.R. 1343, Protecting Married Seniors from Impoverishment Act - discussed and shared AARPs support for the bill. S. 296, Home Health Planning Improvement Act - discussed and shared support for the bill. No bill number - discussed issues affecting dully eligible individuals. Discussed surprise billing and health care price transparency. Discussed oral health coverage in Medicare. S. 668/H.R. 1570 - Removing Barriers to Colorectal Cancer Screening Act of 2019 - joined letter of endorsement. S. 286/H.R. 945 - Mental Health Access Improvement Act - sent letter of endorsement. H.R. 1301 - Mental Health Telemedicine Expansion Act - sent letter of endorsement. S.1999 - Improving Low Income Access to Prescription Drugs Act. H.R. 1682/S. 753, Improving Access to Medicare Coverage Act - discussed support for bill and urged cosponsorship. H.R. 2150, Home Health Care Planning Improvement Act - discussed and shared support letter for bill. Discussed extension of Money Follows the Person Rebalancing Demonstration Program and Medicaid home and community-based services spousal impoverishment protections. Lobbied House and Senate staff. S. 2000, Protecting Married Spouses from Impoverishment Act - discussed and supported bill with Senate staff. H.R. 1342, EMPOWER Care Act - discussed support for the bill and provided information on the Money Follows the Person Rebalancing Demonstration Program. H.R. 555/S. 117, Disability Integration Act - discussed the bill and shared endorsement letter. S. 1895 - Lower Health Care Costs Act - Discussed and sent letter to HELP committee S. 1531 - Stopping The Outrages Practice (STOP) of Surprise Medical Bills Act - Discussed with bill sponsors S. 1280/H.R. 2477 - Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act - Sent letter of endorsement No bill number. Provided feedback on Home Health Care CAHPS survey (CMS). No bill number. Discussed nursing home bill regarding nursing home resident personal needs allowances. No bill number. Discussed Medicaid provisions in federal domestic worker bill of rights. No bill number. Discussed nursing home quality, regulation, enforcement, and arbitration. No bill number - discussed skilled nursing facility value-based purchasing. No bill number - responded to inquiry regarding Medicaid and Senior Care Act. S. 1202, Independence at Home Act of 2019 - discussed the bill. No bill number. Discussed Medicaid managed long-term services and supports and family caregiving. No bill number - Discussed draft No Surprises Act bill on surprise medical billing Discussed oral health coverage in Medicare

Independence at Home, S. 1202 - A bill to amend title XVIII of the Social Security Act to provide for a permanent Independence at Home medical practice program under the Medicare program, Primary Care Reimbursement for Medicare, Medicare Advantage

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

Government targets: Administration on Aging, Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), Government Accountability Office (GAO), 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 Personnel Management (OPM), SENATE, White House Office

Independence at Home, S. 1202 - A bill to amend title XVIII of the Social Security Act to provide for a permanent Independence at Home medical practice program under the Medicare program, Primary Care Reimbursement for Medicare, Medicare Advantage

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

Government targets: Administration on Aging, Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), Government Accountability Office (GAO), 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 Personnel Management (OPM), SENATE, White House Office