Primary Care Patient Protection Act of 2019

Defending independent-contractor status; seeking reinstatement of companionship services exemption to the FLSA; urging harmonization of the definition of "employee" for purposes of federal statutes; supporting the Modern Worker Empowerment Act, H.R. 4069 and S. 2793; advocated for inclusion of 1099 income received by essential workers in "payroll" costs for purposes of new SBA loans under CARES Act.

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

Government targets: HOUSE OF REPRESENTATIVES, Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Small Business Administration (SBA)

S. 3198 Suicide Prevention Act: Legislator inquiry/Expand suicide prevention grant pilot program to primary care physicians. S. 3599; HR 6788: Healthcare workforce Resilience Act: recapture 15,000 unused employment-based physician immigrant visas from prior fiscal years to bolster physician workforce during COVID pandemic. S 3750; HR 6837: Medicare Accelerated and Advance Payments Improvement Act of 2020: Advanced payments to medicare Part B providers. S. 4088; HR 6149: Ensuring Access to Primary Care for Women and Children Act; Kids Access to Primary Care Act: Increase Medicaid payment rates for primary care. HR 748 - CARES Act: Fund CHC & THCGME, promote telemedicine in primary care, set Medicaid at Medicare parity. HR 2774, S 2793 - Primary Care Patient Protection Act: create a primary care benefit in high deductible health plans. HR 2895 Conrad State 30 &Physician Access Act; expand program, streamlined eligibility. HR 6074 - Coronavirus Preparedness & Response Supplemental Act - Ensure adequate PPE, funding and loans, telehealth care payment. HR 6201 - Families First Coronavirus Response Act: Support for small business and non-profits during pandemic. HR 7059: Coronavirus Provider Protection Act: Targeted and limited liability protections for healthcare providers responding to COVID pandemic. HR 7158 Health Enterprise Zone: Legislator inquiry/Reducing health disparities in underserved areas. No Bill No: communication with CMS on the 2021 and 2022 Part C and D proposed rule; Medicare Advantage, price transparency. No Bill No: communication with CMS on rural maternal health; Improving rural maternal health. No Bill No: communication with CMS on Covid-19 policy changes; payment for telehealth changes. No Bill No. - Congressional Primary Care Caucus: 116th Congress Membership in the bipartisan CPCC No Bill No. - Teaching Health Centers GME; Community Health Centers; National Health Service Corps; Special Diabetes Program; Special Diabetes Program for Indians; increased finding, five-year reauthorization. No Bill No. - 501(c)(6) Non-Profits Relief; include emergency financial relief for 501(c)(6) organizations in COVID response legislation. No Bill No.: Emergency Financial relief for Primary Care Physicians: additional financial support for primary care physicians; additional financial support for primary care clinicians to stabilize our nation's primary care infrastructure. No Bill No.: Expansion of telehealth: Protecting Access to post COVID -19 telehealth act: Expansion of telehealth services for primary care; coverage and payment parity during PHE. No Bill No.: DACA status during the Covid-19 National Emergency: Maintain work authorization for individuals currently in DACA status during the covid 19 national emergency. No Bill No. - CHC & National Health Service Corps reauthorization: Health care access, scholarships and medical student debt relief. No Bill No. - Administrative Simplification: Promote reduced administrative burden on family physicians of prior authorization, EMR.

HR 748 - CARES Act: Fund CHC & THCGME, promote telemedicine in primary care, set Medicaid at Medicare parity. HR 2774, S 2793 - Primary Care Patient Protection Act: create a primary care benefit in high deductible health plans. HR 6074 - Coronavirus Preparedness & Response Supplemental Act - Ensure adequate PPE, funding and loans, telehealth care payment. HR 6201 - Families First Coronavirus Response Act: Support for small business and non-profits during pandemic.

Client expense: $908,864 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE, White House Office

HR 2774, S 2793 - Primary Care Patient Protection Act: create a primary care benefit in high deductible health plans. No Bill No. - Administrative Simplification: Promote reduced administrative burden on family physicians of prior authorization, EMR. No Bill No. - Administrative Simplification: Promote reduced administrative burden on family physicians of prior authorization, EMR.

Client expense: $908,864 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE, White House Office

Emergency federal response to COVID-19 (including S 3548, HR 6800), Medicare reimbursement and incident to billing, Medicare hospice restrictions, Medicare definition of PA services, transparency, healthcare competition, PA Direct Payment Act (S 596, HR 1052), implementation of home health provisions and other provisions of the Coronavirus Aid, Relief, and Economic Security (CARES) Act ), Promoting Access to Diabetic Shoes Act (S 237, HR 808), the Mainstreaming Addiction Treatment Act (S 2074, HR 2482), Medication Access and Training Expansion Act (HR 4974), Increasing Access to Quality Cardiac Rehabilitation Care Act (S 2842, HR 3911), ACO Assignment Improvement Act (HR 900), PA Educational and Workforce Training Programs, surprise billing, Rural Health Clinic Modernization Act (S 1037 HR 2788), medical record documentation, federal PA workforce issues at the Departments of Veterans Affairs, Indian Health Services, and Bureau of Prisons, and requirements and restrictions related to federal DEA waivers to prescribe buprenorphine to treat opioid use disorder, ensuring PAs considered primary care and behavioral health providers (S 2793, HR 2774, HR 5575)

Client expense: $180,000 · Firm income: Not reported

Defending independent-contractor status; seeking reinstatement of companionship services exemption to the FLSA; urging harmonization of the definition of "employee" for purposes of federal statutes; supporting the Modern Worker Empowerment Act, H.R. 4069 and S. 2793.

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

Government targets: HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), SENATE

S 289: Physician Workforce/GME Reform: Increasing the number of family medicine residency slots; GME reform to support rural residency training. HR 748 - CARES Act: Fund CHC & THCGME, promote telemedicine in primary care, set Medicaid at Medicare parity. HR 3107 - Prior Authorization: Improve healthcare access & reduce administrative burden. HR 4996 - Support MOMS Act: Support or legislation to increase Medicaid funding to support postpartum care and to reduce maternal mortality. HR 4996, HR 4995, S. 2793, S. 289, S. 916. S. 289 - Maternal Health: Letter to the Senate Finance Cmt urging support for health care best practices and maternal health bills focused on Medicaid, quality improvement, data collection, primary care access under high deductible health care plans, unconscious bias, and rural health care. HR 5741 - Strengthening Innovation in Medicare and Medicaid Act: Oppose the effort to stifle CMMI innovation. HR 5800 - Surprise Billing: Hold patients to in-network rates and prevent premium hikes. HR 6074 - Coronavirus Preparedness & Response Supplemental Act - Ensure adequate PPE, funding and loans, telehealth care payment. No Bill No.: Advisory Committee on Training and Primary Care Medicine & Dentistry-Title VII Primary Care Training & Enhancement grants. No Bill No. - GME Reform: GME reform to increase family physician workforce. No Bill No. - Congressional Primary Care Caucus: 116th Congress Membership in the bipartisan CPCC. No Bill No. - Administrative Simplification: Promote reduced administrative burden on family physicians of prior authorization, EMR. No Bill No. - Communicaeion to CMS on scope of practice: maintain state rights. No Bill No. - Communicate to CME on transparency in coverage: regarding insurance coverage. No Bill No. - Communicate to CMS on ACA benefit and payment parameters for 2021: Regarding Insurance coverage. No Bill No. - communication to CMS on MIPS and extreme circumstances: Extending MIPS deadlines. No Bill No. - Communicate with CMS on 2021/2022 Part C/D: Medicare Advantage and prescription drugs.

HR 2774, S 2793 - Primary Care Patient Protection Act: create a primary care benefit in high deductible health plans. No Bill No. - Administrative Simplification: Promote reduced administrative burden on family physicians of prior authorization, EMR.

Client expense: $1,039,649 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE

S 289: Physician Workforce/GME Reform: Increasing the number of family medicine residency slots; GME reform to support rural residency training S 1191; HR 2815; HR 2328 - Teaching Health Center GME Re-authorization: Support for increased and long-term funding for the HRSA THCGME funding. HR 4996, HR 4995, S. 2793, S. 289, S. 916. S. 289 - Maternal Health: Letter to the Senate Finance Cmt urging support for health care best practices and maternal health bills focused on Medicaid, quality improvement, data collection, primary care access under high deductible health care plans, unconscious bias, and rural health care. No Bill No.: Advisory Committee on Training and Primary Care Medicine & Dentistry-Title VII Primary Care Training & Enhancement grants. No Bill No. - GME Reform: GME reform to increase family physician workforce. No Bill No.- CDC FY 2021 budget request: Family medicine public health priorities. No Bill No. - CHC & National Health Service Corps reauthorization: Health care access, scholarships and medical student debt relief. No Bill No. - Congressional Primary Care Caucus: 116th Congress Membership in the bipartisan CPCC. No Bill No.: Black Maternal Health Momnibus Act: Support for a comprehensive bill to address maternal Health disparities.

Client expense: $1,039,649 · Firm income: Not reported

HR 748 - CARES Act: Fund CHC & THCGME, promote telemedicine in primary care, set Medicaid at Medicare parity. HR 2774, S 2793 - Primary Care Patient Protection Act: create a primary care benefit in high deductible health plans. HR 6074 - Coronavirus Preparedness & Response Supplemental Act - Ensure adequate PPE, funding and loans, telehealth care payment. HR 6201 - Families First Coronavirus Response Act: Support for small business and non-profits during pandemic.

Client expense: $1,039,649 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE

S 289: Physician Workforce/GME Reform: Increasing the number of family medicine residency slots; GME reform to support rural residency training. HR 748 - CARES Act: Fund CHC & THCGME, promote telemedicine in primary care, set Medicaid at Medicare parity. S. 304; S 1191; HR 2815; HR 2328 - Teaching Health Center GME Re-authorization: Support for increased and long-term funding for the HRSA THCGME funding; funding for new rural programs. HR 2339 - Tobacco Use Prevention: Urged support for the Preventing the Youth Tobacco Epidemic Act. HR 2774, S 2793 - Primary Care Patient Protection Act: create a primary care benefit in high deductible health plans. HR 3107 - Prior Authorization: Improve healthcare access & reduce administrative burden. HR 4995 - Maternal Health Quality Improvement Act: Legislation to support best practice programs and safety bundles. HR 4996, HR 4995, S. 2793, S. 289, S. 916. S. 289 - Maternal Health: Letter to the Senate Finance Cmt urging support for health care best practices and maternal health bills focused on Medicaid, quality improvement, data collection, primary care access under high deductible health care plans, unconscious bias, and rural health care. HR 5741 - Strengthening Innovation in Medicare and Medicaid Act: Oppose the effort to stifle CMMI innovation. HR 5800 - Surprise Billing: Hold patients to in-network rates and prevent premium hikes. HR 6379 - Take Responsibility for Workers and Families Act: Include healthcare providers in emergency leave requirements. HR 6074 - Coronavirus Preparedness & Response Supplemental Act - Ensure adequate PPE, funding and loans, telehealth care payment. HR 6201 - Families First Coronavirus Response Act: Support for small business and non-profits during pandemic. No Bill No.- CDC FY 2021 budget request: Family medicine public health priorities. No Bill No. - CHC & National Health Service Corps reauthorization: Health care access, scholarships and medical student debt relief. No Bill No. - AHRQ FY 2021 budget request: primary care research. No Bill No. - Congressional Primary Care Caucus: 116th Congress Membership in the bipartisan CPCC. No Bill No. - Non-compete clauses in physician employment contracts: Restrictive covenants can disrupt the patient-physician relationship. No Bill No. - Administrative Simplification: Promote reduced administrative burden on family physicians of prior authorization, EMR. No Bill No. - Truth in Healthcare Marketing Act: Prevent deceptive advertising on health care licensure. No Bill No. - Abortion Access: Letter to FDA urging flexibility from current safety protocols to allow physicians to administer drugs via telehealth. No Bill No. - Community Health Center Funding: Letters, briefing to support funding for community health centers. Outreach to Hill offices to urge support for health extenders, which includes THCGME, community health centers, and National Health Service Corps. No Bill No.: Black Maternal Health Momnibus Act: Support for a comprehensive bill to address maternal Health disparities. No Bill No. - Defeat Infant and Maternal Mortality Act (DIMMA): Supporting legislation to allow the Department of Defense to share information with civilian entities on maternal and infant health. No Bill No. - Health IT interoperability: Ensure Health IT interoperability regulations and recommendations promote primary care/do not burden physicians. No Bill No. - CDC prevention issues to cover: communication on What work the CDC should do.

Defending independent-contractor status; seeking reinstatement of companionship services exemption to the FLSA; urging harmonization of the definition of "employee" for purposes of federal statutes; supporting the Modern Worker Empowerment Act, H.R. 4069 and S. 2793; advocated for inclusion of 1099 income received by essential workers in "payroll" costs for purposes of new SBA loans under CARES Act.

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

Government targets: HOUSE OF REPRESENTATIVES, Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Small Business Administration (SBA)

Emergency federal response to COVID-19 (HR 748, HR 6201, S 3548), Medicare reimbursement and incident to billing, Medicare hospice restrictions, Medicare definition of PA services, transparency, healthcare competition, PA Direct Payment Act (S 596, HR 1052), Home Health Care Planning Improvement Act (S 296, HR 2150), Promoting Access to Diabetic Shoes Act (S 237, HR 808), the Mainstreaming Addiction Treatment Act (S 2074, HR 2482), Medication Access and Training Expansion Act (HR 4974), Increasing Access to Quality Cardiac Rehabilitation Care Act (S 2842, HR 3911), ACO Assignment Improvement Act (HR 900), PA Educational and Workforce Training Programs, surprise billing, Rural Health Clinic Modernization Act (S 1037 HR 2788), medical record documentation, federal PA workforce issues at the Departments of Veterans Affairs, Indian Health Services, and Bureau of Prisons, and requirements and restrictions related to federal DEA waivers to prescribe buprenorphine to treat opioid use disorder, ensuring PAs considered primary care and behavioral health providers (S 2793, HR 2774, HR 5575)

Client expense: $170,000 · Firm income: Not reported

S 289, HR 1358 - Physician Workforce/GME Reform: Increasing the number of family medicine residency slots; GME reform to support rural residency training; correct rotator problems. S 304; S 1191; HR 2815; HR 2328 - Teaching Health Center GME Re-authorization: Support for increased, extended THCGME funding. S106; S192; S 962; HR1943; HR1983; HR 2328, - National Health Service Corps: Medical Student Debt Relief and Rural and Under-served area access. S. 1895 - Surprise medical billing: Eliminate barriers to patient access to primary care, fund THCGME program. HR 3; S 2543 - Drug pricing legislation: Support THGME, primary care in HDHP, Medicare and Medicaid. HR 2339 - Nicotine usage: Urged support for reversing the youth tobacco epidemic, tobacco 21 and the vaping flavors ban. HR 2694 - Pregnant workers Fairness Act: AAFP signed a joint letter supporting HR 2694. HR 2774 - Primary Care Patient Protection Act: Create a Primary Care benefit in high deductible health plans. HR 2774, S 2793, HR 5575 - Primary Care Benefit: establish standard primary care benefit in private health insurance plans. HR 3030; HR 1965 - Patient Centered Outcomes Research Institute reauthorization: Evidence based primary care research. HR 3107 - Administrative Burden/Prior Authorization: Reduce administrative burden. HR 4995; 4996 - Maternal Health: AAFP supported maternal health bills to expand medicaid access and bolster training and best practices. No Bill No. - Advisory Committee Training in Primary Care Medicine and Dentistry: Title VII Primary Care Training and Enhancement Grants. No Bill No. - Rural Health: Improved access to quality care for rural populations. No Bill No. - Insurance network adequacy to avoid "surprise medical bills": protecting patients and families from unanticipated medical bills. No Bill No. - Primary Care Investment: Increased spending on primary care. No Bill No. - Congressional Primary Care Caucus: 116th Congress Membership in the bipartisan CPCC. No Bill No. - AHRQ Center for Primary Care Research: Primary Care research at AHRQ. No Bill No. - Primary Care Innovation: Increased awareness of primary care payment and delivery. No Bill No. - Rural Access Issues: How to increase supply of PCP's in rural areas. No Bill No. - RFI on opioid addiction and access to medication-assisted treatment: Chronic pain management. No Bill No. - Confidentiality of Substance Use Disorder: Opioid issues. No Bill No. - 2020 National Vaccine plan: How to improve vaccination rates. No Bill No. - Concerns with EO provisions on scope of practice. No Bill No. - Concerns with flavored e-cigarettes: Youth e-cig epidemic. No Bill No. - Revising two screening code descriptors: Depression and alcohol misuse screening descriptors. No Bill No. - Fraud and safe harbors in medicare: How to address safe harbors in payment models. No Bill No. - Modernizing self-referral laws: How to improve Stark for payment model arrangements. No Bill No. - Lower Health Care Costs Act/Surprise Billing: Support for vaccines, maternal health, transparency, and reducing administrative burdens. Also, support for reauthorizing the Teaching Health Center GME (THCGME) program, along with Community Health Centers and National Health Service Corps. No Bill No. - Medicare Payment: Educated staff about the Medicare Physician Fee Schedule's E&M code increase.

HR 2774 - Primary Care Patient Protection Act: Create a Primary Care benefit in high deductible health plans. HR 2774, S 2793, HR 5575 - Primary Care Benefit: establish standard primary care benefit in private health insurance plans.

Client expense: $1,218,792 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), White House Office

HR 2774 - Primary Care Patient Protection Act: Create a Primary Care benefit in high deductible health plans. HR 2774, S 2793, HR 5575 - Primary Care Benefit: establish standard primary care benefit in private health insurance plans. HR 3107 - Administrative Burden/Prior Authorization: Reduce administrative burden. No Bill No. - Lower Health Care Costs Act/Surprise Billing: Support for vaccines, maternal health, transparency, and reducing administrative burdens. Also, support for reauthorizing the Teaching Health Center GME (THCGME) program, along with Community Health Centers and National Health Service Corps. No Bill No. - Insurance network adequacy to avoid "surprise medical bills": protecting patients and families from unanticipated medical bills; health care coverage for all, administration simplification.

Client expense: $1,218,792 · Firm income: Not reported

S. 12, Health Savings Act (Rubio) - HSA improvements S. 80, Jobs and Premium Protection Act (Barrasso) - health insurance tax S. 172, Health Insurance Tax Relief Act (Gardner) - health insurance tax S. 684, Middle Class Health Benefits Tax Repeal Act (Heinrich) - Cadillac tax on employer-provided coverage S. 1089, Restoring Access to Medication Act (Roberts) - paying for OTC products with HSA funds S. 2366, Commonsense Reporting Act of 2019 (Warner)-Reporting system for employers and plans S. 2414, A bill to amend the Internal Revenue Code of 1986 to extend the Health Coverage Tax Credit (Portman)- using tax credits for health coverage S. 2440, Qualified Health Savings Account Distribution Act of 2019 (Sasse)- HSAs S. 2785, Fair Indexing for Health Care Affordability Act (Shaheen) - premium tax credit eligibility, MOOPs S. 2793, Primary Care Patient Protection Act of 2019 (King) - HDHPs deductible S. 3112, Personalized Care Act of 2019 (Cruz)- HSAs H.R. 603, Health Savings Account Expansion Act (Gallagher) - HSA improvements H.R. 748, Middle Class Health Benefits Tax Repeal Act (Courtney) - Cadillac tax on employer-provided coverage H.R. 1398, Health Insurance Tax Relief Act (Bera) - health insurance tax H.R. 1865, Further Consolidated Appropriations Act 2020 (Pascrell) - HIT repeal H.R. 2447, Jobs and Premium Protection Act (Brindisi) - health insurance tax H.R. 3709, Chronic Disease Management Act of 2019 (Blumenauer)- HSAs and HDHPs H.R. 4070, Commonsense Reporting Act of 2019 (Thompson)-Reporting system for employers and plans H.R. 4631, Excise Narcotics Distribution in the Epidemic Act of 2019 (Rose) - excise tax on opioid manufacturers H.R. 4651, American Future Healthcare Act of 2019 (King) - amends the Internal Revenue Code to expand health savings accounts H.R. 4652, Individual Health Insurance Marketplace Improvement Act (Langevin) - Individual Market Reinsurance fund H.R. 4716, Inhaler Coverage and Access Now Act (Cox) - provides a safe harbor for high deductible health plans without a deductible for certain inhalers Regulatory Issues: Annual insurer provider fees; issues concerning the patient-centered outcomes research fee; employer coverage mandate; W-2 reporting requirements; health reimbursement accounts; deductibility limits for insurer compensation; health insurer and employer reporting of health coverage; issues related to implementation of health insurance tax; issues related to the refundable credit for coverage under a qualified health plan; issues related to coverage of chronic conditions in high deductible health plans; issues related to health savings accounts; issues related to the deductibility of employer-sponsored health coverage; issues related to Patient-Centered Outcomes Research Institute (PCORI) re-authorization; issues related to enhancing tax treatment of long-term care insurance; issues related to qualified small employer health reimbursement accounts (QSEHRAs); issues related to implementation of the excise tax on high cost employer-sponsored health coverage; and other issues relating to health care reform implementation.

S. 2793, Export-Import Bank Reauthorization Act of 2019; H.R. 3407, United States Export Finance Agency Act of 2019. H.R. 1865, Title IV of Division I, Export-Import Bank Extension. H.R. 5430, USMCA Implementation Act.

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

Government targets: Energy, Dept of, Export-Import Bank of the United States (EXIM Bank), HOUSE OF REPRESENTATIVES, SENATE, State, Dept of (DOS), Treasury, Dept of, U.S. Trade Representative (USTR), White House Office

Defending independent-contractor status; seeking reinstatement of companionship services exemption to the FLSA; urging harmonization of the definition of "employee" for purposes of federal statutes; supporting the Modern Worker Empowerment Act, H.R. 4069 and S. 2793.

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

Government targets: HOUSE OF REPRESENTATIVES, Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Small Business Administration (SBA)

S. 2793, Export-Import Bank Reauthorization Act of 2019; H.R. 3407, United States Export Finance Agency Act of 2019 and Export-Import Bank nominations USMCA; USMCA trade agreement (yet to be introduced).

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

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