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Advancing Care for Exceptional Kids Act of 2019 or the ACE Kids Act of 2019 This bill establishes a state Medicaid option to provide for medical assistance with respect to coordinated care provided through a health home (i.e., a designated provider or team of health-care professionals) for children with medically complex conditions. States must determine payment methodologies in accordance with specified requirements; payments also temporarily qualify for an enhanced federal matching rate.
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Filing registrants (35)
Read twice and referred to the Committee on Finance.
Introduced in Senate
Bills with similar content found using semantic analysis.
Sources: Congress.gov
2020 · fourth_quarter · Medicare/Medicaid
Advancing Care for Exceptional Kids Act of 2019 (ACE Kids Act) (S.317/H.R.1226) CARING for Kids Act (H.R. 6151) Covering life-saving investigations needed in cancer and other life-threatening conditions through timely use of resources for easy and affordable treatment for Medicaid enrollees in need today act (CLINICAL TREATMENTS ACT) (H.R.913) Helping MOMS Act of 2020 (HR 4996) Increasing Access to Quality Cardiac Rehabilitation Care Act of 2019 (H.R. 3911/S.2842) Medicaid Services Investment & Accountability Act of 2019 (H.R.1839) Medicaid Waivers Provider scope of practice for cardiac and pulmonary rehabilitation
Client expense: $125,000 · Firm income: Not reported
Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Federal Reserve System, Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Interior, Dept of (DOI), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Transportation, Dept of (DOT), Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office
2020 · fourth_quarter · Medicare/Medicaid
HR1839; S.237/HR808; S.317/H.R.1226; S.433; HR748; HR133
Client expense: Not reported · Firm income: $10,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2020 · fourth_quarter · Medicare/Medicaid
-Medicare and Medicaid payment quality programs and policies, including healthcare associated complications, infections, readmissions, payment bundling, potentially avoidable events, quality outcomes, transparency, site-neutral payment policy, and value-based payment policies -Medicare and Medicaid data, Medicaid Scorecards, health information exchanges (HIEs), interoperability, patient-centered medical records policies, and all-payer claims databases (APCDs) - Labor, Health and Human Services Appropriations - Public health initiatives related to COVID-19 -Implementation of the Patient Protection and Affordable Care Act (PL 111-148) -Implementation of the Helping Hospitals Improve Patient Care Act 21st Century Cures Act (Public Law No: 114-255) -Implementation of The Health Information Technology for Economic and Clinical Health Act (HITECH Act - part of the American Recovery and Reinvestment Act of 2009, PL 111-5). -Regulations and legislation related to International Classification of Diseases, version 10 (ICD-10) -S.317, ACE Kids Act -H.R. 1226, ACE Kids Act -S. 1895, Lower Health Care Costs Act -Healthcare Outcomes Act
Client expense: $80,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of the Vice President of the United States, SENATE
2020 · fourth_quarter · Health Issues
-Medicare and Medicaid payment quality programs and policies, including healthcare associated complications, infections, readmissions, payment bundling, potentially avoidable events, quality outcomes, transparency, site-neutral payment policy, and value-based payment policies -Medicare and Medicaid data, Medicaid Scorecards, health information exchanges (HIEs), interoperability, patient-centered medical records policies, and all-payer claims databases (APCDs) - Labor, Health and Human Services Appropriations - Public health initiatives related to COVID-19 -Implementation of the Patient Protection and Affordable Care Act (PL 111-148) -Implementation of the Helping Hospitals Improve Patient Care Act 21st Century Cures Act (Public Law No: 114-255) -Implementation of The Health Information Technology for Economic and Clinical Health Act (HITECH Act - part of the American Recovery and Reinvestment Act of 2009, PL 111-5) -Regulations and legislation related to International Classification of Diseases, version 10 (ICD-10) -S.317, ACE Kids Act -H.R. 1226, ACE Kids Act -S. 1895, Lower Health Care Costs Act -Healthcare Outcomes Act
Client expense: $80,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of the Vice President of the United States, SENATE
2020 · fourth_quarter · Health Issues
Medicare and Medicaid payment quality programs and policies, including healthcare associated complications, infections, readmission, payment bundling, potentially avoidable event, quality outcomes, transparency, site-neutral payment policy, and value-based payment policies. Medicare and Medicaid data, Medicaid Scorecards, health information exchanges (HIEs), interoperability, and patient-centered medical records policies, all-payer claims databases (APCDs) Implementation of the Patient Protection and Affordable Care Act (PL 111-148). Implementation of the Helping Hospitals Improve Patient Care Act 21st Century Cures Act (Public Law No: 114-255). Implementation of The Health Information Technology for Economic and Clinical Health Act (HITECH Act - part of the American Recovery and Reinvestment Act of 2009, PL 111-5). Regulations and legislation related to International Classification of Diseases, version 10 (ICD-10). S.317/H.R. 1226 - ACE Kids Act S. 1895, Lower Health Care Costs Act Healthcare Outcomes Act Public Health Initiatives responding to COVID-19
Client expense: Not reported · Firm income: $50,000
| Republican |
| AR |
| Kyrsten Sinema | Independent | AZ |
| Marco Rubio | Republican | FL |
| Marsha Blackburn | Republican | TN |
| Michael F. Bennet | Democratic | CO |
| Patrick J. Leahy | Democratic | VT |
| Patty Murray | Democratic | WA |
| Rob Portman | Republican | OH |
| Roger F. Wicker | Republican | MS |
| Roy Blunt | Republican | MO |
| Susan M. Collins | Republican | ME |
| Tim Kaine | Democratic | VA |
| Tim Scott | Republican | SC |
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2020 · fourth_quarter · Medicare/Medicaid
Medicare and Medicaid payment quality programs and policies, including healthcare associated complications, infections, readmission, payment bundling, potentially avoidable events, quality outcomes, transparency, site-neutral payment policy, and value-based payment policies. Medicare and Medicaid data, Medicaid Scorecards, health information exchanges (HIEs), interoperability, and patient-centered medical records policies, all-payer claims databases (APCDs) Implementation of the Patient Protection and Affordable Care Act (PL 111-148). Implementation of the Helping Hospitals Improve Patient Care Act 21st Century Cures Act (Public Law No: 114-255). Implementation of The Health Information Technology for Economic and Clinical Health Act (HITECH Act - part of the American Recovery and Reinvestment Act of 2009, PL 111-5). Regulations and legislation related to International Classification of Diseases, version 10 (ICD-10). S.317/H.R. 1226 - ACE Kids Act S. 1895, Lower Health Care Costs Act Healthcare Outcomes Act Public Health Initiatives responding to COVID-19
Client expense: Not reported · Firm income: $50,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2020 · fourth_quarter · Medicare/Medicaid
PL 111-148 - The Patient Protection and Affordable Care Act, implementation H.R. 259 - Medicaid Extenders Act of 2019 H.R. 1839 - Medicaid Services Investment and Accountability Act of 2019 H.R. 1226/S. 317 - ACE Kids Act of 2019 H.R. 133 - Consolidated Appropriations Act, 2021 no specific bills, Medicare and Medicaid Fraud, Advantage, Medicare Part D, Medicaid, Medicaid expansion, Electronic Prescribing, Dual Eligibles, Medigap reform, claims resolution, risk adjustment, Delivery System Reform, Special Needs Plans, Star Ratings, call letter, program integrity, Alzheimer's care, telehealth, chronic care, coding intensity, Medicaid per capita caps, block grant, long term services and supports, value based purchasing, Medicaid MLR, spread pricing, social determinants of health, mental health and substance abuse
Client expense: Not reported · Firm income: $90,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, White House Office
2020 · third_quarter · Medicare/Medicaid
Advancing Care for Exceptional Kids Act of 2019 (ACE Kids Act) (S.317/H.R.1226) CARING for Kids Act (H.R. 6151) Covering life-saving investigations needed in cancer and other life-threatening conditions through timely use of resources for easy and affordable treatment for Medicaid enrollees in need today act (CLINICAL TREATMENTS ACT) (H.R.913) Increasing Access to Quality Cardiac Rehabilitation Care Act of 2019 (H.R. 3911/S.2842) Medicaid Services Investment & Accountability Act of 2019 (H.R.1839) Medicaid Waivers Provider scope of practice for cardiac and pulmonary rehabilitation
Client expense: $170,000 · Firm income: Not reported
Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Federal Reserve System, Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Interior, Dept of (DOI), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Transportation, Dept of (DOT), Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office
2020 · third_quarter · Medicare/Medicaid
HR1839; S.237/HR808; S.317/H.R.1226; S.433; HR748
Client expense: Not reported · Firm income: $10,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2020 · third_quarter · Medicare/Medicaid
HR1839; S.237/HR808; S.317/H.R.1226; S.433; HR748
Client expense: Not reported · Firm income: $10,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2020 · third_quarter · Medicare/Medicaid
-Medicare and Medicaid payment quality programs and policies, including healthcare associated complications, infections, readmissions, payment bundling, potentially avoidable events, quality outcomes, transparency, site-neutral payment policy, and value-based payment policies -Medicare and Medicaid data, Medicaid Scorecards, health information exchanges (HIEs), interoperability, patient-centered medical records policies, and all-payer claims databases (APCDs) - Labor, Health and Human Services Appropriations - Public health initiatives related to COVID-19 -Implementation of the Patient Protection and Affordable Care Act (PL 111-148) -Implementation of the Helping Hospitals Improve Patient Care Act 21st Century Cures Act (Public Law No: 114-255) -Implementation of The Health Information Technology for Economic and Clinical Health Act (HITECH Act - part of the American Recovery and Reinvestment Act of 2009, PL 111-5). -Regulations and legislation related to International Classification of Diseases, version 10 (ICD-10) -S.317, ACE Kids Act -H.R. 1226, ACE Kids Act -S. 1895, Lower Health Care Costs Act -Healthcare Outcomes Act
Client expense: $70,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of the Vice President of the United States, SENATE
2020 · third_quarter · Health Issues
-Medicare and Medicaid payment quality programs and policies, including healthcare associated complications, infections, readmissions, payment bundling, potentially avoidable events, quality outcomes, transparency, site-neutral payment policy, and value-based payment policies -Medicare and Medicaid data, Medicaid Scorecards, health information exchanges (HIEs), interoperability, patient-centered medical records policies, and all-payer claims databases (APCDs) - Labor, Health and Human Services Appropriations - Public health initiatives related to COVID-19 -Implementation of the Patient Protection and Affordable Care Act (PL 111-148) -Implementation of the Helping Hospitals Improve Patient Care Act 21st Century Cures Act (Public Law No: 114-255) -Implementation of The Health Information Technology for Economic and Clinical Health Act (HITECH Act - part of the American Recovery and Reinvestment Act of 2009, PL 111-5) -Regulations and legislation related to International Classification of Diseases, version 10 (ICD-10) -S.317, ACE Kids Act -H.R. 1226, ACE Kids Act -S. 1895, Lower Health Care Costs Act -Healthcare Outcomes Act
Client expense: $70,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of the Vice President of the United States, SENATE
2020 · third_quarter · Medicare/Medicaid
Medicare and Medicaid payment quality programs and policies, including healthcare associated complications, infections, readmission, payment bundling, potentially avoidable events, quality outcomes, transparency, site-neutral payment policy, and value-based payment policies. Medicare and Medicaid data, Medicaid Scorecards, health information exchanges (HIEs), interoperability, and patient-centered medical records policies, all-payer claims databases (APCDs) Implementation of the Patient Protection and Affordable Care Act (PL 111-148). Implementation of the Helping Hospitals Improve Patient Care Act 21st Century Cures Act (Public Law No: 114-255). Implementation of The Health Information Technology for Economic and Clinical Health Act (HITECH Act - part of the American Recovery and Reinvestment Act of 2009, PL 111-5). Regulations and legislation related to International Classification of Diseases, version 10 (ICD-10). S.317/H.R. 1226 - ACE Kids Act S. 1895, Lower Health Care Costs Act Healthcare Outcomes Act Public Health Initiatives responding to COVID-19
Client expense: Not reported · Firm income: $50,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2020 · third_quarter · Health Issues
Medicare and Medicaid payment quality programs and policies, including healthcare associated complications, infections, readmission, payment bundling, potentially avoidable event, quality outcomes, transparency, site-neutral payment policy, and value-based payment policies. Medicare and Medicaid data, Medicaid Scorecards, health information exchanges (HIEs), interoperability, and patient-centered medical records policies, all-payer claims databases (APCDs) Implementation of the Patient Protection and Affordable Care Act (PL 111-148). Implementation of the Helping Hospitals Improve Patient Care Act 21st Century Cures Act (Public Law No: 114-255). Implementation of The Health Information Technology for Economic and Clinical Health Act (HITECH Act - part of the American Recovery and Reinvestment Act of 2009, PL 111-5). Regulations and legislation related to International Classification of Diseases, version 10 (ICD-10). S.317/H.R. 1226 - ACE Kids Act S. 1895, Lower Health Care Costs Act Healthcare Outcomes Act Public Health Initiatives responding to COVID-19
Client expense: Not reported · Firm income: $50,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2020 · third_quarter · Health Issues
Monitor federal activity related to quality indications and specialty requirements for pediatric hospitals. Monitor movement toward alternative payment methodologies for childrens hospitals providing services. S. 317, ACE Kids Act of 2019. H.R. 1226, ACE Kids Act of 2019.
Client expense: Not reported · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS)
2020 · third_quarter · Medicare/Medicaid
PL 111-148 - The Patient Protection and Affordable Care Act, implementation H.R. 259 - Medicaid Extenders Act of 2019 H.R. 1839 - Medicaid Services Investment and Accountability Act of 2019 H.R. 1226/S. 317 - ACE Kids Act of 2019 no specific bills, Medicare and Medicaid Fraud, Advantage, Medicare Part D, Medicaid, Medicaid expansion, Electronic Prescribing, Dual Eligibles, Medigap reform, claims resolution, risk adjustment, Delivery System Reform, Special Needs Plans, Star Ratings, call letter, program integrity, Alzheimer's care, telehealth, chronic care, coding intensity, Medicaid per capita caps, block grant, long term services and supports, value based purchasing, Medicaid MLR, spread pricing, social determinants of health, mental health and substance abuse
Client expense: Not reported · Firm income: $90,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, White House Office
2020 · second_quarter · Medicare/Medicaid
Advancing Care for Exceptional Kids Act of 2019 (ACE Kids Act) (S.317/H.R.1226) CARING for Kids Act (H.R. 6151) Covering life-saving investigations needed in cancer and other life-threatening conditions through timely use of resources for easy and affordable treatment for Medicaid enrollees in need today act (CLINICAL TREATMENTS ACT) (H.R.913) Increasing Access to Quality Cardiac Rehabilitation Care Act of 2019 (H.R. 3911/S.2842) Medicaid Services Investment & Accountability Act of 2019 (H.R.1839) Medicaid Waivers Provider scope of practice for cardiac and pulmonary rehabilitation
Client expense: $582,750 · Firm income: Not reported
Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Environmental Protection Agency (EPA), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Transportation, Dept of (DOT), Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office
2020 · second_quarter · Health Issues
-Medicare and Medicaid payment quality programs and policies, including healthcare associated complications, infections, readmissions, payment bundling, potentially avoidable events, quality outcomes, transparency, site-neutral payment policy, and value-based payment policies -Medicare and Medicaid data, Medicaid Scorecards, health information exchanges (HIEs), interoperability, patient-centered medical records policies, and all-payer claims databases (APCDs) - Labor, Health and Human Services Appropriations - Public health initiatives related to COVID-19 -Implementation of the Patient Protection and Affordable Care Act (PL 111-148) -Implementation of the Helping Hospitals Improve Patient Care Act 21st Century Cures Act (Public Law No: 114-255) -Implementation of The Health Information Technology for Economic and Clinical Health Act (HITECH Act - part of the American Recovery and Reinvestment Act of 2009, PL 111-5) -Regulations and legislation related to International Classification of Diseases, version 10 (ICD-10) -S.317, ACE Kids Act -H.R. 1226, ACE Kids Act -S. 1895, Lower Health Care Costs Act -Healthcare Outcomes Act
Client expense: $130,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of the Vice President of the United States, SENATE
2020 · second_quarter · Medicare/Medicaid
-Medicare and Medicaid payment quality programs and policies, including healthcare associated complications, infections, readmissions, payment bundling, potentially avoidable events, quality outcomes, transparency, site-neutral payment policy, and value-based payment policies -Medicare and Medicaid data, Medicaid Scorecards, health information exchanges (HIEs), interoperability, patient-centered medical records policies, and all-payer claims databases (APCDs) - Labor, Health and Human Services Appropriations - Public health initiatives related to COVID-19 -Implementation of the Patient Protection and Affordable Care Act (PL 111-148) -Implementation of the Helping Hospitals Improve Patient Care Act 21st Century Cures Act (Public Law No: 114-255) -Implementation of The Health Information Technology for Economic and Clinical Health Act (HITECH Act - part of the American Recovery and Reinvestment Act of 2009, PL 111-5). -Regulations and legislation related to International Classification of Diseases, version 10 (ICD-10) -S.317, ACE Kids Act -H.R. 1226, ACE Kids Act -S. 1895, Lower Health Care Costs Act -Healthcare Outcomes Act
Client expense: $130,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of the Vice President of the United States, SENATE
2020 · second_quarter · Medicare/Medicaid
Issues related to payment and delivery reforms, Medicaid benefits, children's hospital reimbursement, telehealth, surprise medical billing, and COVID-19 response; H.R.1226/S.317, ACE Kids Act of 2019; H.R.6074, Coronavirus Preparedness and Response Supplemental Appropriations Act; H.R.6201, Families First Coronavirus Response Act; H.R.748, CARES Act (P.L.116-136); H.R.6800, The HEROES Act.
Client expense: Not reported · Firm income: $30,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2020 · second_quarter · Medicare/Medicaid
HR1839; S.237/HR808; Ace Kids Act S.317/H.R.1226; S.433; HR748
Client expense: Not reported · Firm income: $10,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2020 · second_quarter · Medicare/Medicaid
PL 111-148 - The Patient Protection and Affordable Care Act, implementation H.R. 259 - Medicaid Extenders Act of 2019 H.R. 1839 - Medicaid Services Investment and Accountability Act of 2019 H.R. 1226/S. 317 - ACE Kids Act of 2019 no specific bills, Medicare and Medicaid Fraud, Advantage, Medicare Part D, Medicaid, Medicaid expansion, Electronic Prescribing, Dual Eligibles, Medigap reform, claims resolution, risk adjustment, Delivery System Reform, Special Needs Plans, Star Ratings, call letter, program integrity, Alzheimer's care, telehealth, chronic care, coding intensity, Medicaid per capita caps, block grant, long term services and supports, value based purchasing, Medicaid MLR, spread pricing, social determinants of health, mental health and substance abuse
Client expense: Not reported · Firm income: $90,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, White House Office
2020 · second_quarter · Medicare/Medicaid
Medicare and Medicaid payment quality programs and policies, including healthcare associated complications, infections, readmission, payment bundling, potentially avoidable events, quality outcomes, transparency, site-neutral payment policy, and value-based payment policies. Medicare and Medicaid data, Medicaid Scorecards, health information exchanges (HIEs), interoperability, and patient-centered medical records policies, all-payer claims databases (APCDs) Implementation of the Patient Protection and Affordable Care Act (PL 111-148). Implementation of the Helping Hospitals Improve Patient Care Act 21st Century Cures Act (Public Law No: 114-255). Implementation of The Health Information Technology for Economic and Clinical Health Act (HITECH Act - part of the American Recovery and Reinvestment Act of 2009, PL 111-5). Regulations and legislation related to International Classification of Diseases, version 10 (ICD-10). S.317/H.R. 1226 - ACE Kids Act S. 1895, Lower Health Care Costs Act Healthcare Outcomes Act Public Health Initiatives responding to COVID-19
Client expense: Not reported · Firm income: $50,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2020 · second_quarter · Health Issues
Medicare and Medicaid payment quality programs and policies, including healthcare associated complications, infections, readmission, payment bundling, potentially avoidable event, quality outcomes, transparency, site-neutral payment policy, and value-based payment policies. Medicare and Medicaid data, Medicaid Scorecards, health information exchanges (HIEs), interoperability, and patient-centered medical records policies, all-payer claims databases (APCDs) Implementation of the Patient Protection and Affordable Care Act (PL 111-148). Implementation of the Helping Hospitals Improve Patient Care Act 21st Century Cures Act (Public Law No: 114-255). Implementation of The Health Information Technology for Economic and Clinical Health Act (HITECH Act - part of the American Recovery and Reinvestment Act of 2009, PL 111-5). Regulations and legislation related to International Classification of Diseases, version 10 (ICD-10). S.317/H.R. 1226 - ACE Kids Act S. 1895, Lower Health Care Costs Act Healthcare Outcomes Act Public Health Initiatives responding to COVID-19
Client expense: Not reported · Firm income: $50,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2020 · first_quarter · Health Issues
Medicare and Medicaid payment quality programs and policies, including healthcare associated complications, infections, readmissions, payment bundling, potentially avoidable events, quality outcomes, transparency, site-neutral payment policy, and value-based payment policies Medicare and Medicaid data, Medicaid Scorecards, health information exchanges (HIEs), interoperability, patient-centered medical records policies, and all-payer claims databases (APCDs) Implementation of the Patient Protection and Affordable Care Act (PL 111-148) Implementation of the Helping Hospitals Improve Patient Care Act 21st Century Cures Act (Public Law No: 114-255) Implementation of The Health Information Technology for Economic and Clinical Health Act (HITECH Act - part of the American Recovery and Reinvestment Act of 2009, PL 111-5) Regulations and legislation related to International Classification of Diseases, version 10 (ICD-10) S.317, ACE Kids Act H.R. 1226, ACE Kids Act S. 1895, Lower Health Care Costs Act Healthcare Outcomes Act
Client expense: $30,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2020 · first_quarter · Medicare/Medicaid
Medicare and Medicaid payment quality programs and policies, including healthcare associated complications, infections, readmissions, payment bundling, potentially avoidable events, quality outcomes, transparency, site-neutral payment policy, and value-based payment policies Medicare and Medicaid data, Medicaid Scorecards, health information exchanges (HIEs), interoperability, patient-centered medical records policies, and all-payer claims databases (APCDs) Implementation of the Patient Protection and Affordable Care Act (PL 111-148) Implementation of the Helping Hospitals Improve Patient Care Act 21st Century Cures Act (Public Law No: 114-255) Implementation of The Health Information Technology for Economic and Clinical Health Act (HITECH Act - part of the American Recovery and Reinvestment Act of 2009, PL 111-5). Regulations and legislation related to International Classification of Diseases, version 10 (ICD-10) S.317, ACE Kids Act H.R. 1226, ACE Kids Act S. 1895, Lower Health Care Costs Act Healthcare Outcomes Act
Client expense: $30,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2020 · first_quarter · Medicare/Medicaid
Advancing Care for Exceptional Kids Act of 2019 (ACE Kids Act) (S.317/H.R.1226) CARING for Kids Act (H.R. 6151) Covering life-saving investigations needed in cancer and other life-threatening conditions through timely use of resources for easy and affordable treatment for Medicaid enrollees in need today act (CLINICAL TREATMENTS ACT) (H.R.913) Increasing Access to Quality Cardiac Rehabilitation Care Act of 2019 (H.R. 3911/S.2842) Medicaid Services Investment & Accountability Act of 2019 (H.R.1839) Medicaid Waivers Provider scope of practice for cardiac and pulmonary rehabilitation
Client expense: $250,000 · Firm income: Not reported
Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Environmental Protection Agency (EPA), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Transportation, Dept of (DOT), Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office
2020 · first_quarter · Insurance
Advancing Care for Exceptional Kids Act (HR 3325) (HR 1226/S317); Social determinants of health; Rx Drug Pricing; ACA reform efforts; CREATES ACT; 1332 Waivers Application Process; Surprise Billing legislation; Coronavirus Aid, Relief, and Economic Security (CARES) Act (P.L. 116-136); Families First Coronvirus Reponse Act (P.L. 116-127); Coronvirus Preparedness and Response Supplemental Appropriations Act (P.L. 116-123); H.R. 6379
Client expense: Not reported · Firm income: $30,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE
2020 · first_quarter · Health Issues
Advancing Care for Exceptional Kids Act (HR 3325) (HR 1226/S317); Social determinants of health; Rx Drug Pricing; ACA reform efforts; CREATES ACT; 1332 Waivers Application Process; Coronavirus Aid, Relief, and Economic Security (CARES) Act (P.L. 116-136); Families First Coronvirus Reponse Act (P.L. 116-127); Coronvirus Preparedness and Response Supplemental Appropriations Act (P.L. 116-123); H.R. 6379
Client expense: Not reported · Firm income: $30,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE
2020 · first_quarter · Medicare/Medicaid
Advancing Care for Exceptional Kids Act (HR 3325) (HR 1226/S317); Social determinants of health; Rx Drug Pricing; ACA reform efforts; CREATES ACT; 1332 Waivers Application Process; Social Determinants of Health Accelerator Act, HR 4004; Surprise Billing legislation; Medicaid MCO; Coronavirus Aid, Relief, and Economic Security (CARES) Act (P.L. 116-136); Families First Coronvirus Reponse Act (P.L. 116-127); Coronvirus Preparedness and Response Supplemental Appropriations Act (P.L. 116-123); H.R. 6379
Client expense: Not reported · Firm income: $30,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE
2020 · first_quarter · Medicare/Medicaid
340B Program; To amend title XVIII of the Social Security Act to establish a program to allow qualified group practices to furnish certain items and services at qualified skilled nursing facilities to individuals entitled to benefits under part A and enrolled under part B of the Medicare program to reduce unnecessary hospitalizations, and for other purposes. Advancing Care for Exceptional Kids Act HR 3325 (HR 1226/S317); Social determinants of health; Telehealth reimbursement for SNFs; Surprise billing; executive compensation for not-for-profits; price transparency; Rx Drug Pricing; Advancing Care for Exceptional Kids (HR 1226/S317); CREATES Act; Fairness for High-Skilled Immigrants Act of 2019 (S. 386); Social Determinants of Health Accelerator Act, HR 4004; HR 3; Surprise Billing Legislation; Medicaid MCO; DSH payments, Cadillac tax, device tax; Coronavirus Aid, Relief, and Economic Security (CARES) Act (P.L. 116-136); Families First Coronvirus Reponse Act (P.L. 116-127); Coronvirus Preparedness and Response Supplemental Appropriations Act (P.L. 116-123); H.R. 6379
Client expense: Not reported · Firm income: $120,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE
2020 · first_quarter · Medicare/Medicaid
Issues related to payment and delivery reforms, Medicaid benefits and children's hospital reimbursement; H.R.1226/S.317, ACE Kids Act of 2019. H.R.6074, Coronavirus Preparedness and Response Supplemental Appropriations Act; Families First Coronavirus Response Act (H.R. 6201); H.R. 748, Coronavirus Aid, Relief, and Economic Security Act.
Client expense: Not reported · Firm income: $30,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2020 · first_quarter · Medicare/Medicaid
Medicare and Medicaid payment quality programs and policies, including healthcare associated complications, infections, readmission, payment bundling, potentially avoidable events, quality outcomes, transparency, site-neutral payment policy, and value-based payment policies. Medicare and Medicaid data, Medicaid Scorecards, health information exchanges (HIEs), interoperability, and patient-centered medical records policies, all-payer claims databases (APCDs) Implementation of the Patient Protection and Affordable Care Act (PL 111-148). Implementation of the Helping Hospitals Improve Patient Care Act 21st Century Cures Act (Public Law No: 114-255). Implementation of The Health Information Technology for Economic and Clinical Health Act (HITECH Act - part of the American Recovery and Reinvestment Act of 2009, PL 111-5). Regulations and legislation related to International Classification of Diseases, version 10 (ICD-10). S.317/H.R. 1226 - ACE Kids Act S. 1895, Lower Health Care Costs Act Healthcare Outcomes Act
Client expense: Not reported · Firm income: $50,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2020 · first_quarter · Health Issues
Medicare and Medicaid payment quality programs and policies, including healthcare associated complications, infections, readmission, payment bundling, potentially avoidable event, quality outcomes, transparency, site-neutral payment policy, and value-based payment policies. Medicare and Medicaid data, Medicaid Scorecards, health information exchanges (HIEs), interoperability, and patient-centered medical records policies, all-payer claims databases (APCDs) Implementation of the Patient Protection and Affordable Care Act (PL 111-148). Implementation of the Helping Hospitals Improve Patient Care Act 21st Century Cures Act (Public Law No: 114-255). Implementation of The Health Information Technology for Economic and Clinical Health Act (HITECH Act - part of the American Recovery and Reinvestment Act of 2009, PL 111-5). Regulations and legislation related to International Classification of Diseases, version 10 (ICD-10). S.317/H.R. 1226 - ACE Kids Act S. 1895, Lower Health Care Costs Act Healthcare Outcomes Act
Client expense: Not reported · Firm income: $50,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2020 · first_quarter · Medicare/Medicaid
HR1839; S.237/HR808; Ace Kids Act S.317/H.R.1226; S.433; HR748
Client expense: Not reported · Firm income: $10,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2020 · first_quarter · Medicare/Medicaid
PL 111-148 - The Patient Protection and Affordable Care Act, implementation H.R. 259 - Medicaid Extenders Act of 2019 H.R. 1839 - Medicaid Services Investment and Accountability Act of 2019 H.R. 1226/S. 317 - ACE Kids Act of 2019 no specific bills, Medicare and Medicaid Fraud, Advantage, Medicare Part D, Medicaid, Medicaid expansion, Electronic Prescribing, Dual Eligibles, Medigap reform, claims resolution, risk adjustment, Delivery System Reform, Special Needs Plans, Star Ratings, call letter, program integrity, Alzheimer's care, telehealth, chronic care, coding intensity, Medicaid per capita caps, block grant, long term services and supports, value based purchasing, Medicaid MLR, spread pricing, social determinants of health, mental health and substance abuse
Client expense: Not reported · Firm income: $90,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, White House Office
2019 · second_quarter · Medicare/Medicaid
Issues pertaining to Medicaid reform, block grant proposals, per capita caps Medicare and Medicaid Graduate Medical Education Medicaid provider taxes Medicare bad debt payments Medicaid waivers Medicaid Expansion Issues Medicaid Disproportionate Share Hospital Payments Medicare Disproportionate Share Hospital Payments Legislation related to chronic care treatment Legislation related to Medicare reimbursement for telehealth service Medicaid managed care policies rulemaking Medicaid supplemental payments to hospitals Medicare site neutral payments for hospitals outpatient departments Legislation related to healthcare disparities Medicaid State Flexibility Medicaid 1115 & 1332 Waivers Upper Payment Limit payments State Financing of Medicaid Medicare Part B Cuts-OPPS proposed rule to 340B covered entities Medicaid Pediatric Health Homes Hospital Price Transparency Empower Act (S.227/H.R. 5306) Medicaid Services Investment and Accountability Act (H.R. 1839) Advancing Care for Exceptional Kids Act (S.317/H.R. 1226) National Quality Forum Funding Medicaid & CHIP Coverage Medicaid Funding for Certified Community Behavioral Health Centers Medicaid Funding for Community-Based long-term care
Client expense: $310,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE, White House Office
2019 · second_quarter · Health Issues
Repeal of the Affordable Care Act Development of legislation to protect essential hospitals Issues related to telehealth Mental Health Essential Health Benefits created by the Affordable Care Act Access to hospital emergency services Issues related to the 340B Drug Pricing Program ACA Cost Sharing Reduction Subsidies 340B dug pricing program CMS OPPS 340B rule moratorium-related legislation 42 CFR Part 2 IMD Exclusion Prescription drug monitoring programs Poison Center Network Enhancement Act A Bill to support the peer support specialist workforce CREATES Act-H.R. 965 The Advancing Care for Exceptional (ACE) Kids Act-H.R. 1226/S. 317 Cassidy Surprise Billing Draft Protecting Patients from Surprise Medical Bills Excellence in Metal Health Act (S. 824/H.R. 1767) Pandemic and All-Hazards Preparedness and Advancing Innovation Act (H.R. 269/S.1379) Patient Centered Outcomes Research Institute Funding No Surprises Act Lower Health Care Costs Act
Client expense: $310,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE, White House Office
2019 · first_quarter · Health Issues
H.R.582, the Raise the Wage Act, related to providing for increases in the Federal minimum wage, and for other purposes, all provisions; H.R.873 / S.260, the Transformation to Competitive Employment Act, related to assisting employers providing employment under special certificates issued under section 14(c) of the Fair Labor Standards Act of 1938 to transform their business and program models, to support individuals with disabilities to transition to competitive integrated employment, to phase out the use of such special certificates, and for other purposes, all provisions; H.R. 989, the Promoting Apprenticeships through Regional Training Networks for Employers Required Skills (PARTNERS) Act of 2019, related to promoting registered apprenticeships and other work-based learning programs for small and medium-sized businesses within in-demand industry sectors, through the establishment and support of industry or sector partnerships, all provisions; H.R.1058 / S.427, the Autism Collaboration, Accountability, Research, Education, and Support (Autism CARES) Act, related to amending the Public Health Service Act to enhance activities of the National Institutes of Health with respect to research on autism spectrum disorder and enhance programs relating to autism, and for other purposes, all provisions; H.R.1226 / S.317, the Advancing Care for Exceptional (ACE) Kids Act, related to amending title XIX of the Social Security Act to provide States with the option of providing coordinated care for children with complex medical conditions through a health home, all provisions; H.R. 1342 / S.548, the Ensuring Medicaid Provides Opportunities for Widespread Equity, Resources, and Care (EMPOWER Care) Act, related to reauthorizing the Money Follows the Person Demonstration Program, all provisions; H.R.1434 / S.634, the Education Freedom Scholarships and Opportunity Act, related to amending the Internal Revenue Code of 1986 to establish tax credits to encourage individual and corporate taxpayers to contribute to scholarships for elementary and secondary students through eligible scholarship-granting organizations, and for other purposes, all provisions; H.R. 1662, the Cultivating Learning Assistance for Student Success Act, related to directing the Secretary of Education to establish a pilot program to provide grants to secondary schools for assistive technology devices and assistive technology services and to create programs to benefit students with autism or apraxia, and for other purposes, all provisions; H.R. 21 / H.R. 264 / H.R.265 / H.R.266 / H.R.267 / H.R. 648, related to appropriations; A bill not yet introduced to amend the Small Business Act (P.L. 85-536) A bill not yet introduced to amend portions of the Individuals with Disabilities Education Act (P.L. 89-10) A bill not yet introduced to amend the Social Security Amendments of 1965 (P.L. 89-97); A bill not yet introduced to amend the Higher Education Act (P.L. 89-329); A bill not yet introduced to reauthorize the Education Sciences Reform Act (P.L. 107-279); A bill not yet introduced to prohibit and prevent the use of seclusion and reduce of the use of physical restraint in schools, and for other purposes; Implementation of the Individuals with Disabilities Education Act (P.L. 89-10); Implementation of the Social Security Amendments of 1965 (P.L. 89-97); Implementation of the National Apprenticeship Act (P.L. 89-554); Implementation of the Rehabilitation Act of 1973 (P.L. 93-112); Implementation of the Workforce Innovation and Opportunity Act (P.L. 113-128); and Implementation of the Elementary and Secondary Education Act (P.L. 114-95).
Client expense: $100,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Education, Dept of, HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), Natl Institute of Mental Health (NIMH), Natl Institutes of Health (NIH), SENATE
2019 · fourth_quarter · Medicare/Medicaid
S. 62, Empowering Medicare Seniors to Negotiate Drug Prices Act (Klobuchar) - Part D price negotiations S. 99, Medicare Drug Price Negotiation Act (Sanders) - Part D price negotiations, formulary changes S. 205, Right Rebate Act (Wyden) - Medicaid drug rebate program S. 317, ACE Kids Act (Grassley) - health homes for children with medically complex conditions S. 377, Medicare Negotiation and Competitive Licensing Act (Brown) - Part D price negotiation S. 470, Medicare at 50 Act (Stabenow) - Medicare buy-in option S. 475, RxCAP Act (Wyden) - Part D cost-sharing S. 489, State Public Option Act (Schatz) - Medicaid buy-in option S. 516, Prescription Drug Monitoring Act (Klobuchar) - required use of PDMPs S. 548, EMPOWER Care Act (Portman) - MFP demonstration S. 640, Phair Pricing Act (Kennedy) -- Part D rebates at the point of sale S. 691, Medicare Extra Rx HELP Act (Casey) - Part D assistance for low-income seniors S. 709, Prescription Drug Pricing Dashboard Act (Casey) - interactive dashboard with drug price and utilization data for federal programs S. 773, Telehealth Innovation and Improvement Act (Gardner) - testing expanded coverage of telehealth services in Medicare S. 988, Improving Transparency and Accuracy in Medicare Part D Spending Act (Capito) - payments on clean claims S. 1114, Medicare Advantage Quality Payment Relief Act (Daines-King) - MA benchmark cap S. 2081, Stop Drug Companies from Overcharging Seniors in Medicare Part B Act of 2019 (Peters)- drugs in Part B S. 2252, Empowering States to Address Drug Costs Act (Van Hollen)- drug pricing S. 2446, Medicare Audiologist Access and Services Act of 2019 (Warren)-Medicare coverage of audiologist services S. 2650 - Medicare Prescription Drug Savings and Choice Act of 2019 (Durbin) - lowering prescription drug costs S. 2807, Hospice Care Improvement Act of 2019 (Portman) - Medicare hospice programs S. 2846, Protecting Patients Transportation to Care Act (Isakson) - Medicaid coverage of transportation S. 2911, Seniors Prescription Drug Relief Act of 2019 (Cassidy) - Part D smoothing S. 3000, Patient Shared Savings Act (Cassidy) - prescription drug plans S. 3001, Permanent Relief for Seniors and Medicare, Medicaid, Human Services Extension Act of 2019 (Toomey) - extensions S. 3029, Territories Medicare Prescription Drug Assistance Equity Act of 2019 (Menendez) - Territories, low-income Medicare part D beneficiaries S. 3078, Audit & Appeals Fairness, Integrity, and Reforms in Medicare Act of 2019 (Grassley) - Medicare appeals process S. 3129, Lower Costs, More Cures Act of 2019 (Crapo) - drug pricing H.R. 19, Lower Costs, More Cures Act of 2019 (Walden) - drug pricing H.R. 259, Medicaid Extenders Act (Pallone) - MFP demonstration, spousal impoverishment protections H.R. 448, Medicare Drug Price Negotiation Act (Cummings) - Part D price negotiations, formulary changes H.R. 789, Improving Transparency and Accuracy in Medicare Part D Spending Act (Welch) - payments on clean claims H.R. 937, Right Rebate Act (Schrader) - Medicaid drug rebate program H.R. 1034, Phair Pricing Act (Collins) - Part D rebates at the point of sale H.R. 1035, Prescription Drug Price Transparency Act (Collins) - Medicare PBM standards H.R. 1046, Medicare Negotiation and Competitive Licensing Act (Doggett) - Part D price negotiation H.R. 1226, ACE Kids Act (Castor) - health homes for children with medically complex conditions H.R. 1277, State Public Option Act (Lujan) - Medicaid buy-in option H.R. 1301, Mental Health Telemedicine Expansion Act (DelBene) - Medicare coverage of mental health telehealth services H.R. 1342, EMPOWER Care Act (Dingell) - MFP demonstration H.R. 1343, Protecting Married Seniors from Impoverishment Act (Dingell) - spousal impoverishment protections H.R. 1346, Medicare Buy-In and Health Care Stabilization Act (Higgins) - Medicare buy-in option H.R. 1375, PAID Act (Kind) - transparency of Medicare secondary payer information H.R. 1394, Medigap Consumer Protection Act (Doggett) - Medicare supplemental consumer protections H.R. 1551, Quality Care for Moms and Babies Act (Engel) - quality measures in Medicaid and CHIP H.R. 1781, Payment Commission Data Act (Carter) - MedPAC and MACPAC access to drug pricing and rebate data in Medicare and Medicaid H.R. 1839, Medicaid Services Investment and Accountability Act (Ruiz) - MFP demonstration, spousal impoverishment protections, ACE Kids Act, Medicaid drug rebate program, health homes for children with medically complex conditions H.R. 2131, Medicare Advantage Quality Payment Relief Act (Kind-Kelly) - MA benchmark cap H.R. 2757, Creating Lower Cost Alternatives for Your Prescription Drugs Act (Cunningham) - eliminate copay for generic drugs in Medicare Part D H.R. 3107, Improving Seniors' Timely Access to Care Act (DelBene) - Medicare Advantage prior authorization H.R. 3253, Empowering Beneficiaries, Ensuring Access, and Strengthening Accountability Act (Dingell) - MFP demonstration, spousal impoverishment protections, Medicaid drug rebate program H.R. 3417, Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act (Neal) - funding for quality measurement initiatives, Medicare coverage of mental health telehealth services, real-time benefit tools in Medicare Part D, Medicare eligibility and enrollment notices H.R. 3461, Community-Based Independence for Seniors Act (Sanchez-Kelly) - Community-Based Institutional Special Needs Plan H.R. 3613, State Accountability, Flexibility, and Equity for Hospitals Act of 2019 (Bilirakis) -Medicaid DSH payments H.R. 3631, Territories Health Care Improvement Act (Soto) -Medicaid funding H.R. 3644, Independence at Home Demonstration Act of 2019 (Burgess)-Medicare demonstration program H.R. 3925, Reducing Barriers to Substance Use Treatment Act (Tonko)- Opioids H.R. 3935, Protecting Patients Transportation to Care Act (Carter)-Medicaid coverage for transportation H.R. 4378, Continuing Appropriations Act, 2020, and Health Extenders Act of 2019 (Lowey)-Health extenders H.R. 4453, Protecting Seniors from Health Care Fraud Act of 2019 (Ruiz)-Distributing information to Medicare beneficiaries to prevent fraud H.R. 4527, Expanding Health Care Options for Early Retirees Act (Malinowski)-Option for first responders to buy-in to Medicare H.R. 4529, Promoting Access to Broadband Act of 2019 (Maloney)-Medicaid H.R. 4583, Medicare Extra Rx Higher Eligibility Limits in Part D Act of 2019 (Schneider) - prescription drug affordability H.R. 4597, Acting to Cancel Copays and Ensure Substantial Savings for Biosimilars Act of 2019 (Peters) - biosimilars, Part B H.R. 4618, Medicare Hearing Act of 2019 (McBath) - coverage for certain hearing items and services under part B H.R. 4619, Pharmaceutical Rebates for Excessive Pricing Above Inflation Act (Schakowsky) - drug rebates, Part D H.R. 4620, More Help for Seniors Act of 2019 (Rose) - expand eligibility for low-income subsidies under Part D of the Medicare program H.R. 4621, Collecting and Analyzing Resources Integral and Necessary for Guidance for Social Determinants Act of 2019 (Blunt Rochester) - best practices re social determinants of health H.R. 4628, Better Tools to Lower Costs Act of 2019 (Scanlon) - resource requirements H.R. 4629, Star Rating for Biosimilars Act (Tonko) - biosimilars H.R. 4632, Better Transparency in Information for Medicare Beneficiaries Act of 2019 (Kind) - provides consumers information regarding premiums under LIS benchmark plans H.R. 4649, Capping Drug Costs for Seniors Act of 2019 (Horsford) - cap on beneficiary liability under part D of the Medicare program H.R. 4650, Medicare Dental Act of 2019 (Kelly) - Medicare dental coverage H.R. 4655, Enhancing Retirement Security for Medicare Beneficiaries Act of 2019 (Lee) - eligibility of individuals for premium and cost-sharing subsidies under part D H.R. 4661, Advancing Enrollment and Reducing Drug Costs Act of 2019 (Pappas) - Medicaid in territories H.R. 4663, Freedom from Price Gouging Act (Porter) - drug rebates, Part B H.R. 4665, Medicare Vision Act of 2019 (Schrier) - vision items and services under part B H.R. 4666, To amend title XVIII of the Social Security Act to provide certain low-income territorial residents with automatic eligibility for premium and cost-sharing subsidies under the Medicare program, and for other purposes (Shalala) - Medicare in territories H.R. 4669, Maximizing Drug Coverage for Low-Income Seniors Act of 2019 (Stevens) - auto enrollment and intelligent assignment H.R. 4671, Helping Seniors Afford Health Care Act (Kim) - Medicare affordability and low income beneficiaries H.R. 4676, Protecting Medicare Beneficiaries with Pre-Existing Conditions Act (Schneider) - Medigap H.R. 4699, To amend title XIX of the Social Security Act to remove the matching requirement for a territory to use specially allocated Federal funds for Medicare covered part D drugs for low-income individuals (Gonzales-Colon) - Part D, territories H.R. 4769, Medicare Prescription Drug Savings and Choice Act of 2019 (Schakowsky) - lowering prescription drug costs H.R. 4946, Ensuring Seniors Access to Local Pharmacies Act of 2019 (Welch) - equal access of Medicare beneficiaries to community pharmacies in underserved areas H.R. 4996, Helping Medicaid Offer Maternity Services Act of 2019 (Kelly) - State extension of Medicaid H.R. 5006, Expanding Access to Inpatient Mental Health Act (Emmer) - Medicaid coverage for SUD/mental health for institutionalized H.R. 5039, Life Sustaining Prescription Drug Price Relief Act of 2019 (Lipinski) - part D H.R. 5057, Pass- Through Technical Corrections Act (Tonko) - drug pass-through status under Medicare outpatient payment H.R. 5201, Telemental Health Expansion Act of 2019 (Matsui) - Medicare coverage of mental telehealth H.R. 5232, Road to Recovery Act (Fitzpatrick) - Medicaid and CHIP SUD treatment H.R. 5281, Drug Price Transparency in Medicaid Act of 2019 (Carter) - transparency and spread pricing affordability Discussion Draft, Medicare Part D Reform (Neal-Pallone-Brady-Walden) - maximum out-of-pocket limit, federal reinsurance payments 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 risk adjustment data validation (RADV) audit issues including proposed RADV regulation for MA; 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 2021 policy and technical regulation for MA and Part D; MA and Part D proposed rule on drug pricing changes for 2020; Part D reform, out of pocket limits; issues related to Medicare for All, Medicare buy-in and public option; CMSs price transparency proposal for direct-to-consumer advertisements; issues relating to 2021 Rate Notice and Call Letter; issues related to MLTSS; issues related to proposed changes to removal of safe harbor protection for rebates (proposed rule); in-home health risk assessments; Medicare Medical Loss Ratio issues; implementation of sequestration under the Medicare Advantage and Part D programs; implications of the health insurer fee for MA and Part D plans; application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, enrollment rules, requirements for notice and denial forms, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible SNPs; Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, Part D coverage gap discount program, including employer group waiver plan (EGWP) issues, and other operational issues; issues raised by Part D coverage of new specialty drugs, the Part D non-interference policy and related issues (e.g., preferred pharmacy and any willing pharmacy requirements, standards for network pharmacy reimbursement, and policies regarding sponsor negotiation of pharmacy price concessions); issues related to the international price index; issues related to child and maternal health; issues related to Medicaid supplemental and disproportionate share hospital (DSH) funding; issues related to Medicaid funding for territories; issues related to medical management; issues relating to MA supplemental benefits; 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; issues related to health homes for children with medically complex conditions; socioeconomic status impacts on star ratings related to MA and Part D programs; and other issues relating to health care reform implementation.
Client expense: $2,340,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Treasury, Dept of, White House Office
2019 · fourth_quarter · Medicare/Medicaid
Advancing Care for Exceptional Kids Act of 2019 (ACE Kids Act) (S.317/H.R.1226) Covering life-saving investigations needed in cancer and other life-threatening conditions through timely use of resources for easy and affordable treatment for Medicaid enrollees in need today act (CLINICAL TREATMENTS ACT) (H.R.913) Increasing Access to Quality Cardiac Rehabilitation Care Act of 2019 (H.R. 3911/S.2842) Lower Health Care Cost Act (S.1895) Medicaid Services Investment & Accountability Act of 2019 (H.R.1839)
Client expense: $160,000 · Firm income: Not reported
Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Environmental Protection Agency (EPA), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Transportation, Dept of (DOT), Treasury, Dept of, White House Office
2019 · fourth_quarter · Health Issues
Medicare and Medicaid payment quality programs and policies, including healthcare associated complications, infections, readmissions, payment bundling, potentially avoidable events, quality outcomes, transparency, site-neutral payment policy, and value-based payment policies Medicare and Medicaid data, Medicaid Scorecards, health information exchanges (HIEs), interoperability, patient-centered medical records policies, and all-payer claims databases (APCDs) Labor, Health and Human Services Appropriations Implementation of the Patient Protection and Affordable Care Act (PL 111-148) Implementation of the Helping Hospitals Improve Patient Care Act 21st Century Cures Act (Public Law No: 114-255) Implementation of The Health Information Technology for Economic and Clinical Health Act (HITECH Act - part of the American Recovery and Reinvestment Act of 2009, PL 111-5) Regulations and legislation related to International Classification of Diseases, version 10 (ICD-10) S.317, ACE Kids Act H.R. 1226, ACE Kids Act S. 1895, Lower Health Care Costs Act Healthcare Outcomes Act
Client expense: $170,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2019 · fourth_quarter · Medicare/Medicaid
Medicare and Medicaid payment quality programs and policies, including healthcare associated complications, infections, readmissions, payment bundling, potentially avoidable events, quality outcomes, transparency, site-neutral payment policy, and value-based payment policies Medicare and Medicaid data, Medicaid Scorecards, health information exchanges (HIEs), interoperability, patient-centered medical records policies, and all-payer claims databases (APCDs) Labor, Health and Human Services Appropriations Implementation of the Patient Protection and Affordable Care Act (PL 111-148) Implementation of the Helping Hospitals Improve Patient Care Act 21st Century Cures Act (Public Law No: 114-255) Implementation of The Health Information Technology for Economic and Clinical Health Act (HITECH Act - part of the American Recovery and Reinvestment Act of 2009, PL 111-5). Regulations and legislation related to International Classification of Diseases, version 10 (ICD-10) S.317, ACE Kids Act H.R. 1226, ACE Kids Act S. 1895, Lower Health Care Costs Act Healthcare Outcomes Act
Client expense: $170,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2019 · fourth_quarter · Medicare/Medicaid
340B Program; To amend title XVIII of the Social Security Act to establish a program to allow qualified group practices to furnish certain items and services at qualified skilled nursing facilities to individuals entitled to benefits under part A and enrolled under part B of the Medicare program to reduce unnecessary hospitalizations, and for other purposes. Advancing Care for Exceptional Kids Act HR 3325 (HR 1226/S317); Social determinants of health; Telehealth reimbursement for SNFs; Surprise billing; executive compensation for not-for-profits; price transparency; Rx Drug Pricing; Advancing Care for Exceptional Kids (HR 1226/S317); CREATES Act; Fairness for High-Skilled Immigrants Act of 2019 (S. 386); Social Determinants of Health Accelerator Act, HR 4004; HR 3; Surprise Billing Legislation; Medicaid MCO; DSH payments, Cadillac tax, device tax
Client expense: Not reported · Firm income: $120,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE
2019 · fourth_quarter · Medicare/Medicaid
Advancing Care for Exceptional Kids Act (HR 3325) (HR 1226/S317); Social determinants of health; Rx Drug Pricing; ACA reform efforts; CREATES ACT; 1332 Waivers Application Process; Social Determinants of Health Accelerator Act, HR 4004; Surprise Billing legislation; Medicaid MCO
Client expense: Not reported · Firm income: $30,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE
2019 · fourth_quarter · Insurance
Advancing Care for Exceptional Kids Act (HR 3325) (HR 1226/S317); Social determinants of health; Rx Drug Pricing; ACA reform efforts; CREATES ACT; 1332 Waivers Application Process; Surprise Billing legislation
Client expense: Not reported · Firm income: $30,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE
2019 · fourth_quarter · Health Issues
Advancing Care for Exceptional Kids Act (HR 3325) (HR 1226/S317); Social determinants of health; Rx Drug Pricing; ACA reform efforts; CREATES ACT; 1332 Waivers Application Process;
Client expense: Not reported · Firm income: $30,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE
2019 · fourth_quarter · Medicare/Medicaid
HR1839; S.237/HR808; Ace Kids Act S.317/H.R.1226; S.433;
Client expense: Not reported · Firm income: $10,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2019 · fourth_quarter · Medicare/Medicaid
Issues related to payment and delivery reforms, Medicaid benefits and children's hospital reimbursement; H.R.1226/S.317, ACE Kids Act of 2019.
Client expense: Not reported · Firm income: $30,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2019 · fourth_quarter · Medicare/Medicaid
PL 111-148 - The Patient Protection and Affordable Care Act, implementation H.R. 259 - Medicaid Extenders Act of 2019 H.R. 1839 - Medicaid Services Investment and Accountability Act of 2019 H.R. 1226/S. 317 - ACE Kids Act of 2019 no specific bills, Medicare and Medicaid Fraud, Advantage, Medicare Part D, Medicaid, Medicaid expansion, Electronic Prescribing, Dual Eligibles, Medigap reform, claims resolution, risk adjustment, Delivery System Reform, Special Needs Plans, Star Ratings, call letter, program integrity, Alzheimer's care, telehealth, chronic care, coding intensity, Medicaid per capita caps, block grant, long term services and supports, value based purchasing, Medicaid MLR, spread pricing, social determinants of health, mental health and substance abuse
Client expense: Not reported · Firm income: $90,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, White House Office