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Telehealth Modernization Act This bill modifies requirements relating to coverage of telehealth services under Medicare. Specifically, the bill extends certain flexibilities that were initially authorized during the public health emergency relating to COVID-19 (i.e., coronavirus disease 2019). Among other things, the bill allows (1) rural health clinics and federally qualified health centers to serve as the distant site (i.e., the location of the health care practitioner); (2) the home of a beneficiary to serve as the originating site (i.e., the location of the beneficiary) for all services (rather than for only certain services); and (3) all types of practitioners to furnish telehealth services, as determined by the Centers for Medicare & Medicaid Services.
These links require the bill number to appear in the filing's source-reported specific issue text. Client expenses and lobbying-firm income are separate disclosure fields.
Filing registrants (11)
Read twice and referred to the Committee on Finance. (Sponsor introductory remarks on measure: CR S4635-4636)
Introduced in Senate
Bills with similar content found using semantic analysis.
Sources: Congress.gov
2020 · fourth_quarter · Medicare/Medicaid
H.R. 8840, Medicare Sequester COVID Moratorium Act, all provisions H.R. 8702, Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020, all provisions S. 5007, Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020, all provisions H.R. 7154, Outpatient Therapy Modernization and Stabilization Act, all provisions H.R. 3107, Improving Seniors Timely Access to Care Act of 2019, all provisions S. 5044, Improving Seniors Timely Access to Care Act of 2020y, all provisions H.R. 8727, Telehealth Modernization Act, all provisions S. 4375, Telehealth Modernization Act, all provisions H.R. 7663, Protecting Access to Post-COVID-19 Telehealth Act of 2020, all provisions H.R. 7391, Protect Telehealth Access Act of 2020, all provisions H.R. 1301, Mental Health Telemedicine Expansion Act, all provisions H.R. 3417, Beneficiary Education Tools, Telehealth, and Extenders Reauthorization (BETTER) Act of 2019, all provisions H.R. 5201, Telemental Health Expansion Act of 2020, provisions relating to 1834(m) of the Social Security Act; geographic and originating sites H.R. 7233, Knowing the Efficiency and Efficacy of Permanent (KEEP) Telehealth Options Act of 2020, all provisions H.R. 5172, Non-Opioids Prevent Addiction In the Nation (NOPAIN) Act, All provisions S. 3067, Non-Opioids Prevent Addiction In the Nation (NOPAIN) Act, All provisions H.R. 3414, Opioid Workforce Act of 2019, all provisions H.R. 7791, Value in Health Care Act of 2020, provisions relating to qualifying APM physician thresholds H.R. 6837, Medicare Accelerated and Advance Payments Improvement Act of 2020, all provisions S. 3750, Medicare Accelerated and Advance Payments Improvement Act, all provisions H.R. 8505, To amend title XVIII of the Social Security Act to provide for a one-year waiver of budget neutrality adjustments under the Medicare physician fee schedule, and for other purposes, all provisions H.R. 884, Medicare Mental Health Access Act, all provisions H.R. 945, Mental Health Access Improvement Act of 2019, all provisions H.R. 6744, Medically Tailored Home-Delivered Meals Demonstration Pilot Act of 2020, all provisions H.R. 4004, Social Determinants Accelerator Act of 2019, all provisions H.R. 4932, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019, all provisions S. 2741, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019, all provisions H.R. 5534, Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act of 2020, all provisions S. 3353, Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act of 2020, all provisions H.R. 3, Elijah E. Cummings Lower Drug Costs Now Act, provisions related to PBM and prescription drug price transparency H.R. 19, Lower Costs, More Cures Act of 2019, provisions related to PBM and prescription drug price transparency H.R. 4996, Helping Medicaid Offer Maternity Services (MOMS) Act of 2020, all provisions H.R. 6090, Physician Shortage GME Cap Flex Act of 2020, all provisions H.R. 6142, Black Maternal Health Momnibus Act of 2020, all provisions Medicare program: P.L. 114-10 Medicare Access and CHIP Reauthorization Act (MACRA) implementation/Accountable Care Organizations/APM thresholds Medicare program: Patient Protection and Affordable Care Act (PPACA)/Prior authorization provider and patient burdens/patient electronic access to health information Medicare program: P.L. 113-93 Protecting Access to Medicare Act (PAMA)/Imaging appropriate use criteria/Radiation Oncology APM Medicare program: FY 2021 Inpatient Rehab Facility Prospective Payment System (IRF PPS)/scope of practice issues Medicare program: CY 2021 physician fee schedule/E&M services/Budget neutrality/Part B/Sequester Medicare program: Alternative payment models (APMs) Medicare program: Merit-based Incentive Payment System (MIPS)/cost/quality/interoperability/hardship exemption Medicare program: Regulatory relief/Advanced APMs, prior authorization, and utilization management Medicare program: Shared Savings Program Medicare program: Quality Payment Program/prior authorization/electronic funds transfer Medicare program: Surprise medical billing Medicare program: Medicare-For-All Medicare program: Electronic Health Records (EHR) Certification Medicare program: 21st Century Cures Act Medicare program: Quality payment program/physician burdens Medicare program: National Coverage determination/validated home blood pressure monitors Medicare program: Health IT/physician burden Medicare program: Drug pricing Medicare program: Most favored nation drug pricing Medicare program: Provider compliance/regulatory relief Medicare program: Provider Enrollment, Chain and Ownership (PECOS) enrollment/revalidation Medicare and Medicaid programs: 21st Century Cures Act/health data and privacy Medicaid program: CMS proposed regulation Medicaid Program Medicaid program: FMAP increases Medicaid program: Interoperability
Client expense: $3,870,000 · Firm income: Not reported
Government targets: Agriculture, Dept of (USDA), Bureau of Citizenship & Immigration Services (BCIS), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), SENATE, Veterans Affairs, Dept of (VA), White House Office
2020 · fourth_quarter · Medicare/Medicaid
Telehealth coverage and reimbursement; H.R. 7663, Protecting Access to Post-COVID-19 Telehealth Act; S. 4375, Telehealth Modernization Act.
Client expense: Not reported · Firm income: $75,000
Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2020 · fourth_quarter · Medicare/Medicaid
H.R. 3107 - Improving Seniors' Timely Access to Care Act of 2019 - DelBene - prior authorization in Medicare Advantage 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. 4453 - Protecting Seniors from Health Care Fraud Act of 2019 - Ruiz -Distributing information to Medicare beneficiaries to prevent fraud 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. 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. 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. 4671 - Helping Seniors Afford Health Care Act - Kim - Medicare affordability and low income beneficiaries H.R. 4996 - Helping Medicaid Offer Maternity Services Act of 2020 - Kelly - extend Medicaid coverage post-partum H.R. 5006 - Expanding Access to Inpatient Mental Health Act - Emmer - Medicaid coverage for SUD/mental health for institutionalized 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. 5693 - Primary Health Services Enhancement Act - Kind - Medicare rural health H.R. 5808 - Save Rural Communities Act of 2020 - Arrington - rural emergency medical access services under Medicare H.R. 5833 - To amend title XVIII of the Social Security Act to permit the use of certain psychological evaluation via telehealth for Medicare coverage of neurostimulation services for the treatment of chronic pain - Latta - Medicare coverage in telehealth H.R. 5882 - GENE Therapy Payment Act - Schrader - value based care H.R. 6098 - To amend title XXI of the Social Security Act to allow States to expand income eligibility standards under the Children's Health Insurance Program -Barragan - CHIP eligibility H.R. 6151 - CARING for Kids Act - Fineknauer - CHIP H.R. 6179 - Increasing Access to Biosimilars Act of 2020 - Cardenas - payments to providers of biosimilars under Medicare H.R. 6209 - Reducing Unnecessary Senior Hospitalizations Act of 2020 or the RUSH Act of 2020 -Kuster - Medicare coverage for certain services in hospital emergency departments H.R. 6244 - To amend titles XVIII and XIX to provide for coverage at no cost sharing of COVID-19 testing under the Medicaid program and Children's Health Insurance Program - Kelly - Medicaid coverage of COVID-19 related visits and testing H.R. 6263 - To amend title XVIII of the Social Security Act to waive cost sharing under the Medicare program for certain visits relating to testing for COVID-19 -Sarbanes - Medicare coverage of COVID-19 related visits and testing H.R. 6273 - Protecting Vulnerable Americans in Times of Crisis Act of 2020 - Butterfield - FMAP H.R. 6311 - Care for COVID-19 Act - Ruiz - COVID-19 cost sharing H.R. 6336 - Increasing Hospital Capacity to Fight the Coronavirus Act of 2020 - Bishop - Medicare and Medicaid payments during COVID-19 emergency H.R. 6462 - Emergency Medicaid for Coronavirus Treatment Act - Gallego - Medicaid coverage H.R. 6511 - Ensuring Vaccination and Treatment Affordability Act - Pappas - COVID H.R. 6521 - To prohibit the Secretary of Health and Human Services from taking certain actions with respect to Medicaid supplemental payments reporting requirements, and for other purposes - Diaz Barragan - Medicaid, delays implementation of MFAR H.R. 6538 - Modernized Medicine Act - Kennedy - Medicaid, Telehealth H.R. 6539 - Coronavirus Medicaid Response Act - Lee - FMAP H.R. 6572 - To direct the Secretary of Health and Human Services, acting through the Director of the Centers for Disease Control and Prevention, to carry out a national campaign to increase awareness and knowledge of COVID-19. -Bilirakis - COVID H.R. 6583 - To amend title XVIII of the Social Security Act to establish a risk corridor program for Medicare Advantage plans during the COVID-19 emergency, and for other purposes. - Houlahan - COVID H.R. 6616 - Stronger Medicaid Response to the COVID-19 Pandemic Act -Cardenas - COVID H.R. 6640 - Medicare Advantage COVID Treatment Act - Mucarsel-Powell - COVID H.R. 6658 - Insular Area Medicaid Coronavirus Recovery Act - Sablan - FMAP H.R. 6727 - To hold Medicare beneficiaries harmless for specified COVID-19 treatment services furnished under part A or part B of the Medicare program - Schrier - COVID H.R. 6744 - Computer and Internet Equity Act - Davis - internet access for Lifeline program H.R. 6753 - Save Rural Hospitals Act of 2020 - Finkenauer - Medicare hospital payments H.R. 6792 - Improving Telehealth for Underserved Communities Act of 2020 - Smith - telehealth H.R. 6797 - CHIPPER Act - Wild - CHIP, COVID H.R. 6837 - Medicare Accelerated and Advance Payments Improvement Act of 2020 -Schneider - COVID H.R. 7154 - Outpatient Therapy Modernization and Stabilization Act -Boyle - outpatient therapy services H.R. 7187 - HEALTH Act of 2020 -Thompson -Smith - telehealth H.R. 7292 - To amend title XVIII of the Social Security Act to provide for forgiveness of certain accelerated and advance payments under parts A and B of the Medicare program. - Kaptur - advance payments H.R. 7338 - To amend title XVIII of the Social Security Act to permit the Secretary of Health and Human Services to waive requirements relating to the furnishing of telehealth services under the Medicare program, and for other purposes. - Cheney - Telehealth H.R. 7391 - To amend title XVIII of the Social Security Act to remove certain geographic and originating site restrictions on the furnishing of telehealth services under the Medicare program - Sherrill- Telehealth H.R. 7606 - MFAR Transparency Act - Williams - report on impact of MFAR to Congress H.R. 7627 - MORE Savings Act - Dean - Medicare access to opioid treatment and MAT H.R. 7663 - Protecting Access to Post-COVID-19 Telehealth Act of 2020 - Thompson - waive or modify application of Medicare requirements with respect to telehealth during PHE H.R. 7791 - Value in Health Care Act of 2020 - Welch - Medicare shared savings program and alternative payment arrangements H.R. 7877 - Lowering Drug Costs for Seniors Act of 2020 - Katko - Medicare Part D costs H.R. 7892 - Medicaid Expansion During Crisis Act - Coleman - extend eligibility period for Medicaid enrollment application H.R. 8177 - Renal Anemia Innovation Support and Expansion Act - OHalleran - Medicare prescription drug coverage for chronic kidney disease H.R. 8218 - Rural Ambulance Reimbursement Fairness Act - Gianforte - Medicare payment for rural ambulance services H.R. 8254 - Bringing Enhanced Treatments and Therapies to ESRD Recipients Kidney Care Act - Blumenauer - integrated care for Medicare beneficiaries with ESRD H.R. 8427 - To provide for certain reports on enrollment in the Lifeline program, and for other purposes - Luria - Lifeline program H.R. 8476 - TIKES Act -Blunt Rochester - telehealth coverage in Medicaid H.R. 8505 - To amend title XVIII of the Social Security Act to provide for a one-year waiver of budget neutrality adjustments under the Medicare physician fee schedule - Burgess - Medicare physician fee schedule H.R. 8525 - Expanded Genetic Screening Act of 2020 - Speier - Medicaid coverage of non-invasive prenatal genetic screening H.R. 8529 - Protecting Access to Affordable Medicines Act of 2020 - Butterfield - rebates under the Medicaid program for certain noninnovator multiple source drugs H.R. 8546 - Fair Drug Prices for Kids Act -Wild - Medicaid drug rebate program in CHIP H.R. 8558 - Comprehensive Breast Reconstruction Act of 2020 - Hastings - extends coverage of certain breast reconstructive services following mastectomy under the Medicare and Medicaid programs H.R. 8561 - Restoring Fairness to Medicaid Reimbursement Act of 2020 - Johnson - FMAP H.R. 8574 - PROTECT Long Term Care Facilities Act -Sherrill - long term care in COVID-19 H.R. 8586 - Medicaid Coverage for Addiction Recovery Expansion Act -Foster - Substance Use Disorder H.R. 8623 - SAVE for Seniors Act - Spanberger - Medicare coverage of COVID-19 vaccines H.R. 8624 - Protecting Access to Innovation During COVID-19 Act - Wenstrup - extension of pass-through status under the Medicare program H.R. 8702 - Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020 -Bera - part B Medicare payments during COVID H.R. 8725 - HAPI Act - Soto - Medicaid Coverage of adult vaccines H.R. 8727 - Telehealth Modernization Act - Carter - Medicare telehealth payments H.R. 8755 - Expanded Telehealth Access Act -Sherrill - Medicare telehealth coverage H.R. 8756 - COVID Health Care Provider Assurance Act of 2020 - Riggleman - Medicare Part B payments during COVID-19 H.R. 8826 - The Resetting the Impact Act (TRIA) of 2020 - Sewell - amends the IMPACT Act of 2014 H.R. 8840 - Medicare Sequester COVID Moratorium Act - Schneider - extend temporary Medicare sequestration H.R. 8871 - COVID HCBS Relief Act of 2020 - Dingell - funding for state Medicaid programs HCBS H.R. 8934 - Community Integration Act of 2020 - Cartwright - Medicaid HCBS H.R. 8958 - Supporting Best Practices for Healthy Moms Act - Kelly - guidance for state Medicaid programs on maternal health H.R. 9002 - To amend title XIX of the Social Security Act to provide States an option to cover a children's program of all-inclusive coordinated care (ChiPACC) under Medicaid program - DeGette - Childrens health under Medicaid H.R. 9006 - To amend title XIX of the Social Security Act to provide for coverage under the Medicaid program under such title of routine patient costs associated with participation in certain clinical trials - Garcia - Medicaid coverage of clinical trials H.R. 9035 - Permanency for Audio-Only Telehealth Act - Smith - Audio only telehealth in Medicare 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. 3013 - Encouraging Innovative Benefit Design to Lower Costs for Seniors Act - Crapo - offer additional prescription drugs under Part D S. 3220 - Ensuring Access to Direct Support Professionals Act - Portman - Medicaid coverage in acute care hospitals S. 3238 - Preventive Home Visit Act - King - preventative home visits S. 3277 - HCBS Infrastructure Improvement Act - Casey - access to community based services S. 3353 - Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act of 2020 - Cassidy - Medicare coverage of kidney transplant services S. 3384 - Lowering Prescription Drug Prices for America's Seniors and Families Act of 2020 - McSally - Medicare Part D drug pricing negotiation S. 3399 - FCHIP Extension Act - Tester - rural health S. 3442 - Care for COVID-19 Act - Booker - COVID-19 cost sharing S. 3443 - Improving Coverage and Care for Mothers Act - Casey - Medicaid coverage for all pregnant and postpartum women S. 3447 - RUSH Act of 2020 - Thune - Medicare coverage for certain services in hospital emergency departments S. 3466 - ACCESS for Biosimilars Act of 2020 - McSally - eliminates cost sharing for biosimilar biological products furnished under part B of the Medicare program S. 3615 - Rural Community Hospital Demonstration Extension Act of 2020 - Murkowski - rural community hospital demonstration program S. 3665 - Save Rural Hospitals Act of 2020 - Alexander - Medicare hospital payments S. 3750 - Medicare Accelerated and Advance Payments Improvement Act of 2020 - Shaheen - COVID S. 3881 - CHIPPER Act - Casey - CHIP, COVID S. 3998 - HEALTH Act of 2020 - Hyde-Smith - telehealth S. 3999 - Mental and Behavioral Health Connectivity Act - King - Mental Health S. 4108 - A bill to amend title XIX of the Social Security Act to increase Federal support to State Medicaid programs during economic downturns - Casey - FMAP S. 4151 - SOS: Sustaining Outpatient Services Act - Hoeven - Medicare OPPS coverage S. 4230 - Telehealth Expansion Act of 2020 - Wyden - Telehealth mental health services in Medicare S. 4274 - Legalizing Drug Discounts for Seniors Act of 2020 - Paul - exclude discounts for covered part D drugs from the anti-kickback prohibition S. 4295 - Public Health Emergency Pass-Through Payment Fairness Act of 2020 - Paul - access to drugs and devices under Medicare S. 4358 - Stronger Medicaid Response to the COVID-19 Pandemic Act - Bennet - Medicaid coverage for vaccines and treatment for COVID-19 for uninsured without cost-sharing S. 4375 - Telehealth Modernization Act - Alexander - make permanent Medicare telehealth flexibilities S. 4423 - COVID-19 Hospice Respite Care Relief Act of 2020 - Brown - Medicare hospice care S. 4448- Fair Drug Prices for Kids Act - Warner - extend Medicaid drug rebate program to CHIP S. 4574 - Bringing Enhanced Treatments and Therapies to ESRD Recipients Kidney Care Act - Young - integrated care for Medicare beneficiaries with ESRD S. 4690 - Maternal Immunization Enhancement Act - Hassan - Medicaid and maternal health S. 4705 - Maternal Immunization Coverage Act - Cassidy - Medicaid coverage S. 4717 - Accelerating Kids Access to Care Act - Grassley - Medicaid enrollment S. 4742 - CLINICAL TREATMENT Act - Burr - Medicaid coverage S. 4825 - Ensuring Access to COVID-19 Vaccines for Seniors Act - Reed - Medicare coverage of COVID-19 vaccines S. 4840 - Ensuring Parity in MA for Audio-Only Telehealth Act of 2020 -Roberts - audio-only risk adjustment in Medicare Advantage S. 4859 - Connected MOM Act - Cassidy - expanded coverage of remote physiologic devices and related services under Medicaid S. 4864 - HAPI Act - Brown - Medicaid coverage of adult vaccines S. 4944 - Equality in Medicare and Medicaid Treatment Act of 2020 - Booker - CMMI models for SDOH in Medicare/Medicaid S. 4949 - Supporting Best Practices for Healthy Moms Act - Toomey - guidance for state Medicaid programs on maternal health S. 4957 - COVID HCBS Relief Act of 2020 - Casey - funding for state Medicaid programs HCBS S. 5007 - Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020 - Boozman - increase in Medicare part B payment S. 5044 - Bill to amend title XVIII of the SSA to establish requirement with respect to the use of prior authorization under the Medicare Advantage plans - Brown - Prior authorization S. 5077 - A bill to amend title XIX of the Social Security Act to adjust the limitations on Medicaid disproportionate share hospital payments - Cornyn - Medicaid DSH 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 2022 Rate Notice; Executive Orders relating to international pricing, Part D rebates, insulin costs, and importation; issues related to MLTSS; issues related to removal of safe harbor protection for rebates; issues relating to COVID-19, including testing; issues related to audio-only telehealth; issues related to addressing the social determinants of health, including housing, transportation, nutrition, and educational opportunities; issues related to Medicaid presumptive eligibility and continuous eligibility; issues relating to Medicaid best price; in-home health risk assessments; Medicare Medical Loss Ratio issues; issues related to changes to prior authorization regulations, electronic documentation, and related issues; issues relating to sequestration under the Medicare Advantage and Part D programs; issues related to health insurance tax for MA and Part D plans; implications of physician fee schedule on MA; 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 health plan models; 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.
2020 · fourth_quarter · Health Issues
H.R.133 - Consolidated Appropriations Act, 2021 H.R.4932/S. 2741 - Creating Opportunities Now for the Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019 H.R. 7190 - Increasing Rural Health Access During the COVID-19 Public Health Emergency Act of 2020 H.R.8723 - To condition receipt of State funding from the Bureau of Health Workforce on adoption by the State of the Interstate Medical Licensure Compact, and for other purposes H.R. 8861 - Promoting Responsible and Effective Virtual Experiences through Novel Technology to Deliver Improved Access and Better Engagement with Tested and Evidence-Based Strategies (PREVENT DIABETES) Act S 4375 - Telehealth Modernization Act CY 2021 Physician Fee Schedule Final Rule The Anti-Kickback Statute and Stark Law Regulatory Relief To Support Economic Recovery
Client expense: $80,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2020 · fourth_quarter · Medicare/Medicaid
CY 2021 Physician Fee Schedule Final Rule S 4375 - Telehealth Modernization Act Regulatory Relief To Support Economic Recovery
Client expense: $80,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
| Republican |
| TN |
| Roger F. Wicker | Republican | MS |
| Susan M. Collins | Republican | ME |
Client expense: $2,400,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Council of Economic Advisers (CEA), Executive Office of the President (EOP), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of the Vice President of the United States, SENATE, Treasury, Dept of, White House Office
2020 · fourth_quarter · Health Issues
Issues related to Healthcare IT; COVID 19 related issues; HR7948 - Tribal Health Data Improvement Act of 2020; HR 6561 - Improving Social Determinants of Health Act of 2020; S.4375 - Telehealth Modernization Act; H.R.6561 - Improving Social Determinants of Health Act of 2020
Client expense: $140,000 · Firm income: Not reported
Government targets: Defense, Dept of (DOD), HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA)
2020 · fourth_quarter · Medicare/Medicaid
H.R. 8840, Medicare Sequester COVID Moratorium Act, all provisions H.R. 8702, Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020, all provisions S. 5007, Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020, all provisions H.R. 7154, Outpatient Therapy Modernization and Stabilization Act, all provisions H.R. 3107, Improving Seniors Timely Access to Care Act of 2019, all provisions S. 5044, Improving Seniors Timely Access to Care Act of 2020y, all provisions H.R. 8727, Telehealth Modernization Act, all provisions S. 4375, Telehealth Modernization Act, all provisions H.R. 7663, Protecting Access to Post-COVID-19 Telehealth Act of 2020, all provisions H.R. 7391, Protect Telehealth Access Act of 2020, all provisions H.R. 1301, Mental Health Telemedicine Expansion Act, all provisions H.R. 3417, Beneficiary Education Tools, Telehealth, and Extenders Reauthorization (BETTER) Act of 2019, all provisions H.R. 5201, Telemental Health Expansion Act of 2020, provisions relating to 1834(m) of the Social Security Act; geographic and originating sites H.R. 7233, Knowing the Efficiency and Efficacy of Permanent (KEEP) Telehealth Options Act of 2020, all provisions H.R. 5172, Non-Opioids Prevent Addiction In the Nation (NOPAIN) Act, All provisions S. 3067, Non-Opioids Prevent Addiction In the Nation (NOPAIN) Act, All provisions H.R. 3414, Opioid Workforce Act of 2019, all provisions H.R. 7791, Value in Health Care Act of 2020, provisions relating to qualifying APM physician thresholds H.R. 6837, Medicare Accelerated and Advance Payments Improvement Act of 2020, all provisions S. 3750, Medicare Accelerated and Advance Payments Improvement Act, all provisions H.R. 8505, To amend title XVIII of the Social Security Act to provide for a one-year waiver of budget neutrality adjustments under the Medicare physician fee schedule, and for other purposes, all provisions H.R. 884, Medicare Mental Health Access Act, all provisions H.R. 945, Mental Health Access Improvement Act of 2019, all provisions H.R. 6744, Medically Tailored Home-Delivered Meals Demonstration Pilot Act of 2020, all provisions H.R. 4004, Social Determinants Accelerator Act of 2019, all provisions H.R. 4932, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019, all provisions S. 2741, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019, all provisions H.R. 5534, Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act of 2020, all provisions S. 3353, Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act of 2020, all provisions H.R. 3, Elijah E. Cummings Lower Drug Costs Now Act, provisions related to PBM and prescription drug price transparency H.R. 19, Lower Costs, More Cures Act of 2019, provisions related to PBM and prescription drug price transparency H.R. 4996, Helping Medicaid Offer Maternity Services (MOMS) Act of 2020, all provisions H.R. 6090, Physician Shortage GME Cap Flex Act of 2020, all provisions H.R. 6142, Black Maternal Health Momnibus Act of 2020, all provisions Medicare program: P.L. 114-10 Medicare Access and CHIP Reauthorization Act (MACRA) implementation/Accountable Care Organizations/APM thresholds Medicare program: Patient Protection and Affordable Care Act (PPACA)/Prior authorization provider and patient burdens/patient electronic access to health information Medicare program: P.L. 113-93 Protecting Access to Medicare Act (PAMA)/Imaging appropriate use criteria/Radiation Oncology APM Medicare program: FY 2021 Inpatient Rehab Facility Prospective Payment System (IRF PPS)/scope of practice issues Medicare program: CY 2021 physician fee schedule/E&M services/Budget neutrality/Part B/Sequester Medicare program: Alternative payment models (APMs) Medicare program: Merit-based Incentive Payment System (MIPS)/cost/quality/interoperability/hardship exemption Medicare program: Regulatory relief/Advanced APMs, prior authorization, and utilization management Medicare program: Shared Savings Program Medicare program: Quality Payment Program/prior authorization/electronic funds transfer Medicare program: Surprise medical billing Medicare program: Medicare-For-All Medicare program: Electronic Health Records (EHR) Certification Medicare program: 21st Century Cures Act Medicare program: Quality payment program/physician burdens Medicare program: National Coverage determination/validated home blood pressure monitors Medicare program: Health IT/physician burden Medicare program: Drug pricing Medicare program: Most favored nation drug pricing Medicare program: Provider compliance/regulatory relief Medicare program: Provider Enrollment, Chain and Ownership (PECOS) enrollment/revalidation Medicare and Medicaid programs: 21st Century Cures Act/health data and privacy Medicaid program: CMS proposed regulation Medicaid Program Medicaid program: FMAP increases Medicaid program: Interoperability
Client expense: $4,170,000 · Firm income: Not reported
Government targets: Agriculture, Dept of (USDA), Bureau of Citizenship & Immigration Services (BCIS), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), SENATE, Veterans Affairs, Dept of (VA), White House Office
2020 · fourth_quarter · Medicare/Medicaid
No bill: Support inclusion of occupational therapy services via telehealth under Medicare Part B, Medicare Advantage and any demonstration programs such as telehealth within accountable care organizations. HR 3127/S 1725 - The Home Health Flexibility Act: Support the ability of occupational therapists to conduct the initial and comprehensive assessments for Medicare Home Health cases. No bill: Support for Congressional attention to the issue of falls related injuries and falls prevention. HR 4932/S 2741 - CONNECT for Health Act of 2019: Support expanded coverage for services provided to Medicare patients via telehealth, including occupational therapy and other therapy services. HR 1329 - Medicaid Reentry Act (mental health and Medicaid policy): Support passage S 1754/HR 3215 - The Disaster Relief Medicaid Act (DRMA): Support passage No bill: Support for Medicare payment for evidence-based programs, led by occupational therapists, that support caregivers for people with dementia. No bill: Support for Medicare payment for evidence-based programs, led by occupational therapists, to support aging in place. S 1202 - Independence At Home Act: support passage HR 7154 - Outpatient Therapy Modernization and Stabilization Act: Support passage. HR 6634 - Emergency COVID Telehealth Response Act: Support introduction and passage. S. 4375/HR 8727 - Telehealth Modernization Act: Advocate for provisions that would allow the Secretary of Health and Human Services to permanently add occupational therapy practitioners to the Medicare telehealth benefit. Support passage. Support various House and Senate proposals to extend and make permanent the Public Health Emergency provisions that enable occupational therapists to provide services to Medicare patients via telehealth. HR 8755-Expanded Telehealth Access Act: Support passage of bill that would allow occupational therapists and other therapists to provide services to Medicare Part B Patients via telehealth after public health emergency ends. S 4343/HR 8581-Triple A Study Bill: advocate to add occupational therapists to list of providers included in legislation mandating study of amputee healthcare. H.R. 133 - Consolidated Appropriations Act of 2021, Division CC Section 115: Advocate to permit occupational therapists to conduct the initial assessment visit and complete the comprehensive assessment with respect to certain rehabilitation services for home health agencies under the Medicare Part B program. HR 8702/S. 5007 - Holding Providers Harmless from Medicare Cuts During COVID-19 Act of 2020; Division CC Section 113 of HR 133-Consolidated Appropriations Act, 2021; and HR 8505-a bill to provide a one year waiver of budget neutrality under the Medicare physician fee schedule: Advocate for changes to evaluation and management coding redistribution in Revisions to Payment Policies under the Medicare Physician Fee Schedule, Quality Payment Program and Other Revisions to Part B for CY 2021 (CMS-1734-F). No bill: Advocated to pause Medicare sequestration for 2021.
Client expense: $160,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2020 · fourth_quarter · Health Issues
General issues related to consumer health data privacy; Telehealth Modernization Act of 2020 (S. 4375); The Protecting Access to Post-COVID-19 Telehealth Act of 2020 (H.R. 7663); The Consolidated Appropriations Act, 2021 (HR 133), issues related to Medicare telehealth coverage
Client expense: Not reported · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2020 · fourth_quarter · Medicare/Medicaid
Support H.R.1265 &H.R.4468 - Nursing Home Workforce Quality Act- to end the mandatory certified nursing assistant training lock out. Support H.R.1343 Protecting Married Seniors from Impoverishment Act, to extend the Money Follows the Person Act and protection against impoverishment for spouses of Medicaid beneficiaries receiving long term services and supports at home. Support H.R.1342 - EMPOWER Care Act, to reauthorize Money Follows the Person for 5 years. Support H.R 1682/S. 753- Improving Access to Medicare Coverage Act of 2019, to solve the Medicare "observation days" issue by counting all time a beneficiary spends in a hospital toward the 3-day stay requirement for coverage of post-acute care. Support H.R 6698- Quality Care for Nursing Home Residents and Workers During COVID-19 Act Support H.R.2594/ S.1190 - Rural Access to Hospice Act of 2019 Support H.R 2150, Home Health Care Planning Improvement Act Support H.R.4063 - Medicare Adult Day Services Act of 2019 Support- H.R.748 - CARES Act Support H.R.5821 - HOSPICE Act Support S. 3544 Coronavirus Relief for Seniors and People with Disabilities Act of 2020 Support H.R. 6305 Coronavirus Relief for Seniors and People with Disabilities Act of 2020 Support H.R 8727/S.4375 Telehealth Modernization Act Support H.R 7663 Protecting Access to Post COVID-19 Telehealth Act of 2020
Client expense: $31,167 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2020 · fourth_quarter · Health Issues
Childcare Issues related to childcare - no specific bill COVID-19 Pandemic H.R. 6800 - Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act S. 3599/H.R.6788 - Healthcare Workforce Resilience Act H.R. 6793 - Pandemic Production Act H.R. 266 - Paycheck Protection Program and Health Care Enhancement Act H.R.7010 - Paycheck Protection Program Flexibility Act of 2020 H.R.6720 - Student Loan Forgiveness for Frontline Health Workers Act H.R. 7059 - Coronavirus Provider Protection Act H.R. 748 - The Coronavirus Aid, Relief, and Economic Security Act or the CARES Act Issues related to the COVID-19 Pandemic including: - no specific bill Financial assistance for health care providers Medicare Accelerated and Advance Payment Program Medicare and Medicaid payment rates Federal Medicaid Match Liability protection for health care providers Demographic data for the COVID-19 response Access to personal protective equipment (PPE) and medical supplies PPE supply chain improvements Access to testing for COVID-19 Telemedicine/telehealth Small Business Administration loans Support for contact tracing programs Mental and behavioral health Support for programs addressing domestic violence and child maltreatment Support for resident physicians and medical students Student loan forgiveness/debt relief State and local funding General advocacy on a COVID-19 stimulus/relief package FMAP increase in the Families First Coronavirus Response Act (P.L. 116-127) H.R.6793, the Pandemic Production Act (PPA) S.4349/ H.R.8094, the Dr. Lorna Breen Health Care Provider Protection Act H.R.7819 - Eliminating the Provider Relief Fund Tax Penalties Act of 2020 H.R. 8702 Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020 S. 5082 - Expanding COVID-19 Testing Capacity Act of 2020 H.R. 133 - Consolidated Appropriations Act, 2021 Immigration Public Charge - no specific bill S. 948/H.R. 2895, Conrad State 30 and Physician Access Reauthorization Act S. 3599/H.R. 6788 - the Healthcare Workforce Resilience Act Interoperability/ONC Issues related to interoperability - no specific bill Medicare/Medicaid The Medicare Access and CHIP Reauthorization Act (MACRA) Medicaid Fiscal Accountability regulation Block Grants - no specific bill Issues related to Medicare Physician Payments H.R. 133 - Consolidated Appropriations Act, 2021 Prior Authorization - no specific bill Publications Open access to information based on publicly funded research OSTP Request for Information - FR Doc. 2020-06622 - Public Access to Peer-Reviewed Scholarly Publications, Data and Code Resulting From Federally Funded Research Issues related to scholarly and scientific publishing and public access H.R. 133 - Consolidated Appropriations Act, 2021 Racial Justice/Health Equity Issues related to racial justice/health care equity - no specific bill Scope of Practice - no specific bill Surprise Billing S. 1895 - Lower Health Care Costs Act H.R. 3630 - No Surprises Act S 1531 - Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019 Consumer Protections Against Surprise Medical Bills Act of 2020 - House Ways & Means Issues related to surprise medical billing/out-of-network medical billing No Surprises Act (compromise legislative proposal between House Ways & Means, Energy & Commerce, Education & Labor Committees and Senate HELP committee - no specific bill number) H.R. 133 - Consolidated Appropriations Act, 2021 Telehealth S. 4375, the Telehealth Modernization Act of 2020 Issues related to telehealth - no specific bill Vaccines Issues related to vaccines - no specific bill Regulatory Comments Revisions to Payment Policies under the Medicare Physician Fee Schedule, Quality Payment Program and Other Revisions to Part B for CY 2021
Client expense: $50,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Office of Science & Technology Policy (OSTP), SENATE
2020 · fourth_quarter · Medicare/Medicaid
Childcare Issues related to childcare - no specific bill COVID-19 Pandemic H.R. 6800 - Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act S. 3599/H.R.6788 - Healthcare Workforce Resilience Act H.R. 6793 - Pandemic Production Act H.R. 266 - Paycheck Protection Program and Health Care Enhancement Act H.R.7010 - Paycheck Protection Program Flexibility Act of 2020 H.R.6720 - Student Loan Forgiveness for Frontline Health Workers Act H.R. 7059 - Coronavirus Provider Protection Act H.R. 748 - The Coronavirus Aid, Relief, and Economic Security Act or the CARES Act Issues related to the COVID-19 Pandemic including: - no specific bill Financial assistance for health care providers Medicare Accelerated and Advance Payment Program Medicare and Medicaid payment rates Federal Medicaid Match Liability protection for health care providers Demographic data for the COVID-19 response Access to personal protective equipment (PPE) and medical supplies PPE supply chain improvements Access to testing for COVID-19 Telemedicine/telehealth Small Business Administration loans Support for contact tracing programs Mental and behavioral health Support for programs addressing domestic violence and child maltreatment Support for resident physicians and medical students Student loan forgiveness/debt relief State and local funding General advocacy on a COVID-19 stimulus/relief package FMAP increase in the Families First Coronavirus Response Act (P.L. 116-127) H.R.6793, the Pandemic Production Act (PPA) S.4349/ H.R.8094, the Dr. Lorna Breen Health Care Provider Protection Act H.R.7819 - Eliminating the Provider Relief Fund Tax Penalties Act of 2020 H.R. 8702 Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020 S. 5082 - Expanding COVID-19 Testing Capacity Act of 2020 H.R. 133 - Consolidated Appropriations Act, 2021 Immigration Public Charge - no specific bill S. 948/H.R. 2895, Conrad State 30 and Physician Access Reauthorization Act S. 3599/H.R. 6788 - the Healthcare Workforce Resilience Act Interoperability/ONC Issues related to interoperability - no specific bill Medicare/Medicaid The Medicare Access and CHIP Reauthorization Act (MACRA) Medicaid Fiscal Accountability regulation Block Grants - no specific bill Issues related to Medicare Physician Payments H.R. 133 - Consolidated Appropriations Act, 2021 Prior Authorization - no specific bill Publications Open access to information based on publicly funded research OSTP Request for Information - FR Doc. 2020-06622 - Public Access to Peer-Reviewed Scholarly Publications, Data and Code Resulting From Federally Funded Research Issues related to scholarly and scientific publishing and public access H.R. 133 - Consolidated Appropriations Act, 2021 Racial Justice/Health Equity Issues related to racial justice/health care equity - no specific bill Scope of Practice - no specific bill Surprise Billing S. 1895 - Lower Health Care Costs Act H.R. 3630 - No Surprises Act S 1531 - Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019 Consumer Protections Against Surprise Medical Bills Act of 2020 - House Ways & Means Issues related to surprise medical billing/out-of-network medical billing No Surprises Act (compromise legislative proposal between House Ways & Means, Energy & Commerce, Education & Labor Committees and Senate HELP committee - no specific bill number) H.R. 133 - Consolidated Appropriations Act, 2021 Telehealth S. 4375, the Telehealth Modernization Act of 2020 Issues related to telehealth - no specific bill Vaccines Issues related to vaccines - no specific bill Regulatory Comments Revisions to Payment Policies under the Medicare Physician Fee Schedule, Quality Payment Program and Other Revisions to Part B for CY 2021
Client expense: $50,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Office of Science & Technology Policy (OSTP), SENATE
2020 · fourth_quarter · Health Issues
S. 4375 / H.R. 4832; The WEAR IT Act (draft legislation to update Flex Spending Account / Health Savings Account statutes).
Client expense: $10,000 · Firm income: Not reported
Government targets: Federal Communications Commission (FCC), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2020 · fourth_quarter · Health Issues
-CARES Act Provider Relief Fund Distributions. -Regulatory Relief to Support Economic Recovery. -Request for Information (RFI) Telehealth Flexibilities. .HR 133 Consolidated Omnibus Appropriations Act or 2021 and COVID-19 Relief. -COVID 19 public health, vaccines, testing, provider relief, paycheck protection program. -Program Extensions for: Community Health Centers, National Health Service Corps and the Teaching Health Center Graduate Medical Education Program, and the No Surprises Act. -S 4375/HR 8727 The Telehealth Modernization Act. -HR 6800 The Heroes Act COVID-19 Response. -HR 2328 No Surprises Act. -HR 3502 Protecting People from Surprise Medical Bills Act. -HR 5826 Consumer Protections from Surprise Medical Bills Act of 2020. -S 1531 Stop Surprise Medical Bills Act. -HR 3107 Seniors Timely Access to Care Act. -HR 4607 Stopping Doctor Shortages Act. -S 3746 Stopping Doctor Shortages Act. -Public Health Issues.
Client expense: $50,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2020 · third_quarter · Medicare/Medicaid
Telehealth coverage and reimbursement; H.R. 7663, Protecting Access to Post-COVID-19 Telehealth Act; S. 4375, Telehealth Modernization Act.
Client expense: Not reported · Firm income: $75,000
Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2020 · third_quarter · Health Issues
General issues related to consumer health data privacy; Telehealth Modernization Act of 2020 (S. 4375); The Protecting Access to Post-COVID-19 Telehealth Act of 2020 (H.R. 7663)
Client expense: Not reported · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2020 · third_quarter · Medicare/Medicaid
H.R. 3107 - Improving Seniors' Timely Access to Care Act of 2019 - DelBene - prior authorization in Medicare Advantage 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. 4453 - Protecting Seniors from Health Care Fraud Act of 2019 - Ruiz -Distributing information to Medicare beneficiaries to prevent fraud 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. 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. 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. 4671 - Helping Seniors Afford Health Care Act - Kim - Medicare affordability and low income beneficiaries H.R. 4996 - Helping Medicaid Offer Maternity Services Act of 2020 - Kelly - extend Medicaid coverage post-partum H.R. 5006 - Expanding Access to Inpatient Mental Health Act - Emmer - Medicaid coverage for SUD/mental health for institutionalized 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. 5693 - Primary Health Services Enhancement Act - Kind - Medicare rural health H.R. 5808 - Save Rural Communities Act of 2020 - Arrington - rural emergency medical access services under Medicare H.R. 5833 - To amend title XVIII of the Social Security Act to permit the use of certain psychological evaluation via telehealth for Medicare coverage of neurostimulation services for the treatment of chronic pain - Latta - Medicare coverage in telehealth H.R. 5882 - GENE Therapy Payment Act - Schrader - value based care H.R. 6098 - To amend title XXI of the Social Security Act to allow States to expand income eligibility standards under the Children's Health Insurance Program -Barragan - CHIP eligibility H.R. 6151 - CARING for Kids Act - Fineknauer - CHIP H.R. 6179 - Increasing Access to Biosimilars Act of 2020 - Cardenas - payments to providers of biosimilars under Medicare H.R. 6209 - Reducing Unnecessary Senior Hospitalizations Act of 2020 or the RUSH Act of 2020 -Kuster - Medicare coverage for certain services in hospital emergency departments H.R. 6244 - To amend titles XVIII and XIX to provide for coverage at no cost sharing of COVID-19 testing under the Medicaid program and Children's Health Insurance Program - Kelly - Medicaid coverage of COVID-19 related visits and testing H.R. 6263 - To amend title XVIII of the Social Security Act to waive cost sharing under the Medicare program for certain visits relating to testing for COVID-19 -Sarbanes - Medicare coverage of COVID-19 related visits and testing H.R. 6273 - Protecting Vulnerable Americans in Times of Crisis Act of 2020 - Butterfield - FMAP H.R. 6311 - Care for COVID-19 Act - Ruiz - COVID-19 cost sharing H.R. 6336 - Increasing Hospital Capacity to Fight the Coronavirus Act of 2020 - Bishop - Medicare and Medicaid payments during COVID-19 emergency H.R. 6462 - Emergency Medicaid for Coronavirus Treatment Act - Gallego - Medicaid coverage H.R. 6511 - Ensuring Vaccination and Treatment Affordability Act - Pappas - COVID H.R. 6521 - To prohibit the Secretary of Health and Human Services from taking certain actions with respect to Medicaid supplemental payments reporting requirements, and for other purposes - Diaz Barragan - Medicaid, delays implementation of MFAR H.R. 6538 - Modernized Medicine Act - Kennedy - Medicaid, Telehealth H.R. 6539 - Coronavirus Medicaid Response Act - Lee - FMAP H.R. 6572 - To direct the Secretary of Health and Human Services, acting through the Director of the Centers for Disease Control and Prevention, to carry out a national campaign to increase awareness and knowledge of COVID-19. -Bilirakis - COVID H.R. 6583 - To amend title XVIII of the Social Security Act to establish a risk corridor program for Medicare Advantage plans during the COVID-19 emergency, and for other purposes. - Houlahan - COVID H.R. 6616 - Stronger Medicaid Response to the COVID-19 Pandemic Act -Cardenas - COVID H.R. 6640 - Medicare Advantage COVID Treatment Act - Mucarsel-Powell - COVID H.R. 6658 - Insular Area Medicaid Coronavirus Recovery Act - Sablan - FMAP H.R. 6727 - To hold Medicare beneficiaries harmless for specified COVID-19 treatment services furnished under part A or part B of the Medicare program - Schrier - COVID H.R. 6744 - Computer and Internet Equity Act - Davis - internet access for Lifeline program H.R. 6753 - Save Rural Hospitals Act of 2020 - Finkenauer - Medicare hospital payments H.R. 6792 - Improving Telehealth for Underserved Communities Act of 2020 - Smith - telehealth H.R. 6797 - CHIPPER Act - Wild - CHIP, COVID H.R. 6837 - Medicare Accelerated and Advance Payments Improvement Act of 2020 -Schneider - COVID H.R. 7154 - Outpatient Therapy Modernization and Stabilization Act -Boyle - outpatient therapy services H.R. 7187 - HEALTH Act of 2020 -Thompson -Smith - telehealth H.R. 7292 - To amend title XVIII of the Social Security Act to provide for forgiveness of certain accelerated and advance payments under parts A and B of the Medicare program. - Kaptur - advance payments H.R. 7338 - To amend title XVIII of the Social Security Act to permit the Secretary of Health and Human Services to waive requirements relating to the furnishing of telehealth services under the Medicare program, and for other purposes. - Cheney - Telehealth H.R. 7391 - To amend title XVIII of the Social Security Act to remove certain geographic and originating site restrictions on the furnishing of telehealth services under the Medicare program - Sherrill- Telehealth H.R. 7606 - MFAR Transparency Act - Williams - report on impact of MFAR to Congress H.R. 7627 - MORE Savings Act - Dean - Medicare access to opioid treatment and MAT H.R. 7663 - Protecting Access to Post-COVID-19 Telehealth Act of 2020 - Thompson - waive or modify application of Medicare requirements with respect to telehealth during PHE H.R. 7791 - Value in Health Care Act of 2020 - Welch - Medicare shared savings program and alternative payment arrangements H.R. 7877 - Lowering Drug Costs for Seniors Act of 2020 - Katko - Medicare Part D costs H.R. 7892 - Medicaid Expansion During Crisis Act - Coleman - extend eligibility period for Medicaid enrollment application H.R. 8177 - Renal Anemia Innovation Support and Expansion Act - OHalleran - Medicare prescription drug coverage for chronic kidney disease H.R. 8218 - Rural Ambulance Reimbursement Fairness Act - Gianforte - Medicare payment for rural ambulance services H.R. 8254 - Bringing Enhanced Treatments and Therapies to ESRD Recipients Kidney Care Act - Blumenauer - integrated care for Medicare beneficiaries with ESRD H.R. 8427 - To provide for certain reports on enrollment in the Lifeline program, and for other purposes - Luria - Lifeline program 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. 3013 - Encouraging Innovative Benefit Design to Lower Costs for Seniors Act - Crapo - offer additional prescription drugs under Part D S. 3220 - Ensuring Access to Direct Support Professionals Act - Portman - Medicaid coverage in acute care hospitals S. 3238 - Preventive Home Visit Act - King - preventative home visits S. 3277 - HCBS Infrastructure Improvement Act - Casey - access to community based services S. 3353 - Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act of 2020 - Cassidy - Medicare coverage of kidney transplant services S. 3384 - Lowering Prescription Drug Prices for America's Seniors and Families Act of 2020 - McSally - Medicare Part D drug pricing negotiation S. 3399 - FCHIP Extension Act - Tester - rural health S. 3442 - Care for COVID-19 Act - Booker - COVID-19 cost sharing S. 3443 - Improving Coverage and Care for Mothers Act - Casey - Medicaid coverage for all pregnant and postpartum women S. 3447 - RUSH Act of 2020 - Thune - Medicare coverage for certain services in hospital emergency departments S. 3466 - ACCESS for Biosimilars Act of 2020 - McSally - eliminates cost sharing for biosimilar biological products furnished under part B of the Medicare program S. 3615 - Rural Community Hospital Demonstration Extension Act of 2020 - Murkowski - rural community hospital demonstration program S. 3665 - Save Rural Hospitals Act of 2020 - Alexander - Medicare hospital payments S. 3750 - Medicare Accelerated and Advance Payments Improvement Act of 2020 - Shaheen - COVID S. 3881 - CHIPPER Act - Casey - CHIP, COVID S. 3998 - HEALTH Act of 2020 - Hyde-Smith - telehealth S. 3999 - Mental and Behavioral Health Connectivity Act - King - Mental Health S. 4108 - A bill to amend title XIX of the Social Security Act to increase Federal support to State Medicaid programs during economic downturns - Casey - FMAP S. 4151 - SOS: Sustaining Outpatient Services Act - Hoeven - Medicare OPPS coverage S. 4230 - Telehealth Expansion Act of 2020 - Wyden - Telehealth mental health services in Medicare S. 4274 - Legalizing Drug Discounts for Seniors Act of 2020 - Paul - exclude discounts for covered part D drugs from the anti-kickback prohibition S. 4295 - Public Health Emergency Pass-Through Payment Fairness Act of 2020 - Paul - access to drugs and devices under Medicare S. 4358 - Stronger Medicaid Response to the COVID-19 Pandemic Act - Bennet - Medicaid coverage for vaccines and treatment for COVID-19 for uninsured without cost-sharing S. 4375 - Telehealth Modernization Act - Alexander - make permanent Medicare telehealth flexibilities S. 4423 - COVID-19 Hospice Respite Care Relief Act of 2020 - Brown - Medicare hospice care S. 4448 - Fair Drug Prices for Kids Act - Warner - extend Medicaid drug rebate program to CHIP S. 4574 - Bringing Enhanced Treatments and Therapies to ESRD Recipients Kidney Care Act - Young - integrated care for Medicare beneficiaries with ESRD S. 4690 - A bill to increase vaccination rates among pregnant women enrolled in Medicaid or CHIP, and for other purposes - Hassan - Medicaid and maternal health S. 4705 - A bill to amend title XIX requiring coverage under Medicaid of vaccines for pregnant women - Cassidy - Medicaid coverage S. 4717 - A bill to amend title XIX of the Social Security Act to streamline enrollment of certain Medicaid providers across State lines, and for other purposes - Grassley - Medicaid enrollment S. 4742 - A bill to amend title XIX of the Social Security Act to promote access to life-saving therapies for Medicaid enrollees by ensuring coverage of routine patient costs for items and services furnished in connection with participation in qualifying clinical trials, and for other purposes - Burr - Medicaid coverage 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 2022 Rate Notice; Executive Orders relating to international pricing, Part D rebates, insulin costs, and importation; issues related to MLTSS; issues related to proposed changes to removal of safe harbor protection for rebates (proposed rule); issues relating to COVID-19, including testing; issues related to audio-only telehealth; issues related to addressing the social determinants of health, including housing, transportation, nutrition, and educational opportunities; issues related to Medicaid presumptive eligibility and continuous eligibility; issues relating to Medicaid best price; 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: $2,230,000 · Firm income: Not reported
Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE, Treasury, Dept of, White House Office
2020 · third_quarter · Health Issues
S. 4375 / H.R. 4832; The WEAR IT Act (draft legislation to update Flex Spending Account / Health Savings Account statutes).
Client expense: $23,000 · Firm income: Not reported
Government targets: Federal Communications Commission (FCC), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2020 · third_quarter · Medicare/Medicaid
H.R. 5201, Telemental Health Expansion Act of 2019, provisions relating to 1834(m) of the Social Security Act; geographic and originating sites H.R. 3417, Beneficiary Education Tools, Telehealth, and Extenders Reauthorization (BETTER) Act of 2019, all provisions H.R. 7391, Protect Telehealth Access Act of 2020, all provisions H.R. 7233, KEEP Telehealth Options Act of 2020, all provisions H.R. 7663, Protecting Access to Post-COVID-19 Telehealth Act of 2020, all provisions S. 4375, Telehealth Modernization Act, all provisions H.R. 1301, Mental Health Telemedicine Expansion Act, all provisions H.R. 3, Elijah E. Cummings Lower Drug Costs Now Act, all provisions H.R. 19, Lower Costs, More Cures Act of 2019, all provisions H.R. 3414, Opioid Workforce Act of 2019, all provisions H.R. 7791, Value in Health Care Act of 2020, all provisions H.R. 3107, Improving Seniors' Timely Access to Care Act of 2019, all provisions H.R. 6379, Take Responsibility for Workers and Families Act, provisions related to Medicare and Medicaid H.R. 6837, Medicare Accelerated and Advance Payments Improvement Act of 2020, all provisions S. 3750, Medicare Accelerated and Advance Payments Improvement Act of 2020, all provisions H.R. 7154, Outpatient Therapy Modernization and Stabilization Act, all provisions H.R. 6585, Equitable Data Collection and Disclosure on COVID-19 Act, all provisions H.R. 884, Medicare Mental Health Access Act, all provisions S. 2772, Medicare Mental Health Access Act, all provisions H.R. 945, Mental Health Access Improvement Act of 2019, all provisions H.R. 1763, Resident Physician Shortage Reduction Act of 2019, all provisions H.R. 6774, Medically Tailored Home-Delivered Meals Demonstration Pilot Act of 2020, all provisions H.R. 4004, Social Determinants Accelerator Act of 2019, all provisions H.R. 4996, Helping Medicaid Offer Maternity Services (MOMS) Act of 2020, all provisions H.R. 6090, Physician Shortage GME Cap Flex Act of 2020, all provisions H.R. 913, CLINICAL TREATMENT Act, all provisions H.R. 4932, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019, all provisions S, 2741, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019, all provisions Medicare program: P.L. 113-93 Protecting Access to Medicare Act (PAMA), provisions relating to imaging appropriate use criteria Medicare program: Sequester exemption Medicare program: Laboratory developed tests for COVID-19/coverage Medicare program: Medicare for All Medicare program: CY 2021 Medicare Physician Fee Schedule/E&M/Budget Neutrality Medicare program: Inpatient Rehab Facility/Prospective Payment System (IRF/PPS)/Scope issues Medicare program: Public Health Emergency/Scope and licensure waivers sunset Medicare program: Medicare Advanced Payment Program improvements Medicare program: Regulatory Relief/Advanced Alternative Payment Models (APMs)/Prior authorization and utilization management Medicare program: Merit-based Incentive Payment System (MIPS)/Quality/cost/improvement activity/interoperability Medicare program: Program integrity Medicare program: Interoperability and data blocking Medicare program: Quality Payment Program/physician burdens Medicare program: Health IT physician burdens Medicare program: Open Payments Medicare program: PECOS Enrollment/Revalidation Medicare program: Graduate Medical Education/cap flexibility Medicare program: Diabetes Prevention Program Medicare program: MACRA/Alternative Payment Model (APM) bonus payments Medicare program: MACRA/radiation oncology payments Medicare program: Accelerated and Advance Payment Program/physician relief Medicare and Medicaid programs: Medicare Provider Relief Fund extension Medicare and Medicaid programs: 21st Century Cures Act/health data and privacy Medicare and Medicaid program: Electronic health record (EHR) certification Medicare and Medicaid programs: P.L. 114-10 Medicare Access and CHIP Reauthorization Act (MACRA) Medicare and Medicaid programs: Accountable Care Organizations Medicare and Medicaid programs: Telehealth waivers Medicare and Medicaid programs: Qualifying APM Physician Thresholds Medicare and Medicaid programs: Opioid use disorder Medicare and Medicaid programs: Validated home blood pressure monitors/coverage Medicaid program: Federal Medical Assistance Percentages (FMAP) increases Medicaid program: Georgia's Section 1332 waiver
Client expense: $4,260,000 · Firm income: Not reported
Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Federal Trade Commission (FTC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Natl Institutes of Health (NIH), Office of Natl Drug Control Policy (NDCP), President of the U.S., SENATE, State, Dept of (DOS), U.S. Immigration & Customs Enforcement (ICE), Veterans Affairs, Dept of (VA), White House Office
2020 · third_quarter · Medicare/Medicaid
No bill: Support inclusion of occupational therapy services via telehealth under Medicare Part B, Medicare Advantage and any demonstration programs such as telehealth within accountable care organizations. HR 3127/S 1725 - The Home Health Flexibility Act: Support the ability of occupational therapists to conduct the initial and comprehensive assessments for Medicare Home Health cases. S 518/HR 1948 - Lymphedema Treatment Act - Support passage. No bill: Advocate for Congressional oversight of new Medicare payment models - PDPM & PDGM. No bill: Support for Congressional attention to the issue of falls related injuries and falls prevention. No bill: Advocated to stop proposed cuts to therapy services in the 2021 Physician Fee Schedule. HR 4932/S 2741 - CONNECT for Health Act of 2019: Support expanded coverage for services provided to Medicare patients via telehealth, including occupational therapy and other therapy services. HR 1329 - Medicaid Reentry Act (mental health and Medicaid policy): Support passage S 1754/HR 3215 - The Disaster Relief Medicaid Act (DRMA): Support passage No bill: Support for Medicare payment for evidence-based programs, led by occupational therapists, that support caregivers for people with dementia. No bill: Support for Medicare payment for evidence-based programs, led by occupational therapists, to support aging in place. S 1202 - Independence At Home Act: support passage HR2408 - Ensuring Access to Complex Rehabilitation Technology Act of 2019: support passage HR 748, CARES Act: Advocated to include occupational therapy practitioners as eligible Medicare telehealth service providers for both the duration of the COVID-19 public health emergency and on a permanent basis. HR 7154 - Outpatient Therapy Modernization and Stabilization Act: Support passage. HR 6634 - Emergency COVID Telehealth Response Act: Support introduction and passage. No bill #: Support for waiving statutory budget neutrality requirements, or exempting certain provider specialties from the application of budget neutrality, for the implementation of new Evaluation and Management Codes in the 2021 Medicare Physician Fee Schedule, and inclusion of this waiver in any COVID-19 legislation. HR 6365/3559 -Immediate Relief for Rural Facilities and Providers Act of 2020: Support passage. CMS - Met with CMS to discuss Medicare Part B payment reductions to therapy provider payments proposed in the 2021 physician fee schedule: Participants included Demetrios Kouzoukas, Director of Medicare. S. 4375 - Telehealth Modernization Act: Support , particularly for provisions that would allow the Secretary of Health and Human Services to permanently add occupational therapy practitioners to the Medicare telehealth benefit. Support various House and Senate proposals to extend and make permanent the Public Health Emergency provisions that enable occupational therapists to provide services to Medicare patients via telehealth.
Client expense: $130,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE
2020 · third_quarter · Medicare/Medicaid
Childcare Issues related to childcare - no specific bill COVID-19 Pandemic H.R. 6800 - Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act S. 3599/H.R.6788 - Healthcare Workforce Resilience Act H.R. 6793 - Pandemic Production Act H.R. 266 - Paycheck Protection Program and Health Care Enhancement Act H.R.7010 - Paycheck Protection Program Flexibility Act of 2020 H.R.6720 - Student Loan Forgiveness for Frontline Health Workers Act H.R. 7059 - Coronavirus Provider Protection Act H.R. 748 - The Coronavirus Aid, Relief, and Economic Security Act or the CARES Act Issues related to the COVID-19 Pandemic including: - no specific bill Financial assistance for health care providers Medicare Accelerated and Advance Payment Program Medicare and Medicaid payment rates Federal Medicaid Match Liability protection for health care providers Demographic data for the COVID-19 response Access to personal protective equipment (PPE) and medical supplies PPE supply chain improvements Access to testing for COVID-19 Telemedicine/telehealth Small Business Administration loans Support for contact tracing programs Mental and behavioral health Support for programs addressing domestic violence and child maltreatment Support for resident physicians and medical students Student loan forgiveness/debt relief State and local funding General advocacy on a COVID-19 stimulus/relief package FMAP increase in the Families First Coronavirus Response Act (P.L. 116-127) H.R.6793, the Pandemic Production Act (PPA) S.4349/ H.R.8094, the Dr. Lorna Breen Health Care Provider Protection Act H.R.7819 - Eliminating the Provider Relief Fund Tax Penalties Act of 2020 Immigration Public Charge - no specific bill S. 948/H.R. 2895, Conrad State 30 and Physician Access Reauthorization Act Interoperability/ONC Issues related to interoperability - no specific bill Medicare/Medicaid The Medicare Access and CHIP Reauthorization Act (MACRA) Medicaid Fiscal Accountability regulation Block Grants - no specific bill Issues related to Medicare Payments Prior Authorization - no specific bill Publications Open access to information based on publicly funded research OSTP Request for Information - FR Doc. 2020-06622 - Public Access to Peer-Reviewed Scholarly Publications, Data and Code Resulting From Federally Funded Research Issues related to scholarly and scientific publishing and public access Racial Justice/Health Equity Issues related to racial justice/health care equity - no specific bill Scope of Practice - no specific bill Surprise Billing S. 1895 - Lower Health Care Costs Act H.R. 3630 - No Surprises Act S 1531 - Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019 Consumer Protections Against Surprise Medical Bills Act of 2020 - House Ways & Means Telehealth S. 4375, the Telehealth Modernization Act of 2020 Issues related to telehealth - no specific bill Vaccines Issues related to vaccines - no specific bill Regulatory Comments Revisions to Payment Policies under the Medicare Physician Fee Schedule, Quality Payment Program and Other Revisions to Part B for CY 2021
Client expense: $40,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Office of Science & Technology Policy (OSTP), SENATE
2020 · third_quarter · Health Issues
Childcare Issues related to childcare - no specific bill COVID-19 Pandemic H.R. 6800 - Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act S. 3599/H.R.6788 - Healthcare Workforce Resilience Act H.R. 6793 - Pandemic Production Act H.R. 266 - Paycheck Protection Program and Health Care Enhancement Act H.R.7010 - Paycheck Protection Program Flexibility Act of 2020 H.R.6720 - Student Loan Forgiveness for Frontline Health Workers Act H.R. 7059 - Coronavirus Provider Protection Act H.R. 748 - The Coronavirus Aid, Relief, and Economic Security Act or the CARES Act Issues related to the COVID-19 Pandemic including: - no specific bill Financial assistance for health care providers Medicare Accelerated and Advance Payment Program Medicare and Medicaid payment rates Federal Medicaid Match Liability protection for health care providers Demographic data for the COVID-19 response Access to personal protective equipment (PPE) and medical supplies PPE supply chain improvements Access to testing for COVID-19 Telemedicine/telehealth Small Business Administration loans Support for contact tracing programs Mental and behavioral health Support for programs addressing domestic violence and child maltreatment Support for resident physicians and medical students Student loan forgiveness/debt relief State and local funding General advocacy on a COVID-19 stimulus/relief package FMAP increase in the Families First Coronavirus Response Act (P.L. 116-127) H.R.6793, the Pandemic Production Act (PPA) S.4349/ H.R.8094, the Dr. Lorna Breen Health Care Provider Protection Act H.R.7819 - Eliminating the Provider Relief Fund Tax Penalties Act of 2020 Immigration Public Charge - no specific bill S. 948/H.R. 2895, Conrad State 30 and Physician Access Reauthorization Act Interoperability/ONC Issues related to interoperability - no specific bill Medicare/Medicaid The Medicare Access and CHIP Reauthorization Act (MACRA) Medicaid Fiscal Accountability regulation Block Grants - no specific bill Issues related to Medicare Payments Prior Authorization - no specific bill Publications Open access to information based on publicly funded research OSTP Request for Information - FR Doc. 2020-06622 - Public Access to Peer-Reviewed Scholarly Publications, Data and Code Resulting From Federally Funded Research Issues related to scholarly and scientific publishing and public access Racial Justice/Health Equity Issues related to racial justice/health care equity - no specific bill Scope of Practice - no specific bill Surprise Billing S. 1895 - Lower Health Care Costs Act H.R. 3630 - No Surprises Act S 1531 - Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019 Consumer Protections Against Surprise Medical Bills Act of 2020 - House Ways & Means Telehealth S. 4375, the Telehealth Modernization Act of 2020 Issues related to telehealth - no specific bill Vaccines Issues related to vaccines - no specific bill Regulatory Comments Revisions to Payment Policies under the Medicare Physician Fee Schedule, Quality Payment Program and Other Revisions to Part B for CY 2021
Client expense: $40,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Office of Science & Technology Policy (OSTP), SENATE