COVID–19 Treatment Coverage Act

H.R. 3630, No Surprises Act; S. 1531, Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019; S. 1895, Lower Health Care Costs Act; H.R. 5800, Ban Surprise Billing Act; H.R. 5826 Consumer Protections Against Surprise Medical Bills Act; H.R. 1730/S 741, the Cancer Drug Parity Act; Texas v US lawsuit implications for protections for people with pre-existing conditions; federal regulation of Short-Term Limited-Duration Insurance (STLDI) and other junk insurance; S. 4469, the COVID-19 Treatment Coverage Act

Client expense: $90,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Access to immunizations; Maternal immunizations; Immunization infrastructure; Health information technology/IIS; Quality measures; H.R. 2862, VACCINES Act; HR 6800, Health and Economic Recovery Omnibus Emergency Solutions Act or the HEROES Act; HR 925, Health and Economic Recovery Omnibus Emergency Solutions Act 2.0 or the HEROES Act 2.0; HR8061/S.4737 Community Immunity During COVID-19 Act of 2020; S.4269 Mothers and Newborns Success Act; S.4469 - 116th Congress (2019-2020) COVID-19 Treatment Coverage 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

H.R. 748 - CARES Act - Courtney - COVID-19 coverage H.R. 1418 - Competitive Health Insurance Reform Act of 2020 - DeFazio - antitrust laws, health insurance H.R. 3630 - No Surprises Act - Pallone - surprise medical billing H.R. 3784 - Air Ambulance Affordability Act of 2019 - Neguse - air ambulances H.R. 4223 - Protecting Patients from Surprise Medical Bills Act - Spano - surprise medical billing H.R. 5121 - Healthcare Cost Transparency Act - Beyer - provider price comparison tool H.R. 5239 - Prescription Drug Price Reporting Act - Joyce - reporting on drug expenditures and price changes under group health plans H.R. 5575 - Primary and Behavioral Health Care Access Act of 2020 -Underwood - coverage of primary care and behavioral health visits H.R. 6005 - Know the Price Act - Malinowski - health plan transparency H.R. 6173 - Covering Coronavirus Test Act of 2020 - DeGette - COVID-19 testing coverage H.R. 6193 - Medication Access in Emergencies Act of 2020 - Pappas - coverage of prescription drugs during emergency periods H.R. 6201 - Families First Coronavirus Response Act - Lowey - includes several provisions related to COVID-19 testing coverage H.R. 6213 - No Cost for COVID-19 Testing Act - Wilson - COVID-19 testing coverage H.R. 6214 - To amend title XVIII of the Social Security Act to provide for coverage of testing for COVID-19 at no cost sharing under the Medicare Advantage program - Kind - Medicare Advantage coverage of COVID-19 related visits and testing H.R. 6222 - Ensuring Affordable COVID-19 Preventive Care Act of 2020 - Schakowsky - coverage of certain new preventative services related to COVID-19 H.R. 6231 - Ensuring Access to COVID-19 Preventive Care Act of 2020 - Bucshon - coverage of certain vaccines and testing services during the COVID-19 emergency H.R. 6299 - Rapid Coverage of COVID-19 Vaccine Act of 2020 - Courtney - COVID-19 coverage H.R. 6317 - To provide for special enrollment periods during public health emergencies, coverage of services related to public health emergencies, and for other purposes - Doggett - special enrollment periods in public health emergency H.R. 6338 - To waive high deductible health plan requirements for health savings accounts -Budd - HDHP coverage during COVID H.R. 6486 - Care for COVID-19 Act 2.0 -Ruiz - COVID H.R. 6514 - Worker Health Coverage Protection Act - Scott - COVID H.R. 6518 - Stop Health Premium Spikes Act of 2020 - Peters - risk corridors H.R. 6532 - COVID Special Enrollment Act of 2020 - Doggett - COVID H.R. 6568 - Coverage for COVID-19 Treatment Act of 2020 - Rochester - COVID H.R. 6644 - To require group health plans and health insurance issuers offering group or individual health insurance coverage to provide coverage for services furnished via telehealth if such services would be covered if furnished in-person during the COVID-19 emergency. -Schrier - COVID H.R. 6674 - Medicare Crisis Program Act of 2020 -Jayapal - COVID H.R. 6712 - American Healthshare Plans Act of 2020 - Curtis - health share pools H.R. 6810 - Health Care Protection Act -Davis - COVID H.R. 7006 - Improving Care in Home Health Agencies Act - Velazquez - home health services H.R. 7267 - To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to prohibit a group health plan and a health insurance issuer offering group or individual health insurance coverage from reducing contracted rates, or terminating contracts, with health care providers during a public health emergency. - Porter - ERISA H.R. 7475 - Ensuring FEHBP Coverage During Pandemic Act - Vela - special enrollment period H.R. 7539 - Strengthening Behavioral Health Parity Act - Kennedy - strengthen mental health and SUD benefits H.R. 7647 - To provide for a COVID-19-related delay regarding annual limitation on cost-sharing for group health plans and individual and small group health insurance coverage - McEachin - drug manufacturer support applied to patient out-of-pocket limit H.R. 7659 - Ensuring Parity in MA for Audio-Only Telehealth Act of 2020 - Sewell - inclusion of certain audio-only diagnoses in the determination of risk adjustment for MA plans H.R. 7676 - Health Care Prices Revealed and Information to Consumers Explained Transparency Act - Flores - hospital and insurer price transparency H.R. 7722 - Matts Act - Fortenberry - limit price of insulin drugs accessible for those enrolled in group or indiv. health insurance coverage, group health plans, uninsured H.R. 7921 - Connecting Communities to Grant Opportunities Act of 2020 - Velazquez - navigator programs H.R. 7942 - Public Health Emergency COBRA Extension Act -Sanchez - COBRA extension H.R. 8060 - Tele-Mental Health Improvement Act - Trone - parity in mental health and SUD service under private insurance H.R. 8181 - Jack Reynolds Memory MediGap Expansion - Axne - Medigap coverage for Medicare ESRD H.R. 8308 - Telehealth Coverage and Payment Parity Act - Phillips - coverage for services furnished through telehealth H.R. 8330 - No Surprise Bills for New Moms Act - Porter - health coverage of newborns S. 1531 - STOP Surprise Medical Bills Act - Cassidy-Bennet - surprise medical billing S. 1948 - Chronic Disease Management Act - Thune - pre-deductible coverage of chronic disease prevention services S. 2546 - Safe Step Act - Murkowski - Step therapy exceptions S. 3200 - Chronic Disease Management Act of 2020 - Thune - coverage of chronic disease prevention services S. 3383 - Continuing Coverage for Preexisting Conditions Act of 2020 -Kennedy - preexisting conditions S. 3499 - A bill to amend coverage requirements to ensure that no person incurs cost sharing when receiving a test to confirm a COVID-19 infection - Smith - COVID-19 cost -sharing S. 3505 - A bill to require private health insurance to rapidly cover preventive services and vaccines related to the coronavirus - Jones - rapid COVID-19 coverage S. 3536 - A bill to provide for special enrollment periods during public health emergencies, coverage of services related to public health emergencies, and for other purposes - Casey - COVID-19 coverage S. 3610 - American Healthshare Plans Act of 2020 - Paul - health share pools S. 3631 - Relief for Rural Providers During Emergencies Act - Sasse - COVID S. 3741 - Health Care at Home Act of 2020 - Smith - COVID S. 3792 - Tele-Mental Health Improvement Act - Smith - parity S. 3821 - Affordable Health Care Options Act of 2020 - Loeffler - affordability S. 3991 - Coronavirus 2019 Special Enrollment Period Act - Duckworth - SEP S. 4106 - A bill to amend the Public Health Service Act to provide for hospital and insurer price transparency - Braun - price transparency S. 4185 - End Surprise Medical Bills for Air Ambulances Act of 2020 - Wicker - establish an IDR for air ambulance S. 4198 - Affordable Coronavirus Testing Act - Scott - coverage for COVID serology testing S. 4255 - Katherines Lung Cancer Early Detection and Survival Act of 2020 - Smith - group health plans, group and indiv coverage benefits for lung cancer screenings S. 4329 - Continuous Health Coverage for Workers Act - McSally - COBRA continuation coverage S. 4469 - COVID-19 Treatment Coverage Act - Smith - COVID treatment Medicaid/MA/Private/Medicare coverage S. 4506 - Pre-Existing Conditions Protection Act of 2020 - Gardner - coverage of pre-ex conditions under private insurance S. 4521 - Health Care Improvement Act of 2020 - Warner - expand ACA coverage S. 4557 - COVid Enrollment Response Act - Baldwin - assistance enrolling in health care coverage S. 4609 - Vaccine And Coverage Certainty Act - Wyden - coverage of COVID vaccine under Medicare/Medicaid, CHIP S. 4653 - A bill to prevent efforts of the Department of Justice to advocate courts to strike down the Patient Protection and Affordable Care Act - Schumer - ACA S. 4761 - A bill to amend the Employee Retirement Income Security Act of 1974, title XXVII of the Public Health Service Act, and the Internal Revenue Code of 1986 to require group health plans and health insurance issuers offering group or individual health insurance coverage to provide for 3 primary care visits and 3 behavioral health care visits without application of any cost-sharing requirement - King - coverage and cost-sharing Regulatory Issues: Insurance regulatory reform; issues related to the coordination of private and public disability income benefits; disability risk management; disability income insurance enrollment and awareness; issues related to COBRA continuation coverage; issues related to behavioral health benefits; issues related to encouraging impaired workers to stay in/return to the workforce; issues related to expanding long-term care insurance coverage; issues relating to COVID-19, including testing, vaccines and therapeutics; issues related to addressing the social determinants of health, including housing, transportation, nutrition, and educational opportunities; issues relating to Medicaid best price; issues relating to the coordination of benefits between private health insurance plans and Medicaid; Medigap claims processing and crossover fees; Medigap cross-over claim issues, Medigap coverage, implementation of Medigap standardized plan offerings; Medigap carrier recoveries related to CMS fraud and abuse enforcement activities, and issues related to Medigap educational materials, and other Medigap issues; fraud and abuse issues affecting public and private insurance coverage; issues relating to antitrust; implementation of the Mental Health Parity Act requirements; implementation of the 21st Century Cures Act requirements; summary of benefits and coverage disclosures; prior authorization; accountable care organizations; coverage of preventive services; preexisting condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; health reimbursement accounts; dependent coverage; treatment of expatriate plans; issues related to surprise medical bills; issues related to all payor claims databases; issues related to association health plans; issues related to substance abuse and provider treatment records (42 CFR Part 2); issues related to medical management; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations, non-discriminatory wellness programs; issues related to supplemental products; issues relating to dental coverage; issues relating to proposals for single-payer and Medicare/Medicaid buy-in options; issues related to implementation of the Telephone Consumer Protection Act; issues relating to third party payment of premiums; issues related to cost-sharing reductions (CSRs); issues related to interoperability and price transparency; issues related to the employer market; issues relating to the individual market; and other issues relating to health care reform implementation.

Maternal and child health legislation,focusing on National Children's Study (ECHO), Zika preparedness, tobacco control, opioids legislation and neonatal abstinence syndrome (NAS), antibiotic resistance, environmental health, vaccination, newborn screening, Healthy Start, maternal mental health. Specific legislation includes: MOMMAs Act (H.R. 1897/S. 916, MOMs Act (S. 116),MOMMIES Act (H.R. 2602, S. 1343), Quality Care for Moms and Babies Act (H.R. 1551/S. 1960), Maternal CARE Act (H.R. 6698/S. 1600), The Healthy Maternity and Obstetric Medicine Act (Healthy MOM Act) (H.R. 2778/S. 1481), Rural Maternal and Obstetric Modernization of Services (MOMS) Act (S. 2373), the Maternal Outcomes Matter Act of 2019 (S. 2586), Healthy Maternity and Obstetric Medicine Act (H.R. 2778, S. 1481), H.R. 4995, Maternal Health Quality Improvement Act of 2019, H.R. 4996, Helping Medicaid Offer Maternity Services Act of 2019, Reversing the Youth Tobacco Epidemic Act (H.R. 2339), Public Health Funding Restoration Act (H.R. 3447, S. 1944), and the Comprehensive Addiction Resources Emergency CARE Act (H.R. 2569, S. 1365), Newborn Screening Saves Lives Reauthorization Act of 2019 (HR 2507/S. 2158), Traveling Parents Screening Consistency Act (HR 3246), the Tobacco Tax Equity Act (S. 2517), EQUIP Act of 2020 (HR 6178), and the Protecting American Lungs Act of 2019 (HR 4742). Black Maternal Health Momnibus Act of 2020 (HR 6142)including the Social Determinants for Moms Act (HR 6132), the Protecting Moms who Served Act (HR 6164), the Data to Save Moms Act (HR 6165), the Moms MATTER Act (HR 6143), and Kira Johnson Act (HR 6144). Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 (P.L. 116-123), Families First Coronavirus Response Act (P.L. 116-127), Coronavirus Aid, Relief, and Economic Security (CARES) Act (HR 748) (P.L. 116-136), and HEROES Act (H.R. 6800). Mothers and Newborns Success Act (S.4269), Maternal Health Pandemic Response Act of 2020 (H.R. 8027), Community Immunity During COVID-19 Act of 2020 (H.R. 8061), Maternal Immunization Enhancement Act (S.4690), Public Health Infrastructure Saves Lives Act (PHISLA), COVID-19 Treatment Coverage Act (S.4469)

H.R. 6800: HEROES Act, Sec. 30205 Requiring Coverage Under Medicare PDPs and MA-PD Plans Without the Imposition of Cost Sharing or Utilization Management Requirements of Drugs Intended to Treat COVID-During Certain Emergencies. S. 4469: COVID-19 Treatment Coverage Act Sec. 6 Coverage of COVID-19 Drugs at no cost sharing under Medicare prescription drug plans. Value-based contracting and Medicaid Best Price. Implementation of Sec. 20003 the SUPPORT Act for Patients and Communities Act, provisions related to the implementation of Every Prescription Conveyed Securely Act. S. 3013: Encouraging Innovative Benefit Design to Lower Costs for Seniors Act, to amend Title XVIII of the Social Security Act to allow for the offering of additional prescription drug plans under Medicare Part D. Presidential Executive Order on Lowering Prices for Patients by Eliminating Kickbacks to Middlemen, issued July 24, 2020 requiring the completion of rulemaking to exclude from safe harbor protection drug rebates in Medicare Part D. Presidential Executive Order on Lowering Drug Prices by Putting America First, issued September 13, 2020 creating a Most Favored Nation Price for drugs in Medicare Part B and Part D. Outreach on pharmacy direct and indirect remuneration in Medicare Part D and on real time benefit tools.

Client expense: $110,000 · Firm income: Not reported

Health and Economic Recovery Omnibus Emergency Solutions Act (HEROES Act, H.R. 6800), Sec. 30205 ; COVID-19 Treatment Coverage Act (S. 4469), Sec. 6; value-based contracting and Medicaid Best Price; Presidential Executive Order on Lowering Prices for Patients by Eliminating Kickbacks to Middlemen, Issued July 24, 2020; Presidential Executive Order on Lowering Drug Prices by Putting America First, Issued September 13, 2020; issues related to pharmacy direct and indirect remuneration in Medicare Part D.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE