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vs 5,357 other S bills in the 117th — cohort avg 38d
Choose Medicare Act This bill requires the Department of Health and Human Services (HHS) to establish public health insurance plans and addresses health insurance costs. Such public plans must be offered on health insurance exchanges and (1) meet the requirements of a qualified health plan; (2) cover benefits at the gold plan level; and (3) cover reproductive services, including abortions. Additionally, the bill makes a series of changes related to health insurance costs, including requiring employers to refer employees to health care navigators to assist with enrollment, establishing an annual limit on out-of-pocket costs for services under Medicare, providing HHS with the authority to negotiate prices under the Medicare prescription drug benefit program, expanding the premium-assistance credit by benchmarking the credit amount to the second-lowest cost gold plan and increasing the income threshold for eligibility, requiring qualified health plans to reduce cost sharing for low-income plan holders, providing funding for states to provide reinsurance to health insurance issuers and to assist individuals with out-of-pocket costs for plans offered through health insurance exchanges, applying the premium rate-setting requirements to large group health plans, and requiring HHS or states to take corrective actions to address unreasonable premium rates set by insurance issuers.
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Filing registrants (4)
2022 · fourth_quarter · Medicare/Medicaid
S.2999 A bill to prohibit the Secretary of Health and Human Services, any officer or employee of the Department of Health and Human Services, and States from requiring COVID-19 vaccination as a condition of eligibility for benefits or assistance under the Medicare, Medicaid, or CHIP program; S.J.Res.32 A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Centers for Medicare & Medicaid Services relating to Medicare and Medicaid Programs; Omnibus COVID-19 Health Care Staff Vaccination; H.R.1677 - KEEP Telehealth Options Act of 2021 To direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission, and the Medicaid and CHIP Payment and Access Commission to conduct studies and report to Congress on actions taken to expand access to telehealth services under the Medicare, Medicaid, and Children's Health Insurance programs during the COVID-19 emergency; S.620 KEEP Telehealth Options Act of 2021; S104 HR379 Improving Social Determinants of Health Act of 2021; H.R.1227, S386 Medicare-X Choice Act of 2021; HR 3322-S826 Medicare Patient Empowerment Act of 2021; HR2410 Medicare & You Handbook Improvement Act of 2021; S1180 Choose Medicare Act' S748 Medicare Sequester Relief Act; HR 315 Medicare Sequester COVID Moratorium Act; HR599 Protecting Medicare Beneficiaries with Pre-Existing Conditions Act; S.2146 Improving Medicare Beneficiary Access to Innovative Diabetes Technologies Act of 2021; S.4067 A bill to amend title XI of the Social Security Act to improve access to care for all Medicare and Medicaid beneficiaries through models tested under the Center for Medicare and Medicaid Innovation, and for other purposes; H.R.3755 Women's Health Protection Act of 2022; . S.J.Res.32 - A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Centers for Medicare & Medicaid Services relating to "Medicare and Medicaid Programs; Omnibus COVID-19 Health Care Staff Vaccination"; H.J.Res.79 - Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Department of the Treasury and the Centers for Medicare & Medicaid Services relating to "Patient Protection and Affordable Care Act; Updating Payment Parameters, Section 1332 Waiver Implementing Regulations, and Improving Health Insurance Markets for 2022 and Beyond".
Read twice and referred to the Committee on Finance.
Introduced in Senate
Bills with similar content found using semantic analysis.
Sources: Congress.gov
Client expense: Not reported · Firm income: $11,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · fourth_quarter · Medicare/Medicaid
Regulations related to the 2023 Medicare Physician Fee Schedule Rule. S.97 & H.R.502 - Medicare Dental Benefit Act of 2021 H.R.1794 - Foster Youth Dental Act of 2021 H.R.4311 - Medicare Dental, Vision, and Hearing Benefit Act of 2021 H.R.4439 - Medicaid Dental Benefit Act H.R.4650 - Medicare Dental Coverage Act of 2021 H.R.5376 - Build Back Better Act S.560 - Oral Health for Moms Act H.R.5110 - Medicare Medically Necessary Dental Care Act of 2021 S.1180 - Choose Medicare Act S.3166 - Medicaid Dental Benefit Act of 2021 S.1279 - Medicare at 50 Act S.2618 - Medicare and Medicaid Dental, Vision, and Hearing Benefit Act of 2021
Client expense: Not reported · Firm income: $20,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE
2022 · third_quarter · Medicare/Medicaid
Regulations related to the 2023 Medicare Physician Fee Schedule Rule. S.97 & H.R.502 - Medicare Dental Benefit Act of 2021 H.R.1794 - Foster Youth Dental Act of 2021 H.R.4311 - Medicare Dental, Vision, and Hearing Benefit Act of 2021 H.R.4439 - Medicaid Dental Benefit Act H.R.4650 - Medicare Dental Coverage Act of 2021 H.R.5376 - Build Back Better Act S.560 - Oral Health for Moms Act H.R.5110 - Medicare Medically Necessary Dental Care Act of 2021 S.1180 - Choose Medicare Act S.3166 - Medicaid Dental Benefit Act of 2021 S.1279 - Medicare at 50 Act S.2618 - Medicare and Medicaid Dental, Vision, and Hearing Benefit Act of 2021
Client expense: Not reported · Firm income: $20,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE
2022 · third_quarter · Medicare/Medicaid
S.2999 A bill to prohibit the Secretary of Health and Human Services, any officer or employee of the Department of Health and Human Services, and States from requiring COVID-19 vaccination as a condition of eligibility for benefits or assistance under the Medicare, Medicaid, or CHIP program; S.J.Res.32 A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Centers for Medicare & Medicaid Services relating to Medicare and Medicaid Programs; Omnibus COVID-19 Health Care Staff Vaccination; H.R.1677 - KEEP Telehealth Options Act of 2021 To direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission, and the Medicaid and CHIP Payment and Access Commission to conduct studies and report to Congress on actions taken to expand access to telehealth services under the Medicare, Medicaid, and Children's Health Insurance programs during the COVID-19 emergency; S.620 KEEP Telehealth Options Act of 2021; S104 HR379 Improving Social Determinants of Health Act of 2021; H.R.1227, S386 Medicare-X Choice Act of 2021; HR 3322-S826 Medicare Patient Empowerment Act of 2021; HR2410 Medicare & You Handbook Improvement Act of 2021; S1180 Choose Medicare Act' S748 Medicare Sequester Relief Act; HR 315 Medicare Sequester COVID Moratorium Act; HR599 Protecting Medicare Beneficiaries with Pre-Existing Conditions Act; S.2146 Improving Medicare Beneficiary Access to Innovative Diabetes Technologies Act of 2021; S.4067 A bill to amend title XI of the Social Security Act to improve access to care for all Medicare and Medicaid beneficiaries through models tested under the Center for Medicare and Medicaid Innovation, and for other purposes; H.R.3755 Women's Health Protection Act of 2022; . S.J.Res.32 - A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Centers for Medicare & Medicaid Services relating to "Medicare and Medicaid Programs; Omnibus COVID-19 Health Care Staff Vaccination"; H.J.Res.79 - Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Department of the Treasury and the Centers for Medicare & Medicaid Services relating to "Patient Protection and Affordable Care Act; Updating Payment Parameters, Section 1332 Waiver Implementing Regulations, and Improving Health Insurance Markets for 2022 and Beyond".
Client expense: Not reported · Firm income: $11,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · second_quarter · Medicare/Medicaid
S.97 & H.R.502 - Medicare Dental Benefit Act of 2021 H.R.1794 - Foster Youth Dental Act of 2021 H.R.4311 - Medicare Dental, Vision, and Hearing Benefit Act of 2021 H.R.4439 - Medicaid Dental Benefit Act H.R.4650 - Medicare Dental Coverage Act of 2021 H.R.5376 - Build Back Better Act S.560 - Oral Health for Moms Act H.R.5110 - Medicare Medically Necessary Dental Care Act of 2021 S.1180 - Choose Medicare Act S.3166 - Medicaid Dental Benefit Act of 2021 S.1279 - Medicare at 50 Act S.2618 - Medicare and Medicaid Dental, Vision, and Hearing Benefit Act of 2021
Client expense: Not reported · Firm income: $20,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · second_quarter · Medicare/Medicaid
S.2999 A bill to prohibit the Secretary of Health and Human Services, any officer or employee of the Department of Health and Human Services, and States from requiring COVID-19 vaccination as a condition of eligibility for benefits or assistance under the Medicare, Medicaid, or CHIP program; S.J.Res.32 A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Centers for Medicare & Medicaid Services relating to Medicare and Medicaid Programs; Omnibus COVID-19 Health Care Staff Vaccination; H.R.1677 - KEEP Telehealth Options Act of 2021 To direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission, and the Medicaid and CHIP Payment and Access Commission to conduct studies and report to Congress on actions taken to expand access to telehealth services under the Medicare, Medicaid, and Children's Health Insurance programs during the COVID-19 emergency; S.620 KEEP Telehealth Options Act of 2021; S104 HR379 Improving Social Determinants of Health Act of 2021; H.R.1227, S386 Medicare-X Choice Act of 2021; HR 3322-S826 Medicare Patient Empowerment Act of 2021; HR2410 Medicare & You Handbook Improvement Act of 2021; S1180 Choose Medicare Act' S748 Medicare Sequester Relief Act; HR 315 Medicare Sequester COVID Moratorium Act; HR599 Protecting Medicare Beneficiaries with Pre-Existing Conditions Act; S.2146 Improving Medicare Beneficiary Access to Innovative Diabetes Technologies Act of 2021; S.4067 A bill to amend title XI of the Social Security Act to improve access to care for all Medicare and Medicaid beneficiaries through models tested under the Center for Medicare and Medicaid Innovation, and for other purposes; H.R.3755 Women's Health Protection Act of 2022; . S.J.Res.32 - A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Centers for Medicare & Medicaid Services relating to "Medicare and Medicaid Programs; Omnibus COVID-19 Health Care Staff Vaccination"; H.J.Res.79 - Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Department of the Treasury and the Centers for Medicare & Medicaid Services relating to "Patient Protection and Affordable Care Act; Updating Payment Parameters, Section 1332 Waiver Implementing Regulations, and Improving Health Insurance Markets for 2022 and Beyond".
Client expense: Not reported · Firm income: $11,000
2022 · first_quarter · Medicare/Medicaid
S.97 & H.R.502 - Medicare Dental Benefit Act of 2021 H.R.1794 - Foster Youth Dental Act of 2021 H.R.4311 - Medicare Dental, Vision, and Hearing Benefit Act of 2021 H.R.4439 - Medicaid Dental Benefit Act H.R.4650 - Medicare Dental Coverage Act of 2021 H.R.5376 - Build Back Better Act S.560 - Oral Health for Moms Act H.R.5110 - Medicare Medically Necessary Dental Care Act of 2021 S.1180 - Choose Medicare Act S.3166 - Medicaid Dental Benefit Act of 2021 S.1279 - Medicare at 50 Act S.2618 - Medicare and Medicaid Dental, Vision, and Hearing Benefit Act of 2021
Client expense: Not reported · Firm income: $20,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · first_quarter · Medicare/Medicaid
S.2999 A bill to prohibit the Secretary of Health and Human Services, any officer or employee of the Department of Health and Human Services, and States from requiring COVID-19 vaccination as a condition of eligibility for benefits or assistance under the Medicare, Medicaid, or CHIP program; S.J.Res.32 A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Centers for Medicare & Medicaid Services relating to "Medicare and Medicaid Programs; Omnibus COVID-19 Health Care Staff Vaccination";H.R.1677 To direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission, and the Medicaid and CHIP Payment and Access Commission to conduct studies and report to Congress on actions taken to expand access to telehealth services under the Medicare, Medicaid, and Children's Health Insurance programs during the COVID-19 emergency; . S.620 KEEP Telehealth Options Act of 2021; S104 HR379 Improving Social Determinants of Health Act of 2021; H.R.2517, S1125 To recommend that the Center for Medicare and Medicaid Innovation test the effect of a dementia care management model, and for other purposes; H.R.1227, S386 Medicare-X Choice Act of 2021; HR 3322-S826 Medicare Patient Empowerment Act of 2021; HR2410 Medicare & You Handbook Improvement Act of 2021; S1180 Choose Medicare Act' S748 Medicare Sequester Relief Act; HR 315 Medicare Sequester COVID Moratorium Act; HR599 Protecting Medicare Beneficiaries with Pre-Existing Conditions Act; S.2146 Improving Medicare Beneficiary Access to Innovative Diabetes Technologies Act of 2021; S.4067 A bill to amend title XI of the Social Security Act to improve access to care for all Medicare and Medicaid beneficiaries through models tested under the Center for Medicare and Medicaid Innovation, and for other purposes.
2021 · fourth_quarter · Medicare/Medicaid
S.97 & H.R.502 - Medicare Dental Benefit Act of 2021 H.R.1794 - Foster Youth Dental Act of 2021 H.R.4311 - Medicare Dental, Vision, and Hearing Benefit Act of 2021 H.R.4439 - Medicaid Dental Benefit Act H.R.4650 - Medicare Dental Coverage Act of 2021 H.R.5376 - Build Back Better Act S.560 - Oral Health for Moms Act H.R.5110 - Medicare Medically Necessary Dental Care Act of 2021 S.1180 - Choose Medicare Act S.3166 - Medicaid Dental Benefit Act of 2021 S.1279 - Medicare at 50 Act S.2618 - Medicare and Medicaid Dental, Vision, and Hearing Benefit Act of 2021
Client expense: Not reported · Firm income: $20,000
Government targets: Centers For Disease Control & Prevention (CDC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), Occupational Safety & Health Administration (OSHA), SENATE, Treasury, Dept of, White House Office
2021 · fourth_quarter · Medicare/Medicaid
H.R. 19 - Lower Costs, More Cures Act of 2021 - Rep. McMorris Rodgers, Cathy [R-WA-5] - Medicare and Medicaid reforms H.R. 56 - Patient Access to Medical Foods Act - Rep. Biggs, Andy [R-AZ-5] - coverage of medical foods H.R. 66 - CARING for Kids Act - Rep. Buchanan, Vern [R-FL-16] - CHIP extension H.R. 315 - Medicare Sequester COVID Moratorium Act - Rep. Schneider, Bradley Scott [D-IL-10] - Medicare Sequester H.R. 340 - Incentivizing Medicaid Expansion Act of 2021 - Rep. Veasey, Marc A. [D-TX-33] - Medicaid expansion H.R. 502 - Medicare Dental Benefit Act of 2021 - Rep. Barragan, Nanette Diaz [D-CA-44] - Medicare dental coverage H.R. 525 - COVID HCBS Relief Act of 2021 - Rep. Dingell, Debbie [D-MI-12] - HCBS H.R. 599 - Protecting Medicare Beneficiaries with Pre-Existing Conditions Act - Rep. Schneider, Bradley Scott [D-IL-10] - pre-existing conditions H.R. 722 - Ensuring Vaccination and Treatment Affordability Act - Rep. Pappas, Chris [D-NH-1] - cost-sharing for COVID-19 vaccines H.R. 918 - Stronger Medicaid Response to the COVID-19 Pandemic Act - Rep. Cardenas, Tony [D-CA-29] - Medicaid & COVID-19 H.R. 955 - Medicaid Reentry Act of 2021 - Rep. Tonko, Paul [D-NY-20] - Medicaid coverage H.R. 975 - Ensuring Seniors Access to COVID Treatments Act - Rep. Casten, Sean [D-IL-6] - coverage of COVID-19 drugs H.R. 1227 - Medicare-X Choice Act of 2021 - Rep. Delgado, Antonio [D-NY-19] - Medicare-X H.R. 1495 - Jim Ramstad Legacy of Recovery Act - Rep. Emmer, Tom [R-MN-6] - Medicaid coverage for SUD H.R. 1717 - Protecting Married Seniors from Impoverishment Act of 2021 - Rep. Upton, Fred [R-MI-6] - HCBS and spousal impoverishment H.R. 1722 - Puerto Rico Health Care Fairness, Accountability, and Beneficiary Access Act of 2021 - Rep. Velazquez, Nydia M. [D-NY-7] - Medicaid for territories H.R. 1791 - CHIPP Act - Rep. Barragan, Nanette Diaz [D-CA-44] - CHIP extension H.R. 1795 - Expanded Coverage for Former Foster Youth Act - Rep. Bass, Karen [D-CA-37] - coverage for foster youth H.R. 1880 - To amend the Deficit Reduction Act of 2005 to make permanent the Money Follows the Person Rebalancing Demonstration - Rep. Dingell, Debbie [D-MI-12] - Money Follows the Person extension H.R. 1969 - Medicare Advantage Integrity Act - Resident Commissioner Gonzalez-Colon, Jenniffer [R-PR-At Large] - Medicare Advantage benchmark rates H.R. 1976 - Medicare for All Act of 2021 - Rep. Jayapal, Pramila [D-WA-7] - Medicare for All H.R. 1978 - Protecting Seniors Through Immunization Act of 2021 - Rep. Kuster, Ann M. [D-NH-2] - cost sharing for vaccines under Medicare part D H.R. 1999 - Protect Seniors and Cut Waste Act - Rep. Smith, Jason [R-MO-8] - sequester for Pay-As-You-Go H.R. 2166 - Ensuring Parity in MA and PACE for Audio-Only Telehealth Act of 2021 - Rep. Sewell, Terri A. [D-AL-7] - Medicare coverage of telehealth H.R. 2217 - Territory Federal Matching Requirement Equity Act of 2021 - Resident Commissioner Gonzalez-Colon, Jenniffer [R-PR-At Large] - FMAP for territories H.R. 2297 - MIND Act - Rep. Boyle, Brendan F. [D-PA-2] - Medicaid payment for services provided in institutions for mental diseases H.R. 2464 - More Help for Seniors Act of 2021 - Rep. Craig, Angie [D-MN-2] - Medicare prescription drug benefit H.R. 2881 - Medicare Buy-In and Health Care Stabilization Act of 2021 - Rep. Higgins, Brian [D-NY-26] - Medicare public insurance H.R. 3108 - Medical Nutrition Therapy Act of 2021 - Rep. Kelly, Robin L. [D-IL-2] - coverage of medical foods H.R. 3173 - Improving Seniors Timely Access to Care Act of 2021 - Rep. DelBene, Suzan K. [D-WA-1] - prior authorization H.R. 3447 - Permanency for Audio-Only Telehealth Act - Rep. Smith, Jason [R-MO-8] - Medicare telehealth coverage H.R. 3450 - Medicaid Bump Act - Rep. Tonko, Paul [D-NY-20] - Medicaid funding and behavioral health H.R. 3894 - CARING for Social Determinants Act of 2021- Rep. Blunt Rochester, Lisa [D-DE-At Large] - Medicaid and SDOH H.R. 3961 - COVER Now Act - Rep. Doggett, Lloyd [D-TX-35] - Medicaid expansion H.R. 4040 Advancing Telehealth Beyond COVID-19 Act of 2021- Rep. Cheney, Liz [R-WY-At Large] - Medicare telehealth coverage H.R. 4043 - Ensuring Patient Access to Critical Breakthrough Products Act of 2021 - Rep. DelBene, Suzan K. [D-WA-1] - Medicare coverage of breakthrough devices H.R. 4074 - Addressing Social Determinants in Medicare Advantage Act of 2021 - Rep. Bilirakis, Gus M. [R-FL-12] - Medicare Advantage supplemental benefits H.R. 4158 - Insulin Access for All Act of 2021 - Rep. Rush, Bobby L. [D-IL-1] - cost sharing for insulin H.R. 4187 - Medicare Vision Act of 2021 - Rep. Schrier, Kim [D-WA - Medicare vision coverage H.R. 4263 - Patient Parity Protection Act of 2021 - Rep. Gottheimer, Josh [D-NJ-5] - out-of-network services H.R. 4311 - Medicare Dental, Vision, and Hearing Benefit Act of 2021 - Rep. Doggett, Lloyd [D-TX-35] - Medicare dental, vision, and hearing benefits H.R. 4406 - Supporting Medicaid in the U.S. Territories Act of 2021 - Rep. Soto, Darren [D-FL-9] - Medicaid support in U.S. territories H.R. 4439 - Medicaid Dental Benefit Act - Rep. Barragan, Nanette Diaz [D-CA-44] - Medicaid dental benefit H.R. 4640 - Close the Medigap Act of 2021 - Rep. Doggett, Lloyd [D-TX-35] - Medicare supplemental health insurance policies H.R. 4650 - Medicare Dental Coverage Act of 2021 - Rep. Kelly, Robin L. [D-IL-2] - Medicare dental benefit H.R. 4941 - PACE Part D Choice Act of 2021 - Rep. Blumenauer, Earl [D-OR-3] - prescription drug plans in the Medicare-only PACE program H.R. 4942 - BETTER Kidney Care Act - Rep. Blumenauer, Earl [D-OR-3] - demonstration program for Medicare enrollees with ESRD H.R. 4974 - State Public Option Act - Rep. Schrier, Kim [D-WA-8] - Medicaid public option H.R. 5099 - Lowering Medicare Premiums and Prescription Drug Costs Act - Rep. Schneider, Bradley Scott [D-IL-10] - Medicare cost-sharing benefits H.R. 5110 - Medicare Medically Necessary Dental Care Act of 2021 - Rep. Cohen, Steve [D-TN-9] - Medicare dental benefits H.R. 5165 - Improving Medicare Coverage Act - Rep. Jayapal, Pramila [D-WA-7] - Medicare eligibility age H.R. 5414 - Ensuring Medicaid Continuity for Children in Foster Care Act of 2021 - Rep. Bilirakis, Gus M. [R-FL-12] - Medicaid coverage for children in foster care H.R. 5425 - Protecting Rural Telehealth Access Act - Rep. O'Halleran, Tom [D-AZ-1] - Medicare telehealth services H.R. 5576 - Fair Drug Prices for Kids Act - Rep. Wild, Susan [D-PA-7] - Medicaid Drug Rebate Program under CHIP H.R. 5632 - Long-Term Care Pharmacy Definition Act of 2021 - Rep. Schrader, Kurt [D-OR-5] - Medicare long term care pharmacy H.R. 5674 - Medicare Mental Health Inpatient Equity Act of 2021 - Rep. Tonko, Paul [D-NY-20] - inpatient psychiatric hospital services under Medicare H.R. 6101 - Drug Price Transparency in Medicaid Act of 2021 - Rep. Carter, Earl L. "Buddy" [R-GA-1] - drug pricing in Medicaid S. 97 - Medicare Dental Benefit Act of 2021 - Sen. Cardin, Benjamin L. [D-MD] - Medicare dental coverage S. 150 - Ensuring Parity in MA for Audio-Only Telehealth Act of 2021 - Sen. Cortez Masto, Catherine [D-NV] - Medicaid telehealth coverage S. 151 - COVID HCBS Relief Act of 2021 - Sen. Casey, Robert P., Jr. [D-PA] - HCBS S. 274 - Stronger Medicaid Response to the COVID-19 Pandemic Act - Sen. Bennet, Michael F. [D-CO] - Medicaid & COVID-19 S. 340 - TREATS Act - Sen. Portman, Rob [R-OH] - telehealth - Medicare telehealth coverage S. 386 - Medicare-X Choice Act of 2021 - Sen. Bennet, Michael F. [D-CO] - Medicare-X S. 448 - Ensuring Kids Have Access to Medically Necessary Dental Care Act - Sen. Cardin, Benjamin L. [D-MD] - CHIP S. 653 - COMP Act - Sen. Portman, Rob [R-OH] - Medicare secondary payer rules S. 748 - Medicare Sequester Relief Act - Sen. Shaheen, Jeanne [D-NH] - Medicare sequestration S. 1180 - Choose Medicare Act - Sen. Merkley, Jeff [D-OR] - Medicare public insurance S. 1536 - Medical Nutrition Therapy Act of 2021 - Sen. Collins, Susan M. [R-ME] - coverage of medical foods S. 1727 - Medicaid Bump Act - Sen. Smith, Tina [D-MN] - Medicaid funding and behavioral health S. 1844 - Lowering Medicare Premiums and Prescription Drug Costs Act - Sen. Casey, Robert P., Jr. [D-PA] - Medicare premiums and drug costs S. 2111 - Audio-Only Telehealth for Emergencies Act - Sen. Kennedy, John [R-LA] - Medicare coverage of telehealth S. 2112 - EASE Behavioral Health Services Act - Sen. Kennedy, John [R-LA] - telehealth S. 2164 - Lower Costs, More Cures Act of 2021 - Sen. Crapo, Mike [R-ID] - Medicare and Medicaid reforms S. 2197 - Rural and Frontier Telehealth Expansion Act - Sen. Rosen, Jacky [D-NV] - FMAP & telehealth S. 2210 - Better Care Better Jobs Act - Sen. Casey, Robert P., Jr. [D-PA] - HCBS S. 2236 - Expanding Health Care Options for Early Retirees Act - Sen. Brown, Sherrod [D-OH] - Medicare buy-in S. 2315 - Medicaid Saves Lives Act - Sen. Warnock, Raphael [D-GA] - Medicaid expansion S. 2618 - Medicare and Medicaid Dental, Vision, and Hearing Benefit Act of 2021 - Sen. Casey, Bob [D-PA] - Medicaid dental, vision, and hearing benefits S. 2639 - State Public Option Act - Sen. Schatz, Brian [D-HI] - Medicaid public option S. 2689 - Ensuring Medicaid Continuity for Children in Foster Care Act of 2021 - Sen. Burr, Richard [R-NC] - Medicaid-eligibility for children in foster care S. 3018 - Improving Seniors Timely Access to Care Act of 2021 - Sen. Marshall, Roger [R-KS] - prior authorization under MA S. 3061 - Medicare Mental Health Inpatient Equity Act of 2021 - Sen. Collins, Susan M. [R-ME] - inpatient psychiatric hospital services under Medicare S. 3193 - Expanded Telehealth Access Act - Sen. Daines, Steve [R-MT] - Medicare telehealth service providers S. 3332 - Let States Innovate Under Medicaid Act - Sen. Braun, Mike [R-IN] - Medicaid program promotion 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 2022 policy and technical regulation for MA and Part D; Part D reform, out of pocket limits; issues related to Medicare for All, Medicare buy-in, reduced Medicare eligibility age, and public option; issues relating to 2022 Rate Notice; issues related to coverage in non-Medicaid Expansion States (e.g., Gap Population); issues related to expanded Medicare fee for service benefits (dental, hearing and vision); issues related to Medicaid coverage gap; potential Medicare NCD relating to monoclonal antibodies for treatment of Alzheimers disease; 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 and vaccines; issues related to health equity; issues related to vaccination; issues related to audio-only telehealth; issues related to addressing the social determinants of health, including housing, transportation, nutrition, educational opportunities, and MA supplemental benefits; 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; 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 value based payment 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; 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; issues relating to MACRA, including implications for MA and Part D plans; 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 Affordable Care Act (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; 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.
2021 · fourth_quarter · Medicare/Medicaid
S.2999 A bill to prohibit the Secretary of Health and Human Services, any officer or employee of the Department of Health and Human Services, and States from requiring COVID-19 vaccination as a condition of eligibility for benefits or assistance under the Medicare, Medicaid, or CHIP program; S.J.Res.32 A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Centers for Medicare & Medicaid Services relating to "Medicare and Medicaid Programs; Omnibus COVID-19 Health Care Staff Vaccination";H.R.1677 To direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission, and the Medicaid and CHIP Payment and Access Commission to conduct studies and report to Congress on actions taken to expand access to telehealth services under the Medicare, Medicaid, and Children's Health Insurance programs during the COVID-19 emergency; . S.620 KEEP Telehealth Options Act of 2021; S104 HR379 Improving Social Determinants of Health Act of 2021; H.R.2517, S1125 To recommend that the Center for Medicare and Medicaid Innovation test the effect of a dementia care management model, and for other purposes; H.R.1227, S386 Medicare-X Choice Act of 2021; HR 3322-S826 Medicare Patient Empowerment Act of 2021; HR2410 Medicare & You Handbook Improvement Act of 2021; S1180 Choose Medicare Act' S748 Medicare Sequester Relief Act; HR 315 Medicare Sequester COVID Moratorium Act; HR599 Protecting Medicare Beneficiaries with Pre-Existing Conditions Act; S.2146 Improving Medicare Beneficiary Access to Innovative Diabetes Technologies Act of 2021.
Client expense: Not reported · Firm income: $11,000
2021 · third_quarter · Taxation/Internal Revenue Code
H.R. 5376 (Build Back Better Act): This bill provides funding, establishes programs, and otherwise modifies provisions relating to a broad array of areas, including education, labor, child care, health care, taxes, immigration, and the environment. (The bill is commonly referred to as the Build Back Better Act.) H.R.3684 - Infrastructure Investment and Jobs Act: This bill addresses provisions related to federal-aid highway, transit, highway safety, motor carrier, research, hazardous materials, and rail programs of the Department of Transportation (DOT). H.R.5318 - Commonsense Reporting Act of 2021: To streamline the employer reporting process and strengthen the eligibility verification process for the premium assistance tax credit and cost-sharing subsidy. H.R.341 - Ensuring Telehealth Expansion Act of 2021: To make permanent certain telehealth flexibilities established in response to COVID-19. H.R.5318 - Commonsense Reporting Act of 2021: This bill addresses the eligibility verification process for the premium assistance tax credit and cost-sharing subsidy under the Patient Protection and Affordable Care Act (PPACA). It requires the Department of the Treasury to develop and implement a reporting system that allows employers to voluntarily report information about their health plans for the current plan year prior to the beginning of open enrollment. The bill also allows electronic transmission of employee and enrollee statements and permits Treasury to accept full names and dates of birth in lieu of dependents' and spouses' Social Security numbers. H.R. 3650 (Improving Access to Medicare Coverage Act of 2021): This bill deems an individual receiving outpatient observation services in a hospital as an inpatient for purposes of satisfying the three-day inpatient hospital-stay requirement with respect to Medicare coverage of skilled nursing facility services. S.2048 (Improving Access to Medicare Coverage Act of 2021): This bill deems an individual receiving outpatient observation services in a hospital as an inpatient for purposes of satisfying the three-day inpatient hospital-stay requirement with respect to Medicare coverage of skilled nursing facility services. H.R. 3 (Elijah E. Cummings Lower Drug Costs Now Act): This bill establishes several programs and requirements relating to the prices of prescription drugs. H.R. 19 (Lower Costs, More Cures Act of 2021): To provide for certain reforms with respect to the Medicare program under title XVIII of the Social Security Act, the Medicaid program under title XIX of such Act, the Food and Drug Administration, and for other purposes. H.R.1799 (PPP Extension Act of 2021): This bill extends the Paycheck Protection Program, established to support small businesses in response to COVID-19 (i.e., coronavirus disease 2019), through June 30, 2021. H.R. 3775 (State-Based Universal Health Care Act of 2021): To amend title I of the Patient Protection and Affordable Care Act to authorize the establishment of, and provide support for, State-based universal health care systems that provide comprehensive health benefits to State residents, and for other purposes. S. 1180 (Choose Medicare Act): Would establish a Medicare Part E that individuals and employers can opt into. H.R.3684 (INVEST in America Act): This bill addresses provisions related to federal-aid highway, transit, highway safety, motor carrier, research, hazardous materials, and rail programs of the Department of Transportation. H.R. 1319 (American Rescue Plan Act): To provide for reconciliation pursuant to title II of S. Con. Res. 5. S. 1180: Choose Medicare Act: Would establish a Medicare Part E that individuals and employers can opt into. H.R. 1868 (Medicare Sequester): Extends a suspension of Medicare sequestration and make other technical changes to Medicare payments and Medicaid eligibility.
2021 · third_quarter · Health Issues
H.R. 5376 (Build Back Better Act): This bill provides funding, establishes programs, and otherwise modifies provisions relating to a broad array of areas, including education, labor, child care, health care, taxes, immigration, and the environment. (The bill is commonly referred to as the Build Back Better Act.) H.R.3684 - Infrastructure Investment and Jobs Act: This bill addresses provisions related to federal-aid highway, transit, highway safety, motor carrier, research, hazardous materials, and rail programs of the Department of Transportation (DOT). H.R.5318 - Commonsense Reporting Act of 2021: To streamline the employer reporting process and strengthen the eligibility verification process for the premium assistance tax credit and cost-sharing subsidy. H.R.341 - Ensuring Telehealth Expansion Act of 2021: To make permanent certain telehealth flexibilities established in response to COVID-19. H.R.5318 - Commonsense Reporting Act of 2021: This bill addresses the eligibility verification process for the premium assistance tax credit and cost-sharing subsidy under the Patient Protection and Affordable Care Act (PPACA). It requires the Department of the Treasury to develop and implement a reporting system that allows employers to voluntarily report information about their health plans for the current plan year prior to the beginning of open enrollment. The bill also allows electronic transmission of employee and enrollee statements and permits Treasury to accept full names and dates of birth in lieu of dependents' and spouses' Social Security numbers. H.R. 3650 (Improving Access to Medicare Coverage Act of 2021): This bill deems an individual receiving outpatient observation services in a hospital as an inpatient for purposes of satisfying the three-day inpatient hospital-stay requirement with respect to Medicare coverage of skilled nursing facility services. S.2048 (Improving Access to Medicare Coverage Act of 2021): This bill deems an individual receiving outpatient observation services in a hospital as an inpatient for purposes of satisfying the three-day inpatient hospital-stay requirement with respect to Medicare coverage of skilled nursing facility services. H.R. 3 (Elijah E. Cummings Lower Drug Costs Now Act): This bill establishes several programs and requirements relating to the prices of prescription drugs. H.R. 19 (Lower Costs, More Cures Act of 2021): To provide for certain reforms with respect to the Medicare program under title XVIII of the Social Security Act, the Medicaid program under title XIX of such Act, the Food and Drug Administration, and for other purposes. H.R.1799 (PPP Extension Act of 2021): This bill extends the Paycheck Protection Program, established to support small businesses in response to COVID-19 (i.e., coronavirus disease 2019), through June 30, 2021. H.R. 3775 (State-Based Universal Health Care Act of 2021): To amend title I of the Patient Protection and Affordable Care Act to authorize the establishment of, and provide support for, State-based universal health care systems that provide comprehensive health benefits to State residents, and for other purposes. S. 1180 (Choose Medicare Act): Would establish a Medicare Part E that individuals and employers can opt into. H.R. 1319 (American Rescue Plan Act): To provide for reconciliation pursuant to title II of S. Con. Res. 5. S. 1180: Choose Medicare Act: Would establish a Medicare Part E that individuals and employers can opt into. H.R. 1868 (Medicare Sequester): Extends a suspension of Medicare sequestration and make other technical changes to Medicare payments and Medicaid eligibility.
2021 · third_quarter · Medicare/Medicaid
H.R. 5376 (Build Back Better Act): This bill provides funding, establishes programs, and otherwise modifies provisions relating to a broad array of areas, including education, labor, child care, health care, taxes, immigration, and the environment. (The bill is commonly referred to as the Build Back Better Act.) H.R.5318 - Commonsense Reporting Act of 2021: To streamline the employer reporting process and strengthen the eligibility verification process for the premium assistance tax credit and cost-sharing subsidy. H.R.341 - Ensuring Telehealth Expansion Act of 2021: To make permanent certain telehealth flexibilities established in response to COVID-19. H.R.5318 - Commonsense Reporting Act of 2021: This bill addresses the eligibility verification process for the premium assistance tax credit and cost-sharing subsidy under the Patient Protection and Affordable Care Act (PPACA). It requires the Department of the Treasury to develop and implement a reporting system that allows employers to voluntarily report information about their health plans for the current plan year prior to the beginning of open enrollment. The bill also allows electronic transmission of employee and enrollee statements and permits Treasury to accept full names and dates of birth in lieu of dependents' and spouses' Social Security numbers. H.R. 3650 (Improving Access to Medicare Coverage Act of 2021): This bill deems an individual receiving outpatient observation services in a hospital as an inpatient for purposes of satisfying the three-day inpatient hospital-stay requirement with respect to Medicare coverage of skilled nursing facility services. S.2048 (Improving Access to Medicare Coverage Act of 2021): This bill deems an individual receiving outpatient observation services in a hospital as an inpatient for purposes of satisfying the three-day inpatient hospital-stay requirement with respect to Medicare coverage of skilled nursing facility services. H.R. 3 (Elijah E. Cummings Lower Drug Costs Now Act): This bill establishes several programs and requirements relating to the prices of prescription drugs. H.R. 19 (Lower Costs, More Cures Act of 2021): To provide for certain reforms with respect to the Medicare program under title XVIII of the Social Security Act, the Medicaid program under title XIX of such Act, the Food and Drug Administration, and for other purposes. H.R. 1319 (American Rescue Plan Act): To provide for reconciliation pursuant to title II of S. Con. Res. 5. S. 1180: Choose Medicare Act: Would establish a Medicare Part E that individuals and employers can opt into. H.R. 1868 (Medicare Sequester): Extends a suspension of Medicare sequestration and make other technical changes to Medicare payments and Medicaid eligibility.
2021 · third_quarter · Pharmacy
H.R. 5376 (Build Back Better Act): This bill provides funding, establishes programs, and otherwise modifies provisions relating to a broad array of areas, including education, labor, child care, health care, taxes, immigration, and the environment. (The bill is commonly referred to as the Build Back Better Act.) H.R.3684 - Infrastructure Investment and Jobs Act: This bill addresses provisions related to federal-aid highway, transit, highway safety, motor carrier, research, hazardous materials, and rail programs of the Department of Transportation (DOT). H.R.5318 - Commonsense Reporting Act of 2021: To streamline the employer reporting process and strengthen the eligibility verification process for the premium assistance tax credit and cost-sharing subsidy. H.R.341 - Ensuring Telehealth Expansion Act of 2021: To make permanent certain telehealth flexibilities established in response to COVID-19. H.R. 3 (Elijah E. Cummings Lower Drug Costs Now Act): This bill establishes several programs and requirements relating to the prices of prescription drugs. H.R. 19 (Lower Costs, More Cures Act of 2021): To provide for certain reforms with respect to the Medicare program under title XVIII of the Social Security Act, the Medicaid program under title XIX of such Act, the Food and Drug Administration, and for other purposes. H.R. 3775 (State-Based Universal Health Care Act of 2021): To amend title I of the Patient Protection and Affordable Care Act to authorize the establishment of, and provide support for, State-based universal health care systems that provide comprehensive health benefits to State residents, and for other purposes. S. 1180 (Choose Medicare Act): Would establish a Medicare Part E that individuals and employers can opt into. H.R. 1319 (American Rescue Plan Act): To provide for reconciliation pursuant to title II of S. Con. Res. 5. S. 1180: Choose Medicare Act: Would establish a Medicare Part E that individuals and employers can opt into. H.R. 1868 (Medicare Sequester): Extends a suspension of Medicare sequestration and make other technical changes to Medicare payments and Medicaid eligibility.
2021 · third_quarter · Medicare/Medicaid
H.R. 19 - Lower Costs, More Cures Act of 2021 - Rep. McMorris Rodgers, Cathy [R-WA-5] - Medicare and Medicaid reforms H.R. 56 - Patient Access to Medical Foods Act - Rep. Biggs, Andy [R-AZ-5] - coverage of medical foods H.R. 66 - CARING for Kids Act - Rep. Buchanan, Vern [R-FL-16] - CHIP extension H.R. 315 - Medicare Sequester COVID Moratorium Act - Rep. Schneider, Bradley Scott [D-IL-10] - Medicare Sequester H.R. 340 - Incentivizing Medicaid Expansion Act of 2021 - Rep. Veasey, Marc A. [D-TX-33] - Medicaid expansion H.R. 502 - Medicare Dental Benefit Act of 2021 - Rep. Barragan, Nanette Diaz [D-CA-44] - Medicare dental coverage H.R. 525 - COVID HCBS Relief Act of 2021 - Rep. Dingell, Debbie [D-MI-12] - HCBS H.R. 599 - Protecting Medicare Beneficiaries with Pre-Existing Conditions Act - Rep. Schneider, Bradley Scott [D-IL-10] - pre-existing conditions H.R. 722 - Ensuring Vaccination and Treatment Affordability Act - Rep. Pappas, Chris [D-NH-1] - cost-sharing for COVID-19 vaccines H.R. 918 - Stronger Medicaid Response to the COVID-19 Pandemic Act - Rep. Cardenas, Tony [D-CA-29] - Medicaid & COVID-19 H.R. 955 - Medicaid Reentry Act of 2021 - Rep. Tonko, Paul [D-NY-20] - Medicaid coverage H.R. 975 - Ensuring Seniors Access to COVID Treatments Act - Rep. Casten, Sean [D-IL-6] - coverage of COVID-19 drugs H.R. 1227 - Medicare-X Choice Act of 2021 - Rep. Delgado, Antonio [D-NY-19] - Medicare-X H.R. 1495 - Jim Ramstad Legacy of Recovery Act - Rep. Emmer, Tom [R-MN-6] - Medicaid coverage for SUD H.R. 1717 - Protecting Married Seniors from Impoverishment Act of 2021 - Rep. Upton, Fred [R-MI-6] - HCBS and spousal impoverishment H.R. 1722 - Puerto Rico Health Care Fairness, Accountability, and Beneficiary Access Act of 2021 - Rep. Velazquez, Nydia M. [D-NY-7] - Medicaid for territories H.R. 1791 - CHIPP Act - Rep. Barragan, Nanette Diaz [D-CA-44] - CHIP extension H.R. 1795 - Expanded Coverage for Former Foster Youth Act - Rep. Bass, Karen [D-CA-37] - coverage for foster youth H.R. 1880 - To amend the Deficit Reduction Act of 2005 to make permanent the Money Follows the Person Rebalancing Demonstration - Rep. Dingell, Debbie [D-MI-12] - Money Follows the Person extension H.R. 1969 - Medicare Advantage Integrity Act - Resident Commissioner Gonzalez-Colon, Jenniffer [R-PR-At Large] - Medicare Advantage benchmark rates H.R. 1976 - Medicare for All Act of 2021 - Rep. Jayapal, Pramila [D-WA-7] - Medicare for All H.R. 1978 - Protecting Seniors Through Immunization Act of 2021 - Rep. Kuster, Ann M. [D-NH-2] - cost sharing for vaccines under Medicare part D H.R. 1999 - Protect Seniors and Cut Waste Act - Rep. Smith, Jason [R-MO-8] - sequester for Pay-As-You-Go H.R. 2166 - Ensuring Parity in MA and PACE for Audio-Only Telehealth Act of 2021 - Rep. Sewell, Terri A. [D-AL-7] - Medicare coverage of telehealth H.R. 2217 - Territory Federal Matching Requirement Equity Act of 2021 - Resident Commissioner Gonzalez-Colon, Jenniffer [R-PR-At Large] - FMAP for territories H.R. 2297 - MIND Act - Rep. Boyle, Brendan F. [D-PA-2] - Medicaid payment for services provided in institutions for mental diseases H.R. 2464 - More Help for Seniors Act of 2021 - Rep. Craig, Angie [D-MN-2] - Medicare prescription drug benefit H.R. 2881 - Medicare Buy-In and Health Care Stabilization Act of 2021 - Rep. Higgins, Brian [D-NY-26] - Medicare public insurance H.R. 3108 - Medical Nutrition Therapy Act of 2021 - Rep. Kelly, Robin L. [D-IL-2] - coverage of medical foods H.R. 3173 - Improving Seniors Timely Access to Care Act of 2021 - Rep. DelBene, Suzan K. [D-WA-1] - prior authorization H.R. 3447 - Permanency for Audio-Only Telehealth Act - Rep. Smith, Jason [R-MO-8] - Medicare telehealth coverage H.R. 3450 - Medicaid Bump Act - Rep. Tonko, Paul [D-NY-20] - Medicaid funding and behavioral health H.R. 3894 - CARING for Social Determinants Act of 2021- Rep. Blunt Rochester, Lisa [D-DE-At Large] - Medicaid and SDOH H.R. 3961 - COVER Now Act - Rep. Doggett, Lloyd [D-TX-35] - Medicaid expansion H.R. 4040 Advancing Telehealth Beyond COVID-19 Act of 2021- Rep. Cheney, Liz [R-WY-At Large] - Medicare telehealth coverage H.R. 4043 - Ensuring Patient Access to Critical Breakthrough Products Act of 2021 - Rep. DelBene, Suzan K. [D-WA-1] - Medicare coverage of breakthrough devices H.R. 4074 - Addressing Social Determinants in Medicare Advantage Act of 2021 - Rep. Bilirakis, Gus M. [R-FL-12] - Medicare Advantage supplemental benefits H.R. 4158 - Insulin Access for All Act of 2021 - Rep. Rush, Bobby L. [D-IL-1] - cost sharing for insulin H.R. 4187 - Medicare Vision Act of 2021 - Rep. Schrier, Kim [D-WA - Medicare vision coverage H.R. 4263 - Patient Parity Protection Act of 2021 - Rep. Gottheimer, Josh [D-NJ-5] - out-of-network services H.R. 4311 - Medicare Dental, Vision, and Hearing Benefit Act of 2021 - Rep. Doggett, Lloyd [D-TX-35] - Medicare dental, vision, and hearing benefits H.R. 4406 - Supporting Medicaid in the U.S. Territories Act of 2021 - Rep. Soto, Darren [D-FL-9] - Medicaid support in U.S. territories H.R. 4439 - Medicaid Dental Benefit Act - Rep. Barragan, Nanette Diaz [D-CA-44] - Medicaid dental benefit H.R. 4640 - Close the Medigap Act of 2021 - Rep. Doggett, Lloyd [D-TX-35] - Medicare supplemental health insurance policies H.R. 4650 - Medicare Dental Coverage Act of 2021 - Rep. Kelly, Robin L. [D-IL-2] - Medicare dental benefit H.R. 4941 - PACE Part D Choice Act of 2021 - Rep. Blumenauer, Earl [D-OR-3] - prescription drug plans in the Medicare-only PACE program H.R. 4942 - BETTER Kidney Care Act - Rep. Blumenauer, Earl [D-OR-3] - demonstration program for Medicare enrollees with ESRD H.R. 4974 - State Public Option Act - Rep. Schrier, Kim [D-WA-8] - Medicaid public option H.R. 5099 - Lowering Medicare Premiums and Prescription Drug Costs Act - Rep. Schneider, Bradley Scott [D-IL-10] - Medicare cost-sharing benefits H.R. 5110 - Medicare Medically Necessary Dental Care Act of 2021 - Rep. Cohen, Steve [D-TN-9] - Medicare dental benefits H.R. 5165 - Improving Medicare Coverage Act - Rep. Jayapal, Pramila [D-WA-7] - Medicare eligibility age H.R. 5414 - Ensuring Medicaid Continuity for Children in Foster Care Act of 2021 - Rep. Bilirakis, Gus M. [R-FL-12] - Medicaid coverage for children in foster care H.R. 5425 - Protecting Rural Telehealth Access Act - Rep. O'Halleran, Tom [D-AZ-1] - Medicare telehealth services S. 97 - Medicare Dental Benefit Act of 2021 - Sen. Cardin, Benjamin L. [D-MD] - Medicare dental coverage S. 150 - Ensuring Parity in MA for Audio-Only Telehealth Act of 2021 - Sen. Cortez Masto, Catherine [D-NV] - Medicaid telehealth coverage S. 151 - COVID HCBS Relief Act of 2021 - Sen. Casey, Robert P., Jr. [D-PA] - HCBS S. 274 - Stronger Medicaid Response to the COVID-19 Pandemic Act - Sen. Bennet, Michael F. [D-CO] - Medicaid & COVID-19 S. 340 - TREATS Act - Sen. Portman, Rob [R-OH] - telehealth - Medicare telehealth coverage S. 386 - Medicare-X Choice Act of 2021 - Sen. Bennet, Michael F. [D-CO] - Medicare-X S. 448 - Ensuring Kids Have Access to Medically Necessary Dental Care Act - Sen. Cardin, Benjamin L. [D-MD] - CHIP S. 653 - COMP Act - Sen. Portman, Rob [R-OH] - Medicare secondary payer rules S. 748 - Medicare Sequester Relief Act - Sen. Shaheen, Jeanne [D-NH] - Medicare sequestration S. 1180 - Choose Medicare Act - Sen. Merkley, Jeff [D-OR] - Medicare public insurance S. 1536 - Medical Nutrition Therapy Act of 2021 - Sen. Collins, Susan M. [R-ME] - coverage of medical foods S. 1727 - Medicaid Bump Act - Sen. Smith, Tina [D-MN] - Medicaid funding and behavioral health S. 1844 - Lowering Medicare Premiums and Prescription Drug Costs Act - Sen. Casey, Robert P., Jr. [D-PA] - Medicare premiums and drug costs S. 2111 - Audio-Only Telehealth for Emergencies Act - Sen. Kennedy, John [R-LA] - Medicare coverage of telehealth S. 2112 - EASE Behavioral Health Services Act - Sen. Kennedy, John [R-LA] - telehealth S. 2164 - Lower Costs, More Cures Act of 2021 - Sen. Crapo, Mike [R-ID] - Medicare and Medicaid reforms S. 2197 - Rural and Frontier Telehealth Expansion Act - Sen. Rosen, Jacky [D-NV] - FMAP & telehealth S. 2210 - Better Care Better Jobs Act - Sen. Casey, Robert P., Jr. [D-PA] - HCBS S. 2236 - Expanding Health Care Options for Early Retirees Act - Sen. Brown, Sherrod [D-OH] - Medicare buy-in S. 2315 - Medicaid Saves Lives Act - Sen. Warnock, Raphael [D-GA] - Medicaid expansion S. 2618 - Medicare and Medicaid Dental, Vision, and Hearing Benefit Act of 2021 - Sen. Casey, Bob [D-PA] - Medicaid dental, vision, and hearing benefits S. 2639 - State Public Option Act - Sen. Schatz, Brian [D-HI] - Medicaid public option S. 2689 - Ensuring Medicaid Continuity for Children in Foster Care Act of 2021 - Sen. Burr, Richard [R-NC] - Medicaid-eligibility for children in foster care 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 2022 policy and technical regulation for MA and Part D; Part D reform, out of pocket limits; issues related to Medicare for All, Medicare buy-in, reduced Medicare eligibility age, and public option; issues relating to 2022 Rate Notice; issues related to coverage in non-Medicaid Expansion States (e.g., Gap Population); issues related to expanded Medicare fee for service benefits (dental, hearing and vision); issues related to Medicaid coverage gap; potential Medicare NCD relating to monoclonal antibodies for treatment of Alzheimers disease; 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 and vaccines; issues related to health equity; issues related to vaccination; issues related to audio-only telehealth; issues related to addressing the social determinants of health, including housing, transportation, nutrition, educational opportunities, and MA supplemental benefits; 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; 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 value based payment 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; 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; issues relating to MACRA, including implications for MA and Part D plans; 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 Affordable Care Act (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; 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. *Add MACPAC to Agency List.
2021 · third_quarter · Medicare/Medicaid
H.R.1677 To direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission, and the Medicaid and CHIP Payment and Access Commission to conduct studies and report to Congress on actions taken to expand access to telehealth services under the Medicare, Medicaid, and Children's Health Insurance programs during the COVID-19 emergency; . S.620 KEEP Telehealth Options Act of 2021; S104 HR379 Improving Social Determinants of Health Act of 2021; H.R.2517, S1125 To recommend that the Center for Medicare and Medicaid Innovation test the effect of a dementia care management model, and for other purposes; H.R.1227, S386 Medicare-X Choice Act of 2021; HR 3322-S826 Medicare Patient Empowerment Act of 2021; HR2410 Medicare & You Handbook Improvement Act of 2021; S1180 Choose Medicare Act' S748 Medicare Sequester Relief Act; HR 315 Medicare Sequester COVID Moratorium Act; HR599 Protecting Medicare Beneficiaries with Pre-Existing Conditions Act; S.2146 Improving Medicare Beneficiary Access to Innovative Diabetes Technologies Act of 2021.
Client expense: Not reported · Firm income: $11,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2021 · second_quarter · Medicare/Medicaid
H.R. 19 - Lower Costs, More Cures Act of 2021 - Rep. McMorris Rodgers, Cathy [R-WA-5] - Medicare and Medicaid reforms H.R. 56 - Patient Access to Medical Foods Act - Rep. Biggs, Andy [R-AZ-5] - coverage of medical foods H.R. 66 - CARING for Kids Act - Rep. Buchanan, Vern [R-FL-16] - CHIP extension H.R. 315 - Medicare Sequester COVID Moratorium Act - Rep. Schneider, Bradley Scott [D-IL-10] - Medicare Sequester H.R. 340 - Incentivizing Medicaid Expansion Act of 2021 - Rep. Veasey, Marc A. [D-TX-33] - Medicaid expansion H.R. 502 - Medicare Dental Benefit Act of 2021 - Rep. Barragan, Nanette Diaz [D-CA-44] - Medicare dental coverage H.R. 525 - COVID HCBS Relief Act of 2021 - Rep. Dingell, Debbie [D-MI-12] - HCBS H.R. 599 - Protecting Medicare Beneficiaries with Pre-Existing Conditions Act - Rep. Schneider, Bradley Scott [D-IL-10] - pre-existing conditions H.R. 722 - Ensuring Vaccination and Treatment Affordability Act - Rep. Pappas, Chris [D-NH-1] - cost-sharing for COVID-19 vaccines H.R. 918 - Stronger Medicaid Response to the COVID-19 Pandemic Act - Rep. Cardenas, Tony [D-CA-29] - Medicaid & COVID-19 H.R. 955 - Medicaid Reentry Act of 2021 - Rep. Tonko, Paul [D-NY-20] - Medicaid coverage H.R. 975 - Ensuring Seniors Access to COVID Treatments Act - Rep. Casten, Sean [D-IL-6] - coverage of COVID-19 drugs H.R. 1167 - Advancing Enrollment and Reducing Drug Costs Act of 2021 - Rep. Pappas, Chris [D-NH-1] - Medicare prescription drug benefit H.R. 1227 - Medicare-X Choice Act of 2021 - Rep. Delgado, Antonio [D-NY-19] - Medicare-X H.R. 1495 - To amend title XIX of the Social Security Act to provide coverage under the Medicaid program for services for the treatment of psychiatric or substance use disorders furnished to certain individuals in an institution for mental diseases, and for other purposes - Rep. Emmer, Tom [R-MN-6] - Medicaid coverage for SUD H.R. 1717 - To amend title XIX of the Social Security Act to make permanent the protections under Medicaid for recipients of home and community-based services against spousal impoverishment - Rep. Upton, Fred [R-MI-6] - HCBS and spousal impoverishment H.R. 1722 - To amend titles XI and XIX of the Social Security Act to stabilize the Medicaid program in Puerto Rico - Rep. Velazquez, Nydia M. [D-NY-7] - Medicaid for territories H.R. 1791 - To amend title XXI of the Social Security Act to permanently extend the Children's Health Insurance Program, and for other purposes - Rep. Barragan, Nanette Diaz [D-CA-44] - CHIP extension H.R. 1795 - To amend title XIX of the Social Security Act to ensure health insurance coverage continuity for former foster youth - Rep. Bass, Karen [D-CA-37] - coverage for foster youth H.R. 1880 - To amend the Deficit Reduction Act of 2005 to make permanent the Money Follows the Person Rebalancing Demonstration - Rep. Dingell, Debbie [D-MI-12] - Money Follows the Person extension H.R. 1969 - To amend title XVIII of the Social Security Act to address disparity in Medicare Advantage benchmark rates for regions with low Medicare fee-for-service penetration - Resident Commissioner Gonzalez-Colon, Jenniffer [R-PR-At Large] - Medicare Advantage benchmark rates H.R. 1976 - To establish an improved Medicare for All national health insurance program - Rep. Jayapal, Pramila [D-WA-7] - Medicare for All H.R. 1978 - To amend title XVIII of the Social Security Act to provide information regarding vaccines for seniors as part of the Medicare & You handbook and to ensure that the treatment of cost sharing for vaccines under Medicare part D is consistent with the treatment of vaccines under Medicare part B, and for other purposes - Rep. Kuster, Ann M. [D-NH-2] - cost sharing for vaccines under Medicare part D H.R. 1999 - To delay and offset the sequester under the Statutory Pay-As-You-Go Act of 2010 as a result of the enactment of the American Rescue Plan Act of 2021, and for other purpose - Rep. Smith, Jason [R-MO-8] - sequester for Pay-As-You-Go H.R. 2166 - Ensuring Parity in MA and PACE for Audio-Only Telehealth Act of 2021 - Rep. Sewell, Terri A. [D-AL-7] - Medicare coverage of telehealth H.R. 2217 - Territory Federal Matching Requirement Equity Act of 2021 - Resident Commissioner Gonzalez-Colon, Jenniffer [R-PR-At Large] - FMAP for territories H.R. 2297 - MIND Act - Rep. Boyle, Brendan F. [D-PA-2] - Medicaid payment for services provided in institutions for mental diseases H.R. 2464 - More Help for Seniors Act of 2021 - Rep. Craig, Angie [D-MN-2] - Medicare prescription drug benefit H.R. 2881 - Medicare Buy-In and Health Care Stabilization Act of 2021 - Rep. Higgins, Brian [D-NY-26] - Medicare public insurance H.R. 3108 - Medical Nutrition Therapy Act of 2021 - Rep. Kelly, Robin L. [D-IL-2] - coverage of medical foods H.R. 3173 - Improving Seniors Timely Access to Care Act of 2021 - Rep. DelBene, Suzan K. [D-WA-1] - prior authorization H.R. 3447 - To amend title XVIII of the Social Security Act to expand accessibility to certain telehealth services under the Medicare program - Rep. Smith, Jason [R-MO-8] - Medicare telehealth coverage H.R. 3450 - Medicaid Bump Act - Rep. Tonko, Paul [D-NY-20] - Medicaid funding and behavioral health H.R. 3894 - To require the Secretary of Health and Human Services to issue and disseminate guidance to States to clarify strategies to address social determinants of health under the Medicaid program and the Children's Health Insurance Program - Rep. Blunt Rochester, Lisa [D-DE-At Large] - Medicaid and SDOH H.R. 3961 - To amend title XIX of the Social Security Act to provide for a demonstration project under the Medicaid program for political subdivisions of States to provide medical assistance for the expansion population under such program - Rep. Doggett, Lloyd [D-TX-35] - Medicaid expansion H.R. 4040 - To amend title XVIII of the Social Security Act to extend telehealth flexibilities under the Medicare program - Rep. Cheney, Liz [R-WY-At Large] - Medicare telehealth coverage H.R. 4043 - To amend title XVIII of the Social Security Act to ensure prompt coverage of breakthrough devices under the Medicare program - Rep. DelBene, Suzan K. [D-WA-1] - Medicare coverage of breakthrough devices H.R. 4074 - To amend title XVIII of the Social Security Act to expand the availability of supplemental benefits to certain Medicare Advantage enrollees - Rep. Bilirakis, Gus M. [R-FL-12] - Medicare Advantage supplemental benefits H.R. 4158 - To amend titles XVIII and XIX of the Social Security Act to eliminate cost sharing with respect to coverage of insulin as a covered part D drug under the Medicare program or as a covered outpatient drug under the Medicaid program - Rep. Rush, Bobby L. [D-IL-1] - cost sharing for insulin H.R. 4187 - To amend title XVIII of the Social Security Act to provide coverage for certain vision items and services under part B of the Medicare program - Rep. Schrier, Kim [D-WA] - Medicare vision coverage H.R. 4263 - To amend title XVIII of the Social Security Act to provide for an exception to the definition of an off-campus outpatient department of a provider under the Medicare program for certain departments of a provider if such provider was forced to relocate its campus - Rep. Gottheimer, Josh [D-NJ-5] - out-of-network services S. 97 - Medicare Dental Benefit Act of 2021 - Sen. Cardin, Benjamin L. [D-MD] - Medicare dental coverage S. 150 - Ensuring Parity in MA for Audio-Only Telehealth Act of 2021 - Sen. Cortez Masto, Catherine [D-NV] - Medicaid telehealth coverage S. 151 - COVID HCBS Relief Act of 2021 - Sen. Casey, Robert P., Jr. [D-PA] - HCBS S. 274 - Stronger Medicaid Response to the COVID-19 Pandemic Act - Sen. Bennet, Michael F. [D-CO] - Medicaid & COVID-19 S. 340 - TREATS Act - Sen. Portman, Rob [R-OH] - telehealth - Medicare telehealth coverage S. 386 - Medicare-X Choice Act of 2021 - Sen. Bennet, Michael F. [D-CO] - Medicare-X S. 448 - Ensuring Kids Have Access to Medically Necessary Dental Care Act - Sen. Cardin, Benjamin L. [D-MD] - CHIP S. 653 - A bill to amend title XVIII of the Social Security Act to provide for the application of Medicare secondary payer rules to certain workers' compensation settlement agreements and qualified Medicare set-aside provisions - Sen. Portman, Rob [R-OH] - Medicare secondary payer rules S. 748 - A bill to provide for an extension of the temporary suspension of Medicare sequestration during the COVID-19 public health emergency - Sen. Shaheen, Jeanne [D-NH] - Medicare sequestration S. 1180 - Choose Medicare Act - Sen. Merkley, Jeff [D-OR] - Medicare public insurance S. 1536 - Medical Nutrition Therapy Act of 2021 - Sen. Collins, Susan M. [R-ME] - coverage of medical foods S. 1727 - Medicaid Bump Act - Sen. Smith, Tina [D-MN] - Medicaid funding and behavioral health S. 1844 - Lowering Medicare Premiums and Prescription Drug Costs Act - Sen. Casey, Robert P., Jr. [D-PA] - Medicare premiums and drug costs S. 2111 - A bill to amend title XVIII of the Social Security Act to provide for the waiver of certain telehealth requirements to permit reimbursement for audio-only telehealth services under the Medicare program during emergency declarations - Sen. Kennedy, John [R-LA] - Medicare coverage of telehealth S. 2112 - A bill to amend title XVIII of the Social Security Act and the SUPPORT for Patients and Communities Act to provide for Medicare and Medicaid mental and behavioral health treatment through telehealth - Sen. Kennedy, John [R-LA] - telehealth S. 2164 - Lower Costs, More Cures Act of 2021 - Sen. Crapo, Mike [R-ID] - Medicare and Medicaid reforms S. 2197 - A bill to amend title XIX of the Social Security Act to increase the Federal medical assistance percentage for States that provide Medicaid coverage for telehealth services - Sen. Rosen, Jacky [D-NV] - FMAP & telehealth S. 2210 - A bill to amend title XIX of the Social Security Act to expand access to home and community-based services (HCBS) under Medicaid - Sen. Casey, Robert P., Jr. [D-PA] - HCBS S. 2236 - A bill to amend title XVIII of the Social Security Act to provide an option for first responders age 50 to 64 who are separated from service due to retirement or disability to buy into Medicare - Sen. Brown, Sherrod [D-OH] - Medicare buy-in 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; Part D reform, out of pocket limits; issues related to Medicare for All, Medicare buy-in, reduced Medicare eligibility age, and public option; issues relating to 2022 Rate Notice; issues related to coverage in non-Medicaid Expansion States (e.g., Gap Population); issues related to expanded Medicare fee for service benefits (dental, hearing and vision); issues related to Medicaid coverage gap; potential Medicare NCD relating to monoclonal antibodies for treatment of Alzheimers disease; 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 and vaccines; issues related to health equity; issues related to vaccination; issues related to audio-only telehealth; issues related to addressing the social determinants of health, including housing, transportation, nutrition, educational opportunities, and MA supplemental benefits; 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; 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 value based payment 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; 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; issues relating to MACRA, including implications for MA and Part D plans; 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 Affordable Care Act (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; 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.
2021 · second_quarter · Medicare/Medicaid
H.R.1677 To direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission, and the Medicaid and CHIP Payment and Access Commission to conduct studies and report to Congress on actions taken to expand access to telehealth services under the Medicare, Medicaid, and Children's Health Insurance programs during the COVID-19 emergency; . S.620 KEEP Telehealth Options Act of 2021; S104 HR379 Improving Social Determinants of Health Act of 2021; H.R.2517, S1125 To recommend that the Center for Medicare and Medicaid Innovation test the effect of a dementia care management model, and for other purposes; H.R.1227, S386 Medicare-X Choice Act of 2021; HR 3322-S826 Medicare Patient Empowerment Act of 2021; HR2410 Medicare & You Handbook Improvement Act of 2021; S1180 Choose Medicare Act' S748 Medicare Sequester Relief Act; HR 315 Medicare Sequester COVID Moratorium Act; HR599 Protecting Medicare Beneficiaries with Pre-Existing Conditions Act.
Client expense: Not reported · Firm income: $11,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2021 · second_quarter · Taxation/Internal Revenue Code
H.R. 3650 (Improving Access to Medicare Coverage Act of 2021): This bill deems an individual receiving outpatient observation services in a hospital as an inpatient for purposes of satisfying the three-day inpatient hospital-stay requirement with respect to Medicare coverage of skilled nursing facility services. S.2048 (Improving Access to Medicare Coverage Act of 2021): This bill deems an individual receiving outpatient observation services in a hospital as an inpatient for purposes of satisfying the three-day inpatient hospital-stay requirement with respect to Medicare coverage of skilled nursing facility services. H.R. 3 (Elijah E. Cummings Lower Drug Costs Now Act): This bill establishes several programs and requirements relating to the prices of prescription drugs. H.R. 19 (Lower Costs, More Cures Act of 2021): To provide for certain reforms with respect to the Medicare program under title XVIII of the Social Security Act, the Medicaid program under title XIX of such Act, the Food and Drug Administration, and for other purposes. H.R.1799 (PPP Extension Act of 2021): This bill extends the Paycheck Protection Program, established to support small businesses in response to COVID-19 (i.e., coronavirus disease 2019), through June 30, 2021. H.R. 3775 (State-Based Universal Health Care Act of 2021): To amend title I of the Patient Protection and Affordable Care Act to authorize the establishment of, and provide support for, State-based universal health care systems that provide comprehensive health benefits to State residents, and for other purposes. S. 1180 (Choose Medicare Act): Would establish a Medicare Part E that individuals and employers can opt into. H.R.3684 (INVEST in America Act): This bill addresses provisions related to federal-aid highway, transit, highway safety, motor carrier, research, hazardous materials, and rail programs of the Department of Transportation. H.R. 1319 (American Rescue Plan Act): To provide for reconciliation pursuant to title II of S. Con. Res. 5. S. 1180: Choose Medicare Act: Would establish a Medicare Part E that individuals and employers can opt into. H.R. 1868 (Medicare Sequester): Extends a suspension of Medicare sequestration and make other technical changes to Medicare payments and Medicaid eligibility.
2021 · second_quarter · Health Issues
H.R. 3650 (Improving Access to Medicare Coverage Act of 2021): This bill deems an individual receiving outpatient observation services in a hospital as an inpatient for purposes of satisfying the three-day inpatient hospital-stay requirement with respect to Medicare coverage of skilled nursing facility services. S.2048 (Improving Access to Medicare Coverage Act of 2021): This bill deems an individual receiving outpatient observation services in a hospital as an inpatient for purposes of satisfying the three-day inpatient hospital-stay requirement with respect to Medicare coverage of skilled nursing facility services. H.R. 3 (Elijah E. Cummings Lower Drug Costs Now Act): This bill establishes several programs and requirements relating to the prices of prescription drugs. H.R. 19 (Lower Costs, More Cures Act of 2021): To provide for certain reforms with respect to the Medicare program under title XVIII of the Social Security Act, the Medicaid program under title XIX of such Act, the Food and Drug Administration, and for other purposes. H.R.1799 (PPP Extension Act of 2021): This bill extends the Paycheck Protection Program, established to support small businesses in response to COVID-19 (i.e., coronavirus disease 2019), through June 30, 2021. H.R. 3775 (State-Based Universal Health Care Act of 2021): To amend title I of the Patient Protection and Affordable Care Act to authorize the establishment of, and provide support for, State-based universal health care systems that provide comprehensive health benefits to State residents, and for other purposes. S. 1180 (Choose Medicare Act): Would establish a Medicare Part E that individuals and employers can opt into. H.R. 1319 (American Rescue Plan Act): To provide for reconciliation pursuant to title II of S. Con. Res. 5. S. 1180: Choose Medicare Act: Would establish a Medicare Part E that individuals and employers can opt into. H.R. 1868 (Medicare Sequester): Extends a suspension of Medicare sequestration and make other technical changes to Medicare payments and Medicaid eligibility.
2021 · second_quarter · Medicare/Medicaid
H.R. 3650 (Improving Access to Medicare Coverage Act of 2021): This bill deems an individual receiving outpatient observation services in a hospital as an inpatient for purposes of satisfying the three-day inpatient hospital-stay requirement with respect to Medicare coverage of skilled nursing facility services. S.2048 (Improving Access to Medicare Coverage Act of 2021): This bill deems an individual receiving outpatient observation services in a hospital as an inpatient for purposes of satisfying the three-day inpatient hospital-stay requirement with respect to Medicare coverage of skilled nursing facility services. H.R. 3 (Elijah E. Cummings Lower Drug Costs Now Act): This bill establishes several programs and requirements relating to the prices of prescription drugs. H.R. 19 (Lower Costs, More Cures Act of 2021): To provide for certain reforms with respect to the Medicare program under title XVIII of the Social Security Act, the Medicaid program under title XIX of such Act, the Food and Drug Administration, and for other purposes. H.R. 1319 (American Rescue Plan Act): To provide for reconciliation pursuant to title II of S. Con. Res. 5. S. 1180: Choose Medicare Act: Would establish a Medicare Part E that individuals and employers can opt into. H.R. 1868 (Medicare Sequester): Extends a suspension of Medicare sequestration and make other technical changes to Medicare payments and Medicaid eligibility.
Client expense: $330,000 · Firm income: Not reported
2021 · second_quarter · Pharmacy
H.R. 3 (Elijah E. Cummings Lower Drug Costs Now Act): This bill establishes several programs and requirements relating to the prices of prescription drugs. H.R. 19 (Lower Costs, More Cures Act of 2021): To provide for certain reforms with respect to the Medicare program under title XVIII of the Social Security Act, the Medicaid program under title XIX of such Act, the Food and Drug Administration, and for other purposes. H.R. 3775 (State-Based Universal Health Care Act of 2021): To amend title I of the Patient Protection and Affordable Care Act to authorize the establishment of, and provide support for, State-based universal health care systems that provide comprehensive health benefits to State residents, and for other purposes. S. 1180 (Choose Medicare Act): Would establish a Medicare Part E that individuals and employers can opt into. H.R. 1319 (American Rescue Plan Act): To provide for reconciliation pursuant to title II of S. Con. Res. 5. S. 1180: Choose Medicare Act: Would establish a Medicare Part E that individuals and employers can opt into. H.R. 1868 (Medicare Sequester): Extends a suspension of Medicare sequestration and make other technical changes to Medicare payments and Medicaid eligibility.
Client expense: $330,000 · Firm income: Not reported
2021 · first_quarter · Medicare/Medicaid
H.R. 1319 (American Rescue Plan Act): To provide for reconciliation pursuant to title II of S. Con. Res. 5. S. 1180: Choose Medicare Act: Would establish a Medicare Part E that individuals and employers can opt into. H.R. 1868 (Medicare Sequester): Extends a suspension of Medicare sequestration and make other technical changes to Medicare payments and Medicaid eligibility.
Client expense: $330,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Treasury, Dept of, White House Office
2021 · first_quarter · Health Issues
H.R. 1319 (American Rescue Plan Act): To provide for reconciliation pursuant to title II of S. Con. Res. 5. S. 1180: Choose Medicare Act: Would establish a Medicare Part E that individuals and employers can opt into. H.R. 1868 (Medicare Sequester): Extends a suspension of Medicare sequestration and make other technical changes to Medicare payments and Medicaid eligibility.
Client expense: $330,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Treasury, Dept of, White House Office
2021 · first_quarter · Pharmacy
H.R. 1319 (American Rescue Plan Act): To provide for reconciliation pursuant to title II of S. Con. Res. 5. S. 1180: Choose Medicare Act: Would establish a Medicare Part E that individuals and employers can opt into. H.R. 1868 (Medicare Sequester): Extends a suspension of Medicare sequestration and make other technical changes to Medicare payments and Medicaid eligibility.
Client expense: $330,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Treasury, Dept of, White House Office
2021 · first_quarter · Taxation/Internal Revenue Code
H.R. 1319 (American Rescue Plan Act): To provide for reconciliation pursuant to title II of S. Con. Res. 5. S. 1180: Choose Medicare Act: Would establish a Medicare Part E that individuals and employers can opt into. H.R. 1868 (Medicare Sequester): Extends a suspension of Medicare sequestration and make other technical changes to Medicare payments and Medicaid eligibility.
Client expense: $330,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Treasury, Dept of, White House Office
| Democratic |
| NJ |
| Dianne Feinstein | Democratic | CA |
| Jack Reed | Democratic | RI |
| Jeanne Shaheen | Democratic | NH |
| Richard Blumenthal | Democratic | CT |
| Richard J. Durbin | Democratic | IL |
| Tammy Baldwin | Democratic | WI |
| Tammy Duckworth | Democratic | IL |
| Tina Smith | Democratic | MN |
Government targets: HOUSE OF REPRESENTATIVES, SENATE
Client expense: Not reported · Firm income: $11,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
Client expense: $2,630,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Treasury, Dept of, White House Office
Government targets: HOUSE OF REPRESENTATIVES, SENATE
Client expense: $330,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Treasury, Dept of, White House Office
Client expense: $330,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Treasury, Dept of, White House Office
Client expense: $330,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Treasury, Dept of, White House Office
Client expense: $330,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Treasury, Dept of, White House Office
Client expense: $2,250,000 · Firm income: Not reported
Government targets: 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), Office of Management & Budget (OMB), SENATE, Treasury, Dept of, White House Office
Client expense: $2,510,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of Personnel Management (OPM), SENATE, Treasury, Dept of, White House Office
Client expense: $330,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Treasury, Dept of, White House Office
Client expense: $330,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Treasury, Dept of, White House Office
Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Treasury, Dept of, White House Office
Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Treasury, Dept of, White House Office