Ensuring Parity in MA for Audio-Only Telehealth Act of 2021

Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, star ratings, extreme and uncontrollable circumstances policy, normalization factors, stars contract consolidation, ESRD, audio-only telehealth) Medicare RAD-V Mental Health and Substance Use (42 CFR Part 2) Medicaid Managed Care Medicaid Expansion Medicaid Reform Medicaid Redeterminations CHIP Reauthorization Medicaid Actuarial Soundness Long-term Services and Supports Medicare Part D prescription drug program Medicare Advantage Pilot Program in TRICARE Pharmacy Benefit Manager (PBM) Operations and Practices, Spread Pricing Direct and Indirect Remuneration (DIR) reforms in the FY 2023 Medicare Part D Notice Affordable Insulin Now Act (H.R.6833) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Social Determents of Health (SDOH) Addressing Social Determinants in Medicare Advantage Act of 2021 (H.R.4074) Health Equity/Health Disparities Maternal health (Medicaid postpartum coverage extension, H.R.959 Black Maternal Health Momnibus Act of 2021) Helping MOMS Act of 2021 Medicare Audio-Only Telehealth (H.R.2166, S.150) Medicaid Funding for Puerto Rico Medicare Savings Program (MSP) in Medicaid Increasing on the Medicare Advantage Benchmarks to a Minimum Level H.R. 7997 (to Amend the SS Act to establish a floor in MA benchmark rates for regions with low Medicare fee-for-service penetration and to make the Medicare Savings Program available in all jurisdictions) H.R. 2217 (Territory Federal Matching Requirement Equity Act of 2021) H.R. 1825 (A Bill to Remove the Matching Requirement for Medicare Part D Drugs) H.R. 1826 (Fairness in Medicare Part B Enrollment Act) S. 3778 (Territories Medicare Prescription Drug Assistance Equity Act of 2022). Build Back Better Act (H.R.5376) Medicaid Eligibility and Redeterminations Inflation Reduction Act of 2022 (H.R. 5376) Medicare Advantage Supplemental Benefits Timely Access to Care Act (H.R. 3173 and S. 3018) 2023 Omnibus Appropriations Bill Mental Health Parity Restore Protections for Dialysis Patients Act (H.R.8594)

Client expense: $1,270,000 · Firm income: Not reported

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

H.R. 66 - CARING for Kids Act - Rep. Buchanan, Vern - CHIP H.R. 265 - Insular Area Medicaid Parity Act - Rep. Sablan, Gregorio Kilili Camacho - Medicaid funding H.R. 315 - Medicare Sequester COVID Moratorium Act - Rep. Schneider, Bradley Scott - Medicare sequestration H.R.340 - Incentivizing Medicaid Expansion Act of 2021 - Rep. Veasey, Marc - Medicaid expansion H.R. 432 - Mental Health Access Improvement Act of 2021 - Rep. Thompson, Mike -Medicare coverage of marriage and family therapist services and mental health counselor H.R. 502 - Medicare Dental Benefit Act of 2021 - Rep. Barragan, Nanette Diaz - Medicare coverage of dental and oral health services H.R. 525 - COVID HCBS Relief Act of 2021 - Rep. Dingell, Debbie - increased FMAP for HCBS H.R. 871 - Expand Medicaid Now Act - Rep. Fletcher, Lizzie - FMAP H.R. 918 - Stronger Medicaid Response to the COVID-19 Pandemic Act - Rep. Cardenas, Tony - COVID-19 coverage for the uninsured via Medicaid H.R. 955 - Medicaid Reentry Act of 2021 - Rep. Tonko, Paul -Medicaid coverage for incarcerated individuals H.R. 1167 - Advancing Enrollment and Reducing Drug Costs Act of 2021 - Rep. Pappas, Chris - Medicaid eligibility for low-income subsidies H.R. 1227 - Medicare-X Choice Act of 2021 - Rep. Delgado, Antonio - Medicare public option H.R. 1332 - Telehealth Modernization Act - Rep. Carter, Earl - telehealth services under Medicare H.R. 1349 - The COVID-19 Hospital and Health Provider Loan Conversion Act of 2021- Rep. Kaptur, Marcy - advance payments under parts A and B of Medicare H.R. 1353 - Coronavirus Medicaid Response Act - Rep. Lee, Susie - FMAP H.R. 1390 - CHIPPER Act - Rep. Wild, Susan - CHIP funding H.R. 1397 - TIKES Act - Rep. Blunt Rochester, Lisa - telehealth under Medicaid and CHIP H.R. 1609 - Treatment in Place Act - Rep. Axne, Cynthia - Medicare coverage of ambulance services H.R. 1676 - Jack Reynolds Memory Medigap Expansion Act - Rep. Axne, Cynthia - Medigap coverage for ESRD H.R. 1677 - KEEP Telehealth Options Act of 2021 - Rep. Balderson, Troy - telehealth expansion H.R. 1717 - Protecting Married Seniors from Impoverishment Act of 2021 - Rep. Upton, Fred - permanent protections against spousal impoverishment H.R. 1722 - Puerto Rico Health Care Fairness, Accountability, and Beneficiary Access Act of 2021 - Rep. Velazquez, Nydia - Medicaid in Puerto Rico H.R. 1738 - Stabilize Medicaid and CHIP Coverage Act - Rep. Dingell, Debbie - Medicaid and CHIP continuous enrollment H.R. 1784 - Medicaid REACH Act - Rep. Doggett, Lloyd - requirements for non-expansion H.R. 1791 - CHIPP Act - Rep. Barragan, Nanette Diaz - extending CHIP H.R. 1792 - Ensuring Kids Have Access to Medically Necessary Dental Care Act - Rep. Barragan, Nanette Diaz - dental coverage under CHIP H.R. 1793 - Immediate Coverage for Former Foster Youth Act - Rep. Bass, Karen - Medicaid coverage for foster youth H.R. 1794 - Foster Youth Dental Act of 2021 - Rep. Bass, Karen - Medicaid dental coverage for foster youth H.R. 1823 - To amend title XIX of the Social Security Act to remove the matching requirement for a territory to use specially allocated Federal funds for Medicare covered part D drugs for low-income individuals - Resident Commissioner Gonzalez-Colon, Jenniffer - Medicare covered part D H.R. 1825 - Territories Medicare Prescription Drug Assistance Equality Act of 2021 - Resident Commissioner Gonzalez-Colon, Jenniffer - Medicare Part D premium and cost-sharing subsidies H.R. 1826 - Fairness in Medicare Part B Enrollment Act of 2021 - Resident Commissioner Gonzalez-Colon, Jenniffer - late enrollment penalties under part B of the Medicare program H.R. 1880 - To amend the Deficit Reduction Act of 2005 to make permanent the Money Follows the Person Rebalancing Demonstration - Rep. Dingell, Debbie - Money Follows the Person Rebalancing Demonstration H.R. 1885 - RUSH Protection Act of 2021 - Rep. Kind, Ron - Medicare rural health clinic payments H.R. 1887 - Rural Hospital Support Act - Rep. Reed, Tom - Medicare payments for hospitals H.R. 1890 - Health Insurance Consumer Protection Act - Rep. Schakowsky, Janice D. - network adequacy standards and premium rates H.R. 1914 - CAHOOTS Act - Rep. DeFazio, Peter A. - Medicaid mobile crisis intervention services H.R. 1969 - Medicare Advantage Integrity Act - Resident Commissioner Gonzalez-Colon, Jenniffer - disparity in MA benchmark rates H.R. 2035 - Improving Access to Mental Health Act of 2021 - Rep. Lee, Barbara - mental health services under Medicare H.R. 2080 - SAVE Act - Rep. Bishop, Sanford D., Jr. - Medicare coverage of transportation services H.R. 2166 - Ensuring Parity in MA and PACE for Audio-Only Telehealth Act of 2021 - Rep. Sewell, Terri - Medicare Advantage payments for audio-only diagnoses H.R. 2168 - Expanded Telehealth Access Act - Rep. Sherrill, Mikie - Medicare payment for telehealth services H.R. 2170 - HAPI Act - Rep. Soto, Darren - access to vaccines and Medicaid H.R. 2179 - Affordable Insulin for the COVID-19 Emergency Act - Rep. Waters, Maxine - cost-sharing regarding insulin coverage H.R. 2217 - Territory Federal Matching Requirement Equity Act of 2021 - Resident Commissioner Gonzalez-Colon, Jenniffer - Medicaid FMAP for Territories H.R. 2228 - Rural Behavioral Health Access Act of 2021 - Rep. Kildee, Daniel - Medicare coverage of outpatient telehealth services H.R. 4074 - Addressing Social Determinants in Medicare Advantage Act of 2021 - Rep. Bilirakis, Gus M. - Medicare Advantage supplemental benefits H.R. 4640 - Close the Medigap Act of 2021 - Rep. Doggett, Lloyd - Medigap policies H.R. 6833 - Affordable Insulin Now Act - Rep. Craig, Angie - Insulin prices and cost sharing S. 150 - Ensuring Parity in MA for Audio-Only Telehealth Act of 2021 - Sen. Cortez-Masto, Catherine - coverage of audio-only telehealth services in MA S. 151 - COVID HCBS Relief Act of 2021 - Sen. Casey, Robert - FMAP and HCBS S. 245 - SAME Act of 2021 - Sen. Warner, Mark - Medicaid expansion S. 274 - Stronger Medicaid Response to the COVID-19 Pandemic Act - Sen. Bennet, Michael - COVID-19 coverage for the uninsured via Medicaid S. 285 - Medicaid Reentry Act of 2021 - Sen. Baldwin, Tammy - Medicaid coverage for incarcerated individuals S. 368 - Telehealth Modernization Act - Sen. Scott, Tim - coverage of telehealth services under Medicare S. 386 - Medicare-X Choice Act of 2021 - Sen. Bennet, Michael - Medicare public option S. 439 - Coronavirus Medicaid Response Act - Sen. Casey, Robert - increases FMAP S. 440 - Continued Funding for Senior Services During COVID-19 Act - Sen. Casey, Robert - funding for services under the Older Americans Act of 1965 S. 453 - CHIPPER Act - Sen. Casey, Robert - CHIP funding S. 581 - HAPI Act -Sen. Brown, Sherrod - vaccines under Medicaid S. 620 - KEEP Telehealth Options Act of 2021 - Sen. Fischer, Deb - telehealth expansion S. 644 - Rural Hospital Closure Relief Act of 2021 - Sen. Durbin, Richard - Medicare coverage for critical access hospitals S. 646 - Stabilize Medicaid and CHIP Coverage Act of 2021 - Sen. Brown, Sherrod - Medicaid and CHIP enrollment S. 653 - COMP Act - Sen. Portman, Rob - Medicare secondary payer rules S. 712 - Dosha Joi Immediate Coverage for Former Foster Youth Act - Sen. Casey, Robert P., Jr. - Medicaid coverage for foster youth S. 748 - Medicare Sequester Relief Act - Sen. Shaheen, Jeanne - Medicare payment sequestration S. 764 - CAHOOTS Act - Sen. Wyden, Ron - Medicaid mobile crisis intervention services S. 826 - Medicare Patient Empowerment Act of 2021 - Sen. Paul, Rand - Medicaid payment options S. 870 - Improving Access to Mental Health Act of 2021 - Sen. Stabenow, Debbie - mental health services in Medicare S. 999 - Save Rural Hospitals Act of 2021 - Sen. Warner, Mark - Medicare hospital payments Regulatory Issues: Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, network adequacy and provider directories, encounter data and other data-related issues, and risk adjustment data validation (RADV) audit issues including proposed RADV regulation for MA; bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, Part D direct and indirect remuneration (DIR), and audits); issues related to Medicare for All, Medicare buy-in, reduced Medicare eligibility age, and public option; issues relating to 2024 Rate Notice; issues related to the expiration of Medicaid continuous eligibility and transitions in coverage; issues related to coverage of EUA drugs under Medicare Part D; 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; issues related to specialty infant formula; issues related to the Inflation Reduction Act passage and implementation; contraceptive coverage and reproductive health; Medicare NCD relating to monoclonal antibodies for treatment of Alzheimers disease; issues related to Managed Long Term Services and Supports (MLTSS); issues related to removal of safe harbor protection for rebates; issues relating to COVID-19, including testing, vaccines and therapeutics; issues related to the end of the public health emergency; telehealth; issues related to the cost of insulin, including price, copays, rebates, and medical management tools; 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 or legislation, 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); issues relating to potential Medicare mental health parity requirements; 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; 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.

Client expense: $2,470,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

Legislative and administrative monitoring and outreach on healthcare policy. Legislative and administrative monitoring and outreach on prescription drug pricing/PBMs. Legislative and administrative monitoring and outreach on policy issues affecting Medicaid programs. S. 150, Ensuring Parity in MA for Audio-Only Telehealth Act of 2021. H.R. 955, Medicaid Reentry Act of 2021. H.R. 379, Improving Social Determinants of Health Act of 2021. H.R. 2903, CONNECT for Health Act of 2021. S. 1512 CONNECT for Health Act of 2021. S. 151, COVID HCBS Relief Act of 2021. H.R. 525, COVID HCBS Relief Act of 2021. H.R. 3203, To enable certain hospitals that were participating in or applied for the drug discount program under section 340B of the Public Health Service Act prior to the COVID-19 public health emergency to temporarily maintain eligibility for such program, and for other purposes. S. 1388, Prescription Pricing for the People Act of 2021. S. 773, A bill to enable certain hospitals that were participating in or applied for the drug discount program under section 340B of the Public Health Service Act prior to the COVID-19 public health emergency to temporarily maintain eligibility for such program, and for other purposes. S. 3799, PREVENT Pandemics Act. H.R. 6963, Accelerated Approval Integrity Act of 2022. H.R. 6996, Accelerating Access for Patients Act of 2022. H.R, 7007, COVID Supplemental Appropriations Act, 2022. H.R. 6833, Affordable Insulin Now Act. S. 4348, Food and Drug Administration Safety and Landmark Advancements (FDASLA) Act of 2022. H.R. 7667, Food and Drug Amendments of 2022. Implementation of H.R.5376, Inflation Reduction Act (Pub.L. 117-169) H.R.2617, Consolidated Appropriations Act, 2023

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3, Elijah E. Cummings Lower Drug Costs Now Act H.R. 1319, American Rescue Plan Act of 2021 H.R. 1976, Medicare for All Act of 2021 H.R. 2471, Consolidated Appropriations Act, 2022 H.R. 2873, Affordable Prescriptions for Patients Through Promoting Competition Act of 2021 H.R. 2884, Affordable Prescriptions for Patients Through Improvements to Patent Litigation Act H.R. 2891, Preserve Access to Affordable Generics and Biosimilars Act H.R. 3114, Longshore and Harbor Workers COVID-19 Compensation Act of 2021 H.R. 4502, Labor, Health and Human Services, Education, Agriculture, Rural Development, Energy and Water Development, Financial Services and General Government, Interior, Environment, Military Construction, Veterans Affairs, Transportation, and Housing and Urban Development Appropriations Act, 2022 H.R. 5981/S.1704, Telehealth Expansion Act of 2021 H.R. 8295, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2023 H.R. 8594/S. 4750, Restore Protections for Dialysis Patients Act S. 150, Ensuring Parity in Medicare Advantage for Audio-Only Telehealth Act S. 380, Health Savings Act of 2021 S. 1428, Preserve Access to Affordable Generics and Biosimilars Act S. 1435, Affordable Prescriptions for Patients Act of 2021 Implementation of the Transparency in Coverage Final Rule; Internal Revenue Service, Department of the Treasury; Employee Benefits Security Administration, Department of Labor; Centers for Medicare & Medicaid Services, Department of Health and Human Services (85 Fed. Reg. 72,158 - 72,310, November 12, 2020) Requirements Related to Surprise Billing; Internal Revenue Service; Employee Benefits Security Administration; Department of Health and Human Services (87 Fed. Reg. 52,618-52,655, August 26, 2022) Request for Information, Centers for Medicare & Medicaid Services; Medicare Program (87 Fed. Reg. 46,918-46,921, August 1, 2022) Notice of Proposed Rule, Employee Benefits Security Administration; Proposed Amendment to Prohibited Transaction Class Exemption 84-14 (the QPAM Exemption (87 Fed. Reg. 45,204-45,232, July 27, 2022) Affordability of Employer Coverage for Family Members of Employees (Family Glitch Regulation) (87 Fed. Reg. 20,354-20,364, April 7, 2022) Various issues relating to the employer-sponsored health care system, the "family glitch", implementation of regulatory process, provider network adequacy, health savings account (HSAs), health reimbursement account (HRAs), employer mandate; coronavirus pandemic; vaccine distribution, PPE, testing, medications and treatments, and vaccination incentives; digital health credentials; vaccine diplomacy; COVID-19 vaccine requirements, including a potential Emergency Temporary Standard from the Occupational Safety and Health Administration relating to employers with more than 100 employees; vaccine requirements for federal contractors; Executive Order 14042, Ensuring Adequate COVID Safety Protocols for Federal Contractors; implementation of the American Rescue Plan Act (P.L. 117-2); balance or surprise billing and related issues; single-payer health care options; health reimbursement arrangements and other account-based group health plans; Health and Human Services international pricing index (IPI) model; mental health parity; drug pricing; COBRA subsidies; Federal Trade Commissions multilateral pharmaceutical merger taskforce; telehealth, including coverage of telehealth under High Deductible Health Plans (HDHPs) and expanding telehealth options for employees; impact of Pharmacy Benefit Managers Practices; FTC-2022-0015; petition to HHS to grant march-in rights for the patents on the drug Xtandi; comments on COVID-19 Telehealth Program Application Evaluation Metrics (WC Docket No. 20-89); efforts to reform the World Health Organizations (WHO) engagement with private sector; continued U.S. membership to the World Health Organization (WHO); support for necessary market conditions to incentivize health sector investment from private sector; support for private sector involvement in health systems strengthening; greater harmonization of standards and investment in digital health internationally; role of private sector related pandemic prevention, preparedness and response

Client expense: $20,990,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), SENATE, State, Dept of (DOS), U.S. Agency for International Development (USAID), U.S. Trade & Development Agency (USTDA), U.S. Trade Representative (USTR)

H.R. 4911, Medicare Advantage Quality Payment Relief Act; S. 150/H.R. 2166 Ensuring Parity in MA and PACE for Audio-Only Telehealth Act of 2021; CY 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Programs H.R. 3173/S. 3018, Improving Seniors Timely Access to Care Act H.R. 2167, Consolidated Appropriations Act of 2023

Client expense: Not reported · Firm income: $30,000

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H.R. 4911, Medicare Advantage Quality Payment Relief Act; S. 150/H.R. 2166 Ensuring Parity in MA and PACE for Audio-Only Telehealth Act of 2021; CY 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Programs H.R. 3173/S. 3018, Improving Seniors Timely Access to Care Act H.R. 2167, Consolidated Appropriations Act of 2023

Client expense: Not reported · Firm income: $30,000

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H.R. 4911, Medicare Advantage Quality Payment Relief Act S. 150/H.R. 2166 Ensuring Parity in MA and PACE for Audio-Only Telehealth Act of 2021 S. 2411/ H.R. 533 Stop COVID-19 Test Surprise Medical Bills Act of 2021 H.R. 5376 Inflation Reduction Act H.R. 3173/S. 3018, Improving Seniors Timely Access to Care Act H.R. 2167, Consolidated Appropriations Act of 2023

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

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H.R. 4911, Medicare Advantage Quality Payment Relief Act S. 150/H.R. 2166 Ensuring Parity in MA and PACE for Audio-Only Telehealth Act of 2021 S. 2411/ H.R. 533 Stop COVID-19 Test Surprise Medical Bills Act of 2021 H.R. 5376 Inflation Reduction Act H.R. 3173/S. 3018, Improving Seniors Timely Access to Care Act H.R. 2167, Consolidated Appropriations Act of 2023

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

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Telehealth Expansion Act; Telehealth issues related to COVID-19; S. 150/H.R. 2166, Ensuring Parity in MA for Audio-Only Telehealth Act of 2021; Continued monitoring of Provider Relief Fund; H.R. 8800, Supporting Medicare Providers Act of 2022; Issues related to physician payment cuts, including APM bonuses; Issues related to Inflation Reduction Act of 2022 (PL 117-169) and implementation

Client expense: Not reported · Firm income: $50,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Implementation of American Rescue Plan Act of 2021 (PL 117-2); Continued monitoring of Consolidated Appropriations Act, 2021 (PL 116-260); Extension of the Medicare Sequester; H.R. 1868, To prevent across-the-board direct spending cuts, and for other purposes; S. 748, Medicare Sequester Relief Act; Telehealth Expansion Act; Telehealth issues related to COVID-19; S. 150/H.R. 2166, Ensuring Parity in MA for Audio-Only Telehealth Act of 2021; Medicare Advantage flexibilities; Monitoring of Medicare Advantage, particularly as it relates to changes in coding intensity, benchmarks, and health risk assessments; CMS Advance Notice of Methodological Changes for Calendar Year (CY) 2023 for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies; Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model; S. 4293, Pharmacy Benefit Manager Transparency Act of 2022; Issues related to the OIG, GAO, MedPAC reports on Medicare Advantage; S. 3018/H.R. 3173, Improving Seniors Timely Access to Care Act of 2021; CMS RFI on Medicare Advantage S. 4605/H.R. 8581, The Preserving Access to Home Health Act of 2022; Advancing Interoperability and Improving Prior Authorization Processes Proposed Rule CMS-0057-P; Contract Year 2024 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs Proposed Rule CMS-4201-P; CY 2023 Home Health Prospective Payment System Rate Update and Home Infusion Therapy Services Requirements - Final Rule CMS-1766-F

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare and Medicaid dual eligible integration; Performance evaluation/quality oversight; SES (socio-economic status) issues related to SNP payment rates and quality measures; Telehealth issues related to COVID-19; S. 150/H.R. 2166, Ensuring Parity in MA for Audio-Only Telehealth Act of 2021; Drug pricing proposals and impact to SNP plans serving beneficiaries with high-cost drugs; Monitoring of Medicare Advantage, particularly as it relates to changes in coding intensity, benchmarks, and health risk assessments; CMS Advance Notice of Methodological Changes for Calendar Year (CY) 2023 for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies; Issues related to the OIG, GAO, MedPAC reports on Medicare Advantage; S. 4264, Advancing Integration in Medicare and Medicaid (AIM) Act; S. 4273, Supporting States in Integrating Care Act of 2022; S. 3018/H.R. 3173, Improving Seniors Timely Access to Care Act of 2021; CMS RFI on Medicare Advantage; Cassidy/Scott RFI on dual eligible beneficiaries; Contract Year 2024 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs Proposed Rule CMS-4201-P

Client expense: Not reported · Firm income: $50,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare and Medicaid dual eligible integration; SES (socio-economic status) issues (including Homelessness) related to special needs plan (SNP) payment rates and quality measures; CMMI discussions re: homelessness and healthcare; Health equity issues; Telehealth issues related to COVID-19; S. 150/H.R. 2166, Ensuring Parity in MA for Audio-Only Telehealth Act of 2021; Monitoring of Medicare Advantage, particularly as it relates to changes in coding intensity, benchmarks, and health risk assessments; CMS Advance Notice of Methodological Changes for Calendar Year (CY) 2023 for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies; Draft legislation that seeks to reduce health equity gaps in the Medicare Advantage program; Issues related to the OIG, GAO, MedPAC reports on Medicare Advantage; S. 3018/H.R. 3173, Improving Seniors Timely Access to Care Act of 2021; CMS RFI on Medicare Advantage; Cassidy/Scott RFI on dual eligible beneficiaries; Contract Year 2024 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs Proposed Rule CMS-4201-P

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Value of prescription drugs; Monitor drug pricing legislation, including H.R. 3, Elijah E. Cummings Lower Drug Costs Now; Prescription Drug Pricing Reduction Act; Extension of the Medicare Sequester; S. 748, Medicare Sequester Relief Act; Telehealth Expansion Act; Telehealth issues related to COVID-19; S. 150/H.R. 2166, Ensuring Parity in MA for Audio-Only Telehealth Act of 2021; Proposed repeal of the CMS Rule on Most Favored Nation Model; Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model; Issues related to the OIG, GAO, MedPAC reports on Medicare Advantage; S. 3018/HR. 3173, Improving Seniors Timely Access to Care Act of 2021; Cassidy/Scott RFI on dual eligible beneficiaries; Contract Year 2024 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs Proposed Rule CMS-4201-P

Client expense: Not reported · Firm income: $60,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Inflation Reduction Act of 2022 (PL 117-169) - extending enhanced premium assistance for ACA marketplace plans through 2025; H.R. 2617, Consolidated Appropriations Act, 2023 - extending all Medicare telehealth flexibilities extended in the Consolidated Appropriations Act of 2022 through December 31, 2024 and possible changes to Medicare provider directory policies; Committee Print 117-1 - Improvements to Medicare Inpatient and Outpatient Mental Health Services (H.R. 8879, Inpatient Psychiatric Facility Improvement Act; H.R. 8878, To amend title XVIII of the Social Security Act to ensure adequate coverage of outpatient mental health services under the Medicare program); Committee Print 117-2 - Improvements to the Medicare Program Related to Physician Services and Education (H.R. 432, Mental Health Access Improvement Act of 2021; H.R. 8910, Behavioral Health Integration Awareness Act of 2022; H.R. 8884, To direct the Secretary of Health and Human Services to provide outreach and reporting on opioid use disorder treatment services furnished by opioid treatment programs under the Medicare program; H.R. 8890, Physician Wellness Program Act of 2022; H.R. 8908, Fighting Stimulant and other Substance Use Disorders Act); Committee Print 117-3 - Requiring Coverage of Forensic Medical Exams with No Cost Sharing (H.R. 8891, No Surprises for Survivors Act of 2022); Committee Print 117-4 - Improved Information in Provider Directories, Plan Definitions and Crisis Services for Private Insurance Plans (H.R. 8885, Better Health Care Directories Act; H.R. 8886, Promoting Clarity in Mental Health and Substance Use Disorder Treatment Act; H.R. 8892, To direct the Secretary of Health and Human Services to conduct a public outreach campaign to inform individuals covered under a group health plan or group or individual health insurance coverage of Federal requirements relating to mental health and substance use disorder crisis services, and for other purposes); Committee Print 117-5 - Improved Information for Network Coverage and Plan Documents in Private Insurance Plans (H.R. 8881, To amend the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to require group health plans and health insurance issuers offering group or individual health insurance coverage to disclose the percentage of in-network participation for certain provider types, and for other purposes; H.R. 8889, Readable Insurance Coverage Explanations Act (RICE Act)); Telehealth issues related to COVID-19; S. 150/H.R. 2166, Ensuring Parity in MA for Audio-Only Telehealth Act of 2021; HELP Committee bipartisan efforts to improve public health and medical preparedness/response programs; Over the Counter Covid Testing Guidance; Test to Treat Initiative; Issues related to the implementation of the No Surprises Act; S. 3799, PREVENT Pandemics Act; S. 3700/H.R. 6833, Affordable Insulin Now Act; Issues related to the Senate Finance report on mental health and mental health legislation; Senate Finance Committee bipartisan Discussion Draft: Ensuring Access to Telemental Health Services; Senate Finance Committee bipartisan Discussion Draft: Improving Access to Physical and Mental Health Care for Children and Youth under Medicaid and CHIP; Senate Finance Committee bipartisan Discussion Draft: Mental Health Workforce; Bipartisan Safer Communities Act, P.L. 117-159, specifically policy related to access to mental health services for youth and families through Medicaid and CHIP and telehealth; H.R. 7666, Restoring Hope for Mental Health and Well-Being Act of 2022; Issues related to FDA user fee reauthorization bills (H.R. 7667, Food and Drug Amendments of 2022; S. 4348, Food and Drug Administration Safety and Landmark Advancements Act of 2022 (FDSLA Act of 2022), including accelerated approval, reimportation, and orphan drugs; Issues related to the Public Health Emergency; H.R. 7007, COVID Supplemental Appropriations Act, 2022; S. 4293, Pharmacy Benefit Manager Transparency Act of 2022; Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act; Executive Order Directing HHS to Explore Additional Actions to Lower Prescription Drug Costs

Client expense: Not reported · Firm income: $80,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 150, Ensuring Parity in MA for Audio-Only Telehealth Act of 2021, all provisions H.R. 2166, Ensuring Parity in MA and PACE for Audio-Only Telehealth Act, all provisions Issues related to Medicare Advantage

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Implementation of HR 1319, American Rescue Plan Act of 2021; S. 150, Ensuring Parity in MA for Audio-Only Telehealth Act of 2021; FMAP Issues; 340B issues; S. 386, Telemedicine Modernization Act; HR 1332, Telemedicine Modernization Act; Hospital Consolidation issues; The Connect for Health Act (H.R. 2903/S.1512); Protecting Medicare and American Farmers from Sequester Cuts Act PL 117-71; PA Medicaid MCO contract requirements; Prescription drug coverage; Medicare Advantage issues; Inflation Reduction Act, healthcare provisions; Improving Seniors Timely Access to Care Act of 2021 H.R. 3173; mental health and substance abuse; Consolidated Appropriations Act, 2023 (P.L. 117-328)

Client expense: Not reported · Firm income: $120,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

Sequestration relief (Protecting Medicare and American Farmers from Sequester Cuts Act - S. 610) Rural hospital policies [Rural Health Clinic payment - Rural and Underserved Small Hospital Protection Act/RUSH Act (H.R. 1885), Rural HELP Act - HR 1749; Rural Hospital Closure Relief Act (H.R. 1639/S.644)] Graduate Medical Education (GME) funding (Resident Physician Shortage Reduction Act of 2021 - S. 834/H.R. 2256; Opioid Workforce Act, S. 1438)/ Substance Use Disorder Workforce Act, H.R. 3441) H.R. 1749 (study on potential disparities in incurred costs for rural and urban hospitals and authorizing appropriate payment adjustments) S. 439, Coronavirus Medicaid Response Act (addressing FMAP) Telehealth flexibilities and payment (TREAT Act - S. 168/H.R. 708; Telehealth Modernization Act -S. 368/H.R. 1332; TREATS Act - S. 340; CONNECT for Health Act S. 1512/H.R. 2903; Ensuring Parity in MA and PACE for Audio-Only Telehealth Act S. 150/H.R. 2166; Consolidated Appropriations Act of 2022, HR 2471) Prior Authorization reform - Improving Seniors Timely Access to Care Act of 2021 (H.R. 3173/S.3018) S.586 / H.R. 3259 - Non-Opioids Prevent Addiction In the Nation (NOPAIN) Act Annual Prospective Payment System Rules S. 408, Supporting Best Practices for Healthy Moms Act (to reduce maternal mortality) Nursing and allied health education (NAHE) program funding Technical Reset to Advance the Instruction of Nurses (TRAIN) Act (S. 1568 / HR 4407) - Nursing and allied health education payments Organ acquisition payment policies Clinical lab fee schedule Medicare Mental Health Inpatient Equity Act (S. 3061/H.R. 5674) HR 4040: Advancing Telehealth Beyond COVID-19 Act

Client expense: $250,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Advantage data and quality improvement. Telehealth coverage under Medicare Advantage Program; Issues related to systems improvement for STARS rating. H.R.2166 - To amend title XVIII of the Social Security Act to require the inclusion of certain audio-only diagnoses in the determination of risk adjustment for Medicare Advantage plans and PACE programs, and for other purposes. S.150 - Ensuring Parity in MA for Audio-Only Telehealth Act of 2021. Issues related to assignment of patients for Direct Contracting Entities. Medicare sequestration delay; statutory pay-go. Social determinants of Health; Health equity. ACO Reach Model. H.R. 2617 - Consolidated Appropriation Act, 2023.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, White House Office

Medicare Advantage. Rebate Rule. Prescription Drug Pricing. Medicare expansions and Medicare for all. Medicare Part D reform. Medicaid expansion. Medicare for All Act of 2021. H.R.1868 - To prevent across-the-board direct spending cuts, and for other purposes. S.150 - Raise the Wage Act. H.R.2166/S.150 - Global Health Security Act of 2020 on audio-only telehealth parity. Medicare vision, dental, and hearing. Medicare sequestration, statutory pay-go applicability to providers and health plans. CY 2023 Medicare Advantage and Part D Proposed Rule (CMS-4192-P). H.R. 8885 - Better Healthcare Directories Act. H.R. 8886 - Promoting Clarity in Mental Health Substance Use Disorder Treatment Act. H.R.8892 - To direct the Secretary of Health and Human Services to conduct a public outreach campaign to inform individuals covered under a group health plan or group or individual health insurance coverage of Federal requirements relating to mental health and substance use disorder crisis services, and for other purposes. H.R.8881 - To amend the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to require group health plans and health insurance issuers offering group or individual health insurance coverage to disclose the percentage of in-network participation for certain provider types, and for other purposes. H.R.8889 - RICE Act. Implementation of Inflation Reduction Act (H.R. 5376) Public Law 117-169. H.R. 2617 - Consolidated Appropriations Act, 2023.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, White House Office

Issues related to Medicare Advantage and Part D prescription drug programs; Issues related to Prescription Drug Rebates; Issues related to Dual Eligible and Medicare Advantage Special Needs Plans; Issues related to Social Determinants of Health (SDOH)/Health Equity; and Issues related to Telehealth. 117th Congress Inflation Reduction Act of 2022 Budget Reconciliation/Biden Administration Build Back Better Plan COVID-19 American Rescue Plan American Jobs Plan Medicare Sequester COVID Moratorium Act (H.R. 315) Delay of the Prescription Drug Rebate Rule Ensuring Parity in MA for Audio-Only Telehealth Act of 2021 (S. 150) The Ensuring Parity in MA and PACE for Audio-Only Telehealth Act (HR 2166) Previous Congresses H.R. 3461, Community-Based Independence for Seniors Act H.R. 3877, Bipartisan Budget Act H.R. 19, Lower Costs, More Cures Act of 2019 S. 3013, Encouraging Innovative Benefit Design to Lower Costs for Seniors Act H.R. 6074, Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 H.R. 6201, Families First Coronavirus Response Act H.R. 748, CARES Act H.R. 6800, HEROES Act H.R. 7659, Ensuring Parity in MA for Audio-Only Telehealth Act of 2020 S. 4318, American Workers, Families and Employers Assistance Act S. 4199, Prescription Drug Pricing Reduction Act of 2020 S.4840, Ensuring Parity in MA for Audio-Only Telehealth Act of 2020 Bipartisan Coronavirus Relief and Omnibus Funding Bill H.R. 4074, Addressing Social Determinants in Medicare Advantage PL 115-123: H.R. 1892, The bipartisan Budget Act of 2018; H.R. 3168, To amend title XVIII of the Social Security Act to provide continued access to specialized Medicare Advantage plans for special needs individuals, and for other purposes; S. 870, CHRONIC Care Bill PL 115-271: H.R. 6, SUPPORT for Patients and Communities Act

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

HR 3173/S 3018: Seniors Timely Access to Care Act : Medicare Advantage Prior Authorization Reform. HR 8800 Supporting Medicare Providers Act of 2022: Stops the 2023 Medicare Fee Schedule Payment cuts of 4.42%. RFI (Bera, Bucshon) on Medicare Payment Reform. HR 7995: The GOLD CARD Act of 2022: Medicare Advantage Prior Authorization Reform. HR 4587 Value in Health Care Act to Improve the Medicare APM Programs and extend the APM/ACO 5% incentive payments. S 150: Ensuring Parity in Medicare Advantage for Audio-only Telehealth Act. CMS-0057-P; RIN 0938-AU87: Advancing Interoperability and Improving Prior Authorization Processes for Medicare Advantage Organizations, Medicaid Managed Care Plans. State Medicaid Agencies, Childrens Health Insurance Program (CHIP) Agencies, and CHIP Managed Care Entities, Issuers. CMS 9899-P; RIN 0938-AU97: Patient Protection and Affordable Care Act HHS Notice of Benefit and Payment Parameters (NBPP) for 2024. CMS File Code 1770-P; Medicare and Medicaid Programs; CY 2023 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment Policies. Medicare Shared Savings Program Requirements. Covid-19 Provider Relief Fund Distribution and Reporting Requirements. No Surprise Act Final Rule: HHS 45 CFR Part 149; CMS-9909-F and CMS 9908-F; RIN 0938-AU62 and RIN 0938-AU63. Requirements Related to Surprise Billing.

Client expense: $55,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

HR 5376 Inflation Reduction Act of 2022. Provisions related to health care coverage, Medicare, Medicaid, COVID funding and mental/behavioral health HR 4128 VALID Act HR 8487 - Improving Seniors' Timely Access to Care Act of 2022 S 3792 & HR 7053 Hospital Inpatient Services Modernization Act HR 959 Black Maternal Health Omnibus Act of 2021 HR 4074 Addressing Social Determinants in Medicare Advantage Act of 2021 HR 4911 Medicare Advantage Quality Payment Relief Act HR 5370 Medically Tailored Home-Delivered Meals Demonstration Pilot Act of 2021 HR 5376 Build Back Better Act, to provide for Budget Reconciliation HR 3 Elijah E. Cummings Lower Drug Costs Now Act HR 19 and S. 2164 Lower Costs, More Cures Act of 2021 HR 3063 Maximizing Outcomes for Moms through Medicaid Improvement and Enhancement of Services (Mommies) Act HR 3172 Homes for Every Local Protector, Educator, and Responder (HELPER) Act of 2021 HR 2166 & S 150 Ensuring Parity in MA for Audio-Only Telehealth Act of 2021 S 833 Empowering Medicare Seniors to Negotiate Drug Prices Act of 2021 S 908 Medicare Drug Price Negotiation Act HR 2139 Medicare Drug Price Negotiation Act

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

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Sequestration relief (Protecting Medicare and American Farmers from Sequester Cuts Act - S. 610) Rural hospital policies [Rural Health Clinic payment - Rural and Underserved Small Hospital Protection Act/RUSH Act (H.R. 1885), Rural HELP Act - HR 1749; Rural Hospital Closure Relief Act (H.R. 1639/S.644)] Graduate Medical Education (GME) funding (Resident Physician Shortage Reduction Act of 2021 - S. 834/H.R. 2256; Opioid Workforce Act, S. 1438)/ Substance Use Disorder Workforce Act, H.R. 3441) H.R. 1749 (study on potential disparities in incurred costs for rural and urban hospitals and authorizing appropriate payment adjustments) S. 439, Coronavirus Medicaid Response Act (addressing FMAP) Telehealth flexibilities and payment (TREAT Act - S. 168/H.R. 708; Telehealth Modernization Act -S. 368/H.R. 1332; TREATS Act - S. 340; CONNECT for Health Act S. 1512/H.R. 2903; Ensuring Parity in MA and PACE for Audio-Only Telehealth Act S. 150/H.R. 2166; Consolidated Appropriations Act of 2022, HR 2471) Resetting the Impact (TRIA) Act of 2021 (H.R. 2455) Prior Authorization reform - Improving Seniors Timely Access to Care Act of 2021 (H.R. 3173/S.3018) S.586 / H.R. 3259 - Non-Opioids Prevent Addiction In the Nation (NOPAIN) Act Annual Prospective Payment System Rules Accelerated and Advance Payment Program repayment flexibility (H.R. 1349, The COVID-19 Hospital and Health Provider Loan Conversion Act of 2021; H.R. 2407, Better Way for Providers to Repay Act of 2021) S. 408, Supporting Best Practices for Healthy Moms Act (to reduce maternal mortality) Nursing and allied health education (NAHE) program funding Technical Reset to Advance the Instruction of Nurses (TRAIN) Act (S. 1568 / HR 4407) - Nursing and allied health education payments Organ acquisition payment policies Clinical lab fee schedule False Claims Act amendments CMS Omnibus COVID-19 Health Care Staff Vaccination Interim Final Rule Hospital Inpatient Services Modernization Act (H.R. 7053 /S. 3792) - to extend the hospital at home waiver program Medicare Mental Health Inpatient Equity Act (S. 3061/H.R. 5674) HR 4040: Advancing Telehealth Beyond COVID-19 Act HELP Act Inpatient Psychiatric Facility Improvement Act MIND Act

Client expense: $70,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

TRAIN Act (S. 1568/H.R. 4407) to stop cuts to nursing and allied health programs Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 7961) to protect healthcare workers. Sequestration relief Rural hospital policies (Rural Health Clinic payment - H.R. 1868; Rural Hospital Closure Relief Act H.R. 1639/S.644; Rural and Underserved Small Hospital Protection Act/RUSH Act (H.R. 1885); Rural America Health Corps Act (S. 924/H.R. 2130); Rural America Health Corps Act S.54); Rural Hospital Support Act (S. 4009) and the Assistance for Rural Community Hospitals (ARCH) Act (H.R. 8747) to extend the MDH and LVA programs) Hospital Inpatient Services Modernization Act (S. 3792/H.R. 7053) Value in Health Care Act (H.R. 4587) Graduate Medical Education (GME) funding (Resident Physician Shortage Reduction Act of 2021 S. 834/H.R. 2256); Opioid Workforce Act S. 1438/ Substance Use Disorder Workforce Act H.R. 3441 Telehealth flexibilities and payment (Telehealth Extension Act - H.R. 6202; TREAT Act - S. 168/H.R. 708; Telehealth Modernization Act - S. 368/H.R. 1332; TREATS Act - S. 340; CONNECT for Health Act S. 1512/H.R. 2903; Ensuring Parity in MA and PACE for Audio-Only Telehealth Act S. 150/H.R. 2166) Resetting the Impact (TRIA) Act of 2021 H.R. 2455 Technical Reset to Advance the Instruction of Nurses (TRAIN) Act Value in Healthcare Act (H.R. 4587) Improving Seniors Timely Access to Care Act (S. 3018/H.R. 3173) Annual Prospective Payment System Rules

Client expense: $200,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H.R. 2166/S. 150 - Ensuring Parity in MA and PACE for Audio-Only Telehealth Act of 2021 PACE regulations and PACE demonstration. Medicaid and Medicare reimbursement. Medicare Part D reform. COVID provider relief fund, access to COVID treatments and vaccines. Issues related to Audio only Medicare. HCBS issues. Medicare sequestration delay; statutory pay-go impact on Medicare providers. S. 3626 - PACE Expanded Act. H.R. 4941/S. 5106 - PACE Part D Choice Act of 2021. H.R 6770/S. 1162 - PACE Plus Act. H.R. 2617 - Consolidated Appropriations Act, 2023.

Client expense: Not reported · Firm income: $30,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE

Medicare Advantage (MLR, risk adjustment, star ratings, supplemental benefits), Medicare Prior Authorization (H.R. 3173), Prescription Drug Rebates, Medicare Part D and Part D restructuring (H.R. 3, H.R. 19, S. 2164), Insulin Affordability (S. 3700, H.R. 6833), Telehealth, Build Back Better Act (H. Res. 601 & S. Con. Res. 14), Federal Coronavirus Response (American Rescue Plan, H.R. 1319), Parity for Audio-Only Risk Adjustment (H.R. 2166, S. 150), Inflation Reduction Act (P.L. 117-169), Third Party Marketing Organization Requirements, Behavioral Health (House Ways and Means Committee prints 117-1 & 117-2), Consolidated Appropriations Act, 2023 (P.L. 117-403).

Client expense: $570,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

H.R. 5487 - Value in Health Care Act of 2021 S. 2652 / H.R. 5067 - Preserving Patient Access to Home Infusion Act S.308 / H.R.1436 - PPE in America Act S.1260 - United States Innovation and Competition Act of 2021 S. 936 / H.R. 5502 - INFORM Consumers Act S. 2648 - Rural ACO Improvement Act S. 1574 / H.R.5632 - Long-Term Care Pharmacy Definition Act S. 834 / H.R. 2256 - Resident Physician Shortage Reduction Act of 2021 H.R.3173 / S 3018 - Improving Seniors Timely Access to Care Act of 2021 H.R. 3746 - Accountable Care in Rural America Act H.R. 959 / S. 364 - Black Maternal Health Momnibus Act of 2021 H.R. 4387 / S. 1675 - Maternal Health Quality Improvement Act of 2021 S. 168 / H.R. 708 - Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act S. 150 - Ensuring Parity in MA for Audio Only-Telehealth Act S. 3146 - The Protecting Patients from Counterfeit Medical Devices Act S. 3799 - The PREVENT Pandemics Act H.R. 6520 - The Medical and Health Stockpile Accountability Act of 2022, automated data collection infrastructure for healthcare supply chain S. 3416 - The Protecting Patients from Counterfeit Medical Devices Act S. 3493 - Drug Shortages Shelf Life Extension Act H.R. 4521 - America COMPETES Act of 2022 S.610 - Protecting Medicare and American Farmers from Sequester Cuts Act H.R.3684 - Infrastructure Investment and Jobs Act H.R. 4735 / S. 2493 - The Provider Relief Extension Act H.R. 3589 - Better Way for Providers To Repay Act of 2021 H.R. 3203 / S. 773 - To allow hospitals that were participating in or applied for the 340B drug discount program before the public health emergency to temporarily maintain eligibility H.R. 7961 - Safety from Violence for Healthcare Employees (SAVE) Act H.R. 7410 - The American Made Medicine Act H.R. 7053/S. 3792 - Hospital Inpatient Services Modernization Act H.R. 8747 - Assistance for Rural Community Hospitals (ARCH) Act H.R. 8800 - Supporting Medicare Providers Act of 2022 H.R. 4040 - Advancing Telehealth Beyond COVID-19 Act FY 2022 Omnibus Appropriations Bill S. 5249 - Preserving Patient Access to Value-Based Care Act 340B Drug Discount Program eligbility Incentivize Domestic Manufacturing Hospital Infrastructure Support FDA User Fee Reauthorization Bills Healthcare workforce (Graduate medical education , health professional training programs, recruitment and retension incentives) Medicare provider payment cuts (Medicare sequestration cuts, physician fee schedule 3.75% reduction due to evaluation & management code increases/budget neturality adjustment, Pay-as-You-Go reductions due to American Rescue Plan) Climate change healthcare impact HHS FY 2023 appropriations - Removal of a ban on using federal funds for implementing a unique patient identification system (Section 510) and fuding for Childrens Hospitals Graduate Medical Education (CHGME) Program ACO Assignment Bill NQF/Quality Measurement funding authorization Preparing for the next pandemic and supply chain resiliency

Client expense: $240,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Executive Office of the President (EOP), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H.R.6833 - Making continuing appropriations for fiscal year 2023, and for other purposes. Medicare and Medicaid dual eligible integration; Telehealth issues related to PHE/COVID-19; SDOH and SES issues related to SNP payment rates and quality measures; S. 150/H.R. 2166, Ensuring Parity in MA for Audio-Only Telehealth Act of 2021; Drug pricing proposals and impact to SNP plans serving beneficiaries with high-cost drugs; Monitoring of Medicare Advantage coding intensity Monitor mental health legislative efforts HR 5376 Inflation Reduction Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Implementation of HR 1319, American Rescue Plan Act of 2021; S. 150, Ensuring Parity in MA for Audio-Only Telehealth Act of 2021; FMAP Issues; 340B issues; S. 386, Telemedicine Modernization Act; HR 1332, Telemedicine Modernization Act; Hospital Consolidation issues; The Connect for Health Act (H.R. 2903/S.1512); Protecting Medicare and American Farmers from Sequester Cuts Act PL 117-71; PA Medicaid MCO contract requirements; Prescription drug coverage; Medicare Advantage issues; Inflation Reduction Act, healthcare provisions; Improving Seniors Timely Access to Care Act of 2021 H.R. 3173; mental health and substance abuse

Client expense: Not reported · Firm income: $120,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, star ratings, extreme and uncontrollable circumstances policy, normalization factors, stars contract consolidation, ESRD, audio-only telehealth) Medicare RAD-V Mental health and substance use (42 CFR Part 2) Medicaid managed care (IMD Exclusion) Medicaid expansion Medicaid reform (block grants, per capita caps) Medicaid and CHIP reauthorization Medicaid actuarial soundness Long-term services and supports Medicare Part D prescription drug program and Medicare Part D coverage gap (donut hole) Opioid addiction issues and response (prescription drug monitoring programs) Medicaid medical loss ratio remittance Medicare Advantage Pilot Program in TRICARE Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing Direct and Indirect Remuneration (DIR) reforms in the FY 2023 Medicare Part D Notice H.R.6833 - Affordable Insulin Now Act Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act H.R.7666 - Restoring Hope for Mental Health and Well-Being Act of 2022 Social Determents of Health (SDOH) H.R.4074 - Addressing Social Determinants in Medicare Advantage Act of 2021 Health Equity/Health Disparities Maternal health (Medicaid postpartum coverage extension, H.R.959 Black Maternal Health Momnibus Act of 2021) Helping MOMS Act of 2021 Medicare Audio-Only Telehealth (H.R.2166, S.150) Continuing Resolution (CR)FY 2022 Medicaid Funding for Puerto Rico Medicare Savings Program (MSP) in Medicaid Increasing on the Medicare Advantage benchmarks to a minimum level H.R. 7997 (to Amend the SS Act to establish a floor in MA benchmark rates for regions with low Medicare fee-for-service penetration and to make the Medicare Savings Program available in all jurisdictions) H.R. 2217 (Territory Federal Matching Requirement Equity Act of 2021) H.R. 1825 (A Bill to Remove the Matching Requirement for Medicare Part D Drugs) H.R. 1826 (Fairness in Medicare Part B Enrollment Act) S. 3778 (Territories Medicare Prescription Drug Assistance Equity Act of 2022). H.R.5376 - Build Back Better Act Medicaid eligibility and redeterminations H.R. 5376 - Inflation Reduction Act of 2022 Medicare Advantage Supplemental Benefits

Client expense: $1,590,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE, White House Office

COVID-19 Response, including COVID-19 bills legislation implementation Medicare Advantage Policy and Reimbursement 2023 Medicare Advantage Advance Rate Notice CMS-4192-P 2023 Medicare Care Advantage Part D Proposed Rule Medicare Part D Issues Medicaid and Dual Eligible Issues Pharmacy Reimbursement Issues Medicare Home Health Issues Prescription Drug Rebate issues, including Removal of Safe Harbor Protection for Rebates Involving Prescription Pharmaceuticals and Creation of New Safe Harbor Protection for Certain Point-of-Sale Reductions in Price on Prescription Pharmaceuticals and Certain Pharmacy Benefit Manager Service Fees S. 150/H.R. 2166, Ensuring Parity in MA for Audio-Only Telehealth Act of 2021 H.R. 4074, A bill to expand the availability of supplemental benefits to certain Medicare Advantage enrollees Medicare Hospice Issues Medicare Vision, Dental & Hearing Inflation Reduction Act of 2022 (HR 5376) Public Law No. 117-169 CMS-1772-P CY 2023 Hospital Outpatient PPS Policy Changes and Payment Rates and Ambulatory Surgical Center Payment System Policy Changes and Payment Rates CMS-1771-P Hospital Inpatient Prospective Payment System for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal Year 2023 Rates CMS-1770-P Revisions to Payment Policies under the Medicare Physician Fee Schedule, Quality Payment Program and Other Revisions to Part B for CY 2023 S. 3018/H.R. 3173, Improving Seniors Timely Access to Care Act CMS-1766-P CY 2023 Home Health Prospective Payment System Rate Update; Home Health Quality Reporting Program Requirements; Home Health Value-Based Purchasing Expanded Model Requirements; and Home Infusion Therapy Services Requirements CMS-4203-NC Medicare Program; Request for Information on Medicare

Client expense: $1,220,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, White House Office

Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, star ratings, extreme and uncontrollable circumstances policy, normalization factors, stars contract consolidation, ESRD, audio-only telehealth H.R. 4074 -To amend title XVIII of the Social Security Act Medicare RAD-V Mental health and substance use (42 CFR Part 2) Medicaid (IMD Exclusion) Medicaid expansion Medicaid reform (block grants, per capita caps) Medicaid and CHIP reauthorization Medicaid actuarial soundness Long-term services and supports Social Determents of Health (SDOH) Medicare Part D prescription drug program and Medicare Part D coverage gap (donut hole) Opioid addiction issues and response (prescription drug monitoring programs) Medicaid medical loss ratio remittance Medicare Advantage Pilot Program in TRICARE Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing Against Direct and Indirect Remuneration (DIR) reforms in the FY 2023 Medicare Part D Notice H.R.6833 - Affordable Insulin Now Act Maternal health (Medicaid postpartum coverage extension, H.R.959 Black Maternal Health Momnibus Act of 2021) Helping MOMS Act of 2021 CMS Extreme & Uncontrollable Circumstances Policy Medicare Sequester (H.R.315, S.748) Medicare Audio-Only Telehealth (H.R.2166, S.150) Continuing Resolution (CR)FY 2022 Medicaid Funding for Puerto Rico Medicaid Funding for Puerto Rico including discussions on the FMAP, ESRD, and LTSS. Medicare Advantage issues such as rates, benchmarks, providers payments, and disparities in funding for territories. Medicare Advantage asks regarding the underfunding and disparity for Puerto Rico H.R.5376 - Build Back Better Act Medicaid eligibility Health Equity/Health Disparities

Client expense: $1,570,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE, Treasury, Dept of

H.R. 66 - CARING for Kids Act - Rep. Buchanan, Vern - CHIP H.R. 265 - Insular Area Medicaid Parity Act - Rep. Sablan, Gregorio Kilili Camacho - Medicaid funding H.R. 315 - Medicare Sequester COVID Moratorium Act - Rep. Schneider, Bradley Scott - Medicare sequestration H.R. 340 - Incentivizing Medicaid Expansion Act of 2021 - Rep. Veasey, Marc - Medicaid expansion H.R. 432 - Mental Health Access Improvement Act of 2021 - Rep. Thompson, Mike -Medicare coverage of marriage and family therapist services and mental health counselor H.R. 502 - Medicare Dental Benefit Act of 2021 - Rep. Barragan, Nanette Diaz - Medicare coverage of dental and oral health services H.R. 525 - COVID HCBS Relief Act of 2021 - Rep. Dingell, Debbie - increased FMAP for HCBS H.R. 871 - Expand Medicaid Now Act - Rep. Fletcher, Lizzie - FMAP H.R. 918 - Stronger Medicaid Response to the COVID-19 Pandemic Act - Rep. Cardenas, Tony - COVID-19 coverage for the uninsured via Medicaid H.R. 955 - Medicaid Reentry Act of 2021 - Rep. Tonko, Paul -Medicaid coverage for incarcerated individuals H.R. 1167 - Advancing Enrollment and Reducing Drug Costs Act of 2021 - Rep. Pappas, Chris - Medicaid eligibility for low-income subsidies H.R. 1227 - Medicare-X Choice Act of 2021 - Rep. Delgado, Antonio - Medicare public option H.R. 1332 - Telehealth Modernization Act - Rep. Carter, Earl - telehealth services under Medicare H.R. 1349 - The COVID-19 Hospital and Health Provider Loan Conversion Act of 2021- Rep. Kaptur, Marcy - advance payments under parts A and B of Medicare H.R. 1353 - Coronavirus Medicaid Response Act - Rep. Lee, Susie - FMAP H.R. 1390 - CHIPPER Act - Rep. Wild, Susan - CHIP funding H.R. 1397 - TIKES Act - Rep. Blunt Rochester, Lisa - telehealth under Medicaid and CHIP H.R. 1609 - Treatment in Place Act - Rep. Axne, Cynthia - Medicare coverage of ambulance services H.R. 1676 - Jack Reynolds Memory Medigap Expansion Act - Rep. Axne, Cynthia - Medigap coverage for ESRD H.R. 1677 - KEEP Telehealth Options Act of 2021 - Rep. Balderson, Troy - telehealth expansion H.R. 1717 - Protecting Married Seniors from Impoverishment Act of 2021 - Rep. Upton, Fred - permanent protections against spousal impoverishment H.R. 1722 - Puerto Rico Health Care Fairness, Accountability, and Beneficiary Access Act of 2021 - Rep. Velazquez, Nydia - Medicaid in Puerto Rico H.R. 1738 - Stabilize Medicaid and CHIP Coverage Act - Rep. Dingell, Debbie - Medicaid and CHIP continuous enrollment H.R. 1784 - Medicaid REACH Act - Rep. Doggett, Lloyd - requirements for non-expansion H.R. 1791 - CHIPP Act - Rep. Barragan, Nanette Diaz - extending CHIP H.R. 1792 - Ensuring Kids Have Access to Medically Necessary Dental Care Act - Rep. Barragan, Nanette Diaz - dental coverage under CHIP H.R. 1793 - Immediate Coverage for Former Foster Youth Act - Rep. Bass, Karen - Medicaid coverage for foster youth H.R. 1794 - Foster Youth Dental Act of 2021 - Rep. Bass, Karen - Medicaid dental coverage for foster youth H.R. 1823 - To amend title XIX of the Social Security Act to remove the matching requirement for a territory to use specially allocated Federal funds for Medicare covered part D drugs for low-income individuals - Resident Commissioner Gonzalez-Colon, Jenniffer - Medicare covered part D H.R. 1825 - Territories Medicare Prescription Drug Assistance Equality Act of 2021 - Resident Commissioner Gonzalez-Colon, Jenniffer - Medicare Part D premium and cost-sharing subsidies H.R. 1826 - Fairness in Medicare Part B Enrollment Act of 2021 - Resident Commissioner Gonzalez-Colon, Jenniffer - late enrollment penalties under part B of the Medicare program H.R. 1880 - To amend the Deficit Reduction Act of 2005 to make permanent the Money Follows the Person Rebalancing Demonstration - Rep. Dingell, Debbie - Money Follows the Person Rebalancing Demonstration H.R. 1885 - RUSH Protection Act of 2021 - Rep. Kind, Ron - Medicare rural health clinic payments H.R. 1887 - Rural Hospital Support Act - Rep. Reed, Tom - Medicare payments for hospitals H.R. 1890 - Health Insurance Consumer Protection Act - Rep. Schakowsky, Janice D. - network adequacy standards and premium rates H.R. 1914 - CAHOOTS Act - Rep. DeFazio, Peter A. - Medicaid mobile crisis intervention services H.R. 1969 - Medicare Advantage Integrity Act - Resident Commissioner Gonzalez-Colon, Jenniffer - disparity in MA benchmark rates H.R. 2035 - Improving Access to Mental Health Act of 2021 - Rep. Lee, Barbara - mental health services under Medicare H.R. 2080 - SAVE Act - Rep. Bishop, Sanford D., Jr. - Medicare coverage of transportation services H.R. 2166 - Ensuring Parity in MA and PACE for Audio-Only Telehealth Act of 2021 - Rep. Sewell, Terri - Medicare Advantage payments for audio-only diagnoses H.R. 2168 - Expanded Telehealth Access Act - Rep. Sherrill, Mikie - Medicare payment for telehealth services H.R. 2170 - HAPI Act - Rep. Soto, Darren - access to vaccines and Medicaid H.R. 2179 - Affordable Insulin for the COVID-19 Emergency Act - Rep. Waters, Maxine - cost-sharing regarding insulin coverage H.R. 2217 - Territory Federal Matching Requirement Equity Act of 2021 - Resident Commissioner Gonzalez-Colon, Jenniffer - Medicaid FMAP for Territories H.R. 2228 - Rural Behavioral Health Access Act of 2021 - Rep. Kildee, Daniel - Medicare coverage of outpatient telehealth services H.R. 4074 - Addressing Social Determinants in Medicare Advantage Act of 2021 - Rep. Bilirakis, Gus M. - Medicare Advantage supplemental benefits H.R. 4640 - Close the Medigap Act of 2021 - Rep. Doggett, Lloyd - Medigap policies H.R. 6833 - Affordable Insulin Now Act - Rep. Craig, Angie - Insulin prices and cost sharing S. 150 - Ensuring Parity in MA for Audio-Only Telehealth Act of 2021 - Sen. Cortez-Masto, Catherine - coverage of audio-only telehealth services in MA S. 151 - COVID HCBS Relief Act of 2021 - Sen. Casey, Robert - FMAP and HCBS S. 245 - SAME Act of 2021 - Sen. Warner, Mark - Medicaid expansion S. 274 - Stronger Medicaid Response to the COVID-19 Pandemic Act - Sen. Bennet, Michael - COVID-19 coverage for the uninsured via Medicaid S. 285 - Medicaid Reentry Act of 2021 - Sen. Baldwin, Tammy - Medicaid coverage for incarcerated individuals S. 368 - Telehealth Modernization Act - Sen. Scott, Tim - coverage of telehealth services under Medicare S. 386 - Medicare-X Choice Act of 2021 - Sen. Bennet, Michael - Medicare public option S. 439 - Coronavirus Medicaid Response Act - Sen. Casey, Robert - increases FMAP S. 440 - Continued Funding for Senior Services During COVID-19 Act - Sen. Casey, Robert - funding for services under the Older Americans Act of 1965 S. 453 - CHIPPER Act - Sen. Casey, Robert - CHIP funding S. 581 - HAPI Act -Sen. Brown, Sherrod - vaccines under Medicaid S. 620 - KEEP Telehealth Options Act of 2021 - Sen. Fischer, Deb - telehealth expansion S. 644 - Rural Hospital Closure Relief Act of 2021 - Sen. Durbin, Richard - Medicare coverage for critical access hospitals S. 646 - Stabilize Medicaid and CHIP Coverage Act of 2021 - Sen. Brown, Sherrod - Medicaid and CHIP enrollment S. 653 - COMP Act - Sen. Portman, Rob - Medicare secondary payer rules S. 712 - Dosha Joi Immediate Coverage for Former Foster Youth Act - Sen. Casey, Robert P., Jr. - Medicaid coverage for foster youth S. 748 - Medicare Sequester Relief Act - Sen. Shaheen, Jeanne - Medicare payment sequestration S. 764 - CAHOOTS Act - Sen. Wyden, Ron - Medicaid mobile crisis intervention services S. 826 - Medicare Patient Empowerment Act of 2021 - Sen. Paul, Rand - Medicaid payment options S. 870 - Improving Access to Mental Health Act of 2021 - Sen. Stabenow, Debbie - mental health services in Medicare S. 999 - Save Rural Hospitals Act of 2021 - Sen. Warner, Mark - Medicare hospital payments Regulatory Issues: Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, network adequacy and provider directories, encounter data and other data-related issues, and risk adjustment data validation (RADV) audit issues including proposed RADV regulation for MA; bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, Part D direct and indirect remuneration (DIR), and audits); calendar year 2023 policy and technical regulation for MA and Part D; issues related to Medicare for All, Medicare buy-in, reduced Medicare eligibility age, and public option; issues relating to 2023 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; issues related to specialty infant formula; issues related to the Inflation Reduction Act passage and implementation; contraceptive coverage and reproductive health; Medicare NCD relating to monoclonal antibodies for treatment of Alzheimers disease; issues related to Managed Long Term Services and Supports (MLTSS); issues related to removal of safe harbor protection for rebates; issues relating to COVID-19, including testing, vaccines and therapeutics; issues related to the end of the public health emergency; telehealth; issues related to the cost of insulin, including price, copays, rebates, and medical management tools; 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 or legislation, 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); issues relating to potential Medicare mental health parity requirements; 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; 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.

Client expense: $3,230,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

HR 5376 Inflation Reduction Act of 2022. Provisions related to health care coverage, Medicare, Medicaid, COVID funding and mental/behavioral health HR 4128 VALID Act HR 8487 - Improving Seniors' Timely Access to Care Act of 2022 S 3792 & HR 7053 Hospital Inpatient Services Modernization Act HR 959 Black Maternal Health Omnibus Act of 2021 HR 4074 Addressing Social Determinants in Medicare Advantage Act of 2021 HR 4911 Medicare Advantage Quality Payment Relief Act HR 5370 Medically Tailored Home-Delivered Meals Demonstration Pilot Act of 2021 HR 5376 Build Back Better Act, to provide for Budget Reconciliation HR 3 Elijah E. Cummings Lower Drug Costs Now Act HR 19 and S. 2164 Lower Costs, More Cures Act of 2021 HR 3063 Maximizing Outcomes for Moms through Medicaid Improvement and Enhancement of Services (Mommies) Act HR 3172 Homes for Every Local Protector, Educator, and Responder (HELPER) Act of 2021 HR 2166 & S 150 Ensuring Parity in MA for Audio-Only Telehealth Act of 2021 S 833 Empowering Medicare Seniors to Negotiate Drug Prices Act of 2021 S 908 Medicare Drug Price Negotiation Act HR 2139 Medicare Drug Price Negotiation Act

Client expense: $2,580,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H.R. 3, Elijah E. Cummings Lower Drug Costs Now Act H.R. 1319, American Rescue Plan Act of 2021 H.R. 1976, Medicare for All Act of 2021 H.R. 2471, Consolidated Appropriations Act, 2022 H.R. 2873, Affordable Prescriptions for Patients Through Promoting Competition Act of 2021 H.R. 2884, Affordable Prescriptions for Patients Through Improvements to Patent Litigation Act H.R. 2891, Preserve Access to Affordable Generics and Biosimilars Act H.R. 3114, Longshore and Harbor Workers COVID-19 Compensation Act of 2021 H.R. 4502, Labor, Health and Human Services, Education, Agriculture, Rural Development, Energy and Water Development, Financial Services and General Government, Interior, Environment, Military Construction, Veterans Affairs, Transportation, and Housing and Urban Development Appropriations Act, 2022 H.R. 8295, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2023 S. 150, Ensuring Parity in Medicare Advantage for Audio-Only Telehealth Act S. 380, Health Savings Act of 2021 S. 1428, Preserve Access to Affordable Generics and Biosimilars Act S. 1435, Affordable Prescriptions for Patients Act of 2021 Nomination of Robert Gordon to be Assistant Secretary for Financial Resources at the Department of Health and Human Services Implementation of the Transparency in Coverage Final Rule; Internal Revenue Service, Department of the Treasury; Employee Benefits Security Administration, Department of Labor; Centers for Medicare & Medicaid Services, Department of Health and Human Services (85 Fed. Reg. 72,158 - 72,310, November 12, 2020) Requirements Related to Surprise Billing; Internal Revenue Service; Employee Benefits Security Administration; Department of Health and Human Services (87 Fed. Reg. 52,618-52,655, August 26, 2022) Request for Information, Centers for Medicare & Medicaid Services; Medicare Program (87 Fed. Reg. 46,918-46,921, August 1, 2022) Affordability of Employer Coverage for Family Members of Employees (Family Glitch Regulation) (87 Fed. Reg. 20,354-20,364, April 7, 2022) Various issues relating to Patient Protection and Affordable Care Act (P.L. 111-148) and the Health Care and Education Affordability Reconciliation Act of 2010 (P.L. 111-152), including the employer-sponsored health care system, implementation of regulatory process, provider network adequacy, delivery system reform, health savings account (HSAs), health reimbursement account (HRAs), and flexible spending account (FSAs) changes, IPAB, employer mandate, reporting requirements for issuers and applicable large employers, premium stabilization programs, medical loss ratio, medical malpractice reform, exchanges, the impact on small business; coronavirus pandemic; vaccine distribution, PPE, testing, medications and treatments, and vaccination incentives; digital health credentials; vaccine diplomacy; COVID-19 vaccine requirements, including a potential Emergency Temporary Standard from the Occupational Safety and Health Administration relating to employers with more than 100 employees; vaccine requirements for federal contractors; Executive Order 14042, Ensuring Adequate COVID Safety Protocols for Federal Contractors; implementation of the American Rescue Plan Act (P.L. 117-2); balance or surprise billing and related issues; single-payer health care options; health reimbursement arrangements and other account-based group health plans; Health and Human Services international pricing index (IPI) model; mental health parity; drug pricing; COBRA subsidies; Federal Trade Commissions multilateral pharmaceutical merger taskforce; telehealth, including coverage of telehealth under High Deductible Health Plans (HDHPs) and expanding telehealth options for employees; impact of Pharmacy Benefit Managers Practices; FTC-2022-0015; petition to HHS to grant march-in rights for the patents on the drug Xtandi; petition to the Department of Labor Requesting a 60-Day Extension to Comment on Proposed Amendment(s) to Prohibited Transaction Class Exemption 84-14; comments on COVID-19 Telehealth Program Application Evaluation Metrics (WC Docket No. 20-89); efforts to reform the World Health Organizations (WHO) engagement with private sector; continued U.S. membership to the World Health Organization (WHO); support for necessary market conditions to incentivize health sector investment from private sector; support for private sector involvement in health system strengthening; greater harmonization of standards and investment in digital health internationally; role of private sector related pandemic prevention, preparedness and response

Client expense: $23,940,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), SENATE, State, Dept of (DOS)

HR 5376: Inflation Reduction Act: Authorizes Medicare drug price negotiation; Extends the Affordable Care Act premium tax credits for 3 years and addresses climate change. HR 3173/S 3018: Seniors Timely Access to Care Act : Medicare Advantage Prior Authorization Reform. HR 8800 Supporting Medicare Providers Act of 2022: Stops the 2023 Medicare Fee Schedule Payment cuts of 4.42%. Additional Medicare Payment Reform (Legislation to be introduced): - Provide an automatic annual Medicare inflation update for physicians based on the Medicare Economic Index. - Stop the 4% PAYGO-related Medicare physician payment cut for 2023. - RFI (Bera, Bucshon) on Medicare Payment Reform. S 150: Ensuring Parity in Medicare Advantage for Audio-only Telehealth Act. HR 7995: The GOLD CARD Act of 2022: Medicare Advantage Prior Authorization Reform. HR 4587 Value in Health Care Act to Improve the Medicare APM Programs and extend the APM/ACO 5% incentive payments. S 150: Ensuring Parity in Medicare Advantage for Audio-only Telehealth Act. CMS File Code 1770-P; Medicare and Medicaid Programs; CY 2023 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment Policies. Medicare Shared Savings Program Requirements. Covid-19 Provider Relief Fund Distribution and Reporting Requirements. No Surprise Act Final Rule: HHS 45 CFR Part 149; CMS-9909-F and CMS 9908-F; RIN 0938-AU62 and RIN 0938-AU63. Requirements Related to Surprise Billing.

Client expense: $55,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

H.R. 4911, Medicare Advantage Quality Payment Relief Act; S. 150/H.R. 2166 Ensuring Parity in MA and PACE for Audio-Only Telehealth Act of 2021; CY 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Programs H.R. 3173/S. 3018, Improving Seniors Timely Access to Care Act

Client expense: Not reported · Firm income: $30,000

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H.R. 4911, Medicare Advantage Quality Payment Relief Act; S. 150/H.R. 2166 Ensuring Parity in MA and PACE for Audio-Only Telehealth Act of 2021; CY 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Programs H.R. 3173/S. 3018, Improving Seniors Timely Access to Care Act

Client expense: Not reported · Firm income: $30,000

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H.R. 4911, Medicare Advantage Quality Payment Relief Act; S. 150/H.R. 2166 Ensuring Parity in MA and PACE for Audio-Only Telehealth Act of 2021; S. 2411/ H.R. 533 Stop COVID-19 Test Surprise Medical Bills Act of 2021; H.R. 5376 Build Back Better Act

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

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H.R. 4911, Medicare Advantage Quality Payment Relief Act; S. 150/H.R. 2166 Ensuring Parity in MA and PACE for Audio-Only Telehealth Act of 2021; S. 2411/ H.R. 533 Stop COVID-19 Test Surprise Medical Bills Act of 2021; H.R. 5376 Build Back Better Act

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

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Sequestration relief (Protecting Medicare and American Farmers from Sequester Cuts Act - S. 610) Rural hospital policies [Rural Health Clinic payment - Rural and Underserved Small Hospital Protection Act/RUSH Act (H.R. 1885), Rural HELP Act - HR 1749; Rural Hospital Closure Relief Act (H.R. 1639/S.644)] Graduate Medical Education (GME) funding (Resident Physician Shortage Reduction Act of 2021 - S. 834/H.R. 2256; Opioid Workforce Act, S. 1438)/ Substance Use Disorder Workforce Act, H.R. 3441) H.R. 1749 (study on potential disparities in incurred costs for rural and urban hospitals and authorizing appropriate payment adjustments) S. 439, Coronavirus Medicaid Response Act (addressing FMAP) Telehealth flexibilities and payment (TREAT Act - S. 168/H.R. 708; Telehealth Modernization Act -S. 368/H.R. 1332; TREATS Act - S. 340; CONNECT for Health Act S. 1512/H.R. 2903; Ensuring Parity in MA and PACE for Audio-Only Telehealth Act S. 150/H.R. 2166; Consolidated Appropriations Act of 2022, HR 2471) Resetting the Impact (TRIA) Act of 2021 (H.R. 2455) Prior Authorization reform - Improving Seniors Timely Access to Care Act of 2021 (H.R. 3173/S.3018) S.586 / H.R. 3259 - Non-Opioids Prevent Addiction In the Nation (NOPAIN) Act Annual Prospective Payment System Rules Accelerated and Advance Payment Program repayment flexibility (H.R. 1349, The COVID-19 Hospital and Health Provider Loan Conversion Act of 2021; H.R. 2407, Better Way for Providers to Repay Act of 2021) S. 408, Supporting Best Practices for Healthy Moms Act (to reduce maternal mortality) Nursing and allied health education (NAHE) program funding Technical Reset to Advance the Instruction of Nurses (TRAIN) Act (S. 1568 / HR 4407) - Nursing and allied health education payments Organ acquisition payment policies Clinical lab fee schedule False Claims Act amendments CMS Omnibus COVID-19 Health Care Staff Vaccination Interim Final Rule Hospital Inpatient Services Modernization Act (H.R. 7053 /S. 3792) - to extend the hospital at home waiver program Medicare Mental Health Inpatient Equity Act (S. 3061/H.R. 5674) HR 4040: Advancing Telehealth Beyond COVID-19 Act HELP Act Inpatient Psychiatric Facility Improvement Act MIND Act

Client expense: $80,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Advantage. Rebate Rule. Prescription Drug Pricing. Medicare expansions and Medicare for all. Medicare Part D reform. Medicaid expansion. Medicare for All Act of 2021. H.R.1868 - To prevent across-the-board direct spending cuts, and for other purposes. S.150 - Raise the Wage Act. H.R.2166/S.150 - Global Health Security Act of 2020 on audio-only telehealth parity. Medicare vision, dental, and hearing. Medicare sequestration, statutory pay-go applicability to providers and health plans. CY 2023 Medicare Advantage and Part D Proposed Rule (CMS-4192-P). Inflation Reduction Act (HR 5376) Public Law 117-169. H.R. 6833 - Continuing Resolution. H.R. 8885 - Better Healthcare Directories Act. H.R. 8886 - Promoting Clarity in Mental Health Substance Use Disorder Treatment Act. H.R.8892 - To direct the Secretary of Health and Human Services to conduct a public outreach campaign to inform individuals covered under a group health plan or group or individual health insurance coverage of Federal requirements relating to mental health and substance use disorder crisis services, and for other purposes. H.R.8881 - To amend the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to require group health plans and health insurance issuers offering group or individual health insurance coverage to disclose the percentage of in-network participation for certain provider types, and for other purposes. H.R.8889 - RICE Act.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, White House Office

Implementation of American Rescue Plan Act of 2021 (PL 117-2); Continued monitoring of Consolidated Appropriations Act, 2021 (PL 116-260); Extension of the Medicare Sequester; H.R. 1868, To prevent across-the-board direct spending cuts, and for other purposes; S. 748, Medicare Sequester Relief Act; Telehealth Expansion Act; Telehealth issues related to COVID-19; S. 150/H.R. 2166, Ensuring Parity in MA for Audio-Only Telehealth Act of 2021; Medicare Advantage flexibilities; Monitoring of Medicare Advantage, particularly as it relates to changes in coding intensity, benchmarks, and health risk assessments; CMS Advance Notice of Methodological Changes for Calendar Year (CY) 2023 for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies; Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model; S. 4293, Pharmacy Benefit Manager Transparency Act of 2022; Issues related to the OIG, GAO, MedPAC reports on Medicare Advantage; S. 3018/H.R. 3173, Improving Seniors Timely Access to Care Act of 2021; CMS RFI on Medicare Advantage S. 4605/H.R. 8581, The Preserving Access to Home Health Act of 2022

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

Medicare and Medicaid dual eligible integration; Performance evaluation/quality oversight; SES (socio-economic status) issues related to SNP payment rates and quality measures; Telehealth issues related to COVID-19; S. 150/H.R. 2166, Ensuring Parity in MA for Audio-Only Telehealth Act of 2021; Drug pricing proposals and impact to SNP plans serving beneficiaries with high-cost drugs; Monitoring of Medicare Advantage, particularly as it relates to changes in coding intensity, benchmarks, and health risk assessments; CMS Advance Notice of Methodological Changes for Calendar Year (CY) 2023 for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies; Issues related to the OIG, GAO, MedPAC reports on Medicare Advantage; S. 4264, Advancing Integration in Medicare and Medicaid (AIM) Act; S. 4273, Supporting States in Integrating Care Act of 2022; S. 3018/H.R. 3173, Improving Seniors Timely Access to Care Act of 2021; CMS RFI on Medicare Advantage

Client expense: Not reported · Firm income: $50,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE