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Protecting Access to Lifesaving Screenings Act of 2021
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Protecting Access to Lifesaving Screenings Act of 2021 or the PALS Act This bill makes a series of changes relating to health insurance coverage of screening mammography. Specifically, the bill requires that any provision of law referring to current recommendations of the U.S. Preventive Services Task Force (USPSTF) with respect to breast cancer screening mammography be administered as if (1) the provision referred to USPSTF recommendations last issued before 2009; and (2) those recommendations applied to any screening mammography modality, including any digital modality of such a procedure. This requirement shall also apply to the Veterans Health Administration's policy on mammography screening for veterans. In addition, the bill preserves Medicare coverage for screening mammography, without a requirement for coinsurance, and expands the definition of screening mammography to include any digital modality of such a procedure. Further, the Centers for Medicare & Medicaid Services may not decrease the frequency with which screening mammography may be paid by Medicare for a woman over 39 years of age. In 2009, the USPSTF updated its guidelines to recommend against routine screening mammography for women between 40 to 49 years of age and to recommend biennial, instead of annual, screening mammography for most women between 50 to 74 years of age. In 2015, through the appropriations process, a three-year moratorium was placed on implementing the guidelines; the moratorium was subsequently renewed until January 1, 2023.
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Filing registrants (3)
2022 · fourth_quarter · Insurance
H.R. 4612/S. 2412 - Protecting Access to Lifesaving Screenings Act of 2021; a bill to make a series of changes relating to health insurance coverage of screening mammography H.R. 5769/S. 1067 - Access to Breast Cancer Diagnosis Act; bill to reduce out-of-pocket costs for medical-necessary diagnostic breast imaging H.R. 2163/S. 464 - Safe Step Act; bill to require a group health plan or health insurance coverage offered in connection with such a plan to provide an exceptions process for any medication step therapy protocol, and for other purposes H.R. 4385/S.3080 - Cancer Drug Parity Act; bill to require health plans that cover anticancer medications administered by a health care provider to provide no less favorable cost sharing for patient-administered anticancer medications. H.R. 5801 - Help Ensure Lower Patient (HELP) Copays Act; a bill to amend title XXVII of the Public Health Service Act to apply additional payments, discounts, and other financial assistance towards the cost-sharing requirements of health insurance plans, and for other purposes H.R. 7045/S. 3796 - Closing Health Coverage Gaps for Public Servants Act; a bill to eliminate the opt-out for nonfederal governmental health plans, including the opt-out for coverage for full mastectomy and reconstruction care Administrative actions necessary to reduce out-of-pocket costs for medical-necessary diagnostic breast imaging Issues related to regulation of short-term limited duration plans Implementation of the No Surprises Act Implementation of the Inflation Reduction Act Implementation of the Affordable Care Act Policies regarding White House Cancer Moonshot implementation Public and private insurance adjustments and other policy changes due to the COVID-19 emergency, including those impacting the immunocompromised populations S. 942 - No Junk Plans Act; bill to overturn previous administration rule expanding non-comprehensive health insurance plans that dont have to provide healthcare coverage for people with pre-existing conditions S. 1002 - Junk Plan Accountability and Disclosure Act; a bill which establishes requirements for certain noncomprehensive health insurance coverage and provides for additional outreach activities to increase enrollment in qualified health plans Policies related to co-pay assistance programs Comments in response to the RFI on Advanced Explanation of Benefits and Good Faith Estimate for Covered Individuals (CMS9900-NC) Comments regarding Section 1557 Nondiscrimination in Health Programs and Activities (RIN 0945-AA17)
Read twice and referred to the Committee on Finance. (Sponsor introductory remarks on measure: CR S5020)
Introduced in Senate
Bills with similar content found using semantic analysis.
Sources: Congress.gov
Client expense: $50,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Personnel Management (OPM), Office of Science & Technology Policy (OSTP), SENATE, Treasury, Dept of, White House Office
2022 · fourth_quarter · Medicare/Medicaid
H.R. 469 - Comprehensive Breast Reconstruction Act of 2021; bill provides for Medicare, Medicaid, and private health insurance coverage of certain tattooing services in connection with post-mastectomy breast reconstruction, and aligns the scope of Medicare and Medicaid coverage of such breast reconstruction with that of private health insurance. H.R. 1946/S. 1873 -Medicare Multi-Cancer Early Detections Screening and Coverage Act; bill to amend title XVIII of the Social Security Act to provide for Medicare coverage of multi-cancer early detection screening test H.R. 3183/S. 1312 - Metastatic Breast Cancer Access to Care Act; bill to exempt individuals with metastatic breast cancer from certain waiting periods for disability insurance benefits under the Old-Age, Survivors, and Disability Insurance program and related Medicare coverage H.R. 2903/S. 1512 - CONNECT for Health Act; a bill to expand the use of telehealth and remote patient monitoring services in Medicare H.R. 3087/S. 2051 - Breast Cancer Patient Equity Act; a bill to provide for Medicare coverage of custom fabricated breast prostheses H.R. 3630/S. 1315 - Lymphedema Treatment Act; bill to include certain lymphedema compression treatment items as covered durable medical equipment under Medicare following the surgical removal of the breast (i.e., a mastectomy), including replacements of such prostheses H.R. 4110 - Reducing Hereditary Cancer Act of 2021; a bill to provide hereditary cancer genetic testing for individuals with a history of a hereditary cancer gene mutation in a blood relative or a personal or ancestral history suspicious for hereditary cancer, and to provide coverage of certain cancer screenings or preventive surgeries that would reduce the risk for individuals with a germline (inherited) mutation associated with a high risk of developing a preventable cancer H.R. 4612/S. 2412 - Protecting Access to Lifesaving Screenings Act of 2021; a bill to make a series of changes relating to health insurance coverage of screening mammography including preserving Medicare coverage for screening mammography, without a requirement for coinsurance, and expands the definition of screening mammography to include any digital modality of such a procedure S. 2327 - Seniors Prescription Drug Relief Act; a bill to amend title XVIII of the Social Security Act to provide for a Medicare part D modernization redesign and to establish a monthly out-of-pocket cost sharing maximum for enrollees who incur a significant portion of costs towards the annual out-of-pocket threshold under Medicare part D H.R. 3173/S. 3018 - Improving Seniors Timely Access to Care Act; a bill which establishes several requirements and standards relating to prior authorization processes under Medicare Advantage (MA) plans H.R. 7213, Equitable Community Access to Pharmacist Services Act; a bill to provide pharmacy reimbursement for COVID-19-related and future emergency services. H.R. 9505, Find It Early Act; a bill to provide for health coverage with no cost-sharing additional breast screenings for certain individuals Comments regarding the temporary increase in federal medical assistance percentage (FMAP) in response to the COVID-19 Public Health Emergency (PHE) (CMS-9912-N) Comments in response to the Medicaid Eligibility and Enrollment NPRM (CMS-2421-P) Comments in response to the RFI regarding National Directory of Healthcare Providers & Services (CMS-0058-NC) Comments in response to the RFI regarding accessing healthcare and related challenges, understanding provider experiences, advancing health equity, and assessing the impact of waivers and flexibilities provided in response to the COVID-19 Public Health Emergency (PHE) Issues related to the upcoming Notice on Benefit and Payment Parameters for FY2024 Medicare coverage policy for drugs and drug pricing Medicare coverage policy for breast cancer treatments and services Proposed waivers under Sections 1115 and 1332 of the Social Security Act; policies related to work requirements, reinsurance and block grants in Medicaid Policies related to funding, state incentives, and federal efforts for for Medicaid expansion Coverage for telemedicine in Medicare
Client expense: $50,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Science & Technology Policy (OSTP), SENATE, Treasury, Dept of, White House Office
2022 · fourth_quarter · Insurance
Access to Breast Cancer Diagnosis (ABCD) Act (S. 1067/ H.R. 5769) Metastatic Breast Cancer Access to Care Act (S. 1312 / HR 3182) Cancer Drug Coverage Parity Act (HR 4385) Protecting Access to Lifesaving Screening (PALS) Act(HR 4612/S.2412) Safe Step Act (H.R. 2163/S. 464) The Closing Health Coverage Gaps for Public Servants Act (H.R. 7045/S. 3796) Implementation of the Affordable Care Act Implementation of the No Surprises Act Policies related to insurance coverage and COVID-19 Junk Plan Accountability and Disclosure Act (S. 1002) No Junk Plans Act (S. 942) HELP Copays Act (H.R.5801), accumulator adjustor issues Cancer survivorship issues Issues related to prescription drug affordability for patients Administrative actions necessary to reduce out-of-pocket costs for medical-necessary diagnostic breast imaging Issues related to regulation of short-term limited duration plans H.R. 9505 - Find It Early Act; a bill to provide for health coverage with no cost-sharing for additional breast screenings for certain individuals Comments in response to the RFI on Advanced Explanation of Benefits and Good Faith Estimate for Covered Individuals (CMS9900-NC) Implementation of the No Surprises Act
Client expense: Not reported · Firm income: $40,000
Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Personnel Management (OPM), Office of Science & Technology Policy (OSTP), SENATE
2022 · third_quarter · Insurance
H.R. 4612/S. 2412 - Protecting Access to Lifesaving Screenings Act of 2021; a bill to make a series of changes relating to health insurance coverage of screening mammography H.R. 5769/S. 1067 - Access to Breast Cancer Diagnosis Act; bill to reduce out-of-pocket costs for medical-necessary diagnostic breast imaging H.R. 2163/S. 464 - Safe Step Act; bill to require a group health plan or health insurance coverage offered in connection with such a plan to provide an exceptions process for any medication step therapy protocol, and for other purposes H.R. 4385/S.3080 - Cancer Drug Parity Act; bill to require health plans that cover anticancer medications administered by a health care provider to provide no less favorable cost sharing for patient-administered anticancer medications. H.R. 5376 - Inflation Reduction Act of 2022; a budget reconciliation bill which included provisions to continue subsidies on private insurance premiums, address out of pocket costs in Medicare Part D, and more H.R. 5801 - Help Ensure Lower Patient (HELP) Copays Act; a bill to amend title XXVII of the Public Health Service Act to apply additional payments, discounts, and other financial assistance towards the cost-sharing requirements of health insurance plans, and for other purposes H.R. 7045/S. 3796 - Closing Health Coverage Gaps for Public Servants Act; a bill to eliminate the opt-out for nonfederal governmental health plans, including the opt-out for coverage for full mastectomy and reconstruction care Administrative actions necessary to reduce out-of-pocket costs for medical-necessary diagnostic breast imaging Issues related to regulation of short-term limited duration plans Implementation of the Affordable Care Act Policies regarding White House Cancer Moonshot implementation Public and private insurance adjustments and other policy changes due to the COVID-19 emergency, including those impacting the immunocompromised populations S. 942 - No Junk Plans Act; bill to overturn previous administration rule expanding non-comprehensive health insurance plans that dont have to provide healthcare coverage for people with pre-existing conditions S. 1002 - Junk Plan Accountability and Disclosure Act; a bill which establishes requirements for certain noncomprehensive health insurance coverage and provides for additional outreach activities to increase enrollment in qualified health plans Policies related to co-pay assistance programs Policies related to the extension of Advanced Premium Tax Credits provided by the American Rescue Plan Comments on future rulemaking for the 2024 Notice on Benefit and Payment Parameters
Client expense: $50,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Personnel Management (OPM), Office of Science & Technology Policy (OSTP), SENATE, Treasury, Dept of, White House Office
2022 · third_quarter · Medicare/Medicaid
H.R. 469 - Comprehensive Breast Reconstruction Act of 2021; bill provides for Medicare, Medicaid, and private health insurance coverage of certain tattooing services in connection with post-mastectomy breast reconstruction, and aligns the scope of Medicare and Medicaid coverage of such breast reconstruction with that of private health insurance. H.R. 1946/S. 1873 -Medicare Multi-Cancer Early Detections Screening and Coverage Act; bill to amend title XVIII of the Social Security Act to provide for Medicare coverage of multi-cancer early detection screening test H.R. 3183/S. 1312 - Metastatic Breast Cancer Access to Care Act; bill to exempt individuals with metastatic breast cancer from certain waiting periods for disability insurance benefits under the Old-Age, Survivors, and Disability Insurance program and related Medicare coverage H.R. 2903/S. 1512 - CONNECT for Health Act; a bill to expand the use of telehealth and remote patient monitoring services in Medicare H.R. 3087/S. 2051 - Breast Cancer Patient Equity Act; a bill to provide for Medicare coverage of custom fabricated breast prostheses H.R. 3630/S. 1315 - Lymphedema Treatment Act; bill to include certain lymphedema compression treatment items as covered durable medical equipment under Medicare following the surgical removal of the breast (i.e., a mastectomy), including replacements of such prostheses H.R. 4110 - Reducing Hereditary Cancer Act of 2021; a bill to provide hereditary cancer genetic testing for individuals with a history of a hereditary cancer gene mutation in a blood relative or a personal or ancestral history suspicious for hereditary cancer, and to provide coverage of certain cancer screenings or preventive surgeries that would reduce the risk for individuals with a germline (inherited) mutation associated with a high risk of developing a preventable cancer H.R. 4612/S. 2412 - Protecting Access to Lifesaving Screenings Act of 2021; a bill to make a series of changes relating to health insurance coverage of screening mammography including preserving Medicare coverage for screening mammography, without a requirement for coinsurance, and expands the definition of screening mammography to include any digital modality of such a procedure S. 2327 - Seniors Prescription Drug Relief Act; a bill to amend title XVIII of the Social Security Act to provide for a Medicare part D modernization redesign and to establish a monthly out-of-pocket cost sharing maximum for enrollees who incur a significant portion of costs towards the annual out-of-pocket threshold under Medicare part D H.R. 3173/S. 3018 - Improving Seniors Timely Access to Care Act; a bill which establishes several requirements and standards relating to prior authorization processes under Medicare Advantage (MA) plans H.R. 5376 - Inflation Reduction Act of 2022; a budget reconciliation bill which included provisions to continue subsidies on private insurance premiums, address out of pocket costs in Medicare Part D, and more H.R. 7213, Equitable Community Access to Pharmacist Services Act; a bill to provide pharmacy reimbursement for COVID-19-related and future emergency services. Comments in response to CMS Proposed Rule on CY 2023 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System (CMS 1772-P) Comments in response to CMS Request for Information on Medicare Advantage (CMS-4203-NC ) Comments in response to CY2023 Medicare Physician Fee Schedule (CMS-1770-P) Issues related to the upcoming Notice on Benefit and Payment Parameters for FY2024 Medicare coverage policy for drugs and drug pricing Medicare coverage policy for breast cancer treatments and services Proposed waivers under Sections 1115 and 1332 of the Social Security Act; policies related to work requirements, reinsurance and block grants in Medicaid Policies related to funding, state incentives, and federal efforts for for Medicaid expansion Coverage for telemedicine in Medicare
Client expense: $50,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Science & Technology Policy (OSTP), SENATE, Treasury, Dept of, White House Office
2022 · third_quarter · Insurance
Access to Breast Cancer Diagnosis (ABCD) Act (S. 1067/ H.R. 5769) Metastatic Breast Cancer Access to Care Act (S. 1312 / HR 3182) Cancer Drug Coverage Parity Act (HR 4385) Protecting Access to Lifesaving Screening (PALS) Act(HR 4612/S.2412) Safe Step Act (H.R. 2163/S. 464) The Closing Health Coverage Gaps for Public Servants Act (H.R. 7045/S. 3796) Implementation of the Affordable Care Act Implementation of the No Surprises Act Policies related to insurance coverage and COVID-19 Junk Plan Accountability and Disclosure Act (S. 1002) No Junk Plans Act (S. 942) HELP Copays Act (H.R.5801), accumulator adjustor issues Cancer survivorship issues Issues related to prescription drug affordability for patients Administrative actions necessary to reduce out-of-pocket costs for medical-necessary diagnostic breast imaging Policies regarding White House Cancer Moonshot implementation Issues related to regulation of short-term limited duration plans H.R. 5376 - Inflation Reduction Act of 2022; a budget reconciliation bill which included provisions to continue subsidies on private insurance premiums, address out of pocket costs in Medicare Part D, and more Comments on future rulemaking for the 2024 Notice on Benefit and Payment Parameters
Client expense: Not reported · Firm income: $42,000
2022 · second_quarter · Medicare/Medicaid
H.R. 469 - Comprehensive Breast Reconstruction Act of 2021; bill provides for Medicare, Medicaid, and private health insurance coverage of certain tattooing services in connection with post-mastectomy breast reconstruction, and aligns the scope of Medicare and Medicaid coverage of such breast reconstruction with that of private health insurance. H.R. 1946/S. 1873 -Medicare Multi-Cancer Early Detections Screening and Coverage Act; bill to amend title XVIII of the Social Security Act to provide for Medicare coverage of multi-cancer early detection screening test H.R. 3183/S. 1312 - Metastatic Breast Cancer Access to Care Act; bill to exempt individuals with metastatic breast cancer from certain waiting periods for disability insurance benefits under the Old-Age, Survivors, and Disability Insurance program and related Medicare coverage H.R. 2903/S. 1512 - CONNECT for Health Act; a bill to expand the use of telehealth and remote patient monitoring services in Medicare H.R. 3087/S. 2051 - Breast Cancer Patient Equity Act; a bill to provide for Medicare coverage of custom fabricated breast prostheses H.R. 3630/S. 1315 - Lymphedema Treatment Act; bill to include certain lymphedema compression treatment items as covered durable medical equipment under Medicare following the surgical removal of the breast (i.e., a mastectomy), including replacements of such prostheses H.R. 4110 - Reducing Hereditary Cancer Act of 2021; a bill to provide hereditary cancer genetic testing for individuals with a history of a hereditary cancer gene mutation in a blood relative or a personal or ancestral history suspicious for hereditary cancer, and to provide coverage of certain cancer screenings or preventive surgeries that would reduce the risk for individuals with a germline (inherited) mutation associated with a high risk of developing a preventable cancer H.R. 4612/S. 2412 - Protecting Access to Lifesaving Screenings Act of 2021; a bill to make a series of changes relating to health insurance coverage of screening mammography including preserving Medicare coverage for screening mammography, without a requirement for coinsurance, and expands the definition of screening mammography to include any digital modality of such a procedure S. 2327 - Seniors Prescription Drug Relief Act; a bill to amend title XVIII of the Social Security Act to provide for a Medicare part D modernization redesign and to establish a monthly out-of-pocket cost sharing maximum for enrollees who incur a significant portion of costs towards the annual out-of-pocket threshold under Medicare part D H.R. 3173/S. 3018 - Improving Seniors Timely Access to Care Act; a bill which establishes several requirements and standards relating to prior authorization processes under Medicare Advantage (MA) plans H.R. 7213, Equitable Community Access to Pharmacist Services Act; a bill to provide pharmacy reimbursement for COVID-19-related and future emergency services. Medicare coverage policy for drugs and drug pricing Medicare coverage policy for breast cancer treatments and services Proposed waivers under Sections 1115 and 1332 of the Social Security Act; policies related to work requirements, reinsurance and block grants in Medicaid Policies related to funding, state incentives, and federal efforts for for Medicaid expansion Coverage for telemedicine in Medicare Comments in response to CMS Request for Information on Access to Coverage and Care in Medicaid and Chip Issues related to the upcoming Notice on Benefit and Payment Parameters for FY2024
2022 · second_quarter · Insurance
H.R. 4612/S. 2412 - Protecting Access to Lifesaving Screenings Act of 2021; a bill to make a series of changes relating to health insurance coverage of screening mammography H.R. 5769/S. 1067 - Access to Breast Cancer Diagnosis Act; bill to reduce out-of-pocket costs for medical-necessary diagnostic breast imaging H.R. 2163/S. 464 - Safe Step Act; bill to require a group health plan or health insurance coverage offered in connection with such a plan to provide an exceptions process for any medication step therapy protocol, and for other purposes H.R. 4385/S.3080 - Cancer Drug Parity Act; bill to require health plans that cover anticancer medications administered by a health care provider to provide no less favorable cost sharing for patient-administered anticancer medications. H.R. 5801 - Help Ensure Lower Patient (HELP) Copays Act; a bill to amend title XXVII of the Public Health Service Act to apply additional payments, discounts, and other financial assistance towards the cost-sharing requirements of health insurance plans, and for other purposes H.R. 7045/S. 3796 - Closing Health Coverage Gaps for Public Servants Act; a bill to eliminate the opt-out for nonfederal governmental health plans, including the opt-out for coverage for full mastectomy and reconstruction care Administrative actions necessary to reduce out-of-pocket costs for medical-necessary diagnostic breast imaging Issues related to regulation of short-term limited duration plans Implementation of the No Surprises Act Implementation of the Affordable Care Act Policies regarding White House Cancer Moonshot implementation Public and private insurance adjustments and other policy changes due to the COVID-19 emergency, including those impacting the immunocompromised populations S. 942 - No Junk Plans Act; bill to overturn previous administration rule expanding non-comprehensive health insurance plans that dont have to provide healthcare coverage for people with pre-existing conditions S. 1002 - Junk Plan Accountability and Disclosure Act; a bill which establishes requirements for certain noncomprehensive health insurance coverage and provides for additional outreach activities to increase enrollment in qualified health plans Policies related to co-pay assistance programs Policies related to the extension of Advanced Premium Tax Credits provided by the American Rescue Plan Comments on the Affordability of Employer Coverage for Family Members of Employees; IRS-2022-0006
2022 · second_quarter · Insurance
Access to Breast Cancer Diagnosis (ABCD) Act (S. 1067) Metastatic Breast Cancer Access to Care Act (S. 1312 / HR 3182) Cancer Drug Coverage Parity Act (HR 4385) Protecting Access to Lifesaving Screening (PALS) Act(HR 4612/S.2412) Safe Step Act (H.R. 2163/S. 464) The Closing Health Coverage Gaps for Public Servants Act (S. 3796) Implementation of the Affordable Care Act Implementation of the No Surprises Act Policies related to insurance coverage and COVID-19 Junk Plan Accountability and Disclosure Act (S. 1002) No Junk Plans Act (S. 942) HELP Copays Act (H.R.5801), accumulator adjustor issues Cancer survivorship issues Issues related to prescription drug affordability for patients Administrative actions necessary to reduce out-of-pocket costs for medical-necessary diagnostic breast imaging Policies regarding White House Cancer Moonshot implementation Issues related to regulation of short-term limited duration plans Comments on the Affordability of Employer Coverage for Family Members of Employees
Client expense: Not reported · Firm income: $42,000
2022 · first_quarter · Insurance
Access to Breast Cancer Diagnosis (ABCD) Act (S. 1067) Metastatic Breast Cancer Access to Care Act (S. 1312 / HR 3182) Cancer Drug Coverage Parity Act (HR 4385) Protecting Access to Lifesaving Screening (PALS) Act(HR 4612/S.2412) Safe Step Act (H.R. 2163/S. 464) The Closing Health Coverage Gaps for Public Servants Act (S. 3796) Implementation of the Affordable Care Act Implementation of the No Surprises Act Policies related to insurance coverage and COVID-19 Junk Plan Accountability and Disclosure Act (S. 1002) No Junk Plans Act HELP Copays Act (H.R.5801), accumulator adjustor issues Cancer survivorship issues Issues related to prescription drug affordability for patients Administrative actions necessary to reduce out-of-pocket costs for medical-necessary diagnostic breast imaging Policies regarding White House Cancer Moonshot implementation Issues related to regulation of short-term limited duration plans
Client expense: Not reported · Firm income: $42,000
Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Personnel Management (OPM), Office of Science & Technology Policy (OSTP), SENATE
2022 · first_quarter · Insurance
H.R. 4612/S. 2412 - Protecting Access to Lifesaving Screenings Act of 2021; a bill to make a series of changes relating to health insurance coverage of screening mammography H.R. 5769/S. 1067 - Access to Breast Cancer Diagnosis Act; bill to reduce out-of-pocket costs for medical-necessary diagnostic breast imaging H.R. 2163/S. 464 - Safe Step Act; bill to require a group health plan or health insurance coverage offered in connection with such a plan to provide an exceptions process for any medication step therapy protocol, and for other purposes H.R. 4385/S.3080 - Cancer Drug Parity Act; bill to require health plans that cover anticancer medications administered by a health care provider to provide no less favorable cost sharing for patient-administered anticancer medications. H.R. 5801 - Help Ensure Lower Patient (HELP) Copays Act; a bill to amend title XXVII of the Public Health Service Act to apply additional payments, discounts, and other financial assistance towards the cost-sharing requirements of health insurance plans, and for other purposes H.R. 7045/S. 3796 - Closing Health Coverage Gaps for Public Servants Act; a bill to eliminate the opt-out for nonfederal governmental health plans, including the opt-out for coverage for full mastectomy and reconstruction care Administrative actions necessary to reduce out-of-pocket costs for medical-necessary diagnostic breast imaging Issues related to regulation of short-term limited duration plans Implementation of the No Surprises Act Implementation of the Affordable Care Act Policies regarding White House Cancer Moonshot implementation Public and private insurance adjustments and other policy changes due to the COVID-19 emergency, including those impacting the immunocompromised populations S. 942 - No Junk Plans Act; bill to overturn previous administration rule expanding non-comprehensive health insurance plans that dont have to provide healthcare coverage for people with pre-existing conditions S. 1002 - Junk Plan Accountability and Disclosure Act; a bill which establishes requirements for certain noncomprehensive health insurance coverage and provides for additional outreach activities to increase enrollment in qualified health plans Policies related to co-pay assistance programs
2022 · first_quarter · Medicare/Medicaid
H.R. 469 - Comprehensive Breast Reconstruction Act of 2021; bill provides for Medicare, Medicaid, and private health insurance coverage of certain tattooing services in connection with post-mastectomy breast reconstruction, and aligns the scope of Medicare and Medicaid coverage of such breast reconstruction with that of private health insurance. H.R. 1946/S. 1873 -Medicare Multi-Cancer Early Detections Screening and Coverage Act; bill to amend title XVIII of the Social Security Act to provide for Medicare coverage of multi-cancer early detection screening test H.R. 3183/S. 1312 - Metastatic Breast Cancer Access to Care Act; bill to exempt individuals with metastatic breast cancer from certain waiting periods for disability insurance benefits under the Old-Age, Survivors, and Disability Insurance program and related Medicare coverage H.R. 2903/S. 1512 - CONNECT for Health Act; a bill to expand the use of telehealth and remote patient monitoring services in Medicare H.R. 3087/S. 2051 - Breast Cancer Patient Equity Act; a bill to provide for Medicare coverage of custom fabricated breast prostheses H.R. 3630/S. 1315 - Lymphedema Treatment Act; bill to include certain lymphedema compression treatment items as covered durable medical equipment under Medicare following the surgical removal of the breast (i.e., a mastectomy), including replacements of such prostheses H.R. 4110 - Reducing Hereditary Cancer Act of 2021; a bill to provide hereditary cancer genetic testing for individuals with a history of a hereditary cancer gene mutation in a blood relative or a personal or ancestral history suspicious for hereditary cancer, and to provide coverage of certain cancer screenings or preventive surgeries that would reduce the risk for individuals with a germline (inherited) mutation associated with a high risk of developing a preventable cancer H.R. 4612/S. 2412 - Protecting Access to Lifesaving Screenings Act of 2021; a bill to make a series of changes relating to health insurance coverage of screening mammography including preserving Medicare coverage for screening mammography, without a requirement for coinsurance, and expands the definition of screening mammography to include any digital modality of such a procedure S. 2327 - Seniors Prescription Drug Relief Act; a bill to amend title XVIII of the Social Security Act to provide for a Medicare part D modernization redesign and to establish a monthly out-of-pocket cost sharing maximum for enrollees who incur a significant portion of costs towards the annual out-of-pocket threshold under Medicare part D H.R. 3173/S. 3018 - Improving Seniors Timely Access to Care Act; a bill which establishes several requirements and standards relating to prior authorization processes under Medicare Advantage (MA) plans H.R. 7213, Equitable Community Access to Pharmacist Services Act; a bill to provide pharmacy reimbursement for COVID-19-related and future emergency services. Comments regarding the Notice on Benefit and Payment Parameters for FY2023 CMS-2021-0196 Medicare coverage policy for drugs and drug pricing Medicare coverage policy for breast cancer treatments and services Proposed waivers under Sections 1115 and 1332 of the Social Security Act; policies related to work requirements, reinsurance and block grants in Medicaid Policies related to funding, state incentives, and federal efforts for for Medicaid expansion Coverage for telemedicine in Medicare Policies related to the Radiation Oncology Alternative Payment Model Comments related to the design of an Advanced Projects Research Agency for Health
2021 · fourth_quarter · Insurance
H.R. 4612/S. 2412 - Protecting Access to Lifesaving Screenings Act of 2021; a bill to make a series of changes relating to health insurance coverage of screening mammography H.R. 5769/S. 1067 - Access to Breast Cancer Diagnosis Act; bill to reduce out-of-pocket costs for medical-necessary diagnostic breast imaging H.R. 2163/S. 464 - Safe Step Act; bill to require a group health plan or health insurance coverage offered in connection with such a plan to provide an exceptions process for any medication step therapy protocol, and for other purposes H.R. 4385/S.3080 - Cancer Drug Parity Act; bill to require health plans that cover anticancer medications administered by a health care provider to provide no less favorable cost sharing for patient-administered anticancer medications. H.R. 5801 - Help Ensure Lower Patient (HELP) Copays Act; a bill to amend title XXVII of the Public Health Service Act to apply additional payments, discounts, and other financial assistance towards the cost-sharing requirements of health insurance plans, and for other purposes Implementation of the No Surprises Act including comments related to Requirements Related to Air Ambulance Services, Agent and Broker Disclosures, and Provider Enforcement (CMS-2021-0147) and Requirements Related to Surprise Billing Part II (CMS-2021-0156) Implementation of the Affordable Care Act Public and private insurance adjustments and other policy changes due to the COVID-19 emergency, including those impacting the immunocompromised populations S. 942 - No Junk Plans Act; bill to overturn previous administration rule expanding non-comprehensive health insurance plans that dont have to provide healthcare coverage for people with pre-existing conditions S. 1002 - Junk Plan Accountability and Disclosure Act; a bill which establishes requirements for certain noncomprehensive health insurance coverage and provides for additional outreach activities to increase enrollment in qualified health plans Policies related to co-pay assistance programs
2021 · fourth_quarter · Medicare/Medicaid
H.R. 469 - Comprehensive Breast Reconstruction Act of 2021; bill provides for Medicare, Medicaid, and private health insurance coverage of certain tattooing services in connection with post-mastectomy breast reconstruction, and aligns the scope of Medicare and Medicaid coverage of such breast reconstruction with that of private health insurance. H.R. 1946/S. 1873 -Medicare Multi-Cancer Early Detections Screening and Coverage Act; bill to amend title XVIII of the Social Security Act to provide for Medicare coverage of multi-cancer early detection screening test H.R. 3183/S. 1312 - Metastatic Breast Cancer Access to Care Act; bill to exempt individuals with metastatic breast cancer from certain waiting periods for disability insurance benefits under the Old-Age, Survivors, and Disability Insurance program and related Medicare coverage H.R. 2903/S. 1512 - CONNECT for Health Act; a bill to expand the use of telehealth and remote patient monitoring services in Medicare H.R. 3087/S. 2051 - Breast Cancer Patient Equity Act; a bill to provide for Medicare coverage of custom fabricated breast prostheses H.R. 3630/S. 1315 - Lymphedema Treatment Act; bill to include certain lymphedema compression treatment items as covered durable medical equipment under Medicare following the surgical removal of the breast (i.e., a mastectomy), including replacements of such prostheses H.R. 4110 - Reducing Hereditary Cancer Act of 2021; a bill to provide hereditary cancer genetic testing for individuals with a history of a hereditary cancer gene mutation in a blood relative or a personal or ancestral history suspicious for hereditary cancer, and to provide coverage of certain cancer screenings or preventive surgeries that would reduce the risk for individuals with a germline (inherited) mutation associated with a high risk of developing a preventable cancer H.R. 4414 - Cancer Care Planning and Communications Act of 2021; a bill to provide for Medicare coverage and payment of cancer care planning and coordination services for individuals who are diagnosed with or treated for cancer, including the development of treatment plans, follow-up care, and any necessary revisions H.R. 4612/S. 2412 - Protecting Access to Lifesaving Screenings Act of 2021; a bill to make a series of changes relating to health insurance coverage of screening mammography including preserving Medicare coverage for screening mammography, without a requirement for coinsurance, and expands the definition of screening mammography to include any digital modality of such a procedure S. 2327 - Seniors Prescription Drug Relief Act; a bill to amend title XVIII of the Social Security Act to provide for a Medicare part D modernization redesign and to establish a monthly out-of-pocket cost sharing maximum for enrollees who incur a significant portion of costs towards the annual out-of-pocket threshold under Medicare part D H.R. 3173/S. 3018 - Improving Seniors Timely Access to Care Act; a bill which establishes several requirements and standards relating to prior authorization processes under Medicare Advantage (MA) plans Medicare coverage policy for drugs and drug pricing Medicare coverage policy for breast cancer treatments and services Proposed waivers under Sections 1115 and 1332 of the Social Security Act; policies related to work requirements, reinsurance and block grants in Medicaid Policies related to funding, state incentives, and federal efforts for for Medicaid expansion Coverage for telemedicine in Medicare Policies related to the Radiation Oncology Alternative Payment Model Comments regarding the recission of the Indexed Price Concession Model/ Most Favored Nation Model for Medicare Part B drugs (CMS-2018-0132) Comments related to the design of an Advanced Projects Research Agency for Health
2021 · fourth_quarter · Insurance
Access to Breast Cancer Diagnosis (ABCD) Act (S. 1067) Metastatic Breast Cancer Access to Care Act (S. 1312 / HR 3182) Cancer Drug Coverage Parity Act (HR 4385) Protecting Access to Lifesaving Screening (PALS) Act(S.2412) Safe Step Act (H.R. 2163/S. 464) Implementation of the Affordable Care Act Implementation of the No Surprises Act Policies related to insurance coverage and COVID-19 Junk Plan Accountability and Disclosure Act (S. 1002) No Junk Plans Act HELP Copays Act (H.R.5801), accumulator adjustor issues Cancer survivorship issues Issues related to prescription drug affordability for patients
Client expense: Not reported · Firm income: $42,000
Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE
2021 · fourth_quarter · Health Issues
Issues related to third-party servicing of medical devices, including H.R. 4006, the Fair Repair Act. Issues related to focused ultrasound, including in H.R.4355, the Military Construction, Veterans Affairs, and Related Agencies Appropriations Act 2022. General issues related to medical device cybersecurity, AI, the healthcare supply chain, and provider assistance. Discussions related to medical device user fees. Issues related to coverage for certain medical devices, including in Cures 2.0 Act. Issues related to H.R. 4043, the Ensuring Patient Access to Critical Breakthrough Products Act of 2021. Issues related to H.R. 4479/S.2609, the Facilitating Innovative Nuclear Diagnostics (FIND) Act of 2021. Issues related to H.R. 4612/S.2412, Protecting Access to Lifesaving Screenings (PALS) Act of 2021.
Client expense: Not reported · Firm income: $80,000
2021 · third_quarter · Medicare/Medicaid
H.R. 469 - Comprehensive Breast Reconstruction Act of 2021; bill provides for Medicare, Medicaid, and private health insurance coverage of certain tattooing services in connection with post-mastectomy breast reconstruction, and aligns the scope of Medicare and Medicaid coverage of such breast reconstruction with that of private health insurance. H.R. 1946/S. 1873 - Multi-Cancer Early Detections Screening and Coverage Act; bill to amend title XVIII of the Social Security Act to provide for Medicare coverage of multi-cancer early detection screening test H.R. 3183/S. 1312 - Metastatic Breast Cancer Access to Care Act; bill to exempt individuals with metastatic breast cancer from certain waiting periods for disability insurance benefits under the Old-Age, Survivors, and Disability Insurance program and related Medicare coverage H.R. 2903/S. 1512 - CONNECT for Health Act; a bill to expand the use of telehealth and remote patient monitoring services in Medicare H.R. 3087/S. 2051 - Breast Cancer Patient Equity Act; a bill to provide for Medicare coverage of custom fabricated breast prostheses H.R. 3517/S. 1943 - Increasing Access to Osteoporosis Testing for Medicare Beneficiaries Act; a bill to improve access to, and utilization of, bone mass measurement benefits under part B of the Medicare program by establishing a minimum payment amount under such part for bone mass measurement H.R. 3630/S. 1315 - Lymphedema Treatment Act; bill to include certain lymphedema compression treatment items as covered durable medical equipment under Medicare following the surgical removal of the breast (i.e., a mastectomy), including replacements of such prostheses H.R. 4110 - Reducing Hereditary Cancer Act of 2021; a bill to provide hereditary cancer genetic testing for individuals with a history of a hereditary cancer gene mutation in a blood relative or a personal or ancestral history suspicious for hereditary cancer, and to provide coverage of certain cancer screenings or preventive surgeries that would reduce the risk for individuals with a germline (inherited) mutation associated with a high risk of developing a preventable cancer H.R. 4414 - Cancer Care Planning and Communications Act of 2021; a bill to provide for Medicare coverage and payment of cancer care planning and coordination services for individuals who are diagnosed with or treated for cancer, including the development of treatment plans, follow-up care, and any necessary revisions H.R. 4612/S. 2412 - Protecting Access to Lifesaving Screenings Act of 2021; a bill to make a series of changes relating to health insurance coverage of screening mammography including preserving Medicare coverage for screening mammography, without a requirement for coinsurance, and expands the definition of screening mammography to include any digital modality of such a procedure S. 2327 - Seniors Prescription Drug Relief Act; a bill to amend title XVIII of the Social Security Act to provide for a Medicare part D modernization redesign and to establish a monthly out-of-pocket cost sharing maximum for enrollees who incur a significant portion of costs towards the annual out-of-pocket threshold under Medicare part D Medicare coverage policy for drugs and drug pricing Medicare coverage policy for breast cancer treatments and services Proposed waivers under Sections 1115 and 1332 of the Social Security Act; policies related to work requirements, reinsurance and block grants in Medicaid Policies related to funding, state incentives, and federal efforts for for Medicaid expansion Coverage for telemedicine in Medicare Comments related to the design of an Advanced Projects Research Agency for Health Comments related to CY 2022 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment Policies (CMS-1751-P) Comments Related to Notice on Benefit and Payment Parameters; Patient Protection and Affordable Care Act; Updating Payment Parameters, Section 1332 Waiver Implementing Regulations, and Improving Health Insurance Markets for 2022 and Beyond Proposed Rule Comments to Centers for Medicare and Medicaid Services on Patient Protection and Affordable Care Act; Updating Payment Parameters, Section 1332 Waiver Implementing Regulations, and Improving Health Insurance Markets for 2022 and Beyond Proposed Rule
2021 · third_quarter · Insurance
H.R. 4612/S. 2412 - Protecting Access to Lifesaving Screenings Act of 2021; a bill to make a series of changes relating to health insurance coverage of screening mammography S. 1067 - Access to Breast Cancer Diagnosis Act; bill to reduce out-of-pocket costs for medical-necessary diagnostic breast imaging H.R. 2163/S. 464 - Safe Step Act; bill to require a group health plan or health insurance coverage offered in connection with such a plan to provide an exceptions process for any medication step therapy protocol, and for other purposes H.R. 4385 - Cancer Drug Parity Act; bill to require health plans that cover anticancer medications administered by a health care provider to provide no less favorable cost sharing for patient-administered anticancer medications. Implementation of the No Surprises Act including comments related to PRA Listings for the Implementation of the No Surprises Act (CMS-10780 & CMS-10779) Implementation of the Affordable Care Act Public and private insurance adjustments and other policy changes due to the COVID-19 emergency, including those impacting the immunocompromised populations No Junk Plans Act; bill to overturn previous administration rule expanding non-comprehensive health insurance plans that dont have to provide healthcare coverage for people with pre-existing conditions Policies related to co-pay assistance programs
Client expense: $60,000 · Firm income: Not reported
| Democratic |
| NH |
| Marsha Blackburn | Republican | TN |
| Shelley Moore Capito | Republican | WV |
Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Personnel Management (OPM), Office of Science & Technology Policy (OSTP), SENATE
Client expense: $80,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Science & Technology Policy (OSTP), SENATE, Treasury, Dept of, White House Office
Client expense: $80,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Personnel Management (OPM), Office of Science & Technology Policy (OSTP), SENATE, Treasury, Dept of, White House Office
Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Personnel Management (OPM), Office of Science & Technology Policy (OSTP), SENATE
Client expense: $90,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Personnel Management (OPM), Office of Science & Technology Policy (OSTP), SENATE, Treasury, Dept of, Vice President of the U.S., White House Office
Client expense: $90,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Science & Technology Policy (OSTP), SENATE, Treasury, Dept of, White House Office
Client expense: $50,000 · Firm income: Not reported
Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Office of Personnel Management (OPM), SENATE, Treasury, Dept of, White House Office
Client expense: $50,000 · Firm income: Not reported
Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Office of Personnel Management (OPM), SENATE, Treasury, Dept of, White House Office
Government targets: Commerce, Dept of (DOC), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, SENATE, U.S. Trade Representative (USTR)
Client expense: $60,000 · Firm income: Not reported
Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Office of Science & Technology Policy (OSTP), SENATE, Treasury, Dept of, White House Office
Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Office of Science & Technology Policy (OSTP), SENATE, Treasury, Dept of, White House Office