Medicare Mental Health Inpatient Equity Act of 2021
Legislative Progress
Introduced
October 25, 2021
Latest Action
October 25, 2021
Primary Sponsor
Susan M. CollinsRepublican(ME)
Momentum (last 30 days)
0
score
0 actions · 0 new cosponsors · 0 votes
Speed vs cohort
0pct
0d open
vs 5,357 other S bills in the 117th — cohort avg 38d
Medicare Mental Health Inpatient Equity Act of 2021 This bill removes the 190-day lifetime limit on inpatient psychiatric hospital services under Medicare.
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Filing registrants (8)
Read twice and referred to the Committee on Finance. (Sponsor introductory remarks on measure: CR S7340-7341)
Introduced in Senate
Bills with similar content found using semantic analysis.
Sources: Congress.gov
2022 · fourth_quarter · Medicare/Medicaid
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
2022 · fourth_quarter · Medicare/Medicaid
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
2022 · fourth_quarter · Health Issues
Cures 2.0 Act, H.R.6000; Medicare Mental Health Inpatient Equity Act of 2021 (H.R.5674/S.3061); Increasing Behavioral Health Treatment Act, H.R.2611; Brycen Gray and Ben Price COVID-19 Neurological Impact Act, H.R.5772; FY22 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, H.R.4502; FY22 Labor, Health and Human Services, Education, and Related Agencies Subcommittee Appropriations Act, H.R.4502 2022 Consolidated Appropriations Act, H.R.2471; Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, H.R.8295; Restoring Hope for Mental Health and Well-Being Act, H.R.7666; 2023 Consolidated Appropriations Act, H.R.2617
Client expense: Not reported · Firm income: $30,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · fourth_quarter · Medicare/Medicaid
H.R. 8800, Supporting Medicare Providers Act of 2022 Medicare coverage policies and statutes affecting psychologists and psychology trainees practice and reimbursement Draft Legislation - IMD Medicaid (Napolitano) S. 586: NO PAIN Act H.R. 1551/S 584: Nutrition Counseling Aiding Recover for Eating Disorders Act H.R. 1738/S. 646: Stabilize Medicaid and CHIP Coverage Act H.R. 3450/S. 1727: Medicaid Bump Act H.R. 3447: Permanency for Audio Only Telehealth Act H.R. 4058/ S. 2061: Telemental Health Care Access Act S. 2069: Excellence in Mental Health and Addiction Treatment Act S.285: Medicaid Reentry Act S.340: TREATS Act H.R. 1577/S. 596: Treat and Reduce Obesity Act H.R. 314: Medicare Sequester COVID Moratorium Act H.R 1868: To prevent across the board direct spending cuts S. 1512/H.R. 2903: CONNECT for Health Act H.R. 4480: Telehealth Coverage and Payment Parity Act S. 1798/H.R. 1398: TIKES Act H.R. 5674 / S. 3061: Medicare Mental Health Inpatient Equity Act H.R. 2503 Social Determinants Accelerator Act of 2021 Medicaid/Medicare/Private Insurance provisions in the Build Back Better Act S. 610, Public Law 117-71: Protecting Medicare and American Farmers from Sequester Cuts Act H.R. 4406 Supporting Medicaid in the U.S. Territories Act H.R. 341 Ensuring Telemental Health Expansion Act of 2021 H.R. 6698 Stop Unfair Medicaid Recoveries Act H.R. 6636 / S. 2697 Due Process Continuity of Care Act HR 3173/S. 3018 Improving Seniors Access to Timely Care Act H.R. 4040, Advancing Telehealth Beyond COVID-19 Act of 2021 S. 5272 / H.R. 9577, Increasing Mental Health Options Act Draft bill re: Medicare reimbursement of services provided by advanced trainees Response to RFI re: Medicaid and behavioral health access Meeting with CMS staff re: digital therapeutics coding proposal
Client expense: $480,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE
2022 · fourth_quarter · Medicare/Medicaid
H.R. 8800, Supporting Medicare Providers Act of 2022 Medicare coverage policies and statutes affecting psychologists and psychology trainees practice and reimbursement Draft Legislation - IMD Medicaid (Napolitano) S. 586: NO PAIN Act H.R. 1551/S 584: Nutrition Counseling Aiding Recover for Eating Disorders Act H.R. 1738/S. 646: Stabilize Medicaid and CHIP Coverage Act H.R. 3450/S. 1727: Medicaid Bump Act H.R. 3447: Permanency for Audio Only Telehealth Act H.R. 4058/ S. 2061: Telemental Health Care Access Act S. 2069: Excellence in Mental Health and Addiction Treatment Act S.285: Medicaid Reentry Act S.340: TREATS Act H.R. 1577/S. 596: Treat and Reduce Obesity Act H.R. 314: Medicare Sequester COVID Moratorium Act H.R 1868: To prevent across the board direct spending cuts S. 1512/H.R. 2903: CONNECT for Health Act H.R. 4480: Telehealth Coverage and Payment Parity Act S. 1798/H.R. 1398: TIKES Act H.R. 5674 / S. 3061: Medicare Mental Health Inpatient Equity Act H.R. 2503 Social Determinants Accelerator Act of 2021 Medicaid/Medicare/Private Insurance provisions in the Build Back Better Act S. 610, Public Law 117-71: Protecting Medicare and American Farmers from Sequester Cuts Act H.R. 4406 Supporting Medicaid in the U.S. Territories Act H.R. 341 Ensuring Telemental Health Expansion Act of 2021 H.R. 6698 Stop Unfair Medicaid Recoveries Act H.R. 6636 / S. 2697 Due Process Continuity of Care Act HR 3173/S. 3018 Improving Seniors Access to Timely Care Act H.R. 4040, Advancing Telehealth Beyond COVID-19 Act of 2021 S. 5272 / H.R. 9577, Increasing Mental Health Options Act Draft bill re: Medicare reimbursement of services provided by advanced trainees Response to RFI re: Medicaid and behavioral health access Meeting with CMS staff re: digital therapeutics coding proposal
Client expense: $480,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE
2022 · third_quarter · Medicare/Medicaid
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
2022 · third_quarter · Medicare/Medicaid
H.R. 8800, Supporting Medicare Providers Act of 2022 Medicare coverage policies and statutes affecting psychologists and psychology trainees practice and reimbursement Draft Legislation - IMD Medicaid (Napolitano) S. 586: NO PAIN Act H.R. 1551/S 584: Nutrition Counseling Aiding Recover for Eating Disorders Act H.R. 1738/S. 646: Stabilize Medicaid and CHIP Coverage Act H.R. 3450/S. 1727: Medicaid Bump Act H.R. 3447: Permanency for Audio Only Telehealth Act H.R. 4058/ S. 2061: Telemental Health Care Access Act S. 2069: Excellence in Mental Health and Addiction Treatment Act S.285: Medicaid Reentry Act S.340: TREATS Act H.R. 1577/S. 596: Treat and Reduce Obesity Act H.R. 314: Medicare Sequester COVID Moratorium Act H.R 1868: To prevent across the board direct spending cuts S. 1512/H.R. 2903: CONNECT for Health Act H.R. 4480: Telehealth Coverage and Payment Parity Act S. 1798/H.R. 1398: TIKES Act H.R. 5674 / S. 3061: Medicare Mental Health Inpatient Equity Act H.R. 2503 Social Determinants Accelerator Act of 2021 Medicaid/Medicare/Private Insurance provisions in the Build Back Better Act S. 610, Public Law 117-71: Protecting Medicare and American Farmers from Sequester Cuts Act H.R. 4406 Supporting Medicaid in the U.S. Territories Act H.R. 341 Ensuring Telemental Health Expansion Act of 2021 H.R. 6698 Stop Unfair Medicaid Recoveries Act H.R. 6636 / S. 2697 Due Process Continuity of Care Act HR 3173/S. 3018 Improving Seniors Access to Timely Care Act H.R. 4040, Advancing Telehealth Beyond COVID-19 Act of 2021 Draft bill re: Medicare reimbursement of services provided by advanced trainees
Client expense: $520,000 · Firm income: Not reported
2022 · third_quarter · Health Issues
Cures 2.0 Act, H.R.6000; Medicare Mental Health Inpatient Equity Act of 2021 (H.R.5674/S.3061); Increasing Behavioral Health Treatment Act, H.R.2611; Brycen Gray and Ben Price COVID-19 Neurological Impact Act, H.R.5772; FY22 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, H.R.4502; FY22 Labor, Health and Human Services, Education, and Related Agencies Subcommittee Appropriations Act, H.R.4502 2022 Consolidated Appropriations Act, H.R.2471; Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, H.R.8295; Restoring Hope for Mental Health and Well-Being Act, H.R.7666
Client expense: Not reported · Firm income: $30,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · second_quarter · Medicare/Medicaid
Draft Legislation - IMD Medicaid (Napolitano) S. 586: NO PAIN Act H.R. 1551/S 584: Nutrition Counseling Aiding Recover for Eating Disorders Act H.R. 3450/S. 1727: Medicaid Bump Act H.R. 3447: Permanency for Audio Only Telehealth Act H.R. 4058: Telemental Health Care Access Act S. 2061: Telemental Health Care Access Act S. 2069: Excellence in Mental Health and Addiction Treatment Act H.R. 1738/S. 646: Stabilize Medicaid and CHIP Coverage Act S.285: Medicaid Reentry Act S.340: TREATS Act H.R. 1577/S. 596: Treat and Reduce Obesity Act H.R. 314: Medicare Sequester COVID Moratorium Act H.R 1868: To prevent across the board direct spending cuts S. 1512/H.R. 2903: CONNECT for Health Act H.R. 4480: Telehealth Coverage and Payment Parity Act S. 1798/H.R. 1398: TIKES Act H.R. 5674 / S. 3061: Medicare Mental Health Inpatient Equity Act H.R. 2503 Social Determinants Accelerator Act of 2021 Medicaid/Medicare/Private Insurance provisions in the Build Back Better Act S. 610, Public Law 117-71: Protecting Medicare and American Farmers from Sequester Cuts Act H.R. 4406 Supporting Medicaid in the U.S. Territories Act H.R. 341 Ensuring Telemental Health Expansion Act of 2021 H.R. 6698 Stop Unfair Medicaid Recoveries Act H.R. 6636 / S. 2697 Due Process Continuity of Care Act HR 3173/S. 3018 Improving Seniors Access to Timely Care Act Draft bill re: Medicare reimbursement of services provided by advanced trainees
Client expense: $260,000 · Firm income: Not reported
2022 · second_quarter · Medicare/Medicaid
Draft Legislation - IMD Medicaid (Napolitano) S. 586: NO PAIN Act H.R. 1551/S 584: Nutrition Counseling Aiding Recover for Eating Disorders Act H.R. 3450/S. 1727: Medicaid Bump Act H.R. 3447: Permanency for Audio Only Telehealth Act H.R. 4058: Telemental Health Care Access Act S. 2061: Telemental Health Care Access Act S. 2069: Excellence in Mental Health and Addiction Treatment Act H.R. 1738/S. 646: Stabilize Medicaid and CHIP Coverage Act S.285: Medicaid Reentry Act S.340: TREATS Act H.R. 1577/S. 596: Treat and Reduce Obesity Act H.R. 314: Medicare Sequester COVID Moratorium Act H.R 1868: To prevent across the board direct spending cuts S. 1512/H.R. 2903: CONNECT for Health Act H.R. 4480: Telehealth Coverage and Payment Parity Act S. 1798/H.R. 1398: TIKES Act H.R. 5674 / S. 3061: Medicare Mental Health Inpatient Equity Act H.R. 2503 Social Determinants Accelerator Act of 2021 Medicaid/Medicare/Private Insurance provisions in the Build Back Better Act S. 610, Public Law 117-71: Protecting Medicare and American Farmers from Sequester Cuts Act H.R. 4406 Supporting Medicaid in the U.S. Territories Act H.R. 341 Ensuring Telemental Health Expansion Act of 2021 H.R. 6698 Stop Unfair Medicaid Recoveries Act H.R. 6636 / S. 2697 Due Process Continuity of Care Act HR 3173/S. 3018 Improving Seniors Access to Timely Care Act Draft bill re: Medicare reimbursement of services provided by advanced trainees
Client expense: $260,000 · Firm income: Not reported
2022 · second_quarter · Health Issues
Cures 2.0 Act, H.R.6000; Medicare Mental Health Inpatient Equity Act of 2021 (H.R.5674/S.3061); Increasing Behavioral Health Treatment Act, H.R.2611; Brycen Gray and Ben Price COVID-19 Neurological Impact Act, H.R.5772; FY22 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, H.R.4502; FY22 Labor, Health and Human Services, Education, and Related Agencies Subcommittee Appropriations Act, H.R.4502 2022 Consolidated Appropriations Act, H.R.2471; Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, H.R.8295; Restoring Hope for Mental Health and Well-Being Act, H.R.7666
Client expense: Not reported · Firm income: $30,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · second_quarter · Medicare/Medicaid
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 CMS review of Medicaid Managed Care contracts and approval 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)
2022 · second_quarter · Medicare/Medicaid
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) S. 408, Supporting Best Practices for Healthy Moms Act (to reduce maternal mortality) S. 439, Coronavirus Medicaid Response Act (addressing FMAP) 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 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.586 / H.R. 3259 - Non-Opioids Prevent Addiction In the Nation (NOPAIN) Act Annual Prospective Payment System Rules Organ acquisition payment policies False Claims Act amendments 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) CMS review of Medicaid Managed Care contracts and approval process
Client expense: $260,000 · Firm income: Not reported
2022 · second_quarter · Medicare/Medicaid
Draft Legislation - IMD Medicaid (Napolitano) S. 586: NO PAIN Act H.R. 1551/S 584: Nutrition Counseling Aiding Recover for Eating Disorders Act H.R. 3450/S. 1727: Medicaid Bump Act H.R. 3447: Permanency for Audio Only Telehealth Act H.R. 4058: Telemental Health Care Access Act S. 2061: Telemental Health Care Access Act S. 2069: Excellence in Mental Health and Addiction Treatment Act H.R. 1738/S. 646: Stabilize Medicaid and CHIP Coverage Act S.285: Medicaid Reentry Act S.340: TREATS Act H.R. 1577/S. 596: Treat and Reduce Obesity Act H.R. 314: Medicare Sequester COVID Moratorium Act H.R 1868: To prevent across the board direct spending cuts S. 1512/H.R. 2903: CONNECT for Health Act H.R. 4480: Telehealth Coverage and Payment Parity Act S. 1798/H.R. 1398: TIKES Act H.R. 5674 / S. 3061: Medicare Mental Health Inpatient Equity Act H.R. 2503 Social Determinants Accelerator Act of 2021 Medicaid/Medicare/Private Insurance provisions in the Build Back Better Act S. 610, Public Law 117-71: Protecting Medicare and American Farmers from Sequester Cuts Act H.R. 4406 Supporting Medicaid in the U.S. Territories Act H.R. 341 Ensuring Telemental Health Expansion Act of 2021 H.R. 6698 Stop Unfair Medicaid Recoveries Act H.R. 6636 / S. 2697 Due Process Continuity of Care Act HR 3173/S. 3018 Improving Seniors Access to Timely Care Act Draft bill re: Medicare reimbursement of services provided by advanced trainees
Client expense: $260,000 · Firm income: Not reported
2022 · first_quarter · Health Issues
Cures 2.0 Act, H.R.6000; Medicare Mental Health Inpatient Equity Act of 2021 (H.R.5674/S.3061); Increasing Behavioral Health Treatment Act, H.R.2611; Brycen Gray and Ben Price COVID-19 Neurological Impact Act, H.R.5772; FY22 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, H.R.4502; FY22 Labor, Health and Human Services, Education, and Related Agencies Subcommittee Appropriations Act, H.R.4502; 2022 Consolidated Appropriations Act, H.R.2471;
Client expense: Not reported · Firm income: $30,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · first_quarter · Medicare/Medicaid
Sequestration relief (Protecting Medicare and American Farmers from Sequester Cuts Act - S. 610) 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) 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. 408, Supporting Best Practices for Healthy Moms Act (to reduce maternal mortality) S. 439, Coronavirus Medicaid Response Act (addressing FMAP) 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 S. 999, (addressing the Area Wage Index for rural hospitals) 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.586 / H.R. 3259 - Non-Opioids Prevent Addiction In the Nation (NOPAIN) Act Annual Prospective Payment System Rules 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) CMS review of Medicaid Managed Care contracts and approval process
2022 · first_quarter · Medicare/Medicaid
Draft Legislation - IMD Medicaid (Napolitano) S. 586: NO PAIN Act H.R. 1551/S 584: Nutrition Counseling Aiding Recover for Eating Disorders Act H.R. 3450/S. 1727: Medicaid Bump Act H.R. 3447: Permanency for Audio Only Telehealth Act H.R. 4058: Telemental Health Care Access Act S. 2061: Telemental Health Care Access Act S. 2069: Excellence in Mental Health and Addiction Treatment Act H.R. 1738/S. 646: Stabilize Medicaid and CHIP Coverage Act S.285: Medicaid Reentry Act S.340: TREATS Act H.R. 1577/S. 596: Treat and Reduce Obesity Act H.R. 314: Medicare Sequester COVID Moratorium Act H.R 1868: To prevent across the board direct spending cuts S. 1512/H.R. 2903: CONNECT for Health Act H.R. 4480: Telehealth Coverage and Payment Parity Act S. 1798/H.R. 1398: TIKES Act Letter to CMS re: TN Medicaid proposed amendment (Coalition letter) H.R. 5674 / S. 3061: Medicare Mental Health Inpatient Equity Act H.R. 2503 Social Determinants Accelerator Act of 2021 Medicaid/Medicare/Private Insurance provisions in the Build Back Better Act S. 610, Public Law 117-71: Protecting Medicare and American Farmers from Sequester Cuts Act H.R. 4406 Supporting Medicaid in the U.S. Territories Act H.R. 341 Ensuring Telemental Health Expansion Act of 2021 H.R. 6698 Stop Unfair Medicaid Recoveries Act H.R. 6636 / S. 2697 Due Process Continuity of Care Act
Client expense: $226,000 · Firm income: Not reported
2022 · first_quarter · Health Issues
Public Health Emergency Extension; HRSA Provider Relief Fund Phase 4; Omnibus COVID-19 Health Care Staff Vaccination Interim Final Rule with Comment Period (CMS-3415-IFC); Medicare GME Final Rule with Comment Period - Distribution of Residency Slots (CMS-1752-FC3); Medicare Area Wage Index - New Brunswick-Lakewood CBSA (CMS-1752-F); Surprise Billing - Qualified Payment Amount, Good Faith Estimates (CMS-9908-IFC)/No Surprises Act (P. L. 116-260); Site-neutral payment/BBA 2015 Sec. 603 (P.L. 114-74); Hospital Price Transparency Final Rule (CMS-1753-F); CY 2023 Medicare Advantage and Part D Proposed Rule - Prior Authorization for Hospital Transfers to Post-Acute Settings during PHE (CMS-4192-P); Request for Information: Electronic Prior Authorization Standards, Implementation Specifications, and Certification Criteria (RIN - 0955-AA04); FY 2022 Hospice Wage Index and Payment Rate Update, Hospice Conditions of Participation Updates, Hospice and Home Health Quality Reporting Program Requirements (CMS-1754-P); Occupational Exposure to COVID-19 in Healthcare Settings - Emergency Temporary Standard (OSHA-2020-0004); Health Care Workplace Violence; HRSA Uninsured Program - Claims for Testing and Treatment for Uninsured Patients; Public Charge Ground of Inadmissibility NPRM (USCIS-2021-0013); Build Back Better Act (H.R. 5376); Dr. Lorna Breen Health Care Provider Protection Act (H.R. 1667/P.L. 117-105); Healthcare Cybersecurity Act (S. 3904); Telehealth Modernization Act (S. 368/H.R. 1332); Telehealth Extension and Evaluation Act (H.R. 6202/S. 3593); 340B Eligibility Exceptions due to COVID-19 PHE (H.R. 4390/P. L. 117-103); Further Additional Extending Government Funding Act (P.L. 117-86); Consolidated Appropriations Act, 2022 (P.L. 117-103); Medicare Sequestration; Resident Physician Shortage Reduction Act of 2021 (S. 834); Opioid Workforce Act (S. 1438); Healthcare Workforce Resilience Act (H.R. 2255/S. 1024); Anticompetitive Behavior by Nurse Staffing Agencies; Provider Relief Fund Improvement Act (H.R. 5963/S. 3611); Better Way for Providers to Repay Act (H.R. 2407); Parity Enforcement Act (H.R. 1364); Medicare Mental Health Inpatient Equity Act (H.R. 5674/S. 3061); Post-Disaster Mental Health Response Act (H.R. 5703/S. 3677); Opioid Treatment Access Act (H.R. 6279); PACE Plus Act (S. 1162); Improving Access to Medicare Coverage Act (H.R. 3650/S. 2048); Hospital Inpatient Services Modernization Act (H.R. 7053/S. 3792); PREVENT Pandemics Act (S. 3799); Supplemental Funding for COVID-19 Relief.
2021 · fourth_quarter · Health Issues
S. 2086, Resilience Investment, Support, and Expansion (RISE) from Trauma Act. H.R. 4502/S. 3061, Labor-HHS-Education Appropriations Act for FY2022, provisions on funding for trauma-informed care and mental health.
Client expense: Not reported · Firm income: $20,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2021 · third_quarter · Health Issues
S. 2086, Resilience Investment, Support, and Expansion (RISE) from Trauma Act. H.R. 4502/S. 3061, Labor-HHS-Education Appropriations Act for FY2022, provisions on funding for trauma-informed care and mental health.
Client expense: Not reported · Firm income: $20,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2021 · second_quarter · Health Issues
S. 2086, Resilience Investment, Support, and Expansion (RISE) from Trauma Act. H.R. 4502/S. 3061, Labor-HHS-Education Appropriations Act for FY2022, provisions on funding for trauma-informed care and mental health.
Client expense: Not reported · Firm income: $20,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2021 · first_quarter · Health Issues
Resilience Investment, Support, and Expansion (RISE) from Trauma Act (draft legislation). H.R. 4502/S. 3061, Labor-HHS-Education Appropriations Act for FY2022, provisions on funding for trauma-informed care and mental health.
Client expense: Not reported · Firm income: $20,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2021 · fourth_quarter · Medicare/Medicaid
H.R. 19 - Lower Costs, More Cures Act of 2021 - Rep. McMorris Rodgers, Cathy [R-WA-5] - Medicare and Medicaid reforms H.R. 56 - Patient Access to Medical Foods Act - Rep. Biggs, Andy [R-AZ-5] - coverage of medical foods H.R. 66 - CARING for Kids Act - Rep. Buchanan, Vern [R-FL-16] - CHIP extension H.R. 315 - Medicare Sequester COVID Moratorium Act - Rep. Schneider, Bradley Scott [D-IL-10] - Medicare Sequester H.R. 340 - Incentivizing Medicaid Expansion Act of 2021 - Rep. Veasey, Marc A. [D-TX-33] - Medicaid expansion H.R. 502 - Medicare Dental Benefit Act of 2021 - Rep. Barragan, Nanette Diaz [D-CA-44] - Medicare dental coverage H.R. 525 - COVID HCBS Relief Act of 2021 - Rep. Dingell, Debbie [D-MI-12] - HCBS H.R. 599 - Protecting Medicare Beneficiaries with Pre-Existing Conditions Act - Rep. Schneider, Bradley Scott [D-IL-10] - pre-existing conditions H.R. 722 - Ensuring Vaccination and Treatment Affordability Act - Rep. Pappas, Chris [D-NH-1] - cost-sharing for COVID-19 vaccines H.R. 918 - Stronger Medicaid Response to the COVID-19 Pandemic Act - Rep. Cardenas, Tony [D-CA-29] - Medicaid & COVID-19 H.R. 955 - Medicaid Reentry Act of 2021 - Rep. Tonko, Paul [D-NY-20] - Medicaid coverage H.R. 975 - Ensuring Seniors Access to COVID Treatments Act - Rep. Casten, Sean [D-IL-6] - coverage of COVID-19 drugs H.R. 1227 - Medicare-X Choice Act of 2021 - Rep. Delgado, Antonio [D-NY-19] - Medicare-X H.R. 1495 - Jim Ramstad Legacy of Recovery Act - Rep. Emmer, Tom [R-MN-6] - Medicaid coverage for SUD H.R. 1717 - Protecting Married Seniors from Impoverishment Act of 2021 - Rep. Upton, Fred [R-MI-6] - HCBS and spousal impoverishment H.R. 1722 - Puerto Rico Health Care Fairness, Accountability, and Beneficiary Access Act of 2021 - Rep. Velazquez, Nydia M. [D-NY-7] - Medicaid for territories H.R. 1791 - CHIPP Act - Rep. Barragan, Nanette Diaz [D-CA-44] - CHIP extension H.R. 1795 - Expanded Coverage for Former Foster Youth Act - Rep. Bass, Karen [D-CA-37] - coverage for foster youth H.R. 1880 - To amend the Deficit Reduction Act of 2005 to make permanent the Money Follows the Person Rebalancing Demonstration - Rep. Dingell, Debbie [D-MI-12] - Money Follows the Person extension H.R. 1969 - Medicare Advantage Integrity Act - Resident Commissioner Gonzalez-Colon, Jenniffer [R-PR-At Large] - Medicare Advantage benchmark rates H.R. 1976 - Medicare for All Act of 2021 - Rep. Jayapal, Pramila [D-WA-7] - Medicare for All H.R. 1978 - Protecting Seniors Through Immunization Act of 2021 - Rep. Kuster, Ann M. [D-NH-2] - cost sharing for vaccines under Medicare part D H.R. 1999 - Protect Seniors and Cut Waste Act - Rep. Smith, Jason [R-MO-8] - sequester for Pay-As-You-Go H.R. 2166 - Ensuring Parity in MA and PACE for Audio-Only Telehealth Act of 2021 - Rep. Sewell, Terri A. [D-AL-7] - Medicare coverage of telehealth H.R. 2217 - Territory Federal Matching Requirement Equity Act of 2021 - Resident Commissioner Gonzalez-Colon, Jenniffer [R-PR-At Large] - FMAP for territories H.R. 2297 - MIND Act - Rep. Boyle, Brendan F. [D-PA-2] - Medicaid payment for services provided in institutions for mental diseases H.R. 2464 - More Help for Seniors Act of 2021 - Rep. Craig, Angie [D-MN-2] - Medicare prescription drug benefit H.R. 2881 - Medicare Buy-In and Health Care Stabilization Act of 2021 - Rep. Higgins, Brian [D-NY-26] - Medicare public insurance H.R. 3108 - Medical Nutrition Therapy Act of 2021 - Rep. Kelly, Robin L. [D-IL-2] - coverage of medical foods H.R. 3173 - Improving Seniors Timely Access to Care Act of 2021 - Rep. DelBene, Suzan K. [D-WA-1] - prior authorization H.R. 3447 - Permanency for Audio-Only Telehealth Act - Rep. Smith, Jason [R-MO-8] - Medicare telehealth coverage H.R. 3450 - Medicaid Bump Act - Rep. Tonko, Paul [D-NY-20] - Medicaid funding and behavioral health H.R. 3894 - CARING for Social Determinants Act of 2021- Rep. Blunt Rochester, Lisa [D-DE-At Large] - Medicaid and SDOH H.R. 3961 - COVER Now Act - Rep. Doggett, Lloyd [D-TX-35] - Medicaid expansion H.R. 4040 Advancing Telehealth Beyond COVID-19 Act of 2021- Rep. Cheney, Liz [R-WY-At Large] - Medicare telehealth coverage H.R. 4043 - Ensuring Patient Access to Critical Breakthrough Products Act of 2021 - Rep. DelBene, Suzan K. [D-WA-1] - Medicare coverage of breakthrough devices H.R. 4074 - Addressing Social Determinants in Medicare Advantage Act of 2021 - Rep. Bilirakis, Gus M. [R-FL-12] - Medicare Advantage supplemental benefits H.R. 4158 - Insulin Access for All Act of 2021 - Rep. Rush, Bobby L. [D-IL-1] - cost sharing for insulin H.R. 4187 - Medicare Vision Act of 2021 - Rep. Schrier, Kim [D-WA - Medicare vision coverage H.R. 4263 - Patient Parity Protection Act of 2021 - Rep. Gottheimer, Josh [D-NJ-5] - out-of-network services H.R. 4311 - Medicare Dental, Vision, and Hearing Benefit Act of 2021 - Rep. Doggett, Lloyd [D-TX-35] - Medicare dental, vision, and hearing benefits H.R. 4406 - Supporting Medicaid in the U.S. Territories Act of 2021 - Rep. Soto, Darren [D-FL-9] - Medicaid support in U.S. territories H.R. 4439 - Medicaid Dental Benefit Act - Rep. Barragan, Nanette Diaz [D-CA-44] - Medicaid dental benefit H.R. 4640 - Close the Medigap Act of 2021 - Rep. Doggett, Lloyd [D-TX-35] - Medicare supplemental health insurance policies H.R. 4650 - Medicare Dental Coverage Act of 2021 - Rep. Kelly, Robin L. [D-IL-2] - Medicare dental benefit H.R. 4941 - PACE Part D Choice Act of 2021 - Rep. Blumenauer, Earl [D-OR-3] - prescription drug plans in the Medicare-only PACE program H.R. 4942 - BETTER Kidney Care Act - Rep. Blumenauer, Earl [D-OR-3] - demonstration program for Medicare enrollees with ESRD H.R. 4974 - State Public Option Act - Rep. Schrier, Kim [D-WA-8] - Medicaid public option H.R. 5099 - Lowering Medicare Premiums and Prescription Drug Costs Act - Rep. Schneider, Bradley Scott [D-IL-10] - Medicare cost-sharing benefits H.R. 5110 - Medicare Medically Necessary Dental Care Act of 2021 - Rep. Cohen, Steve [D-TN-9] - Medicare dental benefits H.R. 5165 - Improving Medicare Coverage Act - Rep. Jayapal, Pramila [D-WA-7] - Medicare eligibility age H.R. 5414 - Ensuring Medicaid Continuity for Children in Foster Care Act of 2021 - Rep. Bilirakis, Gus M. [R-FL-12] - Medicaid coverage for children in foster care H.R. 5425 - Protecting Rural Telehealth Access Act - Rep. O'Halleran, Tom [D-AZ-1] - Medicare telehealth services H.R. 5576 - Fair Drug Prices for Kids Act - Rep. Wild, Susan [D-PA-7] - Medicaid Drug Rebate Program under CHIP H.R. 5632 - Long-Term Care Pharmacy Definition Act of 2021 - Rep. Schrader, Kurt [D-OR-5] - Medicare long term care pharmacy H.R. 5674 - Medicare Mental Health Inpatient Equity Act of 2021 - Rep. Tonko, Paul [D-NY-20] - inpatient psychiatric hospital services under Medicare H.R. 6101 - Drug Price Transparency in Medicaid Act of 2021 - Rep. Carter, Earl L. "Buddy" [R-GA-1] - drug pricing in Medicaid S. 97 - Medicare Dental Benefit Act of 2021 - Sen. Cardin, Benjamin L. [D-MD] - Medicare dental coverage S. 150 - Ensuring Parity in MA for Audio-Only Telehealth Act of 2021 - Sen. Cortez Masto, Catherine [D-NV] - Medicaid telehealth coverage S. 151 - COVID HCBS Relief Act of 2021 - Sen. Casey, Robert P., Jr. [D-PA] - HCBS S. 274 - Stronger Medicaid Response to the COVID-19 Pandemic Act - Sen. Bennet, Michael F. [D-CO] - Medicaid & COVID-19 S. 340 - TREATS Act - Sen. Portman, Rob [R-OH] - telehealth - Medicare telehealth coverage S. 386 - Medicare-X Choice Act of 2021 - Sen. Bennet, Michael F. [D-CO] - Medicare-X S. 448 - Ensuring Kids Have Access to Medically Necessary Dental Care Act - Sen. Cardin, Benjamin L. [D-MD] - CHIP S. 653 - COMP Act - Sen. Portman, Rob [R-OH] - Medicare secondary payer rules S. 748 - Medicare Sequester Relief Act - Sen. Shaheen, Jeanne [D-NH] - Medicare sequestration S. 1180 - Choose Medicare Act - Sen. Merkley, Jeff [D-OR] - Medicare public insurance S. 1536 - Medical Nutrition Therapy Act of 2021 - Sen. Collins, Susan M. [R-ME] - coverage of medical foods S. 1727 - Medicaid Bump Act - Sen. Smith, Tina [D-MN] - Medicaid funding and behavioral health S. 1844 - Lowering Medicare Premiums and Prescription Drug Costs Act - Sen. Casey, Robert P., Jr. [D-PA] - Medicare premiums and drug costs S. 2111 - Audio-Only Telehealth for Emergencies Act - Sen. Kennedy, John [R-LA] - Medicare coverage of telehealth S. 2112 - EASE Behavioral Health Services Act - Sen. Kennedy, John [R-LA] - telehealth S. 2164 - Lower Costs, More Cures Act of 2021 - Sen. Crapo, Mike [R-ID] - Medicare and Medicaid reforms S. 2197 - Rural and Frontier Telehealth Expansion Act - Sen. Rosen, Jacky [D-NV] - FMAP & telehealth S. 2210 - Better Care Better Jobs Act - Sen. Casey, Robert P., Jr. [D-PA] - HCBS S. 2236 - Expanding Health Care Options for Early Retirees Act - Sen. Brown, Sherrod [D-OH] - Medicare buy-in S. 2315 - Medicaid Saves Lives Act - Sen. Warnock, Raphael [D-GA] - Medicaid expansion S. 2618 - Medicare and Medicaid Dental, Vision, and Hearing Benefit Act of 2021 - Sen. Casey, Bob [D-PA] - Medicaid dental, vision, and hearing benefits S. 2639 - State Public Option Act - Sen. Schatz, Brian [D-HI] - Medicaid public option S. 2689 - Ensuring Medicaid Continuity for Children in Foster Care Act of 2021 - Sen. Burr, Richard [R-NC] - Medicaid-eligibility for children in foster care S. 3018 - Improving Seniors Timely Access to Care Act of 2021 - Sen. Marshall, Roger [R-KS] - prior authorization under MA S. 3061 - Medicare Mental Health Inpatient Equity Act of 2021 - Sen. Collins, Susan M. [R-ME] - inpatient psychiatric hospital services under Medicare S. 3193 - Expanded Telehealth Access Act - Sen. Daines, Steve [R-MT] - Medicare telehealth service providers S. 3332 - Let States Innovate Under Medicaid Act - Sen. Braun, Mike [R-IN] - Medicaid program promotion Regulatory Issues: Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, network adequacy and provider directories, encounter data and other data-related issues, and risk adjustment data validation (RADV) audit issues including proposed RADV regulation for MA; bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, Part D direct and indirect remuneration (DIR), and audits); calendar year 2022 policy and technical regulation for MA and Part D; Part D reform, out of pocket limits; issues related to Medicare for All, Medicare buy-in, reduced Medicare eligibility age, and public option; issues relating to 2022 Rate Notice; issues related to coverage in non-Medicaid Expansion States (e.g., Gap Population); issues related to expanded Medicare fee for service benefits (dental, hearing and vision); issues related to Medicaid coverage gap; potential Medicare NCD relating to monoclonal antibodies for treatment of Alzheimers disease; Executive Orders relating to international pricing, Part D rebates, insulin costs, and importation; issues related to MLTSS; issues related to removal of safe harbor protection for rebates; issues relating to COVID-19, including testing and vaccines; issues related to health equity; issues related to vaccination; issues related to audio-only telehealth; issues related to addressing the social determinants of health, including housing, transportation, nutrition, educational opportunities, and MA supplemental benefits; issues related to Medicaid presumptive eligibility and continuous eligibility; issues relating to Medicaid best price; in-home health risk assessments; Medicare Medical Loss Ratio issues; issues related to changes to prior authorization regulations, electronic documentation, and related issues; issues relating to sequestration under the Medicare Advantage and Part D programs; implications of physician fee schedule on MA; application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, enrollment rules, requirements for notice and denial forms, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible SNPs; Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, Part D coverage gap discount program, including employer group waiver plan (EGWP) issues, and other operational issues; issues raised by Part D coverage of new specialty drugs, the Part D non-interference policy and related issues (e.g., preferred pharmacy and any willing pharmacy requirements, standards for network pharmacy reimbursement, and policies regarding sponsor negotiation of pharmacy price concessions); issues related to the international price index; issues related to child and maternal health; issues related to Medicaid supplemental and disproportionate share hospital (DSH) funding; issues related to Medicaid funding for territories; issues related to medical management; issues relating to MA supplemental benefits; Medication Therapy Management Program requirements and the Center for Medicare and Medicaid Innovation (CMMI) Demonstration; MA EGWP issues; CMMI's value based payment models; Part D requirements for offering basic and enhanced alternative plans; MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; issues relating to MA and Part D Star Rating system including measures, the methodology for calculating ratings, and the role of the ratings for payment purposes; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education Program; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; issues relating to MACRA, including implications for MA and Part D plans; Medicare/Medicaid integration for dual eligibles, including implementation of the Capitated Financial Alignment Demonstration and related issues (e.g., quality ratings); Medicaid managed care regulations and policies, including CMS's substantial revisions to the managed care regulations, mental health parity rules, the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, fraud and abuse compliance, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including block grants, the calculation of the federal medical assistance (federal matching) percentage (FMAP), and intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost issues affecting Medicaid health plans including issues raised by Medicaid coverage of new specialty drugs; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues and CHIP reauthorization; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including Medicaid managed care organization provider tax issues; standards for electronic prescribing; implementation of Medicaid changes of interest to Medicaid health plans made in the Affordable Care Act (ACA) including Medicaid expansion, the managed care organization (MCO) prescription drug rebate provisions, minimum payments to primary care providers (PCPs), interactions between the Medicaid program and health insurance exchanges, and Medicaid and CHIP maintenance of effort (MOE) requirements; implications of the health insurer fee for Medicaid health plans; issues related to Medicaid Managed long-term care including home and community-based waiver services (HCBS); expanding the availability of Medicare Advantage and Medicaid health plan telemedicine programs; implications of the new non-discrimination rules for health plans participating in public programs; issues related to Medigap coverage; issues related to business continuity in relation to pandemics or natural events (e.g., hurricane, tornado, etc.); cybersecurity; provider directories; value-based insurance design models; Part D prescriber enrollment requirements; Part D recovery audit contractor programs; issues relating to enrollment of beneficiaries with ESRD into MA plans; issues related to health homes for children with medically complex conditions; socioeconomic status impacts on star ratings related to MA and Part D programs; and other issues relating to health care reform implementation.
2021 · fourth_quarter · Health Issues
H.R. 586/ S. 1391 - STANDUP Act of 2021 H.R. 654 - Drug-Free Communities Pandemic Relief Act H.R. 925 - Data to Save Moms Act H.R. 1475/ S.1795 - Pursuing Equity in Mental Health Act H.R. 1667 / S.610 - Lorna Breen Health Care Provider Protection Act H.R. 2051 - Methamphetamine Response Act of 2021 H.R. 2163 / S. 464 - Safe Step Act H.R. 2255/ S. 1024 - Healthcare Workforce Resilience Act H.R. 2256/ S. 834 -Resident Physician Shortage Reduction Act H.R. 2364 - Synthetic Opioid Danger Awareness Act H.R. 2379 - State Opioid Response Grant Authorization Act of 2021 H.R. 2503 - Social Determinants Accelerator Act of 2021 H.R. 3173/ S. 3018 - Improving Seniors' Timely Access to Care Act H.R 3441/S. 1438 - Substance Use Disorder Workforce Act/ Opioid Workforce Act H.R. 3407/ S. 411 - MOMMAs Act H.R. 3447 - Permanency for Audio-Only Telehealth Act H.R. 3541/ S. 1810 - Conrad State 30 and Physician Access Reauthorization Act H.R. 3753/S. 1962 - Parity Implementation Assistance Act H.R. 3894 - Collecting and Analyzing Resources Integral and Necessary for Guidance (CARING) for Social Determinants Act of 2021 H.R. 4026 - Social Determinants of Health Data Analysis Act of 2021 H.R. 4058/S. 2061 - Telemental Health Care Access Act H.R. 4194 - People's Response Act H.R. 4387 - Maternal Health Quality Improvement Act of 2021 H.R. 4406 - Supporting Medicaid in the U.S. Territories Act of 2021 H.R. 4770 - Evaluating Disparities and Outcomes of Telehealth (EDOT) Act of 2021 H.R. 4943 - Childrens Mental Health Infrastructure Act of 2021 H.R. 4944 - Helping Kids Cope Act of 2021 HR 5218 - Collaborate in an Orderly and Cohesive Manner Act H.R. 5235 - Student Mental Health Helpline Act of 2021 H.R. 5407 - Enhancing Mental Health and Suicide Prevention Through Campus Planning Act H.R. 5435/ S. 3427 - BRAIN Act of 2021/Neuroscience Center of Excellence Act of 2021 H.R. 5611/ S.1902 - Behavioral Health Crisis Services Expansion Act H.R. 5674/ S. 3061 - Medicare Mental Health Inpatient Equity Act H.R. 5837 - A bill to expand telehealth services relating to substance use disorder H.R.5950 - Improving Patient Access to Care and Treatment Act H.R. 6000 - Cures 2.0 Act H.R. 6020/ S. 3314 - Supporting Medicare Providers Act of 2021 H.R. 6202 - Telehealth Extension Act of 2021 S. 610 - Protecting Medicare and American Farmers from Sequester Cuts Act (No legislation) Implementation of No Surprises Act
2021 · fourth_quarter · Health Issues
Cures 2.0 Act, H.R.6000; Medicare Mental Health Inpatient Equity Act of 2021 (H.R.5674/S.3061); Increasing Behavioral Health Treatment Act, H.R.2611; Brycen Gray and Ben Price COVID-19 Neurological Impact Act, H.R.5772; FY22 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, H.R.4502; FY22 Labor, Health and Human Services, Education, and Related Agencies Subcommittee Appropriations Act, H.R.4502
Client expense: Not reported · Firm income: $30,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2021 · fourth_quarter · Medicare/Medicaid
Draft Legislation - IMD Medicaid (Napolitano) S. 586: NO PAIN Act H.R. 1551/S 584: Nutrition Counseling Aiding Recover for Eating Disorders Act H.R. 3450/S. 1727: Medicaid Bump Act H.R. 3447: Permanency for Audio Only Telehealth Act H.R. 4058: Telemental Health Care Access Act S. 2061: Telemental Health Care Access Act S. 2069: Excellence in Mental Health and Addiction Treatment Act H.R. 1738/S. 646: Stabilize Medicaid and CHIP Coverage Act S.285: Medicaid Reentry Act S.340: TREATS Act H.R. 1577/S. 596: Treat and Reduce Obesity Act H.R. 314: Medicare Sequester COVID Moratorium Act H.R 1868: To prevent across the board direct spending cuts S. 1512/H.R. 2903: CONNECT for Health Act H.R. 4480: Telehealth Coverage and Payment Parity Act S. 1798/H.R. 1398: TIKES Act Letter to CMS re: TN Medicaid proposed amendment (Coalition letter) H.R. 5674 / S. 3061: Medicare Mental Health Inpatient Equity Act H.R. 2503 Social Determinants Accelerator Act of 2021 Medicaid/Medicare/Private Insurance provisions in the Build Back Better Act S. 610, Public Law 117-71: Protecting Medicare and American Farmers from Sequester Cuts Act H.R. 4406 Supporting Medicaid in the U.S. Territories Act H.R. 341 Ensuring Telemental Health Expansion Act of 2021
Client expense: $300,000 · Firm income: Not reported
Client expense: $80,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
Government targets: HOUSE OF REPRESENTATIVES, SENATE
Government targets: HOUSE OF REPRESENTATIVES, SENATE, White House Office
Government targets: HOUSE OF REPRESENTATIVES, SENATE
Client expense: $70,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
Government targets: HOUSE OF REPRESENTATIVES, SENATE
Government targets: HOUSE OF REPRESENTATIVES, SENATE
Client expense: $80,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE
Client expense: $40,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
Client expense: $2,630,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Treasury, Dept of, White House Office
Client expense: $83,505 · Firm income: Not reported
Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Treasury, Dept of, Veterans Affairs, Dept of (VA)
Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, Environmental Protection Agency (EPA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Indian Health Service, Justice, Dept of (DOJ), Natl Science Foundation (NSF), Office of Management & Budget (OMB), Office of Science & Technology Policy (OSTP), SENATE, Veterans Affairs, Dept of (VA), White House Office