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Legislative Progress
Introduced
February 23, 2021
Latest Action
February 23, 2021
Primary Sponsor
Michael F. BennetDemocratic(CO)
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-X Choice Act of 20 21 This bill establishes and funds the Medicare Exchange health plan, which allows individuals who are not otherwise eligible for Medicare to enroll in a government-administered health insurance plan. The Centers for Medicare & Medicaid Services (CMS) must offer such plan in certain individual health insurance exchanges beginning plan year 2022 and offer it in all individual health insurance exchanges beginning plan year 2025. CMS must offer the plan in the small group market in all geographic areas for plan year 2025. The plan must cover primary care services without cost sharing and meet the same requirements, including essential health benefits, as existing health insurance exchange plans. Unless they opt out, health care providers enrolled under Medicare or under a state Medicaid plan must participate in the plan and are reimbursed at Medicare rates. The bill establishes a grants program for community organizations, educational institutions, and health agencies to create service partnerships and establish interactive data systems for health care providers. Additionally, the bill expands the premium tax credit available for plans purchased through an exchange and eliminates the restriction on the Department of Health and Human Services negotiating prescription drug prices for Medicare.
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Filing registrants (17)
Read twice and referred to the Committee on Finance.
Introduced in Senate
Bills with similar content found using semantic analysis.
Sources: Congress.gov
2022 · fourth_quarter · Health Issues
H.R. 1195, Workplace Violence Prevention for Health Care and Social Service Worker Act OSHA Funding Draft resolution on treating racism as a public health crisis H.R. 9475, TEACH Act S. 3663, Kids Online Safety Act Draft educator mental health bill H.R.1195, Workplace Violence Prevention for Health Care and Social Service Workers Act, Entirety Health Worker Shortage/Staffing Crisis Visas for international healthcare professionals Green New Deal for Health, Entirety Monitor the following: Public Law 117-169, Inflation Reduction Act, Prescription drug reform Public Law 117-159, Bipartisan Safer Communities Act H.R.5015, the Medicaid DSH Payment Adjustment Fairness Act, Hospital funding formula Abortion Access related issues H.R.7784, the Supporting Trauma Informed Education Practices Act H.R.7666, Restoring Hope for Mental Health and Well‐Being Act S.2110, Better Care Better Jobs Act Nurse Overtime and Patient Safety Act S.632, Health Force and Resilience Force Act, H.R.959/S.346, Black Maternal Health Momnibus Act Student Loan Forgiveness for Frontline Health Workers S.102, the Prescription Drug Price Relief Act S.99, the Medicare Drug Price Negotiation Act S.97, the Affordable and Safe Prescription Drug Importation Act H.R.1391/S.482, Taxpayer Research and Coronavirus Knowledge Act, Entirety H.R.7296/S.4439, Make Medications Affordable by Preventing Pandemic Pricegouging Act, Entirety Affordability of pharmaceuticals, generally Treating gun violence as a public health epidemic related issues The National Nurse Act, Entirety Health Equity Issues during COVID Pandemic H.R.728/S.187, Pandemic Emergency Manufacturing Act of 2021, Entirety Support Medicare/ACA enrollment H.R. 6637, Health Equity and Accountability Act, Entirety Delivery of healthcare services to students during COVID pandemic Telehealth issues H.R.1227/S.386, Medicare X Choice Act Rural Healthcare related issues and initiatives Federal response to COVID-19 Pandemic H.R.3755, the Women's Health Protection Act, Entirety H.R.7116, 9-8-8 Implementation Act H.R.6833, the Affordable Insulin Now Act Mental health supports for educators S.3796/H.R.7045, Closing Health Coverage Gaps for Public Servants Act Dobbs v. Jackson, United States Supreme Court decision Public Law 117-168, Honoring our Promise to Address Comprehensive Toxics (PACT) Act, Entirety
Client expense: $380,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · fourth_quarter · Medicare/Medicaid
H.R. 66 - CARING for Kids Act - Rep. Buchanan, Vern - CHIP H.R. 265 - Insular Area Medicaid Parity Act - Rep. Sablan, Gregorio Kilili Camacho - Medicaid funding H.R. 315 - Medicare Sequester COVID Moratorium Act - Rep. Schneider, Bradley Scott - Medicare sequestration H.R.340 - Incentivizing Medicaid Expansion Act of 2021 - Rep. Veasey, Marc - Medicaid expansion H.R. 432 - Mental Health Access Improvement Act of 2021 - Rep. Thompson, Mike -Medicare coverage of marriage and family therapist services and mental health counselor H.R. 502 - Medicare Dental Benefit Act of 2021 - Rep. Barragan, Nanette Diaz - Medicare coverage of dental and oral health services H.R. 525 - COVID HCBS Relief Act of 2021 - Rep. Dingell, Debbie - increased FMAP for HCBS H.R. 871 - Expand Medicaid Now Act - Rep. Fletcher, Lizzie - FMAP H.R. 918 - Stronger Medicaid Response to the COVID-19 Pandemic Act - Rep. Cardenas, Tony - COVID-19 coverage for the uninsured via Medicaid H.R. 955 - Medicaid Reentry Act of 2021 - Rep. Tonko, Paul -Medicaid coverage for incarcerated individuals H.R. 1167 - Advancing Enrollment and Reducing Drug Costs Act of 2021 - Rep. Pappas, Chris - Medicaid eligibility for low-income subsidies H.R. 1227 - Medicare-X Choice Act of 2021 - Rep. Delgado, Antonio - Medicare public option H.R. 1332 - Telehealth Modernization Act - Rep. Carter, Earl - telehealth services under Medicare H.R. 1349 - The COVID-19 Hospital and Health Provider Loan Conversion Act of 2021- Rep. Kaptur, Marcy - advance payments under parts A and B of Medicare H.R. 1353 - Coronavirus Medicaid Response Act - Rep. Lee, Susie - FMAP H.R. 1390 - CHIPPER Act - Rep. Wild, Susan - CHIP funding H.R. 1397 - TIKES Act - Rep. Blunt Rochester, Lisa - telehealth under Medicaid and CHIP H.R. 1609 - Treatment in Place Act - Rep. Axne, Cynthia - Medicare coverage of ambulance services H.R. 1676 - Jack Reynolds Memory Medigap Expansion Act - Rep. Axne, Cynthia - Medigap coverage for ESRD H.R. 1677 - KEEP Telehealth Options Act of 2021 - Rep. Balderson, Troy - telehealth expansion H.R. 1717 - Protecting Married Seniors from Impoverishment Act of 2021 - Rep. Upton, Fred - permanent protections against spousal impoverishment H.R. 1722 - Puerto Rico Health Care Fairness, Accountability, and Beneficiary Access Act of 2021 - Rep. Velazquez, Nydia - Medicaid in Puerto Rico H.R. 1738 - Stabilize Medicaid and CHIP Coverage Act - Rep. Dingell, Debbie - Medicaid and CHIP continuous enrollment H.R. 1784 - Medicaid REACH Act - Rep. Doggett, Lloyd - requirements for non-expansion H.R. 1791 - CHIPP Act - Rep. Barragan, Nanette Diaz - extending CHIP H.R. 1792 - Ensuring Kids Have Access to Medically Necessary Dental Care Act - Rep. Barragan, Nanette Diaz - dental coverage under CHIP H.R. 1793 - Immediate Coverage for Former Foster Youth Act - Rep. Bass, Karen - Medicaid coverage for foster youth H.R. 1794 - Foster Youth Dental Act of 2021 - Rep. Bass, Karen - Medicaid dental coverage for foster youth H.R. 1823 - To amend title XIX of the Social Security Act to remove the matching requirement for a territory to use specially allocated Federal funds for Medicare covered part D drugs for low-income individuals - Resident Commissioner Gonzalez-Colon, Jenniffer - Medicare covered part D H.R. 1825 - Territories Medicare Prescription Drug Assistance Equality Act of 2021 - Resident Commissioner Gonzalez-Colon, Jenniffer - Medicare Part D premium and cost-sharing subsidies H.R. 1826 - Fairness in Medicare Part B Enrollment Act of 2021 - Resident Commissioner Gonzalez-Colon, Jenniffer - late enrollment penalties under part B of the Medicare program H.R. 1880 - To amend the Deficit Reduction Act of 2005 to make permanent the Money Follows the Person Rebalancing Demonstration - Rep. Dingell, Debbie - Money Follows the Person Rebalancing Demonstration H.R. 1885 - RUSH Protection Act of 2021 - Rep. Kind, Ron - Medicare rural health clinic payments H.R. 1887 - Rural Hospital Support Act - Rep. Reed, Tom - Medicare payments for hospitals H.R. 1890 - Health Insurance Consumer Protection Act - Rep. Schakowsky, Janice D. - network adequacy standards and premium rates H.R. 1914 - CAHOOTS Act - Rep. DeFazio, Peter A. - Medicaid mobile crisis intervention services H.R. 1969 - Medicare Advantage Integrity Act - Resident Commissioner Gonzalez-Colon, Jenniffer - disparity in MA benchmark rates H.R. 2035 - Improving Access to Mental Health Act of 2021 - Rep. Lee, Barbara - mental health services under Medicare H.R. 2080 - SAVE Act - Rep. Bishop, Sanford D., Jr. - Medicare coverage of transportation services H.R. 2166 - Ensuring Parity in MA and PACE for Audio-Only Telehealth Act of 2021 - Rep. Sewell, Terri - Medicare Advantage payments for audio-only diagnoses H.R. 2168 - Expanded Telehealth Access Act - Rep. Sherrill, Mikie - Medicare payment for telehealth services H.R. 2170 - HAPI Act - Rep. Soto, Darren - access to vaccines and Medicaid H.R. 2179 - Affordable Insulin for the COVID-19 Emergency Act - Rep. Waters, Maxine - cost-sharing regarding insulin coverage H.R. 2217 - Territory Federal Matching Requirement Equity Act of 2021 - Resident Commissioner Gonzalez-Colon, Jenniffer - Medicaid FMAP for Territories H.R. 2228 - Rural Behavioral Health Access Act of 2021 - Rep. Kildee, Daniel - Medicare coverage of outpatient telehealth services H.R. 4074 - Addressing Social Determinants in Medicare Advantage Act of 2021 - Rep. Bilirakis, Gus M. - Medicare Advantage supplemental benefits H.R. 4640 - Close the Medigap Act of 2021 - Rep. Doggett, Lloyd - Medigap policies H.R. 6833 - Affordable Insulin Now Act - Rep. Craig, Angie - Insulin prices and cost sharing S. 150 - Ensuring Parity in MA for Audio-Only Telehealth Act of 2021 - Sen. Cortez-Masto, Catherine - coverage of audio-only telehealth services in MA S. 151 - COVID HCBS Relief Act of 2021 - Sen. Casey, Robert - FMAP and HCBS S. 245 - SAME Act of 2021 - Sen. Warner, Mark - Medicaid expansion S. 274 - Stronger Medicaid Response to the COVID-19 Pandemic Act - Sen. Bennet, Michael - COVID-19 coverage for the uninsured via Medicaid S. 285 - Medicaid Reentry Act of 2021 - Sen. Baldwin, Tammy - Medicaid coverage for incarcerated individuals S. 368 - Telehealth Modernization Act - Sen. Scott, Tim - coverage of telehealth services under Medicare S. 386 - Medicare-X Choice Act of 2021 - Sen. Bennet, Michael - Medicare public option S. 439 - Coronavirus Medicaid Response Act - Sen. Casey, Robert - increases FMAP S. 440 - Continued Funding for Senior Services During COVID-19 Act - Sen. Casey, Robert - funding for services under the Older Americans Act of 1965 S. 453 - CHIPPER Act - Sen. Casey, Robert - CHIP funding S. 581 - HAPI Act -Sen. Brown, Sherrod - vaccines under Medicaid S. 620 - KEEP Telehealth Options Act of 2021 - Sen. Fischer, Deb - telehealth expansion S. 644 - Rural Hospital Closure Relief Act of 2021 - Sen. Durbin, Richard - Medicare coverage for critical access hospitals S. 646 - Stabilize Medicaid and CHIP Coverage Act of 2021 - Sen. Brown, Sherrod - Medicaid and CHIP enrollment S. 653 - COMP Act - Sen. Portman, Rob - Medicare secondary payer rules S. 712 - Dosha Joi Immediate Coverage for Former Foster Youth Act - Sen. Casey, Robert P., Jr. - Medicaid coverage for foster youth S. 748 - Medicare Sequester Relief Act - Sen. Shaheen, Jeanne - Medicare payment sequestration S. 764 - CAHOOTS Act - Sen. Wyden, Ron - Medicaid mobile crisis intervention services S. 826 - Medicare Patient Empowerment Act of 2021 - Sen. Paul, Rand - Medicaid payment options S. 870 - Improving Access to Mental Health Act of 2021 - Sen. Stabenow, Debbie - mental health services in Medicare S. 999 - Save Rural Hospitals Act of 2021 - Sen. Warner, Mark - Medicare hospital payments Regulatory Issues: Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, network adequacy and provider directories, encounter data and other data-related issues, and risk adjustment data validation (RADV) audit issues including proposed RADV regulation for MA; bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, Part D direct and indirect remuneration (DIR), and audits); issues related to Medicare for All, Medicare buy-in, reduced Medicare eligibility age, and public option; issues relating to 2024 Rate Notice; issues related to the expiration of Medicaid continuous eligibility and transitions in coverage; issues related to coverage of EUA drugs under Medicare Part D; issues related to coverage in non-Medicaid Expansion States (e.g., Gap Population); issues related to expanded Medicare fee for service benefits (dental, hearing and vision); issues related to Medicaid coverage gap; issues related to specialty infant formula; issues related to the Inflation Reduction Act passage and implementation; contraceptive coverage and reproductive health; Medicare NCD relating to monoclonal antibodies for treatment of Alzheimers disease; issues related to Managed Long Term Services and Supports (MLTSS); issues related to removal of safe harbor protection for rebates; issues relating to COVID-19, including testing, vaccines and therapeutics; issues related to the end of the public health emergency; telehealth; issues related to the cost of insulin, including price, copays, rebates, and medical management tools; issues related to health equity; issues related to vaccination; issues related to audio-only telehealth; issues related to addressing the social determinants of health, including housing, transportation, nutrition, educational opportunities, and MA supplemental benefits; issues related to Medicaid presumptive eligibility and continuous eligibility; issues relating to Medicaid best price; in-home health risk assessments; Medicare Medical Loss Ratio issues; issues related to changes to prior authorization regulations or legislation, electronic documentation, and related issues; issues relating to sequestration under the Medicare Advantage and Part D programs; implications of physician fee schedule on MA; application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, enrollment rules, requirements for notice and denial forms, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible SNPs; Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, Part D coverage gap discount program, including employer group waiver plan (EGWP) issues, and other operational issues; issues raised by Part D coverage of new specialty drugs, the Part D non-interference policy and related issues (e.g., preferred pharmacy and any willing pharmacy requirements, standards for network pharmacy reimbursement, and policies regarding sponsor negotiation of pharmacy price concessions); issues related to the international price index; issues related to child and maternal health; issues related to Medicaid supplemental and disproportionate share hospital (DSH) funding; issues related to Medicaid funding for territories; issues related to medical management; issues relating to MA supplemental benefits; Medication Therapy Management Program requirements and the Center for Medicare and Medicaid Innovation (CMMI) Demonstration; MA EGWP issues; CMMI's value based payment models; Part D requirements for offering basic and enhanced alternative plans; MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; issues relating to MA and Part D Star Rating system including measures, the methodology for calculating ratings, and the role of the ratings for payment purposes; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education Program; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; issues relating to MACRA, including implications for MA and Part D plans; Medicare/Medicaid integration for dual eligibles, including implementation of the Capitated Financial Alignment Demonstration and related issues (e.g., quality ratings); issues relating to potential Medicare mental health parity requirements; Medicaid managed care regulations and policies, including CMS's substantial revisions to the managed care regulations, mental health parity rules, the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, fraud and abuse compliance, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including block grants, the calculation of the federal medical assistance (federal matching) percentage (FMAP), and intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost issues affecting Medicaid health plans including issues raised by Medicaid coverage of new specialty drugs; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues and CHIP reauthorization; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including Medicaid managed care organization provider tax issues; standards for electronic prescribing; implementation of Medicaid changes of interest to Medicaid health plans made in the Affordable Care Act (ACA) including Medicaid expansion, the managed care organization (MCO) prescription drug rebate provisions, minimum payments to primary care providers (PCPs), interactions between the Medicaid program and health insurance exchanges, and Medicaid and CHIP maintenance of effort (MOE) requirements; issues related to Medicaid Managed long-term care including home and community-based waiver services (HCBS); expanding the availability of Medicare Advantage and Medicaid health plan telemedicine programs; implications of the new non-discrimination rules for health plans participating in public programs; issues related to Medigap coverage; issues related to business continuity in relation to pandemics or natural events (e.g., hurricane, tornado, etc.); cybersecurity; provider directories; value-based insurance design models; Part D prescriber enrollment requirements; Part D recovery audit contractor programs; issues relating to enrollment of beneficiaries with ESRD into MA plans; issues related to health homes for children with medically complex conditions; socioeconomic status impacts on star ratings related to MA and Part D programs; and other issues relating to health care reform implementation.
2022 · fourth_quarter · Medicare/Medicaid
Legislative proposals affecting Medicare and Medicaid hospital reimbursement policies Build Back Better Act proposals related to health care, Medicare, workforce and hospital emergency preparedness H.R. 1227/S. 386, "Medicare-X Choice Act" - provisions related to the establishment of a public health plan H.R. 1976, To establish an improved Medicare for All national health insurance program - provisions related to establishment of a Medicare for America health program to provide for comprehensive health coverage for all Americans Proposals to reduce drug costs H.R.2617 - Consolidated Appropriations Act, 2023 - provisions related to Medicare and Medicaid
Client expense: Not reported · Firm income: $30,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · fourth_quarter · Insurance
Implementation of HR 1319, American Rescue Plan; S. 386/ HR 1332, Telemedicine Modernization Act; The Connect for Health Act (H.R. 2903/S.1512); Protecting Medicare and American Farmers from Sequester Cuts Act PL 117-71; Consolidated Appropriations Act, 2023 (P.L. 117-328)
Client expense: Not reported · Firm income: $20,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2022 · fourth_quarter · Medicare/Medicaid
Implementation of HR 1319, American Rescue Plan; S. 386/ HR 1332, Telemedicine Modernization Act; The Connect for Health Act (H.R. 2903/S.1512); Protecting Medicare and American Farmers from Sequester Cuts Act PL 117-71; Consolidated Appropriations Act, 2023 (P.L. 117-328)
Client expense: Not reported · Firm income: $20,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
| Democratic |
| MI |
| Gary C. Peters | Democratic | MI |
| Jeanne Shaheen | Democratic | NH |
| John W. Hickenlooper | Democratic | CO |
| Patrick J. Leahy | Democratic | VT |
| Raphael G. Warnock | Democratic | GA |
| Richard J. Durbin | Democratic | IL |
| Tammy Duckworth | Democratic | IL |
| Tim Kaine | Democratic | VA |
| Tina Smith | Democratic | MN |
Client expense: $2,470,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office
2022 · fourth_quarter · Health Issues
Implementation of HR 1319, American Rescue Plan; S. 386/ HR 1332, Telemedicine Modernization Act; The Connect for Health Act (H.R. 2903/S.1512); Protecting Medicare and American Farmers from Sequester Cuts Act PL 117-71; Inflation Reduction Act; Consolidated Appropriations Act, 2023 (P.L. 117-328)
Client expense: Not reported · Firm income: $20,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2022 · fourth_quarter · Medicare/Medicaid
Legislative proposals affecting Medicare and Medicaid hospital reimbursement policies Medicare Graduate Medical Education S. 834/H.R. 2256 - the Physician Shortage Reduction Act of 2021 H.R. 1887/S. 4009, the Rural Hospital Support Act Site-neutral payment policies Build Back Better Act proposals related to health policy, Medicare, workforce and hospital emergency preparedness Proposals to prevent future sequester cuts, including reductions in Medicare payments H.R. 1227/S. 386, "Medicare-X Choice Act" - provisions related to the establishment of a public health plan H.R. 1976, To establish an improved Medicare for All national health insurance program - provisions related to establishment of a Medicare for America health program to provide for comprehensive health coverage for all Americans Proposals to reduce drug costs Hospital at Home Care Model H.R. 7053/S. 3792, Hospital Inpatient Services Modernization Act - provisions related to extending the CMS waiver beyond the end of the PHE H.R.2617 - Consolidated Appropriations Act, 2023 - provisions related to Medicare and Medicaid
Client expense: Not reported · Firm income: $75,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · fourth_quarter · Health Issues
Implementation of American Rescue Plan Act of 2021 (H.R. 1319); HR 943, Social Determinants for Moms Act; S. 386, Telemedicine Modernization Act; HR 1332, Telemedicine Modernization Act; The Connect for Health Act (H.R. 2903/S.1512); PA Medicaid MCO contract requirements; Medicare Advantage; Inflation Reduction Act, healthcare provisions; Improving Seniors Timely Access to Care Act of 2021 H.R. 3173; Consolidated Appropriations Act, 2023 (P.L. 117-328)
Client expense: Not reported · Firm income: $30,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · fourth_quarter · Medicare/Medicaid
Implementation of HR 1319, American Rescue Plan Act of 2021; HR 943, Social Determinants for Moms Act; FMAP issues; S. 386, Telemedicine Modernization Act; HR 1332, Telemedicine Modernization Act; Protecting Medicare and American Farmers from Sequester Cuts Act PL 117-71; PA Medicaid MCO contract requirements; Medicare Advantage; Inflation Reduction Act, healthcare provisions; Improving Seniors Timely Access to Care Act of 2021 H.R. 3173; Consolidated Appropriations Act, 2023 (P.L. 117-328)
Client expense: Not reported · Firm income: $30,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE
2022 · fourth_quarter · Medicare/Medicaid
Implementation of HR 1319, American Rescue Plan Act of 2021; S. 150, Ensuring Parity in MA for Audio-Only Telehealth Act of 2021; FMAP Issues; 340B issues; S. 386, Telemedicine Modernization Act; HR 1332, Telemedicine Modernization Act; Hospital Consolidation issues; The Connect for Health Act (H.R. 2903/S.1512); Protecting Medicare and American Farmers from Sequester Cuts Act PL 117-71; PA Medicaid MCO contract requirements; Prescription drug coverage; Medicare Advantage issues; Inflation Reduction Act, healthcare provisions; Improving Seniors Timely Access to Care Act of 2021 H.R. 3173; mental health and substance abuse; Consolidated Appropriations Act, 2023 (P.L. 117-328)
Client expense: Not reported · Firm income: $120,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE
2022 · fourth_quarter · Health Issues
HR 959, Black Maternal Health Modernization Act of 2021; HR 943, Social Determinants for Moms Act; S. 386, Telemedicine Modernization Act; HR 1332, Telemedicine Modernization Act; Hospital Consolidation issues; The Connect for Health Act (H.R. 2903/S.1512); PA Medicaid MCO contract requirements; Prescription drug coverage; Medicare Advantage issues; Inflation Reduction Act, healthcare provisions; Improving Seniors Timely Access to Care Act of 2021 H.R. 3173; mental health and substance abuse; Consolidated Appropriations Act, 2023 (P.L. 117-328)
Client expense: Not reported · Firm income: $120,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · fourth_quarter · Medicare/Medicaid
Proposals to prevent future sequester cuts, reducing Medicare payments Changes to Medicare policy Site-neutral payments H.R. 1227/S. 386, "Medicare-X Choice Act" - provisions related to the establishment of a public health plan H.R. 1976, To establish an improved Medicare for All national health insurance program - provisions related to establishment of a Medicare for America health program to provide for comprehensive health coverage for all Americans S. 834/H.R. 2256, the "Physician Shortage Reduction Act of 2021" H.R. 7053/S. 3792, Hospital Inpatient Services Modernization Act - provisions to extend the CMS waiver supporting Hospital at Home H.R.2617 - Consolidated Appropriations Act, 2023 - provisions related to Medicare and Medicaid
Client expense: Not reported · Firm income: $50,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · fourth_quarter · Health Issues
HR 2617 Consolidated Appropriations Act. Provisions related to health care coverage, Medicare, Medicaid, COVID funding, mental/behavioral health and pensions HR 8542 "Mental health justice Act of 2022" HR 7780 - Mental Health Matters Act HR 8152 - American Data Privacy and Protection Act HR 8885-Better Health Care Directories Act HR 8886-Promoting Clarity in Mental Health and Substance Use Disorder Treatment Act HR 8892-regarding coverage of federal requirements relating to mental health and substance use disorder crisis services HR 7666 Restoring Hope for Mental Health and Well Being Act S 3799 PREVENT Pandemics Act HR 6000 Cures 2.0 Act (drugs/pharmaceuticals) HR 4026 Social Determinants of Health Data Analysis Act of 2021 HR 5376 Build Back Better Act, to provide for Budget Reconciliation HR 3947 Justice for Patients Act (arbitration) HR 2903 and S 1512 Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) of 2021 Act S 386 Medicare-X Choice Act of 2021 HR 1976 Medicare for All Act of 2021
Client expense: $180,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2022 · fourth_quarter · Health Issues
H.R. 1976 / S. 4204- "Medicare for All Act" - Single-payer healthcare systems. H.R. 2617 - Consolidated Appropriations Act, 2023 - Provisions related to health care H.R. 1227/ S.386 - "Medicare-X Choice Act of 2021" - Public Option Healthcare systems S. 2428 - False Claims Amendments Act of 2021 - False Claims Act Amendments H.R. 8201 - Promoting Health Care Quality Act of 2022 - Health care quality provisions under the Medicare program. S. 3799 - "PREVENT Pandemics Act" - pandemic preparedness H.R.3932/ S. 2076 - "PASTEUR Act of 2021" - addressing antimicrobial resistance (AMR) Support continued Congressional work on behavioral health
Client expense: $620,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE, White House Office
2022 · fourth_quarter · Medicare/Medicaid
HR 1976 Medicare for All Act of 2021 (all sections of full text)(oppose) S 2315 Medicaid Saves Lives Act (all sections of full text) HR 4595 Medicaid Saves Lives Act (all sections of full text) Discussions pertaining to reductions to the Medicaid disproportionate share hospital (DSH) program Monitored S 4204 Medicare for All Act of 2022 Monitored S 386 Medicare-X Choice Act of 2021 Monitored HR 1227 Medicare-X Choice Act of 2021 Monitored HR 1330 Patient Access to Higher Quality Health Care Act of 2021 Monitored S 4130 Patient Access to Higher Quality Health Care Act of 2022
Client expense: Not reported · Firm income: $100,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · fourth_quarter · Health Issues
S.1895 - The Lower Health Care Costs Act S.386 - Medicare-X Choice Act of 2021 H.R.1976 - To establish an improved Medicare for All national health insurance program S.5149 - A bill to amend title XVIII of the Social Security Act to exclude independent agents and brokers from requirement to record calls with beneficiaries under the Medicare Advantage and Prescription Drug Benefit programs
Client expense: $190,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE
2022 · fourth_quarter · Medicare/Medicaid
S.2999 A bill to prohibit the Secretary of Health and Human Services, any officer or employee of the Department of Health and Human Services, and States from requiring COVID-19 vaccination as a condition of eligibility for benefits or assistance under the Medicare, Medicaid, or CHIP program; S.J.Res.32 A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Centers for Medicare & Medicaid Services relating to Medicare and Medicaid Programs; Omnibus COVID-19 Health Care Staff Vaccination; H.R.1677 - KEEP Telehealth Options Act of 2021 To direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission, and the Medicaid and CHIP Payment and Access Commission to conduct studies and report to Congress on actions taken to expand access to telehealth services under the Medicare, Medicaid, and Children's Health Insurance programs during the COVID-19 emergency; S.620 KEEP Telehealth Options Act of 2021; S104 HR379 Improving Social Determinants of Health Act of 2021; H.R.1227, S386 Medicare-X Choice Act of 2021; HR 3322-S826 Medicare Patient Empowerment Act of 2021; HR2410 Medicare & You Handbook Improvement Act of 2021; S1180 Choose Medicare Act' S748 Medicare Sequester Relief Act; HR 315 Medicare Sequester COVID Moratorium Act; HR599 Protecting Medicare Beneficiaries with Pre-Existing Conditions Act; S.2146 Improving Medicare Beneficiary Access to Innovative Diabetes Technologies Act of 2021; S.4067 A bill to amend title XI of the Social Security Act to improve access to care for all Medicare and Medicaid beneficiaries through models tested under the Center for Medicare and Medicaid Innovation, and for other purposes; H.R.3755 Women's Health Protection Act of 2022; . S.J.Res.32 - A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Centers for Medicare & Medicaid Services relating to "Medicare and Medicaid Programs; Omnibus COVID-19 Health Care Staff Vaccination"; H.J.Res.79 - Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Department of the Treasury and the Centers for Medicare & Medicaid Services relating to "Patient Protection and Affordable Care Act; Updating Payment Parameters, Section 1332 Waiver Implementing Regulations, and Improving Health Insurance Markets for 2022 and Beyond".
Client expense: Not reported · Firm income: $11,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · third_quarter · Medicare/Medicaid
Implementation of HR 1319, American Rescue Plan Act of 2021; S. 150, Ensuring Parity in MA for Audio-Only Telehealth Act of 2021; FMAP Issues; 340B issues; S. 386, Telemedicine Modernization Act; HR 1332, Telemedicine Modernization Act; Hospital Consolidation issues; The Connect for Health Act (H.R. 2903/S.1512); Protecting Medicare and American Farmers from Sequester Cuts Act PL 117-71; PA Medicaid MCO contract requirements; Prescription drug coverage; Medicare Advantage issues; Inflation Reduction Act, healthcare provisions; Improving Seniors Timely Access to Care Act of 2021 H.R. 3173; mental health and substance abuse
Client expense: Not reported · Firm income: $120,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE
2022 · third_quarter · Health Issues
HR 959, Black Maternal Health Modernization Act of 2021; HR 943, Social Determinants for Moms Act; S. 386, Telemedicine Modernization Act; HR 1332, Telemedicine Modernization Act; Hospital Consolidation issues; The Connect for Health Act (H.R. 2903/S.1512); PA Medicaid MCO contract requirements; Prescription drug coverage; Medicare Advantage issues; Inflation Reduction Act, healthcare provisions; Improving Seniors Timely Access to Care Act of 2021 H.R. 3173; mental health and substance abuse
Client expense: Not reported · Firm income: $120,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · third_quarter · Health Issues
Implementation of HR 1319, American Rescue Plan; S. 386/ HR 1332, Telemedicine Modernization Act; The Connect for Health Act (H.R. 2903/S.1512); Protecting Medicare and American Farmers from Sequester Cuts Act PL 117-71; Inflation Reduction Act
Client expense: Not reported · Firm income: $20,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2022 · third_quarter · Insurance
Implementation of HR 1319, American Rescue Plan; S. 386/ HR 1332, Telemedicine Modernization Act; The Connect for Health Act (H.R. 2903/S.1512); Protecting Medicare and American Farmers from Sequester Cuts Act PL 117-71
Client expense: Not reported · Firm income: $20,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2022 · third_quarter · Medicare/Medicaid
Implementation of HR 1319, American Rescue Plan; S. 386/ HR 1332, Telemedicine Modernization Act; The Connect for Health Act (H.R. 2903/S.1512); Protecting Medicare and American Farmers from Sequester Cuts Act PL 117-71
Client expense: Not reported · Firm income: $20,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2022 · third_quarter · Medicare/Medicaid
Implementation of HR 1319, American Rescue Plan Act of 2021; HR 943, Social Determinants for Moms Act; FMAP issues; S. 386, Telemedicine Modernization Act; HR 1332, Telemedicine Modernization Act; Protecting Medicare and American Farmers from Sequester Cuts Act PL 117-71; PA Medicaid MCO contract requirements; Medicare Advantage; Inflation Reduction Act, healthcare provisions; Improving Seniors Timely Access to Care Act of 2021 H.R. 3173
Client expense: Not reported · Firm income: $30,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE
2022 · third_quarter · Health Issues
Implementation of American Rescue Plan Act of 2021 (H.R. 1319); HR 943, Social Determinants for Moms Act; S. 386, Telemedicine Modernization Act; HR 1332, Telemedicine Modernization Act; The Connect for Health Act (H.R. 2903/S.1512); PA Medicaid MCO contract requirements; Medicare Advantage; Inflation Reduction Act, healthcare provisions; Improving Seniors Timely Access to Care Act of 2021 H.R. 3173
Client expense: Not reported · Firm income: $30,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · third_quarter · Medicare/Medicaid
H.R. 66 - CARING for Kids Act - Rep. Buchanan, Vern - CHIP H.R. 265 - Insular Area Medicaid Parity Act - Rep. Sablan, Gregorio Kilili Camacho - Medicaid funding H.R. 315 - Medicare Sequester COVID Moratorium Act - Rep. Schneider, Bradley Scott - Medicare sequestration H.R. 340 - Incentivizing Medicaid Expansion Act of 2021 - Rep. Veasey, Marc - Medicaid expansion H.R. 432 - Mental Health Access Improvement Act of 2021 - Rep. Thompson, Mike -Medicare coverage of marriage and family therapist services and mental health counselor H.R. 502 - Medicare Dental Benefit Act of 2021 - Rep. Barragan, Nanette Diaz - Medicare coverage of dental and oral health services H.R. 525 - COVID HCBS Relief Act of 2021 - Rep. Dingell, Debbie - increased FMAP for HCBS H.R. 871 - Expand Medicaid Now Act - Rep. Fletcher, Lizzie - FMAP H.R. 918 - Stronger Medicaid Response to the COVID-19 Pandemic Act - Rep. Cardenas, Tony - COVID-19 coverage for the uninsured via Medicaid H.R. 955 - Medicaid Reentry Act of 2021 - Rep. Tonko, Paul -Medicaid coverage for incarcerated individuals H.R. 1167 - Advancing Enrollment and Reducing Drug Costs Act of 2021 - Rep. Pappas, Chris - Medicaid eligibility for low-income subsidies H.R. 1227 - Medicare-X Choice Act of 2021 - Rep. Delgado, Antonio - Medicare public option H.R. 1332 - Telehealth Modernization Act - Rep. Carter, Earl - telehealth services under Medicare H.R. 1349 - The COVID-19 Hospital and Health Provider Loan Conversion Act of 2021- Rep. Kaptur, Marcy - advance payments under parts A and B of Medicare H.R. 1353 - Coronavirus Medicaid Response Act - Rep. Lee, Susie - FMAP H.R. 1390 - CHIPPER Act - Rep. Wild, Susan - CHIP funding H.R. 1397 - TIKES Act - Rep. Blunt Rochester, Lisa - telehealth under Medicaid and CHIP H.R. 1609 - Treatment in Place Act - Rep. Axne, Cynthia - Medicare coverage of ambulance services H.R. 1676 - Jack Reynolds Memory Medigap Expansion Act - Rep. Axne, Cynthia - Medigap coverage for ESRD H.R. 1677 - KEEP Telehealth Options Act of 2021 - Rep. Balderson, Troy - telehealth expansion H.R. 1717 - Protecting Married Seniors from Impoverishment Act of 2021 - Rep. Upton, Fred - permanent protections against spousal impoverishment H.R. 1722 - Puerto Rico Health Care Fairness, Accountability, and Beneficiary Access Act of 2021 - Rep. Velazquez, Nydia - Medicaid in Puerto Rico H.R. 1738 - Stabilize Medicaid and CHIP Coverage Act - Rep. Dingell, Debbie - Medicaid and CHIP continuous enrollment H.R. 1784 - Medicaid REACH Act - Rep. Doggett, Lloyd - requirements for non-expansion H.R. 1791 - CHIPP Act - Rep. Barragan, Nanette Diaz - extending CHIP H.R. 1792 - Ensuring Kids Have Access to Medically Necessary Dental Care Act - Rep. Barragan, Nanette Diaz - dental coverage under CHIP H.R. 1793 - Immediate Coverage for Former Foster Youth Act - Rep. Bass, Karen - Medicaid coverage for foster youth H.R. 1794 - Foster Youth Dental Act of 2021 - Rep. Bass, Karen - Medicaid dental coverage for foster youth H.R. 1823 - To amend title XIX of the Social Security Act to remove the matching requirement for a territory to use specially allocated Federal funds for Medicare covered part D drugs for low-income individuals - Resident Commissioner Gonzalez-Colon, Jenniffer - Medicare covered part D H.R. 1825 - Territories Medicare Prescription Drug Assistance Equality Act of 2021 - Resident Commissioner Gonzalez-Colon, Jenniffer - Medicare Part D premium and cost-sharing subsidies H.R. 1826 - Fairness in Medicare Part B Enrollment Act of 2021 - Resident Commissioner Gonzalez-Colon, Jenniffer - late enrollment penalties under part B of the Medicare program H.R. 1880 - To amend the Deficit Reduction Act of 2005 to make permanent the Money Follows the Person Rebalancing Demonstration - Rep. Dingell, Debbie - Money Follows the Person Rebalancing Demonstration H.R. 1885 - RUSH Protection Act of 2021 - Rep. Kind, Ron - Medicare rural health clinic payments H.R. 1887 - Rural Hospital Support Act - Rep. Reed, Tom - Medicare payments for hospitals H.R. 1890 - Health Insurance Consumer Protection Act - Rep. Schakowsky, Janice D. - network adequacy standards and premium rates H.R. 1914 - CAHOOTS Act - Rep. DeFazio, Peter A. - Medicaid mobile crisis intervention services H.R. 1969 - Medicare Advantage Integrity Act - Resident Commissioner Gonzalez-Colon, Jenniffer - disparity in MA benchmark rates H.R. 2035 - Improving Access to Mental Health Act of 2021 - Rep. Lee, Barbara - mental health services under Medicare H.R. 2080 - SAVE Act - Rep. Bishop, Sanford D., Jr. - Medicare coverage of transportation services H.R. 2166 - Ensuring Parity in MA and PACE for Audio-Only Telehealth Act of 2021 - Rep. Sewell, Terri - Medicare Advantage payments for audio-only diagnoses H.R. 2168 - Expanded Telehealth Access Act - Rep. Sherrill, Mikie - Medicare payment for telehealth services H.R. 2170 - HAPI Act - Rep. Soto, Darren - access to vaccines and Medicaid H.R. 2179 - Affordable Insulin for the COVID-19 Emergency Act - Rep. Waters, Maxine - cost-sharing regarding insulin coverage H.R. 2217 - Territory Federal Matching Requirement Equity Act of 2021 - Resident Commissioner Gonzalez-Colon, Jenniffer - Medicaid FMAP for Territories H.R. 2228 - Rural Behavioral Health Access Act of 2021 - Rep. Kildee, Daniel - Medicare coverage of outpatient telehealth services H.R. 4074 - Addressing Social Determinants in Medicare Advantage Act of 2021 - Rep. Bilirakis, Gus M. - Medicare Advantage supplemental benefits H.R. 4640 - Close the Medigap Act of 2021 - Rep. Doggett, Lloyd - Medigap policies H.R. 6833 - Affordable Insulin Now Act - Rep. Craig, Angie - Insulin prices and cost sharing S. 150 - Ensuring Parity in MA for Audio-Only Telehealth Act of 2021 - Sen. Cortez-Masto, Catherine - coverage of audio-only telehealth services in MA S. 151 - COVID HCBS Relief Act of 2021 - Sen. Casey, Robert - FMAP and HCBS S. 245 - SAME Act of 2021 - Sen. Warner, Mark - Medicaid expansion S. 274 - Stronger Medicaid Response to the COVID-19 Pandemic Act - Sen. Bennet, Michael - COVID-19 coverage for the uninsured via Medicaid S. 285 - Medicaid Reentry Act of 2021 - Sen. Baldwin, Tammy - Medicaid coverage for incarcerated individuals S. 368 - Telehealth Modernization Act - Sen. Scott, Tim - coverage of telehealth services under Medicare S. 386 - Medicare-X Choice Act of 2021 - Sen. Bennet, Michael - Medicare public option S. 439 - Coronavirus Medicaid Response Act - Sen. Casey, Robert - increases FMAP S. 440 - Continued Funding for Senior Services During COVID-19 Act - Sen. Casey, Robert - funding for services under the Older Americans Act of 1965 S. 453 - CHIPPER Act - Sen. Casey, Robert - CHIP funding S. 581 - HAPI Act -Sen. Brown, Sherrod - vaccines under Medicaid S. 620 - KEEP Telehealth Options Act of 2021 - Sen. Fischer, Deb - telehealth expansion S. 644 - Rural Hospital Closure Relief Act of 2021 - Sen. Durbin, Richard - Medicare coverage for critical access hospitals S. 646 - Stabilize Medicaid and CHIP Coverage Act of 2021 - Sen. Brown, Sherrod - Medicaid and CHIP enrollment S. 653 - COMP Act - Sen. Portman, Rob - Medicare secondary payer rules S. 712 - Dosha Joi Immediate Coverage for Former Foster Youth Act - Sen. Casey, Robert P., Jr. - Medicaid coverage for foster youth S. 748 - Medicare Sequester Relief Act - Sen. Shaheen, Jeanne - Medicare payment sequestration S. 764 - CAHOOTS Act - Sen. Wyden, Ron - Medicaid mobile crisis intervention services S. 826 - Medicare Patient Empowerment Act of 2021 - Sen. Paul, Rand - Medicaid payment options S. 870 - Improving Access to Mental Health Act of 2021 - Sen. Stabenow, Debbie - mental health services in Medicare S. 999 - Save Rural Hospitals Act of 2021 - Sen. Warner, Mark - Medicare hospital payments Regulatory Issues: Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, network adequacy and provider directories, encounter data and other data-related issues, and risk adjustment data validation (RADV) audit issues including proposed RADV regulation for MA; bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, Part D direct and indirect remuneration (DIR), and audits); calendar year 2023 policy and technical regulation for MA and Part D; issues related to Medicare for All, Medicare buy-in, reduced Medicare eligibility age, and public option; issues relating to 2023 Rate Notice; issues related to coverage in non-Medicaid Expansion States (e.g., Gap Population); issues related to expanded Medicare fee for service benefits (dental, hearing and vision); issues related to Medicaid coverage gap; issues related to specialty infant formula; issues related to the Inflation Reduction Act passage and implementation; contraceptive coverage and reproductive health; Medicare NCD relating to monoclonal antibodies for treatment of Alzheimers disease; issues related to Managed Long Term Services and Supports (MLTSS); issues related to removal of safe harbor protection for rebates; issues relating to COVID-19, including testing, vaccines and therapeutics; issues related to the end of the public health emergency; telehealth; issues related to the cost of insulin, including price, copays, rebates, and medical management tools; issues related to health equity; issues related to vaccination; issues related to audio-only telehealth; issues related to addressing the social determinants of health, including housing, transportation, nutrition, educational opportunities, and MA supplemental benefits; issues related to Medicaid presumptive eligibility and continuous eligibility; issues relating to Medicaid best price; in-home health risk assessments; Medicare Medical Loss Ratio issues; issues related to changes to prior authorization regulations or legislation, electronic documentation, and related issues; issues relating to sequestration under the Medicare Advantage and Part D programs; implications of physician fee schedule on MA; application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, enrollment rules, requirements for notice and denial forms, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible SNPs; Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, Part D coverage gap discount program, including employer group waiver plan (EGWP) issues, and other operational issues; issues raised by Part D coverage of new specialty drugs, the Part D non-interference policy and related issues (e.g., preferred pharmacy and any willing pharmacy requirements, standards for network pharmacy reimbursement, and policies regarding sponsor negotiation of pharmacy price concessions); issues related to the international price index; issues related to child and maternal health; issues related to Medicaid supplemental and disproportionate share hospital (DSH) funding; issues related to Medicaid funding for territories; issues related to medical management; issues relating to MA supplemental benefits; Medication Therapy Management Program requirements and the Center for Medicare and Medicaid Innovation (CMMI) Demonstration; MA EGWP issues; CMMI's value based payment models; Part D requirements for offering basic and enhanced alternative plans; MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; issues relating to MA and Part D Star Rating system including measures, the methodology for calculating ratings, and the role of the ratings for payment purposes; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education Program; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; issues relating to MACRA, including implications for MA and Part D plans; Medicare/Medicaid integration for dual eligibles, including implementation of the Capitated Financial Alignment Demonstration and related issues (e.g., quality ratings); issues relating to potential Medicare mental health parity requirements; Medicaid managed care regulations and policies, including CMS's substantial revisions to the managed care regulations, mental health parity rules, the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, fraud and abuse compliance, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including block grants, the calculation of the federal medical assistance (federal matching) percentage (FMAP), and intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost issues affecting Medicaid health plans including issues raised by Medicaid coverage of new specialty drugs; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues and CHIP reauthorization; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including Medicaid managed care organization provider tax issues; standards for electronic prescribing; implementation of Medicaid changes of interest to Medicaid health plans made in the Affordable Care Act (ACA) including Medicaid expansion, the managed care organization (MCO) prescription drug rebate provisions, minimum payments to primary care providers (PCPs), interactions between the Medicaid program and health insurance exchanges, and Medicaid and CHIP maintenance of effort (MOE) requirements; issues related to Medicaid Managed long-term care including home and community-based waiver services (HCBS); expanding the availability of Medicare Advantage and Medicaid health plan telemedicine programs; implications of the new non-discrimination rules for health plans participating in public programs; issues related to Medigap coverage; issues related to business continuity in relation to pandemics or natural events (e.g., hurricane, tornado, etc.); cybersecurity; provider directories; value-based insurance design models; Part D prescriber enrollment requirements; Part D recovery audit contractor programs; issues relating to enrollment of beneficiaries with ESRD into MA plans; issues related to health homes for children with medically complex conditions; socioeconomic status impacts on star ratings related to MA and Part D programs; and other issues relating to health care reform implementation. *Add MACPAC to Agency List.
Client expense: $3,230,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office
2022 · third_quarter · Health Issues
HR 5376 Inflation Reduction Act of 2022. Provisions related to health care coverage, Medicare, Medicaid, COVID funding and mental/behavioral health HR 8542 "Mental health justice Act of 2022" HR 6833 Continuing Appropriations and Ukraine Supplemental Appropriations Act, 2023 Potential inclusion of provisions related to health care coverage, Medicare, Medicaid, COVID funding and mental/behavioral health HR 7780 - Mental Health Matters Act HR 8152 - American Data Privacy and Protection Act HR 8885-Better Health Care Directories Act HR 8886-Promoting Clarity in Mental Health and Substance Use Disorder Treatment Act HR 8892-regarding coverage of federal requirements relating to mental health and substance use disorder crisis services HR 7666 Restoring Hope for Mental Health and Well Being Act S 3799 PREVENT Pandemics Act HR 6000 Cures 2.0 Act (drugs/pharmaceuticals) HR 4026 Social Determinants of Health Data Analysis Act of 2021 HR 5376 Build Back Better Act, to provide for Budget Reconciliation HR 3947 Justice for Patients Act (arbitration) HR 2903 and S 1512 Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) of 2021 Act S 386 Medicare-X Choice Act of 2021 HR 1976 Medicare for All Act of 2021
Client expense: $2,580,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2022 · third_quarter · Health Issues
Public Law 117-169, Inflation Reduction Act, Prescription drug reform Public Law 117-159, Bipartisan Safer Communities Act Monitor the following: H.R.5015, the Medicaid DSH Payment Adjustment Fairness Act, Hospital funding formula Abortion Access related issues H.R.7784, the Supporting Trauma Informed Education Practices Act H.R.7666, Restoring Hope for Mental Health and Well‐Being Act S.2110, Better Care Better Jobs Act Nurse Overtime and Patient Safety Act H.R.1195, Workplace Violence Prevention for Health Care and Social Service Workers Act, Entirety S.632, Health Force and Resilience Force Act, H.R.959/S.346, Black Maternal Health Momnibus Act Student Loan Forgiveness for Frontline Health Workers S.102, the Prescription Drug Price Relief Act S.99, the Medicare Drug Price Negotiation Act S.97, the Affordable and Safe Prescription Drug Importation Act H.R.1391/S.482, Taxpayer Research and Coronavirus Knowledge Act, Entirety H.R.7296/S.4439, Make Medications Affordable by Preventing Pandemic Pricegouging Act, Entirety Affordability of pharmaceuticals, generally Treating gun violence as a public health epidemic related issues The National Nurse Act, Entirety Health Equity Issues during COVID Pandemic H.R.728/S.187, Pandemic Emergency Manufacturing Act of 2021, Entirety Support Medicare/ACA enrollment H.R. 6637, Health Equity and Accountability Act, Entirety Delivery of healthcare services to students during COVID pandemic Telehealth issues H.R.1227/S.386, Medicare X Choice Act Rural Healthcare related issues and initiatives Federal response to COVID-19 Pandemic H.R.3755, the Women's Health Protection Act, Entirety Health Worker Shortage/Staffing Crisis H.R.7116, 9-8-8 Implementation Act H.R.6833, the Affordable Insulin Now Act Mental health supports for educators S.3796/H.R.7045, Closing Health Coverage Gaps for Public Servants Act S.4182, Workplace Violence Prevention for Health Care and Social Service Worker Act Dobbs v. Jackson, United States Supreme Court decision Visas for international healthcare professionals Public Law 117-168, Honoring our Promise to Address Comprehensive Toxics (PACT) Act, Entirety
Client expense: $370,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · third_quarter · Health Issues
H.R. 1976 / S. 4204- "Medicare for All Act" - Single-payer healthcare systems. H.R. 5376 - "Build Back Better Act" - Provisions related to healthcare and tax. H.R. 1227/ S.386 - "Medicare-X Choice Act of 2021" - Public Option Healthcare systems S. 2428 - False Claims Amendments Act of 2021 - False Claims Act Amendments H.R. 8201 - Promoting Health Care Quality Act of 2022 -Health care quality provisions under the Medicare program. H.R. 7961 - Safety from Violence for Healthcare Employees (SAVE) Act - protections for health care workers from violence in the workplace. H.R. 5376 - "Inflation Reduction Act of 2022" - Health Care Provisions, such as extension of enhanced ACA subsidies.
Client expense: $640,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE, White House Office
2022 · third_quarter · Medicare/Medicaid
Legislative proposals affecting Medicare and Medicaid hospital reimbursement policies Build Back Better Act proposals related to health care, Medicare, workforce and hospital emergency preparedness H.R. 1227/S. 386, "Medicare-X Choice Act" - provisions related to the establishment of a public health plan H.R. 1976, To establish an improved Medicare for All national health insurance program - provisions related to establishment of a Medicare for America health program to provide for comprehensive health coverage for all Americans Proposals to reduce drug costs H.R 5376, Inflation Reduction Act
Client expense: Not reported · Firm income: $30,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · third_quarter · Medicare/Medicaid
Legislative proposals affecting Medicare and Medicaid hospital reimbursement policies Medicare Graduate Medical Education S. 834/H.R. 2256 - the Physician Shortage Reduction Act of 2021 H.R. 1887/S. 4009, the Rural Hospital Support Act Site-neutral payment policies Build Back Better Act proposals related to health policy, Medicare, workforce and hospital emergency preparedness Proposals to prevent future sequester cuts, including reductions in Medicare payments H.R. 1227/S. 386, "Medicare-X Choice Act" - provisions related to the establishment of a public health plan H.R. 1976, To establish an improved Medicare for All national health insurance program - provisions related to establishment of a Medicare for America health program to provide for comprehensive health coverage for all Americans Proposals to reduce drug costs Hospital at Home Care Model H.R. 7053/S. 3792, Hospital Inpatient Services Modernization Act - provisions related to extending the CMS waiver beyond the end of the PHE
Client expense: Not reported · Firm income: $75,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · third_quarter · Medicare/Medicaid
Proposals to prevent future sequester cuts, reducing Medicare payments Changes to Medicare policy Site-neutral payments H.R. 1227/S. 386, "Medicare-X Choice Act" - provisions related to the establishment of a public health plan H.R. 1976, To establish an improved Medicare for All national health insurance program - provisions related to establishment of a Medicare for America health program to provide for comprehensive health coverage for all Americans S. 834/H.R. 2256, the "Physician Shortage Reduction Act of 2021" H.R. 7053/S. 3792, Hospital Inpatient Services Modernization Act - provisions to extend the CMS waiver supporting Hospital at Home H.R. 5376, Inflation Reduction Act - provisions related to Medicare and Medicare drug price negotiation
Client expense: Not reported · Firm income: $50,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · third_quarter · Medicare/Medicaid
S.2999 A bill to prohibit the Secretary of Health and Human Services, any officer or employee of the Department of Health and Human Services, and States from requiring COVID-19 vaccination as a condition of eligibility for benefits or assistance under the Medicare, Medicaid, or CHIP program; S.J.Res.32 A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Centers for Medicare & Medicaid Services relating to Medicare and Medicaid Programs; Omnibus COVID-19 Health Care Staff Vaccination; H.R.1677 - KEEP Telehealth Options Act of 2021 To direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission, and the Medicaid and CHIP Payment and Access Commission to conduct studies and report to Congress on actions taken to expand access to telehealth services under the Medicare, Medicaid, and Children's Health Insurance programs during the COVID-19 emergency; S.620 KEEP Telehealth Options Act of 2021; S104 HR379 Improving Social Determinants of Health Act of 2021; H.R.1227, S386 Medicare-X Choice Act of 2021; HR 3322-S826 Medicare Patient Empowerment Act of 2021; HR2410 Medicare & You Handbook Improvement Act of 2021; S1180 Choose Medicare Act' S748 Medicare Sequester Relief Act; HR 315 Medicare Sequester COVID Moratorium Act; HR599 Protecting Medicare Beneficiaries with Pre-Existing Conditions Act; S.2146 Improving Medicare Beneficiary Access to Innovative Diabetes Technologies Act of 2021; S.4067 A bill to amend title XI of the Social Security Act to improve access to care for all Medicare and Medicaid beneficiaries through models tested under the Center for Medicare and Medicaid Innovation, and for other purposes; H.R.3755 Women's Health Protection Act of 2022; . S.J.Res.32 - A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Centers for Medicare & Medicaid Services relating to "Medicare and Medicaid Programs; Omnibus COVID-19 Health Care Staff Vaccination"; H.J.Res.79 - Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Department of the Treasury and the Centers for Medicare & Medicaid Services relating to "Patient Protection and Affordable Care Act; Updating Payment Parameters, Section 1332 Waiver Implementing Regulations, and Improving Health Insurance Markets for 2022 and Beyond".
Client expense: Not reported · Firm income: $11,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · third_quarter · Health Issues
S.1895 - The Lower Health Care Costs Act S.386 - Medicare-X Choice Act of 2021 H.R.1976 - To establish an improved Medicare for All national health insurance program CMS Medicare Recording Requirement
Client expense: $360,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE
2022 · third_quarter · Medicare/Medicaid
Discussions pertaining to reductions to the Medicaid disproportionate share hospital (DSH) program HR 1976 Medicare for All Act of 2021 (all sections of full text)(oppose) S 2315 Medicaid Saves Lives Act (all sections of full text) HR 4595 Medicaid Saves Lives Act (all sections of full text) Monitored S 4204 Medicare for All Act of 2022 Monitored S 386 Medicare-X Choice Act of 2021 Monitored HR 1227 Medicare-X Choice Act of 2021 Monitored CMS regulations and reporting requirements under the Emergency Medical Treatment and Labor Act, in the COVID-19 emergency declaration Monitored HR 1330 Patient Access to Higher Quality Health Care Act of 2021 Monitored S 4130 Patient Access to Higher Quality Health Care Act of 2022
Client expense: Not reported · Firm income: $100,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · second_quarter · Health Issues
HR 7666 Restoring Hope for Mental Health and Well Being Act S 3799 PREVENT Pandemics Act HR 2471 Consolidated Appropriations Act of 2022 HR 7007 Coronavirus Supplemental Appropriations Act of 2022 HR 6000 Cures 2.0 Act (drugs/pharmaceuticals) HR 4026 Social Determinants of Health Data Analysis Act of 2021 HR 5376 Build Back Better Act, to provide for Budget Reconciliation HR 3947 Justice for Patients Act (arbitration) HR 2903 and S 1512 Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) of 2021 Act HR 3076 Postal Service Reform Act of 2022 S 386 Medicare-X Choice Act of 2021 HR 1976 Medicare for All Act of 2021 HR 1848 Leading Infrastructure for Tomorrows America (LIFT) Act
Client expense: $2,170,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2022 · second_quarter · Health Issues
HR 959, Black Maternal Health Modernization Act of 2021; HR 943, Social Determinants for Moms Act; S. 386, Telemedicine Modernization Act; HR 1332, Telemedicine Modernization Act; Hospital Consolidation issues; The Connect for Health Act (H.R. 2903/S.1512); PA Medicaid MCO contract requirements; Prescription drug coverage; Medicare Advantage issues; Budget reconciliation package
Client expense: Not reported · Firm income: $120,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · second_quarter · Medicare/Medicaid
Implementation of HR 1319, American Rescue Plan Act of 2021; S. 150, Ensuring Parity in MA for Audio-Only Telehealth Act of 2021; FMAP Issues; 340B issues; S. 386, Telemedicine Modernization Act; HR 1332, Telemedicine Modernization Act; Hospital Consolidation issues; The Connect for Health Act (H.R. 2903/S.1512); Protecting Medicare and American Farmers from Sequester Cuts Act PL 117-71; PA Medicaid MCO contract requirements; Prescription drug coverage; Medicare Advantage issues; Budget reconciliation package
Client expense: Not reported · Firm income: $120,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE
2022 · second_quarter · Health Issues
H.Res.1141, Educator Mental Health Awareness Week Resolution Mental health supports for educators H.R.7828, the PRICED Act H.R. 4132, the Womens Health Protection Act Prescription drug reform, reconciliation H.R. 7784, the Supporting Trauma Informed Education Practices Act Medicare for All H.R.7666, Restoring Hope for Mental Health and Well‐Being Act S.3796/H.R.7045, Closing Health Coverage Gaps for Public Servants Act S.4182, Workplace Violence Prevention for Health Care and Social Service Worker Act Dobbs v. Jackson, United States Supreme Court decision Monitor the following: H.R.5015, the Medicaid DSH Payment Adjustment Fairness Act, Hospital funding formula Reconciliation bill Abortion Access related issues S.2110, Better Care Better Jobs Act Nurse Overtime and Patient Safety Act H.R.1195, Workplace Violence Prevention for Health Care and Social Service Workers Act, Entirety S.632, Health Force and Resilience Force Act, H.R.959/S.346, Black Maternal Health Momnibus Act Student Loan Forgiveness for Frontline Health Workers S.102, the Prescription Drug Price Relief Act S.99, the Medicare Drug Price Negotiation Act S.97, the Affordable and Safe Prescription Drug Importation Act H.R.1391/S.482, Taxpayer Research and Coronavirus Knowledge Act, Entirety H.R.7296/S.4439, Make Medications Affordable by Preventing Pandemic Pricegouging Act, Entirety Affordability of pharmaceuticals, generally Treating gun violence as a public health epidemic related issues The National Nurse Act, Entirety Health Equity Issues during COVID Pandemic H.R.728/S.187, Pandemic Emergency Manufacturing Act of 2021, Entirety Support Medicare/ACA enrollment H.R. 6637, Health Equity and Accountability Act, Entirety Delivery of healthcare services to students during COVID pandemic Telehealth issues H.R.1227/S.386, Medicare X Choice Act Rural Healthcare related issues and initiatives Federal response to COVID-19 Pandemic H.R.3755, the Women's Health Protection Act, Entirety Health Worker Shortage/Staffing Crisis H.R.7116, 9-8-8 Implementation Act H.R.6833, the Affordable Insulin Now Act
Client expense: $350,000 · Firm income: Not reported
Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, SENATE
2022 · second_quarter · Medicare/Medicaid
H.R. 66 - CARING for Kids Act - Rep. Buchanan, Vern - CHIP H.R. 265 - Insular Area Medicaid Parity Act - Rep. Sablan, Gregorio Kilili Camacho - Medicaid funding H.R. 315 - Medicare Sequester COVID Moratorium Act - Rep. Schneider, Bradley Scott - Medicare sequestration H.R. 340 - Incentivizing Medicaid Expansion Act of 2021 - Rep. Veasey, Marc - Medicaid expansion H.R. 432 - Mental Health Access Improvement Act of 2021 - Rep. Thompson, Mike -Medicare coverage of marriage and family therapist services and mental health counselor H.R. 502 - Medicare Dental Benefit Act of 2021 - Rep. Barragan, Nanette Diaz - Medicare coverage of dental and oral health services H.R. 525 - COVID HCBS Relief Act of 2021 - Rep. Dingell, Debbie - increased FMAP for HCBS H.R. 871 - Expand Medicaid Now Act - Rep. Fletcher, Lizzie - FMAP H.R. 918 - Stronger Medicaid Response to the COVID-19 Pandemic Act - Rep. Cardenas, Tony - COVID-19 coverage for the uninsured via Medicaid H.R. 955 - Medicaid Reentry Act of 2021 - Rep. Tonko, Paul -Medicaid coverage for incarcerated individuals H.R. 1167 - Advancing Enrollment and Reducing Drug Costs Act of 2021 - Rep. Pappas, Chris - Medicaid eligibility for low-income subsidies H.R. 1227 - Medicare-X Choice Act of 2021 - Rep. Delgado, Antonio - Medicare public option H.R. 1332 - Telehealth Modernization Act - Rep. Carter, Earl - telehealth services under Medicare H.R. 1349 - The COVID-19 Hospital and Health Provider Loan Conversion Act of 2021- Rep. Kaptur, Marcy - advance payments under parts A and B of Medicare H.R. 1353 - Coronavirus Medicaid Response Act - Rep. Lee, Susie - FMAP H.R. 1390 - CHIPPER Act - Rep. Wild, Susan - CHIP funding H.R. 1397 - TIKES Act - Rep. Blunt Rochester, Lisa - telehealth under Medicaid and CHIP H.R. 1609 - Treatment in Place Act - Rep. Axne, Cynthia - Medicare coverage of ambulance services H.R. 1676 - Jack Reynolds Memory Medigap Expansion Act - Rep. Axne, Cynthia - Medigap coverage for ESRD H.R. 1677 - KEEP Telehealth Options Act of 2021 - Rep. Balderson, Troy - telehealth expansion H.R. 1717 - Protecting Married Seniors from Impoverishment Act of 2021 - Rep. Upton, Fred - permanent protections against spousal impoverishment H.R. 1722 - Puerto Rico Health Care Fairness, Accountability, and Beneficiary Access Act of 2021 - Rep. Velazquez, Nydia - Medicaid in Puerto Rico H.R. 1738 - Stabilize Medicaid and CHIP Coverage Act - Rep. Dingell, Debbie - Medicaid and CHIP continuous enrollment H.R. 1784 - Medicaid REACH Act - Rep. Doggett, Lloyd - requirements for non-expansion H.R. 1791 - CHIPP Act - Rep. Barragan, Nanette Diaz - extending CHIP H.R. 1792 - Ensuring Kids Have Access to Medically Necessary Dental Care Act - Rep. Barragan, Nanette Diaz - dental coverage under CHIP H.R. 1793 - Immediate Coverage for Former Foster Youth Act - Rep. Bass, Karen - Medicaid coverage for foster youth H.R. 1794 - Foster Youth Dental Act of 2021 - Rep. Bass, Karen - Medicaid dental coverage for foster youth H.R. 1823 - To amend title XIX of the Social Security Act to remove the matching requirement for a territory to use specially allocated Federal funds for Medicare covered part D drugs for low-income individuals - Resident Commissioner Gonzalez-Colon, Jenniffer - Medicare covered part D H.R. 1825 - Territories Medicare Prescription Drug Assistance Equality Act of 2021 - Resident Commissioner Gonzalez-Colon, Jenniffer - Medicare Part D premium and cost-sharing subsidies H.R. 1826 - Fairness in Medicare Part B Enrollment Act of 2021 - Resident Commissioner Gonzalez-Colon, Jenniffer - late enrollment penalties under part B of the Medicare program H.R. 1880 - To amend the Deficit Reduction Act of 2005 to make permanent the Money Follows the Person Rebalancing Demonstration - Rep. Dingell, Debbie - Money Follows the Person Rebalancing Demonstration H.R. 1885 - RUSH Protection Act of 2021 - Rep. Kind, Ron - Medicare rural health clinic payments H.R. 1887 - Rural Hospital Support Act - Rep. Reed, Tom - Medicare payments for hospitals H.R. 1890 - Health Insurance Consumer Protection Act - Rep. Schakowsky, Janice D. - network adequacy standards and premium rates H.R. 1914 - CAHOOTS Act - Rep. DeFazio, Peter A. - Medicaid mobile crisis intervention services H.R. 1969 - Medicare Advantage Integrity Act - Resident Commissioner Gonzalez-Colon, Jenniffer - disparity in MA benchmark rates H.R. 2035 - Improving Access to Mental Health Act of 2021 - Rep. Lee, Barbara - mental health services under Medicare H.R. 2080 - SAVE Act - Rep. Bishop, Sanford D., Jr. - Medicare coverage of transportation services H.R. 2166 - Ensuring Parity in MA and PACE for Audio-Only Telehealth Act of 2021 - Rep. Sewell, Terri - Medicare Advantage payments for audio-only diagnoses H.R. 2168 - Expanded Telehealth Access Act - Rep. Sherrill, Mikie - Medicare payment for telehealth services H.R. 2170 - HAPI Act - Rep. Soto, Darren - access to vaccines and Medicaid H.R. 2179 - Affordable Insulin for the COVID-19 Emergency Act - Rep. Waters, Maxine - cost-sharing regarding insulin coverage H.R. 2217 - Territory Federal Matching Requirement Equity Act of 2021 - Resident Commissioner Gonzalez-Colon, Jenniffer - Medicaid FMAP for Territories H.R. 2228 - Rural Behavioral Health Access Act of 2021 - Rep. Kildee, Daniel - Medicare coverage of outpatient telehealth services H.R. 4074 - Addressing Social Determinants in Medicare Advantage Act of 2021 - Rep. Bilirakis, Gus M. - Medicare Advantage supplemental benefits H.R. 4640 - Close the Medigap Act of 2021 - Rep. Doggett, Lloyd - Medigap policies H.R. 6833 - Affordable Insulin Now Act - Rep. Craig, Angie - Insulin prices and cost sharing S. 150 - Ensuring Parity in MA for Audio-Only Telehealth Act of 2021 - Sen. Cortez-Masto, Catherine - coverage of audio-only telehealth services in MA S. 151 - COVID HCBS Relief Act of 2021 - Sen. Casey, Robert - FMAP and HCBS S. 245 - SAME Act of 2021 - Sen. Warner, Mark - Medicaid expansion S. 274 - Stronger Medicaid Response to the COVID-19 Pandemic Act - Sen. Bennet, Michael - COVID-19 coverage for the uninsured via Medicaid S. 285 - Medicaid Reentry Act of 2021 - Sen. Baldwin, Tammy - Medicaid coverage for incarcerated individuals S. 368 - Telehealth Modernization Act - Sen. Scott, Tim - coverage of telehealth services under Medicare S. 386 - Medicare-X Choice Act of 2021 - Sen. Bennet, Michael - Medicare public option S. 439 - Coronavirus Medicaid Response Act - Sen. Casey, Robert - increases FMAP S. 440 - Continued Funding for Senior Services During COVID-19 Act - Sen. Casey, Robert - funding for services under the Older Americans Act of 1965 S. 453 - CHIPPER Act - Sen. Casey, Robert - CHIP funding S. 581 - HAPI Act -Sen. Brown, Sherrod - vaccines under Medicaid S. 620 - KEEP Telehealth Options Act of 2021 - Sen. Fischer, Deb - telehealth expansion S. 644 - Rural Hospital Closure Relief Act of 2021 - Sen. Durbin, Richard - Medicare coverage for critical access hospitals S. 646 - Stabilize Medicaid and CHIP Coverage Act of 2021 - Sen. Brown, Sherrod - Medicaid and CHIP enrollment S. 653 - COMP Act - Sen. Portman, Rob - Medicare secondary payer rules S. 712 - Dosha Joi Immediate Coverage for Former Foster Youth Act - Sen. Casey, Robert P., Jr. - Medicaid coverage for foster youth S. 748 - Medicare Sequester Relief Act - Sen. Shaheen, Jeanne - Medicare payment sequestration S. 764 - CAHOOTS Act - Sen. Wyden, Ron - Medicaid mobile crisis intervention services S. 826 - Medicare Patient Empowerment Act of 2021 - Sen. Paul, Rand - Medicaid payment options S. 870 - Improving Access to Mental Health Act of 2021 - Sen. Stabenow, Debbie - mental health services in Medicare S. 999 - Save Rural Hospitals Act of 2021 - Sen. Warner, Mark - Medicare hospital payments Regulatory Issues: Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, network adequacy and provider directories, encounter data and other data-related issues, and risk adjustment data validation (RADV) audit issues including proposed RADV regulation for MA; bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, Part D direct and indirect remuneration (DIR), and audits); calendar year 2023 policy and technical regulation for MA and Part D; 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 2023 Rate Notice; issues related to coverage in non-Medicaid Expansion States (e.g., Gap Population); issues related to expanded Medicare fee for service benefits (dental, hearing and vision); issues related to Medicaid coverage gap; contraceptive coverage and reproductive health; 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, vaccines and therapeutics; issues related to the end of the public health emergency; telehealth; issues related to the cost of insulin, including price, copays, rebates, and medical management tools; issues related to health equity; issues related to vaccination; issues related to audio-only telehealth; issues related to addressing the social determinants of health, including housing, transportation, nutrition, educational opportunities, and MA supplemental benefits; issues related to Medicaid presumptive eligibility and continuous eligibility; issues relating to Medicaid best price; in-home health risk assessments; Medicare Medical Loss Ratio issues; issues related to changes to prior authorization regulations or legislation, electronic documentation, and related issues; issues relating to sequestration under the Medicare Advantage and Part D programs; implications of physician fee schedule on MA; application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, enrollment rules, requirements for notice and denial forms, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible SNPs; Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, Part D coverage gap discount program, including employer group waiver plan (EGWP) issues, and other operational issues; issues raised by Part D coverage of new specialty drugs, the Part D non-interference policy and related issues (e.g., preferred pharmacy and any willing pharmacy requirements, standards for network pharmacy reimbursement, and policies regarding sponsor negotiation of pharmacy price concessions); issues related to the international price index; issues related to child and maternal health; issues related to Medicaid supplemental and disproportionate share hospital (DSH) funding; issues related to Medicaid funding for territories; issues related to medical management; issues relating to MA supplemental benefits; Medication Therapy Management Program requirements and the Center for Medicare and Medicaid Innovation (CMMI) Demonstration; MA EGWP issues; CMMI's value based payment models; Part D requirements for offering basic and enhanced alternative plans; MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; issues relating to MA and Part D Star Rating system including measures, the methodology for calculating ratings, and the role of the ratings for payment purposes; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education Program; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; issues relating to MACRA, including implications for MA and Part D plans; Medicare/Medicaid integration for dual eligibles, including implementation of the Capitated Financial Alignment Demonstration and related issues (e.g., quality ratings); issues relating to potential Medicare mental health parity requirements; Medicaid managed care regulations and policies, including CMS's substantial revisions to the managed care regulations, mental health parity rules, the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, fraud and abuse compliance, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including block grants, the calculation of the federal medical assistance (federal matching) percentage (FMAP), and intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost issues affecting Medicaid health plans including issues raised by Medicaid coverage of new specialty drugs; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues and CHIP reauthorization; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including Medicaid managed care organization provider tax issues; standards for electronic prescribing; implementation of Medicaid changes of interest to Medicaid health plans made in the Affordable Care Act (ACA) including Medicaid expansion, the managed care organization (MCO) prescription drug rebate provisions, minimum payments to primary care providers (PCPs), interactions between the Medicaid program and health insurance exchanges, and Medicaid and CHIP maintenance of effort (MOE) requirements; 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.
Client expense: $2,890,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office
2022 · second_quarter · Medicare/Medicaid
Legislative proposals affecting Medicare and Medicaid hospital reimbursement policies Build Back Better Act proposals related to health care, Medicare, workforce and hospital emergency preparedness H.R. 1227/S. 386, "Medicare-X Choice Act" - provisions related to the establishment of a public health plan H.R. 1976, To establish an improved Medicare for All national health insurance program - provisions related to establishment of a Medicare for America health program to provide for comprehensive health coverage for all Americans Proposals to reduce drug costs
Client expense: Not reported · Firm income: $30,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · second_quarter · Medicare/Medicaid
Legislative proposals affecting Medicare and Medicaid hospital reimbursement policies Medicare Graduate Medical Education S. 834/H.R. 2256 - the Physician Shortage Reduction Act of 2021 Site-neutral payment policies Build Back Better Act proposals related to health policy, Medicare, workforce and hospital emergency preparedness H.R. 1227/S. 386, "Medicare-X Choice Act" - provisions related to the establishment of a public health plan H.R. 1976, To establish an improved Medicare for All national health insurance program - provisions related to establishment of a Medicare for America health program to provide for comprehensive health coverage for all Americans Proposals to reduce drug costs H.R. 1349, "COVID-19 Hospital and Health Provider Loan Conversion Act of 2021"
Client expense: Not reported · Firm income: $30,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · second_quarter · Medicare/Medicaid
Legislative proposals affecting Medicare and Medicaid hospital reimbursement policies Medicare Graduate Medical Education S. 834/H.R. 2256 - the Physician Shortage Reduction Act of 2021 H.R. 1887/S. 4009, the Rural Hospital Support Act Site-neutral payment policies Build Back Better Act proposals related to health policy, Medicare, workforce and hospital emergency preparedness Proposals to prevent future sequester cuts, including reductions in Medicare payments H.R. 1227/S. 386, "Medicare-X Choice Act" - provisions related to the establishment of a public health plan H.R. 1976, To establish an improved Medicare for All national health insurance program - provisions related to establishment of a Medicare for America health program to provide for comprehensive health coverage for all Americans Proposals to reduce drug costs Hospital at Home Care Model H.R. 7053/S. 3792, Hospital Inpatient Services Modernization Act - provisions related to extending the CMS waiver beyond the end of the PHE
Client expense: Not reported · Firm income: $110,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · second_quarter · Medicare/Medicaid
Proposals to prevent future sequester cuts, reducing Medicare payments Changes to Medicare policy Build Back Better Act proposals - provisions related to health policy, Medicare, workforce and hospital emergency preparedness Site-neutral payments H.R. 1227/S. 386, "Medicare-X Choice Act" - provisions related to the establishment of a public health plan H.R. 1976, To establish an improved Medicare for All national health insurance program - provisions related to establishment of a Medicare for America health program to provide for comprehensive health coverage for all Americans S. 834/H.R. 2256, the "Physician Shortage Reduction Act of 2021" H.R. 7053/S. 3792, Hospital Inpatient Services Modernization Act - provisions to extend the CMS waiver supporting Hospital at Home
Client expense: Not reported · Firm income: $50,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · second_quarter · Medicare/Medicaid
Implementation of HR 1319, American Rescue Plan; S. 386/ HR 1332, Telemedicine Modernization Act; The Connect for Health Act (H.R. 2903/S.1512); Protecting Medicare and American Farmers from Sequester Cuts Act PL 117-71
Client expense: Not reported · Firm income: $20,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2022 · second_quarter · Health Issues
Implementation of HR 1319, American Rescue Plan; S. 386/ HR 1332, Telemedicine Modernization Act; The Connect for Health Act (H.R. 2903/S.1512); Protecting Medicare and American Farmers from Sequester Cuts Act PL 117-71
Client expense: Not reported · Firm income: $20,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2022 · second_quarter · Insurance
Implementation of HR 1319, American Rescue Plan; S. 386/ HR 1332, Telemedicine Modernization Act; The Connect for Health Act (H.R. 2903/S.1512); Protecting Medicare and American Farmers from Sequester Cuts Act PL 117-71
Client expense: Not reported · Firm income: $20,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2022 · second_quarter · Medicare/Medicaid
Implementation of HR 1319, American Rescue Plan Act of 2021; HR 943, Social Determinants for Moms Act; FMAP issues; S. 386, Telemedicine Modernization Act; HR 1332, Telemedicine Modernization Act; Protecting Medicare and American Farmers from Sequester Cuts Act PL 117-71; PA Medicaid MCO contract requirements; Medicare Advantage; Budget Reconciliation Package
Client expense: Not reported · Firm income: $30,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE
2022 · second_quarter · Health Issues
Implementation of American Rescue Plan Act of 2021 (H.R. 1319); HR 943, Social Determinants for Moms Act; S. 386, Telemedicine Modernization Act; HR 1332, Telemedicine Modernization Act; The Connect for Health Act (H.R. 2903/S.1512); PA Medicaid MCO contract requirements; Medicare Advantage; Budget Reconciliation Package
Client expense: Not reported · Firm income: $30,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · second_quarter · Health Issues
S.1895 - The Lower Health Care Costs Act S.386 - Medicare-X Choice Act of 2021 H.R.1976 - To establish an improved Medicare for All national health insurance program
Client expense: $380,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE
2022 · second_quarter · Health Issues
H.R. 1976 / S. 4204- "Medicare for All Act" - Single-payer healthcare systems. Recommendations for appropriate rulemaking associated with No Surprises Act. H.R. 5376 - "Build Back Better Act" - Provisions related to healthcare and tax. H.R. 1227/ S.386 - "Medicare-X Choice Act of 2021" - Public option healthcare systems. COVID Provider Relief Fund - Continuing viability of the HRSA COVID-19 Uninsured Program. S. 2428 - False Claims Amendments Act of 2021 - False Claims Act amendments. H.R. 8201 - Promoting Health Care Quality Act of 2022 -Health care quality provisions under the Medicare program. H.R. 7961 - Safety from Violence for Healthcare Employees (SAVE) Act - protections for health care workers from violence in the workplace.
Client expense: $820,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE, White House Office