Legislative Progress
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
Save Rural Hospitals Act of 2021 This bill establishes an area wage adjustment floor for Medicare hospital payments in states that are not frontier states and excludes such adjustments from certain budget neutrality rules.
These links require the bill number to appear in the filing's source-reported specific issue text. Client expenses and lobbying-firm income are separate disclosure fields.
Filing registrants (8)
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 · 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.
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 · Medicare/Medicaid
Area wage index - Save Rural Hospitals Act (S.999, H.R. 4066); behavioral health; Workforce -Resident Physician Shortage Reduction Act of 2021 (S. 834/ H.R. 2256); Healthcare Workforce Resilience Act (S. 1024); Future Advancement of Academic Nursing Act (S. 246/H.R. 851); Dr. Lorna Breen Health Care Provider Protection Act (H.R. 1667); rural hospital medical residency and health workforce programs - Rural Health Health Corps Act (S. 924/H.R. 2130); post-acute care/inpatient rehabilitation facilities - IMPACT Act (TRIA) of 2021 (H.R. 2455),IRF CMS Review Choice Demonstration; 340b Eligibility requirements waiver - H.R. 3203 and S.773; Disproportionate Share Hospital and Uncompensated Care funding cuts in the Build Back Better; relief to repay payments received through the Medicare Accelerated and Advance Payments program.
Client expense: Not reported · Firm income: $20,000
2022 · fourth_quarter · Health Issues
General health care issues; S. 999/H.R. 4066, Save Rural Hospitals Act of 2021.
Client expense: Not reported · Firm income: $20,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · fourth_quarter · Medicare/Medicaid
General health care issues; S. 999/H.R. 4066, Save Rural Hospitals Act of 2021.
Client expense: Not reported · Firm income: $20,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · fourth_quarter · Health Issues
S.999, Save Rural Hospitals Act and H.R.4066, the Save Rural Hospitals Act of 2021; issues related to workforce and staffing; reauthorization of the Medicare-Dependent Hospital Program and the Low-Volume Hospital Program; issues related to health care financing and delivery innovation, generally.
Client expense: Not reported · Firm income: $80,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · fourth_quarter · Medicare/Medicaid
S2999 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 programs; HR 1349 The COVID-19 Hospital and Health Provider Loan Conversion Act of 2021; H.R.2228 To allow for payment of outpatient critical access hospital services furnished through telehealth under the Medicare program. S999 A bill to amend the title XVIII of the Social Security Act to preserve access to rural health care by ensuring fairness in Medicare hospital payments; H.R.1887 To amend title XVIII of the Social Security Act to rebase the calculation of payments for sole community hospitals and Medicare-dependent hospitals, and for other purposes; S.2048 -HR3650 Improving Access to care Coverage Act of 2021;. H.R. 1330 Patient Access to Higher Quality Health Care Act of 2021;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.67 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;S.4050 Medicare Advantage Quality Payment Relief Act of 2022; H.R.6895 Commission on Sustaining Medicare and Social Security Act of 2022.
Client expense: Not reported · Firm income: $15,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · fourth_quarter · Medicare/Medicaid
The Medicare-dependent Hospitals (MDH) and Low-volume Hospital (LVH) adjustment programs o The Assistance for Rural Community Hospitals (ARCH) Act (H.R. 8747) would extend the Medicare-dependent hospital (MDH) program and low-volume hospital (LVH) adjustment for five years. o The Rural Hospital Support Act (H.R. 1887 / S.4009) would make both the MDH and the enhanced LVH adjustment programs permanent. PAYGO cut Extend Telehealth flexibilities - Advancing Telehealth Beyond COVID-19 Act (H.R. 4040) Hospital at Home waiver - Hospital Inpatient Services Modernization Act would extend by 2 years the Hospital at Home waiver program (S. 3792/ H.R. 7053). The Rural America Health Corps Act (S. 924/H.R. 2130) - support for this legislation which will provide incentives for clinicians to practice in rural health professional shortage areas. Improving Seniors Timely Access to Care Act (S. 3018 / H.R. 3173) - steamline Medicare Advantage Prior Authorization Conrad State 30 and Physician Access Reauthorization Act (S. 1810 / H.R. 3541) Mental and Behavioral Health - Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R. 7666) Area wage index - Save Rural Hospitals Act (S.999, H.R. 4066); Inpatient Rehabilitation Facilities - CMS Review Choice Demonstration
Client expense: $30,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · fourth_quarter · Medicare/Medicaid
Issues related to the Medicare Wage Index and hospital price transparency; S.999, Save Rural Hospitals Act of 2021; H.R.4066, To amend the title XVIII of the Social Security Act to preserve access to rural health care by ensuring fairness in Medicare hospital payments.
Client expense: Not reported · Firm income: $50,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE
2022 · third_quarter · Medicare/Medicaid
Area wage index - Save Rural Hospitals Act (S.999, H.R. 4066); behavioral health; Workforce -Resident Physician Shortage Reduction Act of 2021 (S. 834/ H.R. 2256); Healthcare Workforce Resilience Act (S. 1024); Future Advancement of Academic Nursing Act (S. 246/H.R. 851); Dr. Lorna Breen Health Care Provider Protection Act (H.R. 1667); rural hospital medical residency and health workforce programs - Rural Health Health Corps Act (S. 924/H.R. 2130); post-acute care/inpatient rehabilitation facilities - IMPACT Act (TRIA) of 2021 (H.R. 2455),IRF CMS Review Choice Demonstration; 340b Eligibility requirements waiver - H.R. 3203 and S.773; Disproportionate Share Hospital and Uncompensated Care funding cuts in the Build Back Better; relief to repay payments received through the Medicare Accelerated and Advance Payments program.
Client expense: Not reported · Firm income: $20,000
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.
2022 · third_quarter · Medicare/Medicaid
H.R. 1330 / S. 4130 - "Patient Access to Higher Quality Health Care Act of 2021" - Provisions that would weaken or repeal current law limiting self-referral to physician-owned hospitals. Advocate for legislation that would reform rural hospital DSH payments. H.R. 4040 - "Advancing Telehealth Beyond COVID-19 Act of 2021" - Expanding access to telehealth beyond PHE. S. 1568 / H.R. 4407 - "Technical Reset to Advance the Instruction of Nurses Act" - CMS payments for Nursing Education Hospitals. H.R. 1887 / S. 4009 - "Rural Hospital Support Act" - Rural Extenders. H.R. 4066 / S. 999 - "Save Rural Hospitals Act of 2021" - Area wage adjustment for certain Medicare hospitals. H.R. 3173/H.R. 8487 - The Improving Seniors Timely Access to Care Act of 2021 - Simplify/streamline Medicare Advantage prior authorization process. Urge Congress to Support Improvements to IPPS Proposed Rule. H.R. 8747 - "The Assistance for Rural Community Hospitals (ARCH) Act" - Rural health payment program extensions. H.R. 6833 - "Legislative Vehicle for Continuing Resolution Until Dec. 16" - Rural health payment program extensions. S. 1512 / H.R. 2903- "Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2021" - Telehealth provisions. H.R. 2455 - The Resetting the IMPACT Act (TRIA) of 2021 - IMPACT Act implementation / unified payment timeline reset. Garner Congressional support for CMS to withdraw the Inpatient Rehabilitation Facility Review Choice Demonstration (IRF RCD). Discussions with Congress regarding waiving PAYGO.
Client expense: $640,000 · Firm income: Not reported
2022 · third_quarter · Medicare/Medicaid
General health care issues; S. 999/H.R. 4066, Save Rural Hospitals Act of 2021.
Client expense: Not reported · Firm income: $20,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · third_quarter · Health Issues
General health care issues; S. 999/H.R. 4066, Save Rural Hospitals Act of 2021.
Client expense: Not reported · Firm income: $20,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · third_quarter · Medicare/Medicaid
S2999 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 programs; HR 1349 The COVID-19 Hospital and Health Provider Loan Conversion Act of 2021; H.R.2228 To allow for payment of outpatient critical access hospital services furnished through telehealth under the Medicare program. S999 A bill to amend the title XVIII of the Social Security Act to preserve access to rural health care by ensuring fairness in Medicare hospital payments; H.R.1887 To amend title XVIII of the Social Security Act to rebase the calculation of payments for sole community hospitals and Medicare-dependent hospitals, and for other purposes; S.2048 -HR3650 Improving Access to care Coverage Act of 2021;. H.R. 1330 Patient Access to Higher Quality Health Care Act of 2021;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.67 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;S.4050 Medicare Advantage Quality Payment Relief Act of 2022; H.R.6895 Commission on Sustaining Medicare and Social Security Act of 2022.
Client expense: Not reported · Firm income: $15,000
2022 · third_quarter · Medicare/Medicaid
The Medicare-dependent Hospitals (MDH) and Low-volume Hospital (LVH) adjustment programs o The Assistance for Rural Community Hospitals (ARCH) Act (H.R. 8747) would extend the Medicare-dependent hospital (MDH) program and low-volume hospital (LVH) adjustment for five years. o The Rural Hospital Support Act (H.R. 1887 / S.4009) would make both the MDH and the enhanced LVH adjustment programs permanent. PAYGO cut Extend Telehealth flexibilities - Advancing Telehealth Beyond COVID-19 Act (H.R. 4040) Hospital at Home waiver - Hospital Inpatient Services Modernization Act would extend by 2 years the Hospital at Home waiver program (S. 3792/ H.R. 7053). The Rural America Health Corps Act (S. 924/H.R. 2130) - support for this legislation which will provide incentives for clinicians to practice in rural health professional shortage areas. Improving Seniors Timely Access to Care Act (S. 3018 / H.R. 3173) - steamline Medicare Advantage Prior Authorization Conrad State 30 and Physician Access Reauthorization Act (S. 1810 / H.R. 3541) Mental and Behavioral Health - Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R. 7666) Area wage index - Save Rural Hospitals Act (S.999, H.R. 4066); Inpatient Rehabilitation Facilities - CMS Review Choice Demonstration
Client expense: $30,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · third_quarter · Health Issues
S.999, Save Rural Hospitals Act and H.R. 4066, the Save Rural Hospitals Act of 2021; issues related to workforce and staffing; issues related to FY23 IPPS proposed rule; reauthorization of the Medicare-Dependent Hospital Program and the Low-Volume Hospital Program; issues related to health care financing and delivery innovation, generally; FY23 Labor-HHS-Education appropriations, community funding projects.
Client expense: Not reported · Firm income: $80,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · third_quarter · Medicare/Medicaid
Issues related to the Medicare Wage Index and hospital price transparency; S.999, Save Rural Hospitals Act of 2021; H.R.4066, To amend the title XVIII of the Social Security Act to preserve access to rural health care by ensuring fairness in Medicare hospital payments.
Client expense: Not reported · Firm income: $50,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE
2022 · second_quarter · Medicare/Medicaid
Area wage index - Save Rural Hospitals Act (S.999, H.R. 4066); behavioral health; Workforce -Resident Physician Shortage Reduction Act of 2021 (S. 834/ H.R. 2256); Healthcare Workforce Resilience Act (S. 1024); Future Advancement of Academic Nursing Act (S. 246/H.R. 851); Dr. Lorna Breen Health Care Provider Protection Act (H.R. 1667); rural hospital medical residency and health workforce programs - Rural Health Health Corps Act (S. 924/H.R. 2130); post-acute care/inpatient rehabilitation facilities - IMPACT Act (TRIA) of 2021 (H.R. 2455),IRF CMS Review Choice Demonstration; 340b Eligibility requirements waiver - H.R. 3203 and S.773; Disproportionate Share Hospital and Uncompensated Care funding cuts in the Build Back Better; relief to repay payments received through the Medicare Accelerated and Advance Payments program.
Client expense: Not reported · Firm income: $20,000
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.
2022 · second_quarter · Medicare/Medicaid
Area wage index - Save Rural Hospitals Act (S.999, H.R. 4066); behavioral health; Workforce - Resident Physician Shortage Reduction Act of 2021 (S. 834/ H.R. 2256); Healthcare Workforce Resilience Act (S. 1024); Future Advancement of Academic Nursing Act (S. 246/H.R. 851); Dr. Lorna Breen Health Care Provider Protection Act (H.R. 1667); rural hospital medical residency and health workforce programs - Rural Health Health Corps Act (S. 924/H.R. 2130); post-acute care/inpatient rehabilitation facilities - IMPACT Act (TRIA) of 2021 (H.R. 2455),IRF CMS Review Choice Demonstration; 340b Eligibility requirements waiver - H.R. 3203 and S.773; Disproportionate Share Hospital and Uncompensated Care funding cuts in the Build Back Better; relief to repay payments received through the Medicare Accelerated and Advance Payments program.
Client expense: $30,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE
2022 · second_quarter · Health Issues
General health care issues; S. 999/H.R. 4066, Save Rural Hospitals Act of 2021.
Client expense: Not reported · Firm income: $20,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · second_quarter · Medicare/Medicaid
General health care issues; S. 999/H.R. 4066, Save Rural Hospitals Act of 2021.
Client expense: Not reported · Firm income: $20,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · second_quarter · Health Issues
S.999, Save Rural Hospitals Act and H.R.4066, the Save Rural Hospitals Act of 2021; issues related to workforce and staffing; issues related to health care financing and delivery innovation, generally; FY23 Labor-HHS-Education appropriations, community funding projects.
Client expense: Not reported · Firm income: $80,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · second_quarter · Medicare/Medicaid
Issues related to the Medicare Wage Index and hospital price transparency; S.999, Save Rural Hospitals Act of 2021; H.R.4066, To amend the title XVIII of the Social Security Act to preserve access to rural health care by ensuring fairness in Medicare hospital payments.
Client expense: Not reported · Firm income: $50,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE
2022 · second_quarter · Medicare/Medicaid
S2999 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 programs; HR 1349 The COVID-19 Hospital and Health Provider Loan Conversion Act of 2021; H.R.2228 To allow for payment of outpatient critical access hospital services furnished through telehealth under the Medicare program. S999 A bill to amend the title XVIII of the Social Security Act to preserve access to rural health care by ensuring fairness in Medicare hospital payments; H.R.1887 To amend title XVIII of the Social Security Act to rebase the calculation of payments for sole community hospitals and Medicare-dependent hospitals, and for other purposes; S.2048 -HR3650 Improving Access to care Coverage Act of 2021;. H.R. 1330 Patient Access to Higher Quality Health Care Act of 2021;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.67 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;S.4050 Medicare Advantage Quality Payment Relief Act of 2022; H.R.6895 Commission on Sustaining Medicare and Social Security Act of 2022.
Client expense: Not reported · Firm income: $15,000
2022 · first_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; 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, 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.
2022 · first_quarter · Medicare/Medicaid
Area wage index - Save Rural Hospitals Act (S.999, H.R. 4066); behavioral health; Workforce -Resident Physician Shortage Reduction Act of 2021 (S. 834/ H.R. 2256); Healthcare Workforce Resilience Act (S. 1024); Future Advancement of Academic Nursing Act (S. 246/H.R. 851); Dr. Lorna Breen Health Care Provider Protection Act (H.R. 1667); rural hospital medical residency and health workforce programs - Rural Health Health Corps Act (S. 924/H.R. 2130); post-acute care/inpatient rehabilitation facilities - IMPACT Act (TRIA) of 2021 (H.R. 2455),IRF CMS Review Choice Demonstration; 340b Eligibility requirements waiver - H.R. 3203 and S.773; Disproportionate Share Hospital and Uncompensated Care funding cuts in the Build Back Better; relief to repay payments received through the Medicare Accelerated and Advance Payments program.
Client expense: Not reported · Firm income: $20,000
2022 · first_quarter · Health Issues
General health care issues; S. 999/H.R. 4066, Save Rural Hospitals Act of 2021.
Client expense: Not reported · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · first_quarter · Medicare/Medicaid
General health care issues; S. 999/H.R. 4066, Save Rural Hospitals Act of 2021.
Client expense: Not reported · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · first_quarter · Medicare/Medicaid
Area wage index - Save Rural Hospitals Act (S.999, H.R. 4066); behavioral health; Workforce - Resident Physician Shortage Reduction Act of 2021 (S. 834/ H.R. 2256); Healthcare Workforce Resilience Act (S. 1024); Future Advancement of Academic Nursing Act (S. 246/H.R. 851); Dr. Lorna Breen Health Care Provider Protection Act (H.R. 1667); rural hospital medical residency and health workforce programs - Rural Health Health Corps Act (S. 924/H.R. 2130); post-acute care/inpatient rehabilitation facilities - IMPACT Act (TRIA) of 2021 (H.R. 2455),IRF CMS Review Choice Demonstration; 340b Eligibility requirements waiver - H.R. 3203 and S.773; Disproportionate Share Hospital and Uncompensated Care funding cuts in the Build Back Better; relief to repay payments received through the Medicare Accelerated and Advance Payments program.
Client expense: $30,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE
2022 · first_quarter · Medicare/Medicaid
S2999 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 programs; HR 1349 The COVID-19 Hospital and Health Provider Loan Conversion Act of 2021; H.R.2228 To allow for payment of outpatient critical access hospital services furnished through telehealth under the Medicare program. S999 A bill to amend the title XVIII of the Social Security Act to preserve access to rural health care by ensuring fairness in Medicare hospital payments; H.R.1887 To amend title XVIII of the Social Security Act to rebase the calculation of payments for sole community hospitals and Medicare-dependent hospitals, and for other purposes; S.2048 -HR3650 Improving Access to Medicare Coverage Act of 2021;. H.R. 1330 Patient Access to Higher Quality Health Care Act of 2021; .
Client expense: Not reported · Firm income: $15,000
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 · Health Issues
S.999, Save Rural Hospitals Act and H.R.4066, the Save Rural Hospitals Act of 2021; S.773, to enable certain hospitals that were participating in or applied for the drug discount program under Section 340B of the Public Health Service Act prior to the COVID-19 public health emergency to temporarily maintain eligibility for such program, and for other purposes; policies related to the Covid-19 response; issues related to workforce and staffing; status of H.R.2471, FY2022 Consolidated Appropriations Act, Division H (Labor-HHS-Education)
Client expense: Not reported · Firm income: $80,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2022 · first_quarter · Medicare/Medicaid
Issues related to the Medicare Wage Index and hospital price transparency; S.999, Save Rural Hospitals Act of 2021; H.R.4066, To amend the title XVIII of the Social Security Act to preserve access to rural health care by ensuring fairness in Medicare hospital payments.
Client expense: Not reported · Firm income: $50,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE
2021 · fourth_quarter · Medicare/Medicaid
Area Wage Index - Save Rural Hospitals Act (S. 999, H.R. 4066); Behavioral Health: (regulation) repeal the Institutions for Mental Disease Exclusion, Opioid Workforce Act of 2021 (S. 1438) & Substance Use Disorder Workforce Act of 2021 (H.R. 3441); Workforce: Resident Physician Shortage Reduction Act of 2021 (S. 834/ H.R. 2256), Healthcare Workforce Resilience Act (S. 1024), Future Advancement of Academic Nursing Act (S. 246/H.R. 851), Dr. Lorna Breen Health Care Provider Protection Act (H.R. 1667); Expand Medicaid coverage for individuals in Tennessee and extend provisions to reduce the cost of the Marketplace coverage for all subsidy-eligible individuals and families; Rural Hospitals: Invest in rural medical residency and health workforce programs - Rural Health Health Corps Act (S. 924/H.R. 2130), (regulation) Rural Emergency Hospital (REH) Medicare designation - support payment reform and equity for rural hospitals, including new payment demonstrations; Post-Acute Care / Inpatient Rehabilitation Facilities: Aid payment transition by supporting The Resetting the IMPACT Act (TRIA) of 2021 (H.R. 2455), IRF CMS Review Choice Demonstration; 340B - Waive 340b Eligibility requirements support legislation H.R. 3203 and S. 773; lobbied against Disproportionate Share Hospital and Uncompensated Care funding cuts in the Build Back Better Reconciliation bill.
Client expense: Not reported · Firm income: $20,000
2021 · fourth_quarter · Medicare/Medicaid
Area Wage Index - Save Rural Hospitals Act (S. 999, H.R. 4066); Behavioral Health: (regulation) repeal the Institutions for Mental Disease Exclusion, Opioid Workforce Act of 2021 (S. 1438) & Substance Use Disorder Workforce Act of 2021 (H.R. 3441); Workforce: Resident Physician Shortage Reduction Act of 2021 (S. 834/ H.R. 2256), Healthcare Workforce Resilience Act (S. 1024), Future Advancement of Academic Nursing Act (S. 246/H.R. 851), Dr. Lorna Breen Health Care Provider Protection Act (H.R. 1667); Expand Medicaid coverage for individuals in Tennessee and extend provisions to reduce the cost of the Marketplace coverage for all subsidy-eligible individuals and families; Rural Hospitals: Invest in rural medical residency and health workforce programs - Rural Health Health Corps Act (S. 924/H.R. 2130), (regulation) Rural Emergency Hospital (REH) Medicare designation - support payment reform and equity for rural hospitals, including new payment demonstrations; Post-Acute Care / Inpatient Rehabilitation Facilities: Aid payment transition by supporting The Resetting the IMPACT Act (TRIA) of 2021 (H.R. 2455), IRF CMS Review Choice Demonstration; 340B - Waive 340b Eligibility requirements support legislation H.R. 3203 and S. 773; lobbied against Disproportionate Share Hospital and Uncompensated Care funding cuts in the Build Back Better Reconciliation bill.
Client expense: $40,000 · Firm income: Not reported
2021 · fourth_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 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) 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
2021 · fourth_quarter · Medicare/Medicaid
Issues related to the Medicare Wage Index and hospital price transparency; S.999, Save Rural Hospitals Act of 2021; H.R.4066, To amend the title XVIII of the Social Security Act to preserve access to rural health care by ensuring fairness in Medicare hospital payments.
Client expense: Not reported · Firm income: $50,000
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE
2021 · fourth_quarter · Medicare/Medicaid
S2999 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 programs; HR 1349 The COVID-19 Hospital and Health Provider Loan Conversion Act of 2021; H.R.2228 To allow for payment of outpatient critical access hospital services furnished through telehealth under the Medicare program. S999 A bill to amend the title XVIII of the Social Security Act to preserve access to rural health care by ensuring fairness in Medicare hospital payments; H.R.1887 To amend title XVIII of the Social Security Act to rebase the calculation of payments for sole community hospitals and Medicare-dependent hospitals, and for other purposes; S.2048 -HR3650 Improving Access to Medicare Coverage Act of 2021;. H.R. 1330 Patient Access to Higher Quality Health Care Act of 2021.
Client expense: Not reported · Firm income: $15,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2021 · fourth_quarter · Health Issues
S.999, Save Rural Hospitals Act and H.R. 4066, the Save Rural Hospitals Act of 2021; S.773, to enable certain hospitals that were participating in or applied for the drug discount program under Section 340B of the Public Health Service Act prior to the COVID-19 public health emergency to temporarily maintain eligibility for such program, and for other purposes; Provider Relief Fund relief distribution and other policies related to the Covid-19 response; workforce issues; health care financing and delivery innovation
Client expense: Not reported · Firm income: $80,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2021 · third_quarter · Medicare/Medicaid
H.R. 1330 - "Patient Access to Higher Quality Health Care Act of 2021" - Oppose legislation that would repeal current law limiting self-referral to physician-owned hospitals. H.R. 2455 - "The Resetting the IMPACT Act (TRIA) of 2021" - Support legislation to refresh the unified PAC PPS timeline and process under the IMPACT Act. S. 999/H.R. 4066 - "Save Rural Hospitals Act of 2021" - Support a national wage index floor of .85 in a non-budget neutral manner. S. 1512 - "Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2021" - Advocate in support of the CONNECT Act to expand access to telehealth services. H.R. 4587 - "Value in Health Care Act of 2021" - Support ACO program reforms. S. 1568 / H.R. 4407 - "Technical Reset to Advance the Instruction of Nurses Act" - Support legislation that would direct CMS not to seek repayment from nursing and allied health programs. H.R. 1887 - "Rural Hospital Support Act" - Support rural MDH and LVH program extensions. H.R. 3746 - "Accountable Care In Rural America Act" - Support rural health ACOs. Rural - Seek introduction of legislation that would remove the current 12% DSH payment cap that currently applies to rural hospitals (with some exceptions) as well as urban hospitals under 100 beds. Urged Congress to waive Statutory PAYGO and advocated for extending the 2% Medicare sequester moratorium.
Client expense: $600,000 · Firm income: Not reported
2021 · third_quarter · Medicare/Medicaid
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)] Sequestration relief (H.R. 1868) 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) Disproportionate share hospital allotment increase (technical correction) 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 S. 999, (addressing the Area Wage Index for rural hospitals) OMB recommendations on Metropolitan Statistical Areas Telehealth flexibilities and payment (TREAT Act - S. 168/H.R. 708; Telehealth Modernization Act -S. 368/H.R. 1332; TREATS Act - S. 340) 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
Client expense: $60,000 · Firm income: Not reported
2021 · third_quarter · Medicare/Medicaid
H.R. 1330 - "Patient Access to Higher Quality Health Care Act of 2021" - Oppose legislation that would repeal current law limiting self-referral to physician-owned hospitals. H.R. 2455 - "The Resetting the IMPACT Act (TRIA) of 2021" - Support legislation to refresh the unified PAC PPS timeline and process under the IMPACT Act. S. 999/H.R. 4066 - "Save Rural Hospitals Act of 2021" - Support a national wage index floor of .85 in a non-budget neutral manner. S. 1512 - "Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2021" - Advocate in support of the CONNECT Act to expand access to telehealth services. H.R. 4587 - "Value in Health Care Act of 2021" - Support ACO program reforms. S. 1568 / H.R. 4407 - "Technical Reset to Advance the Instruction of Nurses Act" - Support legislation that would direct CMS not to seek repayment from nursing and allied health programs. H.R. 1887 - "Rural Hospital Support Act" - Support rural MDH and LVH program extensions. H.R. 3746 - "Accountable Care In Rural America Act" - Support rural health ACOs. Rural - Seek introduction of legislation that would remove the current 12% DSH payment cap that currently applies to rural hospitals (with some exceptions) as well as urban hospitals under 100 beds. Urged Congress to waive Statutory PAYGO and advocated for extending the 2% Medicare sequester moratorium.
Client expense: $570,000 · Firm income: Not reported
2021 · third_quarter · Medicare/Medicaid
HR 1349 The COVID-19 Hospital and Health Provider Loan Conversion Act of 2021; H.R.2228 To allow for payment of outpatient critical access hospital services furnished through telehealth under the Medicare program. S999 A bill to amend the title XVIII of the Social Security Act to preserve access to rural health care by ensuring fairness in Medicare hospital payments; H.R.1887 To amend title XVIII of the Social Security Act to rebase the calculation of payments for sole community hospitals and Medicare-dependent hospitals, and for other purposes; H.R.2228 To allow for payment of outpatient critical access hospital services furnished through telehealth under the Medicare program; S.2048 -HR3650 Improving Access to Medicare Coverage Act of 2021;. H.R. 1330 Patient Access to Higher Quality Health Care Act of 2021.
Client expense: Not reported · Firm income: $15,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2021 · third_quarter · Health Issues
S. 999, Save Rural Hospitals Act and H.R. 4066, the Save Rural Hospitals Act of 2021; S. 773, To enable certain hospitals that were participating in or applied for the drug discount program under section 340B of the Public Health Service Act prior to the COVID-19 public health emergency to temporarily maintain eligibility for such program, and for other purposes; Provider Relief Fund relief distribution and other policies related to the Covid-19 response.
Client expense: Not reported · Firm income: $80,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2021 · third_quarter · Medicare/Medicaid
Issues related to the Medicare Wage Index and hospital price transparency; S.999, Save Rural Hospitals Act of 2021; H.R.4066, To amend the title XVIII of the Social Security Act to preserve access to rural health care by ensuring fairness in Medicare hospital payments.
Client expense: Not reported · Firm income: $50,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2021 · second_quarter · Medicare/Medicaid
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, H.R. 1868) Sequestration relief (H.R. 1868) 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) Disproportionate share hospital allotment increase (technical correction) 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 S. 999, (addressing the Area Wage Index for rural hospitals) OMB recommendations on Metropolitan Statistical Areas Telehealth flexibilities and payment (TREAT Act - S. 168/H.R. 708; Telehealth Modernization Act -S. 368/H.R. 1332; TREATS Act - S. 340) 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 Guidance on State Directed Payments in Medicaid Managed Care
Client expense: $80,000 · Firm income: Not reported
2021 · second_quarter · Medicare/Medicaid
HR 1349 The COVID-19 Hospital and Health Provider Loan Conversion Act of 2021; H.R.2228 To allow for payment of outpatient critical access hospital services furnished through telehealth under the Medicare program. S999 A bill to amend the title XVIII of the Social Security Act to preserve access to rural health care by ensuring fairness in Medicare hospital payments; H.R.1887 To amend title XVIII of the Social Security Act to rebase the calculation of payments for sole community hospitals and Medicare-dependent hospitals, and for other purposes; H.R.2228 To allow for payment of outpatient critical access hospital services furnished through telehealth under the Medicare program; S.2048 -HR3650 Improving Access to Medicare Coverage Act of 2021;. H.R. 1330 Patient Access to Higher Quality Health Care Act of 2021.
Client expense: Not reported · Firm income: $15,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2021 · second_quarter · Health Issues
Issues related to rural health care, generally; S. 999, Save Rural Hospitals Act, and S. 773, to enable certain hospitals that were participating in or applied for the drug discount program under Section 340B of the Public Health Service Act prior to the COVID-19 public health emergency to temporarily maintain eligibility for such program, and for other purposes.
Client expense: Not reported · Firm income: $80,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2021 · second_quarter · Medicare/Medicaid
Issues related to the Medicare Wage Index and hospital price transparency; S.999, Save Rural Hospitals Act of 2021; H.R.4066, To amend the title XVIII of the Social Security Act to preserve access to rural health care by ensuring fairness in Medicare hospital payments.
Client expense: Not reported · Firm income: $50,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
| Republican |
| TN |
| Raphael G. Warnock | Democratic | GA |
| Richard C. Shelby | Republican | AL |
| Roger F. Wicker | Republican | MS |
| Tim Kaine | Democratic | VA |
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
Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office
Government targets: HOUSE OF REPRESENTATIVES, SENATE
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
Government targets: HOUSE OF REPRESENTATIVES, SENATE
Client expense: $4,680,000 · 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
Client expense: $80,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
Government targets: HOUSE OF REPRESENTATIVES, SENATE
Client expense: $60,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office
Government targets: HOUSE OF REPRESENTATIVES, SENATE
Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office
Government targets: HOUSE OF REPRESENTATIVES, SENATE