No UPCODE Act

Draft, Medicare Compare Website (no bill number) - Rep. Guthrie, Brett - improvements to CMS Medicare compare website H.R. 3875 - Expanded Telehealth Access Act - Rep. Sherrill, Mikie - Medicare payment for telehealth services H.R. 4411 - Medicare Advantage Integrity Act - Resident Commissioner Gonzalez-Colon, Jenniffer - disparity in MA benchmark rates H.R. 4818 - Treat and Reduce Obesity Act of 2023 - Rep. Wenstrup, Brad - Medicare Coverage of weight loss treatment H.R. 5526 - Seniors' Access to Critical Medications Act of 2023 - Rep. Harshbarger, Diana - exception for physician self-referral H.R. 5746 - Addressing Whole Health in Medicare Advantage Act - Rep. Bilirakis, Gus - Medicare Advantage supplemental benefits H.R. 5854 - Medicare Advantage Consumer Protection and Transparency Act - Rep. Porter, Katie - Medicare Advantage organization reporting H.R. 6400 - To amend title XVIII of the Social Security Act to extend eligibility for certain payment increases for biosimilar biological products under the Medicare program - Rep. Cardenas, Tony - Medicare payment increase for biosimilars H.R. 7148 - Medicare Home Health Accessibility Act - Rep. Smucker, Lloyd - occupational therapy eligibility for home health coverage under Medicare H.R. 7512 - Real-Time Benefit Tool Implementation Act - Rep. Arrington, Jodey - implementation of real-time benefit tools under part D of under Medicare H.R. 7623 - Telehealth Modernization Act of 2024 - Rep. Carter, Earl L. Buddy - makes certain telehealth flexibilities permanent under Medicare and adds requirements for Part D plan contracts with PBMs including reporting and delinking provisions H.R. 7996 - Improving CARE for Youth Act - Rep. Dunn, Neal - allows for same-day billing for mental health services for youth Medicaid beneficiaries who are being seen for a primary care service H.R. 8064 - Help Extend Auditory Relief Act of 2024- Rep. Cartwright, Matt - Medicare coverage of hearing aids H.R. 8075 - Improving Access to Home Dialysis Act of 2024- Rep. Miller, Carol - Medicare coverage of home dialysis H.R. 8115 - To amend title XIX of the Social Security Act to allow for the deferral or disallowance of portions of payments for certain managed care violations under Medicaid- Rep. Sarbanes, John - Medicaid managed care payment deferral H.R. 8261 - Preserving Telehealth, Hospital, and Ambulance Access Act- Rep. Schweikert, David - extend flexibilities and payment for Medicare H.R. 8702 - Improving Seniors Timely Access to Care Act - Rep. Mike Kelly - prior authorization, transparency, MA S. 838 - Improving Access to Mental Health Act - Sen. Stabenow, Debbie - mental health services in Medicare S. 948 - Healthy Moms and Babies Act - Sen. Grassley, Chuck - establishes programs and requirements to support maternal health services under Medicaid and CHIP S. 1002 - No UPCODE Act - Sen. Cassidy, Bill - modifies certain factors that are used to determine Medicare Advantage (MA) payments, particularly relating to health status and related data S. 2880 - Expanded Telehealth Access Act - Sen. Daines, Steve - Medicare payment for telehealth services S. 3573 - Medicare Advantage Supplemental Benefits Transparency Act- Sen. Warner, Mike - MA, data transparency, supplemental benefits S. 3578 - Protect Medicaid Act - Sen. Cassidy, Bill - prohibits federal payments under Medicaid for noncitizens, requires reporting to HHS of states that provide such health benefits S. 3630 - Medicare Transaction Fraud Prevention Act- Sen. Braun, Mike- pilot program for predictive risk-scoring algorithm, oversight, Medicare S. 3651 - Telemental Health Care Access Act of 2024- Sen. Cassidy, Bill - Medicare, mental health services, telehealth S. 3882 - Helping States Integrate Medicare and Medicaid Act- Sen. Casey, Robert - dual eligibles, quality measures, access, enrollment S. 3934 - Increasing Access to Biosimilars Act of 2023- Sen. Cornyn, John - Medicare drug access S. 3950 - Delivering Unified Access to Lifesaving Services Act of 2024 - Sen. Cassidy, Bill - reforming Integrated Medicare/Medicaid Care Programs for Dually Eligible Individuals S. 4532 - Improving Seniors Timely Access to Care Act - Sen. Marshall, Roger - prior authorization, transparency, MA S. 4767 - Insurance Fraud Accountability Act - Sen. Wyden, Ron - reduces fraudulent enrollments in qualified health plans Issues related to mental health and Medicare; Medicare and Medicaid funding; Medicaid expansion; State innovation waivers; Medicaid and CHIP; Medicaid FMAP; Medicare Supplement Coverage; Medicare Transparency in Coverage; Medicaid Access Final Rule; Medicaid Redeterminations; Medicaid rate actuarial soundness; value of Medicaid Managed Care; Medicare Advantage Health Risk Assessment and chart reviews; Medicare Advantage supplemental benefits and Social Determinants of health; CBO estimates of MA and FFS costs; coverage of weight loss drugs; and Inflation Reduction Act implementation.

Client expense: $2,610,000 · Firm income: Not reported

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

Medicare Advantage coding and reimbursement issues. 2025 Medicare Advantage and Part D Rate Announcement. Medicare Special Needs Plans Access. Health care workforce issues. Health equity. Maternal health. Digital health and telehealth. S. 1002 - The No Unreasonable Payments, Coding, or Diagnoses for the Elderly Act of 2023. H.R. 5378 - Lower Cost, More Transparency Act. Issues related to Medicaid access and reimbursement. Medicaid directed payment programs. Medicare site neutral payments. FY 2025 Labor, Health & Human Services Appropriations. H.R. 10545 - American Relief Act

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

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

Legislation and regulation related to the Medicare Advantage program and Medicare/Medicaid coverage, care delivery and financing. HR 8260 Hospital Inpatient Services Modernization Act H.R. 8235 the Rural Physician Workforce Preservation Act H.R. 8261, the Preserving Telehealth, Hospital, and Ambulance Access Act HR 3171/S. 3018 The Improving Seniors Timely Access to Care Act H.R. 1110, KEEP Telehealth Options Act of 2023 H.R. 3875, Expanded Telehealth Access Act H.R. 5541, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act H.R. 5611, Helping Ensure Access to Local TeleHealth (HEALTH) Act of 2023 H.R. 6033, Supporting Patient Education And Knowledge (SPEAK) Act of 2023 H.R. 7149, Equal Access to Specialty Care Everywhere (EASE) Act of 2024 H.R. 7623, The Telehealth Modernization Act of 2024 H.R. 7711, To amend title XVIII of the Social Security Act to make permanent certain telehealth flexibilities under the Medicare program H.R. 7858, Telehealth Enhancement for Mental Health Act of 2024 H.R. 7863, To require the Secretary of Health and Human Services to issue guidance on furnishing behavioral health services via telehealth to individuals with limited English proficiency under Medicare program H.R. 5386, Cutting Copays Act H.R. 5380, To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage H.R. 5372, Expanding Seniors Access to Lower Cost Medicines Act of 2023 S. 3059 the REAL Health Provider Act (Bennet, Tillis) S. 2973 Modernizing and Ensuring PBM Accountability Act H.R. 2880, the Protecting Patients Against PBM Abuses Act S.1002 - No UPCODE Act H.R. 3282, the Promoting Transparency and Healthy Competition in Medicare Act H.R. 3284, the Providers and Payers COMPETE Act H.R. 3237, To amend title XVIII of the Social Security Act to require each outpatient department of a provider to include a unique identification number on claims for services, and to require hospitals with an outpatient department of a provider to submit to the Centers for Medicare & Medicaid Services an attestation with respect to each outpatient department

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

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

Draft, Medicare Compare Website (no bill number) - Rep. Guthrie, Brett - improvements to CMS Medicare compare website H.R. 35 - Close the Medigap Act of 2023 - Rep. Doggett, Lloyd - Medigap policies H.R. 3746 - Fiscal Responsibility Act of 2023 - Rep. McHenry, Patrick - work requirements for federal programs H.R. 3875 - Expanded Telehealth Access Act - Rep. Sherrill, Mikie - Medicare payment for telehealth services H.R. 4411 - Medicare Advantage Integrity Act - Resident Commissioner Gonzalez-Colon, Jenniffer - disparity in MA benchmark rates H.R. 4818 - Treat and Reduce Obesity Act of 2023 - Rep. Wenstrup, Brad -Medicare Coverage of weight loss treatment H.R. 5526 - Seniors' Access to Critical Medications Act of 2023 - Rep. Harshbarger, Diana - exception for physician self-referral H.R. 5584 - Medicaid Third Party Liability Act - Rep. Burgess, Michael - amends Medicaid Third Party liability requirements H.R. 5746 - Addressing Whole Health in Medicare Advantage Act - Rep. Bilirakis, Gus - Medicare Advantage supplemental benefits H.R. 5854 - Medicare Advantage Consumer Protection and Transparency Act - Rep. Porter, Katie - Medicare Advantage organization reporting H.R. 6364 - Medicare Telehealth Privacy Act of 2023 - Rep. Balderson, Troy - Provider privacy provisions for telehealth under Medicare H.R. 6400 - To amend title XVIII of the Social Security Act to extend eligibility for certain payment increases for biosimilar biological products under the Medicare program - Rep. Cardenas, Tony - Medicare payment increase for biosimilars H.R. 6445 - Medicare Audiology Access Improvement Act of 2023 - Rep. Bilirakis, Gus - Medicare Audiology Coverage H.R. 7147 - Medicare Transaction Fraud Prevention Act - Rep. Schweikert, David - oversight of payments for medical equipment & clinical DLTs under Medicare H.R. 7148 - Medicare Home Health Accessibility Act - Rep. Smucker, Lloyd - occupational therapy eligibility for home health coverage under Medicare H.R. 7254 - Hearing Device Coverage Clarification Act - Rep. Fischbach, Michelle - excludes fully implanted active middle ear hearing devices from the hearing aid coverage exclusion under Medicare H.R. 7274 - Connecting Caregivers to Medicare Act of 2024 - Rep. Carey, Mike - outreach, education, and simplify information for family caregivers on Medicare benefits H.R. 7432 - Sickle Cell Disease Comprehensive Care Act - Rep. Burgess, Michael - enables State Medicaid programs to provide coordinated care through health home to individuals with sickle cell disease H.R. 7512 - Real-Time Benefit Tool Implementation Act - Rep. Arrington, Jodey - implementation of real-time benefit tools under part D of under Medicare H.R. 7573 - Stop Unfair Medicaid Recoveries Act - Rep. Schakowsky, Janice - Medicaid Estate Recovery Program H.R. 7619 - Expand the Behavioral Health Workforce Now Act - Rep. Neguse, Joe - education, training, recruitment, and retention of mental health and substance use disorder providers under Medicaid and CHIP H.R. 7623 - Telehealth Modernization Act of 2024 - Rep. Carter, Earl L. Buddy - makes certain telehealth flexibilities permanent under Medicare and adds requirements for Part D plan contracts with PBMs including reporting and delinking provisions H.R. 7856 - Promoting Responsible and Effective Virtual Experiences through Novel Technology to Deliver Improved Access and Better Engagement with Tested and Evidence-based Strategies Act (PREVENT DIABETES Act)- Rep. DeGette, Diana - Medicare, coverage, preventive care, chronic care H.R. 7863 - To require the Secretary of Health and Human Services to issue guidance on furnishing behavioral health services via telehealth to individuals with limited English proficiency under Medicare program. - Rep. Steel, Michelle - Medicare, behavioral health, telehealth, accessibility H.R. 7939 - Patient Access to Innovative New Technologies Act of 2024 - Rep. Carey, Mike - Medicare, quality, medical devices, coverage H.R. 7996 - Improving CARE for Youth Act - Rep. Dunn, Neal - allows for same-day billing for mental health services for youth Medicaid beneficiaries who are being seen for a primary care service H.R. 8018 - Alleviating Barriers for Caregivers Act- Rep. Cammack, Kat - review and simplify caregiver paperwork, CHIP, Medicare, Medicaid H.R. 8064 - Help Extend Auditory Relief Act of 2024- Rep. Cartwright, Matt - Medicare coverage of hearing aids H.R. 8075 - Improving Access to Home Dialysis Act of 2024- Rep. Miller, Carol - Medicare coverage of home dialysis H.R. 8115 - To amend title XIX of the Social Security Act to allow for the deferral or disallowance of portions of payments for certain managed care violations under Medicaid- Rep. Sarbanes, John - Medicaid managed care payment deferral H.R. 8261 - Preserving Telehealth, Hospital, and Ambulance Access Act- Rep. Schweikert, David - extend flexibilities and payment for Medicare H.R. 8702 - Improving Seniors Timely Access to Care Act - Rep. Mike Kelly - prior authorization, transparency, MA S. 838 - Improving Access to Mental Health Act - Sen. Stabenow, Debbie - mental health services in Medicare S. 948 - Healthy Moms and Babies Act - Sen. Grassley, Chuck - establishes programs and requirements to support maternal health services under Medicaid and CHIP S. 1002 - No UPCODE Act - Sen. Cassidy, Bill - modifies certain factors that are used to determine Medicare Advantage (MA) payments, particularly relating to health status and related data S. 2880 - Expanded Telehealth Access Act - Sen. Daines, Steve - Medicare payment for telehealth services S. 3573 - Medicare Advantage Supplemental Benefits Transparency Act- Sen. Warner, Mike - MA, data transparency, supplemental benefits S. 3578 - Protect Medicaid Act - Sen. Cassidy, Bill - prohibits federal payments under Medicaid for noncitizens, requires reporting to HHS of states that provide such health benefits S. 3630 - Medicare Transaction Fraud Prevention Act- Sen. Braun, Mike- pilot program for predictive risk-scoring algorithm, oversight, Medicare S. 3651 - Telemental Health Care Access Act of 2024- Sen. Cassidy, Bill - Medicare, mental health services, telehealth S. 3766 - Connecting Caregivers to Medicare Act of 2024- Sen. Tillis, Thomas - Medicare, outreach and education, caregivers S. 3882 - Helping States Integrate Medicare and Medicaid Act- Sen. Casey, Robert - dual eligibles, quality measures, access, enrollment S. 3934 - Increasing Access to Biosimilars Act of 2023- Sen. Cornyn, John - Medicare drug access S. 3950 - Delivering Unified Access to Lifesaving Services Act of 2024 - Sen. Cassidy, Bill - reforming Integrated Medicare/Medicaid Care Programs for Dually Eligible Individuals S. 4094 - PREVENT DIABETES Act - Sen. Scott, Tim - Medicare, coverage, preventive care, chronic care S. 4532 - Improving Seniors Timely Access to Care Act - Sen. Marshall, Roger - prior authorization, transparency, MA S. 4767 - Insurance Fraud Accountability Act - Sen. Wyden, Ron - reduces fraudulent enrollments in qualified health plans Issues related to mental health and Medicare; Medicare and Medicaid funding; Medicaid expansion; State innovation waivers; Medicaid and CHIP; Medicaid FMAP; Medicare Supplement Coverage; Medicare Transparency in Coverage; Medicaid Access Final Rule; Medicaid Redeterminations; Medicaid rate actuarial soundness; value of Medicaid Managed Care; Medicare Advantage Health Risk Assessment and chart reviews; Medicare Advantage supplemental benefits and Social Determinants of health; coverage of weight loss drugs; and Inflation Reduction Act implementation.

Client expense: $2,560,000 · 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

HR 8260 Hospital Inpatient Services Modernization Act H.R. 8235 the Rural Physician Workforce Preservation Act H.R. 8261, the Preserving Telehealth, Hospital, and Ambulance Access Act HR 3171/S. 3018 The Improving Seniors Timely Access to Care Act H.R. 1110, KEEP Telehealth Options Act of 2023 H.R. 3875, Expanded Telehealth Access Act H.R. 5541, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act H.R. 5611, Helping Ensure Access to Local TeleHealth (HEALTH) Act of 2023 H.R. 6033, Supporting Patient Education And Knowledge (SPEAK) Act of 2023 H.R. 7149, Equal Access to Specialty Care Everywhere (EASE) Act of 2024 H.R. 7623, The Telehealth Modernization Act of 2024 H.R. 7711, To amend title XVIII of the Social Security Act to make permanent certain telehealth flexibilities under the Medicare program H.R. 7858, Telehealth Enhancement for Mental Health Act of 2024 H.R. 7863, To require the Secretary of Health and Human Services to issue guidance on furnishing behavioral health services via telehealth to individuals with limited English proficiency under Medicare program H.R. 5386, Cutting Copays Act H.R. 5380, To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage H.R. 5372, Expanding Seniors Access to Lower Cost Medicines Act of 2023 S. 3059 the REAL Health Provider Act (Bennet, Tillis) S. 2973 Modernizing and Ensuring PBM Accountability Act H.R. 2880, the Protecting Patients Against PBM Abuses Act S.1002 - No UPCODE Act H.R. 3282, the Promoting Transparency and Healthy Competition in Medicare Act H.R. 3284, the Providers and Payers COMPETE Act H.R. 3237, To amend title XVIII of the Social Security Act to require each outpatient department of a provider to include a unique identification number on claims for services, and to require hospitals with an outpatient department of a provider to submit to the Centers for Medicare & Medicaid Services an attestation with respect to each outpatient department Legislation and regulation related to the Medicare Advantage program and Medicare/Medicaid coverage, care delivery and financing.

Client expense: $210,000 · Firm income: Not reported

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

Medicare Advantage coding and reimbursement issues. 2025 Medicare Advantage and Part D Rate Announcement. Medicare Special Needs Plans Access. Health care workforce issues. Health equity. Maternal health. Digital health and telehealth. S. 1002 - The No Unreasonable Payments, Coding, or Diagnoses for the Elderly Act of 2023. H.R. 5378 - Lower Cost, More Transparency Act. Issues related to Medicaid access and reimbursement. Medicaid directed payment programs. Medicare site neutral payments. FY 2025 Labor, Health & Human Services Appropriations.

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

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

H.R. 8235 the Rural Physician Workforce Preservation Act H.R. 8261, the Preserving Telehealth, Hospital, and Ambulance Access Act HR 3171/S. 3018 The Improving Seniors Timely Access to Care Act H.R. 1110, KEEP Telehealth Options Act of 2023 H.R. 3875, Expanded Telehealth Access Act H.R. 5541, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act H.R. 5611, Helping Ensure Access to Local TeleHealth (HEALTH) Act of 2023 H.R. 6033, Supporting Patient Education And Knowledge (SPEAK) Act of 2023 H.R. 7149, Equal Access to Specialty Care Everywhere (EASE) Act of 2024 H.R. 7623, The Telehealth Modernization Act of 2024 H.R. 7711, To amend title XVIII of the Social Security Act to make permanent certain telehealth flexibilities under the Medicare program H.R. 7858, Telehealth Enhancement for Mental Health Act of 2024 H.R. 7863, To require the Secretary of Health and Human Services to issue guidance on furnishing behavioral health services via telehealth to individuals with limited English proficiency under Medicare program H.R. 5386, Cutting Copays Act H.R. 5380, To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage H.R. 5372, Expanding Seniors Access to Lower Cost Medicines Act of 2023 S. 3059 the REAL Health Provider Act (Bennet, Tillis) S. 2973 Modernizing and Ensuring PBM Accountability Act H.R. 2880, the Protecting Patients Against PBM Abuses Act S.1002 - No UPCODE Act H.R. 3282, the Promoting Transparency and Healthy Competition in Medicare Act H.R. 3284, the Providers and Payers COMPETE Act H.R. 3237, To amend title XVIII of the Social Security Act to require each outpatient department of a provider to include a unique identification number on claims for services, and to require hospitals with an outpatient department of a provider to submit to the Centers for Medicare & Medicaid Services an attestation with respect to each outpatient department Legislation and regulation related to the Medicare Advantage program and Medicare/Medicaid coverage, care delivery and financing.

Client expense: $680,000 · Firm income: Not reported

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

Medicare Advantage coding and reimbursement issues. 2025 Medicare Advantage and Part D Rate Announcement. Health care workforce issues. Health equity. Maternal health. Digital health and telehealth. H.R. 3561 - PATIENT Act. S. 1002 - The No Unreasonable Payments, Coding, or Diagnoses for the Elderly Act of 2023. H.R. 5378 - Lower Cost, More Transparency Act. Issues related to Medicaid access and reimbursement. Medicaid directed payment programs. Medicare site neutral payments. FY 2025 Labor, Health & Human Services Appropriations.

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

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

Medicare Advantage, Risk Adjustment, Star Ratings, Health Equity Index, Change Healthcare Cyber attack, Prior Authorization, Medicaid Redeterminations, Site Neutral Payments, Social Determinants of Health Senate Finance Committee PBM Reform Framework H.R.5746 - Addressing Whole Health in Medicare Advantage Act - A bill To amend title XVIII of the Social Security Act to expand the availability of supplemental benefits to certain Medicare Advantage enrollees. S.1038/H.R.1613 - Drug Price Transparency in Medicaid Act - A bill to amend title XIX of the Social Security Act to improve transparency and prevent the use of abusive spread pricing and related practices in the Medicaid program. S. 1002 -- No UPCODE Act -- To amend title XVIII of the Social Security Act to improve risk adjustment under Medicare Advantage. Improving Seniors Timely Access to Care Act - to establish requirements with respect to the use of prior authorization under Medicare Advantage plans.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1110, KEEP Telehealth Options Act of 2023 H.R. 3875, Expanded Telehealth Access Act H.R. 5541, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act H.R. 5611, Helping Ensure Access to Local TeleHealth (HEALTH) Act of 2023 H.R. 6033, Supporting Patient Education And Knowledge (SPEAK) Act of 2023 H.R. 7149, Equal Access to Specialty Care Everywhere (EASE) Act of 2024 H.R. 7623, The Telehealth Modernization Act of 2024 H.R. 7711, To amend title XVIII of the Social Security Act to make permanent certain telehealth flexibilities under the Medicare program H.R. 7858, Telehealth Enhancement for Mental Health Act of 2024 H.R. 7863, To require the Secretary of Health and Human Services to issue guidance on furnishing behavioral health services via telehealth to individuals with limited English proficiency under Medicare program H.R. 5386, Cutting Copays Act H.R. 5380, To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage H.R. 5372, Expanding Seniors Access to Lower Cost Medicines Act of 2023 S. 3059 the REAL Health Provider Act (Bennet, Tillis) S. 2973 Modernizing and Ensuring PBM Accountability Act H.R. 2880, the Protecting Patients Against PBM Abuses Act S.1002 - No UPCODE Act H.R. 3282, the Promoting Transparency and Healthy Competition in Medicare Act H.R. 3284, the Providers and Payers COMPETE Act H.R. 3237, To amend title XVIII of the Social Security Act to require each outpatient department of a provider to include a unique identification number on claims for services, and to require hospitals with an outpatient department of a provider to submit to the Centers for Medicare & Medicaid Services an attestation with respect to each outpatient department Legislation and regulation related to the Medicare Advantage program and Medicare/Medicaid coverage, care delivery and financing.

Client expense: $140,000 · Firm income: Not reported

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

Medicare Advantage, Risk Adjustment, Star Ratings, Health Equity Index, Change Healthcare Cyber attack, Prior Authorization, Medicaid Redeterminations, Site Neutral Payments, Social Determinants of Health H.R.5746 - Addressing Whole Health in Medicare Advantage Act - A bill To amend title XVIII of the Social Security Act to expand the availability of supplemental benefits to certain Medicare Advantage enrollees. S.1038/H.R.1613 - Drug Price Transparency in Medicaid Act - A bill to amend title XIX of the Social Security Act to improve transparency and prevent the use of abusive spread pricing and related practices in the Medicaid program. S. 1002 -- No UPCODE Act -- To amend title XVIII of the Social Security Act to improve risk adjustment under Medicare Advantage.

Client expense: $150,000 · Firm income: Not reported

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

Medicare Advantage coding and reimbursement issues. 2025 Medicare Advantage and Part D Rate Announcement. Health care workforce issues. Health equity. Maternal health. Digital health and telehealth. H.R. 3561 - PATIENT Act. S. 1002 - The No Unreasonable Payments, Coding, or Diagnoses for the Elderly Act of 2023. H.R. 5378 - Lower Cost, More Transparency Act. Issues related to Medicaid access and reimbursement. Medicaid directed payment programs. PL 118-42/H.R. 4366 - Consolidated Appropriations Act, 2024. PL 118-47/H.R. 2882 - Consolidated Appropriations Act, 2024.

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

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

Provider Directories; Medicaid Redeterminations & renewals; Same-day billing restrictions in Medicaid; Medicare Advantage Health Equity Index; Star Ratings in Medicare Advantage; Payment under the Informal Dispute Resolution (IDR) process; Medicare Advantage; Transitional Coverage of Emerging Technologies (TCET); Site Neutral Payments and Payment Accuracy; MA RADV Rule; Medicare Advantage Advance Rate Notice; H.R.5746 - Addressing Whole Health in Medicare Advantage Act To amend title XVIII of the Social Security Act to expand the availability of supplemental benefits to certain Medicare Advantage enrollees. Sponsor: Rep. Bilirakis, Gus M. [R-FL-12] H.R.5386 - Cutting Copays Act To amend title XVIII of the Social Security Act to provide for adjustments to the Medicare part D cost-sharing reductions for low-income individuals. Sponsor: Rep. McGarvey, Morgan [D-KY-3] H.R.5380 - To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage. To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage. Sponsor: Rep. Sarbanes, John P. [D-MD-3] H.R.2880 - Protecting Patients Against PBM Abuses Act To amend title XVIII of the Social Security Act to establish certain requirements for pharmacy benefit managers under part D of the Medicare program. Sponsor: Rep. Carter, Earl L. "Buddy" [R-GA-1] H.R.5385 - Medicare PBM Accountability Act To amend title XVIII of the Social Security Act to establish pharmacy benefit manager reporting requirements with respect to prescription drug plans and MA-PD plans under Medicare part D. Sponsor:Rep. Landsman, Greg [D-OH-1] S.2556 - Improving CARE for Youth Act To amend title XIX of the Social Security Act to ensure Medicaid coverage of mental health services and primary care services furnished on the same day. Sponsor: Sen. Carper, Thomas R. [D-DE] S.1002 - No UPCODE Act To amend title XVIII of the Social Security Act to improve risk adjustment under Medicare Advantage. Sponsor: Sen. Cassidy, Bill [R-LA] H.R.5388 - Supporting Innovation for Seniors Act To amend title XVIII of the Social Security Act to provide coverage of certain technologies and medical devices under the Medicare program. Sponsor: Rep. Balderson, Troy [R-OH-12] H.R.5393 - To amend title XVIII of the Social Security Act to ensure fair assessment of pharmacy performance and quality under Medicare part D, and for other purposes. To amend title XVIII of the Social Security Act to ensure fair assessment of pharmacy performance and quality under Medicare part D, and for other purposes. Sponsor: Rep. Griffith, H. Morgan [R-VA-9] H.R.4881 - To amend title XVIII of the Social Security Act to limit cost sharing for drugs under the Medicare program. To amend title XVIII of the Social Security Act to limit cost sharing for drugs under the Medicare program. Sponsor: Rep. Malliotakis, Nicole [R-NY-11] H.R.5396 - Coverage Determination Clarity Act of 2023 To amend title XVIII of the Social Security Act to prohibit Medicare local coverage determinations from restricting access to care, and for other purposes. Sponsor: Rep. Bucshon, Larry [R-IN-8] H.R.6364 - Medicare Telehealth Privacy Act of 2023 To amend title XVIII of the Social Security Act to maintain certain telehealth flexibilities relating to provider privacy under the Medicare program. Sponsor: Rep. Balderson, Troy [R-OH-12] S.2973 - Modernizing and Ensuring PBM Accountability Act To amend titles XVIII and XIX of the Social Security Act to establish requirements relating to pharmacy benefit managers under the Medicare and Medicaid programs, and for other purposes. Sponsor: Sen. Wyden, Ron [D-OR]

Client expense: $1,800,000 · Firm income: Not reported

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

H.R. 5386, Cutting Copays Act H.R. 5380, To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage H.R. 5372, Expanding Seniors Access to Lower Cost Medicines Act of 2023 S. 3059 the REAL Health Provider Act (Bennet, Tillis) S. 2973 Modernizing and Ensuring PBM Accountability Act H.R. 2880, the Protecting Patients Against PBM Abuses Act S.1002 - No UPCODE Act H.R. 3282, the Promoting Transparency and Healthy Competition in Medicare Act H.R. 3284, the Providers and Payers COMPETE Act H.R. 3237, To amend title XVIII of the Social Security Act to require each outpatient department of a provider to include a unique identification number on claims for services, and to require hospitals with an outpatient department of a provider to submit to the Centers for Medicare & Medicaid Services an attestation with respect to each outpatient department Legislation and regulation related to the Medicare Advantage program and Medicare/Medicaid coverage, care delivery and financing.

Client expense: $1,640,000 · Firm income: Not reported

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

Provider Directories; Medicaid Redeterminations & renewals; Same-day billing restrictions in Medicaid; Medicare Advantage Health Equity Index; Star Ratings in Medicare Advantage; Payment under the Informal Dispute Resolution (IDR) process; Medicare Advantage; Transitional Coverage of Emerging Technologies (TCET); Site Neutral Payments and Payment Accuracy; MA RADY Rule; Medicare Advantage Advance Rate Notice; H.R.5746 -Addressing Whole Health in Medicare Advantage Act To amend title XVIII of the Social Security Act to expand the availability of supplemental benefits to certain Medicare Advantage enrollees. Sponsor: Rep. Bilirakis, Gus M. [R-FL-12] H.R.5386 - Cutting Copays Act To amend title XVIII of the Social Security Act to provide for adjustments to the Medicare part D cost-sharing reductions for low-income individuals. Sponsor: Rep. McGarvey, Morgan [D-KY-3] H.R.5380 - To amend title XVlll of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage. To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage. Sponsor: Rep. Sarbanes, John P. [D-MD-3] H.R.2880 - Protecting Patients Against PBM Abuses Act To amend title XVIII of the Social Security Act to establish certain requirements for pharmacy benefit managers under part D of the Medicare program. Sponsor: Rep. Carter, Earl L. "Buddy" [R-GA-1] H.R.5385 - Medicare PBM Accountability Act To amend title XVIII of the Social Security Act to establish pharmacy benefit manager reporting requirements with respect to prescription drug plans and MA-PD plans under Medicare part D. Sponsor:Rep. Landsman, Greg [D-OH-1] S.2556 - Improving CARE for Youth Act To amend title XIX of the Social Security Act to ensure Medicaid coverage of mental health services and primary care services furnished on the same day. Sponsor: Sen. Carper, Thomas R. [D-DE] S.1002 -No UPCODEAct To amend title XVIII of the Social Security Act to improve risk adjustment under Medicare Advantage. Sponsor: Sen. Cassidy, Bill [R-LA] H.R.5388 - Supporting Innovation for Seniors Act To amend title XVIII of the Social Security Act to provide coverage of certain technologies and medical devices under the Medicare program. Sponsor: Rep. Balderson, Troy [R-OH-12] H.R.4881 - To amend title XVIII of the Social Security Act to limit cost sharing for drugs under the Medicare program. To amend title XVIII of the Social Security Act to limit cost sharing for drugs under the Medicare program. Sponsor: Rep. Malliotakis, Nicole [R-NY-11] H.R.6364 - Medicare Telehealth Privacy Act of2023 To amend title XVIII of the Social Security Act to maintain certain telehealth flexibilities relating to provider privacy under the Medicare program. Sponsor: Rep. Balderson, Troy [R-OH-12] S.2973 - Modernizing and Ensuring PBM Accountability Act To amend titles XVIII and XIX of the Social Security Act to establish requirements relating to pharmacy benefit managers under the Medicare and Medicaid programs, and for other purposes. Sponsor: Sen. Wyden, Ron [D-OR]

Client expense: $269,075 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Advantage, Risk Adjustment, Star Ratings, Health Equity Index, Prior Authorization, Medicaid Redeterminations, Site Neutral Payments, Social Determinants of Health Senate Finance Committee PBM Reform Framework H.R.5746 - Addressing Whole Health in Medicare Advantage Act - A bill To amend title XVIII of the Social Security Act to expand the availability of supplemental benefits to certain Medicare Advantage enrollees. S.1038/H.R.1613 - Drug Price Transparency in Medicaid Act - A bill to amend title XIX of the Social Security Act to improve transparency and prevent the use of abusive spread pricing and related practices in the Medicaid program. S. 1002 -- No UPCODE Act -- To amend title XVIII of the Social Security Act to improve risk adjustment under Medicare Advantage.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Advantage coding and reimbursement issues. 2024 Medicare Advantage and Part D Rate Announcement. Health care workforce issues. Health equity. Maternal health. Digital health and telehealth. H.R. 3561 - PATIENT Act. S. 1002 - The No Unreasonable Payments, Coding, or Diagnoses for the Elderly Act of 2023. H.R. 5378 - Lower Cost, More Transparency Act. Issues related to Medicaid access and reimbursement. Medicaid directed payment programs.

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

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

Provider Directories; Medicaid Redeterminations; Draft Duals Legislation; IRA Copay Smoothing; MA Health Equity Index HR 2880 (118th Congress), Protecting Patients Against PBM Abuses Act, by Rep. Earl Carter (R-GA). To amend title XVIII of the Social Security Act to establish certain requirements for pharmacy benefit managers under Part D of the Medicare program. HR 4881 (118th Congress), by Rep. Nicole Malliotakis (R-NY). To amend title XVIII of the Social Security Act to limit cost sharing for drugs under the Medicare program. HR 5380 (118th Congress), by Rep. John Sarbanes (D-MD). To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage. HR 5385 (118th Congress), Medicare PBM Accountability Act, by Rep. Greg Landsman (D-OH). To amend title XVIII of the Social Security Act to establish pharmacy benefit manager reporting requirements with respect to prescription drug plans and MA-PD plans under Medicare Part D. HR 5386 (118th Congress), Cutting Copays Act, by Rep. Morgan McGarvey (D-KY). To amend title XVIII of the Social Security Act to provide for adjustments to the Medicare Part D cost-sharing reductions for low-income individuals. HR 5388 (118th Congress), Supporting Innovation for Seniors Act, by Rep. Troy Balderson (R-OH). To amend title XVIII of the Social Security Act to provide coverage of certain technologies and medical devices under the Medicare program. HR 5393 (118th Congress), by Rep. Morgan Griffith (R-VA). To amend title XVIII of the Social Security Act to ensure fair assessment of pharmacy performance and quality under Medicare Part D. HR 5396 (118th Congress), Coverage Determination Clarity Act of 2023, by Rep. Larry Bucshon (R-IN). To amend title XVIII of the Social Security Act to prohibit Medicare local coverage determinations from restricting access to care. H.R.5746 (118th Congress), Addressing Whole Health in Medicare Advantage Act, by Rep. Gus Bilirakis (R-FL). To amend title XVIII of the Social Security Act to expand the availability of supplemental benefits to certain Medicare Advantage enrollees. HR 6364 (118th Congress), Medicare Telehealth Privacy Act of 2023, by Rep. Troy Balderson (R-OH). To amend title XVIII of the Social Security Act to maintain certain telehealth flexibilities relating to provider privacy under the Medicare program. S 1002 (118th Congress), No UPCODE Act, by Sen. Bill Cassidy (R-LA). To amend title XVIII of the Social Security Act to improve risk adjustment under Medicare Advantage. S 2973 (118th Congress), Modernizing and Ensuring PBM Accountability Act, by Sen. Ron Wyden (D-OR). To amend titles XVIII and XIX of the Social Security Act to establish requirements relating to pharmacy benefit managers under the Medicare and Medicaid programs.

Client expense: $10,000 · Firm income: Not reported

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

Provider Directories; Medicaid Redeterminations and Renewals; MA Health Equity Index; MA Star Ratings; Site Neutral Payments and Payment Accuracy; MA RADV Rule, MA Advance Rate Notice HR 2880 (118th Congress), Protecting Patients Against PBM Abuses Act, by Rep. Earl Carter (R-GA). To amend title XVIII of the Social Security Act to establish certain requirements for pharmacy benefit managers under Part D of the Medicare program. HR 4881 (118th Congress), by Rep. Nicole Malliotakis (R-NY). To amend title XVIII of the Social Security Act to limit cost sharing for drugs under the Medicare program. HR 5380 (118th Congress), by Rep. John Sarbanes (D-MD). To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage. HR 5385 (118th Congress), Medicare PBM Accountability Act, by Rep. Greg Landsman (D-OH). To amend title XVIII of the Social Security Act to establish pharmacy benefit manager reporting requirements with respect to prescription drug plans and MA-PD plans under Medicare Part D. HR 5386 (118th Congress), Cutting Copays Act, by Rep. Morgan McGarvey (D-KY). To amend title XVIII of the Social Security Act to provide for adjustments to the Medicare Part D cost-sharing reductions for low-income individuals. HR 5388 (118th Congress), Supporting Innovation for Seniors Act, by Rep. Troy Balderson (R-OH). To amend title XVIII of the Social Security Act to provide coverage of certain technologies and medical devices under the Medicare program. HR 5393 (118th Congress), by Rep. Morgan Griffith (R-VA). To amend title XVIII of the Social Security Act to ensure fair assessment of pharmacy performance and quality under Medicare Part D. HR 5396 (118th Congress), Coverage Determination Clarity Act of 2023, by Rep. Larry Bucshon (R-IN). To amend title XVIII of the Social Security Act to prohibit Medicare local coverage determinations from restricting access to care. H.R.5746 (118th Congress), Addressing Whole Health in Medicare Advantage Act, by Rep. Gus Bilirakis (R-FL). To amend title XVIII of the Social Security Act to expand the availability of supplemental benefits to certain Medicare Advantage enrollees. HR 6364 (118th Congress), Medicare Telehealth Privacy Act of 2023, by Rep. Troy Balderson (R-OH). To amend title XVIII of the Social Security Act to maintain certain telehealth flexibilities relating to provider privacy under the Medicare program. S 1002 (118th Congress), No UPCODE Act, by Sen. Bill Cassidy (R-LA). To amend title XVIII of the Social Security Act to improve risk adjustment under Medicare Advantage. S 2973 (118th Congress), Modernizing and Ensuring PBM Accountability Act, by Sen. Ron Wyden (D-OR). To amend titles XVIII and XIX of the Social Security Act to establish requirements relating to pharmacy benefit managers under the Medicare and Medicaid programs.

Client expense: $150,000 · Firm income: Not reported

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

Health Care Workforce Programs and Policies. H.R. 3281, the Transparent PRICE Act. All Provisions. H.R. 2666, the Medicaid VBPs for Patients (MVP) Act. All Provisions. H.R. 3284, the Providers and Payers COMPETE Act. All Provisions. H.R. 3290, To amend title III of the Public Health Service Act. All Provisions. H.R. 3237 - Requiring a Separate Identification Number and an Attestation for Each Off-Campus Outpatient Department of a Provider. All Provisions. H.R. 3262 - Mandatory Reporting with Respect to Certain Health-Related Ownership Information. All Provisions. H.R. 3248 - The Diagnostic Lab Testing Transparency Act. All Provisions H.R. 3282 - The Promoting Transparency and Healthy Competition in Medicare Act. All Provisions H.R. 2679 - The PBM Accountability Act. All Provisions. H.R. 2559 - The Strengthening Community Care Act of 2023. All Provisions. H.R. 2550 - The Special Diabetes Program Reauthorization Act of 2023. All Provisions H.R. 2547 - The Special Diabetes Program for Indians Reauthorization Act of 2023. All Provisions. H.R. 2665 - The Supporting Safety Net Hospitals Act. All Provisions. H.R. 1613 - The Drug Price Transparency in Medicaid Act of 2023. All Provisions. S. 1002, No Unreasonable Payments, Coding, or Diagnoses for Elderly (No UPCODE Act). All Provisions. S. 1182 - 340B - To amend the Public Health Service Act to increase the transparency and accountability of the drug discount program, and for other purposes. All Provisions. S.1403 Medical Student Authorization Act of 2023. All Provisions. S.2840 Bipartisan Primary Care and Health Workforce Act. All Provisions. H.R. 5378 Lower Cost, More Transparency Act. All Provisions. Potential Grants and Procurement Programs Related to U.S. based manufacturing of Personal Protective Equipment (PPE).

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

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

CMS'CY 2024 Advance Notice of Methodological Changes for Medicare Capitation Rates for Part C and Part D Payment Policies. Issues surrounding changes to risk adjustment mechanisms. Nomination of Chief Executive Officer for appointment to the Medicaid and CHIP Payment and Access Commission H.R. 3281, the Transparent PRICE Act. All Provisions. H.R. 2666, the Medicaid VBPs for Patients (MVP) Act. All Provisions. H.R. 3284, the Providers and Payers COMPETE Act. All Provisions. H.R. 3290, To amend title III of the Public Health Service Act. All Provisions. H.R. 3237 - Requiring a Separate Identification Number and an Attestation for Each Off-Campus Outpatient Department of a Provider. All Provisions. H.R. 3262 - Mandatory Reporting with Respect to Certain Health-Related Ownership Information. All Provisions. H.R. 3248 - The Diagnostic Lab Testing Transparency Act. All Provisions H.R. 3282 - The Promoting Transparency and Healthy Competition in Medicare Act. All Provisions H.R. 2679 - The PBM Accountability Act. All Provisions. H.R. 2559 - The Strengthening Community Care Act of 2023. All Provisions. H.R. 2550 - The Special Diabetes Program Reauthorization Act of 2023. All Provisions H.R. 2547 - The Special Diabetes Program for Indians Reauthorization Act of 2023. All Provisions. H.R. 2665 - The Supporting Safety Net Hospitals Act. All Provisions. H.R. 1613 - The Drug Price Transparency in Medicaid Act of 2023. All Provisions. S. 1002, No Unreasonable Payments, Coding, or Diagnoses for Elderly (No UPCODE Act). All Provisions. S. 1182 - 340B - To amend the Public Health Service Act to increase the transparency and accountability of the drug discount program, and for other purposes. All Provisions. H.R. 5378 Lower Cost, More Transparency Act. All Provisions. H.R. 5013 Value in Health Care Act of 2023. All Provisions. Medicaid Supplemental Payment Technical Assistance

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

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

S. 2973 Modernizing and Ensuring PBM Accountability Act H.R. 2880, the Protecting Patients Against PBM Abuses Act S.1002 - No UPCODE Act H.R. 3282, the Promoting Transparency and Healthy Competition in Medicare Act H.R. 3284, the Providers and Payers COMPETE Act H.R. 3237, To amend title XVIII of the Social Security Act to require each outpatient department of a provider to include a unique identification number on claims for services, and to require hospitals with an outpatient department of a provider to submit to the Centers for Medicare & Medicaid Services an attestation with respect to each outpatient department Legislation and regulation related to the Medicare Advantage program and Medicare/Medicaid coverage, care delivery and financing.

Client expense: $790,000 · Firm income: Not reported

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

Medicare Advantage Rate Notice, Risk Adjustment, Star Ratings, Prior Authorization in Medicare Advantage, Medicaid Redeterminations, Site Neutral Payments, Social Determinants of Health H.R.5746 - Addressing Whole Health in Medicare Advantage Act - A bill To amend title XVIII of the Social Security Act to expand the availability of supplemental benefits to certain Medicare Advantage enrollees. S.1038/H.R.1613 - Drug Price Transparency in Medicaid Act - A bill to amend title XIX of the Social Security Act to improve transparency and prevent the use of abusive spread pricing and related practices in the Medicaid program. S. 1002 -- No UPCODE Act -- To amend title XVIII of the Social Security Act to improve risk adjustment under Medicare Advantage.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Advantage coding and reimbursement issues. 2024 Medicare Advantage and Part D Rate Announcement. Health care workforce issues. Health equity. Maternal health. Digital health and telehealth. H.R. 3561 - PATIENT Act. S. 1002 - The No Unreasonable Payments, Coding, or Diagnoses for the Elderly Act of 2023. H.R. 5378 - Lower Cost, More Transparency Act. Issues related to Medicaid access and reimbursement.

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

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

CMS'CY 2024 Advance Notice of Methodological Changes for Medicare Capitation Rates for Part C and Part D Payment Policies. Issues surrounding changes to risk adjustment mechanisms. Nomination of Chief Executive Officer for appointment to the Medicaid and CHIP Payment and Access Commission H.R. 3281, the Transparent PRICE Act. All Provisions. H.R. 2666, the Medicaid VBPs for Patients (MVP) Act. All Provisions. H.R. 3284, the Providers and Payers COMPETE Act. All Provisions. H.R. 3290, To amend title III of the Public Health Service Act. All Provisions. H.R. 3237 - Requiring a Separate Identification Number and an Attestation for Each Off-Campus Outpatient Department of a Provider. All Provisions. H.R. 3262 - Mandatory Reporting with Respect to Certain Health-Related Ownership Information. All Provisions. H.R. 3248 - The Diagnostic Lab Testing Transparency Act. All Provisions H.R. 3282 - The Promoting Transparency and Healthy Competition in Medicare Act. All Provisions H.R. 2679 - The PBM Accountability Act. All Provisions. H.R. 2559 - The Strengthening Community Care Act of 2023. All Provisions. H.R. 2550 - The Special Diabetes Program Reauthorization Act of 2023. All Provisions H.R. 2547 - The Special Diabetes Program for Indians Reauthorization Act of 2023. All Provisions. H.R. 2665 - The Supporting Safety Net Hospitals Act. All Provisions. H.R. 1613 - The Drug Price Transparency in Medicaid Act of 2023. All Provisions. S. 1002, No Unreasonable Payments, Coding, or Diagnoses for Elderly (No UPCODE Act). All Provisions. S. 1182 - 340B - To amend the Public Health Service Act to increase the transparency and accountability of the drug discount program, and for other purposes. All Provisions. H.R. 5378 Lower Cost, More Transparency Act. All Provisions. H.R. 5013 Value in Health Care Act of 2023. All Provisions.

Client expense: $175,000 · Firm income: Not reported

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

Health Care Workforce Programs and Policies. H.R. 3281, the Transparent PRICE Act. All Provisions. H.R. 2666, the Medicaid VBPs for Patients (MVP) Act. All Provisions. H.R. 3284, the Providers and Payers COMPETE Act. All Provisions. H.R. 3290, To amend title III of the Public Health Service Act. All Provisions. H.R. 3237 - Requiring a Separate Identification Number and an Attestation for Each Off-Campus Outpatient Department of a Provider. All Provisions. H.R. 3262 - Mandatory Reporting with Respect to Certain Health-Related Ownership Information. All Provisions. H.R. 3248 - The Diagnostic Lab Testing Transparency Act. All Provisions H.R. 3282 - The Promoting Transparency and Healthy Competition in Medicare Act. All Provisions H.R. 2679 - The PBM Accountability Act. All Provisions. H.R. 2559 - The Strengthening Community Care Act of 2023. All Provisions. H.R. 2550 - The Special Diabetes Program Reauthorization Act of 2023. All Provisions H.R. 2547 - The Special Diabetes Program for Indians Reauthorization Act of 2023. All Provisions. H.R. 2665 - The Supporting Safety Net Hospitals Act. All Provisions. H.R. 1613 - The Drug Price Transparency in Medicaid Act of 2023. All Provisions. S. 1002, No Unreasonable Payments, Coding, or Diagnoses for Elderly (No UPCODE Act). All Provisions. S. 1182 - 340B - To amend the Public Health Service Act to increase the transparency and accountability of the drug discount program, and for other purposes. All Provisions. S.1403 Medical Student Authorization Act of 2023. All Provisions. S.2840 Bipartisan Primary Care and Health Workforce Act. All Provisions. H.R. 5378 Lower Cost, More Transparency Act. All Provisions.

Client expense: $175,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.1002 - No UPCODE Act H.R. 3282, the Promoting Transparency and Healthy Competition in Medicare Act H.R. 3284, the Providers and Payers COMPETE Act H.R. 3237, To amend title XVIII of the Social Security Act to require each outpatient department of a provider to include a unique identification number on claims for services, and to require hospitals with an outpatient department of a provider to submit to the Centers for Medicare & Medicaid Services an attestation with respect to each outpatient department Legislation and regulation related to the Medicare Advantage program and Medicare/Medicaid coverage, care delivery and financing.

Client expense: $760,000 · Firm income: Not reported

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

Medicare Advantage Rate Notice, Risk Adjustment, Star Ratings, Prior Authorization in Medicare Advantage, Medicaid Redeterminations, Site Neutral Payments, Social Determinants of Health S. 1002 -- No UPCODE Act -- To amend title XVIII of the Social Security Act to improve risk adjustment under Medicare Advantage.

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

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

Medicare Advantage coding and reimbursement issues. 2024 Medicare Advantage and Part D Rate Announcement. Health care workforce issues. Health equity. Maternal health. Digital health and telehealth. Site Neutral Payment issues. H.R. 3561 - PATIENT Act. S. 1002 -The No Unreasonable Payments, Coding, or Diagnoses for the Elderly Act of 2023.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3746, Fiscal Responsibility Act of 2023, including provisions related to Medicaid. S. 1002, No Unreasonable Payments, Coding, Or Diagnoses for the Elderly (No UPCODE) Act, including provisions that would alter MA payment model by requiring the use of two years of diagnostic data instead of one year in calculating health status data, excluding the ability of plans to solely use chart reviews and health risk assessments in calculating adjustments in payment based on health status, and evaluating the coding intensity at the plan or contract level and making adjustments to make it more in-line with the coding intensity for FFS. Issues related to implications of the Medicare Advantage rate notice and proposed alternatives. Issues related to the status of state-based Medicaid redetermination process. Issues related to Medicaid Redetermination unwinding process. Issues related to Medicare Advantage and staying connected on impact info on the new MA risk adjustment model.

Client expense: $1,210,000 · Firm income: Not reported

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

CMS'CY 2024 Advance Notice of Methodological Changes for Medicare Capitation Rates for Part C and Part D Payment Policies. Issues surrounding changes to risk adjustment mechanisms. Nomination of Chief Executive Officer for appointment to the Medicaid and CHIP Payment and Access Commission H.R. 3281, the Transparent PRICE Act. All Provisions. H.R. 2666, the Medicaid VBPs for Patients (MVP) Act. All Provisions. H.R. 3284, the Providers and Payers COMPETE Act. All Provisions. H.R. 3290, To amend title III of the Public Health Service Act. All Provisions. H.R. 3237 - Requiring a Separate Identification Number and an Attestation for Each Off-Campus Outpatient Department of a Provider. All Provisions. H.R. 3262 - Mandatory Reporting with Respect to Certain Health-Related Ownership Information. All Provisions. H.R. 3248 - The Diagnostic Lab Testing Transparency Act. All Provisions H.R. 3282 - The Promoting Transparency and Healthy Competition in Medicare Act. All Provisions H.R. 2679 - The PBM Accountability Act. All Provisions. H.R. 2559 - The Strengthening Community Care Act of 2023. All Provisions. H.R. 2550 - The Special Diabetes Program Reauthorization Act of 2023. All Provisions H.R. 2547 - The Special Diabetes Program for Indians Reauthorization Act of 2023. All Provisions. H.R. 2665 - The Supporting Safety Net Hospitals Act. All Provisions. H.R. 1613 - The Drug Price Transparency in Medicaid Act of 2023. All Provisions. S. 1002, No Unreasonable Payments, Coding, or Diagnoses for Elderly (No UPCODE Act). All Provisions. S. 1182 - 340B - To amend the Public Health Service Act to increase the transparency and accountability of the drug discount program, and for other purposes. All Provisions.

Client expense: $175,000 · Firm income: Not reported

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

Health Care Workforce Programs and Policies. H.R. 3281, the Transparent PRICE Act. All Provisions. H.R. 2666, the Medicaid VBPs for Patients (MVP) Act. All Provisions. H.R. 3284, the Providers and Payers COMPETE Act. All Provisions. H.R. 3290, To amend title III of the Public Health Service Act. All Provisions. H.R. 3237 - Requiring a Separate Identification Number and an Attestation for Each Off-Campus Outpatient Department of a Provider. All Provisions. H.R. 3262 - Mandatory Reporting with Respect to Certain Health-Related Ownership Information. All Provisions. H.R. 3248 - The Diagnostic Lab Testing Transparency Act. All Provisions H.R. 3282 - The Promoting Transparency and Healthy Competition in Medicare Act. All Provisions H.R. 2679 - The PBM Accountability Act. All Provisions. H.R. 2559 - The Strengthening Community Care Act of 2023. All Provisions. H.R. 2550 - The Special Diabetes Program Reauthorization Act of 2023. All Provisions H.R. 2547 - The Special Diabetes Program for Indians Reauthorization Act of 2023. All Provisions. H.R. 2665 - The Supporting Safety Net Hospitals Act. All Provisions. H.R. 1613 - The Drug Price Transparency in Medicaid Act of 2023. All Provisions. S. 1002, No Unreasonable Payments, Coding, or Diagnoses for Elderly (No UPCODE Act). All Provisions. S. 1182 - 340B - To amend the Public Health Service Act to increase the transparency and accountability of the drug discount program, and for other purposes. All Provisions.

Client expense: $175,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Advantage Rate Notice, Risk Adjustment, Star Ratings, Medicare Advantage RADV Rule, Prior Authorization in Medicare Advantage, Medicaid Redeterminations, Site Neutral Payments, Social Determinants of Health S. 1002 -- No UPCODE Act A bill to amend title XVIII of the Social Security Act to improve risk adjustment under Medicare Advantage.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE