Insurance Fraud Accountability Act

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

H.R. 4818 - Treat and Reduce Obesity Act - Rep. Wenstrup, Brad - weight loss coverage H.R. 6860 - Restore Protections for Dialysis Patients Act - Rep. Kelly, Mike - ESRD coverage H.R. 8084 - Leveraging Integrity and Verification of Eligibility for Beneficiaries Act - Rep. Bilirakis, Gus - eligibility criteria verification S. 655 - Chronic Disease Management Act of 2023 - Sen. Thune, John - increase the flexibility of HSA-HDHPs to cover chronic disease services on pre-deductible basis S. 1001 - Telehealth Expansion Act of 2023 - Sen. Daines, Steve - exemption of high deductible health plans from the requirement of a deductible for telehealth and other remote care services S. 2407 - Treat and Reduce Obesity Act - Sen. Carper, Tom - weight loss coverage S. 2771 - Increasing Access to Dental Insurance Act - Sen. Hassan, Maggie - permits individuals to enroll in a dental benefits plan on a health insurance exchange without also enrolling in a qualified health plan S. 4445 - Right to IVF Act- Sen. Duckworth, Tammy - protecting right to fertility treatment S. 4767 - Insurance Fraud Accountability Act - Sen. Wyden, Ron - reduces fraudulent enrollments in qualified health plans S. 5218 - Health Infrastructure Security and Accountability Act of 2024 - Sen. Wyden, Ron - cyber security standards Issues related to implementation rule implementing the No Suprises Act prohibiting surprise medical bills; parity in mental health benefits; ERISA preemption; paperless delivery for health plan disclosures; Unauthorized Enrollments/Unauthorized Plan Switching; ACA Tax Credits (Inflation Reduction Act); pending rulemaking related to insurance requirements under the Mental Health Parity and Addiction Equity Act; final rule on Section 1557 of the ACA and its impact on Medigap plans; ACA Marketplace Enrollment and Agents and Brokers; Vaccine Coverage; Preventative Services Coverage; the Advanced Explanation of Benefits; and coverage of weight loss drugs.

S.8 - Improving Health Insurance Affordability Act of 2023 H.R.1692 - Health Care Affordability Act of 2023 S.4767 - Insurance Fraud Accountability Act S.4684 - Bridge to Medicaid Act of 2024

Client expense: $40,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues relating to Third Party Marketing Organizations Issues relating to The Patient Protection and Affordable Care Act Issues relating to Healthcare.gov and Medicare.gov under the Labor/HHS Appropriations Act Issues related to efficient online and telephonic enrollment into Medicare Advantage and Medicare Prescription Drug Plans Issues related to Medicare Advantage and Part D Plan broker compensation Issues related to lead generation policies Issues relating to the Telephone Consumer Protection Act regarding lead generation for health plan coverage Issues related to the CHOICE Arrangement Act - HR 3799 Issues pertaining to short-term limited duration plans Issues relating to S. 4767, Insurance Fraud Accountability Act

Client expense: $110,000 · Firm income: Not reported

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

Affordable Care Act--extending enhanced APTCs (H.R. 9774) and unauthorized enrollments in Marketplace plans (S. 4767), Affordability (H.R. 3589), Behavioral Health, Health Equity, Maternal Health, Surprise Billing, Health IT, Cybersecurity, Interoperability, Value-Based Care, Health Care Innovation, Telehealth-extending flexibilities, Transparency & PBMs (S. 127, S. 1339, S. 3430, H.R. 3651, H.R. 4507, H.R. 4508, H.R. 4509, H.R. 4527, H.R. 4822, H.R. 5378), Provider Directories (S. 3430, Sec. 109), Prescription Drugs (S. 150, S. 1067, S. 1114, S. 2305)

Client expense: $660,000 · Firm income: Not reported

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