Legislative Progress
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vs 5,674 other S bills in the 119th — cohort avg 32d
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Read twice and referred to the Committee on Finance.
Introduced in Senate
Bills with similar content found using semantic analysis.
Sources: Congress.gov
2026 · third_quarter · Medicare/Medicaid
Draft, Medicare Compare Website (no bill number) - Rep. Guthrie, Brett - improvements to CMS' Medicare compare website Draft, HELP STATES Act (no bill number) - Rep. Kean, Tom - Medicaid fraud and program integrity H.R. 1 - One Big Beautiful Bill Act - Rep. Arrington, Jodey - Medicaid eligibility and state financing, Marketplace coverage and enrollment, Health Savings Account expansion, Pharmacy Benefit Manager financing and regulation H.R. 497 - Medicaid Third Party Liability Act - Rep. Crenshaw, Dan - Medicaid liable third-party exceptions H.R. 584 - No Medicaid for Illegal Immigrants Act - Rep. Kiley, Kevin - Medicaid eligibility requirements H.R. 610 - Close the Medigap Act - Rep. Doggett, Lloyd - Medigap plan reform H.R. 879 - Medicare Patient Access and Practice Stabilization Act - Rep. Murphy, Gregory - Medicare physician reimbursement H.R. 1019 - Medicaid Program Improvement Act - Rep. Miller-Meeks, Mariannette - Medicaid management care reporting H.R. 1059 - Jobs and Opportunities for Medicaid Act - Rep. Crenshaw, Dan - Medicaid eligibility requirements H.R. 1162 - Medicaid Primary Care Improvement Act - Rep. Crenshaw, Dan - Medicaid direct primary care arrangements H.R. 1195 - Protect Medicaid Act - Rep. Hudson, Richard - Medicaid eligibility requirements H.R. 1279 - To amend title XIX of the Social Security Act to establish a community engagement requirement for certain individuals under the Medicaid program. - Rep. Bean, Aaron - Medicaid eligibility requirements H.R. 1403 - LIVE Beneficiaries Act - Rep. Bilirakis, Gus - Medicaid registration audits H.R. 1598 - Ensuring Access to Medicaid Buy-in Programs Act - Rep. Ciscomani, Juan - Medicaid eligibility requirements H.R. 1924 - Securing Access to Care for Seniors in Critical Condition Act - Rep. Hern, Kevin - Medicare site-neutral payments for LTC hospitals H.R. 2045 - Medicare Dental, Vision, and Hearing Benefit Act - Rep. Doggett, Lloyd - Medicare dental, vision, and hearing coverage H.R. 2263 - Telehealth Coverage Act - Rep. Khanna, Ro - Telehealth flexibilities in Medicare H.R. 2309 - Medicare and Medicaid Fraud Prevention Act - Rep. Peters, Scott - provider screening for Federal programs H.R. 2433 - Reducing Medically Unnecessary Delays in Care Act - Rep. Green, Mark - Medicare Advantage prior authorization H.R. 2586 - Reentry Act - Rep. Tonko, Paul - Medicaid coverage for incarcerated population H.R. 2610 - Protecting Options for Seniors Act - Rep. Tenney, Claudia - MA wage index reclassification H.R. 3023 - Preventing Hospital Overbilling of Medicare Act - Rep. Spartz, Victoria - Site-neutral payment reform H.R. 3069 - Medicare for All Act - Rep. Jayapal, Pramila - New national health insurance program H.R. 3222 - SMART Health Care Act - Rep. Spartz, Victoria - MA risk adjustment H.R. 3321 - Ending Medicaid Discrimination Against the Most Vulnerable Act - Rep. Roy, Chip - Enhance FMAP phase out H.R. 3415 - Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act - Rep. Schakowsky, Janice - Nurse staffing ratio requirements H.R. 3467 - To amend title XVIII to reform the Medicare Advantage program - Rep. Schweikert, David - MA reforms H.R. 3808 - Expanding Seniors Access to Mental Health Services Act - Rep. Fitzpatrick, Brian - Medicare mental health services H.R. 4093 - Apples to Apples Comparison Act - Rep. Bean, Aaron - Medicare and Medicare Advantage spending reports H.R. 4139 - Cutting Copays Act - Rep. McGarvey, Morgan - Medicare cost-sharing for generic drugs H.R. 4313 - Hospital Inpatient Services Modernization Act - Rep. Buchanan, Vern - Acute hospital care at home waiver H.R. 4559 - Prompt and Fair Pay Act - Rep. Doggett, Lloyd - Payment parity for MA and FFS; MA reimbursement requirements H.R. 4641 - Keep Kids Covered Act - Rep. Castor, Kathy - Continuous eligibility for children in Medicaid/CHIP H.R. 4807 - Protect Our Hospitals Act - Rep. Landsman, Greg - Medicaid provider tax repeal H.R. 5243 - To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage. - Rep. McClellan, Jennifer - MA supplemental benefits data reporting H.R. 5281 - REAL Health Providers Act - Rep. Panetta, Jimmy - MA provider directory requirements H.R. 5584 - Medicaid Third Party Liability Act - Rep. Burgess, Michael - Impact of Third Party Liability on MCOs H.R. 6109 - To amend title XVIII of the Social Security Act to establish certain requirements with respect to rates of reversed prior authorization coverage determinations under Medicare Advantage plans. - Rep. Pocan, Mark - prior authorization under Medicare Advantage H.R. 6110 - To amend title XVIII of the Social Security Act to require Medicare Advantage plans to automatically reconsider determinations denying coverage. - Rep. Pocan, Mark - reconsider denials under Medicare Advantage H.R. 6111 - To amend title XVIII of the Social Security Act to require any advertisement of a Medicare Advantage plan to include information related to the rates of prior authorization denials under such plan. - Rep. Pocan, Mark - advertise rates of prior authorization denials under Medicare Advantage H.R. 6112 - To amend title XVIII of the Social Security Act to establish certain requirements with respect to the average monthly cost to provide coverage to an enrollee under Medicare Advantage plans. - Rep. Pocan, Mark - require monthly coverage cost to enrollees under Medicare Advantage H.R. 6113 - To amend title XVIII of the Social Security Act to impose limitations on contracts with Medicare Advantage organizations offering multiple Medicare Advantage plans under the Medicare program. - Rep. Pocan, Mark - limit multiple Medicare Advantage plans H.R. 6114 - To prohibit funds made available to the Department of Health and Human Services by previous Appropriations Acts from being used for any activity that makes Medicare Advantage the default under the Medicare program. - Rep. Pocan, Mark - prohibit Medicare Advantage from becoming the default H.R. 6254 - Medicaid Staffing Flexibility and Protection Act of 2025 - Rep. Carter, Earl - extend eligibility determinations and redeterminations for Medicaid H.R. 6361 - Ban AI Denials in Medicare Act - Rep. Landsman, Greg - limit WISeR model H.R. 6951 - Stop Unfair Medicaid Recoveries Act - Rep. Schakowsky, Janice - State Medicaid cost recoupment H.R. 6974 - Improving MA SNP Act of 2026 - Rep. Arrington, Jodey - MA SNP beneficiary approval H.R. 7803 - Save Medicare Act - Rep. Pocan, Mark - Renames Medicare Advantage H.R. 7871 - MVP Act - Rep. Guthrie, Brett - Value-based purchasing arrangements in Medicaid H.R. 8375 - Medicare Advantage Improvement Act - Rep. Joyce, John - MA programmatic reforms H.R. 8377 - Stop Deadly Denials Act - Rep. Khanna, Ro - MA prior authorization prohibition H.R. 8875 - Improving Home Dialysis Act - Rep. Miller, Carol - Home dialysis coverage under Medicare H.R. 9542 - Protecting Health Care and Lowering Costs Act - Rep. Boyle, Brendan - Medicaid reforms H.R. 9544 - Save MEDICARE Act - Rep. Doggett, Lloyd - MA risk adjustment and requirements H.R. 9644 - Medicare Advantage MLR Transparency Act - Rep. Moran, Nathaniel - MA plan revenue and benefits reporting H.R. 9693 - Patients First Act - Rep. Joyce, John - Medicare physician fee schedule reform H.R. 10374 - Affordable Premiums for Seniors Act - Rep. Sewell, Terri - Part D premium stabilization demo H.R. 10521 - MA STARS Act - Rep. Kelly, Mike - MA star ratings reform S. 523 - Protect Medicaid Act - Sen. Cassidy, Bill - Medicaid eligibility requirements S. 678 - LIVE Beneficiaries Act - Sen. Scott, Rick - Medicaid enrollment audits S. 717 - Increasing Access to Quality Cardiac Rehabilitation Care Act - Sen. Capito, Shelley Moore - Expanding cardiac care coverage in Medicare S. 752 - Accelerating Kids' Access to Care Act - Sen. Grassley, Chuck - Out-of-state provider access for Medicaid S. 939 - Medicare Dental, Hearing, and Vision Expansion Act - Sen. Sanders, Bernard - Medicare coverage requirements S. 1082 - Safeguarding Medicaid Act - Sen. Barrasso, John - Medicaid enrollee asset verification S. 1105 - No UPCODE Act - Sen. Cassidy, Bill - MA risk adjustment S. 1399 - Health Tech Investment Act - Sen. Rounds, Mike - Medicare coverage for algorithm-based services S. 1506 - Medicare for All Act - Sen. Sanders, Bernard - New national health insurance program S. 1629 - Same Care, Lower Cost Act - Sen. Kennedy, John - Medicare site-neutral payment reform S. 1637 - MVP Act - Sen. Mullin, Markwayne - Medicaid value-based purchasing agreements S. 1816 - Improving Seniors' Timely Access to Care Act - Sen. Marshall, Roger - MA prior authorization S. 1903 - A bill to prohibit changes to Medicare and Medicaid in reconciliation - Sen. Reed, Jack - Medicare and Medicaid safeguards against reconciliation cuts S. 2237 - Hospital Inpatient Services Modernization Act - Sen. Scott, Tim - Acute hospital care at home waiver S. 2279 - Protect Medicaid and Rural Hospitals Act - Sen. Hawley, Josh - Medicaid provider tax and State directed payments S. 2289 - Healthy Moms and Babies Act - Sen. Grassley, Chuck - Medicaid/CHIP maternal health coverage improvements S. 2496 - Keep Kids Covered Act - Sen. Bennet, Michael - Continuous eligibility for children in Medicaid/CHIP S. 2497 - Fair Billing Act - Sen. Hassan, Maggie - Medicare site-neutral transparency and identification requirements S. 2556 - Protecting Healthcare and Lowering Costs Act - Sen. Schumer, Charles - repeal of Medicaid provisions in the One Big Beautiful Bill Act S. 2793 - Ensuring Access to Essential Providers Act - Sen. Cassidy, Bill - Essential community provider coverage requirements for MA S. 3642 - WALZ Act - Sen. Marshall, Roger - Medicaid payment investigation and audits S. 3690 - Ensuring Access to Medicaid Buy-in Programs - Sen. Blackburn, Marsha - Medicaid eligibility parameters S. 3729 - PBM Reporting Transparency Act - Sen. Warner, Mark - MedPAC reports on PBMs S. 3750 - REAL Health Providers Act - Sen. Bennet, Michael - MA provider directory accuracy S. 3762 - Prior Authorization Relief Act - Sen. Whitehouse, Sheldon - MA prior authorization restrictions S. 3848 - Apples to Apples Comparison Act - Sen. Scott, Tim - Medicare and Medicare Advantage spending reports S. 3886 - Nurses Belong in Nursing Homes Act - Sen. Wyden, Ron - Nursing home staffing hours S. 4384 - Medicare Advantage Improvement Act - Sen. Marshall, Roger - MA programmatic reforms S. 5034 - Medicare Advantage Supplemental Benefits Transparency Act - Sen. Warner, Mark - MA supplemental benefits reporting requirements S. 5037 - MediKids Act - Sen. Kim, Andy - Universal Medicaid eligibility for youth 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; Waste Fraud and Abuse; Medicaid Access Final Rule; Medicaid Redeterminations; Medicaid rate actuarial soundness; value of Medicaid Managed Care; value of Medicare Advantage; Affordability; public option; Dental, Hearing, Vision benchmarks; HCBS; Home Health FFS Coverage; 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; Inflation Reduction Act implementation; Medicare Advantage Rate Notice; Part D Payment Issues; Part D VBID Issues; RADV; MA payment issues; Part D issues; prior authorization; MA prompt pay; agent/broker issues; MA reporting requirements; MA provider networks and network adequacy; nursing home staffing requirements; implementation of the One Big Beautiful Bill Act; Medicaid provider taxes; MA Star Ratings; Medicaid community engagement requirements; and VA's community care program.
Client expense: $3,010,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2026 · second_quarter · Health Issues
ERISA preemption, ERISA self-funded health plans Health Savings Accounts (HSA) and High-Deductible Health Plans, permanent safe harbor for HSA-eligible plans to cover specific benefits, direct primary care, chronic disease coverage, on-site clinics Tax treatment of employer-sponsored health benefit plans Health care price transparency, prescription drug price transparency, Pharmacy Benefit Manufacturer (PBM) price transparency, hospital price transparency, ERISA fiduciary duties for health care plans, (S. 3345, S. 526) Hospital consolidation and billing practices, site neutral payment reform, anti-competitive practices (S. 2497) Healthy Competition for Better Care Act (HR 6248) Patients Deserve Price Tags Act (HR 5582 / S. 2355) End-stage renal disease, Restore Protections for Dialysis Patients Act (HR 2199) Surprise Medical Billing, No Surprises Enforcement Act (HR 4710), enforcement and reform Voluntary Employee Beneficiary Associations Consolidated Appropriations Act of 2026 Mental Health Parity and substance addiction Proposed Regulation regarding PBM transparency under sec. 408(b)(2) of ERISA Paid leave; bipartisan Interstate Paid Leave Action Network
Client expense: $270,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Treasury, Dept of
2026 · second_quarter · Medicare/Medicaid
Draft, Medicare Compare Website (no bill number) - Rep. Guthrie, Brett - improvements to CMS' Medicare compare website H.R. 1 - One Big Beautiful Bill Act - Rep. Arrington, Jodey - Medicaid eligibility and state financing, Marketplace coverage and enrollment, Health Savings Account expansion, Pharmacy Benefit Manager financing and regulation H.R. 497 - Medicaid Third Party Liability Act - Rep. Crenshaw, Dan - Medicaid liable third-party exceptions H.R. 538 - Critical Access Hospital Relief Act - Rep. Smith, Adrian - Medicare physician certification requirement H.R. 584 - No Medicaid for Illegal Immigrants Act - Rep. Kiley, Kevin - Medicaid eligibility requirements H.R. 608 - COVER Now Act - Rep. Doggett, Lloyd - Medicaid expansion demo H.R. 610 - Close the Medigap Act - Rep. Doggett, Lloyd - Medigap plan reform H.R. 879 - Medicare Patient Access and Practice Stabilization Act - Rep. Murphy, Gregory - Medicare physician reimbursement H.R. 936 - Medicaid Improvement and State Flexibility Act - Rep. Green, Mark - Medicaid demonstration programs H.R. 1019 - Medicaid Program Improvement Act - Rep. Miller-Meeks, Mariannette - Medicaid management care reporting H.R. 1059 - Jobs and Opportunities for Medicaid Act - Rep. Crenshaw, Dan - Medicaid eligibility requirements H.R. 1162 - Medicaid Primary Care Improvement Act - Rep. Crenshaw, Dan - Medicaid direct primary care arrangements H.R. 1191 - Supporting Access to Rural Community Hospitals Act - Rep. Flood, Mike - Medicare critical access hospitals definition H.R. 1195 - Protect Medicaid Act - Rep. Hudson, Richard - Medicaid eligibility requirements H.R. 1279 - To amend title XIX of the Social Security Act to establish a community engagement requirement for certain individuals under the Medicaid program. - Rep. Bean, Aaron - Medicaid eligibility requirements H.R. 1403 - LIVE Beneficiaries Act - Rep. Bilirakis, Gus - Medicaid registration audits H.R. 1598 - Ensuring Access to Medicaid Buy-in Programs Act - Rep. Ciscomani, Juan - Medicaid eligibility requirements H.R. 1683 - Protecting Rural Seniors' Access to Care Act - Rep. Fischbach, Michelle - Minimum nursing home staffing H.R. 1775 - Second Chances for Rural Hospitals Act - Rep. Arrington, Jodey -Definition of rural emergency hospitals H.R. 1805 - ARCH Act - Rep. Miller, Carol - Extend Medicare-dependent and low-value hospitals payments H.R. 1924 - Securing Access to Care for Seniors in Critical Condition Act - Rep. Hern, Kevin - Medicare site-neutral payments for LTC hospitals H.R. 2045 - Medicare Dental, Vision, and Hearing Benefit Act - Rep. Doggett, Lloyd - Medicare dental, vision, and hearing coverage H.R. 2263 - Telehealth Coverage Act - Rep. Khanna, Ro - Telehealth flexibilities in Medicare H.R. 2309 - Medicare and Medicaid Fraud Prevention Act - Rep. Peters, Scott - provider screening for Federal programs H.R. 2433 - Reducing Medically Unnecessary Delays in Care Act - Rep. Green, Mark - Medicare Advantage prior authorization H.R. 2533 - EASE Act - Rep. Arrington, Jodey - CMS model for virtual technology H.R. 2586 - Reentry Act - Rep. Tonko, Paul - Medicaid coverage for incarcerated population H.R. 2590 - Mental and Physical Health Care Comorbidities Act - Rep. Boyle, Brendan - CMS demonstration to treat comorbidities H.R. 2610 - Protecting Options for Seniors Act - Rep. Tenney, Claudia - MA wage index reclassification H.R. 3023 - Preventing Hospital Overbilling of Medicare Act - Rep. Spartz, Victoria - Site-neutral payment reform H.R. 3069 - Medicare for All Act - Rep. Jayapal, Pramila - New national health insurance program H.R. 3222 - SMART Health Care Act - Rep. Spartz, Victoria - MA risk adjustment H.R. 3263 - PATCH Act - Rep. Tokuda, Jill - Medicare geographic practice cost indices H.R. 3321 - Ending Medicaid Discrimination Against the Most Vulnerable Act - Rep. Roy, Chip - Enhance FMAP phase out H.R. 3415 - Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act - Rep. Schakowsky, Janice - Nurse staffing ratio requirements H.R. 3467 - To amend title XVIII to reform the Medicare Advantage program - Rep. Schweikert, David - MA reforms H.R. 3808 - Expanding Seniors Access to Mental Health Services Act - Rep. Fitzpatrick, Brian - Medicare mental health services H.R. 4093 - Apples to Apples Comparison Act - Rep. Bean, Aaron - Medicare and Medicare Advantage spending reports H.R. 4139 - Cutting Copays Act - Rep. McGarvey, Morgan - Medicare cost-sharing for generic drugs H.R. 4277 - Rural Emergency Hospital Financial Stability Act - Rep. Davis, Donald - Medicaid treatment of rural emergency hospitals H.R. 4313 - Hospital Inpatient Services Modernization Act - Rep. Buchanan, Vern - Acute hospital care at home waiver H.R. 4559 - Prompt and Fair Pay Act - Rep. Doggett, Lloyd - Payment parity for MA and FFS; MA reimbursement requirements H.R. 4641 - Keep Kids Covered Act - Rep. Castor, Kathy - Continuous eligibility for children in Medicaid/CHIP H.R. 4807 - Protect Our Hospitals Act - Rep. Landsman, Greg - Medicaid provider tax repeal H.R. 5243 - To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage. - Rep. McClellan, Jennifer - MA supplemental benefits data reporting H.R. 5281 - REAL Health Providers Act - Rep. Panetta, Jimmy - MA provider directory requirements H.R. 5584 - Medicaid Third Party Liability Act - Rep. Burgess, Michael - Impact of Third Party Liability on MCOs H.R. 6109 - To amend title XVIII of the Social Security Act to establish certain requirements with respect to rates of reversed prior authorization coverage determinations under Medicare Advantage plans. - Rep. Pocan, Mark - prior authorization under Medicare Advantage H.R. 6110 - To amend title XVIII of the Social Security Act to require Medicare Advantage plans to automatically reconsider determinations denying coverage. - Rep. Pocan, Mark - reconsider denials under Medicare Advantage H.R. 6111 - To amend title XVIII of the Social Security Act to require any advertisement of a Medicare Advantage plan to include information related to the rates of prior authorization denials under such plan. - Rep. Pocan, Mark - advertise rates of prior authorization denials under Medicare Advantage H.R. 6112 - To amend title XVIII of the Social Security Act to establish certain requirements with respect to the average monthly cost to provide coverage to an enrollee under Medicare Advantage plans. - Rep. Pocan, Mark - require monthly coverage cost to enrollees under Medicare Advantage H.R. 6113 - To amend title XVIII of the Social Security Act to impose limitations on contracts with Medicare Advantage organizations offering multiple Medicare Advantage plans under the Medicare program. - Rep. Pocan, Mark - limit multiple Medicare Advantage plans H.R. 6114 - To prohibit funds made available to the Department of Health and Human Services by previous Appropriations Acts from being used for any activity that makes Medicare Advantage the default under the Medicare program. - Rep. Pocan, Mark - prohibit Medicare Advantage from becoming the default H.R. 6254 - Medicaid Staffing Flexibility and Protection Act of 2025 - Rep. Carter, Earl - extend eligibility determinations and redeterminations for Medicaid H.R. 6361 - Ban AI Denials in Medicare Act - Rep. Landsman, Greg - limit WISeR model H.R. 6951 - Stop Unfair Medicaid Recoveries Act - Rep. Schakowsky, Janice - State Medicaid cost recoupment H.R. 6974 - Improving MA SNP Act of 2026 - Rep. Arrington, Jodey - MA SNP beneficiary approval H.R. 7189 - PrEP Access Act - Rep. Pocan, Mark - HIV prevention services under Medicare H.R. 7409 - Defend Rural Health Act - Rep. Taylor, Dave - Medicare definition of rural hospital H.R. 7727 - Sustaining Rural Healthcare Act - Rep. Alford, Mark - Medicare CAH designation H.R. 7778 - Medicaid PNA Modernization Act - Rep. Subramanyam, Suhas - Medicaid minimum monthly personal needs allowance H.R. 7803 - Save Medicare Act - Rep. Pocan, Mark - Renames Medicare Advantage H.R. 7871 - MVP Act - Rep. Guthrie, Brett - Value-based purchasing arrangements in Medicaid H.R. 8375 - Medicare Advantage Improvement Act - Rep. Joyce, John - MA programmatic reforms H.R. 8377 - Stop Deadly Denials Act - Rep. Khanna, Ro - MA prior authorization prohibition H.R. 8875 - Improving Home Dialysis Act - Rep. Miller, Carol - Home dialysis coverage under Medicare S. 523 - Protect Medicaid Act - Sen. Cassidy, Bill - Medicaid eligibility requirements S. 678 - LIVE Beneficiaries Act - Sen. Scott, Rick - Medicaid enrollment audits S. 717 - Increasing Access to Quality Cardiac Rehabilitation Care Act - Sen. Capito, Shelley Moore - Expanding cardiac care coverage in Medicare S. 750 - Protecting Rural Seniors' Access to Care Act - Sen. Fischer, Deb - Medicaid nursing home staff requirements S. 752 - Accelerating Kids' Access to Care Act - Sen. Grassley, Chuck - Out-of-state provider access for Medicaid S. 939 - Medicare Dental, Hearing, and Vision Expansion Act - Sen. Sanders, Bernard - Medicare coverage requirements S. 1082 - Safeguarding Medicaid Act - Sen. Barrasso, John - Medicaid enrollee asset verification S. 1105 - No UPCODE Act - Sen. Cassidy, Bill - MA risk adjustment S. 1264 - Mental and Physical Health Care Comorbidities Act - Sen. Bennet, Michael - CMS demonstration to treat comorbidities S. 1399 - Health Tech Investment Act - Sen. Rounds, Mike - Medicare coverage for algorithm-based services S. 1506 - Medicare for All Act - Sen. Sanders, Bernard - New national health insurance program S. 1624 - PATCH Act - Sen. Schatz, Brian - Medicare geographic practice cost indices S. 1629 - Same Care, Lower Cost Act - Sen. Kennedy, John - Medicare site-neutral payment reform S. 1637 - MVP Act - Sen. Mullin, Markwayne - Medicaid value-based purchasing agreements S. 1709 - Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act - Sen. Padilla, Alex - Nurse staffing ratio requirements S. 1816 - Improving Seniors' Timely Access to Care Act - Sen. Marshall, Roger - MA prior authorization S. 1903 - A bill to prohibit changes to Medicare and Medicaid in reconciliation - Sen. Reed, Jack - Medicare and Medicaid safeguards against reconciliation cuts S. 2237 - Hospital Inpatient Services Modernization Act - Sen. Scott, Tim - Acute hospital care at home waiver S. 2279 - Protect Medicaid and Rural Hospitals Act - Sen. Hawley, Josh - Medicaid provider tax and State directed payments S. 2289 - Healthy Moms and Babies Act - Sen. Grassley, Chuck - Medicaid/CHIP maternal health coverage improvements S. 2496 - Keep Kids Covered Act - Sen. Bennet, Michael - Continuous eligibility for children in Medicaid/CHIP S. 2497 - Fair Billing Act - Sen. Hassan, Maggie - Medicare site-neutral transparency and identification requirements S. 2556 - Protecting Healthcare and Lowering Costs Act - Sen. Schumer, Charles - repeal of Medicaid provisions in the One Big Beautiful Bill Act S. 2793 - Ensuring Access to Essential Providers Act - Sen. Cassidy, Bill - Essential community provider coverage requirements for MA S. 3642 - WALZ Act - Sen. Marshall, Roger - Medicaid payment investigation and audits S. 3690 - Ensuring Access to Medicaid Buy-in Programs - Sen. Blackburn, Marsha - Medicaid eligibility parameters S. 3727 - Putting an N to Learing about Fraud Act - Sen. Ernst, Joni - Federal program fraud prevention S. 3729 - PBM Reporting Transparency Act - Sen. Warner, Mark - MedPAC reports on PBMs S. 3750 - REAL Health Providers Act - Sen. Bennet, Michael - MA provider directory accuracy S. 3762 - Prior Authorization Relief Act - Sen. Whitehouse, Sheldon - MA prior authorization restrictions S. 3848 - Apples to Apples Comparison Act - Sen. Scott, Tim - Medicare and Medicare Advantage spending reports S. 3886 - Nurses Belong in Nursing Homes Act - Sen. Wyden, Ron - Nursing home staffing hours S. 4384 - Medicare Advantage Improvement Act - Sen. Marshall, Roger - MA programmatic reforms 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; Waste Fraud and Abuse; Medicaid Access Final Rule; Medicaid Redeterminations; Medicaid rate actuarial soundness; value of Medicaid Managed Care; value of Medicare Advantage; 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; Inflation Reduction Act implementation; Medicare Advantage Rate Notice; Part D Payment Issues; Part D VBID Issues; RADV; MA payment issues; Part D issues; prior authorization; MA prompt pay; agent/broker issues; MA reporting requirements; MA provider networks and network adequacy; implementation of the One Big Beautiful Bill Act; Medicaid provider taxes; Medicaid community engagement requirements; and VA's community care program.
Client expense: $3,010,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2026 · second_quarter · Health Issues
ERISA preemption, ERISA self-funded health plans Health Savings Accounts (HSA) and High-Deductible Health Plans, permanent safe harbor for HSA-eligible plans to cover specific benefits, direct primary care, chronic disease coverage, on-site clinics Tax treatment of employer-sponsored health benefit plans Health care price transparency, prescription drug price transparency, Pharmacy Benefit Manufacturer (PBM) price transparency, hospital price transparency, ERISA fiduciary duties for health care plans, (S. 3345, S. 526) Hospital consolidation and billing practices, site neutral payment reform, anti-competitive practices (S. 2497) Healthy Competition for Better Care Act (HR 6248) Patients Deserve Price Tags Act (HR 5582 / S. 2355) End-stage renal disease, Restore Protections for Dialysis Patients Act (HR 2199) Surprise Medical Billing, No Surprises Enforcement Act (HR 4710), enforcement and reform Voluntary Employee Beneficiary Associations Consolidated Appropriations Act of 2026 Mental Health Parity and substance addiction Proposed Regulation regarding PBM transparency under sec. 408(b)(2) of ERISA Paid leave; bipartisan Interstate Paid Leave Action Network
Client expense: $214,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Treasury, Dept of
2026 · first_quarter · Medicare/Medicaid
Draft, Medicare Compare Website (no bill number) - Rep. Guthrie, Brett - improvements to CMS Medicare compare website H.R. 1 - One Big Beautiful Bill Act - Rep. Arrington, Jodey - Medicaid eligibility and state financing, Marketplace coverage and enrollment, Health Savings Account expansion, Pharmacy Benefit Manager financing and regulation H.R. 497 - Medicaid Third Party Liability Act - Rep. Crenshaw, Dan - Medicaid liable third-party exceptions H.R. 538 - Critical Access Hospital Relief Act - Rep. Smith, Adrian - Medicare physician certification requirement H.R. 584 - No Medicaid for Illegal Immigrants Act - Rep. Kiley, Kevin - Medicaid eligibility requirements H.R. 608 - COVER Now Act - Rep. Doggett, Lloyd - Medicaid expansion demo H.R. 610 - Close the Medigap Act - Rep. Doggett, Lloyd - Medigap plan reform H.R. 879 - Medicare Patient Access and Practice Stabilization Act - Rep. Murphy, Gregory - Medicare physician reimbursement H.R. 936 - Medicaid Improvement and State Flexibility Act - Rep. Green, Mark - Medicaid demonstration programs H.R. 1019 - Medicaid Program Improvement Act - Rep. Miller-Meeks, Mariannette - Medicaid management care reporting H.R. 1059 - Jobs and Opportunities for Medicaid Act - Rep. Crenshaw, Dan - Medicaid eligibility requirements H.R. 1162 - Medicaid Primary Care Improvement Act - Rep. Crenshaw, Dan - Medicaid direct primary care arrangements H.R. 1191 - Supporting Access to Rural Community Hospitals Act - Rep. Flood, Mike - Medicare critical access hospitals definition H.R. 1195 - Protect Medicaid Act - Rep. Hudson, Richard - Medicaid eligibility requirements H.R. 1279 - To amend title XIX of the Social Security Act to establish a community engagement requirement for certain individuals under the Medicaid program. - Rep. Bean, Aaron - Medicaid eligibility requirements H.R. 1403 - LIVE Beneficiaries Act - Rep. Bilirakis, Gus - Medicaid registration audits H.R. 1598 - Ensuring Access to Medicaid Buy-in Programs Act - Rep. Ciscomani, Juan - Medicaid eligibility requirements H.R. 1683 - Protecting Rural Seniors Access to Care Act - Rep. Fischbach, Michelle - Minimum nursing home staffing H.R. 1775 - Second Chances for Rural Hospitals Act - Rep. Arrington, Jodey -Definition of rural emergency hospitals H.R. 1805 - ARCH Act - Rep. Miller, Carol - Extend Medicare-dependent and low-value hospitals payments H.R. 1924 - Securing Access to Care for Seniors in Critical Condition Act - Rep. Hern, Kevin - Medicare site-neutral payments for LTC hospitals H.R. 2045 - Medicare Dental, Vision, and Hearing Benefit Act - Rep. Doggett, Lloyd - Medicare dental, vision, and hearing coverage H.R. 2263 - Telehealth Coverage Act - Rep. Khanna, Ro - Telehealth flexibilities in Medicare H.R. 2309 - Medicare and Medicaid Fraud Prevention Act - Rep. Peters, Scott - provider screening for Federal programs H.R. 2433 - Reducing Medically Unnecessary Delays in Care Act - Rep. Green, Mark - Medicare Advantage prior authorization H.R. 2533 - EASE Act - Rep. Arrington, Jodey - CMS model for virtual technology H.R. 2586 - Reentry Act - Rep. Tonko, Paul - Medicaid coverage for incarcerated population H.R. 2590 - Mental and Physical Health Care Comorbidities Act - Rep. Boyle, Brendan - CMS demonstration to treat comorbidities H.R. 2610 - Protecting Options for Seniors Act - Rep. Tenney, Claudia - MA wage index reclassification H.R. 3023 - Preventing Hospital Overbilling of Medicare Act - Rep. Spartz, Victoria - Site-neutral payment reform H.R. 3069 - Medicare for All Act - Rep. Jayapal, Pramila - New national health insurance program H.R. 3222 - SMART Health Care Act - Rep. Spartz, Victoria - MA risk adjustment H.R. 3263 - PATCH Act - Rep. Tokuda, Jill - Medicare geographic practice cost indices H.R. 3321 - Ending Medicaid Discrimination Against the Most Vulnerable Act - Rep. Roy, Chip - Enhance FMAP phase out H.R. 3415 - Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act - Rep. Schakowsky, Janice - Nurse staffing ratio requirements H.R. 3467 - To amend title XVIII to reform the Medicare Advantage program - Rep. Schweikert, David - MA reforms H.R. 3808 - Expanding Seniors Access to Mental Health Services Act - Rep. Fitzpatrick, Brian - Medicare mental health services H.R. 4093 - Apples to Apples Comparison Act - Rep. Bean, Aaron - Medicare and Medicare Advantage spending reports H.R. 4139 - Cutting Copays Act - Rep. McGarvey, Morgan - Medicare cost-sharing for generic drugs H.R. 4277 - Rural Emergency Hospital Financial Stability Act - Rep. Davis, Donald - Medicaid treatment of rural emergency hospitals H.R. 4313 - Hospital Inpatient Services Modernization Act - Rep. Buchanan, Vern - Acute hospital care at home waiver H.R. 4559 - Prompt and Fair Pay Act - Rep. Doggett, Lloyd - Payment parity for MA and FFS; MA reimbursement requirements H.R. 4641 - Keep Kids Covered Act - Rep. Castor, Kathy - Continuous eligibility for children in Medicaid/CHIP H.R. 4807 - Protect Our Hospitals Act - Rep. Landsman, Greg - Medicaid provider tax repeal H.R. 5243 - To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage. - Rep. McClellan, Jennifer - MA supplemental benefits data reporting H.R. 5281 - REAL Health Providers Act - Rep. Panetta, Jimmy - MA provider directory requirements H.R. 5584 - Medicaid Third Party Liability Act - Rep. Burgess, Michael - Impact of Third Party Liability on MCOs H.R. 6109 - To amend title XVIII of the Social Security Act to establish certain requirements with respect to rates of reversed prior authorization coverage determinations under Medicare Advantage plans. - Rep. Pocan, Mark -prior authorization under Medicare Advantage H.R. 6110 -To amend title XVIII of the Social Security Act to require Medicare Advantage plans to automatically reconsider determinations denying coverage. - Rep. Pocan, Mark - reconsider denials under Medicare Advantage H.R. 6111 - To amend title XVIII of the Social Security Act to require any advertisement of a Medicare Advantage plan to include information related to the rates of prior authorization denials under such plan. - Rep. Pocan, Mark - advertise rates of prior authorization denials under Medicare Advantage H.R. 6112 - To amend title XVIII of the Social Security Act to establish certain requirements with respect to the average monthly cost to provide coverage to an enrollee under Medicare Advantage plans. - Rep. Pocan, Mark - require monthly coverage cost to enrollees under Medicare Advantage H.R. 6113 - To amend title XVIII of the Social Security Act to impose limitations on contracts with Medicare Advantage organizations offering multiple Medicare Advantage plans under the Medicare program. - Rep. Pocan, Mark - limit multiple Medicare Advantage plans H.R. 6114 - To prohibit funds made available to the Department of Health and Human Services by previous Appropriations Acts from being used for any activity that makes Medicare Advantage the default under the Medicare program. - Rep. Pocan, Mark - prohibit Medicare Advantage from becoming the default H.R. 6254 - Medicaid Staffing Flexibility and Protection Act of 2025 - Rep. Carter, Earl - extend eligibility determinations and redeterminations for Medicaid H.R. 6361 - Ban AI Denials in Medicare Act - Rep. Landsman, Greg - limit WISeR model H.R. 6951 - Stop Unfair Medicaid Recoveries Act - Rep. Schakowsky, Janice - State Medicaid cost recoupment H.R. 6974 - Improving MA SNP Act of 2026 - Rep. Arrington, Jodey - MA SNP beneficiary approval H.R. 7189 - PrEP Access Act - Rep. Pocan, Mark - HIV prevention services under Medicare H.R. 7409 - Defend Rural Health Act - Rep. Taylor, Dave - Medicare definition of rural hospital H.R. 7727 - Sustaining Rural Healthcare Act - Rep. Alford, Mark - Medicare CAH designation H.R. 7778 - Medicaid PNA Modernization Act - Rep. Subramanyam, Suhas - Medicaid minimum monthly personal needs allowance H.R. 7803 - Save Medicare Act - Rep. Pocan, Mark - Renames Medicare Advantage H.R. 7871 - MVP Act - Rep. Guthrie, Brett - Value-based purchasing arrangements in Medicaid S. 523 - Protect Medicaid Act - Sen. Cassidy, Bill - Medicaid eligibility requirements S. 678 - LIVE Beneficiaries Act - Sen. Scott, Rick - Medicaid enrollment audits S. 717 - Increasing Access to Quality Cardiac Rehabilitation Care Act - Sen. Capito, Shelley Moore - Expanding cardiac care coverage in Medicare S. 750 - Protecting Rural Seniors Access to Care Act - Sen. Fischer, Deb - Medicaid nursing home staff requirements S. 752 - Accelerating Kids Access to Care Act - Sen. Grassley, Chuck - Out-of-state provider access for Medicaid S. 939 - Medicare Dental, Hearing, and Vision Expansion Act - Sen. Sanders, Bernard - Medicare coverage requirements S. 1082 - Safeguarding Medicaid Act - Sen. Barrasso, John - Medicaid enrollee asset verification S. 1105 - No UPCODE Act - Sen. Cassidy, Bill - MA risk adjustment S. 1264 - Mental and Physical Health Care Comorbidities Act - Sen. Bennet, Michael - CMS demonstration to treat comorbidities S. 1399 - Health Tech Investment Act - Sen. Rounds, Mike - Medicare coverage for algorithm-based services S. 1506 - Medicare for All Act - Sen. Sanders, Bernard - New national health insurance program S. 1624 - PATCH Act - Sen. Schatz, Brian - Medicare geographic practice cost indices S. 1629 - Same Care, Lower Cost Act - Sen. Kennedy, John - Medicare site-neutral payment reform S. 1637 - MVP Act - Sen. Mullin, Markwayne - Medicaid value-based purchasing agreements S. 1709 - Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act - Sen. Padilla, Alex - Nurse staffing ratio requirements S. 1816 - Improving Seniors Timely Access to Care Act - Sen. Marshall, Roger - MA prior authorization S. 1903 - A bill to prohibit changes to Medicare and Medicaid in reconciliation - Sen. Reed, Jack - Medicare and Medicaid safeguards against reconciliation cuts S. 2237 - Hospital Inpatient Services Modernization Act - Sen. Scott, Tim - Acute hospital care at home waiver S. 2279 - Protect Medicaid and Rural Hospitals Act - Sen. Hawley, Josh - Medicaid provider tax and State directed payments S. 2289 - Healthy Moms and Babies Act - Sen. Grassley, Chuck - Medicaid/CHIP maternal health coverage improvements S. 2496 - Keep Kids Covered Act - Sen. Bennet, Michael - Continuous eligibility for children in Medicaid/CHIP S. 2497 - Fair Billing Act - Sen. Hassan, Maggie - Medicare site-neutral transparency and identification requirements S. 2556 - Protecting Healthcare and Lowering Costs Act - Sen. Schumer, Charles - repeal of Medicaid provisions in the One Big Beautiful Bill Act S. 2793 - Ensuring Access to Essential Providers Act - Sen. Cassidy, Bill - Essential community provider coverage requirements for MA S. 3642 - WALZ Act - Sen. Marshall, Roger - Medicaid payment investigation and audits S. 3690 - Ensuring Access to Medicaid Buy-in Programs - Sen. Blackburn, Marsha - Medicaid eligibility parameters S. 3727 - Putting an N to Learing about Fraud Act - Sen. Ernst, Joni - Federal program fraud prevention S. 3729 - PBM Reporting Transparency Act - Sen. Warner, Mark - MedPAC reports on PBMs S. 3750 - REAL Health Providers Act - Sen. Bennet, Michael - MA provider directory accuracy S. 3762 - Prior Authorization Relief Act - Sen. Whitehouse, Sheldon - MA prior authorization restrictions S. 3848 - Apples to Apples Comparison Act - Sen. Scott, Tim - Medicare and Medicare Advantage spending reports S. 3886 - Nurses Belong in Nursing Homes Act - Sen. Wyden, Ron - Nursing home staffing hours 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; value of Medicare Advantage; 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; Inflation Reduction Act implementation; Medicare Advantage Rate Notice; Part D Payment Issues; Part D VBID Issues; RADV; MA payment issues; Part D issues; prior authorization; MA prompt pay; agent/broker issues; implementation of the One Big Beautiful Bill Act; provider taxes; Medicaid community engagement requirements; and VAs community care program.
Client expense: $5,320,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2026 · first_quarter · Medicare/Medicaid
HR 1509 / S 752, Accelerating Kids Access to Care Act (AKACA); S 2497, Fair Billing Act; S 1629, Same Care, Lower Cost Act; HR 7148, Consolidated Appropriations Act, specifically provisions related to Medicaid provider enrollment and a Medicare unique provider identifier requirement for hospital outpatient billing
Client expense: $110,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2025 · third_quarter · Health Issues
ERISA preemption Tax treatment of employer-sponsored health benefit plans; budget reconciliation Health Savings Accounts and High-Deductible Health Plans; permanent safe harbor for HSA-eligible health plans to cover telehealth pre-deductible, HSA flexibility primary care and chronic disease; budget reconciliation; Telehealth Expansion Act (HR 1650 / S. 763 - 119th Congress) Health care cost transparency, prescription drugs, PBM pricing and transparency and hospital and health plan price transparency Hospital consolidation and billing practices, site neutral payment reform; Healthy Competition for Better Care Act Voluntary Employee Beneficiary Associations (VEBAs) End-stage renal disease and Medicare secondary payer issues 340B Prescription Drug Program 408(b)(2) Fee disclosure for health plans Surprise Medical Billing rules Chronic Disease Flexible Coverage Act (HR 919 - 119th Congress) Paid leave, Interstate Paid Leave Action Network (I-PLAN) Act, (HR 3090) More Paid Leave for More Americans Act (HR 3089) Fair Billing Act (S. 2497) Prescription Drug Machine Readable Files (MRF) Prescription Drug Cost ERISA electronic reporting and disclosure, mental health parity, allow HSAs to cover chronic conditions on a pre-deductible basis Form 5500 Simplification legislation
Client expense: $330,000 · Firm income: Not reported
2025 · fourth_quarter · Medicare/Medicaid
Draft, Medicare Compare Website (no bill number) - Rep. Guthrie, Brett - improvements to CMS Medicare compare website H.R. 1 - One Big Beautiful Bill Act - Rep. Arrington, Jodey - Medicaid eligibility and state financing, Marketplace coverage and enrollment, Health Savings Account expansion, Pharmacy Benefit Manager financing and regulation H.R. 497 - Medicaid Third Party Liability Act - Rep. Crenshaw, Dan - Medicaid liable third-party exceptions H.R. 538 - Critical Access Hospital Relief Act - Rep. Smith, Adrian - Medicare physician certification requirement H.R. 584 - No Medicaid for Illegal Immigrants Act - Rep. Kiley, Kevin - Medicaid eligibility requirements H.R. 608 - COVER Now Act - Rep. Doggett, Lloyd - Medicaid expansion demo H.R. 610 - Close the Medigap Act - Rep. Doggett, Lloyd - Medigap plan reform H.R. 879 - Medicare Patient Access and Practice Stabilization Act - Rep. Murphy, Gregory - Medicare physician reimbursement H.R. 936 - Medicaid Improvement and State Flexibility Act - Rep. Green, Mark - Medicaid demonstration programs H.R. 1019 - Medicaid Program Improvement Act - Rep. Miller-Meeks, Mariannette - Medicaid management care reporting H.R. 1059 - Jobs and Opportunities for Medicaid Act - Rep. Crenshaw, Dan - Medicaid eligibility requirements H.R. 1162 - Medicaid Primary Care Improvement Act - Rep. Crenshaw, Dan - Medicaid direct primary care arrangements H.R. 1191 - Supporting Access to Rural Community Hospitals Act - Rep. Flood, Mike - Medicare critical access hospitals definition H.R. 1195 - Protect Medicaid Act - Rep. Hudson, Richard - Medicaid eligibility requirements H.R. 1279 - To amend title XIX of the Social Security Act to establish a community engagement requirement for certain individuals under the Medicaid program. - Rep. Bean, Aaron - Medicaid eligibility requirements H.R. 1403 - LIVE Beneficiaries Act - Rep. Bilirakis, Gus - Medicaid registration audits H.R. 1598 - Ensuring Access to Medicaid Buy-in Programs Act - Rep. Ciscomani, Juan - Medicaid eligibility requirements H.R. 1683 - Protecting Rural Seniors Access to Care Act - Rep. Fischbach, Michelle - Minimum nursing home staffing H.R. 1775 - Second Chances for Rural Hospitals Act - Rep. Arrington, Jodey -Definition of rural emergency hospitals H.R. 1805 - ARCH Act - Rep. Miller, Carol - Extend Medicare-dependent and low-value hospitals payments H.R. 1924 - Securing Access to Care for Seniors in Critical Condition Act - Rep. Hern, Kevin - Medicare site-neutral payments for LTC hospitals H.R. 2045 - Medicare Dental, Vision, and Hearing Benefit Act - Rep. Doggett, Lloyd - Medicare dental, vision, and hearing coverage H.R. 2263 - Telehealth Coverage Act - Rep. Khanna, Ro - Telehealth flexibilities in Medicare H.R. 2309 - Medicare and Medicaid Fraud Prevention Act - Rep. Peters, Scott - provider screening for Federal programs H.R. 2433 - Reducing Medically Unnecessary Delays in Care Act - Rep. Green, Mark - Medicare Advantage prior authorization H.R. 2533 - EASE Act - Rep. Arrington, Jodey - CMS model for virtual technology H.R. 2586 - Reentry Act - Rep. Tonko, Paul - Medicaid coverage for incarcerated population H.R. 2590 - Mental and Physical Health Care Comorbidities Act - Rep. Boyle, Brendan - CMS demonstration to treat comorbidities H.R. 2610 - Protecting Options for Seniors Act - Rep. Tenney, Claudia - MA wage index reclassification H.R. 3023 - Preventing Hospital Overbilling of Medicare Act - Rep. Spartz, Victoria - Site-neutral payment reform H.R. 3069 - Medicare for All Act - Rep. Jayapal, Pramila - New national health insurance program H.R. 3222 - SMART Health Care Act - Rep. Spartz, Victoria - MA risk adjustment H.R. 3263 - PATCH Act - Rep. Tokuda, Jill - Medicare geographic practice cost indices H.R. 3321 - Ending Medicaid Discrimination Against the Most Vulnerable Act - Rep. Roy, Chip - Enhance FMAP phase out H.R. 3415 - Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act - Rep. Schakowsky, Janice - Nurse staffing ratio requirements H.R. 3467 - To amend title XVIII to reform the Medicare Advantage program - Rep. Schweikert, David - MA reforms H.R. 3808 - Expanding Seniors Access to Mental Health Services Act - Rep. Fitzpatrick, Brian - Medicare mental health services H.R. 4093 - Apples to Apples Comparison Act - Rep. Bean, Aaron - Medicare and Medicare Advantage spending reports H.R. 4139 - Cutting Copays Act - Rep. McGarvey, Morgan - Medicare cost-sharing for generic drugs H.R. 4277 - Rural Emergency Hospital Financial Stability Act - Rep. Davis, Donald - Medicaid treatment of rural emergency hospitals H.R. 4313 - Hospital Inpatient Services Modernization Act - Rep. Buchanan, Vern - Acute hospital care at home waiver H.R. 4559 - Prompt and Fair Pay Act - Rep. Doggett, Lloyd - Payment parity for MA and FFS; MA reimbursement requirements H.R. 4641 - Keep Kids Covered Act - Rep. Castor, Kathy - Continuous eligibility for children in Medicaid/CHIP H.R. 4807 - Protect Our Hospitals Act - Rep. Landsman, Greg - Medicaid provider tax repeal H.R. 5243 - To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage. - Rep. McClellan, Jennifer - MA supplemental benefits data reporting H.R. 5281 - REAL Health Providers Act - Rep. Panetta, Jimmy - MA provider directory requirements H.R. 5584 - Medicaid Third Party Liability Act - Rep. Burgess, Michael - Impact of Third Party Liability on MCOs H.R. 6109 - To amend title XVIII of the Social Security Act to establish certain requirements with respect to rates of reversed prior authorization coverage determinations under Medicare Advantage plans. - Rep. Pocan, Mark -prior authorization under Medicare Advantage H.R. 6110 -To amend title XVIII of the Social Security Act to require Medicare Advantage plans to automatically reconsider determinations denying coverage. - Rep. Pocan, Mark - reconsider denials under Medicare Advantage H.R. 6111 - To amend title XVIII of the Social Security Act to require any advertisement of a Medicare Advantage plan to include information related to the rates of prior authorization denials under such plan. - Rep. Pocan, Mark - advertise rates of prior authorization denials under Medicare Advantage H.R. 6112 - To amend title XVIII of the Social Security Act to establish certain requirements with respect to the average monthly cost to provide coverage to an enrollee under Medicare Advantage plans. - Rep. Pocan, Mark - require monthly coverage cost to enrollees under Medicare Advantage H.R. 6113 - To amend title XVIII of the Social Security Act to impose limitations on contracts with Medicare Advantage organizations offering multiple Medicare Advantage plans under the Medicare program. - Rep. Pocan, Mark - limit multiple Medicare Advantage plans H.R. 6114 - To prohibit funds made available to the Department of Health and Human Services by previous Appropriations Acts from being used for any activity that makes Medicare Advantage the default under the Medicare program. - Rep. Pocan, Mark - prohibit Medicare Advantage from becoming the default H.R. 6254 - Medicaid Staffing Flexibility and Protection Act of 2025 - Rep. Carter, Earl - extend eligibility determinations and redeterminations for Medicaid H.R. 6361 - Ban AI Denials in Medicare Act - Rep. Landsman, Greg - limit WISeR model S. 523 - Protect Medicaid Act - Sen. Cassidy, Bill - Medicaid eligibility requirements S. 678 - LIVE Beneficiaries Act - Sen. Scott, Rick - Medicaid enrollment audits S. 717 - Increasing Access to Quality Cardiac Rehabilitation Care Act - Sen. Capito, Shelley Moore - Expanding cardiac care coverage in Medicare S. 750 - Protecting Rural Seniors Access to Care Act - Sen. Fischer, Deb - Medicaid nursing home staff requirements S. 752 - Accelerating Kids Access to Care Act - Sen. Grassley, Chuck - Out-of-state provider access for Medicaid S. 939 - Medicare Dental, Hearing, and Vision Expansion Act - Sen. Sanders, Bernard - Medicare coverage requirements S. 1082 - Safeguarding Medicaid Act - Sen. Barrasso, John - Medicaid enrollee asset verification S. 1105 - No UPCODE Act - Sen. Cassidy, Bill - MA risk adjustment S. 1264 - Mental and Physical Health Care Comorbidities Act - Sen. Bennet, Michael - CMS demonstration to treat comorbidities S. 1399 - Health Tech Investment Act - Sen. Rounds, Mike - Medicare coverage for algorithm-based services S. 1506 - Medicare for All Act - Sen. Sanders, Bernard - New national health insurance program S. 1624 - PATCH Act - Sen. Schatz, Brian - Medicare geographic practice cost indices S. 1629 - Same Care, Lower Cost Act - Sen. Kennedy, John - Medicare site-neutral payment reform S. 1637 - MVP Act - Sen. Mullin, Markwayne - Medicaid value-based purchasing agreements S. 1709 - Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act - Sen. Padilla, Alex - Nurse staffing ratio requirements S. 1816 - Improving Seniors Timely Access to Care Act - Sen. Marshall, Roger - MA prior authorization S. 1903 - A bill to prohibit changes to Medicare and Medicaid in reconciliation - Sen. Reed, Jack - Medicare and Medicaid safeguards against reconciliation cuts S. 2237 - Hospital Inpatient Services Modernization Act - Sen. Scott, Tim - Acute hospital care at home waiver S. 2279 - Protect Medicaid and Rural Hospitals Act - Sen. Hawley, Josh - Medicaid provider tax and State directed payments S. 2289 - Healthy Moms and Babies Act - Sen. Grassley, Chuck - Medicaid/CHIP maternal health coverage improvements S. 2496 - Keep Kids Covered Act - Sen. Bennet, Michael - Continuous eligibility for children in Medicaid/CHIP S. 2497 - Fair Billing Act - Sen. Hassan, Maggie - Medicare site-neutral transparency and identification requirements S. 2556 - Protecting Healthcare and Lowering Costs Act - Sen. Schumer, Charles - repeal of Medicaid provisions in the One Big Beautiful Bill Act S. 2793 - Ensuring Access to Essential Providers Act - Sen. Cassidy, Bill - Essential community provider coverage requirements for MA 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; value of Medicare Advantage; 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; Inflation Reduction Act implementation; Medicare Advantage Rate Notice; Part D Payment Issues; Part D VBID Issues; RADV; MA payment issues; Part D issues; prior authorization; MA prompt pay; agent/broker issues; implementation of the One Big Beautiful Bill Act; provider taxes; Medicaid community engagement requirements; and VAs community care program.
2025 · fourth_quarter · Health Issues
HCR - Health Issues Issues: Affordable Care Act (ACA), ACA subsidies and tax credits; Telehealth/ telehealth flexibilities; ACA Fraud; Transparency in coverage; Surprise Billing; 2025 Proposed NBPP/Individual Market/ACA exchanges; Rural healthcare; Prior Authorization; Hospital Consolidation; Employer-provided health coverage; Cyber Attack/ Cyber Security; Provider Directories; Community Health + Maternal Health; Hospital Billing; Anti-tiering, Anti-steering; Community Health; Program integrity in the individual marketplace; Federal Budget Process; Artificial Intelligence; Vaccine Coverage; Marketplace Renewal Notices; Cell and Gene Therapies; Food as Medicine; Health Disparities; Individual Market Reforms and eAPTC Extension; Health Savings Accounts Bills: H.R.3417 - FAIR Act (118th) To ensure fair billing practices for items and services furnished by off-campus outpatient departments of a provider. Sponsor: Rep. Hern, Kevin [R-OK-1] (118th) H.R. 5378 Lower Costs, More Transparency Act (118th) To promote price transparency in the health care sector, and for other purposes. Sponsor: Rep. McMorris Rodgers, Cathy [R-WA-5] H.R.2483 - Support for Patients and Communities Reauthorization Act To reauthorize certain programs that provide for opioid use disorder prevention, treatment, and recovery, and for other purposes. Sponsor: Rep. Guthrie, Brett [R-KY-2] S.2121 - SUPPORT for Patients and Communities Reauthorization Act of 2025 To reauthorize certain programs that provide for opioid use disorder prevention, treatment, and recovery, and for other purposes. Sponsor: Sen. Cassidy, Bill [R-LA] S.46 - Health Care Affordability Act of 2025 A bill to amend the Internal Revenue Code of 1986 to expand eligibility for the refundable credit for coverage under a qualified health plan. Sponsor: Sen. Shaheen, Jeanne [D-NH] H.R.247 - Health Care Affordability Act of 2025 To amend the Internal Revenue Code of 1986 to expand eligibility for the refundable credit for coverage under a qualified health plan. Sponsor: Rep. Underwood, Lauren [D-IL-14] H.R.3237 To amend title XVIII of the Social Security Act to require each off-campus outpatient department of a provider to include a unique identifier on claims for items and services, and to require providers with a department of a provider to submit to the Centers for Medicare & Medicaid Services an attestation with respect to each such department. Sponsor: Rep. Joyce, John [R-PA-13] S.5535 - No Surprises Act Enforcement Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to increase penalties for group health plans and health insurance issuers for practices that violate balance billing requirements, and for other purposes. Sponsor: Sen. Marshall, Roger [R-KS] H.R.2571 - Self-Insurance Protection Act To amend the Employee Retirement Income Security Act of 1974 to exclude from the definition of health insurance coverage certain medical stop-loss insurance obtained by certain plan sponsors of group health plans, and for other purposes. Sponsor: Rep. Onder, Robert [R-MO-3] H.R.2079 - Insurance Fraud Accountability Act To amend the Patient Protection and Affordable Care Act to reduce fraudulent enrollments in qualified health plans, and for other purposes. Sponsor: Rep. Ross, Deborah K. [D-NC-2] S.976 - Insurance Fraud Accountability Act To amend the Patient Protection and Affordable Care Act to reduce fraudulent enrollments in qualified health plans, and for other purposes. Sponsor: Sen. Wyden, Ron [D-OR] H.R.4710 - No Surprises Act Enforcement Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to increase penalties for group health plans and health insurance issuers for practices that violate balance billing requirements, and for other purposes. Sponsor: Rep. Murphy, Gregory F. [R-NC-3] S.2420 - No Surprises Act Enforcement Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to increase penalties for group health plans, health insurance issuers, and nonparticipating providers or facilities for practices that violate balance billing requirements, and for other purposes. Sponsor: Sen. Marshall, Roger [R-KS] H.R.3841 - Healthcare Cybersecurity Act of 2025 To enhance the cybersecurity of the Healthcare and Public Health Sector. Sponsor: Rep. Crow, Jason [D-CO-6] S.1851 - Healthcare Cybersecurity Act of 2025 To enhance the cybersecurity of the Healthcare and Public Health Sector. Sponsor: Sen. Rosen, Jacky [D-NV] H.R.3419 To amend the Public Health Service Act to reauthorize the telehealth network and telehealth resource centers grant programs. Sponsor: Rep. Valadao, David G. [R-CA-22] H.R.2493 - Improving Care in Rural America Reauthorization Act of 2025 To reauthorize certain programs regarding rural health care. Sponsor: Rep. Carter, Earl L. "Buddy" [R-GA-1] S.2301 - Improving Care in Rural America Reauthorization Act of 2025 To reauthorize certain programs regarding rural health care. Sponsor: Sen. Scott, Tim [R-SC] H.R.4262 To reauthorize programs related to health professions education, and for other purposes. Sponsor: Rep. Schakowsky, Janice D. [D-IL-9] H.R.3302 - Healthy Start Reauthorization Act of 2025 To amend the Public Health Service Act to reauthorize the Healthy Start Initiative. Sponsor: Rep. Ocasio-Cortez, Alexandria [D-NY-14] H.R.2528 - Association Health Plans Act To amend the Employee Retirement Income Security Act of 1974 to clarify the treatment of certain association health plans as employers, and for other purposes. Sponsor: Rep. Walberg, Tim [R-MI-5] H.R.2509 - COMPLETE Care Act To amend title XVIII of the Social Security Act to provide incentives for behavioral health integration. Sponsor: Rep. Malliotakis, Nicole [R-NY-11] S.931 - COMPLETE Care Act To amend title XVIII of the Social Security Act to provide incentives for behavioral health integration. Sponsor: Sen. Cortez Masto, Catherine [D-NV] H.R.6703 - Lower Health Care Premiums for All Americans Act To ensure access to affordable health insurance. Sponsor: Rep. Miller-Meeks, Mariannette [R-IA-1] S.2497 - Fair Billing Act To amend title XVIII of the Social Security Act to require a separate identification number and an attestation for each off-campus outpatient department of a provider. Sponsor: Sen. Hassan, Margaret Wood [D-NH] H.R.5972 - Right to Enroll Act of 2025 To direct the Secretary of Health and Human Services to extend the annual open enrollment period for enrolling in a qualified health plan offered by an Exchange for plan year 2026. Sponsor: Rep. Pappas, Chris [D-NH-1] H.R.6232 - HOPE Act To amend the Internal Revenue Code of 1986 to extend and modify the enhanced premium tax credit, and to amend the Patient Protection and Affordable Care Act to make certain adjustments to the operation of the Exchanges established under such Act. Sponsor: Rep. Suozzi, Thomas R. [D-NY-3] H.R.5463 - Choice Arrangement To amend the Internal Revenue Code of 1986 to provide for the treatment of employer-provided health reimbursement arrangements that are integrated with individual market coverage, and for other purposes. Sponsor: Rep. Hern, Kevin [R-OK-1]
2025 · fourth_quarter · Health Issues
Affordable Care Act (ACA), ACA subsidies and tax credits; Telehealth/ telehealth flexibilities; ACA Fraud; Transparency in coverage; Surprise Billing; 2025 Proposed NBPP/Individual Market/ACA exchanges; Rural healthcare; Prior Authorization; Hospital Consolidation; Employer-provided health coverage; Cyber Attack/ Cyber Security Maternal Health; Hospital Billing; Anti-tiering, Anti-steering; Federal Budget Process; Artificial Intelligence; Vaccine Coverage; Marketplace Renewal Notices; Food as Medicine; Individual Market Reforms and eAPTC Extension; Health Savings Accounts; Critical Access Hospitals; Healthcare workforce shortage S. 1451 Healthy Competition for Better Care Act (118th) To ban anticompetitive terms in facility and insurance contracts that limit access to higher quality, lower cost care. Sponsor: Sen. Braun, Mike [R-IN] H.R.3120 - Healthy Competition for Better Care Act (118th) To ban anticompetitive terms in facility and insurance contracts that limit access to higher quality, lower cost care. Sponsor: Rep. Steel, Michelle [R-CA-45] S.2903 - Safe Step Act To amend the Employee Retirement Income Security Act of 1974 to require a group health plan or health insurance coverage offered in connection with such a plan to provide an exceptions process for any medication step therapy protocol, and for other purposes. Sponsor: Sen. Murkowski, Lisa [R-AK] H.R.3417 - FAIR Act (118th) To ensure fair billing practices for items and services furnished by off-campus outpatient departments of a provider. Sponsor: Rep. Hern, Kevin [R-OK-1] (118th) H.R. 5378 Lower Costs, More Transparency Act (118th) To promote price transparency in the health care sector, and for other purposes. Sponsor: Rep. McMorris Rodgers, Cathy [R-WA-5] H.R.2483 - Support for Patients and Communities Reauthorization Act To reauthorize certain programs that provide for opioid use disorder prevention, treatment, and recovery, and for other purposes. Sponsor: Rep. Guthrie, Brett [R-KY-2] S.2121 - SUPPORT for Patients and Communities Reauthorization Act of 2025 To reauthorize certain programs that provide for opioid use disorder prevention, treatment, and recovery, and for other purposes. Sponsor: Sen. Cassidy, Bill [R-LA] H.R.1909 - Preventing Maternal Deaths Reauthorization Act of 2025 To amend the Public Health Service Act to reauthorize support for State-based maternal mortality review committees, to direct the Secretary of Health and Human Services to disseminate best practices on maternal mortality prevention to hospitals, State-based professional societies, and perinatal quality collaboratives, and for other purposes. Sponsor: Rep. Carter, Earl L. "Buddy" [R-GA-1] H.R.1197 - PREEMIE Reauthorization Act of 2025 To reauthorize the Prematurity Research Expansion and Education for Mothers who deliver Infants Early Act. Sponsor: Rep. Kelly, Robin L. [D-IL-2] S.46 - Health Care Affordability Act of 2025 A bill to amend the Internal Revenue Code of 1986 to expand eligibility for the refundable credit for coverage under a qualified health plan. Sponsor: Sen. Shaheen, Jeanne [D-NH] H.R.247 - Health Care Affordability Act of 2025 To amend the Internal Revenue Code of 1986 to expand eligibility for the refundable credit for coverage under a qualified health plan. Sponsor: Rep. Underwood, Lauren [D-IL-14] H.R.3237 To amend title XVIII of the Social Security Act to require each off-campus outpatient department of a provider to include a unique identifier on claims for items and services, and to require providers with a department of a provider to submit to the Centers for Medicare & Medicaid Services an attestation with respect to each such department. Sponsor: Rep. Joyce, John [R-PA-13] S.5535 - No Surprises Act Enforcement Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to increase penalties for group health plans and health insurance issuers for practices that violate balance billing requirements, and for other purposes. Sponsor: Sen. Marshall, Roger [R-KS] H.R.2079 - Insurance Fraud Accountability Act To amend the Patient Protection and Affordable Care Act to reduce fraudulent enrollments in qualified health plans, and for other purposes. Sponsor: Rep. Ross, Deborah K. [D-NC-2] S.976 - Insurance Fraud Accountability Act To amend the Patient Protection and Affordable Care Act to reduce fraudulent enrollments in qualified health plans, and for other purposes. Sponsor: Sen. Wyden, Ron [D-OR] H.R.4710 - No Surprises Act Enforcement Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to increase penalties for group health plans and health insurance issuers for practices that violate balance billing requirements, and for other purposes. Sponsor: Rep. Murphy, Gregory F. [R-NC-3] S.2420 - No Surprises Act Enforcement Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to increase penalties for group health plans, health insurance issuers, and nonparticipating providers or facilities for practices that violate balance billing requirements, and for other purposes. Sponsor: Sen. Marshall, Roger [R-KS] H.R.3841 - Healthcare Cybersecurity Act of 2025 To enhance the cybersecurity of the Healthcare and Public Health Sector. Sponsor: Rep. Crow, Jason [D-CO-6] S.1851 - Healthcare Cybersecurity Act of 2025 To enhance the cybersecurity of the Healthcare and Public Health Sector. Sponsor: Sen. Rosen, Jacky [D-NV] H.R.3419 To amend the Public Health Service Act to reauthorize the telehealth network and telehealth resource centers grant programs. Sponsor: Rep. Valadao, David G. [R-CA-22] H.R.2493 - Improving Care in Rural America Reauthorization Act of 2025 To reauthorize certain programs regarding rural health care. Sponsor: Rep. Carter, Earl L. "Buddy" [R-GA-1] S.2301 - Improving Care in Rural America Reauthorization Act of 2025 To reauthorize certain programs regarding rural health care. Sponsor: Sen. Scott, Tim [R-SC] H.R.3593 - Title VIII Nursing Workforce Reauthorization Act of 2025 To amend the Public Health Service Act to reauthorize certain nursing workforce development programs, and for other purposes. Sponsor: Rep. Joyce, David P. [R-OH-14] S.1874 - Title VIII Nursing Workforce Reauthorization Act of 2025 To amend the Public Health Service Act to reauthorize certain nursing workforce development programs, and for other purposes. Sponsor: Sen. Merkley, Jeff [D-OR] H.R.2528 - Association Health Plans Act To amend the Employee Retirement Income Security Act of 1974 to clarify the treatment of certain association health plans as employers, and for other purposes. Sponsor: Rep. Walberg, Tim [R-MI-5] S.2355 - Patients Deserve Price Tags Act To amend the Public Health Service Act to provide for hospital and insurer price transparency. Sponsor: Sen. Marshall, Roger [R-KS] H.R.2509 - COMPLETE Care Act To amend title XVIII of the Social Security Act to provide incentives for behavioral health integration. Sponsor: Rep. Malliotakis, Nicole [R-NY-11] S.931 - COMPLETE Care Act To amend title XVIII of the Social Security Act to provide incentives for behavioral health integration. Sponsor: Sen. Cortez Masto, Catherine [D-NV] H.R.6703 - Lower Health Care Premiums for All Americans Act To ensure access to affordable health insurance. Sponsor: Rep. Miller-Meeks, Mariannette [R-IA-1] S.2497 - Fair Billing Act To amend title XVIII of the Social Security Act to require a separate identification number and an attestation for each off-campus outpatient department of a provider. Sponsor: Sen. Hassan, Margaret Wood [D-NH] H.R.5972 - Right to Enroll Act of 2025 To direct the Secretary of Health and Human Services to extend the annual open enrollment period for enrolling in a qualified health plan offered by an Exchange for plan year 2026. Sponsor: Rep. Pappas, Chris [D-NH-1] H.R.6232 - HOPE Act To amend the Internal Revenue Code of 1986 to extend and modify the enhanced premium tax credit, and to amend the Patient Protection and Affordable Care Act to make certain adjustments to the operation of the Exchanges established under such Act. Sponsor: Rep. Suozzi, Thomas R. [D-NY-3] S.958 - Tech to Save Moms Act To support the use of technology in maternal health care, and for other purposes. Sponsor: Sen. Lujan, Ben Ray [D-NM] H.R.5463 - Choice Arrangement To amend the Internal Revenue Code of 1986 to provide for the treatment of employer-provided health reimbursement arrangements that are integrated with individual market coverage, and for other purposes. Sponsor: Rep. Hern, Kevin [R-OK-1]
2025 · fourth_quarter · Medicare/Medicaid
HR 1, To provide for reconciliation pursuant to title II of H Con Res 14; HR 1509 / S 752, Accelerating Kids Access to Care Act (AKACA); S 2497, Fair Billing Act; S 1629, Same Care, Lower Cost Act; Proposals to adopt a unique national provider identifier for individual HOPD sites
Client expense: $610,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
2025 · fourth_quarter · Health Issues
Affordable Care Act (ACA), ACA subsidies and tax credits; ACA Fraud; Transparency in coverage; Surprise Billing; 2025 Proposed NBPP/Individual Market/ACA exchanges; Rural healthcare; Prior Authorization; Hospital Consolidation; Employer-provided health coverage; Hospital Billing; Program integrity in the individual marketplace; Federal Budget Process; Artificial Intelligence; Marketplace Renewal Notices; Individual Market Reforms and eAPTC Extension. H.R.3417 - FAIR Act (118th) To ensure fair billing practices for items and services furnished by off-campus outpatient departments of a provider. H.R. 5378 Lower Costs, More Transparency Act (118th) To promote price transparency in the health care sector, and for other purposes. H.R.3237 To amend title XVIII of the Social Security Act to require each off-campus outpatient department of a provider to include a unique identifier on claims for items and services, and to require providers with a department of a provider to submit to the Centers for Medicare & Medicaid Services an attestation with respect to each such department. H.R.6703 - Lower Health Care Premiums for All Americans Act To ensure access to affordable health insurance. S.2497 - Fair Billing Act To amend title XVIII of the Social Security Act to require a separate identification number and an attestation for each off-campus outpatient department of a provider. H.R.5972 - Right to Enroll Act of 2025 To direct the Secretary of Health and Human Services to extend the annual open enrollment period for enrolling in a qualified health plan offered by an Exchange for plan year 2026. H.R.6232 - HOPE Act To amend the Internal Revenue Code of 1986 to extend and modify the enhanced premium tax credit, and to amend the Patient Protection and Affordable Care Act to make certain adjustments to the operation of the Exchanges established under such Act. S.958 - Tech to Save Moms Act To support the use of technology in maternal health care, and for other purposes. H.R.5463 - Choice Arrangement To amend the Internal Revenue Code of 1986 to provide for the treatment of employer-provided health reimbursement arrangements that are integrated with individual market coverage, and for other purposes.
2025 · fourth_quarter · Health Issues
Issues: Affordable Care Act (ACA), ACA subsidies and tax credits; Telehealth/ telehealth flexibilities; ACA Fraud; Transparency in coverage; Surprise Billing; 2025 Proposed NBPP/Individual Market/ACA exchanges; Rural healthcare; Prior Authorization; Hospital Consolidation; Employer-provided health coverage; Cyber Attack/ Cyber Security; Provider Directories; Community Health + Maternal Health; Hospital Billing; Anti-tiering, Anti-steering; Community Health; Program integrity in the individual marketplace; Federal Budget Process; Artificial Intelligence; Vaccine Coverage; Marketplace Renewal Notices; Cell and Gene Therapies; Food as Medicine; Health Disparities; Individual Market Reforms and eAPTC Extension; Health Savings Accounts Bills: S. 1451 Healthy Competition for Better Care Act (118th) To ban anticompetitive terms in facility and insurance contracts that limit access to higher quality, lower cost care. Sponsor: Sen. Braun, Mike [R-IN] H.R.3120 - Healthy Competition for Better Care Act (118th) To ban anticompetitive terms in facility and insurance contracts that limit access to higher quality, lower cost care. Sponsor: Rep. Steel, Michelle [R-CA-45] S.2903 - Safe Step Act To amend the Employee Retirement Income Security Act of 1974 to require a group health plan or health insurance coverage offered in connection with such a plan to provide an exceptions process for any medication step therapy protocol, and for other purposes. Sponsor: Sen. Murkowski, Lisa [R-AK] H.R.3417 - FAIR Act (118th) To ensure fair billing practices for items and services furnished by off-campus outpatient departments of a provider. Sponsor: Rep. Hern, Kevin [R-OK-1] (118th) H.R. 5378 Lower Costs, More Transparency Act (118th) To promote price transparency in the health care sector, and for other purposes. Sponsor: Rep. McMorris Rodgers, Cathy [R-WA-5] H.R.2483 - Support for Patients and Communities Reauthorization Act To reauthorize certain programs that provide for opioid use disorder prevention, treatment, and recovery, and for other purposes. Sponsor: Rep. Guthrie, Brett [R-KY-2] S.2121 - SUPPORT for Patients and Communities Reauthorization Act of 2025 To reauthorize certain programs that provide for opioid use disorder prevention, treatment, and recovery, and for other purposes. Sponsor: Sen. Cassidy, Bill [R-LA] H.R.1909 - Preventing Maternal Deaths Reauthorization Act of 2025 To amend the Public Health Service Act to reauthorize support for State-based maternal mortality review committees, to direct the Secretary of Health and Human Services to disseminate best practices on maternal mortality prevention to hospitals, State-based professional societies, and perinatal quality collaboratives, and for other purposes. Sponsor: Rep. Carter, Earl L. "Buddy" [R-GA-1] H.R.1197 - PREEMIE Reauthorization Act of 2025 To reauthorize the Prematurity Research Expansion and Education for Mothers who deliver Infants Early Act. Sponsor: Rep. Kelly, Robin L. [D-IL-2] S.46 - Health Care Affordability Act of 2025 A bill to amend the Internal Revenue Code of 1986 to expand eligibility for the refundable credit for coverage under a qualified health plan. Sponsor: Sen. Shaheen, Jeanne [D-NH] H.R.247 - Health Care Affordability Act of 2025 To amend the Internal Revenue Code of 1986 to expand eligibility for the refundable credit for coverage under a qualified health plan. Sponsor: Rep. Underwood, Lauren [D-IL-14] H.R.3237 To amend title XVIII of the Social Security Act to require each off-campus outpatient department of a provider to include a unique identifier on claims for items and services, and to require providers with a department of a provider to submit to the Centers for Medicare & Medicaid Services an attestation with respect to each such department. Sponsor: Rep. Joyce, John [R-PA-13] S.5535 - No Surprises Act Enforcement Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to increase penalties for group health plans and health insurance issuers for practices that violate balance billing requirements, and for other purposes. Sponsor: Sen. Marshall, Roger [R-KS] H.R.2571 - Self-Insurance Protection Act To amend the Employee Retirement Income Security Act of 1974 to exclude from the definition of health insurance coverage certain medical stop-loss insurance obtained by certain plan sponsors of group health plans, and for other purposes. Sponsor: Rep. Onder, Robert [R-MO-3] H.R.3277 - Ensuring Lasting Smiles Act To provide health insurance benefits for outpatient and inpatient items and services related to the diagnosis and treatment of a congenital anomaly or birth defect. Sponsor: Rep. Dunn, Neal P. [R-FL-2] S.1677 - Ensuring Lasting Smiles Act To provide health insurance benefits for outpatient and inpatient items and services related to the diagnosis and treatment of a congenital anomaly or birth defect. Sponsor: Sen. Baldwin, Tammy [D-WI] H.R.2079 - Insurance Fraud Accountability Act To amend the Patient Protection and Affordable Care Act to reduce fraudulent enrollments in qualified health plans, and for other purposes. Sponsor: Rep. Ross, Deborah K. [D-NC-2] S.976 - Insurance Fraud Accountability Act To amend the Patient Protection and Affordable Care Act to reduce fraudulent enrollments in qualified health plans, and for other purposes. Sponsor: Sen. Wyden, Ron [D-OR] H.R.4710 - No Surprises Act Enforcement Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to increase penalties for group health plans and health insurance issuers for practices that violate balance billing requirements, and for other purposes. Sponsor: Rep. Murphy, Gregory F. [R-NC-3] S.2420 - No Surprises Act Enforcement Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to increase penalties for group health plans, health insurance issuers, and nonparticipating providers or facilities for practices that violate balance billing requirements, and for other purposes. Sponsor: Sen. Marshall, Roger [R-KS] H.R.3841 - Healthcare Cybersecurity Act of 2025 To enhance the cybersecurity of the Healthcare and Public Health Sector. Sponsor: Rep. Crow, Jason [D-CO-6] S.1851 - Healthcare Cybersecurity Act of 2025 To enhance the cybersecurity of the Healthcare and Public Health Sector. Sponsor: Sen. Rosen, Jacky [D-NV] H.R.3419 To amend the Public Health Service Act to reauthorize the telehealth network and telehealth resource centers grant programs. Sponsor: Rep. Valadao, David G. [R-CA-22] H.R.2493 - Improving Care in Rural America Reauthorization Act of 2025 To reauthorize certain programs regarding rural health care. Sponsor: Rep. Carter, Earl L. "Buddy" [R-GA-1] S.2301 - Improving Care in Rural America Reauthorization Act of 2025 To reauthorize certain programs regarding rural health care. Sponsor: Sen. Scott, Tim [R-SC] H.R.4262 To reauthorize programs related to health professions education, and for other purposes. Sponsor: Rep. Schakowsky, Janice D. [D-IL-9] H.R.3302 - Healthy Start Reauthorization Act of 2025 To amend the Public Health Service Act to reauthorize the Healthy Start Initiative. Sponsor: Rep. Ocasio-Cortez, Alexandria [D-NY-14] H.R.3593 - Title VIII Nursing Workforce Reauthorization Act of 2025 To amend the Public Health Service Act to reauthorize certain nursing workforce development programs, and for other purposes. Sponsor: Rep. Joyce, David P. [R-OH-14] S.1874 - Title VIII Nursing Workforce Reauthorization Act of 2025 To amend the Public Health Service Act to reauthorize certain nursing workforce development programs, and for other purposes. Sponsor: Sen. Merkley, Jeff [D-OR] H.R.2528 - Association Health Plans Act To amend the Employee Retirement Income Security Act of 1974 to clarify the treatment of certain association health plans as employers, and for other purposes. Sponsor: Rep. Walberg, Tim [R-MI-5] S.2355 - Patients Deserve Price Tags Act To amend the Public Health Service Act to provide for hospital and insurer price transparency. Sponsor: Sen. Marshall, Roger [R-KS] H.R.2509 - COMPLETE Care Act To amend title XVIII of the Social Security Act to provide incentives for behavioral health integration. Sponsor: Rep. Malliotakis, Nicole [R-NY-11] S.931 - COMPLETE Care Act To amend title XVIII of the Social Security Act to provide incentives for behavioral health integration. Sponsor: Sen. Cortez Masto, Catherine [D-NV] H.R.6703 - Lower Health Care Premiums for All Americans Act To ensure access to affordable health insurance. Sponsor: Rep. Miller-Meeks, Mariannette [R-IA-1] S.2497 - Fair Billing Act To amend title XVIII of the Social Security Act to require a separate identification number and an attestation for each off-campus outpatient department of a provider. Sponsor: Sen. Hassan, Margaret Wood [D-NH] H.R.5972 - Right to Enroll Act of 2025 To direct the Secretary of Health and Human Services to extend the annual open enrollment period for enrolling in a qualified health plan offered by an Exchange for plan year 2026. Sponsor: Rep. Pappas, Chris [D-NH-1] H.R.6232 - HOPE Act To amend the Internal Revenue Code of 1986 to extend and modify the enhanced premium tax credit, and to amend the Patient Protection and Affordable Care Act to make certain adjustments to the operation of the Exchanges established under such Act. Sponsor: Rep. Suozzi, Thomas R. [D-NY-3] S.958 - Tech to Save Moms Act To support the use of technology in maternal health care, and for other purposes. Sponsor: Sen. Lujan, Ben Ray [D-NM] H.R.5463 - Choice Arrangement To amend the Internal Revenue Code of 1986 to provide for the treatment of employer-provided health reimbursement arrangements that are integrated with individual market coverage, and for other purposes. Sponsor: Rep. Hern, Kevin [R-OK-1]
2025 · fourth_quarter · Health Issues
Affordable Care Act (ACA), ACA subsidies and tax credits; Telehealth/ telehealth flexibilities; ACA Fraud; Transparency in coverage; Surprise Billing; 2025 Proposed NBPP/Individual Market/ACA exchanges; Rural healthcare; Prior Authorization; Hospital Consolidation; Employer-provided health coverage; Cyber Attack/ Cyber Security; Provider Directories; Community Health + Maternal Health; Hospital Billing; Anti-tiering, Anti-steering; Community Health; Program integrity in the individual marketplace; Federal Budget Process; Artificial Intelligence; Vaccine Coverage; Marketplace Renewal Notices; Cell and Gene Therapies; Food as Medicine; Health Disparities; Individual Market Reforms and eAPTC Extension; Health Savings Accounts S. 1451 Healthy Competition for Better Care Act (118th) To ban anticompetitive terms in facility and insurance contracts that limit access to higher quality, lower cost care. Sponsor: Sen. Braun, Mike [R-IN] H.R.3120 - Healthy Competition for Better Care Act (118th) To ban anticompetitive terms in facility and insurance contracts that limit access to higher quality, lower cost care. Sponsor: Rep. Steel, Michelle [R-CA-45] S.2903 - Safe Step Act To amend the Employee Retirement Income Security Act of 1974 to require a group health plan or health insurance coverage offered in connection with such a plan to provide an exceptions process for any medication step therapy protocol, and for other purposes. Sponsor: Sen. Murkowski, Lisa [R-AK] H.R.3417 - FAIR Act (118th) To ensure fair billing practices for items and services furnished by off-campus outpatient departments of a provider. Sponsor: Rep. Hern, Kevin [R-OK-1] (118th) H.R. 5378 Lower Costs, More Transparency Act (118th) To promote price transparency in the health care sector, and for other purposes. Sponsor: Rep. McMorris Rodgers, Cathy [R-WA-5] H.R.2483 - Support for Patients and Communities Reauthorization Act To reauthorize certain programs that provide for opioid use disorder prevention, treatment, and recovery, and for other purposes. Sponsor: Rep. Guthrie, Brett [R-KY-2] S.2121 - SUPPORT for Patients and Communities Reauthorization Act of 2025 To reauthorize certain programs that provide for opioid use disorder prevention, treatment, and recovery, and for other purposes. Sponsor: Sen. Cassidy, Bill [R-LA] H.R.1909 - Preventing Maternal Deaths Reauthorization Act of 2025 To amend the Public Health Service Act to reauthorize support for State-based maternal mortality review committees, to direct the Secretary of Health and Human Services to disseminate best practices on maternal mortality prevention to hospitals, State-based professional societies, and perinatal quality collaboratives, and for other purposes. Sponsor: Rep. Carter, Earl L. "Buddy" [R-GA-1] H.R.1197 - PREEMIE Reauthorization Act of 2025 To reauthorize the Prematurity Research Expansion and Education for Mothers who deliver Infants Early Act. Sponsor: Rep. Kelly, Robin L. [D-IL-2] S.46 - Health Care Affordability Act of 2025 A bill to amend the Internal Revenue Code of 1986 to expand eligibility for the refundable credit for coverage under a qualified health plan. Sponsor: Sen. Shaheen, Jeanne [D-NH] H.R.247 - Health Care Affordability Act of 2025 To amend the Internal Revenue Code of 1986 to expand eligibility for the refundable credit for coverage under a qualified health plan. Sponsor: Rep. Underwood, Lauren [D-IL-14] H.R.3237 To amend title XVIII of the Social Security Act to require each off-campus outpatient department of a provider to include a unique identifier on claims for items and services, and to require providers with a department of a provider to submit to the Centers for Medicare & Medicaid Services an attestation with respect to each such department. Sponsor: Rep. Joyce, John [R-PA-13] S.5535 - No Surprises Act Enforcement Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to increase penalties for group health plans and health insurance issuers for practices that violate balance billing requirements, and for other purposes. Sponsor: Sen. Marshall, Roger [R-KS] H.R.2571 - Self-Insurance Protection Act To amend the Employee Retirement Income Security Act of 1974 to exclude from the definition of health insurance coverage certain medical stop-loss insurance obtained by certain plan sponsors of group health plans, and for other purposes. Sponsor: Rep. Onder, Robert [R-MO-3] H.R.3277 - Ensuring Lasting Smiles Act To provide health insurance benefits for outpatient and inpatient items and services related to the diagnosis and treatment of a congenital anomaly or birth defect. Sponsor: Rep. Dunn, Neal P. [R-FL-2] S.1677 - Ensuring Lasting Smiles Act To provide health insurance benefits for outpatient and inpatient items and services related to the diagnosis and treatment of a congenital anomaly or birth defect. Sponsor: Sen. Baldwin, Tammy [D-WI] H.R.2079 - Insurance Fraud Accountability Act To amend the Patient Protection and Affordable Care Act to reduce fraudulent enrollments in qualified health plans, and for other purposes. Sponsor: Rep. Ross, Deborah K. [D-NC-2] S.976 - Insurance Fraud Accountability Act To amend the Patient Protection and Affordable Care Act to reduce fraudulent enrollments in qualified health plans, and for other purposes. Sponsor: Sen. Wyden, Ron [D-OR] H.R.4710 - No Surprises Act Enforcement Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to increase penalties for group health plans and health insurance issuers for practices that violate balance billing requirements, and for other purposes. Sponsor: Rep. Murphy, Gregory F. [R-NC-3] S.2420 - No Surprises Act Enforcement Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to increase penalties for group health plans, health insurance issuers, and nonparticipating providers or facilities for practices that violate balance billing requirements, and for other purposes. Sponsor: Sen. Marshall, Roger [R-KS] H.R.3841 - Healthcare Cybersecurity Act of 2025 To enhance the cybersecurity of the Healthcare and Public Health Sector. Sponsor: Rep. Crow, Jason [D-CO-6] S.1851 - Healthcare Cybersecurity Act of 2025 To enhance the cybersecurity of the Healthcare and Public Health Sector. Sponsor: Sen. Rosen, Jacky [D-NV] H.R.3419 To amend the Public Health Service Act to reauthorize the telehealth network and telehealth resource centers grant programs. Sponsor: Rep. Valadao, David G. [R-CA-22] H.R.2493 - Improving Care in Rural America Reauthorization Act of 2025 To reauthorize certain programs regarding rural health care. Sponsor: Rep. Carter, Earl L. "Buddy" [R-GA-1] S.2301 - Improving Care in Rural America Reauthorization Act of 2025 To reauthorize certain programs regarding rural health care. Sponsor: Sen. Scott, Tim [R-SC] H.R.4262 To reauthorize programs related to health professions education, and for other purposes. Sponsor: Rep. Schakowsky, Janice D. [D-IL-9] H.R.3302 - Healthy Start Reauthorization Act of 2025 To amend the Public Health Service Act to reauthorize the Healthy Start Initiative. Sponsor: Rep. Ocasio-Cortez, Alexandria [D-NY-14] H.R.3593 - Title VIII Nursing Workforce Reauthorization Act of 2025 To amend the Public Health Service Act to reauthorize certain nursing workforce development programs, and for other purposes. Sponsor: Rep. Joyce, David P. [R-OH-14] S.1874 - Title VIII Nursing Workforce Reauthorization Act of 2025 To amend the Public Health Service Act to reauthorize certain nursing workforce development programs, and for other purposes. Sponsor: Sen. Merkley, Jeff [D-OR] H.R.2528 - Association Health Plans Act To amend the Employee Retirement Income Security Act of 1974 to clarify the treatment of certain association health plans as employers, and for other purposes. Sponsor: Rep. Walberg, Tim [R-MI-5] S.2355 - Patients Deserve Price Tags Act To amend the Public Health Service Act to provide for hospital and insurer price transparency. Sponsor: Sen. Marshall, Roger [R-KS] H.R.2509 - COMPLETE Care Act To amend title XVIII of the Social Security Act to provide incentives for behavioral health integration. Sponsor: Rep. Malliotakis, Nicole [R-NY-11] S.931 - COMPLETE Care Act To amend title XVIII of the Social Security Act to provide incentives for behavioral health integration. Sponsor: Sen. Cortez Masto, Catherine [D-NV] H.R.6703 - Lower Health Care Premiums for All Americans Act To ensure access to affordable health insurance. Sponsor: Rep. Miller-Meeks, Mariannette [R-IA-1] S.2497 - Fair Billing Act To amend title XVIII of the Social Security Act to require a separate identification number and an attestation for each off-campus outpatient department of a provider. Sponsor: Sen. Hassan, Margaret Wood [D-NH] H.R.5972 - Right to Enroll Act of 2025 To direct the Secretary of Health and Human Services to extend the annual open enrollment period for enrolling in a qualified health plan offered by an Exchange for plan year 2026. Sponsor: Rep. Pappas, Chris [D-NH-1] H.R.6232 - HOPE Act To amend the Internal Revenue Code of 1986 to extend and modify the enhanced premium tax credit, and to amend the Patient Protection and Affordable Care Act to make certain adjustments to the operation of the Exchanges established under such Act. Sponsor: Rep. Suozzi, Thomas R. [D-NY-3] S.958 - Tech to Save Moms Act To support the use of technology in maternal health care, and for other purposes. Sponsor: Sen. Lujan, Ben Ray [D-NM] H.R.5463 - Choice Arrangement To amend the Internal Revenue Code of 1986 to provide for the treatment of employer-provided health reimbursement arrangements that are integrated with individual market coverage, and for other purposes. Sponsor: Rep. Hern, Kevin [R-OK-1]
2025 · third_quarter · Medicare/Medicaid
HR 1, To provide for reconciliation pursuant to title II of H Con Res 14; HR 1509 / S 752, Accelerating Kids Access to Care Act (AKACA); S 2497, Fair Billing Act; S 1629, Same Care, Lower Cost Act;
Client expense: $140,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2025 · third_quarter · Medicare/Medicaid
Draft, Medicare Compare Website (no bill number) - Rep. Guthrie, Brett - improvements to CMS Medicare compare website H.R. 1 - One Big Beautiful Bill Act - Rep. Arrington, Jodey - Medicaid eligibility and state financing, Marketplace coverage and enrollment, Health Savings Account expansion, Pharmacy Benefit Manager financing and regulation H.R. 497 - Medicaid Third Party Liability Act - Rep. Crenshaw, Dan - Medicaid liable third-party exceptions H.R. 538 - Critical Access Hospital Relief Act - Rep. Smith, Adrian - Medicare physician certification requirement H.R. 584 - No Medicaid for Illegal Immigrants Act - Rep. Kiley, Kevin - Medicaid eligibility requirements H.R. 608 - COVER Now Act - Rep. Doggett, Lloyd - Medicaid expansion demo H.R. 610 - Close the Medigap Act - Rep. Doggett, Lloyd - Medigap plan reform H.R. 879 - Medicare Patient Access and Practice Stabilization Act - Rep. Murphy, Gregory - Medicare physician reimbursement H.R. 936 - Medicaid Improvement and State Flexibility Act - Rep. Green, Mark - Medicaid demonstration programs H.R. 1019 - Medicaid Program Improvement Act - Rep. Miller-Meeks, Mariannette - Medicaid management care reporting H.R. 1059 - Jobs and Opportunities for Medicaid Act - Rep. Crenshaw, Dan - Medicaid eligibility requirements H.R. 1162 - Medicaid Primary Care Improvement Act - Rep. Crenshaw, Dan - Medicaid direct primary care arrangements H.R. 1191 - Supporting Access to Rural Community Hospitals Act - Rep. Flood, Mike - Medicare critical access hospitals definition H.R. 1195 - Protect Medicaid Act - Rep. Hudson, Richard - Medicaid eligibility requirements H.R. 1279 - To amend title XIX of the Social Security Act to establish a community engagement requirement for certain individuals under the Medicaid program. - Rep. Bean, Aaron - Medicaid eligibility requirements H.R. 1403 - LIVE Beneficiaries Act - Rep. Bilirakis, Gus - Medicaid registration audits H.R. 1598 - Ensuring Access to Medicaid Buy-in Programs Act - Rep. Ciscomani, Juan - Medicaid eligibility requirements H.R. 1683 - Protecting Rural Seniors Access to Care Act - Rep. Fischbach, Michelle - Minimum nursing home staffing H.R. 1775 - Second Chances for Rural Hospitals Act - Rep. Arrington, Jodey -Definition of rural emergency hospitals H.R. 1805 - ARCH Act - Rep. Miller, Carol - Extend Medicare-dependent and low-value hospitals payments H.R. 1924 - Securing Access to Care for Seniors in Critical Condition Act - Rep. Hern, Kevin - Medicare site-neutral payments for LTC hospitals H.R. 2045 - Medicare Dental, Vision, and Hearing Benefit Act - Rep. Doggett, Lloyd - Medicare dental, vision, and hearing coverage H.R. 2263 - Telehealth Coverage Act - Rep. Khanna, Ro - Telehealth flexibilities in Medicare H.R. 2309 - Medicare and Medicaid Fraud Prevention Act - Rep. Peters, Scott - provider screening for Federal programs H.R. 2433 - Reducing Medically Unnecessary Delays in Care Act - Rep. Green, Mark - Medicare Advantage prior authorization H.R. 2533 - EASE Act - Rep. Arrington, Jodey - CMS model for virtual technology H.R. 2586 - Reentry Act - Rep. Tonko, Paul - Medicaid coverage for incarcerated population H.R. 2590 - Mental and Physical Health Care Comorbidities Act - Rep. Boyle, Brendan - CMS demonstration to treat comorbidities H.R. 2610 - Protecting Options for Seniors Act - Rep. Tenney, Claudia - MA wage index reclassification H.R. 3023 - Preventing Hospital Overbilling of Medicare Act - Rep. Spartz, Victoria - Site-neutral payment reform H.R. 3069 - Medicare for All Act - Rep. Jayapal, Pramila - New national health insurance program H.R. 3222 - SMART Health Care Act - Rep. Spartz, Victoria - MA risk adjustment H.R. 3263 - PATCH Act - Rep. Tokuda, Jill - Medicare geographic practice cost indices H.R. 3321 - Ending Medicaid Discrimination Against the Most Vulnerable Act - Rep. Roy, Chip - Enhance FMAP phase out H.R. 3415 - Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act - Rep. Schakowsky, Janice - Nurse staffing ratio requirements H.R. 3467 - To amend title XVIII to reform the Medicare Advantage program - Rep. Schweikert, David - MA reforms H.R. 3808 - Expanding Seniors Access to Mental Health Services Act - Rep. Fitzpatrick, Brian - Medicare mental health services H.R. 4139 - Cutting Copays Act - Rep. McGarvey, Morgan - Medicare cost-sharing for generic drugs H.R. 4277 - Rural Emergency Hospital Financial Stability Act - Rep. Davis, Donald - Medicaid treatment of rural emergency hospitals H.R. 4313 - Hospital Inpatient Services Modernization Act - Rep. Buchanan, Vern - Acute hospital care at home waiver H.R. 4559 - Prompt and Fair Pay Act - Rep. Doggett, Lloyd - Payment parity for MA and FFS; MA reimbursement requirements H.R. 4641 - Keep Kids Covered Act - Rep. Castor, Kathy - Continuous eligibility for children in Medicaid/CHIP H.R. 4807 - Protect Our Hospitals Act - Rep. Landsman, Greg - Medicaid provider tax repeal H.R. 5243 - To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage. - Rep. McClellan, Jennifer - MA supplemental benefits data reporting H.R. 5281 - REAL Health Providers Act - Rep. Panetta, Jimmy - MA provider directory requirements H.R. 5454 - Medicare Advantage Prompt Pay Act - Rep. Arrington, Jodey - payment delivery requirements for MA plans H.R. 5584 - Medicaid Third Party Liability Act - Rep. Burgess, Michael - Impact of Third Party Liability on MCOs S. 523 - Protect Medicaid Act - Sen. Cassidy, Bill - Medicaid eligibility requirements S. 678 - LIVE Beneficiaries Act - Sen. Scott, Rick - Medicaid enrollment audits S. 717 - Increasing Access to Quality Cardiac Rehabilitation Care Act - Sen. Capito, Shelley Moore - Expanding cardiac care coverage in Medicare S. 750 - Protecting Rural Seniors Access to Care Act - Sen. Fischer, Deb - Medicaid nursing home staff requirements S. 752 - Accelerating Kids Access to Care Act - Sen. Grassley, Chuck - Out-of-state provider access for Medicaid S. 939 - Medicare Dental, Hearing, and Vision Expansion Act - Sen. Sanders, Bernard - Medicare coverage requirements S. 1082 - Safeguarding Medicaid Act - Sen. Barrasso, John - Medicaid enrollee asset verification S. 1105 - No UPCODE Act - Sen. Cassidy, Bill - MA risk adjustment S. 1264 - Mental and Physical Health Care Comorbidities Act - Sen. Bennet, Michael - CMS demonstration to treat comorbidities S. 1399 - Health Tech Investment Act - Sen. Rounds, Mike - Medicare coverage for algorithm-based services S. 1506 - Medicare for All Act - Sen. Sanders, Bernard - New national health insurance program S. 1624 - PATCH Act - Sen. Schatz, Brian - Medicare geographic practice cost indices S. 1629 - Same Care, Lower Cost Act - Sen. Kennedy, John - Medicare site-neutral payment reform S. 1637 - MVP Act - Sen. Mullin, Markwayne - Medicaid value-based purchasing agreements S. 1709 - Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act - Sen. Padilla, Alex - Nurse staffing ratio requirements S. 1816 - Improving Seniors Timely Access to Care Act - Sen. Marshall, Roger - MA prior authorization S. 1903 - A bill to prohibit changes to Medicare and Medicaid in reconciliation - Sen. Reed, Jack - Medicare and Medicaid safeguards against reconciliation cuts S. 2237 - Hospital Inpatient Services Modernization Act - Sen. Scott, Tim - Acute hospital care at home waiver S. 2279 - Protect Medicaid and Rural Hospitals Act - Sen. Hawley, Josh - Medicaid provider tax and State directed payments S. 2289 - Healthy Moms and Babies Act - Sen. Grassley, Chuck - Medicaid/CHIP maternal health coverage improvements S. 2496 - Keep Kids Covered Act - Sen. Bennet, Michael - Continuous eligibility for children in Medicaid/CHIP S. 2497 - Fair Billing Act - Sen. Hassan, Maggie - Medicare site-neutral transparency and identification requirements S. 2793 - Ensuring Access to Essential Providers Act - Sen. Cassidy, Bill - Essential community provider coverage requirements for MA 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; Inflation Reduction Act implementation; Medicare Advantage Rate Notice; Part D Payment Issues; Part D VBID Issues; RADV; MA payment issues; Part D issues; prior authorization; MedPAC spending comparisons; and MA prompt pay.
2025 · third_quarter · Health Issues
ERISA preemption Tax treatment of employer-sponsored health benefit plans; budget reconciliation Health Savings Accounts and High-Deductible Health Plans; permanent safe harbor for HSA-eligible health plans to cover telehealth pre-deductible, HSA flexibility primary care and chronic disease; budget reconciliation; Telehealth Expansion Act (HR 1650 / S. 763 - 119th Congress) Health care cost transparency, prescription drugs, PBM pricing and transparency and hospital and health plan price transparency Hospital consolidation and billing practices, site neutral payment reform; Healthy Competition for Better Care Act Voluntary Employee Beneficiary Associations (VEBAs) End-stage renal disease and Medicare secondary payer issues 340B Prescription Drug Program 408(b)(2) Fee disclosure for health plans Surprise Medical Billing rules Chronic Disease Flexible Coverage Act (HR 919 - 119th Congress) Paid leave, Interstate Paid Leave Action Network (I-PLAN) Act, (HR 3090) More Paid Leave for More Americans Act (HR 3089) Fair Billing Act (S. 2497) Prescription Drug Machine Readable Files (MRF) Prescription Drug Cost ERISA electronic reporting and disclosure, mental health parity, allow HSAs to cover chronic conditions on a pre-deductible basis Form 5500 Simplification legislation
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), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Treasury, Dept of, White House Office
Client expense: $4,120,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA), White House Office
Client expense: $265,983 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
Client expense: $10,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
Client expense: $730,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
Client expense: $90,000 · 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), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, White House Office
Client expense: $1,440,000 · 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), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, White House Office
Client expense: $4,230,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Treasury, Dept of, White House Office