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Ensuring Access to Medicaid Buy-in Programs Act of 2026
Legislative Progress
Introduced
January 27, 2026
Latest Action
January 27, 2026
Primary Sponsor
Marsha BlackburnRepublican(TN)
Momentum (last 30 days)
0
score
0 actions · 0 new cosponsors · 0 votes
Speed vs cohort
0pct
0d open
vs 5,674 other S bills in the 119th — cohort avg 32d
No CRS summary is available for this bill yet. The source title, actions, sponsors, and text versions below come from Congress.gov.
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Filing registrants (2)
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.
Read twice and referred to the Committee on Finance.
Introduced in Senate
Bills with similar content found using semantic analysis.
Sources: Congress.gov
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 · third_quarter · Medicare/Medicaid
H.R. 1096: HOPE and Mental Wellbeing Act of 2025 mandates coverage of three annual primary care visits without cost-sharing under Medicare and Medicaid. H.R. 1867: Removes in-person requirements for mental health services under Medicare. H.R. 1598: Ensuring Access to Medicaid Buy-in Programs Act lifts the age cap for Medicaid buy-in programs for those with disabilities who choose to work S. 752/H.R. 1509: Accelerating Kids Access to Care Act expands Medicaid enrollment across state lines. S. 683: More Behavioral Health Providers Act of 2025 creates workforce incentives under Medicare. H.R. 2540: SSI Savings Penalty Elimination Act updates resource limits for SSI income eligibility. Reject cuts to Medicaid and other mental health and or substance use disorder programs in the reconciliation process. Support for state waivers for federal financial participation for services furnished to Medicaid members during short-term stays for acute care in psychiatric hospitals or residential treatment facilities that qualify as institutions for mental disease. -- H.R. 1: One Big Beautiful Bill Act reauthorizes and reforms major federal programs including Medicaid. H.R. 2590: Mental and Physical Health Care Comorbidities Act of 2025 establishes a Medicare demonstration program to promote collaborative treatment of mental and physical health comorbidities. S. 1264/H.R. 3320: Strengthening Medicaid for Serious Mental Illness Act increases federal Medicaid funding for states providing intensive community-based services for adults with serious mental illness. H.R. 4022: Increasing Behavioral Health Treatment Act removes the Medicaid exclusion for mental health services in institutions for mental diseases for patients under 65. S. 2011/H.R. 3884: Telemental Health Care Access Act removes the statutory requirement that Medicare beneficiaries be seen in-person within six months of being treated for mental and behavioral health services through telehealth. S. 2024/H.R. 3907: Expand Navigators Resources for Outreach, Learning, and Longevity (ENROLL) Act strengthens and expands the navigator program by increasing funding, broadening duties, and ensuring nonprofit participation. H.R. 2495: Nutrition CARE Act of 2025 provides Medicare coverage for medical nutrition therapy for individuals with eating disorders. H.R. 2263: Telehealth Coverage Act of 2025: permanently expands telehealth services under Medicare H.R. 3384 Telemental Health Care Access Act: Expands Medicaid to include both mental and behavioral health services provided by telehealth. H.R. 4037/S.2847: Occupational Therapy Mental Health parity Act: Clarifies that Medicare covers occupational therapy for mental health and substance use disorders HR 4619 Medicare Mental Health Impatient Equity Act of 2025: Removes the 190-day lifetime limit on Medicare coverage on inpatient Psychiatric hospital services. HR 5462: Michelle Alyssa Go Act: Would expand Medicaid coverage for mental health and substance use disorder treatment by increasing the facility size limit from 16 to 36 beds. S. 2401/H.R. 4745: Medicaid Bump Act: Increase federal Medicaid funds for certain mental health services S. 1797 Expanding Seniors Access to Mental Health Services Act: expands Medicaid coverage and reimbursement for clinical social workers to provide mental health services S.2050 ASSIST Act: Increases federal Medicaid funding for school-based behavioral health services S.2069/HR 4028: Stabilize Medicaid and CHIP Coverage Act: mandates 12-month continuous enrollment for all individuals in Medicaid and CHIP S.2037/H.R.4313 Hospital Inpatient Services Modernization Act: Extends Medicare's acute hospital care at home waiver flexibilities S.2709/ H.R.5081: Telehealth Modernization Act: Extends and expands Medicare telehealth flexibilities S.3300/H.R.6408: ANCHOR Act of 2025 allows states to expand Medicaid coverage to low income, uninsured individuals with serious mental illness or substance use disorders S.3486 Expand the Behavioral Health Workforce Now Act: Requires federal guidance to help states strengthen the behavioral health workforce in Medicaid and CHIP S. 3522 No Red Tape for Addiction Treatment Act: Requires State Medicaid programs to cover at least one formulation of each medication for opioid use disorder without prior Authorization H.R. 6096 NEST Act funds and distributes essential newborn supply kits to mothers. S.1816/ H.R. 3514: Improving Seniors' Timely Access to Care Act: Streamlining prior authorization to increase timely access to care. Support for the extension of the enhanced advance premium tax credits (eAPTC) Support for an extension or permanent authorization of telehealth/telemental health flexibilities Support for continued access to Medicaid Ensuring that new community engagement requirements do not lead to individuals being unfairly removed from Medicaid. H.R. 7535: Second Chance Mental Health Access Act of 2026 requires Medicaid to cover 12 annual mental health telehealth visits for individuals transitioning from incarceration to home confinement. H.R. 5662: Improving Access to Institutional Mental Health Care Act removes the Medicaid exclusion for coverage of services provided to patients in mental health institutions. H.R. 6296: Advancing Access to Telehealth Act makes several telehealth flexibilities permanent under Medicare. H.R. 6727: Repealing the IMD Exclusion Act removes the Medicaid exclusion for mental health and substance use disorder treatment in institutions for mental diseases. H.R. 7324: More Behavioral Health Providers Act of 2026 expands Medicare bonus payments to a wider range of behavioral health practitioners. S. 2709: Telehealth Modernization Act extends and expands Medicare telehealth flexibilities. S. 3521/H.R. 6841: PEERS Act of 2025 expands Medicare to cover peer support services for mental health and substance use recovery. S. 3690: Ensuring Access to Medicaid Buy-in Programs Act of 2026 removes the age limit for working adults with disabilities to qualify for Medicaid buy-in programs. S. 3750: REAL Health Providers Act requires Medicare Advantage plans to maintain accurate provider directories. S. 4076: Removing Medicare Mental Health Inpatient Limitations Act of 2026 removes the 190-day lifetime limit on Medicare coverage for inpatient psychiatric hospital services. S. 4202: Mental Health Access and Provider Support Act of 2026 increases Medicare reimbursement rates for certain mental health providers. ___ H.R. 3514: Improving Seniors Timely Access to Care Act of 2025 requires Medicare Advantage plans to implement electronic prior authorization, increase transparency, protect enrollees, and adhere to new response timeframes H.R. 5944: Restoring Inpatient Mental Health Access Act of 2025 allows federal Medicaid funding for inpatient mental health services in institutions for mental diseases H.R. 8081: Mental Health Access and Provider Support Act of 2026 increases Medicare reimbursement rates for certain mental health providers H.R. 8487: Ensuring Excellence in Mental Health Act expands and standardizes Certified Community Behavioral Health Clinics under Medicaid and Medicare H.R.8261: Chronic Care Management Improvement Act of 2026 eliminates all cost-sharing for chronic care management services under Medicare Part B S. 4481: IMPACT to Save Moms Act demonstration project for states to test innovative Medicaid and CHIP payment models for maternity care __ Support for the continuation of the enhanced FMAP rate for mobile crisis response programs. H.R. 10240: Behavioral Health Crisis Services Expansion Act of 2026 requires Medicare, Medicaid, CHIP, TRICARE, veterans health care, FEHB, and private health insurance to cover behavioral health crisis response services. H.R. 10270: Supporting 988 Crisis Stabilization Act revises Medicaid's IMD exclusion to expand coverage for crisis stabilization and urgent mental health care facilities. H.R. 10287: 988 Crisis Response Act increases funding and expands Medicaid coverage for mental health crisis response services. H.R. 8540: HCBS Access Act a comprehensive legislative proposal aimed at transforming the delivery and accessibility of Home and Community-Based Services (HCBS) under Medicaid. H.R. 8891: Rural MOMS Act of 2026 amends Medicare regulations to exclude beds used solely for labor and delivery from the acute care inpatient bed count for critical access hospitals. H.R. 9488: Health Disparity Zones Act of 2026 establishes designated areas with significant health disparities and provides tax incentives, grants, loan repayment programs, and increased Medicare payments. H.R. 9538: Residential Recovery for Seniors Act establish Medicare coverage for residential substance use disorder services. H.R. 9847: Improving CARE for Youth Act requires Medicaid to cover and reimburse for mental health, substance use disorder, and primary care services provided to the same individual on the same day. H.R. 9867: Expand the Behavioral Health Workforce Now Act requires federal guidance to states on using Medicaid and CHIP to strengthen the behavioral health workforce. S. 5231: Equity in Pretrial Health Coverage Act removes federal restrictions that previously denied Medicaid, Medicare, CHIP, and VA health benefits to individuals in custody pending trial. S. 5236: Improving CARE for Youth Act requires Medicaid to cover both mental health and primary care services provided to an individual on the same day. S. 5321: HCBS Access Act expands and standardizes access to HCBS under Medicaid. S. 5428/H.R. 930 Stop the Wait Act eliminates the waiting periods for Social Security Disability Insurance and Medicare coverage.
Client expense: $10,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office
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 · Medicare/Medicaid
H.R. 1096: HOPE and Mental Wellbeing Act of 2025 mandates coverage of three annual primary care visits without cost-sharing under Medicare and Medicaid. H.R. 1867: Removes in-person requirements for mental health services under Medicare. H.R. 1598: Ensuring Access to Medicaid Buy-in Programs Act lifts the age cap for Medicaid buy-in programs for those with disabilities who choose to work S. 752/H.R. 1509: Accelerating Kids Access to Care Act expands Medicaid enrollment across state lines. S. 683: More Behavioral Health Providers Act of 2025 creates workforce incentives under Medicare. H.R. 2540: SSI Savings Penalty Elimination Act updates resource limits for SSI income eligibility. Reject cuts to Medicaid and other mental health and or substance use disorder programs in the reconciliation process. Support for state waivers for federal financial participation for services furnished to Medicaid members during short-term stays for acute care in psychiatric hospitals or residential treatment facilities that qualify as institutions for mental disease. -- H.R. 1: One Big Beautiful Bill Act reauthorizes and reforms major federal programs including Medicaid. H.R. 2590: Mental and Physical Health Care Comorbidities Act of 2025 establishes a Medicare demonstration program to promote collaborative treatment of mental and physical health comorbidities. S. 1264/H.R. 3320: Strengthening Medicaid for Serious Mental Illness Act increases federal Medicaid funding for states providing intensive community-based services for adults with serious mental illness. H.R. 4022: Increasing Behavioral Health Treatment Act removes the Medicaid exclusion for mental health services in institutions for mental diseases for patients under 65. S. 2011/H.R. 3884: Telemental Health Care Access Act removes the statutory requirement that Medicare beneficiaries be seen in-person within six months of being treated for mental and behavioral health services through telehealth. S. 2024/H.R. 3907: Expand Navigators Resources for Outreach, Learning, and Longevity (ENROLL) Act strengthens and expands the navigator program by increasing funding, broadening duties, and ensuring nonprofit participation. H.R. 2495: Nutrition CARE Act of 2025 provides Medicare coverage for medical nutrition therapy for individuals with eating disorders. H.R. 2263: Telehealth Coverage Act of 2025: permanently expands telehealth services under Medicare H.R. 3384 Telemental Health Care Access Act: Expands Medicaid to include both mental and behavioral health services provided by telehealth. H.R. 4037/S.2847: Occupational Therapy Mental Health parity Act: Clarifies that Medicare covers occupational therapy for mental health and substance use disorders HR 4619 Medicare Mental Health Impatient Equity Act of 2025: Removes the 190-day lifetime limit on Medicare coverage on inpatient Psychiatric hospital services. HR 5462: Michelle Alyssa Go Act: Would expand Medicaid coverage for mental health and substance use disorder treatment by increasing the facility size limit from 16 to 36 beds. S. 2401/H.R. 4745: Medicaid Bump Act: Increase federal Medicaid funds for certain mental health services S. 1797 Expanding Seniors Access to Mental Health Services Act: expands Medicaid coverage and reimbursement for clinical social workers to provide mental health services S.2050 ASSIST Act: Increases federal Medicaid funding for school-based behavioral health services S.2069/HR 4028: Stabilize Medicaid and CHIP Coverage Act: mandates 12-month continuous enrollment for all individuals in Medicaid and CHIP S.2037/H.R.4313 Hospital Inpatient Services Modernization Act: Extends Medicare's acute hospital care at home waiver flexibilities S.2709/ H.R.5081: Telehealth Modernization Act: Extends and expands Medicare telehealth flexibilities S.3300/H.R.6408: ANCHOR Act of 2025 allows states to expand Medicaid coverage to low income, uninsured individuals with serious mental illness or substance use disorders S.3486 Expand the Behavioral Health Workforce Now Act: Requires federal guidance to help states strengthen the behavioral health workforce in Medicaid and CHIP S. 3522 No Red Tape for Addiction Treatment Act: Requires State Medicaid programs to cover at least one formulation of each medication for opioid use disorder without prior Authorization H.R. 6096 NEST Act funds and distributes essential newborn supply kits to mothers. S.1816/ H.R. 3514: Improving Seniors' Timely Access to Care Act: Streamlining prior authorization to increase timely access to care. Support for the extension of the enhanced advance premium tax credits (eAPTC) Support for an extension or permanent authorization of telehealth/telemental health flexibilities Support for continued access to Medicaid Ensuring that new community engagement requirements do not lead to individuals being unfairly removed from Medicaid. H.R. 7535: Second Chance Mental Health Access Act of 2026 requires Medicaid to cover 12 annual mental health telehealth visits for individuals transitioning from incarceration to home confinement. H.R. 5662: Improving Access to Institutional Mental Health Care Act removes the Medicaid exclusion for coverage of services provided to patients in mental health institutions. H.R. 6296: Advancing Access to Telehealth Act makes several telehealth flexibilities permanent under Medicare. H.R. 6727: Repealing the IMD Exclusion Act removes the Medicaid exclusion for mental health and substance use disorder treatment in institutions for mental diseases. H.R. 7324: More Behavioral Health Providers Act of 2026 expands Medicare bonus payments to a wider range of behavioral health practitioners. S. 2709: Telehealth Modernization Act extends and expands Medicare telehealth flexibilities. S. 3521/H.R. 6841: PEERS Act of 2025 expands Medicare to cover peer support services for mental health and substance use recovery. S. 3690: Ensuring Access to Medicaid Buy-in Programs Act of 2026 removes the age limit for working adults with disabilities to qualify for Medicaid buy-in programs. S. 3750: REAL Health Providers Act requires Medicare Advantage plans to maintain accurate provider directories. S. 4076: Removing Medicare Mental Health Inpatient Limitations Act of 2026 removes the 190-day lifetime limit on Medicare coverage for inpatient psychiatric hospital services. S. 4202: Mental Health Access and Provider Support Act of 2026 increases Medicare reimbursement rates for certain mental health providers. ___ H.R. 3514: Improving Seniors Timely Access to Care Act of 2025 requires Medicare Advantage plans to implement electronic prior authorization, increase transparency, protect enrollees, and adhere to new response timeframes H.R. 5944: Restoring Inpatient Mental Health Access Act of 2025 allows federal Medicaid funding for inpatient mental health services in institutions for mental diseases H.R. 8081: Mental Health Access and Provider Support Act of 2026 increases Medicare reimbursement rates for certain mental health providers H.R. 8487: Ensuring Excellence in Mental Health Act expands and standardizes Certified Community Behavioral Health Clinics under Medicaid and Medicare H.R.8261: Chronic Care Management Improvement Act of 2026 eliminates all cost-sharing for chronic care management services under Medicare Part B S. 4481: IMPACT to Save Moms Act demonstration project for states to test innovative Medicaid and CHIP payment models for maternity care
Client expense: $20,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office
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
H.R. 1096: HOPE and Mental Wellbeing Act of 2025 mandates coverage of three annual primary care visits without cost-sharing under Medicare and Medicaid. H.R. 1867: Removes in-person requirements for mental health services under Medicare. H.R. 1598: Ensuring Access to Medicaid Buy-in Programs Act lifts the age cap for Medicaid buy-in programs for those with disabilities who choose to work S. 752/H.R. 1509: Accelerating Kids Access to Care Act expands Medicaid enrollment across state lines. S. 683: More Behavioral Health Providers Act of 2025 creates workforce incentives under Medicare. H.R. 2540: SSI Savings Penalty Elimination Act updates resource limits for SSI income eligibility. Reject cuts to Medicaid and other mental health and or substance use disorder programs in the reconciliation process. Support for state waivers for federal financial participation for services furnished to Medicaid members during short-term stays for acute care in psychiatric hospitals or residential treatment facilities that qualify as institutions for mental disease. -- H.R. 1: One Big Beautiful Bill Act reauthorizes and reforms major federal programs including Medicaid. H.R. 2590: Mental and Physical Health Care Comorbidities Act of 2025 establishes a Medicare demonstration program to promote collaborative treatment of mental and physical health comorbidities. S. 1264/H.R. 3320: Strengthening Medicaid for Serious Mental Illness Act increases federal Medicaid funding for states providing intensive community-based services for adults with serious mental illness. H.R. 4022: Increasing Behavioral Health Treatment Act removes the Medicaid exclusion for mental health services in institutions for mental diseases for patients under 65. S. 2011/H.R. 3884: Telemental Health Care Access Act removes the statutory requirement that Medicare beneficiaries be seen in-person within six months of being treated for mental and behavioral health services through telehealth. S. 2024/H.R. 3907: Expand Navigators Resources for Outreach, Learning, and Longevity (ENROLL) Act strengthens and expands the navigator program by increasing funding, broadening duties, and ensuring nonprofit participation. H.R. 2495: Nutrition CARE Act of 2025 provides Medicare coverage for medical nutrition therapy for individuals with eating disorders. H.R. 2263: Telehealth Coverage Act of 2025: permanently expands telehealth services under Medicare H.R. 3384 Telemental Health Care Access Act: Expands Medicaid to include both mental and behavioral health services provided by telehealth. H.R. 4037/S.2847: Occupational Therapy Mental Health parity Act: Clarifies that Medicare covers occupational therapy for mental health and substance use disorders HR 4619 Medicare Mental Health Impatient Equity Act of 2025: Removes the 190-day lifetime limit on Medicare coverage on inpatient Psychiatric hospital services. HR 5462: Michelle Alyssa Go Act: Would expand Medicaid coverage for mental health and substance use disorder treatment by increasing the facility size limit from 16 to 36 beds. S. 2401/H.R. 4745: Medicaid Bump Act: Increase federal Medicaid funds for certain mental health services S. 1797 Expanding Seniors Access to Mental Health Services Act: expands Medicaid coverage and reimbursement for clinical social workers to provide mental health services S.2050 ASSIST Act: Increases federal Medicaid funding for school-based behavioral health services S.2069/HR 4028: Stabilize Medicaid and CHIP Coverage Act: mandates 12-month continuous enrollment for all individuals in Medicaid and CHIP S.2037/H.R.4313 Hospital Inpatient Services Modernization Act: Extends Medicare's acute hospital care at home waiver flexibilities S.2709/ H.R.5081: Telehealth Modernization Act: Extends and expands Medicare telehealth flexibilities S.3300/H.R.6408: ANCHOR Act of 2025 allows states to expand Medicaid coverage to low income, uninsured individuals with serious mental illness or substance use disorders S.3486 Expand the Behavioral Health Workforce Now Act: Requires federal guidance to help states strengthen the behavioral health workforce in Medicaid and CHIP S. 3522 No Red Tape for Addiction Treatment Act: Requires State Medicaid programs to cover at least one formulation of each medication for opioid use disorder without prior Authorization H.R. 6096 NEST Act funds and distributes essential newborn supply kits to mothers. S.1816/ H.R. 3514: Improving Seniors' Timely Access to Care Act: Streamlining prior authorization to increase timely access to care. Support for the extension of the enhanced advance premium tax credits (eAPTC) Support for an extension or permanent authorization of telehealth/telemental health flexibilities Support for continued access to Medicaid Ensuring that new community engagement requirements do not lead to individuals being unfairly removed from Medicaid. H.R. 7535: Second Chance Mental Health Access Act of 2026 requires Medicaid to cover 12 annual mental health telehealth visits for individuals transitioning from incarceration to home confinement. H.R. 5662: Improving Access to Institutional Mental Health Care Act removes the Medicaid exclusion for coverage of services provided to patients in mental health institutions. H.R. 6296: Advancing Access to Telehealth Act makes several telehealth flexibilities permanent under Medicare. H.R. 6727: Repealing the IMD Exclusion Act removes the Medicaid exclusion for mental health and substance use disorder treatment in institutions for mental diseases. H.R. 7324: More Behavioral Health Providers Act of 2026 expands Medicare bonus payments to a wider range of behavioral health practitioners. S. 2709: Telehealth Modernization Act extends and expands Medicare telehealth flexibilities. S. 3521/H.R. 6841: PEERS Act of 2025 expands Medicare to cover peer support services for mental health and substance use recovery. S. 3690: Ensuring Access to Medicaid Buy-in Programs Act of 2026 removes the age limit for working adults with disabilities to qualify for Medicaid buy-in programs. S. 3750: REAL Health Providers Act requires Medicare Advantage plans to maintain accurate provider directories. S. 4076: Removing Medicare Mental Health Inpatient Limitations Act of 2026 removes the 190-day lifetime limit on Medicare coverage for inpatient psychiatric hospital services. S. 4202: Mental Health Access and Provider Support Act of 2026 increases Medicare reimbursement rates for certain mental health providers.
Client expense: $10,000 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office