HCBS Access Act

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

H.R. 869/S.343, Keep Our PACT Act, all provisions H.R. 1520/S. 1782, CharlotteWoodwardOrgan Transplant Discrimination Prevention Act, all provisions H.R. 2540/S.1234, SSI Savings Penalty Elimination Act, all provisions H.R. 2598/S.1277, IDEA Full Funding Act, all provisions H.R. 3049, HEADs UP Act of 2025, all provisions H.R. 3939, RISE Act, all provisions H.R. 4086, Autism Family Caregivers Act, all provisions H.R. 4644/S.2459, ABLE Employment Flexibility Act, all provisions H.R. 6147/S. 3211, Recognizing the Role of Direct Support Professionals Act, all provisions H.R. 6602/S.4089, Supporting Blue Envelope Programs Act, all provisions H.R.8298, SSISavingsandEfficiencyAct of 2026, all provisions H.R. 8540/S. 5321, HCBS Access Act, all provisions H.R. 8620, CARES Hotline Act, all provisions H.R. 8845, Commerce, Justice, Science, and Related Agencies Appropriations Act, 2027, provisions related to funding for the Kevin and Avonte's Law Program H.R. 9260, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2027, provisions related to funding autism research and services at the National Institutes of Health, Centers for Disease Control and Prevention, Health Resources and Services Administration; assistive technology programs and special education at the Department of Education H.R.9495, Department of Defense Appropriations Act, 2027, provisions related to funding for the congressionally directed medical research autism research program H.R. 9809, Disabled Access Credit Modernization Act, all provisions H.R. 10049/S. 5285, Visitable Inclusive Tax Credits for Accessible Living (VITAL) Act, all provisions H.R. 10446, Incentivizing Small Business Employee Retention Act of 2026, all provisions S. 4492, ABLE MATCH (Making Able a Tool to Combat Hardship) Act, all provisions S. 4493, A bill to clarify the use of direct deposit for contributions to ABLE programs, all provisions S. 4498, ABLE Tomorrow Act, all provisions S.4784, National Defense Authorization Act for Fiscal Year 2027, provisions related to the Exceptional Family Member Program and TRICARE Autism Care Demonstration S. 5006, Work Without Worry Act of 2026, all provisions Implementation of Public Law 118-80, Autism CARES Act of 2024, all provisions Implementation of Medicaid home and community-based services policies Implementation of Medicaid program integrity policies related to autism services A bill not yet introduced to permanently extend the Money Follows the Person program and protections against spousal impoverishment for recipients of Medicaid home and community based services A bill not introduced related to Fiscal Year 2027 appropriations by the Senate, provisions related to funding autism research and services at the National Institutes of Health, Centers for Disease Control and Prevention, Health Resources and Services Administration; assistive technology programs and special education at the Department of Education; study of housing needs of autistic adults at the Department of Housing and Urban Development, funding for the Kevin and Avonte's Law Program; and the congressionally directed medical research autism research program A bill not yet introduced in the Senate to enhance skills related to family caregivers and developmental disabilities A bill not yet introduced to reauthorize the Kevin and Avonte's Law program

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

Medicare Observation Stays. The Improving Access to Medicare Coverage Act (H.R. 3954/S. 4641): Proposals to count time spent in observation status toward the three-day prior inpatient stay required under Medicare for coverage of a subsequent stay in a skilled nursing facility. Medicare Drug Costs. The Pharmaceutical Research Transparency Act (No bill): Proposal to amend the Public Health Service Act and the Security Exchange Act to require pharmaceutical manufacturers to report their costs related to clinical trials and research and development. Medicare Prescription Drugs. Drug Costs. Inflation Reduction Act (Public Law No: 117-169): Law to allow Medicare to negotiate prices with drug makers, cap prices at inflation in Part B and D, cap beneficiary out-of-pocket costs in Part D, eliminate cost-sharing for vaccines, eliminate cost-sharing in the catastrophic phase of Part D, and to raise the income threshold for the Low-Income Subsidy program offering assistance in paying for drugs. Medicare Prescription Drugs. (No bill): A regulatory proposal encouraging the Secretaries of the Departments of Health and Human Services (HHS) and Commerce to exercise march in rights that would aim to better control the pricing of prescription drugs. Medicare Prescription Drugs. (No bill): An HHS regulatory proposal to ensure robust negotiation rules and processes that aim to curtail the cost of certain prescription drugs, as authorized by the Inflation Reduction Act (Public Law No: 117-169). Medicare and Medicaid Prescription Drugs. (No bill): Joined comments with 19 other organizations urging HHS to use its existing authority to license competition in order to lower consumer and taxpayer costs for semaglutide drugs treating diabetes and weight management (e.g., Ozempic and Wegovy). Medicare Savings Program and Low-Income Subsidy (LIS) Programs. (No bill): Proposals to make enrollment of dually eligible individuals in the Medicare Savings Programs (MSP) and the LIS program easier, so that low-income beneficiaries can more readily access financial assistance for Medicare copayments, premiums and deductibles, and to be able to access needed medications at prices they can afford. Medicare Reform. The Assuring Medicares Promise Act (H.R. 609): Proposals to close the loophole for wealthy individuals who bypass paying net investment income tax (NIIT) and directing the revenue to the Hospital Insurance Trust Fund, which pays for Medicare Part A that covers inpatient care in hospitals, and to the Social Security Trust Funds. Medicare Dental, Hearing and Vision Coverage. Medicare Dental, Vision, and Hearing Benefit Act of 2025 (H.R. 2045): Proposal to add dental, vision and hearing benefits to Medicare. Medicare Hearing Coverage: The Medicare Hearing Aid Coverage Act of 2025 (H.R. 500): Proposals to add hearing benefits to Medicare. Medicare Advantage (MA). (No bill): Proposals to create transparency around Medicare Advantage plans using prior authorization and supplemental benefits that are not offered under traditional Medicare. Medicare Advantage. (No bill): Proposals to apply a higher coding adjustment factor to fully account for intensive upcoding by MA plans and to exclude certain information for MA risk adjustment scores and payments; to use two years of traditional Medicare and MA diagnostic data for calculating MA risk-adjusted payments; and to promulgate more fundamental changes to the Hierarchical Condition Category (HCC) risk adjustment model. Medicare Advantage. (H.R. 3467) Proposal to make Medicare Advantage plans the default choice during initial enrollment periods. Medicare Privatization (No bill): Proposals to create policies in traditional Medicare that mimic those used by private health insurance plans. Medicaid. The HCBS Access Act (H.R. 8540/S. 5321): Proposals to expand Medicaid home and community-based services (HCBS) by elevating them to a mandatory entitlement. H.R. 8540 would reduce waitlists and guarantee seniors and individuals with disabilities a choice between home care and institutional care. Would also establish new grant programs and a technical assistance center to improve the wages, benefits, and training pathways for the direct care workforce. Medicare, Medicaid and Social Security. The Alleviating Barriers for Caregivers (ABC) Act (H.R. 2491 and S. 1227): Proposals would require HHS and SSA to review application processes, procedures, forms, and communications for Medicare, Medicaid, Childrens Health Insurance Program, and Social Security programs in order to reduce administrative barriers facing family caregivers. The bill requires agencies to identify and report to Congress on actions that can be taken to streamline eligibility and assistance for family caregivers within existing programs. Medicare, Medicaid Nursing Homes. The Protecting Americas Seniors Access to Care Act (H.R. 1303): Proposal to prohibit the HHS Secretary from promulgating national staffing standards in nursing homes. Medicare, Medicaid Nursing Homes. The Nurses Belong in Nursing Homes Act (S. 3886): Proposal aims to establish federal minimum staffing standards, specifically requiring 3.48 hours per resident per day (HPRD) of total nursing care and 24/7 on-site Registered Nurse (RN) coverage. Medicare, Medicaid Nursing homes. The Safe Staffing Saves Lives Act (H.R. 8100): Proposals to establish a minimum of 4.1 hours of direct nursing home care per resident per day, and a Registered Nurse on duty on-site 24/7. Adds penalties for facilities failing to meet required minimums. Medicare, Medicaid Nursing Homes. The Building Americas Health Care Workforce Act (No bill): Proposal to allow time spent working in a nursing home (prior to any formal training, and permitted during the COVID-19 pandemic) to count toward a 75-hour minimum federal training standard that is required for certified nursing assistants. Medicare, Medicaid Nursing Homes. The Ensuring Seniors Access to Quality Care Act (H.R. 7096): Proposal to repeal regulations that prohibit certified nursing assistant training and competency evaluation programs in skilled nursing facilities that have a record of health and safety deficiencies and have incurred penalties (e.g., civil monetary penalties for substandard quality of care). Medicare Treatment for Osteoporosis (No bill): Support for making payment revisions to the 2026 Physician Fee Schedule that would accelerate treatment improvements for beneficiaries with osteoporosis and help prevent repeat fractures. Medicare and Medicaid Waste, Fraud and Abuse (No bill): Submitted comments with other organizations to a CMS Request for Information (RFI) Related to Comprehensive Regulations To Uncover Suspicious Healthcare (CRUSH), 91 Fed. Reg. 9803 (February 27, 2026) CMS-6098-NC. Medicaid Work Requirements Affecting Eligibility (No bill): Submitted comments with other organizations to request CMS to clarify in regulations that people with disabilities, older adults, and caregivers are exempt from the Medicaid working requirements in P.L. 119-21. Health Insurance. Health Insurance Premium Fairness Act (H.R. 6455). Proposal to close loophole that penalizes couples with one spouse in Medicare and one receiving health care through Affordable Care Act (ACA) exchanges, by allowing for subtraction of Medicare premiums from the maximum premium paid for a marketplace plan. Health Insurance. (H.R. 1834). Proposals to extend the Enhanced Premium Tax Credits for ACA marketplace health insurance plans. Health Insurance. The Lower Health Care Premiums for All Americans Act (H.R. 6703) Proposals to weakening consumer protections and destabilizing markets by allowing skimpier, less‑regulated plans that can cherry‑pick healthier groups and leave higher‑cost enrollees in the ACA‑regulated small‑group and individual markets with higher premiums. Medicaid and Health Insurance. Protecting Health Care and Lowering Costs Act (S. 2556, H.R. 4849): Proposals to restore massive funding cuts to Medicaid that were included in the 2025 budget reconciliation law, and to make permanent ACA enhanced premium tax credits. Medicare. The Medicare Cost Cap Act (S. 4886): Proposals to add a $5,000 annual cap on out-of-pocket costs for traditional Medicare (Part A and Part B) beneficiaries. Would require Medicare to pay 100 percent of covered health care costs once the $5,000 cap is reached. Prescription Drugs. The Affordable Pricing for Taxpayer-Funded Prescription Drugs Act (H.R. 10094): Proposals that would lower prices or shorten exclusivity periods when revenues exceed targets, which exceed a standard of cost per health benefit achieved, and constitute significant barriers to access or fiscal burdens on patients.

Client expense: $190,000 · Firm income: Not reported

Government targets: Administration on Aging, Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE