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Income and expense are whole-filing amounts associated with this lobbyist, not personal compensation or an allocated share.
No topic inference: each bill number appears in source LDA issue text assigned to this lobbyist.
Territories Medicare Prescription Drug Assistance Equality Act of 2021
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, star ratings, extreme and uncontrollable circumstances policy, normalization factors, stars contract consolidation, ESRD, audio-only telehealth) Medicare RAD-V Mental Health and Substance Use (42 CFR Part 2) Medicaid Managed Care Medicaid Expansion Medicaid Reform Medicaid Redeterminations CHIP Reauthorization Medicaid Actuarial Soundness Long-term Services and Supports Medicare Part D prescription drug program Medicare Advantage Pilot Program in TRICARE Pharmacy Benefit Manager (PBM) Operations and Practices, Spread Pricing Direct and Indirect Remuneration (DIR) reforms in the FY 2023 Medicare Part D Notice Affordable Insulin Now Act (H.R.6833) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Social Determents of Health (SDOH) Addressing Social Determinants in Medicare Advantage Act of 2021 (H.R.4074) Health Equity/Health Disparities Maternal health (Medicaid postpartum coverage extension, H.R.959 Black Maternal Health Momnibus Act of 2021) Helping MOMS Act of 2021 Medicare Audio-Only Telehealth (H.R.2166, S.150) Medicaid Funding for Puerto Rico Medicare Savings Program (MSP) in Medicaid Increasing on the Medicare Advantage Benchmarks to a Minimum Level H.R. 7997 (to Amend the SS Act to establish a floor in MA benchmark rates for regions with low Medicare fee-for-service penetration and to make the Medicare Savings Program available in all jurisdictions) H.R. 2217 (Territory Federal Matching Requirement Equity Act of 2021) H.R. 1825 (A Bill to Remove the Matching Requirement for Medicare Part D Drugs) H.R. 1826 (Fairness in Medicare Part B Enrollment Act) S. 3778 (Territories Medicare Prescription Drug Assistance Equity Act of 2022). Build Back Better Act (H.R.5376) Medicaid Eligibility and Redeterminations Inflation Reduction Act of 2022 (H.R. 5376) Medicare Advantage Supplemental Benefits Timely Access to Care Act (H.R. 3173 and S. 3018) 2023 Omnibus Appropriations Bill Mental Health Parity Restore Protections for Dialysis Patients Act (H.R.8594)
Specific issues are shown only where the LDA source assigned them to this lobbyist. Targets apply to the associated filing.
ELEVANCE HEALTH, INC. via ELEVANCE HEALTH, INC.
2022 · fourth_quarter · Q4
Federal Medical Assistance Percentages (FMAP) increase COVID-19 Testing, Vaccinations, Cost Sharing for COVID-19 Testing APTC Expansion and Permanency CARES Act
Price of prescription drugs; antitrust issues; Prescription Drug Pricing Reduction Act Pharmacy Benefit Manager (PBM) operations and practices, Spread Pricing Direct and Indirect Remuneration (DIR) Drug Rebate Rule/Executive Order Senate Finance Committee Prescription Drug Pricing Reduction Act Lower Drug Costs Now Act (H.R. 3) Drug Patent Reform Robinson-Patman Reform Inflation Reduction Act of 2022 (H.R. 5376) Pharmacy Benefit Manager Transparency Act (S. 4293) PBM Transparency Language in the Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) 2023 Omnibus Appropriations Bill
Source: Senate LDA
Territories Medicare Prescription Drug Assistance Equality Act of 2021
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, star ratings, extreme and uncontrollable circumstances policy, normalization factors, stars contract consolidation, ESRD, audio-only telehealth H.R. 4074 -To amend title XVIII of the Social Security Act Medicare RAD-V Mental health and substance use (42 CFR Part 2) Medicaid (IMD Exclusion) Medicaid expansion Medicaid reform (block grants, per capita caps) Medicaid and CHIP reauthorization Medicaid actuarial soundness Long-term services and supports Social Determents of Health (SDOH) Medicare Part D prescription drug program and Medicare Part D coverage gap (donut hole) Opioid addiction issues and response (prescription drug monitoring programs) Medicaid medical loss ratio remittance Medicare Advantage Pilot Program in TRICARE Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing Direct and Indirect Remuneration (DIR) reforms in the FY 2023 Medicare Part D Notice H.R.6833 - Affordable Insulin Now Act Maternal health (Medicaid postpartum coverage extension, H.R.959 Black Maternal Health Momnibus Act of 2021) Helping MOMS Act of 2021 CMS Extreme & Uncontrollable Circumstances Policy Medicare Sequester (H.R.315, S.748) Medicare Audio-Only Telehealth (H.R.2166, S.150, H.R.3447) H.R. 4406, the Supporting Medicaid in the U.S. Territories Act, Continuing Resolution (CR)FY 2022 Medicaid Funding for Puerto Rico Medicare Advantage asks regarding the underfunding and disparity for Puerto Rico H.R.5376 - Build Back Better Act Medicaid eligibility Health Equity/Health Disparities HR1826 - Fairness in Medicare Part B Enrollment Act HR2217 - Territory Federal Matching Requirement Equity Act of 2021 HR1825 - A Bill to Remove the Matching Requirement for Medicate Part D Drugs.
Territories Medicare Prescription Drug Assistance Equality Act of 2021
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, star ratings, extreme and uncontrollable circumstances policy, normalization factors, stars contract consolidation, ESRD, audio-only telehealth) Medicare RAD-V Mental health and substance use (42 CFR Part 2) Medicaid managed care (IMD Exclusion) Medicaid expansion Medicaid reform (block grants, per capita caps) Medicaid and CHIP reauthorization Medicaid actuarial soundness Long-term services and supports Medicare Part D prescription drug program and Medicare Part D coverage gap (donut hole) Opioid addiction issues and response (prescription drug monitoring programs) Medicaid medical loss ratio remittance Medicare Advantage Pilot Program in TRICARE Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing Direct and Indirect Remuneration (DIR) reforms in the FY 2023 Medicare Part D Notice H.R.6833 - Affordable Insulin Now Act Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act H.R.7666 - Restoring Hope for Mental Health and Well-Being Act of 2022 Social Determents of Health (SDOH) H.R.4074 - Addressing Social Determinants in Medicare Advantage Act of 2021 Health Equity/Health Disparities Maternal health (Medicaid postpartum coverage extension, H.R.959 Black Maternal Health Momnibus Act of 2021) Helping MOMS Act of 2021 Medicare Audio-Only Telehealth (H.R.2166, S.150) Continuing Resolution (CR)FY 2022 Medicaid Funding for Puerto Rico Medicare Savings Program (MSP) in Medicaid Increasing on the Medicare Advantage benchmarks to a minimum level H.R. 7997 (to Amend the SS Act to establish a floor in MA benchmark rates for regions with low Medicare fee-for-service penetration and to make the Medicare Savings Program available in all jurisdictions) H.R. 2217 (Territory Federal Matching Requirement Equity Act of 2021) H.R. 1825 (A Bill to Remove the Matching Requirement for Medicare Part D Drugs) H.R. 1826 (Fairness in Medicare Part B Enrollment Act) S. 3778 (Territories Medicare Prescription Drug Assistance Equity Act of 2022). H.R.5376 - Build Back Better Act Medicaid eligibility and redeterminations H.R. 5376 - Inflation Reduction Act of 2022 Medicare Advantage Supplemental Benefits
Fairness in Medicare Part B Enrollment Act of 2021
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, star ratings, extreme and uncontrollable circumstances policy, normalization factors, stars contract consolidation, ESRD, audio-only telehealth H.R. 4074 -To amend title XVIII of the Social Security Act Medicare RAD-V Mental health and substance use (42 CFR Part 2) Medicaid (IMD Exclusion) Medicaid expansion Medicaid reform (block grants, per capita caps) Medicaid and CHIP reauthorization Medicaid actuarial soundness Long-term services and supports Social Determents of Health (SDOH) Medicare Part D prescription drug program and Medicare Part D coverage gap (donut hole) Opioid addiction issues and response (prescription drug monitoring programs) Medicaid medical loss ratio remittance Medicare Advantage Pilot Program in TRICARE Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing Direct and Indirect Remuneration (DIR) reforms in the FY 2023 Medicare Part D Notice H.R.6833 - Affordable Insulin Now Act Maternal health (Medicaid postpartum coverage extension, H.R.959 Black Maternal Health Momnibus Act of 2021) Helping MOMS Act of 2021 CMS Extreme & Uncontrollable Circumstances Policy Medicare Sequester (H.R.315, S.748) Medicare Audio-Only Telehealth (H.R.2166, S.150, H.R.3447) H.R. 4406, the Supporting Medicaid in the U.S. Territories Act, Continuing Resolution (CR)FY 2022 Medicaid Funding for Puerto Rico Medicare Advantage asks regarding the underfunding and disparity for Puerto Rico H.R.5376 - Build Back Better Act Medicaid eligibility Health Equity/Health Disparities HR1826 - Fairness in Medicare Part B Enrollment Act HR2217 - Territory Federal Matching Requirement Equity Act of 2021 HR1825 - A Bill to Remove the Matching Requirement for Medicate Part D Drugs.
Fairness in Medicare Part B Enrollment Act of 2021
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, star ratings, extreme and uncontrollable circumstances policy, normalization factors, stars contract consolidation, ESRD, audio-only telehealth) Medicare RAD-V Mental Health and Substance Use (42 CFR Part 2) Medicaid Managed Care Medicaid Expansion Medicaid Reform Medicaid Redeterminations CHIP Reauthorization Medicaid Actuarial Soundness Long-term Services and Supports Medicare Part D prescription drug program Medicare Advantage Pilot Program in TRICARE Pharmacy Benefit Manager (PBM) Operations and Practices, Spread Pricing Direct and Indirect Remuneration (DIR) reforms in the FY 2023 Medicare Part D Notice Affordable Insulin Now Act (H.R.6833) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Social Determents of Health (SDOH) Addressing Social Determinants in Medicare Advantage Act of 2021 (H.R.4074) Health Equity/Health Disparities Maternal health (Medicaid postpartum coverage extension, H.R.959 Black Maternal Health Momnibus Act of 2021) Helping MOMS Act of 2021 Medicare Audio-Only Telehealth (H.R.2166, S.150) Medicaid Funding for Puerto Rico Medicare Savings Program (MSP) in Medicaid Increasing on the Medicare Advantage Benchmarks to a Minimum Level H.R. 7997 (to Amend the SS Act to establish a floor in MA benchmark rates for regions with low Medicare fee-for-service penetration and to make the Medicare Savings Program available in all jurisdictions) H.R. 2217 (Territory Federal Matching Requirement Equity Act of 2021) H.R. 1825 (A Bill to Remove the Matching Requirement for Medicare Part D Drugs) H.R. 1826 (Fairness in Medicare Part B Enrollment Act) S. 3778 (Territories Medicare Prescription Drug Assistance Equity Act of 2022). Build Back Better Act (H.R.5376) Medicaid Eligibility and Redeterminations Inflation Reduction Act of 2022 (H.R. 5376) Medicare Advantage Supplemental Benefits Timely Access to Care Act (H.R. 3173 and S. 3018) 2023 Omnibus Appropriations Bill Mental Health Parity Restore Protections for Dialysis Patients Act (H.R.8594)
Fairness in Medicare Part B Enrollment Act of 2021
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, star ratings, extreme and uncontrollable circumstances policy, normalization factors, stars contract consolidation, ESRD, audio-only telehealth) Medicare RAD-V Mental health and substance use (42 CFR Part 2) Medicaid managed care (IMD Exclusion) Medicaid expansion Medicaid reform (block grants, per capita caps) Medicaid and CHIP reauthorization Medicaid actuarial soundness Long-term services and supports Medicare Part D prescription drug program and Medicare Part D coverage gap (donut hole) Opioid addiction issues and response (prescription drug monitoring programs) Medicaid medical loss ratio remittance Medicare Advantage Pilot Program in TRICARE Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing Direct and Indirect Remuneration (DIR) reforms in the FY 2023 Medicare Part D Notice H.R.6833 - Affordable Insulin Now Act Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act H.R.7666 - Restoring Hope for Mental Health and Well-Being Act of 2022 Social Determents of Health (SDOH) H.R.4074 - Addressing Social Determinants in Medicare Advantage Act of 2021 Health Equity/Health Disparities Maternal health (Medicaid postpartum coverage extension, H.R.959 Black Maternal Health Momnibus Act of 2021) Helping MOMS Act of 2021 Medicare Audio-Only Telehealth (H.R.2166, S.150) Continuing Resolution (CR)FY 2022 Medicaid Funding for Puerto Rico Medicare Savings Program (MSP) in Medicaid Increasing on the Medicare Advantage benchmarks to a minimum level H.R. 7997 (to Amend the SS Act to establish a floor in MA benchmark rates for regions with low Medicare fee-for-service penetration and to make the Medicare Savings Program available in all jurisdictions) H.R. 2217 (Territory Federal Matching Requirement Equity Act of 2021) H.R. 1825 (A Bill to Remove the Matching Requirement for Medicare Part D Drugs) H.R. 1826 (Fairness in Medicare Part B Enrollment Act) S. 3778 (Territories Medicare Prescription Drug Assistance Equity Act of 2022). H.R.5376 - Build Back Better Act Medicaid eligibility and redeterminations H.R. 5376 - Inflation Reduction Act of 2022 Medicare Advantage Supplemental Benefits
Ensuring Parity in MA and PACE for Audio-Only Telehealth Act of 2021
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, star ratings, extreme and uncontrollable circumstances policy, normalization factors, stars contract consolidation, ESRD, audio-only telehealth) Medicare RAD-V Mental health and substance use (42 CFR Part 2) Medicaid managed care (IMD Exclusion) Medicaid expansion Medicaid reform (block grants, per capita caps) Medicaid and CHIP reauthorization Medicaid actuarial soundness Long-term services and supports Medicare Part D prescription drug program and Medicare Part D coverage gap (donut hole) Opioid addiction issues and response (prescription drug monitoring programs) Medicaid medical loss ratio remittance Medicare Advantage Pilot Program in TRICARE Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing Direct and Indirect Remuneration (DIR) reforms in the FY 2023 Medicare Part D Notice H.R.6833 - Affordable Insulin Now Act Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act H.R.7666 - Restoring Hope for Mental Health and Well-Being Act of 2022 Social Determents of Health (SDOH) H.R.4074 - Addressing Social Determinants in Medicare Advantage Act of 2021 Health Equity/Health Disparities Maternal health (Medicaid postpartum coverage extension, H.R.959 Black Maternal Health Momnibus Act of 2021) Helping MOMS Act of 2021 Medicare Audio-Only Telehealth (H.R.2166, S.150) Continuing Resolution (CR)FY 2022 Medicaid Funding for Puerto Rico Medicare Savings Program (MSP) in Medicaid Increasing on the Medicare Advantage benchmarks to a minimum level H.R. 7997 (to Amend the SS Act to establish a floor in MA benchmark rates for regions with low Medicare fee-for-service penetration and to make the Medicare Savings Program available in all jurisdictions) H.R. 2217 (Territory Federal Matching Requirement Equity Act of 2021) H.R. 1825 (A Bill to Remove the Matching Requirement for Medicare Part D Drugs) H.R. 1826 (Fairness in Medicare Part B Enrollment Act) S. 3778 (Territories Medicare Prescription Drug Assistance Equity Act of 2022). H.R.5376 - Build Back Better Act Medicaid eligibility and redeterminations H.R. 5376 - Inflation Reduction Act of 2022 Medicare Advantage Supplemental Benefits
Ensuring Parity in MA and PACE for Audio-Only Telehealth Act of 2021
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, star ratings, extreme and uncontrollable circumstances policy, normalization factors, stars contract consolidation, ESRD, audio-only telehealth) Medicare RAD-V Mental Health and Substance Use (42 CFR Part 2) Medicaid Managed Care Medicaid Expansion Medicaid Reform Medicaid Redeterminations CHIP Reauthorization Medicaid Actuarial Soundness Long-term Services and Supports Medicare Part D prescription drug program Medicare Advantage Pilot Program in TRICARE Pharmacy Benefit Manager (PBM) Operations and Practices, Spread Pricing Direct and Indirect Remuneration (DIR) reforms in the FY 2023 Medicare Part D Notice Affordable Insulin Now Act (H.R.6833) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Social Determents of Health (SDOH) Addressing Social Determinants in Medicare Advantage Act of 2021 (H.R.4074) Health Equity/Health Disparities Maternal health (Medicaid postpartum coverage extension, H.R.959 Black Maternal Health Momnibus Act of 2021) Helping MOMS Act of 2021 Medicare Audio-Only Telehealth (H.R.2166, S.150) Medicaid Funding for Puerto Rico Medicare Savings Program (MSP) in Medicaid Increasing on the Medicare Advantage Benchmarks to a Minimum Level H.R. 7997 (to Amend the SS Act to establish a floor in MA benchmark rates for regions with low Medicare fee-for-service penetration and to make the Medicare Savings Program available in all jurisdictions) H.R. 2217 (Territory Federal Matching Requirement Equity Act of 2021) H.R. 1825 (A Bill to Remove the Matching Requirement for Medicare Part D Drugs) H.R. 1826 (Fairness in Medicare Part B Enrollment Act) S. 3778 (Territories Medicare Prescription Drug Assistance Equity Act of 2022). Build Back Better Act (H.R.5376) Medicaid Eligibility and Redeterminations Inflation Reduction Act of 2022 (H.R. 5376) Medicare Advantage Supplemental Benefits Timely Access to Care Act (H.R. 3173 and S. 3018) 2023 Omnibus Appropriations Bill Mental Health Parity Restore Protections for Dialysis Patients Act (H.R.8594)
Ensuring Parity in MA and PACE for Audio-Only Telehealth Act of 2021
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, star ratings, extreme and uncontrollable circumstances policy, normalization factors, stars contract consolidation, ESRD, audio-only telehealth H.R. 4074 -To amend title XVIII of the Social Security Act Medicare RAD-V Mental health and substance use (42 CFR Part 2) Medicaid (IMD Exclusion) Medicaid expansion Medicaid reform (block grants, per capita caps) Medicaid and CHIP reauthorization Medicaid actuarial soundness Long-term services and supports Social Determents of Health (SDOH) Medicare Part D prescription drug program and Medicare Part D coverage gap (donut hole) Opioid addiction issues and response (prescription drug monitoring programs) Medicaid medical loss ratio remittance Medicare Advantage Pilot Program in TRICARE Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing Against Direct and Indirect Remuneration (DIR) reforms in the FY 2023 Medicare Part D Notice H.R.6833 - Affordable Insulin Now Act Maternal health (Medicaid postpartum coverage extension, H.R.959 Black Maternal Health Momnibus Act of 2021) Helping MOMS Act of 2021 CMS Extreme & Uncontrollable Circumstances Policy Medicare Sequester (H.R.315, S.748) Medicare Audio-Only Telehealth (H.R.2166, S.150) Continuing Resolution (CR)FY 2022 Medicaid Funding for Puerto Rico Medicaid Funding for Puerto Rico including discussions on the FMAP, ESRD, and LTSS. Medicare Advantage issues such as rates, benchmarks, providers payments, and disparities in funding for territories. Medicare Advantage asks regarding the underfunding and disparity for Puerto Rico H.R.5376 - Build Back Better Act Medicaid eligibility Health Equity/Health Disparities
Ensuring Parity in MA and PACE for Audio-Only Telehealth Act of 2021
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, star ratings, extreme and uncontrollable circumstances policy, normalization factors, stars contract consolidation, ESRD, audio-only telehealth H.R. 4074 -To amend title XVIII of the Social Security Act Medicare RAD-V Mental health and substance use (42 CFR Part 2) Medicaid (IMD Exclusion) Medicaid expansion Medicaid reform (block grants, per capita caps) Medicaid and CHIP reauthorization Medicaid actuarial soundness Long-term services and supports Social Determents of Health (SDOH) Medicare Part D prescription drug program and Medicare Part D coverage gap (donut hole) Opioid addiction issues and response (prescription drug monitoring programs) Medicaid medical loss ratio remittance Medicare Advantage Pilot Program in TRICARE Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing Direct and Indirect Remuneration (DIR) reforms in the FY 2023 Medicare Part D Notice H.R.6833 - Affordable Insulin Now Act Maternal health (Medicaid postpartum coverage extension, H.R.959 Black Maternal Health Momnibus Act of 2021) Helping MOMS Act of 2021 CMS Extreme & Uncontrollable Circumstances Policy Medicare Sequester (H.R.315, S.748) Medicare Audio-Only Telehealth (H.R.2166, S.150, H.R.3447) H.R. 4406, the Supporting Medicaid in the U.S. Territories Act, Continuing Resolution (CR)FY 2022 Medicaid Funding for Puerto Rico Medicare Advantage asks regarding the underfunding and disparity for Puerto Rico H.R.5376 - Build Back Better Act Medicaid eligibility Health Equity/Health Disparities HR1826 - Fairness in Medicare Part B Enrollment Act HR2217 - Territory Federal Matching Requirement Equity Act of 2021 HR1825 - A Bill to Remove the Matching Requirement for Medicate Part D Drugs.
Territory Federal Matching Requirement Equity Act of 2021
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, star ratings, extreme and uncontrollable circumstances policy, normalization factors, stars contract consolidation, ESRD, audio-only telehealth H.R. 4074 -To amend title XVIII of the Social Security Act Medicare RAD-V Mental health and substance use (42 CFR Part 2) Medicaid (IMD Exclusion) Medicaid expansion Medicaid reform (block grants, per capita caps) Medicaid and CHIP reauthorization Medicaid actuarial soundness Long-term services and supports Social Determents of Health (SDOH) Medicare Part D prescription drug program and Medicare Part D coverage gap (donut hole) Opioid addiction issues and response (prescription drug monitoring programs) Medicaid medical loss ratio remittance Medicare Advantage Pilot Program in TRICARE Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing Direct and Indirect Remuneration (DIR) reforms in the FY 2023 Medicare Part D Notice H.R.6833 - Affordable Insulin Now Act Maternal health (Medicaid postpartum coverage extension, H.R.959 Black Maternal Health Momnibus Act of 2021) Helping MOMS Act of 2021 CMS Extreme & Uncontrollable Circumstances Policy Medicare Sequester (H.R.315, S.748) Medicare Audio-Only Telehealth (H.R.2166, S.150, H.R.3447) H.R. 4406, the Supporting Medicaid in the U.S. Territories Act, Continuing Resolution (CR)FY 2022 Medicaid Funding for Puerto Rico Medicare Advantage asks regarding the underfunding and disparity for Puerto Rico H.R.5376 - Build Back Better Act Medicaid eligibility Health Equity/Health Disparities HR1826 - Fairness in Medicare Part B Enrollment Act HR2217 - Territory Federal Matching Requirement Equity Act of 2021 HR1825 - A Bill to Remove the Matching Requirement for Medicate Part D Drugs.
Territory Federal Matching Requirement Equity Act of 2021
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, star ratings, extreme and uncontrollable circumstances policy, normalization factors, stars contract consolidation, ESRD, audio-only telehealth) Medicare RAD-V Mental health and substance use (42 CFR Part 2) Medicaid managed care (IMD Exclusion) Medicaid expansion Medicaid reform (block grants, per capita caps) Medicaid and CHIP reauthorization Medicaid actuarial soundness Long-term services and supports Medicare Part D prescription drug program and Medicare Part D coverage gap (donut hole) Opioid addiction issues and response (prescription drug monitoring programs) Medicaid medical loss ratio remittance Medicare Advantage Pilot Program in TRICARE Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing Direct and Indirect Remuneration (DIR) reforms in the FY 2023 Medicare Part D Notice H.R.6833 - Affordable Insulin Now Act Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act H.R.7666 - Restoring Hope for Mental Health and Well-Being Act of 2022 Social Determents of Health (SDOH) H.R.4074 - Addressing Social Determinants in Medicare Advantage Act of 2021 Health Equity/Health Disparities Maternal health (Medicaid postpartum coverage extension, H.R.959 Black Maternal Health Momnibus Act of 2021) Helping MOMS Act of 2021 Medicare Audio-Only Telehealth (H.R.2166, S.150) Continuing Resolution (CR)FY 2022 Medicaid Funding for Puerto Rico Medicare Savings Program (MSP) in Medicaid Increasing on the Medicare Advantage benchmarks to a minimum level H.R. 7997 (to Amend the SS Act to establish a floor in MA benchmark rates for regions with low Medicare fee-for-service penetration and to make the Medicare Savings Program available in all jurisdictions) H.R. 2217 (Territory Federal Matching Requirement Equity Act of 2021) H.R. 1825 (A Bill to Remove the Matching Requirement for Medicare Part D Drugs) H.R. 1826 (Fairness in Medicare Part B Enrollment Act) S. 3778 (Territories Medicare Prescription Drug Assistance Equity Act of 2022). H.R.5376 - Build Back Better Act Medicaid eligibility and redeterminations H.R. 5376 - Inflation Reduction Act of 2022 Medicare Advantage Supplemental Benefits
Territory Federal Matching Requirement Equity Act of 2021
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, star ratings, extreme and uncontrollable circumstances policy, normalization factors, stars contract consolidation, ESRD, audio-only telehealth) Medicare RAD-V Mental Health and Substance Use (42 CFR Part 2) Medicaid Managed Care Medicaid Expansion Medicaid Reform Medicaid Redeterminations CHIP Reauthorization Medicaid Actuarial Soundness Long-term Services and Supports Medicare Part D prescription drug program Medicare Advantage Pilot Program in TRICARE Pharmacy Benefit Manager (PBM) Operations and Practices, Spread Pricing Direct and Indirect Remuneration (DIR) reforms in the FY 2023 Medicare Part D Notice Affordable Insulin Now Act (H.R.6833) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Social Determents of Health (SDOH) Addressing Social Determinants in Medicare Advantage Act of 2021 (H.R.4074) Health Equity/Health Disparities Maternal health (Medicaid postpartum coverage extension, H.R.959 Black Maternal Health Momnibus Act of 2021) Helping MOMS Act of 2021 Medicare Audio-Only Telehealth (H.R.2166, S.150) Medicaid Funding for Puerto Rico Medicare Savings Program (MSP) in Medicaid Increasing on the Medicare Advantage Benchmarks to a Minimum Level H.R. 7997 (to Amend the SS Act to establish a floor in MA benchmark rates for regions with low Medicare fee-for-service penetration and to make the Medicare Savings Program available in all jurisdictions) H.R. 2217 (Territory Federal Matching Requirement Equity Act of 2021) H.R. 1825 (A Bill to Remove the Matching Requirement for Medicare Part D Drugs) H.R. 1826 (Fairness in Medicare Part B Enrollment Act) S. 3778 (Territories Medicare Prescription Drug Assistance Equity Act of 2022). Build Back Better Act (H.R.5376) Medicaid Eligibility and Redeterminations Inflation Reduction Act of 2022 (H.R. 5376) Medicare Advantage Supplemental Benefits Timely Access to Care Act (H.R. 3173 and S. 3018) 2023 Omnibus Appropriations Bill Mental Health Parity Restore Protections for Dialysis Patients Act (H.R.8594)
Elijah E. Cummings Lower Drug Costs Now Act
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
Price of prescription drugs; antitrust issues; Prescription Drug Pricing Reduction Act Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Drug Rebate Rule/Executive Order Senate Finance Committee Prescription Drug Pricing Reduction Act Lower Drug Costs Now Act (H.R. 3) Drug Patent Reform Robinson-Patman Reform
Elijah E. Cummings Lower Drug Costs Now Act
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
Price of prescription drugs; antitrust issues; Prescription Drug Pricing Reduction Act Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Drug Rebate Rule/Executive Order Senate Finance Committee Prescription Drug Pricing Reduction Act Lower Drug Costs Now Act (H.R. 3) Drug Patent Reform Robinson-Patman Reform
Elijah E. Cummings Lower Drug Costs Now Act
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
Price of prescription drugs; antitrust issues; Prescription Drug Pricing Reduction Act Pharmacy Benefit Manager (PBM) operations and practices, Spread Pricing Direct and Indirect Remuneration (DIR) Drug Rebate Rule/Executive Order Senate Finance Committee Prescription Drug Pricing Reduction Act Lower Drug Costs Now Act (H.R. 3) Drug Patent Reform Robinson-Patman Reform Inflation Reduction Act of 2022 (H.R. 5376) Pharmacy Benefit Manager Transparency Act (S. 4293) PBM Transparency Language in the Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) 2023 Omnibus Appropriations Bill
Elijah E. Cummings Lower Drug Costs Now Act
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
Price of prescription drugs; antitrust issues; Prescription Drug Pricing Reduction Act Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing Direct and Indirect Remuneration (DIR) Drug Rebate Rule/Executive Order Senate Finance Committee Prescription Drug Pricing Reduction Act Lower Drug Costs Now Act (H.R. 3) Drug Patent Reform Robinson-Patman Reform H.R. 5376 - Inflation Reduction Act of 2022 Pharmacy Benefit Manager Transparency Act (S. 4293)
Elijah E. Cummings Lower Drug Costs Now Act
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
Price of prescription drugs; antitrust issues; Prescription Drug Pricing Reduction Act Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Drug Rebate Rule/Executive Order Senate Finance Committee Prescription Drug Pricing Reduction Act Lower Drug Costs Now Act (H.R. 3) Drug Patent Reform Robinson-Patman Reform
Helping to Encourage Real Opportunities (HERO) for Youth Act of 2021
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) ACA 1332 Waivers Individual market and exchange stabilization Prior authorization and Utilization Management, (H.R. 3107); Hospital Consolidation Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use,42 CFR Part 2, Parity and compliance issues; Surprise medical billing; No Surprises Act Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, COVID-19 testing, vaccines, treatment, cost sharing Medical Loss Ratio; H.R. 3969 - To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios Federal Medical Assistance Percentages (FMAP) increase Short Term Limited Duration health plans Special Enrollment Period CONNECT for Health Act Hospital Claims Form Issues H.R.5376 - Build Back Better Act KEEP Telehealth Options Act Opioid use disorders (OUD) and substance use disorders (SUD) treatment Agent/broker compensation disclosures under the Consolidated Appropriations Act. CAA regulation implementation Hospital Competition Act Postal Service Reform Act of 2022; Postal Service Retiree Benefits Reform Defense Health Programs (FY2022 Budget and FY2023 Budget Request Veterans Health Care (U.S. Department of Veterans Affairs Assets and Infrastructure Review Report) Veterans Records Access (Access for Veterans to Records Act)
Medicare Sequester COVID Moratorium Act
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, star ratings, extreme and uncontrollable circumstances policy, normalization factors, stars contract consolidation, ESRD, audio-only telehealth H.R. 4074 -To amend title XVIII of the Social Security Act Medicare RAD-V Mental health and substance use (42 CFR Part 2) Medicaid (IMD Exclusion) Medicaid expansion Medicaid reform (block grants, per capita caps) Medicaid and CHIP reauthorization Medicaid actuarial soundness Long-term services and supports Social Determents of Health (SDOH) Medicare Part D prescription drug program and Medicare Part D coverage gap (donut hole) Opioid addiction issues and response (prescription drug monitoring programs) Medicaid medical loss ratio remittance Medicare Advantage Pilot Program in TRICARE Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing Direct and Indirect Remuneration (DIR) reforms in the FY 2023 Medicare Part D Notice H.R.6833 - Affordable Insulin Now Act Maternal health (Medicaid postpartum coverage extension, H.R.959 Black Maternal Health Momnibus Act of 2021) Helping MOMS Act of 2021 CMS Extreme & Uncontrollable Circumstances Policy Medicare Sequester (H.R.315, S.748) Medicare Audio-Only Telehealth (H.R.2166, S.150, H.R.3447) H.R. 4406, the Supporting Medicaid in the U.S. Territories Act, Continuing Resolution (CR)FY 2022 Medicaid Funding for Puerto Rico Medicare Advantage asks regarding the underfunding and disparity for Puerto Rico H.R.5376 - Build Back Better Act Medicaid eligibility Health Equity/Health Disparities HR1826 - Fairness in Medicare Part B Enrollment Act HR2217 - Territory Federal Matching Requirement Equity Act of 2021 HR1825 - A Bill to Remove the Matching Requirement for Medicate Part D Drugs.
Medicare Sequester COVID Moratorium Act
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, star ratings, extreme and uncontrollable circumstances policy, normalization factors, stars contract consolidation, ESRD, audio-only telehealth H.R. 4074 -To amend title XVIII of the Social Security Act Medicare RAD-V Mental health and substance use (42 CFR Part 2) Medicaid (IMD Exclusion) Medicaid expansion Medicaid reform (block grants, per capita caps) Medicaid and CHIP reauthorization Medicaid actuarial soundness Long-term services and supports Social Determents of Health (SDOH) Medicare Part D prescription drug program and Medicare Part D coverage gap (donut hole) Opioid addiction issues and response (prescription drug monitoring programs) Medicaid medical loss ratio remittance Medicare Advantage Pilot Program in TRICARE Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing Against Direct and Indirect Remuneration (DIR) reforms in the FY 2023 Medicare Part D Notice H.R.6833 - Affordable Insulin Now Act Maternal health (Medicaid postpartum coverage extension, H.R.959 Black Maternal Health Momnibus Act of 2021) Helping MOMS Act of 2021 CMS Extreme & Uncontrollable Circumstances Policy Medicare Sequester (H.R.315, S.748) Medicare Audio-Only Telehealth (H.R.2166, S.150) Continuing Resolution (CR)FY 2022 Medicaid Funding for Puerto Rico Medicaid Funding for Puerto Rico including discussions on the FMAP, ESRD, and LTSS. Medicare Advantage issues such as rates, benchmarks, providers payments, and disparities in funding for territories. Medicare Advantage asks regarding the underfunding and disparity for Puerto Rico H.R.5376 - Build Back Better Act Medicaid eligibility Health Equity/Health Disparities
Improving Seniors’ Timely Access to Care Act of 2021
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, star ratings, extreme and uncontrollable circumstances policy, normalization factors, stars contract consolidation, ESRD, audio-only telehealth) Medicare RAD-V Mental Health and Substance Use (42 CFR Part 2) Medicaid Managed Care Medicaid Expansion Medicaid Reform Medicaid Redeterminations CHIP Reauthorization Medicaid Actuarial Soundness Long-term Services and Supports Medicare Part D prescription drug program Medicare Advantage Pilot Program in TRICARE Pharmacy Benefit Manager (PBM) Operations and Practices, Spread Pricing Direct and Indirect Remuneration (DIR) reforms in the FY 2023 Medicare Part D Notice Affordable Insulin Now Act (H.R.6833) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Social Determents of Health (SDOH) Addressing Social Determinants in Medicare Advantage Act of 2021 (H.R.4074) Health Equity/Health Disparities Maternal health (Medicaid postpartum coverage extension, H.R.959 Black Maternal Health Momnibus Act of 2021) Helping MOMS Act of 2021 Medicare Audio-Only Telehealth (H.R.2166, S.150) Medicaid Funding for Puerto Rico Medicare Savings Program (MSP) in Medicaid Increasing on the Medicare Advantage Benchmarks to a Minimum Level H.R. 7997 (to Amend the SS Act to establish a floor in MA benchmark rates for regions with low Medicare fee-for-service penetration and to make the Medicare Savings Program available in all jurisdictions) H.R. 2217 (Territory Federal Matching Requirement Equity Act of 2021) H.R. 1825 (A Bill to Remove the Matching Requirement for Medicare Part D Drugs) H.R. 1826 (Fairness in Medicare Part B Enrollment Act) S. 3778 (Territories Medicare Prescription Drug Assistance Equity Act of 2022). Build Back Better Act (H.R.5376) Medicaid Eligibility and Redeterminations Inflation Reduction Act of 2022 (H.R. 5376) Medicare Advantage Supplemental Benefits Timely Access to Care Act (H.R. 3173 and S. 3018) 2023 Omnibus Appropriations Bill Mental Health Parity Restore Protections for Dialysis Patients Act (H.R.8594)
Permanency for Audio-Only Telehealth Act
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, star ratings, extreme and uncontrollable circumstances policy, normalization factors, stars contract consolidation, ESRD, audio-only telehealth H.R. 4074 -To amend title XVIII of the Social Security Act Medicare RAD-V Mental health and substance use (42 CFR Part 2) Medicaid (IMD Exclusion) Medicaid expansion Medicaid reform (block grants, per capita caps) Medicaid and CHIP reauthorization Medicaid actuarial soundness Long-term services and supports Social Determents of Health (SDOH) Medicare Part D prescription drug program and Medicare Part D coverage gap (donut hole) Opioid addiction issues and response (prescription drug monitoring programs) Medicaid medical loss ratio remittance Medicare Advantage Pilot Program in TRICARE Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing Direct and Indirect Remuneration (DIR) reforms in the FY 2023 Medicare Part D Notice H.R.6833 - Affordable Insulin Now Act Maternal health (Medicaid postpartum coverage extension, H.R.959 Black Maternal Health Momnibus Act of 2021) Helping MOMS Act of 2021 CMS Extreme & Uncontrollable Circumstances Policy Medicare Sequester (H.R.315, S.748) Medicare Audio-Only Telehealth (H.R.2166, S.150, H.R.3447) H.R. 4406, the Supporting Medicaid in the U.S. Territories Act, Continuing Resolution (CR)FY 2022 Medicaid Funding for Puerto Rico Medicare Advantage asks regarding the underfunding and disparity for Puerto Rico H.R.5376 - Build Back Better Act Medicaid eligibility Health Equity/Health Disparities HR1826 - Fairness in Medicare Part B Enrollment Act HR2217 - Territory Federal Matching Requirement Equity Act of 2021 HR1825 - A Bill to Remove the Matching Requirement for Medicate Part D Drugs.
To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios.
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) ACA 1332 Waivers Individual market and exchange stabilization Prior authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use, Parity and compliance issues. Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Mental health parity and MHPAEA compliance Surprise medical billing; Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Chronic Kidney Disease Conditions of Coverage Reform COVID-19 testing, vaccines, treatment, cost sharing Medicare Sequestration, ACA subsidies, COVID vaccines and testing, Consolidated Appropriations Act Behavioral Health Telehealth Short Term Limited Duration health plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio; To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios (H.R. 3969) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Period CONNECT for Health Act Hospital Claims Form Issues Build Back Better Act (H.R.5376) KEEP Telehealth Options Act Agent/broker compensation disclosures under the Consolidated Appropriations Act. CAA regulation implementation Hospital Competition Act Medicaid eligibility Health Equity/Health Disparities Postal Service Reform Act of 2022 Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care (U.S. Department of Veterans Affairs Assets and Infrastructure Review Report) 2018 MISSION Act Veterans PACT Act Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) Bipartisan Safer Communities Act
To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios.
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) ACA 1332 Waivers Individual market and exchange stabilization Prior authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use, Parity and compliance issues. Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Mental health parity and MHPAEA compliance Surprise medical billing; Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Chronic Kidney Disease Conditions of Coverage Reform COVID-19 testing, vaccines, treatment, cost sharing Medicare Sequestration, ACA subsidies, COVID vaccines and testing, Consolidated Appropriations Act Behavioral Health Telehealth Short Term Limited Duration health plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio; To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios (H.R. 3969) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Period CONNECT for Health Act Hospital Claims Form Issues Build Back Better Act (H.R.5376) KEEP Telehealth Options Act Agent/broker compensation disclosures under the Consolidated Appropriations Act. CAA regulation implementation Hospital Competition Act Medicaid eligibility Health Equity/Health Disparities Postal Service Reform Act of 2022 Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care (U.S. Department of Veterans Affairs Assets and Infrastructure Review Report) 2018 MISSION Act Veterans PACT Act Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) Bipartisan Safer Communities Act
To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios.
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
ACA 1332 Waivers Individual Market and Exchange Stabilization Prior Authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Flexibility in Hospital Ownership Act Oversight of Anti-Competitive Behavior of Non-Profit Hospitals Act Consumer Choice of Care Act Competition in State Healthcare Markets Act Addressing Anti-Competitive Contracting Clauses Act Increasing Competition for Medical Residency Act Hospital Claims Form Issues Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios. (H.R.3969) Mental Health and Substance Use, CFR Part 2, Parity and MHPAEA Compliance Issues Mental Health Matters Act (H.R. 7780) Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Bipartisan Safer Communities Act MAT Act Surprise Medical Billing Price of Prescription Drugs Pharmacy Benefit Manager (PBM) Operations and Practices, Spread Pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Chronic Kidney Disease Conditions of Coverage Reform COVID-19 Testing, Vaccines, Treatment, Cost Sharing Medicare Sequestration Telehealth KEEP Telehealth Options Act Telehealth Expansion Act (H.R. 5981) Short Term Limited Duration Health Plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Periods Hospital Claims Form Issues Build Back Better Act (H.R.5376) Inflation Reduction Act of 2022 Medicaid Eligibility Health Equity/Health Disparities Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care VA Community Care Network Program Veterans PACT Act Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022 Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) TCPA Insurance Navigators Network Adequacy Provider Directories 2023 Omnibus Appropriations Bill Originating Site Requirements Provider and Nursing Licensing Issues Inpatient Only List Site Neutrality Biosimilar Red Tape Elimination Act Biologics Competition Act
To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios.
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
ACA 1332 Waivers Individual Market and Exchange Stabilization Prior Authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Flexibility in Hospital Ownership Act Oversight of Anti-Competitive Behavior of Non-Profit Hospitals Act Consumer Choice of Care Act Competition in State Healthcare Markets Act Addressing Anti-Competitive Contracting Clauses Act Increasing Competition for Medical Residency Act Hospital Claims Form Issues Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios. (H.R.3969) Mental Health and Substance Use, CFR Part 2, Parity and MHPAEA Compliance Issues Mental Health Matters Act (H.R. 7780) Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Bipartisan Safer Communities Act MAT Act Surprise Medical Billing Price of Prescription Drugs Pharmacy Benefit Manager (PBM) Operations and Practices, Spread Pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Chronic Kidney Disease Conditions of Coverage Reform COVID-19 Testing, Vaccines, Treatment, Cost Sharing Medicare Sequestration Telehealth KEEP Telehealth Options Act Telehealth Expansion Act (H.R. 5981) Short Term Limited Duration Health Plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Periods Hospital Claims Form Issues Build Back Better Act (H.R.5376) Inflation Reduction Act of 2022 Medicaid Eligibility Health Equity/Health Disparities Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care VA Community Care Network Program Veterans PACT Act Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022 Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) TCPA Insurance Navigators Network Adequacy Provider Directories 2023 Omnibus Appropriations Bill Originating Site Requirements Provider and Nursing Licensing Issues Inpatient Only List Site Neutrality Biosimilar Red Tape Elimination Act Biologics Competition Act
To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios.
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) ACA 1332 Waivers Individual market and exchange stabilization Prior authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use, Parity and compliance issues. Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Mental health parity and MHPAEA compliance Surprise medical billing; Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Chronic Kidney Disease Conditions of Coverage Reform COVID-19 testing, vaccines, treatment, cost sharing Medicare Sequestration, ACA subsidies, COVID vaccines and testing, Consolidated Appropriations Act Behavioral Health Telehealth Short Term Limited Duration health plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio; To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios (H.R. 3969) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Period CONNECT for Health Act Hospital Claims Form Issues Build Back Better Act (H.R.5376) KEEP Telehealth Options Act Agent/broker compensation disclosures under the Consolidated Appropriations Act. CAA regulation implementation Hospital Competition Act Medicaid eligibility Health Equity/Health Disparities Postal Service Reform Act of 2022 Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care (U.S. Department of Veterans Affairs Assets and Infrastructure Review Report) 2018 MISSION Act Veterans PACT Act Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) Bipartisan Safer Communities Act
To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios.
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) ACA 1332 Waivers Individual market and exchange stabilization Prior authorization Hospital Consolidation Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use, Parity and compliance issues; Surprise medical billing; No Surprises Act Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Medicare Sequestration, ACA subsidies, COVID vaccines and testing, Consolidated Appropriations Act Behavioral Health Telehealth Short Term Limited Duration health plans Consolidated Appropriations Act, HR 133 Medical Loss Ratio; H.R. 3969 - To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Period CONNECT for Health Act Hospital Claims Form Issues H.R.5376 - Build Back Better Act KEEP Telehealth Options Act Opioid use disorders (OUD) and substance use disorders (SUD) treatment Agent/broker compensation disclosures under the Consolidated Appropriations Act. CAA regulation implementation Hospital Competition Act Medicaid eligibility Health Equity/Health Disparities Postal Service Reform Act of 2022; Postal Service Retiree Benefits Reform Defense Health Programs (FY2022 Budget and FY2023 Budget Request Veterans Health Care (U.S. Department of Veterans Affairs Assets and Infrastructure Review Report) Veterans Records Access (Access for Veterans to Records Act)
To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios.
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) ACA 1332 Waivers Individual market and exchange stabilization Prior authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use, Parity and compliance issues. Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Mental health parity and MHPAEA compliance Surprise medical billing; Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Chronic Kidney Disease Conditions of Coverage Reform COVID-19 testing, vaccines, treatment, cost sharing Medicare Sequestration, ACA subsidies, COVID vaccines and testing, Consolidated Appropriations Act Behavioral Health Telehealth Short Term Limited Duration health plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio; To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios (H.R. 3969) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Period CONNECT for Health Act Hospital Claims Form Issues Build Back Better Act (H.R.5376) KEEP Telehealth Options Act Agent/broker compensation disclosures under the Consolidated Appropriations Act. CAA regulation implementation Hospital Competition Act Medicaid eligibility Health Equity/Health Disparities Postal Service Reform Act of 2022 Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care (U.S. Department of Veterans Affairs Assets and Infrastructure Review Report) 2018 MISSION Act Veterans PACT Act Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) Bipartisan Safer Communities Act
To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios.
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) ACA 1332 Waivers Individual market and exchange stabilization Prior authorization and Utilization Management, (H.R. 3107); Hospital Consolidation Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use,42 CFR Part 2, Parity and compliance issues; Surprise medical billing; No Surprises Act Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, COVID-19 testing, vaccines, treatment, cost sharing Medical Loss Ratio; H.R. 3969 - To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios Federal Medical Assistance Percentages (FMAP) increase Short Term Limited Duration health plans Special Enrollment Period CONNECT for Health Act Hospital Claims Form Issues H.R.5376 - Build Back Better Act KEEP Telehealth Options Act Opioid use disorders (OUD) and substance use disorders (SUD) treatment Agent/broker compensation disclosures under the Consolidated Appropriations Act. CAA regulation implementation Hospital Competition Act Postal Service Reform Act of 2022; Postal Service Retiree Benefits Reform Defense Health Programs (FY2022 Budget and FY2023 Budget Request Veterans Health Care (U.S. Department of Veterans Affairs Assets and Infrastructure Review Report) Veterans Records Access (Access for Veterans to Records Act)
To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios.
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) ACA 1332 Waivers Individual market and exchange stabilization Prior authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use, Parity and compliance issues. Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Mental health parity and MHPAEA compliance Surprise medical billing; Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Chronic Kidney Disease Conditions of Coverage Reform COVID-19 testing, vaccines, treatment, cost sharing Medicare Sequestration, ACA subsidies, COVID vaccines and testing, Consolidated Appropriations Act Behavioral Health Telehealth Short Term Limited Duration health plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio; To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios (H.R. 3969) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Period CONNECT for Health Act Hospital Claims Form Issues Build Back Better Act (H.R.5376) KEEP Telehealth Options Act Agent/broker compensation disclosures under the Consolidated Appropriations Act. CAA regulation implementation Hospital Competition Act Medicaid eligibility Health Equity/Health Disparities Postal Service Reform Act of 2022 Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care (U.S. Department of Veterans Affairs Assets and Infrastructure Review Report) 2018 MISSION Act Veterans PACT Act Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) Bipartisan Safer Communities Act
Addressing Social Determinants in Medicare Advantage Act of 2021
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, star ratings, extreme and uncontrollable circumstances policy, normalization factors, stars contract consolidation, ESRD, audio-only telehealth) Medicare RAD-V Mental health and substance use (42 CFR Part 2) Medicaid managed care (IMD Exclusion) Medicaid expansion Medicaid reform (block grants, per capita caps) Medicaid and CHIP reauthorization Medicaid actuarial soundness Long-term services and supports Medicare Part D prescription drug program and Medicare Part D coverage gap (donut hole) Opioid addiction issues and response (prescription drug monitoring programs) Medicaid medical loss ratio remittance Medicare Advantage Pilot Program in TRICARE Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing Direct and Indirect Remuneration (DIR) reforms in the FY 2023 Medicare Part D Notice H.R.6833 - Affordable Insulin Now Act Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act H.R.7666 - Restoring Hope for Mental Health and Well-Being Act of 2022 Social Determents of Health (SDOH) H.R.4074 - Addressing Social Determinants in Medicare Advantage Act of 2021 Health Equity/Health Disparities Maternal health (Medicaid postpartum coverage extension, H.R.959 Black Maternal Health Momnibus Act of 2021) Helping MOMS Act of 2021 Medicare Audio-Only Telehealth (H.R.2166, S.150) Continuing Resolution (CR)FY 2022 Medicaid Funding for Puerto Rico Medicare Savings Program (MSP) in Medicaid Increasing on the Medicare Advantage benchmarks to a minimum level H.R. 7997 (to Amend the SS Act to establish a floor in MA benchmark rates for regions with low Medicare fee-for-service penetration and to make the Medicare Savings Program available in all jurisdictions) H.R. 2217 (Territory Federal Matching Requirement Equity Act of 2021) H.R. 1825 (A Bill to Remove the Matching Requirement for Medicare Part D Drugs) H.R. 1826 (Fairness in Medicare Part B Enrollment Act) S. 3778 (Territories Medicare Prescription Drug Assistance Equity Act of 2022). H.R.5376 - Build Back Better Act Medicaid eligibility and redeterminations H.R. 5376 - Inflation Reduction Act of 2022 Medicare Advantage Supplemental Benefits
Addressing Social Determinants in Medicare Advantage Act of 2021
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, star ratings, extreme and uncontrollable circumstances policy, normalization factors, stars contract consolidation, ESRD, audio-only telehealth) Medicare RAD-V Mental Health and Substance Use (42 CFR Part 2) Medicaid Managed Care Medicaid Expansion Medicaid Reform Medicaid Redeterminations CHIP Reauthorization Medicaid Actuarial Soundness Long-term Services and Supports Medicare Part D prescription drug program Medicare Advantage Pilot Program in TRICARE Pharmacy Benefit Manager (PBM) Operations and Practices, Spread Pricing Direct and Indirect Remuneration (DIR) reforms in the FY 2023 Medicare Part D Notice Affordable Insulin Now Act (H.R.6833) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Social Determents of Health (SDOH) Addressing Social Determinants in Medicare Advantage Act of 2021 (H.R.4074) Health Equity/Health Disparities Maternal health (Medicaid postpartum coverage extension, H.R.959 Black Maternal Health Momnibus Act of 2021) Helping MOMS Act of 2021 Medicare Audio-Only Telehealth (H.R.2166, S.150) Medicaid Funding for Puerto Rico Medicare Savings Program (MSP) in Medicaid Increasing on the Medicare Advantage Benchmarks to a Minimum Level H.R. 7997 (to Amend the SS Act to establish a floor in MA benchmark rates for regions with low Medicare fee-for-service penetration and to make the Medicare Savings Program available in all jurisdictions) H.R. 2217 (Territory Federal Matching Requirement Equity Act of 2021) H.R. 1825 (A Bill to Remove the Matching Requirement for Medicare Part D Drugs) H.R. 1826 (Fairness in Medicare Part B Enrollment Act) S. 3778 (Territories Medicare Prescription Drug Assistance Equity Act of 2022). Build Back Better Act (H.R.5376) Medicaid Eligibility and Redeterminations Inflation Reduction Act of 2022 (H.R. 5376) Medicare Advantage Supplemental Benefits Timely Access to Care Act (H.R. 3173 and S. 3018) 2023 Omnibus Appropriations Bill Mental Health Parity Restore Protections for Dialysis Patients Act (H.R.8594)
Addressing Social Determinants in Medicare Advantage Act of 2021
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, star ratings, extreme and uncontrollable circumstances policy, normalization factors, stars contract consolidation, ESRD, audio-only telehealth H.R. 4074 -To amend title XVIII of the Social Security Act Medicare RAD-V Mental health and substance use (42 CFR Part 2) Medicaid (IMD Exclusion) Medicaid expansion Medicaid reform (block grants, per capita caps) Medicaid and CHIP reauthorization Medicaid actuarial soundness Long-term services and supports Social Determents of Health (SDOH) Medicare Part D prescription drug program and Medicare Part D coverage gap (donut hole) Opioid addiction issues and response (prescription drug monitoring programs) Medicaid medical loss ratio remittance Medicare Advantage Pilot Program in TRICARE Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing Against Direct and Indirect Remuneration (DIR) reforms in the FY 2023 Medicare Part D Notice H.R.6833 - Affordable Insulin Now Act Maternal health (Medicaid postpartum coverage extension, H.R.959 Black Maternal Health Momnibus Act of 2021) Helping MOMS Act of 2021 CMS Extreme & Uncontrollable Circumstances Policy Medicare Sequester (H.R.315, S.748) Medicare Audio-Only Telehealth (H.R.2166, S.150) Continuing Resolution (CR)FY 2022 Medicaid Funding for Puerto Rico Medicaid Funding for Puerto Rico including discussions on the FMAP, ESRD, and LTSS. Medicare Advantage issues such as rates, benchmarks, providers payments, and disparities in funding for territories. Medicare Advantage asks regarding the underfunding and disparity for Puerto Rico H.R.5376 - Build Back Better Act Medicaid eligibility Health Equity/Health Disparities
Addressing Social Determinants in Medicare Advantage Act of 2021
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, star ratings, extreme and uncontrollable circumstances policy, normalization factors, stars contract consolidation, ESRD, audio-only telehealth H.R. 4074 -To amend title XVIII of the Social Security Act Medicare RAD-V Mental health and substance use (42 CFR Part 2) Medicaid (IMD Exclusion) Medicaid expansion Medicaid reform (block grants, per capita caps) Medicaid and CHIP reauthorization Medicaid actuarial soundness Long-term services and supports Social Determents of Health (SDOH) Medicare Part D prescription drug program and Medicare Part D coverage gap (donut hole) Opioid addiction issues and response (prescription drug monitoring programs) Medicaid medical loss ratio remittance Medicare Advantage Pilot Program in TRICARE Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing Direct and Indirect Remuneration (DIR) reforms in the FY 2023 Medicare Part D Notice H.R.6833 - Affordable Insulin Now Act Maternal health (Medicaid postpartum coverage extension, H.R.959 Black Maternal Health Momnibus Act of 2021) Helping MOMS Act of 2021 CMS Extreme & Uncontrollable Circumstances Policy Medicare Sequester (H.R.315, S.748) Medicare Audio-Only Telehealth (H.R.2166, S.150, H.R.3447) H.R. 4406, the Supporting Medicaid in the U.S. Territories Act, Continuing Resolution (CR)FY 2022 Medicaid Funding for Puerto Rico Medicare Advantage asks regarding the underfunding and disparity for Puerto Rico H.R.5376 - Build Back Better Act Medicaid eligibility Health Equity/Health Disparities HR1826 - Fairness in Medicare Part B Enrollment Act HR2217 - Territory Federal Matching Requirement Equity Act of 2021 HR1825 - A Bill to Remove the Matching Requirement for Medicate Part D Drugs.
Supporting Medicaid in the U.S. Territories Act of 2021
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, star ratings, extreme and uncontrollable circumstances policy, normalization factors, stars contract consolidation, ESRD, audio-only telehealth H.R. 4074 -To amend title XVIII of the Social Security Act Medicare RAD-V Mental health and substance use (42 CFR Part 2) Medicaid (IMD Exclusion) Medicaid expansion Medicaid reform (block grants, per capita caps) Medicaid and CHIP reauthorization Medicaid actuarial soundness Long-term services and supports Social Determents of Health (SDOH) Medicare Part D prescription drug program and Medicare Part D coverage gap (donut hole) Opioid addiction issues and response (prescription drug monitoring programs) Medicaid medical loss ratio remittance Medicare Advantage Pilot Program in TRICARE Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing Direct and Indirect Remuneration (DIR) reforms in the FY 2023 Medicare Part D Notice H.R.6833 - Affordable Insulin Now Act Maternal health (Medicaid postpartum coverage extension, H.R.959 Black Maternal Health Momnibus Act of 2021) Helping MOMS Act of 2021 CMS Extreme & Uncontrollable Circumstances Policy Medicare Sequester (H.R.315, S.748) Medicare Audio-Only Telehealth (H.R.2166, S.150, H.R.3447) H.R. 4406, the Supporting Medicaid in the U.S. Territories Act, Continuing Resolution (CR)FY 2022 Medicaid Funding for Puerto Rico Medicare Advantage asks regarding the underfunding and disparity for Puerto Rico H.R.5376 - Build Back Better Act Medicaid eligibility Health Equity/Health Disparities HR1826 - Fairness in Medicare Part B Enrollment Act HR2217 - Territory Federal Matching Requirement Equity Act of 2021 HR1825 - A Bill to Remove the Matching Requirement for Medicate Part D Drugs.
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, star ratings, extreme and uncontrollable circumstances policy, normalization factors, stars contract consolidation, ESRD, audio-only telehealth H.R. 4074 -To amend title XVIII of the Social Security Act Medicare RAD-V Mental health and substance use (42 CFR Part 2) Medicaid (IMD Exclusion) Medicaid expansion Medicaid reform (block grants, per capita caps) Medicaid and CHIP reauthorization Medicaid actuarial soundness Long-term services and supports Social Determents of Health (SDOH) Medicare Part D prescription drug program and Medicare Part D coverage gap (donut hole) Opioid addiction issues and response (prescription drug monitoring programs) Medicaid medical loss ratio remittance Medicare Advantage Pilot Program in TRICARE Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing Direct and Indirect Remuneration (DIR) reforms in the FY 2023 Medicare Part D Notice H.R.6833 - Affordable Insulin Now Act Maternal health (Medicaid postpartum coverage extension, H.R.959 Black Maternal Health Momnibus Act of 2021) Helping MOMS Act of 2021 CMS Extreme & Uncontrollable Circumstances Policy Medicare Sequester (H.R.315, S.748) Medicare Audio-Only Telehealth (H.R.2166, S.150, H.R.3447) H.R. 4406, the Supporting Medicaid in the U.S. Territories Act, Continuing Resolution (CR)FY 2022 Medicaid Funding for Puerto Rico Medicare Advantage asks regarding the underfunding and disparity for Puerto Rico H.R.5376 - Build Back Better Act Medicaid eligibility Health Equity/Health Disparities HR1826 - Fairness in Medicare Part B Enrollment Act HR2217 - Territory Federal Matching Requirement Equity Act of 2021 HR1825 - A Bill to Remove the Matching Requirement for Medicate Part D Drugs.
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) ACA 1332 Waivers Individual market and exchange stabilization Prior authorization and Utilization Management, (H.R. 3107); Hospital Consolidation Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use,42 CFR Part 2, Parity and compliance issues; Surprise medical billing; No Surprises Act Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, COVID-19 testing, vaccines, treatment, cost sharing Medical Loss Ratio; H.R. 3969 - To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios Federal Medical Assistance Percentages (FMAP) increase Short Term Limited Duration health plans Special Enrollment Period CONNECT for Health Act Hospital Claims Form Issues H.R.5376 - Build Back Better Act KEEP Telehealth Options Act Opioid use disorders (OUD) and substance use disorders (SUD) treatment Agent/broker compensation disclosures under the Consolidated Appropriations Act. CAA regulation implementation Hospital Competition Act Postal Service Reform Act of 2022; Postal Service Retiree Benefits Reform Defense Health Programs (FY2022 Budget and FY2023 Budget Request Veterans Health Care (U.S. Department of Veterans Affairs Assets and Infrastructure Review Report) Veterans Records Access (Access for Veterans to Records Act)
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) ACA 1332 Waivers Individual market and exchange stabilization Prior authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Flexibility in Hospital Ownership Act Oversight of Anti-Competitive Behavior of Non-Profit Hospitals Act Consumer Choice of Care Act Competition in State Healthcare Markets Act Addressing Anti-Competitive Contracting Clauses Act Increasing Competition for Medical Residency Act Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use, CFR Part 2, Parity and compliance issues H.R. 7780 - Mental Health Matters Act Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Mental health parity and MHPAEA compliance Surprise medical billing Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Chronic Kidney Disease Conditions of Coverage Reform COVID-19 testing, vaccines, treatment, cost sharing Medicare Sequestration, ACA subsidies, COVID vaccines and testing, Consolidated Appropriations Act Telehealth KEEP Telehealth Options Act Short Term Limited Duration health plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Period Hospital Claims Form Issues Build Back Better Act (H.R.5376) Inflation Reduction Act of 2022 Medicaid eligibility Health Equity/Health Disparities Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care Veterans PACT Act Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022 Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) TCPA Insurance Navigators Network Adequacy Provider Directories Bipartisan Safer Communities Act
ACA 1332 Waivers Individual Market and Exchange Stabilization Prior Authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Flexibility in Hospital Ownership Act Oversight of Anti-Competitive Behavior of Non-Profit Hospitals Act Consumer Choice of Care Act Competition in State Healthcare Markets Act Addressing Anti-Competitive Contracting Clauses Act Increasing Competition for Medical Residency Act Hospital Claims Form Issues Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios. (H.R.3969) Mental Health and Substance Use, CFR Part 2, Parity and MHPAEA Compliance Issues Mental Health Matters Act (H.R. 7780) Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Bipartisan Safer Communities Act MAT Act Surprise Medical Billing Price of Prescription Drugs Pharmacy Benefit Manager (PBM) Operations and Practices, Spread Pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Chronic Kidney Disease Conditions of Coverage Reform COVID-19 Testing, Vaccines, Treatment, Cost Sharing Medicare Sequestration Telehealth KEEP Telehealth Options Act Telehealth Expansion Act (H.R. 5981) Short Term Limited Duration Health Plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Periods Hospital Claims Form Issues Build Back Better Act (H.R.5376) Inflation Reduction Act of 2022 Medicaid Eligibility Health Equity/Health Disparities Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care VA Community Care Network Program Veterans PACT Act Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022 Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) TCPA Insurance Navigators Network Adequacy Provider Directories 2023 Omnibus Appropriations Bill Originating Site Requirements Provider and Nursing Licensing Issues Inpatient Only List Site Neutrality Biosimilar Red Tape Elimination Act Biologics Competition Act
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) ACA 1332 Waivers Individual market and exchange stabilization Prior authorization Hospital Consolidation Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use, Parity and compliance issues; Surprise medical billing; No Surprises Act Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Medicare Sequestration, ACA subsidies, COVID vaccines and testing, Consolidated Appropriations Act Behavioral Health Telehealth Short Term Limited Duration health plans Consolidated Appropriations Act, HR 133 Medical Loss Ratio; H.R. 3969 - To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Period CONNECT for Health Act Hospital Claims Form Issues H.R.5376 - Build Back Better Act KEEP Telehealth Options Act Opioid use disorders (OUD) and substance use disorders (SUD) treatment Agent/broker compensation disclosures under the Consolidated Appropriations Act. CAA regulation implementation Hospital Competition Act Medicaid eligibility Health Equity/Health Disparities Postal Service Reform Act of 2022; Postal Service Retiree Benefits Reform Defense Health Programs (FY2022 Budget and FY2023 Budget Request Veterans Health Care (U.S. Department of Veterans Affairs Assets and Infrastructure Review Report) Veterans Records Access (Access for Veterans to Records Act)
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) ACA 1332 Waivers Individual market and exchange stabilization Prior authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use, Parity and compliance issues. Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Mental health parity and MHPAEA compliance Surprise medical billing; Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Chronic Kidney Disease Conditions of Coverage Reform COVID-19 testing, vaccines, treatment, cost sharing Medicare Sequestration, ACA subsidies, COVID vaccines and testing, Consolidated Appropriations Act Behavioral Health Telehealth Short Term Limited Duration health plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio; To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios (H.R. 3969) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Period CONNECT for Health Act Hospital Claims Form Issues Build Back Better Act (H.R.5376) KEEP Telehealth Options Act Agent/broker compensation disclosures under the Consolidated Appropriations Act. CAA regulation implementation Hospital Competition Act Medicaid eligibility Health Equity/Health Disparities Postal Service Reform Act of 2022 Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care (U.S. Department of Veterans Affairs Assets and Infrastructure Review Report) 2018 MISSION Act Veterans PACT Act Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) Bipartisan Safer Communities Act
ACA 1332 Waivers Individual Market and Exchange Stabilization Prior Authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Flexibility in Hospital Ownership Act Oversight of Anti-Competitive Behavior of Non-Profit Hospitals Act Consumer Choice of Care Act Competition in State Healthcare Markets Act Addressing Anti-Competitive Contracting Clauses Act Increasing Competition for Medical Residency Act Hospital Claims Form Issues Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios. (H.R.3969) Mental Health and Substance Use, CFR Part 2, Parity and MHPAEA Compliance Issues Mental Health Matters Act (H.R. 7780) Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Bipartisan Safer Communities Act MAT Act Surprise Medical Billing Price of Prescription Drugs Pharmacy Benefit Manager (PBM) Operations and Practices, Spread Pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Chronic Kidney Disease Conditions of Coverage Reform COVID-19 Testing, Vaccines, Treatment, Cost Sharing Medicare Sequestration Telehealth KEEP Telehealth Options Act Telehealth Expansion Act (H.R. 5981) Short Term Limited Duration Health Plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Periods Hospital Claims Form Issues Build Back Better Act (H.R.5376) Inflation Reduction Act of 2022 Medicaid Eligibility Health Equity/Health Disparities Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care VA Community Care Network Program Veterans PACT Act Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022 Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) TCPA Insurance Navigators Network Adequacy Provider Directories 2023 Omnibus Appropriations Bill Originating Site Requirements Provider and Nursing Licensing Issues Inpatient Only List Site Neutrality Biosimilar Red Tape Elimination Act Biologics Competition Act
Price of prescription drugs; antitrust issues; Prescription Drug Pricing Reduction Act Pharmacy Benefit Manager (PBM) operations and practices, Spread Pricing Direct and Indirect Remuneration (DIR) Drug Rebate Rule/Executive Order Senate Finance Committee Prescription Drug Pricing Reduction Act Lower Drug Costs Now Act (H.R. 3) Drug Patent Reform Robinson-Patman Reform Inflation Reduction Act of 2022 (H.R. 5376) Pharmacy Benefit Manager Transparency Act (S. 4293) PBM Transparency Language in the Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) 2023 Omnibus Appropriations Bill
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, star ratings, extreme and uncontrollable circumstances policy, normalization factors, stars contract consolidation, ESRD, audio-only telehealth H.R. 4074 -To amend title XVIII of the Social Security Act Medicare RAD-V Mental health and substance use (42 CFR Part 2) Medicaid (IMD Exclusion) Medicaid expansion Medicaid reform (block grants, per capita caps) Medicaid and CHIP reauthorization Medicaid actuarial soundness Long-term services and supports Social Determents of Health (SDOH) Medicare Part D prescription drug program and Medicare Part D coverage gap (donut hole) Opioid addiction issues and response (prescription drug monitoring programs) Medicaid medical loss ratio remittance Medicare Advantage Pilot Program in TRICARE Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing Against Direct and Indirect Remuneration (DIR) reforms in the FY 2023 Medicare Part D Notice H.R.6833 - Affordable Insulin Now Act Maternal health (Medicaid postpartum coverage extension, H.R.959 Black Maternal Health Momnibus Act of 2021) Helping MOMS Act of 2021 CMS Extreme & Uncontrollable Circumstances Policy Medicare Sequester (H.R.315, S.748) Medicare Audio-Only Telehealth (H.R.2166, S.150) Continuing Resolution (CR)FY 2022 Medicaid Funding for Puerto Rico Medicaid Funding for Puerto Rico including discussions on the FMAP, ESRD, and LTSS. Medicare Advantage issues such as rates, benchmarks, providers payments, and disparities in funding for territories. Medicare Advantage asks regarding the underfunding and disparity for Puerto Rico H.R.5376 - Build Back Better Act Medicaid eligibility Health Equity/Health Disparities
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) ACA 1332 Waivers Individual market and exchange stabilization Prior authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use, Parity and compliance issues. Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Mental health parity and MHPAEA compliance Surprise medical billing; Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Chronic Kidney Disease Conditions of Coverage Reform COVID-19 testing, vaccines, treatment, cost sharing Medicare Sequestration, ACA subsidies, COVID vaccines and testing, Consolidated Appropriations Act Behavioral Health Telehealth Short Term Limited Duration health plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio; To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios (H.R. 3969) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Period CONNECT for Health Act Hospital Claims Form Issues Build Back Better Act (H.R.5376) KEEP Telehealth Options Act Agent/broker compensation disclosures under the Consolidated Appropriations Act. CAA regulation implementation Hospital Competition Act Medicaid eligibility Health Equity/Health Disparities Postal Service Reform Act of 2022 Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care (U.S. Department of Veterans Affairs Assets and Infrastructure Review Report) 2018 MISSION Act Veterans PACT Act Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) Bipartisan Safer Communities Act
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) ACA 1332 Waivers Individual market and exchange stabilization Prior authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use, Parity and compliance issues. Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Mental health parity and MHPAEA compliance Surprise medical billing; Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Chronic Kidney Disease Conditions of Coverage Reform COVID-19 testing, vaccines, treatment, cost sharing Medicare Sequestration, ACA subsidies, COVID vaccines and testing, Consolidated Appropriations Act Behavioral Health Telehealth Short Term Limited Duration health plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio; To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios (H.R. 3969) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Period CONNECT for Health Act Hospital Claims Form Issues Build Back Better Act (H.R.5376) KEEP Telehealth Options Act Agent/broker compensation disclosures under the Consolidated Appropriations Act. CAA regulation implementation Hospital Competition Act Medicaid eligibility Health Equity/Health Disparities Postal Service Reform Act of 2022 Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care (U.S. Department of Veterans Affairs Assets and Infrastructure Review Report) 2018 MISSION Act Veterans PACT Act Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) Bipartisan Safer Communities Act
Price of prescription drugs; antitrust issues; Prescription Drug Pricing Reduction Act Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing Direct and Indirect Remuneration (DIR) Drug Rebate Rule/Executive Order Senate Finance Committee Prescription Drug Pricing Reduction Act Lower Drug Costs Now Act (H.R. 3) Drug Patent Reform Robinson-Patman Reform H.R. 5376 - Inflation Reduction Act of 2022 Pharmacy Benefit Manager Transparency Act (S. 4293)
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) ACA 1332 Waivers Individual market and exchange stabilization Prior authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Flexibility in Hospital Ownership Act Oversight of Anti-Competitive Behavior of Non-Profit Hospitals Act Consumer Choice of Care Act Competition in State Healthcare Markets Act Addressing Anti-Competitive Contracting Clauses Act Increasing Competition for Medical Residency Act Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use, CFR Part 2, Parity and compliance issues H.R. 7780 - Mental Health Matters Act Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Mental health parity and MHPAEA compliance Surprise medical billing Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Chronic Kidney Disease Conditions of Coverage Reform COVID-19 testing, vaccines, treatment, cost sharing Medicare Sequestration, ACA subsidies, COVID vaccines and testing, Consolidated Appropriations Act Telehealth KEEP Telehealth Options Act Short Term Limited Duration health plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Period Hospital Claims Form Issues Build Back Better Act (H.R.5376) Inflation Reduction Act of 2022 Medicaid eligibility Health Equity/Health Disparities Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care Veterans PACT Act Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022 Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) TCPA Insurance Navigators Network Adequacy Provider Directories Bipartisan Safer Communities Act
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, star ratings, extreme and uncontrollable circumstances policy, normalization factors, stars contract consolidation, ESRD, audio-only telehealth) Medicare RAD-V Mental Health and Substance Use (42 CFR Part 2) Medicaid Managed Care Medicaid Expansion Medicaid Reform Medicaid Redeterminations CHIP Reauthorization Medicaid Actuarial Soundness Long-term Services and Supports Medicare Part D prescription drug program Medicare Advantage Pilot Program in TRICARE Pharmacy Benefit Manager (PBM) Operations and Practices, Spread Pricing Direct and Indirect Remuneration (DIR) reforms in the FY 2023 Medicare Part D Notice Affordable Insulin Now Act (H.R.6833) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Social Determents of Health (SDOH) Addressing Social Determinants in Medicare Advantage Act of 2021 (H.R.4074) Health Equity/Health Disparities Maternal health (Medicaid postpartum coverage extension, H.R.959 Black Maternal Health Momnibus Act of 2021) Helping MOMS Act of 2021 Medicare Audio-Only Telehealth (H.R.2166, S.150) Medicaid Funding for Puerto Rico Medicare Savings Program (MSP) in Medicaid Increasing on the Medicare Advantage Benchmarks to a Minimum Level H.R. 7997 (to Amend the SS Act to establish a floor in MA benchmark rates for regions with low Medicare fee-for-service penetration and to make the Medicare Savings Program available in all jurisdictions) H.R. 2217 (Territory Federal Matching Requirement Equity Act of 2021) H.R. 1825 (A Bill to Remove the Matching Requirement for Medicare Part D Drugs) H.R. 1826 (Fairness in Medicare Part B Enrollment Act) S. 3778 (Territories Medicare Prescription Drug Assistance Equity Act of 2022). Build Back Better Act (H.R.5376) Medicaid Eligibility and Redeterminations Inflation Reduction Act of 2022 (H.R. 5376) Medicare Advantage Supplemental Benefits Timely Access to Care Act (H.R. 3173 and S. 3018) 2023 Omnibus Appropriations Bill Mental Health Parity Restore Protections for Dialysis Patients Act (H.R.8594)
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, star ratings, extreme and uncontrollable circumstances policy, normalization factors, stars contract consolidation, ESRD, audio-only telehealth) Medicare RAD-V Mental health and substance use (42 CFR Part 2) Medicaid managed care (IMD Exclusion) Medicaid expansion Medicaid reform (block grants, per capita caps) Medicaid and CHIP reauthorization Medicaid actuarial soundness Long-term services and supports Medicare Part D prescription drug program and Medicare Part D coverage gap (donut hole) Opioid addiction issues and response (prescription drug monitoring programs) Medicaid medical loss ratio remittance Medicare Advantage Pilot Program in TRICARE Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing Direct and Indirect Remuneration (DIR) reforms in the FY 2023 Medicare Part D Notice H.R.6833 - Affordable Insulin Now Act Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act H.R.7666 - Restoring Hope for Mental Health and Well-Being Act of 2022 Social Determents of Health (SDOH) H.R.4074 - Addressing Social Determinants in Medicare Advantage Act of 2021 Health Equity/Health Disparities Maternal health (Medicaid postpartum coverage extension, H.R.959 Black Maternal Health Momnibus Act of 2021) Helping MOMS Act of 2021 Medicare Audio-Only Telehealth (H.R.2166, S.150) Continuing Resolution (CR)FY 2022 Medicaid Funding for Puerto Rico Medicare Savings Program (MSP) in Medicaid Increasing on the Medicare Advantage benchmarks to a minimum level H.R. 7997 (to Amend the SS Act to establish a floor in MA benchmark rates for regions with low Medicare fee-for-service penetration and to make the Medicare Savings Program available in all jurisdictions) H.R. 2217 (Territory Federal Matching Requirement Equity Act of 2021) H.R. 1825 (A Bill to Remove the Matching Requirement for Medicare Part D Drugs) H.R. 1826 (Fairness in Medicare Part B Enrollment Act) S. 3778 (Territories Medicare Prescription Drug Assistance Equity Act of 2022). H.R.5376 - Build Back Better Act Medicaid eligibility and redeterminations H.R. 5376 - Inflation Reduction Act of 2022 Medicare Advantage Supplemental Benefits
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) ACA 1332 Waivers Individual market and exchange stabilization Prior authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use, Parity and compliance issues. Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Mental health parity and MHPAEA compliance Surprise medical billing; Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Chronic Kidney Disease Conditions of Coverage Reform COVID-19 testing, vaccines, treatment, cost sharing Medicare Sequestration, ACA subsidies, COVID vaccines and testing, Consolidated Appropriations Act Behavioral Health Telehealth Short Term Limited Duration health plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio; To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios (H.R. 3969) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Period CONNECT for Health Act Hospital Claims Form Issues Build Back Better Act (H.R.5376) KEEP Telehealth Options Act Agent/broker compensation disclosures under the Consolidated Appropriations Act. CAA regulation implementation Hospital Competition Act Medicaid eligibility Health Equity/Health Disparities Postal Service Reform Act of 2022 Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care (U.S. Department of Veterans Affairs Assets and Infrastructure Review Report) 2018 MISSION Act Veterans PACT Act Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) Bipartisan Safer Communities Act
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) ACA 1332 Waivers Individual market and exchange stabilization Prior authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use, Parity and compliance issues. Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Mental health parity and MHPAEA compliance Surprise medical billing; Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Chronic Kidney Disease Conditions of Coverage Reform COVID-19 testing, vaccines, treatment, cost sharing Medicare Sequestration, ACA subsidies, COVID vaccines and testing, Consolidated Appropriations Act Behavioral Health Telehealth Short Term Limited Duration health plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio; To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios (H.R. 3969) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Period CONNECT for Health Act Hospital Claims Form Issues Build Back Better Act (H.R.5376) KEEP Telehealth Options Act Agent/broker compensation disclosures under the Consolidated Appropriations Act. CAA regulation implementation Hospital Competition Act Medicaid eligibility Health Equity/Health Disparities Postal Service Reform Act of 2022 Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care (U.S. Department of Veterans Affairs Assets and Infrastructure Review Report) 2018 MISSION Act Veterans PACT Act Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) Bipartisan Safer Communities Act
Telehealth Expansion Act of 2021
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
ACA 1332 Waivers Individual Market and Exchange Stabilization Prior Authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Flexibility in Hospital Ownership Act Oversight of Anti-Competitive Behavior of Non-Profit Hospitals Act Consumer Choice of Care Act Competition in State Healthcare Markets Act Addressing Anti-Competitive Contracting Clauses Act Increasing Competition for Medical Residency Act Hospital Claims Form Issues Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios. (H.R.3969) Mental Health and Substance Use, CFR Part 2, Parity and MHPAEA Compliance Issues Mental Health Matters Act (H.R. 7780) Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Bipartisan Safer Communities Act MAT Act Surprise Medical Billing Price of Prescription Drugs Pharmacy Benefit Manager (PBM) Operations and Practices, Spread Pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Chronic Kidney Disease Conditions of Coverage Reform COVID-19 Testing, Vaccines, Treatment, Cost Sharing Medicare Sequestration Telehealth KEEP Telehealth Options Act Telehealth Expansion Act (H.R. 5981) Short Term Limited Duration Health Plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Periods Hospital Claims Form Issues Build Back Better Act (H.R.5376) Inflation Reduction Act of 2022 Medicaid Eligibility Health Equity/Health Disparities Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care VA Community Care Network Program Veterans PACT Act Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022 Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) TCPA Insurance Navigators Network Adequacy Provider Directories 2023 Omnibus Appropriations Bill Originating Site Requirements Provider and Nursing Licensing Issues Inpatient Only List Site Neutrality Biosimilar Red Tape Elimination Act Biologics Competition Act
Telehealth Expansion Act of 2021
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
ACA 1332 Waivers Individual Market and Exchange Stabilization Prior Authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Flexibility in Hospital Ownership Act Oversight of Anti-Competitive Behavior of Non-Profit Hospitals Act Consumer Choice of Care Act Competition in State Healthcare Markets Act Addressing Anti-Competitive Contracting Clauses Act Increasing Competition for Medical Residency Act Hospital Claims Form Issues Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios. (H.R.3969) Mental Health and Substance Use, CFR Part 2, Parity and MHPAEA Compliance Issues Mental Health Matters Act (H.R. 7780) Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Bipartisan Safer Communities Act MAT Act Surprise Medical Billing Price of Prescription Drugs Pharmacy Benefit Manager (PBM) Operations and Practices, Spread Pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Chronic Kidney Disease Conditions of Coverage Reform COVID-19 Testing, Vaccines, Treatment, Cost Sharing Medicare Sequestration Telehealth KEEP Telehealth Options Act Telehealth Expansion Act (H.R. 5981) Short Term Limited Duration Health Plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Periods Hospital Claims Form Issues Build Back Better Act (H.R.5376) Inflation Reduction Act of 2022 Medicaid Eligibility Health Equity/Health Disparities Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care VA Community Care Network Program Veterans PACT Act Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022 Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) TCPA Insurance Navigators Network Adequacy Provider Directories 2023 Omnibus Appropriations Bill Originating Site Requirements Provider and Nursing Licensing Issues Inpatient Only List Site Neutrality Biosimilar Red Tape Elimination Act Biologics Competition Act
Continuing Appropriations and Ukraine Supplemental Appropriations Act, 2023
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, star ratings, extreme and uncontrollable circumstances policy, normalization factors, stars contract consolidation, ESRD, audio-only telehealth H.R. 4074 -To amend title XVIII of the Social Security Act Medicare RAD-V Mental health and substance use (42 CFR Part 2) Medicaid (IMD Exclusion) Medicaid expansion Medicaid reform (block grants, per capita caps) Medicaid and CHIP reauthorization Medicaid actuarial soundness Long-term services and supports Social Determents of Health (SDOH) Medicare Part D prescription drug program and Medicare Part D coverage gap (donut hole) Opioid addiction issues and response (prescription drug monitoring programs) Medicaid medical loss ratio remittance Medicare Advantage Pilot Program in TRICARE Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing Against Direct and Indirect Remuneration (DIR) reforms in the FY 2023 Medicare Part D Notice H.R.6833 - Affordable Insulin Now Act Maternal health (Medicaid postpartum coverage extension, H.R.959 Black Maternal Health Momnibus Act of 2021) Helping MOMS Act of 2021 CMS Extreme & Uncontrollable Circumstances Policy Medicare Sequester (H.R.315, S.748) Medicare Audio-Only Telehealth (H.R.2166, S.150) Continuing Resolution (CR)FY 2022 Medicaid Funding for Puerto Rico Medicaid Funding for Puerto Rico including discussions on the FMAP, ESRD, and LTSS. Medicare Advantage issues such as rates, benchmarks, providers payments, and disparities in funding for territories. Medicare Advantage asks regarding the underfunding and disparity for Puerto Rico H.R.5376 - Build Back Better Act Medicaid eligibility Health Equity/Health Disparities
Continuing Appropriations and Ukraine Supplemental Appropriations Act, 2023
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, star ratings, extreme and uncontrollable circumstances policy, normalization factors, stars contract consolidation, ESRD, audio-only telehealth) Medicare RAD-V Mental health and substance use (42 CFR Part 2) Medicaid managed care (IMD Exclusion) Medicaid expansion Medicaid reform (block grants, per capita caps) Medicaid and CHIP reauthorization Medicaid actuarial soundness Long-term services and supports Medicare Part D prescription drug program and Medicare Part D coverage gap (donut hole) Opioid addiction issues and response (prescription drug monitoring programs) Medicaid medical loss ratio remittance Medicare Advantage Pilot Program in TRICARE Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing Direct and Indirect Remuneration (DIR) reforms in the FY 2023 Medicare Part D Notice H.R.6833 - Affordable Insulin Now Act Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act H.R.7666 - Restoring Hope for Mental Health and Well-Being Act of 2022 Social Determents of Health (SDOH) H.R.4074 - Addressing Social Determinants in Medicare Advantage Act of 2021 Health Equity/Health Disparities Maternal health (Medicaid postpartum coverage extension, H.R.959 Black Maternal Health Momnibus Act of 2021) Helping MOMS Act of 2021 Medicare Audio-Only Telehealth (H.R.2166, S.150) Continuing Resolution (CR)FY 2022 Medicaid Funding for Puerto Rico Medicare Savings Program (MSP) in Medicaid Increasing on the Medicare Advantage benchmarks to a minimum level H.R. 7997 (to Amend the SS Act to establish a floor in MA benchmark rates for regions with low Medicare fee-for-service penetration and to make the Medicare Savings Program available in all jurisdictions) H.R. 2217 (Territory Federal Matching Requirement Equity Act of 2021) H.R. 1825 (A Bill to Remove the Matching Requirement for Medicare Part D Drugs) H.R. 1826 (Fairness in Medicare Part B Enrollment Act) S. 3778 (Territories Medicare Prescription Drug Assistance Equity Act of 2022). H.R.5376 - Build Back Better Act Medicaid eligibility and redeterminations H.R. 5376 - Inflation Reduction Act of 2022 Medicare Advantage Supplemental Benefits
Continuing Appropriations and Ukraine Supplemental Appropriations Act, 2023
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, star ratings, extreme and uncontrollable circumstances policy, normalization factors, stars contract consolidation, ESRD, audio-only telehealth H.R. 4074 -To amend title XVIII of the Social Security Act Medicare RAD-V Mental health and substance use (42 CFR Part 2) Medicaid (IMD Exclusion) Medicaid expansion Medicaid reform (block grants, per capita caps) Medicaid and CHIP reauthorization Medicaid actuarial soundness Long-term services and supports Social Determents of Health (SDOH) Medicare Part D prescription drug program and Medicare Part D coverage gap (donut hole) Opioid addiction issues and response (prescription drug monitoring programs) Medicaid medical loss ratio remittance Medicare Advantage Pilot Program in TRICARE Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing Direct and Indirect Remuneration (DIR) reforms in the FY 2023 Medicare Part D Notice H.R.6833 - Affordable Insulin Now Act Maternal health (Medicaid postpartum coverage extension, H.R.959 Black Maternal Health Momnibus Act of 2021) Helping MOMS Act of 2021 CMS Extreme & Uncontrollable Circumstances Policy Medicare Sequester (H.R.315, S.748) Medicare Audio-Only Telehealth (H.R.2166, S.150, H.R.3447) H.R. 4406, the Supporting Medicaid in the U.S. Territories Act, Continuing Resolution (CR)FY 2022 Medicaid Funding for Puerto Rico Medicare Advantage asks regarding the underfunding and disparity for Puerto Rico H.R.5376 - Build Back Better Act Medicaid eligibility Health Equity/Health Disparities HR1826 - Fairness in Medicare Part B Enrollment Act HR2217 - Territory Federal Matching Requirement Equity Act of 2021 HR1825 - A Bill to Remove the Matching Requirement for Medicate Part D Drugs.
Continuing Appropriations and Ukraine Supplemental Appropriations Act, 2023
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, star ratings, extreme and uncontrollable circumstances policy, normalization factors, stars contract consolidation, ESRD, audio-only telehealth) Medicare RAD-V Mental Health and Substance Use (42 CFR Part 2) Medicaid Managed Care Medicaid Expansion Medicaid Reform Medicaid Redeterminations CHIP Reauthorization Medicaid Actuarial Soundness Long-term Services and Supports Medicare Part D prescription drug program Medicare Advantage Pilot Program in TRICARE Pharmacy Benefit Manager (PBM) Operations and Practices, Spread Pricing Direct and Indirect Remuneration (DIR) reforms in the FY 2023 Medicare Part D Notice Affordable Insulin Now Act (H.R.6833) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Social Determents of Health (SDOH) Addressing Social Determinants in Medicare Advantage Act of 2021 (H.R.4074) Health Equity/Health Disparities Maternal health (Medicaid postpartum coverage extension, H.R.959 Black Maternal Health Momnibus Act of 2021) Helping MOMS Act of 2021 Medicare Audio-Only Telehealth (H.R.2166, S.150) Medicaid Funding for Puerto Rico Medicare Savings Program (MSP) in Medicaid Increasing on the Medicare Advantage Benchmarks to a Minimum Level H.R. 7997 (to Amend the SS Act to establish a floor in MA benchmark rates for regions with low Medicare fee-for-service penetration and to make the Medicare Savings Program available in all jurisdictions) H.R. 2217 (Territory Federal Matching Requirement Equity Act of 2021) H.R. 1825 (A Bill to Remove the Matching Requirement for Medicare Part D Drugs) H.R. 1826 (Fairness in Medicare Part B Enrollment Act) S. 3778 (Territories Medicare Prescription Drug Assistance Equity Act of 2022). Build Back Better Act (H.R.5376) Medicaid Eligibility and Redeterminations Inflation Reduction Act of 2022 (H.R. 5376) Medicare Advantage Supplemental Benefits Timely Access to Care Act (H.R. 3173 and S. 3018) 2023 Omnibus Appropriations Bill Mental Health Parity Restore Protections for Dialysis Patients Act (H.R.8594)
Restoring Hope for Mental Health and Well-Being Act of 2022
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
ACA 1332 Waivers Individual Market and Exchange Stabilization Prior Authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Flexibility in Hospital Ownership Act Oversight of Anti-Competitive Behavior of Non-Profit Hospitals Act Consumer Choice of Care Act Competition in State Healthcare Markets Act Addressing Anti-Competitive Contracting Clauses Act Increasing Competition for Medical Residency Act Hospital Claims Form Issues Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios. (H.R.3969) Mental Health and Substance Use, CFR Part 2, Parity and MHPAEA Compliance Issues Mental Health Matters Act (H.R. 7780) Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Bipartisan Safer Communities Act MAT Act Surprise Medical Billing Price of Prescription Drugs Pharmacy Benefit Manager (PBM) Operations and Practices, Spread Pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Chronic Kidney Disease Conditions of Coverage Reform COVID-19 Testing, Vaccines, Treatment, Cost Sharing Medicare Sequestration Telehealth KEEP Telehealth Options Act Telehealth Expansion Act (H.R. 5981) Short Term Limited Duration Health Plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Periods Hospital Claims Form Issues Build Back Better Act (H.R.5376) Inflation Reduction Act of 2022 Medicaid Eligibility Health Equity/Health Disparities Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care VA Community Care Network Program Veterans PACT Act Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022 Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) TCPA Insurance Navigators Network Adequacy Provider Directories 2023 Omnibus Appropriations Bill Originating Site Requirements Provider and Nursing Licensing Issues Inpatient Only List Site Neutrality Biosimilar Red Tape Elimination Act Biologics Competition Act
Restoring Hope for Mental Health and Well-Being Act of 2022
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) ACA 1332 Waivers Individual market and exchange stabilization Prior authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use, Parity and compliance issues. Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Mental health parity and MHPAEA compliance Surprise medical billing; Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Chronic Kidney Disease Conditions of Coverage Reform COVID-19 testing, vaccines, treatment, cost sharing Medicare Sequestration, ACA subsidies, COVID vaccines and testing, Consolidated Appropriations Act Behavioral Health Telehealth Short Term Limited Duration health plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio; To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios (H.R. 3969) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Period CONNECT for Health Act Hospital Claims Form Issues Build Back Better Act (H.R.5376) KEEP Telehealth Options Act Agent/broker compensation disclosures under the Consolidated Appropriations Act. CAA regulation implementation Hospital Competition Act Medicaid eligibility Health Equity/Health Disparities Postal Service Reform Act of 2022 Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care (U.S. Department of Veterans Affairs Assets and Infrastructure Review Report) 2018 MISSION Act Veterans PACT Act Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) Bipartisan Safer Communities Act
Restoring Hope for Mental Health and Well-Being Act of 2022
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, star ratings, extreme and uncontrollable circumstances policy, normalization factors, stars contract consolidation, ESRD, audio-only telehealth) Medicare RAD-V Mental health and substance use (42 CFR Part 2) Medicaid managed care (IMD Exclusion) Medicaid expansion Medicaid reform (block grants, per capita caps) Medicaid and CHIP reauthorization Medicaid actuarial soundness Long-term services and supports Medicare Part D prescription drug program and Medicare Part D coverage gap (donut hole) Opioid addiction issues and response (prescription drug monitoring programs) Medicaid medical loss ratio remittance Medicare Advantage Pilot Program in TRICARE Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing Direct and Indirect Remuneration (DIR) reforms in the FY 2023 Medicare Part D Notice H.R.6833 - Affordable Insulin Now Act Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act H.R.7666 - Restoring Hope for Mental Health and Well-Being Act of 2022 Social Determents of Health (SDOH) H.R.4074 - Addressing Social Determinants in Medicare Advantage Act of 2021 Health Equity/Health Disparities Maternal health (Medicaid postpartum coverage extension, H.R.959 Black Maternal Health Momnibus Act of 2021) Helping MOMS Act of 2021 Medicare Audio-Only Telehealth (H.R.2166, S.150) Continuing Resolution (CR)FY 2022 Medicaid Funding for Puerto Rico Medicare Savings Program (MSP) in Medicaid Increasing on the Medicare Advantage benchmarks to a minimum level H.R. 7997 (to Amend the SS Act to establish a floor in MA benchmark rates for regions with low Medicare fee-for-service penetration and to make the Medicare Savings Program available in all jurisdictions) H.R. 2217 (Territory Federal Matching Requirement Equity Act of 2021) H.R. 1825 (A Bill to Remove the Matching Requirement for Medicare Part D Drugs) H.R. 1826 (Fairness in Medicare Part B Enrollment Act) S. 3778 (Territories Medicare Prescription Drug Assistance Equity Act of 2022). H.R.5376 - Build Back Better Act Medicaid eligibility and redeterminations H.R. 5376 - Inflation Reduction Act of 2022 Medicare Advantage Supplemental Benefits
Restoring Hope for Mental Health and Well-Being Act of 2022
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) ACA 1332 Waivers Individual market and exchange stabilization Prior authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Flexibility in Hospital Ownership Act Oversight of Anti-Competitive Behavior of Non-Profit Hospitals Act Consumer Choice of Care Act Competition in State Healthcare Markets Act Addressing Anti-Competitive Contracting Clauses Act Increasing Competition for Medical Residency Act Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use, CFR Part 2, Parity and compliance issues H.R. 7780 - Mental Health Matters Act Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Mental health parity and MHPAEA compliance Surprise medical billing Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Chronic Kidney Disease Conditions of Coverage Reform COVID-19 testing, vaccines, treatment, cost sharing Medicare Sequestration, ACA subsidies, COVID vaccines and testing, Consolidated Appropriations Act Telehealth KEEP Telehealth Options Act Short Term Limited Duration health plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Period Hospital Claims Form Issues Build Back Better Act (H.R.5376) Inflation Reduction Act of 2022 Medicaid eligibility Health Equity/Health Disparities Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care Veterans PACT Act Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022 Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) TCPA Insurance Navigators Network Adequacy Provider Directories Bipartisan Safer Communities Act
Restoring Hope for Mental Health and Well-Being Act of 2022
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
Price of prescription drugs; antitrust issues; Prescription Drug Pricing Reduction Act Pharmacy Benefit Manager (PBM) operations and practices, Spread Pricing Direct and Indirect Remuneration (DIR) Drug Rebate Rule/Executive Order Senate Finance Committee Prescription Drug Pricing Reduction Act Lower Drug Costs Now Act (H.R. 3) Drug Patent Reform Robinson-Patman Reform Inflation Reduction Act of 2022 (H.R. 5376) Pharmacy Benefit Manager Transparency Act (S. 4293) PBM Transparency Language in the Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) 2023 Omnibus Appropriations Bill
Restoring Hope for Mental Health and Well-Being Act of 2022
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) ACA 1332 Waivers Individual market and exchange stabilization Prior authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use, Parity and compliance issues. Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Mental health parity and MHPAEA compliance Surprise medical billing; Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Chronic Kidney Disease Conditions of Coverage Reform COVID-19 testing, vaccines, treatment, cost sharing Medicare Sequestration, ACA subsidies, COVID vaccines and testing, Consolidated Appropriations Act Behavioral Health Telehealth Short Term Limited Duration health plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio; To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios (H.R. 3969) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Period CONNECT for Health Act Hospital Claims Form Issues Build Back Better Act (H.R.5376) KEEP Telehealth Options Act Agent/broker compensation disclosures under the Consolidated Appropriations Act. CAA regulation implementation Hospital Competition Act Medicaid eligibility Health Equity/Health Disparities Postal Service Reform Act of 2022 Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care (U.S. Department of Veterans Affairs Assets and Infrastructure Review Report) 2018 MISSION Act Veterans PACT Act Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) Bipartisan Safer Communities Act
Restoring Hope for Mental Health and Well-Being Act of 2022
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
ACA 1332 Waivers Individual Market and Exchange Stabilization Prior Authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Flexibility in Hospital Ownership Act Oversight of Anti-Competitive Behavior of Non-Profit Hospitals Act Consumer Choice of Care Act Competition in State Healthcare Markets Act Addressing Anti-Competitive Contracting Clauses Act Increasing Competition for Medical Residency Act Hospital Claims Form Issues Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios. (H.R.3969) Mental Health and Substance Use, CFR Part 2, Parity and MHPAEA Compliance Issues Mental Health Matters Act (H.R. 7780) Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Bipartisan Safer Communities Act MAT Act Surprise Medical Billing Price of Prescription Drugs Pharmacy Benefit Manager (PBM) Operations and Practices, Spread Pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Chronic Kidney Disease Conditions of Coverage Reform COVID-19 Testing, Vaccines, Treatment, Cost Sharing Medicare Sequestration Telehealth KEEP Telehealth Options Act Telehealth Expansion Act (H.R. 5981) Short Term Limited Duration Health Plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Periods Hospital Claims Form Issues Build Back Better Act (H.R.5376) Inflation Reduction Act of 2022 Medicaid Eligibility Health Equity/Health Disparities Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care VA Community Care Network Program Veterans PACT Act Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022 Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) TCPA Insurance Navigators Network Adequacy Provider Directories 2023 Omnibus Appropriations Bill Originating Site Requirements Provider and Nursing Licensing Issues Inpatient Only List Site Neutrality Biosimilar Red Tape Elimination Act Biologics Competition Act
Restoring Hope for Mental Health and Well-Being Act of 2022
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, star ratings, extreme and uncontrollable circumstances policy, normalization factors, stars contract consolidation, ESRD, audio-only telehealth) Medicare RAD-V Mental Health and Substance Use (42 CFR Part 2) Medicaid Managed Care Medicaid Expansion Medicaid Reform Medicaid Redeterminations CHIP Reauthorization Medicaid Actuarial Soundness Long-term Services and Supports Medicare Part D prescription drug program Medicare Advantage Pilot Program in TRICARE Pharmacy Benefit Manager (PBM) Operations and Practices, Spread Pricing Direct and Indirect Remuneration (DIR) reforms in the FY 2023 Medicare Part D Notice Affordable Insulin Now Act (H.R.6833) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Social Determents of Health (SDOH) Addressing Social Determinants in Medicare Advantage Act of 2021 (H.R.4074) Health Equity/Health Disparities Maternal health (Medicaid postpartum coverage extension, H.R.959 Black Maternal Health Momnibus Act of 2021) Helping MOMS Act of 2021 Medicare Audio-Only Telehealth (H.R.2166, S.150) Medicaid Funding for Puerto Rico Medicare Savings Program (MSP) in Medicaid Increasing on the Medicare Advantage Benchmarks to a Minimum Level H.R. 7997 (to Amend the SS Act to establish a floor in MA benchmark rates for regions with low Medicare fee-for-service penetration and to make the Medicare Savings Program available in all jurisdictions) H.R. 2217 (Territory Federal Matching Requirement Equity Act of 2021) H.R. 1825 (A Bill to Remove the Matching Requirement for Medicare Part D Drugs) H.R. 1826 (Fairness in Medicare Part B Enrollment Act) S. 3778 (Territories Medicare Prescription Drug Assistance Equity Act of 2022). Build Back Better Act (H.R.5376) Medicaid Eligibility and Redeterminations Inflation Reduction Act of 2022 (H.R. 5376) Medicare Advantage Supplemental Benefits Timely Access to Care Act (H.R. 3173 and S. 3018) 2023 Omnibus Appropriations Bill Mental Health Parity Restore Protections for Dialysis Patients Act (H.R.8594)
Restoring Hope for Mental Health and Well-Being Act of 2022
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) ACA 1332 Waivers Individual market and exchange stabilization Prior authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use, Parity and compliance issues. Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Mental health parity and MHPAEA compliance Surprise medical billing; Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Chronic Kidney Disease Conditions of Coverage Reform COVID-19 testing, vaccines, treatment, cost sharing Medicare Sequestration, ACA subsidies, COVID vaccines and testing, Consolidated Appropriations Act Behavioral Health Telehealth Short Term Limited Duration health plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio; To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios (H.R. 3969) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Period CONNECT for Health Act Hospital Claims Form Issues Build Back Better Act (H.R.5376) KEEP Telehealth Options Act Agent/broker compensation disclosures under the Consolidated Appropriations Act. CAA regulation implementation Hospital Competition Act Medicaid eligibility Health Equity/Health Disparities Postal Service Reform Act of 2022 Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care (U.S. Department of Veterans Affairs Assets and Infrastructure Review Report) 2018 MISSION Act Veterans PACT Act Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) Bipartisan Safer Communities Act
Restoring Hope for Mental Health and Well-Being Act of 2022
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) ACA 1332 Waivers Individual market and exchange stabilization Prior authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use, Parity and compliance issues. Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Mental health parity and MHPAEA compliance Surprise medical billing; Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Chronic Kidney Disease Conditions of Coverage Reform COVID-19 testing, vaccines, treatment, cost sharing Medicare Sequestration, ACA subsidies, COVID vaccines and testing, Consolidated Appropriations Act Behavioral Health Telehealth Short Term Limited Duration health plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio; To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios (H.R. 3969) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Period CONNECT for Health Act Hospital Claims Form Issues Build Back Better Act (H.R.5376) KEEP Telehealth Options Act Agent/broker compensation disclosures under the Consolidated Appropriations Act. CAA regulation implementation Hospital Competition Act Medicaid eligibility Health Equity/Health Disparities Postal Service Reform Act of 2022 Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care (U.S. Department of Veterans Affairs Assets and Infrastructure Review Report) 2018 MISSION Act Veterans PACT Act Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) Bipartisan Safer Communities Act
Restoring Hope for Mental Health and Well-Being Act of 2022
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) ACA 1332 Waivers Individual market and exchange stabilization Prior authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Flexibility in Hospital Ownership Act Oversight of Anti-Competitive Behavior of Non-Profit Hospitals Act Consumer Choice of Care Act Competition in State Healthcare Markets Act Addressing Anti-Competitive Contracting Clauses Act Increasing Competition for Medical Residency Act Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use, CFR Part 2, Parity and compliance issues H.R. 7780 - Mental Health Matters Act Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Mental health parity and MHPAEA compliance Surprise medical billing Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Chronic Kidney Disease Conditions of Coverage Reform COVID-19 testing, vaccines, treatment, cost sharing Medicare Sequestration, ACA subsidies, COVID vaccines and testing, Consolidated Appropriations Act Telehealth KEEP Telehealth Options Act Short Term Limited Duration health plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Period Hospital Claims Form Issues Build Back Better Act (H.R.5376) Inflation Reduction Act of 2022 Medicaid eligibility Health Equity/Health Disparities Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care Veterans PACT Act Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022 Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) TCPA Insurance Navigators Network Adequacy Provider Directories Bipartisan Safer Communities Act
Restoring Hope for Mental Health and Well-Being Act of 2022
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) ACA 1332 Waivers Individual market and exchange stabilization Prior authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use, Parity and compliance issues. Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Mental health parity and MHPAEA compliance Surprise medical billing; Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Chronic Kidney Disease Conditions of Coverage Reform COVID-19 testing, vaccines, treatment, cost sharing Medicare Sequestration, ACA subsidies, COVID vaccines and testing, Consolidated Appropriations Act Behavioral Health Telehealth Short Term Limited Duration health plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio; To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios (H.R. 3969) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Period CONNECT for Health Act Hospital Claims Form Issues Build Back Better Act (H.R.5376) KEEP Telehealth Options Act Agent/broker compensation disclosures under the Consolidated Appropriations Act. CAA regulation implementation Hospital Competition Act Medicaid eligibility Health Equity/Health Disparities Postal Service Reform Act of 2022 Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care (U.S. Department of Veterans Affairs Assets and Infrastructure Review Report) 2018 MISSION Act Veterans PACT Act Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) Bipartisan Safer Communities Act
ACA 1332 Waivers Individual Market and Exchange Stabilization Prior Authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Flexibility in Hospital Ownership Act Oversight of Anti-Competitive Behavior of Non-Profit Hospitals Act Consumer Choice of Care Act Competition in State Healthcare Markets Act Addressing Anti-Competitive Contracting Clauses Act Increasing Competition for Medical Residency Act Hospital Claims Form Issues Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios. (H.R.3969) Mental Health and Substance Use, CFR Part 2, Parity and MHPAEA Compliance Issues Mental Health Matters Act (H.R. 7780) Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Bipartisan Safer Communities Act MAT Act Surprise Medical Billing Price of Prescription Drugs Pharmacy Benefit Manager (PBM) Operations and Practices, Spread Pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Chronic Kidney Disease Conditions of Coverage Reform COVID-19 Testing, Vaccines, Treatment, Cost Sharing Medicare Sequestration Telehealth KEEP Telehealth Options Act Telehealth Expansion Act (H.R. 5981) Short Term Limited Duration Health Plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Periods Hospital Claims Form Issues Build Back Better Act (H.R.5376) Inflation Reduction Act of 2022 Medicaid Eligibility Health Equity/Health Disparities Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care VA Community Care Network Program Veterans PACT Act Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022 Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) TCPA Insurance Navigators Network Adequacy Provider Directories 2023 Omnibus Appropriations Bill Originating Site Requirements Provider and Nursing Licensing Issues Inpatient Only List Site Neutrality Biosimilar Red Tape Elimination Act Biologics Competition Act
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) ACA 1332 Waivers Individual market and exchange stabilization Prior authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Flexibility in Hospital Ownership Act Oversight of Anti-Competitive Behavior of Non-Profit Hospitals Act Consumer Choice of Care Act Competition in State Healthcare Markets Act Addressing Anti-Competitive Contracting Clauses Act Increasing Competition for Medical Residency Act Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use, CFR Part 2, Parity and compliance issues H.R. 7780 - Mental Health Matters Act Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Mental health parity and MHPAEA compliance Surprise medical billing Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Chronic Kidney Disease Conditions of Coverage Reform COVID-19 testing, vaccines, treatment, cost sharing Medicare Sequestration, ACA subsidies, COVID vaccines and testing, Consolidated Appropriations Act Telehealth KEEP Telehealth Options Act Short Term Limited Duration health plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Period Hospital Claims Form Issues Build Back Better Act (H.R.5376) Inflation Reduction Act of 2022 Medicaid eligibility Health Equity/Health Disparities Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care Veterans PACT Act Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022 Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) TCPA Insurance Navigators Network Adequacy Provider Directories Bipartisan Safer Communities Act
ACA 1332 Waivers Individual Market and Exchange Stabilization Prior Authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Flexibility in Hospital Ownership Act Oversight of Anti-Competitive Behavior of Non-Profit Hospitals Act Consumer Choice of Care Act Competition in State Healthcare Markets Act Addressing Anti-Competitive Contracting Clauses Act Increasing Competition for Medical Residency Act Hospital Claims Form Issues Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios. (H.R.3969) Mental Health and Substance Use, CFR Part 2, Parity and MHPAEA Compliance Issues Mental Health Matters Act (H.R. 7780) Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Bipartisan Safer Communities Act MAT Act Surprise Medical Billing Price of Prescription Drugs Pharmacy Benefit Manager (PBM) Operations and Practices, Spread Pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Chronic Kidney Disease Conditions of Coverage Reform COVID-19 Testing, Vaccines, Treatment, Cost Sharing Medicare Sequestration Telehealth KEEP Telehealth Options Act Telehealth Expansion Act (H.R. 5981) Short Term Limited Duration Health Plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Periods Hospital Claims Form Issues Build Back Better Act (H.R.5376) Inflation Reduction Act of 2022 Medicaid Eligibility Health Equity/Health Disparities Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care VA Community Care Network Program Veterans PACT Act Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022 Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) TCPA Insurance Navigators Network Adequacy Provider Directories 2023 Omnibus Appropriations Bill Originating Site Requirements Provider and Nursing Licensing Issues Inpatient Only List Site Neutrality Biosimilar Red Tape Elimination Act Biologics Competition Act
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) ACA 1332 Waivers Individual market and exchange stabilization Prior authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Flexibility in Hospital Ownership Act Oversight of Anti-Competitive Behavior of Non-Profit Hospitals Act Consumer Choice of Care Act Competition in State Healthcare Markets Act Addressing Anti-Competitive Contracting Clauses Act Increasing Competition for Medical Residency Act Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use, CFR Part 2, Parity and compliance issues H.R. 7780 - Mental Health Matters Act Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Mental health parity and MHPAEA compliance Surprise medical billing Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Chronic Kidney Disease Conditions of Coverage Reform COVID-19 testing, vaccines, treatment, cost sharing Medicare Sequestration, ACA subsidies, COVID vaccines and testing, Consolidated Appropriations Act Telehealth KEEP Telehealth Options Act Short Term Limited Duration health plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Period Hospital Claims Form Issues Build Back Better Act (H.R.5376) Inflation Reduction Act of 2022 Medicaid eligibility Health Equity/Health Disparities Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care Veterans PACT Act Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022 Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) TCPA Insurance Navigators Network Adequacy Provider Directories Bipartisan Safer Communities Act
Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, star ratings, extreme and uncontrollable circumstances policy, normalization factors, stars contract consolidation, ESRD, audio-only telehealth) Medicare RAD-V Mental Health and Substance Use (42 CFR Part 2) Medicaid Managed Care Medicaid Expansion Medicaid Reform Medicaid Redeterminations CHIP Reauthorization Medicaid Actuarial Soundness Long-term Services and Supports Medicare Part D prescription drug program Medicare Advantage Pilot Program in TRICARE Pharmacy Benefit Manager (PBM) Operations and Practices, Spread Pricing Direct and Indirect Remuneration (DIR) reforms in the FY 2023 Medicare Part D Notice Affordable Insulin Now Act (H.R.6833) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Social Determents of Health (SDOH) Addressing Social Determinants in Medicare Advantage Act of 2021 (H.R.4074) Health Equity/Health Disparities Maternal health (Medicaid postpartum coverage extension, H.R.959 Black Maternal Health Momnibus Act of 2021) Helping MOMS Act of 2021 Medicare Audio-Only Telehealth (H.R.2166, S.150) Medicaid Funding for Puerto Rico Medicare Savings Program (MSP) in Medicaid Increasing on the Medicare Advantage Benchmarks to a Minimum Level H.R. 7997 (to Amend the SS Act to establish a floor in MA benchmark rates for regions with low Medicare fee-for-service penetration and to make the Medicare Savings Program available in all jurisdictions) H.R. 2217 (Territory Federal Matching Requirement Equity Act of 2021) H.R. 1825 (A Bill to Remove the Matching Requirement for Medicare Part D Drugs) H.R. 1826 (Fairness in Medicare Part B Enrollment Act) S. 3778 (Territories Medicare Prescription Drug Assistance Equity Act of 2022). Build Back Better Act (H.R.5376) Medicaid Eligibility and Redeterminations Inflation Reduction Act of 2022 (H.R. 5376) Medicare Advantage Supplemental Benefits Timely Access to Care Act (H.R. 3173 and S. 3018) 2023 Omnibus Appropriations Bill Mental Health Parity Restore Protections for Dialysis Patients Act (H.R.8594)
Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) ACA 1332 Waivers Individual market and exchange stabilization Prior authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Flexibility in Hospital Ownership Act Oversight of Anti-Competitive Behavior of Non-Profit Hospitals Act Consumer Choice of Care Act Competition in State Healthcare Markets Act Addressing Anti-Competitive Contracting Clauses Act Increasing Competition for Medical Residency Act Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use, CFR Part 2, Parity and compliance issues H.R. 7780 - Mental Health Matters Act Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Mental health parity and MHPAEA compliance Surprise medical billing Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Chronic Kidney Disease Conditions of Coverage Reform COVID-19 testing, vaccines, treatment, cost sharing Medicare Sequestration, ACA subsidies, COVID vaccines and testing, Consolidated Appropriations Act Telehealth KEEP Telehealth Options Act Short Term Limited Duration health plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Period Hospital Claims Form Issues Build Back Better Act (H.R.5376) Inflation Reduction Act of 2022 Medicaid eligibility Health Equity/Health Disparities Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care Veterans PACT Act Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022 Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) TCPA Insurance Navigators Network Adequacy Provider Directories Bipartisan Safer Communities Act
Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
ACA 1332 Waivers Individual Market and Exchange Stabilization Prior Authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Flexibility in Hospital Ownership Act Oversight of Anti-Competitive Behavior of Non-Profit Hospitals Act Consumer Choice of Care Act Competition in State Healthcare Markets Act Addressing Anti-Competitive Contracting Clauses Act Increasing Competition for Medical Residency Act Hospital Claims Form Issues Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios. (H.R.3969) Mental Health and Substance Use, CFR Part 2, Parity and MHPAEA Compliance Issues Mental Health Matters Act (H.R. 7780) Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Bipartisan Safer Communities Act MAT Act Surprise Medical Billing Price of Prescription Drugs Pharmacy Benefit Manager (PBM) Operations and Practices, Spread Pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Chronic Kidney Disease Conditions of Coverage Reform COVID-19 Testing, Vaccines, Treatment, Cost Sharing Medicare Sequestration Telehealth KEEP Telehealth Options Act Telehealth Expansion Act (H.R. 5981) Short Term Limited Duration Health Plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Periods Hospital Claims Form Issues Build Back Better Act (H.R.5376) Inflation Reduction Act of 2022 Medicaid Eligibility Health Equity/Health Disparities Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care VA Community Care Network Program Veterans PACT Act Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022 Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) TCPA Insurance Navigators Network Adequacy Provider Directories 2023 Omnibus Appropriations Bill Originating Site Requirements Provider and Nursing Licensing Issues Inpatient Only List Site Neutrality Biosimilar Red Tape Elimination Act Biologics Competition Act
Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) ACA 1332 Waivers Individual market and exchange stabilization Prior authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use, Parity and compliance issues. Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Mental health parity and MHPAEA compliance Surprise medical billing; Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Chronic Kidney Disease Conditions of Coverage Reform COVID-19 testing, vaccines, treatment, cost sharing Medicare Sequestration, ACA subsidies, COVID vaccines and testing, Consolidated Appropriations Act Behavioral Health Telehealth Short Term Limited Duration health plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio; To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios (H.R. 3969) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Period CONNECT for Health Act Hospital Claims Form Issues Build Back Better Act (H.R.5376) KEEP Telehealth Options Act Agent/broker compensation disclosures under the Consolidated Appropriations Act. CAA regulation implementation Hospital Competition Act Medicaid eligibility Health Equity/Health Disparities Postal Service Reform Act of 2022 Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care (U.S. Department of Veterans Affairs Assets and Infrastructure Review Report) 2018 MISSION Act Veterans PACT Act Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) Bipartisan Safer Communities Act
Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) ACA 1332 Waivers Individual market and exchange stabilization Prior authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use, Parity and compliance issues. Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Mental health parity and MHPAEA compliance Surprise medical billing; Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Chronic Kidney Disease Conditions of Coverage Reform COVID-19 testing, vaccines, treatment, cost sharing Medicare Sequestration, ACA subsidies, COVID vaccines and testing, Consolidated Appropriations Act Behavioral Health Telehealth Short Term Limited Duration health plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio; To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios (H.R. 3969) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Period CONNECT for Health Act Hospital Claims Form Issues Build Back Better Act (H.R.5376) KEEP Telehealth Options Act Agent/broker compensation disclosures under the Consolidated Appropriations Act. CAA regulation implementation Hospital Competition Act Medicaid eligibility Health Equity/Health Disparities Postal Service Reform Act of 2022 Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care (U.S. Department of Veterans Affairs Assets and Infrastructure Review Report) 2018 MISSION Act Veterans PACT Act Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) Bipartisan Safer Communities Act
Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) ACA 1332 Waivers Individual market and exchange stabilization Prior authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Flexibility in Hospital Ownership Act Oversight of Anti-Competitive Behavior of Non-Profit Hospitals Act Consumer Choice of Care Act Competition in State Healthcare Markets Act Addressing Anti-Competitive Contracting Clauses Act Increasing Competition for Medical Residency Act Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use, CFR Part 2, Parity and compliance issues H.R. 7780 - Mental Health Matters Act Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Mental health parity and MHPAEA compliance Surprise medical billing Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Chronic Kidney Disease Conditions of Coverage Reform COVID-19 testing, vaccines, treatment, cost sharing Medicare Sequestration, ACA subsidies, COVID vaccines and testing, Consolidated Appropriations Act Telehealth KEEP Telehealth Options Act Short Term Limited Duration health plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Period Hospital Claims Form Issues Build Back Better Act (H.R.5376) Inflation Reduction Act of 2022 Medicaid eligibility Health Equity/Health Disparities Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care Veterans PACT Act Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022 Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) TCPA Insurance Navigators Network Adequacy Provider Directories Bipartisan Safer Communities Act
Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) ACA 1332 Waivers Individual market and exchange stabilization Prior authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use, Parity and compliance issues. Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Mental health parity and MHPAEA compliance Surprise medical billing; Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Chronic Kidney Disease Conditions of Coverage Reform COVID-19 testing, vaccines, treatment, cost sharing Medicare Sequestration, ACA subsidies, COVID vaccines and testing, Consolidated Appropriations Act Behavioral Health Telehealth Short Term Limited Duration health plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio; To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios (H.R. 3969) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Period CONNECT for Health Act Hospital Claims Form Issues Build Back Better Act (H.R.5376) KEEP Telehealth Options Act Agent/broker compensation disclosures under the Consolidated Appropriations Act. CAA regulation implementation Hospital Competition Act Medicaid eligibility Health Equity/Health Disparities Postal Service Reform Act of 2022 Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care (U.S. Department of Veterans Affairs Assets and Infrastructure Review Report) 2018 MISSION Act Veterans PACT Act Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) Bipartisan Safer Communities Act
Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
ACA 1332 Waivers Individual Market and Exchange Stabilization Prior Authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Flexibility in Hospital Ownership Act Oversight of Anti-Competitive Behavior of Non-Profit Hospitals Act Consumer Choice of Care Act Competition in State Healthcare Markets Act Addressing Anti-Competitive Contracting Clauses Act Increasing Competition for Medical Residency Act Hospital Claims Form Issues Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios. (H.R.3969) Mental Health and Substance Use, CFR Part 2, Parity and MHPAEA Compliance Issues Mental Health Matters Act (H.R. 7780) Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Bipartisan Safer Communities Act MAT Act Surprise Medical Billing Price of Prescription Drugs Pharmacy Benefit Manager (PBM) Operations and Practices, Spread Pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Chronic Kidney Disease Conditions of Coverage Reform COVID-19 Testing, Vaccines, Treatment, Cost Sharing Medicare Sequestration Telehealth KEEP Telehealth Options Act Telehealth Expansion Act (H.R. 5981) Short Term Limited Duration Health Plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Periods Hospital Claims Form Issues Build Back Better Act (H.R.5376) Inflation Reduction Act of 2022 Medicaid Eligibility Health Equity/Health Disparities Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care VA Community Care Network Program Veterans PACT Act Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022 Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) TCPA Insurance Navigators Network Adequacy Provider Directories 2023 Omnibus Appropriations Bill Originating Site Requirements Provider and Nursing Licensing Issues Inpatient Only List Site Neutrality Biosimilar Red Tape Elimination Act Biologics Competition Act
Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) ACA 1332 Waivers Individual market and exchange stabilization Prior authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use, Parity and compliance issues. Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Mental health parity and MHPAEA compliance Surprise medical billing; Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Chronic Kidney Disease Conditions of Coverage Reform COVID-19 testing, vaccines, treatment, cost sharing Medicare Sequestration, ACA subsidies, COVID vaccines and testing, Consolidated Appropriations Act Behavioral Health Telehealth Short Term Limited Duration health plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio; To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios (H.R. 3969) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Period CONNECT for Health Act Hospital Claims Form Issues Build Back Better Act (H.R.5376) KEEP Telehealth Options Act Agent/broker compensation disclosures under the Consolidated Appropriations Act. CAA regulation implementation Hospital Competition Act Medicaid eligibility Health Equity/Health Disparities Postal Service Reform Act of 2022 Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care (U.S. Department of Veterans Affairs Assets and Infrastructure Review Report) 2018 MISSION Act Veterans PACT Act Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) Bipartisan Safer Communities Act
Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) ACA 1332 Waivers Individual market and exchange stabilization Prior authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use, Parity and compliance issues. Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Mental health parity and MHPAEA compliance Surprise medical billing; Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Chronic Kidney Disease Conditions of Coverage Reform COVID-19 testing, vaccines, treatment, cost sharing Medicare Sequestration, ACA subsidies, COVID vaccines and testing, Consolidated Appropriations Act Behavioral Health Telehealth Short Term Limited Duration health plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio; To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios (H.R. 3969) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Period CONNECT for Health Act Hospital Claims Form Issues Build Back Better Act (H.R.5376) KEEP Telehealth Options Act Agent/broker compensation disclosures under the Consolidated Appropriations Act. CAA regulation implementation Hospital Competition Act Medicaid eligibility Health Equity/Health Disparities Postal Service Reform Act of 2022 Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care (U.S. Department of Veterans Affairs Assets and Infrastructure Review Report) 2018 MISSION Act Veterans PACT Act Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) Bipartisan Safer Communities Act
Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, star ratings, extreme and uncontrollable circumstances policy, normalization factors, stars contract consolidation, ESRD, audio-only telehealth) Medicare RAD-V Mental health and substance use (42 CFR Part 2) Medicaid managed care (IMD Exclusion) Medicaid expansion Medicaid reform (block grants, per capita caps) Medicaid and CHIP reauthorization Medicaid actuarial soundness Long-term services and supports Medicare Part D prescription drug program and Medicare Part D coverage gap (donut hole) Opioid addiction issues and response (prescription drug monitoring programs) Medicaid medical loss ratio remittance Medicare Advantage Pilot Program in TRICARE Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing Direct and Indirect Remuneration (DIR) reforms in the FY 2023 Medicare Part D Notice H.R.6833 - Affordable Insulin Now Act Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act H.R.7666 - Restoring Hope for Mental Health and Well-Being Act of 2022 Social Determents of Health (SDOH) H.R.4074 - Addressing Social Determinants in Medicare Advantage Act of 2021 Health Equity/Health Disparities Maternal health (Medicaid postpartum coverage extension, H.R.959 Black Maternal Health Momnibus Act of 2021) Helping MOMS Act of 2021 Medicare Audio-Only Telehealth (H.R.2166, S.150) Continuing Resolution (CR)FY 2022 Medicaid Funding for Puerto Rico Medicare Savings Program (MSP) in Medicaid Increasing on the Medicare Advantage benchmarks to a minimum level H.R. 7997 (to Amend the SS Act to establish a floor in MA benchmark rates for regions with low Medicare fee-for-service penetration and to make the Medicare Savings Program available in all jurisdictions) H.R. 2217 (Territory Federal Matching Requirement Equity Act of 2021) H.R. 1825 (A Bill to Remove the Matching Requirement for Medicare Part D Drugs) H.R. 1826 (Fairness in Medicare Part B Enrollment Act) S. 3778 (Territories Medicare Prescription Drug Assistance Equity Act of 2022). H.R.5376 - Build Back Better Act Medicaid eligibility and redeterminations H.R. 5376 - Inflation Reduction Act of 2022 Medicare Advantage Supplemental Benefits
Transparency of Hospital Billing Act
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) ACA 1332 Waivers Individual market and exchange stabilization Prior authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use, Parity and compliance issues. Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Mental health parity and MHPAEA compliance Surprise medical billing; Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Chronic Kidney Disease Conditions of Coverage Reform COVID-19 testing, vaccines, treatment, cost sharing Medicare Sequestration, ACA subsidies, COVID vaccines and testing, Consolidated Appropriations Act Behavioral Health Telehealth Short Term Limited Duration health plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio; To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios (H.R. 3969) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Period CONNECT for Health Act Hospital Claims Form Issues Build Back Better Act (H.R.5376) KEEP Telehealth Options Act Agent/broker compensation disclosures under the Consolidated Appropriations Act. CAA regulation implementation Hospital Competition Act Medicaid eligibility Health Equity/Health Disparities Postal Service Reform Act of 2022 Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care (U.S. Department of Veterans Affairs Assets and Infrastructure Review Report) 2018 MISSION Act Veterans PACT Act Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) Bipartisan Safer Communities Act
Transparency of Hospital Billing Act
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) ACA 1332 Waivers Individual market and exchange stabilization Prior authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Flexibility in Hospital Ownership Act Oversight of Anti-Competitive Behavior of Non-Profit Hospitals Act Consumer Choice of Care Act Competition in State Healthcare Markets Act Addressing Anti-Competitive Contracting Clauses Act Increasing Competition for Medical Residency Act Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use, CFR Part 2, Parity and compliance issues H.R. 7780 - Mental Health Matters Act Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Mental health parity and MHPAEA compliance Surprise medical billing Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Chronic Kidney Disease Conditions of Coverage Reform COVID-19 testing, vaccines, treatment, cost sharing Medicare Sequestration, ACA subsidies, COVID vaccines and testing, Consolidated Appropriations Act Telehealth KEEP Telehealth Options Act Short Term Limited Duration health plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Period Hospital Claims Form Issues Build Back Better Act (H.R.5376) Inflation Reduction Act of 2022 Medicaid eligibility Health Equity/Health Disparities Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care Veterans PACT Act Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022 Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) TCPA Insurance Navigators Network Adequacy Provider Directories Bipartisan Safer Communities Act
Transparency of Hospital Billing Act
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
ACA 1332 Waivers Individual Market and Exchange Stabilization Prior Authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Flexibility in Hospital Ownership Act Oversight of Anti-Competitive Behavior of Non-Profit Hospitals Act Consumer Choice of Care Act Competition in State Healthcare Markets Act Addressing Anti-Competitive Contracting Clauses Act Increasing Competition for Medical Residency Act Hospital Claims Form Issues Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios. (H.R.3969) Mental Health and Substance Use, CFR Part 2, Parity and MHPAEA Compliance Issues Mental Health Matters Act (H.R. 7780) Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Bipartisan Safer Communities Act MAT Act Surprise Medical Billing Price of Prescription Drugs Pharmacy Benefit Manager (PBM) Operations and Practices, Spread Pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Chronic Kidney Disease Conditions of Coverage Reform COVID-19 Testing, Vaccines, Treatment, Cost Sharing Medicare Sequestration Telehealth KEEP Telehealth Options Act Telehealth Expansion Act (H.R. 5981) Short Term Limited Duration Health Plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Periods Hospital Claims Form Issues Build Back Better Act (H.R.5376) Inflation Reduction Act of 2022 Medicaid Eligibility Health Equity/Health Disparities Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care VA Community Care Network Program Veterans PACT Act Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022 Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) TCPA Insurance Navigators Network Adequacy Provider Directories 2023 Omnibus Appropriations Bill Originating Site Requirements Provider and Nursing Licensing Issues Inpatient Only List Site Neutrality Biosimilar Red Tape Elimination Act Biologics Competition Act
Transparency of Hospital Billing Act
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) ACA 1332 Waivers Individual market and exchange stabilization Prior authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use, Parity and compliance issues. Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Mental health parity and MHPAEA compliance Surprise medical billing; Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Chronic Kidney Disease Conditions of Coverage Reform COVID-19 testing, vaccines, treatment, cost sharing Medicare Sequestration, ACA subsidies, COVID vaccines and testing, Consolidated Appropriations Act Behavioral Health Telehealth Short Term Limited Duration health plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio; To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios (H.R. 3969) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Period CONNECT for Health Act Hospital Claims Form Issues Build Back Better Act (H.R.5376) KEEP Telehealth Options Act Agent/broker compensation disclosures under the Consolidated Appropriations Act. CAA regulation implementation Hospital Competition Act Medicaid eligibility Health Equity/Health Disparities Postal Service Reform Act of 2022 Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care (U.S. Department of Veterans Affairs Assets and Infrastructure Review Report) 2018 MISSION Act Veterans PACT Act Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) Bipartisan Safer Communities Act
Transparency of Hospital Billing Act
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
ACA 1332 Waivers Individual Market and Exchange Stabilization Prior Authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Flexibility in Hospital Ownership Act Oversight of Anti-Competitive Behavior of Non-Profit Hospitals Act Consumer Choice of Care Act Competition in State Healthcare Markets Act Addressing Anti-Competitive Contracting Clauses Act Increasing Competition for Medical Residency Act Hospital Claims Form Issues Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios. (H.R.3969) Mental Health and Substance Use, CFR Part 2, Parity and MHPAEA Compliance Issues Mental Health Matters Act (H.R. 7780) Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Bipartisan Safer Communities Act MAT Act Surprise Medical Billing Price of Prescription Drugs Pharmacy Benefit Manager (PBM) Operations and Practices, Spread Pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Chronic Kidney Disease Conditions of Coverage Reform COVID-19 Testing, Vaccines, Treatment, Cost Sharing Medicare Sequestration Telehealth KEEP Telehealth Options Act Telehealth Expansion Act (H.R. 5981) Short Term Limited Duration Health Plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Periods Hospital Claims Form Issues Build Back Better Act (H.R.5376) Inflation Reduction Act of 2022 Medicaid Eligibility Health Equity/Health Disparities Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care VA Community Care Network Program Veterans PACT Act Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022 Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) TCPA Insurance Navigators Network Adequacy Provider Directories 2023 Omnibus Appropriations Bill Originating Site Requirements Provider and Nursing Licensing Issues Inpatient Only List Site Neutrality Biosimilar Red Tape Elimination Act Biologics Competition Act
Transparency of Hospital Billing Act
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) ACA 1332 Waivers Individual market and exchange stabilization Prior authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use, Parity and compliance issues. Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Mental health parity and MHPAEA compliance Surprise medical billing; Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Chronic Kidney Disease Conditions of Coverage Reform COVID-19 testing, vaccines, treatment, cost sharing Medicare Sequestration, ACA subsidies, COVID vaccines and testing, Consolidated Appropriations Act Behavioral Health Telehealth Short Term Limited Duration health plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio; To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios (H.R. 3969) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Period CONNECT for Health Act Hospital Claims Form Issues Build Back Better Act (H.R.5376) KEEP Telehealth Options Act Agent/broker compensation disclosures under the Consolidated Appropriations Act. CAA regulation implementation Hospital Competition Act Medicaid eligibility Health Equity/Health Disparities Postal Service Reform Act of 2022 Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care (U.S. Department of Veterans Affairs Assets and Infrastructure Review Report) 2018 MISSION Act Veterans PACT Act Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) Bipartisan Safer Communities Act
Transparency of Hospital Billing Act
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) ACA 1332 Waivers Individual market and exchange stabilization Prior authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use, Parity and compliance issues. Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Mental health parity and MHPAEA compliance Surprise medical billing; Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Chronic Kidney Disease Conditions of Coverage Reform COVID-19 testing, vaccines, treatment, cost sharing Medicare Sequestration, ACA subsidies, COVID vaccines and testing, Consolidated Appropriations Act Behavioral Health Telehealth Short Term Limited Duration health plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio; To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios (H.R. 3969) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Period CONNECT for Health Act Hospital Claims Form Issues Build Back Better Act (H.R.5376) KEEP Telehealth Options Act Agent/broker compensation disclosures under the Consolidated Appropriations Act. CAA regulation implementation Hospital Competition Act Medicaid eligibility Health Equity/Health Disparities Postal Service Reform Act of 2022 Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care (U.S. Department of Veterans Affairs Assets and Infrastructure Review Report) 2018 MISSION Act Veterans PACT Act Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) Bipartisan Safer Communities Act
Transparency of Hospital Billing Act
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) ACA 1332 Waivers Individual market and exchange stabilization Prior authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Flexibility in Hospital Ownership Act Oversight of Anti-Competitive Behavior of Non-Profit Hospitals Act Consumer Choice of Care Act Competition in State Healthcare Markets Act Addressing Anti-Competitive Contracting Clauses Act Increasing Competition for Medical Residency Act Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use, CFR Part 2, Parity and compliance issues H.R. 7780 - Mental Health Matters Act Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Mental health parity and MHPAEA compliance Surprise medical billing Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Chronic Kidney Disease Conditions of Coverage Reform COVID-19 testing, vaccines, treatment, cost sharing Medicare Sequestration, ACA subsidies, COVID vaccines and testing, Consolidated Appropriations Act Telehealth KEEP Telehealth Options Act Short Term Limited Duration health plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Period Hospital Claims Form Issues Build Back Better Act (H.R.5376) Inflation Reduction Act of 2022 Medicaid eligibility Health Equity/Health Disparities Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care Veterans PACT Act Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022 Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) TCPA Insurance Navigators Network Adequacy Provider Directories Bipartisan Safer Communities Act
Transparency of Hospital Billing Act
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) ACA 1332 Waivers Individual market and exchange stabilization Prior authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use, Parity and compliance issues. Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Mental health parity and MHPAEA compliance Surprise medical billing; Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Chronic Kidney Disease Conditions of Coverage Reform COVID-19 testing, vaccines, treatment, cost sharing Medicare Sequestration, ACA subsidies, COVID vaccines and testing, Consolidated Appropriations Act Behavioral Health Telehealth Short Term Limited Duration health plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio; To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios (H.R. 3969) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Period CONNECT for Health Act Hospital Claims Form Issues Build Back Better Act (H.R.5376) KEEP Telehealth Options Act Agent/broker compensation disclosures under the Consolidated Appropriations Act. CAA regulation implementation Hospital Competition Act Medicaid eligibility Health Equity/Health Disparities Postal Service Reform Act of 2022 Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care (U.S. Department of Veterans Affairs Assets and Infrastructure Review Report) 2018 MISSION Act Veterans PACT Act Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) Bipartisan Safer Communities Act
Restore Protections for Dialysis Patients Act
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, star ratings, extreme and uncontrollable circumstances policy, normalization factors, stars contract consolidation, ESRD, audio-only telehealth) Medicare RAD-V Mental Health and Substance Use (42 CFR Part 2) Medicaid Managed Care Medicaid Expansion Medicaid Reform Medicaid Redeterminations CHIP Reauthorization Medicaid Actuarial Soundness Long-term Services and Supports Medicare Part D prescription drug program Medicare Advantage Pilot Program in TRICARE Pharmacy Benefit Manager (PBM) Operations and Practices, Spread Pricing Direct and Indirect Remuneration (DIR) reforms in the FY 2023 Medicare Part D Notice Affordable Insulin Now Act (H.R.6833) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Social Determents of Health (SDOH) Addressing Social Determinants in Medicare Advantage Act of 2021 (H.R.4074) Health Equity/Health Disparities Maternal health (Medicaid postpartum coverage extension, H.R.959 Black Maternal Health Momnibus Act of 2021) Helping MOMS Act of 2021 Medicare Audio-Only Telehealth (H.R.2166, S.150) Medicaid Funding for Puerto Rico Medicare Savings Program (MSP) in Medicaid Increasing on the Medicare Advantage Benchmarks to a Minimum Level H.R. 7997 (to Amend the SS Act to establish a floor in MA benchmark rates for regions with low Medicare fee-for-service penetration and to make the Medicare Savings Program available in all jurisdictions) H.R. 2217 (Territory Federal Matching Requirement Equity Act of 2021) H.R. 1825 (A Bill to Remove the Matching Requirement for Medicare Part D Drugs) H.R. 1826 (Fairness in Medicare Part B Enrollment Act) S. 3778 (Territories Medicare Prescription Drug Assistance Equity Act of 2022). Build Back Better Act (H.R.5376) Medicaid Eligibility and Redeterminations Inflation Reduction Act of 2022 (H.R. 5376) Medicare Advantage Supplemental Benefits Timely Access to Care Act (H.R. 3173 and S. 3018) 2023 Omnibus Appropriations Bill Mental Health Parity Restore Protections for Dialysis Patients Act (H.R.8594)
Black Maternal Health Momnibus Act of 2021
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, star ratings, extreme and uncontrollable circumstances policy, normalization factors, stars contract consolidation, ESRD, audio-only telehealth H.R. 4074 -To amend title XVIII of the Social Security Act Medicare RAD-V Mental health and substance use (42 CFR Part 2) Medicaid (IMD Exclusion) Medicaid expansion Medicaid reform (block grants, per capita caps) Medicaid and CHIP reauthorization Medicaid actuarial soundness Long-term services and supports Social Determents of Health (SDOH) Medicare Part D prescription drug program and Medicare Part D coverage gap (donut hole) Opioid addiction issues and response (prescription drug monitoring programs) Medicaid medical loss ratio remittance Medicare Advantage Pilot Program in TRICARE Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing Against Direct and Indirect Remuneration (DIR) reforms in the FY 2023 Medicare Part D Notice H.R.6833 - Affordable Insulin Now Act Maternal health (Medicaid postpartum coverage extension, H.R.959 Black Maternal Health Momnibus Act of 2021) Helping MOMS Act of 2021 CMS Extreme & Uncontrollable Circumstances Policy Medicare Sequester (H.R.315, S.748) Medicare Audio-Only Telehealth (H.R.2166, S.150) Continuing Resolution (CR)FY 2022 Medicaid Funding for Puerto Rico Medicaid Funding for Puerto Rico including discussions on the FMAP, ESRD, and LTSS. Medicare Advantage issues such as rates, benchmarks, providers payments, and disparities in funding for territories. Medicare Advantage asks regarding the underfunding and disparity for Puerto Rico H.R.5376 - Build Back Better Act Medicaid eligibility Health Equity/Health Disparities
Black Maternal Health Momnibus Act of 2021
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, star ratings, extreme and uncontrollable circumstances policy, normalization factors, stars contract consolidation, ESRD, audio-only telehealth H.R. 4074 -To amend title XVIII of the Social Security Act Medicare RAD-V Mental health and substance use (42 CFR Part 2) Medicaid (IMD Exclusion) Medicaid expansion Medicaid reform (block grants, per capita caps) Medicaid and CHIP reauthorization Medicaid actuarial soundness Long-term services and supports Social Determents of Health (SDOH) Medicare Part D prescription drug program and Medicare Part D coverage gap (donut hole) Opioid addiction issues and response (prescription drug monitoring programs) Medicaid medical loss ratio remittance Medicare Advantage Pilot Program in TRICARE Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing Direct and Indirect Remuneration (DIR) reforms in the FY 2023 Medicare Part D Notice H.R.6833 - Affordable Insulin Now Act Maternal health (Medicaid postpartum coverage extension, H.R.959 Black Maternal Health Momnibus Act of 2021) Helping MOMS Act of 2021 CMS Extreme & Uncontrollable Circumstances Policy Medicare Sequester (H.R.315, S.748) Medicare Audio-Only Telehealth (H.R.2166, S.150, H.R.3447) H.R. 4406, the Supporting Medicaid in the U.S. Territories Act, Continuing Resolution (CR)FY 2022 Medicaid Funding for Puerto Rico Medicare Advantage asks regarding the underfunding and disparity for Puerto Rico H.R.5376 - Build Back Better Act Medicaid eligibility Health Equity/Health Disparities HR1826 - Fairness in Medicare Part B Enrollment Act HR2217 - Territory Federal Matching Requirement Equity Act of 2021 HR1825 - A Bill to Remove the Matching Requirement for Medicate Part D Drugs.
Black Maternal Health Momnibus Act of 2021
Client: ELEVANCE HEALTH, INC. · Firm: ELEVANCE HEALTH, INC.
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, star ratings, extreme and uncontrollable circumstances policy, normalization factors, stars contract consolidation, ESRD, audio-only telehealth) Medicare RAD-V Mental health and substance use (42 CFR Part 2) Medicaid managed care (IMD Exclusion) Medicaid expansion Medicaid reform (block grants, per capita caps) Medicaid and CHIP reauthorization Medicaid actuarial soundness Long-term services and supports Medicare Part D prescription drug program and Medicare Part D coverage gap (donut hole) Opioid addiction issues and response (prescription drug monitoring programs) Medicaid medical loss ratio remittance Medicare Advantage Pilot Program in TRICARE Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing Direct and Indirect Remuneration (DIR) reforms in the FY 2023 Medicare Part D Notice H.R.6833 - Affordable Insulin Now Act Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act H.R.7666 - Restoring Hope for Mental Health and Well-Being Act of 2022 Social Determents of Health (SDOH) H.R.4074 - Addressing Social Determinants in Medicare Advantage Act of 2021 Health Equity/Health Disparities Maternal health (Medicaid postpartum coverage extension, H.R.959 Black Maternal Health Momnibus Act of 2021) Helping MOMS Act of 2021 Medicare Audio-Only Telehealth (H.R.2166, S.150) Continuing Resolution (CR)FY 2022 Medicaid Funding for Puerto Rico Medicare Savings Program (MSP) in Medicaid Increasing on the Medicare Advantage benchmarks to a minimum level H.R. 7997 (to Amend the SS Act to establish a floor in MA benchmark rates for regions with low Medicare fee-for-service penetration and to make the Medicare Savings Program available in all jurisdictions) H.R. 2217 (Territory Federal Matching Requirement Equity Act of 2021) H.R. 1825 (A Bill to Remove the Matching Requirement for Medicare Part D Drugs) H.R. 1826 (Fairness in Medicare Part B Enrollment Act) S. 3778 (Territories Medicare Prescription Drug Assistance Equity Act of 2022). H.R.5376 - Build Back Better Act Medicaid eligibility and redeterminations H.R. 5376 - Inflation Reduction Act of 2022 Medicare Advantage Supplemental Benefits
ACA 1332 Waivers Individual Market and Exchange Stabilization Prior Authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Flexibility in Hospital Ownership Act Oversight of Anti-Competitive Behavior of Non-Profit Hospitals Act Consumer Choice of Care Act Competition in State Healthcare Markets Act Addressing Anti-Competitive Contracting Clauses Act Increasing Competition for Medical Residency Act Hospital Claims Form Issues Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios. (H.R.3969) Mental Health and Substance Use, CFR Part 2, Parity and MHPAEA Compliance Issues Mental Health Matters Act (H.R. 7780) Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Bipartisan Safer Communities Act MAT Act Surprise Medical Billing Price of Prescription Drugs Pharmacy Benefit Manager (PBM) Operations and Practices, Spread Pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Chronic Kidney Disease Conditions of Coverage Reform COVID-19 Testing, Vaccines, Treatment, Cost Sharing Medicare Sequestration Telehealth KEEP Telehealth Options Act Telehealth Expansion Act (H.R. 5981) Short Term Limited Duration Health Plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Periods Hospital Claims Form Issues Build Back Better Act (H.R.5376) Inflation Reduction Act of 2022 Medicaid Eligibility Health Equity/Health Disparities Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care VA Community Care Network Program Veterans PACT Act Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022 Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) TCPA Insurance Navigators Network Adequacy Provider Directories 2023 Omnibus Appropriations Bill Originating Site Requirements Provider and Nursing Licensing Issues Inpatient Only List Site Neutrality Biosimilar Red Tape Elimination Act Biologics Competition Act
ACA 1332 Waivers Individual Market and Exchange Stabilization Prior Authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Flexibility in Hospital Ownership Act Oversight of Anti-Competitive Behavior of Non-Profit Hospitals Act Consumer Choice of Care Act Competition in State Healthcare Markets Act Addressing Anti-Competitive Contracting Clauses Act Increasing Competition for Medical Residency Act Hospital Claims Form Issues Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios. (H.R.3969) Mental Health and Substance Use, CFR Part 2, Parity and MHPAEA Compliance Issues Mental Health Matters Act (H.R. 7780) Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Bipartisan Safer Communities Act MAT Act Surprise Medical Billing Price of Prescription Drugs Pharmacy Benefit Manager (PBM) Operations and Practices, Spread Pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Chronic Kidney Disease Conditions of Coverage Reform COVID-19 Testing, Vaccines, Treatment, Cost Sharing Medicare Sequestration Telehealth KEEP Telehealth Options Act Telehealth Expansion Act (H.R. 5981) Short Term Limited Duration Health Plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Periods Hospital Claims Form Issues Build Back Better Act (H.R.5376) Inflation Reduction Act of 2022 Medicaid Eligibility Health Equity/Health Disparities Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care VA Community Care Network Program Veterans PACT Act Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022 Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) TCPA Insurance Navigators Network Adequacy Provider Directories 2023 Omnibus Appropriations Bill Originating Site Requirements Provider and Nursing Licensing Issues Inpatient Only List Site Neutrality Biosimilar Red Tape Elimination Act Biologics Competition Act
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, star ratings, extreme and uncontrollable circumstances policy, normalization factors, stars contract consolidation, ESRD, audio-only telehealth) Medicare RAD-V Mental Health and Substance Use (42 CFR Part 2) Medicaid Managed Care Medicaid Expansion Medicaid Reform Medicaid Redeterminations CHIP Reauthorization Medicaid Actuarial Soundness Long-term Services and Supports Medicare Part D prescription drug program Medicare Advantage Pilot Program in TRICARE Pharmacy Benefit Manager (PBM) Operations and Practices, Spread Pricing Direct and Indirect Remuneration (DIR) reforms in the FY 2023 Medicare Part D Notice Affordable Insulin Now Act (H.R.6833) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Social Determents of Health (SDOH) Addressing Social Determinants in Medicare Advantage Act of 2021 (H.R.4074) Health Equity/Health Disparities Maternal health (Medicaid postpartum coverage extension, H.R.959 Black Maternal Health Momnibus Act of 2021) Helping MOMS Act of 2021 Medicare Audio-Only Telehealth (H.R.2166, S.150) Medicaid Funding for Puerto Rico Medicare Savings Program (MSP) in Medicaid Increasing on the Medicare Advantage Benchmarks to a Minimum Level H.R. 7997 (to Amend the SS Act to establish a floor in MA benchmark rates for regions with low Medicare fee-for-service penetration and to make the Medicare Savings Program available in all jurisdictions) H.R. 2217 (Territory Federal Matching Requirement Equity Act of 2021) H.R. 1825 (A Bill to Remove the Matching Requirement for Medicare Part D Drugs) H.R. 1826 (Fairness in Medicare Part B Enrollment Act) S. 3778 (Territories Medicare Prescription Drug Assistance Equity Act of 2022). Build Back Better Act (H.R.5376) Medicaid Eligibility and Redeterminations Inflation Reduction Act of 2022 (H.R. 5376) Medicare Advantage Supplemental Benefits Timely Access to Care Act (H.R. 3173 and S. 3018) 2023 Omnibus Appropriations Bill Mental Health Parity Restore Protections for Dialysis Patients Act (H.R.8594)
Filing targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office
ELEVANCE HEALTH, INC. via ELEVANCE HEALTH, INC.
2022 · third_quarter · Q3
Federal Medical Assistance Percentages (FMAP) increase COVID-19 testing, vaccinations, cost sharing for COVID-19 testing APTC Expansion and Permanency CARES Act
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) ACA 1332 Waivers Individual market and exchange stabilization Prior authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Flexibility in Hospital Ownership Act Oversight of Anti-Competitive Behavior of Non-Profit Hospitals Act Consumer Choice of Care Act Competition in State Healthcare Markets Act Addressing Anti-Competitive Contracting Clauses Act Increasing Competition for Medical Residency Act Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use, CFR Part 2, Parity and compliance issues H.R. 7780 - Mental Health Matters Act Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Mental health parity and MHPAEA compliance Surprise medical billing Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Chronic Kidney Disease Conditions of Coverage Reform COVID-19 testing, vaccines, treatment, cost sharing Medicare Sequestration, ACA subsidies, COVID vaccines and testing, Consolidated Appropriations Act Telehealth KEEP Telehealth Options Act Short Term Limited Duration health plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Period Hospital Claims Form Issues Build Back Better Act (H.R.5376) Inflation Reduction Act of 2022 Medicaid eligibility Health Equity/Health Disparities Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care Veterans PACT Act Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022 Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) TCPA Insurance Navigators Network Adequacy Provider Directories Bipartisan Safer Communities Act
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) ACA 1332 Waivers Individual market and exchange stabilization Prior authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Flexibility in Hospital Ownership Act Oversight of Anti-Competitive Behavior of Non-Profit Hospitals Act Consumer Choice of Care Act Competition in State Healthcare Markets Act Addressing Anti-Competitive Contracting Clauses Act Increasing Competition for Medical Residency Act Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use, CFR Part 2, Parity and compliance issues H.R. 7780 - Mental Health Matters Act Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Mental health parity and MHPAEA compliance Surprise medical billing Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Chronic Kidney Disease Conditions of Coverage Reform COVID-19 testing, vaccines, treatment, cost sharing Medicare Sequestration, ACA subsidies, COVID vaccines and testing, Consolidated Appropriations Act Telehealth KEEP Telehealth Options Act Short Term Limited Duration health plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Period Hospital Claims Form Issues Build Back Better Act (H.R.5376) Inflation Reduction Act of 2022 Medicaid eligibility Health Equity/Health Disparities Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care Veterans PACT Act Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022 Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) TCPA Insurance Navigators Network Adequacy Provider Directories Bipartisan Safer Communities Act
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, star ratings, extreme and uncontrollable circumstances policy, normalization factors, stars contract consolidation, ESRD, audio-only telehealth) Medicare RAD-V Mental health and substance use (42 CFR Part 2) Medicaid managed care (IMD Exclusion) Medicaid expansion Medicaid reform (block grants, per capita caps) Medicaid and CHIP reauthorization Medicaid actuarial soundness Long-term services and supports Medicare Part D prescription drug program and Medicare Part D coverage gap (donut hole) Opioid addiction issues and response (prescription drug monitoring programs) Medicaid medical loss ratio remittance Medicare Advantage Pilot Program in TRICARE Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing Direct and Indirect Remuneration (DIR) reforms in the FY 2023 Medicare Part D Notice H.R.6833 - Affordable Insulin Now Act Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act H.R.7666 - Restoring Hope for Mental Health and Well-Being Act of 2022 Social Determents of Health (SDOH) H.R.4074 - Addressing Social Determinants in Medicare Advantage Act of 2021 Health Equity/Health Disparities Maternal health (Medicaid postpartum coverage extension, H.R.959 Black Maternal Health Momnibus Act of 2021) Helping MOMS Act of 2021 Medicare Audio-Only Telehealth (H.R.2166, S.150) Continuing Resolution (CR)FY 2022 Medicaid Funding for Puerto Rico Medicare Savings Program (MSP) in Medicaid Increasing on the Medicare Advantage benchmarks to a minimum level H.R. 7997 (to Amend the SS Act to establish a floor in MA benchmark rates for regions with low Medicare fee-for-service penetration and to make the Medicare Savings Program available in all jurisdictions) H.R. 2217 (Territory Federal Matching Requirement Equity Act of 2021) H.R. 1825 (A Bill to Remove the Matching Requirement for Medicare Part D Drugs) H.R. 1826 (Fairness in Medicare Part B Enrollment Act) S. 3778 (Territories Medicare Prescription Drug Assistance Equity Act of 2022). H.R.5376 - Build Back Better Act Medicaid eligibility and redeterminations H.R. 5376 - Inflation Reduction Act of 2022 Medicare Advantage Supplemental Benefits
Price of prescription drugs; antitrust issues; Prescription Drug Pricing Reduction Act Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing Direct and Indirect Remuneration (DIR) Drug Rebate Rule/Executive Order Senate Finance Committee Prescription Drug Pricing Reduction Act Lower Drug Costs Now Act (H.R. 3) Drug Patent Reform Robinson-Patman Reform H.R. 5376 - Inflation Reduction Act of 2022 Pharmacy Benefit Manager Transparency Act (S. 4293)
Filing targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE, White House Office
ELEVANCE HEALTH, INC. via ELEVANCE HEALTH, INC.
2022 · second_quarter · 2A
Price of prescription drugs; antitrust issues; Prescription Drug Pricing Reduction Act Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Drug Rebate Rule/Executive Order Senate Finance Committee Prescription Drug Pricing Reduction Act Lower Drug Costs Now Act (H.R. 3) Drug Patent Reform Robinson-Patman Reform
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, star ratings, extreme and uncontrollable circumstances policy, normalization factors, stars contract consolidation, ESRD, audio-only telehealth H.R. 4074 -To amend title XVIII of the Social Security Act Medicare RAD-V Mental health and substance use (42 CFR Part 2) Medicaid (IMD Exclusion) Medicaid expansion Medicaid reform (block grants, per capita caps) Medicaid and CHIP reauthorization Medicaid actuarial soundness Long-term services and supports Social Determents of Health (SDOH) Medicare Part D prescription drug program and Medicare Part D coverage gap (donut hole) Opioid addiction issues and response (prescription drug monitoring programs) Medicaid medical loss ratio remittance Medicare Advantage Pilot Program in TRICARE Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing Against Direct and Indirect Remuneration (DIR) reforms in the FY 2023 Medicare Part D Notice H.R.6833 - Affordable Insulin Now Act Maternal health (Medicaid postpartum coverage extension, H.R.959 Black Maternal Health Momnibus Act of 2021) Helping MOMS Act of 2021 CMS Extreme & Uncontrollable Circumstances Policy Medicare Sequester (H.R.315, S.748) Medicare Audio-Only Telehealth (H.R.2166, S.150) Continuing Resolution (CR)FY 2022 Medicaid Funding for Puerto Rico Medicaid Funding for Puerto Rico including discussions on the FMAP, ESRD, and LTSS. Medicare Advantage issues such as rates, benchmarks, providers payments, and disparities in funding for territories. Medicare Advantage asks regarding the underfunding and disparity for Puerto Rico H.R.5376 - Build Back Better Act Medicaid eligibility Health Equity/Health Disparities
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) ACA 1332 Waivers Individual market and exchange stabilization Prior authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use, Parity and compliance issues. Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Mental health parity and MHPAEA compliance Surprise medical billing; Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Chronic Kidney Disease Conditions of Coverage Reform COVID-19 testing, vaccines, treatment, cost sharing Medicare Sequestration, ACA subsidies, COVID vaccines and testing, Consolidated Appropriations Act Behavioral Health Telehealth Short Term Limited Duration health plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio; To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios (H.R. 3969) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Period CONNECT for Health Act Hospital Claims Form Issues Build Back Better Act (H.R.5376) KEEP Telehealth Options Act Agent/broker compensation disclosures under the Consolidated Appropriations Act. CAA regulation implementation Hospital Competition Act Medicaid eligibility Health Equity/Health Disparities Postal Service Reform Act of 2022 Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care (U.S. Department of Veterans Affairs Assets and Infrastructure Review Report) 2018 MISSION Act Veterans PACT Act Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) Bipartisan Safer Communities Act
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) ACA 1332 Waivers Individual market and exchange stabilization Prior authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use, Parity and compliance issues. Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Mental health parity and MHPAEA compliance Surprise medical billing; Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Chronic Kidney Disease Conditions of Coverage Reform COVID-19 testing, vaccines, treatment, cost sharing Medicare Sequestration, ACA subsidies, COVID vaccines and testing, Consolidated Appropriations Act Behavioral Health Telehealth Short Term Limited Duration health plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio; To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios (H.R. 3969) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Period CONNECT for Health Act Hospital Claims Form Issues Build Back Better Act (H.R.5376) KEEP Telehealth Options Act Agent/broker compensation disclosures under the Consolidated Appropriations Act. CAA regulation implementation Hospital Competition Act Medicaid eligibility Health Equity/Health Disparities Postal Service Reform Act of 2022 Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care (U.S. Department of Veterans Affairs Assets and Infrastructure Review Report) 2018 MISSION Act Veterans PACT Act Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) Bipartisan Safer Communities Act
Federal Medical Assistance Percentages (FMAP) increase COVID-19 testing, vaccinations, cost sharing for COVID-19 testing APTC Expansion and Permanency CARES Act Blockchain
Filing targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE, Treasury, Dept of
ELEVANCE HEALTH, INC. via ELEVANCE HEALTH, INC.
2022 · second_quarter · Q2
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) ACA 1332 Waivers Individual market and exchange stabilization Prior authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use, Parity and compliance issues. Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Mental health parity and MHPAEA compliance Surprise medical billing; Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Chronic Kidney Disease Conditions of Coverage Reform COVID-19 testing, vaccines, treatment, cost sharing Medicare Sequestration, ACA subsidies, COVID vaccines and testing, Consolidated Appropriations Act Behavioral Health Telehealth Short Term Limited Duration health plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio; To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios (H.R. 3969) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Period CONNECT for Health Act Hospital Claims Form Issues Build Back Better Act (H.R.5376) KEEP Telehealth Options Act Agent/broker compensation disclosures under the Consolidated Appropriations Act. CAA regulation implementation Hospital Competition Act Medicaid eligibility Health Equity/Health Disparities Postal Service Reform Act of 2022 Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care (U.S. Department of Veterans Affairs Assets and Infrastructure Review Report) 2018 MISSION Act Veterans PACT Act Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) Bipartisan Safer Communities Act
Federal Medical Assistance Percentages (FMAP) increase COVID-19 testing, vaccinations, cost sharing for COVID-19 testing APTC Expansion and Permanency CARES Act Blockchain
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) ACA 1332 Waivers Individual market and exchange stabilization Prior authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use, Parity and compliance issues. Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Mental health parity and MHPAEA compliance Surprise medical billing; Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Chronic Kidney Disease Conditions of Coverage Reform COVID-19 testing, vaccines, treatment, cost sharing Medicare Sequestration, ACA subsidies, COVID vaccines and testing, Consolidated Appropriations Act Behavioral Health Telehealth Short Term Limited Duration health plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio; To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios (H.R. 3969) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Period CONNECT for Health Act Hospital Claims Form Issues Build Back Better Act (H.R.5376) KEEP Telehealth Options Act Agent/broker compensation disclosures under the Consolidated Appropriations Act. CAA regulation implementation Hospital Competition Act Medicaid eligibility Health Equity/Health Disparities Postal Service Reform Act of 2022 Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care (U.S. Department of Veterans Affairs Assets and Infrastructure Review Report) 2018 MISSION Act Veterans PACT Act Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) Bipartisan Safer Communities Act
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) ACA 1332 Waivers Individual market and exchange stabilization Prior authorization Hospital Consolidation Transparency of Hospital Billing Act (H.R.8133) Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use, Parity and compliance issues. Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R.7666) Behavioral Health Crisis Intervention and 9-8-8 hotline services Mental health parity and MHPAEA compliance Surprise medical billing; Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Pharmacy Benefit Manager Transparency Act (S. 4293) Chronic Kidney Disease Conditions of Coverage Reform COVID-19 testing, vaccines, treatment, cost sharing Medicare Sequestration, ACA subsidies, COVID vaccines and testing, Consolidated Appropriations Act Behavioral Health Telehealth Short Term Limited Duration health plans Consolidated Appropriations Act (H.R. 133) Medical Loss Ratio; To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios (H.R. 3969) Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Period CONNECT for Health Act Hospital Claims Form Issues Build Back Better Act (H.R.5376) KEEP Telehealth Options Act Agent/broker compensation disclosures under the Consolidated Appropriations Act. CAA regulation implementation Hospital Competition Act Medicaid eligibility Health Equity/Health Disparities Postal Service Reform Act of 2022 Defense Health Programs (FY2022 Budget and FY2023 Budget Request) Veterans Health Care (U.S. Department of Veterans Affairs Assets and Infrastructure Review Report) 2018 MISSION Act Veterans PACT Act Achieving Equity in the Treatment of Dual Eligible Beneficiaries Act (H.R. 7997) Bipartisan Safer Communities Act
Price of prescription drugs; antitrust issues; Prescription Drug Pricing Reduction Act Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Drug Rebate Rule/Executive Order Senate Finance Committee Prescription Drug Pricing Reduction Act Lower Drug Costs Now Act (H.R. 3) Drug Patent Reform Robinson-Patman Reform
Filing targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE, Treasury, Dept of
ELEVANCE HEALTH, INC. via ELEVANCE HEALTH, INC.
2022 · first_quarter · Q1
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, star ratings, extreme and uncontrollable circumstances policy, normalization factors, stars contract consolidation, ESRD, audio-only telehealth H.R. 4074 -To amend title XVIII of the Social Security Act Medicare RAD-V Mental health and substance use (42 CFR Part 2) Medicaid (IMD Exclusion) Medicaid expansion Medicaid reform (block grants, per capita caps) Medicaid and CHIP reauthorization Medicaid actuarial soundness Long-term services and supports Social Determents of Health (SDOH) Medicare Part D prescription drug program and Medicare Part D coverage gap (donut hole) Opioid addiction issues and response (prescription drug monitoring programs) Medicaid medical loss ratio remittance Medicare Advantage Pilot Program in TRICARE Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing Direct and Indirect Remuneration (DIR) reforms in the FY 2023 Medicare Part D Notice H.R.6833 - Affordable Insulin Now Act Maternal health (Medicaid postpartum coverage extension, H.R.959 Black Maternal Health Momnibus Act of 2021) Helping MOMS Act of 2021 CMS Extreme & Uncontrollable Circumstances Policy Medicare Sequester (H.R.315, S.748) Medicare Audio-Only Telehealth (H.R.2166, S.150, H.R.3447) H.R. 4406, the Supporting Medicaid in the U.S. Territories Act, Continuing Resolution (CR)FY 2022 Medicaid Funding for Puerto Rico Medicare Advantage asks regarding the underfunding and disparity for Puerto Rico H.R.5376 - Build Back Better Act Medicaid eligibility Health Equity/Health Disparities HR1826 - Fairness in Medicare Part B Enrollment Act HR2217 - Territory Federal Matching Requirement Equity Act of 2021 HR1825 - A Bill to Remove the Matching Requirement for Medicate Part D Drugs.
Federal Medical Assistance Percentages (FMAP) increase COVID-19 testing, vaccinations, cost sharing for COVID-19 testing APTC Expansion and Permanency CARES Act Blockchain
Price of prescription drugs; antitrust issues; Prescription Drug Pricing Reduction Act Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Drug Rebate Rule/Executive Order Senate Finance Committee Prescription Drug Pricing Reduction Act Lower Drug Costs Now Act (H.R. 3) Drug Patent Reform Robinson-Patman Reform
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) ACA 1332 Waivers Individual market and exchange stabilization Prior authorization and Utilization Management, (H.R. 3107); Hospital Consolidation Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use,42 CFR Part 2, Parity and compliance issues; Surprise medical billing; No Surprises Act Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, COVID-19 testing, vaccines, treatment, cost sharing Medical Loss Ratio; H.R. 3969 - To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios Federal Medical Assistance Percentages (FMAP) increase Short Term Limited Duration health plans Special Enrollment Period CONNECT for Health Act Hospital Claims Form Issues H.R.5376 - Build Back Better Act KEEP Telehealth Options Act Opioid use disorders (OUD) and substance use disorders (SUD) treatment Agent/broker compensation disclosures under the Consolidated Appropriations Act. CAA regulation implementation Hospital Competition Act Postal Service Reform Act of 2022; Postal Service Retiree Benefits Reform Defense Health Programs (FY2022 Budget and FY2023 Budget Request Veterans Health Care (U.S. Department of Veterans Affairs Assets and Infrastructure Review Report) Veterans Records Access (Access for Veterans to Records Act)
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) ACA 1332 Waivers Individual market and exchange stabilization Prior authorization Hospital Consolidation Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use, Parity and compliance issues; Surprise medical billing; No Surprises Act Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Medicare Sequestration, ACA subsidies, COVID vaccines and testing, Consolidated Appropriations Act Behavioral Health Telehealth Short Term Limited Duration health plans Consolidated Appropriations Act, HR 133 Medical Loss Ratio; H.R. 3969 - To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Period CONNECT for Health Act Hospital Claims Form Issues H.R.5376 - Build Back Better Act KEEP Telehealth Options Act Opioid use disorders (OUD) and substance use disorders (SUD) treatment Agent/broker compensation disclosures under the Consolidated Appropriations Act. CAA regulation implementation Hospital Competition Act Medicaid eligibility Health Equity/Health Disparities Postal Service Reform Act of 2022; Postal Service Retiree Benefits Reform Defense Health Programs (FY2022 Budget and FY2023 Budget Request Veterans Health Care (U.S. Department of Veterans Affairs Assets and Infrastructure Review Report) Veterans Records Access (Access for Veterans to Records Act)
Filing targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE, Treasury, Dept of, U.S. Postal Service (USPS)
ELEVANCE HEALTH, INC. via ELEVANCE HEALTH, INC.
2021 · fourth_quarter · Q4
Price of prescription drugs; antitrust issues; Prescription Drug Pricing Reduction Act Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Drug Rebate Rule/Executive Order Senate Finance Committee Prescription Drug Pricing Reduction Act Lower Drug Costs Now Act (H.R. 3) Drug Patent Reform Robinson-Patman Reform
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) Individual market and exchange stabilization Prior authorization and Utilization Management, (H.R. 3107); Hospital Consolidation Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use,42 CFR Part 2, Parity and compliance issues; Surprise medical billing; Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, COVID-19 testing, vaccines, treatment, cost sharing Medical Loss Ratio; H.R. 3969 - To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios Federal Medical Assistance Percentages (FMAP) increase Short Term Limited Duration health plans Special Enrollment Period CONNECT for Health Act Hospital Claims Form Issues H.R.5376 - Build Back Better Act KEEP Telehealth Options Act Opioid use disorders (OUD) and substance use disorders (SUD) treatment Agent/broker compensation disclosures under the Consolidated Appropriations Act. CAA regulation implementation Hospital Competition Act
ELEVANCE HEALTH, INC. via ELEVANCE HEALTH, INC.
2021 · third_quarter · Q3
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) Individual market and exchange stabilization Prior authorization and Utilization Management, (H.R. 3107); Hospital Consolidation Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use,42 CFR Part 2, Parity and compliance issues; Surprise medical billing; Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, COVID-19 testing, vaccines, treatment, cost sharing Medical Loss Ratio; H.R. 3969 - To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios Federal Medical Assistance Percentages (FMAP) increase Short Term Limited Duration health plans Special Enrollment Period CONNECT for Health Act Hospital Claims Form Issues H.R.5376 - Build Back Better Act KEEP Telehealth Options Act Hospital Competition Act
ELEVANCE HEALTH, INC. via ELEVANCE HEALTH, INC.
2021 · second_quarter · Q2
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) Individual market and exchange stabilization Prior authorization Hospital Consolidation Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use, Parity and compliance issues; Surprise medical billing; Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Medicare Sequestration, ACA subsidies, COVID vaccines and testing, Consolidated Appropriations Act Behavioral Health Telehealth Short Term Limited Duration health plans Consolidated Appropriations Act, HR 133 Medical Loss Ratio; H.R. 3969 - To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Period CONNECT for Health Act Hospital Claims Form Issues
ELEVANCE HEALTH, INC. via ELEVANCE HEALTH, INC.
2021 · first_quarter · Q1
Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Drug Rebate Rule/Executive Order
COBRA Subsidies Federal Medical Assistance Percentages (FMAP) increase COVID-19 testing, vaccinations, cost sharing for COVID-19 testing
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) Individual market and exchange stabilization Prior authorization Hospital Consolidation Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use, Parity and compliance issues; Surprise medical billing; Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Medicare Sequestration, ACA subsidies, COVID vaccines and testing, COBRA subsidies, Consolidated Appropriations Act Behavioral Health Telehealth Short Term Limited Duration health plans Consolidated Appropriations Act, HR 133 Federal Medical Assistance Percentages (FMAP) increase
ELEVANCE HEALTH, INC. via ELEVANCE HEALTH, INC.
2020 · fourth_quarter · Q4
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, reauthorization of special need plans, star ratings, extreme and uncontrollable circumstances policy, normalization factors, stars contract consolidation, ESRD, audio-only telehealth) Medicare RAD-V Mental health and substance use (42 CFR Part 2) Medicaid managed care (MIND Act) (H.R. 6926) (IMD Exclusion) Medicaid expansion Medicaid reform (block grants, per capita caps) Medicaid and CHIP reauthorization Medicaid actuarial soundness Long-term services and supports Social Determents of Health (SDOH) Medicare Part D prescription drug program and Medicare Part D coverage gap (donut hole) Opioid addiction issues and response (prescription drug monitoring programs) Medicaid medical loss ratio remittance Medicare Advantage Pilot Program in TRICARE Maternal Health Quality Improvement Act (H.R. 4995) Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing Non Emergency Medical Transportation (The Protecting Patients Transportation to Care Act)(S.2846); the Consolidated Appropriations Act (H.R. 133) Medicaid maternal health coverage expansion (H.R.6800)
ELEVANCE HEALTH, INC. via ELEVANCE HEALTH, INC.
2020 · third_quarter · Q3
Senate HELP Committee Lower Health Care Costs Act Senate Finance Committee Prescription Drug Pricing Reduction Act; HR 3 Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing,Lower Health Care Cost Act of 2019 (S. 1895), (H.R. 5304)
Coronavirus Aid, Relief, and Economic Security (CARES) Act COVID-19 Legislation (Phase I, II, III and other) Commercial paper market stability COBRA Subsidies Federal Medical Assistance Percentages (FMAP) increase Special enrollment period State and local funding support COVID-19 testing, vaccinations, cost sharing for COVID-19 testing
ELEVANCE HEALTH, INC. via ELEVANCE HEALTH, INC.
2020 · second_quarter · Q2
Senate HELP Committee Lower Health Care Costs Act Senate Finance Committee Prescription Drug Pricing Reduction Act; HR 3 Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing,Lower Health Care Cost Act of 2019 (S. 1895), (H.R. 5304)
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (reconciliation, individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) Individual market and exchange stabilization Prior authorization, (H.R. 3107) Hospital Consolidation Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use,42 CFR Part 2, Parity and compliance issues Surprise medical billing; Lower Health Care Cost Act of 2019 (S. 1895), and No Surprises Act (H.R. 3630) Price of prescription drugs Commercial Risk adjustment data validation (RADV) Senate HELP Committee Lower Health Care Costs Act Senate Finance Committee Prescription Drug Pricing Reduction Act; (H.R. 3) Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Lower Health Care Cost Act of 2019 (S. 1895) COVID-19 legislation (Phase I, II, III and other); Commercial paper market stability; Families First Coronavirus Response Act (H.R. 6201); Coronavirus Aid, Relief, and Economic Security (CARES) Act; SEPs; Risk Mitigation and Excess Loss; COBRA; Coverage Mandates Federal Medical Assistance Percentages (FMAP) increase
ELEVANCE HEALTH, INC. via ELEVANCE HEALTH, INC.
2020 · first_quarter · Q1
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (reconciliation, individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) Individual market and exchange stabilization Prior authorization, (H.R. 3107) Hospital Consolidation Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Association health plans Mental health and substance use,42 CFR Part 2, Parity and compliance issues Surprise medical billing; Lower Health Care Cost Act of 2019 (S. 1895), and No Surprises Act (H.R. 3630) Price of prescription drugs Commercial Risk adjustment data validation (RADV) Senate HELP Committee Lower Health Care Costs Act Senate Finance Committee Prescription Drug Pricing Reduction Act; HR 3 Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Lower Health Care Cost Act of 2019 (S. 1895) COVID-19 legislation (Phase I, II, III and other); Commercial paper market stability; Families First Coronavirus Response Act (HR 6201); Coronavirus Aid, Relief, and Economic Security (CARES) Act; SEPs; Risk Mitigation and Excess Loss; COBRA; Coverage Mandates
ELEVANCE HEALTH, INC. via ELEVANCE HEALTH, INC.
2019 · fourth_quarter · Q4
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, reauthorization of special need plans, star ratings, normalization factors, stars contract consolidation) Medicare RAD-V Mental health and substance use (42 CFR Part 2) Medicaid managed care Medicaid expansion Medicaid reform (block grants, per capita caps) Medicaid and CHIP reauthorization Medicaid actuarial soundness Long-term services and supports Social Determents of Health (SDOH) Medicare Part D prescription drug program and Medicare Part D coverage gap (donut hole) Medicare Part D crosswalk policy Opioid addiction issues and response (prescription drug monitoring programs) Medicaid medical loss ratio remittance Medicaid non-emergency medical transportation Medicare Advantage Pilot Program in TRICARE Kentucky Medicaid RFP Decision Maternal Health Quality Improvement Act (H.R. 4995) Medicaid Maternal Health Outcomes and Coverage; Helping Medicaid Offer Maternity Services (MOMS) Act of 2019 (H.R. 4996) Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Drug Price Transparency in Medicaid Act of 2019 (H.R. 5281)
ELEVANCE HEALTH, INC. via ELEVANCE HEALTH, INC.
2019 · third_quarter · Q3
Senate HELP Committee Lower Health Care Costs Act Senate Finance Committee Prescription Drug Pricing Reduction Act; HR 3 Price of prescription drugs
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, reauthorization of special need plans, star ratings, normalization factors, stars contract consolidation) Medicare RAD-V Mental health and substance use (42 CFR Part 2) Medicaid managed care Medicaid expansion Medicaid reform (block grants, per capita caps) Medicaid and CHIP reauthorization Medicaid actuarial soundness Long-term services and supports Social Determents of Health (SDOH) Medicare Part D prescription drug program and Medicare Part D coverage gap (donut hole) Removal of safe harbor protections for rebates involving prescription drugs and the creation of new safe harbor protection for certain point-of-sale reductions on price on prescription drugs and certain Pharmacy Benefit Manager (PBM) service fees Medicare Part D crosswalk policy Opioid addiction issues and response (prescription drug monitoring programs) Medicaid medical loss ratio remittance Medicaid non-emergency medical transportation Medicare Advantage Pilot Program in TRICARE
ELEVANCE HEALTH, INC. via ELEVANCE HEALTH, INC.
2019 · second_quarter · Q2
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (reconciliation, individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) Individual market and exchange stabilization Commercial Risk adjustment data validation (RADV) Strengthening Health Care and Lowering Prescription Drug Costs Act (H.R. 987) Patient Affordability Value and Efficiency Act (PAVE Act) Creating and Restoring Equal Access To Equivalent Samples (CREATES) Act of 2019 (S. 340 and H.R. 965) Mental health and substance use,42 CFR Part 2, Parity and compliance issues Surprise medical billing; Lower Health Care Cost Act of 2019 (S. 1895), and No Surprises Act (H.R. 3630) Telehealth Price of prescription drugs Prior authorization Hospital Consolidation (The Hospital Competition Act of 2018, H.R. 7084) Social Determinants of Health (SDOH) Privacy and Healthcare Cybersecurity Health information exchange and interoperability Association health plans ACA third party payments Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Lower Health Care Cost Act of 2019 (S. 1895) Readiness for Elders and Americans with Disabilities Inclusion (READI) for Disaster Act (S. 3679)
ELEVANCE HEALTH, INC. via ELEVANCE HEALTH, INC.
2019 · first_quarter · Q1
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, reauthorization of special need plans, star ratings, normalization factors, stars contract consolidation) Medicare expansion Mental health and substance use (42 CFR Part 2) Medicaid managed care Medicaid expansion Medicaid reform (block grants, per capita caps) Medicaid and CHIP reauthorization Medicaid actuarial soundness Long-term services and supports Social Determents of Health (SDOH) Medicare Part D prescription drug program and Medicare Part D coverage gap (donut hole) Removal of safe harbor protections for rebates involving prescription drugs and the creation of new safe harbor protection for certain point-of-sale reductions on price on prescription drugs and certain Pharmacy Benefit Manager (PBM) service fees Opioid addiction issues and response (prescription drug monitoring programs) Medicaid medical loss ratio remittance Medicaid non-emergency medical transportation ACE Kids Act of 2019 and the Medicaid Services Investment and Accountability Act of 2019 (S. 317, H.R. 1226, and H.R. 1839) Medicare Advantage Pilot Program in TRICARE
ELEVANCE HEALTH, INC. via ELEVANCE HEALTH, INC.
2018 · fourth_quarter · Q4
Telephone Consumer Protection Act
To extend the moratorium and/or repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act (H.R. 246) To delay the reimposition of the annual fee on health insurance providers until after 2020 (H.R. 5963) Health Insurance Tax Relief Act of 2018 (S. 3063) The Bipartisan Budget Act of 2018 (H.R. 1892) Tax exclusion for employer-sponsored health insurance
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (reconciliation, individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) The Bipartisan Budget Act of 2018 (H.R. 1892) Creating and Restoring Equal Access To Equivalent Samples (CREATES) Act of 2017 (S. 974 and H.R. 2212) Overdose Prevention and Patient Safety Act (H.R. 3545 and H.R. 6082) Jessies Law (H.R. 5009) Mental health and substance use (42 CFR Part 2) Individual market and exchange stabilization Association health plans Short Term Limited Duration Plans Out of network billing (FAA Reauthorization Act of 2018, H.R. 302) ACA third party payments Telehealth Price of prescription drugs Opioid addiction issues and response (prescription drug monitoring programs) Prior authorization SUPPORT for Patients and Communities Act (H.R. 6) Veterans health care Task Force on the Impact of Affordable Housing Crisis Act of 2018 (S. 3231) Readiness for Elders and Americans with Disabilities Inclusion (READI) for Disaster Act (S. 3679)
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) Individual market and exchange stabilization Prior authorization Hospital Consolidation Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use, Parity and compliance issues; Surprise medical billing; Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Medicare Sequestration, ACA subsidies, COVID vaccines and testing, Consolidated Appropriations Act Behavioral Health Telehealth Short Term Limited Duration health plans Consolidated Appropriations Act, HR 133 Medical Loss Ratio; H.R. 3969 - To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Period CONNECT for Health Act Hospital Claims Form Issues H.R.5376 - Build Back Better Act KEEP Telehealth Options Act Opioid use disorders (OUD) and substance use disorders (SUD) treatment Agent/broker compensation disclosures under the Consolidated Appropriations Act. CAA regulation implementation Hospital Competition Act Medicaid eligibility Health Equity/Health Disparities
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, star ratings, extreme and uncontrollable circumstances policy, normalization factors, stars contract consolidation, ESRD, audio-only telehealth H.R. 4074 -To amend title XVIII of the Social Security Act Medicare RAD-V Mental health and substance use (42 CFR Part 2) Medicaid (IMD Exclusion) Medicaid expansion Medicaid reform (block grants, per capita caps) Medicaid and CHIP reauthorization Medicaid actuarial soundness Long-term services and supports Social Determents of Health (SDOH) Medicare Part D prescription drug program and Medicare Part D coverage gap (donut hole) Opioid addiction issues and response (prescription drug monitoring programs) Medicaid medical loss ratio remittance Medicare Advantage Pilot Program in TRICARE Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing Maternal health (Medicaid postpartum coverage extension, H.R.959 Black Maternal Health Momnibus Act of 2021) Helping MOMS Act of 2021 CMS Extreme & Uncontrollable Circumstances Policy Medicare Sequester (H.R.315, S.748) Medicare Audio-Only Telehealth (H.R.2166, S.150) H.R. 4406, the Supporting Medicaid in the U.S. Territories Act, Continuing Resolution (CR)FY 2022 Medicaid Funding for Puerto Rico Medicare Advantage asks regarding the underfunding and disparity for Puerto Rico H.R.5376 - Build Back Better Act Medicaid eligibility Health Equity/Health Disparities
Federal Medical Assistance Percentages (FMAP) increase COVID-19 testing, vaccinations, cost sharing for COVID-19 testing APTC Expansion and Permanency CARES Act Blockchain
Filing targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, star ratings, extreme and uncontrollable circumstances policy, normalization factors, stars contract consolidation, ESRD, audio-only telehealth H.R. 4074 -To amend title XVIII of the Social Security Act Medicare RAD-V Mental health and substance use (42 CFR Part 2) Medicaid (IMD Exclusion) Medicaid expansion Medicaid reform (block grants, per capita caps) Medicaid and CHIP reauthorization Medicaid actuarial soundness Long-term services and supports Social Determents of Health (SDOH) Medicare Part D prescription drug program and Medicare Part D coverage gap (donut hole) Opioid addiction issues and response (prescription drug monitoring programs) Medicaid medical loss ratio remittance Medicare Advantage Pilot Program in TRICARE Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing Maternal health (Medicaid postpartum coverage extension, H.R.959 Black Maternal Health Momnibus Act of 2021) Helping MOMS Act of 2021 CMS Extreme & Uncontrollable Circumstances Policy Medicare Sequester (H.R.315, S.748) Medicare Audio-Only Telehealth (H.R.2166, S.150) H.R. 4406, the Supporting Medicaid in the U.S. Territories Act, Continuing Resolution (CR)FY 2022 Medicaid Funding for Puerto Rico Medicare Advantage asks regarding the underfunding and disparity for Puerto Rico H.R.5376 - Build Back Better Act
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) Individual market and exchange stabilization Prior authorization Hospital Consolidation Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use, Parity and compliance issues; Surprise medical billing; Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Medicare Sequestration, ACA subsidies, COVID vaccines and testing, Consolidated Appropriations Act Behavioral Health Telehealth Short Term Limited Duration health plans Consolidated Appropriations Act, HR 133 Medical Loss Ratio; H.R. 3969 - To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios Federal Medical Assistance Percentages (FMAP) increase Special Enrollment Period CONNECT for Health Act Hospital Claims Form Issues H.R.5376 - Build Back Better Act KEEP Telehealth Options Act Hospital Competition Act
Price of prescription drugs; antitrust issues; Prescription Drug Pricing Reduction Act Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Drug Rebate Rule/Executive Order Senate Finance Committee Prescription Drug Pricing Reduction Act Lower Drug Costs Now Act (H.R. 3) Drug Patent Reform Robinson-Patman Reform
Federal Medical Assistance Percentages (FMAP) increase COVID-19 testing, vaccinations, cost sharing for COVID-19 testing APTC Expansion and Permanency CARES Act American Rescue Plan Blockchain
Filing targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE, White House Office
Federal Medical Assistance Percentages (FMAP) increase COVID-19 testing, vaccinations, cost sharing for COVID-19 testing APTC Expansion and Permanency CARES Act American Rescue Plan Blockchain
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) Individual market and exchange stabilization Prior authorization and Utilization Management, (H.R. 3107); Hospital Consolidation Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use,42 CFR Part 2, Parity and compliance issues; Surprise medical billing; Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, COVID-19 testing, vaccines, treatment, cost sharing Medical Loss Ratio; H.R. 3969 - To amend title XXVII of the Public Health Service Act to include activities to address social determinants of health in the calculation of medical loss ratios Federal Medical Assistance Percentages (FMAP) increase Short Term Limited Duration health plans Special Enrollment Period CONNECT for Health Act Hospital Claims Form Issues
Price of prescription drugs; antitrust issues; Prescription Drug Pricing Reduction Act Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Drug Rebate Rule/Executive Order Senate Finance Committee Prescription Drug Pricing Reduction Act Lower Drug Costs Now Act (H.R. 3) Drug Patent Reform
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, star ratings, extreme and uncontrollable circumstances policy, normalization factors, stars contract consolidation, ESRD, audio-only telehealth H.R. 4074 -To amend title XVIII of the Social Security Act Medicare RAD-V Mental health and substance use (42 CFR Part 2) Medicaid (IMD Exclusion) Medicaid expansion Medicaid reform (block grants, per capita caps) Medicaid and CHIP reauthorization Medicaid actuarial soundness Long-term services and supports Social Determents of Health (SDOH) Medicare Part D prescription drug program and Medicare Part D coverage gap (donut hole) Opioid addiction issues and response (prescription drug monitoring programs) Medicaid medical loss ratio remittance Medicare Advantage Pilot Program in TRICARE Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing Maternal health (Medicaid postpartum coverage extension, H.R.959 Black Maternal Health Momnibus Act of 2021) Helping MOMS Act of 2021 CMS Extreme & Uncontrollable Circumstances Policy Medicare Sequester (H.R.315, S.748) Medicare Audio-Only Telehealth (H.R.2166, S.150) H.R. 4406, the Supporting Medicaid in the U.S. Territories Act
Filing targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, reauthorization of special need plans, star ratings, extreme and uncontrollable circumstances policy, normalization factors, stars contract consolidation, ESRD, audio-only telehealth Medicare RAD-V Mental health and substance use (42 CFR Part 2) Medicaid (IMD Exclusion) Medicaid expansion Medicaid reform (block grants, per capita caps) Medicaid and CHIP reauthorization Medicaid actuarial soundness Long-term services and supports Social Determents of Health (SDOH) Medicare Part D prescription drug program and Medicare Part D coverage gap (donut hole) Opioid addiction issues and response (prescription drug monitoring programs) Medicaid medical loss ratio remittance Medicare Advantage Pilot Program in TRICARE Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing Non Emergency Medical Transportation the Consolidated Appropriations Act (H.R. 133) Maternal health (Medicaid postpartum coverage extension, H.R.959 Black Maternal Health Momnibus Act of 2021)
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) Individual market and exchange stabilization Prior authorization and Utilization Management, (H.R. 3107); Hospital Consolidation Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use,42 CFR Part 2, Parity and compliance issues; Surprise medical billing; Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, COVID-19 testing, vaccines, treatment, cost sharing Federal Medical Assistance Percentages (FMAP) increase Short Term Limited Duration health plans
Filing targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) Individual market and exchange stabilization Prior authorization and Utilization Management, (H.R. 3107); Hospital Consolidation Privacy and Healthcare Cybersecurity Digital, AI, and Blockchain Social Determinants of Health (SDOH) Mental health and substance use,42 CFR Part 2, Parity and compliance issues; H.R.7539 -Strengthening Behavioral Health Parity Act and the Consolidated Appropriations Act (H.R. 133) Surprise medical billing; Lower Health Care Cost Act of 2019 (S. 1895), and No Surprises Act (H.R. 3630); and the Consolidated Appropriations Act (H.R. 133) Price of prescription drugs Commercial Risk adjustment data validation (RADV) Senate HELP Committee Lower Health Care Costs Act Senate Finance Committee Prescription Drug Pricing Reduction Act; (H.R. 3) Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Lower Health Care Cost Act of 2019 (S. 1895) and the Consolidated Appropriations Act (H.R. 133) COVID-19 legislation (Phase I, II, III and other); Families First Coronavirus Response Act (H.R. 6201); Coronavirus Aid, Relief, and Economic Security (CARES) Act; The Heroes Act (H.R. 925 and 6800); HEALS Act (S. 1624); the Consolidated Appropriations Act (H.R. 133); SEPs; Risk Mitigation and Excess Loss; COBRA; Testing and Coverage Mandates Federal Medical Assistance Percentages (FMAP) increase McCarran-Ferguson Act repeal; the Competitive Health Insurance Reform Act of 2020 (S. 350) and Competitive Health Insurance Reform Act of 2019 (H.R. 1418)
Coronavirus Aid, Relief, and Economic Security (CARES) Act COVID-19 Legislation (Phase I, II, III and other) Commercial paper market stability COBRA Subsidies Federal Medical Assistance Percentages (FMAP) increase Special enrollment period State and local funding support COVID-19 testing, vaccinations, cost sharing for COVID-19 testing
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) Individual market and exchange stabilization Prior authorization and Utilization Management, (H.R. 3107); Hospital Consolidation Privacy and Healthcare Cybersecurity Digital, AI, and Blockchain Social Determinants of Health (SDOH) Mental health and substance use,42 CFR Part 2, Parity and compliance issues; H.R.7539 -Strengthening Behavioral Health Parity Act and the Consolidated Appropriations Act (H.R. 133) Surprise medical billing; Lower Health Care Cost Act of 2019 (S. 1895), and No Surprises Act (H.R. 3630); and the Consolidated Appropriations Act (H.R. 133) Price of prescription drugs Commercial Risk adjustment data validation (RADV) Senate HELP Committee Lower Health Care Costs Act Senate Finance Committee Prescription Drug Pricing Reduction Act; (H.R. 3) Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Lower Health Care Cost Act of 2019 (S. 1895) and the Consolidated Appropriations Act (H.R. 133) COVID-19 legislation (Phase I, II, III and other); Families First Coronavirus Response Act (H.R. 6201); Coronavirus Aid, Relief, and Economic Security (CARES) Act; The Heroes Act (H.R. 925 and 6800); HEALS Act (S. 1624); the Consolidated Appropriations Act (H.R. 133); SEPs; Risk Mitigation and Excess Loss; COBRA; Testing and Coverage Mandates Federal Medical Assistance Percentages (FMAP) increase McCarran-Ferguson Act repeal; the Competitive Health Insurance Reform Act of 2020 (S. 350) and Competitive Health Insurance Reform Act of 2019 (H.R. 1418)
Senate HELP Committee Lower Health Care Costs Act Senate Finance Committee Prescription Drug Pricing Reduction Act; HR 3 Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing,Lower Health Care Cost Act of 2019 (S. 1895), (H.R. 5304); and the Consolidated Appropriations Act (H.R. 133)
Filing targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (reconciliation, individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) Individual market and exchange stabilization Prior authorization and Utilization Management, (H.R. 3107); Uterine Fibroids Coverage Hospital Consolidation Privacy and Healthcare Cybersecurity Digital, AI, and Blockchain Social Determinants of Health (SDOH) Mental health and substance use,42 CFR Part 2, Parity and compliance issues Surprise medical billing; Lower Health Care Cost Act of 2019 (S. 1895), and No Surprises Act (H.R. 3630) Price of prescription drugs Commercial Risk adjustment data validation (RADV) Senate HELP Committee Lower Health Care Costs Act Senate Finance Committee Prescription Drug Pricing Reduction Act; (H.R. 3) Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Lower Health Care Cost Act of 2019 (S. 1895) COVID-19 legislation (Phase I, II, III and other); Families First Coronavirus Response Act (H.R. 6201); Coronavirus Aid, Relief, and Economic Security (CARES) Act; The Heroes Act (H.R. 6800); HEALS Act (S. 1624); SEPs; Risk Mitigation and Excess Loss; COBRA; Testing and Coverage Mandates Federal Medical Assistance Percentages (FMAP) increase
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (reconciliation, individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) Individual market and exchange stabilization Prior authorization and Utilization Management, (H.R. 3107); Uterine Fibroids Coverage Hospital Consolidation Privacy and Healthcare Cybersecurity Digital, AI, and Blockchain Social Determinants of Health (SDOH) Mental health and substance use,42 CFR Part 2, Parity and compliance issues Surprise medical billing; Lower Health Care Cost Act of 2019 (S. 1895), and No Surprises Act (H.R. 3630) Price of prescription drugs Commercial Risk adjustment data validation (RADV) Senate HELP Committee Lower Health Care Costs Act Senate Finance Committee Prescription Drug Pricing Reduction Act; (H.R. 3) Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Lower Health Care Cost Act of 2019 (S. 1895) COVID-19 legislation (Phase I, II, III and other); Families First Coronavirus Response Act (H.R. 6201); Coronavirus Aid, Relief, and Economic Security (CARES) Act; The Heroes Act (H.R. 6800); HEALS Act (S. 1624); SEPs; Risk Mitigation and Excess Loss; COBRA; Testing and Coverage Mandates Federal Medical Assistance Percentages (FMAP) increase
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, reauthorization of special need plans, star ratings, extreme and uncontrollable circumstances policy, normalization factors, stars contract consolidation, ESRD, audio-only telehealth) Medicare RAD-V Mental health and substance use (42 CFR Part 2) Medicaid managed care (MIND Act) (H.R. 6926) (IMD Exclusion) Medicaid expansion Medicaid reform (block grants, per capita caps) Medicaid and CHIP reauthorization Medicaid actuarial soundness Long-term services and supports Social Determents of Health (SDOH) Medicare Part D prescription drug program and Medicare Part D coverage gap (donut hole) Opioid addiction issues and response (prescription drug monitoring programs) Medicaid medical loss ratio remittance Medicare Advantage Pilot Program in TRICARE Maternal Health Quality Improvement Act (H.R. 4995) Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing Non Emergency Medical Transportation (The Protecting Patients Transportation to Care Act)(S.2846) Medicaid maternal health coverage expansion (H.R.6800)
Filing targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (reconciliation, individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) Individual market and exchange stabilization Prior authorization, (H.R. 3107) Hospital Consolidation Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Mental health and substance use,42 CFR Part 2, Parity and compliance issues Surprise medical billing; Lower Health Care Cost Act of 2019 (S. 1895), and No Surprises Act (H.R. 3630) Price of prescription drugs Commercial Risk adjustment data validation (RADV) Senate HELP Committee Lower Health Care Costs Act Senate Finance Committee Prescription Drug Pricing Reduction Act; (H.R. 3) Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Lower Health Care Cost Act of 2019 (S. 1895) COVID-19 legislation (Phase I, II, III and other); Commercial paper market stability; Families First Coronavirus Response Act (H.R. 6201); Coronavirus Aid, Relief, and Economic Security (CARES) Act; SEPs; Risk Mitigation and Excess Loss; COBRA; Coverage Mandates Federal Medical Assistance Percentages (FMAP) increase
Coronavirus Aid, Relief, and Economic Security (CARES) Act COVID-19 Legislation (Phase I, II, III and other) Commercial paper market stability COBRA Subsidies Federal Medical Assistance Percentages (FMAP) increase Special enrollment period State and local funding support COVID-19 testing, vaccinations, cost sharing for COVID-19 testing
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, reauthorization of special need plans, star ratings, normalization factors, stars contract consolidation, ESRD, audio-only telehealth) Medicare RAD-V Mental health and substance use (42 CFR Part 2) Medicaid managed care (MIND Act) (H.R. 6926) (IMD Exclusion) Medicaid expansion Medicaid reform (block grants, per capita caps) Medicaid and CHIP reauthorization Medicaid actuarial soundness Long-term services and supports Social Determents of Health (SDOH) Medicare Part D prescription drug program and Medicare Part D coverage gap (donut hole) Medicare Part D crosswalk policy Opioid addiction issues and response (prescription drug monitoring programs) Medicaid medical loss ratio remittance Medicaid non-emergency medical transportation Medicare Advantage Pilot Program in TRICARE Maternal Health Quality Improvement Act (H.R. 4995) Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Drug Price Transparency in Medicaid Act of 2019 (H.R. 5281) Non Emergency Medical Transportation (The Protecting Patients Transportation to Care Act)(S.2846) Medicaid maternal health coverage expansion (H.R.6800)
Filing targets: Centers For Medicare and Medicaid Services (CMS), Federal Reserve System, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Economic Council (NEC), SENATE, Treasury, Dept of, White House Office
Coronavirus Aid, Relief, and Economic Security (CARES) Act COVID-19 Legislation (Phase I, II, III and other) Commercial paper market stability
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, reauthorization of special need plans, star ratings, normalization factors, stars contract consolidation) Medicare RAD-V Mental health and substance use (42 CFR Part 2) Medicaid managed care Medicaid expansion Medicaid reform (block grants, per capita caps) Medicaid and CHIP reauthorization Medicaid actuarial soundness Long-term services and supports Social Determents of Health (SDOH) Medicare Part D prescription drug program and Medicare Part D coverage gap (donut hole) Medicare Part D crosswalk policy Opioid addiction issues and response (prescription drug monitoring programs) Medicaid medical loss ratio remittance Medicaid non-emergency medical transportation Medicare Advantage Pilot Program in TRICARE Maternal Health Quality Improvement Act (H.R. 4995) Medicaid Maternal Health Outcomes and Coverage; Helping Medicaid Offer Maternity Services (MOMS) Act of 2019 (H.R. 4996) Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Drug Price Transparency in Medicaid Act of 2019 (H.R. 5281) Telehealth
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (reconciliation, individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) Individual market and exchange stabilization Prior authorization, (H.R. 3107) Hospital Consolidation Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Association health plans Mental health and substance use,42 CFR Part 2, Parity and compliance issues Surprise medical billing; Lower Health Care Cost Act of 2019 (S. 1895), and No Surprises Act (H.R. 3630) Price of prescription drugs Commercial Risk adjustment data validation (RADV) Senate HELP Committee Lower Health Care Costs Act Senate Finance Committee Prescription Drug Pricing Reduction Act; HR 3 Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Lower Health Care Cost Act of 2019 (S. 1895) COVID-19 legislation (Phase I, II, III and other); Commercial paper market stability; Families First Coronavirus Response Act (HR 6201); Coronavirus Aid, Relief, and Economic Security (CARES) Act; SEPs; Risk Mitigation and Excess Loss; COBRA; Coverage Mandates
Senate HELP Committee Lower Health Care Costs Act Senate Finance Committee Prescription Drug Pricing Reduction Act; HR 3 Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Drug Price Transparency in Medicaid Act of 2019 (H.R. 5281) S.3031, Toomey Crapo prescription drug alternative proposal to Grassley/Wyden
Filing targets: Centers For Medicare and Medicaid Services (CMS), Federal Reserve System, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Natl Economic Council (NEC), SENATE, White House Office
Senate HELP Committee Lower Health Care Costs Act Senate Finance Committee Prescription Drug Pricing Reduction Act; HR 3 Price of prescription drugs Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Drug Price Transparency in Medicaid Act of 2019 (H.R. 5281)
To extend the moratorium and/or repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act Health Insurance Tax Relief Act of 2019 (H.R. 1398) Jobs and Premium Protection Act (H.R. 2447) Jobs and Premium Protection Act (S. 80) Health Insurance Tax Relief Act of 2019 (S.172) Tax exclusion for employer-sponsored health insurance Spending Agreement to fund Federal Government for 2020 fiscal year; National Security minibus (H.R. 1158) and the Domestic Priorities and International Assistance minibus of appropriations bills (H.R.1865)
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (reconciliation, individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) Individual market and exchange stabilization Prior authorization Hospital Consolidation Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Association health plans Mental health and substance use,42 CFR Part 2, Parity and compliance issues Surprise medical billing; Lower Health Care Cost Act of 2019 (S. 1895), and No Surprises Act (H.R. 3630) Price of prescription drugs Medical Loss Ratios Commercial Risk adjustment data validation (RADV) Senate HELP Committee Lower Health Care Costs Act Senate Finance Committee Prescription Drug Pricing Reduction Act; HR 3 Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Lower Health Care Cost Act of 2019 (S. 1895) Spending Agreement to fund Federal Government for 2020 fiscal year; National Security minibus (H.R. 1158) and the Domestic Priorities and International Assistance minibus of appropriations bills (H.R.1865)
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (reconciliation, individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) Individual market and exchange stabilization Prior authorization Hospital Consolidation Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Association health plans Mental health and substance use,42 CFR Part 2, Parity and compliance issues Surprise medical billing; Lower Health Care Cost Act of 2019 (S. 1895), and No Surprises Act (H.R. 3630) Price of prescription drugs Medical Loss Ratios Commercial Risk adjustment data validation (RADV) Senate HELP Committee Lower Health Care Costs Act Senate Finance Committee Prescription Drug Pricing Reduction Act; HR 3 Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Lower Health Care Cost Act of 2019 (S. 1895) Spending Agreement to fund Federal Government for 2020 fiscal year; National Security minibus (H.R. 1158) and the Domestic Priorities and International Assistance minibus of appropriations bills (H.R.1865)
Filing targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), SENATE
To extend the moratorium and/or repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act Health Insurance Tax Relief Act of 2019 (H.R. 1398) Jobs and Premium Protection Act (H.R. 2447) Jobs and Premium Protection Act (S. 80) Health Insurance Tax Relief Act of 2019 (S.172) Tax exclusion for employer-sponsored health insurance
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (reconciliation, individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) Individual market and exchange stabilization Prior authorization Hospital Consolidation Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Association health plans Mental health and substance use,42 CFR Part 2, Parity and compliance issues Surprise medical billing; Lower Health Care Cost Act of 2019 (S. 1895), and No Surprises Act (H.R. 3630) Price of prescription drugs Medical Loss Ratios Commercial Risk adjustment data validation (RADV) Senate HELP Committee Lower Health Care Costs Act Senate Finance Committee Prescription Drug Pricing Reduction Act; HR 3 Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Lower Health Care Cost Act of 2019 (S. 1895)
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (reconciliation, individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) Individual market and exchange stabilization Prior authorization Hospital Consolidation Privacy and Healthcare Cybersecurity Social Determinants of Health (SDOH) Association health plans Mental health and substance use,42 CFR Part 2, Parity and compliance issues Surprise medical billing; Lower Health Care Cost Act of 2019 (S. 1895), and No Surprises Act (H.R. 3630) Price of prescription drugs Medical Loss Ratios Commercial Risk adjustment data validation (RADV) Senate HELP Committee Lower Health Care Costs Act Senate Finance Committee Prescription Drug Pricing Reduction Act; HR 3 Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Lower Health Care Cost Act of 2019 (S. 1895)
Filing targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, White House Office
Telephone Consumer Protection Act
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, reauthorization of special need plans, star ratings, normalization factors, stars contract consolidation) Medicare expansion Mental health and substance use (42 CFR Part 2) Medicaid managed care Medicaid expansion Medicaid reform (block grants, per capita caps) Medicaid and CHIP reauthorization Medicaid actuarial soundness Long-term services and supports Social Determents of Health (SDOH) Medicare Part D prescription drug program and Medicare Part D coverage gap (donut hole) Removal of safe harbor protections for rebates involving prescription drugs and the creation of new safe harbor protection for certain point-of-sale reductions on price on prescription drugs and certain Pharmacy Benefit Manager (PBM) service fees Medicare Part D crosswalk policy Opioid addiction issues and response (prescription drug monitoring programs) Medicaid medical loss ratio remittance Medicaid non-emergency medical transportation ACE Kids Act of 2019 and the Medicaid Services Investment and Accountability Act of 2019 (S. 317, H.R. 1226, and H.R. 1839) Medicare Advantage Pilot Program in TRICARE
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (reconciliation, individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) Individual market and exchange stabilization Commercial Risk adjustment data validation (RADV) Strengthening Health Care and Lowering Prescription Drug Costs Act (H.R. 987) Patient Affordability Value and Efficiency Act (PAVE Act) Creating and Restoring Equal Access To Equivalent Samples (CREATES) Act of 2019 (S. 340 and H.R. 965) Mental health and substance use,42 CFR Part 2, Parity and compliance issues Surprise medical billing; Lower Health Care Cost Act of 2019 (S. 1895), and No Surprises Act (H.R. 3630) Telehealth Price of prescription drugs Prior authorization Hospital Consolidation (The Hospital Competition Act of 2018, H.R. 7084) Social Determinants of Health (SDOH) Privacy and Healthcare Cybersecurity Health information exchange and interoperability Association health plans ACA third party payments Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing, Lower Health Care Cost Act of 2019 (S. 1895) Readiness for Elders and Americans with Disabilities Inclusion (READI) for Disaster Act (S. 3679
To extend the moratorium and/or repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act Health Insurance Tax Relief Act of 2019 (H.R. 1398) Jobs and Premium Protection Act (H.R. 2447) Jobs and Premium Protection Act (S. 80) Health Insurance Tax Relief Act of 2019 (S.172) Tax exclusion for employer-sponsored health insurance
Filing targets: Centers For Medicare and Medicaid Services (CMS), Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, White House Office
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (reconciliation, individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) Individual market and exchange stabilization State Health Care Premium Reduction Act (H.R. 1425), Expand Navigators Resources for Outreach, Learning, and Longevity (ENROLL) Act (H.R. 1386), and State Allowance for a Variety of Exchanges (SAVE) Act (H.R. 1385) Creating and Restoring Equal Access To Equivalent Samples (CREATES) Act of 2019 (S. 340 and H.R. 965) Mental health and substance use (42 CFR Part 2) Surprise Medical Billing Telehealth Price of prescription drugs Opioid addiction issues Prior authorization Hospital Consolidation (The Hospital Competition Act of 2018, H.R. 7084) Social Determinants of Health (SDOH) Privacy and Healthcare Cybersecurity Health information exchange and interoperability
Telephone Consumer Protection Act
To extend the moratorium and/or repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act Health Insurance Tax Relief Act of 2019 (H.R. 1398) Jobs and Premium Protection Act (S. 80) Health Insurance Tax Relief Act of 2019 (S.172) The Bipartisan Budget Act of 2018 (H.R. 1892) Tax exclusion for employer-sponsored health insurance
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (reconciliation, individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) Individual market and exchange stabilization State Health Care Premium Reduction Act (H.R. 1425), Expand Navigators Resources for Outreach, Learning, and Longevity (ENROLL) Act (H.R. 1386), and State Allowance for a Variety of Exchanges (SAVE) Act (H.R. 1385) Creating and Restoring Equal Access To Equivalent Samples (CREATES) Act of 2019 (S. 340 and H.R. 965) Mental health and substance use (42 CFR Part 2) Surprise Medical Billing Telehealth Price of prescription drugs Opioid addiction issues Prior authorization Hospital Consolidation (The Hospital Competition Act of 2018, H.R. 7084) Social Determinants of Health (SDOH) Privacy and Healthcare Cybersecurity Health information exchange and interoperability
Filing targets: Centers For Medicare and Medicaid Services (CMS), Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, White House Office
Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, reauthorization of special need plans, star ratings, normalization factors, stars contract consolidation) Mental health and substance use (42 CFR Part 2) The Bipartisan Budget Act of 2018 (H.R. 1892) Medicaid managed care Medicaid expansion Medicaid reform (block grants, per capita caps) Medicaid and CHIP reauthorization Long-term services and supports Medicare Part D prescription drug program and Medicare Part D coverage gap (donut hole) Clinical decision support Opioid addiction issues and response (prescription drug monitoring programs) Medicaid medical loss ratio remittance and IMD exclusion for inpatient Medicaid payments Medicaid non-emergency medical transportation ACE Kids Act (H.R. 3325) Dialysis Patient Access to Integrated-care, Empowerment, Nephrologists, Treatment, and Services (PATIENTS) Demonstration Act of 2017 (H.R. 4143) Improving Medicaid Programs and Opportunities for Eligible Beneficiaries (IMPROVE) Act (H.R. 7217)
ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (reconciliation, individual mandate, cost sharing reduction subsidies, reinsurance transitional policies) The Bipartisan Budget Act of 2018 (H.R. 1892) Creating and Restoring Equal Access To Equivalent Samples (CREATES) Act of 2017 (S. 974 and H.R. 2212) Overdose Prevention and Patient Safety Act (H.R. 3545 and H.R. 6082) Jessies Law (H.R. 5009) Mental health and substance use (42 CFR Part 2) Individual market and exchange stabilization Association health plans Short Term Limited Duration Plans Out of network billing (FAA Reauthorization Act of 2018, H.R. 302) ACA third party payments Telehealth Price of prescription drugs Opioid addiction issues and response (prescription drug monitoring programs) Prior authorization SUPPORT for Patients and Communities Act (H.R. 6) Veterans health care Task Force on the Impact of Affordable Housing Crisis Act of 2018 (S. 3231) Readiness for Elders and Americans with Disabilities Inclusion (READI) for Disaster Act (S. 3679)
Filing targets: Centers For Medicare and Medicaid Services (CMS), Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, White House Office