DENISE HENRY MORRISEY

Adequacy of Medicare physician payments for physicians and implementation of the Medicare Access and CHIP Reauthorization Act, including related provisions in H.R. 879 Medicare Patient and Practice Stabilization Act of 2025 and S. 891 the Bipartisan Health Care Act of 2025 and related to physician payment adjustment of 2.5%. Issues related to adequate network coverage for ophthalmology care within Medicare Advantage plans and advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans, Medicare reimbursement for telemedicine, and extending Medicare Telehealth Flexibilities. Use of step therapy in Medicare and health insurance coverage. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor CMMI Medicare Part B drug-related demonstrations.

Update and reforms to Medicare payments for physicians and implementation of related provisions of the Medicare Access and CHIP Reauthorization Act (MACRA), including regulatory relief for physicians in the MACRA Quality Payment Program, evaluation and management (E/M) codes and related legislative issues related to payment for E/M codes, and qualified clinical data registries, including related provisions in H.R. 6545, the Physician Fee Schedule Update and Improvements Act; H.R. 2474, the Strengthening Medicare for Patients and Providers Act; and H.R. 6683, the Preserving Seniors' Access to Physicians Act of 2023. Issues related to adequate network coverage for dermatologic care within Medicare Advantage plans and advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans, including related provisions in S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans.

Adequacy of Medicare physician payments for physicians and implementation of the Medicare Access and CHIP Reauthorization Act, including related provisions in: (1) S. 4935 Physician Fee Stabilization Act and H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; (2) H.R. 6683, the Preserving Seniors Access to Physicians Act; (3) H.R. 2474, the Strengthening Medicare for Patients and Providers Act; and (4) HR ____ Further Continuing Appropriations and Disaster Relief Supplemental Appropriations Act, 2025-related to physician payment adjustment of 2.5%. Issues related to adequate network coverage for ophthalmology care within Medicare Advantage plans and advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans, including related provisions in: H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Medicare reimbursement for telemedicine, including related provisions in S. 3430, the Better Mental Health Care, Lower Costs Drugs, and Extenders Act, including Sec. 105 regarding Medicare payment for mental health services furnished through telehealth, and Sec. 107 regarding communications regarding telehealth and interstate licensure requirements; H.R. 7623, The Telehealth Modernization Act of 2024; SEC. 101. Extension of Certain Telehealth Flexibilities; H.R. 8261, the Preserving Telehealth, Hospital, and Ambulance Access Act; Section 2, extending Medicare Telehealth Flexibilities. Use of step therapy in Medicare and health insurance coverage, including related provisions in H.R. 2630/S. 652, the Safe Step Act. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor CMMI Medicare Part B drug-related demonstrations.

Adequacy of Medicare physician payments for physicians and implementation of the Medicare Access and CHIP Reauthorization Act, including related provisions in: (1) S. 4935 Physician Fee Stabilization Act and H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; (2) H.R. 6683, the Preserving Seniors Access to Physicians Act; and (3) H.R. 2474, the Strengthening Medicare for Patients and Providers Act. Issues related to adequate network coverage for ophthalmology care within Medicare Advantage plans and advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans, including related provisions in: H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Medicare reimbursement for telemedicine, including related provisions in S. 3430, the Better Mental Health Care, Lower Costs Drugs, and Extenders Act, including Sec. 105 regarding Medicare payment for mental health services furnished through telehealth, and Sec. 107 regarding communications regarding telehealth and interstate licensure requirements; H.R. 7623, The Telehealth Modernization Act of 2024; SEC. 101. Extension of Certain Telehealth Flexibilities; H.R. 8261, the Preserving Telehealth, Hospital, and Ambulance Access Act; Section 2, extending Medicare Telehealth Flexibilities. Use of step therapy in Medicare and health insurance coverage, including related provisions in H.R. 2630/S. 652, the Safe Step Act. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor CMMI Medicare Part B drug-related demonstrations.

340B Program issues and patient access to pharmaceuticals, including related provisions in H.R. 3290, to amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program." Legislative issues associated with patient access to treatment, including: the CMMI Most Favored Nation and related demonstration initiatives; and step therapy, including related provisions in H.R. 2630/S. 652, the Safe Step Act. Medical Supply Chain, including issues related to a new rating system; targeted action to support the diversification of certain supplies; additional funding to the Strategic National Stockpile (SNS) and more diverse stockpile; increasing flexibility for supply chains. Enhanced FDA reporting and risk mitigation plans for certain medicines. Incentives for antimicrobial and antiviral research and novel product development.

340B Program issues and patient access to pharmaceuticals, including related provisions in H.R. 3290, to amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program." Legislative issues associated with patient access to treatment, including: the CMMI Most Favored Nation and related demonstration initiatives; and step therapy, including related provisions in H.R. 2630/S. 652, the Safe Step Act. Medical Supply Chain, including issues related to a new rating system; targeted action to support the diversification of certain supplies; additional funding to the Strategic National Stockpile (SNS) and more diverse stockpile; increasing flexibility for supply chains. Enhanced FDA reporting and risk mitigation plans for certain medicines. Incentives for antimicrobial and antiviral research, medical countermeasures, and novel product development.

Adequacy of Medicare physician payments for physicians and implementation of the Medicare Access and CHIP Reauthorization Act, including related provisions in: (1) S. 4935 Physician Fee Stabilization Act and H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; (2) H.R. 6683, the Preserving Seniors Access to Physicians Act; (3) H.R. 2474, the Strengthening Medicare for Patients and Providers Act; and (4) HR ____ Further Continuing Appropriations and Disaster Relief Supplemental Appropriations Act, 2025-related to physician payment adjustment of 2.5%. Issues related to adequate network coverage for ophthalmology care within Medicare Advantage plans and advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans, including related provisions in: H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Medicare reimbursement for telemedicine, including related provisions in S. 3430, the Better Mental Health Care, Lower Costs Drugs, and Extenders Act, including Sec. 105 regarding Medicare payment for mental health services furnished through telehealth, and Sec. 107 regarding communications regarding telehealth and interstate licensure requirements; H.R. 7623, The Telehealth Modernization Act of 2024; SEC. 101. Extension of Certain Telehealth Flexibilities; H.R. 8261, the Preserving Telehealth, Hospital, and Ambulance Access Act; Section 2, extending Medicare Telehealth Flexibilities. Use of step therapy in Medicare and health insurance coverage, including related provisions in H.R. 2630/S. 652, the Safe Step Act. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor CMMI Medicare Part B drug-related demonstrations.

Adequacy of Medicare physician payments for physicians and implementation of the Medicare Access and CHIP Reauthorization Act, including related provisions in: (1) S. 4935 Physician Fee Stabilization Act and H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; (2) H.R. 6683, the Preserving Seniors Access to Physicians Act; and (3) H.R. 2474, the Strengthening Medicare for Patients and Providers Act. Issues related to adequate network coverage for ophthalmology care within Medicare Advantage plans and advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans, including related provisions in: H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Medicare reimbursement for telemedicine, including related provisions in S. 3430, the Better Mental Health Care, Lower Costs Drugs, and Extenders Act, including Sec. 105 regarding Medicare payment for mental health services furnished through telehealth, and Sec. 107 regarding communications regarding telehealth and interstate licensure requirements; H.R. 7623, The Telehealth Modernization Act of 2024; SEC. 101. Extension of Certain Telehealth Flexibilities; H.R. 8261, the Preserving Telehealth, Hospital, and Ambulance Access Act; Section 2, extending Medicare Telehealth Flexibilities. Use of step therapy in Medicare and health insurance coverage, including related provisions in H.R. 2630/S. 652, the Safe Step Act. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor CMMI Medicare Part B drug-related demonstrations.

Update and reforms to Medicare payments for physicians and implementation of related provisions of the Medicare Access and CHIP ReauthorizationAct (MACRA), including regulatory relief for physicians in the MACRA Quality Payment Program, evaluation and management (E/M) codes andrelated legislative issues related to payment for E/M codes, and qualified clinical data registries, including Medicare physician payment provisions in:(1) S. 3430, the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act, Sec. 403 to extend work geographic index floor under Medicare; Sec. 404 to extend incentive payments for participation in eligible alternative payment models; and Sec. 407 to increase support for physicians and other professionals in adjusting to Medicare payment changes; (2) H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; and (3) H.R. 4366, the Consolidated Appropriations Act, 2024, P.L. 118-42: Sec.304, Extending Incentive Payments for Participation in Eligible Alternative Payment Models; and Sec. 305, Temporary Payment Increase under the Medicare Physician Fee Schedule to Account for Exceptional Circumstances and Atypical Timing of Enactment. Maintain patient access to In-Office Ancillary Services. Issues related to adequate network coverage for ophthalmology care within Medicare Advantage plans and advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans, including related provisions in: H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. MA plan provider directory accuracy issues, including related provisions in S. 3430, the Better Mental Health Care, Lower Cost Drugs, and Extenders Act of 2023, in Sec. 109, to require MA plans to maintain accurate provider directories on a public website. Legislative issues regarding implementation of Meaningful Use of Electronic Health Records. Medicare reimbursement for telemedicine, including related provisions in S. 3430, the Better Mental Health Care, Lower Costs Drugs, and Extenders Act, including Sec. 105 regarding Medicare payment for mental health services furnished through telehealth, and Sec. 107 regarding communications regarding telehealth and interstate licensure requirements; H.R. 7623, The Telehealth Modernization Act of 2024; SEC. 101. Extension of Certain Telehealth Flexibilities; H.R. 8261, the Preserving Telehealth, Hospital, and Ambulance Access Act; Section 2, extending Medicare Telehealth Flexibilities. Medicare RAC reform and use of step therapy in Medicare and health insurance coverage including related provisions in H.R. 2630/S. 652, the SafeStep Act. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor CMMI Medicare Part B drug-related demonstrations.

Update and reforms to Medicare payments for physicians and implementation of related provisions of the Medicare Access and CHIP Reauthorization Act (MACRA), including regulatory relief for physicians in the MACRA Quality Payment Program, evaluation and management (E/M) codes and related legislative issues related to payment for E/M codes, and qualified clinical data registries. Maintain patient access to In-Office Ancillary Services. Issues related to adequate network coverage for dermatologic care within Medicare Advantage plans and advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans. Legislative issues regarding implementation of Meaningful Use of Electronic Health Records. Medicare reimbursement for telemedicine. Medicare RAC reform and use of step therapy in Medicare and health insurance coverage including related provisions in H.R. 2630/S. 652, the Safe Step Act. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor CMMI Medicare Part B drug-related demonstrations.

340B Program issues and patient access to pharmaceuticals, including related provisions in H.R. 3290, to amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program." Legislative issues associated with patient access to treatment, including: the CMMI Most Favored Nation and related demonstration initiatives; and step therapy, including related provisions in H.R. 2630/S. 652, the Safe Step Act. Medical Supply Chain, including issues related to a new rating system; targeted action to support the diversification of certain supplies; additional funding to the Strategic National Stockpile (SNS) and more diverse stockpile; increasing flexibility for supply chains. Enhanced FDA reporting and risk mitigation plans for certain medicines. Incentives for antimicrobial and antiviral research and novel product development.

340B Program issues and patient access to pharmaceuticals, including related provisions in H.R. 3290, to amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program." Legislative issues associated with patient access to treatment, including: the CMMI Most Favored Nation and related demonstration initiatives; and step therapy, including related provisions in H.R. 2630/S. 652, the Safe Step Act. Medical Supply Chain, including issues related to a new rating system; targeted action to support the diversification of certain supplies; additional funding to the Strategic National Stockpile (SNS) and more diverse stockpile; increasing flexibility for supply chains. Enhanced FDA reporting and risk mitigation plans for certain medicines. Incentives for antimicrobial and antiviral research, medical countermeasures, and novel product development.

Update and reforms to Medicare payments for physicians and implementation of related provisions of the Medicare Access and CHIP Reauthorization Act (MACRA), including regulatory relief for physicians in the MACRA Quality Payment Program, evaluation and management (E/M) codes and related legislative issues related to payment for E/M codes, and qualified clinical data registries, including Medicare physician payment provisions in: (1) S. 3430, the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act, Sec. 403 to extend work geographic index floor under Medicare; Sec. 404 to extend incentive payments for participation in eligible alternative payment models; and Sec. 407 to increase support for physicians and other professionals in adjusting to Medicare payment changes; (2) H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; and (3) H.R. 4366, the Consolidated Appropriations Act, 2024, P.L. 118-42: Sec. 304, Extending Incentive Payments for Participation in Eligible Alternative Payment Models; and Sec. 305, Temporary Payment Increase under the Medicare Physician Fee Schedule to Account for Exceptional Circumstances and Atypical Timing of Enactment. Maintain patient access to In-Office Ancillary Services. Issues related to adequate network coverage for ophthalmology care within Medicare Advantage plans and advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans, including related provisions in: (1) H.R. 4822, the Health Care Price Transparency Act, to require Medicare Advantage plans to institute electronic prior authorization and establish requirements related to real time decisions; and (2) prior authorization transparency requirements included in H.R. 5378, the Lower Costs, More Transparency Act, and H.R. 4822, the Health Care Price Transparency Act; and MA plan provider directory accuracy issues, including provisions in S. 3430, the Better Mental Health Care, Lower Cost Drugs, and Extenders Act of 2023, in Sec. 109, to require MA plans to maintain accurate provider directories on a public website. Legislative issues regarding implementation of Meaningful Use of Electronic Health Records. Medicare reimbursement for telemedicine, including related provisions in S. 3430, the Better Mental Health Care, Lower Costs Drugs, and Extenders Act, including Sec. 105 regarding Medicare payment for mental health services furnished through telehealth, and Sec. 107 regarding communications regarding telehealth and interstate licensure requirements. Medicare RAC reform and use of step therapy in Medicare and health insurance coverage including related provisions in H.R. 2630/S. 652, the Safe Step Act. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor CMMI Medicare Part B drug-related demonstrations.

340B Program issues and patient access to pharmaceuticals, including related provisions in H.R. 3290, to amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program." Legislative issues associated with patient access to treatment, including: the CMMI Most Favored Nation and related demonstration initiatives; and step therapy, including related provisions in H.R. 2630/S. 652, the Safe Step Act. Medical Supply Chain, including issues related to a new rating system; targeted action to support the diversification of certain supplies; additional funding to the Strategic National Stockpile (SNS) and more diverse stockpile; increasing flexibility for supply chains. Enhanced FDA reporting and risk mitigation plans for certain medicines. Incentives for antimicrobial and antiviral research and novel product development.

340B Program issues and patient access to pharmaceuticals, including related provisions in H.R. 3290, to amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program." Legislative issues associated with patient access to treatment, including: the CMMI Most Favored Nation and related demonstration initiatives; and step therapy, including related provisions in H.R. 2630/S. 652, the Safe Step Act. Medical Supply Chain, including issues related to a new rating system; targeted action to support the diversification of certain supplies; additional funding to the Strategic National Stockpile (SNS) and more diverse stockpile; increasing flexibility for supply chains. Enhanced FDA reporting and risk mitigation plans for certain medicines. Incentives for antimicrobial and antiviral research, medical countermeasures, and novel product development.

340B Program issues and patient access to pharmaceuticals, including related provisions in H.R. 3290, to amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program." Legislative issues associated with patient access to treatment, including: the CMMI Most Favored Nation and related demonstration initiatives; and step therapy, including related provisions in H.R. 2630/S. 652, the Safe Step Act. Medical Supply Chain, including issues related to a new rating system; targeted action to support the diversification of certain supplies; additional funding to the Strategic National Stockpile (SNS) and more diverse stockpile; increasing flexibility for supply chains. Enhanced FDA reporting and risk mitigation plans for certain medicines. Incentives for antimicrobial and antiviral research and novel product development.

340B Program issues and patient access to pharmaceuticals, including related provisions in H.R. 3290, to amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program." Legislative issues associated with patient access to treatment, including: the CMMI Most Favored Nation and related demonstration initiatives; and step therapy, including related provisions in H.R. 2630/S. 652, the Safe Step Act. Medical Supply Chain, including issues related to a new rating system; targeted action to support the diversification of certain supplies; additional funding to the Strategic National Stockpile (SNS) and more diverse stockpile; increasing flexibility for supply chains. Enhanced FDA reporting and risk mitigation plans for certain medicines. Incentives for antimicrobial and antiviral research, medical countermeasures, and novel product development.

Enhance Medicare beneficiary access to genetic counseling services and advocacy on coverage of services furnished by genetic counselors under Medicare Part B. Advocate for H.R. 3876, and S. 2323, the Access to Genetic Counselor Services Act.

Enhance Medicare beneficiary access to genetic counseling services and advocacy on coverage of services furnished by genetic counselors under Medicare Part B. Advocate for H.R. 3876, and S. 2323, the Access to Genetic Counselor Services Act.

Enhance Medicare beneficiary access to genetic counseling services and advocacy on coverage of services furnished by genetic counselors under Medicare Part B. Advocate for H.R. 3876, and S. 2323, the Access to Genetic Counselor Services Act.

Update and reforms to Medicare payments for physicians and implementation of related provisions of the Medicare Access and CHIP Reauthorization Act (MACRA), including regulatory relief for physicians in the MACRA Quality Payment Program, evaluation and management (E/M) codes and related legislative issues related to payment for E/M codes, and qualified clinical data registries, including Medicare physician payment provisions in: (1) S. 3430, the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act, Sec. 403 to extend work geographic index floor under Medicare; Sec. 404 to extend incentive payments for participation in eligible alternative payment models; and Sec. 407 to increase support for physicians and other professionals in adjusting to Medicare payment changes; (2) H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; and (3) H.R. 4366, the Consolidated Appropriations Act, 2024, P.L. 118-42: Sec. 304, Extending Incentive Payments for Participation in Eligible Alternative Payment Models; and Sec. 305, Temporary Payment Increase under the Medicare Physician Fee Schedule to Account for Exceptional Circumstances and Atypical Timing of Enactment. Maintain patient access to In-Office Ancillary Services. Issues related to adequate network coverage for ophthalmology care within Medicare Advantage plans and advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans, including related provisions in: (1) H.R. 4822, the Health Care Price Transparency Act, to require Medicare Advantage plans to institute electronic prior authorization and establish requirements related to real time decisions; and (2) prior authorization transparency requirements included in H.R. 5378, the Lower Costs, More Transparency Act, and H.R. 4822, the Health Care Price Transparency Act; and MA plan provider directory accuracy issues, including provisions in S. 3430, the Better Mental Health Care, Lower Cost Drugs, and Extenders Act of 2023, in Sec. 109, to require MA plans to maintain accurate provider directories on a public website. Legislative issues regarding implementation of Meaningful Use of Electronic Health Records. Medicare reimbursement for telemedicine, including related provisions in S. 3430, the Better Mental Health Care, Lower Costs Drugs, and Extenders Act, including Sec. 105 regarding Medicare payment for mental health services furnished through telehealth, and Sec. 107 regarding communications regarding telehealth and interstate licensure requirements. Medicare RAC reform and use of step therapy in Medicare and health insurance coverage including related provisions in H.R. 2630/S. 652, the Safe Step Act. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor CMMI Medicare Part B drug-related demonstrations.

Recovery audit contractor reform. Medicare regulatory reform, including physician payment reforms, including Medicare physician payment provisions in: (1) S. 3430, the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act, Sec. 403 to extend work geographic index floor under Medicare; Sec. 404 to extend incentive payments for participation in eligible alternative payment models; and Sec. 407 to increase support for physicians and other professionals in adjusting to Medicare payment changes; (2) H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; and (3) H.R. 4366, the Consolidated Appropriations Act, 2024, P.L. 118-42: Sec. 304, Extending Incentive Payments for Participation in Eligible Alternative Payment Models; and Sec. 305, Temporary Payment Increase under the Medicare Physician Fee Schedule to Account for Exceptional Circumstances and Atypical Timing of Enactment. Network adequacy oversight, including Medicare Advantage plan provider directory accuracy issues, including provisions in S. 3430, the Better Mental Health Care, Lower Cost Drugs, and Extenders Act of 2023, in Sec. 109, to require MA plans to maintain accurate provider directories on a public website. Medicare accountable care organizations. Electronic health record interoperability and vendor accountability. Medicare Parts C and D prior authorization reforms, including related provisions in: H.R. 4968, the GOLD Card Act; H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Physician-led hospital barriers, including related provisions in H.R. 977/S. 470, the Patient Access to Higher Quality Care Act. Medicare physician fee schedule and sequestration relief, and Draft Legislation by Rep. Burgess to amend title XVIII of the Social Security Act to revise certain physician self-referral exemptions relating to physician-owned hospitals in rural areas. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor: (1) implementation of provisions in the Inflation Reduction Act of 2022 (P.L. 117-169), Subtitle B, Part 1, sec. (b), to modify Medicare Part B reimbursement by application of Maximum Fair Prices and Conforming Amendments, to selected Medicare Part B covered drugs; and (2) CMMI Medicare Part B drug demonstrations, including the Most Favored Nation demonstration.

Recovery audit contractor reform. Medicare regulatory reform, including physician payment reforms, including Medicare physician payment provisions in: (1) S. 3430, the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act, Sec. 403 to extend work geographic index floor under Medicare; Sec. 404 to extend incentive payments for participation in eligible alternative payment models; and Sec. 407 to increase support for physicians and other professionals in adjusting to Medicare payment changes; (2) H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; and (3) H.R. 4366, the Consolidated Appropriations Act, 2024, P.L. 118-42: Sec. 304, Extending Incentive Payments for Participation in Eligible Alternative Payment Models; and Sec. 305, Temporary Payment Increase under the Medicare Physician Fee Schedule to Account for Exceptional Circumstances and Atypical Timing of Enactment. Network adequacy oversight, including Medicare Advantage plan provider directory accuracy issues, including provisions in S. 3430, the Better Mental Health Care, Lower Cost Drugs, and Extenders Act of 2023, in Sec. 109, to require MA plans to maintain accurate provider directories on a public website. Medicare accountable care organizations. Electronic health record interoperability and vendor accountability. Medicare Parts C and D prior authorization reforms, including related provisions in the GOLD Card Act, H.R. 4968; H.R. 4822, the Health Care Price Transparency Act - including requirements for Medicare Advantage electronic prior authorization and real-time decisions; and prior authorization transparency provisions in H.R. 4822, and H.R. 5378, the Lower Costs, More Transparency Act. Physician-led hospital barriers, including related provisions in H.R. 977/S. 470, the Patient Access to Higher Quality Care Act. Medicare physician fee schedule and sequestration relief, and Draft Legislation by Rep. Burgess to amend title XVIII of the Social Security Act to revise certain physician self-referral exemptions relating to physician-owned hospitals in rural areas. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor: (1) implementation of provisions in the Inflation Reduction Act of 2022 (P.L. 117-169), Subtitle B, Part 1, sec. (b), to modify Medicare Part B reimbursement by application of Maximum Fair Prices and Conforming Amendments, to selected Medicare Part B covered drugs; and (2) CMMI Medicare Part B drug demonstrations, including the Most Favored Nation demonstration.

Recovery audit contractor reform. Medicare regulatory reform, including Medicare physician fee schedule and sequestration relief and payment reforms, including Medicare physician payment provisions in: (1) S. 3430, the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act, Sec. 403 to extend work geographic index floor under Medicare; Sec. 404 to extend incentive payments for participation in eligible alternative payment models; and Sec. 407 to increase support for physicians and other professionals in adjusting to Medicare payment changes; (2) H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; (3) H.R. 4366, the Consolidated Appropriations Act, 2024, P.L. 118-42: Sec. 304, Extending Incentive Payments for Participation in Eligible Alternative Payment Models; and Sec. 305, Temporary Payment Increase under the Medicare Physician Fee Schedule to Account for Exceptional Circumstances and Atypical Timing of Enactment; and (4) HR ____ Further Continuing Appropriations and Disaster Relief Supplemental Appropriations Act, 2025-related to physician payment adjustment of 2.5%. Network adequacy oversight, including Medicare Advantage plan provider directory accuracy issues, including provisions in S. 3430, the Better Mental Health Care, Lower Cost Drugs, and Extenders Act of 2023, in Sec. 109, to require MA plans to maintain accurate provider directories on a public website. Medicare accountable care organizations. Electronic health record interoperability and vendor accountability. Medicare Parts C and D prior authorization reforms, including related provisions in: H.R. 4968, the GOLD Card Act; H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Physician-led hospital barriers, including related provisions in H.R. 977/S. 470, the Patient Access to Higher Quality Care Act, and H.R. 9001, the Physician Led and Rural Access to Quality Care Act, to revise certain physician self-referral exemptions relating to physician-owned hospitals in rural areas. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor: (1) implementation of provisions in the Inflation Reduction Act of 2022 (P.L. 117-169), Subtitle B, Part 1, sec. (b), to modify Medicare Part B reimbursement by application of Maximum Fair Prices and Conforming Amendments, to selected Medicare Part B covered drugs; and (2) CMMI Medicare Part B drug demonstrations, including the Most Favored Nation demonstration.

Update and reforms to Medicare payments for physicians and implementation of related provisions of the Medicare Access and CHIP ReauthorizationAct (MACRA), including regulatory relief for physicians in the MACRA Quality Payment Program, evaluation and management (E/M) codes andrelated legislative issues related to payment for E/M codes, and qualified clinical data registries, including Medicare physician payment provisions in:(1) S. 3430, the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act, Sec. 403 to extend work geographic index floor under Medicare; Sec. 404 to extend incentive payments for participation in eligible alternative payment models; and Sec. 407 to increase support for physicians and other professionals in adjusting to Medicare payment changes; (2) H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; and (3) H.R. 4366, the Consolidated Appropriations Act, 2024, P.L. 118-42: Sec.304, Extending Incentive Payments for Participation in Eligible Alternative Payment Models; and Sec. 305, Temporary Payment Increase under the Medicare Physician Fee Schedule to Account for Exceptional Circumstances and Atypical Timing of Enactment. Maintain patient access to In-Office Ancillary Services. Issues related to adequate network coverage for ophthalmology care within Medicare Advantage plans and advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans, including related provisions in: H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. MA plan provider directory accuracy issues, including related provisions in S. 3430, the Better Mental Health Care, Lower Cost Drugs, and Extenders Act of 2023, in Sec. 109, to require MA plans to maintain accurate provider directories on a public website. Legislative issues regarding implementation of Meaningful Use of Electronic Health Records. Medicare reimbursement for telemedicine, including related provisions in S. 3430, the Better Mental Health Care, Lower Costs Drugs, and Extenders Act, including Sec. 105 regarding Medicare payment for mental health services furnished through telehealth, and Sec. 107 regarding communications regarding telehealth and interstate licensure requirements; H.R. 7623, The Telehealth Modernization Act of 2024; SEC. 101. Extension of Certain Telehealth Flexibilities; H.R. 8261, the Preserving Telehealth, Hospital, and Ambulance Access Act; Section 2, extending Medicare Telehealth Flexibilities. Medicare RAC reform and use of step therapy in Medicare and health insurance coverage including related provisions in H.R. 2630/S. 652, the SafeStep Act. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor CMMI Medicare Part B drug-related demonstrations.

Recovery audit contractor reform. Medicare regulatory reform, including Medicare physician fee schedule and sequestration relief and payment reforms, including Medicare physician payment provisions in: (1) S. 3430, the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act, Sec. 403 to extend work geographic index floor under Medicare; Sec. 404 to extend incentive payments for participation in eligible alternative payment models; and Sec. 407 to increase support for physicians and other professionals in adjusting to Medicare payment changes; (2) H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; and (3) H.R. 4366, the Consolidated Appropriations Act, 2024, P.L. 118-42: Sec. 304, Extending Incentive Payments for Participation in Eligible Alternative Payment Models; and Sec. 305, Temporary Payment Increase under the Medicare Physician Fee Schedule to Account for Exceptional Circumstances and Atypical Timing of Enactment. Network adequacy oversight, including Medicare Advantage plan provider directory accuracy issues, including provisions in S. 3430, the Better Mental Health Care, Lower Cost Drugs, and Extenders Act of 2023, in Sec. 109, to require MA plans to maintain accurate provider directories on a public website. Medicare accountable care organizations. Electronic health record interoperability and vendor accountability. Medicare Parts C and D prior authorization reforms, including related provisions in: H.R. 4968, the GOLD Card Act; H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Physician-led hospital barriers, including related provisions in H.R. 977/S. 470, the Patient Access to Higher Quality Care Act, and H.R. 9001, the Physician Led and Rural Access to Quality Care Act, to revise certain physician self-referral exemptions relating to physician-owned hospitals in rural areas. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor: (1) implementation of provisions in the Inflation Reduction Act of 2022 (P.L. 117-169), Subtitle B, Part 1, sec. (b), to modify Medicare Part B reimbursement by application of Maximum Fair Prices and Conforming Amendments, to selected Medicare Part B covered drugs; and (2) CMMI Medicare Part B drug demonstrations, including the Most Favored Nation demonstration.

Repeal Section 6001 of the Affordable Care Act - section 6001 prohibits expansion of physician-led hospitals - including related provisions in H.R. 977/S. 470, the Patient Access to Higher Quality Care Act; and in H.R. 9001, the Physician Led and Rural Access to Quality Care Act, to revise certain physician self-referral exemptions relating to physician-owned hospitals in rural areas; and related issues regarding hospital competition and consolidation. Center for Medicare & Medicaid Innovation demonstration to expand patient access to physician-led hospitals. Reform Medicare Advantage prior authorization, including related provisions in: H.R. 4968, the GOLD Card Act; H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Advocacy related to H.R. 8246, Second Chances for Rural Hospitals Act, and access to physician-led entities.

Recovery audit contractor reform. Medicare regulatory reform, including Medicare physician fee schedule and sequestration relief and payment reforms, including Medicare physician payment provisions in: (1) S. 3430, the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act, Sec. 403 to extend work geographic index floor under Medicare; Sec. 404 to extend incentive payments for participation in eligible alternative payment models; and Sec. 407 to increase support for physicians and other professionals in adjusting to Medicare payment changes; (2) H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; (3) H.R. 4366, the Consolidated Appropriations Act, 2024, P.L. 118-42: Sec. 304, Extending Incentive Payments for Participation in Eligible Alternative Payment Models; and Sec. 305, Temporary Payment Increase under the Medicare Physician Fee Schedule to Account for Exceptional Circumstances and Atypical Timing of Enactment; and (4) HR ____ Further Continuing Appropriations and Disaster Relief Supplemental Appropriations Act, 2025-related to physician payment adjustment of 2.5%. Network adequacy oversight, including Medicare Advantage plan provider directory accuracy issues, including provisions in S. 3430, the Better Mental Health Care, Lower Cost Drugs, and Extenders Act of 2023, in Sec. 109, to require MA plans to maintain accurate provider directories on a public website. Medicare accountable care organizations. Electronic health record interoperability and vendor accountability. Medicare Parts C and D prior authorization reforms, including related provisions in: H.R. 4968, the GOLD Card Act; H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Physician-led hospital barriers, including related provisions in H.R. 977/S. 470, the Patient Access to Higher Quality Care Act, and H.R. 9001, the Physician Led and Rural Access to Quality Care Act, to revise certain physician self-referral exemptions relating to physician-owned hospitals in rural areas. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor: (1) implementation of provisions in the Inflation Reduction Act of 2022 (P.L. 117-169), Subtitle B, Part 1, sec. (b), to modify Medicare Part B reimbursement by application of Maximum Fair Prices and Conforming Amendments, to selected Medicare Part B covered drugs; and (2) CMMI Medicare Part B drug demonstrations, including the Most Favored Nation demonstration.

Recovery audit contractor reform. Medicare regulatory reform, including physician payment reforms, including Medicare physician payment provisions in: (1) S. 3430, the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act, Sec. 403 to extend work geographic index floor under Medicare; Sec. 404 to extend incentive payments for participation in eligible alternative payment models; and Sec. 407 to increase support for physicians and other professionals in adjusting to Medicare payment changes; (2) H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; and (3) H.R. 4366, the Consolidated Appropriations Act, 2024, P.L. 118-42: Sec. 304, Extending Incentive Payments for Participation in Eligible Alternative Payment Models; and Sec. 305, Temporary Payment Increase under the Medicare Physician Fee Schedule to Account for Exceptional Circumstances and Atypical Timing of Enactment. Network adequacy oversight, including Medicare Advantage plan provider directory accuracy issues, including provisions in S. 3430, the Better Mental Health Care, Lower Cost Drugs, and Extenders Act of 2023, in Sec. 109, to require MA plans to maintain accurate provider directories on a public website. Medicare accountable care organizations. Electronic health record interoperability and vendor accountability. Medicare Parts C and D prior authorization reforms, including related provisions in the GOLD Card Act, H.R. 4968; H.R. 4822, the Health Care Price Transparency Act - including requirements for Medicare Advantage electronic prior authorization and real-time decisions; and prior authorization transparency provisions in H.R. 4822, and H.R. 5378, the Lower Costs, More Transparency Act. Physician-led hospital barriers, including related provisions in H.R. 977/S. 470, the Patient Access to Higher Quality Care Act. Medicare physician fee schedule and sequestration relief, and Draft Legislation by Rep. Burgess to amend title XVIII of the Social Security Act to revise certain physician self-referral exemptions relating to physician-owned hospitals in rural areas. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor: (1) implementation of provisions in the Inflation Reduction Act of 2022 (P.L. 117-169), Subtitle B, Part 1, sec. (b), to modify Medicare Part B reimbursement by application of Maximum Fair Prices and Conforming Amendments, to selected Medicare Part B covered drugs; and (2) CMMI Medicare Part B drug demonstrations, including the Most Favored Nation demonstration.

Repeal Section 6001 of the Affordable Care Act - section 6001 prohibits expansion of physician-led hospitals - including related provisions in H.R. 977/S. 470, the Patient Access to Higher Quality Care Act; and in Draft Legislation by Rep. Burgess to amend title XVIII of the Social Security Act to revise certain physician self-referral exemptions relating to physician-owned hospitals in rural areas; and related issues regarding hospital competition and consolidation. Center for Medicare & Medicaid Innovation demonstration to expand patient access to physician-led hospitals. Reform Medicare Advantage prior authorization, including related provisions in the GOLD Card Act, H.R. 4968; H.R. 4822, the Health Care Price Transparency Act - including requirements for Medicare Advantage electronic prior authorization and real-time decisions; and prior authorization transparency provisions in H.R. 4822, and H.R. 5378, the Lower Costs, More Transparency Act.

Repeal Section 6001 of the Affordable Care Act - section 6001 prohibits expansion of physician-led hospitals - including related provisions in H.R. 977/S. 470, the Patient Access to Higher Quality Care Act; and in H.R. 9001, the Physician Led and Rural Access to Quality Care Act, to revise certain physician self-referral exemptions relating to physician-owned hospitals in rural areas; and related issues regarding hospital competition and consolidation. Center for Medicare & Medicaid Innovation demonstration to expand patient access to physician-led hospitals. Reform Medicare Advantage prior authorization, including related provisions in: H.R. 4968, the GOLD Card Act; H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Advocacy related to H.R. 8246, Second Chances for Rural Hospitals Act, and access to physician-led entities.

Repeal Section 6001 of the Affordable Care Act - section 6001 prohibits expansion of physician-led hospitals - including related provisions in H.R. 977/S. 470, the Patient Access to Higher Quality Care Act; and in Draft Legislation by Rep. Burgess to amend title XVIII of the Social Security Act to revise certain physician self-referral exemptions relating to physician-owned hospitals in rural areas; and related issues regarding hospital competition and consolidation. Center for Medicare & Medicaid Innovation demonstration to expand patient access to physician-led hospitals. Reform Medicare Advantage prior authorization, including related provisions in: H.R. 4968, the GOLD Card Act; H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans.

Update and reforms to Medicare payments for physicians and implementation of related provisions of the Medicare Access and CHIP ReauthorizationAct (MACRA), including regulatory relief for physicians in the MACRA Quality Payment Program, evaluation and management (E/M) codes andrelated legislative issues related to payment for E/M codes, and qualified clinical data registries, including Medicare physician payment provisions in:(1) S. 3430, the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act, Sec. 403 to extend work geographic index floor under Medicare; Sec. 404 to extend incentive payments for participation in eligible alternative payment models; and Sec. 407 to increase support for physicians and other professionals in adjusting to Medicare payment changes; (2) H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; and (3) H.R. 4366, the Consolidated Appropriations Act, 2024, P.L. 118-42: Sec.304, Extending Incentive Payments for Participation in Eligible Alternative Payment Models; and Sec. 305, Temporary Payment Increase under the Medicare Physician Fee Schedule to Account for Exceptional Circumstances and Atypical Timing of Enactment. Maintain patient access to In-Office Ancillary Services. Issues related to adequate network coverage for ophthalmology care within Medicare Advantage plans and advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans, including related provisions in: H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. MA plan provider directory accuracy issues, including related provisions in S. 3430, the Better Mental Health Care, Lower Cost Drugs, and Extenders Act of 2023, in Sec. 109, to require MA plans to maintain accurate provider directories on a public website. Legislative issues regarding implementation of Meaningful Use of Electronic Health Records. Medicare reimbursement for telemedicine, including related provisions in S. 3430, the Better Mental Health Care, Lower Costs Drugs, and Extenders Act, including Sec. 105 regarding Medicare payment for mental health services furnished through telehealth, and Sec. 107 regarding communications regarding telehealth and interstate licensure requirements; H.R. 7623, The Telehealth Modernization Act of 2024; SEC. 101. Extension of Certain Telehealth Flexibilities; H.R. 8261, the Preserving Telehealth, Hospital, and Ambulance Access Act; Section 2, extending Medicare Telehealth Flexibilities. Medicare RAC reform and use of step therapy in Medicare and health insurance coverage including related provisions in H.R. 2630/S. 652, the SafeStep Act. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor CMMI Medicare Part B drug-related demonstrations.

Adequacy of Medicare physician payments for physicians and implementation of the Medicare Access and CHIP Reauthorization Act, including related provisions in: (1) S. 4935 Physician Fee Stabilization Act and H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; (2) H.R. 6683, the Preserving Seniors Access to Physicians Act; and (3) H.R. 2474, the Strengthening Medicare for Patients and Providers Act. Issues related to adequate network coverage for ophthalmology care within Medicare Advantage plans and advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans, including related provisions in: H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Medicare reimbursement for telemedicine, including related provisions in S. 3430, the Better Mental Health Care, Lower Costs Drugs, and Extenders Act, including Sec. 105 regarding Medicare payment for mental health services furnished through telehealth, and Sec. 107 regarding communications regarding telehealth and interstate licensure requirements; H.R. 7623, The Telehealth Modernization Act of 2024; SEC. 101. Extension of Certain Telehealth Flexibilities; H.R. 8261, the Preserving Telehealth, Hospital, and Ambulance Access Act; Section 2, extending Medicare Telehealth Flexibilities. Use of step therapy in Medicare and health insurance coverage, including related provisions in H.R. 2630/S. 652, the Safe Step Act. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor CMMI Medicare Part B drug-related demonstrations.

Recovery audit contractor reform. Medicare regulatory reform, including physician payment reforms, including Medicare physician payment provisions in: (1) S. 3430, the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act, Sec. 403 to extend work geographic index floor under Medicare; Sec. 404 to extend incentive payments for participation in eligible alternative payment models; and Sec. 407 to increase support for physicians and other professionals in adjusting to Medicare payment changes; (2) H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; and (3) H.R. 4366, the Consolidated Appropriations Act, 2024, P.L. 118-42: Sec. 304, Extending Incentive Payments for Participation in Eligible Alternative Payment Models; and Sec. 305, Temporary Payment Increase under the Medicare Physician Fee Schedule to Account for Exceptional Circumstances and Atypical Timing of Enactment. Network adequacy oversight, including Medicare Advantage plan provider directory accuracy issues, including provisions in S. 3430, the Better Mental Health Care, Lower Cost Drugs, and Extenders Act of 2023, in Sec. 109, to require MA plans to maintain accurate provider directories on a public website. Medicare accountable care organizations. Electronic health record interoperability and vendor accountability. Medicare Parts C and D prior authorization reforms, including related provisions in: H.R. 4968, the GOLD Card Act; H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Physician-led hospital barriers, including related provisions in H.R. 977/S. 470, the Patient Access to Higher Quality Care Act. Medicare physician fee schedule and sequestration relief, and Draft Legislation by Rep. Burgess to amend title XVIII of the Social Security Act to revise certain physician self-referral exemptions relating to physician-owned hospitals in rural areas. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor: (1) implementation of provisions in the Inflation Reduction Act of 2022 (P.L. 117-169), Subtitle B, Part 1, sec. (b), to modify Medicare Part B reimbursement by application of Maximum Fair Prices and Conforming Amendments, to selected Medicare Part B covered drugs; and (2) CMMI Medicare Part B drug demonstrations, including the Most Favored Nation demonstration.

Update and reforms to Medicare payments for physicians and implementation of related provisions of the Medicare Access and CHIP Reauthorization Act (MACRA), including regulatory relief for physicians in the MACRA Quality Payment Program, evaluation and management (E/M) codes and related legislative issues related to payment for E/M codes, and qualified clinical data registries, including Medicare physician payment provisions in: (1) S. 3430, the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act, Sec. 403 to extend work geographic index floor under Medicare; Sec. 404 to extend incentive payments for participation in eligible alternative payment models; and Sec. 407 to increase support for physicians and other professionals in adjusting to Medicare payment changes; (2) H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; and (3) H.R. 4366, the Consolidated Appropriations Act, 2024, P.L. 118-42: Sec. 304, Extending Incentive Payments for Participation in Eligible Alternative Payment Models; and Sec. 305, Temporary Payment Increase under the Medicare Physician Fee Schedule to Account for Exceptional Circumstances and Atypical Timing of Enactment. Maintain patient access to In-Office Ancillary Services. Issues related to adequate network coverage for ophthalmology care within Medicare Advantage plans and advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans, including related provisions in: (1) H.R. 4822, the Health Care Price Transparency Act, to require Medicare Advantage plans to institute electronic prior authorization and establish requirements related to real time decisions; and (2) prior authorization transparency requirements included in H.R. 5378, the Lower Costs, More Transparency Act, and H.R. 4822, the Health Care Price Transparency Act; and MA plan provider directory accuracy issues, including provisions in S. 3430, the Better Mental Health Care, Lower Cost Drugs, and Extenders Act of 2023, in Sec. 109, to require MA plans to maintain accurate provider directories on a public website. Legislative issues regarding implementation of Meaningful Use of Electronic Health Records. Medicare reimbursement for telemedicine, including related provisions in S. 3430, the Better Mental Health Care, Lower Costs Drugs, and Extenders Act, including Sec. 105 regarding Medicare payment for mental health services furnished through telehealth, and Sec. 107 regarding communications regarding telehealth and interstate licensure requirements. Medicare RAC reform and use of step therapy in Medicare and health insurance coverage including related provisions in H.R. 2630/S. 652, the Safe Step Act. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor CMMI Medicare Part B drug-related demonstrations.

Adequacy of Medicare physician payments for physicians and implementation of the Medicare Access and CHIP Reauthorization Act, including related provisions in: (1) S. 4935 Physician Fee Stabilization Act and H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; (2) H.R. 6683, the Preserving Seniors Access to Physicians Act; (3) H.R. 2474, the Strengthening Medicare for Patients and Providers Act; and (4) HR ____ Further Continuing Appropriations and Disaster Relief Supplemental Appropriations Act, 2025-related to physician payment adjustment of 2.5%. Issues related to adequate network coverage for ophthalmology care within Medicare Advantage plans and advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans, including related provisions in: H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Medicare reimbursement for telemedicine, including related provisions in S. 3430, the Better Mental Health Care, Lower Costs Drugs, and Extenders Act, including Sec. 105 regarding Medicare payment for mental health services furnished through telehealth, and Sec. 107 regarding communications regarding telehealth and interstate licensure requirements; H.R. 7623, The Telehealth Modernization Act of 2024; SEC. 101. Extension of Certain Telehealth Flexibilities; H.R. 8261, the Preserving Telehealth, Hospital, and Ambulance Access Act; Section 2, extending Medicare Telehealth Flexibilities. Use of step therapy in Medicare and health insurance coverage, including related provisions in H.R. 2630/S. 652, the Safe Step Act. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor CMMI Medicare Part B drug-related demonstrations.

Recovery audit contractor reform. Medicare regulatory reform, including Medicare physician fee schedule and sequestration relief and payment reforms, including Medicare physician payment provisions in: (1) S. 3430, the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act, Sec. 403 to extend work geographic index floor under Medicare; Sec. 404 to extend incentive payments for participation in eligible alternative payment models; and Sec. 407 to increase support for physicians and other professionals in adjusting to Medicare payment changes; (2) H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; and (3) H.R. 4366, the Consolidated Appropriations Act, 2024, P.L. 118-42: Sec. 304, Extending Incentive Payments for Participation in Eligible Alternative Payment Models; and Sec. 305, Temporary Payment Increase under the Medicare Physician Fee Schedule to Account for Exceptional Circumstances and Atypical Timing of Enactment. Network adequacy oversight, including Medicare Advantage plan provider directory accuracy issues, including provisions in S. 3430, the Better Mental Health Care, Lower Cost Drugs, and Extenders Act of 2023, in Sec. 109, to require MA plans to maintain accurate provider directories on a public website. Medicare accountable care organizations. Electronic health record interoperability and vendor accountability. Medicare Parts C and D prior authorization reforms, including related provisions in: H.R. 4968, the GOLD Card Act; H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Physician-led hospital barriers, including related provisions in H.R. 977/S. 470, the Patient Access to Higher Quality Care Act, and H.R. 9001, the Physician Led and Rural Access to Quality Care Act, to revise certain physician self-referral exemptions relating to physician-owned hospitals in rural areas. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor: (1) implementation of provisions in the Inflation Reduction Act of 2022 (P.L. 117-169), Subtitle B, Part 1, sec. (b), to modify Medicare Part B reimbursement by application of Maximum Fair Prices and Conforming Amendments, to selected Medicare Part B covered drugs; and (2) CMMI Medicare Part B drug demonstrations, including the Most Favored Nation demonstration.

Recovery audit contractor reform. Medicare regulatory reform, including Medicare physician fee schedule and sequestration relief and payment reforms, including Medicare physician payment provisions in: (1) S. 3430, the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act, Sec. 403 to extend work geographic index floor under Medicare; Sec. 404 to extend incentive payments for participation in eligible alternative payment models; and Sec. 407 to increase support for physicians and other professionals in adjusting to Medicare payment changes; (2) H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; and (3) H.R. 4366, the Consolidated Appropriations Act, 2024, P.L. 118-42: Sec. 304, Extending Incentive Payments for Participation in Eligible Alternative Payment Models; and Sec. 305, Temporary Payment Increase under the Medicare Physician Fee Schedule to Account for Exceptional Circumstances and Atypical Timing of Enactment. Network adequacy oversight, including Medicare Advantage plan provider directory accuracy issues, including provisions in S. 3430, the Better Mental Health Care, Lower Cost Drugs, and Extenders Act of 2023, in Sec. 109, to require MA plans to maintain accurate provider directories on a public website. Medicare accountable care organizations. Electronic health record interoperability and vendor accountability. Medicare Parts C and D prior authorization reforms, including related provisions in: H.R. 4968, the GOLD Card Act; H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Physician-led hospital barriers, including related provisions in H.R. 977/S. 470, the Patient Access to Higher Quality Care Act, and H.R. 9001, the Physician Led and Rural Access to Quality Care Act, to revise certain physician self-referral exemptions relating to physician-owned hospitals in rural areas. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor: (1) implementation of provisions in the Inflation Reduction Act of 2022 (P.L. 117-169), Subtitle B, Part 1, sec. (b), to modify Medicare Part B reimbursement by application of Maximum Fair Prices and Conforming Amendments, to selected Medicare Part B covered drugs; and (2) CMMI Medicare Part B drug demonstrations, including the Most Favored Nation demonstration.

Recovery audit contractor reform. Medicare regulatory reform, including physician payment reforms, including Medicare physician payment provisions in: (1) S. 3430, the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act, Sec. 403 to extend work geographic index floor under Medicare; Sec. 404 to extend incentive payments for participation in eligible alternative payment models; and Sec. 407 to increase support for physicians and other professionals in adjusting to Medicare payment changes; (2) H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; and (3) H.R. 4366, the Consolidated Appropriations Act, 2024, P.L. 118-42: Sec. 304, Extending Incentive Payments for Participation in Eligible Alternative Payment Models; and Sec. 305, Temporary Payment Increase under the Medicare Physician Fee Schedule to Account for Exceptional Circumstances and Atypical Timing of Enactment. Network adequacy oversight, including Medicare Advantage plan provider directory accuracy issues, including provisions in S. 3430, the Better Mental Health Care, Lower Cost Drugs, and Extenders Act of 2023, in Sec. 109, to require MA plans to maintain accurate provider directories on a public website. Medicare accountable care organizations. Electronic health record interoperability and vendor accountability. Medicare Parts C and D prior authorization reforms, including related provisions in the GOLD Card Act, H.R. 4968; H.R. 4822, the Health Care Price Transparency Act - including requirements for Medicare Advantage electronic prior authorization and real-time decisions; and prior authorization transparency provisions in H.R. 4822, and H.R. 5378, the Lower Costs, More Transparency Act. Physician-led hospital barriers, including related provisions in H.R. 977/S. 470, the Patient Access to Higher Quality Care Act. Medicare physician fee schedule and sequestration relief, and Draft Legislation by Rep. Burgess to amend title XVIII of the Social Security Act to revise certain physician self-referral exemptions relating to physician-owned hospitals in rural areas. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor: (1) implementation of provisions in the Inflation Reduction Act of 2022 (P.L. 117-169), Subtitle B, Part 1, sec. (b), to modify Medicare Part B reimbursement by application of Maximum Fair Prices and Conforming Amendments, to selected Medicare Part B covered drugs; and (2) CMMI Medicare Part B drug demonstrations, including the Most Favored Nation demonstration.

Repeal Section 6001 of the Affordable Care Act - section 6001 prohibits expansion of physician-led hospitals - including related provisions in H.R. 977/S. 470, the Patient Access to Higher Quality Care Act; and in H.R. 9001, the Physician Led and Rural Access to Quality Care Act, to revise certain physician self-referral exemptions relating to physician-owned hospitals in rural areas; and related issues regarding hospital competition and consolidation. Center for Medicare & Medicaid Innovation demonstration to expand patient access to physician-led hospitals. Reform Medicare Advantage prior authorization, including related provisions in: H.R. 4968, the GOLD Card Act; H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Advocacy related to H.R. 8246, Second Chances for Rural Hospitals Act, and access to physician-led entities.

Repeal Section 6001 of the Affordable Care Act - section 6001 prohibits expansion of physician-led hospitals - including related provisions in H.R. 977/S. 470, the Patient Access to Higher Quality Care Act; and in H.R. 9001, the Physician Led and Rural Access to Quality Care Act, to revise certain physician self-referral exemptions relating to physician-owned hospitals in rural areas; and related issues regarding hospital competition and consolidation. Center for Medicare & Medicaid Innovation demonstration to expand patient access to physician-led hospitals. Reform Medicare Advantage prior authorization, including related provisions in: H.R. 4968, the GOLD Card Act; H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Advocacy related to H.R. 8246, Second Chances for Rural Hospitals Act, and access to physician-led entities.

Repeal Section 6001 of the Affordable Care Act - section 6001 prohibits expansion of physician-led hospitals - including related provisions in H.R. 977/S. 470, the Patient Access to Higher Quality Care Act; and in Draft Legislation by Rep. Burgess to amend title XVIII of the Social Security Act to revise certain physician self-referral exemptions relating to physician-owned hospitals in rural areas; and related issues regarding hospital competition and consolidation. Center for Medicare & Medicaid Innovation demonstration to expand patient access to physician-led hospitals. Reform Medicare Advantage prior authorization, including related provisions in the GOLD Card Act, H.R. 4968; H.R. 4822, the Health Care Price Transparency Act - including requirements for Medicare Advantage electronic prior authorization and real-time decisions; and prior authorization transparency provisions in H.R. 4822, and H.R. 5378, the Lower Costs, More Transparency Act.

Repeal Section 6001 of the Affordable Care Act - section 6001 prohibits expansion of physician-led hospitals - including related provisions in H.R. 977/S. 470, the Patient Access to Higher Quality Care Act; and in Draft Legislation by Rep. Burgess to amend title XVIII of the Social Security Act to revise certain physician self-referral exemptions relating to physician-owned hospitals in rural areas; and related issues regarding hospital competition and consolidation. Center for Medicare & Medicaid Innovation demonstration to expand patient access to physician-led hospitals. Reform Medicare Advantage prior authorization, including related provisions in: H.R. 4968, the GOLD Card Act; H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans.

Recovery audit contractor reform. Medicare regulatory reform, including physician payment reforms, including Medicare physician payment provisions in: (1) S. 3430, the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act, Sec. 403 to extend work geographic index floor under Medicare; Sec. 404 to extend incentive payments for participation in eligible alternative payment models; and Sec. 407 to increase support for physicians and other professionals in adjusting to Medicare payment changes; (2) H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; and (3) H.R. 4366, the Consolidated Appropriations Act, 2024, P.L. 118-42: Sec. 304, Extending Incentive Payments for Participation in Eligible Alternative Payment Models; and Sec. 305, Temporary Payment Increase under the Medicare Physician Fee Schedule to Account for Exceptional Circumstances and Atypical Timing of Enactment. Network adequacy oversight, including Medicare Advantage plan provider directory accuracy issues, including provisions in S. 3430, the Better Mental Health Care, Lower Cost Drugs, and Extenders Act of 2023, in Sec. 109, to require MA plans to maintain accurate provider directories on a public website. Medicare accountable care organizations. Electronic health record interoperability and vendor accountability. Medicare Parts C and D prior authorization reforms, including related provisions in: H.R. 4968, the GOLD Card Act; H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Physician-led hospital barriers, including related provisions in H.R. 977/S. 470, the Patient Access to Higher Quality Care Act. Medicare physician fee schedule and sequestration relief, and Draft Legislation by Rep. Burgess to amend title XVIII of the Social Security Act to revise certain physician self-referral exemptions relating to physician-owned hospitals in rural areas. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor: (1) implementation of provisions in the Inflation Reduction Act of 2022 (P.L. 117-169), Subtitle B, Part 1, sec. (b), to modify Medicare Part B reimbursement by application of Maximum Fair Prices and Conforming Amendments, to selected Medicare Part B covered drugs; and (2) CMMI Medicare Part B drug demonstrations, including the Most Favored Nation demonstration.

Recovery audit contractor reform. Medicare regulatory reform, including Medicare physician fee schedule and sequestration relief and payment reforms, including Medicare physician payment provisions in: (1) S. 3430, the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act, Sec. 403 to extend work geographic index floor under Medicare; Sec. 404 to extend incentive payments for participation in eligible alternative payment models; and Sec. 407 to increase support for physicians and other professionals in adjusting to Medicare payment changes; (2) H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; (3) H.R. 4366, the Consolidated Appropriations Act, 2024, P.L. 118-42: Sec. 304, Extending Incentive Payments for Participation in Eligible Alternative Payment Models; and Sec. 305, Temporary Payment Increase under the Medicare Physician Fee Schedule to Account for Exceptional Circumstances and Atypical Timing of Enactment; and (4) HR ____ Further Continuing Appropriations and Disaster Relief Supplemental Appropriations Act, 2025-related to physician payment adjustment of 2.5%. Network adequacy oversight, including Medicare Advantage plan provider directory accuracy issues, including provisions in S. 3430, the Better Mental Health Care, Lower Cost Drugs, and Extenders Act of 2023, in Sec. 109, to require MA plans to maintain accurate provider directories on a public website. Medicare accountable care organizations. Electronic health record interoperability and vendor accountability. Medicare Parts C and D prior authorization reforms, including related provisions in: H.R. 4968, the GOLD Card Act; H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Physician-led hospital barriers, including related provisions in H.R. 977/S. 470, the Patient Access to Higher Quality Care Act, and H.R. 9001, the Physician Led and Rural Access to Quality Care Act, to revise certain physician self-referral exemptions relating to physician-owned hospitals in rural areas. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor: (1) implementation of provisions in the Inflation Reduction Act of 2022 (P.L. 117-169), Subtitle B, Part 1, sec. (b), to modify Medicare Part B reimbursement by application of Maximum Fair Prices and Conforming Amendments, to selected Medicare Part B covered drugs; and (2) CMMI Medicare Part B drug demonstrations, including the Most Favored Nation demonstration.

Repeal Section 6001 of the Affordable Care Act - section 6001 prohibits expansion of physician-led hospitals - including related provisions in H.R. 977/S. 470, the Patient Access to Higher Quality Care Act; and in H.R. 9001, the Physician Led and Rural Access to Quality Care Act, to revise certain physician self-referral exemptions relating to physician-owned hospitals in rural areas; and related issues regarding hospital competition and consolidation. Center for Medicare & Medicaid Innovation demonstration to expand patient access to physician-led hospitals. Reform Medicare Advantage prior authorization, including related provisions in: H.R. 4968, the GOLD Card Act; H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Advocacy related to H.R. 8246, Second Chances for Rural Hospitals Act, and access to physician-led entities.

Recovery audit contractor reform. Medicare regulatory reform, including Medicare physician fee schedule and sequestration relief and payment reforms, including Medicare physician payment provisions in: (1) S. 3430, the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act, Sec. 403 to extend work geographic index floor under Medicare; Sec. 404 to extend incentive payments for participation in eligible alternative payment models; and Sec. 407 to increase support for physicians and other professionals in adjusting to Medicare payment changes; (2) H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; (3) H.R. 4366, the Consolidated Appropriations Act, 2024, P.L. 118-42: Sec. 304, Extending Incentive Payments for Participation in Eligible Alternative Payment Models; and Sec. 305, Temporary Payment Increase under the Medicare Physician Fee Schedule to Account for Exceptional Circumstances and Atypical Timing of Enactment; and (4) HR ____ Further Continuing Appropriations and Disaster Relief Supplemental Appropriations Act, 2025-related to physician payment adjustment of 2.5%. Network adequacy oversight, including Medicare Advantage plan provider directory accuracy issues, including provisions in S. 3430, the Better Mental Health Care, Lower Cost Drugs, and Extenders Act of 2023, in Sec. 109, to require MA plans to maintain accurate provider directories on a public website. Medicare accountable care organizations. Electronic health record interoperability and vendor accountability. Medicare Parts C and D prior authorization reforms, including related provisions in: H.R. 4968, the GOLD Card Act; H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Physician-led hospital barriers, including related provisions in H.R. 977/S. 470, the Patient Access to Higher Quality Care Act, and H.R. 9001, the Physician Led and Rural Access to Quality Care Act, to revise certain physician self-referral exemptions relating to physician-owned hospitals in rural areas. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor: (1) implementation of provisions in the Inflation Reduction Act of 2022 (P.L. 117-169), Subtitle B, Part 1, sec. (b), to modify Medicare Part B reimbursement by application of Maximum Fair Prices and Conforming Amendments, to selected Medicare Part B covered drugs; and (2) CMMI Medicare Part B drug demonstrations, including the Most Favored Nation demonstration.

Update and reforms to Medicare payments for physicians and implementation of related provisions of the Medicare Access and CHIP ReauthorizationAct (MACRA), including regulatory relief for physicians in the MACRA Quality Payment Program, evaluation and management (E/M) codes andrelated legislative issues related to payment for E/M codes, and qualified clinical data registries, including Medicare physician payment provisions in:(1) S. 3430, the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act, Sec. 403 to extend work geographic index floor under Medicare; Sec. 404 to extend incentive payments for participation in eligible alternative payment models; and Sec. 407 to increase support for physicians and other professionals in adjusting to Medicare payment changes; (2) H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; and (3) H.R. 4366, the Consolidated Appropriations Act, 2024, P.L. 118-42: Sec.304, Extending Incentive Payments for Participation in Eligible Alternative Payment Models; and Sec. 305, Temporary Payment Increase under the Medicare Physician Fee Schedule to Account for Exceptional Circumstances and Atypical Timing of Enactment. Maintain patient access to In-Office Ancillary Services. Issues related to adequate network coverage for ophthalmology care within Medicare Advantage plans and advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans, including related provisions in: H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. MA plan provider directory accuracy issues, including related provisions in S. 3430, the Better Mental Health Care, Lower Cost Drugs, and Extenders Act of 2023, in Sec. 109, to require MA plans to maintain accurate provider directories on a public website. Legislative issues regarding implementation of Meaningful Use of Electronic Health Records. Medicare reimbursement for telemedicine, including related provisions in S. 3430, the Better Mental Health Care, Lower Costs Drugs, and Extenders Act, including Sec. 105 regarding Medicare payment for mental health services furnished through telehealth, and Sec. 107 regarding communications regarding telehealth and interstate licensure requirements; H.R. 7623, The Telehealth Modernization Act of 2024; SEC. 101. Extension of Certain Telehealth Flexibilities; H.R. 8261, the Preserving Telehealth, Hospital, and Ambulance Access Act; Section 2, extending Medicare Telehealth Flexibilities. Medicare RAC reform and use of step therapy in Medicare and health insurance coverage including related provisions in H.R. 2630/S. 652, the SafeStep Act. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor CMMI Medicare Part B drug-related demonstrations.

Repeal Section 6001 of the Affordable Care Act - section 6001 prohibits expansion of physician-led hospitals - including related provisions in H.R. 977/S. 470, the Patient Access to Higher Quality Care Act; and in H.R. 9001, the Physician Led and Rural Access to Quality Care Act, to revise certain physician self-referral exemptions relating to physician-owned hospitals in rural areas; and related issues regarding hospital competition and consolidation. Center for Medicare & Medicaid Innovation demonstration to expand patient access to physician-led hospitals. Reform Medicare Advantage prior authorization, including related provisions in: H.R. 4968, the GOLD Card Act; H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Advocacy related to H.R. 8246, Second Chances for Rural Hospitals Act, and access to physician-led entities.

Recovery audit contractor reform. Medicare regulatory reform, including physician payment reforms, including Medicare physician payment provisions in: (1) S. 3430, the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act, Sec. 403 to extend work geographic index floor under Medicare; Sec. 404 to extend incentive payments for participation in eligible alternative payment models; and Sec. 407 to increase support for physicians and other professionals in adjusting to Medicare payment changes; (2) H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; and (3) H.R. 4366, the Consolidated Appropriations Act, 2024, P.L. 118-42: Sec. 304, Extending Incentive Payments for Participation in Eligible Alternative Payment Models; and Sec. 305, Temporary Payment Increase under the Medicare Physician Fee Schedule to Account for Exceptional Circumstances and Atypical Timing of Enactment. Network adequacy oversight, including Medicare Advantage plan provider directory accuracy issues, including provisions in S. 3430, the Better Mental Health Care, Lower Cost Drugs, and Extenders Act of 2023, in Sec. 109, to require MA plans to maintain accurate provider directories on a public website. Medicare accountable care organizations. Electronic health record interoperability and vendor accountability. Medicare Parts C and D prior authorization reforms, including related provisions in: H.R. 4968, the GOLD Card Act; H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Physician-led hospital barriers, including related provisions in H.R. 977/S. 470, the Patient Access to Higher Quality Care Act. Medicare physician fee schedule and sequestration relief, and Draft Legislation by Rep. Burgess to amend title XVIII of the Social Security Act to revise certain physician self-referral exemptions relating to physician-owned hospitals in rural areas. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor: (1) implementation of provisions in the Inflation Reduction Act of 2022 (P.L. 117-169), Subtitle B, Part 1, sec. (b), to modify Medicare Part B reimbursement by application of Maximum Fair Prices and Conforming Amendments, to selected Medicare Part B covered drugs; and (2) CMMI Medicare Part B drug demonstrations, including the Most Favored Nation demonstration.

Repeal Section 6001 of the Affordable Care Act - section 6001 prohibits expansion of physician-led hospitals - including related provisions in H.R. 977/S. 470, the Patient Access to Higher Quality Care Act; and in Draft Legislation by Rep. Burgess to amend title XVIII of the Social Security Act to revise certain physician self-referral exemptions relating to physician-owned hospitals in rural areas; and related issues regarding hospital competition and consolidation. Center for Medicare & Medicaid Innovation demonstration to expand patient access to physician-led hospitals. Reform Medicare Advantage prior authorization, including related provisions in: H.R. 4968, the GOLD Card Act; H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans.

Repeal Section 6001 of the Affordable Care Act - section 6001 prohibits expansion of physician-led hospitals - including related provisions in H.R. 977/S. 470, the Patient Access to Higher Quality Care Act; and in Draft Legislation by Rep. Burgess to amend title XVIII of the Social Security Act to revise certain physician self-referral exemptions relating to physician-owned hospitals in rural areas; and related issues regarding hospital competition and consolidation. Center for Medicare & Medicaid Innovation demonstration to expand patient access to physician-led hospitals. Reform Medicare Advantage prior authorization, including related provisions in the GOLD Card Act, H.R. 4968; H.R. 4822, the Health Care Price Transparency Act - including requirements for Medicare Advantage electronic prior authorization and real-time decisions; and prior authorization transparency provisions in H.R. 4822, and H.R. 5378, the Lower Costs, More Transparency Act.

Update and reforms to Medicare payments for physicians and implementation of related provisions of the Medicare Access and CHIP Reauthorization Act (MACRA), including regulatory relief for physicians in the MACRA Quality Payment Program, evaluation and management (E/M) codes and related legislative issues related to payment for E/M codes, and qualified clinical data registries, including Medicare physician payment provisions in: (1) S. 3430, the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act, Sec. 403 to extend work geographic index floor under Medicare; Sec. 404 to extend incentive payments for participation in eligible alternative payment models; and Sec. 407 to increase support for physicians and other professionals in adjusting to Medicare payment changes; (2) H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; and (3) H.R. 4366, the Consolidated Appropriations Act, 2024, P.L. 118-42: Sec. 304, Extending Incentive Payments for Participation in Eligible Alternative Payment Models; and Sec. 305, Temporary Payment Increase under the Medicare Physician Fee Schedule to Account for Exceptional Circumstances and Atypical Timing of Enactment. Maintain patient access to In-Office Ancillary Services. Issues related to adequate network coverage for ophthalmology care within Medicare Advantage plans and advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans, including related provisions in: (1) H.R. 4822, the Health Care Price Transparency Act, to require Medicare Advantage plans to institute electronic prior authorization and establish requirements related to real time decisions; and (2) prior authorization transparency requirements included in H.R. 5378, the Lower Costs, More Transparency Act, and H.R. 4822, the Health Care Price Transparency Act; and MA plan provider directory accuracy issues, including provisions in S. 3430, the Better Mental Health Care, Lower Cost Drugs, and Extenders Act of 2023, in Sec. 109, to require MA plans to maintain accurate provider directories on a public website. Legislative issues regarding implementation of Meaningful Use of Electronic Health Records. Medicare reimbursement for telemedicine, including related provisions in S. 3430, the Better Mental Health Care, Lower Costs Drugs, and Extenders Act, including Sec. 105 regarding Medicare payment for mental health services furnished through telehealth, and Sec. 107 regarding communications regarding telehealth and interstate licensure requirements. Medicare RAC reform and use of step therapy in Medicare and health insurance coverage including related provisions in H.R. 2630/S. 652, the Safe Step Act. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor CMMI Medicare Part B drug-related demonstrations.

Adequacy of Medicare physician payments for physicians and implementation of the Medicare Access and CHIP Reauthorization Act, including related provisions in: (1) S. 4935 Physician Fee Stabilization Act and H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; (2) H.R. 6683, the Preserving Seniors Access to Physicians Act; (3) H.R. 2474, the Strengthening Medicare for Patients and Providers Act; and (4) HR ____ Further Continuing Appropriations and Disaster Relief Supplemental Appropriations Act, 2025-related to physician payment adjustment of 2.5%. Issues related to adequate network coverage for ophthalmology care within Medicare Advantage plans and advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans, including related provisions in: H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Medicare reimbursement for telemedicine, including related provisions in S. 3430, the Better Mental Health Care, Lower Costs Drugs, and Extenders Act, including Sec. 105 regarding Medicare payment for mental health services furnished through telehealth, and Sec. 107 regarding communications regarding telehealth and interstate licensure requirements; H.R. 7623, The Telehealth Modernization Act of 2024; SEC. 101. Extension of Certain Telehealth Flexibilities; H.R. 8261, the Preserving Telehealth, Hospital, and Ambulance Access Act; Section 2, extending Medicare Telehealth Flexibilities. Use of step therapy in Medicare and health insurance coverage, including related provisions in H.R. 2630/S. 652, the Safe Step Act. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor CMMI Medicare Part B drug-related demonstrations.

Adequacy of Medicare physician payments for physicians and implementation of the Medicare Access and CHIP Reauthorization Act, including related provisions in: (1) S. 4935 Physician Fee Stabilization Act and H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; (2) H.R. 6683, the Preserving Seniors Access to Physicians Act; and (3) H.R. 2474, the Strengthening Medicare for Patients and Providers Act. Issues related to adequate network coverage for ophthalmology care within Medicare Advantage plans and advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans, including related provisions in: H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Medicare reimbursement for telemedicine, including related provisions in S. 3430, the Better Mental Health Care, Lower Costs Drugs, and Extenders Act, including Sec. 105 regarding Medicare payment for mental health services furnished through telehealth, and Sec. 107 regarding communications regarding telehealth and interstate licensure requirements; H.R. 7623, The Telehealth Modernization Act of 2024; SEC. 101. Extension of Certain Telehealth Flexibilities; H.R. 8261, the Preserving Telehealth, Hospital, and Ambulance Access Act; Section 2, extending Medicare Telehealth Flexibilities. Use of step therapy in Medicare and health insurance coverage, including related provisions in H.R. 2630/S. 652, the Safe Step Act. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor CMMI Medicare Part B drug-related demonstrations.

Recovery audit contractor reform. Medicare regulatory reform, including Medicare physician fee schedule and sequestration relief and payment reforms, including Medicare physician payment provisions in: (1) S. 3430, the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act, Sec. 403 to extend work geographic index floor under Medicare; Sec. 404 to extend incentive payments for participation in eligible alternative payment models; and Sec. 407 to increase support for physicians and other professionals in adjusting to Medicare payment changes; (2) H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; and (3) H.R. 4366, the Consolidated Appropriations Act, 2024, P.L. 118-42: Sec. 304, Extending Incentive Payments for Participation in Eligible Alternative Payment Models; and Sec. 305, Temporary Payment Increase under the Medicare Physician Fee Schedule to Account for Exceptional Circumstances and Atypical Timing of Enactment. Network adequacy oversight, including Medicare Advantage plan provider directory accuracy issues, including provisions in S. 3430, the Better Mental Health Care, Lower Cost Drugs, and Extenders Act of 2023, in Sec. 109, to require MA plans to maintain accurate provider directories on a public website. Medicare accountable care organizations. Electronic health record interoperability and vendor accountability. Medicare Parts C and D prior authorization reforms, including related provisions in: H.R. 4968, the GOLD Card Act; H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Physician-led hospital barriers, including related provisions in H.R. 977/S. 470, the Patient Access to Higher Quality Care Act, and H.R. 9001, the Physician Led and Rural Access to Quality Care Act, to revise certain physician self-referral exemptions relating to physician-owned hospitals in rural areas. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor: (1) implementation of provisions in the Inflation Reduction Act of 2022 (P.L. 117-169), Subtitle B, Part 1, sec. (b), to modify Medicare Part B reimbursement by application of Maximum Fair Prices and Conforming Amendments, to selected Medicare Part B covered drugs; and (2) CMMI Medicare Part B drug demonstrations, including the Most Favored Nation demonstration.

Recovery audit contractor reform. Medicare regulatory reform, including physician payment reforms, including Medicare physician payment provisions in: (1) S. 3430, the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act, Sec. 403 to extend work geographic index floor under Medicare; Sec. 404 to extend incentive payments for participation in eligible alternative payment models; and Sec. 407 to increase support for physicians and other professionals in adjusting to Medicare payment changes; (2) H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; and (3) H.R. 4366, the Consolidated Appropriations Act, 2024, P.L. 118-42: Sec. 304, Extending Incentive Payments for Participation in Eligible Alternative Payment Models; and Sec. 305, Temporary Payment Increase under the Medicare Physician Fee Schedule to Account for Exceptional Circumstances and Atypical Timing of Enactment. Network adequacy oversight, including Medicare Advantage plan provider directory accuracy issues, including provisions in S. 3430, the Better Mental Health Care, Lower Cost Drugs, and Extenders Act of 2023, in Sec. 109, to require MA plans to maintain accurate provider directories on a public website. Medicare accountable care organizations. Electronic health record interoperability and vendor accountability. Medicare Parts C and D prior authorization reforms, including related provisions in: H.R. 4968, the GOLD Card Act; H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Physician-led hospital barriers, including related provisions in H.R. 977/S. 470, the Patient Access to Higher Quality Care Act. Medicare physician fee schedule and sequestration relief, and Draft Legislation by Rep. Burgess to amend title XVIII of the Social Security Act to revise certain physician self-referral exemptions relating to physician-owned hospitals in rural areas. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor: (1) implementation of provisions in the Inflation Reduction Act of 2022 (P.L. 117-169), Subtitle B, Part 1, sec. (b), to modify Medicare Part B reimbursement by application of Maximum Fair Prices and Conforming Amendments, to selected Medicare Part B covered drugs; and (2) CMMI Medicare Part B drug demonstrations, including the Most Favored Nation demonstration.

Recovery audit contractor reform. Medicare regulatory reform, including physician payment reforms, including Medicare physician payment provisions in: (1) S. 3430, the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act, Sec. 403 to extend work geographic index floor under Medicare; Sec. 404 to extend incentive payments for participation in eligible alternative payment models; and Sec. 407 to increase support for physicians and other professionals in adjusting to Medicare payment changes; (2) H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; and (3) H.R. 4366, the Consolidated Appropriations Act, 2024, P.L. 118-42: Sec. 304, Extending Incentive Payments for Participation in Eligible Alternative Payment Models; and Sec. 305, Temporary Payment Increase under the Medicare Physician Fee Schedule to Account for Exceptional Circumstances and Atypical Timing of Enactment. Network adequacy oversight, including Medicare Advantage plan provider directory accuracy issues, including provisions in S. 3430, the Better Mental Health Care, Lower Cost Drugs, and Extenders Act of 2023, in Sec. 109, to require MA plans to maintain accurate provider directories on a public website. Medicare accountable care organizations. Electronic health record interoperability and vendor accountability. Medicare Parts C and D prior authorization reforms, including related provisions in the GOLD Card Act, H.R. 4968; H.R. 4822, the Health Care Price Transparency Act - including requirements for Medicare Advantage electronic prior authorization and real-time decisions; and prior authorization transparency provisions in H.R. 4822, and H.R. 5378, the Lower Costs, More Transparency Act. Physician-led hospital barriers, including related provisions in H.R. 977/S. 470, the Patient Access to Higher Quality Care Act. Medicare physician fee schedule and sequestration relief, and Draft Legislation by Rep. Burgess to amend title XVIII of the Social Security Act to revise certain physician self-referral exemptions relating to physician-owned hospitals in rural areas. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor: (1) implementation of provisions in the Inflation Reduction Act of 2022 (P.L. 117-169), Subtitle B, Part 1, sec. (b), to modify Medicare Part B reimbursement by application of Maximum Fair Prices and Conforming Amendments, to selected Medicare Part B covered drugs; and (2) CMMI Medicare Part B drug demonstrations, including the Most Favored Nation demonstration.

Update and reforms to Medicare payments for physicians and implementation of related provisions of the Medicare Access and CHIP Reauthorization Act (MACRA), including regulatory relief for physicians in the MACRA Quality Payment Program, evaluation and management (E/M) codes and related legislative issues related to payment for E/M codes, and qualified clinical data registries, including Medicare physician payment provisions in: (1) S. 3430, the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act, Sec. 403 to extend work geographic index floor under Medicare; Sec. 404 to extend incentive payments for participation in eligible alternative payment models; and Sec. 407 to increase support for physicians and other professionals in adjusting to Medicare payment changes; (2) H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; and (3) H.R. 4366, the Consolidated Appropriations Act, 2024, P.L. 118-42: Sec. 304, Extending Incentive Payments for Participation in Eligible Alternative Payment Models; and Sec. 305, Temporary Payment Increase under the Medicare Physician Fee Schedule to Account for Exceptional Circumstances and Atypical Timing of Enactment. Maintain patient access to In-Office Ancillary Services. Issues related to adequate network coverage for ophthalmology care within Medicare Advantage plans and advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans, including related provisions in: (1) H.R. 4822, the Health Care Price Transparency Act, to require Medicare Advantage plans to institute electronic prior authorization and establish requirements related to real time decisions; and (2) prior authorization transparency requirements included in H.R. 5378, the Lower Costs, More Transparency Act, and H.R. 4822, the Health Care Price Transparency Act; and MA plan provider directory accuracy issues, including provisions in S. 3430, the Better Mental Health Care, Lower Cost Drugs, and Extenders Act of 2023, in Sec. 109, to require MA plans to maintain accurate provider directories on a public website. Legislative issues regarding implementation of Meaningful Use of Electronic Health Records. Medicare reimbursement for telemedicine, including related provisions in S. 3430, the Better Mental Health Care, Lower Costs Drugs, and Extenders Act, including Sec. 105 regarding Medicare payment for mental health services furnished through telehealth, and Sec. 107 regarding communications regarding telehealth and interstate licensure requirements. Medicare RAC reform and use of step therapy in Medicare and health insurance coverage including related provisions in H.R. 2630/S. 652, the Safe Step Act. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor CMMI Medicare Part B drug-related demonstrations.

Recovery audit contractor reform. Medicare regulatory reform, including Medicare physician fee schedule and sequestration relief and payment reforms, including Medicare physician payment provisions in: (1) S. 3430, the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act, Sec. 403 to extend work geographic index floor under Medicare; Sec. 404 to extend incentive payments for participation in eligible alternative payment models; and Sec. 407 to increase support for physicians and other professionals in adjusting to Medicare payment changes; (2) H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; (3) H.R. 4366, the Consolidated Appropriations Act, 2024, P.L. 118-42: Sec. 304, Extending Incentive Payments for Participation in Eligible Alternative Payment Models; and Sec. 305, Temporary Payment Increase under the Medicare Physician Fee Schedule to Account for Exceptional Circumstances and Atypical Timing of Enactment; and (4) HR ____ Further Continuing Appropriations and Disaster Relief Supplemental Appropriations Act, 2025-related to physician payment adjustment of 2.5%. Network adequacy oversight, including Medicare Advantage plan provider directory accuracy issues, including provisions in S. 3430, the Better Mental Health Care, Lower Cost Drugs, and Extenders Act of 2023, in Sec. 109, to require MA plans to maintain accurate provider directories on a public website. Medicare accountable care organizations. Electronic health record interoperability and vendor accountability. Medicare Parts C and D prior authorization reforms, including related provisions in: H.R. 4968, the GOLD Card Act; H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Physician-led hospital barriers, including related provisions in H.R. 977/S. 470, the Patient Access to Higher Quality Care Act, and H.R. 9001, the Physician Led and Rural Access to Quality Care Act, to revise certain physician self-referral exemptions relating to physician-owned hospitals in rural areas. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor: (1) implementation of provisions in the Inflation Reduction Act of 2022 (P.L. 117-169), Subtitle B, Part 1, sec. (b), to modify Medicare Part B reimbursement by application of Maximum Fair Prices and Conforming Amendments, to selected Medicare Part B covered drugs; and (2) CMMI Medicare Part B drug demonstrations, including the Most Favored Nation demonstration.

Adequacy of Medicare physician payments for physicians and implementation of the Medicare Access and CHIP Reauthorization Act, including related provisions in: (1) S. 4935 Physician Fee Stabilization Act and H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; (2) H.R. 6683, the Preserving Seniors Access to Physicians Act; (3) H.R. 2474, the Strengthening Medicare for Patients and Providers Act; and (4) HR ____ Further Continuing Appropriations and Disaster Relief Supplemental Appropriations Act, 2025-related to physician payment adjustment of 2.5%. Issues related to adequate network coverage for ophthalmology care within Medicare Advantage plans and advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans, including related provisions in: H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Medicare reimbursement for telemedicine, including related provisions in S. 3430, the Better Mental Health Care, Lower Costs Drugs, and Extenders Act, including Sec. 105 regarding Medicare payment for mental health services furnished through telehealth, and Sec. 107 regarding communications regarding telehealth and interstate licensure requirements; H.R. 7623, The Telehealth Modernization Act of 2024; SEC. 101. Extension of Certain Telehealth Flexibilities; H.R. 8261, the Preserving Telehealth, Hospital, and Ambulance Access Act; Section 2, extending Medicare Telehealth Flexibilities. Use of step therapy in Medicare and health insurance coverage, including related provisions in H.R. 2630/S. 652, the Safe Step Act. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor CMMI Medicare Part B drug-related demonstrations.

Adequacy of Medicare physician payments for physicians and implementation of the Medicare Access and CHIP Reauthorization Act, including related provisions in: (1) S. 4935 Physician Fee Stabilization Act and H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; (2) H.R. 6683, the Preserving Seniors Access to Physicians Act; and (3) H.R. 2474, the Strengthening Medicare for Patients and Providers Act. Issues related to adequate network coverage for ophthalmology care within Medicare Advantage plans and advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans, including related provisions in: H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Medicare reimbursement for telemedicine, including related provisions in S. 3430, the Better Mental Health Care, Lower Costs Drugs, and Extenders Act, including Sec. 105 regarding Medicare payment for mental health services furnished through telehealth, and Sec. 107 regarding communications regarding telehealth and interstate licensure requirements; H.R. 7623, The Telehealth Modernization Act of 2024; SEC. 101. Extension of Certain Telehealth Flexibilities; H.R. 8261, the Preserving Telehealth, Hospital, and Ambulance Access Act; Section 2, extending Medicare Telehealth Flexibilities. Use of step therapy in Medicare and health insurance coverage, including related provisions in H.R. 2630/S. 652, the Safe Step Act. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor CMMI Medicare Part B drug-related demonstrations.

Update and reforms to Medicare payments for physicians and implementation of related provisions of the Medicare Access and CHIP ReauthorizationAct (MACRA), including regulatory relief for physicians in the MACRA Quality Payment Program, evaluation and management (E/M) codes andrelated legislative issues related to payment for E/M codes, and qualified clinical data registries, including Medicare physician payment provisions in:(1) S. 3430, the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act, Sec. 403 to extend work geographic index floor under Medicare; Sec. 404 to extend incentive payments for participation in eligible alternative payment models; and Sec. 407 to increase support for physicians and other professionals in adjusting to Medicare payment changes; (2) H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; and (3) H.R. 4366, the Consolidated Appropriations Act, 2024, P.L. 118-42: Sec.304, Extending Incentive Payments for Participation in Eligible Alternative Payment Models; and Sec. 305, Temporary Payment Increase under the Medicare Physician Fee Schedule to Account for Exceptional Circumstances and Atypical Timing of Enactment. Maintain patient access to In-Office Ancillary Services. Issues related to adequate network coverage for ophthalmology care within Medicare Advantage plans and advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans, including related provisions in: H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. MA plan provider directory accuracy issues, including related provisions in S. 3430, the Better Mental Health Care, Lower Cost Drugs, and Extenders Act of 2023, in Sec. 109, to require MA plans to maintain accurate provider directories on a public website. Legislative issues regarding implementation of Meaningful Use of Electronic Health Records. Medicare reimbursement for telemedicine, including related provisions in S. 3430, the Better Mental Health Care, Lower Costs Drugs, and Extenders Act, including Sec. 105 regarding Medicare payment for mental health services furnished through telehealth, and Sec. 107 regarding communications regarding telehealth and interstate licensure requirements; H.R. 7623, The Telehealth Modernization Act of 2024; SEC. 101. Extension of Certain Telehealth Flexibilities; H.R. 8261, the Preserving Telehealth, Hospital, and Ambulance Access Act; Section 2, extending Medicare Telehealth Flexibilities. Medicare RAC reform and use of step therapy in Medicare and health insurance coverage including related provisions in H.R. 2630/S. 652, the SafeStep Act. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor CMMI Medicare Part B drug-related demonstrations.

Recovery audit contractor reform. Medicare regulatory reform, including Medicare physician fee schedule and sequestration relief and payment reforms, including Medicare physician payment provisions in: (1) S. 3430, the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act, Sec. 403 to extend work geographic index floor under Medicare; Sec. 404 to extend incentive payments for participation in eligible alternative payment models; and Sec. 407 to increase support for physicians and other professionals in adjusting to Medicare payment changes; (2) H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; and (3) H.R. 4366, the Consolidated Appropriations Act, 2024, P.L. 118-42: Sec. 304, Extending Incentive Payments for Participation in Eligible Alternative Payment Models; and Sec. 305, Temporary Payment Increase under the Medicare Physician Fee Schedule to Account for Exceptional Circumstances and Atypical Timing of Enactment. Network adequacy oversight, including Medicare Advantage plan provider directory accuracy issues, including provisions in S. 3430, the Better Mental Health Care, Lower Cost Drugs, and Extenders Act of 2023, in Sec. 109, to require MA plans to maintain accurate provider directories on a public website. Medicare accountable care organizations. Electronic health record interoperability and vendor accountability. Medicare Parts C and D prior authorization reforms, including related provisions in: H.R. 4968, the GOLD Card Act; H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Physician-led hospital barriers, including related provisions in H.R. 977/S. 470, the Patient Access to Higher Quality Care Act, and H.R. 9001, the Physician Led and Rural Access to Quality Care Act, to revise certain physician self-referral exemptions relating to physician-owned hospitals in rural areas. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor: (1) implementation of provisions in the Inflation Reduction Act of 2022 (P.L. 117-169), Subtitle B, Part 1, sec. (b), to modify Medicare Part B reimbursement by application of Maximum Fair Prices and Conforming Amendments, to selected Medicare Part B covered drugs; and (2) CMMI Medicare Part B drug demonstrations, including the Most Favored Nation demonstration.

Update and reforms to Medicare payments for physicians and implementation of related provisions of the Medicare Access and CHIP Reauthorization Act (MACRA), including regulatory relief for physicians in the MACRA Quality Payment Program, evaluation and management (E/M) codes and related legislative issues related to payment for E/M codes, and qualified clinical data registries, including related provisions in H.R. 6545, the Physician Fee Schedule Update and Improvements Act; H.R. 2474, the Strengthening Medicare for Patients and Providers Act; and H.R. 6683, the Preserving Seniors' Access to Physicians Act of 2023. Issues related to adequate network coverage for dermatologic care within Medicare Advantage plans and advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans, including related provisions in S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans.

Adequacy of Medicare physician payments for physicians and implementation of the Medicare Access and CHIP Reauthorization Act, including related provisions in: (1) S. 4935 Physician Fee Stabilization Act and H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; (2) H.R. 6683, the Preserving Seniors Access to Physicians Act; (3) H.R. 2474, the Strengthening Medicare for Patients and Providers Act; and (4) HR ____ Further Continuing Appropriations and Disaster Relief Supplemental Appropriations Act, 2025-related to physician payment adjustment of 2.5%. Issues related to adequate network coverage for ophthalmology care within Medicare Advantage plans and advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans, including related provisions in: H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Medicare reimbursement for telemedicine, including related provisions in S. 3430, the Better Mental Health Care, Lower Costs Drugs, and Extenders Act, including Sec. 105 regarding Medicare payment for mental health services furnished through telehealth, and Sec. 107 regarding communications regarding telehealth and interstate licensure requirements; H.R. 7623, The Telehealth Modernization Act of 2024; SEC. 101. Extension of Certain Telehealth Flexibilities; H.R. 8261, the Preserving Telehealth, Hospital, and Ambulance Access Act; Section 2, extending Medicare Telehealth Flexibilities. Use of step therapy in Medicare and health insurance coverage, including related provisions in H.R. 2630/S. 652, the Safe Step Act. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor CMMI Medicare Part B drug-related demonstrations.

Adequacy of Medicare physician payments for physicians and implementation of the Medicare Access and CHIP Reauthorization Act, including related provisions in: (1) S. 4935 Physician Fee Stabilization Act and H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; (2) H.R. 6683, the Preserving Seniors Access to Physicians Act; and (3) H.R. 2474, the Strengthening Medicare for Patients and Providers Act. Issues related to adequate network coverage for ophthalmology care within Medicare Advantage plans and advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans, including related provisions in: H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Medicare reimbursement for telemedicine, including related provisions in S. 3430, the Better Mental Health Care, Lower Costs Drugs, and Extenders Act, including Sec. 105 regarding Medicare payment for mental health services furnished through telehealth, and Sec. 107 regarding communications regarding telehealth and interstate licensure requirements; H.R. 7623, The Telehealth Modernization Act of 2024; SEC. 101. Extension of Certain Telehealth Flexibilities; H.R. 8261, the Preserving Telehealth, Hospital, and Ambulance Access Act; Section 2, extending Medicare Telehealth Flexibilities. Use of step therapy in Medicare and health insurance coverage, including related provisions in H.R. 2630/S. 652, the Safe Step Act. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor CMMI Medicare Part B drug-related demonstrations.

Update and reforms to Medicare payments for physicians and implementation of related provisions of the Medicare Access and CHIP Reauthorization Act (MACRA), including regulatory relief for physicians in the MACRA Quality Payment Program, evaluation and management (E/M) codes and related legislative issues related to payment for E/M codes, and qualified clinical data registries, including related provisions in H.R. 6545, the Physician Fee Schedule Update and Improvements Act; H.R. 2474, the Strengthening Medicare for Patients and Providers Act; and H.R. 6683, the Preserving Seniors' Access to Physicians Act of 2023. Issues related to adequate network coverage for dermatologic care within Medicare Advantage plans and advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans, including related provisions in S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans.

Advocacy on Medicare Food as Medicine, improvements to Medicare services related to nutrition clinical care and related physician and hospital reimbursement. Support medically tailored meals for Medicare beneficiaries, including provisions in H.R. 6780, the Medically Tailored Home-Delivered Meals Demonstration Pilot Act, and S. 2133, the Medically Tailored Home-Delivered Meals Demonstration Act. Monitor H.R. 8816, the American Medical Innovation and Investment Act, as amended by the Ways and Means Committee to add Sec. 7, to add a medically-tailored home-delivered meals demonstration program in Medicare.

Advocacy on Medicare Food as Medicine, improvements to Medicare services related to nutrition clinical care and related physician and hospital reimbursement. Support medically tailored meals for Medicare beneficiaries, including provisions in H.R. 6780, the Medically Tailored Home-Delivered Meals Demonstration Pilot Act, and S. 2133, the Medically Tailored Home-Delivered Meals Demonstration Act.

Advocacy on Medicare Food as Medicine, improvements to Medicare services related to nutrition clinical care and related physician and hospital reimbursement. Support medically tailored meals for Medicare beneficiaries, including provisions in H.R. 6780, the Medically Tailored Home-Delivered Meals Demonstration Pilot Act, and S. 2133, the Medically Tailored Home-Delivered Meals Demonstration Act. Monitor H.R. 8816, the American Medical Innovation and Investment Act, as amended by the Ways and Means Committee to add Sec. 7, to add a medically-tailored home-delivered meals demonstration program in Medicare.

Advocacy on Medicare Food as Medicine, improvements to Medicare services related to nutrition clinical care and related physician and hospital reimbursement. Support medically tailored meals for Medicare beneficiaries, including provisions in H.R. 6780, the Medically Tailored Home-Delivered Meals Demonstration Pilot Act, and S. 2133, the Medically Tailored Home-Delivered Meals Demonstration Act. Monitor H.R. 8816, the American Medical Innovation and Investment Act, as amended by the Ways and Means Committee to add Sec. 7, to add a medically-tailored home-delivered meals demonstration program in Medicare.

Monitor healthcare reform and quality initiatives, including implementation of related provisions in the Affordable Care Act. Monitor implementation of health care provider provisions of the Dr. Lorna Breen Health Care Provider Protection Act, Public Law No: 117-105, and reauthorization in H.R. 7153/S. 3679, the Dr. Lorna Breen Health Care Provider Protection Reauthorization Act. Seek changes to draft legislation, American Privacy Rights Act (APRA), Sec. 101. Definitions, to enhance responsible use of de-identified health data. Advocacy related to quality standards for medical evacuation.

Monitor healthcare reform and quality initiatives, including implementation of related provisions in the Affordable Care Act. Monitor implementation of health care provider provisions of the Dr. Lorna Breen Health Care Provider Protection Act, Public Law No: 117-105, and reauthorization in H.R. 7153/S. 3679, the Dr. Lorna Breen Health Care Provider Protection Reauthorization Act. Seek changes to draft legislation, American Privacy Rights Act (APRA), Sec. 101. Definitions, to enhance responsible use of de-identified health data.

Monitor healthcare reform and quality initiatives, including implementation of related provisions in the Affordable Care Act. Monitor implementation of health care provider provisions of the Dr. Lorna Breen Health Care Provider Protection Act, Public Law No: 117-105, and reauthorization in H.R. 7153/S. 3679, the Dr. Lorna Breen Health Care Provider Protection Reauthorization Act.

Monitor healthcare reform and quality initiatives, including implementation of related provisions in the Affordable Care Act. Monitor implementation of health care provider provisions of the Dr. Lorna Breen Health Care Provider Protection Act, Public Law No: 117-105, and reauthorization in H.R. 7153/S. 3679, the Dr. Lorna Breen Health Care Provider Protection Reauthorization Act. Seek changes to draft legislation, American Privacy Rights Act (APRA), Sec. 101. Definitions, to enhance responsible use of de-identified health data.

Monitor implementation of healthcare quality, cost, and access and related health care reform efforts. Monitor implementation of health provisions in the American Rescue Plan Act, P.L. 117-2, and Inflation Reduction Act, P.L. 117-169. Enhance preventive health in health care, including related provisions in H.R. 766/S. 114, the Preventive Health Savings Act, to amend the Congressional Budget Act of 1974 with respect to the scoring of preventive health savings. Medicare reimbursement for telemedicine, including related provisions in: H.R. 7623, the Telehealth Modernization Act of 2024 - Sec. 101, Extension of Certain Telehealth Flexibilities; and H.R. 8261, the Preserving Telehealth, Hospital, and Ambulance Access Act - Sec. 2, Extending Medicare Telehealth Flexibilities.

Monitor implementation of healthcare quality, cost, and access and related health care reform efforts. Monitor implementation of health provisions in the American Rescue Plan Act, P.L. 117-2, and Inflation Reduction Act, P.L. 117-169. Enhance preventive health in health care, including related provisions in H.R. 766/S. 114, the Preventive Health Savings Act, to amend the Congressional Budget Act of 1974 with respect to the scoring of preventive health savings. Medicare reimbursement for telemedicine, including related provisions in: H.R. 7623, the Telehealth Modernization Act of 2024 - Sec. 101, Extension of Certain Telehealth Flexibilities; and H.R. 8261, the Preserving Telehealth, Hospital, and Ambulance Access Act - Sec. 2, Extending Medicare Telehealth Flexibilities. Advocate for extending Medicare flexibilities in telehealth as part of H.R. ____ Further Continuing Appropriations and Disaster Relief Supplemental Appropriations Act, 2025.

Update and reforms to Medicare payments for physicians and implementation of related provisions of the Medicare Access and CHIP ReauthorizationAct (MACRA), including regulatory relief for physicians in the MACRA Quality Payment Program, evaluation and management (E/M) codes andrelated legislative issues related to payment for E/M codes, and qualified clinical data registries, including Medicare physician payment provisions in:(1) S. 3430, the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act, Sec. 403 to extend work geographic index floor under Medicare; Sec. 404 to extend incentive payments for participation in eligible alternative payment models; and Sec. 407 to increase support for physicians and other professionals in adjusting to Medicare payment changes; (2) H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; and (3) H.R. 4366, the Consolidated Appropriations Act, 2024, P.L. 118-42: Sec.304, Extending Incentive Payments for Participation in Eligible Alternative Payment Models; and Sec. 305, Temporary Payment Increase under the Medicare Physician Fee Schedule to Account for Exceptional Circumstances and Atypical Timing of Enactment. Maintain patient access to In-Office Ancillary Services. Issues related to adequate network coverage for ophthalmology care within Medicare Advantage plans and advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans, including related provisions in: H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. MA plan provider directory accuracy issues, including related provisions in S. 3430, the Better Mental Health Care, Lower Cost Drugs, and Extenders Act of 2023, in Sec. 109, to require MA plans to maintain accurate provider directories on a public website. Legislative issues regarding implementation of Meaningful Use of Electronic Health Records. Medicare reimbursement for telemedicine, including related provisions in S. 3430, the Better Mental Health Care, Lower Costs Drugs, and Extenders Act, including Sec. 105 regarding Medicare payment for mental health services furnished through telehealth, and Sec. 107 regarding communications regarding telehealth and interstate licensure requirements; H.R. 7623, The Telehealth Modernization Act of 2024; SEC. 101. Extension of Certain Telehealth Flexibilities; H.R. 8261, the Preserving Telehealth, Hospital, and Ambulance Access Act; Section 2, extending Medicare Telehealth Flexibilities. Medicare RAC reform and use of step therapy in Medicare and health insurance coverage including related provisions in H.R. 2630/S. 652, the SafeStep Act. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor CMMI Medicare Part B drug-related demonstrations.

Adequacy of Medicare physician payments for physicians and implementation of the Medicare Access and CHIP Reauthorization Act, including related provisions in: (1) S. 4935 Physician Fee Stabilization Act and H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; (2) H.R. 6683, the Preserving Seniors Access to Physicians Act; (3) H.R. 2474, the Strengthening Medicare for Patients and Providers Act; and (4) HR ____ Further Continuing Appropriations and Disaster Relief Supplemental Appropriations Act, 2025-related to physician payment adjustment of 2.5%. Issues related to adequate network coverage for ophthalmology care within Medicare Advantage plans and advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans, including related provisions in: H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Medicare reimbursement for telemedicine, including related provisions in S. 3430, the Better Mental Health Care, Lower Costs Drugs, and Extenders Act, including Sec. 105 regarding Medicare payment for mental health services furnished through telehealth, and Sec. 107 regarding communications regarding telehealth and interstate licensure requirements; H.R. 7623, The Telehealth Modernization Act of 2024; SEC. 101. Extension of Certain Telehealth Flexibilities; H.R. 8261, the Preserving Telehealth, Hospital, and Ambulance Access Act; Section 2, extending Medicare Telehealth Flexibilities. Use of step therapy in Medicare and health insurance coverage, including related provisions in H.R. 2630/S. 652, the Safe Step Act. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor CMMI Medicare Part B drug-related demonstrations.

Monitor implementation of healthcare quality, cost, and access and related health care reform efforts. Monitor implementation of health provisions in the American Rescue Plan Act, P.L. 117-2, and Inflation Reduction Act, P.L. 117-169. Enhance preventive health in health care, including related provisions in H.R. 766/S. 114, the Preventive Health Savings Act, to amend the Congressional Budget Act of 1974 with respect to the scoring of preventive health savings. Medicare reimbursement for telemedicine, including related provisions in: H.R. 7623, the Telehealth Modernization Act of 2024 - Sec. 101, Extension of Certain Telehealth Flexibilities; and H.R. 8261, the Preserving Telehealth, Hospital, and Ambulance Access Act - Sec. 2, Extending Medicare Telehealth Flexibilities.

Adequacy of Medicare physician payments for physicians and implementation of the Medicare Access and CHIP Reauthorization Act, including related provisions in: (1) S. 4935 Physician Fee Stabilization Act and H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; (2) H.R. 6683, the Preserving Seniors Access to Physicians Act; and (3) H.R. 2474, the Strengthening Medicare for Patients and Providers Act. Issues related to adequate network coverage for ophthalmology care within Medicare Advantage plans and advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans, including related provisions in: H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Medicare reimbursement for telemedicine, including related provisions in S. 3430, the Better Mental Health Care, Lower Costs Drugs, and Extenders Act, including Sec. 105 regarding Medicare payment for mental health services furnished through telehealth, and Sec. 107 regarding communications regarding telehealth and interstate licensure requirements; H.R. 7623, The Telehealth Modernization Act of 2024; SEC. 101. Extension of Certain Telehealth Flexibilities; H.R. 8261, the Preserving Telehealth, Hospital, and Ambulance Access Act; Section 2, extending Medicare Telehealth Flexibilities. Use of step therapy in Medicare and health insurance coverage, including related provisions in H.R. 2630/S. 652, the Safe Step Act. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor CMMI Medicare Part B drug-related demonstrations.

Monitor implementation of healthcare quality, cost, and access and related health care reform efforts. Monitor implementation of health provisions in the American Rescue Plan Act, P.L. 117-2, and Inflation Reduction Act, P.L. 117-169. Enhance preventive health in health care, including related provisions in H.R. 766/S. 114, the Preventive Health Savings Act, to amend the Congressional Budget Act of 1974 with respect to the scoring of preventive health savings. Medicare reimbursement for telemedicine, including related provisions in: H.R. 7623, the Telehealth Modernization Act of 2024 - Sec. 101, Extension of Certain Telehealth Flexibilities; and H.R. 8261, the Preserving Telehealth, Hospital, and Ambulance Access Act - Sec. 2, Extending Medicare Telehealth Flexibilities.

Monitor implementation of healthcare quality, cost, and access and related health care reform efforts. Monitor implementation of health provisions in the American Rescue Plan Act, P.L. 117-2, and Inflation Reduction Act, P.L. 117-169. Enhance preventive health in health care, including related provisions in H.R. 766/S. 114, the Preventive Health Savings Act, to amend the Congressional Budget Act of 1974 with respect to the scoring of preventive health savings. Medicare reimbursement for telemedicine, including related provisions in: H.R. 7623, the Telehealth Modernization Act of 2024 - Sec. 101, Extension of Certain Telehealth Flexibilities; and H.R. 8261, the Preserving Telehealth, Hospital, and Ambulance Access Act - Sec. 2, Extending Medicare Telehealth Flexibilities. Advocate for extending Medicare flexibilities in telehealth as part of H.R. ____ Further Continuing Appropriations and Disaster Relief Supplemental Appropriations Act, 2025.

Monitor implementation of healthcare quality, cost, and access and related health care reform efforts. Monitor implementation of health provisions in the American Rescue Plan Act, P.L. 117-2, and Inflation Reduction Act, P.L. 117-169. Enhance preventive health in health care, including related provisions in H.R. 766/S. 114, the Preventive Health Savings Act, to amend the Congressional Budget Act of 1974 with respect to the scoring of preventive health savings. Medicare reimbursement for telemedicine, including related provisions in: H.R. 7623, the Telehealth Modernization Act of 2024 - Sec. 101, Extension of Certain Telehealth Flexibilities; and H.R. 8261, the Preserving Telehealth, Hospital, and Ambulance Access Act - Sec. 2, Extending Medicare Telehealth Flexibilities.

Repeal Section 6001 of the Affordable Care Act - section 6001 prohibits expansion of physician-led hospitals - including related provisions in H.R. 977/S. 470, the Patient Access to Higher Quality Care Act; and in H.R. 9001, the Physician Led and Rural Access to Quality Care Act, to revise certain physician self-referral exemptions relating to physician-owned hospitals in rural areas; and related issues regarding hospital competition and consolidation. Center for Medicare & Medicaid Innovation demonstration to expand patient access to physician-led hospitals. Reform Medicare Advantage prior authorization, including related provisions in: H.R. 4968, the GOLD Card Act; H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Advocacy related to H.R. 8246, Second Chances for Rural Hospitals Act, and access to physician-led entities.

Repeal Section 6001 of the Affordable Care Act - section 6001 prohibits expansion of physician-led hospitals - including related provisions in H.R. 977/S. 470, the Patient Access to Higher Quality Care Act; and in H.R. 9001, the Physician Led and Rural Access to Quality Care Act, to revise certain physician self-referral exemptions relating to physician-owned hospitals in rural areas; and related issues regarding hospital competition and consolidation. Center for Medicare & Medicaid Innovation demonstration to expand patient access to physician-led hospitals. Reform Medicare Advantage prior authorization, including related provisions in: H.R. 4968, the GOLD Card Act; H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Advocacy related to H.R. 8246, Second Chances for Rural Hospitals Act, and access to physician-led entities.

Monitor implementation of healthcare quality, cost, and access and related health care reform efforts. Monitor implementation of health provisions in the American Rescue Plan Act, P.L. 117-2, and Inflation Reduction Act, P.L. 117-169. Enhance preventive health in health care, including related provisions in H.R. 766/S. 114, the Preventive Health Savings Act, to amend the Congressional Budget Act of 1974 with respect to the scoring of preventive health savings. Medicare reimbursement for telemedicine, including related provisions in: H.R. 7623, the Telehealth Modernization Act of 2024 - Sec. 101, Extension of Certain Telehealth Flexibilities; and H.R. 8261, the Preserving Telehealth, Hospital, and Ambulance Access Act - Sec. 2, Extending Medicare Telehealth Flexibilities.

Adequacy of Medicare physician payments for physicians and implementation of the Medicare Access and CHIP Reauthorization Act, including related provisions in: (1) S. 4935 Physician Fee Stabilization Act and H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; (2) H.R. 6683, the Preserving Seniors Access to Physicians Act; (3) H.R. 2474, the Strengthening Medicare for Patients and Providers Act; and (4) HR ____ Further Continuing Appropriations and Disaster Relief Supplemental Appropriations Act, 2025-related to physician payment adjustment of 2.5%. Issues related to adequate network coverage for ophthalmology care within Medicare Advantage plans and advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans, including related provisions in: H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Medicare reimbursement for telemedicine, including related provisions in S. 3430, the Better Mental Health Care, Lower Costs Drugs, and Extenders Act, including Sec. 105 regarding Medicare payment for mental health services furnished through telehealth, and Sec. 107 regarding communications regarding telehealth and interstate licensure requirements; H.R. 7623, The Telehealth Modernization Act of 2024; SEC. 101. Extension of Certain Telehealth Flexibilities; H.R. 8261, the Preserving Telehealth, Hospital, and Ambulance Access Act; Section 2, extending Medicare Telehealth Flexibilities. Use of step therapy in Medicare and health insurance coverage, including related provisions in H.R. 2630/S. 652, the Safe Step Act. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor CMMI Medicare Part B drug-related demonstrations.

Monitor implementation of healthcare quality, cost, and access and related health care reform efforts. Monitor implementation of health provisions in the American Rescue Plan Act, P.L. 117-2, and Inflation Reduction Act, P.L. 117-169. Enhance preventive health in health care, including related provisions in H.R. 766/S. 114, the Preventive Health Savings Act, to amend the Congressional Budget Act of 1974 with respect to the scoring of preventive health savings. Medicare reimbursement for telemedicine, including related provisions in: H.R. 7623, the Telehealth Modernization Act of 2024 - Sec. 101, Extension of Certain Telehealth Flexibilities; and H.R. 8261, the Preserving Telehealth, Hospital, and Ambulance Access Act - Sec. 2, Extending Medicare Telehealth Flexibilities.

Adequacy of Medicare physician payments for physicians and implementation of the Medicare Access and CHIP Reauthorization Act, including related provisions in: (1) S. 4935 Physician Fee Stabilization Act and H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; (2) H.R. 6683, the Preserving Seniors Access to Physicians Act; and (3) H.R. 2474, the Strengthening Medicare for Patients and Providers Act. Issues related to adequate network coverage for ophthalmology care within Medicare Advantage plans and advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans, including related provisions in: H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Medicare reimbursement for telemedicine, including related provisions in S. 3430, the Better Mental Health Care, Lower Costs Drugs, and Extenders Act, including Sec. 105 regarding Medicare payment for mental health services furnished through telehealth, and Sec. 107 regarding communications regarding telehealth and interstate licensure requirements; H.R. 7623, The Telehealth Modernization Act of 2024; SEC. 101. Extension of Certain Telehealth Flexibilities; H.R. 8261, the Preserving Telehealth, Hospital, and Ambulance Access Act; Section 2, extending Medicare Telehealth Flexibilities. Use of step therapy in Medicare and health insurance coverage, including related provisions in H.R. 2630/S. 652, the Safe Step Act. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor CMMI Medicare Part B drug-related demonstrations.

Monitor implementation of healthcare quality, cost, and access and related health care reform efforts. Monitor implementation of health provisions in the American Rescue Plan Act, P.L. 117-2, and Inflation Reduction Act, P.L. 117-169. Enhance preventive health in health care, including related provisions in H.R. 766/S. 114, the Preventive Health Savings Act, to amend the Congressional Budget Act of 1974 with respect to the scoring of preventive health savings. Medicare reimbursement for telemedicine, including related provisions in: H.R. 7623, the Telehealth Modernization Act of 2024 - Sec. 101, Extension of Certain Telehealth Flexibilities; and H.R. 8261, the Preserving Telehealth, Hospital, and Ambulance Access Act - Sec. 2, Extending Medicare Telehealth Flexibilities. Advocate for extending Medicare flexibilities in telehealth as part of H.R. ____ Further Continuing Appropriations and Disaster Relief Supplemental Appropriations Act, 2025.

Update and reforms to Medicare payments for physicians and implementation of related provisions of the Medicare Access and CHIP ReauthorizationAct (MACRA), including regulatory relief for physicians in the MACRA Quality Payment Program, evaluation and management (E/M) codes andrelated legislative issues related to payment for E/M codes, and qualified clinical data registries, including Medicare physician payment provisions in:(1) S. 3430, the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act, Sec. 403 to extend work geographic index floor under Medicare; Sec. 404 to extend incentive payments for participation in eligible alternative payment models; and Sec. 407 to increase support for physicians and other professionals in adjusting to Medicare payment changes; (2) H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; and (3) H.R. 4366, the Consolidated Appropriations Act, 2024, P.L. 118-42: Sec.304, Extending Incentive Payments for Participation in Eligible Alternative Payment Models; and Sec. 305, Temporary Payment Increase under the Medicare Physician Fee Schedule to Account for Exceptional Circumstances and Atypical Timing of Enactment. Maintain patient access to In-Office Ancillary Services. Issues related to adequate network coverage for ophthalmology care within Medicare Advantage plans and advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans, including related provisions in: H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. MA plan provider directory accuracy issues, including related provisions in S. 3430, the Better Mental Health Care, Lower Cost Drugs, and Extenders Act of 2023, in Sec. 109, to require MA plans to maintain accurate provider directories on a public website. Legislative issues regarding implementation of Meaningful Use of Electronic Health Records. Medicare reimbursement for telemedicine, including related provisions in S. 3430, the Better Mental Health Care, Lower Costs Drugs, and Extenders Act, including Sec. 105 regarding Medicare payment for mental health services furnished through telehealth, and Sec. 107 regarding communications regarding telehealth and interstate licensure requirements; H.R. 7623, The Telehealth Modernization Act of 2024; SEC. 101. Extension of Certain Telehealth Flexibilities; H.R. 8261, the Preserving Telehealth, Hospital, and Ambulance Access Act; Section 2, extending Medicare Telehealth Flexibilities. Medicare RAC reform and use of step therapy in Medicare and health insurance coverage including related provisions in H.R. 2630/S. 652, the SafeStep Act. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor CMMI Medicare Part B drug-related demonstrations.

Repeal Section 6001 of the Affordable Care Act - section 6001 prohibits expansion of physician-led hospitals - including related provisions in H.R. 977/S. 470, the Patient Access to Higher Quality Care Act; and in H.R. 9001, the Physician Led and Rural Access to Quality Care Act, to revise certain physician self-referral exemptions relating to physician-owned hospitals in rural areas; and related issues regarding hospital competition and consolidation. Center for Medicare & Medicaid Innovation demonstration to expand patient access to physician-led hospitals. Reform Medicare Advantage prior authorization, including related provisions in: H.R. 4968, the GOLD Card Act; H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Advocacy related to H.R. 8246, Second Chances for Rural Hospitals Act, and access to physician-led entities.

Adequacy of Medicare physician payments for physicians and implementation of the Medicare Access and CHIP Reauthorization Act, including related provisions in: (1) S. 4935 Physician Fee Stabilization Act and H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; (2) H.R. 6683, the Preserving Seniors Access to Physicians Act; and (3) H.R. 2474, the Strengthening Medicare for Patients and Providers Act. Issues related to adequate network coverage for ophthalmology care within Medicare Advantage plans and advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans, including related provisions in: H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Medicare reimbursement for telemedicine, including related provisions in S. 3430, the Better Mental Health Care, Lower Costs Drugs, and Extenders Act, including Sec. 105 regarding Medicare payment for mental health services furnished through telehealth, and Sec. 107 regarding communications regarding telehealth and interstate licensure requirements; H.R. 7623, The Telehealth Modernization Act of 2024; SEC. 101. Extension of Certain Telehealth Flexibilities; H.R. 8261, the Preserving Telehealth, Hospital, and Ambulance Access Act; Section 2, extending Medicare Telehealth Flexibilities. Use of step therapy in Medicare and health insurance coverage, including related provisions in H.R. 2630/S. 652, the Safe Step Act. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor CMMI Medicare Part B drug-related demonstrations.