MICHELLE MATHY

Legislative and regulatory issues related to emergency medicine, including provisions found in H.R. 1, the One Big Beautiful Bill Act (OBBB) P.L. 119-21. Additionally, issues such as surprise medical billing; mental health including H.R.929 / S.266, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act; Medicare payment including, H.R. 879 Medicare Patient and Practice Stabilization Act of 2025; workforce issues, drug shortages and rural emergency hospitals. Support of S. 891 the Bipartisan Health Care Act, S.1974 the Addressing Boarding and Crowding in the Emergency Department (ABC-ED) Act of 2025.

Monitoring legislative and regulatory issues related to pharmacies. Medicaid prescription drug reimbursement. Pharmacy Benefit Manager provisions included in H.R. 1 the One Big Beautiful Bill Act (OBBB) P.L. 119-21.

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, S. 891 the Bipartisan Health Care Act of 2025 and H.R. 1, the One Big Beautiful Bill Act (OBBB) P.L. 119-21, 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. 879 - Medicare Patient and Practice Stabilization Act of 2025, S. 891 - Bipartisan Health Care Act, and H.R. 1, the One Big Beautiful Bill Act (OBBB) P.L. 119-21. 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 related to Medicare Part B prescription drug reimbursement. Pharmacy Benefit Management Reform in Medicare Part D, including provisions found in H.R. 1, the One Big Beautiful Bill Act (OBBB) P.L. 119-21.

Legislative issues related to access to pharmaceuticals; Rebates in Medicaid and for dual-eligibles; Medicaid coverage issues; 340B Drug Program; Medicare Part B and D prescription drug reimbursement. Pharmacy Benefit Management Reform in Medicare Part D, including provisions found in H.R. 1, the One Big Beautiful Bill Act (OBBB) P.L. 119-21.

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, S. 891 the Bipartisan Health Care Act of 2025 and H.R. 1, the One Big Beautiful Bill Act (OBBB) P.L. 119-21, 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.

Monitoring legislative and regulatory issues related to pharmacies. Medicaid prescription drug reimbursement. Pharmacy Benefit Manager provisions included in H.R. 1 the One Big Beautiful Bill Act (OBBB) P.L. 119-21.

Issues regarding the Inflation Reduction Act (IRA) P.L. No: 117-169, drug pricing, and efforts to create a Neuroscience Center of Excellence at FDA. PBM Issues, including H.R./S._ Modernizing and Ensuring PBM Accountability Act and H.R./S._Lower Costs, More Transparency Act. Issues regarding effective solutions for improving clinical care in long-term care settings and other solutions aimed at improving the diagnosis and management of neuropsychiatric symptoms (NPS) in dementia. Orphan Drug Provisions included in HR.1, the One Big Beautiful Bill Act (OBBB) P.L. 119-21.

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. 879 - Medicare Patient and Practice Stabilization Act of 2025, S. 891 - Bipartisan Health Care Act, and H.R. 1, the One Big Beautiful Bill Act (OBBB) P.L. 119-21. 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.

Repeal Section 6001 of the Affordable Care Act - section 6001 prohibits expansion of physician-led hospitals - including related provisions in H.R. 2191. Issues regarding CMMI demonstration and Medicare 2-2-2 policy.

Repeal Section 6001 of the Affordable Care Act - section 6001 prohibits expansion of physician-led hospitals - including related provisions in H.R. 2191. Issues regarding CMMI demonstration and Medicare 2-2-2 policy.

Repeal Section 6001 of the Affordable Care Act - section 6001 prohibits expansion of physician-led hospitals - including related provisions in H.R. 2191. Issues regarding CMMI demonstration and Medicare 2-2-2 policy.

Legislative and regulatory issues related to emergency medicine, including surprise medical billing; mental health including H.R.929 / S.266, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act; Medicare payment including H.R. 879 Medicare Patient and Practice Stabilization Act of 2025; workforce issues, drug shortages and rural emergency hospitals. Support of S. 891 the Bipartisan Health Care Act.

Legislative and regulatory issues related to emergency medicine, including provisions found in H.R. 1, the One Big Beautiful Bill Act (OBBB) P.L. 119-21. Additionally, issues such as surprise medical billing; mental health including H.R.929 / S.266, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act; Medicare payment including, H.R. 879 Medicare Patient and Practice Stabilization Act of 2025; workforce issues, drug shortages and rural emergency hospitals. Support of S. 891 the Bipartisan Health Care Act, S.1974 the Addressing Boarding and Crowding in the Emergency Department (ABC-ED) Act of 2025.

Legislative and regulatory issues related to emergency medicine, including provisions found in H.R. 1, the One Big Beautiful Bill Act (OBBB) P.L. 119-21. Additionally, issues such as surprise medical billing; mental health including H.R.929 / S.266, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act; Medicare payment including, H.R. 879 Medicare Patient and Practice Stabilization Act of 2025; workforce issues, drug shortages and rural emergency hospitals. Support of S. 891 the Bipartisan Health Care 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 related provisions in H.R. 879 - Medicare Patient and Practice Stabilization Act of 2025, S. 891 - Bipartisan Health Care Act, and H.R. 1, the One Big Beautiful Bill Act (OBBB) P.L. 119-21. 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.

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, S. 891 the Bipartisan Health Care Act of 2025 and H.R. 1, the One Big Beautiful Bill Act (OBBB) P.L. 119-21, 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. 879 - Medicare Patient and Practice Stabilization Act of 2025, S. 891 - Bipartisan Health Care Act, and H.R. 1, the One Big Beautiful Bill Act (OBBB) P.L. 119-21. 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.

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, S. 891 the Bipartisan Health Care Act of 2025 and H.R. 1, the One Big Beautiful Bill Act (OBBB) P.L. 119-21, 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.

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. 879 - Medicare Patient and Practice Stabilization Act of 2025 and S. 891 - Bipartisan Health Care Act. 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 and regulatory issues related to emergency medicine, including surprise medical billing; mental health including H.R.929 / S.266, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act; Medicare payment including H.R. 879 Medicare Patient and Practice Stabilization Act of 2025; workforce issues, drug shortages and rural emergency hospitals. Support of S. 891 the Bipartisan Health Care Act.

Legislative and regulatory issues related to emergency medicine, including provisions found in H.R. 1, the One Big Beautiful Bill Act (OBBB) P.L. 119-21. Additionally, issues such as surprise medical billing; mental health including H.R.929 / S.266, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act; Medicare payment including, H.R. 879 Medicare Patient and Practice Stabilization Act of 2025; workforce issues, drug shortages and rural emergency hospitals. Support of S. 891 the Bipartisan Health Care Act.

Legislative and regulatory issues related to emergency medicine, including provisions found in H.R. 1, the One Big Beautiful Bill Act (OBBB) P.L. 119-21. Additionally, issues such as surprise medical billing; mental health including H.R.929 / S.266, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act; Medicare payment including, H.R. 879 Medicare Patient and Practice Stabilization Act of 2025; workforce issues, drug shortages and rural emergency hospitals. Support of S. 891 the Bipartisan Health Care Act, S.1974 the Addressing Boarding and Crowding in the Emergency Department (ABC-ED) Act of 2025.

Legislative and regulatory issues related to emergency medicine, including provisions found in H.R. 1, the One Big Beautiful Bill Act (OBBB) P.L. 119-21. Additionally, issues such as surprise medical billing; mental health including H.R.929 / S.266, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act; Medicare payment including, H.R. 879 Medicare Patient and Practice Stabilization Act of 2025; workforce issues, drug shortages and rural emergency hospitals. Support of S. 891 the Bipartisan Health Care Act, S.1974 the Addressing Boarding and Crowding in the Emergency Department (ABC-ED) Act of 2025.

Legislative and regulatory issues related to emergency medicine, including provisions found in H.R. 1, the One Big Beautiful Bill Act (OBBB) P.L. 119-21. Additionally, issues such as surprise medical billing; mental health including H.R.929 / S.266, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act; Medicare payment including, H.R. 879 Medicare Patient and Practice Stabilization Act of 2025; workforce issues, drug shortages and rural emergency hospitals. Support of S. 891 the Bipartisan Health Care Act.

Legislative and regulatory issues related to emergency medicine, including provisions found in H.R. 1, the One Big Beautiful Bill Act (OBBB) P.L. 119-21. Additionally, issues such as surprise medical billing; mental health including H.R.929 / S.266, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act; Medicare payment including, H.R. 879 Medicare Patient and Practice Stabilization Act of 2025; workforce issues, drug shortages and rural emergency hospitals. Support of S. 891 the Bipartisan Health Care Act, S.1974 the Addressing Boarding and Crowding in the Emergency Department (ABC-ED) Act of 2025.

Legislative and regulatory issues related to emergency medicine, including surprise medical billing; mental health including H.R.929 / S.266, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act; Medicare payment including H.R. 879 Medicare Patient and Practice Stabilization Act of 2025; workforce issues, drug shortages and rural emergency hospitals. Support of S. 891 the Bipartisan Health Care Act.

Legislative and regulatory issues related to emergency medicine, including provisions found in H.R. 1, the One Big Beautiful Bill Act (OBBB) P.L. 119-21. Additionally, issues such as surprise medical billing; mental health including H.R.929 / S.266, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act; Medicare payment including, H.R. 879 Medicare Patient and Practice Stabilization Act of 2025; workforce issues, drug shortages and rural emergency hospitals. Support of S. 891 the Bipartisan Health Care 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 related provisions in H.R. 879 - Medicare Patient and Practice Stabilization Act of 2025, S. 891 - Bipartisan Health Care Act, and H.R. 1, the One Big Beautiful Bill Act (OBBB) P.L. 119-21. 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.

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, S. 891 the Bipartisan Health Care Act of 2025 and H.R. 1, the One Big Beautiful Bill Act (OBBB) P.L. 119-21, 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.

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. 879 - Medicare Patient and Practice Stabilization Act of 2025, S. 891 - Bipartisan Health Care Act, and H.R. 1, the One Big Beautiful Bill Act (OBBB) P.L. 119-21. 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 and regulatory issues related to emergency medicine, including provisions found in H.R. 1, the One Big Beautiful Bill Act (OBBB) P.L. 119-21. Additionally, issues such as surprise medical billing; mental health including H.R.929 / S.266, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act; Medicare payment including, H.R. 879 Medicare Patient and Practice Stabilization Act of 2025; workforce issues, drug shortages and rural emergency hospitals. Support of S. 891 the Bipartisan Health Care Act, S.1974 the Addressing Boarding and Crowding in the Emergency Department (ABC-ED) Act of 2025.

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, S. 891 the Bipartisan Health Care Act of 2025 and H.R. 1, the One Big Beautiful Bill Act (OBBB) P.L. 119-21, 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. 879 - Medicare Patient and Practice Stabilization Act of 2025 and S. 891 - Bipartisan Health Care Act. 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 and regulatory issues related to emergency medicine, including surprise medical billing; mental health including H.R.929 / S.266, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act; Medicare payment including H.R. 879 Medicare Patient and Practice Stabilization Act of 2025; workforce issues, drug shortages and rural emergency hospitals. Support of S. 891 the Bipartisan Health Care Act.

Issues related to appropriate payment legislation for diagnostic radiopharmaceuticals. H.R.1199 - Facilitating Innovative Nuclear Diagnostics Act of 2023.

Issues related to appropriate payment legislation for diagnostic radiopharmaceuticals. H.R.1199 - Facilitating Innovative Nuclear Diagnostics Act of 2023.

To gain support for adequate Medicare reimbursement for diagnostic radiopharmaceuticals; H.R.1199 - Facilitating Innovative Nuclear Diagnostics Act of 2023.

To gain support for adequate Medicare reimbursement for diagnostic radiopharmaceuticals; H.R.1199 - Facilitating Innovative Nuclear Diagnostics Act of 2023.

Issues related to appropriate payment legislation for diagnostic radiopharmaceuticals. H.R.1199 - Facilitating Innovative Nuclear Diagnostics Act of 2023.

Issues related to appropriate payment legislation for diagnostic radiopharmaceuticals. H.R.1199 - Facilitating Innovative Nuclear Diagnostics Act of 2023.

To gain support for adequate Medicare reimbursement for diagnostic radiopharmaceuticals; H.R.1199 - Facilitating Innovative Nuclear Diagnostics Act of 2023.

To gain support for adequate Medicare reimbursement for diagnostic radiopharmaceuticals; H.R.1199 - Facilitating Innovative Nuclear Diagnostics Act of 2023.

To gain support for adequate Medicare reimbursement for diagnostic radiopharmaceuticals; H.R.1199 - Facilitating Innovative Nuclear Diagnostics Act of 2023.

To gain support for adequate Medicare reimbursement for diagnostic radiopharmaceuticals; H.R.1199 - Facilitating Innovative Nuclear Diagnostics Act of 2023.

To gain support for adequate Medicare reimbursement for diagnostic radiopharmaceuticals; H.R.1199 - Facilitating Innovative Nuclear Diagnostics Act of 2023.

Issues related to appropriate payment legislation for diagnostic radiopharmaceuticals. H.R.1199 - Facilitating Innovative Nuclear Diagnostics Act of 2023.

To gain support for adequate Medicare reimbursement for diagnostic radiopharmaceuticals; H.R.1199 - Facilitating Innovative Nuclear Diagnostics Act of 2023.

Package Inserts/E-Labeling Issues (H.R. 1503 Prescription Information Modernization Act of 2023). Issues related to the Vaccine Injury Compensation Program.

Package Inserts/E-Labeling Issues (H.R. 1503 Prescription Information Modernization Act of 2023). Issues related to the Vaccine Injury Compensation Program.

Package Inserts/E-Labeling Issues (H.R. 1503 Prescription Information Modernization Act of 2023). Issues related to the Vaccine Injury Compensation Program.

Package Inserts/E-Labeling Issues (H.R. 1503 Prescription Information Modernization Act of 2023). Issues related to the Vaccine Injury Compensation Program.

Regulation of Ethylene Oxide; H.R. 2369 VALID Act of 2023; H.R. 1691 the Ensuring Patient Access to Critical Breakthrough Products Act of 2023.

Regulation of Ethylene Oxide; H.R. 2369 VALID Act of 2023; H.R. 1691 the Ensuring Patient Access to Critical Breakthrough Products Act of 2023.

Regulation of Ethylene Oxide; H.R. 2369 VALID Act of 2023; H.R. 1691 the Ensuring Patient Access to Critical Breakthrough Products Act of 2023.

Regulation of Ethylene Oxide; H.R. 2369 VALID Act of 2023; H.R. 1691 the Ensuring Patient Access to Critical Breakthrough Products Act of 2023.

Regulation of Ethylene Oxide; H.R. 2369 VALID Act of 2023; H.R. 1691 the Ensuring Patient Access to Critical Breakthrough Products Act of 2023.

Regulation of Ethylene Oxide; H.R. 2369 VALID Act of 2023; H.R. 1691 the Ensuring Patient Access to Critical Breakthrough Products Act of 2023.

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; 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.

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.

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 S. 4935 Physician Fee Stabilization Act, 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.

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 S. 4935 Physician Fee Stabilization Act, 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.

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.

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.

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.

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.

Issues related to Medicare Part D and prescription drug pricing and patient access, including monitor implementation of related provisions in H.R. 5376, the Inflation Reduction Act of 2022 (P.L. 117-169), including provisions in Title 1, Subtitle B - Prescription Drug Pricing Reform: Part 1, Lowering Prices Through Drug Price Negotiation; Part 2, Prescription Drug Inflation Rebates; and Part 3, Part D Improvements and Maximum Out-of-Pocket Cap for Medicare Beneficiaries. Issues related to pharmacy benefit manager transparency, including related provisions in S. 2973, the Modernizing and Ensuring PBM Accountability Act, H.R. 5378, the Lower Costs, More Transparency Act, H.R. 4822, the Health Care Price Transparency Act; H.R. 2880, the Protecting Patients Against PBM Abuses Act, including provisions to establish new requirements for PBMs in Medicare Part D; and H.R. 5385, the Medicare PBM Accountability Act, including provisions to enhance PBM reporting requirements and reporting drug pricing information to HHS.

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, 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.

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.

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.

Issues related to Medicare Part D and prescription drug pricing and patient access, including monitor implementation of related provisions in H.R. 5376, the Inflation Reduction Act of 2022 (P.L. 117-169), including provisions in Title 1, Subtitle B - Prescription Drug Pricing Reform: Part 1, Lowering Prices Through Drug Price Negotiation; Part 2, Prescription Drug Inflation Rebates; and Part 3, Part D Improvements and Maximum Out-of-Pocket Cap for Medicare Beneficiaries. Issues related to pharmacy benefit manager transparency, including related provisions in S. 2973, the Modernizing and Ensuring PBM Accountability Act, H.R. 5378, the Lower Costs, More Transparency Act, H.R. 4822, the Health Care Price Transparency Act; H.R. 2880, the Protecting Patients Against PBM Abuses Act, including provisions to establish new requirements for PBMs in Medicare Part D; and H.R. 5385, the Medicare PBM Accountability Act, including provisions to enhance PBM reporting requirements and reporting drug pricing information to HHS.

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.

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.

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.

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.

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 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.

Advocating on behalf of ASC reimbursement and payment policy, including HR 972/S312 - the Outpatient Surgery and Quality Access Act. H.R. 5181 - Outpatient Surgery Quality and Access Act of 2023; H.R. 5378, the Lower Costs, More Transparency Act; S 1130 Health Care Prices Revealed and Information to Consumers Explained Transparency Act or the Health Care PRICE Transparency Act.

Advocating on behalf of ASC reimbursement and payment policy, including HR 972/S312 - the Outpatient Surgery and Quality Access Act. H.R. 5181 - Outpatient Surgery Quality and Access Act of 2023; H.R. 5378, the Lower Costs, More Transparency Act; S 1130 Health Care Prices Revealed and Information to Consumers Explained Transparency Act or the Health Care PRICE Transparency Act.

Advocating on behalf of ASC reimbursement and payment policy, including HR 972/S312 - the Outpatient Surgery and Quality Access Act. H.R. 5181 - Outpatient Surgery Quality and Access Act of 2023; H.R. 5378, the Lower Costs, More Transparency Act; S 1130 Health Care Prices Revealed and Information to Consumers Explained Transparency Act or the Health Care PRICE Transparency Act.

Advocating on behalf of ASC reimbursement and payment policy, including HR 972/S312 - the Outpatient Surgery and Quality Access Act. H.R. 5181 - Outpatient Surgery Quality and Access Act of 2023; H.R. 5378, the Lower Costs, More Transparency Act; S 1130 Health Care Prices Revealed and Information to Consumers Explained Transparency Act or the Health Care PRICE Transparency Act.

Advocating on behalf of ASC reimbursement and payment policy, including HR 972/S312 - the Outpatient Surgery and Quality Access Act. H.R. 5181 - Outpatient Surgery Quality and Access Act of 2023; H.R. 5378, the Lower Costs, More Transparency Act; S 1130 Health Care Prices Revealed and Information to Consumers Explained Transparency Act or the Health Care PRICE Transparency Act.

Advocating on behalf of ASC reimbursement and payment policy, including HR 972/S312 - the Outpatient Surgery and Quality Access Act. H.R. 5181 - Outpatient Surgery Quality and Access Act of 2023; H.R. 5378, the Lower Costs, More Transparency Act; S 1130 Health Care Prices Revealed and Information to Consumers Explained Transparency Act or the Health Care PRICE Transparency Act.

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.

Issues regarding Pill Penalty caused by the Inflation Reduction Act (IRA) P.L. No: 117-169, drug pricing and efforts to create a Neuroscience Center of Excellence at FDA. PBM Issues, including S.2973 - Modernizing and Ensuring PBM Accountability Act and H.R.5378 - 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.