Reported covered position: Legislative Aide,U.S. Senator Ron Wyden Legislative Assistant,U.S. Senator Ron Wyden Health Policy Director,U.S. Representative Diana DeGette Health Policy Advisor,U.S. Senator Barbara Boxer Senior Health Policy Advisor,U.S. Senator Barbara Boxer
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Income and expense are whole-filing amounts associated with this lobbyist, not personal compensation or an allocated share.
No topic inference: each bill number appears in source LDA issue text assigned to this lobbyist.
Phair Pricing Act of 2019
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Ongoing implementation of payment and regulatory issues for the Medicare Advantage program. CMS-4182-P/CMS-4182-CN: Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2019. Medical utilization management and Medicare Advantage program policy and operations. -Issues related to the drug pricing RFI, the Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs. -Proposals that impact Medicare Part D such as formulary requirements, pharmacy benefit manager (PBM) disclosure provisions, closing the Part D coverage gap and direct negotiation of prescription drug prices. -Policy and technical changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2020 (CMS-4185-P). -Pharmacy Direct and Indirect Remuneration (DIR) H.R. 1034, the Phair Pricing Act of 2019; S.640, the Phair Pricing Act of 2019; H.R. 803, the Improving Transparency and Accuracy in Medicare Part D Spending Act; H.R. 1035, the Improving Transparency and Accuracy in Medicare Part D Spending Act. -Medicare Part B reforms. S 476, the Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2019; S.657, the Drug Price Transparency Act. Issues related to H.R. 2115, Public Disclosure of Drug Discounts Act. -Issues related to H.R. 2113, Prescription Drug Sunshine, Transparency, Accountability And Reporting (STAR) Act. -The Prescription Drug Pricing Reduction Act of 2019 (Chairman's Mark). -H.R. 2996, the More Efficient Tools to Realize Information For Consumers (METRIC) Act.
Specific issues are shown only where the LDA source assigned them to this lobbyist. Targets apply to the associated filing.
-Design, coverage and affordability of pharmacy benefits in Exchanges and the commercial market, including: e-Prescribing (eRx), Electronic Prescribing for Controlled Substances (EPCS), electronic prior authorization, step therapy, Pharmacy Benefit Manager (PBM) disclosure, medical loss ratio (MLR), and specialty pharmacy tiering. Implementation of biosimilars pathway from the Biologics Price Competition and Innovation Act (BPCIA). -Issues related to the proposed rule: Removal of Safe Harbor Protection for Rebates Involving Prescription Pharmaceuticals and Creation of New Safe Harbor Protection for Certain Point-of-Sale Reductions in Price on Prescription Pharmaceuticals and Certain Pharmacy Benefit Manager Service Fees. -Draft Patient Affordability, Value and Efficiency Act, legislation to facilitate new pharmacy payment models. -Risk Evaluation and Mitigation Strategies (REMS) reform. H.R. 965/S. 340, the CREATES Act of 2019. -Drug patent settlements. H.R. 1499, the Protecting Consumer Access to Generic Drugs Act of 2019; S.64, the Preserve Access to Affordable Generics and Biosimilars Act. -H.R. 2279, Safe Step Act (Step Therapy Bill). -Pharmacy issues related to S. 1895, the Lower Health Care Costs Act. -Issues related to S. 1384, the Prescription Drug Rebate Reform Act of 2019. -Issues related to H.R. 3, the Lower Drug Costs Now Act of 2019.
Source: Senate LDA
Phair Pricing Act of 2019
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Ongoing implementation of payment and regulatory issues for the Medicare Advantage program. CMS-4182-P/CMS-4182-CN: Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2019. Medical utilization management and Medicare Advantage program policy and operations. -Issues related to the drug pricing RFI, the Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs. -Proposals that impact Medicare Part D such as formulary requirements, pharmacy benefit manager (PBM) disclosure provisions, closing the Part D coverage gap and direct negotiation of prescription drug prices. -Policy and technical changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2020 (CMS-4185-P). -Pharmacy Direct and Indirect Remuneration (DIR) H.R. 1034, the Phair Pricing Act of 2019; S.640, the Phair Pricing Act of 2019; H.R. 803, the Improving Transparency and Accuracy in Medicare Part D Spending Act; H.R. 1035, the Improving Transparency and Accuracy in Medicare Part D Spending Act. -Medicare Part B reforms. S 476, the Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2019; S.657, the Drug Price Transparency Act. Issues related to H.R. 2115, Public Disclosure of Drug Discounts Act. -Issues related to H.R. 2113, Prescription Drug Sunshine, Transparency, Accountability And Reporting (STAR) Act.
Phair Pricing Act of 2019
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Ongoing implementation of payment and regulatory issues for the Medicare Advantage program. CMS-4182-P/CMS-4182-CN: Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2019. Medical utilization management and Medicare Advantage program policy and operations. -Issues related to the drug pricing RFI, the Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs. -Proposals that impact Medicare Part D such as formulary requirements, pharmacy benefit manager (PBM) disclosure provisions, closing the Part D coverage gap and direct negotiation of prescription drug prices. -Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2020 (CMS-4185-P). -Pharmacy Direct and Indirect Remuneration (DIR) H.R. 1034, the Phair Pricing Act of 2019; S.640, the Phair Pricing Act of 2019; H.R. 803, the Improving Transparency and Accuracy in Medicare Part D Spending Act; H.R. 1035, the Improving Transparency and Accuracy in Medicare Part D Spending Act. -Medicare Part B reforms. S 476, the Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2019; S.657, the Drug Price Transparency Act.
Prescription Drug Price Transparency Act
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Ongoing implementation of payment and regulatory issues for the Medicare Advantage program. CMS-4182-P/CMS-4182-CN: Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2019. Medical utilization management and Medicare Advantage program policy and operations. -Issues related to the drug pricing RFI, the Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs. -Proposals that impact Medicare Part D such as formulary requirements, pharmacy benefit manager (PBM) disclosure provisions, closing the Part D coverage gap and direct negotiation of prescription drug prices. -Policy and technical changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2020 (CMS-4185-P). -Pharmacy Direct and Indirect Remuneration (DIR) H.R. 1034, the Phair Pricing Act of 2019; S.640, the Phair Pricing Act of 2019; H.R. 803, the Improving Transparency and Accuracy in Medicare Part D Spending Act; H.R. 1035, the Improving Transparency and Accuracy in Medicare Part D Spending Act. -Medicare Part B reforms. S 476, the Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2019; S.657, the Drug Price Transparency Act. Issues related to H.R. 2115, Public Disclosure of Drug Discounts Act. -Issues related to H.R. 2113, Prescription Drug Sunshine, Transparency, Accountability And Reporting (STAR) Act. -The Prescription Drug Pricing Reduction Act of 2019 (Chairman's Mark). -H.R. 2996, the More Efficient Tools to Realize Information For Consumers (METRIC) Act.
Prescription Drug Price Transparency Act
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Ongoing implementation of payment and regulatory issues for the Medicare Advantage program. CMS-4182-P/CMS-4182-CN: Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2019. Medical utilization management and Medicare Advantage program policy and operations. -Issues related to the drug pricing RFI, the Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs. -Proposals that impact Medicare Part D such as formulary requirements, pharmacy benefit manager (PBM) disclosure provisions, closing the Part D coverage gap and direct negotiation of prescription drug prices. -Policy and technical changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2020 (CMS-4185-P). -Pharmacy Direct and Indirect Remuneration (DIR) H.R. 1034, the Phair Pricing Act of 2019; S.640, the Phair Pricing Act of 2019; H.R. 803, the Improving Transparency and Accuracy in Medicare Part D Spending Act; H.R. 1035, the Improving Transparency and Accuracy in Medicare Part D Spending Act. -Medicare Part B reforms. S 476, the Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2019; S.657, the Drug Price Transparency Act. Issues related to H.R. 2115, Public Disclosure of Drug Discounts Act. -Issues related to H.R. 2113, Prescription Drug Sunshine, Transparency, Accountability And Reporting (STAR) Act.
Prescription Drug Price Transparency Act
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Ongoing implementation of payment and regulatory issues for the Medicare Advantage program. CMS-4182-P/CMS-4182-CN: Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2019. Medical utilization management and Medicare Advantage program policy and operations. -Issues related to the drug pricing RFI, the Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs. -Proposals that impact Medicare Part D such as formulary requirements, pharmacy benefit manager (PBM) disclosure provisions, closing the Part D coverage gap and direct negotiation of prescription drug prices. -Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2020 (CMS-4185-P). -Pharmacy Direct and Indirect Remuneration (DIR) H.R. 1034, the Phair Pricing Act of 2019; S.640, the Phair Pricing Act of 2019; H.R. 803, the Improving Transparency and Accuracy in Medicare Part D Spending Act; H.R. 1035, the Improving Transparency and Accuracy in Medicare Part D Spending Act. -Medicare Part B reforms. S 476, the Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2019; S.657, the Drug Price Transparency Act.
Health Insurance Tax Relief Act of 2019
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Issues related to P.L. 111-148, the Patient Protection and Affordable Care Act and P.L. 111-152, the Health Care and Education Reconciliation Act. -Issues related to the implementation of international tax provisions under P.L. 115-97, the Tax Cuts and Jobs Act. -H.R. 748/S. 684, Middle Class Health Benefits Tax Repeal Act of 2019, legislation to repeal a 40% ACA excise tax on certain employer-sponsored health insurance plans. -S.172/H.R. 1398, the Health Insurance Tax (HIT) Relief Act of 2019, legislation to suspend the ACA's health insurance tax (HIT) in 2020 and 2021. S.80, Jobs and Premium Protection Act, full repeal of the HIT.
Health Insurance Tax Relief Act of 2019
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Issues related to P.L. 111-148, the Patient Protection and Affordable Care Act and P.L. 111-152, the Health Care and Education Reconciliation Act. -H.R. 748/S. 684, Middle Class Health Benefits Tax Repeal Act of 2019, legislation to repeal a 40% ACA excise tax on certain employer-sponsored health insurance plans. -S.172/H.R. 1398, the Health Insurance Tax (HIT) Relief Act of 2019, legislation to suspend the ACA's health insurance tax (HIT) in 2020 and 2021. S.80, Jobs and Premium Protection Act, full repeal of the HIT.
Health Insurance Tax Relief Act of 2019
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Issues related to P.L. 111-148, the Patient Protection and Affordable Care Act and P.L. 111-152, the Health Care and Education Reconciliation Act. -H.R. 748/S. 684, Middle Class Health Benefits Tax Repeal Act of 2019, legislation to repeal a 40% ACA excise tax on certain employer-sponsored health insurance plans. -S.172/H.R. 1398, the Health Insurance Tax (HIT) Relief Act of 2019, legislation to suspend the ACA's health insurance tax (HIT) in 2020 and 2021. S.80, Jobs and Premium Protection Act, full repeal of the HIT.
Protecting Consumer Access to Generic Drugs Act of 2019
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Design, coverage and affordability of pharmacy benefits in Exchanges and the commercial market, including: e-Prescribing (eRx), Electronic Prescribing for Controlled Substances (EPCS), electronic prior authorization, step therapy, Pharmacy Benefit Manager (PBM) disclosure, medical loss ratio (MLR), and specialty pharmacy tiering. Implementation of biosimilars pathway from the Biologics Price Competition and Innovation Act (BPCIA). -Issues related to the proposed rule: Removal of Safe Harbor Protection for Rebates Involving Prescription Pharmaceuticals and Creation of New Safe Harbor Protection for Certain Point-of-Sale Reductions in Price on Prescription Pharmaceuticals and Certain Pharmacy Benefit Manager Service Fees. -Draft Patient Affordability, Value and Efficiency Act, legislation to facilitate new pharmacy payment models. -Risk Evaluation and Mitigation Strategies (REMS) reform. H.R. 965/S. 340, the CREATES Act of 2019. -Drug patent settlements. H.R. 1499, the Protecting Consumer Access to Generic Drugs Act of 2019; S.64, the Preserve Access to Affordable Generics and Biosimilars Act. -H.R. 2279, Safe Step Act (Step Therapy Bill). -Pharmacy issues related to S. 1895, the Lower Health Care Costs Act. -Issues related to S. 1384, the Prescription Drug Rebate Reform Act of 2019. -Issues related to H.R. 3, the Lower Drug Costs Now Act of 2019.
Protecting Consumer Access to Generic Drugs Act of 2019
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Design, coverage and affordability of pharmacy benefits in Exchanges and the commercial market, including: e-Prescribing (eRx), Electronic Prescribing for Controlled Substances (EPCS), electronic prior authorization, step therapy, Pharmacy Benefit Manager (PBM) disclosure, medical loss ratio (MLR), and specialty pharmacy tiering. Implementation of biosimilars pathway from the Biologics Price Competition and Innovation Act (BPCIA). -Issues related to the proposed rule: Removal of Safe Harbor Protection for Rebates Involving Prescription Pharmaceuticals and Creation of New Safe Harbor Protection for Certain Point-of-Sale Reductions in Price on Prescription Pharmaceuticals and Certain Pharmacy Benefit Manager Service Fees. -Draft Patient Affordability, Value and Efficiency Act, legislation to facilitate new pharmacy payment models. -Risk Evaluation and Mitigation Strategies (REMS) reform. H.R. 965/S. 340, the CREATES Act of 2019. -Drug patent settlements. H.R. 1499, the Protecting Consumer Access to Generic Drugs Act of 2019; S.64, the Preserve Access to Affordable Generics and Biosimilars Act. -H.R. 2279, Safe Step Act (Step Therapy Bill). -Pharmacy issues related to S. 1895, the Lower Health Care Costs Act. -Issues related to S. 1384, the Prescription Drug Rebate Reform Act of 2019.
Protecting Consumer Access to Generic Drugs Act of 2019
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Design, coverage and affordability of pharmacy benefits in Exchanges and the commercial market, including: e-Prescribing (eRx), Electronic Prescribing for Controlled Substances (EPCS), electronic prior authorization, Pharmacy Benefit Manager (PBM) disclosure, medical loss ratio (MLR), and specialty pharmacy tiering. Implementation of biosimilars pathway from the Biologics Price Competition and Innovation Act (BPCIA). -Issues related to the proposed rule: Removal of Safe Harbor Protection for Rebates Involving Prescription Pharmaceuticals and Creation of New Safe Harbor Protection for Certain Point-of-Sale Reductions in Price on Prescription Pharmaceuticals and Certain Pharmacy Benefit Manager Service Fees. -Draft Patient Affordability, Value and Efficiency Act, legislation to facilitate new pharmacy payment models. -Risk Evaluation and Mitigation Strategies (REMS) reform. H.R. 965/S. 340, the CREATES Act of 2019. -Drug patent settlements. H.R. 1499, the Protecting Consumer Access to Generic Drugs Act of 2019; S.64, the Preserve Access to Affordable Generics and Biosimilars Act.
Overdose Prevention and Patient Safety Act
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Issues relating to P.L. 111-148, the Patient Protection and Affordable Care Act and P.L. 111-152, the Health Care and Education Reconciliation Act, including exchanges, cost sharing reduction, market reforms and coverage expansion proposals, stand-alone dental plans and non-discrimination provisions. -21st Century Cures Act, section 4004, Reducing Regulatory and Administrative Burden Relating to the Use of Health IT and EHRs, information blocking and interoperability. -Implementation of the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA), as amended by the Affordable Care Act, the 21st Century Cures Act, and ERISA, including DOL proposed FAQs about Mental Health and Substance Use Disorder Parity Implementation. -Issues related to H.R. 861, the End Surprise Billing Act and "No Surprises Act" Discussion Draft. -Issues related to 42 C.F.R. Part 2, in H.R. 2062, The Overdose Prevention and Patient Safety Act and S. 1012, the the Protecting Jessica Grubbs Legacy Act. -Issues related to S. 1895, the Lower Health Care Costs Act, including: surprise billing, and transparency and information sharing in the individual and commercial markets.
Overdose Prevention and Patient Safety Act
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Issues relating to P.L. 111-148, the Patient Protection and Affordable Care Act and P.L. 111-152, the Health Care and Education Reconciliation Act, including exchanges, cost sharing reduction, market reforms and coverage expansion proposals, stand-alone dental plans and non-discrimination provisions. -21st Century Cures Act, section 4004, Reducing Regulatory and Administrative Burden Relating to the Use of Health IT and EHRs, information blocking and interoperability. -Implementation of the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA), as amended by the Affordable Care Act, the 21st Century Cures Act, and ERISA, including DOL proposed FAQs about Mental Health and Substance Use Disorder Parity Implementation. -Issues related to H.R. 861, the End Surprise Billing Act; H.R. 3502, The Protecting People from Surprise Medical Bills Act; H.R.2328, Community Health Investment, Modernization, and Excellence Act of 2019 and H.R. 3630, The No Surprises Act. -Issues related to 42 C.F.R. Part 2, in H.R. 2062, The Overdose Prevention and Patient Safety Act and S. 1012, the the Protecting Jessica Grubbs Legacy Act. -Issues related to S. 1895, the Lower Health Care Costs Act, including: surprise billing, and transparency and information sharing in the individual and commercial markets. -June 24, 2019 Executive Order, "Improving Price and Quality Transparency in American Healthcare to Put Patients First". -S.1323, the UNDERSTAND Act, legislation to improve the collection of social determinates of health (SDOH) data using ICD-10 Z-codes to track and report standardized definitions of SDOH affecting patients. -Issues related to utilization management and S.2546, The Safe Step Act of 2019, legislation to amend the Employee Retirement Income Security Act (ERISA) to require group health plans to streamline step therapy protocols and better ensure patients are able to access treatment.
Prescription Drug STAR Act
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Ongoing implementation of payment and regulatory issues for the Medicare Advantage program. CMS-4182-P/CMS-4182-CN: Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2019. Medical utilization management and Medicare Advantage program policy and operations. -Issues related to the drug pricing RFI, the Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs. -Proposals that impact Medicare Part D such as formulary requirements, pharmacy benefit manager (PBM) disclosure provisions, closing the Part D coverage gap and direct negotiation of prescription drug prices. -Policy and technical changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2020 (CMS-4185-P). -Pharmacy Direct and Indirect Remuneration (DIR) H.R. 1034, the Phair Pricing Act of 2019; S.640, the Phair Pricing Act of 2019; H.R. 803, the Improving Transparency and Accuracy in Medicare Part D Spending Act; H.R. 1035, the Improving Transparency and Accuracy in Medicare Part D Spending Act. -Medicare Part B reforms. S 476, the Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2019; S.657, the Drug Price Transparency Act. Issues related to H.R. 2115, Public Disclosure of Drug Discounts Act. -Issues related to H.R. 2113, Prescription Drug Sunshine, Transparency, Accountability And Reporting (STAR) Act. -The Prescription Drug Pricing Reduction Act of 2019 (Chairman's Mark). -H.R. 2996, the More Efficient Tools to Realize Information For Consumers (METRIC) Act.
Prescription Drug STAR Act
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Ongoing implementation of payment and regulatory issues for the Medicare Advantage program. CMS-4182-P/CMS-4182-CN: Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2019. Medical utilization management and Medicare Advantage program policy and operations. -Issues related to the drug pricing RFI, the Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs. -Proposals that impact Medicare Part D such as formulary requirements, pharmacy benefit manager (PBM) disclosure provisions, closing the Part D coverage gap and direct negotiation of prescription drug prices. -Policy and technical changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2020 (CMS-4185-P). -Pharmacy Direct and Indirect Remuneration (DIR) H.R. 1034, the Phair Pricing Act of 2019; S.640, the Phair Pricing Act of 2019; H.R. 803, the Improving Transparency and Accuracy in Medicare Part D Spending Act; H.R. 1035, the Improving Transparency and Accuracy in Medicare Part D Spending Act. -Medicare Part B reforms. S 476, the Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2019; S.657, the Drug Price Transparency Act. Issues related to H.R. 2115, Public Disclosure of Drug Discounts Act. -Issues related to H.R. 2113, Prescription Drug Sunshine, Transparency, Accountability And Reporting (STAR) Act.
Public Disclosure of Drug Discounts and Real-Time Beneficiary Drug Cost Act
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Ongoing implementation of payment and regulatory issues for the Medicare Advantage program. CMS-4182-P/CMS-4182-CN: Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2019. Medical utilization management and Medicare Advantage program policy and operations. -Issues related to the drug pricing RFI, the Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs. -Proposals that impact Medicare Part D such as formulary requirements, pharmacy benefit manager (PBM) disclosure provisions, closing the Part D coverage gap and direct negotiation of prescription drug prices. -Policy and technical changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2020 (CMS-4185-P). -Pharmacy Direct and Indirect Remuneration (DIR) H.R. 1034, the Phair Pricing Act of 2019; S.640, the Phair Pricing Act of 2019; H.R. 803, the Improving Transparency and Accuracy in Medicare Part D Spending Act; H.R. 1035, the Improving Transparency and Accuracy in Medicare Part D Spending Act. -Medicare Part B reforms. S 476, the Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2019; S.657, the Drug Price Transparency Act. Issues related to H.R. 2115, Public Disclosure of Drug Discounts Act. -Issues related to H.R. 2113, Prescription Drug Sunshine, Transparency, Accountability And Reporting (STAR) Act. -The Prescription Drug Pricing Reduction Act of 2019 (Chairman's Mark). -H.R. 2996, the More Efficient Tools to Realize Information For Consumers (METRIC) Act.
Public Disclosure of Drug Discounts and Real-Time Beneficiary Drug Cost Act
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Ongoing implementation of payment and regulatory issues for the Medicare Advantage program. CMS-4182-P/CMS-4182-CN: Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2019. Medical utilization management and Medicare Advantage program policy and operations. -Issues related to the drug pricing RFI, the Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs. -Proposals that impact Medicare Part D such as formulary requirements, pharmacy benefit manager (PBM) disclosure provisions, closing the Part D coverage gap and direct negotiation of prescription drug prices. -Policy and technical changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2020 (CMS-4185-P). -Pharmacy Direct and Indirect Remuneration (DIR) H.R. 1034, the Phair Pricing Act of 2019; S.640, the Phair Pricing Act of 2019; H.R. 803, the Improving Transparency and Accuracy in Medicare Part D Spending Act; H.R. 1035, the Improving Transparency and Accuracy in Medicare Part D Spending Act. -Medicare Part B reforms. S 476, the Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2019; S.657, the Drug Price Transparency Act. Issues related to H.R. 2115, Public Disclosure of Drug Discounts Act. -Issues related to H.R. 2113, Prescription Drug Sunshine, Transparency, Accountability And Reporting (STAR) Act.
Safe Step Act
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Design, coverage and affordability of pharmacy benefits in Exchanges and the commercial market, including: e-Prescribing (eRx), Electronic Prescribing for Controlled Substances (EPCS), electronic prior authorization, step therapy, Pharmacy Benefit Manager (PBM) disclosure, medical loss ratio (MLR), and specialty pharmacy tiering. Implementation of biosimilars pathway from the Biologics Price Competition and Innovation Act (BPCIA). -Issues related to the proposed rule: Removal of Safe Harbor Protection for Rebates Involving Prescription Pharmaceuticals and Creation of New Safe Harbor Protection for Certain Point-of-Sale Reductions in Price on Prescription Pharmaceuticals and Certain Pharmacy Benefit Manager Service Fees. -Draft Patient Affordability, Value and Efficiency Act, legislation to facilitate new pharmacy payment models. -Risk Evaluation and Mitigation Strategies (REMS) reform. H.R. 965/S. 340, the CREATES Act of 2019. -Drug patent settlements. H.R. 1499, the Protecting Consumer Access to Generic Drugs Act of 2019; S.64, the Preserve Access to Affordable Generics and Biosimilars Act. -H.R. 2279, Safe Step Act (Step Therapy Bill). -Pharmacy issues related to S. 1895, the Lower Health Care Costs Act. -Issues related to S. 1384, the Prescription Drug Rebate Reform Act of 2019. -Issues related to H.R. 3, the Lower Drug Costs Now Act of 2019.
Safe Step Act
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Design, coverage and affordability of pharmacy benefits in Exchanges and the commercial market, including: e-Prescribing (eRx), Electronic Prescribing for Controlled Substances (EPCS), electronic prior authorization, step therapy, Pharmacy Benefit Manager (PBM) disclosure, medical loss ratio (MLR), and specialty pharmacy tiering. Implementation of biosimilars pathway from the Biologics Price Competition and Innovation Act (BPCIA). -Issues related to the proposed rule: Removal of Safe Harbor Protection for Rebates Involving Prescription Pharmaceuticals and Creation of New Safe Harbor Protection for Certain Point-of-Sale Reductions in Price on Prescription Pharmaceuticals and Certain Pharmacy Benefit Manager Service Fees. -Draft Patient Affordability, Value and Efficiency Act, legislation to facilitate new pharmacy payment models. -Risk Evaluation and Mitigation Strategies (REMS) reform. H.R. 965/S. 340, the CREATES Act of 2019. -Drug patent settlements. H.R. 1499, the Protecting Consumer Access to Generic Drugs Act of 2019; S.64, the Preserve Access to Affordable Generics and Biosimilars Act. -H.R. 2279, Safe Step Act (Step Therapy Bill). -Pharmacy issues related to S. 1895, the Lower Health Care Costs Act. -Issues related to S. 1384, the Prescription Drug Rebate Reform Act of 2019.
REACH Act
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Issues relating to P.L. 111-148, the Patient Protection and Affordable Care Act and P.L. 111-152, the Health Care and Education Reconciliation Act, including exchanges, cost sharing reduction, market reforms and coverage expansion proposals, stand-alone dental plans and non-discrimination provisions. -21st Century Cures Act, section 4004, Reducing Regulatory and Administrative Burden Relating to the Use of Health IT and EHRs, information blocking and interoperability. -Implementation of the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA), as amended by the Affordable Care Act, the 21st Century Cures Act, and ERISA, including DOL proposed FAQs about Mental Health and Substance Use Disorder Parity Implementation. -Issues related to H.R. 861, the End Surprise Billing Act; H.R. 3502, The Protecting People from Surprise Medical Bills Act; H.R.2328, Community Health Investment, Modernization, and Excellence Act of 2019 and H.R. 3630, The No Surprises Act. -Issues related to 42 C.F.R. Part 2, in H.R. 2062, The Overdose Prevention and Patient Safety Act and S. 1012, the the Protecting Jessica Grubbs Legacy Act. -Issues related to S. 1895, the Lower Health Care Costs Act, including: surprise billing, and transparency and information sharing in the individual and commercial markets. -June 24, 2019 Executive Order, "Improving Price and Quality Transparency in American Healthcare to Put Patients First". -S.1323, the UNDERSTAND Act, legislation to improve the collection of social determinates of health (SDOH) data using ICD-10 Z-codes to track and report standardized definitions of SDOH affecting patients. -Issues related to utilization management and S.2546, The Safe Step Act of 2019, legislation to amend the Employee Retirement Income Security Act (ERISA) to require group health plans to streamline step therapy protocols and better ensure patients are able to access treatment.
National Defense Authorization Act for Fiscal Year 2020
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
Pharmacy issues related to S. 1215 and H.R. 2500, the National Defense Authorization Act for Fiscal Year 2020.
Labor, Human, and Civil Rights Trade Policy Act
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Ongoing implementation of payment and regulatory issues for the Medicare Advantage program. CMS-4182-P/CMS-4182-CN: Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2019. Medical utilization management and Medicare Advantage program policy and operations. -Issues related to the drug pricing RFI, the Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs. -Proposals that impact Medicare Part D such as formulary requirements, pharmacy benefit manager (PBM) disclosure provisions, closing the Part D coverage gap and direct negotiation of prescription drug prices. -Policy and technical changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2020 (CMS-4185-P). -Pharmacy Direct and Indirect Remuneration (DIR) H.R. 1034, the Phair Pricing Act of 2019; S.640, the Phair Pricing Act of 2019; H.R. 803, the Improving Transparency and Accuracy in Medicare Part D Spending Act; H.R. 1035, the Improving Transparency and Accuracy in Medicare Part D Spending Act. -Medicare Part B reforms. S 476, the Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2019; S.657, the Drug Price Transparency Act. Issues related to H.R. 2115, Public Disclosure of Drug Discounts Act. -Issues related to H.R. 2113, Prescription Drug Sunshine, Transparency, Accountability And Reporting (STAR) Act. -The Prescription Drug Pricing Reduction Act of 2019 (Chairman's Mark). -H.R. 2996, the More Efficient Tools to Realize Information For Consumers (METRIC) Act.
Elijah E. Cummings Lower Drug Costs Now Act
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Design, coverage and affordability of pharmacy benefits in Exchanges and the commercial market, including: e-Prescribing (eRx), Electronic Prescribing for Controlled Substances (EPCS), electronic prior authorization, step therapy, Pharmacy Benefit Manager (PBM) disclosure, medical loss ratio (MLR), and specialty pharmacy tiering. Implementation of biosimilars pathway from the Biologics Price Competition and Innovation Act (BPCIA). -Issues related to the proposed rule: Removal of Safe Harbor Protection for Rebates Involving Prescription Pharmaceuticals and Creation of New Safe Harbor Protection for Certain Point-of-Sale Reductions in Price on Prescription Pharmaceuticals and Certain Pharmacy Benefit Manager Service Fees. -Draft Patient Affordability, Value and Efficiency Act, legislation to facilitate new pharmacy payment models. -Risk Evaluation and Mitigation Strategies (REMS) reform. H.R. 965/S. 340, the CREATES Act of 2019. -Drug patent settlements. H.R. 1499, the Protecting Consumer Access to Generic Drugs Act of 2019; S.64, the Preserve Access to Affordable Generics and Biosimilars Act. -H.R. 2279, Safe Step Act (Step Therapy Bill). -Pharmacy issues related to S. 1895, the Lower Health Care Costs Act. -Issues related to S. 1384, the Prescription Drug Rebate Reform Act of 2019. -Issues related to H.R. 3, the Lower Drug Costs Now Act of 2019.
Protecting People From Surprise Medical Bills Act
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Issues relating to P.L. 111-148, the Patient Protection and Affordable Care Act and P.L. 111-152, the Health Care and Education Reconciliation Act, including exchanges, cost sharing reduction, market reforms and coverage expansion proposals, stand-alone dental plans and non-discrimination provisions. -21st Century Cures Act, section 4004, Reducing Regulatory and Administrative Burden Relating to the Use of Health IT and EHRs, information blocking and interoperability. -Implementation of the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA), as amended by the Affordable Care Act, the 21st Century Cures Act, and ERISA, including DOL proposed FAQs about Mental Health and Substance Use Disorder Parity Implementation. -Issues related to H.R. 861, the End Surprise Billing Act; H.R. 3502, The Protecting People from Surprise Medical Bills Act; H.R.2328, Community Health Investment, Modernization, and Excellence Act of 2019 and H.R. 3630, The No Surprises Act. -Issues related to 42 C.F.R. Part 2, in H.R. 2062, The Overdose Prevention and Patient Safety Act and S. 1012, the the Protecting Jessica Grubbs Legacy Act. -Issues related to S. 1895, the Lower Health Care Costs Act, including: surprise billing, and transparency and information sharing in the individual and commercial markets. -June 24, 2019 Executive Order, "Improving Price and Quality Transparency in American Healthcare to Put Patients First". -S.1323, the UNDERSTAND Act, legislation to improve the collection of social determinates of health (SDOH) data using ICD-10 Z-codes to track and report standardized definitions of SDOH affecting patients. -Issues related to utilization management and S.2546, The Safe Step Act of 2019, legislation to amend the Employee Retirement Income Security Act (ERISA) to require group health plans to streamline step therapy protocols and better ensure patients are able to access treatment.
No Surprises Act
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Issues relating to P.L. 111-148, the Patient Protection and Affordable Care Act and P.L. 111-152, the Health Care and Education Reconciliation Act, including exchanges, cost sharing reduction, market reforms and coverage expansion proposals, stand-alone dental plans and non-discrimination provisions. -21st Century Cures Act, section 4004, Reducing Regulatory and Administrative Burden Relating to the Use of Health IT and EHRs, information blocking and interoperability. -Implementation of the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA), as amended by the Affordable Care Act, the 21st Century Cures Act, and ERISA, including DOL proposed FAQs about Mental Health and Substance Use Disorder Parity Implementation. -Issues related to H.R. 861, the End Surprise Billing Act; H.R. 3502, The Protecting People from Surprise Medical Bills Act; H.R.2328, Community Health Investment, Modernization, and Excellence Act of 2019 and H.R. 3630, The No Surprises Act. -Issues related to 42 C.F.R. Part 2, in H.R. 2062, The Overdose Prevention and Patient Safety Act and S. 1012, the the Protecting Jessica Grubbs Legacy Act. -Issues related to S. 1895, the Lower Health Care Costs Act, including: surprise billing, and transparency and information sharing in the individual and commercial markets. -June 24, 2019 Executive Order, "Improving Price and Quality Transparency in American Healthcare to Put Patients First". -S.1323, the UNDERSTAND Act, legislation to improve the collection of social determinates of health (SDOH) data using ICD-10 Z-codes to track and report standardized definitions of SDOH affecting patients. -Issues related to utilization management and S.2546, The Safe Step Act of 2019, legislation to amend the Employee Retirement Income Security Act (ERISA) to require group health plans to streamline step therapy protocols and better ensure patients are able to access treatment.
CARES Act
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Issues related to P.L. 111-148, the Patient Protection and Affordable Care Act and P.L. 111-152, the Health Care and Education Reconciliation Act. -Issues related to the implementation of international tax provisions under P.L. 115-97, the Tax Cuts and Jobs Act. -H.R. 748/S. 684, Middle Class Health Benefits Tax Repeal Act of 2019, legislation to repeal a 40% ACA excise tax on certain employer-sponsored health insurance plans. -S.172/H.R. 1398, the Health Insurance Tax (HIT) Relief Act of 2019, legislation to suspend the ACA's health insurance tax (HIT) in 2020 and 2021. S.80, Jobs and Premium Protection Act, full repeal of the HIT.
CARES Act
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Issues related to P.L. 111-148, the Patient Protection and Affordable Care Act and P.L. 111-152, the Health Care and Education Reconciliation Act. -H.R. 748/S. 684, Middle Class Health Benefits Tax Repeal Act of 2019, legislation to repeal a 40% ACA excise tax on certain employer-sponsored health insurance plans. -S.172/H.R. 1398, the Health Insurance Tax (HIT) Relief Act of 2019, legislation to suspend the ACA's health insurance tax (HIT) in 2020 and 2021. S.80, Jobs and Premium Protection Act, full repeal of the HIT.
CARES Act
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Issues related to P.L. 111-148, the Patient Protection and Affordable Care Act and P.L. 111-152, the Health Care and Education Reconciliation Act. -H.R. 748/S. 684, Middle Class Health Benefits Tax Repeal Act of 2019, legislation to repeal a 40% ACA excise tax on certain employer-sponsored health insurance plans. -S.172/H.R. 1398, the Health Insurance Tax (HIT) Relief Act of 2019, legislation to suspend the ACA's health insurance tax (HIT) in 2020 and 2021. S.80, Jobs and Premium Protection Act, full repeal of the HIT.
Improving Transparency and Accuracy in Medicare Part D Spending Act
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Ongoing implementation of payment and regulatory issues for the Medicare Advantage program. CMS-4182-P/CMS-4182-CN: Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2019. Medical utilization management and Medicare Advantage program policy and operations. -Issues related to the drug pricing RFI, the Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs. -Proposals that impact Medicare Part D such as formulary requirements, pharmacy benefit manager (PBM) disclosure provisions, closing the Part D coverage gap and direct negotiation of prescription drug prices. -Policy and technical changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2020 (CMS-4185-P). -Pharmacy Direct and Indirect Remuneration (DIR) H.R. 1034, the Phair Pricing Act of 2019; S.640, the Phair Pricing Act of 2019; H.R. 803, the Improving Transparency and Accuracy in Medicare Part D Spending Act; H.R. 1035, the Improving Transparency and Accuracy in Medicare Part D Spending Act. -Medicare Part B reforms. S 476, the Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2019; S.657, the Drug Price Transparency Act. Issues related to H.R. 2115, Public Disclosure of Drug Discounts Act. -Issues related to H.R. 2113, Prescription Drug Sunshine, Transparency, Accountability And Reporting (STAR) Act. -The Prescription Drug Pricing Reduction Act of 2019 (Chairman's Mark). -H.R. 2996, the More Efficient Tools to Realize Information For Consumers (METRIC) Act.
Improving Transparency and Accuracy in Medicare Part D Spending Act
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Ongoing implementation of payment and regulatory issues for the Medicare Advantage program. CMS-4182-P/CMS-4182-CN: Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2019. Medical utilization management and Medicare Advantage program policy and operations. -Issues related to the drug pricing RFI, the Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs. -Proposals that impact Medicare Part D such as formulary requirements, pharmacy benefit manager (PBM) disclosure provisions, closing the Part D coverage gap and direct negotiation of prescription drug prices. -Policy and technical changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2020 (CMS-4185-P). -Pharmacy Direct and Indirect Remuneration (DIR) H.R. 1034, the Phair Pricing Act of 2019; S.640, the Phair Pricing Act of 2019; H.R. 803, the Improving Transparency and Accuracy in Medicare Part D Spending Act; H.R. 1035, the Improving Transparency and Accuracy in Medicare Part D Spending Act. -Medicare Part B reforms. S 476, the Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2019; S.657, the Drug Price Transparency Act. Issues related to H.R. 2115, Public Disclosure of Drug Discounts Act. -Issues related to H.R. 2113, Prescription Drug Sunshine, Transparency, Accountability And Reporting (STAR) Act.
Improving Transparency and Accuracy in Medicare Part D Spending Act
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Ongoing implementation of payment and regulatory issues for the Medicare Advantage program. CMS-4182-P/CMS-4182-CN: Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2019. Medical utilization management and Medicare Advantage program policy and operations. -Issues related to the drug pricing RFI, the Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs. -Proposals that impact Medicare Part D such as formulary requirements, pharmacy benefit manager (PBM) disclosure provisions, closing the Part D coverage gap and direct negotiation of prescription drug prices. -Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2020 (CMS-4185-P). -Pharmacy Direct and Indirect Remuneration (DIR) H.R. 1034, the Phair Pricing Act of 2019; S.640, the Phair Pricing Act of 2019; H.R. 803, the Improving Transparency and Accuracy in Medicare Part D Spending Act; H.R. 1035, the Improving Transparency and Accuracy in Medicare Part D Spending Act. -Medicare Part B reforms. S 476, the Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2019; S.657, the Drug Price Transparency Act.
End Surprise Billing Act of 2019
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Issues relating to P.L. 111-148, the Patient Protection and Affordable Care Act and P.L. 111-152, the Health Care and Education Reconciliation Act, including exchanges, cost sharing reduction, market reforms and coverage expansion proposals, and non-discrimination provisions. -21st Century Cures Act, section 4004, Reducing Regulatory and Administrative Burden Relating to the Use of Health IT and EHRs, information blocking and interoperability. -Implementation of the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA), as amended by the Affordable Care Act, the 21st Century Cures Act, and ERISA, including DOL proposed FAQs about Mental Health and Substance Use Disorder Parity Implementation. -Issues related to H.R. 861, the End Surprise Billing Act.
End Surprise Billing Act of 2019
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Issues relating to P.L. 111-148, the Patient Protection and Affordable Care Act and P.L. 111-152, the Health Care and Education Reconciliation Act, including exchanges, cost sharing reduction, market reforms and coverage expansion proposals, stand-alone dental plans and non-discrimination provisions. -21st Century Cures Act, section 4004, Reducing Regulatory and Administrative Burden Relating to the Use of Health IT and EHRs, information blocking and interoperability. -Implementation of the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA), as amended by the Affordable Care Act, the 21st Century Cures Act, and ERISA, including DOL proposed FAQs about Mental Health and Substance Use Disorder Parity Implementation. -Issues related to H.R. 861, the End Surprise Billing Act and "No Surprises Act" Discussion Draft. -Issues related to 42 C.F.R. Part 2, in H.R. 2062, The Overdose Prevention and Patient Safety Act and S. 1012, the the Protecting Jessica Grubbs Legacy Act. -Issues related to S. 1895, the Lower Health Care Costs Act, including: surprise billing, and transparency and information sharing in the individual and commercial markets.
End Surprise Billing Act of 2019
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Issues relating to P.L. 111-148, the Patient Protection and Affordable Care Act and P.L. 111-152, the Health Care and Education Reconciliation Act, including exchanges, cost sharing reduction, market reforms and coverage expansion proposals, stand-alone dental plans and non-discrimination provisions. -21st Century Cures Act, section 4004, Reducing Regulatory and Administrative Burden Relating to the Use of Health IT and EHRs, information blocking and interoperability. -Implementation of the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA), as amended by the Affordable Care Act, the 21st Century Cures Act, and ERISA, including DOL proposed FAQs about Mental Health and Substance Use Disorder Parity Implementation. -Issues related to H.R. 861, the End Surprise Billing Act; H.R. 3502, The Protecting People from Surprise Medical Bills Act; H.R.2328, Community Health Investment, Modernization, and Excellence Act of 2019 and H.R. 3630, The No Surprises Act. -Issues related to 42 C.F.R. Part 2, in H.R. 2062, The Overdose Prevention and Patient Safety Act and S. 1012, the the Protecting Jessica Grubbs Legacy Act. -Issues related to S. 1895, the Lower Health Care Costs Act, including: surprise billing, and transparency and information sharing in the individual and commercial markets. -June 24, 2019 Executive Order, "Improving Price and Quality Transparency in American Healthcare to Put Patients First". -S.1323, the UNDERSTAND Act, legislation to improve the collection of social determinates of health (SDOH) data using ICD-10 Z-codes to track and report standardized definitions of SDOH affecting patients. -Issues related to utilization management and S.2546, The Safe Step Act of 2019, legislation to amend the Employee Retirement Income Security Act (ERISA) to require group health plans to streamline step therapy protocols and better ensure patients are able to access treatment.
CREATES Act of 2019
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Design, coverage and affordability of pharmacy benefits in Exchanges and the commercial market, including: e-Prescribing (eRx), Electronic Prescribing for Controlled Substances (EPCS), electronic prior authorization, step therapy, Pharmacy Benefit Manager (PBM) disclosure, medical loss ratio (MLR), and specialty pharmacy tiering. Implementation of biosimilars pathway from the Biologics Price Competition and Innovation Act (BPCIA). -Issues related to the proposed rule: Removal of Safe Harbor Protection for Rebates Involving Prescription Pharmaceuticals and Creation of New Safe Harbor Protection for Certain Point-of-Sale Reductions in Price on Prescription Pharmaceuticals and Certain Pharmacy Benefit Manager Service Fees. -Draft Patient Affordability, Value and Efficiency Act, legislation to facilitate new pharmacy payment models. -Risk Evaluation and Mitigation Strategies (REMS) reform. H.R. 965/S. 340, the CREATES Act of 2019. -Drug patent settlements. H.R. 1499, the Protecting Consumer Access to Generic Drugs Act of 2019; S.64, the Preserve Access to Affordable Generics and Biosimilars Act. -H.R. 2279, Safe Step Act (Step Therapy Bill). -Pharmacy issues related to S. 1895, the Lower Health Care Costs Act. -Issues related to S. 1384, the Prescription Drug Rebate Reform Act of 2019. -Issues related to H.R. 3, the Lower Drug Costs Now Act of 2019.
CREATES Act of 2019
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Design, coverage and affordability of pharmacy benefits in Exchanges and the commercial market, including: e-Prescribing (eRx), Electronic Prescribing for Controlled Substances (EPCS), electronic prior authorization, step therapy, Pharmacy Benefit Manager (PBM) disclosure, medical loss ratio (MLR), and specialty pharmacy tiering. Implementation of biosimilars pathway from the Biologics Price Competition and Innovation Act (BPCIA). -Issues related to the proposed rule: Removal of Safe Harbor Protection for Rebates Involving Prescription Pharmaceuticals and Creation of New Safe Harbor Protection for Certain Point-of-Sale Reductions in Price on Prescription Pharmaceuticals and Certain Pharmacy Benefit Manager Service Fees. -Draft Patient Affordability, Value and Efficiency Act, legislation to facilitate new pharmacy payment models. -Risk Evaluation and Mitigation Strategies (REMS) reform. H.R. 965/S. 340, the CREATES Act of 2019. -Drug patent settlements. H.R. 1499, the Protecting Consumer Access to Generic Drugs Act of 2019; S.64, the Preserve Access to Affordable Generics and Biosimilars Act. -H.R. 2279, Safe Step Act (Step Therapy Bill). -Pharmacy issues related to S. 1895, the Lower Health Care Costs Act. -Issues related to S. 1384, the Prescription Drug Rebate Reform Act of 2019.
CREATES Act of 2019
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Design, coverage and affordability of pharmacy benefits in Exchanges and the commercial market, including: e-Prescribing (eRx), Electronic Prescribing for Controlled Substances (EPCS), electronic prior authorization, Pharmacy Benefit Manager (PBM) disclosure, medical loss ratio (MLR), and specialty pharmacy tiering. Implementation of biosimilars pathway from the Biologics Price Competition and Innovation Act (BPCIA). -Issues related to the proposed rule: Removal of Safe Harbor Protection for Rebates Involving Prescription Pharmaceuticals and Creation of New Safe Harbor Protection for Certain Point-of-Sale Reductions in Price on Prescription Pharmaceuticals and Certain Pharmacy Benefit Manager Service Fees. -Draft Patient Affordability, Value and Efficiency Act, legislation to facilitate new pharmacy payment models. -Risk Evaluation and Mitigation Strategies (REMS) reform. H.R. 965/S. 340, the CREATES Act of 2019. -Drug patent settlements. H.R. 1499, the Protecting Consumer Access to Generic Drugs Act of 2019; S.64, the Preserve Access to Affordable Generics and Biosimilars Act.
Protecting Jessica Grubb’s Legacy Act
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Issues relating to P.L. 111-148, the Patient Protection and Affordable Care Act and P.L. 111-152, the Health Care and Education Reconciliation Act, including exchanges, cost sharing reduction, market reforms and coverage expansion proposals, stand-alone dental plans and non-discrimination provisions. -21st Century Cures Act, section 4004, Reducing Regulatory and Administrative Burden Relating to the Use of Health IT and EHRs, information blocking and interoperability. -Implementation of the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA), as amended by the Affordable Care Act, the 21st Century Cures Act, and ERISA, including DOL proposed FAQs about Mental Health and Substance Use Disorder Parity Implementation. -Issues related to H.R. 861, the End Surprise Billing Act and "No Surprises Act" Discussion Draft. -Issues related to 42 C.F.R. Part 2, in H.R. 2062, The Overdose Prevention and Patient Safety Act and S. 1012, the the Protecting Jessica Grubbs Legacy Act. -Issues related to S. 1895, the Lower Health Care Costs Act, including: surprise billing, and transparency and information sharing in the individual and commercial markets.
Protecting Jessica Grubb’s Legacy Act
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Issues relating to P.L. 111-148, the Patient Protection and Affordable Care Act and P.L. 111-152, the Health Care and Education Reconciliation Act, including exchanges, cost sharing reduction, market reforms and coverage expansion proposals, stand-alone dental plans and non-discrimination provisions. -21st Century Cures Act, section 4004, Reducing Regulatory and Administrative Burden Relating to the Use of Health IT and EHRs, information blocking and interoperability. -Implementation of the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA), as amended by the Affordable Care Act, the 21st Century Cures Act, and ERISA, including DOL proposed FAQs about Mental Health and Substance Use Disorder Parity Implementation. -Issues related to H.R. 861, the End Surprise Billing Act; H.R. 3502, The Protecting People from Surprise Medical Bills Act; H.R.2328, Community Health Investment, Modernization, and Excellence Act of 2019 and H.R. 3630, The No Surprises Act. -Issues related to 42 C.F.R. Part 2, in H.R. 2062, The Overdose Prevention and Patient Safety Act and S. 1012, the the Protecting Jessica Grubbs Legacy Act. -Issues related to S. 1895, the Lower Health Care Costs Act, including: surprise billing, and transparency and information sharing in the individual and commercial markets. -June 24, 2019 Executive Order, "Improving Price and Quality Transparency in American Healthcare to Put Patients First". -S.1323, the UNDERSTAND Act, legislation to improve the collection of social determinates of health (SDOH) data using ICD-10 Z-codes to track and report standardized definitions of SDOH affecting patients. -Issues related to utilization management and S.2546, The Safe Step Act of 2019, legislation to amend the Employee Retirement Income Security Act (ERISA) to require group health plans to streamline step therapy protocols and better ensure patients are able to access treatment.
National Defense Authorization Act for Fiscal Year 2020
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
Pharmacy issues related to S. 1215 and H.R. 2500, the National Defense Authorization Act for Fiscal Year 2020.
UNDERSTAND Act
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Issues relating to P.L. 111-148, the Patient Protection and Affordable Care Act and P.L. 111-152, the Health Care and Education Reconciliation Act, including exchanges, cost sharing reduction, market reforms and coverage expansion proposals, stand-alone dental plans and non-discrimination provisions. -21st Century Cures Act, section 4004, Reducing Regulatory and Administrative Burden Relating to the Use of Health IT and EHRs, information blocking and interoperability. -Implementation of the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA), as amended by the Affordable Care Act, the 21st Century Cures Act, and ERISA, including DOL proposed FAQs about Mental Health and Substance Use Disorder Parity Implementation. -Issues related to H.R. 861, the End Surprise Billing Act; H.R. 3502, The Protecting People from Surprise Medical Bills Act; H.R.2328, Community Health Investment, Modernization, and Excellence Act of 2019 and H.R. 3630, The No Surprises Act. -Issues related to 42 C.F.R. Part 2, in H.R. 2062, The Overdose Prevention and Patient Safety Act and S. 1012, the the Protecting Jessica Grubbs Legacy Act. -Issues related to S. 1895, the Lower Health Care Costs Act, including: surprise billing, and transparency and information sharing in the individual and commercial markets. -June 24, 2019 Executive Order, "Improving Price and Quality Transparency in American Healthcare to Put Patients First". -S.1323, the UNDERSTAND Act, legislation to improve the collection of social determinates of health (SDOH) data using ICD-10 Z-codes to track and report standardized definitions of SDOH affecting patients. -Issues related to utilization management and S.2546, The Safe Step Act of 2019, legislation to amend the Employee Retirement Income Security Act (ERISA) to require group health plans to streamline step therapy protocols and better ensure patients are able to access treatment.
Prescription Drug Rebate Reform Act of 2019
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Design, coverage and affordability of pharmacy benefits in Exchanges and the commercial market, including: e-Prescribing (eRx), Electronic Prescribing for Controlled Substances (EPCS), electronic prior authorization, step therapy, Pharmacy Benefit Manager (PBM) disclosure, medical loss ratio (MLR), and specialty pharmacy tiering. Implementation of biosimilars pathway from the Biologics Price Competition and Innovation Act (BPCIA). -Issues related to the proposed rule: Removal of Safe Harbor Protection for Rebates Involving Prescription Pharmaceuticals and Creation of New Safe Harbor Protection for Certain Point-of-Sale Reductions in Price on Prescription Pharmaceuticals and Certain Pharmacy Benefit Manager Service Fees. -Draft Patient Affordability, Value and Efficiency Act, legislation to facilitate new pharmacy payment models. -Risk Evaluation and Mitigation Strategies (REMS) reform. H.R. 965/S. 340, the CREATES Act of 2019. -Drug patent settlements. H.R. 1499, the Protecting Consumer Access to Generic Drugs Act of 2019; S.64, the Preserve Access to Affordable Generics and Biosimilars Act. -H.R. 2279, Safe Step Act (Step Therapy Bill). -Pharmacy issues related to S. 1895, the Lower Health Care Costs Act. -Issues related to S. 1384, the Prescription Drug Rebate Reform Act of 2019. -Issues related to H.R. 3, the Lower Drug Costs Now Act of 2019.
Prescription Drug Rebate Reform Act of 2019
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Design, coverage and affordability of pharmacy benefits in Exchanges and the commercial market, including: e-Prescribing (eRx), Electronic Prescribing for Controlled Substances (EPCS), electronic prior authorization, step therapy, Pharmacy Benefit Manager (PBM) disclosure, medical loss ratio (MLR), and specialty pharmacy tiering. Implementation of biosimilars pathway from the Biologics Price Competition and Innovation Act (BPCIA). -Issues related to the proposed rule: Removal of Safe Harbor Protection for Rebates Involving Prescription Pharmaceuticals and Creation of New Safe Harbor Protection for Certain Point-of-Sale Reductions in Price on Prescription Pharmaceuticals and Certain Pharmacy Benefit Manager Service Fees. -Draft Patient Affordability, Value and Efficiency Act, legislation to facilitate new pharmacy payment models. -Risk Evaluation and Mitigation Strategies (REMS) reform. H.R. 965/S. 340, the CREATES Act of 2019. -Drug patent settlements. H.R. 1499, the Protecting Consumer Access to Generic Drugs Act of 2019; S.64, the Preserve Access to Affordable Generics and Biosimilars Act. -H.R. 2279, Safe Step Act (Step Therapy Bill). -Pharmacy issues related to S. 1895, the Lower Health Care Costs Act. -Issues related to S. 1384, the Prescription Drug Rebate Reform Act of 2019.
Health Insurance Tax Relief Act of 2019
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Issues related to P.L. 111-148, the Patient Protection and Affordable Care Act and P.L. 111-152, the Health Care and Education Reconciliation Act. -Issues related to the implementation of international tax provisions under P.L. 115-97, the Tax Cuts and Jobs Act. -H.R. 748/S. 684, Middle Class Health Benefits Tax Repeal Act of 2019, legislation to repeal a 40% ACA excise tax on certain employer-sponsored health insurance plans. -S.172/H.R. 1398, the Health Insurance Tax (HIT) Relief Act of 2019, legislation to suspend the ACA's health insurance tax (HIT) in 2020 and 2021. S.80, Jobs and Premium Protection Act, full repeal of the HIT.
Health Insurance Tax Relief Act of 2019
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Issues related to P.L. 111-148, the Patient Protection and Affordable Care Act and P.L. 111-152, the Health Care and Education Reconciliation Act. -H.R. 748/S. 684, Middle Class Health Benefits Tax Repeal Act of 2019, legislation to repeal a 40% ACA excise tax on certain employer-sponsored health insurance plans. -S.172/H.R. 1398, the Health Insurance Tax (HIT) Relief Act of 2019, legislation to suspend the ACA's health insurance tax (HIT) in 2020 and 2021. S.80, Jobs and Premium Protection Act, full repeal of the HIT.
Health Insurance Tax Relief Act of 2019
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Issues related to P.L. 111-148, the Patient Protection and Affordable Care Act and P.L. 111-152, the Health Care and Education Reconciliation Act. -H.R. 748/S. 684, Middle Class Health Benefits Tax Repeal Act of 2019, legislation to repeal a 40% ACA excise tax on certain employer-sponsored health insurance plans. -S.172/H.R. 1398, the Health Insurance Tax (HIT) Relief Act of 2019, legislation to suspend the ACA's health insurance tax (HIT) in 2020 and 2021. S.80, Jobs and Premium Protection Act, full repeal of the HIT.
Lower Health Care Costs Act
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Design, coverage and affordability of pharmacy benefits in Exchanges and the commercial market, including: e-Prescribing (eRx), Electronic Prescribing for Controlled Substances (EPCS), electronic prior authorization, step therapy, Pharmacy Benefit Manager (PBM) disclosure, medical loss ratio (MLR), and specialty pharmacy tiering. Implementation of biosimilars pathway from the Biologics Price Competition and Innovation Act (BPCIA). -Issues related to the proposed rule: Removal of Safe Harbor Protection for Rebates Involving Prescription Pharmaceuticals and Creation of New Safe Harbor Protection for Certain Point-of-Sale Reductions in Price on Prescription Pharmaceuticals and Certain Pharmacy Benefit Manager Service Fees. -Draft Patient Affordability, Value and Efficiency Act, legislation to facilitate new pharmacy payment models. -Risk Evaluation and Mitigation Strategies (REMS) reform. H.R. 965/S. 340, the CREATES Act of 2019. -Drug patent settlements. H.R. 1499, the Protecting Consumer Access to Generic Drugs Act of 2019; S.64, the Preserve Access to Affordable Generics and Biosimilars Act. -H.R. 2279, Safe Step Act (Step Therapy Bill). -Pharmacy issues related to S. 1895, the Lower Health Care Costs Act. -Issues related to S. 1384, the Prescription Drug Rebate Reform Act of 2019. -Issues related to H.R. 3, the Lower Drug Costs Now Act of 2019.
Lower Health Care Costs Act
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Design, coverage and affordability of pharmacy benefits in Exchanges and the commercial market, including: e-Prescribing (eRx), Electronic Prescribing for Controlled Substances (EPCS), electronic prior authorization, step therapy, Pharmacy Benefit Manager (PBM) disclosure, medical loss ratio (MLR), and specialty pharmacy tiering. Implementation of biosimilars pathway from the Biologics Price Competition and Innovation Act (BPCIA). -Issues related to the proposed rule: Removal of Safe Harbor Protection for Rebates Involving Prescription Pharmaceuticals and Creation of New Safe Harbor Protection for Certain Point-of-Sale Reductions in Price on Prescription Pharmaceuticals and Certain Pharmacy Benefit Manager Service Fees. -Draft Patient Affordability, Value and Efficiency Act, legislation to facilitate new pharmacy payment models. -Risk Evaluation and Mitigation Strategies (REMS) reform. H.R. 965/S. 340, the CREATES Act of 2019. -Drug patent settlements. H.R. 1499, the Protecting Consumer Access to Generic Drugs Act of 2019; S.64, the Preserve Access to Affordable Generics and Biosimilars Act. -H.R. 2279, Safe Step Act (Step Therapy Bill). -Pharmacy issues related to S. 1895, the Lower Health Care Costs Act. -Issues related to S. 1384, the Prescription Drug Rebate Reform Act of 2019.
Lower Health Care Costs Act
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Issues relating to P.L. 111-148, the Patient Protection and Affordable Care Act and P.L. 111-152, the Health Care and Education Reconciliation Act, including exchanges, cost sharing reduction, market reforms and coverage expansion proposals, stand-alone dental plans and non-discrimination provisions. -21st Century Cures Act, section 4004, Reducing Regulatory and Administrative Burden Relating to the Use of Health IT and EHRs, information blocking and interoperability. -Implementation of the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA), as amended by the Affordable Care Act, the 21st Century Cures Act, and ERISA, including DOL proposed FAQs about Mental Health and Substance Use Disorder Parity Implementation. -Issues related to H.R. 861, the End Surprise Billing Act and "No Surprises Act" Discussion Draft. -Issues related to 42 C.F.R. Part 2, in H.R. 2062, The Overdose Prevention and Patient Safety Act and S. 1012, the the Protecting Jessica Grubbs Legacy Act. -Issues related to S. 1895, the Lower Health Care Costs Act, including: surprise billing, and transparency and information sharing in the individual and commercial markets.
Lower Health Care Costs Act
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Issues relating to P.L. 111-148, the Patient Protection and Affordable Care Act and P.L. 111-152, the Health Care and Education Reconciliation Act, including exchanges, cost sharing reduction, market reforms and coverage expansion proposals, stand-alone dental plans and non-discrimination provisions. -21st Century Cures Act, section 4004, Reducing Regulatory and Administrative Burden Relating to the Use of Health IT and EHRs, information blocking and interoperability. -Implementation of the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA), as amended by the Affordable Care Act, the 21st Century Cures Act, and ERISA, including DOL proposed FAQs about Mental Health and Substance Use Disorder Parity Implementation. -Issues related to H.R. 861, the End Surprise Billing Act; H.R. 3502, The Protecting People from Surprise Medical Bills Act; H.R.2328, Community Health Investment, Modernization, and Excellence Act of 2019 and H.R. 3630, The No Surprises Act. -Issues related to 42 C.F.R. Part 2, in H.R. 2062, The Overdose Prevention and Patient Safety Act and S. 1012, the the Protecting Jessica Grubbs Legacy Act. -Issues related to S. 1895, the Lower Health Care Costs Act, including: surprise billing, and transparency and information sharing in the individual and commercial markets. -June 24, 2019 Executive Order, "Improving Price and Quality Transparency in American Healthcare to Put Patients First". -S.1323, the UNDERSTAND Act, legislation to improve the collection of social determinates of health (SDOH) data using ICD-10 Z-codes to track and report standardized definitions of SDOH affecting patients. -Issues related to utilization management and S.2546, The Safe Step Act of 2019, legislation to amend the Employee Retirement Income Security Act (ERISA) to require group health plans to streamline step therapy protocols and better ensure patients are able to access treatment.
Safe Step Act
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Issues relating to P.L. 111-148, the Patient Protection and Affordable Care Act and P.L. 111-152, the Health Care and Education Reconciliation Act, including exchanges, cost sharing reduction, market reforms and coverage expansion proposals, stand-alone dental plans and non-discrimination provisions. -21st Century Cures Act, section 4004, Reducing Regulatory and Administrative Burden Relating to the Use of Health IT and EHRs, information blocking and interoperability. -Implementation of the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA), as amended by the Affordable Care Act, the 21st Century Cures Act, and ERISA, including DOL proposed FAQs about Mental Health and Substance Use Disorder Parity Implementation. -Issues related to H.R. 861, the End Surprise Billing Act; H.R. 3502, The Protecting People from Surprise Medical Bills Act; H.R.2328, Community Health Investment, Modernization, and Excellence Act of 2019 and H.R. 3630, The No Surprises Act. -Issues related to 42 C.F.R. Part 2, in H.R. 2062, The Overdose Prevention and Patient Safety Act and S. 1012, the the Protecting Jessica Grubbs Legacy Act. -Issues related to S. 1895, the Lower Health Care Costs Act, including: surprise billing, and transparency and information sharing in the individual and commercial markets. -June 24, 2019 Executive Order, "Improving Price and Quality Transparency in American Healthcare to Put Patients First". -S.1323, the UNDERSTAND Act, legislation to improve the collection of social determinates of health (SDOH) data using ICD-10 Z-codes to track and report standardized definitions of SDOH affecting patients. -Issues related to utilization management and S.2546, The Safe Step Act of 2019, legislation to amend the Employee Retirement Income Security Act (ERISA) to require group health plans to streamline step therapy protocols and better ensure patients are able to access treatment.
A bill to promote competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products.
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Design, coverage and affordability of pharmacy benefits in Exchanges and the commercial market, including: e-Prescribing (eRx), Electronic Prescribing for Controlled Substances (EPCS), electronic prior authorization, step therapy, Pharmacy Benefit Manager (PBM) disclosure, medical loss ratio (MLR), and specialty pharmacy tiering. Implementation of biosimilars pathway from the Biologics Price Competition and Innovation Act (BPCIA). -Issues related to the proposed rule: Removal of Safe Harbor Protection for Rebates Involving Prescription Pharmaceuticals and Creation of New Safe Harbor Protection for Certain Point-of-Sale Reductions in Price on Prescription Pharmaceuticals and Certain Pharmacy Benefit Manager Service Fees. -Draft Patient Affordability, Value and Efficiency Act, legislation to facilitate new pharmacy payment models. -Risk Evaluation and Mitigation Strategies (REMS) reform. H.R. 965/S. 340, the CREATES Act of 2019. -Drug patent settlements. H.R. 1499, the Protecting Consumer Access to Generic Drugs Act of 2019; S.64, the Preserve Access to Affordable Generics and Biosimilars Act. -H.R. 2279, Safe Step Act (Step Therapy Bill). -Pharmacy issues related to S. 1895, the Lower Health Care Costs Act. -Issues related to S. 1384, the Prescription Drug Rebate Reform Act of 2019. -Issues related to H.R. 3, the Lower Drug Costs Now Act of 2019.
A bill to promote competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products.
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Design, coverage and affordability of pharmacy benefits in Exchanges and the commercial market, including: e-Prescribing (eRx), Electronic Prescribing for Controlled Substances (EPCS), electronic prior authorization, step therapy, Pharmacy Benefit Manager (PBM) disclosure, medical loss ratio (MLR), and specialty pharmacy tiering. Implementation of biosimilars pathway from the Biologics Price Competition and Innovation Act (BPCIA). -Issues related to the proposed rule: Removal of Safe Harbor Protection for Rebates Involving Prescription Pharmaceuticals and Creation of New Safe Harbor Protection for Certain Point-of-Sale Reductions in Price on Prescription Pharmaceuticals and Certain Pharmacy Benefit Manager Service Fees. -Draft Patient Affordability, Value and Efficiency Act, legislation to facilitate new pharmacy payment models. -Risk Evaluation and Mitigation Strategies (REMS) reform. H.R. 965/S. 340, the CREATES Act of 2019. -Drug patent settlements. H.R. 1499, the Protecting Consumer Access to Generic Drugs Act of 2019; S.64, the Preserve Access to Affordable Generics and Biosimilars Act. -H.R. 2279, Safe Step Act (Step Therapy Bill). -Pharmacy issues related to S. 1895, the Lower Health Care Costs Act. -Issues related to S. 1384, the Prescription Drug Rebate Reform Act of 2019.
A bill to promote competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products.
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Design, coverage and affordability of pharmacy benefits in Exchanges and the commercial market, including: e-Prescribing (eRx), Electronic Prescribing for Controlled Substances (EPCS), electronic prior authorization, Pharmacy Benefit Manager (PBM) disclosure, medical loss ratio (MLR), and specialty pharmacy tiering. Implementation of biosimilars pathway from the Biologics Price Competition and Innovation Act (BPCIA). -Issues related to the proposed rule: Removal of Safe Harbor Protection for Rebates Involving Prescription Pharmaceuticals and Creation of New Safe Harbor Protection for Certain Point-of-Sale Reductions in Price on Prescription Pharmaceuticals and Certain Pharmacy Benefit Manager Service Fees. -Draft Patient Affordability, Value and Efficiency Act, legislation to facilitate new pharmacy payment models. -Risk Evaluation and Mitigation Strategies (REMS) reform. H.R. 965/S. 340, the CREATES Act of 2019. -Drug patent settlements. H.R. 1499, the Protecting Consumer Access to Generic Drugs Act of 2019; S.64, the Preserve Access to Affordable Generics and Biosimilars Act.
Creating Transparency to Have Drug Rebates Unlocked (C–THRU) Act of 2019
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Ongoing implementation of payment and regulatory issues for the Medicare Advantage program. CMS-4182-P/CMS-4182-CN: Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2019. Medical utilization management and Medicare Advantage program policy and operations. -Issues related to the drug pricing RFI, the Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs. -Proposals that impact Medicare Part D such as formulary requirements, pharmacy benefit manager (PBM) disclosure provisions, closing the Part D coverage gap and direct negotiation of prescription drug prices. -Policy and technical changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2020 (CMS-4185-P). -Pharmacy Direct and Indirect Remuneration (DIR) H.R. 1034, the Phair Pricing Act of 2019; S.640, the Phair Pricing Act of 2019; H.R. 803, the Improving Transparency and Accuracy in Medicare Part D Spending Act; H.R. 1035, the Improving Transparency and Accuracy in Medicare Part D Spending Act. -Medicare Part B reforms. S 476, the Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2019; S.657, the Drug Price Transparency Act. Issues related to H.R. 2115, Public Disclosure of Drug Discounts Act. -Issues related to H.R. 2113, Prescription Drug Sunshine, Transparency, Accountability And Reporting (STAR) Act. -The Prescription Drug Pricing Reduction Act of 2019 (Chairman's Mark). -H.R. 2996, the More Efficient Tools to Realize Information For Consumers (METRIC) Act.
Creating Transparency to Have Drug Rebates Unlocked (C–THRU) Act of 2019
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Ongoing implementation of payment and regulatory issues for the Medicare Advantage program. CMS-4182-P/CMS-4182-CN: Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2019. Medical utilization management and Medicare Advantage program policy and operations. -Issues related to the drug pricing RFI, the Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs. -Proposals that impact Medicare Part D such as formulary requirements, pharmacy benefit manager (PBM) disclosure provisions, closing the Part D coverage gap and direct negotiation of prescription drug prices. -Policy and technical changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2020 (CMS-4185-P). -Pharmacy Direct and Indirect Remuneration (DIR) H.R. 1034, the Phair Pricing Act of 2019; S.640, the Phair Pricing Act of 2019; H.R. 803, the Improving Transparency and Accuracy in Medicare Part D Spending Act; H.R. 1035, the Improving Transparency and Accuracy in Medicare Part D Spending Act. -Medicare Part B reforms. S 476, the Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2019; S.657, the Drug Price Transparency Act. Issues related to H.R. 2115, Public Disclosure of Drug Discounts Act. -Issues related to H.R. 2113, Prescription Drug Sunshine, Transparency, Accountability And Reporting (STAR) Act.
Creating Transparency to Have Drug Rebates Unlocked (C–THRU) Act of 2019
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Ongoing implementation of payment and regulatory issues for the Medicare Advantage program. CMS-4182-P/CMS-4182-CN: Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2019. Medical utilization management and Medicare Advantage program policy and operations. -Issues related to the drug pricing RFI, the Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs. -Proposals that impact Medicare Part D such as formulary requirements, pharmacy benefit manager (PBM) disclosure provisions, closing the Part D coverage gap and direct negotiation of prescription drug prices. -Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2020 (CMS-4185-P). -Pharmacy Direct and Indirect Remuneration (DIR) H.R. 1034, the Phair Pricing Act of 2019; S.640, the Phair Pricing Act of 2019; H.R. 803, the Improving Transparency and Accuracy in Medicare Part D Spending Act; H.R. 1035, the Improving Transparency and Accuracy in Medicare Part D Spending Act. -Medicare Part B reforms. S 476, the Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2019; S.657, the Drug Price Transparency Act.
Preserve Access to Affordable Generics and Biosimilars Act
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Design, coverage and affordability of pharmacy benefits in Exchanges and the commercial market, including: e-Prescribing (eRx), Electronic Prescribing for Controlled Substances (EPCS), electronic prior authorization, step therapy, Pharmacy Benefit Manager (PBM) disclosure, medical loss ratio (MLR), and specialty pharmacy tiering. Implementation of biosimilars pathway from the Biologics Price Competition and Innovation Act (BPCIA). -Issues related to the proposed rule: Removal of Safe Harbor Protection for Rebates Involving Prescription Pharmaceuticals and Creation of New Safe Harbor Protection for Certain Point-of-Sale Reductions in Price on Prescription Pharmaceuticals and Certain Pharmacy Benefit Manager Service Fees. -Draft Patient Affordability, Value and Efficiency Act, legislation to facilitate new pharmacy payment models. -Risk Evaluation and Mitigation Strategies (REMS) reform. H.R. 965/S. 340, the CREATES Act of 2019. -Drug patent settlements. H.R. 1499, the Protecting Consumer Access to Generic Drugs Act of 2019; S.64, the Preserve Access to Affordable Generics and Biosimilars Act. -H.R. 2279, Safe Step Act (Step Therapy Bill). -Pharmacy issues related to S. 1895, the Lower Health Care Costs Act. -Issues related to S. 1384, the Prescription Drug Rebate Reform Act of 2019. -Issues related to H.R. 3, the Lower Drug Costs Now Act of 2019.
Preserve Access to Affordable Generics and Biosimilars Act
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Design, coverage and affordability of pharmacy benefits in Exchanges and the commercial market, including: e-Prescribing (eRx), Electronic Prescribing for Controlled Substances (EPCS), electronic prior authorization, step therapy, Pharmacy Benefit Manager (PBM) disclosure, medical loss ratio (MLR), and specialty pharmacy tiering. Implementation of biosimilars pathway from the Biologics Price Competition and Innovation Act (BPCIA). -Issues related to the proposed rule: Removal of Safe Harbor Protection for Rebates Involving Prescription Pharmaceuticals and Creation of New Safe Harbor Protection for Certain Point-of-Sale Reductions in Price on Prescription Pharmaceuticals and Certain Pharmacy Benefit Manager Service Fees. -Draft Patient Affordability, Value and Efficiency Act, legislation to facilitate new pharmacy payment models. -Risk Evaluation and Mitigation Strategies (REMS) reform. H.R. 965/S. 340, the CREATES Act of 2019. -Drug patent settlements. H.R. 1499, the Protecting Consumer Access to Generic Drugs Act of 2019; S.64, the Preserve Access to Affordable Generics and Biosimilars Act. -H.R. 2279, Safe Step Act (Step Therapy Bill). -Pharmacy issues related to S. 1895, the Lower Health Care Costs Act. -Issues related to S. 1384, the Prescription Drug Rebate Reform Act of 2019.
Preserve Access to Affordable Generics and Biosimilars Act
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Design, coverage and affordability of pharmacy benefits in Exchanges and the commercial market, including: e-Prescribing (eRx), Electronic Prescribing for Controlled Substances (EPCS), electronic prior authorization, Pharmacy Benefit Manager (PBM) disclosure, medical loss ratio (MLR), and specialty pharmacy tiering. Implementation of biosimilars pathway from the Biologics Price Competition and Innovation Act (BPCIA). -Issues related to the proposed rule: Removal of Safe Harbor Protection for Rebates Involving Prescription Pharmaceuticals and Creation of New Safe Harbor Protection for Certain Point-of-Sale Reductions in Price on Prescription Pharmaceuticals and Certain Pharmacy Benefit Manager Service Fees. -Draft Patient Affordability, Value and Efficiency Act, legislation to facilitate new pharmacy payment models. -Risk Evaluation and Mitigation Strategies (REMS) reform. H.R. 965/S. 340, the CREATES Act of 2019. -Drug patent settlements. H.R. 1499, the Protecting Consumer Access to Generic Drugs Act of 2019; S.64, the Preserve Access to Affordable Generics and Biosimilars Act.
Phair Pricing Act of 2019
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Ongoing implementation of payment and regulatory issues for the Medicare Advantage program. CMS-4182-P/CMS-4182-CN: Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2019. Medical utilization management and Medicare Advantage program policy and operations. -Issues related to the drug pricing RFI, the Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs. -Proposals that impact Medicare Part D such as formulary requirements, pharmacy benefit manager (PBM) disclosure provisions, closing the Part D coverage gap and direct negotiation of prescription drug prices. -Policy and technical changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2020 (CMS-4185-P). -Pharmacy Direct and Indirect Remuneration (DIR) H.R. 1034, the Phair Pricing Act of 2019; S.640, the Phair Pricing Act of 2019; H.R. 803, the Improving Transparency and Accuracy in Medicare Part D Spending Act; H.R. 1035, the Improving Transparency and Accuracy in Medicare Part D Spending Act. -Medicare Part B reforms. S 476, the Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2019; S.657, the Drug Price Transparency Act. Issues related to H.R. 2115, Public Disclosure of Drug Discounts Act. -Issues related to H.R. 2113, Prescription Drug Sunshine, Transparency, Accountability And Reporting (STAR) Act. -The Prescription Drug Pricing Reduction Act of 2019 (Chairman's Mark). -H.R. 2996, the More Efficient Tools to Realize Information For Consumers (METRIC) Act.
Phair Pricing Act of 2019
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Ongoing implementation of payment and regulatory issues for the Medicare Advantage program. CMS-4182-P/CMS-4182-CN: Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2019. Medical utilization management and Medicare Advantage program policy and operations. -Issues related to the drug pricing RFI, the Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs. -Proposals that impact Medicare Part D such as formulary requirements, pharmacy benefit manager (PBM) disclosure provisions, closing the Part D coverage gap and direct negotiation of prescription drug prices. -Policy and technical changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2020 (CMS-4185-P). -Pharmacy Direct and Indirect Remuneration (DIR) H.R. 1034, the Phair Pricing Act of 2019; S.640, the Phair Pricing Act of 2019; H.R. 803, the Improving Transparency and Accuracy in Medicare Part D Spending Act; H.R. 1035, the Improving Transparency and Accuracy in Medicare Part D Spending Act. -Medicare Part B reforms. S 476, the Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2019; S.657, the Drug Price Transparency Act. Issues related to H.R. 2115, Public Disclosure of Drug Discounts Act. -Issues related to H.R. 2113, Prescription Drug Sunshine, Transparency, Accountability And Reporting (STAR) Act.
Phair Pricing Act of 2019
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Ongoing implementation of payment and regulatory issues for the Medicare Advantage program. CMS-4182-P/CMS-4182-CN: Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2019. Medical utilization management and Medicare Advantage program policy and operations. -Issues related to the drug pricing RFI, the Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs. -Proposals that impact Medicare Part D such as formulary requirements, pharmacy benefit manager (PBM) disclosure provisions, closing the Part D coverage gap and direct negotiation of prescription drug prices. -Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2020 (CMS-4185-P). -Pharmacy Direct and Indirect Remuneration (DIR) H.R. 1034, the Phair Pricing Act of 2019; S.640, the Phair Pricing Act of 2019; H.R. 803, the Improving Transparency and Accuracy in Medicare Part D Spending Act; H.R. 1035, the Improving Transparency and Accuracy in Medicare Part D Spending Act. -Medicare Part B reforms. S 476, the Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2019; S.657, the Drug Price Transparency Act.
A bill to amend title XXVII of the Public Health Service Act to establish requirements with respect to prescription drug benefits.
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Ongoing implementation of payment and regulatory issues for the Medicare Advantage program. CMS-4182-P/CMS-4182-CN: Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2019. Medical utilization management and Medicare Advantage program policy and operations. -Issues related to the drug pricing RFI, the Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs. -Proposals that impact Medicare Part D such as formulary requirements, pharmacy benefit manager (PBM) disclosure provisions, closing the Part D coverage gap and direct negotiation of prescription drug prices. -Policy and technical changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2020 (CMS-4185-P). -Pharmacy Direct and Indirect Remuneration (DIR) H.R. 1034, the Phair Pricing Act of 2019; S.640, the Phair Pricing Act of 2019; H.R. 803, the Improving Transparency and Accuracy in Medicare Part D Spending Act; H.R. 1035, the Improving Transparency and Accuracy in Medicare Part D Spending Act. -Medicare Part B reforms. S 476, the Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2019; S.657, the Drug Price Transparency Act. Issues related to H.R. 2115, Public Disclosure of Drug Discounts Act. -Issues related to H.R. 2113, Prescription Drug Sunshine, Transparency, Accountability And Reporting (STAR) Act. -The Prescription Drug Pricing Reduction Act of 2019 (Chairman's Mark). -H.R. 2996, the More Efficient Tools to Realize Information For Consumers (METRIC) Act.
A bill to amend title XXVII of the Public Health Service Act to establish requirements with respect to prescription drug benefits.
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Ongoing implementation of payment and regulatory issues for the Medicare Advantage program. CMS-4182-P/CMS-4182-CN: Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2019. Medical utilization management and Medicare Advantage program policy and operations. -Issues related to the drug pricing RFI, the Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs. -Proposals that impact Medicare Part D such as formulary requirements, pharmacy benefit manager (PBM) disclosure provisions, closing the Part D coverage gap and direct negotiation of prescription drug prices. -Policy and technical changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2020 (CMS-4185-P). -Pharmacy Direct and Indirect Remuneration (DIR) H.R. 1034, the Phair Pricing Act of 2019; S.640, the Phair Pricing Act of 2019; H.R. 803, the Improving Transparency and Accuracy in Medicare Part D Spending Act; H.R. 1035, the Improving Transparency and Accuracy in Medicare Part D Spending Act. -Medicare Part B reforms. S 476, the Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2019; S.657, the Drug Price Transparency Act. Issues related to H.R. 2115, Public Disclosure of Drug Discounts Act. -Issues related to H.R. 2113, Prescription Drug Sunshine, Transparency, Accountability And Reporting (STAR) Act.
A bill to amend title XXVII of the Public Health Service Act to establish requirements with respect to prescription drug benefits.
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Ongoing implementation of payment and regulatory issues for the Medicare Advantage program. CMS-4182-P/CMS-4182-CN: Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2019. Medical utilization management and Medicare Advantage program policy and operations. -Issues related to the drug pricing RFI, the Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs. -Proposals that impact Medicare Part D such as formulary requirements, pharmacy benefit manager (PBM) disclosure provisions, closing the Part D coverage gap and direct negotiation of prescription drug prices. -Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2020 (CMS-4185-P). -Pharmacy Direct and Indirect Remuneration (DIR) H.R. 1034, the Phair Pricing Act of 2019; S.640, the Phair Pricing Act of 2019; H.R. 803, the Improving Transparency and Accuracy in Medicare Part D Spending Act; H.R. 1035, the Improving Transparency and Accuracy in Medicare Part D Spending Act. -Medicare Part B reforms. S 476, the Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2019; S.657, the Drug Price Transparency Act.
Middle Class Health Benefits Tax Repeal Act of 2019
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Issues related to P.L. 111-148, the Patient Protection and Affordable Care Act and P.L. 111-152, the Health Care and Education Reconciliation Act. -Issues related to the implementation of international tax provisions under P.L. 115-97, the Tax Cuts and Jobs Act. -H.R. 748/S. 684, Middle Class Health Benefits Tax Repeal Act of 2019, legislation to repeal a 40% ACA excise tax on certain employer-sponsored health insurance plans. -S.172/H.R. 1398, the Health Insurance Tax (HIT) Relief Act of 2019, legislation to suspend the ACA's health insurance tax (HIT) in 2020 and 2021. S.80, Jobs and Premium Protection Act, full repeal of the HIT.
Middle Class Health Benefits Tax Repeal Act of 2019
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Issues related to P.L. 111-148, the Patient Protection and Affordable Care Act and P.L. 111-152, the Health Care and Education Reconciliation Act. -H.R. 748/S. 684, Middle Class Health Benefits Tax Repeal Act of 2019, legislation to repeal a 40% ACA excise tax on certain employer-sponsored health insurance plans. -S.172/H.R. 1398, the Health Insurance Tax (HIT) Relief Act of 2019, legislation to suspend the ACA's health insurance tax (HIT) in 2020 and 2021. S.80, Jobs and Premium Protection Act, full repeal of the HIT.
Middle Class Health Benefits Tax Repeal Act of 2019
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Issues related to P.L. 111-148, the Patient Protection and Affordable Care Act and P.L. 111-152, the Health Care and Education Reconciliation Act. -H.R. 748/S. 684, Middle Class Health Benefits Tax Repeal Act of 2019, legislation to repeal a 40% ACA excise tax on certain employer-sponsored health insurance plans. -S.172/H.R. 1398, the Health Insurance Tax (HIT) Relief Act of 2019, legislation to suspend the ACA's health insurance tax (HIT) in 2020 and 2021. S.80, Jobs and Premium Protection Act, full repeal of the HIT.
Jobs and Premium Protection Act
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Issues related to P.L. 111-148, the Patient Protection and Affordable Care Act and P.L. 111-152, the Health Care and Education Reconciliation Act. -Issues related to the implementation of international tax provisions under P.L. 115-97, the Tax Cuts and Jobs Act. -H.R. 748/S. 684, Middle Class Health Benefits Tax Repeal Act of 2019, legislation to repeal a 40% ACA excise tax on certain employer-sponsored health insurance plans. -S.172/H.R. 1398, the Health Insurance Tax (HIT) Relief Act of 2019, legislation to suspend the ACA's health insurance tax (HIT) in 2020 and 2021. S.80, Jobs and Premium Protection Act, full repeal of the HIT.
Jobs and Premium Protection Act
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Issues related to P.L. 111-148, the Patient Protection and Affordable Care Act and P.L. 111-152, the Health Care and Education Reconciliation Act. -H.R. 748/S. 684, Middle Class Health Benefits Tax Repeal Act of 2019, legislation to repeal a 40% ACA excise tax on certain employer-sponsored health insurance plans. -S.172/H.R. 1398, the Health Insurance Tax (HIT) Relief Act of 2019, legislation to suspend the ACA's health insurance tax (HIT) in 2020 and 2021. S.80, Jobs and Premium Protection Act, full repeal of the HIT.
Jobs and Premium Protection Act
Client: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) · Firm: THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)
-Issues related to P.L. 111-148, the Patient Protection and Affordable Care Act and P.L. 111-152, the Health Care and Education Reconciliation Act. -H.R. 748/S. 684, Middle Class Health Benefits Tax Repeal Act of 2019, legislation to repeal a 40% ACA excise tax on certain employer-sponsored health insurance plans. -S.172/H.R. 1398, the Health Insurance Tax (HIT) Relief Act of 2019, legislation to suspend the ACA's health insurance tax (HIT) in 2020 and 2021. S.80, Jobs and Premium Protection Act, full repeal of the HIT.
-Ongoing implementation of payment and regulatory issues for the Medicare Advantage program. CMS-4182-P/CMS-4182-CN: Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2019. Medical utilization management and Medicare Advantage program policy and operations. -Issues related to the drug pricing RFI, the Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs. -Proposals that impact Medicare Part D such as formulary requirements, pharmacy benefit manager (PBM) disclosure provisions, closing the Part D coverage gap and direct negotiation of prescription drug prices. -Policy and technical changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2020 (CMS-4185-P). -Pharmacy Direct and Indirect Remuneration (DIR) H.R. 1034, the Phair Pricing Act of 2019; S.640, the Phair Pricing Act of 2019; H.R. 803, the Improving Transparency and Accuracy in Medicare Part D Spending Act; H.R. 1035, the Improving Transparency and Accuracy in Medicare Part D Spending Act. -Medicare Part B reforms. S 476, the Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2019; S.657, the Drug Price Transparency Act. Issues related to H.R. 2115, Public Disclosure of Drug Discounts Act. -Issues related to H.R. 2113, Prescription Drug Sunshine, Transparency, Accountability And Reporting (STAR) Act. -The Prescription Drug Pricing Reduction Act of 2019 (Chairman's Mark). -H.R. 2996, the More Efficient Tools to Realize Information For Consumers (METRIC) Act.
-Issues related to P.L. 111-148, the Patient Protection and Affordable Care Act and P.L. 111-152, the Health Care and Education Reconciliation Act. -H.R. 748/S. 684, Middle Class Health Benefits Tax Repeal Act of 2019, legislation to repeal a 40% ACA excise tax on certain employer-sponsored health insurance plans. -S.172/H.R. 1398, the Health Insurance Tax (HIT) Relief Act of 2019, legislation to suspend the ACA's health insurance tax (HIT) in 2020 and 2021. S.80, Jobs and Premium Protection Act, full repeal of the HIT.
-Issues relating to P.L. 111-148, the Patient Protection and Affordable Care Act and P.L. 111-152, the Health Care and Education Reconciliation Act, including exchanges, cost sharing reduction, market reforms and coverage expansion proposals, stand-alone dental plans and non-discrimination provisions. -21st Century Cures Act, section 4004, Reducing Regulatory and Administrative Burden Relating to the Use of Health IT and EHRs, information blocking and interoperability. -Implementation of the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA), as amended by the Affordable Care Act, the 21st Century Cures Act, and ERISA, including DOL proposed FAQs about Mental Health and Substance Use Disorder Parity Implementation. -Issues related to H.R. 861, the End Surprise Billing Act; H.R. 3502, The Protecting People from Surprise Medical Bills Act; H.R.2328, Community Health Investment, Modernization, and Excellence Act of 2019 and H.R. 3630, The No Surprises Act. -Issues related to 42 C.F.R. Part 2, in H.R. 2062, The Overdose Prevention and Patient Safety Act and S. 1012, the the Protecting Jessica Grubbs Legacy Act. -Issues related to S. 1895, the Lower Health Care Costs Act, including: surprise billing, and transparency and information sharing in the individual and commercial markets. -June 24, 2019 Executive Order, "Improving Price and Quality Transparency in American Healthcare to Put Patients First". -S.1323, the UNDERSTAND Act, legislation to improve the collection of social determinates of health (SDOH) data using ICD-10 Z-codes to track and report standardized definitions of SDOH affecting patients. -Issues related to utilization management and S.2546, The Safe Step Act of 2019, legislation to amend the Employee Retirement Income Security Act (ERISA) to require group health plans to streamline step therapy protocols and better ensure patients are able to access treatment.
Filing targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Congressional Budget Office (CBO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, U.S. Trade Representative (USTR)
-Design, coverage and affordability of pharmacy benefits in Exchanges and the commercial market, including: e-Prescribing (eRx), Electronic Prescribing for Controlled Substances (EPCS), electronic prior authorization, step therapy, Pharmacy Benefit Manager (PBM) disclosure, medical loss ratio (MLR), and specialty pharmacy tiering. Implementation of biosimilars pathway from the Biologics Price Competition and Innovation Act (BPCIA). -Issues related to the proposed rule: Removal of Safe Harbor Protection for Rebates Involving Prescription Pharmaceuticals and Creation of New Safe Harbor Protection for Certain Point-of-Sale Reductions in Price on Prescription Pharmaceuticals and Certain Pharmacy Benefit Manager Service Fees. -Draft Patient Affordability, Value and Efficiency Act, legislation to facilitate new pharmacy payment models. -Risk Evaluation and Mitigation Strategies (REMS) reform. H.R. 965/S. 340, the CREATES Act of 2019. -Drug patent settlements. H.R. 1499, the Protecting Consumer Access to Generic Drugs Act of 2019; S.64, the Preserve Access to Affordable Generics and Biosimilars Act. -H.R. 2279, Safe Step Act (Step Therapy Bill). -Pharmacy issues related to S. 1895, the Lower Health Care Costs Act. -Issues related to S. 1384, the Prescription Drug Rebate Reform Act of 2019.
-Ongoing implementation of payment and regulatory issues for the Medicare Advantage program. CMS-4182-P/CMS-4182-CN: Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2019. Medical utilization management and Medicare Advantage program policy and operations. -Issues related to the drug pricing RFI, the Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs. -Proposals that impact Medicare Part D such as formulary requirements, pharmacy benefit manager (PBM) disclosure provisions, closing the Part D coverage gap and direct negotiation of prescription drug prices. -Policy and technical changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2020 (CMS-4185-P). -Pharmacy Direct and Indirect Remuneration (DIR) H.R. 1034, the Phair Pricing Act of 2019; S.640, the Phair Pricing Act of 2019; H.R. 803, the Improving Transparency and Accuracy in Medicare Part D Spending Act; H.R. 1035, the Improving Transparency and Accuracy in Medicare Part D Spending Act. -Medicare Part B reforms. S 476, the Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2019; S.657, the Drug Price Transparency Act. Issues related to H.R. 2115, Public Disclosure of Drug Discounts Act. -Issues related to H.R. 2113, Prescription Drug Sunshine, Transparency, Accountability And Reporting (STAR) Act.
-Issues relating to P.L. 111-148, the Patient Protection and Affordable Care Act and P.L. 111-152, the Health Care and Education Reconciliation Act, including exchanges, cost sharing reduction, market reforms and coverage expansion proposals, stand-alone dental plans and non-discrimination provisions. -21st Century Cures Act, section 4004, Reducing Regulatory and Administrative Burden Relating to the Use of Health IT and EHRs, information blocking and interoperability. -Implementation of the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA), as amended by the Affordable Care Act, the 21st Century Cures Act, and ERISA, including DOL proposed FAQs about Mental Health and Substance Use Disorder Parity Implementation. -Issues related to H.R. 861, the End Surprise Billing Act and "No Surprises Act" Discussion Draft. -Issues related to 42 C.F.R. Part 2, in H.R. 2062, The Overdose Prevention and Patient Safety Act and S. 1012, the the Protecting Jessica Grubbs Legacy Act. -Issues related to S. 1895, the Lower Health Care Costs Act, including: surprise billing, and transparency and information sharing in the individual and commercial markets.
-Issues related to P.L. 111-148, the Patient Protection and Affordable Care Act and P.L. 111-152, the Health Care and Education Reconciliation Act. -H.R. 748/S. 684, Middle Class Health Benefits Tax Repeal Act of 2019, legislation to repeal a 40% ACA excise tax on certain employer-sponsored health insurance plans. -S.172/H.R. 1398, the Health Insurance Tax (HIT) Relief Act of 2019, legislation to suspend the ACA's health insurance tax (HIT) in 2020 and 2021. S.80, Jobs and Premium Protection Act, full repeal of the HIT.
Pharmacy issues related to S. 1215 and H.R. 2500, the National Defense Authorization Act for Fiscal Year 2020.
Filing targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
-Issues related to P.L. 111-148, the Patient Protection and Affordable Care Act and P.L. 111-152, the Health Care and Education Reconciliation Act. -Issues related to the implementation of international tax provisions under P.L. 115-97, the Tax Cuts and Jobs Act. -H.R. 748/S. 684, Middle Class Health Benefits Tax Repeal Act of 2019, legislation to repeal a 40% ACA excise tax on certain employer-sponsored health insurance plans. -S.172/H.R. 1398, the Health Insurance Tax (HIT) Relief Act of 2019, legislation to suspend the ACA's health insurance tax (HIT) in 2020 and 2021. S.80, Jobs and Premium Protection Act, full repeal of the HIT.
-Issues relating to P.L. 111-148, the Patient Protection and Affordable Care Act and P.L. 111-152, the Health Care and Education Reconciliation Act, including exchanges, cost sharing reduction, market reforms and coverage expansion proposals, and non-discrimination provisions. -21st Century Cures Act, section 4004, Reducing Regulatory and Administrative Burden Relating to the Use of Health IT and EHRs, information blocking and interoperability. -Implementation of the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA), as amended by the Affordable Care Act, the 21st Century Cures Act, and ERISA, including DOL proposed FAQs about Mental Health and Substance Use Disorder Parity Implementation. -Issues related to H.R. 861, the End Surprise Billing Act.
-Design, coverage and affordability of pharmacy benefits in Exchanges and the commercial market, including: e-Prescribing (eRx), Electronic Prescribing for Controlled Substances (EPCS), electronic prior authorization, Pharmacy Benefit Manager (PBM) disclosure, medical loss ratio (MLR), and specialty pharmacy tiering. Implementation of biosimilars pathway from the Biologics Price Competition and Innovation Act (BPCIA). -Issues related to the proposed rule: Removal of Safe Harbor Protection for Rebates Involving Prescription Pharmaceuticals and Creation of New Safe Harbor Protection for Certain Point-of-Sale Reductions in Price on Prescription Pharmaceuticals and Certain Pharmacy Benefit Manager Service Fees. -Draft Patient Affordability, Value and Efficiency Act, legislation to facilitate new pharmacy payment models. -Risk Evaluation and Mitigation Strategies (REMS) reform. H.R. 965/S. 340, the CREATES Act of 2019. -Drug patent settlements. H.R. 1499, the Protecting Consumer Access to Generic Drugs Act of 2019; S.64, the Preserve Access to Affordable Generics and Biosimilars Act.
-Ongoing implementation of payment and regulatory issues for the Medicare Advantage program. CMS-4182-P/CMS-4182-CN: Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2019. Medical utilization management and Medicare Advantage program policy and operations. -Issues related to the drug pricing RFI, the Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs. -Proposals that impact Medicare Part D such as formulary requirements, pharmacy benefit manager (PBM) disclosure provisions, closing the Part D coverage gap and direct negotiation of prescription drug prices. -Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2020 (CMS-4185-P). -Pharmacy Direct and Indirect Remuneration (DIR) H.R. 1034, the Phair Pricing Act of 2019; S.640, the Phair Pricing Act of 2019; H.R. 803, the Improving Transparency and Accuracy in Medicare Part D Spending Act; H.R. 1035, the Improving Transparency and Accuracy in Medicare Part D Spending Act. -Medicare Part B reforms. S 476, the Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2019; S.657, the Drug Price Transparency Act.
Pharmacy issues related to the 2019 National Defense Authorization Act and implementation.
Filing targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Congressional Budget Office (CBO), Executive Office of the President (EOP), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, U.S. Trade Representative (USTR), White House Office