id,filing_uuid,filing_type,registrant_name,registrant_id,client_name,filing_year,filing_period,issue_code,specific_issues,government_entities,income_amount,expense_amount,is_no_activity,is_termination,received_date
1967630,a008da5e-fa0a-4c7f-8147-2e3cd7dba8a9,2T,"LIBERTY PARTNERS GROUP, LLC",400275281,"SURGICAL CARE AFFILIATES, INC.",2017,second_quarter,MMM,ASC Payment and policy issues,"Health & Human Services, Dept of (HHS),HOUSE OF REPRESENTATIVES,SENATE",20000,,0,1,2017-04-20T11:35:19.883000-04:00
1982440,cf1952c9-b8dd-4aa2-a0c4-7f15b8beb401,2T,THE MICHAEL LEWAN COMPANY,22746,MEDTRONIC,2017,second_quarter,MMM,Presidents Budget Submission,"HOUSE OF REPRESENTATIVES,SENATE",10000,,0,1,2017-06-29T13:20:51.413000-04:00
1982506,405389c9-ea95-4583-8f59-f69af7bacffb,Q2,AMERICAN ASSOCIATION OF COLLEGES OF PHARMACY,46803,AMERICAN ASSOCIATION OF COLLEGES OF PHARMACY,2017,second_quarter,MMM,"S592, HR109","HOUSE OF REPRESENTATIVES,Office of Management & Budget (OMB),SENATE",,30000,0,0,2017-06-30T12:09:38.043000-04:00
1982518,82d22201-d551-4ef1-afc4-d6868bffd95d,Q2,THE METROHEALTH SYSTEM,288236,THE METROHEALTH SYSTEM,2017,second_quarter,MMM,"Medicare and Medicaid DSH, Healthcare Reform, 340B, CHIP, MIECHV","HOUSE OF REPRESENTATIVES,SENATE",,,0,0,2017-06-30T13:19:50.727000-04:00
1982538,a464b7cf-68fe-4e2e-b3e6-ef05454564b2,2T,AKIN GUMP STRAUSS HAUER & FELD,682,NETWORK FOR REGIONAL HEALTHCARE IMPROVEMENT,2017,second_quarter,MMM,Implementation of healthcare delivery system reform; the American Health Care Act (H.R. 1628).,"HOUSE OF REPRESENTATIVES,SENATE",,,0,1,2017-06-30T17:39:16.363000-04:00
1982570,dc311801-a3cb-4662-b690-13be8a79d9b5,Q2,"CORLEY CONSULTING, LLC",400704112,CREATIVE SOLUTIONS IN HEALTH CARE,2017,second_quarter,MMM,Healthcare payment reforms; audit process reforms;,"Centers For Medicare and Medicaid Services (CMS),HOUSE OF REPRESENTATIVES,SENATE",30000,,0,0,2017-07-01T12:50:17.707000-04:00
1982578,963ff524-1255-470c-8ffa-a54f65b9545b,Q2,"CORLEY CONSULTING, LLC",400704112,TARRANT COUNTY GOVERNMENT,2017,second_quarter,MMM,Support for the 1115 waiver; support for local control of medicaid dollars; support for certainty regarding funding uncompensated care pool;,"HOUSE OF REPRESENTATIVES,SENATE",20000,,0,0,2017-07-01T12:56:23.657000-04:00
1982580,07364149-fc30-41c9-a0fc-3a3976c02a48,Q2,"CORLEY CONSULTING, LLC",400704112,JPS HEALTH NETWORK,2017,second_quarter,MMM,Support for the 1115 waiver; support for local control over Medicaid dollars; support for timely payment; support for flexible care systems that address specific community needs;,"HOUSE OF REPRESENTATIVES,SENATE",20000,,0,0,2017-07-01T12:58:25.127000-04:00
1982607,6bf295e8-35d6-407f-b7cb-22ef739c8e12,Q2,MARSHALL BRACHMAN,6848,BAYLOR SCOTT AND WHITE HEALTH -- FORMERLY BAYLOR HEALTH CARE SYSTEM,2017,second_quarter,MMM,monitor post acute care and other site neutral medicare cuts;support HR 1156 and S.1133 on physician owned hospitals;support reforming reimbursement for ASCs (HR 1838 and S.1001);monitor legislation affecting hospital not-for-profit status;monitor 340B program;monitor UNOS/HRSA liver transplant protocols,"HOUSE OF REPRESENTATIVES,SENATE",33000,,0,0,2017-07-01T17:04:48.950000-04:00
1982615,4a8e5507-d50b-4bbe-bfcc-1d46d47866e6,Q2,MARSHALL BRACHMAN,6848,UNITED SURGICAL PARTNERS INTERNATIONAL INC,2017,second_quarter,MMM,"support HR 1156, S.1133 to reverse restrictions on physician owned hospitals;support legislation to increase reimbursement for ambulatory surgical centers (HR1838, S.1001);oppose cuts to advanced medical imaging;support legislation regarding implementation of meaningful use for HIT","HOUSE OF REPRESENTATIVES,SENATE",24000,,0,0,2017-07-01T17:12:52.527000-04:00
1982617,2c3eded6-e329-41ea-9070-abbdb611f7bd,Q2,MARSHALL BRACHMAN,6848,CARDIOLOGY ADVOCACY ALLIANCE,2017,second_quarter,MMM,"oppose cuts to advanced medical imaging;support appropriateness for diagnostic imaging;support IPAB repeal;oppose site neutral cuts;monitor legislation affecting EHR and HIT;support HR 1156, S.1133 on physician owned hospitals","HOUSE OF REPRESENTATIVES,SENATE",21000,,0,0,2017-07-01T17:16:54.353000-04:00
1982648,8c6338a4-23bf-4d2d-80bc-99aac10ae593,Q2,MJWT CONSULTING,69696,WELLMED MEDICAL MANAGEMENT INC,2017,second_quarter,MMM,Medicare/Medicare Advantage legislative. regulatory issues,"HOUSE OF REPRESENTATIVES,SENATE",20000,,0,0,2017-07-03T08:55:52.570000-04:00
1982650,b144f4e8-3e2b-4856-8e30-3b40af487d11,Q2,WESLEY ENHANCED LIVING,401103160,WESLEY ENHANCED LIVING,2017,second_quarter,MMM,Supporting residential-based Coordinated care demonstration project,"HOUSE OF REPRESENTATIVES,SENATE",,,0,0,2017-07-03T09:07:56.160000-04:00
1982742,2b9b43f2-2f62-48d9-8ff2-cf23ef6f21db,Q2,"JEFFREY J. KIMBELL & ASSOCIATES, INC.",46038,U.S. RENAL CARE,2017,second_quarter,MMM,"Issues related to the survey and certification delays for dialysis facilities, policies related to Medicare payment, and policies related to third party payments.","Centers For Medicare and Medicaid Services (CMS),HOUSE OF REPRESENTATIVES,SENATE",40000,,0,0,2017-07-03T12:51:41.540000-04:00
1982744,64032b41-c2f1-44a5-8509-b742b45c6e2f,Q2,"JEFFREY J. KIMBELL & ASSOCIATES, INC.",46038,HEALOGICS,2017,second_quarter,MMM,Issues related to Medicare reimbursement for wound care services.,"HOUSE OF REPRESENTATIVES,SENATE",30000,,0,0,2017-07-03T12:53:43.693000-04:00
1982788,df670885-5bd8-42a5-b565-c6136a86a13b,Q2,HOLLAND & KNIGHT LLP,18466,CLINICAS DEL CAMINO REAL INC,2017,second_quarter,MMM,Federal policy related to participation of Federally Qualified Health Center in Medicaid expansion and Affordable Care Act.,,,,0,0,2017-07-03T13:34:36.370000-04:00
1982810,5debddfd-fffe-424c-890e-feea0931d442,Q2,"PARKER, POE, ADAMS & BERNSTEIN LLP",288098,NATIVE ANGELS HOME CARE AGENCY INC,2017,second_quarter,MMM,Represent client on issues regarding Medicaid/Medicare cap on home care and hospice,"Health & Human Services, Dept of (HHS)",,,0,0,2017-07-03T14:26:11.373000-04:00
1982954,74dc635f-c791-44ac-9924-4cf8aedb0479,Q2,HOSPICE COMPASSUS,401103527,HOSPICE COMPASSUS,2017,second_quarter,MMM,"Medicare hospice, palliative, and advanced illness care issues
Reintroduction of Care Planning Act","Centers For Medicare and Medicaid Services (CMS),HOUSE OF REPRESENTATIVES,Medicare Payment Advisory Commission (MedPAC),SENATE",,70000,0,0,2017-07-05T10:32:46.443000-04:00
1983010,c051b275-ff0b-4d79-b693-2871f3e9bdbd,Q2,MWR CONSULTING,401104301,UNITEDHEALTH GROUP,2017,second_quarter,MMM,Medicare Advantage Program; America's Health Care Act,"HOUSE OF REPRESENTATIVES,SENATE",45000,,0,0,2017-07-05T11:28:53.380000-04:00
1983022,a4d145ac-53e8-4875-aebb-0fe124543d81,Q2,MWR CONSULTING,401104301,"HOLLISTER, INC.",2017,second_quarter,MMM,Reimbursement for medical devices under Medicare & Medicaid,"HOUSE OF REPRESENTATIVES,SENATE",45000,,0,0,2017-07-05T11:36:09.240000-04:00
1983031,1103ba87-2f43-4715-b607-8aa02acefc41,Q2,MWR CONSULTING,401104301,AMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION,2017,second_quarter,MMM,Medicare Reimbursement for Audiology Services,"HOUSE OF REPRESENTATIVES,SENATE",65000,,0,0,2017-07-05T11:42:19.580000-04:00
1983043,1a0c8f11-7f1d-4e4d-b702-eb4deb16a35a,Q2,"NATIONAL ACADEMY OF ELDER LAW ATTORNEYS, INC.",401103322,"NATIONAL ACADEMY OF ELDER LAW ATTORNEYS, INC.",2017,second_quarter,MMM,"H.R. 1628, the American Health Care Act, Sec. 114
The Better Care Reconciliation Act, Medicaid provisions","HOUSE OF REPRESENTATIVES,SENATE",,64000,0,0,2017-07-05T11:48:29.860000-04:00
1983058,463ae58e-5b2c-4155-b196-54fd0e37fe81,2A,MWR CONSULTING,401104301,"HOLLISTER, INC.",2017,second_quarter,MMM,Reimbursement for medical devices under Medicare & Medicaid,"Centers For Medicare and Medicaid Services (CMS),HOUSE OF REPRESENTATIVES,SENATE",45000,,0,0,2017-07-05T11:55:43.047000-04:00
1983063,34102138-e2b4-4b22-8c92-f1adf5c7f1ae,Q2,"KOZAK & SALINA, LLC",400520537,NATIONAL COALITION FOR ASSITIVE REHAB TECHNOLOGY (NCART),2017,second_quarter,MMM,"Develop a legislative and regulatory strategy to lobby and obtain relief for the Complex Rehab Technology industry (H.R. 1361, S. 486).","HOUSE OF REPRESENTATIVES,SENATE",16500,,0,0,2017-07-05T11:59:49.013000-04:00
1983094,82b5e4e5-8c80-4947-948d-7ef5d9566d89,Q2,"BEHAN COMMUNICATIONS, INC.",400524546,GLENS FALLS HOSPITAL,2017,second_quarter,MMM,Reimbursement rates for Medicare/Medicaid,"HOUSE OF REPRESENTATIVES,SENATE",5975,,0,0,2017-07-05T13:00:19.387000-04:00
1983114,be7bb78b-07ef-418e-9df7-78a20f75be44,Q2,HEALTHCARE LEADERSHIP COUNCIL,17933,HEALTHCARE LEADERSHIP COUNCIL,2017,second_quarter,MMM,"H.R. 2938 Removing Barriers to Medicaid and CHIP Addiction Treatment Act of 2017
H.R. 181 Close Annuity Loopholes in Medicaid Act
H.R. 184 Protect Medical Innovation Act
H.R. 244 Consolidated Appropriations Act, 2017
H.R. 284 Advancing Medical Resident Training in Community Hospitals Act
H.R. 372 Competitive Health Insurance Reform Act
H.R. 592 Pharmacy and Medically Underserved Areas Enhancement Act
S. 109 Pharmacy and Medically Underserved Areas Enhancement Act
H.R. 741 Rural Hospital Regulatory Relief Act
S. 243 Rural Hospital Regulatory Relief Act
H.R. 749 Lower Drug Costs through Competition Act
H.R. 766 Amend Title XVII of the Social Security Act to Expand Telehealth in Medicare
H.R. 829 Prioritizing the Most Vulnerable Over Lottery Winners Act
H.R. 849 Protecting Seniors' Access to Medicare Act
S. 260 Protecting Seniors' Access to Medicare Act
H.R. 908 Medicare Advantage Quality Payment Relief Act
H.R. 998 Searching for and Cutting Regulations that are Unnecessarily Burdensome (SCRUB) Act
H.R. 1004 Regulatory Integrity Act
H.R. 1038 Improving Transparency and Accuracy in Medicare Part D Spending
H.R. 1072 Obamacare Replacement Act
S. 222 Obamacare Replacement Act
H.R. 1148 Furthering Access to Stroke Telemedicine (FAST) Act
S. 431 Furthering Access to Stroke Telemedicine (FAST) Act
H.R. 1245 Affordable and Safe Prescription Drug Importation Act
S. 469 Affordable and Safe Prescription Drug Importation Act
H.R. 1565 Saving Lives, Saving Costs Act
H.R. 1628 American Health Care Act  
H.R. 1703 Medical Product Communications Act 
H.R. 1776 Improving Access to Affordable Prescription Drugs Act
S. 771 Improving Access to Affordable Prescription Drugs Act
H.R. 2550 Medicare Telehealth Parity Act 
H.R. 2556 CONNECT for Health Act 
S. 1016 CONNECT for Health Act 
S. 108 Medical Device Access and Innovation Protection Act
S. 251 Protecting Medicare from Executive Action Act
S. 309 Community-Based Independence for Seniors Act
S. 413 Improving Transparency and Accuracy in Medicare Part D Spending
S. 464 Independence at Home Act
S. 469 Affordable and Safe Prescription Drug Importation Act
S. 64 Safe and Affordable Drugs from Canada Act
S. 761 Health Care Options Act 
S. 771 Improving Access to Affordable Prescription Drugs Act
S. 787, Telehealth Innovation and Improvement Act
S. 870 Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act","Centers For Medicare and Medicaid Services (CMS),Congressional Budget Office (CBO),Executive Office of the President (EOP),Health & Human Services, Dept of (HHS),HOUSE OF REPRESENTATIVES,SENATE",,180000,0,0,2017-07-05T13:30:38.053000-04:00
1983141,67c5f587-60e9-4c92-a3f0-9ce61d79976d,Q2,"UPSTREAM CONSULTING, INC.",88278,"AVEXIS, INC",2017,second_quarter,MMM,​clinical-stage gene therapy,"HOUSE OF REPRESENTATIVES,SENATE",36000,,0,0,2017-07-05T14:27:16.797000-04:00
1983174,a467bb73-8867-4655-a74f-5fa22909fad5,Q2,CARTERMCCLEAN LLC,400718159,XTEC,2017,second_quarter,MMM,Advocating the addition of smart card identification technology to assist in combating fraudulent Medicare practices.,"HOUSE OF REPRESENTATIVES,SENATE",30000,,0,0,2017-07-05T14:59:07.567000-04:00
1983214,c912fff0-ad65-41a4-a27b-30e879858069,Q2,AMERICAN AMBULANCE ASSOCIATION,56018,AMERICAN AMBULANCE ASSOCIATION,2017,second_quarter,MMM,"Lobbied for increases in reimbursement for ambulance service agencies and changes in policies to the Medicare ambulance fee schedule. Lobbied on the Medicare Ambulance Access, Fraud Prevention and Reform Act (S. 967) and draft House bill.","Centers For Medicare and Medicaid Services (CMS),HOUSE OF REPRESENTATIVES,SENATE",,280000,0,0,2017-07-05T17:00:49.500000-04:00
1983223,699f52cd-312b-4ad3-8493-13969ad352c8,Q2,MOSAIC,6096,MOSAIC,2017,second_quarter,MMM,Advocated for disability service providers and Medicaid funding for people with disabilities as it pertained to the American Health Care Act- H.R. 1628 and the Better Care Reconciliation Act.,"HOUSE OF REPRESENTATIVES,SENATE",,,0,0,2017-07-05T17:32:54.807000-04:00
1983339,fe56db85-ced5-424a-a044-f8ac84434e1d,Q2,CHRISTOPHER MOYER,401093053,CAMERON COMPANIES,2017,second_quarter,MMM,American Health Care Act as it relates to patient access and affordability to specialized cancer treatment and the adequacy of provider networks.,"HOUSE OF REPRESENTATIVES,SENATE",10000,,0,0,2017-07-06T10:54:11.853000-04:00
1983346,2c95d344-ad71-4281-a002-5ef106ed67d5,Q2,CAMERON COMPANIES,401095057,FOX CHASE CANCER CENTER,2017,second_quarter,MMM,American Health Care Act as it relates to patient access and affordability to specialized cancer treatment and the adequacy of provider networks.,"HOUSE OF REPRESENTATIVES,SENATE",30000,,0,0,2017-07-06T11:01:22.570000-04:00
1983354,44a9250e-e68d-4d92-8262-3d699d743c53,Q2,BAYCARE HEALTH SYSTEM,400855514,BAYCARE HEALTH SYSTEM,2017,second_quarter,MMM,"HR 1628 - American Healthcare Act of 2017: impact on coverage and access for patients. 
S. 428 - ACE Kids Act of 2017: improving delivery of health services to medically complex children.","Centers For Medicare and Medicaid Services (CMS),HOUSE OF REPRESENTATIVES,SENATE",,211558,0,0,2017-07-06T11:19:35.503000-04:00
1983387,55f83551-dc10-499b-87c1-0eb70db2ca35,Q2,AMERICAN COLLEGE OF CLINICAL PHARMACY,57258,AMERICAN COLLEGE OF CLINICAL PHARMACY,2017,second_quarter,MMM,"Promote enhanced quality, structure and information dissemination concerning medication therapy management services (MTMS) under Medicare Part D.","Centers For Medicare and Medicaid Services (CMS),Food & Drug Administration (FDA),Health & Human Services, Dept of (HHS),Health Resources & Services Administration (HRSA),HOUSE OF REPRESENTATIVES,SENATE",,128375,0,0,2017-07-06T12:18:21.283000-04:00
1983420,0f361d3b-deb8-4cca-9b33-e2f57c0a9fd4,Q2,"ALMOST FAMILY, INC.",401012857,"ALMOST FAMILY, INC.",2017,second_quarter,MMM,"Medicare/Medicaid payment and legislative/regulatory issues, program integrity issues and matters related to homecare policy, pre claim review, services payment, ACO matters and value based purchasing","Centers For Medicare and Medicaid Services (CMS),Congressional Budget Office (CBO),Health & Human Services, Dept of (HHS),HOUSE OF REPRESENTATIVES,Medicare Payment Advisory Commission (MedPAC),SENATE",,150000,0,0,2017-07-06T13:10:50.397000-04:00
1983454,9c5ee451-aa9c-42aa-aa82-66f9b38d579e,Q2,THOMAS BRUDERLE,400643941,EYE BANK ASSOCIATION OF AMERICA,2017,second_quarter,MMM,Medicare reimbursement.,,10000,,0,0,2017-07-06T13:59:19.570000-04:00
1983455,b2ba8e93-209e-4d99-9c2c-8f2417365145,Q2,GENESIS HEALTHCARE INC (FORMERLY LISTED AS GENESIS HEALTHCARE CORPORATION),40049384,GENESIS HEALTHCARE INC (FORMERLY LISTED AS GENESIS HEALTHCARE CORPORATION),2017,second_quarter,MMM,"(i) H.R. 1628 the American Health Care Act with primary focus on Medicaid per capita caps provisions affecting the aged, blind and disabled; (ii)HR 807/S 253 Medicare part B therapy cap repeal; (iii) HR 1421/S 568 Medicare Observation Day Relief; (iv) HR 1215 cap on punitive damages; (v) CMS FY18 SNF PPS proposed rule making; (vi) CMS Advanced Notice of proposed rule-making SNF PPS Payment Methodology, and (vii) CMS implementation of quality measures/Access Act provisions","Centers For Medicare and Medicaid Services (CMS),Health & Human Services, Dept of (HHS),HOUSE OF REPRESENTATIVES,SENATE",,96000,0,0,2017-07-06T13:59:21.350000-04:00
1983537,ca5c2b40-568f-4ba1-bf86-376e0791bcda,Q2,UC HEALTH,401103195,UC HEALTH,2017,second_quarter,MMM,"AHCA, BCRA","HOUSE OF REPRESENTATIVES,SENATE",,,0,0,2017-07-06T15:25:53.500000-04:00
1983552,a12d2695-8739-4fdd-a85e-cfb95ee5c146,Q2,STANTON PARK GROUP,83717,NATIONAL KIDNEY FOUNDATION,2017,second_quarter,MMM,promoting payment policies that promote early detection and treatment of chronic kidney disease; ensuring patient access to care that improves outcomes and patients with chronic kidney disease,"HOUSE OF REPRESENTATIVES,SENATE",20000,,0,0,2017-07-06T15:38:07.543000-04:00
1983586,669b2da7-88c6-47d9-8dfa-2af005e64be0,Q2,NELSON MULLINS RILEY & SCARBOROUGH,285871,PHARMACEUTICAL INDUSTRY LABOR MANAGEMENT ASSOCIATION (PILMA),2017,second_quarter,MMM,"Work to protect patent protections for pharmaceutical companies and other general issues relating to the Pharmaceutical Industry, Medicare Part B","HOUSE OF REPRESENTATIVES,SENATE",30000,,0,0,2017-07-06T16:09:41.567000-04:00
1983595,7435076b-fe91-4e63-8f39-92d100c4c929,Q2,NELSON MULLINS RILEY & SCARBOROUGH,285871,PHRMA,2017,second_quarter,MMM,"Work to protect patent protections for pharmaceutical companies and other general issues relating to the Pharmaceutical Industry, Medicare Part B","HOUSE OF REPRESENTATIVES,SENATE",30000,,0,0,2017-07-06T16:11:45.550000-04:00
1983605,7d30523a-8872-41cd-ad46-fc4b1f0ca267,Q2,STANTON PARK GROUP,83717,MCKESSON CORPATION AND ITS AFFILIATE US ONCOLOGY (FORMERLY US ONCOLOGY),2017,second_quarter,MMM,"Medicare, oncology, radiation and imaging reimbursement issues; Medicare physician payments; prompt pay discount; Oncology payment disparities in Medicare; protecting access to community based cancer care","Health & Human Services, Dept of (HHS),HOUSE OF REPRESENTATIVES,SENATE",60000,,0,0,2017-07-06T16:16:56.097000-04:00
1983673,19103d00-b163-411a-ad14-5076c79ec73a,Q2,AMERICAN CAPITOL GROUP,305852,CARDINAL HEALTH,2017,second_quarter,MMM,Issues Related to Distribution and Sale of Pharmaceutical and Medical Products and Services; Center for Medicare and Medicaid Innovation (CMMI); CMS Bundled Payment Programs; and Bundled Payments for Care Improvement (BPCI) Initiative Models,"HOUSE OF REPRESENTATIVES,SENATE",25000,,0,0,2017-07-06T17:09:11.363000-04:00
1983679,eabaa3a7-f07d-4638-90b2-36423cf89163,2A,AMERICAN CAPITOL GROUP,305852,CARDINAL HEALTH,2017,second_quarter,MMM,Issues Related to Distribution and Sale of Pharmaceutical and Medical Products and Services; Center for Medicare and Medicaid Innovation (CMMI); CMS Bundled Payment Programs; and Bundled Payments for Care Improvement (BPCI) Initiative Models,"Health & Human Services, Dept of (HHS),HOUSE OF REPRESENTATIVES,SENATE",25000,,0,0,2017-07-06T17:16:17.237000-04:00
1983703,d7e66422-73dd-4ef7-9b69-c6a7f14a5269,Q2,"DUTKO WORLDWIDE, LLC",12868,AMERICAN COUNSELING ASSOCIATION,2017,second_quarter,MMM,"Support H.R 3032, legislation that adds licensed professional counselors as eligible Medicare providers","Defense, Dept of (DOD),Education, Dept of,Executive Office of the President (EOP),Health Resources & Services Administration (HRSA),HOUSE OF REPRESENTATIVES,SENATE,Substance Abuse & Mental Health Services Administration (SAMHSA),Transportation, Dept of (DOT),Veterans Affairs, Dept of (VA)",10000,,0,0,2017-07-06T17:55:30.407000-04:00
1983746,d2aee519-f0f3-4a54-af69-9fc5fef36f3c,Q2,AMERICAN CAPITOL GROUP,305852,SANOFI US SERVICES INC,2017,second_quarter,MMM,Medicare Part D issues,"Health & Human Services, Dept of (HHS),HOUSE OF REPRESENTATIVES,SENATE",40000,,0,0,2017-07-06T19:00:50.560000-04:00
1983820,201eea9a-037a-48ea-b827-92731887ee6b,Q2,MICHAEL N. MCCARTY LAW OFFICE PLLC,401104300,AMERICAN MEDICAL TECHNOLOGISTS,2017,second_quarter,MMM,Implementation of Section 216 of the Protecting Access to Medicare Act of 2014; revisions to the Medicare Clinical Laboratory Fee Schedule; implementation of the Medicare and CHIP Reauthorization Act of 2015 (MACRA).,"Centers For Medicare and Medicaid Services (CMS),HOUSE OF REPRESENTATIVES,SENATE",10000,,0,0,2017-07-07T10:52:10.747000-04:00
1983846,9f4a8bef-4022-4d2f-9ac2-f9a636f88622,Q2,AMERICAN SOCIETY FOR DERMATOLOGIC SURGERY ASSOCIATION,401103437,AMERICAN SOCIETY FOR DERMATOLOGIC SURGERY ASSOCIATION,2017,second_quarter,MMM,"Repeal of the Independent Payment Advisory Board (IPAB)
Transparency of accrediting organization survey reports 
Social Security Number Removal Initiative from Medicare Beneficiary IDs","Centers For Medicare and Medicaid Services (CMS),HOUSE OF REPRESENTATIVES,SENATE",,,0,0,2017-07-07T11:45:34.467000-04:00
1983888,d90923b0-4200-4a0c-ac24-df7248438294,Q2,"RED MAPLE CONSULTING, LLC",400382761,"POTOMAC PARTNERS DC (ON BEHALF OF ORANGE COUNTY, CA)",2017,second_quarter,MMM,Monitor regulations and legislation changing Medicare and Medicaid policies,"HOUSE OF REPRESENTATIVES,SENATE",20000,,0,0,2017-07-07T12:18:08.950000-04:00
1983926,5f04730a-c020-4349-8443-5c114ba2811b,Q2,MS. CHARITY BRACY,401103158,DISTRICT HOSPITAL LEADERSHIP FORUM,2017,second_quarter,MMM,Medicaid Managed Care Rule issued by CMS,"Centers For Medicare and Medicaid Services (CMS),HOUSE OF REPRESENTATIVES,SENATE",21939,,0,0,2017-07-07T13:29:50.213000-04:00
1983973,c29437b0-d688-4d5a-95be-99ee11e5fc86,Q2,CURATORS OF THE UNIVERSITY OF MISSOURI,43616,CURATORS OF THE UNIVERSITY OF MISSOURI,2017,second_quarter,MMM,"HR 1628, American Health Care Act of 2017, issues pertaining to DSH payments.","HOUSE OF REPRESENTATIVES,SENATE",,80000,0,0,2017-07-07T14:18:28.747000-04:00
1983981,a46d9483-3a67-4501-a9ba-dcef8d005189,Q2,"HALL, RENDER, KILLIAN, HEATH & LYMAN, P.C.",17352,BAKER HEALTHCARE CONSULTING INC.,2017,second_quarter,MMM,MGCRB Appeal,"Centers For Medicare and Medicaid Services (CMS),Health & Human Services, Dept of (HHS),SENATE",25000,,0,0,2017-07-07T14:27:34.087000-04:00
1983982,8917d8b5-d50e-4ef4-b994-326fdc340af9,Q2,"HALL, RENDER, KILLIAN, HEATH & LYMAN, P.C.",17352,"BAYCARE HEALTH SYSTEM, INC.",2017,second_quarter,MMM,Florida Section 1115 Medicaid Waiver Application,"Centers For Medicare and Medicaid Services (CMS),Health & Human Services, Dept of (HHS)",,,0,0,2017-07-07T14:30:36.057000-04:00
1983986,87f5b7f4-a095-4e96-b2ec-3d4a1439482a,Q2,CHANGE HEALTHCARE,401103788,CHANGE HEALTHCARE,2017,second_quarter,MMM,"Medicare Savings Programs, dual eligibles and quality","Centers For Medicare and Medicaid Services (CMS),Health & Human Services, Dept of (HHS),HOUSE OF REPRESENTATIVES,Medicare Payment Advisory Commission (MedPAC),SENATE",,,0,0,2017-07-07T14:36:42.803000-04:00
1984013,0b6f4d72-2477-46c2-88ef-bfba090ee64f,Q2,"HALL, RENDER, KILLIAN, HEATH & LYMAN, P.C.",17352,HANCOCK REGIONAL HOSPITAL,2017,second_quarter,MMM,Medicaid Payment Reform,"HOUSE OF REPRESENTATIVES,SENATE",,,0,0,2017-07-07T15:12:18.903000-04:00
1984014,bb0fdfec-9535-4967-a6cb-3761fd794795,Q2,"HALL, RENDER, KILLIAN, HEATH & LYMAN, P.C.",17352,HENDRICKS REGIONAL HEALTH,2017,second_quarter,MMM,Medicaid Reform,"HOUSE OF REPRESENTATIVES,SENATE",,,0,0,2017-07-07T15:14:20.373000-04:00
1984015,df8688ef-cfb7-4738-81c0-c602ac5104f5,Q2,"HALL, RENDER, KILLIAN, HEATH & LYMAN, P.C.",17352,HENRY COUNTY HOSPITAL,2017,second_quarter,MMM,Medicaid Payment Reform,"HOUSE OF REPRESENTATIVES,SENATE",,,0,0,2017-07-07T15:16:22.497000-04:00
1984018,d0a61484-7a3f-4ca5-8406-26b0a143fd96,Q2,"HALL, RENDER, KILLIAN, HEATH & LYMAN, P.C.",17352,JOHNSON MEMORIAL HOSPITAL,2017,second_quarter,MMM,Medicaid Payment Reform,"HOUSE OF REPRESENTATIVES,SENATE",,,0,0,2017-07-07T15:18:28.747000-04:00
1984135,295f0730-ee17-4374-ac07-e9c05ea50d23,Q2,"CHATMAN, LLC",400678024,LIVINGSTON GROUP FOR RUSH UNIVERSITY MEDICAL CENTER,2017,second_quarter,MMM,Social Workers billing for Medicare Health and Behavior Codes,"HOUSE OF REPRESENTATIVES,SENATE",20000,,0,0,2017-07-08T18:02:04.270000-04:00
1984239,b1193b6d-38ef-4907-a019-9c0fa6d4f527,Q2,PERMANENTE FEDERATION,42796,THE PERMANENTE FEDERATION,2017,second_quarter,MMM,2018 Medicare Advantage Call Letter,"HOUSE OF REPRESENTATIVES,SENATE",,20000,0,0,2017-07-09T19:41:01.450000-04:00
1984274,875df0d2-5589-45f4-9d4d-466006ece2eb,Q2,"HALL, RENDER, KILLIAN, HEATH & LYMAN, P.C.",17352,MAJOR HEALTH PARTNERS,2017,second_quarter,MMM,Medicaid Payment Reform,"HOUSE OF REPRESENTATIVES,SENATE",,,0,0,2017-07-10T09:29:15.767000-04:00
1984301,150c65ac-a0af-4b36-b05f-f42acae28409,Q2,"HALL, RENDER, KILLIAN, HEATH & LYMAN, P.C.",17352,RIVERVIEW HEALTH,2017,second_quarter,MMM,Medicaid payment reform,"HOUSE OF REPRESENTATIVES,SENATE",,,0,0,2017-07-10T10:02:49.587000-04:00
1984302,4a6d5bea-9146-43c5-98ec-5eb65226c58b,Q2,"HALL, RENDER, KILLIAN, HEATH & LYMAN, P.C.",17352,RUSH MEMORIAL HOSPITAL,2017,second_quarter,MMM,Medicaid Payment Reform,"HOUSE OF REPRESENTATIVES,SENATE",,,0,0,2017-07-10T10:03:51.383000-04:00
1984309,3ab62efe-d891-42fc-9aa7-17d5ea302935,Q2,"HALL, RENDER, KILLIAN, HEATH & LYMAN, P.C.",17352,SUBURBAN HEALTH ORGANIZATION,2017,second_quarter,MMM,Medicaid Payment Reform,"Centers For Medicare and Medicaid Services (CMS),Health & Human Services, Dept of (HHS),HOUSE OF REPRESENTATIVES,SENATE",24000,,0,0,2017-07-10T10:06:58.757000-04:00
1984373,16388d54-4f5c-4166-a96f-66a9e5add62b,Q2,AMERICAN UROLOGICAL ASSOCIATION,90352,AMERICAN UROLOGICAL ASSOCIATION,2017,second_quarter,MMM,ensuring appropriate access to Prostate-Specific Antigen screening,"HOUSE OF REPRESENTATIVES,SENATE",,63000,0,0,2017-07-10T11:53:25.837000-04:00
1984398,368f985d-8b37-4351-bdc8-ae229824b9b9,Q2,MCGUIREWOODS CONSULTING (A SUBSIDIARY OF MCGUIREWOODS LLP),24486,THE COOK GROUP INC.,2017,second_quarter,MMM,Medical Device Tax Repeal,"HOUSE OF REPRESENTATIVES,SENATE",40000,,0,0,2017-07-10T12:35:06.500000-04:00
1984413,235b3b67-ff43-4104-9239-a82bdeadea93,Q2,AMERICAN SOCIETY OF CATARACT & REFRACTIVE SURGERY,3402,AMERICAN SOCIETY OF CATARACT & REFRACTIVE SURGERY,2017,second_quarter,MMM,"Medicare reimbursement issues, Merit-Based Incentive Payment System (MIPS) and Quality Payment Program (QPP), misvalued codes, repeal of Independent Payment Advisory Board (IPAB), ambulatory surgery centers, ophthalmic legislation, FDA-related issues, compounded drug issues, quality issues, off-label communication, health information technology, healthcare reform, health insurer anti-trust issues","Centers For Medicare and Medicaid Services (CMS),Food & Drug Administration (FDA),Health & Human Services, Dept of (HHS),HOUSE OF REPRESENTATIVES,SENATE",,154850,0,0,2017-07-10T13:13:28.823000-04:00
1984451,28655048-411c-421a-9cbd-0faba9398dd3,Q2,RED+BLUE STRATEGIES,400693064,EXPRESS SCRIPTS INC.,2017,second_quarter,MMM,"S. 637 - Creating Transparency to have Prescription Drug Rebates Unlocked - Issues related to the alleged relationship between rebates and drug prices.

S. 771 - A bill to Improve Access to Affordable Prescription Drugs - Issue related to bringing drug pricing down including better policies in the Part D coverage gap, couponing and advancing biosimilars. 

Issues related to the price of prescription medications in the United States.","Executive Office of the President (EOP),HOUSE OF REPRESENTATIVES,SENATE",60000,,0,0,2017-07-10T13:37:04.490000-04:00
1984461,5b3a99f8-3104-45e3-9e99-e0a658c2822d,Q2,RED+BLUE STRATEGIES,400693064,CHILDREN'S HOSPITAL ASSOCIATION F/K/A NAT'L ASSOCIATION OF CHILDREN'S HOSPITALS,2017,second_quarter,MMM,"S. 428 - The ACE Kids Act of 2017 - Legislation focused on allowing delivery system reform in Medicaid to further progress in offering comprehensive coverage options for children with multiple complex conditions. 

H.R. 1628 - The American Health Care Act - Issues related to Medicaid and the program's impact on children's health. 

The Better Care Reconciliation Act of 2017 - Issues related to Medicaid and the program's impact on children's health

Issues related to the reauthorization of the Children's Health Insurance Program

Issues related to Children's Hospitals Graduate Medical Education.","Congressional Budget Office (CBO),HOUSE OF REPRESENTATIVES,Office of Management & Budget (OMB),SENATE",70000,,0,0,2017-07-10T13:44:19.787000-04:00
1984496,d8f34a85-2ea2-4807-ad4e-9fbfc4068fd6,Q2,RED+BLUE STRATEGIES,400693064,PHARMACEUTICAL CARE MANAGEMENT ASSOCIATION (PCMA),2017,second_quarter,MMM,"S. 637 - Creating Transparency to Have Prescription Drug Rebates Unlocked - Issues related to the alleged relationship between rebates and drug prices. 

S. 771 - A Bill to Improve Access to Affordable Prescription Drugs - Issues related to bringing drug prices down including strengthening policies in the Part D coverage gap, couponing and advancing biosimilars. 

Issues related to the cost of prescription medications in the Medicare and Medicaid programs.","Executive Office of the President (EOP),HOUSE OF REPRESENTATIVES,Office of Management & Budget (OMB),SENATE",60000,,0,0,2017-07-10T14:04:59.903000-04:00
1984510,20d5b42c-4a2b-4945-8ea6-7fa66c781c92,Q2,WAKE FOREST UNIVERSITY HEALTH SCIENCES,6781,WAKE FOREST UNIVERSITY HEALTH SCIENCES,2017,second_quarter,MMM,Medicaid reform proposals; FY 2018 IPPS Proposed Rule,"Health & Human Services, Dept of (HHS),HOUSE OF REPRESENTATIVES,SENATE",,130000,0,0,2017-07-10T14:18:14.870000-04:00
1984551,78720432-5d0f-4d1a-845c-d7dad7a61db2,Q2,NORTH CAROLINA BAPTIST HOSPITAL,46723,NORTH CAROLINA BAPTIST HOSPITAL,2017,second_quarter,MMM,Medicaid reform proposals; Y 2018 IPPS Proposed Rule,"HOUSE OF REPRESENTATIVES,SENATE",,25000,0,0,2017-07-10T14:43:52.580000-04:00
1984554,fac8943f-589a-4fb2-b2cf-f3e2c2750568,Q2,RED+BLUE STRATEGIES,400693064,PEW CHARITABLE TRUSTS,2017,second_quarter,MMM,"S. 1334/H.R. 2797 - Patient Choice and Quality Care Act of 2017 - Issues related to better integration of end-of-life and palliative care into the nation's health care system. 

Issues related to end of life, palliative care and policies related to hospice programs.

Issues related to health information technology, unique device identifiers on Medicare claims forms, and other critical policies to promote device safety.

Issues related opioid abuse and methods to fight against the opioid epidemic in the United States.
 
Issues related to the Physician Payment Sunshine Act and the Open Payments system.","HOUSE OF REPRESENTATIVES,SENATE",30000,,0,0,2017-07-10T14:44:54.160000-04:00
1984588,0e0d50c4-0cbb-4fc9-b94b-f579f8ca364b,Q2,ALZHEIMER'S FOUNDATION OF AMERICA,323158,ALZHEIMER'S FOUNDATION OF AMERICA,2017,second_quarter,MMM,"S. 445 -  the Home Health Care Planning Improvement Act of 2017 
S. 464 - Independence at Home Act of 2017 
H.R. 1825, the Home Care Planning Act","Administration on Aging,Health & Human Services, Dept of (HHS),HOUSE OF REPRESENTATIVES,Office of Management & Budget (OMB),SENATE,White House Office",,30000,0,0,2017-07-10T14:53:16.110000-04:00
1984652,4acb6f55-5043-46a9-9215-cdc8758f3d61,Q2,RED+BLUE STRATEGIES,400693064,COMMUNITY CATALYST,2017,second_quarter,MMM,"H.R. 1628 - American Health Care Act - Issues impacting individuals receiving insurance through the individual marketplaces and Medicaid program.

Better Care Reconciliation Act (Senate Repeal and Replace bill) - Issues impacting individuals receiving insurance through the individual marketplaces and Medicaid program.

Issues related to delivery system reform. 

Issues related to the reauthorization of the Children's Health Insurance Program.","HOUSE OF REPRESENTATIVES,SENATE",20000,,0,0,2017-07-10T15:39:40.457000-04:00
1984714,9fd67682-bf65-4f8b-87b0-59887a9aac89,Q2,MCDERMOTT+ LLC,401103287,TRINITY HEALTH,2017,second_quarter,MMM,"Medicare and Medicaid payments to hospitals.
Issues affecting hospital systems, including delivery system reform.","HOUSE OF REPRESENTATIVES,SENATE",60000,,0,0,2017-07-10T16:51:41.657000-04:00
1984729,ba828b8b-c3bf-4a76-b728-7cf992e9b8b7,Q2,MCDERMOTT+ LLC,401103287,ALLIANCE FOR RURAL HOSPITAL ACCESS,2017,second_quarter,MMM,Medicare reimbursement for rural referral centers and sole community hospitals.,"Centers For Medicare and Medicaid Services (CMS),HOUSE OF REPRESENTATIVES,SENATE",30000,,0,0,2017-07-10T17:02:56.340000-04:00
1984834,ff8c6638-90e0-4dde-8979-21b9b76601b0,Q2,"THE AFFLERBACH GROUP, LLC",401103165,NATIONAL ADULT DAY SERVICES ASSOCIATION (NADSA),2017,second_quarter,MMM,Affordable Care Act Repeal/Replace; Medicare/Medicaid coverage for Adult Day Services.,"HOUSE OF REPRESENTATIVES,SENATE",10000,,0,0,2017-07-11T08:37:29.747000-04:00
1984839,b5f73727-75f2-4e79-a36d-7f58ccff21a4,Q2,MR. ROBERT LEVI,401104269,UNITED POSTMASTERS AND MANAGERS OF AMERICA,2017,second_quarter,MMM,"Coordination between Medicare and the FEHBP
Medicare Part B Hold Harmless Provision","Federal Retirement Thrift Investment Board,HOUSE OF REPRESENTATIVES,Office of Personnel Management (OPM),Postal Regulatory Commission,SENATE,U.S. Postal Service (USPS)",20000,,0,0,2017-07-11T09:11:36.190000-04:00
1984923,2b92dc80-c06c-43a7-8e94-f68c533afcd3,Q2,MCDERMOTT+ LLC,401103287,POINT OF CARE TESTING ASSOCIATION,2017,second_quarter,MMM,Medicare payment for clinical laboratory services and implementation of Section 216 of the Protecting Access to Medicare Act of 2014.,"Centers For Medicare and Medicaid Services (CMS),HOUSE OF REPRESENTATIVES,SENATE",50000,,0,0,2017-07-11T11:47:32.073000-04:00
1984932,a225b57f-8d33-48c4-af5f-77c830bfad5a,Q2,MCDERMOTT+ LLC,401103287,MEDICARE DEPENDENT RURAL HOSPITAL COALITION,2017,second_quarter,MMM,Medicare reimbursement for Medicare dependent rural hospitals.,"Centers For Medicare and Medicaid Services (CMS),HOUSE OF REPRESENTATIVES,SENATE",20000,,0,0,2017-07-11T11:58:46.850000-04:00
1985026,5e231365-9255-4d8c-aafb-be5807644fd2,Q2,MARSHFIELD CLINIC HEALTH SYSTEM,57830,MARSHFIELD CLINIC HEALTH SYSTEM,2017,second_quarter,MMM,"Many aspects of the Affordable Care Act promote changes that are consistent with the mission of the Marshfield Clinic:
Extends health insurance to the uninsured
Calls for Value Based Purchasing for all providers 
Calls for the establishment of Accountable Care Organizations

The following are key elements of the health policy agenda of the Marshfield Clinic Health System: 

Medicare Access and CHIP Reauthorization Act 
With passage of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), Congress has put to rest the constant threat of massive cuts to Medicare physician fees. Going forward Medicare physician payments will transition to an incentive-based system based on value and accountability.  Starting in 2019, Medicare physician payment will be based on the Merit-Based Incentive Payment System (MIPS). Physicians who perform well on quality, value and IT metrics will be rewarded with higher pay rates and those who perform poorly will face penalties. Participants in Alternative Payment Systems (APMs) such as accountable care organizations that assume financial risk will receive 5% bonuses between 2019 and 2024. Because the language of the statute is not specific, the Centers for Medicare and Medicaid Services (CMS) is developing metrics that will be used to determine the bonus payments and penalties that will start in 2019 in a public rulemaking currently underway. The proposed metrics simplify and consolidate the existing measurements employed under the Meaningful Use Incentive Program, the Physician Reporting System (PQRS), and the Value-Based Modifier (VBM) to streamline the reporting burden for physician practices.  MIPS will then pay physicians based on four weighted performance categories: Quality (50% of total score in year 1), Advancing Care Information (25% of total score in year 1); Clinical Practice Improvement Activities (15% of total score in year 1): Resource Use (10% of total score in year 1, but growing to 30% in subsequent years). Having a source of credible data as the foundation of CMS metrics is critical both to fair payment and maintaining access to medical services in rural areas. CMS will be refining the metrics perpetually throughout the lifespan of this program. Challenges to fair reimbursement persist under the current Medicare fee schedule, which remains the foundation of the reimbursement system, particularly in regard to the valuation of primary care and the geographic adjustment of physician wages. These challenges must be addressed.  Adequate funding for CMS to implement and maintain this new system is critical to patient care, provider education and acceptance of the new program and its long term success. Congress must ensure that CMS has adequate funding to provide oversight of its many programs, including its measurement of resource and input costs and full implementation of the Affordable Care Act and MACRA.
MCHS also supported MACRA provisions that extended funding for the Childrens Health Insurance Program and provided $7.2 billion to community health centers over the next 2 years, postponed cuts in payments to hospitals that treat large numbers of low-income patients; and extended provisions that funded geographic adjustment of the physician work, therapy services and payments for rural hospitals.

Medicare Advantage 

The Medicare Advantage program provides a full-risk, capitated reimbursement to health plans for all Medicare benefits provided to enrolled beneficiaries. We believe that mechanisms for rewarding value in the Medicare Advantage program should offer incentives for those plans that demonstrate superior patient care performance. We recommend that performance bonuses should be provided for plans that:  Achieve predetermined quality performance targets; Adopt health information technology; Meet standards for care coordination; and Provide data on comparative effectiveness. 

The Medicare Advantage Benchmark Cap - ACA SEC. 3201. (b) (4)   By authorizing Quality Incentive Payments for MA plans with star ratings of 4 stars and above, Congress made a significant policy change towards value-based purchasing in the MA program.  If a plan is eligible for a Quality Incentive Payment, it receives it in the form of a 5 percent increase to its benchmark. However, Congress also authorized a new methodology for calculating benchmarks, and mandated that benchmarks under the new methodology cannot be greater than what they would have been under the old benchmark methodology.  This is the benchmark cap.  The benchmark cap reduces or even eliminates Quality Incentive Payments. 

The policy issue is that the cap weakens the incentive for plans to attain higher star ratings and undermines the shift towards paying for performance in the MA program.  We do not think that Congress intended to take away with one provision (the cap) the significant policy change towards paying for value that it enacted in the ACA. This change will have a significant negative impact on Medicare Advantage beneficiaries. CMS has indicated that it wants to remove the cap administratively, and we believe that HHS and CMS have the discretionary authority under law to make the necessary changes.  If HHS and CMS do not make the change, then a statutory change will be necessary in the 115th Congress. The benchmark cap costs Medicare Advantage enrollees in Security Health Plans population more than $25 more in their monthly premium.

Graduate Medical Education

MCHS is concerned about having a sufficient supply of primary care physicians to meet the demands of an expanding and aging population.   This is doubly true for patients and health systems in rural settings.  Currently only about 10% of physicians practice in rural areas while 25% of the population resides there.   While 36% allopathic residents and 50% osteopathic residents who are trained in a rural residency end up practicing in a rural area, only 4% of the residency training actually occurs in rural areas.    Currently there are more US medical students graduating from medical school than there are GME slots.  An increase in GME primary care training positions is essential to maintaining high-quality, accessible, and cost efficient care.  

Teaching hospitals in rural locations provide an environment for residents to learn and faculty to serve as educators, providers and researchers. These roles advance the broad mission of preparing each generation of physicians, provide critical patient care and specialized services, often to the disadvantaged, facilitate the discovery of new therapies and treatments, and enable residents to acclimate to the rural setting. As new payment and delivery models emphasize primary care to improve patient outcomes and reduce costs, and as more care shifts to outpatient settings, teaching faculty and residency programs must increase access to ambulatory residency rotations to serve Americans who live in areas with an under-supply of primary care physicians including Geriatrics and Psychiatry. The purpose and value of residency training in clinical settings and the financial support needed to sustain physician education will only increase as the U.S. population lives longer with more complex health conditions.  To ensure GME can meet the future needs of the newly insured and aging population, Congress must commit to the consistent GME funding and lift Medicares limit on funded residency positions. We support the Teaching Health Center funding in the Medicare Access and CHIP Reauthorization ACT (MACRA) for Community Health Centers but request you extend funding beyond 2017.

Geographic Adjustment of Physician Payments

Recent findings by the Institute of Medicine (IOM) and the Medicare Payment Advisory Commission have demonstrated significant shortcomings in the data utilized to geographically adjust physician payments.  The IOM and MedPAC studies have confirmed that the data sources currently relied upon for geographic adjustment bear no correlation to physician earnings.   CMS officials have admitted that the proxies utilized for the purpose of geographic adjustment have never been validated, and there never has been a new data source utilized in the twenty years since the fee schedule was implemented.  MedPAC data show that the geographic adjustment reference occupations predict earnings of rural physicians to be 25-30% less than physicians in metropolitan areas. MedPAC data show that earnings of primary care physicians in rural areas are, in fact, 13% higher than physicians in metropolitan areas.  Since there is no statistical basis of support for disparities in payment we strongly recommend that Congress require CMS to correct this inequity immediately.  These corrections are necessary to assure the credibility of the changes enacted in MACRA.

Telemedicine in Medicare 

Changes to Medicare law and regulation are needed to improve equity in access for Medicare beneficiaries to services delivered via TeleHealth. Medicare beneficiaries should be allowed to receive services in telemedicine sites located in urban areas.  The necessary changes would remove restrictions on originating sites by removing the rural requirement and the list of originating sites and allowing any certified Medicare facility to provide the services; current requirements that physician must bill for services from the originating site should be removed; restrictions on eligible practitioners should be removed to allow all Medicare approved practitioners to provide telemedicine services; and there should be no restrictions on which Medicare services may be provided through telemedicine.  We recommend that the Medicare requirement for non-MSA geographic location of the patient be expanded to allow all Medicare certified organizations as originating sites regardless of rural or metropolitan statistical area designation.  


In addition, MCHS supports the CONNECT for Health Act that contains a provision which would permit Medicare Advantage plans to use telehealth or remote patient monitoring technologies to provide basic Medicare benefits, without the restrictions that limit originating sites, geographic locations, store-and-forward technologies, and types of health care provider.   We believe that telehealth is a different way of delivering an already covered service, and that Medicare should treat remote access technologies as an alternative modality or complementary means of providing clinical services, and not a service itself.  In other words, telehealth should not be seen as simply a supplement or complement to face-to-face encounters. Patients increasingly expect their health plans to provide the access to services and convenience that remote technologies facilitate. These technologies can increase communication between providers and patients, enhance care coordination, and help physicians and patients work together to treat illness and maintaining health.

Oral Health Coverage for the Medically Compromised and at Risk Populations  There is sufficient data that demonstrates oral health impacts the systemic health of the patient and in doing can reduce the cost of care.  Linkages that encourage patient compliance, patient education, provider education, and bi-directional referral and surveillance should be incented and compensated.   Shared savings demonstrations should be developed for health systems and co-pay incentives developed for patients engaging in and complying with such inter-disciplinary care.


Protecting Access to Medicare Act of 2014 (PAMA)
PAMA includes reforms to the Clinical Lab Fee Schedule (CLFS).  This rule for PAMA requires reporting of Clinical lab prices and volumes.  MCHS requested a delay in the reporting, and changes to expand the definition of applicable lab to represent the true market of all laboratories; requested greater transparency of calculations; more time to allow for gathering data and implementation. 

Flexibility in coverage of care that saves long term costs: Marshfield Clinic Health System has been a leader in providing care in alternative settings that saves cost, maintains quality and improves patient experience. Programs such as our comfort and recovery suites cut approximately a third of the costs vs hospitalization. Marshfield Clinic Health System would advocate for the opportunity to use these programs for any patient, but due to regulatory barriers cannot (e.g. Medicaid beneficiaries).","Centers For Medicare and Medicaid Services (CMS),Health & Human Services, Dept of (HHS),HOUSE OF REPRESENTATIVES,SENATE,Veterans Affairs, Dept of (VA)",,90000,0,0,2017-07-11T13:31:19.420000-04:00
1985059,4679ec12-ab5f-431c-a18d-2b09a5fde08d,Q2,HOLLAND & KNIGHT LLP,18466,"THERMO FISHER SCIENTIFIC, INC.",2017,second_quarter,MMM,Medicare and Medicaid coverage for allergy testing.,"Centers For Medicare and Medicaid Services (CMS),HOUSE OF REPRESENTATIVES,SENATE",100000,,0,0,2017-07-11T13:49:37.040000-04:00
1985147,68954119-41a2-4b7b-8708-2fdf11ba6fce,Q2,"THE CJR GROUP, INC.",288293,UNIVERSITY HOSPITALS HEALTH SYSTEM,2017,second_quarter,MMM,Medicaid and Medicare funding,"HOUSE OF REPRESENTATIVES,SENATE",30000,,0,0,2017-07-11T14:52:54.617000-04:00
1985219,1e2230ec-e253-4373-9367-739f74813da5,Q2,HOLLAND & KNIGHT LLP,18466,FLORIDA HOSPITAL ASSOCIATION,2017,second_quarter,MMM,Implementation of America's Affordable Health Care Act of 2009. Communicating with Florida House and Senate Delegation and CMS regarding Medicaid waiver extension and statewide Medicaid managed care proposals. Advocacy regarding deficit reduction negotiations/Medicaid & Medicare cuts and potential impact on Florida providers and site neutral Medicare payment.,"Centers For Medicare and Medicaid Services (CMS),Health & Human Services, Dept of (HHS),HOUSE OF REPRESENTATIVES,SENATE",80000,,0,0,2017-07-11T15:22:16.623000-04:00
1985356,ae9044c1-a1de-42c4-852f-5c9d0c55851e,Q2,"JOHNSTON GROUP, LLC",400383768,ASTRIA HEALTH (FORMERLY KNOWN AS SUNNYSIDE COMMUNITY HOSPITAL),2017,second_quarter,MMM,"Impact of budget proposed by the Administration on Medicare reimbursement rates.
Support for Critical Access Hospital reimbursement rates without changes.
Support for new CMS program that would allow a Critical Access Hospital to transition to a traditional CMS payment model over a ten year period.
Impact of Section 603 of the Budget Act of 2015 on hospital reimbursement.","HOUSE OF REPRESENTATIVES,SENATE",15000,,0,0,2017-07-11T17:17:12.420000-04:00
1985400,529453ee-0ee7-49d8-9169-c4de86083a37,Q2,BAKER & HOSTETLER LLP,5131,CHILDREN'S HOSPITAL ASSOCIATION,2017,second_quarter,MMM,"Medicaid issues affecting children's hospitals, S. 428 Advancing Care for Exceptional Kids Act of 2017, H.R. 1628 American Health Care Act.","HOUSE OF REPRESENTATIVES,SENATE",110000,,0,0,2017-07-11T20:07:19.187000-04:00
1985423,e47d7afc-d258-43c7-a517-7a871255a180,Q2,MCDERMOTT+ LLC,401103287,HOSPITAL SISTERS HEALTH SYSTEM,2017,second_quarter,MMM,"Issues affecting hospital systems, including delivery system reform and Medicare reimbursement.","HOUSE OF REPRESENTATIVES,SENATE",40000,,0,0,2017-07-12T07:48:27.390000-04:00
1985425,7cabdc69-10d6-4468-aeac-ee341d0fa5c7,Q2,MCDERMOTT+ LLC,401103287,GILLETTE CHILDREN'S SPECIALTY HEALTHCARE,2017,second_quarter,MMM,"Issues of interest to children's hospitals, including CHGME, Medicaid payment and enrollment, and alternative payment models.","HOUSE OF REPRESENTATIVES,SENATE",40000,,0,0,2017-07-12T07:53:29.403000-04:00
1985502,2731ed23-9e85-4bf7-9fb1-81ffc8147ba8,Q2,MEDICAL DEVICE MANUFACTURERS ASSOCIATION,24794,MEDICAL DEVICE MANUFACTURERS ASSOCIATION,2017,second_quarter,MMM,Issues relating to Reimbursement of Medical Devices,"Centers For Medicare and Medicaid Services (CMS),Health Resources & Services Administration (HRSA),HOUSE OF REPRESENTATIVES,Patent & Trademark Office (PTO),SENATE",,300000,0,0,2017-07-12T09:46:16.357000-04:00
1985511,648850f6-4a2d-4c06-bd96-b641f4c8d146,Q2,SOCIAL SECURITY WORKS,401048957,SOCIAL SECURITY WORKS,2017,second_quarter,MMM,"Medicare Expansion
Against, American Health Care Act & Better Care Reconciliation Act
Lowering Prescription Drug Prices
The People's Budget
Against, the President's Budget (SSDI cuts)
Against bad nominees (Price, Mulvaney, Mnuchin)","HOUSE OF REPRESENTATIVES,SENATE,Social Security Administration (SSA)",,12000,0,0,2017-07-12T09:50:22.357000-04:00
1985517,bdffe766-a3dd-4d68-81da-d6464b35cc72,Q2,"WILLIAMS AND JENSEN, PLLC",41454,"MT PHARMA AMERICA, INC.",2017,second_quarter,MMM,Matters affecting access to and pricing of pharmaceuticals; matters affecting the Orphan Drug Act.,"HOUSE OF REPRESENTATIVES,SENATE",30000,,0,0,2017-07-12T09:54:32.433000-04:00
1985578,7700aa74-b9c9-4622-92c1-19e8969ce235,Q2,NELSON MULLINS RILEY & SCARBOROUGH,285871,BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA,2017,second_quarter,MMM,"Processing of Durable Medical Equipment (DME) claims and the Centers for Medicare and Medicaid Services (CMS) Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Program","HOUSE OF REPRESENTATIVES,SENATE",20000,,0,0,2017-07-12T10:33:43.453000-04:00
1985587,8aa3e6b4-94df-426e-86bd-05290ea0301f,Q2,"WILLIAMS AND JENSEN, PLLC",41454,NATIONAL ASSOCIATION OF REHABILITATION PROVIDERS AND AGENCIES,2017,second_quarter,MMM,"Medicare coverage and reimbursement for therapy services; Outpatient therapy caps (H.R. 807, S. 253);Medicare payment reform for post acute care services; and implementation of the Medicare Access and CHIP Reauthorization Act.","Centers For Medicare and Medicaid Services (CMS),HOUSE OF REPRESENTATIVES,SENATE",20000,,0,0,2017-07-12T10:34:49.297000-04:00
1985589,269f179f-84e6-4de6-b7af-349a0e7633fc,Q2,"WILLIAMS AND JENSEN, PLLC",41454,NOVARTIS INC,2017,second_quarter,MMM,Medicare prescription drug benefit; Rebates for Medicare Part D;  Payment policies for Medicare Part B prescription drugs; the Independent Payment Advisory Board (IPAB); repeal of Part D Non-interference provision.,"HOUSE OF REPRESENTATIVES,SENATE",50000,,0,0,2017-07-12T10:35:51.247000-04:00
1985595,3bcd4be4-b6d6-46b5-b096-bb9380a9c20c,Q2,"WILLIAMS AND JENSEN, PLLC",41454,PLASMA PROTEIN THERAPEUTICS ASSOCIATION,2017,second_quarter,MMM,Payment policies for Medicare Part B prescription drugs; Medicare drug coverage and payment policy.,"HOUSE OF REPRESENTATIVES,SENATE",40000,,0,0,2017-07-12T10:37:56.810000-04:00
1985605,5c2c6113-3523-44f8-b6c9-139c1f19e4ab,Q2,"WILLIAMS AND JENSEN, PLLC",41454,"TAKEDA PHARMACEUTICALS AMERICA, INC.",2017,second_quarter,MMM,Medicare prescription drug benefit; Rebates for Medicare Part D; Independent Payment Advisory Board (IPAB);  Medicare coverage for Alzheimer's diagnostics; payment policies for Medicare Part B prescription drugs.,"HOUSE OF REPRESENTATIVES,SENATE",50000,,0,0,2017-07-12T10:39:06.670000-04:00
1985616,c05a1142-e8a4-4b7f-8ed8-c59ebf25fef7,Q2,NATIONAL COMMITTEE TO PRESERVE SOCIAL SECURITY AND MEDICARE,27467,NATIONAL COMMITTEE TO PRESERVE SOCIAL SECURITY AND MEDICARE,2017,second_quarter,MMM,"Medicare Dental, Vision, and Hearing Coverage.  H.R. 508, Seniors Have Eyes, Ears and Teeth Act:  Proposal to expand Medicare coverage to include comprehensive coverage of dental, vision, and hearing care.

Medicare Hearing Coverage.  (No bill)  Medicare Hearing Aid Coverage Act:  Proposal to provide Medicare coverage of hearing aids.

Over-the-Counter Hearing Aids.  S. 670/H.R. 1652, Over-the-Counter Hearing Aid Act of 2017:  Proposal to provide access to more affordable hearing aids for adults with mild to moderate hearing loss.

Medicare Observation Status.  S. 568, H.R. 1421, Improving Access to Medicare Coverage Act of 2017:  Proposal to count days in the hospital in observation status toward meeting the three-day prior hospitalization requirement for skilled nursing facility care eligibility.

Medicare Privatization.  (No bill.)  Proposals to transform traditional Medicare into a private insurance carrier program.

Medicare Eligibility Age.  (No bill.)  Proposal to raise the eligibility age for Medicare from 65 to 67.

Medicare Home Health.  H.R. 1825, Home Health Care Planning Improvement Act of 2017:  Proposal to improve access to home health care services by expanding list of health professionals authorized to certify eligibility for Medicare beneficiaries.

Medicare Speech Generating Devices.  S. 1132/H.R. 2465, Steve Gleason Enduring Voices Act of 2017:  Proposal to make permanent the elimination of a specified payment cap under the Medicare program with respect to speech generating devices.

Medicare Enrollment.  H.R. 2575, Beneficiary Enrollment Notification and Eligibility Simplification Act of 2017 or the BENES Act of 2017:  Proposal to  establish requirements for the Centers for Medicare & Medicaid Services (CMS) to notify individuals of their potential eligibility for Medicare, require the Internal Revenue Service to disclose to CMS specified taxpayer information for the purpose of establishing individuals' potential Medicare eligibility, and restructure Medicare enrollment periods and coverage periods.

Affordable Care Act (ACA) Repeal and Replace.  H. R. 1628, The American Health Care Act (AHCA):  Provisions affecting the solvency of the Medicare Part A Trust Fund, increasing the beneficiary Part B premiums, increasing the costs of private health insurance for older Americans under age 65, restructuring the Medicaid program and institutional and in-home long-term care services. 

Medicare Caregiving. (No bill.) Proposals to have the Centers for Medicare and Medicaid Services assist family caregivers.

Medicare Drug Pricing. Draft Executive Order to address high drug prices in federal health care programs.

Drug Pricing. S.1131, H.R. 2439, Fair Drug Pricing Act: Proposal to require drug manufactuers to submit price justifications when increasing the cost of drugs by 10 percent or more a year.

Drug Pricing. S. 771, Access to Affordable Prescription Drugs Act:  Provisions to allow Medicare to negotiate prescription drugs; prohibit anti-competitive behavior between brand and generic drug makers; allow the importation of prescription drugs from licensed Canadian pharmacies.

Drug Pricing.  S. 469/H.R. 1245, the Affordable and Safe Prescription Drug Importation Act: Proposal to permit wholesalers, licensed pharmacists and individuals to import drugs from Canada.

Drug Pricing. S. 348, the Prescription Drug and Health Improvement Act of 2017: Provisions directing the Secretary of Health and Human Services to negotiate prices for specialty drugs, drugs that account for high levels of spending, and those with dramatic price spikes.

Drug Pricing. H.R. 2212, Creating and Restoring Equal Access to Equivalent Samples Act of 2017:  Proposal to creat a civil cause of action against manufacturers who abuse the Risk Evaluation and Mitigation Strategy (REMS) process by limiting access to samples generic makers need to produce drugs and create competition.

Civil Rights. National Survey of Older American Act Participants.  (No Bill.)  Administration for Community Livings proposal to erase lesbian, gay, bisexual, and transgender older adults from the Survey.","Administration on Aging,Centers For Medicare and Medicaid Services (CMS),Executive Office of the President (EOP),Health & Human Services, Dept of (HHS),HOUSE OF REPRESENTATIVES,Justice, Dept of (DOJ),Labor, Dept of (DOL),Natl Economic Council (NEC),Office of Management & Budget (OMB),President of the U.S.,SENATE,Social Security Administration (SSA),Treasury, Dept of,Vice President of the U.S.",,270000,0,0,2017-07-12T10:48:23.963000-04:00
1985627,0d37a86f-1d2e-4b9a-a701-63e783cd89ab,Q2,AMERICAN ASSOCIATION FOR HOMECARE,55792,AMERICAN ASSOCIATION FOR HOMECARE,2017,second_quarter,MMM,"Issues pertaining to durable medical equipment including: bidding, power wheelchairs, oxygen, diabetic supplies, negative pressure wound therapy, Medicare audits, sequestration; H.R. 750/S. 486 - Ensuring Access to Quality Complex Rehabilitation Technology Act; H.R. 1361 - To amend title XVIII of the Social Security Act to provide for the non-application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs and accessories; Issues related to reimbursement cuts in noncompetitive bidding areas, all provisions; 21st Century Cures Act (H.R. 6/H.R. 34 in the 114th Congress), competitive bidding issues; Complex rehab technology accessories relating to competitive bidding; H.R. 2445 - the DMEPOS Access and Transparency Act (DATA) of 2017, all provisions; Expanding and making permanent the Medicare power mobility device demonstration program; Audit and Appeal Fairness, Integrity, and Reforms in the Medicare Act, all provisions.","Centers For Medicare and Medicaid Services (CMS),Food & Drug Administration (FDA),Government Accountability Office (GAO),Health & Human Services, Dept of (HHS),HOUSE OF REPRESENTATIVES,Office of Management & Budget (OMB),SENATE",,130000,0,0,2017-07-12T11:03:44.210000-04:00
1985644,e8a30034-62be-4bfc-9efc-fbe97bf55e76,Q2,"WILLIAMS AND JENSEN, PLLC",41454,OHIO POLICE AND FIRE PENSION FUND,2017,second_quarter,MMM,Medicare eligibility rules.,"Health & Human Services, Dept of (HHS),HOUSE OF REPRESENTATIVES,Internal Revenue Service (IRS),SENATE,Treasury, Dept of",20000,,0,0,2017-07-12T11:16:08.770000-04:00