2nd Quarter - Report

AMERICA'S HEALTH INSURANCE PLANS, INC. (AHIP) for AMERICA'S HEALTH INSURANCE PLANS INC (AHIP)

Firm
Client
Income
—
Expenses
$2,310,000
Expense method
A: Lobbying Disclosure Act definitions

What was lobbied

5 issue areas, each in the filer's own words, with who lobbied on it and where.

Insurance INS

H.R. 30, Save American Workers Act (Young) - definition of full-time employee H.R. 99, Health Insurance Industry Antitrust Enforcement Act (Conyers) - antitrust policy H.R. 117, Reclaiming Individual Liberty Act (Garrett) - ACA individual mandate H.R. 221, ACA Taxpayer Bailout Prevention Act (Harris) - risk corridors program H.R. 371, Care for All Act (Fortenberry) - catastrophic plans H.R. 494, Competitive Health Insurance Reform Act (Gosar) - antitrust policy H.R. 543, Health Care Choice Act (Blackburn) - national marketplace for individual health insurance H.R. 724, Taxpayer Bailout Protection Act (Lance) - risk corridors program H.R. 815, Access to Independent Health Insurance Advisors Act (Long-Schrader) - treatment of broker compensation in MLR calculation H.R. 1560, Protecting Cyber Networks Act (Nunes) - cybersecurity H.R. 1624, Protecting Affordable Coverage for Employees Act (Guthrie-Cardenas) - ACA definition of small employer H.R. 1731, National Cybersecurity Protection Advancement Act (McCaul) - cybersecurity H.R. 1770, Data Security and Breach Notification Act (Blackburn-Welch) - data security H.R. 2462, Health Insurance Industry Fair Competition Act (DeFazio) - antitrust policy H.R. 2739, Cancer Drug Coverage Parity Act (Lance) - coverage of oral anti-cancer drugs H.R. 2868, Small Business Health Fairness Act (Johnson) - association health plans H.R. 3020, Labor-HHS-Education Appropriations Bill (Cole) - ACA risk corridors provision, HHS appropriations S. 30, Forty Hours Is Full Time Act (Collins) - definition of full-time employee S. 123, ACA Taxpayer Bailout Prevention Act (Rubio) - risk corridors program S. 158, Employee Health Care Protection Act (Cassidy) - grandfathering of health coverage S. 359, Taxpayer Bailout Protection Act (Cassidy) - risk corridors program S. 531, Removing Limitations on Insurance Effectiveness and Flexibility Act (Flake) - catastrophic plans S. 647, Health Care Choice Act (Cruz) - national marketplace for individual health insurance S. 754, Cybersecurity Information Sharing Act (Burr) - cybersecurity S. 1099, Protecting Affordable Coverage for Employees Act (Scott-Shaheen) - ACA definition of small employer S. 1532, Affordability is Access Act (Murray) - coverage of OTC birth control S. 1566, Cancer Drug Coverage Parity Act (Kirk) - coverage of oral anti-cancer drugs S. 1661, Access to Independent Health Insurance Advisors Act (Isakson-Coons) - treatment of broker compensation in MLR calculation S. 1695, Labor-HHS-Education Appropriations Bill (Blunt) - ACA risk corridors provision, HHS appropriations Regulatory Issues: Insurance regulatory reform; issues related to the coordination of private and public disability income benefits; disability risk management; disability income insurance enrollment and awareness; issues related to encouraging impaired workers to stay in/return to the workforce; issues related to the continuation of reporting requirements for state LTCI partnership programs; issues relating to the coordination of benefits between private health insurance plans and Medicaid; Medigap claims processing and crossover fees; Medigap cross-over claim issues, Medigap coverage, implementation of Medigap standardized plan offerings; Medigap carrier recoveries related to CMS fraud and abuse enforcement activities, and issues related to Medigap educational materials, and other Medigap issues; fraud and abuse issues affecting public and private insurance coverage; issues relating to antitrust; implementation of the Mental Health Parity Act requirements; summary of benefits and coverage disclosures; pre-existing condition insurance plans; accountable care organizations; coverage of preventive services; preexisting condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; dependent coverage; treatment of expatriate plans; compliance with the transitional reinsurance program; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations, non-discriminatory wellness programs; application of fiduciary standards to group health plans, issues related to supplemental products, and other issues relating to health care reform implementation.

Contacted: Government Accountability Office (GAO); Justice, Dept of (DOJ); White House Office; Health & Human Services, Dept of (HHS); Pension & Welfare Benefits Administration; Office of Personnel Management (OPM); Labor, Dept of (DOL); Federal Trade Commission (FTC); Centers For Disease Control & Prevention (CDC); Agency for Healthcare Research & Quality (AHRQ); Medicare Payment Advisory Commission (MedPAC); Health Resources & Services Administration (HRSA); Food & Drug Administration (FDA); Executive Office of the President (EOP); Centers For Medicare and Medicaid Services (CMS); HOUSE OF REPRESENTATIVES; SENATE; Office of Management & Budget (OMB); Internal Revenue Service (IRS); Treasury, Dept of

Bills named: H.R. 1624 (114th), H.R. 30 (114th), H.R. 2868 (114th), H.R. 117 (114th), H.R. 1560 (114th), H.R. 1731 (114th), H.R. 494 (114th), S. 1661 (114th), H.R. 2739 (114th), S. 647 (114th), S. 1532 (114th), S. 531 (114th), H.R. 99 (114th), H.R. 1770 (114th), S. 1695 (114th), S. 1566 (114th), H.R. 2462 (114th), S. 158 (114th), S. 1099 (114th), H.R. 724 (114th), H.R. 543 (114th), H.R. 3020 (114th), H.R. 221 (114th), H.R. 815 (114th), H.R. 371 (114th), S. 359 (114th), S. 30 (114th), S. 123 (114th), S. 754 (114th)

Taxation/Internal Revenue Code TAX

H.R. 928 (Boustany-Sinema) - full repeal of ACA health insurance tax H.R. 1270, Restoring Access to Medication Act (Jenkins) - HSA and FSA issues H.R. 1295, Trade Preferences Extension Act (Holding) - TAA health coverage tax credits H.R. 1892, Trade Adjustment Assistance Reauthorization Act (Reichert) - TAA health coverage tax credits H.R. 2050, Middle Class Health Benefits Tax Repeal Act (Courtney) - repeal of ACA excise tax on high-cost coverage S. 183, Jobs and Premium Protection Act (Barrasso) - full repeal of ACA health insurance tax S. 254, Small Business Health Relief Act (Portman) - full repeal of ACA health insurance tax, HSA and FSA issues S. 709, Restoring Access to Medication Act (Roberts) - HSA and FSA issues S. 879, Americans Giving Care to Elders Act (Klobuchar) - tax credits for family caregivers S. 1268, Trade Adjustment Assistance Reauthorization Act (Hatch) - TAA health coverage tax credits H.R. 879 the Ax the Tax on Middle Class Americans Health Plans Act (Guinta) - repeal of the excise tax on high cost employer-sponsored health coverage Regulatory Issues: Annual insurer provider fees; issues concerning the patient-centered outcomes research fee; employer and individual coverage mandate, W-2 reporting requirements, health reimbursement accounts, deductibility limits for insurer compensation, health insurer and employer reporting of health coverage, and other issues relating to health care reform implementation.

Contacted: White House Office; Pension & Welfare Benefits Administration; Health Resources & Services Administration (HRSA); Justice, Dept of (DOJ); Health & Human Services, Dept of (HHS); Centers For Medicare and Medicaid Services (CMS); SENATE; Office of Management & Budget (OMB); Internal Revenue Service (IRS); Agency for Healthcare Research & Quality (AHRQ); Federal Trade Commission (FTC); HOUSE OF REPRESENTATIVES; Treasury, Dept of; Centers For Disease Control & Prevention (CDC); Executive Office of the President (EOP); Office of Personnel Management (OPM); Government Accountability Office (GAO); Labor, Dept of (DOL); Food & Drug Administration (FDA); Medicare Payment Advisory Commission (MedPAC)

Bills named: H.R. 1892 (114th), S. 709 (114th), H.R. 1270 (114th), H.R. 1295 (114th), H.R. 879 (114th), S. 183 (114th), S. 254 (114th), H.R. 2050 (114th), S. 1268 (114th), S. 879 (114th), H.R. 928 (114th)

Health Issues HCR

H.R. 6, 21st Century Cures Act (Upton) - new cures and treatments H.R. 691, Telehealth Modernization Act (Matsui-Johnson) - telemedicine H.R. 1189, Preserving Employee Wellness Programs Act (Kline) - employee wellness programs S. 466, Quality Care for Moms and Babies Act (Stabenow) - pediatric quality measures S. 620, Preserving Employee Wellness Programs Act (Alexander) - employee wellness programs S. 961, Data Security Act (Carper) - data security S. 1077, Advancing Breakthrough Devices for Patients Act (Burr) - priority review of breakthrough medical devices S. 1427, Quality Measure Alignment Act (Stabenow) - facilitating coordination and alignment between public and private sectors on quality and efficiency measures Roadmap for ACA Replacement Legislation (Burr-Hatch-Upton) - health reforms Regulatory Issues: HIPAA administrative simplification issues, including standards for privacy, security, and electronic transactions and code sets (including ICD-10), identifiers including the health plan identifier, enforcement; FEHBP enrollment data clearinghouse initiative, the enrollment reconciliation process, and a related OPM reimbursement factor for records that cannot be reconciled; issues relating to health insurance plan participation in FEHBP, including contract requirements; issues relating to similarly sized subscriber group (SSSG) and MLR requirements under the FEHBP;. implementation of the health savings account provisions of the Medicare Act; issues related to Medicare Secondary Payer requirements; issues related to implementation of the National Health Information Infrastructure; electronic health records, personal health records, and similar technologies; issues relating to market consolidation; issues related to hospital consolidation; issues relating to quality improvement; issues related to potential priority research topics for the effective health care program; issues relating to the national health data stewardship; issues relating to hospital outpatient measurement and reporting; prescription drug pricing; issues related to the collection of race and ethnicity data; issues related to medical loss ratios; reference pricing; review of rates for reasonableness; preexisting condition insurance plans; issues relating to antitrust; accountable care organizations; provider non-discrimination; coverage of preventive services; contraceptive coverage; pre-existing condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; issues relating to the annual fee on health insurance providers; health plan automatic enrollment requirements; issues related to qualified health plans including certification and rate filing templates; health insurance market rules; reinsurance, risk corridors, and risk adjustment (commonly referred to as the 3 Rs); dependent coverage; summary of benefits and coverage disclosures; benefit and payment parameters for 2014; essential health benefits, actuarial value, and accreditation; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations, and issues related to supplemental products; issues related to HIPAA excepted benefits; issues related to the federally-facilitated marketplaces (i.e., Exchanges/formerly referred to as the web portal); financing for infectious disease; and other issues relating to health care reform implementation.

Contacted: Treasury, Dept of; Health Resources & Services Administration (HRSA); Internal Revenue Service (IRS); Labor, Dept of (DOL); Office of Management & Budget (OMB); Office of Personnel Management (OPM); Agency for Healthcare Research & Quality (AHRQ); HOUSE OF REPRESENTATIVES; Health & Human Services, Dept of (HHS); Centers For Disease Control & Prevention (CDC); White House Office; Justice, Dept of (DOJ); Food & Drug Administration (FDA); Government Accountability Office (GAO); Medicare Payment Advisory Commission (MedPAC); Executive Office of the President (EOP); Pension & Welfare Benefits Administration; SENATE; Federal Trade Commission (FTC); Centers For Medicare and Medicaid Services (CMS)

Bills named: S. 1077 (114th), H.R. 6 (114th), H.R. 1189 (114th), S. 620 (114th), H.R. 691 (114th), S. 961 (114th), S. 1427 (114th), S. 466 (114th)

Medicare/Medicaid MMM

H.R. 2, Medicare Access and CHIP Reauthorization Act - Medicare physician payment reform, CHIP funding, Medigap, Medicare Advantage Special Needs Plans, Medicare Cost Plans, fraud provisions, QI and TMA programs H.R. 6, 21st Century Cures Act (Upton) - timing of certain Medicare Part D payments H.R. 588, Medicare Beneficiary Preservation of Choice Act (Rothfus-Schrader) - MA enrollment opportunities H.R. 818, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Roskam-Carney) - reducing fraud H.R. 1021, Protecting the Integrity of Medicare Act (Brady) - reducing fraud H.R. 1892, Trade Adjustment Assistance Reauthorization Act (Reichert) - Medicare sequestration cuts H.R. 2488, Medicare Beneficiary Preservation of Choice Act (Rothfus-Schrader) - MA open enrollment period H.R. 2505, Increasing Access to Data in Medicare Advantage Act (Kelly) - annual reporting of MA enrollment data H.R. 2506, Preventing Unnecessary Plan Terminations Act (Buchanan) - preventing certain MA plan terminations H.R. 2507, Increasing Regulatory Fairness Act (Brady) - rulemaking schedule for MA rates H.R. 2570, Strengthening Medicare Advantage through Innovation and Transparency for Seniors Act (Black) - Value-Based Insurance Design demonstration H.R. 2579, Securing Care for Seniors Act (Black) - MA risk adjustment model H.R. 2581, Preservation of Access for Seniors in Medicare Advantage Act (Brady) - Value-Based Insurance Design demonstration and MA open enrollment period H.R. 2582, Seniors Health Care Plan Protection Act (Buchanan) - preventing certain MA plan terminations, MA risk adjustment model H.Con.Res. 27, Budget Resolution (Price) - Medicare, Medicaid, health policy issues S. 861, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Carper-Enzi) - reducing fraud S. 1268, Trade Adjustment Assistance Reauthorization Act (Hatch) - Medicare sequestration cuts S. 1396, Value-Based Insurance Design Seniors Copayment Reduction Act (Thune-Stabenow) - VBID demonstration S. 1549, Care Planning Act (Warner) - advanced illness care coordination for Medicare beneficiaries S.Con.Res. 11, Budget Resolution (Enzi) - Medicare, Medicaid, health policy issues Regulatory Issues: Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, encounter data and other data-related issues, Recovery Audit Contractor (RAC) audits, Part D prescriber enrollment requirement, and provider directories and audit issues; bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, and audits); in-home health risk assessments; Medicare Medical Loss Ratio issues; implementation of sequestration under the Medicare Advantage and Part D programs; implications of the health insurer fee for MA and Part D plans; application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, SSA and CMS premium withhold processing issues, enrollment rules, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible Special Needs Plans (SNPs); Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, Part D coverage gap discount program, including employer group waiver plan (EGWP) issues, and other operational issues; issues raised by Part D coverage of new specialty drugs, the Part D non-interference policy and related issues (e.g., preferred pharmacy and any willing pharmacy requirements, standards for network pharmacy reimbursement, and policies regarding sponsor negotiation of pharmacy price concessions); ICD-10; Value-Based Insurance Design; Medication Therapy Management Program requirements; Part D requirements for offering basic and enhanced alternative plans; MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; issues relating to MA and Part D Star Rating system including measures, the methodology for calculating ratings, and the role of the ratings for payment purposes; implementation of the Affordable Care Act (ACA) changes to the Part D coverage gap; ongoing implementation issues for the Medicare cost plan program including enrollment, marketing materials review and approval and other operational issues; implementation issues for the Medicare Retiree Drug Subsidy program; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education Program; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; Medicare clinical trials; Medicare/Medicaid integration for dual eligibles, including the Capitated Financial Alignment Demonstration; Medicaid managed care regulations and policies, including the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, fraud and abuse compliance, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including block grants, the calculation of the federal medical assistance (federal matching) percentage (FMAP), and intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost issues affecting Medicaid health plans including issues raised by Medicaid coverage of new specialty drugs; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues and CHIP reauthorization; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including Medicaid managed care organization provider tax issues; standards for electronic prescribing; implementation of Medicaid changes of interest to Medicaid health plans made in the ACA including Medicaid expansion, the managed care organization (MCO) prescription drug rebate provisions, minimum payments to primary care providers (PCPs), interactions between the Medicaid program and health insurance exchanges, and Medicaid and CHIP maintenance of effort (MOE) requirements; implications of the health insurer fee for Medicaid health plans ; issues related to Medigap coverage financing for infectious disease; and other issues relating to health care reform implementation. *Add MACPAC to Agency List

Contacted: Executive Office of the President (EOP); Health Resources & Services Administration (HRSA); Internal Revenue Service (IRS); Government Accountability Office (GAO); Justice, Dept of (DOJ); Office of Personnel Management (OPM); Treasury, Dept of; Food & Drug Administration (FDA); White House Office; Office of Management & Budget (OMB); Centers For Disease Control & Prevention (CDC); Labor, Dept of (DOL); Agency for Healthcare Research & Quality (AHRQ); HOUSE OF REPRESENTATIVES; Centers For Medicare and Medicaid Services (CMS); Federal Trade Commission (FTC); SENATE; Health & Human Services, Dept of (HHS); Medicare Payment Advisory Commission (MedPAC); Pension & Welfare Benefits Administration

Bills named: S. 1268 (114th), H.R. 2582 (114th), H.R. 818 (114th), H.R. 2570 (114th), H.Con.Res. 27 (114th), H.R. 2579 (114th), H.R. 2581 (114th), S. 1549 (114th), H.R. 2507 (114th), S. 1396 (114th), H.R. 2506 (114th), S. 861 (114th), H.R. 2505 (114th), S.Con.Res. 11 (114th), H.R. 588 (114th), H.R. 2 (114th), H.R. 6 (114th), H.R. 2488 (114th), H.R. 1021 (114th), H.R. 1892 (114th)

Pharmacy PHA

H.R. 9, Innovation Act (Goodlatte) - changes to inter partes review process H.R. 1600, Patients' Access to Treatments Act (McKinley-Capps) - specialty drug tiers S. 1137, PATENT Act (Grassley) - changes to inter partes review process Regulatory Issues: Issues relating to long term safety and effectiveness of medical devices and drugs, including registries; issues relating to post-market surveillance of drugs and medical devices; issues relating to access for investigational drugs; and other issues relating to health care reform implementation.

Contacted: Treasury, Dept of; SENATE; Centers For Disease Control & Prevention (CDC); Executive Office of the President (EOP); Federal Trade Commission (FTC); Medicare Payment Advisory Commission (MedPAC); HOUSE OF REPRESENTATIVES; Government Accountability Office (GAO); Pension & Welfare Benefits Administration; Agency for Healthcare Research & Quality (AHRQ); Food & Drug Administration (FDA); Health & Human Services, Dept of (HHS); Centers For Medicare and Medicaid Services (CMS); Labor, Dept of (DOL); Justice, Dept of (DOJ); Office of Personnel Management (OPM); Office of Management & Budget (OMB); Health Resources & Services Administration (HRSA); White House Office; Internal Revenue Service (IRS)

Bills named: S. 1137 (114th), H.R. 1600 (114th), H.R. 9 (114th)

Shown as published by the Senate Office of Public Records and the House Clerk under the Lobbying Disclosure Act. The official filing is the record; open it for the full form.