Our Healthcare Policy Practice is widely recognized for leadership in this complex area, leveraging extensive knowledge of US federal, state and local health care law and policy to counsel and defend clients on issues under congressional consideration, on federal administrative rulemaking processes and on federal or state investigations. Our work encompasses legislative and regulatory advocacy, implementation of the ACA, Medicare and Medicaid coverage and reimbursement, and coalition building and management.
Our team keeps a finger on the pulse of legislative and regulatory healthcare policy in Washington DC. Our long-standing working relationships with Members of Congress and senior staff on each of the House and Senate health-related committees, paired with substantive expertise, enable us to achieve client goals through authorizing and appropriations language, or supporting language in accompanying committee reports, and are particularly useful in preventing unintended or adverse consequences.
Members of our team often participate in the development of legislation on issues of concern to our clients and are frequently consulted as a resource for policy analysis. In addition, we regularly interact with congressional support agencies such as the Congressional Budget Office (CBO), the Medicare Payment Advisory Commission (MedPAC), and the Medicaid and CHIP Payment and Access Commission (MACPAC). We regularly provide healthcare policy guidance, strategic counsel and direct advocacy support to health and hospital systems, physician associations, manufacturers and other healthcare providers.
Our team also encompasses a diverse regulatory practice. We develop and execute clients’ offensive and defensive regulatory strategies by engaging the Centers for Medicare & Medicaid Services (CMS), the Centers for Disease Control and Prevention (CDC), the Health Resources and Services Administration (HRSA), the National Institutes of Health (NIH), the Food and Drug Administration (FDA), the Federal Trade Commission (FTC), and the Department of Defense (DOD), among other federal agencies. Our close working relationships with key officials allow us to carefully follow regulatory developments, including implementation of legislation and development of agency rules and guidance.
Medicare and Medicaid Coverage and Reimbursement
A core focus of our practice involves helping clients navigate the overlapping statutes, legislative changes, regulations, and agency directives governing Medicare and Medicaid coverage and reimbursement. We have a depth of historical knowledge about the Medicare and Medicaid programs and pride ourselves on our battle-tested familiarity with the range of possible approaches to success, as well as our creative responses to challenging problems facing our clients.
Through sophisticated analysis, counseling and advocacy, we help clients obtain coverage and adequate reimbursement for products and services under these programs. We work closely with our FDA team to anticipate and address potential coverage and payment challenges for new products in the pipeline for approval. Lawyers in our Litigation practice are also well-versed in Medicare and Medicaid payment-related litigation, regularly representing both individual and group clients before the Provider Reimbursement Review Board (PRRB) and in federal court.
Implementation of the Affordable Care Act (ACA)
Through our ongoing work with healthcare clients as well as those impacted by the ACA, we are on the front lines of healthcare reform implementation. We are actively engaged in the ongoing rulemaking process and provide regular updates and analysis of implementing rules and guidance. We have a strong presence on the Hill, implementing defensive and offensive strategies to support our clients’ best interests. We are well poised to address the myriad of ACA issues impacting providers, employers, suppliers, beneficiary groups, states, health plans, drug and device manufacturers, investors and other healthcare stakeholders. We also work closely with trade associations and stakeholder coalitions to address healthcare reform implementation and drive regulatory and legislative changes to the ACA.
Our experience includes:
- Conducting ACA impact analyses, including evaluating challenges and opportunities throughout the implementation timeline;
- Assessing and shaping the requirements for private insurance and healthcare exchanges; evaluating Medicaid expansions;
- Promoting innovation in program design in Medicare and Medicaid (including Accountable Care Organizations and bundled payments);
- Direct agency and Congressional lobbying regarding harmful payment reductions and unintended consequences;
- Advancing the use of health information technology and telemedicine in healthcare reform; and
- Implementing programs for beneficiaries dually eligible for Medicare and Medicaid.
We understand the utility of coalitions in affecting positive change and the role of sound organizational management in doing so. We have experience in developing comprehensive contact lists, organizing strategic planning conference calls and meetings and handling external communications and relations for large coalitions.