Health Care Legislative & Public Policy

Overview

In an industry with ever-moving goal posts, you need a health policy team that is both substantive on the issues and well connected with the leaders in government. Our bipartisan team can drive outcomes with senior officials and staff in both parties, regardless of who controls the congressional majority or the White House.

Many of us have served in leadership roles as appointed officials and in senior staff positions, from the Senate to the House and from the Department of Health and Human Services (HHS) to the White House. We also take pride in distinguishing ourselves from others that simply offer “access” or legal analysis. Instead, we are closely connected to the policy-making process and provide you with comprehensive services unique in Washington that assist you at every step of the process.

We offer solutions-driven resources in all aspects of legislative and public policy advocacy, producing meaningful outcomes at the federal agencies affecting health care coverage, payment, and quality, including HHS operating divisions such as the Centers for Medicare & Medicaid Services (CMS) and Health Resources and Services Administration (HRSA), and the congressional committees that authorize them. We also interact with policymakers in HHS operating divisions focusing on research and development, including the Food and Drug Administration (FDA) and National Institutes of Health (NIH).

We deliver a comprehensive suite of health law and policy services targeted to your advocacy needs. Whatever your legislative goals may be, Alston & Bird has the experience, creativity, and relationships to meet your goals.

Experience

Please follow the links provided for our representative experience in:

Executive Branch

• Advocated for adjustments to the billing cycle of continuous glucose monitors (CGMs), requiring coordination across multiple parts of CMS and Medicare durable medical equipment contractors.
• Advised on engaging with the White House and Office of Management and Budget (OMB) on a business-threatening regulation that was ultimately abandoned by the Executive Branch.

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Congress

• Organized and led congressional fly-ins for multiple clients, coordinating meetings with dozens ofHouse and Senate offices.
• Secured an invitation and prepared clients to voluntarily testify before congressional committees, including the House Committee on Energy and Commerce; Senate Committee on Health, Education, Labor, and Pensions (HELP); and Senate Committee on Finance.
• Secured new bill language in applicable appropriations bills to ensure the Administration could not change the indirect cost rate for non-university research institutions. Initial bill language excluded independent research institutions.
• Secured statutory changes numerous times on behalf of the clinical laboratory industry that delayed payment cuts and the reporting of commercial clinical laboratory reimbursement data under the Protecting Access to Medicare Act of 2014.
• Secured multiple legislative extensions of Medicare ambulance add-on payments.
• Advocated on behalf of an insurance company to senior committee staff and others to secure a clarification to a bill under consideration on the House floor that would have affected market access.
• Secured language in the House and Senate committee work products on Federal Aviation Administration reauthorization to help facilitate better use of commercial airlines to transport donated organs.
• Secured concessions in the drug pricing provisions of the Inflation Reduction Act for a biopharmaceutical company.
• Representing clients in congressional investigations and other inquiries.

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Medicare Advantage

• Secured changes to Medicare Advantage (MA) requirements so that MA plans are now able to offer therapeutic massage as a supplemental benefit.
• Counsel to a managed care company on policy issues such as telehealth and Medicare Advantage regulatory updates.
• Providing an insurance advocacy association with public policy and governmental relations services with a recent focus on changes in Medicare Advantage.
• Advising on regulatory issues involving the Medicare Advantage program. We have been instrumental in ensuring our client’s priorities in ongoing administrative and legislative activities.

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Artificial Intelligence (AI)

• On behalf of a coalition of advanced imaging technology companies, developed Medicare payment policies across multiple Medicare payment systems and working with the bipartisan Senate Artificial Intelligence Caucus for their adoption in the Health Care Technology Investment Act.
• Collaborated with U.S. Senators to propose the DIABETES Act, aimed at enhancing access to diabetes treatments and addressing the need for diabetes technology education among Medicare beneficiaries.
• Advising multiple stakeholders on coverage and reimbursement issues related to artificial intelligence, including drafting introduced legislation and influencing CMS rulemaking.

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Hospitals

• Achieved an earmark of $2 million for improving women’s health care services and ensuring safe, efficient, and secure access to medications and supplies in all care areas.
• Advised a health system on securing an earmark to equip and furnish an inpatient unit in a regional behavioral health hospital to increase capacity for adults with mental illnesses.
• Secured an exception to the 250-yard on-campus distance requirement for a hospital’s provider-based facility.
• Provided a state hospital association with legislative and regulatory guidance, policy analysis, drafting assistance, and political insight with a focus on reimbursement.
• Advised on support of Medicare reimbursement issues and federally funded cancer research.
• Counseled a state hospital association and partner organizations in developing and executing a congressional and administrative advocacy strategy that resulted in regulatory relief for hospitals under the Medicare hospital area wage index (AWI).

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Medtech & Medical Device

• Achieved a favorable result for coverage of continuous glucose monitoring technology after extensive stakeholder coordination and advocacy between policymakers on Capitol Hill, CMS, and Medicare durable medical equipment contractors.
• Secured legislation adding an additional year of transitional pass-through status for a medical device manufacturer’s technology beyond the statutorily limited three-year period, which translates into higher Medicare reimbursement for the technology and effectively saving the business.
• Ensured previously-unaccounted-for supplies were captured and included in Medicare rate-setting.
• Secured coverage and expanded coverage through Medicare local coverage determination processes for multiple medical technologies and devices.
• Representing manufacturer clients on tariff, trade, and tax issues.

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Physician Payment

• Prevented a 57% reduction to Medicare payments for ultrasound services.
• Prevented significant payment reductions to a non-invasive cardiovascular therapy, including obtaining new direct practice expense inputs to reflect previously-unaccounted-for costs to provide care.
• Prevented payment reductions to portable imaging services proposed by multiple Medicare administrative contractors.

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