Centene Corporation

Health Issues

Strategic guidance and counsel related to Medicare, Medicaid, and the insurance market.

Health Issues

Issues related to health insurance and affordability.

Medicare/Medicaid

Issues related to Medicaid, Medicare Advantage, behavioral health and prior authorization.

Health Issues

S. 2355, Patients Deserve Price Tags Act, including provisions related to the hold-harmless of insurers. Issues related to health insurance access and affordability. Issues related to the individual insurance market.

Medicare/Medicaid

H.R. 5454, Medicare Advantage Prompt Pay Act, including provisions related to medical claims payment requirements for Medicare Advantage organizations. H.R. 9393, Lower Costs, More Transparency Act of 2026, including provisions related to the current Transparency in Coverage requirements. Issues related to healthcare quality (Medicare Advantage) and MA Stars policy reform. Issues related to Medicare Advantage supplemental benefits, specifically impact of access to healthy foods on health outcomes.

Health Issues

Provided strategic guidance and counsel related to Medicare, Medicaid, and the health insurance market.

Health Issues

Provided strategic guidance and counsel related to Medicare, Medicaid, and the health insurance market.

Health Issues

Strategic guidance and counsel related to Medicare, Medicaid, and the insurance market.

Health Issues

Issues related to health insurance access and affordability. Issues related to the individual insurance market. Issues related to policies dedicated to promoting innovation and healthcare affordability for the insurance marketplace.

Medicare/Medicaid

S. 1105, No UPCODE Act, including issues related to practices and procedures regarding Medicare Advantage and member profile care Issues related to healthcare quality. Issues related to Medicare Advantage and Part D. Issues related to efforts to improve prior authorization processes.

Medicare/Medicaid

Issues related to Medicaid, Medicare Advantage, behavioral health and prior authorization.

Health Issues

Issues related to Advance Premium Tax Credits (APTCs) and cost-sharing reductions.

Medicare/Medicaid

Issues related to Medicaid, Medicare Advantage, behavioral health and prior authorization.

Health Issues

Issues related to Advance Premium Tax Credits (APTCs) and cost-sharing reductions.

Health Issues

Strategic guidance and counsel related to Medicare, Medicaid, and the insurance market.

Health Issues

Issues related to health insurance access and affordability. Issues related to the individual insurance market.

Medicare/Medicaid

Issues related to healthcare quality.

Health Issues

Provided strategic guidance and counsel related to Medicare, Medicaid, and the health insurance market.

Health Issues

Strategic guidance and counsel related to Medicare, Medicaid, and the insurance market.

Health Issues

Issues related to tax credits and general marketplace coverage policies Issues related to the individual insurance market

Medicare/Medicaid

Issues related to the use of IT solutions to streamline Medicaid processes Issues related to healthcare quality Issues related to prescription drug coverage

Medicare/Medicaid

Issues related to Medicaid, Medicare Advantage, behavioral health and prior authorization.

Health Issues

Issues related to Advance Premium Tax Credits (APTCs) and cost-sharing reductions.

Health Issues

Provided strategic guidance and counsel related to Medicare, Medicaid, and the health insurance market.

Health Issues

Strategic guidance and counsel related to Medicare, Medicaid, and the insurance market.

Medicare/Medicaid

Issues related to Medicaid, Medicare Advantage, behavioral health and prior authorization.

Health Issues

Issues related to Advance Premium Tax Credits (APTCs) and cost-sharing reductions.

Health Issues

Issues related to tax credits and general marketplace coverage policies Issues related to the individual insurance market

Medicare/Medicaid

H.R. 1, One Big Beautiful Bill Act, including provisions pertaining to coverage access in Medicaid and marketplace Issues related to the use of IT solutions to streamline Medicaid processes

Health Issues

Provided strategic guidance and counsel related to Medicare, Medicaid, and the health insurance market.

Health Issues

Strategic guidance and counsel related to Medicare, Medicaid, and the insurance market.

Health Issues

Issues related to Affordable Care Act (ACA) enhanced premium tax credits (APTCs) Issues related to Individual Coverage Health Reimbursement Accounts (ICHRA) Issues related to reinstating the Value Based Insurance Design (VBID) program

Medicare/Medicaid

Issues related to budget reconciliation provisions related to Medicaid Issues related to Medicaid policy Issues related to use of IT solutions to streamline Medicaid processes

Medicare/Medicaid

Issues related to Medicaid, Medicare Advantage, behavioral health and prior authorization.

Health Issues

Issues related to upcoming expiration of the Advance Premium Tax Credits (APTCs).

Health Issues

Provided strategic guidance and counsel related to Medicare, Medicaid, and the health insurance market.

Health Issues

Strategic guidance and counsel related to Medicare, Medicaid, and the insurance market.

Medicare/Medicaid

Issues related to behavioral health. Issues related to prior authorization. Issues related to potential Prescription Drug Plan (PDP) increases due to CMS policy from Inflation Reduction Act implementation. Issues related to Medicaid rate adequacy.

Health Issues

Issues related to the timeline and upcoming expiration of the Advance Premium Tax Credits (APTCs).

Health Issues

Strategic guidance and counsel related to Medicare, Medicaid, and the insurance market.

Health Issues

Strategic guidance and counsel related to Medicare, Medicaid, and the insurance market.

Medicare/Medicaid

Issues related to Medicaid Redetermination unwinding process. Issues related to Medicare Advantage. Issues related to Pharmacy Benefit Management (PBM). Issues related to behavioral health. Issues related to prior authorization. Issues related to potential Prescription Drug Plan (PDP) increases due to CMS policy from Inflation Reduction Act implementation.

Health Issues

Issues related to the timeline and upcoming expiration of the Advance Premium Tax Credits (APTCs).

Health Issues

Advised and assisted with outreach to congressional offices on access to behavioral health and substance use care; advised on legislative outlook for extension of telehealth waivers; advised on legislative outlook for Pharmacy Benefit Manager reforms

Medicare/Medicaid

Advised and assisted with outreach to congressional offices on Medicaid coverage redeterminations and managed care; Advised on legislative outlook for Medicare physician reimbursement

Taxation/Internal Revenue Code

Advised and assisted with outreach to congressional offices on Affordable Care Act Marketplace enhanced advanced premium tax credits

Health Issues

Advised on legislative outlook for Medicare physician reimbursement; Medicaid coverage; mental health; Medicare Advantage; Medicare-Medicaid dual eligibles; Pharmacy Benefit Managers; Individual Coverage Health Reimbursement Arrangements; cybersecurity; artificial intelligence; and monitored Medicaid redeterminations and proposed Medicaid managed care regulation. Assist with outreach to congressional offices.

Medicare/Medicaid

Advised on legislative outlook for Medicare physician reimbursement; Medicaid coverage; mental health; Medicare Advantage; Medicare-Medicaid dual eligibles; Pharmacy Benefit Managers; Individual Coverage Health Reimbursement Arrangements; cybersecurity; artificial intelligence; and monitored Medicaid redeterminations and proposed Medicaid managed care regulation. Assist with outreach to congressional offices.

Insurance

Advised on legislative outlook for Medicare physician reimbursement; Medicaid coverage; mental health; Medicare Advantage; Medicare-Medicaid dual eligibles; Pharmacy Benefit Managers; Individual Coverage Health Reimbursement Arrangements; cybersecurity; artificial intelligence; and monitored Medicaid redeterminations and proposed Medicaid managed care regulation. Assist with outreach to congressional offices.

Health Issues

Strategic guidance and counsel related to Medicare, Medicaid, and the insurance market.

Medicare/Medicaid

Issues related to Medicaid Redetermination unwinding process. Issues related to CMMI VBID (Value Based Insurance Design) application and criteria and new guidelines. Issues related to social determinants of health. Issues related to Pharmacy Benefit Management (PBM). Issues related to behavioral health. Issues related to prior authorization. Issues related to potential Prescription Drug Plan (PDP) increases due to CMS policy from Inflation Reduction Act implementation.

Health Issues

Issues related to the timeline and upcoming expiration of the Advance Premium Tax Credits (APTCs).

Taxation/Internal Revenue Code

H.R. 7024, Tax Relief for American Families and Workers Act of 2024, including provisions that allow us to deduct innovation and amortization including deduction for research and experimental expenditures, and the extension of allowance for depreciation, amortization, or depletion in determining the limitation on business interest.

Health Issues

Medicaid funding related to Affordable Care Act of 2010 Public Law 111-148

Insurance

Medicare and Medicaid issues

Health Issues

Strategic guidance and counsel related to Medicare, Medicaid, and the insurance market.

Taxation/Internal Revenue Code

H.R. 7024, Tax Relief for American Families and Workers Act of 2024, including provisions that allow us to deduct innovation and amortization including deduction for research and experimental expenditures, and the extension of allowance for depreciation, amortization, or depletion in determining the limitation on business interest.

Health Issues

Issues related to the timeline and upcoming expiration of the Advance Premium Tax Credits (APTCs).

Medicare/Medicaid

H.R. 4822, Health Care Price Transparency Act of 2023, including provisions related to Improving Seniors Timely Access to Care Act concerning the modernization of the prior authorization process S. 3950, Delivering Unified Access to Lifesaving Services (DUALS) Act of 2024, including provisions requiring each state to select, develop and implement a comprehensive, integrated health plan for dual-eligible beneficiaries, and plans to develop and update care coordination plans, establish ombudsman offices, and establish a care coordinator for each beneficiary, reduce look-alike plans, create a single appeals process, and reduce third-party marketing organization incentives to target beneficiaries, expanding Program of All-Inclusive Care for the Elderly (PACE) coverage, and acknowledge dual eligibles are a diverse group with complex needs, including individuals with multiple chronic conditions, physical disabilities, mental illness, and cognitive impairments such as dementia and developmental disabilities. Issues related to Medicaid Redetermination unwinding process. Issues related to CMMI VBID (Value Based Insurance Design) application and criteria and new guidelines. Issues related to Pharmacy Benefit Management (PBM). Issues related to behavioral health. Issues related to prior authorization.

Health Issues

Advised and assisted with outreach to congressional offices on Affordable Care Act Marketplace enhanced advanced premium tax credits and Medicaid coverage. Advised on legislative outlook for Medicare physician reimbursement; mental health; Medicare-Medicaid dual eligibles; Pharmacy Benefit Managers; and Individual Coverage Health Reimbursement Arrangements. Monitored Medicaid redeterminations; Medicaid managed care regulation; and Medicare Advantage.

Medicare/Medicaid

Advised and assisted with outreach to congressional offices on Affordable Care Act Marketplace enhanced advanced premium tax credits and Medicaid coverage. Advised on legislative outlook for Medicare physician reimbursement; mental health; Medicare-Medicaid dual eligibles; Pharmacy Benefit Managers; and Individual Coverage Health Reimbursement Arrangements. Monitored Medicaid redeterminations; Medicaid managed care regulation; and Medicare Advantage.

Insurance

Advised and assisted with outreach to congressional offices on Affordable Care Act Marketplace enhanced advanced premium tax credits and Medicaid coverage. Advised on legislative outlook for Medicare physician reimbursement; mental health; Medicare-Medicaid dual eligibles; Pharmacy Benefit Managers; and Individual Coverage Health Reimbursement Arrangements. Monitored Medicaid redeterminations; Medicaid managed care regulation; and Medicare Advantage.

Insurance

Medicare and Medicaid issues

Health Issues

Medicaid funding related to Affordable Care Act of 2010 Public Law 111-148

Health Issues

Strategic guidance and counsel related to Medicare, Medicaid, and the insurance market.

Medicare/Medicaid

H.R. 6363, Further Continuing Appropriations and Other Extensions Act, 2024, including provisions related to health care S. 3059, Requiring Enhanced & Accurate Lists of (REAL) Health Providers Act, including provisions establishing provider directory requirements and establishing accountability for provider accuracy under Medicare Advantage (MA) Issues related to the status of state-based Medicaid redetermination process. Issues related to Medicaid Redetermination unwinding process. Issues related to Medicare Advantage and marketing practices. Issues related to Pharmacy Benefit Management (PBM). Issues related to behavioral health. Issues related to prior authorization in Medicaid.

Health Issues

H.R. 5378, Lower Costs, More Transparency Act Issues related to long-term strategy related to stability and affordability of the Marketplace.

Health Issues

Advised on legislative outlook for Medicare physician reimbursement; Medicaid coverage; mental health; Medicare Advantage; Medicare-Medicaid dual eligibles; Pharmacy Benefit Managers; Individual Coverage Health Reimbursement Arrangements and monitored Medicaid redeterminations and proposed Medicaid managed care regulation. Assist with outreach to congressional offices.

Medicare/Medicaid

Advised on legislative outlook for Medicare physician reimbursement; Medicaid coverage; mental health; Medicare Advantage; Medicare-Medicaid dual eligibles; Pharmacy Benefit Managers; Individual Coverage Health Reimbursement Arrangements and monitored Medicaid redeterminations and proposed Medicaid managed care regulation. Assist with outreach to congressional offices.

Insurance

Advised on legislative outlook for Medicare physician reimbursement; Medicaid coverage; mental health; Medicare Advantage; Medicare-Medicaid dual eligibles; Pharmacy Benefit Managers; Individual Coverage Health Reimbursement Arrangements and monitored Medicaid redeterminations and proposed Medicaid managed care regulation. Assist with outreach to congressional offices.

Insurance

Medicare and Medicaid issues

Health Issues

Medicaid funding related to Affordable Care Act of 2010 Public Law 111-148

Health Issues

Strategic guidance and counsel related to Medicare, Medicaid, and the insurance market.

Medicare/Medicaid

H.R. 5860, Continuing Appropriations Act, 2024 and Other Extensions Act, including provisions related to health care Issues related to the status of state-based Medicaid redetermination process. Issues related to Medicaid Redetermination unwinding process. Issues related to Medicare Advantage and marketing practices. Issues related to Pharmacy Benefit Management (PBM). Issues related to behavioral health.

Health Issues

H.R. 5378, Lower Costs, More Transparency Act H.R. 5860, Continuing Appropriations Act, 2024 and Other Extensions Act, including provisions related to health care Issues related to long-term strategy related to stability and affordability of the Marketplace.

Health Issues

Advised on legislative outlook for Medicare physician reimbursement; Medicaid coverage; mental health; Medicare Advantage; Medicare-Medicaid dual eligibles; Pharmacy Benefit Managers; and Individual Coverage Health Reimbursement Arrangements and monitored proposed Medicaid managed care regulation. Assist with outreach to congressional offices.

Medicare/Medicaid

Advised on legislative outlook for Medicare physician reimbursement; Medicaid coverage; mental health; Medicare Advantage; Medicare-Medicaid dual eligibles; Pharmacy Benefit Managers; and Individual Coverage Health Reimbursement Arrangements and monitored proposed Medicaid managed care regulation. Assist with outreach to congressional offices.

Insurance

Advised on legislative outlook for Medicare physician reimbursement; Medicaid coverage; mental health; Medicare Advantage; Medicare-Medicaid dual eligibles; Pharmacy Benefit Managers; and Individual Coverage Health Reimbursement Arrangements and monitored proposed Medicaid managed care regulation. Assist with outreach to congressional offices.

Medicare/Medicaid

Medicare and Medicaid-related matters, as well as working on comprehensive delivery system reform

Health Issues

Medicaid funding related to Affordable Care Act of 2010 Public Law 111-148

Insurance

Medicare and Medicaid issues

Health Issues

Strategic guidance and counsel related to Medicare, Medicaid, and the insurance market.

Medicare/Medicaid

H.R. 3746, Fiscal Responsibility Act of 2023, including provisions related to Medicaid. S. 1002, No Unreasonable Payments, Coding, Or Diagnoses for the Elderly (No UPCODE) Act, including provisions that would alter MA payment model by requiring the use of two years of diagnostic data instead of one year in calculating health status data, excluding the ability of plans to solely use chart reviews and health risk assessments in calculating adjustments in payment based on health status, and evaluating the coding intensity at the plan or contract level and making adjustments to make it more in-line with the coding intensity for FFS. Issues related to implications of the Medicare Advantage rate notice and proposed alternatives. Issues related to the status of state-based Medicaid redetermination process. Issues related to Medicaid Redetermination unwinding process. Issues related to Medicare Advantage and staying connected on impact info on the new MA risk adjustment model.

Health Issues

H.R. 3799, Custom Health Option and Individual Care Expense (CHOICE) Arrangement Act, including provisions related codifying into law a 2019 Administration rule that expanded HRAs to allow employees to purchase their own health insurance plan on the individual market through CHOICE Arrangements. Issues related to provider directories.

Veterans

Issues related to TRICARE and status of contract.

Taxation/Internal Revenue Code

Issues relate to the value of extension of eAPTCs.

Health Issues

Medicaid funding related to Affordable Care Act of 2010 Public Law 111-148

Medicare/Medicaid

Medicare and Medicaid-related matters, as well as working on comprehensive delivery system reform

Health Issues

Advised on legislative outlook for Medicare physician reimbursement; Medicaid coverage; mental health; Medicare Advantage; Medicare-Medicaid dual eligibles; Pharmacy Benefit Managers; and Individual Coverage Health Reimbursement Arrangements and monitored proposed Medicaid managed care regulation. Assist with outreach to congressional offices.

Medicare/Medicaid

Advised on legislative outlook for Medicare physician reimbursement; Medicaid coverage; mental health; Medicare Advantage; Medicare-Medicaid dual eligibles; Pharmacy Benefit Managers; and Individual Coverage Health Reimbursement Arrangements and monitored proposed Medicaid managed care regulation. Assist with outreach to congressional offices.

Insurance

Advised on legislative outlook for Medicare physician reimbursement; Medicaid coverage; mental health; Medicare Advantage; Medicare-Medicaid dual eligibles; Pharmacy Benefit Managers; and Individual Coverage Health Reimbursement Arrangements and monitored proposed Medicaid managed care regulation. Assist with outreach to congressional offices.

Insurance

Medicare and Medicaid issues, COVID relief legislation

Health Issues

Advised on legislative outlook for Medicare physician reimbursement; Medicaid coverage; mental health; and Medicare Advantage. Assist with outreach to congressional offices.

Medicare/Medicaid

Advised on legislative outlook for Medicare physician reimbursement; Medicaid coverage; mental health; and Medicare Advantage. Assist with outreach to congressional offices.

Health Issues

Strategic guidance and counsel related to Medicare, Medicaid, and the insurance market.

Medicare/Medicaid

Issues related to Advance Notice of Methodological Changes for Calendar Year (CY) 2024 for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies. Issues related to status of state-based Medicaid redetermination process. Issues related to impact of advance rate notice proposed methodology on Medicare Advantage program. Issues related to the status of Medicaid redetermination/PHE unwinding process. Issues related to Medicare Advantage and educating on the value of the program, and focus on annual Medicare Advantage Congressional support letter Draft legislation titled No Unreasonable Payments, Coding, or Diagnoses for the Elderly (No UPCODE) Act, including provisions relating to altering the Medicare Advantage payment model by requiring the use of two years of diagnostic data instead of one year in calculating health status data, excluding the ability of plans to solely use chart reviews and health risk assessments in calculating adjustments in payment based on health status, and evaluating the coding intensity at the plan or contract level and making adjustments to make it more in-line with the coding intensity for FFS.