Feb 20, 2017
Washington Healthcare Update
This Week: Price sworn in, meets with Senate Republicans…Congress recesses for Presidents’ Day…Report shows health spending slowed under the Obama administration.
Health Reform Takeaways
House leadership sent a reconciliation package to CBO to be scored.
Markups to follow, possibly the week of Feb. 28.
Humana pulls out of the marketplace for 2018.
Molina warns it may pull out because there are too many unknowns.
Aetna CEO says markets are in a death spiral.
HHS issues its first rule related to the marketplace since Price became
91 percent of population is insured, an all-time high, and health
spending grew more slowly during the Obama years than under other
4. State Activities
5. Regulations Open for Comment
Republican Policy Brief Outlines New ACA Replacement Plan
new brief from the House Ways &
Means and Energy & Commerce Committees, Republicans outline a plan to
pull back Medicaid expansion and convert Medicaid into a per-person pay
The brief, which closely resembles the “A Better Way” plan by House Speaker
Paul Ryan (R-WI), does not go into detail about how lawmakers will
determine the baseline for setting per-capita allotments, nor does it
specify how long states that expanded Medicaid would continue to receive
the enhanced federal match promised by the Affordable Care Act for that
The brief says that Medicaid programs would move to a per-capita allotment
system, although states could opt for a block grant. Congress would set the
federal Medicaid payment to states by multiplying the state’s per-capita
costs for major beneficiary groups—including the aged, blind and disabled;
children; and adults—by the number of enrollees in each group. The states’
per-capita costs for the groups would be based on each state’s average
Medicaid spending in a base year. Payments would grow based on an
inflationary index, though the paper does not specify which one.
The brief does not define a base year, nor does it say whether the base
year would be different for a non-expansion state than for a state that
chose to expand Medicaid. It also says federal funding would be available
to states based on their current federal match percentage, which varies
state to state.
Some payments, including disproportionate share hospital (DSH) payments and
administrative spending, would not be counted toward a per-capita payment.
Should states choose a block grant, the federal government would also set a
base year to decide the grant amount with the assumption that states would
pull coverage of expansion beneficiaries. The only federal mandate on
states would be that they cover “the most vulnerable elderly and disabled
individuals who are mandatory populations under current law.”
The Republican policy brief says states that expanded Medicaid would be
able to keep their enhanced payments for beneficiaries that are currently
part of the expansion population for an unspecified “limited amount of
time.” After that, states could continue enrolling new beneficiaries with
incomes up to 138 percent of the poverty level, but states would be
reimbursed according to the federal match rate for their traditional
Expanded Use of HSAs Considered
AHIP, the health insurance lobby, and congressional Republicans are backing
a policy proposal that would allow consumers to deposit any excess premium
tax credits into a health savings account.
AHIP’s annual survey data shows that enrollment in HSAs linked to
high-deductible health plans has grown steadily since being established in
2005 and HSAs are now in use by more than 20 million people.
According to the GOP policy brief, the reconciliation bill now being
developed would replace existing premium-based subsidies with age-adjusted
tax credits, and allow them to be used to purchase any insurance approved
by a state and sold in the individual market, including catastrophic
coverage. Subsidies could also be used for any unsubsidized COBRA plans.
“If the individual does not use the full value of the credit, he or she can
deposit the excess amount into a health savings account,” the plan says.
The GOP policy brief also proposes increasing the maximum contribution
limits, and notes that the Better Way plan would align limits with maximum
out-of-pocket spending limits. The plan would also allow spouses to
contribute “catch up” amounts, and allow HSAs to be used for expenses
incurred 60 days prior to establishing the account.
Sens. Orrin Hatch (R-UT) and Marco Rubio (R-FL) and Rep. Erik Paulsen
(R-MN) introduced legislation that would make even more changes to HSA
policy. The Hatch-Rubio-Paulsen bill would allow spouses to make catch-up
contributions; let Medicare Part A enrollees aged 65 or over, people
eligible for Indian Health Services and members of health care ministries
contribute to HSAs; and also allow HSA contributions to be used for direct
primary care service arrangements. It would further let consumers use their
HSA funds for prescriptions and over-the-counter drugs, and for purchasing
House Approves Bill Overturning Protections for Planned Parenthood
On Feb. 16, the House approved a bill to negate an Obama administration
rule and allow states to restrict family planning grants to Planned
Parenthood and other abortion providers.
The measure passed 230-188, largely along party lines, and marks
Republicans’ first attempt this year to target Planned Parenthood funding.
The legislation would set up a process for Republicans controlling both
chambers to use the Congressional Review Act to strike the Obama
administration rule, issued in mid-December, with simple majority votes.
The regulation bans states from blocking Title X family planning grants to
Planned Parenthood and other health care providers that offer abortion.
Title X funding covers services such as contraception, STD screenings and
treatments but cannot be used to pay for abortion services.
House Republicans argued that the measure upholds states’ rights and is not
an attack on Planned Parenthood. Democrats branded the legislation an
attack on women’s health.
Thirteen states have restricted Title X grants, a move abortion rights
advocates say has reduced access to care.
House Freedom Caucus Endorses Sen. Rand Paul’s Obamacare Replacement
On Feb. 15, the House Freedom Caucus officially endorsed Sen. Rand Paul’s
(R-KY) Obamacare replacement plan, further signaling the divide among
Republicans on Capitol Hill over how to overhaul the health care law.
House Freedom Caucus Chairman Rep. Mark Meadows (R-NC) said that the group
supports immediately repealing Obamacare with the 2015 reconciliation bill,
and replacing it with Paul’s bill. Rep. Mark Sanford (R-SC) has introduced
its companion measure in the House. That legislation expands health savings
accounts and would allow individuals and small businesses to create their
own markets. The bill does not address the ACA’s Medicaid expansion.
However, Meadows said the HFC supports its repeal.
Additionally, the Freedom Caucus chair said he does not support the newly
unveiled plan to simultaneously repeal and replace the ACA. The caucus has
said the ACA should be repealed in the next two to three months using the
2015 reconciliation package and then the law should be replaced on the same
day. The chair of the House Freedom Caucus said he opposes the leadership
plan because it does not address costs, he prefers a tax deduction over a
credit, and he is against a refundable, advanceable tax credit.
House Oversight Committee Votes to Kill D.C.’s “Right to Die” Law
On Feb. 13, the House Oversight Committee approved a resolution to kill the
District of Columbia’s “right to die” law for terminally ill patients.
In a vote of 22 to 14 along party lines, the committee moved to nullify the
D.C. law, which allows patients with less than six months to live to obtain
life-ending medication from a doctor. Congress can prevent the law from
taking effect if it passes a disapproval resolution and President Donald
Trump signs it within 30 legislative days of Jan. 6, the date it received
The resolution now moves on to the full House.
Six states have similar laws: California, Colorado, Montana, Oregon,
Vermont and Washington.
Senate Confirms OMB Director Mulvaney
Rep. Mick Mulvaney (R-SC) was confirmed as director of the Office of
Management and Budget (OMB) on Feb 16. Sen. John McCain (R-AZ) crossed
party lines to vote against Mulvaney’s confirmation. For the new OMB
director, there is a lot to catch up on. OMB has to help translate each of
Trump’s executive orders into budget policy—something career staff are
likely reticent to do. Mulvaney also will now have to fill key spots such
as deputy directors, associate directors and communications staff to help
carry out Trump’s policies. Since day one, OMB has been without a direct
line to the Trump administration, leaving the 500-person office in a
Senate Confirms Shulkin as VA
On Feb. 13, the Senate unanimously confirmed President Donald Trump’s
nominee David Shulkin for Veterans Affairs secretary.
The vote was 100-0 for Shulkin, a holdover from the Obama administration
who has served as VA undersecretary of health since 2015. A physician and
former health care executive, Shulkin will be the first VA secretary in the
department’s history never to have served in the military.
The Senate set aside just 10 minutes for debate on his nomination. The
Senate Veterans’ Affairs Committee had already unanimously approved
Shulkin’s nomination, and he earned the support of all Senate Democrats
despite concerns over whether Trump might move to privatize the VA.
During his Feb. 1 confirmation hearing, Shulkin allayed Senate Democrats’
concerns that the VA system would be privatized. Shulkin’s confirmation
drew mostly praise from veterans service organizations.
Bipartisan Group of Senators Asks Price to Permit Drug Imports
Sens. Chuck Grassley (R-IA), John McCain (R-AZ) and Amy Klobuchar (D-MN)
wrote a letter
to HHS Secretary Tom Price asking him to use existing authority to fast
track the importation of prescription drugs from Canada to help remedy
drastic drug price increases in the United States.
The senators say Price should use this authority only when a drug is off
patent or no longer marketed in the U.S. by the original manufacturer; has
had a significant, unexplained price increase; has no direct competition
and a competitor drug would help consumers; and the imported product is
made by companies with a reputable record.
They say the policy should be limited so “it does not negatively affect
innovator companies that invested in the development of the drug.”
CMS Awards Funds to Help Small Practices in the Quality Payment Program
On Feb. 17, CMS awarded approximately $20 million to 11 organizations for
the first year of a five-year program to provide on-the-ground training and
education about the Quality Payment Program for clinicians in individual or
small group practices of 15 clinicians or fewer. CMS intends to invest up
to an additional $80 million over the remaining four years.
CMS Delays Medicare Bundled Payments Rule
of new Medicare bundled payment models, citing a “regulatory freeze” that
was imposed following President Donald Trump’s election.
CMS said it will push the effective date for the rule’s first elements to
March 21, roughly a month later than initially planned. The models overhaul
provider Medicare payments for cardiac rehabilitation treatments, as part
of a broader shift toward compensating hospitals and doctors based on care
quality, rather than the amount of care they provide.
The announcement also delays planned changes to Medicare’s payment model
for hip and knee replacement surgeries until March 21.
CMS OACT Releases Projections of National Health Expenditures Data
According to a Feb. 15 report published by Health Affairs, national
health expenditure growth is expected to average 5.6 percent annually over
2016-2025. These projections are constructed using a current-law framework
and do not assume potential legislative changes over the projection period.
The report, authored by the CMS Office of the Actuary (OACT), projects
national health spending growth to outpace projected growth in Gross
Domestic Product (GDP) by 1.2 percentage points. As a result, the report
also projects the health share of the GDP to rise from 17.8 percent in 2015
to 19.9 percent by 2025. Growth in national health expenditures over this
period is largely influenced by projected faster growth in medical prices
compared to recent historically slow growth. This faster expected growth in
prices is projected to be partially offset by slowing growth in the use and
intensity of medical goods and services.
According to the report, for 2016, total health spending is projected to
have reached nearly $3.4 trillion, a 4.8 percent increase from 2015. The
report also found that by 2025, federal, state and local governments are
projected to finance 47 percent of national health spending, a slight
increase from 46 percent in 2015.
Additional findings from the report:
Total national health spending growth:
Growth is projected to have been 4.8 percent in 2016, slower
than the 5.8 percent growth in 2015, as a result of slower Medicaid and
prescription drug spending growth. In 2017, total health spending is
projected to grow by 5.4 percent, led by increases in private health
insurance spending. National health expenditure growth is projected to
be faster and average 5.8 percent for 2018-2025, largely due to
expected faster spending growth in both Medicare and Medicaid.
Medicare spending growth is projected to have been 5.0 percent in 2016
and is expected to average 7.1 percent over the full projection period
2016-2025. Faster expected growth after 2016 primarily reflects
utilization of Medicare covered services increasing to approach rates
closer to Medicare’s longer historical experience. This results in
Medicare spending per beneficiary growth of 4.1 percent over 2016-2025
(compared to 1.6 percent growth for 2010-2015).
Private health insurance:
Spending growth is projected to have slowed from 7.2 percent in 2015 to
5.9 percent in 2016, a trend that is related to slower growth in
private health insurance enrollment. Spending growth is projected to
increase to 6.5 percent in 2017, due in part to faster premium growth
in marketplace plans related to previous underpricing of premiums and
the end of the temporary risk corridors.
Projected spending growth slowed significantly in 2016 to 3.7 percent,
down from 9.7 percent in 2015, largely reflecting slower growth in
Medicaid enrollment. Spending growth is expected to accelerate and
average 5.7 percent for 2017-2025 as projected per-enrollee spending
growth rises over that timeframe. Underlying the faster per enrollee
growth is the increasingly larger share of the Medicaid population who
are aged and disabled and who tend to use more intensive services.
Medical price inflation:
Medical prices are expected to increase more rapidly after historically
low growth in 2015 of 0.8 percent to nearly 3 percent by 2025. This
faster projected growth in prices is influenced by an acceleration in
both economy-wide prices and medical specific prices and is projected
to be partially offset by slowing growth in the use and intensity of
medical goods and services.
Prescription drug spending:
Drug spending growth is projected to have been 5.0 percent in 2016,
following growth of 9.0 percent in 2015, mainly due to slowing use of
expensive drugs that treat hepatitis C. Growth is projected to average
6.4 percent per year for 2017-2025, influenced by higher spending on
expensive specialty drugs.
Insured Share of the Population:
The proportion of the population with health insurance is projected to
increase from 90.9 percent in 2015 to 91.5 percent in 2025.
To see the report,
Anthem Files Lawsuit to Preserve Cigna Deal, After Cigna Files Suit
to block Cigna from terminating its merger agreement. The insurance giant
announced Feb. 15 that it filed a lawsuit seeking to keep alive what has
become essentially a $54 billion hostile takeover of Cigna.
filed a lawsuit
on Feb. 14 seeking to terminate the deal and asking for $13 billion in
damages, in addition to a $1.85 billion breakup fee.
Anthem argues that Cigna has aggressively worked to derail the deal
throughout the integration efforts and during the Justice Department’s
successful effort to block the deal on antitrust grounds.
“Cigna’s lawsuit and purported termination is the next step in Cigna’s
campaign to sabotage the merger and to try to deflect attention from its
repeated willful breaches of the Merger Agreement in support of such
effort,” Anthem said in a statement.
Aetna’s proposed $37 billion acquisition of Humana has also been blocked by
a federal judge. On Feb. 14, the parties mutually announced that they were
calling off the merger.
4. State Activities
California Lawmakers Introduce Single-payer Legislation
California lawmakers introduced legislation Feb. 17 to create a
single-payer health care system in the state as a way of retaining the
gains made under Obamacare and to further expand insurance coverage to all
residents, including those living here illegally.
The bill, titled Californians for a Healthy California Act and
authored by state Sen. Ricardo Lara, would create a health care
system administered by the state that would allow patients to choose their
own doctors and hospitals. The current version of the bill does not detail
how such a system would be funded. Lara said the financing piece will come
later and will rely on pooling the resources the state currently spends on
California and other states—most recently Vermont and Colorado—have made
previous unsuccessful attempts to enact or pass a single payer health
system. But Lara said that with congressional Republicans set to dismantle
the ACA, this time is different.
Florida: Gov. Scott Proposal Reduces Hospital Charity Funding
Florida Hospital and Orlando Regional Medical Center—the hospitals that
treated the Pulse Nightclub shooting victims last summer—do not provide
enough charity care to keep additional Medicaid dollars under the budget
spending proposal being pushed by Gov. Rick Scott.
Scott wants to reduce Orlando Regional Medical Center’s Medicaid charity
funding by nearly $38 million. Florida Hospital would lose just under $50
million, according to a spreadsheet shared by the agency. No hospital would
experience bigger reductions in charity care than the two medical
In all, Scott’s budget reduces hospital funding by about $930 million in
the upcoming fiscal year, which begins July 1. About $300 million comes
from eliminating additional Medicaid payments sent to hospitals for
providing charity care. Scott’s proposal would eliminate the additional
charity payments to any facility with less than a 67 percent ratio of
charity care to operating margin—the average margin at for-profit
Louisiana: Health Department Releases State’s Medicaid Expansion Figures
An estimated 400,635 people have received coverage under Louisiana’s
expanded Medicaid program, according to new figures from the state’s health
department. Since expansion, the rate of uninsured dipped to 12.5 percent
in 2016 from 21.7 percent in 2013.
New Jersey: Gov. Christie Makes Progress on Drug Addiction Reform Plan
New Jersey Gov. Chris Christie signed the centerpiece of his new drug
addiction reform plan into law, which will limit initial opioid
prescriptions to a five-day supply and mandate insurance coverage for
inpatient drug treatment. New Jersey will now have the most stringent law
on limiting opioid prescriptions. Several other states, including
Massachusetts and New York, have adopted a seven-day limit. The governor
also suggested he plans to attack drug addiction on a much larger scale,
saying he discussed the legislation with President Donald Trump at a lunch
Pennsylvania: Gov. Wolf Stresses Importance of Expansion on Substance Abuse Treatment
Pennsylvania Gov. Tom Wolf, in a letter to Senate Finance Committee
Democrats, stressed the importance of maintaining coverage levels and
access to substance abuse treatment in any ACA replacement plan. Wolf’s
letter emphasizes the importance the ACA and Medicaid expansion has had in
addressing the opioid abuse epidemic in his state by dramatically expanding
access to substance abuse treatment. He noted that Pennsylvania is facing a
$3 billion deficit and said if the federal funding match from Medicaid
expansion goes away, it could “quite literally devastate our state from a
financial perspective or force our state to make impossible decisions about
which Pennsylvanians are entitled to quality health care.”
5. Regulations Open for Comment
CMS Proposes Rule for Prosthetics and Orthotics Suppliers
On Jan. 11, CMS issued a proposed rule that would implement statutory
requirements and specify: the qualifications needed for practitioners to
furnish and fabricate prosthetics and custom-fabricated orthotics, and for
qualified suppliers to fabricate prosthetics and custom-fabricated
orthotics; accreditation requirements that qualified suppliers must meet in
order to bill for prosthetics and custom‑fabricated orthotics; requirements
that an organization must meet in order to accredit qualified suppliers to
bill for prosthetics and custom-fabricated orthotics; and a timeframe by
which qualified practitioners and qualified suppliers must meet the
applicable licensure, certification and accreditation requirements. This
rule would also remove the exemption from quality standards and
accreditation that is currently in place in accordance with Section
1834(a)(20) of the Act for certain practitioners and suppliers who furnish
or fabricate prosthetics and custom‑fabricated orthotics. In addition, this
rule also includes authority for the Centers for Medicare & Medicaid
Services (CMS) to revoke the Medicare enrollment of Durable Medical
Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) suppliers that submit claims for items that do
not meet the requirements of the statute and this proposed rule.
Only qualified practitioners who furnish or fabricate prosthetics and
custom‑fabricated orthotics and qualified suppliers that fabricate or bill
for prosthetics and custom‑fabricated orthotics would be subject to these
CMS will accept comments on the proposed rule until March 13, 2017, and
will respond to comments in a final rule.
To see the proposed rule,
FDA Releases Draft Guidance for Interchangeable Biosimilars
On Jan. 17, FDA outlined the criteria companies must meet to get a copycat
biologic deemed interchangeable with its branded counterpart, a
certification that paves the way for the cheaper products to be
automatically substituted at the pharmacy level under state laws.
To get this designation, a biosimilar sponsor must show that its product
can be expected to produce the same clinical result as the branded biologic
in any given patient, for all of the drug’s approved uses, and that there
are no risks if a patient is switched back and forth between the
interchangeable biosimilar and the branded biologic,
per draft guidance
released by FDA.
Interchangeable biosimilars are expected to offer greater savings to the
health system than biosimilars that lack this designation. Without the
interchangeability designation a doctor must proactively write a
prescription for the biosimilar.
The guidance outlines the types of studies and scientific data that
companies will need to submit to FDA to get an interchangeable designation.
When companies seek that designation, FDA recommends they seek approval for
all of the branded biologic approved uses.
FDA is requesting comments on the draft guidance as well as a number of
questions outlined in a
Federal Register notice. FDA wants to know how it should regulate manufacturing changes of
interchangeable products that occur after approval. The agency also wants
to know how it should handle interchangeable designations if a branded
biologic gets another use approved for the drug, after the interchangeable
biosimilar is cleared by FDA.
FDA Releases Draft Guidance on Off-Label Drug Communication
On Jan. 17, FDA
issued draft guidance
that gives drug and device companies more flexibility to communicate
off-label information about their products and avoid charges of
misbranding. The new policy allows companies to promote a drug or device
with information not on the agency-approved label as long as that
information is truthful and non-misleading and is consistent with
Companies have asked FDA for clarity on marketing policies after a 2012
U.S. Court of Appeals decision ruled that under the First Amendment the
government could not prohibit and criminalize the truthful off-label
promotion of FDA-approved drugs.
The guidance outlines how FDA will determine whether a company's
communication is consistent with FDA's required labeling. For example,
companies will not be permitted to communicate information about the drug
or device related to a use that has not yet been approved by FDA. They also
can't promote a patient population for the drug or device that has not been
cleared by the agency.
The agency offers some examples of information companies could communicate
that could be consistent with its FDA-required labels. For example, FDA
said companies can promote testimony of patients who used the drug for its
FDA-approved uses, such as the product's effect on patients' daily
activities. Companies could also communicate long-term safety and efficacy
information about products that were approved for chronic use based on a
six-month trial, if the company now has data on the drug lasting a couple
of years, FDA added.
The guidance also outlines the type of scientific data companies need to
support their off-label claims. Comments on the draft are due in 60 days.
CMS Proposes Average 0.25 Percent Hike for Medicare Advantage Plans
On Feb. 1, the Trump administration issued guidance that proposes updates
to the methodologies used to pay Medicare Advantage plans and Part D
sponsors. The guidance calls for raising Medicare Advantage payments an
average of 0.25 percent.
Health plans take in roughly $200 billion a year from the government to
provide care for seniors enrolled in private Medicare plans. There are
currently more than 18 million people enrolled in Medicare Advantage,
accounting for roughly a third of all of the program's beneficiaries. More
than 1 million seniors have been added to private Medicare plans in the
past year, continuing a trend of robust growth that goes back a decade.
"These proposals will continue to keep Medicare Advantage strong and stable
and provide high quality, affordable care to seniors and people living with
disabilities," said Patrick Conway, acting administrator of the Centers for
Medicare and Medicaid Services.
Obamacare included major cuts to Medicare Advantage—America's Health
Insurance Plans puts the total figure at $200 billion—that were designed to
bring payments more in line with traditional government-run Medicare. Last
year, the federal government paid private plans an average of 102 percent
of traditional fee-for-service costs per member.
UnitedHealth Group and Humana are the biggest national players, accounting
for roughly 40 percent of the Medicare Advantage market in 2015.
CMS will accept comments until March 3 and the final notice will be posted
on April 3.
To read a fact sheet on the rate proposal,
GAO: Enrollment in Private Plans Concentrated Among Small Number of Issuers
In a reissued report, GAO found that enrollment in private health insurance
plans remained concentrated among a small number of issuers in most states
in 2014, including in the newly established exchanges. On average in each
state and the District of Columbia, 11 or more issuers participated in each
of three types of markets—individual, small group and large group—from 2011
through 2014. However, in most states, the 3 largest issuers in each market
had at least an 80 percent share of the market during the period.
To see the full report,
GAO: National Strategy Needed for Food Safety Federal Oversight
In a new report, the GAO finds that a national strategy is needed to
address fragmentation in federal oversight of food safety. The safety and
quality of the food supply is governed by a system administered by 16
federal agencies. For example, one agency regulates frozen cheese pizzas,
another agency regulates frozen pizzas with meat and additional agencies
regulate components of both.
Food safety and government performance experts agree that there is a need
to develop a national strategy to provide a framework for strengthening the
food safety system. GAO recommended that the Executive Office of the
President lead the effort to develop such a strategy.
To see the full report,
GAO: CMS Needs Better Data to Oversee Personal Care Services
In a new report, GAO finds that CMS needs better data to monitor the
provision of and spending on personal care services. Millions of Medicaid
beneficiaries rely on personal care services for help with daily tasks like
bathing and eating. However, these types of services are at high risk for
fraud and abuse—e.g., services that were paid for but never provided. GAO
found that CMS needs better data to oversee these personal care services,
and recommended that the agency issue guidance to states for reporting key
data, ensure that data meet requirements and develop plans to use that data
To see the full report,
Science Panel Warns Against Gene Editing for Enhancement
According to a National Academy of Science and National Academy of Medicine
report, clinical trials that edit inheritable traits in the human genome should
not be permitted at this time.
However, human clinical trials that would alter DNA in human embryos—known
as the human germline—and affect the genomes of future generations could
eventually be permitted and deserve serious consideration, according to the
report. Such activity is banned in the United States and many other
If you have any questions, contact the following individuals at
Kennan, Senior Vice President
Charlie Iovino, Vice
Caroline Perrin, Research Assistant
Founded in 1998, McGuireWoods Consulting LLC
(MWC) is a full-service public affairs firm offering infrastructure and
economic development, strategic communications & grassroots, and government
relations services. McGuireWoods Consulting is a subsidiary of the
law firm and has been named in The National Law Journal's special annual
report, "The Influence 50," for the past several years. In the most recent
report, McGuireWoods Consulting was ranked 15th of the 1,900 government
relations firms in Washington, D.C.
To sign up for the Weekly Washington Healthcare Update, use our online
McGuireWoods Consulting LLC
2001 K Street
Washington, DC 20006-1040