• Policies impacting Medicaid managed care, dual eligible coverage Medicaid expansion and payment reform, Medicaid cuts, changes to the health insurance marketplace and Medicare policies impacting dual-eligibles. Efforts in both chambers to advance policies intended to address the opioid crisis. Supplemental Nutrition Assistance Program (SNAP), issues related to employment and training grants for Medicaid participants.

Duration: November 1, 2011 to March 1, 2019

General Issues: Medicare/Medicaid

Spending: about $1,380,000 (But it's complicated. Here's why.)

It can be tricky to figure out how much an organization spent on a particular lobbying engagement. The law only requires lobbyists to report the amount they were paid for federal lobbying each quarter rounded to the nearest $10,000—and if it's less than $3,000 in a given quarter (or less than $13,000 for organizations with in-house lobbyists), they don't have to disclose it at all. Plus, some organizations include spending that doesn’t belong in the report—for instance, money spent lobbying state governments or other legal work.

Agencies lobbied since 2011: U.S. Senate, House of Representatives, Agriculture - Dept of (USDA), Executive Office of the President (EOP), Centers For Medicare and Medicaid Services (CMS), Health & Human Services - Dept of (HHS), Centers For Medicare and Medicaid Services (CMS), Health & Human Services - Dept of (HHS)