Why It Matters

McDermottPlus LLC terminated its lobbying engagement with Big Health Inc. on August 28, ending a relationship that had spanned more than five years. The termination came as the specialized health policy firm faced broader operational challenges, having filed terminations with multiple clients in recent months.

The digital therapeutics company paid the firm a total of $470,000 across 2020 through 2025, with payments fluctuating significantly year to year. Big Health Inc. was paying $130,000 in 2022, but spending declined substantially afterward. By 2024 and 2025, annual payments dropped to $40,000 and $60,000, respectively.

The Rural Referral Center and Sole Community Hospital Coalition paid the firm $330,000 total, while several other clients, including Ascension, the Association for Community Affiliated Plans, Connections Health Solutions LLC, and the Urgent Care Association, each paid $280,000 across their engagements. Big Health Inc. paid McDermottPlus LLC $470,000 across 2020-2025, Castle Biosciences Inc. paid $160,000, and Gillette Children's Specialty Healthcare paid $160,000.

The firm filed terminations with other clients as well, including PMRI on July 6. According to reporting on the firm's operations, McDermottPlus LLC operated as a distinctive 12-year experiment combining health policy consulting, reimbursement strategy, data analytics, and conventional Washington lobbying, and had been exploring a linkup with a similar private equity-owned company before shutting down.

Broader Context

Big Health Inc. raised $75 million in Series C funding in January 2022, led by SoftBank Vision Fund 2. The company sought a new benefit category for digital therapeutics, and the primary lobbying focus for McDermottPlus LLC and Big Health Inc. was on Medicare/Medicaid issues.

CMS finalized three new Digital Mental Health Treatment G-codes in the CY2025 Medicare Physician Fee Schedule, enabling national Medicare reimbursement for Big Health's SleepioRx and DaylightRx as of January 1, 2025. Medicare reimburses clinical management of Digital Mental Health Treatment but not the software license itself as of 2025, meaning Big Health Inc. faced continued constraints on how its products could be monetized through the federal program.

Broader legislative efforts to expand digital therapeutics coverage had stalled. H.R. 7051, which addressed digital therapeutics policy, was referred to the Committee on Energy and Commerce and the Committee on Ways and Means but did not advance beyond committee referral and was not enacted into law. Successor bills introduced in the 118th Congress, H.R. 1458 and S. 723, also did not pass.

Before shutting down, McDermottPlus LLC had been exploring a linkup with a similar private equity-owned company and had been filing terminations with other clients, including a July 6 termination with PMRI.

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