Small Business Health Relief Act of 2011

S. 20/H.R. 1744 American Job Protection Act; Affordable Care Act, all provisions, including employer penalities, essential health benefits, exchanges, age rate band compression; Health Care Reform; Health Care Mandate Penalties; Employer/Employee Flexibility; Consumer-Directed Health Care; Health Insurance Exchanges; Medicare Secondary Payer Judgments; Comments on FDA's Suggested Questions & Answers for the Final Patient Protection & Affordable Care Act Section 4205 Guidance; Comments on IRS' "Shared Responsibility for Employers Regargding Health Care Coverage (IRC Sec. 1513)"; H.R.1370, To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act, all provisions; H.R.2077, MLR Repeal Act of 2011, all provisions; S.1098, Family and Retirement Health Investment Act of 2011, all provisions; H.R.5/S.1099, Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011, all provisions; H.R.1206, Access to Professional Health Insurance Advisors Act of 2011, all provisions; Summary of Benefit NRPM; Comments regarding employer interactions with insurance exchanges, health premium tax credits, and development of an affordability safe harbor for employers; S.1880, Jobs and Premium Protection Act, all provisions; S.1049/H.R. 2676, Small Business Health Relief Act of 2011, all provisions; H.R.2206, Auto Enroll Repeal Act, all provisions..

Client expense: $900,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Environmental Protection Agency (EPA), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Federal Deposit Insurance Corporation (FDIC), Federal Motor Carrier Safety Administration, Federal Reserve System, Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Interior, Dept of (DOI), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Labor Relations Board (NLRB), Natl Telecommunications & Information Administration (NTIA), SENATE, Securities & Exchange Commission (SEC), Small Business Administration (SBA), State, Dept of (DOS), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Customs & Border Protection, U.S. International Trade Commission (ITC), U.S. Trade Representative (USTR), White House Office

H.R. 5, HEALTH Act (Gingrey) - IPAB repeal, medical liability reform, McCarran-Ferguson, H.R. 452, Medicare Decisions Accountability Act (Roe) - IPAB repeal, medical liability reform, McCarran-Ferguson, H.R.611 -- BEST PRACTICES Act (Rush) - data security, H.R. 1173, Fiscal Responsibility and Retirement Security Act (Boustany) - National Clearinghouse for LTC Information, H.R. 1409, Quality Health Care Coalition Act (Conyers) - antitrust exemption for physicians, H.R. 1707, Data Accountability and Trust Act (Rush) - data security, H.R. 1841, Data Accountability and Trust Act (Stearns) - data security, H.R. 2576, (Black) - eligibility for health care assistance, H.R. 2577, Secure and Fortify Electronic Data Act (Bono Mack) - data security, H.R. 2676, Small Business Health Relief Act (Schweikert) - repeal of premium tax and other ACA provisions, H.R. 4310, National Defense Authorization Act (McKeon) - TRICARE provisions, H.R. 5800, Health Care Price Transparency Promotion Act (Burgess) - price transparency, H.R. 5817, Eliminate Privacy Notice Confusion Act (Luetkemeyer) - privacy, H.R. 5909, Comprehensive Dental Reform Act (Cummings) - expanded access to dental services, H.R. 6684, Spending Reduction Act (Ryan) - ACA provisions, deficit reduction proposals, H.J.Res. 17, Continuing Appropriations Resolution (Rogers) - temporary appropriations for FY 2013, S. 1049, Small Business Health Relief Act (Kyl) - repeal of premium tax and other ACA provisions, S. 1099, HEALTH Act (Blunt) - medical liability reform, S. 1151, Personal Data Privacy and Security Act (Leahy) - privacy, data security, S. 1207, Data Security and Breach Notification Act (Pryor) - data security, S. 1223, Location Privacy Protection Act (Franken) - privacy, S. 1408, Data Breach Notification Act (Feinstein) - data security, S. 1535, Personal Data Protection and Breach Accountability Act (Blumenthal) - data security, S. 1789, 21st Century Postal Service Act (Lieberman) -- health benefits for postal employees, S. 2111, Cyber Crime Protection Security Act (Leahy) - privacy, S. 3254, National Defense Authorization Act (Levin) - TRICARE provisions, S. 3272, Comprehensive Dental Reform Act (Sanders) - expanded access to dental services, S. 3295, Labor, HHS, Education Appropriations Act (Harkin) - funding for HHS programs and agencies, ACA related amendments, S. 3333, Data Security and Breach Notification Act (Toomey) - data security, S. 3351, Protect Our Health Privacy Act (Franken) - privacy, S. 3414, Cybersecurity Act (Lieberman) - privacy, data security, S. 3432 Identity Theft and Tax Fraud Prevention Act (Nelson/Coburn) - privacy

Client expense: Not reported · Firm income: $60,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

- Bills related to the Affordable Care Act. - Legislative ideas for addressing health care costs & financing. - H.R. 1370, a bill to repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act, regarding all provisions. - S.1880, Jobs and Premium Protection Act, regarding all provisions. - S.1049/H.R. 2676 The Small Business Health Relief Act, regarding all provisions.

Client expense: $490,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Treasury, Dept of, White House Office

- Legislative ideas for addressing health care costs, financing & dual eligible demonstration programs. - H.R. 1370, "A bill to repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act", regarding all provisions. - S.1049/H.R. 2676 "The Small Business Health Relief Act", regarding all provisions. - H.R. 5979, "Medicaid Accountability and Care Act", regarding all provisions - H.R. 8, "American Taxpayer Relief Act of 2012", provisions affecting Medicare/Medicaid.

Client expense: $490,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Treasury, Dept of, White House Office

- H. R. 1370, "To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act.", regarding all provisions. - S.1049/H.R. 2676 "The Small Business Health Relief Act", regarding all provisions. - S.1880, "Jobs and Premium Protection Act", regarding all provisions.

Client expense: $490,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Treasury, Dept of, White House Office

H.R. 5, HEALTH Act (Gingrey) IPAB repeal, medical liability reform, McCarran-Ferguson 16. Specific Lobbying Issues (continued): H.R. 452, Medicare Decisions Accountability Act (Roe) IPAB repeal, medical liability reform, McCarran-Ferguson H.R.611 -- BEST PRACTICES Act (Rush) data security H.R. 1173, Fiscal Responsibility and Retirement Security Act (Boustany) National Clearinghouse for LTC Information H.R. 1409, Quality Health Care Coalition Act (Conyers) antitrust exemption for physicians H.R. 1707, Data Accountability and Trust Act (Rush) data security H.R. 1841, Data Accountability and Trust Act (Stearns) data security H.R. 2576, (Black) eligibility for health care assistance H.R. 2577, Secure and Fortify Electronic Data Act (Bono Mack) data security H.R. 2676, Small Business Health Relief Act (Schweikert) repeal of premium tax and other ACA provisions H.R. 4310, National Defense Authorization Act (McKeon) TRICARE provisions H.R. 5800, Health Care Price Transparency Promotion Act (Burgess) price transparency H.R. 5817, Eliminate Privacy Notice Confusion Act (Luetkemeyer) privacy H.R. 5909, Comprehensive Dental Reform Act (Cummings) expanded access to dental services H.R. 6684, Spending Reduction Act (Ryan) ACA provisions, deficit reduction proposals H.J.Res. 17, Continuing Appropriations Resolution (Rogers) temporary appropriations for FY 2013 S. 1049, Small Business Health Relief Act (Kyl) repeal of premium tax and other ACA provisions S. 1099, HEALTH Act (Blunt) medical liability reform S. 1151, Personal Data Privacy and Security Act (Leahy) privacy, data security S. 1207, Data Security and Breach Notification Act (Pryor) data security S. 1223, Location Privacy Protection Act (Franken) privacy S. 1408, Data Breach Notification Act (Feinstein) data security S. 1535, Personal Data Protection and Breach Accountability Act (Blumenthal) data security S. 1789, 21st Century Postal Service Act (Lieberman) -- health benefits for postal employees S. 2111, Cyber Crime Protection Security Act (Leahy) privacy S. 3254, National Defense Authorization Act (Levin) TRICARE provisions S. 3272, Comprehensive Dental Reform Act (Sanders) expanded access to dental services S. 3295, Labor, HHS, Education Appropriations Act (Harkin) funding for HHS programs and agencies, ACA related amendments S. 3333, Data Security and Breach Notification Act (Toomey) data security S. 3351, Protect Our Health Privacy Act (Franken) privacy S. 3414, Cybersecurity Act (Lieberman) privacy, data security S. 3432 Identity Theft and Tax Fraud Prevention Act (Nelson/Coburn) privacy Regulatory Issues: HIPAA administrative simplification issues, including standards for privacy, security, and electronic transactions and code sets, identifiers including the health plan identifier, enforcement; FEHBP enrollment data clearinghouse initiative, the enrollment reconciliation process, and a related OPM reimbursement factor for records that cannot be reconciled; issues relating to health insurance plan participation in FEHBP, including contract requirements; transition from the similarly sized subscriber group (SSSG) requirement to an MLR; OPM data warehouse; implementation of the health savings account provisions of the Medicare Act; issues related to Medicare Secondary Payer requirements; issues related to implementation of the National Health Information Infrastructure; electronic health records, personal health records, and similar technologies; issues relating to market consolidation; issues related to hospital consolidation; issues relating to quality improvement; issues related to potential priority research topics for the effective health care program; issues relating to the national health data stewardship; issues relating to hospital outpatient measurement and reporting; issues relating to data breach requirements; issues relating to "meaningful use" requirements for health information technology; issues related to the collection of race and ethnicity data; issues related to medical loss ratios; review of rates for reasonableness; health insurance exchanges; preexisting condition insurance plans; accountable care organizations; coverage of preventive services; contraceptive coverage; pre-existing condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; issues relating to the annual fee on health insurance providers; health plan automatic enrollment requirements; health insurance web portal Regulatory Descriptions (con't): requirements; issues related to qualified health plans including certification and rate filing templates; health insurance market rules; dependent coverage; summary of benefits and coverage disclosures; benefit and payment parameters for 2014; essential health benefits, actuarial value, and accreditation; and other issues relating to health care reform implementation.

Client expense: $2,020,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Federal Bureau of Investigation (FBI), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Pension & Welfare Benefits Administration, SENATE, Treasury, Dept of, White House Office

H.R. 2, Repealing the Job-Killing Health Care Law Act H.R. 4, Small Business Paperwork Mandate Elimination Act of 2011 H.R. 5, Protecting Access to Healthcare Act H.R. 436, Health Care Cost Reduction Act of 2012 H.R. 450, Restoring Assistance for Families and Seniors Health Expenses Act of 2011 H.R. 452, Medicare Decisions Accountability Act of 2011 H.R. 605 / S. 312, Patients Freedom Choose Act H.R. 1051, Medicare Beneficiary Freedom to Choose Act of 2011 H.R. 1173, Fiscal Responsibility and Retirement Security Act of 2011 H.R. 1370, To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act. H.R. 1509, Medicare Identity Theft Prevention Act of 2011 H.R. 1744 / S. 20, American Job Protection Act H.R. 1845 / S. 960, Medicare IVIG Access Act H.R. 2010, Family and Retirement Health Investment Act of 2011 H.R. 2077, MLR Repeal Act of 2011 H.R. 2529 / S.1368, Restoring Access to Medication Act H.R. 2590, Seniors Protection Act of 2011 H.R. 2676, Small Business Health Relief Act of 2011 H.R. 3682, Patient Centered Healthcare Savings Act of 2011 H.R. 4095 / S. 2002, Online Pharmacy Safety Act H.R. 4626, Health Insurance Fair Competition Act H.R. 5141/S. 3578, Small Business Paperwork Mandate Elimination Act H.R. 5651, Food and Drug Administration Reform Act of 2012 H.R. 5842, Restoring Access to Medication Act of 2012 H.R. 5853, Fiscal Responsibility and Retirement Security Act H.R. 5906, To amend the Internal Revenue Code of 1986 to repeal the excise tax on medical devices H.R. 6048, Healthcare Tax Relief and Mandate Repeal Act S. 17, Medical Device Access and Innovation Protection Act S. 312, Patients Freedom to Choose Act S. 510, FDA Food Safety Modernization Act, including provisions relating to 1099 reporting amendments S. 668, Health Care Bureaucrats Elimination Act S. 720, Repeal the CLASS Entitlement Act S. 848, Consumer Information Enhancement Act of 2011 S. 1049, Small Business Health Relief Act of 2011 S. 1098, Family and Retirement Health Investment Act of 2011 S. 1880, Jobs and Premium Protection Act S. 2068, Access to Independent Health Insurance Advisors Act of 2012 S. 3187, Food and Drug Administration Safety and Innovation Act S. 3501, American Job Protection Act S. 3673, Patients Freedom Choice Act Notice of Proposed Rulemaking and Notice of Public Hearing Regarding Fees on Health Insurance Policies and Self-Insured Plans for the Patient-Centered Outcomes Research Trust Fund (77 Fed. Reg. 22691-22706, Apr. 17, 2012) Notice and Request for Comments on Minimum Value of an Employer-Sponsored Plan (Notice 2012-31, Apr. 26, 2012) Request for Information Regarding Stop Loss Coverage (77 Fed. Reg. 25788-25790, May 1, 2012) Notice and Request for Comments on Reporting of Health Insurance Coverage (Notice 2012-32, May 14, 2012) Notice and Request for Comments on Reporting by Applicable Large Employers on Health Insurance Coverage Under Employer-Sponsored Plans (Notice 2012-33, May 14, 2012) Final Regulations on Health Insurance Premium Tax Credit (77 Fed. Reg. 30377-30400, May 23, 2012 (to be codified at 26 C.F.R. pts 1 and 602)) Notice and Request for Comments on Health Flexible Spending Arrangements (Notice 2012-40, May 30, 2012) Notice and Request for Comments on the Guidance on 90-Day Waiting Period Limitation (DOL Technical Release 2012-02, Aug. 31, 2012) Notice and Request for Comments on Determining Full-Time Employees For Purposes of Shared Responsibility for Employers Regarding Health Coverage (Notice 2012-58, Aug. 31, 2012) Proposed Regulation on the Patient Protection and Affordable Care Act; Standards Related to Essential Health Benefits, Actuarial Value, and Accreditation (77 Fed. Reg. 70,644-70,676, November 26, 2012 (to be codified at 45 CFR pts 147, 155, and 156)) Proposed Rule on the Health Insurance Market Rules; Rate Review (77 Fed. Reg. 70,584-70,617, November 26, 2012 (to be codified at 45 CFR pts 144, 147, and 150)) Proposed Rule on the HHS Notice of Benefit and Payment Parameters for 2014 (77 Fed. Reg. 73,118-73,218, December 7, 2012 (to be codified at 45 CFR pts 153, 155, 156, 157 and 158)) Various issues relating to the implementation of the Patient Protection and Affordable Care Act (P.L. 111-148), including implementation of regulatory process, legislative corrections, coverage, financing, delivery reform, 1099 reporting, Grandfathering, HSA and FSA changes, CMS claims database, IPAB, CLASS program, employer mandate, medical loss ratio, medical malpractice reform, exchanges, and flexible spending accounts and health savings accounts; regulatory process and legislative corrections to Health Care and Education Affordability Reconciliation Act of 2010 (P.L. 111-152), including ERISA preemption and the impact on small business

Client expense: $29,510,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Commerce, Dept of (DOC), Commodity Futures Trading Commission (CFTC), Defense, Dept of (DOD), Education, Dept of, Energy, Dept of, Environmental Protection Agency (EPA), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Federal Deposit Insurance Corporation (FDIC), Federal Highway Administration (FHA), Federal Reserve System, Federal Trade Commission (FTC), Federal Transit Administration (FTA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Interior, Dept of (DOI), Justice, Dept of (DOJ), Labor, Dept of (DOL), Maritime Administration (MARAD), Natl Economic Council (NEC), Natl Institute of Standards & Technology (NIST), Natl Labor Relations Board (NLRB), Natl Security Council (NSC), Office of Management & Budget (OMB), Patent & Trademark Office (PTO), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Small Business Administration (SBA), State, Dept of (DOS), Transportation Security Administration (TSA), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Copyright Office, U.S. Customs & Border Protection, U.S. Trade Representative (USTR), White House Office

**see addendum page PL 111-148 - The Patient Protection and Affordable Care Act, PL 111-152 - The Reconciliation Act of 2010, Sections of Health Care Reform legislation pertaining to proposed annual insurer assessments, and proposed excise tax on high-value health insurance plans S. 1049/H.R. 2676 - Small Business Health Relief Act, insurer excise tax H.R.1370 - to repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act S. 1880 the Jobs and Premium Protection Act, insurer excise tax

Client expense: Not reported · Firm income: $70,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, White House Office

**see addendum page PL 111-148 - The Patient Protection and Affordable Care Act, implementation H.R. 1206 - Access to Professional Health Insurance Advisors Act of 2011, MLR Broker Fee H.R. 371 - Health Care Choice Act of 2011, selling insurance across state lines S. 1049/H.R. 2676 - Small Business Health Relief Act, insurer excise tax H.R.1370 - to repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act S. 1880 - the Jobs and Premium Protection Act, insurer excise tax ***, no specific bill(s), Health Savings Accounts/Medical Savings Accounts, Transparency, Health Information Technology, Electronic Prescribing, Insurance Market Reform, Uninsured, Employer Based Health System, Health Care Reform, Small Group Market Reform, Exchanges, Health Care Reform Implementation, Medical Loss Ratios

Client expense: Not reported · Firm income: $70,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, White House Office

**see addendum page PL 111-148 - The Patient Protection and Affordable Care Act, PL 111-152 - The Reconciliation Act of 2010, Sections of Health Care Reform legislation pertaining to proposed annual insurer assessments, and proposed excise tax on high-value health insurance plans S. 1049/H.R. 2676 - Small Business Health Relief Act, insurer excise tax H.R.1370 - to repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act S. 1880 the Jobs and Premium Protection Act, insurer excise tax ***, no specific bill, IRC Section 833(b) tax provisions

Client expense: Not reported · Firm income: $100,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

**see addendum page PL 111-148 - The Patient Protection and Affordable Care Act, implementation, health care reform H.R. 1206 - Access to Professional Health Insurance Advisors Act of 2011, MLR Broker Fee H.R. 371 - Health Care Choice Act of 2011, selling insurance across state lines S. 1049/H.R. 2676 - Small Business Health Relief Act, insurer excise tax H.R.1370 - to repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act S. 1880 - the Jobs and Premium Protection Act, insurer excise tax ***, no specific bill(s), Health Savings Accounts/Medical Saving Accounts, Transparency, Health Information Technology, Electronic Prescribing, Insurance Market Reform, Government Plan Option, Uninsured, Employer Based Health System, Health Care Reform, Small Group Market Reform, Exchanges, Health Care Reform Implementation, Medical Loss Rates, Federal Employees' Health Benefits Program (FEHBP)

Client expense: Not reported · Firm income: $100,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

Insurance reforms; Health care reform implementation (PL 111-148, The Patient Protection and Affordable Care Act, became law on 323/10) Budget Control Act of 2011 (Became PL 112-25 on August 2, 2011), Implementation S. 1880, The Jobs and Premium Protection Act of 2011. H.R. 2676, The Small Business Health Relief Act of 2011.

Client expense: Not reported · Firm income: $70,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Health reform implementation, including Section 833 of Internal Revenue Code and health insurance regulation. S. 1880, The Jobs and Premium Protection Act of 2011. H.R. 2676, The Small Business Health Relief Act of 2011 Affordable Care Act provisions affecting Section 833 of the Internal Revenue Code

Client expense: Not reported · Firm income: $40,000

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, SENATE

Health reform implementation, including Section 833 of Internal Revenue Code and health insurance regulation. Modifications to ACA provisions affecting treatment of Section 833 of the tax code S. 1880, The Jobs and Premium Protection Act of 2011. H.R. 2676, The Small Business Health Relief Act of 2011

Client expense: Not reported · Firm income: $40,000

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, SENATE

Issues relating to H.R. 1370, S. 1049, H.R. 2676, S. 1880, and other issues affecting small business as a result of implementation of the Patient Protection and Affordable Care Act

Client expense: Not reported · Firm income: $20,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues relating to H.R. 1370, S. 1049, H.R. 2676, S. 1880, and other issues affecting small business as a result of implementation of the Patient Protection and Affordable Care Act

Client expense: Not reported · Firm income: Not reported

H.R. 2 Repealing the Job-Killing Health Care Law Act; H.R. 4 Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act; H.R. 1063 Strengthening Medicare and Repaying Taxpayers Act; S. 18 Small Business Paperwork Mandate Elimination Act; S. 19 American Liberty Restoration Act; S. 20/H.R. 1744 American Job Protection Act; Affordable Care Act, all provisions; S. 192 Repealing the Job-Killing Health Care Law Act; S. 312 Patients Freedom to Choose Act; Health Care Reform; Health Care Mandate Penalties; Employer/Employee Flexibility; Consumer-Directed Health Care; Health Insurance Exchanges; Medicare Secondary Payer Judgments; Comments on FDA's Suggested Questions & Answers for the Final Patient Protection & Affordable Care Act Section 4205 Guidance; Comments on IRS' "Shared Responsibility for Employers Regargding Health Care Coverage (IRC Sec. 1513)"; H.R.1370, To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act, all provisions; H.R.2077, MLR Repeal Act of 2011, all provisions; S.1098, Family and Retirement Health Investment Act of 2011, all provisions; H.R.5/S.1099, Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011, all provisions; H.R.1206, Access to Professional Health Insurance Advisors Act of 2011, all provisions; Summary of Benefit NRPM; Comments regarding employer interactions with insurance exchanges, health premium tax credits, and development of an affordability safe harbor for employers; S.1880, Jobs and Premium Protection Act, all provisions; S.1049/H.R. 2676, Small Business Health Relief Act of 2011, all provisions; H.R.2206, Auto Enroll Repeal Act, all provisions.; H.R. 6079, Repeal of Obamacare Act, all provisions.

Client expense: $820,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Environmental Protection Agency (EPA), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Federal Deposit Insurance Corporation (FDIC), Federal Motor Carrier Safety Administration, Federal Reserve System, Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Interior, Dept of (DOI), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Labor Relations Board (NLRB), Natl Telecommunications & Information Administration (NTIA), SENATE, Securities & Exchange Commission (SEC), Small Business Administration (SBA), State, Dept of (DOS), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Customs & Border Protection, U.S. International Trade Commission (ITC), U.S. Trade Representative (USTR), White House Office

- Bills related to the Affordable Care Act. - Legislative ideas for addressing health care costs & financing. - H.R. 1370, a bill to repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act, regarding all provisions. - S.1880, Jobs and Premium Protection Act, regarding all provisions. - S.1049/H.R. 2676 The Small Business Health Relief Act, regarding all provisions.

Client expense: $440,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Treasury, Dept of, White House Office

- Legislative ideas for addressing health care costs, financing & dual eligible demonstration programs. - H.R. 1370, "A bill to repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act", regarding all provisions. - S.1049/H.R. 2676 "The Small Business Health Relief Act", regarding all provisions. - H.R. 5979, "Medicaid Accountability and Care Act", regarding all provisions

Client expense: $440,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Treasury, Dept of, White House Office

- H. R. 1370, "To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act.", regarding all provisions. - S.1049/H.R. 2676 "The Small Business Health Relief Act", regarding all provisions. - S.1880, "Jobs and Premium Protection Act", regarding all provisions.

Client expense: $440,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Treasury, Dept of, White House Office

**see addendum page PL 111-148 - The Patient Protection and Affordable Care Act, implementation H.R. 1206 - Access to Professional Health Insurance Advisors Act of 2011, MLR Broker Fee H.R. 371 - Health Care Choice Act of 2011, selling insurance across state lines S. 1049/H.R. 2676 - Small Business Health Relief Act, insurer excise tax H.R.1370 - to repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act S. 1880 - the Jobs and Premium Protection Act, insurer excise tax S. 3187 - The Food and Drug Administration Safety and Innovation Act, e-prescribing ***, no specific bill(s), Health Savings Accounts/Medical Savings Accounts, Transparency, Health Information Technology, Electronic Prescribing, Insurance Market Reform, Uninsured, Employer Based Health System, Health Care Reform, Small Group Market Reform, Exchanges, Health Care Reform Implementation, Medical Loss Ratios

Client expense: Not reported · Firm income: $70,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, White House Office

**see addendum page PL 111-148 - The Patient Protection and Affordable Care Act, PL 111-152 - The Reconciliation Act of 2010, Sections of Health Care Reform legislation pertaining to proposed annual insurer assessments, and proposed excise tax on high-value health insurance plans S. 1049/H.R. 2676 - Small Business Health Relief Act, insurer excise tax H.R.1370 - to repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act S. 1880 the Jobs and Premium Protection Act, insurer excise tax

Client expense: Not reported · Firm income: $70,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, White House Office

H.R. 5, HEALTH Act (Gingrey) - IPAB repeal, medical liability reform, McCarran-Ferguson. H.R. 452, Medicare Decisions Accountability Act (Roe) - IPAB repeal, medical liability reform, McCarran-Ferguson. H.R.611 -- BEST PRACTICES Act (Rush) - data security. H.R. 1173, Fiscal Responsibility and Retirement Security Act (Boustany) - National Clearinghouse for LTC Information. H.R. 1409, Quality Health Care Coalition Act (Conyers) - antitrust exemption for physicians. H.R. 1707, Data Accountability and Trust Act (Rush) - data security. H.R. 1841, Data Accountability and Trust Act (Stearns) - data security. H.R. 2576, (Black) - eligibility for health care assistance. H.R. 2577, Secure and Fortify Electronic Data Act (Bono Mack) - data security. H.R. 2676, Small Business Health Relief Act (Schweikert) - repeal of premium tax and other ACA provisions. H.R. 5800, Health Care Price Transparency Promotion Act (Burgess) - price transparency. H.R. 5909, Comprehensive Dental Reform Act (Cummings) - expanded access to dental services. Labor, HHS, Education Appropriations Act (Rehburg) - funding for HHS programs and agencies. H.J.Res. 17, Continuing Appropriations Resolution (Rogers) - temporary appropriations for FY 2013. S. 1049, Small Business Health Relief Act (Kyl) - repeal of premium tax and other ACA provisions. S. 1099, HEALTH Act (Blunt) - medical liability reform. S. 1151, Personal Data Privacy and Security Act (Leahy) - privacy, data security. S. 1207, Data Security and Breach Notification Act (Pryor) - data security. S. 1408, Data Breach Notification Act (Feinstein) - data security. S. 1535, Personal Data Protection and Breach Accountability Act (Blumenthal) - data security. S. 1789, 21st Century Postal Service Act (Lieberman) -- health benefits for postal employees. S. 2111, Cyber Crime Protection Security Act (Leahy) - privacy. S. 3272, Comprehensive Dental Reform Act (Sanders) - expanded access to dental services. S. 3295, Labor, HHS, Education Appropriations Act (Harkin) - funding for HHS programs and agencies, ACA related amendments. S. 3333, Data Security and Breach Notification Act (Toomey) - data security. S. 3351, Protect Our Health Privacy Act (Franken) - privacy. S. 3414, Cybersecurity Act (Lieberman) - privacy, data security. S. 3432 Identity Theft and Tax Fraud Prevention Act (Nelson/Coburn) - privacy.

Client expense: Not reported · Firm income: $60,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 2, Repealing the Job-Killing Health Care Law Act H.R. 4, Small Business Paperwork Mandate Elimination Act of 2011 H.R. 5, Protecting Access to Healthcare Act H.R. 436, Health Care Cost Reduction Act of 2012 H.R. 450, Restoring Assistance for Families and Seniors Health Expenses Act of 2011 H.R. 452, Medicare Decisions Accountability Act of 2011 H.R. 605 / S. 312, Patients Freedom to Choose Act H.R. 1051, Medicare Beneficiary Freedom to Choose Act of 2011 H.R. 1173, Fiscal Responsibility and Retirement Security Act of 2011 H.R. 1370, To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act H.R. 1744 / S. 20, American Job Protection Act H.R. 2010, Family and Retirement Health Investment Act of 2011 H.R. 2077, MLR Repeal Act of 2011 H.R. 2112, Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, Vitter Amendment (#769 - prescription drug reimportation) H.R. 2529, Restoring Access to Medication Act H.R. 2590, Seniors Protection Act of 2011 H.R. 2676, Small Business Health Relief Act of 2011 H.R. 3487, Job Creation Act of 2011 H.R. 3682, Patient Centered Healthcare Savings Act of 2011 H.R. 4095 / S. 2002, Online Pharmacy Safety Act H.R. 4626, Health Insurance Fair Competition Act H.R. 5141/S. 3578, Small Business Paperwork Mandate Elimination Act H.R. 5651, Food and Drug Administration Reform Act of 2012 H.R. 5842, Restoring Access to Medication Act of 2012 H.R. 5853, Fiscal Responsibility and Retirement Security Act H.R. 6048, Healthcare Tax Relief and Mandate Repeal Act H.R. 6079, Repeal of Obamacare Act S. 17, Medical Device Access and Innovation Protection Act S. 20, American Job Protection Act S. 223, FAA Air Transportation Modernization and Safety Improvement Act, including the Amendment offered by Senator McConnell to repeal P.L. 111-148, the Patient Protection and Affordable Care Act and an Amendment offered by Senator Stabenow which would repeal Section 9006 of the Patient Protection and Affordable Care Act S. 493, SBIR/STTR Reauthorization Act of 2011, including an Amendment offered by Senator Johanns which would fully repeal Section 9006 of the Patient Protection and Affordable Care Act and Amendment Number 197 offered by Senator Hutchison S. 510, FDA Food Safety Modernization Act, issues related to 1099 reporting amendments S. 668, Health Care Bureaucrats Elimination Act S. 720, Repeal the CLASS Entitlement Act S. 848, Consumer Information Enhancement Act of 2011 S. 1049, Small Business Health Relief Act of 2011 S. 1098, Family and Retirement Health Investment Act of 2011 S. 1368, Restoring Access to Medication Act S. 1880, Jobs and Premium Protection Act S. 2068, Access to Independent Health Insurance Advisors Act of 2012 S. 3187, Food and Drug Administration Safety and Innovation Act S. 3501, American Job Protection Act S. 3673, Patients Freedom Choice Act Filed comments and met with relevant agencies on regulations implementing health care reform (P.L. 111-148 and P.L. 111-152) Notice of Proposed Rulemaking and Notice of Public Hearing Regarding Fees on Health Insurance Policies and Self-Insured Plans for the Patient-Centered Outcomes Research Trust Fund (77 Fed. Reg. 22691-22706, Apr. 17, 2012) Notice and Request for Comments on Minimum Value of an Employer-Sponsored Plan (Notice 2012-31, Apr. 26, 2012) Request for Information Regarding Stop Loss Coverage (77 Fed. Reg. 25788-25790, May 1, 2012) Notice and Request for Comments on Reporting of Health Insurance Coverage (Notice 2012-32, May 14, 2012) Notice and Request for Comments on Reporting by Applicable Large Employers on Health Insurance Coverage Under Employer-Sponsored Plans (Notice 2012-33, May 14, 2012) Final Regulations on Health Insurance Premium Tax Credit (77 Fed. Reg. 30377-30400, May 23, 2012 (to be codified at 26 C.F.R. pts 1 and 602)) Notice and Request for Comments on Health Flexible Spending Arrangements (Notice 2012-40, May 30, 2012) Notice and Request for Comments on the Guidance on 90-Day Waiting Period Limitation (DOL Technical Release 2012-02, Aug. 31, 2012) Notice and Request for Comments on Determining Full-Time Employees For Purposes of Shared Responsibility for Employers Regarding Health Coverage (Notice 2012-58, Aug. 31, 2012) Various issues relating to the implementation of the Patient Protection and Affordable Care Act (P.L. 111-148), including implementation of regulatory process, legislative corrections, coverage, financing, delivery reform, 1099 reporting, grandfathering, CMS claims database, IPAB, CLASS program, employer mandate, medical loss ratio, mandated insurance requirements, medical malpractice reform, exchanges, Medicare reform, regulatory reform, essential health benefits package, health insurance tax, medical device tax, flexible spending accounts and health savings accounts, cost impact analyses, lack of quantified benefit analysis, and the need for empirical data sources on which to base cost and benefits; regulatory process and legislative corrections to Health Care and Education Affordability Reconciliation Act of 2010 (P.L. 111-152), including ERISA preemption and the impact on small business

Client expense: $31,650,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Commerce, Dept of (DOC), Commodity Futures Trading Commission (CFTC), Defense, Dept of (DOD), Education, Dept of, Energy, Dept of, Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Federal Highway Administration (FHA), Federal Reserve System, Federal Trade Commission (FTC), Federal Transit Administration (FTA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Interior, Dept of (DOI), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Maritime Administration (MARAD), Natl Economic Council (NEC), Natl Institute of Standards & Technology (NIST), Natl Labor Relations Board (NLRB), Natl Security Council (NSC), Office of Management & Budget (OMB), Office of the Vice President of the United States, Patent & Trademark Office (PTO), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Small Business Administration (SBA), State, Dept of (DOS), Transportation Security Administration (TSA), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Copyright Office, U.S. Customs & Border Protection, U.S. Trade Representative (USTR), White House Office

H.R. 5, HEALTH Act (Gingrey) IPAB repeal, medical liability reform, McCarran-Ferguson; 16. Specific Lobbying Issues (continued): H.R. 452, Medicare Decisions Accountability Act (Roe) IPAB repeal, medical liability reform, McCarran-Ferguson H.R.611 -- BEST PRACTICES Act (Rush) data security H.R. 1173, Fiscal Responsibility and Retirement Security Act (Boustany) National Clearinghouse for LTC Information H.R. 1409, Quality Health Care Coalition Act (Conyers) antitrust exemption for physicians H.R. 1707, Data Accountability and Trust Act (Rush) data security H.R. 1841, Data Accountability and Trust Act (Stearns) data security H.R. 2576, (Black) eligibility for health care assistance H.R. 2577, Secure and Fortify Electronic Data Act (Bono Mack) data security H.R. 2676, Small Business Health Relief Act (Schweikert) repeal of premium tax and other ACA provisions H.R. 5800, Health Care Price Transparency Promotion Act (Burgess) price transparency H.R. 5909, Comprehensive Dental Reform Act (Cummings) expanded access to dental services Labor, HHS, Education Appropriations Act (Rehburg) funding for HHS programs and agencies H.J.Res. 17, Continuing Appropriations Resolution (Rogers) temporary appropriations for FY 2013 S. 1049, Small Business Health Relief Act (Kyl) repeal of premium tax and other ACA provisions S. 1099, HEALTH Act (Blunt) medical liability reform S. 1151, Personal Data Privacy and Security Act (Leahy) privacy, data security S. 1207, Data Security and Breach Notification Act (Pryor) data security S. 1408, Data Breach Notification Act (Feinstein) data security S. 1535, Personal Data Protection and Breach Accountability Act (Blumenthal) data security S. 1789, 21st Century Postal Service Act (Lieberman) -- health benefits for postal employees S. 2111, Cyber Crime Protection Security Act (Leahy) privacy S. 3272, Comprehensive Dental Reform Act (Sanders) expanded access to dental services S. 3295, Labor, HHS, Education Appropriations Act (Harkin) funding for HHS programs and agencies, ACA related amendments S. 3333, Data Security and Breach Notification Act (Toomey) data security S. 3351, Protect Our Health Privacy Act (Franken) privacy S. 3414, Cybersecurity Act (Lieberman) privacy, data security S. 3432 Identity Theft and Tax Fraud Prevention Act (Nelson/Coburn) privacy Regulatory Issues: HIPAA administrative simplification issues, including standards for privacy, security, and electronic transactions and code sets, identifiers including the health plan identifier, enforcement; FEHBP enrollment data clearinghouse initiative, the enrollment reconciliation process, and a related OPM reimbursement factor for records that cannot be reconciled; issues relating to health insurance plan participation in FEHBP, including contract requirements; transition from the similarly sized subscriber group (SSSG) requirement to an MLR; OPM data warehouse; implementation of the health savings account provisions of the Medicare Act; issues related to Medicare Secondary Payer requirements; issues related to implementation of the National Health Information Infrastructure; electronic health records, personal health records, and similar technologies; issues relating to market consolidation; issues relating to quality improvement; issues related to potential priority research topics for the effective health care program; issues relating to the national health data stewardship; issues relating to hospital outpatient measurement and reporting; issues relating to data breach requirements; issues relating to "meaningful use" requirements for health information technology; issues related to the collection of race and ethnicity data; issues related to medical loss ratios; review of rates for reasonableness; health insurance exchanges; preexisting condition insurance plans; accountable care organizations; coverage of preventive services; contraceptive coverage; pre-existing condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; issues related to privacy, security, and other regulation of the Internet and electronic commerce; issues relating to the annual fee on health insurance providers; health plan automatic enrollment requirements; health insurance web portal requirements; dependent coverage; summary of benefits and coverage disclosures; and other issues relating to health care reform implementation.

Client expense: $2,630,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Federal Bureau of Investigation (FBI), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Pension & Welfare Benefits Administration, SENATE, Treasury, Dept of, White House Office

H.R.1370, To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act; S.1049/H.R.2676, Small Business Health Relief Act of 2011; S.1880, Jobs and Premium Protection Act; Issues affecting small business as a result of implementation of the Patient Protection and Affordable Care Act.

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Insurance reforms; Health care reform implementation. Budget Control Act of 2011 (Became PL 112-25 on August 2, 2011), Implementation S. 1880, The Jobs and Premium Protection Act of 2011. H.R. 2676, The Small Business Health Relief Act of 2011.

Client expense: Not reported · Firm income: $70,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

**see addendum page PL 111-148 - The Patient Protection and Affordable Care Act, implementation, health care reform H.R. 1206 - Access to Professional Health Insurance Advisors Act of 2011, MLR Broker Fee H.R. 371 - Health Care Choice Act of 2011, selling insurance across state lines S. 1049/H.R. 2676 - Small Business Health Relief Act, insurer excise tax H.R.1370 - to repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act S. 1880 - the Jobs and Premium Protection Act, insurer excise tax ***, no specific bill(s), Health Savings Accounts/Medical Saving Accounts, Transparency, Health Information Technology, Electronic Prescribing, Insurance Market Reform, Government Plan Option, Uninsured, Employer Based Health System, Health Care Reform, Small Group Market Reform, Exchanges, Health Care Reform Implementation, Medical Loss Rates, Federal Employees' Health Benefits Program (FEHBP)

Client expense: Not reported · Firm income: $100,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

**see addendum page PL 111-148 - The Patient Protection and Affordable Care Act, PL 111-152 - The Reconciliation Act of 2010, Sections of Health Care Reform legislation pertaining to proposed annual insurer assessments, and proposed excise tax on high-value health insurance plans S. 1049/H.R. 2676 - Small Business Health Relief Act, insurer excise tax H.R.1370 - to repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act S. 1880 the Jobs and Premium Protection Act, insurer excise tax

Client expense: Not reported · Firm income: $100,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

Health reform implementation, health plan taxation, insurance regulation. Modifications to ACA provisions affecting treatment of Section 833 of the tax code S. 1880, The Jobs and Premium Protection Act of 2011. H.R. 2676, The Small Business Health Relief Act of 2011

Client expense: Not reported · Firm income: $40,000

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, SENATE

Health reform implementation, health plan taxation, insurance regulation. S. 1880, The Jobs and Premium Protection Act of 2011. H.R. 2676, The Small Business Health Relief Act of 2011 Affordable Care Act provisions affecting Section 833 of the Internal Revenue Code

Client expense: Not reported · Firm income: $40,000

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, SENATE

- Bills related to the Affordable Care Act. - Legislative ideas for addressing health care costs & financing. - H.R. 1370, a bill to repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act, regarding all provisions. - S.1880, Jobs and Premium Protection Act, regarding all provisions. - S.1049/H.R. 2676 The Small Business Health Relief Act, regarding all provisions.

Client expense: $480,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Treasury, Dept of, White House Office

- Legislative ideas for addressing health care costs, financing & dual eligible demonstration programs. - H.R. 1370, "A bill to repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act", regarding all provisions. - S.1880, "Jobs and Premium Protection Act", regarding all provisions. - S.1049/H.R. 2676 "The Small Business Health Relief Act", regarding all provisions. - H.R. 5979, "Medicaid Accountability and Care Act", regarding all provisions

Client expense: $480,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Treasury, Dept of, White House Office

- H. R. 1370, "To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act.", regarding all provisions. - S.1049/H.R. 2676 "The Small Business Health Relief Act", regarding all provisions. - S.1880, "Jobs and Premium Protection Act", regarding all provisions.

Client expense: $480,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Treasury, Dept of, White House Office

H.R. 5, HEALTH Act (Gingrey) IPAB repeal, medical liability reform, McCarran-Ferguson 16. Specific Lobbying Issues (continued): H.R. 452, Medicare Decisions Accountability Act (Roe) IPAB repeal, medical liability reform, McCarran-Ferguson H.R.611, BEST PRACTICES Act (Rush) data security H.R. 1173, Fiscal Responsibility and Retirement Security Act (Boustany) National Clearinghouse for LTC Information H.R. 1409, Quality Health Care Coalition Act (Conyers) antitrust exemption for physicians H.R. 1707, Data Accountability and Trust Act (Rush) data security H.R. 1841, Data Accountability and Trust Act (Stearns) data security H.R. 2576, (Black) eligibility for health care assistance H.R. 2577, Secure and Fortify Electronic Data Act (Bono Mack) data security H.R. 2676, Small Business Health Relief Act (Schweikert) repeal of premium tax and other ACA provisions H.R. 5652, Sequester Replacement Reconciliation Act (Ryan) ACA provisions, deficit reduction proposals H.R. 5800, Health Care Price Transparency Promotion Act (Burgess) price transparency H.R. 5909, Comprehensive Dental Reform Act (Cummings) expanded access to dental services S. 1049, Small Business Health Relief Act (Kyl) repeal of premium tax and other ACA provisions S. 1099, HEALTH Act (Blunt) medical liability reform S. 1151, Personal Data Privacy and Security Act (Leahy) privacy, data security S. 1207, Data Security and Breach Notification Act (Pryor) data security S. 1408, Data Breach Notification Act (Feinstein) data security S. 1535, Personal Data Protection and Breach Accountability Act (Blumenthal) data security S. 1789, 21st Century Postal Service Act (Lieberman) -- health benefits for postal employees S. 2111, Cyber Crime Protection Security Act (Leahy) privacy S. 3272, Comprehensive Dental Reform Act (Sanders) expanded access to dental services S. 3295, Labor, HHS, Education Appropriations Act (Harkin) funding for HHS programs and agencies, ACA related amendments S. 3333, Data Security and Breach Notification Act (Toomey) data security S. 3351, Protect Our Health Privacy Act (Franken) privacy Regulatory Issues: HIPAA administrative simplification issues, including standards for privacy, security, and electronic transactions and code sets, identifiers including the health plan identifier, enforcement; FEHBP enrollment data clearinghouse initiative, the enrollment reconciliation process, and a related OPM reimbursement factor for records that cannot be reconciled; issues relating to health insurance plan participation in FEHBP, including contract requirements; transition from the similarly sized subscriber group (SSSG) requirement to an MLR; OPM data warehouse; implementation of the health savings account provisions of the Medicare Act; issues related to Medicare Secondary Payer requirements; issues related to implementation of the National Health Information Infrastructure; electronic health records, personal health records, and similar technologies; issues relating to market consolidation; issues relating to quality improvement; issues related to potential priority research topics for the effective health care program; issues relating to the national health data stewardship; issues relating to hospital outpatient measurement and reporting; issues related to genetics and genetic nondiscrimination; issues relating to data breach requirements; issues relating to "meaningful use" requirements for health information technology; issues related to the collection of race and ethnicity data; issues related to medical loss ratios; review of rates for reasonableness; health insurance exchanges; preexisting condition insurance plans; accountable care organizations; coverage of preventive services; contraceptive coverage; pre-existing condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; issues related to privacy, security, and other regulation of the Internet and electronic commerce; issues relating to the annual fee on health insurance providers; health plan automatic enrollment requirements; health insurance web portal requirements; dependent coverage; summary of benefits and coverage disclosures; and other issues relating to health care reform implementation.

Client expense: $2,240,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Federal Bureau of Investigation (FBI), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Pension & Welfare Benefits Administration, SENATE, Treasury, Dept of, White House Office

H.R.1370, To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act; S.1049/H.R.2676, Small Business Health Relief Act of 2011; S.1880, Jobs and Premium Protection Act; Issues affecting small business as a result of implementation of the Patient Protection and Affordable Care Act.

Client expense: Not reported · Firm income: $60,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 2, Repealing the Job-Killing Health Care Law Act H.R. 4, Small Business Paperwork Mandate Elimination Act of 2011 H.R. 5, Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 H.R. 436, Protect Medical Innovation Act of 2011 H.R. 450, Restoring Assistance for Families and Seniors Health Expenses Act of 2011 H.R. 452, Medicare Decisions Accountability Act H.R. 605 / S. 312, Patients Freedom Choose Act H.R. 1051, Medicare Beneficiary Freedom to Choose Act of 2011 H.R. 1173 / S. 720, Fiscal Responsibility and Retirement Security Act of 2011 H.R. 1370 / S.1880, To repeal the annual fee on health insurance providers enacted by the Patient H.R. 1744 / S. 20, American Job Protection Act Protection and Affordable Care Act H.R. 2010, Family and Retirement Health Investment Act of 2011 H.R. 2077, MLR Repeal Act H.R. 2112, Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, Vitter Amendment (#769 - prescription drug reimportation) H.R. 2529 / S. 1368, Restoring Access to Medication Act H.R. 2590, Seniors Protection Act of 2011 H.R. 2676, Small Business Health Relief Act of 2011H.R. 4095 / S. 2002, The Online Pharmacy Safety Act H.R. 3682, Patient Centered Healthcare Savings Act of 2011 H.R. 4095 / S. 2002, Online Pharmacy Safety Act H.R. 4626, Health Insurance Fair Competition Act H.R. 5141/S. 3578, Small Business Paperwork Mandate Elimination Act H.R. 5842 / S.1368, Restoring Access to Medication Act H.R. 5858, Health Savings Accounts Improvements Act of 2012 H.R. 5651, Food and Drug Administration Reform Act of 2012 H.R. 5853, Fiscal Responsibility and Retirement Security Act S. 1049, Small Business Health Relief Act S. 17, Medical Device Access and Innovation Protection Act S. 223, FAA Air Transportation Modernization and Safety Improvement Act, including the Amendment offered by Senator McConnell to repeal P.L. 111-148, the Patient Protection and Affordable Care Act and an Amendment offered by Senator Stabenow which would repeal Section 9006 of the Patient Protection and Affordable Care Act S. 312, Patients Freedom to Choose Act S. 493, SBIR/STTR Reauthorization Act of 2011, including an Amendment offered by Senator Johanns which would fully repeal Section 9006 of the Patient Protection and Affordable Care Act and Amendment Number 197 offered by Senator Hutchison S. 510, FDA Food Safety Modernization Act, issues related to 1099 reporting amendments S. 668, Health Care Bureaucrats Elimination Act S. 720, Repeal the CLASS Entitlement Act S. 848, Consumer Information Enhancement Act of 2011 S. 1049, Small Business Health Relief Act S. 1098, Family and Retirement Health Investment Act of 2011 S. 1880, Jobs and Premium Protection Act S. 2068, Access to Independent Health Insurance Advisors Act of 2012 S. 2516, Food and Drug Administration Safety and Innovation Act including amendments related to company market exclusivity S. 3187, Food and Drug Administration Safety and Innovation Act including amendments related to company market exclusivity S. 3501, American Job Protection Act S. 3673, Patients Freedom Choice Act Filed comments and met with relevant agencies on regulations implementing health care reform (P.L. 111-148 and P.L. 111-152) Regulations commented on include: Medical Loss Ratio (MLR) Request for Information; Adult Child Coverage (Age 26) Interim Final Rule; Grandfathered Plan Status Interim Final Rule; Preexisting Condition Exclusion; Lifetime & Annual Limits; Rescissions; Patient Protections Interim Final Rule; Preventive Services Coverage Interim Final Rule; Internal Claims & Appeals and External Review Processes Interim Final Rule; Preexisting Condition Insurance Plan (PCIP) Interim Final Rule; 1099 Reporting Requirements Request for Comments; Planning and Establishment of State-level Exchanges Request for Comments; Non-Discrimination in Favor of Highly Compensated Individuals Request for Comments; Essential Health Benefits (IOM Study); Amended Interim Final Rule for Grandfathered Plan Status; Guidance on OTC Medicine & Definition of Medical Expenses; Development of Health Risk Assessment; Medical Loss Ratio; Nondiscrimination in favor of Highly Compensated Individuals - second notice re: timing; DOL: Retrospective Review Under E.O. 13563; Treasury: Retrospective Review Under E.O. 13563; State Innovation Waivers; ACOs & Medicare Shared Savings Program; Shared Responsibility for Employers Regarding Health Coverage (Section 4980H); Amendment to the Interim Final Rule on Internal Claims and Appeals and External Review Processes; HIPAA Privacy Rule Accounting of Disclosures; Medical Data Sharing. Summary of benefits and Coverage and the Uniform Glossary; Exchange Functions in the Individual market; Health Insurance Premium Tax Credit; Establishment of Exchanges and Qualified Health Plans; Health Coverage Affordability Safe Harbor for Employers; Medical Loss Ratio (MLR) Requirements Final Rule; Medical Loss Ratio (MLR) Notice of Rebate Forms; Essential Health Benefits Bulletin - Response to Request for Comments; Establishment of Exchanges and Qualified Health Plans / Exchange Standards for Employers Final Rule and Interim Final Rule; FAQs from Employers Regarding Automatic Enrollment, Employer Shared Responsibility, and Waiting Periods Request for Comments; Notice 2012-31 Minimum Value of an Employer-Sponsored Plan Request for Comments; Notice 2012-32 Reporting of Health Insurance Coverage Request for Comments; Notice 2012-33 Reporting by Applicable Large Employers on Health Insurance Coverage Under Employer-Sponsored Plans Request for Comments. Comprehensive health reform (bills in the Senate and House) including all aspects relating to coverage, financing, and delivery reform, including: 1099 reporting, Grandfathering, HSA and FSA changes, CMS claims database, IPAB, CLASS Act, employer mandate, medical loss ratio, mandated insurance requirements, Exchanges, Medicare reform, regulatory reform, Essential Health Benefits Package, Health Insurance Tax, and the Medical Device Tax Various issues relating to the Patient Protection and Affordable Care Act (P.L. 111-148), including implementation of regulatory process, legislative corrections, coverage, financing, delivery reform, 1099 reporting, grandfathering, HSA and FSA changes, CMS claims database, IPAB, CLASS program, employer mandate, medical loss ratio, medical malpractice reform, exchanges, and flexible spending accounts and health savings accounts; regulatory process and legislative corrections to Health Care and Education Affordability Reconciliation Act of 2010 (P.L. 111-152) including ERISA preemption and the impact on small business; importation of foreign pharmaceuticals into the United States

Client expense: $22,520,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Commerce, Dept of (DOC), Commodity Futures Trading Commission (CFTC), Defense, Dept of (DOD), Education, Dept of, Energy, Dept of, Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Federal Deposit Insurance Corporation (FDIC), Federal Highway Administration (FHA), Federal Reserve System, Federal Transit Administration (FTA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Interior, Dept of (DOI), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Economic Council (NEC), Natl Labor Relations Board (NLRB), Natl Security Council (NSC), Office of Management & Budget (OMB), Office of the Comptroller of the Currency (OCC), Patent & Trademark Office (PTO), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Small Business Administration (SBA), State, Dept of (DOS), Transportation Security Administration (TSA), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Copyright Office, U.S. Customs & Border Protection, U.S. Trade Representative (USTR), White House Office

H.R. 5, HEALTH Act (Gingrey) - IPAB repeal, medical liability reform, McCarran-Ferguson H.R. 452, Medicare Decisions Accountability Act (Roe) - IPAB repeal, medical liability reform, McCarran-Ferguson H.R.611 -- BEST PRACTICES Act (Rush) - data security H.R. 1173, Fiscal Responsibility and Retirement Security Act (Boustany) - National Clearinghouse for LTC Information H.R. 1409, Quality Health Care Coalition Act (Conyers) - antitrust exemption for physicians H.R. 1707, Data Accountability and Trust Act (Rush) - data security H.R. 1841, Data Accountability and Trust Act (Stearns) - data security H.R. 2576, (Black) - eligibility for health care assistance H.R. 2577, Secure and Fortify Electronic Data Act (Bono Mack) - data security H.R. 2676, Small Business Health Relief Act (Schweikert) - repeal of premium tax and other ACA provisions H.R. 5652, Sequester Replacement Reconciliation Act (Ryan) - ACA provisions, deficit reduction proposals H.R. 5800, Health Care Price Transparency Promotion Act (Burgess) - price transparency H.R. 5909, Comprehensive Dental Reform Act (Cummings) - expanded access to dental services S. 1049, Small Business Health Relief Act (Kyl) - repeal of premium tax and other ACA provisions S. 1099, HEALTH Act (Blunt) - medical liability reform S. 1151, Personal Data Privacy and Security Act (Leahy) - privacy, data security S. 1207, Data Security and Breach Notification Act (Pryor) - data security S. 1408, Data Breach Notification Act (Feinstein) - data security S. 1535, Personal Data Protection and Breach Accountability Act (Blumenthal) - data security S. 1789, 21st Century Postal Service Act (Lieberman) -- health benefits for postal employees S. 2111, Cyber Crime Protection Security Act (Leahy) - privacy S. 3272, Comprehensive Dental Reform Act (Sanders) - expanded access to dental services S. 3295, Labor, HHS, Education Appropriations Act (Harkin) - funding for HHS programs and agencies, ACA related amendments S. 3333, Data Security and Breach Notification Act (Toomey) - data security S. 3351, Protect Our Health Privacy Act (Franken) - privacy

Client expense: Not reported · Firm income: $60,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 2 Repealing the Job-Killing Health Care Law Act; HR 4 Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act; HR 1063 Strengthening Medicare and Repaying Taxpayers Act; S. 18 Small Business Paperwork Mandate Elimination Act; S. 19 American Liberty Restoration Act; S. 20/H.R. 1744 American Job Protection Act; Affordable Care Act, all provisions; S. 192 Repealing the Job-Killing Health Care Law Act; S. 312 Patients Freedom to Choose Act; Health Care Reform; Health Care Mandate Penalties; Employer/Employee Flexibility; Consumer-Directed Health Care; Health Insurance Exchanges; Medicare Secondary Payer Judgments; Comments on FDA's Suggested Questions & Answers for the Final Patient Protection & Affordable Care Act Section 4205 Guidance; Comments on IRS' "Shared Responsibility for Employers Regargding Health Care Coverage (IRC Sec. 1513)"; H.R.1370, To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act, all provisions; H.R.2077, MLR Repeal Act of 2011, all provisions; S.1098, Family and Retirement Health Investment Act of 2011, all provisions; H.R.5/S.1099, Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011, all provisions; H.R.1206, Access to Professional Health Insurance Advisors Act of 2011, all provisions; Summary of Benefit NRPM; Comments regarding employer interactions with insurance exchanges, health premium tax credits, and development of an affordability safe harbor for employers; S.1880, Jobs and Premium Protection Act, all provisions; S.1049/H.R. 2676, Small Business Health Relief Act of 2011, all provisions; H.R.2206, Auto Enroll Repeal Act, all provisions.

Client expense: $1,070,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Federal Deposit Insurance Corporation (FDIC), Federal Motor Carrier Safety Administration, Federal Reserve System, Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Interior, Dept of (DOI), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Labor Relations Board (NLRB), Natl Telecommunications & Information Administration (NTIA), SENATE, Securities & Exchange Commission (SEC), Small Business Administration (SBA), State, Dept of (DOS), Treasury, Dept of, U.S. Customs & Border Protection, U.S. International Trade Commission (ITC), U.S. Trade Representative (USTR), White House Office

Implementation of Patient Protection and Affordable Care Act, including Supreme Court case and coverage issues - Proposed legislation re this issues; Executive Branch actions re this issues. Congressional investigation regarding Patient Protection and Affordable Care Act. *Medical Liability reform - HR 5, Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011; S 1099, Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011. *Data Security - HR 611, BEST PRACTICES Act; HR 1707, Data Accountability and Trust Act; HR 1841, Data Accountability and Trust Act (DATA) of 2011; HR 2577, SAFE Data Act; S 1207, Data Security and Breach Notification Act of 2011; S 1408, Data Breach Notification Act of 2011; S 1535, Personal Data Protection and Breach Accountability Act of 2011; S 3333, Data Security and Breach Notification Act of 2012. *Antitrust exemption for physicians - HR 1409, Quality Health Care Coalition Act of 2011. *Repeal of premium tax and other ACA provisions - HR 2676, Small Business Health Relief Act of 2011; S 1049, Small Business Health Relief Act of 2011. *Privacy, data security - S 1151, Personal Data Privacy and Security Act of 2011. *Eligibility for healthcare assistance - HR 2576, To amend the Internal Revenue Code of 1986 to modify the calculation of modified adjusted gross income for purposes of determining eligibility for certain healthcare-related programs. *Privacy - S 2111, Cyber Crime Protection Security Act; S 3351, Protect Our Health Privacy Act. *National Clearinghouse for LTC info - HR 1173, Fiscal Responsibility and Retirement Security Act of 2011. *IPAB repeal, medical liability reform, McCarron-Ferguson - HR 5, Protecting Access to Healthcare Act.; HR 452, Medicare Decisions Accountability Act of 2011. *ACA provisions, deficit reduction proposals - HR 5652, Sequester Replacement Reconciliation Act of 2012. *Price transparency - HR 5800, Health Care Price Transparency Promotion Act of 2012. *Expanded access to dental services - HR 5909, Comprehensive Dental Reform Act of 2012; S 3272, Comprehensive Dental Reform Act of 2012. *Health benefits for postal employees - S 1789, 21st Century Postal Service Act of 2012. *Funding for HHS programs & agencies, ACA-related amendments - S 3295, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2013.

Client expense: Not reported · Firm income: $100,000

Government targets: HOUSE OF REPRESENTATIVES

**see addendum page PL 111-148 - The Patient Protection and Affordable Care Act, implementation, health care reform H.R. 1206 - Access to Professional Health Insurance Advisors Act of 2011, MLR Broker Fee H.R. 371 - Health Care Choice Act of 2011, selling insurance across state lines S. 1049/H.R. 2676 - Small Business Health Relief Act, insurer excise tax H.R.1370 - to repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act S. 1880 - the Jobs and Premium Protection Act, insurer excise tax ***, no specific bill(s), Health Savings Accounts/Medical Saving Accounts, Transparency, Health Information Technology, Electronic Prescribing, Insurance Market Reform, Government Plan Option, Uninsured, Employer Based Health System, Health Care Reform, Small Group Market Reform, Exchanges, Health Care Reform Implementation, Medical Loss Rates, Federal Employees' Health Benefits Program (FEHBP)

Client expense: Not reported · Firm income: $100,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

**see addendum page PL 111-148 - The Patient Protection and Affordable Care Act, PL 111-152 - The Reconciliation Act of 2010, Sections of Health Care Reform legislation pertaining to proposed annual insurer assessments, and proposed excise tax on high-value health insurance plans S. 1049/H.R. 2676 - Small Business Health Relief Act, insurer excise tax H.R.1370 - to repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act S. 1880 the Jobs and Premium Protection Act, insurer excise tax

Client expense: Not reported · Firm income: $100,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

**see addendum page PL 111-148 - The Patient Protection and Affordable Care Act, PL 111-152 - The Reconciliation Act of 2010, Sections of Health Care Reform legislation pertaining to proposed annual insurer assessments, and proposed excise tax on high-value health insurance plans S. 1049/H.R. 2676 - Small Business Health Relief Act, insurer excise tax H.R.1370 - to repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act S. 1880 the Jobs and Premium Protection Act, insurer excise tax

Client expense: Not reported · Firm income: $70,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

**see addendum page PL 111-148 - The Patient Protection and Affordable Care Act, implementation H.R. 1206 - Access to Professional Health Insurance Advisors Act of 2011, MLR Broker Fee H.R. 371 - Health Care Choice Act of 2011, selling insurance across state lines S. 1049/H.R. 2676 - Small Business Health Relief Act, insurer excise tax H.R.1370 - to repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act S. 1880 - the Jobs and Premium Protection Act, insurer excise tax S. 3187 - The Food and Drug Administration Safety and Innovation Act, e-prescribing ***, no specific bill(s), Health Savings Accounts/Medical Savings Accounts, Transparency, Health Information Technology, Electronic Prescribing, Insurance Market Reform, Uninsured, Employer Based Health System, Health Care Reform, Small Group Market Reform, Exchanges, Health Care Reform Implementation, Medical Loss Ratios

Client expense: Not reported · Firm income: $70,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE