Health Savings Accounts Improvements Act of 2012

H.R.369, Health Savings and Affordability Act (Austria) HSA improvements 16. Specific Lobbying Issues (continued): H.R. 436, Health Care Cost Reduction Act (Paulsen) HSA, HRA, FSA provisions, ACA provisions H.R. 450, Restoring Assistance for Families' and Seniors' Health Expenses Act (Reichert) repeal of HSA and FSA restrictions H.R. 524, Restoring Consumer-driven Health Care Act (Quayle) repeal of HSA restrictions H.R. 605, Patients' Freedom to Choose Act (Paulsen) repeal of HSA and FSA restrictions H.R. 1004, Health Flexible Spending Arrangements Improvements Act (Boustany) -- distribution of unused amounts from a Health FSA H.R. 1370, Repeal of ACA Premium Tax (Boustany) H.R. 2010, Family and Retirement Health Investment Act (Paulsen) HSA and FSA improvements H.R. 2529, Restoring Access to Medication Act (Jenkins) use of HSA funds and FSA funds to purchase OTC medications H.R. 5842, Restoring Access to Medication Act (Jenkins) use of HSA, HRA, and FSA funds for over-the-counter medications H.R. 5858, Health Savings Accounts Improvements Act (Herger) HSA provisions H.R. 6005, Long-Term Care and Retirement Security Act (Courtney) tax incentives for purchase of LTC insurance, consumer protections H.R. 6088, Repeal of the Unfair Taxes on Health Care Act (Schweikert) repeal of ACA premium tax and restrictions on HSAs / FSAs H.R. 6137, Helping Save Americans' Health Care Choices Act (Fleming) HSA and FSA provisions H.R. 6162, Ensuring Women's Access to Free-Market Healthcare Act (Cassidy) pregnancy-related coverage by HSA plans S. 312, Patients' Freedom to Choose Act (Hutchison) repeal of HSA and FSA restrictions S. 1098, Family and Retirement Health Investment Act (Hatch) HSA and FSA improvements S. 1368, Restoring Access to Medication Act (Roberts) use of HSA funds and FSA funds to purchase OTC medications S. 1880, Jobs and Premium Protection Act (Barrasso) repeal of health insurance premium tax S. 2237, Small Business Jobs and Tax Relief Act (Reid) amendment to repeal ACA premium tax S. 2516, the FDA Safety and Innovation Act (Harkin) pharmaceutical, medical device issues S. 3187, the FDA Safety and Innovation Act (Harkin) pharmaceutical, medical device issues Regulatory Issues: Annual insurer provider fees; issues concerning the patient-centered outcomes research fee; employer coverage mandate, W-2 reporting requirements, health insurer fee, 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. 436, Health Care Cost Reduction Act of 2012; all provisions 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. 5842, Restoring Access to Medication Act of 2012; all provisions H.R. 5858, Health Savings Accounts Improvements Act of 2012; all provisions S. 1880, Jobs and Premium Protection Act; all provisions PL 111-148, Patient Protection and Affordable Care Act; provisions relating to implementation of employer-provided health plans plus section 10332, section 1241 relating to reinsurance fees, sections 1001 2715, 4980(h) and revenue provisions Bill Number Not Assigned, A bill on entitlement reform

Client expense: $4,480,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Education, Dept of, Environmental Protection Agency (EPA), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, State, Dept of (DOS), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Trade Representative (USTR)

Various issues related to the Patient Protection and Affordable Care Act (P.L. 111-148) and Health Care and Education Reconciliation Act of 2010 (P.L. 111-152); H.R. 1744/S. 20 employer mandate repeal; H.R. 1063/S. 1718 Medicare Secondary Payer reform; H.R. 2206 auto enrollment repeal; consumer directed health products; H.R. 436; H.R. 5842; H.R. 2529; H.R. 1004; H.R. 5858; H.R. 2010; S. 1098; S. 1368; H.R. 605; S. 312; H.R. 450

Client expense: $1,010,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Consumer Product Safety Commission (CPSC), Equal Employment Opportunity Commission (EEOC), Federal Reserve System, Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Labor Relations Board (NLRB), Office of Management & Budget (OMB), Office of the Comptroller of the Currency (OCC), SENATE, Securities & Exchange Commission (SEC), 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

Health Care Reform regulatory implementation and compliance issues from the Patient Protection and Affordable Care Act (PPACA) Public Law No: 111-148 & the Health Care and Education Reconciliation Act of 2010 (HCERA) Public Law No: 111-152 Health Flexible Spending Arrangements Improvements Act of 2012 H.R. 1004 Medicare Beneficiary Freedom to Choose Act of 2011 H.R. 1051 Preserving our Hometown Independent Pharmacies Act of 2011 H.R. 1946 Family and Retirement Health Investment Act of 2011 H.R. 2010 Tax Parity for Health Plan Beneficiaries Act of 2011 H.R. 2088/S. 1171 Restoring Access to Medication Act of 2012 H.R. 2529/5842 Health Savings Accounts Improvements Act of 2012 H.R. 5858 Empowering States to Innovate Act S. 248 Patients Freedom to Choose Act S. 312 Family and Retirement Health Investment Act S. 1098 Other Issues Health care provider compensation Internal Revenue Code Section 162 (m) (6) Electronic disclosure, communication by employee benefit plans Consumer directed health care plans HDHPs, HSAs, HRAs FSA Plan Year Limit transition guidance Mental Health Parity Rules

Client expense: $328,952 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commodity Futures Trading Commission (CFTC), Equal Employment Opportunity Commission (EEOC), Federal Accounting Standards Advisory Board (FASAB), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Treasury, Dept of, White House Office

S. 1506, to prevent the Secretary of the Treasury from expanding United States bank reporting requirements with respect to interest on deposits paid to nonresident aliens. S. 1787, the Wall Street Trading and Speculators Tax Act (provisions to impose a 3-basis-point tax on financial trading transactions) S. 3412, the Middle Class Tax Cut Act (provisions to extend certain current tax rates on income, capital gains, and dividends) H.J. Res. 108, Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rules submitted by the Department of the Treasury and the Internal Revenue Service relating to the reporting requirements for interest that relates to deposits maintained at United States offices of certain financial institutions and is paid to certain nonresident alien individuals. H.R. 1004, the Health Flexible Spending Arrangements Improvements Act of 2012 H.R. 1439, the Business Activity Tax Simplification Act of 2011 (all provisions) H.R. 2568, a bill to prevent the Secretary of the Treasury from expanding United States bank reporting requirements with respect to interest on deposits paid to nonresident aliens. H.R. 3313, the Wall Street Trading and Speculators Tax Act (provisions to impose a 3-basis-point tax on financial trading transactions) H.R. 4336, to amend the Internal Revenue Code of 1986 to extend the exclusion from gross income of discharges of qualified principal residence indebtedness (all provisions) H.R. 4348, the Surface Transportation Extension Act of 2012 (provisions to prohibit U.S. banks from accepting wire transfers or credit cards from certain foreign banks; to reauthorize the National Flood Insurance Program for five years; and to extend for one year the 3.4 percent interest rate on certain federal student loans) H.R. 5842, the Restoring Access to Medication Act of 2012 H.R. 5858, the Health Savings Accounts Improvements Act of 2012

Client expense: $2,110,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.5-Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2011 H.R. 8- American Taxpayer Relief Act of 2012 H.R.157-Health Care Safety Net Enhancement Act of 2011 H.R.314-Medical Liability Procedural Reform Act of 2011 H.R.376-Volunteer Emergency Services Recruitment and Retention Act of 2011 H.R.436-Health Care Cost Reduction Act of 2012 H.R.452-Medicare Decisions Accountability Act of 2011 H.R.541-Pay for all your Undocumented Procedures (PAY UP) Act of 2011 H.R.816-Provider Shield Act of 2011 H.R.896-Medical Justice Act of 2011 H.R.969- Medical Practice Freedom Act of 2011 H.R. 971-Critical Care Assessment and Improvement Act of 2011 H.R.1004-Health Flexible Spending Arrangements Improvements Act of 2012 H.R.1117-Air Ambulance Patient Safety, Protection, and Coordination Act H.R. 1063-Strengthening Medicare And Repaying Taxpayers Act of 2011 H.R. 1206- Access to Professional Health Insurance Advisors Act of 2011 H.R.1256-Medicare Physician Payment Transparency and Assessment Act of 2011 H.R.1310-To amend the Internal Revenue Code of 1986 to exempt certain emergency medical devices from the excise tax on medical devices, and for other purposes H.R.1629-Family Health Care Accessibility Act of 2011 H.R.1668-Danny McIntosh Emergency Medical Service Providers Protection Act H.R.1683-State Flexibility Act H.R.1852-Children's Hospital GME Support Reauthorization Act of 2011 H.R.1941-Hiring Heroes Act of 2011 H.R.2104-Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy (CARE) Act of 2011 H.R.2205-Ending Defensive Medicine and Encouraging Innovative Reforms Act of 2011 H.R.2353-Volunteer Responder Incentive Protection Reauthorization Act of 2011 H.R.2405-Pandemic and All-Hazards Preparedness Reauthorization Act of 2011 H.R.2472-Health Care Professionals Protection Act of 2011 H.R.2488-SERVE Act of 2011 H.R.2523-Physician Availability Act of 2011 H.R.2853-Emergency Medic Transition (EMT) Act of 2011 H.R.2903-Federal Emergency Management Agency (FEMA) Reauthorization Act of 2012 H.R.3000-Empowering Patients First Act H.R.3144-Field EMS Quality Innovation and Cost Effectiveness Improvements Act H.R.3269-Diagnostic Imaging Services Protection Act of 2011 H.R.3511- Cardiac Arrest Survival Act of 2011 H.R.3586-Good Samaritans Health Professionals Act of 2011 H.R.3625-Cardiomyopathy Health Education, Awareness, Risk Assessment, and Training in the Schools (HEARTS) Act of 2011 H.R.4124-Veteran Emergency Medical Technician Support Act of 2012 H.R.4242-Ensuring Quality Health Care for All Americans Act of 2012 H.R.5707-Medicare Physician Payment Innovation Act of 2012 H.R.5842-Restoring Access to Medication Act of 2012 H.R.5858-Health Savings Accounts Improvements Act of 2012 H.R. 6079-Repeal of Obama Care Act H.R. 6142-Assuring Medicare Stability and Access for Seniors Act of 2012 H.R. 6163-National Pediatric Research Network Act of 2012 H.R. 6562-Resident Physician Shortage Reduction Act of 2012 H.R. 6672- Pandemic and All-Hazards Preparedness Reauthorization Act of 2012 H.R. 6719- Telehealth Promotion Act of 2012 S.223-FAA Air Transportation Modernization and Safety Improvement Act S.385-Dale Long Emergency Medical Services Providers Protection Act S.668-Health Care Bureaucrats Elimination Act S.868-State Flexibility Act S.932-SERVE Act of 2011 S.933-Volunteer Responder Incentive Protection Reauthorization Act of 2011 S.951-Hiring Heroes Act of 2011 S.958-Children's Hospital GME Support Reauthorization Act of 2011 S.1059-Family Health Care Accessibility Act of 2011 S.1099-Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2011 S.1407-Air Ambulance Medicare Accreditation and Accountability Act S.1855-Pandemic and All-Hazards Preparedness Reauthorization Act of 2011

Client expense: $695,377 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 1506, to prevent the Secretary of the Treasury from expanding United States bank reporting requirements with respect to interest on deposits paid to nonresident aliens S. 1787, the Wall Street Trading and Speculators Tax Act (provisions to impose a 3-basis-point tax on financial trading transactions)S. 3412, the Middle Class Tax Cut Act (provisions to extend certain current tax rates on income, capital gains, and dividends) H.J. Res. 108, Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rules submitted by the Department of the Treasury and the Internal Revenue Service relating to the reporting requirements for interest that relates to deposits maintained at United States offices of certain financial institutions and is paid to certain nonresident alien individuals. H.R. 1004, the Health Flexible Spending Arrangements Improvements Act of 2012 H.R. 1439, the Business Activity Tax Simplification Act of 2011 (all provisions) H.R. 2568, a bill To prevent the Secretary of the Treasury from expanding United States bank reporting requirements with respect to interest on deposits paid to nonresident aliens. H.R. 3313, the Wall Street Trading and Speculators Tax Act (provisions to impose a 3-basis-point tax on financial trading transactions) H.R. 3630, the Temporary Payroll Tax Cut Continuation Act of 2011 (increase in the Fannie Mae and Freddie Mac credit-risk guarantee fees as revenue offset, included in the conference report) H.R. 4336, to amend the Internal Revenue Code of 1986 to extend the exclusion from gross income of discharges of qualified principal residence indebtedness (all provisions) H.R. 4348, the Surface Transportation Extension Act of 2012 (provisions to prohibit U.S. banks from accepting wire transfers or credit cards from certain foreign banks; to reauthorize the National Flood Insurance Program for five years; and to extend for one year the 3.4 percent interest rate on certain federal student loans) H.R. 5842, the Restoring Access to Medication Act of 2012 H.R. 5858, the Health Savings Accounts Improvements Act of 2012

Client expense: $1,650,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 9 Small Business Tax Cut Act H.R. 436 Protect Medical Innovation Act H.R. 5842 Restoring Access to Medications Act H.R. 5858 Health Savings Account Improvement Act H.R. 1004 Health Flexible Spending Account Improvement Act S. 1796 Free File Improvement Act of 2011 H.R. 5974 Invest in America Now Act of 2012 H.R. 4348 An act to authorize funds for Federal-aid highways, highway safety programs, and transit programs, and for other purposes. H.R. 6079 Repeal of Obamacare Act S. 971 Digital Goods and Services Tax Fairness Act of 2011 H.R. 1860 Digital Goods and Services Tax Fairness Act of 2011 S.1452 Main Street Fairness Act H.R.2701 Main Street Fairness Act H.R.3179 Marketplace Equity Act of 2011 S.1832 Marketplace Fairness Act H.R. 1834 Freedom to Invest Act of 2011 S. 2204 Repeal Big Oil Tax Subsidies Act H.R.8 Job Protection and Recession Prevention Act of 2012 H.R.6169 Pathway to Job Creation through a Simpler, Fairer Tax Code Act of 2012

Client expense: $1,160,000 · Firm income: Not reported

Government targets: Environmental Protection Agency (EPA), Executive Office of the President (EOP), Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, SENATE

S. 3187 Food and Drug Administration Safety and Innovation Act H.R. 436 Protect Medical Innovation Act H.R. 5842 Restoring Access to Medications Act H.R. 5858 Health Savings Account Improvement Act H.R. 1004 Health Flexible Spending Account Improvement Act H.R. 6079 Repeal of Obamacare Act,

Client expense: $1,160,000 · Firm income: Not reported

Government targets: Environmental Protection Agency (EPA), Executive Office of the President (EOP), Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, SENATE

See attached addendum for General Lobbying Issue Area: HCR - Healthcare Successful Insurance Industry Implementation of Health Reforms: reasonable regulatory implementation timeline for compliance with PL 111-148 Affordable Private Health Care: Health Insurance Tax; Affordable Essential Health Benefits; Inextricable link between Individual Mandate and Insurance Reforms; Healthcare Delivery System Reforms; BCBSA's proposal "Building Tomorrow's Healthcare System: The Pathway to High-Quality, Affordable Care in America" State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; existing state regulatory functions; Selling Health Insurance across state lines: HR371 "Health Care Choice Act of 2011"; Multi-State Health Plans Medical Loss Ratios: MLR Broker Fee; State Innovation Waivers; Quality improvement definition; Consistent reporting requirements for all insurers; Transition for smaller states and Plans; include benefits for individuals as well as populations; MLR Broker Fees: HR1206 "Access to Professional Health Insurance Act of 2011", S 2068 "Access to Independent Health Insurance Advisors Act of 2012" Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Comparative Effectiveness Research; Evidence Based Care; Health Disparities; Wellness; Chronic Care Management; Telemedicine Health Information Technology Standards; Health Information Privacy; Electronic Health Records; Administrative Simplification; ICD10 implementation; Data Sharing; Data Aggregation; Centralized All-Payer Database Insurance Market Reform; Individual Market Reform; Small Group Market Reform; Small Business Healthcare; Guaranteed Issue; Community Rating; Age Rating; Health Status Rating; Health Savings Accounts: HR5858 "Health Savings Accounts Improvement Act of 2012"; Individual Mandate; Association Health Plans Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM; HR 2309 "Postal Reform Act of 2011" sections pertaining to FEHBP; S1789 "21st Century Postal Service Act of 2012" sections pertaining to Postal Benefits carveout; OMB Postal Benefit Carveout

Client expense: $1,880,000 · Firm income: Not reported

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

H.R.369, Health Savings and Affordability Act (Austria) - HSA improvements. H.R. 436, Health Care Cost Reduction Act (Paulsen) - HSA, HRA, FSA provisions, ACA provisions. H.R. 450, Restoring Assistance for Families' and Seniors' Health Expenses Act (Reichert) - repeal of HSA and FSA restrictions. H.R. 524, Restoring Consumer-driven Health Care Act (Quayle) - repeal of HSA restrictions. H.R. 605, Patients' Freedom to Choose Act (Paulsen) - repeal of HSA and FSA restrictions. H.R. 1004, Health Flexible Spending Arrangements Improvements Act (Boustany) -- distribution of unused amounts from a Health FSA. H.R. 1370, Repeal of ACA Premium Tax (Boustany). H.R. 2010, Family and Retirement Health Investment Act (Paulsen) - HSA and FSA improvements. H.R. 2529, Restoring Access to Medication Act (Jenkins) - use of HSA funds and FSA funds to purchase OTC medications. H.R. 5842, Restoring Access to Medication Act (Jenkins) - use of HSA, HRA, and FSA funds for over-the-counter medications. H.R. 5858, Health Savings Accounts Improvements Act (Herger) - HSA provisions. H.R. 6005, Long-Term Care and Retirement Security Act (Courtney) - tax incentives for purchase of LTC insurance, consumer protections. H.R. 6088, Repeal of the Unfair Taxes on Health Care Act (Schweikert) - repeal of ACA premium tax and restrictions on HSAs / FSAs. H.R. 6137, Helping Save Americans' Health Care Choices Act (Fleming) - HSA and FSA provisions. H.R. 6162, Ensuring Women's Access to Free-Market Healthcare Act (Cassidy) - pregnancy-related coverage by HSA plans. S. 312, Patients' Freedom to Choose Act (Hutchison) - repeal of HSA and FSA restrictions. S. 1098, Family and Retirement Health Investment Act (Hatch) - HSA and FSA improvements. S. 1368, Restoring Access to Medication Act (Roberts) - use of HSA funds and FSA funds to purchase OTC medications. S. 1880, Jobs and Premium Protection Act (Barrasso) - repeal of health insurance premium tax. S. 2237, Small Business Jobs and Tax Relief Act (Reid) - amendment to repeal ACA premium tax. S. 2516, the FDA Safety and Innovation Act (Harkin) - pharmaceutical, medical device issues. S. 3187, the FDA Safety and Innovation Act (Harkin) - pharmaceutical, medical device issues.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 1506, to prevent the Secretary of the Treasury from expanding United States bank reporting requirements with respect to interest on deposits paid to nonresident aliens S. 1787, the Wall Street Trading and Speculators Tax Act (provisions to impose a 3-basis-point tax on financial trading transactions) S. 3412, the Middle Class Tax Cut Act (provisions to extend certain current tax rates on income, capital gains, and dividends) H.J. Res. 108, Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rules submitted by the Department of the Treasury and the Internal Revenue Service relating to the reporting requirements for interest that relates to deposits maintained at United States offices of certain financial institutions and is paid to certain nonresident alien individuals. H.R. 1004, the Health Flexible Spending Arrangements Improvements Act of 2012 H.R. 1439, the Business Activity Tax Simplification Act of 2011 (all provisions) H.R. 2568, a bill To prevent the Secretary of the Treasury from expanding United States bank reporting requirements with respect to interest on deposits paid to nonresident aliens. H.R. 3313, the Wall Street Trading and Speculators Tax Act (provisions to impose a 3-basis-point tax on financial trading transactions) H.R. 3630, the Temporary Payroll Tax Cut Continuation Act of 2011 (increase in the Fannie Mae and Freddie Mac credit-risk guarantee fees as revenue offset, included in the conference report) H.R. 4336, to amend the Internal Revenue Code of 1986 to extend the exclusion from gross income of discharges of qualified principal residence indebtedness (all provisions) H.R. 4348, the Surface Transportation Extension Act of 2012 (provisions to prohibit U.S. banks from accepting wire transfers or credit cards from certain foreign banks; to reauthorize the National Flood Insurance Program for five years; and to extend for one year the 3.4 percent interest rate on certain federal student loans) H.R. 5842, the Restoring Access to Medication Act of 2012 H.R. 5858, the Health Savings Accounts Improvements Act of 2012

Client expense: $1,650,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 436, Health Care Cost Reduction Act of 2012; all provisions 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. 5842, Restoring Access to Medication Act of 2012; all provisions H.R. 5858, Health Savings Accounts Improvements Act of 2012; all provisions S. 1880, Jobs and Premium Protection Act; all provisions PL 111-148, Patient Protection and Affordable Care Act; provisions relating to implementation of employer-provided health plans plus section 10332, section 1241 relating to reinsurance fees, sections 1001 2715, 4980(h) and revenue provisions

Client expense: $4,010,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Energy, Dept of, Environmental Protection Agency (EPA), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Interior, Dept of (DOI), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, State, Dept of (DOS), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Trade Representative (USTR)

See attached addendum for General Lobbying Issue Area: HCR - Healthcare Successful Insurance Industry Implementation of Health Reforms: reasonable regulatory implementation timeline for compliance with PL 111-148 Affordable Private Health Care: Health Insurance Tax; Affordable Essential Health Benefits; Inextricable link between Individual Mandate and Insurance Reforms; Healthcare Delivery System Reforms State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; existing state regulatory functions Medical Loss Ratios: MLR Broker Fee;Quality improvement definition; Consistent reporting requirements for all insurers; include benefits for individuals as well as populations; MLR Broker Fees: HR1206 "Access to Professional Health Insurance Act of 2011", S 2068 "Access to Independent Health Insurance Advisors Act of 2012" Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Health Disparities; Wellness; Chronic Care Management; Telemedicine Insurance Market Reform; Individual Market Reform; Small Group Market Reform; Small Business Healthcare; Guaranteed Issue; Community Rating; Age Rating; Health Status Rating; Health Savings Accounts: HR5858 "Health Savings Accounts Improvement Act of 2012"; Individual Mandate Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM; HR 2309 "Postal Reform Act of 2011" sections pertaining to FEHBP; S1789 "21st Century Postal Service Act of 2012" sections pertaining to Postal Benefits carveout; OMB Postal Benefit Carveout

Client expense: $159,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

See attached addendum for General Lobbying Issue Area: HCR - Healthcare Successful Insurance Industry Implementation of Health Reforms: reasonable regulatory implementation timeline for compliance with PL 111-148 Affordable Private Health Care: Health Insurance Tax; Affordable Essential Health Benefits; Inextricable link between Individual Mandate and Insurance Reforms; Healthcare Delivery System Reforms; BCBSA's proposal "Building Tomorrow's Healthcare System: The Pathway to High-Quality, Affordable Care in America" State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; existing state regulatory functions; Selling Health Insurance across state lines: HR371 "Health Care Choice Act of 2011"; Multi-State Health Plans Medical Loss Ratios: MLR Broker Fee; State Innovation Waivers; Quality improvement definition; Consistent reporting requirements for all insurers; Transition for smaller states and Plans; include benefits for individuals as well as populations; MLR Broker Fees: HR1206 "Access to Professional Health Insurance Act of 2011", S 2068 "Access to Independent Health Insurance Advisors Act of 2012" Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Comparative Effectiveness Research; Evidence Based Care; Health Disparities; Wellness; Chronic Care Management; Telemedicine Health Information Technology Standards; Health Information Privacy; Electronic Health Records; Administrative Simplification; ICD10 implementation; Data Sharing; Data Aggregation; Centralized All-Payer Database Insurance Market Reform; Individual Market Reform; Small Group Market Reform; Small Business Healthcare; Guaranteed Issue; Community Rating; Age Rating; Health Status Rating; Health Savings Accounts: HR5858 "Health Savings Accounts Improvement Act of 2012"; Individual Mandate; Association Health Plans Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM; HR 2309 "Postal Reform Act of 2011" sections pertaining to FEHBP; S1789 "21st Century Postal Service Act of 2012" sections pertaining to Postal Benefits carveout; OMB Postal Benefit Carveout

Client expense: $450,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Various issues related to the Patient Protection and Affordable Care Act (P.L. 111-148) and Health Care and Education Reconciliation Act of 2010 (P.L. 111-152); H.R. 1744/S. 20 employer mandate repeal; H.R. 1063/S. 1718 Medicare Secondary Payer reform; H.R. 2206 auto enrollment repeal; consumer directed health products; H.R. 436; H.R. 5842; H.R. 2529; H.R. 1004; H.R. 5858; H.R. 2010; S. 1098; S. 1368; H.R. 605; S. 312; H.R. 450.

Client expense: $1,080,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Consumer Product Safety Commission (CPSC), Equal Employment Opportunity Commission (EEOC), Federal Reserve System, Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Labor Relations Board (NLRB), Office of Management & Budget (OMB), Office of Thrift Supervision (OTS), Office of the Comptroller of the Currency (OCC), SENATE, Securities & Exchange Commission (SEC), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Customs & Border Protection, U.S. Trade Representative (USTR), White House Office

See attached addendum for General Lobbying Issue Area: HCR - Healthcare Successful Insurance Industry Implementation of Health Reforms: reasonable regulatory implementation timeline for compliance with PL 111-148 Affordable Private Health Care: Health Insurance Tax; Affordable Essential Health Benefits; Inextricable link between Individual State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; existing state regulatory functions; Selling Health Insurance across state lines: HR371 "Health Care Choice Act of 2011"; Multi-State Health Plans Medical Loss Ratios: MLR Broker Fee; State Innovation Waivers; Quality improvement definition; Consistent reporting requirements for all insurers; Transition for smaller states and Plans; include benefits for individuals as well as populations; MLR Broker Fees: HR1206 "Access to Professional Health Insurance Act of 2011", S 2068 "Access to Independent Health Insurance Advisors Act of 2012" Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Comparative Effectiveness Research; Evidence Based Care; Health Disparities; Wellness; Chronic Care Management; Telemedicine Health Information Technology Standards; Health Information Privacy; Electronic Health Records; Administrative Simplification; ICD10 implementation; Data Sharing; Data Aggregation; Centralized All-Payer Database Insurance Market Reform; Individual Market Reform; Small Group Market Reform; Small Business Healthcare; Guaranteed Issue; Community Rating; Age Rating; Health Status Rating; Health Savings Accounts: HR5858 "Health Savings Accounts Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM; HR 2309 "Postal Reform Act of 2011" sections pertaining to FEHBP; S1789 "21st Century Postal Service Act of 2012" sections pertaining to Postal Benefits carveout; OMB Postal Benefit Carveout

Client expense: $43,000 · Firm income: Not reported

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

H.R.369, Health Savings and Affordability Act (Austria) HSA improvements 16. Specific Lobbying Issues (continued): H.R. 436, Health Care Cost Reduction Act (Paulsen) HSA, HRA, FSA provisions, ACA provisions H.R. 450, Restoring Assistance for Families' and Seniors' Health Expenses Act (Reichert) repeal of HSA and FSA restrictions H.R. 524, Restoring Consumer-driven Health Care Act (Quayle) repeal of HSA restrictions H.R. 605, Patients' Freedom to Choose Act (Paulsen) repeal of HSA and FSA restrictions H.R. 1004, Health Flexible Spending Arrangements Improvements Act (Boustany) -- distribution of unused amounts from a Health FSA H.R. 1370, Repeal of ACA Premium Tax (Boustany) H.R. 2010, Family and Retirement Health Investment Act (Paulsen) HSA and FSA improvements H.R. 2529, Restoring Access to Medication Act (Jenkins) use of HSA funds and FSA funds to purchase OTC medications H.R. 5842, Restoring Access to Medication Act (Jenkins) use of HSA, HRA, and FSA funds for over-the-counter medications H.R. 5858, Health Savings Accounts Improvements Act (Herger) HSA provisions H.R. 6005, Long-Term Care and Retirement Security Act (Courtney) tax incentives for purchase of LTC insurance, consumer protections H.R. 6088, Repeal of the Unfair Taxes on Health Care Act (Schweikert) repeal of ACA premium tax and restrictions on HSAs / FSAs H.R. 6137, Helping Save Americans' Health Care Choices Act (Fleming) HSA and FSA provisions H.R. 6162, Ensuring Women's Access to Free-Market Healthcare Act (Cassidy) pregnancy-related coverage by HSA plans S. 312, Patients' Freedom to Choose Act (Hutchison) repeal of HSA and FSA restrictions S. 1098, Family and Retirement Health Investment Act (Hatch) HSA and FSA improvements S. 1368, Restoring Access to Medication Act (Roberts) use of HSA funds and FSA funds to purchase OTC medications S. 1880, Jobs and Premium Protection Act (Barrasso) repeal of health insurance premium tax S. 2237, Small Business Jobs and Tax Relief Act (Reid) amendment to repeal ACA premium tax S. 2516, the FDA Safety and Innovation Act (Harkin) pharmaceutical, medical device issues S. 3187, the FDA Safety and Innovation Act (Harkin) pharmaceutical, medical device issues Regulatory Issues: Annual insurer provider fees; issues concerning the patient-centered outcomes research fee; employer coverage mandate, W-2 reporting requirements, 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

Patients Freedom to Choose Act H.R. 605 Health Flexible Spending Arrangements Improvements Act of 2012 H.R. 1004 Medicare Beneficiary Freedom to Choose Act of 2011 H.R. 1051 Preserving our Hometown Independent Pharmacies Act of 2011 H.R. 1946 Family and Retirement Health Investment Act of 2011 H.R. 2010 Tax Parity for Health Plan Beneficiaries Act of 2011 H.R. 2088 Restoring Access to Medication Act of 2012 H.R. 2529/5842 Health Savings Accounts Improvements Act of 2012 H.R. 5858 Health Care Reform regulatory implementation and compliance issues from the Patient Protection and Affordable Care Act (PPACA) Public Law No: 111-148 & the Health Care and Education Reconciliation Act of 2010 (HCERA) Public Law No: 111-152 Senate State Leadership in Health Act S. 73 State Health Care Choice Act S. 244 Empowering States to Innovate Act S. 248 Patients Freedom to Choose Act S. 312 Family and Retirement Health Investment Act S. 1098 Tax Parity for Health Plan Beneficiaries Act of 2011 S. 1171 Restoring Access to Medication Act S. 1368 Health Care Reform regulatory implementation and compliance issues from the Patient Protection and Affordable Care Act (PPACA) Public Law No: 111-148 & the Health Care and Education Reconciliation Act of 2010 (HCERA) Public Law 111-152 Regulatory Proposed Health Information Technology for Economic and Clinical Health (HITECH) Act regulations for HIPAA Accounting of Disclosures Request for Information (RFI) streamlining regulations to reduce regulatory burdens - Improving Regulation and Regulatory Review Executive Order 13563 Semi-Annual Regulatory Agendas HHS, Treasury Guidance for and implementation of the Patient Protection and Affordable Care Act (PPACA) & the Health Care and Education Reconciliation Act of 2010 (HCERA) Frequently Asked Questions (FAQs), employer responsibility provisions (shared responsibility, pay to play), quality improvement efforts, Essential Health Benefits (EHB), W2 informational reporting, Summary of Benefits and Coverage Requirements & uniform glossary requirements, automatic enrollment, waiting periods, medical loss ratios (MLRs), contraceptive coverage, state waivers, state health exchanges, reinsurance assessment, public reporting and accountability related to hospital patient safety measures, Patient-Centered Outcomes Research Institute (PCORI), request for transition relief for health flexible spending arrangements (health FSAs) in non-calendar years, Health Insurance Premium Tax Credit, minimum value of an employer sponsored health plan, health insurance premium tax credit/effect of wellness incentive programs, definition of Full-Time Employee, 90-Day waiting period Medicare and Medicaid Programs; Electronic Health Record Incentive Program Stage 2, Health IT Meaningful Use project Health care provider compensation Internal Revenue Code Section 162 (m) (6) Electronic disclosure, communication by employee benefit plans Consumer directed health care plans HDHPs, HSAs, HRAs FSA Plan Year Limit transition guidance Mental Health Parity Rules

Client expense: $216,050 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commodity Futures Trading Commission (CFTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Treasury, Dept of, White House Office

H.R.5-Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2011 H.R.157-Health Care Safety Net Enhancement Act of 2011 H.R.314-Medical Liability Procedural Reform Act of 2011 H.R.376-Volunteer Emergency Services Recruitment and Retention Act of 2011 H.R.436-Health Care Cost Reduction Act of 2012 H.R.452-Medicare Decisions Accountability Act of 2011 H.R.541-Pay for all your Undocumented Procedures (PAY UP) Act of 2011 H.R.816-Provider Shield Act of 2011 H.R.896-Medical Justice Act of 2011 H.R.969- Medical Practice Freedom Act of 2011 H.R. 971-Critical Care Assessment and Improvement Act of 2011 H.R.1004-Health Flexible Spending Arrangements Improvements Act of 2012 H.R.1117-Air Ambulance Patient Safety, Protection, and Coordination Act H.R. 1063-Strengthening Medicare And Repaying Taxpayers Act of 2011 H.R. 1206- Access to Professional Health Insurance Advisors Act of 2011 H.R.1256-Medicare Physician Payment Transparency and Assessment Act of 2011 H.R.1310-To amend the Internal Revenue Code of 1986 to exempt certain emergency medical devices from the excise tax on medical devices, and for other purposes H.R.1629-Family Health Care Accessibility Act of 2011 H.R.1668-Danny McIntosh Emergency Medical Service Providers Protection Act H.R.1683-State Flexibility Act H.R.1852-Children's Hospital GME Support Reauthorization Act of 2011 H.R.1941-Hiring Heroes Act of 2011 H.R.2104-Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy (CARE) Act of 2011 H.R.2205-Ending Defensive Medicine and Encouraging Innovative Reforms Act of 2011 H.R.2353-Volunteer Responder Incentive Protection Reauthorization Act of 2011 H.R.2405-Pandemic and All-Hazards Preparedness Reauthorization Act of 2011 H.R.2472-Health Care Professionals Protection Act of 2011 H.R.2488-SERVE Act of 2011 H.R.2523-Physician Availability Act of 2011 H.R.2853-Emergency Medic Transition (EMT) Act of 2011 H.R.2903-Federal Emergency Management Agency (FEMA) Reauthorization Act of 2012 H.R.3000-Empowering Patients First Act H.R.3144-Field EMS Quality Innovation and Cost Effectiveness Improvements Act H.R.3269-Diagnostic Imaging Services Protection Act of 2011 H.R.3511- Cardiac Arrest Survival Act of 2011 H.R.3586-Good Samaritans Health Professionals Act of 2011 H.R.3625-Cardiomyopathy Health Education, Awareness, Risk Assessment, and Training in the Schools (HEARTS) Act of 2011 H.R.4124-Veteran Emergency Medical Technician Support Act of 2012 H.R.4242-Ensuring Quality Health Care for All Americans Act of 2012 H.R.5707-Medicare Physician Payment Innovation Act of 2012 H.R.5842-Restoring Access to Medication Act of 2012 H.R.5858-Health Savings Accounts Improvements Act of 2012 H.R. 6079-Repeal of Obama Care Act H.R. 6142-Assuring Medicare Stability and Access for Seniors Act of 2012 H.R. 6163-National Pediatric Research Network Act of 2012 S.223-FAA Air Transportation Modernization and Safety Improvement Act S.385-Dale Long Emergency Medical Services Providers Protection Act S.668-Health Care Bureaucrats Elimination Act S.868-State Flexibility Act S.932-SERVE Act of 2011 S.933-Volunteer Responder Incentive Protection Reauthorization Act of 2011 S.951-Hiring Heroes Act of 2011 S.958-Children's Hospital GME Support Reauthorization Act of 2011 S.1059-Family Health Care Accessibility Act of 2011 S.1099-Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2011 S.1407-Air Ambulance Medicare Accreditation and Accountability Act S.1855-Pandemic and All-Hazards Preparedness Reauthorization Act of 2011

Client expense: $433,244 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

See attached addendum for General Lobbying Issue Area: HCR - Healthcare Successful Insurance Industry Implementation of Health Reforms: reasonable regulatory implementation timeline for compliance with PL 111-148 Affordable Private Health Care: Health Insurance Tax; Affordable Essential Health Benefits; Inextricable link between Individual Mandate and Insurance Reforms; Healthcare Delivery System Reforms; BCBSA's proposal "Building Tomorrow's Healthcare System: The Pathway to High-Quality, Affordable Care in America" State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; existing state regulatory functions; Selling Health Insurance across state lines: HR371 "Health Care Choice Act of 2011"; Multi-State Health Plans Medical Loss Ratios: MLR Broker Fee; State Innovation Waivers; Quality improvement definition; Consistent reporting requirements for all insurers; Transition for smaller states and Plans; include benefits for individuals as well as populations; MLR Broker Fees: HR1206 "Access to Professional Health Insurance Act of 2011", S 2068 "Access to Independent Health Insurance Advisors Act of 2012" Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Comparative Effectiveness Research; Evidence Based Care; Health Disparities; Wellness; Chronic Care Management; Telemedicine Health Information Technology Standards; Health Information Privacy; Electronic Health Records; Administrative Simplification; ICD10 implementation; Data Sharing; Data Aggregation; Centralized All-Payer Database Insurance Market Reform; Individual Market Reform; Small Group Market Reform; Small Business Healthcare; Guaranteed Issue; Community Rating; Age Rating; Health Status Rating; Health Savings Accounts: HR5858 "Health Savings Accounts Improvement Act of 2012"; Individual Mandate; Association Health Plans Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM; HR 2309 "Postal Reform Act of 2011" sections pertaining to FEHBP; S1789 "21st Century Postal Service Act of 2012" sections pertaining to Postal Benefits carveout; OMB Postal Benefit Carveout

Client expense: $35,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

See attached addendum for General Issue Area: HCR - Health Issues Successful Insurance Industry Implementation of Health Reforms: reasonable regulatory implementation timeline for compliance with PL 111-148, Retail store Affordable Private Health Care: Health Insurance Tax; Affordable Essential Health Benefits; Inextricable link between Individual Mandate and Insurance Reforms; Healthcare Delivery System Reforms; BCBSA's proposal "Building Tomorrow's Healthcare System: The Pathway to High-Quality, Affordable Care in America" State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; existing state regulatory functions; Selling Health Insurance across state lines: HR371 "Health Care Choice Act of 2011"; Multi-State Health Plans Medical Loss Ratios: MLR Broker Fee; State Innovation Waivers; Quality improvement definition; Consistent reporting requirements for all insurers; Transition for smaller states and Plans; include benefits for individuals as well as populations; MLR Broker Fees: HR1206 "Access to Professional Health Insurance Act of 2011", S 2068 "Access to Independent Health Insurance Advisors Act of 2012" Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Comparative Effectiveness Research; Evidence Based Care; Health Disparities; Wellness; Chronic Care Management; Telemedicine Health Information Technology Standards; Health Information Privacy; Electronic Health Records; Administrative Simplification; ICD10 implementation; Data Sharing; Data Aggregation; Centralized All-Payer Database Insurance Market Reform; Individual Market Reform; Small Group Market Reform; Small Business Healthcare; Guaranteed Issue; Community Rating; Age Rating; Health Status Rating; Health Savings Accounts: HR5858 "Health Savings Accounts Improvement Act of 2012"; Individual Mandate; Association Health Plans Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM; HR 2309 "Postal Reform Act of 2011" sections pertaining to FEHBP; S1789 "21st Century Postal Service Act of 2012" sections pertaining to Postal Benefits carveout; OMB Postal Benefit Carveout

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 6079: Repeal of Obamacare Act S.3228 Sequestration: Transparency Act of 2012 H.R.5872 Sequestration: Transparency Act of 2012 S. 2068: Access to Independent Health Insurance Advisors Act of 2012 H.R. 1206 Access to Professional Health insurance Advisors Act H.R. 6283 Guaranteed Access to Health Insurance Act of 2012 H.R. 5652 Sequester Replacement Reconciliation Act of 2012 H.R. 1004 Health Flexible Spending Arrangements Improvements Act of 2012 H.R. 5858 Health Savings Account Improvements Act of 2012 H.R. 5842 Restoring Access to Medication Act of 2012 H.R. 5651 Food and Drug Administration Reform Act of 2012 S. 2516 Food and Drug Administration Reform Act of 2012 H.R. 436 Protect Medical Innovation Act of 2012 S. 3187 Food and Drug Administration Safety and Innovation Act H.R. 5 Help Efficient, Accessible, Low-cost, and Timely Healthcare Act H.R. 5652 Sequester Replacement Reconciliation Act of 2012 S. 1099 Seniors Choice Act S. 3414 Cybersecurity Act of 2012 S.3351 Protect our Health Privacy Act S. 3333 Data Security and Breach Notification Act of 2012 H.R. 6352 Physician Shortage Reduction and Graduate Medical Education Accountability Act S.3201 Graduate Medical Education Reform Act S.1627 Resident Physician Shortage H.R. 6174 Common Sense Nutrition Disclosure Act H.R.6482 To amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings. H.R.6429 STEM Jobs Act of 2012 S. 3276 FISA Amendments Act Reauthorization Act of 2012 H.R. 5949 FISA Amendments Act Reauthorization Act of 2012 S.3465 Care Coordination for Older Americans Act of 2012 S.3430 National Diabetes Clinical Care Commission Act of 2012 H.R. 6562 Resident Physician Shortage Reduction Act of 2012 H.R.6083 Federal Agriculture Reform and Risk Management Act of 2012 H.R.4348 MAP-21

Client expense: $160,000 · Firm income: Not reported

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

See attached addendum for General Lobbying Issue Area: HCR - Healthcare Successful Insurance Industry Implementation of Health Reforms: good faith compliance standard, reasonable regulatory implementation timeline for compliance with PL 111-148 Affordable Private Health Care: Health Insurance Tax; Affordable Essential Health Benefits; Inextricable link between Individual Mandate and Insurance Reforms; Healthcare Delivery System Reforms; BCBSA's proposal "Building Tomorrow's Healthcare System: The Pathway to High-Quality, Affordable Care in America" State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; existing state regulatory functions; Selling Health Insurance across state lines: HR371 "Health Care Choice Act of 2011" Medical Loss Ratios: MLR Broker Fee; State Innovation Waivers; Quality improvement definition; Consistent reporting requirements for all insurers; Transition for smaller states and Plans; include benefits for individuals as well as populations Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Comparative Effectiveness Research; Evidence Based Care; Health Disparities; Wellness; Chronic Care Management; Telemedicine Health Information Technology Standards; Health Information Privacy; Electronic Health Records; Administrative Simplification; ICD10 implementation; Data Sharing; Data Aggregation; Centralized All-Payer Database Insurance Market Reform; Individual Market Reform; Small Group Market Reform; Small Business Healthcare; Guaranteed Issue; Community Rating; Health Status Rating; Health Savings Accounts: HR5858 "Health Savings Accounts Improvement Act of 2012"; Individual Mandate; Association Health Plans Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM; HR 2309 "Postal Reform Act of 2011" sections pertaining to FEHBP; S1789 "21st Century Postal Service Act of 2012" sections pertaining to Postal Benefits carveout; OMB Postal Benefit Carveout; OPM IG's Statement on FEHBP audits Printed

Client expense: $400,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), SENATE

S. 1506, to prevent the Secretary of the Treasury from expanding United States bank reporting requirements with respect to interest on deposits paid to nonresident aliens. S. 1787, the Wall Street Trading and Speculators Tax Act (provisions to impose a 3-basis-point tax on financial trading transactions). H.J. Res. 108, Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rules submitted by the Department of the Treasury and the Internal Revenue Service relating to the reporting requirements for interest that relates to deposits maintained at United States offices of certain financial institutions and is paid to certain nonresident alien individuals. H.R. 1004, the Health Flexible Spending Arrangements Improvements Act of 2012. H.R. 1439, the Business Activity Tax Simplification Act of 2011 (all provisions). H.R. 2568, a bill To prevent the Secretary of the Treasury from expanding United States bank reporting requirements with respect to interest on deposits paid to nonresident aliens. H.R. 3313, the Wall Street Trading and Speculators Tax Act (provisions to impose a 3-basis-point tax on financial trading transactions). H.R. 3630, the Temporary Payroll Tax Cut Continuation Act of 2011 (increase in the Fannie Mae and Freddie Mac credit-risk guarantee fees as revenue offset, included in the conference report). H.R. 4336, to amend the Internal Revenue Code of 1986 to extend the exclusion from gross income of discharges of qualified principal residence indebtedness (all provisions). H.R. 4348 (tax haven provision to prohibit U.S. banks from accepting wire transfers or credit cards from certain foreign banks). H.R. 5842, the Restoring Access to Medication Act of 2012. H.R. 5858, the Health Savings Accounts Improvements Act of 2012.

Client expense: $2,100,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

See attached addendum for General Lobbying Issue Area: HCR - Healthcare Successful Insurance Industry Implementation of Health Reforms: good faith compliance standard, reasonable regulatory implementation timeline for compliance with PL 111-148 Affordable Private Health Care: Health Insurance Tax; Affordable Essential Health Benefits; Inextricable link between Individual Mandate and Insurance Reforms; Healthcare Delivery System Reforms; State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; existing state regulatory functions; Selling Health Insurance across state lines: HR371 "Health Care Choice Act of 2011" Medical Loss Ratios: MLR Broker Fee; State Innovation Waivers; Quality improvement definition; Consistent reporting requirements for all insurers; Transition for smaller states and Plans; include benefits for individuals as well as populations Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Comparative Effectiveness Research; Evidence Based Care; Health Disparities; Wellness; Chronic Care Management; Telemedicine Health Information Technology Standards; Health Information Privacy; Electronic Health Records; Administrative Simplification; ICD10 implementation; Data Sharing; Data Aggregation; Centralized All-Payer Database Insurance Market Reform: Individual Market Reform; Small Group Market Reform; Small Business Healthcare; Guaranteed Issue; Community Rating; Health Status Rating; Health Savings Accounts: HR5858 "Health Savings Accounts Improvement Actof 2012"; Individual Mandate; Association Health Plans Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM; HR 2309 "Postal Reform Act of 2011" sections pertaining to FEHBP; S1789 "21st Century Postal Service Act of 2012" sections pertaining to Postal Benefits carveout; OMB Postal Benefit Carveout; OPM IG's Statement on FEHBP audits

Client expense: $44,500 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 9 Small Business Tax Cut Act H.R. 436 Protect Medical Innovation Act H.R. 5842 Restoring Access to Medications Act H.R. 5858 Health Savings Account Improvement Act H.R. 1004 Health Flexible Spending Account Improvement Act S. 1796 Free File Improvement Act of 2011 H.R. 5974 Invest in America Now Act of 2012 H.R. 4348 An act to authorize funds for Federal-aid highways, highway safety programs, and transit programs, and for other purposes. H.R. 6079 Repeal of Obamacare Act S. 971 Digital Goods and Services Tax Fairness Act of 2011 H.R. 1860 Digital Goods and Services Tax Fairness Act of 2011 S.1452 Main Street Fairness Act H.R.2701 Main Street Fairness Act H.R.3179 Marketplace Equity Act of 2011 S.1832 Marketplace Fairness Act H.R. 1834 Freedom to Invest Act of 2011 S. 2204 Repeal Big Oil Tax Subsidies Act

Client expense: $170,000 · Firm income: Not reported

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

S. 3187 Food and Drug Administration Safety and Innovation Act H.R. 436 Protect Medical Innovation Act H.R. 5842 Restoring Access to Medications Act H.R. 5858 Health Savings Account Improvement Act H.R. 1004 Health Flexible Spending Account Improvement Act H.R. 6079 Repeal of Obamacare Act,

Client expense: $170,000 · Firm income: Not reported

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

See attached addendum for General Lobbying Issue Area: HCR - Healthcare Successful Insurance Industry Implementation of Health Reforms: good faith compliance standard, reasonable regulatory implementation timeline for compliance with PL 111-148 Affordable Private Health Care: Health Insurance Tax; Affordable Essential Health Benefits; Inextricable link between Individual Mandate and Insurance Reforms; Healthcare Delivery System Reforms State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; existing state regulatory functions; Selling Health Insurance across state lines: HR371 "Health Care Choice Act of 2011" Medical Loss Ratios: MLR Broker Fee; State Innovation Waivers Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Comparative Effectiveness Research; Evidence Based Care; Health Disparities; Wellness; Chronic Care Management; Telemedicine Health Information Technology Standards; Electronic Health Records; Data Sharing; Data Aggregation; Centralized All-Payer Database Insurance Market Reform; Individual Market Reform; Small Group Market Reform; Small Business Healthcare; Guaranteed Issue; Community Rating; Health Status Rating; Health Savings Accounts: HR5858 "Health Savings Accounts Improvement Act of 2012"; Individual Mandate; Association Health Plans Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM; HR 2309 "Postal Reform Act of 2011" sections pertaining to FEHBP; S1789 "21st Century Postal Service Act of 2012" sections pertaining to Postal Benefits carveout; OMB Postal Benefit Carveout

Client expense: $149,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Various issues related to the Patient Protection and Affordable Care Act (P.L. 111-148) and Health Care and Education Reconciliation Act of 2010 (P.L. 111-152); H.R. 1744/S. 20 employer mandate repeal; H.R. 1063/S. 1718 Medicare Secondary Payer reform; H.R. 2206 auto enrollment repeal; consumer directed health products; H.R. 436; H.R. 5842; H.R. 2529; H.R. 1004; H.R. 5858; H.R. 2010; S. 1098; S. 1368; H.R. 605; S. 312; H.R. 450; Small Business Health Options Program.

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

Government targets: Commerce, Dept of (DOC), Consumer Product Safety Commission (CPSC), Equal Employment Opportunity Commission (EEOC), Federal Reserve System, Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Labor Relations Board (NLRB), Office of Management & Budget (OMB), Office of Thrift Supervision (OTS), Office of the Comptroller of the Currency (OCC), SENATE, Securities & Exchange Commission (SEC), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Customs & Border Protection, U.S. Trade Representative (USTR), White House Office

See additional page for details. Bills H.R. 436, the Health Care Cost Reduction Act - Support H.R. 1370, To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act - Support H.R. 4078, the Regulatory Freeze for Jobs Act - Support H.R. 4310, National Defense Authorization Act for FY 2013 - Ask for fair and open competition on federal construction contracts H.R. 4348, the Moving Ahead for Progress in the 21st Century Act - Oppose the on board recorder mandate HR 4480, Domestic Energy and Jobs Act - Support H.R. 4607, the Midnight Rule Relief Act - Support H.R. 4643, Small Business Tax Simplification Act - Support H.R. 5842, the Restoring Access to Medications Act - Support H.R. 5858, the Health Savings Accounts Improvements Act - Support H.R. 6091, an amendment to this Fiscal Year 2013 Interior-Environment Appropriations bill, offered by Representative Rehberg regarding the Renovation, Repair and Painting (RR&P) rule in Section 402 (c) (3) of the Toxics Substance Control Act (TSCA) Support H.ADMT. 1368, an amendment to H.R. 5972, the Transportation, Housing and Urban Development Appropriations Act - Support S. 1880, Jobs and Premium Protection Act - Support S. 2050, Small Business Tax Extenders Act - Support S.2343, the Stop the Student Loan Interest Rate Hike Act - Concerns about the pay-for levied on S-corporations S.3295, Department of Labor Appropriations Act for FY 2013 - Support the Shelby H2B Amendment S.J.Res. 36, a Resolution of Disapproval in response to the National Labor Relations Boards (NLRB) rule related to the union election process S.J. Res. 37, a Resolution of Disapproval pertaining to the Environmental Protection Agencys Utility Maximum Achievable Control Technology (MACT) rule Comments EPA-HQ-OAR-2009-0517 Prevention of Significant Deterioration and Title V Greenhouse Gas Tailoring Rule Step 3, GHG Plantwide Applicability Limitations and GHG Synthetic Minor Limitations RIN 1190-AA69 Delaying the Compliance Date for Certain Requirements of the Regulations Implementing Titles II and III of the Americans With Disabilities Act OMB20100008 Draft 2012 Report to Congress on the Benefits and Costs of Federal Regulations and Unfunded Mandates on State, Local and Tribal Entities IRS Notice 2012-31 - Minimum Value of an Employer-Sponsored Health Plan (IRS Notice 2012-31) IRS Notice 2012-32 - Request for Comments on Reporting of Health Insurance Coverage (IRS Notice 2012-32) IRS Notice 2012-33 - Request for Comments by Applicable Large Employers on Reporting of Health Insurance Coverage Under Employer-Sponsored Plans (IRS Notice 2012-33) HHS Bulletin - Verification of Access to Employer-Sponsored Coverage Bulletin (HHS Bulletin) Other Issues Working with OSHA and employers to improve the regulatory process Environmental Protection Agency and Regulatory Flexibility Act compliance

Client expense: $680,000 · Firm income: Not reported

Government targets: Environmental Protection Agency (EPA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Occupational Safety & Health Administration (OSHA), Office of Management & Budget (OMB), SENATE

S. 1506, to prevent the Secretary of the Treasury from expanding United States bank reporting requirements with respect to interest on deposits paid to nonresident aliens. S. 1787, the Wall Street Trading and Speculators Tax Act (provisions to impose a 3-basis-point tax on financial trading transactions). H.J. Res. 108, Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rules submitted by the Department of the Treasury and the Internal Revenue Service relating to the reporting requirements for interest that relates to deposits maintained at United States offices of certain financial institutions and is paid to certain nonresident alien individuals. H.R. 1004, the Health Flexible Spending Arrangements Improvements Act of 2012. H.R. 1439, the Business Activity Tax Simplification Act of 2011 (all provisions). H.R. 2568, a bill To prevent the Secretary of the Treasury from expanding United States bank reporting requirements with respect to interest on deposits paid to nonresident aliens. H.R. 3313, the Wall Street Trading and Speculators Tax Act (provisions to impose a 3-basis-point tax on financial trading transactions). H.R. 3630, the Temporary Payroll Tax Cut Continuation Act of 2011 (increase in the Fannie Mae and Freddie Mac credit-risk guarantee fees as revenue offset, included in the conference report). H.R. 4336, to amend the Internal Revenue Code of 1986 to extend the exclusion from gross income of discharges of qualified principal residence indebtedness (all provisions). H.R. 4348 (tax haven provision to prohibit U.S. banks from accepting wire transfers or credit cards from certain foreign banks). H.R. 5842, the Restoring Access to Medication Act of 2012. H.R. 5858, the Health Savings Accounts Improvements Act of 2012.

Client expense: $2,100,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.369, Health Savings and Affordability Act (Austria) HSA improvements H.R. 436, Health Care Cost Reduction Act (Paulsen) HSA, HRA, FSA provisions, ACA provisions H.R. 450, Restoring Assistance for Families' and Seniors' Health Expenses Act (Reichert) repeal of HSA and FSA restrictions 16. Specific Lobbying Issues (continued): H.R. 524, Restoring Consumer-driven Health Care Act (Quayle) repeal of HSA restrictions H.R. 605, Patients' Freedom to Choose Act (Paulsen) repeal of HSA and FSA restrictions H.R. 1004, Health Flexible Spending Arrangements Improvements Act (Boustany) -- distribution of unused amounts from a Health FSA H.R. 1370, Repeal of ACA Premium Tax (Boustany) H.R. 2010, Family and Retirement Health Investment Act (Paulsen) HSA and FSA improvements H.R. 2529, Restoring Access to Medication Act (Jenkins) use of HSA funds and FSA funds to purchase OTC medications H.R. 5842, Restoring Access to Medication Act (Jenkins) use of HSA, HRA, and FSA funds for over-the-counter medications H.R. 5858, Health Savings Accounts Improvements Act (Herger) HSA provisions H.R. 6005, Long-Term Care and Retirement Security Act (Courtney) tax incentives for purchase of LTC insurance, consumer protections H.R. 5651, FDA Reform Act (Upton) pharmaceutical, medical device issues S. 312, Patients' Freedom to Choose Act (Hutchison) repeal of HSA and FSA restrictions S. 1098, Family and Retirement Health Investment Act (Hatch) HSA and FSA improvements S. 1368, Restoring Access to Medication Act (Roberts) use of HSA funds and FSA funds to purchase OTC medications S. 1880, Jobs and Premium Protection Act (Barrasso) repeal of health insurance premium tax S. 2516, the FDA Safety and Innovation Act (Harkin) pharmaceutical, medical device issues S. 3187, the FDA Safety and Innovation Act (Harkin) pharmaceutical, medical device issues Regulatory Issues: Annual insurer provider fees; issues concerning the patient-centered outcomes research fee; employer coverage mandate, W-2 reporting requirements, 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

See attached addendum for General Lobbying Issue Area: HCR - Healthcare Successful Insurance Industry Implementation of Health Reforms: good faith compliance standard, reasonable regulatory implementation timeline for compliance with PL 111-148 Affordable Private Health Care: Health Insurance Tax; Affordable Essential Health Benefits; Inextricable link between Individual Mandate and Insurance Reforms; Healthcare Delivery System Reforms; BCBSA's proposal "Building Tomorrow's Healthcare System: The Pathway to High-Quality, Affordable Care in America" State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; existing state regulatory functions; Selling Health Insurance across state lines: HR371 "Health Care Choice Act of 2011" Medical Loss Ratios: MLR Broker Fee; State Innovation Waivers; Quality improvement definition; Consistent reporting requirements for all insurers; Transition for smaller states and Plans; include benefits for individuals as well as populations Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Comparative Effectiveness Research; Evidence Based Care; Health Disparities; Wellness; Chronic Care Management; Telemedicine Health Information Technology Standards; Health Information Privacy; Electronic Health Records; Administrative Simplification; ICD10 implementation; Data Sharing; Data Aggregation; Centralized All-Payer Database Insurance Market Reform; Individual Market Reform; Small Group Market Reform; Small Business Healthcare; Guaranteed Issue; Community Rating; Health Status Rating; Health Savings Accounts: HR5858 "Health Savings Accounts Improvement Act of 2012"; Individual Mandate; Association Health Plans Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM; HR 2309 "Postal Reform Act of 2011" sections pertaining to FEHBP; S1789 "21st Century Postal Service Act of 2012" sections pertaining to Postal Benefits carveout; OMB Postal Benefit Carveout; OPM IG's Statement on FEHBP audits

Client expense: $2,040,000 · Firm income: Not reported

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

S. 1506, to prevent the Secretary of the Treasury from expanding United States bank reporting requirements with respect to interest on deposits paid to nonresident aliens. S. 1787, the Wall Street Trading and Speculators Tax Act (provisions to impose a 3-basis-point tax on financial trading transactions). H.J. Res. 108, Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rules submitted by the Department of the Treasury and the Internal Revenue Service relating to the reporting requirements for interest that relates to deposits maintained at United States offices of certain financial institutions and is paid to certain nonresident alien individuals. H.R. 1004, the Health Flexible Spending Arrangements Improvements Act of 2012. H.R. 1439, the Business Activity Tax Simplification Act of 2011 (all provisions). H.R. 2568, a bill To prevent the Secretary of the Treasury from expanding United States bank reporting requirements with respect to interest on deposits paid to nonresident aliens. H.R. 3313, the Wall Street Trading and Speculators Tax Act (provisions to impose a 3-basis-point tax on financial trading transactions). H.R. 3630, the Temporary Payroll Tax Cut Continuation Act of 2011 (increase in the Fannie Mae and Freddie Mac credit-risk guarantee fees as revenue offset, included in the conference report). H.R. 4336, to amend the Internal Revenue Code of 1986 to extend the exclusion from gross income of discharges of qualified principal residence indebtedness (all provisions). H.R. 4348 (tax haven provision to prohibit U.S. banks from accepting wire transfers or credit cards from certain foreign banks). H.R. 5842, the Restoring Access to Medication Act of 2012. H.R. 5858, the Health Savings Accounts Improvements Act of 2012.

Client expense: $2,100,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1370 / S. 1880, To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act (Public Law 111-148); H.R. 1744 / S. 20, the American Job Protection Act; H.R. 2529, Restoring Access to Medication Act; S. 720, Repeal the CLASS Entitlement Act; H.R. 5, Protecting Access to Healthcare Act; H.R. 436, Health Care Cost Reduction Act of 2012; H.R. 5842, Restoring Access to Medication Act of 2012; H.R. 5858, Health Savings Accounts Improvements Act of 2012; Center for Consumer Information and Insurance Oversight and Centers for Medicare and Medicaid Services: General Guidance on Federally-Facilitated Exchanges; Repealing over the counter restrictions included in the Patient Protection and Affordable Care Act;

Client expense: $470,000 · Firm income: Not reported

Government targets: Defense, Dept of (DOD), Environmental Protection Agency (EPA), Equal Employment Opportunity Commission (EEOC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE

H.R.5-Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2011 H.R.157-Health Care Safety Net Enhancement Act of 2011 H.R.314-Medical Liability Procedural Reform Act of 2011 H.R.376-Volunteer Emergency Services Recruitment and Retention Act of 2011 H.R.436-Health Care Cost Reduction Act of 2012 H.R.452-Medicare Decisions Accountability Act of 2011 H.R.541-Pay for all your Undocumented Procedures (PAY UP) Act of 2011 H.R.816-Provider Shield Act of 2011 H.R.896-Medical Justice Act of 2011 H.R.969- Medical Practice Freedom Act of 2011 H.R. 971-Critical Care Assessment and Improvement Act of 2011 H.R.1004-Health Flexible Spending Arrangements Improvements Act of 2012 H.R.1117-Air Ambulance Patient Safety, Protection, and Coordination Act H.R.1256-Medicare Physician Payment Transparency and Assessment Act of 2011 H.R.1310-To amend the Internal Revenue Code of 1986 to exempt certain emergency medical devices from the excise tax on medical devices, and for other purposes H.R.1629-Family Health Care Accessibility Act of 2011 H.R.1668-Danny McIntosh Emergency Medical Service Providers Protection Act H.R.1683-State Flexibility Act H.R.1852-Children's Hospital GME Support Reauthorization Act of 2011 H.R.1941-Hiring Heroes Act of 2011 H.R.2104-Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy (CARE) Act of 2011 H.R.2205-Ending Defensive Medicine and Encouraging Innovative Reforms Act of 2011 H.R.2353-Volunteer Responder Incentive Protection Reauthorization Act of 2011 H.R.2405-Pandemic and All-Hazards Preparedness Reauthorization Act of 2011 H.R.2472-Health Care Professionals Protection Act of 2011 H.R.2488-SERVE Act of 2011 H.R.2523-Physician Availability Act of 2011 H.R.2853-Emergency Medic Transition (EMT) Act of 2011 H.R.3000-Empowering Patients First Act H.R.3144-Field EMS Quality Innovation and Cost Effectiveness Improvements Act H.R.3269-Diagnostic Imaging Services Protection Act of 2011 H.R.3511- Cardiac Arrest Survival Act of 2011 H.R.3586-Good Samaritans Health Professionals Act of 2011 H.R.3625-Cardiomyopathy Health Education, Awareness, Risk Assessment, and Training in the Schools (HEARTS) Act of 2011 H.R.4124-Veteran Emergency Medical Technician Support Act of 2012 H.R.4242-Ensuring Quality Health Care for All Americans Act of 2012 H.R.5707-Medicare Physician Payment Innovation Act of 2012 H.R.5842-Restoring Access to Medication Act of 2012 H.R.5858-Health Savings Accounts Improvements Act of 2012 S.223-FAA Air Transportation Modernization and Safety Improvement Act S.385-Dale Long Emergency Medical Services Providers Protection Act S.668-Health Care Bureaucrats Elimination Act S.868-State Flexibility Act S.932-SERVE Act of 2011 S.933-Volunteer Responder Incentive Protection Reauthorization Act of 2011 S.951-Hiring Heroes Act of 2011 S.958-Children's Hospital GME Support Reauthorization Act of 2011 S.1059-Family Health Care Accessibility Act of 2011 S.1099-Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2011 S.1407-Air Ambulance Medicare Accreditation and Accountability Act S.1855-Pandemic and All-Hazards Preparedness Reauthorization Act of 2011

Client expense: $891,775 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 436, Health Care Cost Reduction Act of 2012; all provisions H.R. 5842, Restoring Access to Medication Act of 2012; all provisions H.R. 5858, Health Savings Accounts Improvements Act of 2012; all provisions PL 111-148, Patient Protection and Affordable Care Act; provisions relating to implementation of employer-provided health plans plus sections 10332, 1001 2715, 4980(h) and revenue provisions

Client expense: $2,600,000 · Firm income: Not reported

Government targets: Administration for Children & Families (ACF), Commerce, Dept of (DOC), Energy, Dept of, Environmental Protection Agency (EPA), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Interior, Dept of (DOI), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, State, Dept of (DOS), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Trade Representative (USTR)

H.R.5-Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2011 H.R.157-Health Care Safety Net Enhancement Act of 2011 H.R.314-Medical Liability Procedural Reform Act of 2011 H.R.376-Volunteer Emergency Services Recruitment and Retention Act of 2011 H.R.436-Health Care Cost Reduction Act of 2012 H.R.452-Medicare Decisions Accountability Act of 2011 H.R.541-Pay for all your Undocumented Procedures (PAY UP) Act of 2011 H.R.816-Provider Shield Act of 2011 H.R.896-Medical Justice Act of 2011 H.R.969- Medical Practice Freedom Act of 2011 H.R. 971-Critical Care Assessment and Improvement Act of 2011 H.R.1004-Health Flexible Spending Arrangements Improvements Act of 2012 H.R.1117-Air Ambulance Patient Safety, Protection, and Coordination Act H.R.1256-Medicare Physician Payment Transparency and Assessment Act of 2011 H.R.1310-To amend the Internal Revenue Code of 1986 to exempt certain emergency medical devices from the excise tax on medical devices, and for other purposes H.R.1629-Family Health Care Accessibility Act of 2011 H.R.1668-Danny McIntosh Emergency Medical Service Providers Protection Act H.R.1683-State Flexibility Act H.R.1852-Children's Hospital GME Support Reauthorization Act of 2011 H.R.1941-Hiring Heroes Act of 2011 H.R.2104-Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy (CARE) Act of 2011 H.R.2205-Ending Defensive Medicine and Encouraging Innovative Reforms Act of 2011 H.R.2353-Volunteer Responder Incentive Protection Reauthorization Act of 2011 H.R.2405-Pandemic and All-Hazards Preparedness Reauthorization Act of 2011 H.R.2472-Health Care Professionals Protection Act of 2011 H.R.2488-SERVE Act of 2011 H.R.2523-Physician Availability Act of 2011 H.R.2853-Emergency Medic Transition (EMT) Act of 2011 H.R.3000-Empowering Patients First Act H.R.3144-Field EMS Quality Innovation and Cost Effectiveness Improvements Act H.R.3269-Diagnostic Imaging Services Protection Act of 2011 H.R.3511- Cardiac Arrest Survival Act of 2011 H.R.3586-Good Samaritans Health Professionals Act of 2011 H.R.3625-Cardiomyopathy Health Education, Awareness, Risk Assessment, and Training in the Schools (HEARTS) Act of 2011 H.R.4124-Veteran Emergency Medical Technician Support Act of 2012 H.R.4242-Ensuring Quality Health Care for All Americans Act of 2012 H.R.5707-Medicare Physician Payment Innovation Act of 2012 H.R.5842-Restoring Access to Medication Act of 2012 H.R.5858-Health Savings Accounts Improvements Act of 2012 S.223-FAA Air Transportation Modernization and Safety Improvement Act S.385-Dale Long Emergency Medical Services Providers Protection Act S.668-Health Care Bureaucrats Elimination Act S.868-State Flexibility Act S.932-SERVE Act of 2011 S.933-Volunteer Responder Incentive Protection Reauthorization Act of 2011 S.951-Hiring Heroes Act of 2011 S.958-Children's Hospital GME Support Reauthorization Act of 2011 S.1059-Family Health Care Accessibility Act of 2011 S.1099-Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2011 S.1407-Air Ambulance Medicare Accreditation and Accountability Act S.1855-Pandemic and All-Hazards Preparedness Reauthorization Act of 2011

Client expense: $891,775 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

See attached addendum for General Lobbying Issue Area: HCR - Healthcare Successful Insurance Industry Implementation of Health Reforms: good faith compliance standard, reasonable regulatory implementation timeline for compliance with PL 111-148 Affordable Private Health Care: Health Insurance Tax; Affordable Essential Health Benefits; Inextricable link between Individual Mandate and Insurance Reforms; Healthcare Delivery System Reforms; BCBSA's proposal "Building Tomorrow's Healthcare System: The Pathway to High-Quality, Affordable Care in America" State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; existing state regulatory functions; Selling Health Insurance across state lines: HR371 "Health Care Choice Act of 2011" Medical Loss Ratios: MLR Broker Fee; State Innovation Waivers; Quality improvement definition; Consistent reporting requirements for all insurers; Transition for smaller states and Plans; include benefits for individuals as well as populations Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Comparative Effectiveness Research; Evidence Based Care; Health Disparities; Wellness; Chronic Care Management; Telemedicine Health Information Technology Standards; Health Information Privacy; Electronic Health Records; Administrative Simplification; ICD10 implementation; Data Sharing; Data Aggregation; Centralized All-Payer Database Insurance Market Reform; Individual Market Reform; Small Group Market Reform; Small Business Healthcare; Guaranteed Issue; Community Rating; Health Status Rating; Health Savings Accounts: HR5858 "Health Savings Accounts Improvement Act of 2012"; Individual Mandate; Association Health Plans Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM; HR 2309 "Postal Reform Act of 2011" sections pertaining to FEHBP; S1789 "21st Century Postal Service Act of 2012" sections pertaining to Postal Benefits carveout; OMB Postal Benefit Carveout; OPM IG's Statement on FEHBP audits

Client expense: $110,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, 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, 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

See attached addendum for General Lobbying Issue Area: HCR - Healthcare Successful Insurance Industry Implementation of Health Reforms: good faith compliance standard, reasonable regulatory implementation timeline for compliance with PL 111-148 Affordable Private Health Care: Health Insurance Tax; Affordable Essential Health Benefits; Inextricable link between Individual Mandate and Insurance Reforms; Healthcare Delivery System Reforms State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; existing state regulatory functions; Selling Health Insurance across state lines: HR371 "Health Care Choice Act of 2011" Medical Loss Ratios: MLR Broker Fee; State Innovation Waivers; Quality improvement definition; Consistent reporting requirements for all insurers; Transition for smaller states and Plans; include benefits for individuals as well as populations Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Comparative Effectiveness Research; Evidence Based Care; Health Disparities; Wellness; Chronic Care Management; Telemedicine Health Information Technology Standards; Health Information Privacy; Electronic Health Records; Administrative Simplification; ICD10 implementation; Data Sharing; Data Aggregation; Centralized All-Payer Database Insurance Market Reform; Individual Market Reform; Small Group Market Reform; Small Business Healthcare; Guaranteed Issue; Community Rating; Health Status Rating; Health Savings Accounts: HR5858 "Health Savings Accounts Improvement Act of 2012"; Individual Mandate; Association Health Plans

Client expense: $45,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

See attached addendum for General Lobbying Issue Area: HCR - Healthcare Successful Insurance Industry Implementation of Health Reforms: "good faith compliance standard", reasonable regulatory implementation timeline for compliance with PL 111-148. Affordable Private Health Care: Health Insurance Tax; Affordable Essential Health Benefits; Inextricable link between Individual Mandate and Insurance Reforms; Healthcare Delivery System Reforms; BCBSA's proposal "Building Tomorrow's Healthcare System: The Pathway to High-Quality, Affordable Care in America". State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; existing state regulatory functions; Selling Health Insurance across state lines: HR371 "Health Care Choice Act of 2011". Medical Loss Ratios: MLR Broker Fee; State Innovation Waivers; Quality improvement definition; Consistent reporting requirements for all insurers; Transition for smaller states and Plans; include benefits for individuals as well as populations. Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical home; Comparative Effectiveness Research; Evidence Based Care; Health Disparities; Wellness; Chronic Care Management; Telemedicine. Health Information Technology Standards; Health Information Privacy; Electronic Health Records; Administrative Simplification; ICD10 implementation; Data Sharing; Data Aggregation; Centralized All-Payer Database. Insurance Market Reform; Individual Market Reform; Small Group Market Reform; Small Business Healthcare; Guaranteed Issue; Community Rating; Health Status Rating; Health Savings Accounts: HR5858 "Health Savings Accounts Improvement Act of 2012"; Individual Mandate; Association Health Plans. Federal Employed Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM; HR 2309 "Postal reform Act of 2011" sections pertaining to FEHBP; S1789 "21st Century Postal Service Act of 2012" sections pertaining to Postal Benefits carveout; OMB Postal Benefit Carveout; OPM IG's Statement on FEHBP audits.

Client expense: $8,700 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

See attached addendum on General Issue Area Code: HCR - Healthcare Successful Insurance Industry Implementation of Health Reforms: good faith compliance standard, reasonable regulatory implementation timeline for compliance with PL 111-148 Affordable Private Health Care: Health Insurance Tax; Affordable Essential Health Benefits; Inextricable link between Individual Mandate and Insurance Reforms; Healthcare Delivery System Reforms; BCBSA's proposal "Building Tomorrow's Healthcare System: The Pathway to High-Quality, Affordable Care in America" State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; existing state regulatory functions; Selling Health Insurance across state lines: HR371 "Health Care Choice Act of 2011" Medical Loss Ratios: MLR Broker Fee; State Innovation Waivers; Quality improvement definition; Consistent reporting requirements for all insurers; Transition for smaller states and Plans; include benefits for individuals as well as populations Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Comparative Effectiveness Research; Evidence Based Care; Health Disparities; Wellness; Chronic Care Management; Telemedicine Health Information Technology Standards; Health Information Privacy; Electronic Health Records; Administrative Simplification; ICD10 implementation; Data Sharing; Data Aggregation; Centralized All-Payer Database Insurance Market Reform; Individual Market Reform; Small Group Market Reform; Small Business Healthcare; Guaranteed Issue; Community Rating; Health Status Rating; Health Savings Accounts: HR5858 "Health Savings Accounts Improvement Act of 2012"; Individual Mandate; Association Health Plans Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM; HR 2309 "Postal Reform Act of 2011" sections pertaining to FEHBP; S1789 "21st Century Postal Service Act of 2012" sections pertaining to Postal Benefits carveout; OMB Postal Benefit Carveout; OPM IG's Statement on FEHBP audits

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.369, Health Savings and Affordability Act (Austria) - HSA improvements H.R. 436, Health Care Cost Reduction Act (Paulsen) - HSA, HRA, FSA provisions, ACA provisions H.R. 450, Restoring Assistance for Families' and Seniors' Health Expenses Act (Reichert) - repeal of HSA and FSA restrictions H.R. 524, Restoring Consumer-driven Health Care Act (Quayle) - repeal of HSA restrictions H.R. 605, Patients' Freedom to Choose Act (Paulsen) - repeal of HSA and FSA restrictions H.R. 1004, Health Flexible Spending Arrangements Improvements Act (Boustany) -- distribution of unused amounts from a Health FSA H.R. 1370, Repeal of ACA Premium Tax (Boustany) H.R. 2010, Family and Retirement Health Investment Act (Paulsen) - HSA and FSA improvements H.R. 2529, Restoring Access to Medication Act (Jenkins) - use of HSA funds and FSA funds to purchase OTC medications H.R. 5842, Restoring Access to Medication Act (Jenkins) - use of HSA, HRA, and FSA funds for over-the-counter medications H.R. 5858, Health Savings Accounts Improvements Act (Herger) - HSA provisions H.R. 6005, Long-Term Care and Retirement Security Act (Courtney) - tax incentives for purchase of LTC insurance, consumer protections H.R. 5651, FDA Reform Act (Upton) - pharmaceutical, medical device issues S. 312, Patients' Freedom to Choose Act (Hutchison) - repeal of HSA and FSA restrictions S. 1098, Family and Retirement Health Investment Act (Hatch) - HSA and FSA improvements S. 1368, Restoring Access to Medication Act (Roberts) - use of HSA funds and FSA funds to purchase OTC medications S. 1880, Jobs and Premium Protection Act (Barrasso) - repeal of health insurance premium tax S. 2516, the FDA Safety and Innovation Act (Harkin) - pharmaceutical, medical device issues S. 3187, the FDA Safety and Innovation Act (Harkin) - pharmaceutical, medical device issues

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE