Keep Your Health Plan Act of 2013

Legislative issues related to insurance markets; H.R. 3350 Keep Your Health Plan Act of 2013; H.R. 4302; Medicare Advantage; H.R. 3750; Telehealth Modernization Act. ACA implementation issues.

Client expense: Not reported · Firm income: $90,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 83 - Consolidated and Further Continuing Appropriations Act, 2015. HR 416 - Health Insurance Rate Review Act:A bill to amend the Public Health Service Act to provide protection for consumers against excessive, unjustified or unfairly discriminatory increases in premium rates. HR 979 - FEHBP Prescription Drug Integrity, Transparency, and Cost Savings Act: To amend chapter of title 5, United States Code to ensure program integrity, transparency and cost savings in the pricing and contracting of prescription drug benefits under the Federal Employees Health Benefits Program. HR 1370 - To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act. HR 2577 - SAFE Data Act: A bill to protect consumers by requiring reasonable security policies and procedures to protect data containing personal information and to provide for nationwide notice in the event of a security breach. HR 2676 - Small Business Health Relief Act of 2011: To lower health premiums and increase choice for small business. HR 3350 - Keep your Health Plan Act of 2013: To authorize health insurance issuers to continue to offer for sale current individual health insurance coverage in satisfaction of the minimum essential health insurance coverage requirement, and for other purposes. HR 3522 - Employee Health Care Protection Act of 2013: To authorize health insurance issuers to continue to offer for sale current individual health insurance coverage in satisfaction of the minimum essential health insurance coverage requirement and for other purposes. HR 3541 - Obamacare Taxpayer Bailout Prevention Act: To prevent a taxpayer bailout of health insurance issuers. HR 4805 - No subsidies Without Verification Process Act of 2014: To delay the provision of the Affordable Care Act premium and cost-sharing subsidies until the eligibility verification process for such subsidies is complete and for other purposes. HR 5214 - Clinical Data Registries: To require the Secretary of Health & Human Services to provide for recommendations for the development and use of clinical data registries for the improvement of patient care. HR 5364 - CHIP Extension & Improvement Act of 2014: To amend title XXI of the Social Security Act to extend and improve Childrens Health Insurance Program and for other purposes. S 24 - Small Business Health Relief Act of 2013: To lower health premiums and increase choice for small business. S 40 - American Liberty Restoration Act: To restore Americans individual liberty by striking the federal mandate to purchase insurance. S 482 - Health Insurance Rate Review Act: To amend the Public Health Service to provide protections for consumers against excessive, unjustified or unfairly discriminatory increases in premium rates. S 1726 - Obamacare Taxpayer Bailout Prevention Act: To prevent a taxpayer bailout of health insurance issuers. S 1729 - Expanded Consumer Choice Act: To amend the Patient Protection and Affordable Care Act to provide further options with respect to levels of coverage under qualified health plans. S 1880 - Jobs and Premium Protection Act: To repeal the annual fee on health care laws job-killing health insurance tax. S 2174 - Commonsense Competition and Access to Health Insurance Act: To amend the Patient Protection and Affordable Care Act to provide greater flexibility in offering health insurance coverage across state lines. S 2461 - CHIP Extension Act of 2014: Amend title XXI of the Social Security Act to extend & improve the Childrens Health Insurance Program and for other purposes. Department of Health & Human Services Implementation of Medical Loss Ratio arrangements; Implementation of health insurance exchanges; Implementation of Qualified Health Plans, Implementation Essential Health Benefits.

Client expense: $1,510,000 · Firm income: Not reported

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

Legislation and regulations affecting health plans. H.R.763, To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act. H.R.3350, Keep Your Health Plan Act of 2013. H.R.3541/S.1726, Obamacare Taxpayer Bailout Prevention Act. H.R.647, ABLE Act of 2014. H.R.83, Consolidated and Further Continuing Appropriations Act, 2015. S.1439, Care Planning Act of 2013.

Client expense: Not reported · Firm income: $50,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislative issues related to insurance markets; H.R. 3350 Keep Your Health Plan Act of 2013; H.R. 4302; Medicare Advantage; H.R. 3750; Telehealth Modernization Act. ACA implementation issues.

Client expense: Not reported · Firm income: $90,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Americans Giving Care to Elders Act (S.1485) Authority for Mandate Delay Act (H.R.2667) Comments/Testimony to FDA-Sec.907 of FDASIA Comments to CMS-Exchanges & Health Plans Qulaity Rating SystemCommunity Parks Revitalization Act (H.R.2424) Community Prevention Grants Continuous Coverage Act (S.1699) Draft Research Priorities (PCORI) EMS Quality, Innovation, and Cost Effectiveness Improvements Act of 2011 (H.R.3144) Fairness for American Families Act (H.R.2668) Food and Drug Administration Strategic Priorities 2014-2018 (FDA-2014-N-0833) Health Care Waiver Fairness Act (H.R. 2700) Health Equity and Accountability Act (H.R.5294) Healthy Kids Outdoors Act (H.R.4706) HHS- Clinical Trials Insurance Coverage (ACA Sec. 2709) If You Like Your Health Care, You Can Keep It Act (S.1617) Josh Miller Helping Everyone Access Responsive Treatment in Schools (HEARTS) Act (H.R.1377) Keeping the Affordable Care Act Promise Act (S.1642) Keep Your Health Plan Act (H.R.3350) Menu Labeling (ACA Section 4205) Newborn Screening Saves Lives Reauthorization Act of 2013 (H.R. 1281/ S.1471) No Child Left Inside Act of 2013 (H.R.2702) Next Generation Research Act (S.1552) Palliative Care and Hospice Education Training Act (H.R.1339 & S.641) Patient Centered Quality Care for Life Act (H.R.1666) Patient Protection and Affordable Care Act (P.L. 111-148; P.L. 111-152) - Implementation Physical Activity Guidelines for Americans Act (S.531 & H.R.2179) 2015 Physician Fee Schedule (CMS-1612-P) Prevention and Public Health Fund (ACA Section 4002) Proposed Rule on 90-Day Waiting Period (DOL/CMS/IRS) Proposed Rule on Exchange & Market Standards (CMS) Providing Accountability and Transperency to Incentivize Economically Necessary Transition in Health Care Act (H.R. 2688) Quality Rating System Scoring Specifications Comments (CMS) Research for All Act (H.R. 4879) Return to Work Act (S.1026 & H.R.3351) Revised Medical Criteria for Evaluating Neurological Disorders (SSA-2006-0140) The HELP America Act (S.39) To Improve, Coordinate & Enhance Rehabilitation Research at NIH (S.1027) The Helping Sick Americans Now Act (H.R.1549) The Personal Health Investment Today Act (H.R. 956) Veterans Emergency Medical Technician Act of 2013 (H.R. 1281/ S. 1471) Wireless E911 Location Accuracy Requirements (07-114; FCC 14-13) Women's Preventive Health Awareness Campaign Act (H.R. 2457)

Client expense: $19,160 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Education, Dept of, Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Transportation, Dept of (DOT), Treasury, Dept of, White House Office

Monitored HR 344, the Competitive Health Insurance Act Monitored HR 1254, to repeal a requirement that new employees of certain employers be automatically enrolled in their employers health benefit plans Monitored HR 1326, the Health Care Price Transparency Act Monitored HR 1342, to Helping Save Americans Health Care Choices Act Monitored HR 1558, to lower health premiums and increase choice for small business Monitored HR 1990/S 983, the Keep the IRS Off Your Health Care Act Monitored HR 2667, the Authority for Mandate Delay Act Monitored HR 2700, the Health Care Waiver Fairness Act Monitored HR 3046, the Small Business Health Care Tax Credit Improvement Act Monitored HR 4244, the Small Business Health Insurance Affordability Act Monitored S 24, the Small Business Health Relief Act Monitored S 479, the Health Insurance Rate Review Act Monitored S 560, to construe the Individual Mandate of the Patient Protection and Affordable Care Act as a tax Monitored S 610, the Family Health Care Flexibility Act Monitored S 603, the Jobs and Premium Protection Act Monitored S 701, modifying the definition of full time employee for the purposes of the Patient Protection and Affordable Care Act Monitored HR 762, the Health Care Choice Act Monitored S 1154/HR 2938, the Exchange Sunset Act Monitored HR 3350, the Keep Your Health Plan Act Monitored S 1735/HR 3462, the Self-insurance Protection Act Monitored HR 3522, the Employee Health Care Protection Act Monitored S 1894, the Health Insurance Accountability Act Supported S 2205, the Small Business Fairness in Health Care Act

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

H.R. 4, Jobs for America Act (Camp) - ACA provisions H.R. 99, Health Insurance Industry Antitrust Enforcement Act (Conyers) - antitrust policy H.R. 544, LIBERTY Act (Gingrey-Matheson) - age rating rules H.R. 743, Health Insurance Industry Fair Competition Act (DeFazio) - antitrust policy H.R. 762, Health Care Choice Act (Blackburn) - national marketplace for individual coverage H.R. 911, Competitive Health Insurance Reform Act (Gosar) - antitrust policy H.R. 1019, Health Insurance Rate Review Act (Schakowsky) - rate review H.R. 1188, Preserving Our Hometown Independent Pharmacies Act (Marino) - antitrust policy H.R. 1205, Patients Right to Know Act (Walden) - disclosures on SBC documents H.R. 1558, Small Business Health Relief Act (Collins) - HIT repeal, other ACA changes H.R. 2328, Access to Professional Health Insurance Advisors Act (Rogers-Barrow) - MLR impact on agents and brokers H.R. 2668, Fairness for American Families Act (Young) - delay of ACA individual mandate H.R. 2698, Federal Employee Short-Term Disability Insurance Act (Norton) - short-term disability program for federal employees H.R. 3121, American Health Care Reform Act (Roe) - replacement health reforms H.R. 3350, Keep Your Health Plan Act (Upton) - continuation of existing plans H.R. 3425, Health Care Access Fairness and Penalty Delay Act (Lipinski-Sinema) - delay of open enrollment and individual mandate penalties H.R. 3489, (Tiberi) - repeal of ACA transitional reinsurance fee H.R. 3504, Consumer Protection and Rate Review Act (Schakowsky) - rate review H.R. 3517, Federal and State Insurance Exchange Access Fairness and Penalty Delay Act (Schrader) - individual mandate delay H.R. 3522, Employee Health Care Protection Act (Cassidy) - continuation of current group coverage H.R. 3541, Obamacare Taxpayer Bailout Prevention Act (Griffin) - repeal of ACA risk corridor program H.R. 3598, Catastrophic Plan Bill (Fortenberry) - expanded access to catastrophic plans H.R. 3745, Coverage Protection Act (Kirkpatrick) - continuation of coverage for consumers unable to enroll in QHPs H.R. 3812, No Bailouts for Insurance Industry Act (Coffman) - ACA reinsurance and risk corridor programs H.R. 3851, No Bailouts for Insurance Industry Act (Lance) - ACA reinsurance and risk corridor programs H.R. 3985, Stop ACA's Risky Provisions Act (Westmoreland) - ACAs reinsurance, risk corridor, and risk adjustment programs H.R. 4118, SIMPLE Fairness Act (Jenkins) - delay in ACA individual mandate penalties H.R. 4302, Protecting Access to Medicare Act (Pitts) - ACA Limits on Deductibles for Plans in Small Group Market H.R. 4354, ACA Taxpayer Bailout Protection Act (Griffin) - ACA risk corridor program H.R. 4406, Taxpayer Bailout Protection Act (Lance) - ACA risk corridor program H.R. 4414, Expatriate Health Coverage Clarification Act (Carney) - relief from ACA for expatriate health plans H.R. 4735, Health Care Fairness and Stability Act (Nolan-McKinley) - ACA transitional reinsurance program H.R. 5175, Protecting Americans from Illegal Bailouts Act (Lance) - ACA risk corridor program S. 24, Small Business Health Relief Act (Portman) - HIT repeal, other ACA changes S. 482, Health Insurance Rate Review Act (Feinstein) - rate review S. 650, Access to Independent Health Insurance Advisors Act (Landrieu) - MLR impact on agents and brokers S. 764, Patients Right to Know Act (Cornyn) - disclosures on SBC documents S. 1473, Long-Term Care Insurance Consumer Right-to-Know Act (Klobuchar) - model disclosure forms S. 1481, Long Term Care Insurance Integrity Act (Klobuchar) - third party review of disputed claims S. 1642, Keeping the ACA Promise Act (Landrieu-Manchin) - continuation of existing plans, notification requirements S. 1671, (Manchin-Kirk) - individual mandate delay S. 1693, ACA Enrollment Extension Act (Shaheen) - extending open enrollment, delaying individual mandate penalties S. 1699, Continuous Coverage Act (Mark Udall) - continuation of existing plans S. 1726, Obamacare Taxpayer Bailout Prevention Act (Rubio) - repeal of ACA risk corridor program S. 1729, Expanded Consumer Choice Act (Begich) - adding copper level of coverage to ACA Exchanges S. 1866, Coverage Protection Act (Merkley) - continuation of coverage, retroactive coverage S. 2166, Treating Families Fairly Act (Manchin) - ACA determinations of full-time equivalent employees S. 2168, Small Business Stability Act (Heitkamp) - ACA definition of a large employer S. 2173, Consumers Having Options in Choosing Enrollment Act (Landrieu) - ACA direct enrollment S. 2174, Commonsense Competition and Access to Health Insurance Act (Warner) - offering health insurance coverage across state lines S. 2175, Enhancing Access for Agents and Brokers Act (Landrieu) - access for independent agents and brokers to information about Exchange enrollment S. 2176, Commonsense Reporting Act (Warner) - ACA reporting requirements S. 2214, ACA Taxpayer Bailout Protection Act (Rubio) - ACA risk corridor program S. 2253, Health Care Fairness and Stability Act (Franken-Kirk) - ACA transitional reinsurance program S. 2578, Protect Women's Health From Corporate Interference Act (Murray) - contraceptive coverage S. 2733, Obamacare Opt-Out Act (McCain-Barrasso) - certification process for opting out of ACA individual mandate S. 2801, Health Care Consumer Choices Preservation Act (Enzi) - conditions on automatic renewals Insurance regulatory reform; issues related to the coordination of private and public disability income benefits; disability risk management; disability income insurance enrollment and awareness; issues related to the continuation of reporting requirements for state LTCI partnership programs; issues relating to the coordination of benefits between private health insurance plans and Medicaid; Medigap claims processing and crossover fees; Medigap cross-over claim issues, Medigap coverage, implementation of Medigap standardized plan offerings; Medigap carrier recoveries related to CMS fraud and abuse enforcement activities, and issues related to Medigap educational materials, and other Medigap issues; fraud and abuse issues affecting public and private insurance coverage; issues relating to antitrust; implementation of the Mental Health Parity Act requirements; summary of benefits and coverage disclosures; pre-existing condition insurance plans; accountable care organizations; coverage of preventive services; preexisting condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; health insurance web portal requirements; dependent coverage; treatment of expatriate plans; compliance with the transitional reinsurance program; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations, non-discriminatory wellness programs; and issues related to supplemental products, and other issues relating to health care reform implementation.

Client expense: $2,010,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), 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), Government Accountability Office (GAO), 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), SENATE, Social Security Administration (SSA), Treasury, Dept of, White House Office

H.R. 4, Jobs for America Act (Camp) - ACA provisions. H.R. 99, Health Insurance Industry Antitrust Enforcement Act (Conyers) - antitrust policy. H.R. 544, LIBERTY Act (Gingrey-Matheson) - age rating rules. H.R. 743, Health Insurance Industry Fair Competition Act (DeFazio) - antitrust policy. H.R. 762, Health Care Choice Act (Blackburn) - national marketplace for individual coverage. H.R. 911, Competitive Health Insurance Reform Act (Gosar) - antitrust policy. H.R. 1019, Health Insurance Rate Review Act (Schakowsky) - rate review. H.R. 1188, Preserving Our Hometown Independent Pharmacies Act (Marino) - antitrust policy. H.R. 1205, Patients Right to Know Act (Walden) - disclosures on SBC documents. H.R. 1558, Small Business Health Relief Act (Collins) - HIT repeal, other ACA changes. H.R. 2328, Access to Professional Health Insurance Advisors Act (Rogers-Barrow) - MLR impact on agents and brokers. H.R. 2668, Fairness for American Families Act (Young) - delay of ACA individual mandate. H.R. 2698, Federal Employee Short-Term Disability Insurance Act (Norton) - short-term disability program for federal employees. H.R. 3121, American Health Care Reform Act (Roe) - replacement health reforms. H.R. 3350, Keep Your Health Plan Act (Upton) - continuation of existing plans. H.R. 3425, Health Care Access Fairness and Penalty Delay Act (Lipinski-Sinema) - delay of open enrollment and individual mandate penalties. H.R. 3489, (Tiberi) - repeal of ACA transitional reinsurance fee. H.R. 3504, Consumer Protection and Rate Review Act (Schakowsky) - rate review. H.R. 3517, Federal and State Insurance Exchange Access Fairness and Penalty Delay Act (Schrader) - individual mandate delay. H.R. 3522, Employee Health Care Protection Act (Cassidy) - continuation of current group coverage. H.R. 3541, Obamacare Taxpayer Bailout Prevention Act (Griffin) - repeal of ACA risk corridor program. H.R. 3598, Catastrophic Plan Bill (Fortenberry) - expanded access to catastrophic plans. H.R. 3745, Coverage Protection Act (Kirkpatrick) - continuation of coverage for consumers unable to enroll in QHPs. H.R. 3812, No Bailouts for Insurance Industry Act (Coffman) - ACA reinsurance and risk corridor programs. H.R. 3851, No Bailouts for Insurance Industry Act (Lance) - ACA reinsurance and risk corridor programs. H.R. 3985, Stop ACA's Risky Provisions Act (Westmoreland) - ACAs reinsurance, risk corridor, and risk adjustment programs. H.R. 4118, SIMPLE Fairness Act (Jenkins) - delay in ACA individual mandate penalties. H.R. 4302, Protecting Access to Medicare Act (Pitts) - ACA Limits on Deductibles for Plans in Small Group Market. H.R. 4354, ACA Taxpayer Bailout Protection Act (Griffin) - ACA risk corridor program. H.R. 4406, Taxpayer Bailout Protection Act (Lance) - ACA risk corridor program. H.R. 4414, Expatriate Health Coverage Clarification Act (Carney) - relief from ACA for expatriate health plans. H.R. 4735, Health Care Fairness and Stability Act (Nolan-McKinley) - ACA transitional reinsurance program. H.R. 5175, Protecting Americans from Illegal Bailouts Act (Lance) - ACA risk corridor program. S. 24, Small Business Health Relief Act (Portman) - HIT repeal, other ACA changes. S. 482, Health Insurance Rate Review Act (Feinstein) - rate review. S. 650, Access to Independent Health Insurance Advisors Act (Landrieu) - MLR impact on agents and brokers. S. 764, Patients Right to Know Act (Cornyn) - disclosures on SBC documents. S. 1473, Long-Term Care Insurance Consumer Right-to-Know Act (Klobuchar) - model disclosure forms. S. 1481, Long Term Care Insurance Integrity Act (Klobuchar) - third party review of disputed claims. S. 1642, Keeping the ACA Promise Act (Landrieu-Manchin) - continuation of existing plans, notification requirements. S. 1671, (Manchin-Kirk) - individual mandate delay. S. 1693, ACA Enrollment Extension Act (Shaheen) - extending open enrollment, delaying individual mandate penalties. S. 1699, Continuous Coverage Act (Mark Udall) - continuation of existing plans. S. 1726, Obamacare Taxpayer Bailout Prevention Act (Rubio) - repeal of ACA risk corridor program. S. 1729, Expanded Consumer Choice Act (Begich) - adding copper level of coverage to ACA Exchanges. S. 1866, Coverage Protection Act (Merkley) - continuation of coverage, retroactive coverage. S. 2166, Treating Families Fairly Act (Manchin) - ACA determinations of full-time equivalent employees. S. 2168, Small Business Stability Act (Heitkamp) - ACA definition of a large employer. S. 2173, Consumers Having Options in Choosing Enrollment Act (Landrieu) - ACA direct enrollment. S. 2174, Commonsense Competition and Access to Health Insurance Act (Warner) - offering health insurance coverage across state lines. S. 2175, Enhancing Access for Agents and Brokers Act (Landrieu) - access for independent agents and brokers to information about Exchange enrollment. S. 2176, Commonsense Reporting Act (Warner) - ACA reporting requirements. S. 2214, ACA Taxpayer Bailout Protection Act (Rubio) - ACA risk corridor program. S. 2253, Health Care Fairness and Stability Act (Franken-Kirk) - ACA transitional reinsurance program. S. 2578, Protect Women's Health From Corporate Interference Act (Murray) - contraceptive coverage. S. 2733, Obamacare Opt-Out Act (McCain-Barrasso) - certification process for opting out of ACA individual mandate. S. 2801, Health Care Consumer Choices Preservation Act (Enzi) - conditions on automatic renewals.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation and regulations affecting health plans. H.R.763, To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act. H.R.3350, Keep Your Health Plan Act of 2013. H.R.3541/S.1726, Obamacare Taxpayer Bailout Prevention Act.

Client expense: Not reported · Firm income: $50,000

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

H.R. 3350 Keep Your Health Plan Act of 2013; H.R. 4302; Medicare Advantage; H.R. 3750; Telehealth Modernization Act.

Client expense: Not reported · Firm income: $90,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 416 - Health Insurance Rate Review Act:A bill to amend the Public Health Service Act to provide protection for consumers against excessive, unjustified or unfairly discriminatory increases in premium rates. HR 979 - FEHBP Prescription Drug Integrity, Transparency, and Cost Savings Act: To amend chapter of title 5, United States Code to ensure program integrity, transparency and cost savings in the pricing and contracting of prescription drug benefits under the Federal Employees Health Benefits Program. HR 1370 - To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act. HR 2577 - SAFE Data Act: A bill to protect consumers by requiring reasonable security policies and procedures to protect data containing personal information and to provide for nationwide notice in the event of a security breach. HR 2676 - Small Business Health Relief Act of 2011: To lower health premiums and increase choice for small business. HR 3350 - Keep your Health Plan Act of 2013: To authorize health insurance issuers to continue to offer for sale current individual health insurance coverage in satisfaction of the minimum essential health insurance coverage requirement, and for other purposes. HR 3522 - Employee Health Care Protection Act of 2013: To authorize health insurance issuers to continue to offer for sale current individual health insurance coverage in satisfaction of the minimum essential health insurance coverage requirement and for other purposes. HR 3541 - Obamacare Taxpayer Bailout Prevention Act: To prevent a taxpayer bailout of health insurance issuers. HR 4805 - No subsidies Without Verification Process Act of 2014:To delay the provision of the Affordable Care Act premium and cost-sharing subsidies until the eligibility verification process for such subsidies is complete and for other purposes. HR 5214 - Clinical Data Registries: To require the Secretary of Health & Human Services to provide for recommendations for the development and use of clinical data registries for the improvement of patient care. HR 5364 - CHIP Extension & Improvement Act of 2014: To amend title XXI of the Social Security Act to extend and improve Childrens Health Insurance Program and for other purposes. S 24 - Small Business Health Relief Act of 2013: To lower health premiums and increase choice for small business. S 40 - American Liberty Restoration Act: To restore Americans individual liberty by striking the federal mandate to purchase insurance. S 482 - Health Insurance Rate Review Act: To amend the Public Health Service to provide protections for consumers against excessive, unjustified or unfairly discriminatory increases in premium rates. S 1726 - Obamacare Taxpayer Bailout Prevention Act: To prevent a taxpayer bailout of health insurance issuers. S 1729 - Expanded Consumer Choice Act:To amend the Patient Protection and Affordable Care Act to provide further options with respect to levels of coverage under qualified health plans. S 1880 - Jobs and Premium Protection Act: To repeal the annual fee on health care laws job-killing health insurance tax. S 2174 - Commonsense Competition and Access to Health Insurance Act: To amend the Patient Protection and Affordable Care Act to provide greater flexibility in offering health insurance coverage across state lines. S 2461 - CHIP Extension Act of 2014: Amend title XXI of the Social Security Act to extend & improve the Childrens Health Insurance Program and for other purposes. Department of Health & Human Services Implementation of Medical Loss Ratio arrangements; Implementation of health insurance exchanges; Implementation of Qualified Health Plans, Implementation Essential Health Benefits.

Client expense: $130,000 · Firm income: Not reported

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

Americans Giving Care to Elders Act (S.1485) Authority for Mandate Delay Act (H.R.2667) Comments/Testimony to FDA-Sec.907 of FDASIA Comments to CMS-Exchanges & Health Plans Qulaity Rating SystemCommunity Parks Revitalization Act (H.R.2424) Community Prevention Grants Continuous Coverage Act (S.1699) Draft Research Priorities (PCORI) EMS Quality, Innovation, and Cost Effectiveness Improvements Act of 2011 (H.R.3144) Fairness for American Families Act (H.R.2668) Health Care Waiver Fairness Act (H.R. 2700) Healthy Kids Outdoors Act (H.R.4706) HHS- Clinical Trials Insurance Coverage (ACA Sec. 2709) If You Like Your Health Care, You Can Keep It Act (S.1617) Josh Miller Helping Everyone Access Responsive Treatment in Schools (HEARTS) Act (H.R.1377) Keeping the Affordable Care Act Promise Act (S.1642) Keep Your Health Plan Act (H.R.3350) Menu Labeling (ACA Section 4205) Newborn Screening Saves Lives Reauthorization Act of 2013 (H.R. 1281/ S.1471) No Child Left Inside Act of 2013 (H.R.2702) Next Generation Research Act (S.1552) Palliative Care and Hospice Education Training Act (H.R.1339 & S.641) Patient Centered Quality Care for Life Act (H.R.1666) Patient Protection and Affordable Care Act (P.L. 111-148; P.L. 111-152) - Implementation Physical Activity Guidelines for Americans Act (S.531 & H.R.2179) Prevention and Public Health Fund (ACA Section 4002) Proposed Rule on 90-Day Waiting Period (DOL/CMS/IRS) Proposed Rule on Exchange & Market Standards (CMS) Providing Accountability and Transperency to Incentivize Economically Necessary Transition in Health Care Act (H.R. 2688) Quality Rating System Scoring Specifications Comments (CMS) Research for All Act (H.R. 4879) Return to Work Act (S.1026 & H.R.3351) Revised Medical Criteria for Evaluating Neurological Disorders (SSA-2006-0140) The HELP America Act (S.39) The Helping Sick Americans Now Act (H.R.1549) The Personal Health Investment Today Act (H.R. 956) Veterans Emergency Medical Technician Act of 2013 (H.R. 1281/ S. 1471) Wireless E911 Location Accuracy Requirements (07-114; FCC 14-13) Women's Preventive Health Awareness Campaign Act (H.R. 2457)

Client expense: $205,194 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Education, Dept of, Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Transportation, Dept of (DOT), Treasury, Dept of, White House Office

Monitored HR 344, the Competitive Health Insurance Act Monitored HR 1254, to repeal a requirement that new employees of certain employers be automatically enrolled in their employers health benefit plans Monitored HR 1326, the Health Care Price Transparency Act Monitored HR 1342, to Helping Save Americans Health Care Choices Act Monitored HR 1558, to lower health premiums and increase choice for small business Monitored HR 1990/S 983, the Keep the IRS Off Your Health Care Act Monitored HR 2667, the Authority for Mandate Delay Act Monitored HR 2700, the Health Care Waiver Fairness Act Monitored HR 3046, the Small Business Health Care Tax Credit Improvement Act Monitored HR 4244, the Small Business Health Insurance Affordability Act of 2014 Monitored S 24, the Small Business Health Relief Act Monitored S 479, the Health Insurance Rate Review Act Monitored S 560, to construe the Individual Mandate of the Patient Protection and Affordable Care Act as a tax Monitored S 610, the Family Health Care Flexibility Act Monitored S 603, the Jobs and Premium Protection Act Monitored S 701, modifying the definition of full time employee for the purposes of the Patient Protection and Affordable Care Act Monitored HR 762, the Health Care Choice Act Monitored S 1154/HR 2938, the Exchange Sunset Act Monitored HR 3350, the Keep Your Health Plan Act Monitored S 1735/HR 3462, the Self-insurance Protection Act Monitored HR 3522, the Employee Health Care Protection Act Monitored S 1894, the Health Insurance Accountability Act

Client expense: $120,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 99, Health Insurance Industry Antitrust Enforcement Act (Conyers) antitrust policy16. Specific Lobbying Issues (continued): H.R. 544, LIBERTY Act (Gingrey-Matheson) age rating rules H.R. 743, Health Insurance Industry Fair Competition Act (DeFazio) antitrust policy H.R. 762, Health Care Choice Act (Blackburn) national marketplace for individual coverage H.R. 911, Competitive Health Insurance Reform Act (Gosar) antitrust policy H.R. 1019, Health Insurance Rate Review Act (Schakowsky) rate review H.R. 1188, Preserving Our Hometown Independent Pharmacies Act (Marino) antitrust policy H.R. 1205, Patients Right to Know Act (Walden) disclosures on SBC documents H.R. 1558, Small Business Health Relief Act (Collins) HIT repeal, other ACA changes H.R. 2328, Access to Professional Health Insurance Advisors Act (Rogers-Barrow) MLR impact on agents and brokers H.R. 2668, Fairness for American Families Act (Young) delay of ACA individual mandate H.R. 2698, Federal Employee Short-Term Disability Insurance Act (Norton) short-term disability program for federal employees H.R. 3121, American Health Care Reform Act (Roe) replacement health reforms H.R. 3350, Keep Your Health Plan Act (Upton) continuation of existing plans H.R. 3425, Health Care Access Fairness and Penalty Delay Act (Lipinski-Sinema) delay of open enrollment and individual mandate penalties H.R. 3489, (Tiberi) repeal of ACA transitional reinsurance fee H.R. 3504, Consumer Protection and Rate Review Act (Schakowsky) rate review H.R. 3517, Federal and State Insurance Exchange Access Fairness and Penalty Delay Act (Schrader) individual mandate delay H.R. 3522, Employee Health Care Protection Act (Cassidy) continuation of current group coverage H.R. 3541, Obamacare Taxpayer Bailout Prevention Act (Griffin) repeal of ACA risk corridor program H.R. 3598, Catastrophic Plan Bill (Fortenberry) expanded access to catastrophic plans H.R. 3745, Coverage Protection Act (Kirkpatrick) continuation of coverage for consumers unable to enroll in QHPs H.R. 3812, No Bailouts for Insurance Industry Act (Coffman) ACA reinsurance and risk corridor programs H.R. 3851, No Bailouts for Insurance Industry Act (Lance) ACA reinsurance and risk corridor programs H.R. 3985, Stop ACA's Risky Provisions Act (Westmoreland) ACAs reinsurance, risk corridor, and risk adjustment programs H.R. 4118, SIMPLE Fairness Act (Jenkins) delay in ACA individual mandate penalties H.R. 4302, Protecting Access to Medicare Act (Pitts) ACA Limits on Deductibles for Plans in Small Group Market H.R. 4354, ACA Taxpayer Bailout Protection Act (Griffin) ACA risk corridor program H.R. 4406, Taxpayer Bailout Protection Act (Lance) ACA risk corridor program H.R. 4414, Expatriate Health Coverage Clarification Act (Carney) relief from ACA for expatriate health plans H.R. 4735, Health Care Fairness and Stability Act (Nolan-McKinley) ACA transitional reinsurance program S. 24, Small Business Health Relief Act (Portman) HIT repeal, other ACA changes S. 482, Health Insurance Rate Review Act (Feinstein) rate review S. 650, Access to Independent Health Insurance Advisors Act (Landrieu) MLR impact on agents and brokers S. 764, Patients Right to Know Act (Cornyn) disclosures on SBC documents S. 1473, Long-Term Care Insurance Consumer Right-to-Know Act (Klobuchar) model disclosure forms S. 1481, Long Term Care Insurance Integrity Act (Klobuchar) third party review of disputed claims S. 1642, Keeping the ACA Promise Act (Landrieu-Manchin) continuation of existing plans, notification requirements S. 1671, (Manchin-Kirk) individual mandate delay S. 1693, ACA Enrollment Extension Act (Shaheen) extending open enrollment, delaying individual mandate penalties S. 1699, Continuous Coverage Act (Mark Udall) continuation of existing plans S. 1726, Obamacare Taxpayer Bailout Prevention Act (Rubio) repeal of ACA risk corridor program S. 1729, Expanded Consumer Choice Act (Begich) adding copper level of coverage to ACA Exchanges S. 1866, Coverage Protection Act (Merkley) continuation of coverage, retroactive coverage S. 2166, Treating Families Fairly Act (Manchin) ACA determinations of full-time equivalent employees S. 2168, Small Business Stability Act (Heitkamp) ACA definition of a large employer S. 2173, Consumers Having Options in Choosing Enrollment Act (Landrieu) ACA direct enrollment16. Specific Lobbying Issues (continued): S. 2174, Commonsense Competition and Access to Health Insurance Act (Warner) offering health insurance coverage across state lines S. 2175, Enhancing Access for Agents and Brokers Act (Landrieu) access for independent agents and brokers to information about Exchange enrollments. S. 2176, Commonsense Reporting Act (Warner) ACA reporting requirements S. 2214, ACA Taxpayer Bailout Protection Act (Rubio) ACA risk corridor program S. 2253, Health Care Fairness and Stability Act (Franken-Kirk) ACA transitional reinsurance program Regulatory Issues: Insurance regulatory reform; issues related to the coordination of private and public disability income benefits; disability risk management; disability income insurance enrollment and awareness; issues related to the continuation of reporting requirements for state LTCI partnership programs; issues relating to the coordination of benefits between private health insurance plans and Medicaid; Medigap claims processing and crossover fees; Medigap cross-over claim issues, Medigap coverage, implementation of Medigap standardized plan offerings; Medigap carrier recoveries related to CMS fraud and abuse enforcement activities, and issues related to Medigap educational materials, and other Medigap issues; fraud and abuse issues affecting public and private insurance coverage; issues relating to antitrust; implementation of the Mental Health Parity Act requirements; summary of benefits and coverage disclosures; pre-existing condition insurance plans; accountable care organizations; coverage of preventive services; preexisting condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; health insurance web portal requirements; dependent coverage; treatment of expatriate plans; compliance with the transitional reinsurance program; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations, non-discriminatory wellness programs; and issues related to supplemental products, and other issues relating to health care reform implementation.

Client expense: $2,530,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), Government Accountability Office (GAO), 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, Social Security Administration (SSA), Treasury, Dept of, White House Office

Legislation and regulations affecting health plans. H.R.763, To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act. H.R.3350, Keep Your Health Plan Act of 2013. H.R.3541/S.1726, Obamacare Taxpayer Bailout Prevention Act.

Client expense: Not reported · Firm income: $50,000

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

H.R. 99, Health Insurance Industry Antitrust Enforcement Act (Conyers) - antitrust policy. H.R. 544, LIBERTY Act (Gingrey-Matheson) - age rating rules. H.R. 743, Health Insurance Industry Fair Competition Act (DeFazio) - antitrust policy. H.R. 762, Health Care Choice Act (Blackburn) - national marketplace for individual coverage. H.R. 911, Competitive Health Insurance Reform Act (Gosar) - antitrust policy. H.R. 1019, Health Insurance Rate Review Act (Schakowsky) - rate review. H.R. 1188, Preserving Our Hometown Independent Pharmacies Act (Marino) - antitrust policy. H.R. 1205, Patients Right to Know Act (Walden) - disclosures on SBC documents. H.R. 1558, Small Business Health Relief Act (Collins) - HIT repeal, other ACA changes. H.R. 2328, Access to Professional Health Insurance Advisors Act (Rogers-Barrow) - MLR impact on agents and brokers. H.R. 2668, Fairness for American Families Act (Young) - delay of ACA individual mandate. H.R. 2698, Federal Employee Short-Term Disability Insurance Act (Norton) - short-term disability program for federal employees. H.R. 3121, American Health Care Reform Act (Roe) - replacement health reforms. H.R. 3350, Keep Your Health Plan Act (Upton) - continuation of existing plans. H.R. 3425, Health Care Access Fairness and Penalty Delay Act (Lipinski-Sinema) - delay of open enrollment and individual mandate penalties. H.R. 3489, (Tiberi) - repeal of ACA transitional reinsurance fee. H.R. 3504, Consumer Protection and Rate Review Act (Schakowsky) - rate review. H.R. 3517, Federal and State Insurance Exchange Access Fairness and Penalty Delay Act (Schrader) - individual mandate delay. H.R. 3522, Employee Health Care Protection Act (Cassidy) - continuation of current group coverage. H.R. 3541, Obamacare Taxpayer Bailout Prevention Act (Griffin) - repeal of ACA risk corridor program. H.R. 3598, Catastrophic Plan Bill (Fortenberry) - expanded access to catastrophic plans. H.R. 3745, Coverage Protection Act (Kirkpatrick) - continuation of coverage for consumers unable to enroll in QHPs. H.R. 3812, No Bailouts for Insurance Industry Act (Coffman) - ACA reinsurance and risk corridor programs. H.R. 3851, No Bailouts for Insurance Industry Act (Lance) - ACA reinsurance and risk corridor programs. H.R. 3985, Stop ACA's Risky Provisions Act (Westmoreland) - ACAs reinsurance, risk corridor, and risk adjustment programs. H.R. 4118, SIMPLE Fairness Act (Jenkins) - delay in ACA individual mandate penalties. H.R. 4302, Protecting Access to Medicare Act (Pitts) - ACA Limits on Deductibles for Plans in Small Group Market. H.R. 4354, ACA Taxpayer Bailout Protection Act (Griffin) - ACA risk corridor program. H.R. 4406, Taxpayer Bailout Protection Act (Lance) - ACA risk corridor program. H.R. 4414, Expatriate Health Coverage Clarification Act (Carney) - relief from ACA for expatriate health plans. H.R. 4735, Health Care Fairness and Stability Act (Nolan-McKinley) - ACA transitional reinsurance program. S. 24, Small Business Health Relief Act (Portman) - HIT repeal, other ACA changes. S. 482, Health Insurance Rate Review Act (Feinstein) - rate review. S. 650, Access to Independent Health Insurance Advisors Act (Landrieu) - MLR impact on agents and brokers. S. 764, Patients Right to Know Act (Cornyn) - disclosures on SBC documents. S. 1473, Long-Term Care Insurance Consumer Right-to-Know Act (Klobuchar) - model disclosure forms. S. 1481, Long Term Care Insurance Integrity Act (Klobuchar) - third party review of disputed claims. S. 1642, Keeping the ACA Promise Act (Landrieu-Manchin) - continuation of existing plans, notification requirements. S. 1671, (Manchin-Kirk) - individual mandate delay. S. 1693, ACA Enrollment Extension Act (Shaheen) - extending open enrollment, delaying individual mandate penalties. S. 1699, Continuous Coverage Act (Mark Udall) - continuation of existing plans. S. 1726, Obamacare Taxpayer Bailout Prevention Act (Rubio) - repeal of ACA risk corridor program. S. 1729, Expanded Consumer Choice Act (Begich) - adding copper level of coverage to ACA Exchanges. S. 1866, Coverage Protection Act (Merkley) - continuation of coverage, retroactive coverage. S. 2166, Treating Families Fairly Act (Manchin) - ACA determinations of full-time equivalent employees. S. 2168, Small Business Stability Act (Heitkamp) - ACA definition of a large employer. S. 2173, Consumers Having Options in Choosing Enrollment Act (Landrieu) - ACA direct enrollment. S. 2174, Commonsense Competition and Access to Health Insurance Act (Warner) - offering health insurance coverage across state lines. S. 2175, Enhancing Access for Agents and Brokers Act (Landrieu) - access for independent agents and brokers to information about Exchange enrollment. S. 2176, Commonsense Reporting Act (Warner) - ACA reporting requirements. S. 2214, ACA Taxpayer Bailout Protection Act (Rubio) - ACA risk corridor program. S. 2253, Health Care Fairness and Stability Act (Franken-Kirk) - ACA transitional reinsurance program.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

See attached.Monitored HR 344, the Competitive Health Insurance Act Monitored HR 1254, to repeal a requirement that new employees of certain employers be automatically enrolled in their employers health benefit plans Monitored HR 1326, the Health Care Price Transparency Act Monitored HR 1342, to Helping Save Americans Health Care Choices Act Monitored HR 1558, to lower health premiums and increase choice for small business Monitored HR 1990/S 983, the Keep the IRS Off Your Health Care Act Monitored HR 2667, the Authority for Mandate Delay Act Monitored HR 2700, the Health Care Waiver Fairness Act Monitored HR 3046, the Small Business Health Care Tax Credit Improvement Act Monitored HR 4244, the Small Business Health Insurance Affordability Act of 2014 Monitored S 24, the Small Business Health Relief Act Monitored S 479, the Health Insurance Rate Review Act Monitored S 560, to construe the Individual Mandate of the Patient Protection and Affordable Care Act as a tax Monitored S 610, the Family Health Care Flexibility Act Monitored S 603, the Jobs and Premium Protection Act Monitored S 701, modifying the definition of full time employee for the purposes of the Patient Protection and Affordable Care Act Monitored HR 762, the Health Care Choice Act Monitored S 1154/HR 2938, the Exchange Sunset Act Monitored HR 3350, the Keep Your Health Plan Act Monitored S 1735/HR 3462, the Self-insurance Protection Act Monitored HR 3522, the Employee Health Care Protection Act Monitored S 1894, the Health Insurance Accountability Act

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

Government targets: Bureau of Land Management (BLM), HOUSE OF REPRESENTATIVES, SENATE, U.S. Forest Service

Legislation and regulations affecting health plans. H.R. 763, To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act. H.R. 3350, Keep Your Health Plan Act of 2013. H.R. 3541 / S. 1726, Obamacare Taxpayer Bailout Prevention Act.

Client expense: Not reported · Firm income: $50,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Americans Giving Care to Elders Act (S.1485) Authority for Mandate Delay Act (H.R.2667) Comments/Testimony to FDA-Sec.907 of FDASIA Comments to CMS-Exchanges & Health Plans Qulaity Rating SystemCommunity Parks Revitalization Act (H.R.2424) Community Prevention Grants Continuous Coverage Act (S.1699) Draft Research Priorities (PCORI) Education and Training (EAT) for Health Act (H.R.2424) EMS Quality, Innovation, and Cost Effectiveness Improvements Act of 2011 (H.R.3144) Fairness for American Families Act (H.R.2668) Health Care Waiver Fairness Act (H.R. 2700) Health Risk Assessments in Medicare Comments (CDC) Healthy Kids Outdoors Act (TBD) HHS- Clinical Trials Insurance Coverage (ACA Sec. 2709) If You Like Your Health Care, You Can Keep It Act (S.1617) Interest Rate Reduction Act (H.R.4628/S.2366) and other legislation using Prevention Fund to offset student loans Josh Miller Helping Everyone Access Responsive Treatment in Schools (HEARTS) Act (H.R.1377) Keeping the Affordable Care Act Promise Act (S.1642) Keep Your Health Plan Act (H.R.3350) Menu Labeling (ACA Section 4205) Newborn Screening Saves Lives Reauthorization Act of 2013 (H.R. 1281/ S.1471) No Child Left Inside Act of 2013 (H.R.2702) Next Generation Research Act (S.1552) Patient Protection and Affordable Care Act (P.L. 111-148; P.L. 111-152) - Implementation Physical Activity Guidelines for Americans Act (S.531 & H.R.2179) Prevention and Public Health Fund (ACA Section 4002) Proposed rule on Community Health Needs Assessment Requirements for Charitable Hospitals (IRS) Proposed rule on Medicaid Essential Health Benefits (CMS) Proposed rule on Minimum Value of Employer Health Coverage (IRS) Proposed rule on Multi-State Plans Program (OPM) Proposed rule on Workplace Wellness Programs (HHS-Labor) Providing Accountability and Transperency to Incentivize Economically Necessary Transition in Health Care Act (H.R. 2688) Return to Work Act (S.1026 & H.R.3351) Tentative Determination Regarding Partially Hydogenated Oils ( FDA-2013-N-1317) The HELPAmerica Act (S.39) The Helping Sick Americans Now Act (H.R.1549) The Personal Health Investment Today Act (H.R. 956) Veterans Emergency Medical Technician Act of 2013 (H.R. 1281/ S. 1471) Women's Preventive Health Awareness Campaign Act (H.R. 2457)

Client expense: $174,517 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Education, Dept of, Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Transportation, Dept of (DOT), Treasury, Dept of, White House Office

H.R. 99, Health Insurance Industry Antitrust Enforcement Act (Conyers) antitrust policy16. Specific Lobbying Issues (continued): H.R. 544, LIBERTY Act (Gingrey-Matheson) age rating rules H.R. 743, Health Insurance Industry Fair Competition Act (DeFazio) antitrust policy H.R. 762, Health Care Choice Act (Blackburn) national marketplace for individual coverage H.R. 911, Competitive Health Insurance Reform Act (Gosar) antitrust policy H.R. 1019, Health Insurance Rate Review Act (Schakowsky) rate review H.R. 1188, Preserving Our Hometown Independent Pharmacies Act (Marino) antitrust policy H.R. 1205, Patients Right to Know Act (Walden) disclosures on SBC documents H.R. 1558, Small Business Health Relief Act (Collins) HIT repeal, other ACA changes H.R. 2328, Access to Professional Health Insurance Advisors Act (Rogers-Barrow) MLR impact on agents and brokers H.R. 2668, Fairness for American Families Act (Young) delay of ACA individual mandate H.R. 2698, Federal Employee Short-Term Disability Insurance Act (Norton) short-term disability program for federal employees H.R. 3121, American Health Care Reform Act (Roe) replacement health reforms H.R. 3350, Keep Your Health Plan Act (Upton) continuation of existing plans H.R. 3425, Health Care Access Fairness and Penalty Delay Act (Lipinski-Sinema) delay of open enrollment and individual mandate penalties H.R. 3489, (Tiberi) repeal of ACA transitional reinsurance fee H.R. 3504, Consumer Protection and Rate Review Act (Schakowsky) rate review H.R. 3517, Federal and State Insurance Exchange Access Fairness and Penalty Delay Act (Schrader) individual mandate delay H.R. 3522, Employee Health Care Protection Act (Cassidy) continuation of current group coverage H.R. 3541, Obamacare Taxpayer Bailout Prevention Act (Griffin) repeal of ACA risk corridor program H.R. 3745, Coverage Protection Act (Kirkpatrick) continuation of coverage for consumers unable to enroll in QHPs H.R. 3812, No Bailouts for Insurance Industry Act (Coffman) ACA reinsurance and risk corridor programs H.R. 3851, No Bailouts for Insurance Industry Act (Lance) ACA reinsurance and risk corridor programs H.R. 3985, Stop ACA's Risky Provisions Act (Westmoreland) ACAs reinsurance, risk corridor, and risk adjustment programs H.R. 4118, SIMPLE Fairness Act (Jenkins) delay in ACA individual mandate penalties H.R. 4302, Protecting Access to Medicare Act (Pitts) ACA Limits on Deductibles for Plans in Small Group Market S. 24, Small Business Health Relief Act (Portman) HIT repeal, other ACA changes S. 482, Health Insurance Rate Review Act (Feinstein) rate review S. 650, Access to Independent Health Insurance Advisors Act (Landrieu) MLR impact on agents and brokers S. 764, Patients Right to Know Act (Cornyn) disclosures on SBC documents S. 1473, Long-Term Care Insurance Consumer Right-to-Know Act (Klobuchar) model disclosure forms S. 1481, Long Term Care Insurance Integrity Act (Klobuchar) third party review of disputed claims S. 1642, Keeping the ACA Promise Act (Landrieu-Manchin) continuation of existing plans, notification requirements S. 1671, (Manchin-Kirk) individual mandate delay S. 1693, ACA Enrollment Extension Act (Shaheen) extending open enrollment, delaying individual mandate penalties S. 1699, Continuous Coverage Act (Mark Udall) continuation of existing plans S. 1726, Obamacare Taxpayer Bailout Prevention Act (Rubio) repeal of ACA risk corridor program S. 1729, Expanded Consumer Choice Act (Begich) adding copper level of coverage to ACA Exchanges S. 1866, Coverage Protection Act (Merkley) continuation of coverage, retroactive coverage S. 2166, Treating Families Fairly Act (Manchin) ACA determinations of full-time equivalent employees S. 2168, Small Business Stability Act (Heitkamp) ACA definition of a large employer S. 2173, Consumers Having Options in Choosing Enrollment Act (Landrieu) ACA direct enrollment S. 2174, Commonsense Competition and Access to Health Insurance Act (Warner) offering health insurance coverage across state lines S. 2175, Enhancing Access for Agents and Brokers Act (Landrieu) access for independent agents and brokers to information about Exchange enrollment S. 2176, Commonsense Reporting Act (Warner) ACA reporting requirements16. Specific Lobbying Issues (continued): Regulatory Issues: Insurance regulatory reform; issues related to the coordination of private and public disability income benefits; disability risk management; disability income insurance enrollment and awareness; issues related to the continuation of reporting requirements for state LTCI partnership programs; issues relating to the coordination of benefits between private health insurance plans and Medicaid; Medigap claims processing and crossover fees; Medigap cross-over claim issues, Medigap coverage, implementation of Medigap standardized plan offerings; Medigap carrier recoveries related to CMS fraud and abuse enforcement activities, and issues related to Medigap educational materials, and other Medigap issues; fraud and abuse issues affecting public and private insurance coverage; issues relating to antitrust; implementation of the Mental Health Parity Act requirements; summary of benefits and coverage disclosures; pre-existing condition insurance plans; accountable care organizations; coverage of preventive services; preexisting condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; health insurance web portal requirements; dependent coverage; treatment of expatriate plans; compliance with the transitional reinsurance program; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations, non-discriminatory wellness programs; and issues related to supplemental products, and other issues relating to health care reform implementation. 18. Name of Lobbyists (continued): C. Lawrence: Assistant, Legislative Director for Rep. Bill Cassidy (LA-6); May 2008-July 200: Staff Assistant, Legislative Correspondent for Rep. Tom Price (GA-6)

Client expense: $2,430,000 · 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 Trade Commission (FTC), Food & Drug Administration (FDA), Government Accountability Office (GAO), 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. 99, Health Insurance Industry Antitrust Enforcement Act (Conyers) - antitrust policy; H.R. 544, LIBERTY Act (Gingrey-Matheson) - age rating rules; H.R. 743, Health Insurance Industry Fair Competition Act (DeFazio) - antitrust policy; H.R. 762, Health Care Choice Act (Blackburn) - national marketplace for individual coverage; H.R. 911, Competitive Health Insurance Reform Act (Gosar) - antitrust policy; H.R. 1019, Health Insurance Rate Review Act (Schakowsky) - rate review; H.R. 1188, Preserving Our Hometown Independent Pharmacies Act (Marino) - antitrust policy; H.R. 1205, Patients Right to Know Act (Walden) - disclosures on SBC documents; H.R. 1558, Small Business Health Relief Act (Collins) - HIT repeal, other ACA changes; H.R. 2328, Access to Professional Health Insurance Advisors Act (Rogers-Barrow) - MLR impact on agents and brokers; H.R. 2668, Fairness for American Families Act (Young) - delay of ACA individual mandate; H.R. 2698, Federal Employee Short-Term Disability Insurance Act (Norton) - short-term disability program for federal employees; H.R. 3121, American Health Care Reform Act (Roe) - replacement health reforms; H.R. 3350, Keep Your Health Plan Act (Upton) - continuation of existing plans; H.R. 3425, Health Care Access Fairness and Penalty Delay Act (Lipinski-Sinema) - delay of open enrollment and individual mandate penalties; H.R. 3489, (Tiberi) - repeal of ACA transitional reinsurance fee; H.R. 3504, Consumer Protection and Rate Review Act (Schakowsky) - rate review; H.R. 3517, Federal and State Insurance Exchange Access Fairness and Penalty Delay Act (Schrader) - individual mandate delay; H.R. 3522, Employee Health Care Protection Act (Cassidy) - continuation of current group coverage; H.R. 3541, Obamacare Taxpayer Bailout Prevention Act (Griffin) - repeal of ACA risk corridor program; H.R. 3745, Coverage Protection Act (Kirkpatrick) - continuation of coverage for consumers unable to enroll in QHPs; H.R. 3812, No Bailouts for Insurance Industry Act (Coffman) - ACA reinsurance and risk corridor programs; H.R. 3851, No Bailouts for Insurance Industry Act (Lance) - ACA reinsurance and risk corridor programs; H.R. 3985, Stop ACA's Risky Provisions Act (Westmoreland) - ACAs reinsurance, risk corridor, and risk adjustment programs; H.R. 4118, SIMPLE Fairness Act (Jenkins) - delay in ACA individual mandate penalties; H.R. 4302, Protecting Access to Medicare Act (Pitts) - ACA Limits on Deductibles for Plans in Small Group Market; S. 24, Small Business Health Relief Act (Portman) - HIT repeal, other ACA changes; S. 482, Health Insurance Rate Review Act (Feinstein) - rate review; S. 650, Access to Independent Health Insurance Advisors Act (Landrieu) - MLR impact on agents and brokers; S. 764, Patients Right to Know Act (Cornyn) - disclosures on SBC documents; S. 1473, Long-Term Care Insurance Consumer Right-to-Know Act (Klobuchar) - model disclosure forms; S. 1481, Long Term Care Insurance Integrity Act (Klobuchar) - third party review of disputed claims; S. 1642, Keeping the ACA Promise Act (Landrieu-Manchin) - continuation of existing plans, notification requirements; S. 1671, (Manchin-Kirk) - individual mandate delay; S. 1693, ACA Enrollment Extension Act (Shaheen) - extending open enrollment, delaying individual mandate penalties; S. 1699, Continuous Coverage Act (Mark Udall) - continuation of existing plans; S. 1726, Obamacare Taxpayer Bailout Prevention Act (Rubio) - repeal of ACA risk corridor program; S. 1729, Expanded Consumer Choice Act (Begich) - adding copper level of coverage to ACA Exchanges; S. 1866, Coverage Protection Act (Merkley) - continuation of coverage, retroactive coverage; S. 2166, Treating Families Fairly Act (Manchin) - ACA determinations of full-time equivalent employees; S. 2168, Small Business Stability Act (Heitkamp) - ACA definition of a large employer; S. 2173, Consumers Having Options in Choosing Enrollment Act (Landrieu) - ACA direct enrollment; S. 2174, Commonsense Competition and Access to Health Insurance Act (Warner) - offering health insurance coverage across state lines; S. 2175, Enhancing Access for Agents and Brokers Act (Landrieu) - access for independent agents and brokers to information about Exchange enrollment; S. 2176, Commonsense Reporting Act (Warner) - ACA reporting requirements.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Opposed all provisions: H.R. 3350: Keep Your Health Plan Act of 2013 S 1642: Keeping the Affordable Care Act Promise Act S. 1617: If You Like Your Health Plan, You Can Keep it ActOpposed all Provisions: S. 1699: Continuous Coverage Act Opposed Some Health Related Provisions: H.J. Res. 59, Continuing Appropriations Resolution, 2014

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR3350 "Keep Your Health Plan Act of 2013," all provisions. Issues relating to legislative alternatives to the Affordable Care Act. Issues relating to defunding, repealing and replacing "Obamacare" and to positive health care policy solutions. Issues relating to health care site data.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation and regulations affecting health plans. H.R. 763, To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act. H.R. 3350, Keep Your Health Plan Act of 2013. H.J.Res. 59, Continuing Appropriations Resolution, 2014.

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

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

See attached addendum for General Lobbying Issue Area: HCR - HealthcareSuccessful Insurance Industry Implementation of Health Reforms: Reasonable regulatory implementation timeline for compliance with PL 111-148 Affordable Private Health Care: Effect of the Health Insurance Tax, defined Essential Health Benefits, and Age Rating on premiums; 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; Multi-State Health Plans; Centralized All-Payer Database Medical Loss Ratios: Level Playing Field for MLRs; Consistent reporting requirements for all insurers Health Care Quality; Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/ Medical Home; Evidence Based Care; Wellness; Chronic Care Management Insurance Market Reform; Individual Market Reform; Small Group Market Reform; Guaranteed Issue; Community Rating; Age Rating; 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 2667 Introduced by Griffin (R-AR) on July 11, 2013 Authority for Mandate Delay Act HR 2668 Introduced by Young (R-IN) on July 17, 2013 Fairness for Families Act S. 1488 Introduced in Senate September 9, 2013 Fairness for American Families Act - Amends the Internal Revenue Code, as amended by the Patient Protection and Affordable Care Act (PPACA), to delay until 2015 the requirement that individuals maintain minimal essential health care coverage. Authority for Mandate Delay Act - Amends PPACA to delay until 2015 enforcement of requirements that large employers offer their full-time employees the opportunity to enroll in minimum essential coverage. Delays the effective date of related reporting requirements for such employers and for providers of minimum essential coverage. HR 3350 Passed House without amendment November 15, 2013 Keep Your Health Plan Act of 2013 - Permits a health insurance issuer that has in effect health insurance coverage in the individual market as of January 1, 2013, to continue offering such coverage for sale during 2014 outside of a health care exchange established under the Patient Protection and Affordable Care Act. Treats such coverage as a grandfathered health plan for purposes of an individual meeting the requirement to maintain minimum essential health coverage. S. 1486 Introduced August 1, 2013 by Sen. Carper, Thomas R. (D-DE) Postal Reform Act of 2013 - Amends provisions of federal law relating to the funding of the U.S. Postal Service (USPS) retirement and health care systems, operations, revenue, and governance. HR 3362 Introduced October 29, 2013 by Rep. Terry, Lee (R-NE) Exchange Information Disclosure Act - Amends the Patient Protection and Affordable Care Act to expand reporting requirements related to health care exchanges. Requires the Secretary of Health and Human Services (HHS) to publish reports weekly through March 31, 2015, on: (1) consumer interactions with healthcare.gov or subsequent sites and any efforts undertaken to remedy problems that impact taxpayers and consumers, (2) calls to the federal customer service call center, including the number of calls received by the call center, problems identified by users, and referrals of those calls; (3) all navigators and certified application counselors that have been trained and certified by health care exchanges; and (4) all agents and brokers who have been trained and certified by the federal health care exchange.HR 762 Introduced in House February 15, 2013 by Rep. Blackburn, Marsha (R-TN) Health Care Choice Act of 2013 - Repeals the health insurance and health coverage expansion requirements of the Patient Protection and Affordable Care Act and related requirements of the Health Care and Education Reconciliation Act of 2010. Restores provisions of law amended or repealed by such provisions. H.J. Res. 59 making continuing appropriations for fiscal year 2014, and for other purposes; providing for consideration of motions to suspend the rules; providing for proceedings during the period from December 14, 2013, through January 6, 2014. HR 460 Introduced in House February 4, 2013 Rep. McKinley, David B. (R-WV) Patients' Access to Treatments Act of 2013 - Amends the Public Health Service Act to establish cost-sharing limits for health plans that cover prescription drugs and use a formulary or other tiered cost-sharing structure. Prohibits such a health plan from imposing cost-sharing requirements, including co-payment and co-insurance, application to prescription drugs in a specialty drug tier that exceed the dollar amount of cost-sharing requirements applicable to prescription drugs in a non-preferred brand drug tier. Applies the non-preferred brand drug tier for which beneficiary cost-sharing is lowest, if a formulary used by the health plan contains more than one non-preferred brand drug tier. Grandfathering and Delay of Individual Mandate ACA Implementation Multi-state Plan Program Implementation Risk Corridors

Client expense: Not reported · Firm income: Not reported

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

H.R. 763, the Jobs and Premium Protection Act support. H.R. 903, the American Job Protection Act support. H.R. 2542, the Regulatory Flexibility Improvements Act support.H.Res 359, expressing the sense of the House of Representatives that tax reform should jointly address corporate and pass-through entities in a fiscally responsible manner, and that reform should reduce the current tax rate differences between corporate and pass-through entities while maintaining adequate forms of organization for businesses support. H.R. 947, Small Business Accounting and Tax Simplification Act support. H.R. 1406, the Working Families Flexibility Act of 2013 support. H.R. 436, Government Neutrality in Contracting Act - support. H.R. 1120, the Preventing Greater Uncertainty in Labor- Management Relations Act support. H.R. 1772, the Legal Workforce Act. H.R. 2429, Death Tax Repeal Act of 2013 support. H.R. 2122, the Regulatory Accountability Act support. H.R. 3419 Small Business Fairness in Obamacare Act - support. H.R. 2728 Protecting States Rights to Promote American Energy Security Act support. H.R. 3350 Keep Your Health Plan Act of 2013 support. H.R. 2655 Lawsuit Abuse Reduction Act support. H.R. 2937 Commonsense Permitting for Job Creation Act support. H.R. 1488 Fairness for American Families Act support. H.R. 2575 Save American Workers Act support. Farm Bill urging conferees to include the language of H.R. 311, the Farmers Undertake Environmental Land Stewardship (FUELS) Act, in the final Farm Bill H.R. 3413 the True Understanding of the Economy and Safety Act Support H.R. 1324 Small Business Paper Work Relief Act S.Amdt.1871, to S. 1392, the Energy Savings and Industrial Competitiveness Act of 2013 support. S. 399, the American Job Protection Act support. S. 603, the Jobs and Premium Protection Act support. S. 1188, Forty Hours is Full Time Act support. S. 1085, Small Business Tax Certainty and Growth Act of 2013 support. S. 109, Government Neutrality in Contracting Act support. S. 1138, Death Tax Repeal Act of 2013 support. S. 1029, the Regulatory Accountability Act support. S. 460, Fair Minimum Wage Act oppose. S. 1658, Start-up Jobs and Innovation Act support S. 1488 A bill to delay the application of the individual health insurance mandate, to delay the application of the employer health insurance mandate, and for other purposes -support. Unemployment Insurance letter opposing FUTA Tax Increase to House and Senate Budget Committee conferees. Comments - IRS Proposed Rule on 45R Tax Credit for Employee Health Insurance Expenses of Small Employers FDA: Docket No. FDA2011N0921 - Standards for the Growing, Harvesting, Packing, and Holding of Produce for Human Consumption FDA: Docket No. FDA-2011N-0920 Current Good Manufacturing Practice and Hazard Analysis and Risk-Based Preventative Controls for Human Food Letters to Agencies - Letter to HHS regarding SHOP exchange delay, IRC 45R Tax Credit for Employee Health Insurance Expenses of Small Employers, and transitional policy for nonqualified health insurance plansOther Issues - Tax Reform Biennial budget FEHBP Entitlement reform Immigration reform, E-Verify, H2B visas Retirement Issues Keystone XL Project Employer nondiscrimination in PPACA Aggregation rules (ERISA/PPACA) Minimum wage Unemployment insurance Transitional policy on nonqualified plans in PPACA OSHA proposed rule on respirable crystalline silica OSHA proposed rule on electronic reporting EPA/Army Corps of Engineers proposed rule on definition of waters of the United States EPA proposed rule on greenhouse gases emissions from power plants OSHA enforcement DOT Definition of commercial motor vehicle Regulatory reform

Client expense: $730,000 · Firm income: Not reported

Government targets: Energy, Dept of, Environmental Protection Agency (EPA), Executive Office of the President (EOP), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Occupational Safety & Health Administration (OSHA), Office of Management & Budget (OMB), SENATE, Treasury, Dept of

H.R. 99, Health Insurance Industry Antitrust Enforcement Act (Conyers) antitrust policy16. Specific Lobbying Issues (continued): H.R. 544, LIBERTY Act (Gingrey-Matheson) age rating rules H.R. 743, Health Insurance Industry Fair Competition Act (DeFazio) antitrust policy H.R. 762, Health Care Choice Act (Blackburn) national marketplace for individual coverage H.R. 911, Competitive Health Insurance Reform Act (Gosar) antitrust policy H.R. 1019, Health Insurance Rate Review Act (Schakowsky) rate review H.R. 1188, Preserving Our Hometown Independent Pharmacies Act (Marino) antitrust policy H.R. 1205, Patients Right to Know Act (Walden) disclosures on SBC documents H.R. 1558, Small Business Health Relief Act (Collins) HIT repeal, other ACA changes H.R. 2328, Access to Professional Health Insurance Advisors Act (Rogers-Barrow) MLR impact on agents and brokers H.R. 2668, Fairness for American Families Act (Young) delay of ACA individual mandate H.R. 2698, Federal Employee Short-Term Disability Insurance Act (Norton) short-term disability program for federal employees H.R. 3121, American Health Care Reform Act (Roe) replacement health reforms H.R. 3350, Keep Your Health Plan Act (Upton) continuation of existing plans H.R. 3425, Health Care Access Fairness and Penalty Delay Act (Lipinski-Sinema) delay of open enrollment and individual mandate penalties H.R. 3489, (Tiberi) repeal of ACA transitional reinsurance fee H.R. 3504, Consumer Protection and Rate Review Act (Schakowsky) rate review H.R. 3517, Federal and State Insurance Exchange Access Fairness and Penalty Delay Act (Schrader) individual mandate delay H.R. 3522, Employee Health Care Protection Act (Cassidy) continuation of current group coverage H.R. 3541, Obamacare Taxpayer Bailout Prevention Act (Griffin) repeal of ACA risk corridor program H.R. 3745, Coverage Protection Act (Kirkpatrick) continuation of coverage for consumers unable to enroll in QHPs S. 24, Small Business Health Relief Act (Portman) HIT repeal, other ACA changes S. 482, Health Insurance Rate Review Act (Feinstein) rate review S. 650, Access to Independent Health Insurance Advisors Act (Landrieu) MLR impact on agents and brokers S. 764, Patients Right to Know Act (Cornyn) disclosures on SBC documents S. 1473, Long-Term Care Insurance Consumer Right-to-Know Act (Klobuchar) model disclosure forms S. 1481, Long Term Care Insurance Integrity Act (Klobuchar) third party review of disputed claims S. 1642, Keeping the ACA Promise Act (Landrieu-Manchin) continuation of existing plans, notification requirements S. 1671, (Manchin-Kirk) individual mandate delay S. 1693, ACA Enrollment Extension Act (Shaheen) extending open enrollment, delaying individual mandate penalties S. 1699, Continuous Coverage Act (Mark Udall) continuation of existing plans S. 1726, Obamacare Taxpayer Bailout Prevention Act (Rubio) repeal of ACA risk corridor program S. 1729, Expanded Consumer Choice Act (Begich) adding copper level of coverage to ACA Exchanges S. 1866, Coverage Protection Act (Merkley) continuation of coverage, retroactive coverage Regulatory Issues: Insurance regulatory reform; issues related to the coordination of private and public disability income benefits; disability risk management; issues related to the continuation of reporting requirements for state LTCI partnership programs; issues relating to the coordination of benefits between private health insurance plans and Medicaid; Medigap claims processing and crossover fees; Medigap cross-over claim issues, Medigap coverage, implementation of Medigap standardized plan offerings; Medigap carrier recoveries related to CMS fraud and abuse enforcement activities, and issues related to Medigap educational materials, and other Medigap issues; fraud and abuse issues affecting public and private insurance coverage; issues relating to antitrust; implementation of the Mental Health Parity Act requirements; summary of benefits and coverage disclosures; medical loss ratios; review of rates for reasonableness; health insurance exchanges; pre-existing condition insurance plans; accountable care organizations; coverage of preventive services; preexisting condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; health insurance web portal requirements; dependent coverage; treatment of expatriate plans; compliance with the transitional reinsurance program; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations, non-discriminatory wellness programs; and issues related to supplemental products, and other issues relating to health care reform implementation.

Client expense: $3,630,000 · 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

Improving the quality of home care Access to language services in health care S 1562 - Older Americans Reauthorization Act of 2013, programs to help older adults remain as healthy and independent as possible in their homes and communitiesAppropriations and DOL rulemaking HR 3350 - Keep Your Health Plan Act Federal tax exclusion for employer sponsored health insurance Medicare and Medicaid Reform

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

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

S 452 and HR 962, the Medicare Diabetes Prevention Act. H.R. 1915/S. 907, the Gestational Diabetes Act of 2013. H.R. 3350, Keep Your Health Plan Act of 2013. S. 1642, the Keeping the Affordable Care Act Promise Act. S. 1617. S. 1699, the Continuous Coverage Act. H.R. 1249, the Common Sense Nutrition Disclosure Act. H.R. 2178/S. 1033. H.R. 1783, the School Food Modernization Act. H.R. 2343. H.R. 1947. H.R. 2433. H.R. 2663/S. 1422. H.R. 3322. H.R. 3591, Minority Diabetes Initiative Act.S 452 and HR 962, the Medicare Diabetes Prevention Act. Support entire bill providing for Medicare Coverage of National Diabetes Prevention Program. H.R. 1915/S. 907, the Gestational Diabetes Act of 2013. Support entire bill; provides funding for the establishment of a tracking and surveillance system at the Centers for Disease Control and Prevention and provides grant funding for public health research on gestational diabetes. H.R. 3350, Keep Your Health Plan Act of 2013. Oppose entire bill; allows health insurers to continue to sell individual health insurance policies that do not meet standards established under the Affordable Care Act. S. 1642, the Keeping the Affordable Care Act Promise Act. Oppose entire bill; requires insurers to continue issuing existing individual-market plans for current enrollees and to do so in perpetuity. S. 1617, the If You Like Your Health Care, You Can Keep It Act. Oppose entire bill; allows people enrolled in plans prior to December 31, 2014 to keep such coverage indefinitely, even if that policy does not carry consumer protections required under the Affordable Care Act. S. 1699, the Continuous Coverage Act. Oppose entire bill; allows people enrolled in individual-market plans as of September 30, 2013 to remain in those plans for a more limited period of time (through the end of 2015) and maintain some of the requirements and consumer protections under the Affordable Care Act. H.R. 1249, the Common Sense Nutrition Disclosure Act. Oppose entire bill; makes exemptions to nutrition labeling in chain restaurants as required by the Patient Protection and Affordable Care Act. H.R. 2178/S. 1033, the Fitness Integrated in Teaching (FIT) Kids Act. Support entire bill; requires states to report on and reach physical education benchmarks; and requires training of physical education teachers and school administrators; physical education curriculum; and dedicated school space for physical education and physical activity. H.R. 1783, the School Food Modernization Act. Support entire bill, provides loan guarantees and grants for schools to improve their facilities in order to prepare and serve healthier meals. H.R. 2343, the Healthy Food Financing Initiative. Support entire bill; to provide financing to expand or improve supermarkets, grocery stores and other retail food options in underserved areas in order to make healthier food options available. H.R. 1947, the Federal Agriculture Reform and Risk Management Act/S. 954, the Agriculture Reform, Food and Jobs Act (the Farm Bill). Support Healthy Food Financing Provision, to provide financing to expand or improve supermarkets, grocery stores and other retail food options in underserved areas in order to make healthier food options available. H.R. 2433, the Stem Cell Research Advancement Act. Support entire bill; to codify the Obama Administration guidelines regarding human stem cell research, including human embryonic stem cell research, and for other purposes. H.R. 2663/S. 1422, the Preventive Health Savings Act. Support entire bill; to require the Director of the Congressional Budget Office (CBO), upon a request by the chairman or ranking minority member of certain congressional committees, to determine if proposed legislation would result in reductions in budget outlays in budgetary outyears through the use of preventive health and preventive health services. H.R. 3322, Eliminating Disparities in Diabetes Prevention, Access and Care Act. Support entire bill; expands resources at NIH, CDC, HRSA, and IHS to promote research, treatment, and education regarding diabetes in minority populations. H.R. 3591, Minority Diabetes Initiative Act. Support entire bill; provides grants for improved diabetes care for minority populations.Issues worked on the Hill not yet reflected in legislation: United States Preventive Services Task Forcesupport any efforts to require the USPSTF to update its recommendation for diabetes screening including gestational diabetes screening based on new evidence. Seek support for nomination of Dr. Elbert Huang to serve on the USPSTF. Special Diabetes Program educate Congress on the good work the program is doing in research and prevention and the need to reauthorize this program; Also support provision in the Senate Finance mark of the Sustainable Growth Rate which reauthorized the program for 5 years.

Client expense: $198,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Congressional Budget Office (CBO), HOUSE OF REPRESENTATIVES, Natl Institutes of Health (NIH), SENATE, White House Office

See attached addendum for General Lobbying Issue Area: HCR - HealthcareSuccessful Insurance Industry Implementation of Health Reforms: Reasonable regulatory implementation timeline for compliance with PL 111-148 Affordable Private Health Care: Effect of the Health Insurance Tax, defined Essential Health Benefits, and Age Rating on premiums; 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; Multi-State Health Plans; Centralized All-Payer Database Medical Loss Ratios: Level Playing Field for MLRs; Consistent reporting requirements for all insurers; MLR Broker Fees: Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Evidence Based Care; Wellness; Chronic Care Management Insurance Market Reform; Individual Market Reform; Small Group Market Reform; Guaranteed Issue; Community Rating; Age Rating; 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 2667 Introduced by Griffin (R-AR) on July 11, 2013 Authority for Mandate Delay Act HR 2668 Introduced by Young (R-IN) on July 17, 2013 Fairness for Families Act S. 1488 Introduced in Senate September 9, 2013 Fairness for American Families Act - Amends the Internal Revenue Code, as amended by the Patient Protection and Affordable Care Act (PPACA), to delay until 2015 the requirement that individuals maintain minimal essential health care coverage. Authority for Mandate Delay Act - Amends PPACA to delay until 2015 enforcement of requirements that large employers offer their full-time employees the opportunity to enroll in minimum essential coverage. Delays the effective date of related reporting requirements for such employers and for providers of minimum essential coverage. HR 3350 Passed House without amendment November 15, 2013 Keep Your Health Plan Act of 2013 - Permits a health insurance issuer that has in effect health insurance coverage in the individual market as of January 1, 2013, to continue offering such coverage for sale during 2014 outside of a health care exchange established under the Patient Protection and Affordable Care Act. Treats such coverage as a grandfathered health plan for purposes of an individual meeting the requirement to maintain minimum essential health coverage. HR 2328 Introduced in House June 12, 2013 Rep. Rogers, Mike J. (R-MI) Access to Professional Health Insurance Advisors Act of 2013 - Amends the Public Health Service Act to exclude remuneration paid for licensed independent insurance producers from administrative cost calculations for purposes of calculating the medical-loss ratio of a health insurance plan.S. 1486 Introduced August 1, 2013 by Sen. Carper, Thomas R. (D-DE) Postal Reform Act of 2013 - Amends provisions of federal law relating to the funding of the U.S. Postal Service (USPS) retirement and health care systems, operations, revenue, and governance. HR 3362 Introduced October 29,2013 by Rep. Terry, Lee (R-NE) Exchange Information Disclosure Act - Amends the Patient Protection and Affordable Care Act to expand reporting requirements related to health care exchanges. Requires the Secretary of Health and Human Services (HHS) to publish reports weekly through March 31, 2015, on: (1) consumer interactions with healthcare.gov or subsequent sites and any efforts undertaken to remedy problems that impact taxpayers and consumers, (2) calls to the federal customer service call center, including the number of calls received by the call center, problems identified by users, and referrals of those calls; (3) all navigators and certified application counselors that have been trained and certified by health care exchanges; and (4) all agents and brokers who have been trained and certified by the federal health care exchange. HR 762 Introduced in House February 15, 2013 by Rep. Blackburn, Marsha (R-TN) Health Care Choice Act of 2013 - Repeals the health insurance and health coverage expansion requirements of the Patient Protection and Affordable Care Act and related requirements of the Health Care and Education Reconciliation Act of 2010. Restores provisions of law amended or repealed by such provisions. H.J. Res. 59 making continuing appropriations for fiscal year 2014, and for other purposes; providing for consideration of motions to suspend the rules; providing for proceedings during the period from December 14, 2013, through January 6, 2014. HR 460 Introduced in House February 4, 2013 Rep. McKinley, David B. (R-WV) Patients' Access to Treatments Act of 2013 - Amends the Public Health Service Act to establish cost-sharing limits for health plans that cover prescription drugs and use a formulary or other tiered cost-sharing structure. Prohibits such a health plan from imposing cost-sharing requirements, including co-payment and co-insurance, applicable to prescription drugs in a specialty drug tier that exceed the dollar amount of cost-sharing requirements applicable to prescription drugs in a non-preferred brand drug tier. Applies the non-preferred brand drug tier for which beneficiary cost-sharing is lowest, if a formulary used by the health plan contains more than one non-preferred brand drug tier. Grandfathering and Delay of Individual Mandate ACA Implementation Multi-state Plan Program Implementation Risk Corridors

Client expense: $1,960,000 · 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), Office of Personnel Management (OPM), SENATE, Treasury, Dept of, White House Office

H.R. 763, the Jobs and Premium Protection Act support. H.R. 903, the American Job Protection Act support. H.R. 2542, the Regulatory Flexibility Improvements Act support.H.Res 359, expressing the sense of the House of Representatives that tax reform should jointly address corporate and pass-through entities in a fiscally responsible manner, and that reform should reduce the current tax rate differences between corporate and pass-through entities while maintaining adequate forms of organization for businesses support. H.R. 947, Small Business Accounting and Tax Simplification Act support. H.R. 1406, the Working Families Flexibility Act of 2013 support. H.R. 436, Government Neutrality in Contracting Act - support. H.R. 1120, the Preventing Greater Uncertainty in Labor- Management Relations Act support. H.R. 1772, the Legal Workforce Act. H.R. 2429, Death Tax Repeal Act of 2013 support. H.R. 2122, the Regulatory Accountability Act support. H.R. 3419 Small Business Fairness in Obamacare Act - support. H.R. 2728 Protecting States Rights to Promote American Energy Security Act support. H.R. 3350 Keep Your Health Plan Act of 2013 support. H.R. 2655 Lawsuit Abuse Reduction Act support. H.R. 2937 Commonsense Permitting for Job Creation Act support. H.R. 1488 Fairness for American Families Act support. H.R. 2575 Save American Workers Act support. Farm Bill urging conferees to include the language of H.R. 311, the Farmers Undertake Environmental Land Stewardship (FUELS) Act, in the final Farm Bill H.R. 3413 the True Understanding of the Economy and Safety Act Support H.R. 1324 Small Business Paper Work Relief Act S.Amdt.1871, to S. 1392, the Energy Savings and Industrial Competitiveness Act of 2013 support. S. 399, the American Job Protection Act support. S. 603, the Jobs and Premium Protection Act support. S. 1188, Forty Hours is Full Time Act support. S. 1085, Small Business Tax Certainty and Growth Act of 2013 support. S. 109, Government Neutrality in Contracting Act support. S. 1138, Death Tax Repeal Act of 2013 support. S. 1029, the Regulatory Accountability Act support. S. 460, Fair Minimum Wage Act oppose. S. 1658, Start-up Jobs and Innovation Act support S. 1488 A bill to delay the application of the individual health insurance mandate, to delay the application of the employer health insurance mandate, and for other purposes -support. Unemployment Insurance letter opposing FUTA Tax Increase to House and Senate Budget Committee conferees. Comments - IRS Proposed Rule on 45R Tax Credit for Employee Health Insurance Expenses of Small Employers FDA: Docket No. FDA2011N0921 - Standards for the Growing, Harvesting, Packing, and Holding of Produce for Human Consumption FDA: Docket No. FDA-2011N-0920 Current Good Manufacturing Practice and Hazard Analysis and Risk-Based Preventative Controls for Human Food Letters to Agencies - Letter to HHS regarding SHOP exchange delay, IRC 45R Tax Credit for Employee Health Insurance Expenses of Small Employers, and transitional policy for nonqualified health insurance plansOther Issues - Tax Reform Biennial budget FEHBP Entitlement reform Immigration reform, E-Verify, H2B visas Retirement Issues Keystone XL Project Employer nondiscrimination in PPACA Aggregation rules (ERISA/PPACA) Minimum wage Unemployment insurance Transitional policy on nonqualified plans in PPACA OSHA proposed rule on respirable crystalline silica OSHA proposed rule on electronic reporting EPA/Army Corps of Engineers proposed rule on definition of waters of the United States EPA proposed rule on greenhouse gases emissions from power plants OSHA enforcement DOT Definition of commercial motor vehicle Regulatory reform

Client expense: $730,000 · Firm income: Not reported

Government targets: Energy, Dept of, Environmental Protection Agency (EPA), Executive Office of the President (EOP), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Occupational Safety & Health Administration (OSHA), Office of Management & Budget (OMB), SENATE, Treasury, Dept of

HR3350 "Keep Your Health Plan Act of 2013," all provisions. Issues relating to legislative alternatives to the Affordable Care Act. Issues relating to defunding, repealing and replacing "Obamacare" and to positive health care policy solutions. Issues relating to health care site data.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

See attached addendum for General Lobbying Issue Area: HCR - HealthcareSuccessful Insurance Industry Implementation of Health Reforms: Reasonable regulatory implementation timeline for compliance with PL 111-148 Affordable Private Health Care: Effect of the Health Insurance Tax, defined Essential Health Benefits, and Age Rating on premiums; 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; Multi-State Health Plans; Centralized All-Payer Database Medical Loss Ratios: Level Playing Field for MLRs; Consistent reporting requirements for all insurers; MLR Broker Fees: Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Evidence Based Care; Wellness; Chronic Care Management Insurance Market Reform; Individual Market Reform; Small Group Market Reform; Guaranteed Issue; Community Rating; Age Rating; 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 2667 Introduced by Griffin (R-AR) on July 11, 2013 Authority for Mandate Delay Act HR 2668 Introduced by Young (R-IN) on July 17, 2013 Fairness for Families Act S. 1488 Introduced in Senate September 9, 2013 Fairness for American Families Act - Amends the Internal Revenue Code, as amended by the Patient Protection and Affordable Care Act (PPACA), to delay until 2015 the requirement that individuals maintain minimal essential health care coverage. Authority for Mandate Delay Act - Amends PPACA to delay until 2015 enforcement of requirements that large employers offer their full-time employees the opportunity to enroll in minimum essential coverage. Delays the effective date of related reporting requirements for such employers and for providers of minimum essential coverage. HR 3350 Passed House without amendment November 15, 2013 Keep Your Health Plan Act of 2013 - Permits a health insurance issuer that has in effect health insurance coverage in the individual market as of January 1, 2013, to continue offering such coverage for sale during 2014 outside of a health care exchange established under the Patient Protection and Affordable Care Act. Treats such coverage as a grandfathered health plan for purposes of an individual meeting the requirement to maintain minimum essential health coverage. HR 2328 Introduced in House June 12, 2013 Rep. Rogers, Mike J. (R-MI) Access to Professional Health Insurance Advisors Act of 2013 - Amends the Public Health Service Act to exclude remuneration paid for licensed independent insurance producers from administrative cost calculations for purposes of calculating the medical-loss ratio of a health insurance plan.S. 1486 Introduced August 1, 2013 by Sen. Carper, Thomas R. (D-DE) Postal Reform Act of 2013 - Amends provisions of federal law relating to the funding of the U.S. Postal Service (USPS) retirement and health care systems, operations, revenue, and governance. HR 3362 Introduced October 29,2013 by Rep. Terry, Lee (R-NE) Exchange Information Disclosure Act - Amends the Patient Protection and Affordable Care Act to expand reporting requirements related to health care exchanges. Requires the Secretary of Health and Human Services (HHS) to publish reports weekly through March 31, 2015, on: (1) consumer interactions with healthcare.gov or subsequent sites and any efforts undertaken to remedy problems that impact taxpayers and consumers, (2) calls to the federal customer service call center, including the number of calls received by the call center, problems identified by users, and referrals of those calls; (3) all navigators and certified application counselors that have been trained and certified by health care exchanges; and (4) all agents and brokers who have been trained and certified by the federal health care exchange. HR 762 Introduced in House February 15, 2013 by Rep. Blackburn, Marsha (R-TN) Health Care Choice Act of 2013 - Repeals the health insurance and health coverage expansion requirements of the Patient Protection and Affordable Care Act and related requirements of the Health Care and Education Reconciliation Act of 2010. Restores provisions of law amended or repealed by such provisions. H.J. Res. 59 making continuing appropriations for fiscal year 2014, and for other purposes; providing for consideration of motions to suspend the rules; providing for proceedings during the period from December 14, 2013, through January 6, 2014. HR 460 Introduced in House February 4, 2013 Rep. McKinley, David B. (R-WV) Patients' Access to Treatments Act of 2013 - Amends the Public Health Service Act to establish cost-sharing limits for health plans that cover prescription drugs and use a formulary or other tiered cost-sharing structure. Prohibits such a health plan from imposing cost-sharing requirements, including co-payment and co-insurance, applicable to prescription drugs in a specialty drug tier that exceed the dollar amount of cost-sharing requirements applicable to prescription drugs in a non-preferred brand drug tier. Applies the non-preferred brand drug tier for which beneficiary cost-sharing is lowest, if a formulary used by the health plan contains more than one non-preferred brand drug tier. Grandfathering and Delay of Individual Mandate ACA Implementation Multi-state Plan Program Implementation Risk Corridors

Client expense: $520,000 · 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), Office of Personnel Management (OPM), SENATE, Treasury, Dept of, White House Office

Successful Insurance Industry Implementation of Health Reforms: Reasonable regulatory implementation timeline for compliance with PL 111-148 Affordable Private Health Care: Effect of the Health Insurance Tax, defined Essential Health Benefits, and Age Rating onpremiums; 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; Multi-State Health Plans; Centralized All-Payer Database Medical Loss Ratios: Level Playing Field for MLRs; Consistent reporting requirements for all insurers; MLR Broker Fees: Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Evidence Based Care; Wellness; Chronic Care Management Insurance Market Reform; Individual Market Reform; Small Group Market Reform; Guaranteed Issue; Community Rating; Age Rating; 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 Medicare Reforms: Medicare A & B; Delivery System Reforms, Benefit Restructuring; Medigap first dollar coverage; cost contract extension HR 2667 Introduced by Griffin (R-AR) on July 11, 2013 Authority for Mandate Delay Act HR 2668 Introduced by Young (R-IN) on July 17, 2013 Fairness for Families Act S. 1488 Introduced in Senate September 9, 2013 Fairness for American Families Act - Amends the Internal Revenue Code, as amended by the Patient Protection and Affordable Care Act (PPACA), to delay until 2015 the requirement that individuals maintain minimal essential health care coverage. Authority for Mandate Delay Act - Amends PPACA to delay until 2015 enforcement of requirements that large employers offer their full-time employees the opportunity to enroll in minimum essential coverage. Delays the effective date of related reporting requirements for such employers and for providers of minimum essential coverage. HR 3350 Passed House without amendment November 15, 2013 Keep Your Health Plan Act of 2013 - Permits a health insurance issuer that has in effect health insurance coverage in the individual market as of January 1, 2013, to continue offering such coverage for sale during 2014 outside of a health care exchange established under the Patient Protection and Affordable Care Act. Treats such coverage as a grandfathered health plan for purposes of an individual meeting the requirement to maintain minimum essential health coverage. HR 2328 Introduced in House June 12, 2013 Rep. Rogers, Mike J. (R-MI) Access to Professional Health Insurance Advisors Act of 2013 - Amends the Public Health Service Act to exclude remuneration paid for licensed independent insurance producers from administrative cost calculations for purposes of calculating the medical-loss ratio of a health insurance plan. S. 1486 Introduced August 1, 2013 by Sen. Carper, Thomas R. (D-DE) Postal Reform Act of 2013 - Amends provisions of federal law relating to the funding of the U.S. Postal Service (USPS) retirement and health care systems, operations, revenue, and governance. HR 3362 Introduced October 29,2013 by Rep. Terry, Lee (R-NE) Exchange Information Disclosure Act - Amends the Patient Protection and Affordable Care Act to expand reporting requirements related to health care exchanges. Requires the Secretary of Health and Human Services (HHS) to publish reports weekly through March 31, 2015, on: (1) consumer interactions with healthcare.gov or subsequent sites and any efforts undertaken to remedy problems that impact taxpayers and consumers, (2) calls to the federal customer service call center, including the number of calls received by the call center, problems identified by users, and referrals of those calls; (3) all navigators and certified application counselors that have been trained and certified by health care exchanges; and (4) all agents and brokers who have been trained and certified by the federal health care exchange. HR 762 Introduced in House February 15, 2013 by Rep. Blackburn, Marsha (R-TN) Health Care Choice Act of 2013 - Repeals the health insurance and health coverage expansion requirements of the Patient Protection and Affordable Care Act and related requirements of the Health Care and Education Reconciliation Act of 2010. Restores provisions of law amended or repealed by such provisions. H.J. Res. 59 making continuing appropriations for fiscal year 2014, and for other purposes; providing for consideration of motions to suspend the rules; providing for proceedings during the period from December 14, 2013, through January 6, 2014. HR 460 Introduced in House February 4, 2013 Rep. McKinley, David B. (R-WV) Patients' Access to Treatments Act of 2013 - Amends the Public Health Service Act to establish cost-sharing limits for health plans that cover prescription drugs and use a formulary or other tiered cost-sharing structure. Prohibits such a health plan from imposing cost-sharing requirements, including co-payment and co-insurance, applicable to prescription drugs in a specialty drug tier that exceed the dollar amount of cost-sharing requirements applicable to prescription drugs in a non-preferred brand drug tier. Applies the non-preferred brand drug tier for which beneficiary cost-sharing is lowest, if a formulary used by the health plan contains more than one non-preferred brand drug tier. Grandfathering and Delay of Individual Mandate ACA Implementation Multi-state Plan Program Implementation Risk Corridors

Client expense: $38,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Health reform implementation issues, accountable care organizations, small group self-funded insurance, The Keep Your Health Plan Act of 2013 (HR 3350).

Client expense: Not reported · Firm income: $50,000

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

Please see attached addendum for General Issue Area: HCR - Health IssuesSuccessful Insurance Industry Implementation of Health Reforms: Reasonable regulatory implementation timeline for compliance with PL 111-148 Affordable Private Health Care: Effect of the Health Insurance Tax, defined Essential Health Benefits, and Age Rating on premiums; 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; Multi-State Health Plans; Centralized All-Payer Database Medical Loss Ratios: Level Playing Field for MLRs; Consistent reporting requirements for all insurers; MLR Broker Fees: Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Evidence Based Care; Wellness; Chronic Care Management Insurance Market Reform; Individual Market Reform; Small Group Market Reform; Guaranteed Issue; Community Rating; Age Rating; 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 S. 1488 Introduced in Senate September 9, 2013 Fairness for American Families Act - Amends the Internal Revenue Code, as amended by the Patient Protection and Affordable Care Act (PPACA), to delay until 2015 the requirement that individuals maintain minimal essential health care coverage. Authority for Mandate Delay Act - Amends PPACA to delay until 2015 enforcement of requirements that large employers offer their full-time employees the opportunity to enroll in minimum essential coverage. Delays the effective date of related reporting requirements for such employers and for providers of minimum essential coverage. HR 3350 Passed House without amendment November 15, 2013 Keep Your Health Plan Act of 2013 - Permits a health insurance issuer that has in effect health insurance coverage in the individual market as of January 1, 2013, to continue offering such coverage for sale during 2014 outside of a health care exchange established under the Patient Protection and Affordable Care Act. Treats such coverage as a grandfathered health plan for purposes of an individual meeting the requirement to maintain minimum essential health coverage. HR 2328 Introduced in House June 12, 2013 Rep. Rogers, Mike J. (R-MI) Access to Professional Health Insurance Advisors Act of 2013 - Amends the Public Health Service Act to exclude remuneration paid for licensed independent insurance producers from administrative cost calculations for purposes of calculating the medical-loss ratio of a health insurance plan. HR 762 Introduced in House February 15, 2013 by Rep. Blackburn, Marsha (R-TN) Health Care Choice Act of 2013 - Repeals the health insurance and health coverage expansion requirements of the Patient Protection and Affordable Care Act and related requirements of the Health Care and Education Reconciliation Act of 2010. Restores provisions of law amended or repealed by such provisions. Grandfathering and Delay of Individual Mandate ACA Implementation Multi-state Plan Program Implementation Risk Corridors

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

See attached addendum for General Lobbying Issue Area: HCR - HealthcareSuccessful Insurance Industry Implementation of Health Reforms: Reasonable regulatory implementation timeline for compliance with PL 111-148 Affordable Private Health Care: Effect of the Health Insurance Tax, defined Essential Health Benefits, and Age Rating on premiums; 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; Multi-State Health Plans; Centralized All-Payer Database Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Evidence Based Care; Wellness; Chronic Care Management Insurance Market Reform; Individual Market Reform; Small Group Market Reform; Guaranteed Issue; Community Rating; Age Rating; 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 2667 Introduced by Griffin (R-AR) on July 11, 2013 Authority for Mandate Delay Act HR 2668 Introduced by Young (R-IN) on July 17, 2013 Fairness for Families Act S. 1488 Introduced in Senate September 9, 2013 Fairness for American Families Act - Amends the Internal Revenue Code, as amended by the Patient Protection and Affordable Care Act (PPACA), to delay until 2015 the requirement that individuals maintain minimal essential health care coverage. Authority for Mandate Delay Act - Amends PPACA to delay until 2015 enforcement of requirements that large employers offer their full-time employees the opportunity to enroll in minimum essential coverage. Delays the effective date of related reporting requirements for such employers and for providers of minimum essential coverage. HR 3350 Passed House without amendment November 15, 2013 Keep Your Health Plan Act of 2013 - Permits a health insurance issuer that has in effect health insurance coverage in the individual market as of January 1, 2013, to continue offering such coverage for sale during 2014 outside of a health care exchange established under the Patient Protection and Affordable Care Act. Treats such coverage as a grandfathered health plan for purposes of an individual meeting the requirement to maintain minimum essential health coverage. HR 2328 Introduced in House June 12, 2013 Rep. Rogers, Mike J. (R-MI) Access to Professional Health Insurance Advisors Act of 2013 - Amends the Public Health Service Act to exclude remuneration paid for licensed independent insurance producers from administrative cost calculations for purposes of calculating the medical-loss ratio of a health insurance plan.S. 1486 Introduced August 1, 2013 by Sen. Carper, Thomas R. (D-DE) Postal Reform Act of 2013 - Amends provisions of federal law relating to the funding of the U.S. Postal Service (USPS) retirement and health care systems, operations, revenue, and governance. HR 3362 Introduced October 29,2013 by Rep. Terry, Lee (R-NE) Exchange Information Disclosure Act - Amends the Patient Protection and Affordable Care Act to expand reporting requirements related to health care exchanges. Requires the Secretary of Health and Human Services (HHS) to publish reports weekly through March 31, 2015, on: (1) consumer interactions with healthcare.gov or subsequent sites and any efforts undertaken to remedy problems that impact taxpayers and consumers, (2) calls to the federal customer service call center, including the number of calls received by the call center, problems identified by users, and referrals of those calls; (3) all navigators and certified application counselors that have been trained and certified by health care exchanges; and (4) all agents and brokers who have been trained and certified by the federal health care exchange. HR 762 Introduced in House February 15, 2013 by Rep. Blackburn, Marsha (R-TN) Health Care Choice Act of 2013 - Repeals the health insurance and health coverage expansion requirements of the Patient Protection and Affordable Care Act and related requirements of the Health Care and Education Reconciliation Act of 2010. Restores provisions of law amended or repealed by such provisions. H.J. Res. 59 making continuing appropriations for fiscal year 2014, and for other purposes; providing for consideration of motions to suspend the rules; providing for proceedings during the period from December 14, 2013, through January 6, 2014. HR 460 Introduced in House February 4, 2013 Rep. McKinley, David B. (R-WV) Patients' Access to Treatments Act of 2013 - Amends the Public Health Service Act to establish cost-sharing limits for health plans that cover prescription drugs and use a formulary or other tiered cost-sharing structure. Prohibits such a health plan from imposing cost-sharing requirements, including co-payment and co-insurance, applicable to prescription drugs in a specialty drug tier that exceed the dollar amount of cost-sharing requirements applicable to prescription drugs in a non-preferred brand drug tier. Applies the non-preferred brand drug tier for which beneficiary cost-sharing is lowest, if a formulary used by the health plan contains more than one non-preferred brand drug tier. Grandfathering and Delay of Individual Mandate ACA Implementation Multi-state Plan Program Implementation Risk Corridors

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

See attached.Monitored HR 344, the Competitive Health Insurance Act Monitored HR 1254, to repeal a requirement that new employees of certain employers be automatically enrolled in their employers health benefit plans Monitored HR 1326, the Health Care Price Transparency Act Monitored HR 1342, to Helping Save Americans Health Care Choices Act Monitored HR 1558, to lower health premiums and increase choice for small business Monitored HR 1990/S 983, the Keep the IRS Off Your Health Care Act Monitored HR 2667, the Authority for Mandate Delay Act Monitored HR 2700, the Health Care Waiver Fairness Act Monitored HR 3046, the Small Business Health Care Tax Credit Improvement Act Monitored S 24, the Small Business Health Relief Act Monitored S 479, the Health Insurance Rate Review Act Monitored S 560, to construe the Individual Mandate of the Patient Protection and Affordable Care Act as a tax Monitored S 610, the Family Health Care Flexibility Act Monitored S 603, the Jobs and Premium Protection Act Monitored S 701, modifying the definition of full time employee for the purposes of the Patient Protection and Affordable Care Act Monitored HR 762, the Health Care Choice Act Monitored S 1154/HR 2938, the Exchange Sunset Act Monitored HR 3350, the Keep Your Health Plan Act Monitored S 1735/HR 3462, the Self-insurance Protection Act Monitored HR 3522, the Employee Health Care Protection Act Monitored S 1894, the Health Insurance Accountability Act

Client expense: $90,000 · Firm income: Not reported

Government targets: Bureau of Land Management (BLM), HOUSE OF REPRESENTATIVES, SENATE, U.S. Forest Service

Health Insurance Tax repeal legislation - H.R. 763, S. 603 Keep Your Health Plan Act - H.R. 3350

Client expense: $18,863 · Firm income: Not reported

Government targets: Employment & Training Administration, Environmental Protection Agency (EPA), HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), SENATE

H.R. 3350 - Grandfathering; "Keep Your Health Plan Act of 2013". S. 1671- Delay of Individual Mandate; "A bill to delay the implementation of the individual health coverage mandate under the Patient Protection and Affordable Care Act".S. 1693 - Extension of Open Enrollment; the "ACA Enrollment Extension Act". H.R.3541 and S. 1726 - Repeal of the ACA Risk Corridor and Reinsurance Programs within the Affordable Care Act; the Obamacare Taxpayer Bailout Prevention Act; and H.R. 3812- the "No Bailouts for Insurance Industry Act of 2014".

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Impact of budget issues on healthcare, including reinsurance fee - HJRes 59, Continuing Appropriations Resolution, 2014. Implementation of the Affordable Care Act - HR 3350, Keep Your Health Plan Act of 2013.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 99, Health Insurance Industry Antitrust Enforcement Act (Conyers) - antitrust policy. H.R. 544, LIBERTY Act (Gingrey-Matheson) - age rating rules. H.R. 743, Health Insurance Industry Fair Competition Act (DeFazio) - antitrust policy . H.R. 762, Health Care Choice Act (Blackburn) - national marketplace for individual coverage. H.R. 911, Competitive Health Insurance Reform Act (Gosar) - antitrust policy H.R. 1019, Health Insurance Rate Review Act (Schakowsky) - rate review.H.R. 1188, Preserving Our Hometown Independent Pharmacies Act (Marino) - antitrust policy. H.R. 1205, Patients Right to Know Act (Walden) - disclosures on SBC documents. H.R. 1558, Small Business Health Relief Act (Collins) - HIT repeal, other ACA changes. H.R. 2328, Access to Professional Health Insurance Advisors Act (Rogers-Barrow) - MLR impact on agents and brokers. H.R. 2668, Fairness for American Families Act (Young) - delay of ACA individual mandate. H.R. 2698, Federal Employee Short-Term Disability Insurance Act (Norton) - short-term disability program for federal employees. H.R. 3121, American Health Care Reform Act (Roe) - replacement health reforms. H.R. 3350, Keep Your Health Plan Act (Upton) - continuation of existing plans. H.R. 3425, Health Care Access Fairness and Penalty Delay Act (Lipinski-Sinema) - delay of open enrollment and individual mandate penalties. H.R. 3489, (Tiberi) - repeal of ACA transitional reinsurance fee. H.R. 3504, Consumer Protection and Rate Review Act (Schakowsky) - rate review. H.R. 3517, Federal and State Insurance Exchange Access Fairness and Penalty Delay Act (Schrader) - individual mandate delay. H.R. 3522, Employee Health Care Protection Act (Cassidy) - continuation of current group coverage. H.R. 3541, Obamacare Taxpayer Bailout Prevention Act (Griffin) - repeal of ACA risk corridor program H.R. 3745, Coverage Protection Act (Kirkpatrick) - continuation of coverage for consumers unable to enroll in QHPs. S. 24, Small Business Health Relief Act (Portman) - HIT repeal, other ACA changes. S. 482, Health Insurance Rate Review Act (Feinstein) - rate review. S. 650, Access to Independent Health Insurance Advisors Act (Landrieu) - MLR impact on agents and brokers. S. 764, Patients Right to Know Act (Cornyn) - disclosures on SBC documents. S. 1473, Long-Term Care Insurance Consumer Right-to-Know Act (Klobuchar) - model disclosure forms. S. 1481, Long Term Care Insurance Integrity Act (Klobuchar) - third party review of disputed claims. S. 1642, Keeping the ACA Promise Act (Landrieu-Manchin) - continuation of existing plans, notification requirements. S. 1671, (Manchin-Kirk) - individual mandate delay. S. 1693, ACA Enrollment Extension Act (Shaheen) - extending open enrollment, delaying individual mandate penalties. S. 1699, Continuous Coverage Act (Mark Udall) - continuation of existing plans. S. 1726, Obamacare Taxpayer Bailout Prevention Act (Rubio) - repeal of ACA risk corridor program. S. 1729, Expanded Consumer Choice Act (Begich) - adding copper level of coverage to ACA Exchanges. S. 1866, Coverage Protection Act (Merkley) - continuation of coverage, retroactive coverage.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.1642, Keeping the Affordable Care Act Promise Act S.1617, If You Like Your Health Plan, You Can Keep it Act S.1699, Continuous Coverage Act H.R.3350, Keep Your Health Plan Act of 2013Issues related to health care reform, and prescription drug safety, including compounding pharmacies Issues related to patient medication information Issues related to medical device and patient safety Issues related to the implementation and approval of Unique Device Identification (UDI) Issues related to the reauthorization of the Medical Device User Fee and Modernization Act and the Prescription Drug User Fee Act

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

Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Consumer Product Safety Commission (CPSC), Federal Communications Commission (FCC), Federal Deposit Insurance Corporation (FDIC), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Telecommunications & Information Administration (NTIA), Office of Science & Technology Policy (OSTP), SENATE, Transportation, Dept of (DOT), Treasury, Dept of