Ensuring Seniors Access to Local Pharmacies Act of 2014

Provisions of PL 111-148 and PL 111-152 impacting Medicare Part D such as formulary requirements, PBM disclosure provisions, closing the Part D coverage gap Regulatory design and coverage of pharmacy benefits in health reform exchanges and the commercial market (essential health benefits, grandfathering, value-based insurance design, e-prescribing, PBM disclosure requirements, and medical loss ratio). Regulatory and proposed legislative changes to Medicare part D including pharmacy networks, classes of clinical concern, mail-service pharmacy, EGWP waivers, MTM expansion, long term care short-term fills, recovery audit contractors. Implementation of changes to the definition of Average Manufacturer Price in Medicaid Issues related to the management of Medicaid prescription drug benefits Legislation to promote generic drugs. Regulatory Implementation of the HITECH Act. FDA issues related to the Prescription Drug User Fee Act (PDUFA) (generic user fees, pedigree, REMs); implementation of approval pathway for generic biologic drugs, 340B program. S. 77, Prescription Drug and Health Improvement Act S. 557, Medication Therapy Management Empowerment Act H.R. 460, Patients Access to Treatments Act H.R. 1188, Preserving Our Hometown Independent Pharmacies Act H.R. 1367, FEHBP Prescription Drug Integrity, Transparency, and Cost Savings Act H.R. 1024, Medication Therapy Management Empowerment Act HR4577, Ensuring Seniors Access to Local Pharmacies Act of 2014 to Medicare/Medicaid, Pharmacy; and Health Care General

Client expense: $788,488 · Firm income: Not reported

Government targets: Administration for Children & Families (ACF), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE

Provisions of PL 111-148 and PL 111-152 impacting Medicare Part D such as formulary requirements, PBM disclosure provisions, closing the Part D coverage gap Regulatory design and coverage of pharmacy benefits in health reform exchanges and the commercial market (essential health benefits, grandfathering, value-based insurance design, e-prescribing, PBM disclosure requirements, and medical loss ratio). Regulatory and proposed legislative changes to Medicare part D including pharmacy networks, classes of clinical concern, mail-service pharmacy, EGWP waivers, MTM expansion, long term care short-term fills, recovery audit contractors. Implementation of changes to the definition of Average Manufacturer Price in Medicaid Issues related to the management of Medicaid prescription drug benefits Legislation to promote generic drugs. Regulatory Implementation of the HITECH Act. FDA issues related to the Prescription Drug User Fee Act (PDUFA) (generic user fees, pedigree, REMs); implementation of approval pathway for generic biologic drugs, 340B program. Issues related to the compounding of certain drugs. S. 77, Prescription Drug and Health Improvement Act S. 557, Medication Therapy Management Empowerment Act H.R. 460, Patients Access to Treatments Act H.R. 1188, Preserving Our Hometown Independent Pharmacies Act H.R. 1367, FEHBP Prescription Drug Integrity, Transparency, and Cost Savings Act H.R. 1024, Medication Therapy Management Empowerment Act S. 867, Medicare Prescription Drug Program Integrity and Transparency Act H.R. 2960, Medicare Prescription Drug Integrity Act of 2013 H.R., Keep the Promise to Seniors Act H.R. 4577, Ensuring Seniors Access to Local Pharmacies Act of 2014 to Medicare/Medicaid, Pharmacy; and Health Care General H.R. 4418, Expanding the Availability of Medicare Data to Medicare/Medicaid

Client expense: $788,488 · Firm income: Not reported

Government targets: Administration for Children & Families (ACF), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE

Provisions of PL 111-148 and PL 111-152 impacting Medicare Part D such as formulary requirements, PBM disclosure provisions, closing the Part D coverage gap Regulatory design and coverage of pharmacy benefits in health reform exchanges and the commercial market (essential health benefits, grandfathering, value-based insurance design, e-prescribing, PBM disclosure requirements, and medical loss ratio). Regulatory and proposed legislative changes to Medicare part D including pharmacy networks, classes of clinical concern, mail-service pharmacy, EGWP waivers, MTM expansion, long term care short-term fills, recovery audit contractors. Implementation of changes to the definition of Average Manufacturer Price in Medicaid Issues related to the management of Medicaid prescription drug benefits Legislation to promote generic drugs. Regulatory Implementation of the HITECH Act. FDA issues related to the Prescription Drug User Fee Act (PDUFA) (generic user fees, pedigree, REMs); implementation of approval pathway for generic biologic drugs, 340B program. S. 77, Prescription Drug and Health Improvement Act S. 557 / H.R. 1024, Medication Therapy Management Empowerment Act S.867, Medicare Prescription Drug Program Integrity and Transparency Act H.R. 2960, Medicare Prescription Drug Integrity Act of 2013 H.R. 4160, Keep the Promise to Seniors Act H.R. 4577, Ensuring Seniors Access to Local Pharmacies Act of 2014 to Medicare/Medicaid; Pharmacy, and Health Care General H.R. 4418, Expanding the Availability of Medicare Data to Medicare/Medicaid

Client expense: $788,488 · Firm income: Not reported

Government targets: Administration for Children & Families (ACF), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE

Improve prescription drug access: H.R. 460: Patients Access to Treatments Act of 2013, S867. Medicare Prescription Drug Program Integrity and Transparency Act of 2013; provisions related to improving prescription drug access. Issues related to the high cost of specialty drugs; H.R. 4577 about pharmacy access and quality

Client expense: $550,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Treasury, Dept of

HR 4577 - Ensuring Seniors Access to Local Pharmacies Act of 2014

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

Health reform proposals that impact Medicare Part D such as formulary requirements, PBM disclosure provisions, closing of the Part D coverage gap. General legislative and regulatory issues such as direct negotiation (budget proposals). Statutory implementation of changes to the definition of AMP in Medicaid. Exclusion of specialty distributors prompt pay discounts from the definition of average sales price. Medicare audit and preferred network restrictions. S. 867, HR 4437, HR 4577. General issues and legislation (HR 3392) regarding combatting Rx abuse in Medicare and Medicaid (pharmacy lock in, etc.).

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), 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), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Personnel Management (OPM), SENATE, White House Office

Policies related to FEHBP's pharmacy benefit (HR 1367). Regulatory design and coverage of pharmacy benefits in health reform Exchanges and the commercial market, including: EHB, grandfathering, Rx quality, eRx, PBM disclosure, MLR. Specialty pharmacy tiering restrictions (HR 460). Regulatory implementation of a pathway for the approal of biosimilars. REMs. 340b program reform. Policies placing restrictions on pharmcy benefit design. Issues regarding making prescription drugs more affordable, including: generic user fees, pedigree, biosimilars, REMs. General issues dealing with prescription drug abuse (HR 3392) including Medicare Lock-in programs. General issues dealing with regulating pharmacy drug compounding (PDSQ Act). S. 867, HR 4437, HR 4577.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), 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), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Personnel Management (OPM), SENATE, White House Office

S. 557, The Medication Therapy Management Empowerment Act of 2013 H.R. 1024, The Medication Therapy Management Empowerment Act of 2013 H.R. 2810, Medicare Patient Access and Quality Improvement Act The SGR Repeal and Medicare Beneficiary Access Improvement Act of 2013 H.R.4302 - Protecting Access to Medicare Act of 2014 H.R. 4190 - To amend title XVIII of the Social Security Act to provide for coverage under the Medicare program of pharmacist services. H.R. 3890 / S. 1932 - Better Care, Lower Cost Act H.R.4577 - Ensuring Seniors Access to Local Pharmacies Act of 2014

Client expense: $460,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H.R. 351, Protecting Seniors Access to Medicare Act of 2013: Provisions related to the Independent Payment Advisory Board H.R. 460, Patients Access to Treatments Act: Provisions related to cost sharing in the specialty tier H.R. 928, Medicare Prescription Drug Savings and Choice Act of 2013: Provisions related to Part D issues H.R. 1024, Medication Therapy Management Empowerment Act of 2013: Provisions related to medication therapy management in Part D H.R. 1102, Medicare Prescription Drug Price Negotiation Act of 2013: Provisions related to Part D issues and non-interference H.R. 1588, Medicare Drug Savings Act of 2013: Provisions related to Part D issues H.R. 2753 Securing Care for Seniors Act: Provisions related to Value Based Insurance Design H.R. 2810, Medicare Patient Access and Quality Improvement Act: Provisions related to SGR reform H.R. 2827, To amend title XVIII of the Social Security Act to allow for fair application of the exceptions process for drugs in tiers in formularies in prescription drug plans under Medicare part D: Provisions related to Medicare Part D Drug Tier Formularies H.R. 2925, Strengthening Medicare Anti-Fraud Measures Act of 2013: Provisions related to Office of Inspector General (OIG) enforcement of fraud and abuse laws H.R. 3392, Medicare Part D Patient Safety and Drug Abuse Prevention Act of 2013: Provisions related to lock-in programs H.R. 3796, Comprehensive Care Payment Innovation Act: Provisions related to alternative payment models H.R. 3890 Better Care, Lower Cost Act: Provisions related to Part D, value-based insurance design, and chronic disease H.R. 4015, SGR Repeal and Medicare Provider Payment Modernization Act of 2014: Provisions related to sustainable growth rate (SGR) and Medicare provider payment reform H.R. 4160, Keep the Promise to Seniors Act of 2014: Provisions related to Part D issues H.R. 4302, Protecting Access to Medicare Act of 2014: Provisions related to the biopharmaceutical industry H.R. 4577, Ensuring Seniors Access to Local Pharmacies Act of 2014: Provisions related to Part D preferred pharmacy networks H.R. 5183, Value Based Insurance Design for Better Care Act of 2014: Provisions related to valued base insurance design demonstration program H.R. 5558 ACO Improvement Act: Provisions related to alternate payment models H.R. 5780, Protecting Integrity in Medicare Act of 2014: Provisions related to addressing fraud and prescription drug abuse S. 117, Medicare Prescription Drug Price Negotiation Act of 2013: Provisions related to Part D issues and non-interference S. 351, Protecting Seniors Access to Medicare Act of 2013: Provisions related to Independent Payment Advisory Board S. 408, Medicare Prescription Drug Savings and Choice Act of 2013: Provision related to Part D issues S. 557, Medication Therapy Management Empowerment Act of 2013: Provisions related to Part D and medication therapy management S. 740, Medicare Drug Savings Act of 2013: Provisions related to Part D issues Deficit reduction policy issues S. 882, Stop Trafficking of Pills (STOP) Act: Provisions related to lock-in programs (112th Congress) S. 1365, Part D Beneficiary Appeals Fairness Act: Provisions related to the specialty tier in Part D S. 1871, SGR Repeal and Medicare Beneficiary Access Act of 2013: Provisions related to reforming Medicare physician payments S. 1932, Better Care, Lower Cost Act: Provisions related to Part D, value-based insurance design, and chronic disease S. 2000, SGR Repeal and Medicare Provider Payment Modernization Act of 2014: Provisions related to SGR reform S. 2110, Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014: Provisions related to SGR reform Hospital Improvements for Payment (HIP) Act of 2014: Provisions related to Medicare reform (no bill number) Medicare Prescription Drug Diversion and Abuse Prevention Act: Provisions related to diversion and abuse (no bill number) Contract Year 2015 Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefits Programs: Provisions related to Part D Proposals to increase co-payments for Part D beneficiaries receiving the low-income subsidy Medicaid Program, Covered Outpatient Drugs rulemaking Medicare sustainable growth rate policy issues Implementation issues relating to the Physician Payment Sunshine Act, including Medicare, Medicaid, Childrens Health Insurance Programs; Transparency Reports and Reporting of Physician Ownership or Investment Interests rulemaking Issues related to better use of medicine and adherence

Client expense: $3,960,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Medicare Payment Advisory Commission (MedPAC), Patent & Trademark Office (PTO), SENATE, Treasury, Dept of, U.S. Trade Representative (USTR)

H.R. 1285- To Amend the Controlled Substance Act to Make Any Substance Containing Hydrocodone a Schedule II Drug; S.621- The Safe Prescribing Act of 2013; H.R. 1024- The Medication Therapy Management Empowerment Act of 2013; S. 557 Medication Therapy Empowerment Act of 2013; H.R. 1188- The Preserving Our Hometown Independent Pharmacies Act of 2013; CMS proposed and final rule on Medicare Part D; H.R. 4709- Ensuring Patient Access and Effective Drug Enforcement Act of 2014; S.2862 - Regulatory Transparency, Patient Access, and Effective Drug Enforcement Act of 2014; H.R. 4190- To Amend Title XVIII of the Social Security Act to provide for coverage under the Medicare program of pharmacist services; FDAs action on and enforcement of Public Law No: 113-54; H.R.4577 - Ensuring Seniors Access to Local Pharmacies Act of 2014; H.R.4437 - Generic Drug Pricing Fairness Act; S. 1493 - Medicare Efficient Drug Dispensing Act of 2013; Generic Drug Pricing Spikes; The SGR Repeal and Medicare Beneficiary Access Improvement Act of 2013; H.R..3979 Carl Levin and Howard P. Buck Mckeon National Defense Authorization Act for Fiscal Year 2015 (Tricare Provisions); Prescription Drug Abuse and Diversion; H.R. Res. 130-FY 2015 Continuing Resolution (though December 14, 2014); H.J. Res. 291- Making Further Continuing Appropriations for Fiscal Year 2015, And For Other Purposes (Until December 17, 2014); H.R.83 - FY2015 Omnibus; Consolidated and Further Continuing Appropriations Act; H.R. 4709 - Ensuring Patient Access and Effective Drug Enforcement Act of 2014;

Client expense: $420,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Office of Management & Budget (OMB), Office of Personnel Management (OPM), SENATE

Medicare Reforms: Medicare A & B; Delivery System Reforms, Benefit Restructuring ; Medigap first-dollar coverage; Quality Initiatives/SGR Reform, HIPAA Code Adoption Process, Medicare Advantage Risk Delay Part D Cuts, HR 2810 Introduced by Burgess (R-TX) on July 31, 2013 See addendum on additional Medicare/Medicaid issues...Additional Medicare/Medicaid Issues: HR 3392 Introduced October 13, 2013 by Gus Bilirakis (R-FL) To amend title XVIII of the Social Security Act to provide for a PDP safety program to prevent fraud and abuse in the dispensing of controlled substances under part D of the Medicare program, and for other purposes. Multi-State Plan Programs, Medicare Patient Access and Quality Improvement Act of 2013, Medicare Prescription Drug Integrity. Medicare fraud; Provider terminations in Medicare Advantage; CHIP (Children's Health Insurance Program) reauthorization HR 4160 Introduced March 6, 2014 by Renee Ellmers (R-NC) Keep the Promise to Seniors Act of 2014 - Prohibits the Secretary of Health and Human Services (HHS) from taking any action (through promulgation of a final or interim final regulation, issuance of regulatory or program guidance, use of federal payment audit procedures, or other enforcement or administrative action, policy, or practice) to implement any provision of the proposed regulation (relating to policy and technical changes to the MedicareAdvantage and part D programs under Medicare) published in the Federal Register on January 10, 2014, insofar as that regulation relates to part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act (SSA), including its application to MedicareAdvantage- Prescription Drug (MA-PD) plans under part C (Medicare+Choice Program). HR 4930 Introduced June 20, 2014 by Joe Barton (R-TX) Advancing Care for Exceptional Kids Act of 2014 or the ACE Kids Act of 2014 - Amends titles XIX (Medicaid) and XXI (Children's Health Insurance) (CHIP) of the Social Security Act to extend medical assistance to payment for items and services furnished under a Medicaid Children's Care Coordination (MCCC) Program which the state may elect to provide to eligible children with complex medical conditions HR 4577 Introduced May 6, 2014 by H. Griffith (R-VA) Ensuring Seniors Access to Local Pharmacies Act of 2014 - Amends part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act with respect to a prescription drug plan that has, in its network of pharmacies, one or more pharmacies located in a health professional shortage area, in a medically underserved area, or among a medically underserved population, and that provides a reduction in coinsurance or copayments for covered part D drugs dispensed through them. Declares that such a plan shall extend to any pharmacy located in that area or among that population the option to be an in-network pharmacy with respect to such plan under terms and conditions comparable to those the plan has agreed upon with other in-network pharmacies located in the area or among that population. HR 2960 Introduced August 1, 2013 by Frank Pallone (D-NJ) Medicare Prescription Drug Integrity Act of 2013 - Amends part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act (SSA) to require a prescription drug plan (PDP) sponsor to have in place procedures designed to prevent fraud and abuse in PDPs. HR 5083 Introduced July 11, 2014 by Renee Ellmers (R-NC) Medicare DMEPOS Audit Improvement and Reform (AIR) Act of 2014 - Amends title XVIII (Medicare) of the Social Security Act (SSA) to establish a Medicare Administrative Contractor Payment Outreach and Education Program for DMEPOS (durable medical equipment, prosthetics, orthotics, and supplies) suppliers HR 5010 Introduced June 26, 2014 by Jackie Speier (D-CA) To provide greater clarity in the regulation of electronic nicotine delivery systems, including electronic cigarettes, cigars, cigarillos, pipes, and hookahs, and for other purposes. as introduced. HR 5460 Introduced September 11, 2014 by Greg Walden (R-OR) To amend title XVIII of the Social Security Act to increase access to ambulance services under the Medicare program and to reform payments for such services under such program. as introduced. (See following page on additional Medicare/Medicaid issues...)HR 5547 Introduced September 18, 2014 by Matthew Cartwright (D-PA) To ensure that Medicaid beneficiaries have the opportunity to receive care in a home and community-based setting HR 5558 Introduced September 18, 2014 by Diane Black (R-TN) To amend title XVIII of the Social Security Act to improve the Medicare accountable care organization (ACO) program, and for other purposes HR 4494 Introduced June 26, 2014 by Dave Camp (R-MI) Improving Medicare Post-Acute Care Transformation Act of 2014 or the IMPACT Act of 2014 - Amends title XVIII (Medicare) of the Social Security Act to direct the Secretary of Health and Human Services (HHS) to provide for standardized post-acute care assessment data for quality, payment, and discharge planning, and for other purposes. HR 2925 Introduced August 1, 2013 by Kevin Brady (R-TX) Strengthening Medicare Anti-Fraud Measures Act of 2013 - Amends title XI of the Social Security Act to authorize the Secretary of Health and Human Services (HHS) to exclude from participation in any federal health care program entities affiliated with a sanctioned entity, as well as any officer or managing employee of an affiliated entity (currently, only individuals with an ownership or control interest in a sanctioned entity), if the affiliated entity was so affiliated at the time of any of the conduct forming the basis for the conviction or exclusion of the sanctioned entity. HR 647 - ABLE Act Introduced February 13, 2013 by Ander Crenshaw (R-FL) Achieving a Better Life Experience Act of 2014 or the ABLE Act of 2014 - Title I: Qualified ABLE Programs - (Sec. 101) States as the purposes of this title to: (1) encourage and assist individuals and families in saving private funds for the purpose of supporting individuals with disabilities to maintain health, independence, and quality of life; and (2) provide secure funding for disability-related expenses of beneficiaries with disabilities that will supplement, but not supplant, benefits provided through private insurance, title XVI (Supplemental Security Income) and title XIX (Medicaid) of the Social Security Act, the beneficiary's employment, and other sources. HR 4994 Introduced June 26, 2014 by Dave Camp (R-MI) Title XVIII amendments of Social Security Act Other Medicare/Medicaid Issues: Delivery reform and network design; Qualified Health Plan Survey; CHIP Reauthorization;, Medicare co-pay limits

Client expense: $2,030,000 · Firm income: Not reported

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

Medicare Reforms: Medicare A & B; Delivery System Reforms, Benefit Restructuring; Medigap first-dollar coverage; Quality Initiatives/SGR Reform, HIPAA Code Adoption Process, Medicare Advantage Risk Delay Part D Cuts, HR 2810 Introduced by Burgess (R-TX) on July 31, 2013 HR 3392 Introduced October 13, 2013 by Gus Bilirakis (R-FL) To amend title XVIII of the Social Security Act to provide for a PDP safety program to prevent fraud and abuse in the dispensing of controlled substances under Part D of the Medicare program, and for other purposes. Multi-State Plan Programs, Medicare Patient Access and Quality Improvement Act of 2013, Medicare Prescription Drug Integrity. Medicare fraud; Provider terminations in Medicare Advantage; CHIP (Children's Health Insurance Program) reauthorization HR 4160 Introduced March 6, 2014 by Renee Ellmers (R-NC) Keep the Promise to Seniors Act of 2014 - Prohibits the Secretary of Health and Human Services (HHS) from taking any action (through promulgation of a final or interim final regulation, issuance of regulatory or program guidance, use of federal payment audit procedures, or other enforcement or administrative action, policy, or practice) to implement any provision of the proposed regulation (relating to policy and technical changes to the MedicareAdvantage and part D programs under Medicare) published in the Federal Register on January 10, 2014, insofar as that regulation relates to part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act (SSA), including its application to MedicareAdvantage-Prescription Drug (MA-PD) plans under part C (Medicare+Choice Program). HR 4577 Introduced May 6, 2014 by H. Griffith (R-VA) Ensuring Seniors Access to Local Pharmacies Act of 2014 - Amends part D (Voluntary Prescription Drug Benefit Program) of title XVIII(Medicare) of the Social Security Act with respect to a prescription drug plan that has, in its network of pharmacies, one or more pharmacies located in a health professional shortage area, in a medically underserved area, or among a medically underserved population, and that provides a reduction in coinsurance or copayments for covered part D drugs dispensed through them. Declares that such a plan shall extend to any pharmacy located in that area or among that population the option to be an in-network pharmacy with respect to such plan under terms and conditions comparable to those the plan has agreed upon with other in-network pharmacies located in the area or among that population. HR 2960 Introduced August 1, 2013 by Frank Pallone (D-NJ) Medicare Prescription Drug Integrity Act of 2013 - Amends part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act (SSA) to require a prescription drug plan (PDP) sponsor to have in place procedures designed to prevent fraud and abuse in PDPs. HR 5083 Introduced July 11, 2014 by Renee Ellmers (R-NC) Medicare DMEPOS Audit Improvement and Reform (AIR) Act of 2014 - Amends title XVIII (Medicare) of the Social Security Act (SSA) to establish a Medicare Administrative Contractor Payment Outreach and Education Program for DMEPOS (durable medical equipment, prosthetics, orthotics, and supplies) suppliers. HR 5460 Introduced September 11, 2014 by Greg Walden (R-OR) to amend title XVIII of the Social Security Act to increase access to ambulance services under the Medicare program and to reform payments for such services under such program as introduced. HR 5547 Introduced September 18, 2014 by Matthew Cartwright (D-PA) to ensure that Medicaid beneficiaries have the opportunity to receive care in a home and community-based setting. HR 5558 Introduced September 18, 2014 by Diane Black (R-TN) to amend Title XVIII of the Social Security Act to improve the Medicare accountable care organization (ACO) program, and for other purposes. HR 4494 Introduced June 26, 2014 by Dave Camp (R-MI) Improving Medicare Post-Acute Care Transformation Act of 2014 or the IMPACT Act of 2014 - Amends title XVIII (Medicare) of the Social Security Act to direct the Secretary of Health and Human Services (HHS) to provide for standardized post-acute care assessment data for quality, payment, and discharge planning, and for other purposes. HR 2925 Introduced August 1, 2013 by Kevin Brady (R-TX) Strengthening Medicare Anti-Fraud Measures Act of 2013 - Amends title XI of the Social Security Act to authorize the Secretary of HHS to exclude from participation in any federal care program entities affiliated with a sanctioned entity, as well as any officer or managing employee of an affiliated entity (currently, only individuals with an ownership or control interest in a sanctioned entity), if the affiliated entity was so affiliated at the time of any of the conduct forming the basis for the conviction or exclusion of the sanctioned entity. HR 645 - /ABLE Act Introduced February 13, 2013 by Ander Crenshaw (R-FL) Achieving a Better Life Experience Act of 2014 or the ABLE Act of 2014 - Title I: Qualified ABLE Programs - (Sec. 101) States as the purposes of this title to: (1) encourage and assist individuals and families in saving private funds for the purpose of supporting individuals with disabilities to maintain health, independence, and quality of life; and (2) provide secure funding for disability-related expenses of beneficiaries with disabilities that will supplement, but not supplant, benefits provided through private insurance, title XVI (Supplemental Security Income) and title XIX (Medicaid) of the Social SEcurity Act, the beneficiary's employment, and other sources. HR 4994 Introduced June 26, 2014 by Dave Camp (R-MI) Title XVIII amendments of Social Security Act. Other Medicare/Medicaid Issues: Delivery reform and network design; Qualified Health Plan Survey; CHIP Reauthorization; Medicare co-pay limits

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

Prescription Drug Abuse. Support of the Alliance to Prevent the Abuse of Medicines legislative priorities including minimum requirements for state databases, pharmacy lock-in programs, and abuse deterrent technology. Biosimilars - concerns regarding naming (shared names with reference product vs. original names); specialty drug cost trends HR 4577 Ensuring Seniors Access to Local Pharmacies Act - opposed HR 460 Patients Access to Treatment Act - opposed HR 4437 Medication Therapy Empowerment Act - oppose expanding to one condition

Client expense: $250,000 · Firm income: Not reported

Government targets: Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

Prescription Drug Abuse. Support of the Alliance to Prevent the Abuse of Medicines legislative priorities including minimum requirements for state databases, pharmacy lock-in programs, and abuse deterrent technology. Biosimilars - concerns regarding naming (shared names with reference product vs. original names); specialty drug cost trends HR 4577 Ensuring Seniors Access to Local Pharmacies Act - opposed HR 460 Patients Access to Treatment Act - opposed HR 4437 Medication Therapy Empowerment Act - oppose expanding to one condition

Client expense: $250,000 · Firm income: Not reported

Government targets: Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

Opposition to legislation that would amend Medicare Part D to require health plans to include any willing pharmacy in its network if the pharmacy is located in a medically underserved area or among a medically underserved population - HR 4577. Opposition to limiting the ability of health plans to include preferred networks in their pharmacy network.

Client expense: $228,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, SENATE

Policies related to the Federal Employees Health Benefit Program's pharmacy benefit (HR 1367); Regulatory design and coverage of pharmacy benefits in health reform Exchanges and the commercial market (EHB, grandfathering, Rx quality, eRx, PBM disclosure requirements, MLR); specialty pharmacy tiering restrictions (HR 460); regulatory implementation of a pathway for the approval of biosimilars; REMs; 340b program; policies placing restrictions on pharmacy benefit designissues regarding making prescription drugs more affordable (generic user fees; pedigree; pathway for biosimilars; REMs). General issues dealing with prescription drug abuse (HR 3392) including Medicare Lock-in programs. General issues dealing with regulating pharmacy drug compounding (PDSQ Act); S. 867 (and versions HR 4437, HR 4577), the Medicare Prescription Drug Program Integrity and Transparency Act.

Client expense: $500,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), 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), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Personnel Management (OPM), SENATE, White House Office

Health reform proposals that impact Medicare Part D such as formulary requirements, PBM disclosure provisions, closing of the Part D coverage gap. General reg/leg Part D issues such as direct negotiation (budget proposals). Statutory implementation of changes to the definition of AMP in Medicaid. Exclusion of specialty distributors' prompt pay discounts from the definition of Average Sales Price. Medicare audit and preferred network restrictions. S. 867, Medicare Prescription Drug Integrity andAnd Transparency Act of 2013 and other versions (HR 4437, S. 867, HR 4577. General issues and legislation (HR 3392) regarding combatting Rx abuse in Medicare and Medicaid (pharmacy lock-in, etc)

Client expense: $500,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), 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), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Personnel Management (OPM), SENATE, White House Office

HR 4577 Ensuring Seniors Access to Local Pharmacies Act of 2014 - network adequacy HR 460 Patients Acces to Treatments Act - importance of specialty formulary tiers HR 3392 Medicare Part D Patient Safety and Drug Abuse Prevention - support safe pharmacies and access to controlled substances Prescription drug abuse issues - including support for funding of state prescription drug monitoring databases

Client expense: $250,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Office of Natl Drug Control Policy (NDCP), SENATE

HR 460 Patients' Access to Treatments Act of 2013 - importance of specialty formulary tiers HR 3392 Medicare Part D Patient Safety and Drug Abuse PRevention Act of 2013 - support safe pharmacies and access to controlled substances Prescription drug abuse and support for funding of state prescription drug monitoring databases HR 4577 Ensuring Seniors Access to Local Pharmacies Act of 2014 - network adequacy; support use of tiered networks

Client expense: $250,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Office of Natl Drug Control Policy (NDCP), SENATE

Improve prescription drug access: H.R. 460: Patients Access to Treatments Act of 2013, S867. Medicare Prescription Drug Program Integrity and Transparency Act of 2013; provisions related to improving prescription drug access. Issues related to the high cost of specialty drugs; H.R. 4577 about pharmacy access and quality

Client expense: $500,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Treasury, Dept of

H.R. 351, Protecting Seniors Access to Medicare Act of 2013: Provisions related to the Independent Payment Advisory Board H.R. 460, Patients Access to Treatments Act: Provisions related to cost sharing in the specialty tier H.R. 928, Medicare Prescription Drug Savings and Choice Act of 2013: Provisions related to Part D issues H.R. 1024, Medication Therapy Management Empowerment Act of 2013: Provisions related to medication therapy management in Part D H.R. 1102, Medicare Prescription Drug Price Negotiation Act of 2013: Provisions related to Part D issues and non-interference H.R. 1588, Medicare Drug Savings Act of 2013: Provisions related to Part D issues H.R. 2753 Securing Care for Seniors Act: Provisions related to Value Based Insurance Design H.R. 2810, Medicare Patient Access and Quality Improvement Act: Provisions related to SGR reform H.R. 2827, To amend title XVIII of the Social Security Act to allow for fair application of the exceptions process for drugs in tiers in formularies in prescription drug plans under Medicare part D: Provisions related to Medicare Part D Drug Tier Formularies H.R. 2925, Strengthening Medicare Anti-Fraud Measures Act of 2013: Provisions related to fraud and abuse H.R. 3392, Medicare Part D Patient Safety and Drug Abuse Prevention Act of 2013: Provisions related to lock-in programs H.R. 3796, Comprehensive Care Payment Innovation Act: Provisions related to alternative payment models H.R. 3890 Better Care, Lower Cost Act: Provisions related to Part D, value-based insurance design, and chronic disease H.R. 4015, SGR Repeal and Medicare Provider Payment Modernization Act of 2014: Provisions related to sustainable growth rate (SGR) and Medicare provider payment reform H.R. 4160, Keep the Promise to Seniors Act of 2014: Provisions related to Part D issues H.R. 4302, Protecting Access to Medicare Act of 2014: Provisions related to the biopharmaceutical industry H.R. 4577, Ensuring Seniors Access to Local Pharmacies Act of 2014: Provisions related to Part D preferred pharmacy networks H.R. 5183, Value Based Insurance Design for Better Care Act of 2014: Provisions related to valued base insurance design demonstration program H.R. 5558 ACO Improvement Act: Provisions related to alternate payment models S. 117, Medicare Prescription Drug Price Negotiation Act of 2013: Provisions related to Part D issues and non-interference S. 351, Protecting Seniors Access to Medicare Act of 2013: Provisions related to Independent Payment Advisory Board S. 408, Medicare Prescription Drug Savings and Choice Act of 2013: Provision related to Part D issues S. 557, Medication Therapy Management Empowerment Act of 2013: Provisions related to Part D and medication therapy management S. 740, Medicare Drug Savings Act of 2013: Provisions related to Part D issues Deficit reduction policy issues S. 882, Stop Trafficking of Pills (STOP) Act: Provisions related to lock-in programs (112th Congress) S. 1365, Part D Beneficiary Appeals Fairness Act: Provisions related to the specialty tier in Part D S. 1871, SGR Repeal and Medicare Beneficiary Access Act of 2013: Provisions related to reforming Medicare physician payments S. 1932, Better Care, Lower Cost Act: Provisions related to Part D, value-based insurance design, and chronic disease S. 2000, SGR Repeal and Medicare Provider Payment Modernization Act of 2014: Provisions related to SGR reform S. 2110, Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014: Provisions related to SGR reform Medicare Prescription Drug Diversion and Abuse Prevention Act: Provisions related to diversion and abuse (no bill number) Contract Year 2015 Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefits Programs: Provisions related to Part D Proposals to increase co-payments for Part D beneficiaries receiving the low-income subsidy Medicaid Program, Covered Outpatient Drugs rulemaking Medicare sustainable growth rate policy issues Implementation issues relating to the Physician Payment Sunshine Act, including Medicare, Medicaid, Childrens Health Insurance Programs; Transparency Reports and Reporting of Physician Ownership or Investment Interests rulemaking Issues related to better use of medicine and adherence Protecting Integrity in Medicare Act of 2014 (no bill number): Provisions related to addressing fraud, prescription drug abuse, and other issues Lock-in concepts generally

Client expense: $3,680,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Patent & Trademark Office (PTO), SENATE, U.S. Trade Representative (USTR)

Medicare/Medicaid-Issues related to plan design, reimbursement and cost savings proposals. HR 2960 - Medicare Prescription Drug Integrity Act HR 4577-Ensuring Seniors Access to Local Pharmacies Act of 2014

Client expense: $4,290,000 · Firm income: Not reported

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

Medicare Reforms: Medicare A & B; Delivery System Reforms, Benefit Restructuring; Medigap first-dollar coverage; Quality Initiatives/SGR Reform, HIPAA Code Adoption Process, Part D Cuts, HR 2810 Introduced by Burgess (R-TX) on July 31, 2013 HR 3392 Introduced October 13, 2013 by Gus Bilirakis (R-FL) To amend Title XVIII of the Social Security Act to provide fo a PDP safety program to prevent fraud and abuse in the dispensing of controlled substances under Part D of the Medicare program, and for other purposes. HR 4577 Introduced May 6, 2014 by H. Griffith (R-VA) Ensuring Seniors Access to Local Pharmacies Act of 2014 - Amends Part D (Voluntary Prescription Drug Benefit Program) of Title XVIII (Medicare) of the Social Security Act with respect to a prescription drug plan that has, in its network of pharmacies, one or more pharmacies located in a health professional shortage area, in a medically underserved area, or among a medically underserved population, and that provides a reduction in coinsurance or copayments for covered Part D drugs dispensed through them. Declares that such a plan shall extend to any pharmacy located in that area or among that population the option to be an in-network pharmacy with respect to such plan under terms and conditions comparable to those the plan has agreed upon with other in-network pharmacies located in the area or among that population. HR 2960 Introduced August 1, 2013 by Frank Pallone (D-NJ) Medicare Prescription Drug Integrity Act of 2013 - Amends part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act (SSA) to require a prescription drug plan (PDP) sponsor to have in place procedures designed to prevent fraud and abuse in PDPs. HR 5547 Introduced September 18, 2014 by Matthew Cartwright (D-PA) To ensure that Medicaid beneficiaries have the opportunity to receive care in a home and community-based setting. HR 5558 Introduced September 18, 2014 by Diane Black (R-TN) To amend title XVIII of the Social Security Act to improve the Medicare accountable care organization (ACO) program, and for other purposes.

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 Management & Budget (OMB), Office of Personnel Management (OPM), SENATE, Treasury, Dept of

S. 557, The Medication Therapy Management Empowerment Act of 2013 H.R. 1024, The Medication Therapy Management Empowerment Act of 2013 H.R. 2810, Medicare Patient Access and Quality Improvement Act The SGR Repeal and Medicare Beneficiary Access Improvement Act of 2013 H.R.4302 - Protecting Access to Medicare Act of 2014 H.R. 4190 - To amend title XVIII of the Social Security Act to provide for coverage under the Medicare program of pharmacist services. H.R. 3890 / S. 1932 - Better Care, Lower Cost Act H.R.4577 - Ensuring Seniors Access to Local Pharmacies Act of 2014

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Medicare Reforms: Medicare A & B; Delivery System Reforms, Benefit Restructuring ; Quality Initiatives/SGR Reform, HIPAA Code Adoption Process, Medicare Advantage Risk Delay Part D Cuts, HR 2810 Introduced by Burgess (R-TX) on July 31, 2013 See addendum on additional Medicare/Medicaid issues...Addtional Medicare/Medicaid Issues: HR 3392 Introduced October 13, 2013 by Gus Bilirakis (R-FL) To amend title XVIII of the Social Security Act to provide for a PDP safety program to prevent fraud and abuse in the dispensing of controlled substances under part D of the Medicare program, and for other purposes. Multi-State Plan Programs, Medicare Patient Access and Quality Improvement Act of 2013, Medicare Prescription Drug Integrity. Medicare fraud; Provider terminations in Medicare Advantage; CHIP (Children's Health Insurance Program) reauthorization HR 4160 Introduced March 6, 2014 by Renee Ellmers (R-NC) Keep the Promise to Seniors Act of 2014 - Prohibits the Secretary of Health and Human Services (HHS) from taking any action (through promulgation of a final or interim final regulation, issuance of regulatory or program guidance, use of federal payment audit procedures, or other enforcement or administrative action, policy, or practice) to implement any provision of the proposed regulation (relating to policy and technical changes to the MedicareAdvantage and part D programs under Medicare) published in the Federal Register on January 10, 2014, insofar as that regulation relates to part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act (SSA), including its application to MedicareAdvantage- Prescription Drug (MA-PD) plans under part C (Medicare+Choice Program). HR 4577 Introduced May 6, 2014 by H. Griffith (R-VA) Ensuring Seniors Access to Local Pharmacies Act of 2014 - Amends part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act with respect to a prescription drug plan that has, in its network of pharmacies, one or more pharmacies located in a health professional shortage area, in a medically underserved area, or among a medically underserved population, and that provides a reduction in coinsurance or copayments for covered part D drugs dispensed through them. Declares that such a plan shall extend to any pharmacy located in that area or among that population the option to be an in-network pharmacy with respect to such plan under terms and conditions comparable to those the plan has agreed upon with other in-network pharmacies located in the area or among that population. HR 2960 Introduced August 1, 2013 by Frank Pallone (D-NJ) Medicare Prescription Drug Integrity Act of 2013 - Amends part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act (SSA) to require a prescription drug plan (PDP) sponsor to have in place procedures designed to prevent fraud and abuse in PDPs. HR 5547 Introduced September 18, 2014 by Matthew Cartwright (D-PA) To ensure that Medicaid beneficiaries have the opportunity to receive care in a home and community-based setting HR 5558 Introduced September 18, 2014 by Diane Black (R-TN) To amend title XVIII of the Social Security Act to improve the Medicare accountable care organization (ACO) program, and for other purposes HR 4494 Introduced June 26, 2014 by Dave Camp (R-MI) Improving Medicare Post-Acute Care Transformation Act of 2014 or the IMPACT Act of 2014 - Amends title XVIII (Medicare) of the Social Security Act to direct the Secretary of Health and Human Services (HHS) to provide for standardized post-acute care assessment data for quality, payment, and discharge planning, and for other purposes. HR 2925 Introduced August 1, 2013 by Kevin Brady (R-TX) Strengthening Medicare Anti-Fraud Measures Act of 2013 - Amends title XI of the Social Security Act to authorize the Secretary of Health and Human Services (HHS) to exclude from participation in any federal health care program entities affiliated with a sanctioned entity, as well as any officer or managing employee of an affiliated entity (currently, only individuals with an ownership or control interest in a sanctioned entity), if the affiliated entity was so affiliated at the time of any of the conduct forming the basis for the conviction or exclusion of the sanctioned entity.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues relating to prescription drug abuse and diversion; HR 4577 - Ensuring Seniors Access to Local Pharmacies Act of 2014

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

Medicare Reforms: Medicare A & B; Delivery System Reforms, Benefit Restructuring ; Medigap first-dollar coverage; Quality Initiatives/SGR Reform, HIPAA Code Adoption Process, Medicare Advantage Risk Delay Part D Cuts, HR 2810 Introduced by Burgess (R-TX) on July 31, 2013 See addendum on additional Medicare/Medicaid issues...Addtional Medicare/Medicaid Issues: HR 3392 Introduced October 13, 2013 by Gus Bilirakis (R-FL) To amend title XVIII of the Social Security Act to provide for a PDP safety program to prevent fraud and abuse in the dispensing of controlled substances under part D of the Medicare program, and for other purposes. Multi-State Plan Programs, Medicare Patient Access and Quality Improvement Act of 2013, Medicare Prescription Drug Integrity. Medicare fraud; Provider terminations in Medicare Advantage; CHIP (Children's Health Insurance Program) reauthorization HR 4160 Introduced March 6, 2014 by Renee Ellmers (R-NC) Keep the Promise to Seniors Act of 2014 - Prohibits the Secretary of Health and Human Services (HHS) from taking any action (through promulgation of a final or interim final regulation, issuance of regulatory or program guidance, use of federal payment audit procedures, or other enforcement or administrative action, policy, or practice) to implement any provision of the proposed regulation (relating to policy and technical changes to the MedicareAdvantage and part D programs under Medicare) published in the Federal Register on January 10, 2014, insofar as that regulation relates to part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act (SSA), including its application to MedicareAdvantage- Prescription Drug (MA-PD) plans under part C (Medicare+Choice Program). HR 4930 Introduced June 20, 2014 by Joe Barton (R-TX) Advancing Care for Exceptional Kids Act of 2014 or the ACE Kids Act of 2014 - Amends titles XIX (Medicaid) and XXI (Children's Health Insurance) (CHIP) of the Social Security Act to extend medical assistance to payment for items and services furnished under a Medicaid Children's Care Coordination (MCCC) Program which the state may elect to provide to eligible children with complex medical conditions HR 4577 Introduced May 6, 2014 by H. Griffith (R-VA) Ensuring Seniors Access to Local Pharmacies Act of 2014 - Amends part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act with respect to a prescription drug plan that has, in its network of pharmacies, one or more pharmacies located in a health professional shortage area, in a medically underserved area, or among a medically underserved population, and that provides a reduction in coinsurance or copayments for covered part D drugs dispensed through them. Declares that such a plan shall extend to any pharmacy located in that area or among that population the option to be an in-network pharmacy with respect to such plan under terms and conditions comparable to those the plan has agreed upon with other in-network pharmacies located in the area or among that population. HR 2960 Introduced August 1, 2013 by Frank Pallone (D-NJ) Medicare Prescription Drug Integrity Act of 2013 - Amends part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act (SSA) to require a prescription drug plan (PDP) sponsor to have in place procedures designed to prevent fraud and abuse in PDPs. HR 5083 Introduced July 11, 2014 by Renee Ellmers (R-NC) Medicare DMEPOS Audit Improvement and Reform (AIR) Act of 2014 - Amends title XVIII (Medicare) of the Social Security Act (SSA) to establish a Medicare Administrative Contractor Payment Outreach and Education Program for DMEPOS (durable medical equipment, prosthetics, orthotics, and supplies) suppliers HR 5010 Introduced June 26, 2014 by Jackie Speier (D-CA) To provide greater clarity in the regulation of electronic nicotine delivery systems, including electronic cigarettes, cigars, cigarillos, pipes, and hookahs, and for other purposes. as introduced. HR 5460 Introduced September 11, 2014 by Greg Walden (R-OR) To amend title XVIII of the Social Security Act to increase access to ambulance services under the Medicare program and to reform payments for such services under such program. as introduced. (See following page on additional Medicare/Medicaid issues...)HR 5547 Introduced September 18, 2014 by Matthew Cartwright (D-PA) To ensure that Medicaid beneficiaries have the opportunity to receive care in a home and community-based setting HR 5558 Introduced September 18, 2014 by Diane Black (R-TN) To amend title XVIII of the Social Security Act to improve the Medicare accountable care organization (ACO) program, and for other purposes HR 4494 Introduced June 26, 2014 by Dave Camp (R-MI) Improving Medicare Post-Acute Care Transformation Act of 2014 or the IMPACT Act of 2014 - Amends title XVIII (Medicare) of the Social Security Act to direct the Secretary of Health and Human Services (HHS) to provide for standardized post-acute care assessment data for quality, payment, and discharge planning, and for other purposes. HR 2925 Introduced August 1, 2013 by Kevin Brady (R-TX) Strengthening Medicare Anti-Fraud Measures Act of 2013 - Amends title XI of the Social Security Act to authorize the Secretary of Health and Human Services (HHS) to exclude from participation in any federal health care program entities affiliated with a sanctioned entity, as well as any officer or managing employee of an affiliated entity (currently, only individuals with an ownership or control interest in a sanctioned entity), if the affiliated entity was so affiliated at the time of any of the conduct forming the basis for the conviction or exclusion of the sanctioned entity.

Client expense: $1,540,000 · Firm income: Not reported

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

H.R. 1285- To Amend the Controlled Substance Act to Make Any Substance Containing Hydrocodone a Schedule II Drug; S.621- The Safe Prescribing Act of 2013; H.R. 1024- The Medication Therapy Management Empowerment Act of 2013; S. 557 Medication Therapy Empowerment Act of 2013; H.R. 1188- The Preserving Our Hometown Independent Pharmacies Act of 2013; CMS proposed and final rule on Medicare Part D; H.R. 4709- Ensuring Patient Access and Effective Drug Enforcement Act of 2014;S.2862 - Regulatory Transparency, Patient Access, and Effective Drug Enforcement Act of 2014; H.R. 4190- To Amend Title XVIII of the Social Security Act to provide for coverage under the Medicare program of pharmacist services; FDAs action on and enforcement of Public Law No: 113-54; H.R.4577 - Ensuring Seniors Access to Local Pharmacies Act of 2014; H.R.4437 - Generic Drug Pricing Fairness Act; S. 1493 - Medicare Efficient Drug Dispensing Act of 2013; Generic Drug Pricing Spikes; The SGR Repeal and Medicare Beneficiary Access Improvement Act of 2013; H.R..4435 National Defense Authorization Act for Fiscal Year 2015 (Tricare Provisions); S. 2410 National Defense Authorization Act for Fiscal Year 2015 (Tricare Provisions); Perscription Drug Abuse and Diversion; H.Con.Res 25: Establishing the budget for the United States government for Fiscal Year 2014 and setting forth appropriate budgetary levels for Fiscal Year 2015 through 2023; S.Con.Res 8: An original concurrent resolution setting forth the Congressional budget for the United States Government for Fiscal Year 2014, revising the appropriate budgetary levels for Fiscal year 2013, and setting forth the appropriate budgetary levels for Fiscal Years 2015 through 2023.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE

Opposition to legislation that would amend Medicare Part D to require health plans to include any willing pharmacy in its network if the pharmacy is located in a medically underserved area of among a medically underserved population - H.R. 4577. Opposition to limiting the ability of health plans to include preferred networks in their pharmacy network.

Client expense: $210,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, SENATE

Provisions of PL 111-148 and PL 111-152 impacting Medicare Part D such as formulary requirements, PBM disclosure provisions, closing the Part D coverage gap Regulatory design and coverage of pharmacy benefits in health reform exchanges and the commercial market (essential health benefits, grandfathering, value-based insurance design, e-prescribing, PBM disclosure requirements, and medical loss ratio). Regulatory and proposed legislative changes to Medicare part D including pharmacy networks, classes of clinical concern, mail-service pharmacy, EGWP waivers, MTM expansion, long term care short-term fills, recovery audit contractors. Implementation of changes to the definition of Average Manufacturer Price in Medicaid Issues related to the management of Medicaid prescription drug benefits Legislation to promote generic drugs. Regulatory Implementation of the HITECH Act. FDA issues related to the Prescription Drug User Fee Act (PDUFA) (generic user fees, pedigree, REMs); implementation of approval pathway for generic biologic drugs, 340B program. S. 77, Prescription Drug and Health Improvement Act S. 557, Medication Therapy Management Empowerment Act H.R. 460, Patients Access to Treatments Act H.R. 1188, Preserving Our Hometown Independent Pharmacies Act H.R. 1367, FEHBP Prescription Drug Integrity, Transparency, and Cost Savings Act H.R. 1024, Medication Therapy Management Empowerment Act H.R. 4577, Ensuring Seniors Access to Local Pharmacies Act of 2014 to Medicare/Medicaid; Pharmacy; and Health Care General H.R. 4418, Expanding the Availability of Medicare Data Act to Medicare/Medicaid

Client expense: $788,458 · Firm income: Not reported

Government targets: Administration for Children & Families (ACF), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE

Provisions of PL 111-148 and PL 111-152 impacting Medicare Part D such as formulary requirements, PBM disclosure provisions, closing the Part D coverage gap Regulatory design and coverage of pharmacy benefits in health reform exchanges and the commercial market (essential health benefits, grandfathering, value-based insurance design, e-prescribing, PBM disclosure requirements, and medical loss ratio). Regulatory and proposed legislative changes to Medicare part D including pharmacy networks, classes of clinical concern, mail-service pharmacy, EGWP waivers, MTM expansion, long term care short-term fills, recovery audit contractors. Implementation of changes to the definition of Average Manufacturer Price in Medicaid Issues related to the management of Medicaid prescription drug benefits Legislation to promote generic drugs. Regulatory Implementation of the HITECH Act. FDA issues related to the Prescription Drug User Fee Act (PDUFA) (generic user fees, pedigree, REMs); implementation of approval pathway for generic biologic drugs, 340B program. Issues related to the compounding of certain drugs. S. 77, Prescription Drug and Health Improvement Act S. 557, Medication Therapy Management Empowerment Act H.R. 460, Patients Access to Treatments Act H.R. 1188, Preserving Our Hometown Independent Pharmacies Act H.R. 1367, FEHBP Prescription Drug Integrity, Transparency, and Cost Savings Act H.R. 1024, Medication Therapy Management Empowerment Act S.867, Medicare Prescription Drug Program Integrity and Transparency Act H.R. 2960, Medicare Prescription Drug Integrity Act of 2013 H.R. 4160, Keep the Promise to Seniors Act H.R. 4577, Ensuring Seniors Access to Local Pharmacies Act of 2014 to Medicare/Medicaid; Pharmacy; and Health Care General H.R. 4418, Expanding the Availability of Medicare Data Act to Medicare/Medicaid

Client expense: $788,458 · Firm income: Not reported

Government targets: Administration for Children & Families (ACF), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE

Provisions of PL 111-148 and PL 111-152 impacting Medicare Part D such as formulary requirements, PBM disclosure provisions, closing the Part D coverage gap Regulatory design and coverage of pharmacy benefits in health reform exchanges and the commercial market (essential health benefits, grandfathering, value-based insurance design, e-prescribing, PBM disclosure requirements, and medical loss ratio). Regulatory and proposed legislative changes to Medicare part D including pharmacy networks, classes of clinical concern, mail-service pharmacy, EGWP waivers, MTM expansion, long term care short-term fills, recovery audit contractors. Implementation of changes to the definition of Average Manufacturer Price in Medicaid Issues related to the management of Medicaid prescription drug benefits Legislation to promote generic drugs. Regulatory Implementation of the HITECH Act. FDA issues related to the Prescription Drug User Fee Act (PDUFA) (generic user fees, pedigree, REMs); implementation of approval pathway for generic biologic drugs, 340B program. S. 77, Prescription Drug and Health Improvement Act S. 557 / H.R. 1024, Medication Therapy Management Empowerment Act S.867, Medicare Prescription Drug Program Integrity and Transparency Act H.R. 2960, Medicare Prescription Drug Integrity Act of 2013 H.R. 4160, Keep the Promise to Seniors Act H.R. 4577, Ensuring Seniors Access to Local Pharmacies Act of 2014 to Medicare/Medicaid; Pharmacy; and Health Care General H.R. 4418, Expanding the Availability of Medicare Data Act to Medicare/Medicaid

Client expense: $788,458 · Firm income: Not reported

Government targets: Administration for Children & Families (ACF), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE

Policies related to the Federal Employees Health Benefit Program's pharmacy benefit (HR 1367); Regulatory design and coverage of pharmacy benefits in health reform Exchanges and the commercial market (EHB, grandfathering, Rx quality, eRx, PBM disclosure requirements, MLR); specialty pharmacy tiering restrictions (HR 460); regulatory implementation of a pathway for the approval of biosimilars; REMs; 340b program; policies placing restrictions on pharmacy benefit designissues regarding making prescription drugs more affordable (generic user fees; pedigree; pathway for biosimilars; REMs). General issues dealing with prescription drug abuse (HR 3392) including Medicare Lock-in programs. General issues dealing with regulating pharmacy drug compounding (PDSQ Act); S. 867 (and versions HR 4437, HR 4577), the Medicare Prescription Drug Program Integrity and Transparency Act.

Client expense: $500,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), 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), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Personnel Management (OPM), SENATE, White House Office

Health reform proposals that impact Medicare Part D such as formulary requirements, PBM disclosure provisions, closing of the Part D coverage gap. General reg/leg Part D issues such as direct negotiation (budget proposals). Statutory implementation of changes to the definition of AMP in Medicaid. Exclusion of specialty distributors' prompt pay discounts from the definition of Average Sales Price. Medicare audit and preferred network restrictions. S. 867, Medicare Prescription Drug Integrity andAnd Transparency Act of 2013 and other versions (HR 4437, S. 867, HR 4577. General issues and legislation (HR 3392) regarding combatting Rx abuse in Medicare and Medicaid (pharmacy lock-in, etc)

Client expense: $500,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), 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), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Personnel Management (OPM), SENATE, White House Office

Health reform proposals that impact Medicare Part D such as formulary requirements, PBM disclosure provisions, closing of the Part D coverage gap. General reg/leg Part D issues such as direct negotiation (budget proposals). Statutory implementation of changes to the definition of AMP in Medicaid. Exclusion of specialty distributors' prompt pay discounts from the definition of Average Sales Price. Medicare audit and preferred network restrictions. S. 867, Medicare Prescription Drug Integrity andAnd Transparency Act of 2013 and other versions (HR 4437, S. 867, HR 4577. General issues and legislation (HR 3392) regarding combatting Rx abuse in Medicare and Medicaid (pharmacy lock-in, etc)

Client expense: $550,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), 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), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Personnel Management (OPM), SENATE, White House Office

Policies related to the Federal Employees Health Benefit Program's pharmacy benefit (HR 1367); Regulatory design and coverage of pharmacy benefits in health reform Exchanges and the commercial market (EHB, grandfathering, Rx quality, eRx, PBM disclosure requirements, MLR); specialty pharmacy tiering restrictions (HR 460); regulatory implementation of a pathway for the approval of biosimilars; REMs; 340b program; policies placing restrictions on pharmacy benefit designissues regarding making prescription drugs more affordable (generic user fees; pedigree; pathway for biosimilars; REMs). General issues dealing with prescription drug abuse (HR 3392) including Medicare Lock-in programs. General issues dealing with regulating pharmacy drug compounding (PDSQ Act); S. 867 (and versions HR 4437, HR 4577), the Medicare Prescription Drug Program Integrity and Transparency Act.

Client expense: $550,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), 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), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Personnel Management (OPM), SENATE, White House Office

Provisions of PL 111-148 and PL 111-152 impacting Medicare Part D such as formulary requirements, PBM disclosure provisions, closing the Part D coverage gap Regulatory design and coverage of pharmacy benefits in health reform exchanges and the commercial market (essential health benefits, grandfathering, value-based insurance design, e-prescribing, PBM disclosure requirements, and medical loss ratio). Regulatory and proposed legislative changes to Medicare part D including pharmacy networks, classes of clinical concern, mail-service pharmacy, EGWP waivers, MTM expansion, long term care short-term fills, recovery audit contractors. Implementation of changes to the definition of Average Manufacturer Price in Medicaid Issues related to the management of Medicaid prescription drug benefits Legislation to promote generic drugs. Regulatory Implementation of the HITECH Act. FDA issues related to the Prescription Drug User Fee Act (PDUFA) (generic user fees, pedigree, REMs); implementation of approval pathway for generic biologic drugs, 340B program. S. 77, Prescription Drug and Health Improvement Act S. 557, Medication Therapy Management Empowerment Act H.R. 460, Patients Access to Treatments Act H.R. 1188, Preserving Our Hometown Independent Pharmacies Act H.R. 1367, FEHBP Prescription Drug Integrity, Transparency, and Cost Savings Act H.R. 1024, Medication Therapy Management Empowerment Act H.R. 4577, Ensuring Seniors Access to Local Pharmacies Act of 2014 to Medicare/Medicaid ; Pharmacy; and Health Care General H.R. 4418, Expanding the Availability of Medicare Data Act to Medicare/Medicaid

Client expense: $1,318,034 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE

Provisions of PL 111-148 and PL 111-152 impacting Medicare Part D such as formulary requirements, PBM disclosure provisions, closing the Part D coverage gap Regulatory design and coverage of pharmacy benefits in health reform exchanges and the commercial market (essential health benefits, grandfathering, value-based insurance design, e-prescribing, PBM disclosure requirements, and medical loss ratio). Regulatory and proposed legislative changes to Medicare part D including pharmacy networks, classes of clinical concern, mail-service pharmacy, EGWP waivers, MTM expansion, long term care short-term fills, recovery audit contractors. Implementation of changes to the definition of Average Manufacturer Price in Medicaid Issues related to the management of Medicaid prescription drug benefits Legislation to promote generic drugs. Regulatory Implementation of the HITECH Act. FDA issues related to the Prescription Drug User Fee Act (PDUFA) (generic user fees, pedigree, REMs); implementation of approval pathway for generic biologic drugs, 340B program. S. 77, Prescription Drug and Health Improvement Act S. 557 / H.R. 1024, Medication Therapy Management Empowerment Act S.867, Medicare Prescription Drug Program Integrity and Transparency Act H.R. 2960, Medicare Prescription Drug Integrity Act of 2013 H.R. 4160, Keep the Promise to Seniors Act H.R. 4577, Ensuring Seniors Access to Local Pharmacies Act of 2014 to Medicare/Medicaid ; Pharmacy; and Health Care General H.R. 4418, Expanding the Availability of Medicare Data Act to Medicare/Medicaid

Client expense: $1,318,034 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE

Provisions of PL 111-148 and PL 111-152 impacting Medicare Part D such as formulary requirements, PBM disclosure provisions, closing the Part D coverage gap Regulatory design and coverage of pharmacy benefits in health reform exchanges and the commercial market (essential health benefits, grandfathering, value-based insurance design, e-prescribing, PBM disclosure requirements, and medical loss ratio). Regulatory and proposed legislative changes to Medicare part D including pharmacy networks, classes of clinical concern, mail-service pharmacy, EGWP waivers, MTM expansion, long term care short-term fills, recovery audit contractors. Implementation of changes to the definition of Average Manufacturer Price in Medicaid Issues related to the management of Medicaid prescription drug benefits Legislation to promote generic drugs. Regulatory Implementation of the HITECH Act. FDA issues related to the Prescription Drug User Fee Act (PDUFA) (generic user fees, pedigree, REMs); implementation of approval pathway for generic biologic drugs, 340B program. Issues related to the compounding of certain drugs. S. 77, Prescription Drug and Health Improvement Act S. 557, Medication Therapy Management Empowerment Act H.R. 460, Patients Access to Treatments Act H.R. 1188, Preserving Our Hometown Independent Pharmacies Act H.R. 1367, FEHBP Prescription Drug Integrity, Transparency, and Cost Savings Act H.R. 1024, Medication Therapy Management Empowerment Act S.867, Medicare Prescription Drug Program Integrity and Transparency Act H.R. 2960, Medicare Prescription Drug Integrity Act of 2013 H.R. 4160, Keep the Promise to Seniors Act H.R. 4577, Ensuring Seniors Access to Local Pharmacies Act of 2014 to Medicare/Medicaid ; Pharmacy; and Health Care General H.R. 4418, Expanding the Availability of Medicare Data Act to Medicare/Medicaid

Client expense: $1,318,034 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE

Discussions related to pseudoephedrine Discussions related to Medicare Part D, H.R. 4577

Client expense: $1,870,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Commerce, Dept of (DOC), Executive Office of the President (EOP), Federal Reserve System, Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), SENATE, State, Dept of (DOS), Treasury, Dept of, U.S. Agency for International Development (USAID), U.S. Trade Representative (USTR), White House Office

H.R.4577, Ensuring Seniors Access to Local Pharmacies Act of 2014 Issues related to the implementation of health exchanges under the Affordable Care Act Issues related to health care reform, rate reviews, and drug pricing under Medicare and Medicaid Issues related to medical device and patient safetyIssues related to healthcare-acquired infections Issues related to background checks for doctors Issues related to pay for perfomance programs Issues related to the National Practitioner Data Bank Issues related to surgical mesh and reclassification

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

Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Consumer Product Safety Commission (CPSC), Energy, Dept of, Environmental Protection Agency (EPA), Federal Aviation Administration (FAA), Federal Communications Commission (FCC), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Highway Traffic Safety Administration (NHTSA), Natl Telecommunications & Information Administration (NTIA), Office of Management & Budget (OMB), SENATE, Transportation, Dept of (DOT)

Medicare Reforms: Medicare A & B; Delivery System Reforms, Benefit Restructuring ; Medigap first-dollar coverage; Quality Initiatives/SGR Reform, HIPAA Code Adoption Process, Medicare Advantage Risk Delay Part D Cuts, HR 2810 Introduced by Burgess (R-TX) on July 31, 2013 See addendum on additional Medicare/Medicaid issues...Addtional Medicare/Medicaid Issues: HR 3392 Introduced October 13, 2013 by Gus Bilirakis (R-FL) To amend title XVIII of the Social Security Act to provide for a PDP safety program to prevent fraud and abuse in the dispensing of controlled substances under part D of the Medicare program, and for other purposes. Multi-State Plan Programs, Medicare Patient Access and Quality Improvement Act of 2013, Medicare Prescription Drug Integrity. Medicare fraud; Provider terminations in Medicare Advantage HR 4160 Introduced March 6, 2014 by Renee Ellmers (R-NC) Keep the Promise to Seniors Act of 2014 - Prohibits the Secretary of Health and Human Services (HHS) from taking any action (through promulgation of a final or interim final regulation, issuance of regulatory or program guidance, use of federal payment audit procedures, or other enforcement or administrative action, policy, or practice) to implement any provision of the proposed regulation (relating to policy and technical changes to the MedicareAdvantage and part D programs under Medicare) published in the Federal Register on January 10, 2014, insofar as that regulation relates to part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act (SSA), including its application to MedicareAdvantage- Prescription Drug (MA-PD) plans under part C (Medicare+Choice Program). HR 4930 Introduced June 20, 2014 by Joe Barton (R-TX) Advancing Care for Exceptional Kids Act of 2014 or the ACE Kids Act of 2014 - Amends titles XIX (Medicaid) and XXI (Children's Health Insurance) (CHIP) of the Social Security Act to extend medical assistance to payment for items and services furnished under a Medicaid Children's Care Coordination (MCCC) Program which the state may elect to provide to eligible children with complex medical conditions HR 4577 Introduced May 6, 2014 by H. Griffith (R-VA) Ensuring Seniors Access to Local Pharmacies Act of 2014 - Amends part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act with respect to a prescription drug plan that has, in its network of pharmacies, one or more pharmacies located in a health professional shortage area, in a medically underserved area, or among a medically underserved population, and that provides a reduction in coinsurance or copayments for covered part D drugs dispensed through them. Declares that such a plan shall extend to any pharmacy located in that area or among that population the option to be an in-network pharmacy with respect to such plan under terms and conditions comparable to those the plan has agreed upon with other in-network pharmacies located in the area or among that population.

Client expense: $1,820,000 · 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

Issues relating to generic pharmaceutical utilization; HR 4577 - Ensuring Seniors Access to Local Pharmacies Act of 2014

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

Medicare Reforms: Medicare A & B; Delivery System Reforms, Benefit Restructuring ; Quality Initiatives/SGR Reform, HIPAA Code Adoption Process, Medicare Advantage Risk Delay Part D Cuts, HR 2810 Introduced by Burgess (R-TX) on July 31, 2013 Addtional Medicare/Medicaid Issues: HR 3392 Introduced October 13, 2013 by Gus Bilirakis (R-FL) To amend title XVIII of the Social Security Act to provide for a PDP safety program to prevent fraud and abuse in the dispensing of controlled substances under part D of the Medicare program, and for other purposes. Multi-State Plan Programs, Medicare Patient Access and Quality Improvement Act of 2013, Medicare Prescription Drug Integrity. Medicare fraud; Provider terminations in Medicare Advantage HR 4160 Introduced March 6, 2014 by Renee Ellmers (R-NC) Keep the Promise to Seniors Act of 2014 - Prohibits the Secretary of Health and Human Services (HHS) from taking any action (through promulgation of a final or interim final regulation, issuance of regulatory or program guidance, use of federal payment audit procedures, or other enforcement or administrative action, policy, or practice) to implement any provision of the proposed regulation (relating to policy and technical changes to the MedicareAdvantage and part D programs under Medicare) published in the Federal Register on January 10, 2014, insofar as that regulation relates to part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act (SSA), including its application to MedicareAdvantage- Prescription Drug (MA-PD) plans under part C (Medicare+Choice Program). HR 4577 Introduced May 6, 2014 by H. Griffith (R-VA) Ensuring Seniors Access to Local Pharmacies Act of 2014 - Amends part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act with respect to a prescription drug plan that has, in its network of pharmacies, one or more pharmacies located in a health professional shortage area, in a medically underserved area, or among a medically underserved population, and that provides a reduction in coinsurance or copayments for covered part D drugs dispensed through them. Declares that such a plan shall extend to any pharmacy located in that area or among that population the option to be an in-network pharmacy with respect to such plan under terms and conditions comparable to those the plan has agreed upon with other in-network pharmacies located in the area or among that population.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 557, The Medication Therapy Management Empowerment Act of 2013 H.R. 1024, The Medication Therapy Management Empowerment Act of 2013 H.R. 2810, Medicare Patient Access and Quality Improvement Act The SGR Repeal and Medicare Beneficiary Access Improvement Act of 2013 H.R.4302 - Protecting Access to Medicare Act of 2014 H.R. 4190 - To amend title XVIII of the Social Security Act to provide for coverage under the Medicare program of pharmacist services. H.R. 3890 / S. 1932 - Better Care, Lower Cost Act H.R.4577 - Ensuring Seniors Access to Local Pharmacies Act of 2014

Client expense: $640,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE