Cancer Care Payment Reform Act of 2015

Issues pertaining to Medicare reimbursement. Issues pertaining to drug shortages, monitoring legislation regarding the 340B Drug discount program. Issues pertaining to sequestration; H.R. 1934 Cancer Care Payment Reform Act. Issues related to pharmacy benefit managers.

Client expense: Not reported · Firm income: $80,000

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

Issues pertaining to Medicare reimbursement. Issues pertaining to drug shortages, monitoring legislation regarding the 340B Drug discount program. Issues pertaining to sequestration; H.R. 1934 Cancer Care Payment Reform Act. Issues related to pharmacy benefit managers.

Client expense: Not reported · Firm income: $80,000

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

Issues pertaining to Medicare reimbursement. Issues pertaining to drug shortages, monitoring legislation regarding the 340B Drug discount program. Issues pertaining to sequestration; H.R. 1934 Cancer Care Payment Reform Act. Issues related to pharmacy benefit managers.

Client expense: Not reported · Firm income: $80,000

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

Issues pertaining to Medicare reimbursement. Issues pertaining to drug shortages, monitoring legislation regarding the 340B Drug discount program. Issues pertaining to sequestration; H.R. 1934 Cancer Care Payment Reform Act. Issues related to pharmacy benefit managers.

Client expense: Not reported · Firm income: $80,000

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

Issues pertaining to Medicare reimbursement. Issues pertaining to drug shortages, monitoring legislation regarding the 340B Drug discount program. Issues pertaining to sequestration; H.R. 1934 Cancer Care Payment Reform Act. Issues related to pharmacy benefit managers.

Client expense: Not reported · Firm income: $80,000

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

Issues pertaining to Medicare reimbursement. Issues pertaining to drug shortages, monitoring legislation regarding the 340B Drug discount program. Issues pertaining to sequestration; H.R. 1934 Cancer Care Payment Reform Act. Issues related to pharmacy benefit managers.

Client expense: Not reported · Firm income: $80,000

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

Issues pertaining to Medicare reimbursement. Issues pertaining to drug shortages, monitoring legislation regarding the 340B Drug discount program. Issues pertaining to sequestration; H.R. 1934 Cancer Care Payment Reform Act. Issues related to pharmacy benefit managers. HR 1920 Prompt Pay legislation.

Client expense: Not reported · Firm income: $80,000

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

Issues pertaining to Medicare reimbursement. Issues pertaining to drug shortages, monitoring legislation regarding the 340B Drug discount program. Issues pertaining to sequestration; H.R. 1934 Cancer Care Payment Reform Act. Issues related to pharmacy benefit managers. HR 1920 Prompt Pay legislation.

Client expense: Not reported · Firm income: $80,000

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

Issues pertaining to Medicare reimbursement. Issues pertaining to drug shortages, monitoring legislation regarding the 340B Drug discount program. Issues pertaining to sequestration; H.R. 1934 Cancer Care Payment Reform Act. Issues related to pharmacy benefit managers. HR 1920 Prompt Pay legislation.

Client expense: Not reported · Firm income: $80,000

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

Issues pertaining to Medicare reimbursement. Issues pertaining to drug shortages, monitoring legislation regarding the 340B Drug discount program. Issues pertaining to sequestration; H.R. 1934 Cancer Care Payment Reform Act. Issues related to pharmacy benefit managers. HR 1920 Prompt Pay legislation.

Client expense: Not reported · Firm income: $80,000

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

Issues pertaining to Medicare reimbursement. Issues pertaining to drug shortages, monitoring legislation regarding the 340B Drug discount program. Issues pertaining to sequestration; H.R. 1934 Cancer Care Payment Reform Act. Issues related to pharmacy benefit managers. HR 1920 Prompt Pay legislation.

Client expense: Not reported · Firm income: $80,000

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

Issues pertaining to Medicare reimbursement. Issues pertaining to drug shortages, monitoring legislation regarding the 340B Drug discount program. Issues pertaining to sequestration; H.R. 1934 Cancer Care Payment Reform Act. Issues related to pharmacy benefit managers. HR 1920 Prompt Pay legislation.

Client expense: Not reported · Firm income: $80,000

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

Issues pertaining to Medicare reimbursement. Issues pertaining to drug shortages, monitoring legislation regarding the 340B Drug discount program. Issues pertaining to sequestration; H.R. 1934 Cancer Care Payment Reform Act. Medicare Part B Demonstration.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues pertaining to Medicare reimbursement. Issues pertaining to drug shortages, monitoring legislation regarding the 340B Drug discount program. Issues pertaining to sequestration; H.R. 1934 Cancer Care Payment Reform Act. Medicare Part B Demonstration

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues pertaining to Medicare reimbursement. Issues pertaining to drug shortages, monitoring legislation regarding the 340B Drug discount program. Issues pertaining to sequestration; H.R. 1934 Cancer Care Payment Reform Act. Medicare Part B Demonstration

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 696 & S. 506 (Medicare Prompt Pay Discount Exclusion), legislation to ensure more appropriate general payment amount for drugs and biologicals under Part B of the Medicare Program by excluding customary prompt-pay discounts extended to wholesalers from the manufacturer's average sales price. Average Sales Price (ASP) Generally (in the context of Deficit Reduction). H.R. 1416 legislation to exclude cancer drugs from sequestration cuts. H.R. 1934, The Cancer Care Payment Reform Act of 2015. H.R.5122 - To prohibit further action on the proposed Medicare Part B Provider Reimbursement Demonstration Project through CMS/CMMI, Medicare Access and CHIP Reauthorization Act (MACRA) implementation.

Client expense: $610,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1934- Cancer Care Payment Reform Act of 2015 Medicare Part B reimbursement Part B drug payment model S.3211- Cancer Care Payment Reform Act of 2016

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 4959: Ensuring Access to General Surgery Act of 2016 H.R. 105: Quality Health Care Coalition Act of 2015 H.R. 3309: Flex-IT 2 Act H.R. 647: Access to Life-Saving Trauma Care for All Americans Act H.R. 648: Trauma Systems and Regionalization of Emergency Care Reauthorization Act H.R. 836: Health Care Safety Net Enhancement Act of 2015 H.R. 865: Good Samaritan Health Professionals Act of 2015 S. 3101: Good Samaritan Health Professionals Act of 2016 H.R. 1934: Cancer Care Payment Reform Act of 2015 S. 2943/H.R.1735: National Defense Authorization Act (NDAA) H.R.4909 - National Defense Authorization Act for Fiscal Year 2017 H.R. 2739: Cancer Drug Coverage Parity Act of 2015 S. 624/H.R. 1220: Removing Barriers to Colorectal Cancer Screening Act of 2015 S. 3166: Ensuring Access to General Surgery Act of 2016 S. 3522: Graduate Medical Education Equity Act H.R. 1925: To award a Congressional Gold Medal to Dr. Balazs "Ernie" Bodai in recognition of his many outstanding contributions to the Nation, including a tireless commitment to breast cancer research. H.Res. 487: Recognizing the importance of cancer program accreditation in ensuring comprehensive, high quality, patient-centered cancer care Veterans Access, Choice and Accountability Act Concurrent Surgery MACRA Proposed Rule Implementation GME Health Professional Shortage Areas (HPSAs) Health Information Technology (Health IT) Chronic Care Coordination 96-Hour Rule Bleeding Control for the Injured (Stop The Bleed campaign) Opioids Cancer/Appropriations Medicare Part B Merit-Based Incentive Payment System (MIPS) & Alternative Payment Models (APMs) Qualified Clinical Data Registry (QCDR) reporting mechanism Physician Quality Reporting System (PQRS) Video Recording Surgery RAC Audits Energy and Commerce Concussion Initiative Data Use Protection Legislation FOIA Energy and Commerce Pediatric Trauma Caucus Responsible Data Transparency Act

H.R. 4959: Ensuring Access to General Surgery Act of 2016 H.R. 105: Quality Health Care Coalition Act of 2015 H.R. 3309: Flex-IT 2 Act H.R. 647: Access to Life-Saving Trauma Care for All Americans Act H.R. 648: Trauma Systems and Regionalization of Emergency Care Reauthorization Act H.R. 836: Health Care Safety Net Enhancement Act of 2015 H.R. 865: Good Samaritan Health Professionals Act of 2015 S. 3101: Good Samaritan Health Professionals Act of 2016 H.R. 1934: Cancer Care Payment Reform Act of 2015 S. 2943/H.R.1735: National Defense Authorization Act (NDAA) H.R.4909 - National Defense Authorization Act for Fiscal Year 2017 H.R. 2739: Cancer Drug Coverage Parity Act of 2015 S. 624/H.R. 1220: Removing Barriers to Colorectal Cancer Screening Act of 2015 S. 3166: Ensuring Access to General Surgery Act of 2016 S. 3522: Graduate Medical Education Equity Act H.R. 1925: To award a Congressional Gold Medal to Dr. Balazs "Ernie" Bodai in recognition of his many outstanding contributions to the Nation, including a tireless commitment to breast cancer research. H.Res. 487: Recognizing the importance of cancer program accreditation in ensuring comprehensive, high quality, patient-centered cancer care Veterans Access, Choice and Accountability Act Concurrent Surgery MACRA Proposed Rule Implementation GME Health Professional Shortage Areas (HPSAs) Health Information Technology (Health IT) Chronic Care Coordination 96-Hour Rule Bleeding Control for the Injured (Stop The Bleed campaign) Opioids Cancer/Appropriations Medicare Part B Merit-Based Incentive Payment System (MIPS) & Alternative Payment Models (APMs) Qualified Clinical Data Registry (QCDR) reporting mechanism Physician Quality Reporting System (PQRS) Video Recording Surgery RAC Audits Energy and Commerce Concussion Initiative Data Use Protection Legislation FOIA Energy and Commerce Pediatric Trauma Caucus Responsible Data Transparency Act

H.R. 4959: Ensuring Access to General Surgery Act of 2016 H.R. 105: Quality Health Care Coalition Act of 2015 H.R. 3309: Flex-IT 2 Act H.R. 647: Access to Life-Saving Trauma Care for All Americans Act H.R. 648: Trauma Systems and Regionalization of Emergency Care Reauthorization Act H.R. 836: Health Care Safety Net Enhancement Act of 2015 H.R. 865: Good Samaritan Health Professionals Act of 2015 S. 3101: Good Samaritan Health Professionals Act of 2016 H.R. 1934: Cancer Care Payment Reform Act of 2015 S. 2943/H.R.1735: National Defense Authorization Act (NDAA) H.R.4909 - National Defense Authorization Act for Fiscal Year 2017 H.R. 2739: Cancer Drug Coverage Parity Act of 2015 S. 624/H.R. 1220: Removing Barriers to Colorectal Cancer Screening Act of 2015 S. 3166: Ensuring Access to General Surgery Act of 2016 S. 3522: Graduate Medical Education Equity Act H.R. 1925: To award a Congressional Gold Medal to Dr. Balazs "Ernie" Bodai in recognition of his many outstanding contributions to the Nation, including a tireless commitment to breast cancer research. H.Res. 487: Recognizing the importance of cancer program accreditation in ensuring comprehensive, high quality, patient-centered cancer care Veterans Access, Choice and Accountability Act Concurrent Surgery MACRA Proposed Rule Implementation GME Health Professional Shortage Areas (HPSAs) Health Information Technology (Health IT) Chronic Care Coordination 96-Hour Rule Bleeding Control for the Injured (Stop The Bleed campaign) Opioids Cancer/Appropriations Medicare Part B Merit-Based Incentive Payment System (MIPS) & Alternative Payment Models (APMs) Qualified Clinical Data Registry (QCDR) reporting mechanism Physician Quality Reporting System (PQRS) Video Recording Surgery RAC Audits Energy and Commerce Concussion Initiative Data Use Protection Legislation FOIA Energy and Commerce Pediatric Trauma Caucus Responsible Data Transparency Act

H.R. 4959: Ensuring Access to General Surgery Act of 2016 H.R. 105: Quality Health Care Coalition Act of 2015 H.R. 3309: Flex-IT 2 Act H.R. 647: Access to Life-Saving Trauma Care for All Americans Act H.R. 648: Trauma Systems and Regionalization of Emergency Care Reauthorization Act H.R. 836: Health Care Safety Net Enhancement Act of 2015 H.R. 865: Good Samaritan Health Professionals Act of 2015 S. 3101: Good Samaritan Health Professionals Act of 2016 H.R. 1934: Cancer Care Payment Reform Act of 2015 S. 2943/H.R.1735: National Defense Authorization Act (NDAA) H.R.4909 - National Defense Authorization Act for Fiscal Year 2017 H.R. 2739: Cancer Drug Coverage Parity Act of 2015 S. 624/H.R. 1220: Removing Barriers to Colorectal Cancer Screening Act of 2015 S. 3166: Ensuring Access to General Surgery Act of 2016 S. 3522: Graduate Medical Education Equity Act H.R. 1925: To award a Congressional Gold Medal to Dr. Balazs "Ernie" Bodai in recognition of his many outstanding contributions to the Nation, including a tireless commitment to breast cancer research. H.Res. 487: Recognizing the importance of cancer program accreditation in ensuring comprehensive, high quality, patient-centered cancer care Veterans Access, Choice and Accountability Act Concurrent Surgery MACRA Proposed Rule Implementation GME Health Professional Shortage Areas (HPSAs) Health Information Technology (Health IT) Chronic Care Coordination 96-Hour Rule Bleeding Control for the Injured (Stop The Bleed campaign) Opioids Cancer/Appropriations Medicare Part B Merit-Based Incentive Payment System (MIPS) & Alternative Payment Models (APMs) Qualified Clinical Data Registry (QCDR) reporting mechanism Physician Quality Reporting System (PQRS) Video Recording Surgery RAC Audits Energy and Commerce Concussion Initiative Data Use Protection Legislation FOIA Energy and Commerce Pediatric Trauma Caucus Responsible Data Transparency Act

Legislation to reform Medicare payment for oncology: Cancer Care Payment Reform Act (H.R. 1934; S. 3211). Legislation to exclude manufacturer-to-distributor prompt pay discounts from the calculation of ASP-based Medicare Part B drug reimbursement rates (H.R. 696, S. 506). Misc. discussions (no legislation) to address 340B drug discount program, site-of-service payment parity, and Medicare reimbursement for cancer care. General discussion on the CMS/CMMI Medicare Part B Payment Model to cut Medicare Part B drug reimbursement. Specific legislation to stop the Medicare Part B Drug Payment Model (H.R. 5122). Topics related to pharmaceutical benefit managers (PBMs)

Client expense: $112,500 · Firm income: Not reported

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

Affordable Care Act (ACA) Issues; ACA Regulations; Postal Reform; Department of Labor Conflict of Interest Rule; HCR Implementation; Health Savings Accounts (HSAs); Re-insurance; Co-ops; Notice of Benefit and Payment Parameters (NBPP); Health Care Bill; Market Stability; Year-end Priorities; Cost-sharing Reduction (CSR); Better Way; Repeal/Replace Modeling; ACA Reform; Risk Corridors; Chronic Care; Comprehensive Care and Recovery Act (CARA); Mental Health Reform; Premium Education; Third Party Payment of Premiums; Association Health Plans; SEPs; Grace Periods; Age Bands. HR 928 Introduced February 12, 2015 by Charles Boustany (R-LA) This bill repeals a provision of the Patient Protection and Affordable Care Act that imposes an annual fee on a health insurance provider based on its net premium income. HR 1934 Cancer Care Payment Reform Act of 2015 Introduced April 22, 2015 by Cathy McMorris Rodgers To amend title XVIII of the Social Security Act to establish a national Oncology Medical Home Demonstration Project under the Medicare program for the purpose of changing the Medicare payment for cancer care in order to enhance the quality of care and to improve cost efficiency, and for other purposes. HR 2488 Medicare Beneficiary Preservation of Choice Act of 2015 Introduced May 21, 2015 by Keith Rothfus (R-PA) This bill amends title XVIII (Medicare) of the Social Security Act to expand and modify enrollment and disenrollment options for Medicare Advantage (MA) eligible individuals. Specifically, the bill extends the annual period in which an individual enrolled in MA may elect to instead receive benefits under the original Medicare fee-for-service (FFS) program as well as elect to change qualified prescription drug coverage. Furthermore, any MA-eligible individual (whether or not enrolled in MA) may once per period change a previous election with respect to receiving benefits through MA or Medicare FFS, including changing from one MA plan to another. Unsolicited marketing during this period is prohibited. HR 2646 Helping Families in Mental Health Crisis Act of 2015 Introduced May 4, 2015 by Tim Murphy (R-PA) To make available needed psychiatric, psychological, and supportive services for individuals with mental illness and families in mental health crisis, and for other purposes. HR 3244 Providing Innovative Care for Complex Cases Demonstration Act of 2015 Introduced July 28, 2015 by Cathy McMorris Rodgers (R-WA) To amend title XVIII of the Social Security Act to establish a pilot program to improve care for the most costly Medicare fee-for-service beneficiaries through the use of comprehensive and effective care management while reducing costs to the Federal Government for these beneficiaries, and for other purposes. HR 3463 Aligning Childrens Dental Coverage Act Introduced September 9, 2015 by H. Griffith (R-VA) To amend title XXVII of the Public Health Service Act to clarify the treatment of pediatric dental coverage in the individual and group markets outside of Exchanges established under the Patient Protection and Affordable Care Act, and for other purposes as introduced. HR 3742 Access to Marketplace Insurance Act Introduced October 9, 2015 by Kevin Cramer (R-ND) To amend the Patient Protection and Affordable Care Act to allow for certain third party payments. HR 4275 Medicare Advantage Quality Payment Relief Act of 2015 Introduced December 16, 2015 by Mike Kelly (R-PA) To amend title XVIII of the Social Security Act to eliminate a provision under the Medicare Advantage program that inadvertently penalizes Medicare Advantage plans for providing high quality care to Medicare beneficiaries. HR 5273 Helping Hospitals Improve Patient Care Act of 2016 Introduced May 18, 2016 by Patrick Tiberi (R-OH) To amend title XVIII of the Social Security Act to provide for regulatory relief under the Medicare program for certain providers of services and suppliers and increased transparency in hospital coding and enrollment data, and for other purposes. HR 5410 Health Coverage State Flexibility Act of 2016 Introduced June 8, 2016 by Bill Flores (R-TX) to amend the Patient Protection and Affordable Care Act to better align the grace period required for non-payment of premiums before discontinuing coverage under qualified health plans with such grace periods provided for under State law. HR 5447 Small Business Health Care Relief Act of 2016 Introduced June 21, 2016 by Charles Boustany, Jr. (R-LA) To provide an exception from certain group health plan requirements for qualified small employer health reimbursement arrangements. HR 5506 Introduced June 15, 2016 by Todd Young (R-IN) To amend title XVIII of the Social Security Act to establish a demonstration program to provide integrated care for Medicare beneficiaries with end-stage renal disease, and for other purposes. HR 5547 Health Care Price Transparency Promotion Act of 2016 Introduced by Michael Burgess (R-IN) To amend title XIX of the Social Security Act to provide for increased price transparency of hospital information and to provide for additional research on consumer information on charges and out-of-pocket costs. HR 5589 Plan Verification and Fairness Act of 2016 Introduced June 28, 2016 by Marsha Blackburn (R-TN) To amend title I of the Patient Protection and Affordable Care Act to require verification for eligibility for enrollment during special enrollment periods in PPACA insurance plans, and for other purposes. HR 5904 Tax Payers Before Insurers Act Introduced July 14, 2016 by Mark Walker (R-NC) To require the Secretary of Health and Human Services to deposit certain funds into the general fund of the Treasury in accordance with provisions of Federal law with regard to the Patient Protection and Affordable Care Act's Transitional Reinsurance Program. HR 5921 State Age Rating Flexibility Act Introduced July 21, 2016 by Larry Bucshon (R-IN) To amend title XXVII of the Public Health Service Act to change the permissible age variation in health insurance premium rates. S. 524 Comprehensive Addiction and Recovery Act of 2016 Introduced February 12, 2015 by Sheldon Whitehouse (D-RI) Overdoses from heroin, prescription drugs, and opioid pain relievers last year surpassed car accidents as the leading cause of injury-related death in America, according to the Centers for Disease Control. Deaths have reached their highest levels of the 21st century in 2014, the most recent year for which data is available, according to the National Institute on Drug Abuse. Heroin overdoses have more than tripled in the last five years, an issue receiving outsize attention nationally but especially during the presidential campaign season as New Hampshire has been one of the hardest-hit states. S. 1697 Small Business Healthcare Relief Act Introduced June 25, 2015 by Charles Grassley (R-IA) A bill to provide an exception from certain group health plan requirements to allow small businesses to use pre-tax dollars to assist employees in the purchase of policies in the individual health insurance market, and for other purposes. S. 1945 Mental Health Reform Act of 2015 Introduced August 5, 2015 by Bill Cassidy (R-LA) A bill to make available needed psychiatric, psychological, and supportive services for individuals with mental illness and families in mental health crisis, and for other purposes. S. 2713 Introduced March 17, 2016 by Lamar Alexander (R-TN) Advancing Precision Medicine Act of 2016 A bill to provide for the implementation of a Precision Medicine Initiative

Issues pertaining to Medicare reimbursement. Issues pertaining to drug shortages, monitoring legislation regarding the 340B Drug discount program. Issues pertaining to sequestration; H.R. 1934 Cancer Care Payment Reform Act. Medicare Part B Demonstration

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 696 & S. 506 (Medicare Prompt Pay Discount Exclusion), legislation to ensure more appropriate general payment amount for drugs and biologicals under Part B of the Medicare Program by excluding customary prompt-pay discounts extended to wholesalers from the manufacturer's average sales price. Average Sales Price (ASP) Generally (in the context of Deficit Reduction). H.R. 1416 legislation to exclude cancer drugs from sequestration cuts. H.R. 1934, The Cancer Care Payment Reform Act of 2015. H.R.5122 - To prohibit further action on the proposed Medicare Part B Provider Reimbursement Demonstration Project through CMS/CMMI, Medicare Access and CHIP Reauthorization Act (MACRA) implementation.

Client expense: $310,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Affordable Care Act Issues - Chronic Care Innovations; Payment reform 2017 Notice of Benefit and Payment Parameters (NBPP); ACA Regulations, Co-ops, Implementation; Market Stability Department of Labor Conflict of Interest Rule; Grace Periods, Special Enrollment Periods; Reinsurance; Risk Corridors; Risk Mitigation, Risk Programs; Premiums; Health Reimbursment Arrangements (HRA;s) Legislation; Individual Market Reform; Third Party Payments; Exchanges; Age Bands. Other Health Care Issues - Mental Health Parity; Opioid Education, End Stage Renal Disease (ESRD); Zika Virus; Postal Reform, End Stage Renal Disease. HR 928 Introduced February 12, 2015 by Charles Boustany (R-LA) this bill repeals a provision of the Patient Protection and Affordable Care Act that imposes an annual fee on a health insurance provider based on its net premium income. HR 1934 Cancer Care Payment Reform Act of 2015 Introduced April 22, 2015 by Cathy McMorris Rodgers to amend title XVIII of the Social Security Act to establish a national Oncology Medical Home demonstration Project under the Medicare program for the purpose of changing the Medicare payment for cancer care in order to enhance the quality of care and to improve cost efficiency and for other purposes. HR 2488 Medicare Beneficiary Preservation of Choice Act of 2015 Introduced May 21,2015 by Keith Rothfus (R-PA) this bill amends title XVII (Medicare) of the Social Security Act to expand and modify enrollment and disenrollment options for Medicare Advantage (MA) eligible individuals. Specifically, the bill extends the annual period in which an individual enrolled in MA may elect to instead receive benefits under the original Medicare fee-for-service (FFS) program as well as elect to change qualified prescription drug coverage. Furthermore, any MA-eligible individual (whether or not enrolled in MA) may once per period change a previous election with respect to receiving benefits through MA or Medicare FFS, including changing from one MA plan to another. Unsolicited marketing during this period is prohibited. HR 3244 Providing Innovative Care for Complex Cases Demonstration Act of 2015 Introduced July 28, 2015 by Cathy McMorris Rodgers (R-WA) to amend title XVIII of the Social Security Act to establish a pilot program to improve care for the most costly Medicare fee-for-service beneficiaries through the use of comprehensive and effective care management while reducing costs to the Federal Government for these beneficiaries, and for other purposes. HR 3463 Aligning Children's Dental Coverage Act Introduced September 9, 2015 by H. Griffith (R-VA) to amend title XXVII of the Public Health Service Act to clarify the treatment of pediatric dental coverage in the individual and group markets outside of Exchanges established under the Patient Protection and Affordable Care Act, and for other purposes as introduced. HR 3742 Access to Marketplace Insurance Act Introduced October 9, 2015 by Kevin Cramer (R-ND) to amend the Patient Protection and Affordable Care Act to allow for certain third party payments. HR 4275 Medicare Advantage Quality Payment Relief Act of 2015 Introduced December 16, 2015 by Mike Kelly (R-PA) to amend title XVIII of the Social Security Act to eliminate a provision under the Medicare Advantage program that inadvertently penalizes Medicare Advantage plans for providing high quality care to Medicare beneficiaries. HR 5273 Helping Hospitals Improve Patient Care Act of 2016 Introduced May 18, 2016 by Patrick Taberi (R-OH) to amend title XVIII of the Social Security Act to provide for regulatory relief under the Medicare program for certain providers of services and suppliers and increased transparency in hospital coding and enrollment data, and for other purposes. HR 5410 Health Coverage State Flexibility Act of 2016 Introduced June 8, 2016 by Bill Flores (R-TX) to amend the Patient Protection and Affordable Care Act to better align the grace period required for non-payment of premiums before discontinuing coverage under qualified health plans with such grace periods provided for under State Law. HR 5506 Introduced June 15, 2016 by Todd Young (R-IN) to amend title XVIII of the Social Security Act to establish a demonstration program to provide integrated care for Medicare beneficiaries with end-stage renal disease, and for other purposes. HR 5547 Health Care Price Transparency Promotion Act of 2016 Introduced by Michael Burgess (R-IN) to amend title XIX of the Social Security Act to provide for increased price transparency of hospital information and to provide for additional research on consumer information on charges and out-of-pocket costs. HR 5589 Plan Verification and Fairness Act of 2016 Introduced June 28, 2016 by Marsha Blackburn (R-TN) to amend title I of the Patient Protection and Affordable Care Act to require verification for eligibility for enrollment during special enrollment periods in PPACA insurance plans, and for other purposes. HR 5921 State Age Rating Flexibility Act Introduced July 21, 2016 by Larry Bucshon (R-IN) to amend title XXVII of the Public Health Service act to change the permissible age variation in health insurance rates. S. 524 Comprehensive Addiction and Recovery Act of 2016 Introduced February 12, 2015 by Sheldon Whitehouse (D-RI) overdoses from heroin prescription drugs and opioid pain relievers last year surpassed car accidents as the leading cause of injury-related death in America, according to the Center for Disease Control. Deaths have reached their highest levels of the 21st Century in 2014, the most recent year for which data is available, according to the National Institute on Drug Abuse. Heroin overdoses have more than tripled in the last five years, an issue receiving outsize attention nationally but especially during the presidential campaign season as New Hampshire has been one of the hardest-hit states. S. 1697 Small Business Healthcare Relief Act Introduced June 25, 2015 by Charles Grassley (R-IA) a bill to provide an exception from certain group health plan requirements to allow small businesses to use pre-tax dollars to assist employees in the purchase of policies in the individual health insurance market and for other purposes. S. 1945 Introduced August 5, 2015 by Bill Cassidy (R-LA) A bill to make available needed psychiatric, psychological, and supportive services for individuals with mental illness and families in mental health crisis, and for other purposes.

Legislation to reform Medicare payment for oncology: Cancer Care Payment Reform Act (H.R. 1934; S. 3211). Legislation to exclude manufacturer-to-distributor prompt pay discounts from the calculation of ASP-based Medicare Part B drug reimbursement rates (H.R. 696, S. 506). Misc. discussions (no legislation) to address 340B drug discount program, site-of-service payment parity, and Medicare reimbursement for cancer care. General discussion on the CMS/CMMI Medicare Part B Payment Model to cut Medicare Part B drug reimbursement. Specific legislation to stop the Medicare Part B Drug Payment Model (H.R. 5122).

Client expense: $174,500 · Firm income: Not reported

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

H.R. 4959: Ensuring Access to General Surgery Act of 2016 H.R. 105: Quality Health Care Coalition Act of 2015 H.R. 3309: Flex-IT 2 Act H.R. 647: Access to Life-Saving Trauma Care for All Americans Act H.R. 648: Trauma Systems and Regionalization of Emergency Care Reauthorization Act H.R. 836: Health Care Safety Net Enhancement Act of 2015 H.R. 865: Good Samaritan Health Professionals Act of 2015 S. 3101: Good Samaritan Health Professionals Act of 2016 H.R. 1934: Cancer Care Payment Reform Act of 2015 S. 2943/H.R.1735: National Defense Authorization Act (NDAA) H.R.4909 - National Defense Authorization Act for Fiscal Year 2017 H.R. 2739: Cancer Drug Coverage Parity Act of 2015 S. 624/H.R. 1220: Removing Barriers to Colorectal Cancer Screening Act of 2015 S. 3166: Ensuring Access to General Surgery Act of 2016 H.R. 1925: To award a Congressional Gold Medal to Dr. Balazs "Ernie" Bodai in recognition of his many outstanding contributions to the Nation, including a tireless commitment to breast cancer research. H.Res. 487: Recognizing the importance of cancer program accreditation in ensuring comprehensive, high quality, patient-centered cancer care Veterans Access, Choice and Accountability Act Concurrent Surgery MACRA Proposed Rule Implementation GME Health Professional Shortage Areas (HPSAs) Health Information Technology (Health IT) Chronic Care Coordination 96-Hour Rule Bleeding Control for the Injured (Stop The Bleed campaign) Opioids Cancer/Appropriations Medicare Part B Merit-Based Incentive Payment System (MIPS) & Alternative Payment Models (APMs) Qualified Clinical Data Registry (QCDR) reporting mechanism Physician Quality Reporting System (PQRS) Video Recording Surgery RAC Audits Energy and Commerce Concussion Initiative Data Use Protection Legislation FOIA Energy and Commerce Pediatric Trauma Caucus Responsible Data Transparency Act

H.R. 4959: Ensuring Access to General Surgery Act of 2016 H.R. 105: Quality Health Care Coalition Act of 2015 H.R. 3309: Flex-IT 2 Act H.R. 647: Access to Life-Saving Trauma Care for All Americans Act H.R. 648: Trauma Systems and Regionalization of Emergency Care Reauthorization Act H.R. 836: Health Care Safety Net Enhancement Act of 2015 H.R. 865: Good Samaritan Health Professionals Act of 2015 S. 3101: Good Samaritan Health Professionals Act of 2016 H.R. 1934: Cancer Care Payment Reform Act of 2015 S. 2943/H.R.1735: National Defense Authorization Act (NDAA) H.R.4909 - National Defense Authorization Act for Fiscal Year 2017 H.R. 2739: Cancer Drug Coverage Parity Act of 2015 S. 624/H.R. 1220: Removing Barriers to Colorectal Cancer Screening Act of 2015 S. 3166: Ensuring Access to General Surgery Act of 2016 H.R. 1925: To award a Congressional Gold Medal to Dr. Balazs "Ernie" Bodai in recognition of his many outstanding contributions to the Nation, including a tireless commitment to breast cancer research. H.Res. 487: Recognizing the importance of cancer program accreditation in ensuring comprehensive, high quality, patient-centered cancer care Veterans Access, Choice and Accountability Act Concurrent Surgery MACRA Proposed Rule Implementation GME Health Professional Shortage Areas (HPSAs) Health Information Technology (Health IT) Chronic Care Coordination 96-Hour Rule Bleeding Control for the Injured (Stop The Bleed campaign) Opioids Cancer/Appropriations Medicare Part B Merit-Based Incentive Payment System (MIPS) & Alternative Payment Models (APMs) Qualified Clinical Data Registry (QCDR) reporting mechanism Physician Quality Reporting System (PQRS) Video Recording Surgery RAC Audits Energy and Commerce Concussion Initiative Data Use Protection Legislation FOIA Energy and Commerce Pediatric Trauma Caucus Responsible Data Transparency Act

H.R. 4959: Ensuring Access to General Surgery Act of 2016 H.R. 105: Quality Health Care Coalition Act of 2015 H.R. 3309: Flex-IT 2 Act H.R. 647: Access to Life-Saving Trauma Care for All Americans Act H.R. 648: Trauma Systems and Regionalization of Emergency Care Reauthorization Act H.R. 836: Health Care Safety Net Enhancement Act of 2015 H.R. 865: Good Samaritan Health Professionals Act of 2015 S. 3101: Good Samaritan Health Professionals Act of 2016 H.R. 1934: Cancer Care Payment Reform Act of 2015 S. 2943/H.R.1735: National Defense Authorization Act (NDAA) H.R.4909 - National Defense Authorization Act for Fiscal Year 2017 H.R. 2739: Cancer Drug Coverage Parity Act of 2015 S. 624/H.R. 1220: Removing Barriers to Colorectal Cancer Screening Act of 2015 S. 3166: Ensuring Access to General Surgery Act of 2016 H.R. 1925: To award a Congressional Gold Medal to Dr. Balazs "Ernie" Bodai in recognition of his many outstanding contributions to the Nation, including a tireless commitment to breast cancer research. H.Res. 487: Recognizing the importance of cancer program accreditation in ensuring comprehensive, high quality, patient-centered cancer care Veterans Access, Choice and Accountability Act Concurrent Surgery MACRA Proposed Rule Implementation GME Health Professional Shortage Areas (HPSAs) Health Information Technology (Health IT) Chronic Care Coordination 96-Hour Rule Bleeding Control for the Injured (Stop The Bleed campaign) Opioids Cancer/Appropriations Medicare Part B Merit-Based Incentive Payment System (MIPS) & Alternative Payment Models (APMs) Qualified Clinical Data Registry (QCDR) reporting mechanism Physician Quality Reporting System (PQRS) Video Recording Surgery RAC Audits Energy and Commerce Concussion Initiative Data Use Protection Legislation FOIA Energy and Commerce Pediatric Trauma Caucus Responsible Data Transparency Act

H.R. 4959: Ensuring Access to General Surgery Act of 2016 H.R. 105: Quality Health Care Coalition Act of 2015 H.R. 3309: Flex-IT 2 Act H.R. 647: Access to Life-Saving Trauma Care for All Americans Act H.R. 648: Trauma Systems and Regionalization of Emergency Care Reauthorization Act H.R. 836: Health Care Safety Net Enhancement Act of 2015 H.R. 865: Good Samaritan Health Professionals Act of 2015 S. 3101: Good Samaritan Health Professionals Act of 2016 H.R. 1934: Cancer Care Payment Reform Act of 2015 S. 2943/H.R.1735: National Defense Authorization Act (NDAA) H.R.4909 - National Defense Authorization Act for Fiscal Year 2017 H.R. 2739: Cancer Drug Coverage Parity Act of 2015 S. 624/H.R. 1220: Removing Barriers to Colorectal Cancer Screening Act of 2015 S. 3166: Ensuring Access to General Surgery Act of 2016 H.R. 1925: To award a Congressional Gold Medal to Dr. Balazs "Ernie" Bodai in recognition of his many outstanding contributions to the Nation, including a tireless commitment to breast cancer research. H.Res. 487: Recognizing the importance of cancer program accreditation in ensuring comprehensive, high quality, patient-centered cancer care Veterans Access, Choice and Accountability Act Concurrent Surgery MACRA Proposed Rule Implementation GME Health Professional Shortage Areas (HPSAs) Health Information Technology (Health IT) Chronic Care Coordination 96-Hour Rule Bleeding Control for the Injured (Stop The Bleed campaign) Opioids Cancer/Appropriations Medicare Part B Merit-Based Incentive Payment System (MIPS) & Alternative Payment Models (APMs) Qualified Clinical Data Registry (QCDR) reporting mechanism Physician Quality Reporting System (PQRS) Video Recording Surgery RAC Audits Energy and Commerce Concussion Initiative Data Use Protection Legislation FOIA Energy and Commerce Pediatric Trauma Caucus Responsible Data Transparency Act

Affordable Care Act Issues - Chronic Care Innovations; Payment reform; 2017 Notice of Benefit and Payment Parameters (NBPP); ACA Regulations; Co-ops; Implementation; Market Stability; Department of Labor Conflict of Interest Rule; Grace Periods; Special Enrollment Periods (SEPs); Reinsurance; Risk Corridors; Risk Mitigation; Risk Programs; Premiums; Health Reimbursement Arrangements (HRAs) Legislation; Individual Market Reform; Third-party Payments; Exchanges; Age Bands Other Health Care Issues - Mental Health Reform; End Stage Renal Disease (ESRD); Zika Virus; Postal Reform; Health Savings Accounts HR 928 Introduced February 12, 2015 by Charles Boustany (R-LA) This bill repeals a provision of the Patient Protection and Affordable Care Act that imposes an annual fee on a health insurance provider based on its net premium income. HR 1934 Cancer Care Payment Reform Act of 2015 Introduced April 22, 2015 by Cathy McMorris Rodgers To amend title XVIII of the Social Security Act to establish a national Oncology Medical Home Demonstration Project under the Medicare program for the purpose of changing the Medicare payment for cancer care in order to enhance the quality of care and to improve cost efficiency, and for other purposes. HR 2488 Medicare Beneficiary Preservation of Choice Act of 2015 Introduced May 21, 2015 by Keith Rothfus (R-PA) This bill amends title XVIII (Medicare) of the Social Security Act to expand and modify enrollment and disenrollment options for Medicare Advantage (MA) eligible individuals. Specifically, the bill extends the annual period in which an individual enrolled in MA may elect to instead receive benefits under the original Medicare fee-for-service (FFS) program as well as elect to change qualified prescription drug coverage. Furthermore, any MA-eligible individual (whether or not enrolled in MA) may once per period change a previous election with respect to receiving benefits through MA or Medicare FFS, including changing from one MA plan to another. Unsolicited marketing during this period is prohibited. HR 2646 Helping Families in Mental Health Crisis Act of 2015 Introduced May 4, 2015 by Tim Murphy (R-PA) To make available needed psychiatric, psychological, and supportive services for individuals with mental illness and families in mental health crisis, and for other purposes HR 3244 Providing Innovative Care for Complex Cases Demonstration Act of 2015 Introduced July 28, 2015 by Cathy McMorris Rodgers (R-WA) To amend title XVIII of the Social Security Act to establish a pilot program to improve care for the most costly Medicare fee-for-service beneficiaries through the use of comprehensive and effective care management while reducing costs to the Federal Government for these beneficiaries, and for other purposes. HR 3463 Aligning Childrens Dental Coverage Act Introduced September 9, 2015 by H. Griffith (R-VA) To amend title XXVII of the Public Health Service Act to clarify the treatment of pediatric dental coverage in the individual and group markets outside of Exchanges established under the Patient Protection and Affordable Care Act, and for other purposes as introduced. HR 3742 Access to Marketplace Insurance Act Introduced October 9, 2015 by Kevin Cramer (R-ND) To amend the Patient Protection and Affordable Care Act to allow for certain third party payments. HR 4275 Medicare Advantage Quality Payment Relief Act of 2015 Introduced December 16, 2015 by Mike Kelly (R-PA) To amend title XVIII of the Social Security Act to eliminate a provision under the Medicare Advantage program that inadvertently penalizes Medicare Advantage plans for providing high quality care to Medicare beneficiaries. HR 5273 Helping Hospitals Improve Patient Care Act of 2016 Introduced May 18, 2016 by Patrick Taberi (R-OH) To amend title XVIII of the Social Security Act to provide for regulatory relief under the Medicare program for certain providers of services and suppliers and increased transparency in hospital coding and enrollment data, and for other purposes. HR 5410 Health Coverage State Flexibility Act of 2016 Introduced June 8, 2016 by Bill Flores (R-TX) to amend the Patient Protection and Affordable Care Act to better align the grace period required for non-payment of premiums before discontinuing coverage under qualified health plans with such grace periods provided for under State law. HR 5447 Small Business Health Care Relief Act of 2016 Introduced June 21, 2016 by Charles Boustany, Jr. (R-LA) To provide an exception from certain group health plan requirements for qualified small employer health reimbursement arrangements. HR 5506 Introduced June 15, 2016 by Todd Young (R-IN) To amend title XVIII of the Social Security Act to establish a demonstration program to provide integrated care for Medicare beneficiaries with end-stage renal disease, and for other purposes. HR 5547 Health Care Price Transparency Promotion Act of 2016 Introduced by Michael Burgess (R-IN) To amend title XIX of the Social Security Act to provide for increased price transparency of hospital information and to provide for additional research on consumer information on charges and out-of-pocket costs. HR 5589 Plan Verification and Fairness Act of 2016 Introduced June 28, 2016 by Marsha Blackburn (R-TN) To amend title I of the Patient Protection and Affordable Care Act to require verification for eligibility for enrollment during special enrollment periods in PPACA insurance plans, and for other purposes. HR 5904 Tax Payers Before Insurers Act Introduced July 14, 2016 by Mark Walker (R-NC) To require the Secretary of Health and Human Services to deposit certain funds into the general fund of the Treasury in accordance with provisions of Federal law with regard to the Patient Protection and Affordable Care Act's Transitional Reinsurance Program. HR 5921 State Age Rating Flexibility Act Introduced July 21, 2016 by Larry Bucshon (R-IN) To amend title XXVII of the Public Health Service Act to change the permissible age variation in health insurance premium rates. S. 524 Comprehensive Addiction and Recovery Act of 2016 Introduced February 12, 2015 by Sheldon Whitehouse (D-RI) Overdoses from heroin, prescription drugs, and opioid pain relievers last year surpassed car accidents as the leading cause of injury-related death in America, according to the Centers for Disease Control. Deaths have reached their highest levels of the 21st century in 2014, the most recent year for which data is available, according to the National Institute on Drug Abuse. Heroin overdoses have more than tripled in the last five years, an issue receiving outsize attention nationally but especially during the presidential campaign season as New Hampshire has been one of the hardest-hit states. S. 1697 Small Business Healthcare Relief Act Introduced June 25, 2015 by Charles Grassley (R-IA) A bill to provide an exception from certain group health plan requirements to allow small businesses to use pre-tax dollars to assist employees in the purchase of policies in the individual health insurance market, and for other purposes. S. 1945 Mental Health Reform Act of 2015 Introduced August 5, 2015 by Bill Cassidy (R-LA) A bill to make available needed psychiatric, psychological, and supportive services for individuals with mental illness and families in mental health crisis, and for other purposes. S. 2713 Introduced March 17, 2016 by Lamar Alexander (R-TN) Advancing Precision Medicine Act of 2016 A bill to provide for the implementation of a Precision Medicine Initiative.

H.R. 1934- Cancer Care Payment Reform Act of 2015 Medicare Part B reimbursement Part B drug payment model S.3211- Cancer Care Payment Reform Act of 2016

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues pertaining to Medicare reimbursement. Issues pertaining to drug shortages, monitoring legislation regarding the 340B Drug discount program. Issues pertaining to sequestration; H.R. 1934 Cancer Care Payment Reform Act. Medicare Part B Demonstration

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 696 & S. 506 (Medicare Prompt Pay Discount Exclusion), legislation to ensure more appropriate general payment amount for drugs and biologicals under Part B of the Medicare Program by excluding customary prompt-pay discounts extended to wholesalers from the manufacturer's average sales price. Average Sales Price (ASP) Generally (in the context of Deficit Reduction). H.R. 1416 legislation to exclude cancer drugs from sequestration cuts. CMS Medicare Part B Drug Payment Model. H.R. 1934, The Cancer Care Payment Reform Act of 2015.

Client expense: $300,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Affordable Care Act Issues - Chronic Care Innovations; Payment reform; 2017 Notice of Benefit and Payment Parameters (NBPP); ACA Regulations; Implementation; Cyber Security;Open Enrollment; Market Stability; Department of Labor Fiduciary Rule; Grace Periods; Special Enrollment Periods (SEPs); Reinsurance; Taskforce; Premiums; Health Reimbursement Arrangements (HRAs) Legislation; Individual Market Reform Other Health Care Issues - Mental Health Parity; Opioid Education; End Stage Renal Disease (ESRD); Zika Virus; Air Ambulances 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 928 Introduced February 12, 2015 by Charles Boustany (R-LA) This bill repeals a provision of the Patient Protection and Affordable Care Act that imposes an annual fee on a health insurance provider based on its net premium income. HR 1934 Cancer Care Payment Reform Act of 2015 Introduced April 22, 2015 by Cathy McMorris Rodgers To amend title XVIII of the Social Security Act to establish a national Oncology Medical Home Demonstration Project under the Medicare program for the purpose of changing the Medicare payment for cancer care in order to enhance the quality of care and to improve cost efficiency, and for other purposes. HR 2488 Medicare Beneficiary Preservation of Choice Act of 2015 Introduced May 21, 2015 by Keith Rothfus (R-PA) This bill amends title XVIII (Medicare) of the Social Security Act to expand and modify enrollment and disenrollment options for Medicare Advantage (MA) eligible individuals. Specifically, the bill extends the annual period in which an individual enrolled in MA may elect to instead receive benefits under the original Medicare fee-for-service (FFS) program as well as elect to change qualified prescription drug coverage. Furthermore, any MA-eligible individual (whether or not enrolled in MA) may once per period change a previous election with respect to receiving benefits through MA or Medicare FFS, including changing from one MA plan to another. Unsolicited marketing during this period is prohibited. HR 2646 Helping Families in Mental Health Crisis Act of 2015 Introduced May 4, 2015 by Tim Murphy (R-PA) To make available needed psychiatric, psychological, and supportive services for individuals with mental illness and families in mental health crisis, and for other purposes HR 3244 Providing Innovative Care for Complex Cases Demonstration Act of 2015 Introduced July 28, 2015 by Cathy McMorris Rodgers (R-WA) To amend title XVIII of the Social Security Act to establish a pilot program to improve care for the most costly Medicare fee-for-service beneficiaries through the use of comprehensive and effective care management while reducing costs to the Federal Government for these beneficiaries, and for other purposes. HR 3463 Aligning Childrens Dental Coverage Act Introduced September 9, 2015 by H. Griffith (R-VA) To amend title XXVII of the Public Health Service Act to clarify the treatment of pediatric dental coverage in the individual and group markets outside of Exchanges established under the Patient Protection and Affordable Care Act, and for other purposes as introduced. HR 3742 Access to Marketplace Insurance Act Introduced October 9, 2015 by Kevin Cramer (R-ND) To amend the Patient Protection and Affordable Care Act to allow for certain third party payments. HR 4275 Medicare Advantage Quality Payment Relief Act of 2015 Introduced December 16, 2015 by Mike Kelly (R-PA) To amend title XVIII of the Social Security Act to eliminate a provision under the Medicare Advantage program that inadvertently penalizes Medicare Advantage plans for providing high quality care to Medicare beneficiaries. HR 5273 Helping Hospitals Improve Patient Care Act of 2016 Introduced May 18, 2016 by Patrick Taberi (R-OH) To amend title XVIII of the Social Security Act to provide for regulatory relief under the Medicare program for certain providers of services and suppliers and increased transparency in hospital coding and enrollment data, and for other purposes. HR 5410 Health Coverage State Flexibility Act of 2016 Introduced June 8, 2016 by Bill Flores (R-TX) to amend the Patient Protection and Affordable Care Act to better align the grace period required for non-payment of premiums before discontinuing coverage under qualified health plans with such grace periods provided for under State law. HR 5447 Small Business Health Care Relief Act of 2016 Introduced June 21, 2016 by Charles Boustany, Jr. (R-LA) To provide an exception from certain group health plan requirements for qualified small employer health reimbursement arrangements. HR 5506 Introduced June 15, 2016 by Todd Young (R-IN) To amend title XVIII of the Social Security Act to establish a demonstration program to provide integrated care for Medicare beneficiaries with end-stage renal disease, and for other purposes. HR 5547 Health Care Price Transparency Promotion Act of 2016 Introduced by Michael Burgess (R-IN) To amend title XIX of the Social Security Act to provide for increased price transparency of hospital information and to provide for additional research on consumer information on charges and out-of-pocket costs. HR 5589 Plan Verification and Fairness Act of 2016 Introduced June 28, 2016 by Marsha Blackburn (R-TN) To amend title I of the Patient Protection and Affordable Care Act to require verification for eligibility for enrollment during special enrollment periods in PPACA insurance plans, and for other purposes. S. 524 Comprehensive Addiction and Recovery Act of 2016 Introduced February 12, 2015 by Sheldon Whitehouse (D-RI) Overdoses from heroin, prescription drugs, and opioid pain relievers last year surpassed car accidents as the leading cause of injury-related death in America, according to the Centers for Disease Control. Deaths have reached their highest levels of the 21st century in 2014, the most recent year for which data is available, according to the National Institute on Drug Abuse. Heroin overdoses have more than tripled in the last five years, an issue receiving outsize attention nationally but especially during the presidential campaign season as New Hampshire has been one of the hardest-hit states. S. 1697 Small Business Healthcare Relief Act Introduced June 25, 2015 by Charles Grassley (R-IA) A bill to provide an exception from certain group health plan requirements to allow small businesses to use pre-tax dollars to assist employees in the purchase of policies in the individual health insurance market, and for other purposes. S. 1945 Mental Health Reform Act of 2015 Introduced August 5, 2015 by Bill Cassidy (R-LA) A bill to make available needed psychiatric, psychological, and supportive services for individuals with mental illness and families in mental health crisis, and for other purposes. S. 2713 Introduced March 17, 2016 by Lamar Alexander (R-TN) Advancing Precision Medicine Act of 2016 A bill to provide for the implementation of a Precision Medicine Initiative.

H.R. 1934- Cancer Care Payment Reform Act of 2015 Medicare Part B reimbursement Part B drug payment model S.3211- Cancer Care Payment Reform Act of 2016

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Affordable Care Act Issues - Chronic Care Innovations; Payment reform 2017 Notice of Benefit and Payment Parameters (NBPP); ACA Regulations, Implementation; Cyber Security; Open Enrollment; Market Stability; Department of Labor Fiduciary Rule; Grace Periods; Special Enrollment Periods (SEPs); Reinsurance; Taskforce; Premiums; Health Reimbursement Arrangements (HRAs) Legislation; Individual Market Reform Other Health Care Issues - Mental Health Parity; Opioid Education, End Stage Renal Disease (ESRD); Zika Virus; Air Ambulances 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 928 Introduced February 12, 2015 by Charles Boustany (R-LA) this bill repeals a provision of the Patient Protection and Affordable Care Act that imposes an annual fee on a health insurance provider based on its net premium income. HR 1934 Cancer Care Payment Reform Act of 2015 Introduced April 22, 2015 by Cathy McMorris Rodgers to amend title XVIII of the Social Security Act to establish a national Oncology Medical Home demonstration Project under the Medicare program for the purpose of changing the Medicare payment for cancer care in order to enhance the quality of care and to improve cost efficiency and for other purposes. HR 2488 Medicare Beneficiary Preservation of Choice Act of 2015 Introduced May 21,2015 by Keith Rothfus (R-PA) this bill amends title XVII (Medicare) of the Social Security Act to expand and modify enrollment and disenrollment options for Medicare Advantage (MA) eligible individuals. Specifically, the bill extends the annual period in which an individual enrolled in MA may elect to instead receive benefits under the original Medicare fee-for-service (FFS) program as well as elect to change qualified prescription drug coverage. Furthermore, any MA-eligible individual (whether or not enrolled in MA) may once per period change a previous election with respect to receiving benefits through MA or Medicare FFS, including changing from one MA plan to another. Unsolicited marketing during this period is prohibited. HR 2646 Helping Families i Mental Health Crisis Act of 2015 introduced May 4, 2015 by Tim Murphy (R-PA) to make available needed psychiatric, psychological and supportive services for individuals with mental illness and families in mental health crisis and for other purposes. HR 3244 Providing Innovative Care for Complex Cases Demonstration Act of 2015 Introduced July 28, 2015 by Cathy McMorris Rodgers (R-WA) to amend title XVIII of the Social Security Act to establish a pilot program to improve care for the most costly Medicare fee-for-service beneficiaries through the use of comprehensive and effective care management while reducing costs to the Federal Government for these beneficiaries, and for other purposes. HR 3463 Aligning Children's Dental Coverage Act Introduced September 9, 2015 by H. Griffith (R-VA) to amend title XXVII of the Public Health Service Act to clarify the treatment of pediatric dental coverage in the individual and group markets outside of Exchanges established under the Patient Protection and Affordable Care Act, and for other purposes as introduced. HR 3742 Access to Marketplace Insurance Act Introduced October 9, 2015 by Kevin Cramer (R-ND) to amend the Patient Protection and Affordable Care Act to allow for certain third party payments. HR 4275 Medicare Advantage Quality Payment Relief Act of 2015 Introduced December 16, 2015 by Mike Kelly (R-PA) to amend title XVIII of the Social Security Act to eliminate a provision under the Medicare Advantage program that inadvertently penalizes Medicare Advantage plans for providing high quality care to Medicare beneficiaries. HR 5273 Helping Hospitals Improve Patient Care Act of 2016 Introduced May 18, 2016 by Patrick Taberi (R-OH) to amend title XVIII of the Social Security Act to provide for regulatory relief under the Medicare program for certain providers of services and suppliers and increased transparency in hospital coding and enrollment data, and for other purposes. HR 5410 Health Coverage State Flexibility Act of 2016 Introduced June 8, 2016 by Bill Flores (R-TX) to amend the Patient Protection and Affordable Care Act to better align the grace period required for non-payment of premiums before discontinuing coverage under qualified health plans with such grace periods provided for under State Law. HR 5447 Small Business Health Care Relief Act of 2016 Introduced June 21, 2016 by Charles Boustany, Jr. (R-LA) to provide an exception from certain group health plan requirements for qualified small employer health reimbursement arrangements. HR 5506 Introduced June 15, 2016 by Todd Young (R-IN) to amend title XVIII of the Social Security Act to establish a demonstration program to provide integrated care for Medicare beneficiaries with end-stage renal disease, and for other purposes. HR 5547 Health Care Price Transparency Promotion Act of 2016 Introduced by Michael Burgess (R-IN) to amend title XIX of the Social Security Act to provide for increased price transparency of hospital information and to provide for additional research on consumer information on charges and out-of-pocket costs. HR 5589 Plan Verification and Fairness Act of 2016 Introduced June 28, 2016 by Marsha Blackburn (R-TN) to amend title I of the Patient Protection and Affordable Care Act to require verification for eligibility for enrollment during special enrollment periods in PPACA insurance plans, and for other purposes. S. 524 Comprehensive Addiction and Recovery Act of 2016 Introduced February 12, 2015 by Sheldon Whitehouse (D-RI) overdoses from heroin prescription drugs and opioid pain relievers last year surpassed car accidents as the leading cause of injury-related death in America, according to the Center for Disease Control. Deaths have reached their highest levels of the 21st Century in 2014, the most recent year for which data is available, according to the National Institute on Drug Abuse. Heroin overdoses have more than tripled in the last five years, an issue receiving outsize attention nationally but especially during the presidential campaign season as New Hampshire has been one of the hardest-hit states. S. 1697 Small Business Healthcare Relief Act Introduced June 25, 2015 by Charles Grassley (R-IA) a bill to provide an exception from certain group health plan requirements to allow small businesses to use pre-tax dollars to assist employees in the purchase of policies in the individual health insurance market and for other purposes. S. 1945 Introduced August 5, 2015 by Bill Cassidy (R-LA) A bill to make available needed psychiatric, psychological, and supportive services for individuals with mental illness and families in mental health crisis, and for other purposes. S. 2713 Introduced March 17, 2016 by Lamar Alexander (R-TN) Advancing Precision Medicine Act of 2016 A bill to provide for the implementation of a Precision Medicine Initiative.

H.R. 4959: Ensuring Access to General Surgery Act of 2016 H.R. 105: Quality Health Care Coalition Act of 2015 H.R. 3309: Flex-IT 2 Act H.R. 647: Access to Life-Saving Trauma Care for All Americans Act H.R. 648: Trauma Systems and Regionalization of Emergency Care Reauthorization Act H.R. 836: Health Care Safety Net Enhancement Act of 2015 H.R. 865: Good Samaritan Health Professionals Act of 2015 H.R. 1934: Cancer Care Payment Reform Act of 2015 S. 2943/H.R.1735: National Defense Authorization Act (NDAA) H.R. 2739: Cancer Drug Coverage Parity Act of 2015 S. 624/H.R. 1220: Removing Barriers to Colorectal Cancer Screening Act of 2015 H.Res. 487: Recognizing the importance of cancer program accreditation in ensuring comprehensive, high quality, patient-centered cancer care Veterans Access, Choice and Accountability Act Concurrent Surgery MACRA Proposed Rule Implementation GME Health Professional Shortage Areas (HPSAs) Health Information Technology (Health IT) Chronic Care Coordination 96-Hour Rule Bleeding Control for the Injured (B-Con) Opioids Cancer/Appropriations Medicare Part B Merit-Based Incentive Payment System (MIPS) & Alternative Payment Models (APMs) Qualified Clinical Data Registry (QCDR) reporting mechanism Physician Quality Reporting System (PQRS) Video Recording Surgery RAC Audits Energy and Commerce Concussion Initiative Data Use Protection Legislation FOIA Energy and Commerce Pediatric Trauma Caucus Responsible Data Transparency Act

Client expense: $26,700 · Firm income: Not reported

H.R. 4959: Ensuring Access to General Surgery Act of 2016 H.R. 105: Quality Health Care Coalition Act of 2015 H.R. 3309: Flex-IT 2 Act H.R. 647: Access to Life-Saving Trauma Care for All Americans Act H.R. 648: Trauma Systems and Regionalization of Emergency Care Reauthorization Act H.R. 836: Health Care Safety Net Enhancement Act of 2015 H.R. 865: Good Samaritan Health Professionals Act of 2015 H.R. 1934: Cancer Care Payment Reform Act of 2015 S. 2943/H.R.1735: National Defense Authorization Act (NDAA) H.R. 2739: Cancer Drug Coverage Parity Act of 2015 S. 624/H.R. 1220: Removing Barriers to Colorectal Cancer Screening Act of 2015 H.Res. 487: Recognizing the importance of cancer program accreditation in ensuring comprehensive, high quality, patient-centered cancer care Veterans Access, Choice and Accountability Act Concurrent Surgery MACRA Proposed Rule Implementation GME Health Professional Shortage Areas (HPSAs) Health Information Technology (Health IT) Chronic Care Coordination 96-Hour Rule Bleeding Control for the Injured (B-Con) Opioids Cancer/Appropriations Medicare Part B Merit-Based Incentive Payment System (MIPS) & Alternative Payment Models (APMs) Qualified Clinical Data Registry (QCDR) reporting mechanism Physician Quality Reporting System (PQRS) Video Recording Surgery RAC Audits Energy and Commerce Concussion Initiative Data Use Protection Legislation FOIA Energy and Commerce Pediatric Trauma Caucus Responsible Data Transparency Act

Client expense: $26,700 · Firm income: Not reported

H.R. 4959: Ensuring Access to General Surgery Act of 2016 H.R. 105: Quality Health Care Coalition Act of 2015 H.R. 3309: Flex-IT 2 Act H.R. 647: Access to Life-Saving Trauma Care for All Americans Act H.R. 648: Trauma Systems and Regionalization of Emergency Care Reauthorization Act H.R. 836: Health Care Safety Net Enhancement Act of 2015 H.R. 865: Good Samaritan Health Professionals Act of 2015 H.R. 1934: Cancer Care Payment Reform Act of 2015 S. 2943/H.R.1735: National Defense Authorization Act (NDAA) H.R. 2739: Cancer Drug Coverage Parity Act of 2015 S. 624/H.R. 1220: Removing Barriers to Colorectal Cancer Screening Act of 2015 H.Res. 487: Recognizing the importance of cancer program accreditation in ensuring comprehensive, high quality, patient-centered cancer care Veterans Access, Choice and Accountability Act Concurrent Surgery MACRA Proposed Rule Implementation GME Health Professional Shortage Areas (HPSAs) Health Information Technology (Health IT) Chronic Care Coordination 96-Hour Rule Bleeding Control for the Injured (B-Con) Opioids Cancer/Appropriations Medicare Part B Merit-Based Incentive Payment System (MIPS) & Alternative Payment Models (APMs) Qualified Clinical Data Registry (QCDR) reporting mechanism Physician Quality Reporting System (PQRS) Video Recording Surgery RAC Audits Energy and Commerce Concussion Initiative Data Use Protection Legislation FOIA Energy and Commerce Pediatric Trauma Caucus Responsible Data Transparency Act

Client expense: $219,600 · Firm income: Not reported

H.R. 4959: Ensuring Access to General Surgery Act of 2016 H.R. 105: Quality Health Care Coalition Act of 2015 H.R. 3309: Flex-IT 2 Act H.R. 647: Access to Life-Saving Trauma Care for All Americans Act H.R. 648: Trauma Systems and Regionalization of Emergency Care Reauthorization Act H.R. 836: Health Care Safety Net Enhancement Act of 2015 H.R. 865: Good Samaritan Health Professionals Act of 2015 H.R. 1934: Cancer Care Payment Reform Act of 2015 S. 2943/H.R.1735: National Defense Authorization Act (NDAA) H.R. 2739: Cancer Drug Coverage Parity Act of 2015 S. 624/H.R. 1220: Removing Barriers to Colorectal Cancer Screening Act of 2015 H.Res. 487: Recognizing the importance of cancer program accreditation in ensuring comprehensive, high quality, patient-centered cancer care Veterans Access, Choice and Accountability Act Concurrent Surgery MACRA Proposed Rule Implementation GME Health Professional Shortage Areas (HPSAs) Health Information Technology (Health IT) Chronic Care Coordination 96-Hour Rule Bleeding Control for the Injured (B-Con) Opioids Cancer/Appropriations Medicare Part B Merit-Based Incentive Payment System (MIPS) & Alternative Payment Models (APMs) Qualified Clinical Data Registry (QCDR) reporting mechanism Physician Quality Reporting System (PQRS) Video Recording Surgery RAC Audits Energy and Commerce Concussion Initiative Data Use Protection Legislation FOIA Energy and Commerce Pediatric Trauma Caucus Responsible Data Transparency Act

Client expense: $219,600 · Firm income: Not reported

Legislation to reform Medicare payment for oncology: Cancer Care Payment Reform Act (H.R. 1934) and possible Senate companion bill. Legislation to stop CMS from applying the sequester cut to Medicare Part B drugs (H.R. 1416). Legislation to exclude manufacturer-to-distributor prompt pay discounts from the calculation of ASP-based Medicare Part B drug reimbursement rates (H.R. 696, S. 506). Misc. discussions (no legislation) to address 340B drug discount program, site-of-service payment parity, and Medicare reimbursement for cancer care. CMS/CMMI Medicare Part B Payment Model to cut Medicare Part B drug reimbursement.

Client expense: $186,000 · Firm income: Not reported

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

Legislation to reform Medicare payment for oncology: Cancer Care Payment Reform Act (H.R. 1934) and possible Senate companion bill. Legislation to stop CMS from applying the sequester cut to Medicare Part B drugs (H.R. 1416). Legislation to exclude manufacturer-to-distributor prompt pay discounts from the calculation of ASP-based Medicare Part B drug reimbursement rates (H.R. 696, S. 506). Misc. discussions (no legislation) to address 340B drug discount program, site-of-service payment parity, Medicare 14-day rule, and Medicare reimbursement for cancer care. CMS/CMMI Medicare Part B Payment Model to cut Medicare Part B drug reimbursement.

Client expense: $92,700 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues pertaining to Medicare reimbursement. Issues pertaining to drug shortages, monitoring legislation regarding the 340B Drug discount program. Issues pertaining to sequestration; H.R. 1934 Cancer Care Payment Reform Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 696 & S. 506 (Medicare Prompt Pay Discount Exclusion), legislation to ensure more appropriate general payment amount for drugs and biologicals under Part B of the Medicare Program by excluding customary prompt-pay discounts extended to wholesalers from the manufacturer's average sales price. Average Sales Price (ASP) Generally (in the context of Deficit Reduction). H.R. 1416 legislation to exclude cancer drugs from sequestration cuts. CMS Medicare Part B Drug Payment Model. H.R. 1934, The Cancer Care Payment Reform Act of 2015.

Client expense: $370,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE