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.

The Protecting Access to Medicare Act of 2014 (Pub. L. 113-93); The Budget Control Act of 2011 (Pub. L. 112-25); The Patient Protection and Affordable Care Act (Pub. L. 111-148); The Health Care and Education Reconciliation Act of 2010 (Pub. L. 111-152); The American Taxpayer Relief Act of 2012 (Pub. L. 112-240); Medicare Program; End-Stage Renal Disease Prospective Payment System, Quality Incentive Program, and Durable Medical Equipment, Prosthetics, Orthotics, and Supplies; Proposed Rule [CMS-1614-P]; CMS Transmittal 171, CR 8271 Revisions to Medicare Benefit Policy Manual; Centers for Medicare & Medicaid Services, Letter to Issuers on Federally-facilitated Marketplace (Issues related to Marketplace Development); The Achieving a Better Life Experience Act of 2014 (ABLE Act of 2014); the Medicare Access and CHIP Reauthorization Act of 2015 (H.R.1458); HHS Notice of Benefit and Payment Parameters for 2017, Final 2017 Letter to Issuers in the Federally-facilitated Marketplaces; The Dialysis PATIENT Act (S. 3090, H.R. 5506); The End Stage Renal Disease Choice Act (H.R. 5659); CMS 3337-ATII Medicare Program: Conditions for Coverage for End Stage Renal Disease - Third Party Payment; 21st Century Cures Act (H.R.6).

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

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

The Protecting Access to Medicare Act of 2014 (Pub. L. 113-93); The Budget Control Act of 2011 (Pub. L. 112-25); The Patient Protection and Affordable Care Act (Pub. L. 111-148); The Health Care and Education Reconciliation Act of 2010 (Pub. L. 111-152); The American Taxpayer Relief Act of 2012 (Pub. L. 112-240); Medicare Program; End-Stage Renal Disease Prospective Payment System, Quality Incentive Program, and Durable Medical Equipment, Prosthetics, Orthotics, and Supplies; Proposed Rule [CMS-1614-P]; CMS Transmittal 171, CR 8271 Revisions to Medicare Benefit Policy Manual; Centers for Medicare & Medicaid Services, Letter to Issuers on Federally-facilitated Marketplace (Issues related to Marketplace Development); The Achieving a Better Life Experience Act of 2014 (ABLE Act of 2014); the Medicare Access and CHIP Reauthorization Act of 2015 (H.R.1458); HHS Notice of Benefit and Payment Parameters for 2017, Final 2017 Letter to Issuers in the Federally-facilitated Marketplaces; The Dialysis PATIENT Act (S. 3090, H.R. 5506); The End Stage Renal Disease Choice Act (H.R. 5659); CMS 3337-ATII Medicare Program: Conditions for Coverage for End Stage Renal Disease - Third Party Payment; 21st Century Cures Act (H.R.6).

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

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

The Protecting Access to Medicare Act of 2014 (Pub. L. 113-93); The Budget Control Act of 2011 (Pub. L. 112-25); The Patient Protection and Affordable Care Act (Pub. L. 111-148); The Health Care and Education Reconciliation Act of 2010 (Pub. L. 111-152); The American Taxpayer Relief Act of 2012 (Pub. L. 112-240); Medicare Program; End-Stage Renal Disease Prospective Payment System, Quality Incentive Program, and Durable Medical Equipment, Prosthetics, Orthotics, and Supplies; Proposed Rule [CMS-1614-P]; CMS Transmittal 171, CR 8271 Revisions to Medicare Benefit Policy Manual; Centers for Medicare & Medicaid Services, Letter to Issuers on Federally-facilitated Marketplace (Issues related to Marketplace Development); The Achieving a Better Life Experience Act of 2014 (ABLE Act of 2014); the Medicare Access and CHIP Reauthorization Act of 2015 (H.R.1458); HHS Notice of Benefit and Payment Parameters for 2017, Final 2017 Letter to Issuers in the Federally-facilitated Marketplaces; The Dialysis PATIENT Act (S. 3090, H.R. 5506); The End Stage Renal Disease Choice Act (H.R. 5659); CMS 3337-ATII Medicare Program: Conditions for Coverage for End Stage Renal Disease - Third Party Payment; 21st Century Cures Act (H.R.6).

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

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

H.R. 1130, Chronic Kidney Disease Improvement in Research and Treatment Act of 2015. Education related to the issue that ESRD patients have access to Medicare Advantage plans. Survey and Certification of dialysis clinics. Issues related to Medicare advantage risk adjustment and payments; Issues related to improvement of chronic disease. H.R. 5506, the Dialysis Patient Access To Integrated-care, Empowerment, Nephrologists and Treatment Demonstration Act. H.R. 5659 Expanding Seniors Receiving Dialysis (ESRD) Choice Act of 2016. H.R. 5942 - Dialysis Patient Access To Integrated-care, Empowerment, Nephrologists, Treatment, and Services Demonstration Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1130, Chronic Kidney Disease Improvement in Research and Treatment Act of 2015. Education related to the issue that ESRD patients have access to Medicare Advantage plans. Survey and Certification of dialysis clinics. Issues related to Medicare advantage risk adjustment and payments; Issues related to improvement of chronic disease. H.R. 5506, the Dialysis Patient Access To Integrated-care, Empowerment, Nephrologists and Treatment Demonstration Act. H.R. 5659 Expanding Seniors Receiving Dialysis (ESRD) Choice Act of 2016. H.R. 5942 - Dialysis Patient Access To Integrated-care, Empowerment, Nephrologists, Treatment, and Services Demonstration Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 5506 Introduced June 15, 2016 by Todd Young (R-IN) to amend title XVIII of the Social Security to establish a demonstration program to provide integrated care for Medicare beneficiaries with end-stage renal disease, and for other purposes.

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

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

Issues related to Medicare advantage risk adjustment and payments; Issues related to improvement of chronic disease. Issues relate to H.R. 5506, the Dialysis Patient Access To Integrated-care, Empowerment, Nephrologists and Treatment Demonstration Act. H.R. 5659 Expanding Seniors Receiving Dialysis (ESRD) Choice Act of 2016 H.R.5942 - Dialysis Patient Access To Integrated-care, Empowerment, Nephrologists, Treatment, and Services Demonstration Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Affordable Care Act (ACA) Issues; ACA Regulations, HCR Implementation; Market Stability; Health Savings Accounts (HSAs); Notice of Benefits and Payment Parameters (NBPP); Special Enrollment Periods (SEPs); Cost-sharing Reduction (CSR); Re-insurance; Risk Corridors; Better Way; Repeal/Replace Modeling; ACA Reform; Risk Programs; Premium Education; Chronic Care; Individual Market Reform; Third Party Payments of Premiums; Exchanges; Age Bands. 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 928 Introduced February 12, 2015 by Charles Boustany (R-LA). This bill repeals a provision of the ACA that imposes an annual fee on a health insurance provider based on its net premium income. 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 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 5410 Health Coverage State Flexibility Act of 2016, Introduced June 21, 2016 by Bill Flores (R-TX), Amends the Patient Protection and Affordable Care Act to revise the grace period that health insurers must provide to recipients of premium subsidies before discontinuing health coverage for nonpayment of premiums. 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 picket 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 provision of Federal law with regard to the Patient Protection and Affordable Care Acts 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 Services Act to change the permissible age variation in health insurance premium rates. S. 524 Comprehensive Addition and Recovery Act of 2016 Introduced February 12, 2015 by Sheldon Whitehouse (D-RI) Overdoes from heroin, prescription drugs, and opioid pain relievers. 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. The bill authorizes the Attorney General and Secretary of Health and Human Services to award grants to address the national epidemics of prescription opioid abuse and heroin use. 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. Network Adequacy standards and tiered networks.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Implementation of the Protecting Access to Medicare Act of 2014 (Pub. L. 113-93); The Budget Control Act of 2011 (Pub. L. 112-25); Implementation of the Patient Protection and Affordable Care Act (Pub. L. 111-148); The Health Care and Education Reconciliation Act of 2010 (Pub. L. 111-152); The American Taxpayer Relief Act of 2012 (Pub. L. 112-240); Medicare Program; End-Stage Renal Disease Prospective Payment System, Quality Incentive Program, and Durable Medical Equipment, Prosthetics, Orthotics, and Supplies; Proposed Rule [CMS-1614-P]; CMS Transmittal 171, CR 8271 Revisions to Medicare Benefit Policy Manual; Centers for Medicare & Medicaid Services, Letter to Issuers on federally-facilitated Marketplace (Issues related to Marketplace Development); The Achieving a Better Life Experience Act of 2014 (ABLE Act of 2014); The Medicare Access and CHIP Reauthorization Act of 2015 (H.R. 1458); HHS Notice of Benefit and Payment Parameters for 2017, Final 2017 Letter to Issuers in the Federally-facilitated Marketplaces; The Dialysis PATIENT Act (S. 3090, H.R. 5506); The ERSD Choice Act (H.R. 5659); Issues related to ERSD Program; S. 598 and H.R. 1130, the Chronic Kidney Disease Improvement in Research and Treatment Act of 2015; Medicare Advantage; Senate Finance Committee Chronic Care Working Group; Integrated care legislation; Access to coverage in Health Insurance Marketplaces for ESRD; Implementation of Pub. L. 114-27, the Trade Preferences Extension Act of 2015; OCR anti-discrimination proposed and final rules; ERSD quality programs; ERSD payment rules.

Client expense: $270,000 · Firm income: Not reported

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

Implementation of the Protecting Access to Medicare Act of 2014 (Pub. L. 113-93); The Budget Control Act of 2011 (Pub. L. 112-25); Implementation of the Patient Protection and Affordable Care Act (Pub. L. 111-148); The Health Care and Education Reconciliation Act of 2010 (Pub. L. 111-152); The American Taxpayer Relief Act of 2012 (Pub. L. 112-240); Medicare Program; End-Stage Renal Disease Prospective Payment System, Quality Incentive Program, and Durable Medical Equipment, Prosthetics, Orthotics, and Supplies; Proposed Rule [CMS-1614-P]; CMS Transmittal 171, CR 8271 Revisions to Medicare Benefit Policy Manual; Centers for Medicare & Medicaid Services, Letter to Issuers on federally-facilitated Marketplace (Issues related to Marketplace Development); The Achieving a Better Life Experience Act of 2014 (ABLE Act of 2014); The Medicare Access and CHIP Reauthorization Act of 2015 (H.R. 1458); HHS Notice of Benefit and Payment Parameters for 2017, Final 2017 Letter to Issuers in the Federally-facilitated Marketplaces; The Dialysis PATIENT Act (S. 3090, H.R. 5506); The ERSD Choice Act (H.R. 5659); Issues related to ERSD Program; S. 598 and H.R. 1130, the Chronic Kidney Disease Improvement in Research and Treatment Act of 2015; Medicare Advantage; Senate Finance Committee Chronic Care Working Group; Integrated care legislation; Access to coverage in Health Insurance Marketplaces for ESRD; Implementation of Pub. L. 114-27, the Trade Preferences Extension Act of 2015; OCR anti-discrimination proposed and final rules; ERSD quality programs; ERSD payment rules.

Client expense: $270,000 · Firm income: Not reported

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

- Medicare payment for End Stage Renal Disease (ESRD) and Medicare Advantage Issues - H.R. 5506/S. 3090, the Dialysis PATIENT Demo Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Advocacy on kidney research and innovation; the PATIENT Act (HR 5506) and the Choice Act (HR 5659); prize competitions

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

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

HR 5506 Introduced June 15, 2016 by Todd Young (R-IN) to amend title XVIII of the Social Security to establish a demonstration program to provide integrated care for Medicare beneficiaries with end-stage renal disease, and for other purposes.

Client expense: Not reported · Firm income: Not reported

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

HR 5506 Introduced June 15, 2016 by Todd Young (R-IN) to amend title XVIII of the Social Security to establish a demonstration program to provide integrated care for Medicare beneficiaries with end-stage renal disease, and for other purposes.

Client expense: $200,000 · Firm income: Not reported

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

Implementation of P.L. 114-10 (Medicare Access and CHIP Reauthorization Act of 2015) - provisions related to provider participation in MIPS and APM programs; all provisions related to Medicare Advantage participation. H.R. 34 (21st Century Cures Act) - all provisions relating to Medicare Advantage Star Ratings; mental health in Medicaid and Medicare; end stage renal disease (ESRD). House Republican Leadership Task Force Proposal on Medicare and Medicaid (A Better Way) - all provisions relating to Medicare and Medicaid. H.R. 2646 (Helping Families in Mental Health Crisis Act) - all provisions relating to Medicaid and Medicare. S. 2680 (Mental Health Reform Act) - all provisions relating to Medicaid and Medicare. H.R. 5506 and S. 3090 (Dialysis PATIENT Demonstration Act) - all provisions relating to establishing a demonstration project to provide integrated care for Medicare beneficiaries with end-stage renal disease. H.R. 5659 (ESRD Choice Act) - all provisions relating to expanding Medicare Advantage coverage for individuals with end-stage renal disease. Advocated for Medicaid Managed care in any effort to reform the Medicaid program.

Client expense: $260,000 · Firm income: Not reported

Government targets: Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, SENATE

Urge Congress to open Medicare Advantage to dialysis patients (HR 5659); Support ESRD care coordination legislation - the Dialysis PATIENTS Act (HR 5506/S 3090); Encourage support for to improve kidney disease research and treatment (HR 1130/S 598); Protect Medicare funding for dialysis patients; Improve access to home dialysis treatment; and Ensure ESRD patients retain access to commercial insurance.

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

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

End stage renal disease (ESRD) Medicare reimbursement and payment reform. ESRD Quality measurement. Improved policies for Chronic Kidney Disease (CKD). Transplant Initiatives. Dialysis PATIENT Demonstration Act (H.R. 5506/S. 3090/H.R. 5942) ESRD Choice Act (H.R. 5659) Medicare Third Party Payment

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

End stage renal disease (ESRD) rebasing, Medicare reimbursement and payment reform. CMS's Center for Medicare and Medicaid Innovation's comprehensive ESRD Care Initiative and improving overall ESRD patient health quality. Improved policies on chronic kidney disease. Chronic care management reform legislation. ESRD Integrated Care legislation. Transplant Initiatives. Implementation of the Medicare Access and CHIP Reauthorization Act. Living Donor Protection Act (H.R. 4616/S. 2584) ESRD Choice Act (H.R. 5659) Dialysis PATIENT Demonstration Act (H.R. 5506/S. 3090/H.R. 5942) Creating High-Quality Results & Outcomes Necessary to Improve Chronic (CHRONIC) Care Act (S. 3504) 21st Century Cures Act, provisions related to ESRD coverage in Medicare Advantage Medicare Third Party Payment

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), Natl Economic Council (NEC), Office of Science & Technology Policy (OSTP), SENATE

End stage renal disease (ESRD) rebasing, Medicare reimbursement and payment reform. CMS's Center for Medicare and Medicaid Innovation's comprehensive ESRD Care Initiative and improving overall patient health quality. Improved policies on chronic kidney disease. Chronic Care management reform legislation. ESRD Integrated Care Legislation. Transplant Initiatives. Living Donor Protection Act (H.R. 4616/S. 2584) ESRD Choice Act (H.R. 5659) Dialysis PATIENT Demonstration Act (H.R. 5506/S. 3090/H.R. 5942) Implementation of the Medicare Access and CHIP Reauthorization Act Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act(S. 3504) 21st Century Cures Act, provisions related to ESRD coverage in Medicare Advantage

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

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

Client expense: $2,160,000 · Firm income: Not reported

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

S. 3504 - Creating High Quality Results and Outcome Necessary to Improve Chronic Care Act of 2016 - Issues related to ESRD, palliative care, telemedicine and other issues related to better serving Medicare beneficiaries with End Stage Renal Disease. H.R.1130/S.598 - Chronic Kidney Disease Improvement in Research and Treatment Act of 2015 - Issues related to giving ESRD patients greater choice in their Medicare coverage. H.R.5506/S. 3090 - Dialysis PATIENT Demonstration Act - legislation to create a comprehensive care model for individuals living with End Stage Renal Disease. Work on current and potential demonstration projects in Medicare to support better integration of care for ESRD patients with both CMS and Members of Congress. Issues focused on ESRD and Risk Adjustment for chronically ill patients and related work being conducted by the Senate Finance Committee. Legislative and Administrative actions related to factoring in Socio Economic Status into policies impacting all beneficiaries and their providers.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 3504 - Creating High Quality Results and Outcome Necessary to Improve Chronic Care Act of 2016 - Issues related to ESRD, palliative care, telemedicine and other issues related to better serving Medicare beneficiaries with End Stage Renal Disease. H.R.1130/S.598 - Chronic Kidney Disease Improvement in Research and Treatment Act of 2015 - Issues related to giving ESRD patients greater choice in their Medicare coverage. H.R.5506/S. 3090 - Dialysis PATIENT Demonstration Act - legislation to create a comprehensive care model for individuals living with End Stage Renal Disease. Work on current and potential demonstration projects in Medicare to support better integration of care for ESRD patients with both CMS and Members of Congress. Issues focused on ESRD and Risk Adjustment for chronically ill patients and related work being conducted by the Senate Finance Committee. CMS policies related to Medicare Advantage with specific focus on the formula asserted for the Medicare Advantage Risk Adjustment factor and its impact on beneficiaries, plans and providers who serve Medicare Beneficiaries who live with multiple chronic conditions. Legislative and Administrative actions related to factoring in SocioEconomic Status into policies impacting all beneficiaries and their providers.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 5506 and H.R. 5659, Medicare coverage of End-Stage Renal Disease (ESRD). The ESRD Seamless Care Organizations (ESCO), and Chronic Care and Integrated Kidney Care. S. 3090, The Patient Access To Integrated-care, Empowerment, Nephrologists and Treatment Demonstration Act of 2016. H.R. 5942, ERSD Patient Act.

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

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

H.R. 1130, Chronic Kidney Disease Improvement in Research and Treatment Act of 2015. Education related to the issue that ESRD patients have access to Medicare Advantage plans. Survey and Certification of dialysis clinics. Issues related to Medicare advantage risk adjustment and payments; Issues related to improvement of chronic disease. H.R. 5506, the Dialysis Patient Access To Integrated-care, Empowerment, Nephrologists and Treatment Demonstration Act. H.R. 5659 Expanding Seniors Receiving Dialysis (ESRD) Choice Act of 2016. H.R. 5942 - Dialysis Patient Access To Integrated-care, Empowerment, Nephrologists, Treatment, and Services Demonstration Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1130, Chronic Kidney Disease Improvement in Research and Treatment Act of 2015. Education related to the issue that ESRD patients have access to Medicare Advantage plans. Survey and Certification of dialysis clinics. Issues related to Medicare advantage risk adjustment and payments; Issues related to improvement of chronic disease. H.R. 5506, the Dialysis Patient Access To Integrated-care, Empowerment, Nephrologists and Treatment Demonstration Act. H.R. 5659 Expanding Seniors Receiving Dialysis (ESRD) Choice Act of 2016. H.R. 5942 - Dialysis Patient Access To Integrated-care, Empowerment, Nephrologists, Treatment, and Services Demonstration Act.

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

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; 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 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 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 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. H.R. 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. H.R. 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 deaths 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.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

- Medicare payment for End Stage Renal Disease (ESRD) and Medicare Advantage Issues - H.R. 5506/S. 3900, the Dialysis PATIENT Demo Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to Medicare advantage risk adjustment and payments; Issues related to improvement of chronic disease. Issues relate to H.R. 5506, the Dialysis Patient Access To Integrated-care, Empowerment, Nephrologists and Treatment Demonstration Act. H.R. 5659 Expanding Seniors Receiving Dialysis (ESRD) Choice Act of 2016 H.R.5942 - Dialysis Patient Access To Integrated-care, Empowerment, Nephrologists, Treatment, and Services Demonstration Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Implementation of the Protecting Access to Medicare Act of 2014 (Pub. L. 113-93); The Budget Control Act of 2011 (Pub. L. 112-25); Implementation of the Patient Protection and Affordable Care Act (Pub. L. 111-148); The Health Care and Education Reconciliation Act of 2010 (Pub. L. 111-152); The American Taxpayer Relief Act of 2012 (Pub. L. 112-240); Medicare Program; End-Stage Renal Disease Prospective Payment System, Quality Incentive Program, and Durable Medical Equipment, Prosthetics, Orthotics, and Supplies; Proposed Rule [CMS-1614-P]; CMS Transmittal 171, CR 8271 Revisions to Medicare Benefit Policy Manual; Centers for Medicare & Medicaid Services, Letter to Issuers on federally-facilitated Marketplace (Issues related to Marketplace Development); The Achieving a Better Life Experience Act of 2014 (ABLE Act of 2014); The Medicare Access and CHIP Reauthorization Act of 2015 (H.R. 1458); HHS Notice of Benefit and Payment Parameters for 2017, Final 2017 Letter to Issuers in the Federally-facilitated Marketplaces; The Dialysis PATIENT Act (S. 3090, H.R. 5506); The ERSD Choice Act (H.R. 5659); Issues related to ERSD Program; S. 598 and H.R. 1130, the Chronic Kidney Disease Improvement in Research and Treatment Act of 2015; Medicare Advantage; Senate Finance Committee Chronic Care Working Group; Integrated care legislation; Access to coverage in Health Insurance Marketplaces for ESRD; Implementation of Pub. L. 114-27, the Trade Preferences Extension Act of 2015; OCR anti-discrimination proposed and final rules; ERSD quality programs; ERSD payment rules.

Client expense: $230,000 · Firm income: Not reported

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

Implementation of the Protecting Access to Medicare Act of 2014 (Pub. L. 113-93); The Budget Control Act of 2011 (Pub. L. 112-25); Implementation of the Patient Protection and Affordable Care Act (Pub. L. 111-148); The Health Care and Education Reconciliation Act of 2010 (Pub. L. 111-152); The American Taxpayer Relief Act of 2012 (Pub. L. 112-240); Medicare Program; End-Stage Renal Disease Prospective Payment System, Quality Incentive Program, and Durable Medical Equipment, Prosthetics, Orthotics, and Supplies; Proposed Rule [CMS-1614-P]; CMS Transmittal 171, CR 8271 Revisions to Medicare Benefit Policy Manual; Centers for Medicare & Medicaid Services, Letter to Issuers on federally-facilitated Marketplace (Issues related to Marketplace Development); The Achieving a Better Life Experience Act of 2014 (ABLE Act of 2014); The Medicare Access and CHIP Reauthorization Act of 2015 (H.R. 1458); HHS Notice of Benefit and Payment Parameters for 2017, Final 2017 Letter to Issuers in the Federally-facilitated Marketplaces; The Dialysis PATIENT Act (S. 3090, H.R. 5506); The ERSD Choice Act (H.R. 5659); Issues related to ERSD Program; S. 598 and H.R. 1130, the Chronic Kidney Disease Improvement in Research and Treatment Act of 2015; Medicare Advantage; Senate Finance Committee Chronic Care Working Group; Integrated care legislation; Access to coverage in Health Insurance Marketplaces for ESRD; Implementation of Pub. L. 114-27, the Trade Preferences Extension Act of 2015; OCR anti-discrimination proposed and final rules; ERSD quality programs; ERSD payment rules.

Client expense: $230,000 · Firm income: Not reported

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

Raise awareness with legislators about the barriers to and the importance of protecting access for home dialysis. The Chronic Kidney Disease Improvement in Research and Treatment Act is S.598 and H.R.1130 H.R.2948 Medicare Tele-health Parity Act of 2015 ESRD Choice Act HR 5659 CONNECT for Health Act S2484 Dialysis PATIENTS Act HR 5506

Client expense: $350,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 546, ACE Kids Act (Barton) - Medicaid Childrens Care Coordination Program H.R. 588, Medicare Beneficiary Preservation of Choice Act (Rothfus-Schrader) - MA enrollment opportunities H.R. 818, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Roskam-Carney) - reducing fraud H.R. 1021, Protecting the Integrity of Medicare Act (Brady) - reducing fraud H.R. 2488, Medicare Beneficiary Preservation of Choice Act (Rothfus-Schrader) - MA open enrollment period H.R. 2505, Increasing Access to Data in Medicare Advantage Act (Kelly) - annual reporting of MA enrollment data H.R. 2506, Preventing Unnecessary Plan Terminations Act (Buchanan) - preventing certain MA plan terminations H.R. 2507, Increasing Regulatory Fairness Act (Brady) - schedule for MA rates H.R. 2570, Strengthening Medicare Advantage through Innovation and Transparency for Seniors Act (Black) - Value-Based Insurance Design demonstration H.R. 2579, Securing Care for Seniors Act (Black) - MA risk adjustment model H.R. 2581, Preservation of Access for Seniors in Medicare Advantage Act (Brady) - Value-Based Insurance Design demonstration and MA open enrollment period H.R. 2582, Seniors Health Care Plan Protection Act (Buchanan) - preventing certain MA plan terminations, MA risk adjustment model H.R. 3718, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Roskam-Carney) - reducing fraud H.R. 3716, Ensuring Access to Quality Medicaid Providers Act (Bucshon) - oversight of terminated Medicaid providers H.R. 4275, Medicare Advantage Quality Payment Relief Act (Kelly) - calculation of MA benchmark cap H.R. 4442, CONNECT for Health Act (Black-Welch) - telehealth, remote patient monitoring services H.R. 4589, Excellence in Medicare Act (MacArthur) - MA payment cap H.R. 5273, Helping Hospitals Improve Patient Care Act (Tiberi) - MA issues, site-neutral payments H.R. 5506, Dialysis PATIENT Demonstration Act (Young) - demonstration program for Medicare beneficiaries with ESRD H.R. 5659, ESRD Choice Act (Smith) - option for ESRD patients to enroll in MA plans H.R. 5942, Dialysis PATIENTS Demonstration Act (Young) - demonstration program for Medicare beneficiaries with ESRD H.R. 6265, Medigap Reforms (McDermott) S. 298, ACE Kids Act (Grassley) - Medicaid Childrens Care Coordination Program S. 524, Comprehensive Addiction and Recovery Act (Whitehouse) - Medicare Part D lock-in programs S. 861, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Carper-Enzi) - reducing fraud S. 1347, Electronic Health Fairness Act - preventing certain MA plan terminations, annual reporting of MA enrollment data S. 1396, Value-Based Insurance Design Seniors Copayment Reduction Act (Thune-Stabenow) - VBID demonstration S. 1549, Care Planning Act (Warner) - advanced illness care coordination for Medicare beneficiaries S. 1913, Stopping Medication Abuse and Protecting Seniors Act (Toomey) - Medicare Part D lock-in programs S. 2104, Preserving Medicare Advantage for all Medicare Beneficiaries Act (Portman-Casey) - preventing certain MA plan terminations, MA demonstration program S. 2349, Medicare Advantage Coverage Transparency Act (Heller) - MA enrollment data S. 2484, CONNECT for Health Act (Schatz-Wicker) - telehealth, remote patient monitoring services S. 2864, RxCAP Act (Wyden) - Medicare Part D cost-sharing S. 3090, Dialysis PATIENT Demonstration Act (Heller) - demonstration program for Medicare beneficiaries with ESRD Regulatory Issues: Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, network adequacy and provider directories, encounter data and other data-related issues, and audit issues; bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, Part D direct and indirect remuneration (DIR), and audits); in-home health risk assessments; Medicare Medical Loss Ratio issues; implementation of sequestration under the Medicare Advantage and Part D programs; implications of the health insurer fee for MA and Part D plans; application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, enrollment rules, requirements for notice and denial forms, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible SNPs; Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, Part D coverage gap discount program, including employer group waiver plan (EGWP) issues, and other operational issues; issues raised by Part D coverage of new specialty drugs, the Part D non-interference policy and related issues (e.g., preferred pharmacy and any willing pharmacy requirements, standards for network pharmacy reimbursement, and policies regarding sponsor negotiation of pharmacy price concessions); CMS's proposed Part B drug demonstration program; Medication Therapy Management Program requirements and the Center for Medicare and Medicaid Innovation (CMMI) Demonstration; MA EGWP issues; CMMI's value-based insurance design (VBID) demonstration; Part D requirements for offering basic and enhanced alternative plans; MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; issues relating to MA and Part D Star Rating system including measures, the methodology for calculating ratings, and the role of the ratings for payment purposes; implementation of the Affordable Care Act (ACA) changes to the Part D coverage gap; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education Program; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; new payment system for physicians under MACRA, including implications for MA and Part D plans; Medicare clinical trials; Medicare/Medicaid integration for dual eligibles, including implementation of the Capitated Financial Alignment Demonstration and related issues (e.g., quality ratings); Medicaid managed care regulations and policies, including CMS' proposed substantial revisions to the managed care regulations, new mental health parity rules, the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, fraud and abuse compliance, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including block grants, the calculation of the federal medical assistance (federal matching) percentage (FMAP), and intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost issues affecting Medicaid health plans including issues raised by Medicaid coverage of new specialty drugs; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues and CHIP reauthorization; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including Medicaid managed care organization provider tax issues; standards for electronic prescribing; implementation of Medicaid changes of interest to Medicaid health plans made in the ACA including Medicaid expansion, the managed care organization (MCO) prescription drug rebate provisions, minimum payments to primary care providers (PCPs), interactions between the Medicaid program and health insurance exchanges, and Medicaid and CHIP maintenance of effort (MOE) requirements; implications of the health insurer fee for Medicaid health plans; issues related to Medicaid Managed long-term care including home and community-based waiver services (HCBS); expanding the availability of Medicare Advantage and Medicaid health plan telemedicine programs; implications of the new non-discrimination rules for health plans participating in public programs; issues related to Medigap coverage; issues related to business continuity in relation to pandemics or natural events (e.g., hurricane, tornado, etc.); cybersecurity; provider directories; value-based insurance design models; Part D prescriber enrollment requirements; Part D recovery audit contractor programs; issues relating to enrollment of beneficiaries with ESRD into MA plans; socioeconomic status impacts on star ratings related to MA and Part D programs; and other issues relating to health care reform implementation.

Client expense: $1,710,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE, Treasury, Dept of, White House Office

H.R. 546 and S. 298, ACE Kids Act, all provisions regarding care of children with complex medical needs. H.R. 2646, Helping Families in Mental Health Crisis Act, all provisions relating to Medicaid and Medicare. S. 2680, Mental Health Reform Act, all provisions relating to Medicaid and Medicare. H.R. 5506 and S. 3090, Dialysis PATIENT Demonstration Act, all provisions relating to establishing a demonstration project to provide integrated care for Medicare beneficiaries with end-stage renal disease. H.R. 5659, ESRD Choice Act, all provisions relating to expanding Medicare Advantage coverage for individuals with end-stage renal disease. Advocated for Medicaid Managed care in an effort to reform the Medicaid program. S. 524, Comprehensive Addiction and Recovery Act, all provisions relating to opioids in Medicare and Medicaid.

Client expense: $260,000 · Firm income: Not reported

Government targets: Federal Communications Commission (FCC), 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.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

The Protecting Access to Medicare Act of 2014 (Pub. L. 113-93); The Budget Control Act of 2011 (Pub. L. 112-25); The Patient Protection and Affordable Care Act (Pub. L. 111-148); The Health Care and Education Reconciliation Act of 2010 (Pub. L. 111-152); The American Taxpayer Relief Act of 2012 (Pub. L. 112-240); Medicare Program; End-Stage Renal Disease Prospective Payment System, Quality Incentive Program, and Durable Medical Equipment, Prosthetics, Orthotics, and Supplies; Proposed Rule [CMS-1614-P]; CMS Transmittal 171, CR 8271 Revisions to Medicare Benefit Policy Manual; Centers for Medicare & Medicaid Services, Letter to Issuers on Federally-facilitated Marketplace (Issues related to Marketplace Development); The Achieving a Better Life Experience Act of 2014 (ABLE Act of 2014); the Medicare Access and CHIP Reauthorization Act of 2015 (H.R.1458); HHS Notice of Benefit and Payment Parameters for 2017, Final 2017 Letter to Issuers in the Federally-facilitated Marketplaces; The Dialysis PATIENT Act (S. 3090, H.R. 5506); The ESRD Choice Act (H.R. 5659).

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

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

The Protecting Access to Medicare Act of 2014 (Pub. L. 113-93); The Budget Control Act of 2011 (Pub. L. 112-25); The Patient Protection and Affordable Care Act (Pub. L. 111-148); The Health Care and Education Reconciliation Act of 2010 (Pub. L. 111-152); The American Taxpayer Relief Act of 2012 (Pub. L. 112-240); Medicare Program; End-Stage Renal Disease Prospective Payment System, Quality Incentive Program, and Durable Medical Equipment, Prosthetics, Orthotics, and Supplies; Proposed Rule [CMS-1614-P]; CMS Transmittal 171, CR 8271 Revisions to Medicare Benefit Policy Manual; Centers for Medicare & Medicaid Services, Letter to Issuers on Federally-facilitated Marketplace (Issues related to Marketplace Development); The Achieving a Better Life Experience Act of 2014 (ABLE Act of 2014); the Medicare Access and CHIP Reauthorization Act of 2015 (H.R.1458); HHS Notice of Benefit and Payment Parameters for 2017, Final 2017 Letter to Issuers in the Federally-facilitated Marketplaces; The Dialysis PATIENT Act (S. 3090, H.R. 5506); The ESRD Choice Act (H.R. 5659).

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

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

Medicare Advantage; Medicaid; Medicare Access & CHIP Reauthorization Act of 2015 (MACRA); Site-neutral Payments; Rate Notice and Call Letter; QHP Quality Rating System (QRS); ESRD 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 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 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.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

The Protecting Access to Medicare Act of 2014 (Pub. L. 113-93); The Budget Control Act of 2011 (Pub. L. 112-25); The Patient Protection and Affordable Care Act (Pub. L. 111-148); The Health Care and Education Reconciliation Act of 2010 (Pub. L. 111-152); The American Taxpayer Relief Act of 2012 (Pub. L. 112-240); Medicare Program; End-Stage Renal Disease Prospective Payment System, Quality Incentive Program, and Durable Medical Equipment, Prosthetics, Orthotics, and Supplies; Proposed Rule [CMS-1614-P]; CMS Transmittal 171, CR 8271 Revisions to Medicare Benefit Policy Manual; Centers for Medicare & Medicaid Services, Letter to Issuers on Federally-facilitated Marketplace (Issues related to Marketplace Development); The Achieving a Better Life Experience Act of 2014 (ABLE Act of 2014); the Medicare Access and CHIP Reauthorization Act of 2015 (H.R.1458); HHS Notice of Benefit and Payment Parameters for 2017, Final 2017 Letter to Issuers in the Federally-facilitated Marketplaces; The Dialysis PATIENT Act (S. 3090, H.R. 5506); The ESRD Choice Act (H.R. 5659).

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

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

Advocacy on kidney research and innovation; the PATIENT Act (HR 5506) and the Choice Act (HR 5659)

Client expense: Not reported · Firm income: $15,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Affordable Care Act - Chronic Care Innovations; Payment reform; CBPP; 2017 Notice of Benefit and Payment Parameters; ACA Regulations, Implementation; Open Enrollment; Market Stability; Special Enrollment Periods (SEPs); Reinsurance; Risk corridors; Risk Mitigation; Risk Programs; Premiums; Individual Market Reform; Third party payments; Exchanges; Age Bands. Other Health Care Issues- Mental Health Reform; End Stage Renal Disease (ESRD); Health Savings Accounts; Opioid Education. 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 928 Introduced February 12, 2015 by Charles Boustany (R-LA). This bill repeals a provision of the ACA that imposes an annual fee on a health insurance provider based on its net premium income. 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 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 5410 Health Coverage State Flexibility Act of 2016, Introduced June 21, 2016 by Bill Flores (R-TX), Amends the Patient Protection and Affordable Care Act to revise the grace period that health insurers must provide to recipients of premium subsidies before discontinuing health coverage for nonpayment of premiums. 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 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 provision of Federal law with regard to the Patient Protection and Affordable Care Acts 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 Services Act to change the permissible age variation in health insurance premium rates. S. 524 Comprehensive Addition and Recovery Act of 2016 Introduced February 12, 2015 by Sheldon Whitehouse (D-RI) Overdoes from heroin, prescription drugs, and opioid pain relievers. 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. The bill authorizes the Attorney General and Secretary of Health and Human Services to award grants to address the national epidemics of prescription opioid abuse and heroin use. 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 Precision Medicine Initiative. Network Adequacy standards and network tiering.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 5506/ H.R. 5942/S. 3090 Dialysis PATIENT Demonstration Act of 2016 (All provisions) H.R. 5659 ESRD Choice Act of 2016 (All provisions) H.R. 270 Flexibility in Health IT Reporting Act (All provisions) S. 598 Chronic Kidney Disease Improvement in Research and Treatment Act of 2015 (All provisions) H.R. 1130 Chronic Kidney Disease Improvement in Research and Treatment Act of 2015 (All provisions) S. 776 Medication Therapy Management Empowerment Act of 2015 (All provisions) H.R. 244 MAC Transparency Act (All provisions) H.R. 2507 The Increasing Regulatory Fairness Act (All provisions) S. 2484 CONNECT for Health Act (All provisions) Comprehensive reforms to meaningful use; stage 3 meaningful use proposed rule CMS regulations related to the treatment of Medicare Part C and Part D CMS regulations pertaining to reimbursement rates for ESRD-related services CMS survey and certification of kidney dialysis centers CMS vascular care rate change proposal CMS/Medicare Advantage ESRD rate formulation

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

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

H.R. 5506/S. 5090 Dialysis PATIENT Demonstration Act H.R. 5659 ESRD Choice Act of 2016 H.R. 270 Flexibility in Health IT Reporting Act (All provisions) S. 598 Chronic Kidney Disease Improvement in Research and Treatment Act of 2015 (All provisions) H.R. 1130 Chronic Kidney Disease Improvement in Research and Treatment Act of 2015 (All provisions) S. 776 Medication Therapy Management Empowerment Act of 2015 (All provisions) H.R. 244 MAC Transparency Act (All provisions) H.R. 2507 The Increasing Regulatory Fairness Act (All provisions) S. 2484 CONNECT for Health Act (All provisions) Comprehensive reforms to meaningful use; stage 3 meaningful use proposed rule CMS regulations pertaining to reimbursement rates for ESRD-related services CMS survey and certification of kidney dialysis centers CMS regulations related to the treatment of Medicare Part C and Part D CMS regulations pertaining to reimbursement rates for ESRD-related services CMS vascular care rate change proposal CMS/Medicare Advantage ESRD rate formulation

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

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

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.

Client expense: $2,150,000 · Firm income: Not reported

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

H.R.1130/S.598 - Chronic Kidney Disease Improvement in Research and Treatment Act of 2015 - Issues related to giving ESRD patients greater choice in their Medicare coverage. H.R.5506/S. 3090 - Dialysis PATIENT Demonstration Act - legislation to create a comprehensive care model for individuals living with End Stage Renal Disease. Work on current and potential demonstration projects in Medicare to support better integration of care for ESRD patients with both CMS and Members of Congress. Issues focused on ESRD and Risk Adjustment for chronically ill patients and related work being conducted by the Senate Finance Committee. CMS policies related to Medicare Advantage with specific focus on the formula asserted for the Medicare Advantage Risk Adjustment factor and its impact on beneficiaries, plans and providers who serve Medicare Beneficiaries who live with multiple chronic conditions. Legislative and Administrative actions related to factoring in SocioEconomic Status into policies impacting all beneficiaries and their providers.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.1130/S.598 - Chronic Kidney Disease Improvement in Research and Treatment Act of 2015 - Issues related to giving ESRD patients greater choice in their Medicare coverage. H.R.5506/S. 3090 - Dialysis PATIENT Demonstration Act - legislation to create a comprehensive care model for individuals living with End Stage Renal Disease. Work on current and potential demonstration projects in Medicare to support better integration of care for ESRD patients with both CMS and Members of Congress. Issues focused on ESRD and Risk Adjustment for chronically ill patients and related work being conducted by the Senate Finance Committee. Legislative and Administrative actions related to factoring in Socio Economic Status into policies impacting all beneficiaries and their providers.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE