Plan Verification and Fairness Act of 2016

Affordable Care Act Issues - ACA Regulations, Postal Reform; Department of Labor Conflict of Interest Rule; HCR Implementation; Health Savings Accounts (HSA's); 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; 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 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 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 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 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: $60,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.2646, "Helping Families in Mental Health Crisis Act of 2015", regarding all provisions. S.1945, "Mental Health Reform Act of 2015", regarding all provisions. H.R. 5410, "Health Coverage State Flexibility Act of 2016", regarding all provisions. H.R. 5659, "ESRD Choice Act of 2016", regarding all provisions. S. 2803, "Taxpayers Before Insurers Act", regarding all provisions. H.R. 5589, "Plan Verification and Fairness Act of 2016", regarding all provisions. H.R. 3742, "Access to Marketplace Insurance Act", regarding all provisions. H.R. 928, "To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act.", regarding all provisions. H.R. 5447, "Small Business Health Care Relief Act of 2016", regarding all provisions. Issues related to Mental Health Parity. Issues related to the Federal Employee Health Benefit Program (FEHBP). Issues related to the Affordable Care Act including Chronic Care Innovations; Payment reform; 2017 Notice of Benefit and Payment Parameters (NBPP); ACA Regulations; Co-ops; Implementation; Cyber Security; Open Enrollment; Market Stability; Department of Labor Conflict of Interest Rule; Grace Periods; Special Enrollment Periods.

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

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

Implementation of Public Law No. 111-148; H.R. 5410, The Health Coverage State Flexibility Act of 2016 H.R. 5589, The Plan Verification and Fairness Act of 2016 H.R. 5921, The State Age Rating Flexibility Act of 2016

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

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

Discussions regarding H.R. 5589, Plan Verification and Fairness Act of 2016

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (reconciliation, individual mandate, cost sharing reduction subsidies) Reinsurance (Taxpayers Before Insurers Act, S. 2803 and H.R. 5904) Age rating bands in the individual health insurance market (H.R. 5921) ACA Special Enrollment Period verification (H.R. 5589) ACA third party payments (H.R. 3742) ACA grace periods (H.R. 5410) ACA Notice of Benefit and Payment Parameters regulations Mental Health and Substance Use (42 CFR Part 2) Health Reimbursement Arrangements (H.R. 5447) Telehealth (S. 2484 and H.R. 4442) Price of prescription drugs Military health care (S. 2943) Clinical decision support tools

Client expense: $1,140,000 · Firm income: Not reported

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

ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (reconciliation, individual mandate, cost sharing reduction subsidies) Reinsurance (Taxpayers Before Insurers Act, S. 2803 and H.R. 5904) Age rating bands in the individual health insurance market (H.R. 5921) ACA Special Enrollment Period verification (H.R. 5589) ACA third party payments (H.R. 3742) ACA grace periods (H.R. 5410) ACA Notice of Benefit and Payment Parameters regulations Mental Health and Substance Use (42 CFR Part 2) Health Reimbursement Arrangements (H.R. 5447) Telehealth (S. 2484 and H.R. 4442) Price of prescription drugs Military health care (S. 2943) Clinical decision support tools

Client expense: $1,140,000 · Firm income: Not reported

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

Issues related to Public Law 111-148 - The Patient Protection and Affordable Care Act; Issues related to Public Law 111-152- Health Care and Education Reconciliation Act of 2010; Issues related to implementation of the Affordable Care Act, including Exchanges, Essential Health Benefits, affordability, health information technology, transparency, employer regulations, and taxes and fees; Issues related to HR 1624 - to revise the definition of small employer. H.R.5589 the Plan Verification and Fairness Act of 2016

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Affordable Care Act (ACA) Issues; ACA Regulations; HCR Implementation; Re-insurance; Co-ops; Market Stability; Cost-sharing Reduction (CSR); Better Way; ACA Reform; Risk Corridors; Chronic Care; Mental Health Reform; Premium Education; Third Party Payment of Premiums; SEPs; Grace Periods; Age Bands, Individual Mandate. 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 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 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 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 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

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

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

Affordable Care Act Issues: ACA Regulations; Postal Reform; HCR Implementation; Health Savings Accounts (HSAs); Re-insurance; Notice of Benefit and Payment Parameters (NBPP); Health Care Bill; Market Stability; Year-end Priorities; Cost-sharing Reductions (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 1, 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 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 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 iin 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.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 928, To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act. S. 183, Jobs and Premium Protection Act. Affordable Care Act Implementation. Federal Budget issues. Cybersecurity policy. H.R. 6, 21st Century Cures Act. H.R. 221 and S. 123, Obamacare Taxpayer Bailout Protection Act. H.R. 724 and S. 359, Taxpayer Bailout Protection Act. H.R. 5921, State Age Rating Flexibility Act. H.R. 5410, Health Coverage State Flexibility Act. H.R. 5589, Plan Verification and Fairness Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 2646 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 crises, and for other purposes. HR 3742 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 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 under State law. HR 5589 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 periods in PPACA insurance plans, 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

H.R. 815 and S.1661: Legislation which removes broker commissions from the MLR calculation in the health reform law. H.R. 30 and S. 40: To restore the traditional 40-hour workweek from 30-hours H.R. 762 and S. 379: To increase the eligibility and effectiveness of the small business tax credit H.R. 928 and S.183: Legislation to eliminate the new national premium tax H.R. 588: Legislation to restore the open-enrollment period for Medicare beneficiaries to make a one-time plan switch to another Medicare Advantage plan or return to traditional Medicare for 90 days after the beginning of each calendar year. H.R. 290: the CARES act, which would change the three-day inpatient hospital admission requirement for Medicare beneficiaries who are in need of skilled nursing facility services to also allow hospital stays under observation status to count. H.R. 2: Medicare Access and CHIP Reauthorization Act of 2015 H.R. 1624: To amend title I of the Patient Protection and Affordable Care Act and title XXVII of the Public Health Service Act to revise the definition of small employer. Senator Burr, Hatch, and Uptons Patient Choice, Affordability, Responsibility, and Empowerment (CARE) Act which would replace the Affordable Care Act H.R. 876: Amends title XVIII (Medicare) of the Social Security Act to require a hospital with an agreement with the Secretary of Health and Human Services to give each individual entitled to benefits under Medicare part A (Hospital Insurance), whom the hospital classifies for more than 24 hours as an outpatient under observation status or any other similar status, an adequate oral and written notification within 36 hours of that classification. H.R. 1533: To amend the Internal Revenue Code of 1986 to repeal the excise tax on medical devices, and for other purposes. S. 620 and H.R. 1189: The Preserving Employee Wellness Programs Act, looks to reaffirm existing law allowing employee wellness programs tied to financial awards H.R. 1547: To amend the Internal Revenue Code of 1986 to repeal certain limitations on health care benefits enacted as part of the Patient Protection and Affordable Care Act. H.R. 887: Electronic Health Fairness Act of 2015, Amends title XVIII (Medicare) of the Social Security Act to prohibit any patient encounter of an eligible professional occurring at an ambulatory surgical center from being treated as such an encounter in determining whether an eligible professional qualifies as a meaningful electronic health record (EHR) user. H.R. 1570: To provide for greater transparency and information with respect to Federal expenditures under the Medicaid and CHIP programs in the territories of the United States, and for other purposes. S. 254: Small Business Health Relief Act of 2015 H.R. 1270: Repeals provisions of the Internal Revenue Code, as added by the Patient Protection and Affordable Care Act, that limit payments for medications from health savings accounts, medical savings accounts, and health flexible spending arrangements to only prescription drugs or insulin (thus allowing distributions from such accounts for over-the-counter drugs). S. 884: A bill to improve access to emergency medical services, and for other purposes. S. 836: A bill to amend the Internal Revenue Code of 1986 to repeal certain limitations on health care benefits enacted by the Patient Protection and Affordable Care Act. S. 839: A bill to amend title XVIII of the Social Security Act to extend the rural add-on payment in the Medicare home health benefit, and for other purposes. S. 844: A bill to repeal the medical device excise tax, and for other purposes. S. 861: A bill to amend titles XVIII and XIX of the Social Security Act to curb waste, fraud, and abuse in the Medicare and Medicaid programs. H.R. 2712 and S. 1996: Commonsense Reporting and Verification Act of 2015, bill to ease PPACA employer reporting requirements. S. 1099: To amend the Patient Protection and Affordable Care Act to provide States with flexibility in determining the size of employers in the small group market. S. 1415: To amend the Internal Revenue Code of 1986 to modify the definition of large employer for purposes of applying the employer mandate. H.R. 879: This bill repeals, effective for taxable years beginning after 2017, the excise tax on the excess benefit portion of high-cost employer-sponsored health care plans. H.R. 2050: Amends the Internal Revenue Code to repeal, beginning with taxable years beginning after December 31, 2017, the excise tax on employer-sponsored health care coverage for which there is an excess benefit (high-cost plans). H.R.2570: Strengthening Medicare Advantage through Innovation and Transparency for Seniors of 2015 H.R. 2911 and S. 1697: 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. House passed budget resolution for upcoming fiscal year S. 2045: Amends the Internal Revenue Code to repeal, beginning with taxable years beginning after December 31, 2017, the excise tax on employer-sponsored health care coverage for which there is an excess benefit (high-cost plans). S. 2075: This bill amends the Internal Revenue Code to repeal, for taxable years beginning after December 31, 2017, the excise tax on employer-sponsored health care coverage for which there is an excess benefit (high-cost plans). The bill expresses the sense of the Senate that the revenue loss resulting from the repeal of such excise tax should be offset by corresponding revenue. -H.R.3762: Restoring Americans' Healthcare Freedom Reconciliation Act of 2015 -H.R.2029: The Omnibus Appropriations bill -2015 Reconciliation bill -H.R. 5447 and S. 3060: Small Business Health Care Relief Act of 2016 -H.R. 3463: Aligning Children's Dental Coverage Act (ACDC) -H.R. 5589: 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. 3244: The legislation clarifies that people outside the public Exchanges can have the same choices for dental coverage as people inside the public Exchanges. -H.R. 2488: Medicare Beneficiary Preservation of Choice Act of 2015 -H.R. 6184: legislation that would allow seniors enrolled in COBRA coverage to transition to Medicare Part B without a penalty -H.R 2581: Preservation of Access for Seniors in Medicare Advantage Act of 2015 -H.R.173: A bill to amend the Internal Revenue Code of 1986 to repeal the excise tax on high cost employer-sponsored health coverage -S.58: A bill to amend the Internal Revenue Code of 1986 to repeal the excise tax on high cost employer-sponsored health coverage. -H.R.246: A bill to repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act.

Client expense: $330,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Treasury, Dept of, White House Office

P.L. 111-148 Patient Protection and Affordable Care Act: Employer responsibility requirements insurance coverage expansions P.L. 111-152 Health Care and Education Reconciliation Act of 2010: Employer responsibility requirements insurance coverage expansions H.R.2050/S. 2045 Middle Class Health Benefits Tax Repeal Act of 2015: Provisions repealing the tax on high cost health care plans H.R.2712/S. 1996 Commonsense Reporting and Verification Act of 2015: Provisions reducing employers' requirements to report compliance with the ACA employer responsibility requirement S. 2698: Preserving Consumer Health Accounts Act of 2016: Provisions that exempt health savings accounts and flexible spending arrangements from excise tax on high cost health plans S. 2499/H.R. 4469: Health Savings Act of 2016: Provisions that permit expanded use of Health S. 1809, H.R. 863 (STARS Act): Provisions affecting definition of seasonal employment for purposes of ACA employer responsibility S. 3056: CREATES Act of 2016, provisions that limit misuse of drug safety protocols H.R. 879: Ax the Tax on Middle Class Americans' health plans Act: Provisions repealing the tax on high cost health care plans H.R. 1270: Restoring access to medication and improving health savings act of 2016: provisions H.R. 210: Student worker exemption act: provisions H.R. 5573: PRICED Act: provisions H.R. 5410: Health Coverage state flexibility act of 2016: provisions H.R. 5589: Plan verification & fairness act of 2016: provisions HR 4832: Health Savings Protection Act: Provisions that exempt health savings accounts and flexible spending arrangements from excise tax on high cost health plans Legislation to increase the allowed variation in exchange plan premiums based on age: provisions EBSA Miscellaneous regulatory Affordable Care Act repeal replace: analysis ACA implementation S. 3335/HR 6043: Fair Accountability and Innovative Research Drug Pricing Act of 2016: provisions to require manufacturer transparency in setting prices for pharmaceutical drugs

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

Government targets: Defense, Dept of (DOD), Export-Import Bank of the United States (EXIM Bank), HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Labor Relations Board (NLRB), Occupational Safety & Health Administration (OSHA), SENATE, Securities & Exchange Commission (SEC), Social Security Administration (SSA), State, Dept of (DOS), Treasury, Dept of, U.S. Trade Representative (USTR)

HR928; HR2646; HR5589; Insurance Market stabilization (HR5410, HR5589); CMS Notice of Benefit & Payment Parameters; reinsurance; cost-sharing reductions; 3rd party payment of premiums; special enrollment periods; grace periods; age rate bands; Delivery System Incentives to Promote Better Care; Patient Safety and Quality Improvement; Patient-Centered Primary/Medical Home; Bundled Payments; Employer Wellness; Chronic Care & Medical Management; Childhood Obesity; 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 (H.R. 779; President's Budget); S. 1486, Postal Reform Act of 2013; Risk Mitigation Legislation (S. 123, H.R. 221); mental health reform (HR2646/S1945); ACA Implementation and back-end issues; Small Business Health Options Program (SHOP) implementation; ICD-10 implementation; ACA small group definition (S. 1099/H.R. 1624.

Client expense: $30,000 · 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 health care payment and coverage reforms in the Affordable Care Act (ACA), including implementation of ACA grace period for nonpayment of premiums under advanced premium tax credit eligibility and enrollment issues; mental health reform related issues; ACA exchange enrollment and payment restrictions, including related provisions in H.R.5410, the Health Coverage State Flexibility Act, and H.R.5589, the Plan Verification and Fairness Act; and legislation regarding third party payment of premiums, H.R.3742, the Access to Marketplace Insurance Act.

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

Government targets: 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

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

Implementation of health care payment and coverage reforms in the Affordable Care Act (ACA), including implementation of ACA grace period for nonpayment of premiums under advanced premium tax credit eligibility and enrollment issues; mental health reform related issues; ACA exchange enrollment and payment restrictions, including related provisions in H.R.5410, the Health Coverage State Flexibility Act, and H.R.5589, the Plan Verification and Fairness Act; and legislation regarding third party payment of premiums, H.R.3742, the Access to Marketplace Insurance Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.928, To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act S.183, Jobs and Premium Protection Act Affordable Care Act Implementation Federal Budget Issues Cybersecurity Policy H.R. 6, 21st Century Cures Act H.R. 221, Obamacare Taxpayer Bailout Protection Act S. 123, Obamacare Taxpayer Bailout Protection Act H.R. 724, Taxpayer Bailout Protection Act S. 359, Taxpayer Bailout Protection Act H.R. 5410, Health Coverage State Flexibility Act H.R. 5589, Plan Verification and Fairness Act H.R. 5921, State Age Rating Flexibility Act

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

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

Issues related to Public Law 111-148 - The Patient Protection and Affordable Care Act; Issues related to Public Law 111-152- Health Care and Education Reconciliation Act of 2010; Issues related to implementation of the Affordable Care Act, including Exchanges, Essential Health Benefits, affordability, health information technology, transparency, employer regulations, and taxes and fees; Issues related to HR 1624 - to revise the definition of small employer. H.R.5589 the Plan Verification and Fairness Act of 2016

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 30, Save American Workers Act (Young) - definition of full-time employee H.R. 117, Reclaiming Individual Liberty Act (Garrett) - ACA individual mandate H.R. 221, ACA Taxpayer Bailout Prevention Act (Harris) - risk corridors program H.R. 371, Care for All Act (Fortenberry) - catastrophic plans H.R. 494, Competitive Health Insurance Reform Act (Gosar) - antitrust policy H.R. 543, Health Care Choice Act (Blackburn) - national marketplace for individual health insurance H.R. 724, Taxpayer Bailout Protection Act (Lance) - risk corridors program H.R. 815, Access to Independent Health Insurance Advisors Act (Long-Schrader) - treatment of broker compensation in MLR calculation H.R. 954, CO-OP Consumer Protection Act (Smith) - exemption from individual mandate H.R. 1770, Data Security and Breach Notification Act (Blackburn-Welch) - data security H.R. 2205, Data Security Act (Neugebauer) - data security H.R. 2739, Cancer Drug Coverage Parity Act (Lance) - coverage of oral anti-cancer drugs H.R. 2868, Small Business Health Fairness Act (Johnson) - association health plans H.R. 3323, Dental and Optometric Care Access Act (Carter) - dental and vision benefits H.R. 3727, Health Insurance Rate Review Act (Schakowsky) - rate review H.R. 4299, Patient Opportunity Protection Act (Blum) - HIPAA excepted benefits H.R. 5410, Health Coverage State Flexibility Act (Flores) - grace period for recipients of advanced premium tax credits H.R. 5485, Financial Services and General Government Appropriations Act (Crenshaw) - risk corridors amendment H.R. 5589, Plan Verification and Fairness Act (Blackburn) - pre-enrollment verification process H.R. 5921, State Age Rating Flexibility Act (Bucshon) - age rating flexibility H.R. 6019, Relief from Obamacare Mandate Act (Young) - exemption from individual mandate H.R. 6049, Protection from Insurance Exchange Monopolies Act (Heck) - exemption from individual mandate H.R. 5926, FY 2017 Labor-HHS-Education Appropriations Bill (Cole) - ACA risk corridors provision, HHS appropriations H. Res. 887, Public Option (DeFazio) S. 30, Forty Hours Is Full Time Act (Collins) - definition of full-time employee S. 123, ACA Taxpayer Bailout Prevention Act (Rubio) - risk corridors program S. 158, Employee Health Care Protection Act (Cassidy) - grandfathering of health coverage S. 359, Taxpayer Bailout Protection Act (Cassidy) - risk corridors program S. 1099, Protecting Affordable Coverage for Employees Act (Scott-Shaheen) - ACA definition of small employer S. 1532, Affordability is Access Act (Murray) - coverage of OTC birth control S. 1566, Cancer Drug Coverage Parity Act (Kirk) - coverage of oral anti-cancer drugs S. 1661, Access to Independent Health Insurance Advisors Act (Isakson-Coons) - treatment of broker compensation in MLR calculation S. 2172, Health Insurance Rate Review Act (Feinstein) - rate review S. 2803, Taxpayers Before Insurers Act (Sasse) - ACA reinsurance program S. 3296, Protection from ObamaCare Monopolies Act (McCain) - exemption from individual mandate S. 3297, Relief from Obamacare Mandate Act (Cotton) - exemption from individual mandate S. 3326, State Flexibility to Provide Affordable Health Options Act (Alexander) - ACA subsidies, exemption from individual mandate S. Res. 561, Public Option (Merkley) Regulatory Issues: Insurance regulatory reform; issues related to the coordination of private and public disability income benefits; disability risk management; disability income insurance enrollment and awareness; issues related to encouraging impaired workers to stay in/return to the workforce; issues relating to the coordination of benefits between private health insurance plans and Medicaid; Medigap claims processing and crossover fees; Medigap cross-over claim issues, Medigap coverage, implementation of Medigap standardized plan offerings; Medigap carrier recoveries related to CMS fraud and abuse enforcement activities, and issues related to Medigap educational materials, and other Medigap issues; fraud and abuse issues affecting public and private insurance coverage; issues relating to antitrust; implementation of the Mental Health Parity Act requirements; summary of benefits and coverage disclosures; pre-existing condition insurance plans; accountable care organizations; coverage of preventive services; preexisting condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; dependent coverage; treatment of expatriate plans; compliance with the transitional reinsurance program; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations, non-discriminatory wellness programs; issues related to supplemental products; issues related to implementation of the Telephone Consumer Protection Act; 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

ACA implementation (exchange operations and functionality, risk mitigation programs, CO-OP solvency, risk corridors, risk adjustment) Reinsurance (Taxpayers Before Insurers Act, S. 2803 and H.R. 5904) Age rating bands in the individual health insurance market (H.R. 5921) ACA Special Enrollment Period verification (H.R. 5589) ACA third party payments (H.R. 3742) ACA grace periods (H.R. 5410) ACA Notice of Benefit and Payment Parameters regulations Mental Health and Substance Use (H.R. 2646 and H.R. 4276) Federal Mental Health and Substance Use Disorder Task Force Health Reimbursement Arrangements (H.R. 5447) Comprehensive Addiction and Recovery Act (H.R. 953) Fraud, waste, and abuse Telehealth (S. 2484 and H.R. 4442) Price of prescription drugs Military health care (S. 2943 and H.R. 4909)

Client expense: $2,400,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE

ACA implementation (exchange operations and functionality, risk mitigation programs, CO-OP solvency, risk corridors, risk adjustment) Reinsurance (Taxpayers Before Insurers Act, S. 2803 and H.R. 5904) Age rating bands in the individual health insurance market (H.R. 5921) ACA Special Enrollment Period verification (H.R. 5589) ACA third party payments (H.R. 3742) ACA grace periods (H.R. 5410) ACA Notice of Benefit and Payment Parameters regulations Mental Health and Substance Use (H.R. 2646 and H.R. 4276) Federal Mental Health and Substance Use Disorder Task Force Health Reimbursement Arrangements (H.R. 5447) Comprehensive Addiction and Recovery Act (H.R. 953) Fraud, waste, and abuse Telehealth (S. 2484 and H.R. 4442) Price of prescription drugs Military health care (S. 2943 and H.R. 4909)

Client expense: $2,400,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE

H.R.3590, "Patient Protection & Affordable Care Act", the implemenation of various provisions. H.R. 5589, "Plan Verification & Fairness Act of 2016", regarding all provisions.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, SENATE

P.L. 111-148 Patient Protection and Affordable Care Act: Employer responsibility requirements insurance coverage expansions P.L. 111-152 Health Care and Education Reconciliation Act of 2010: Employer responsibility requirements insurance coverage expansions H.R.2050/S. 2045 Middle Class Health Benefits Tax Repeal Act of 2015: Provisions repealing the tax on high cost health care plans H.R.2712/S. 1996 Commonsense Reporting and Verification Act of 2015: Provisions reducing employers' requirements to report compliance with the ACA employer responsibility requirement S. 2075: American Worker Health Care Tax Relief Act of 2015: repealing the tax on high cost health care plans S. 2698: Preserving Consumer Health Accounts Act of 2016: Provisions that exempt health savings accounts and flexible spending arrangements from excise tax on high cost health plans S. 2499/H.R. 4469: Health Savings Act of 2016: Provisions that permit expanded use of Health S. 1809, H.R. 863 (STARS Act): Provisions affecting definition of seasonal employment for purposes of ACA employer responsibility S. 3056: CREATES Act of 2016, prescription drug approvals, provisions H.R. 879: Ax the Tax on Middle Class Americans' health plans Act: Provisions repealing the tax on high cost health care plans H.R. 1270: Restoring access to medication and improving health savings act of 2016: provisions H.R. 210: Student worker exemption act: provisions H.R. 5573: PRICED Act: provisions H.R. 5410: Health Coverage state flexibility act of 2016: provisions H.R. 5589: Plan verification & fairness act of 2016: provisions Health Care prescription drug pricing HR 4832: Health Savings Protection Act: Provisions that exempt health savings accounts and flexible spending arrangements from excise tax on high cost health plans Legislation to increase the allowed variation in exchange plan premiums based on age: provisions Premium Credit Proposed Rule Form 5500 Revision Proposed Rule

Client expense: $720,000 · Firm income: Not reported

Government targets: Defense, Dept of (DOD), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Export-Import Bank of the United States (EXIM Bank), HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), Justice, Dept of (DOJ), Labor, Dept of (DOL), SENATE, Social Security Administration (SSA), State, Dept of (DOS), Treasury, Dept of, U.S. Trade Representative (USTR), White House Office

Implementation of Public Law No. 111-148; H.R. 5410, The Health Coverage State Flexibility Act of 2016 H.R. 5589, The Plan Verification and Fairness Act of 2016 H.R. 5921, The State Age Rating Flexibility Act of 2016

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

Government targets: HOUSE OF REPRESENTATIVES

(1) Issues related to Public Law 111-148 - The Patient Protection and Affordable Care Act (2) Issues related to Public Law 111-152 - Health Care and Education Reconciliation Act of 2010 (3) Issues related to the Health Information Technology for Economic and Clinical Health (HITECH) Act (4) Issues related to implementation of the Affordable Care Act, including Exchanges, Essential Health Benefits, affordability, health information technology, transparency, employer regulations, and taxes and fees (5) Issues related to S. 30 - The Forty Hours is Full-Time Act (6) Issues related to H.R. 879 - Ax the Tax On Middle Class Americans Health Plans Act (7) Issues related to Public Law No: 114-60 - The Protecting Affordable Coverage for Employees Act (8) Issues related to H.R. 2712 - Commonsense Reporting and Verification Act of 2015 (9) Issues related to H.R. 3112 - Be Open Act (10) Issues related to H.R. 5589 - Plan Verification and Fairness Act of 2016

Client expense: $740,000 · 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), Labor, Dept of (DOL), SENATE, Treasury, Dept of

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

H.R.2646, "Helping Families in Mental Health Crisis Act of 2015", regarding all provisions. S.1945, "Mental Health Reform Act of 2015", regarding all provisions. H.R. 5410, "Health Coverage State Flexibility Act of 2016", regarding all provisions. H.R. 5659, "ESRD Choice Act of 2016", regarding all provisions. S. 2803, "Taxpayers Before Insurers Act", regarding all provisions. S. 524, "Comprehensive Addiction and Recovery Act of 2016", regarding all provisions. H.R. 5589, "Plan Verification and Fairness Act of 2016", regarding all provisions. H.R. 3742, "Access to Marketplace Insurance Act", regarding all provisions. Issues related to Mental Health Parity. Issues related to the Federal Employee Health Benefit Program (FEHBP). Issues related to the Affordable Care Act including Chronic Care Innovations; Payment reform; 2017 Notice of Benefit and Payment Parameters (NBPP); ACA Regulations; Co-ops; Implementation; Cyber Security; Open Enrollment; Market Stability; Department of Labor Conflict of Interest Rule; Grace Periods; Special Enrollment Periods.

Client expense: $1,070,000 · Firm income: Not reported

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

Affordable Care Act Issues - Chronic Care Innovations; Payment reform; 2017 Notice of Benefit and Payment Parameters (NBPP); ACA Regulations; Co-ops; Implementation; Market Stability; Special Enrollment Periods (SEPs); Reinsurance; Risk Corridors; Risk Mitigation; Risk Programs; Premiums; Health Reimbursement Arrangements (HRAs) Legislation; Individual Market Reform; Exchanges; 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 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 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 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 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. 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.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

ACA Issues - 2017 Notice of Benefit and Payment Parameters (NBPP); ACA Regulations; Implementation; Open Enrollment; Market Stability; Grace Periods; Special Enrollment Periods (SEPs); Reinsurance; Premiums; Individual Market Reform HR 3742 a bill to amend the Patient Protection and Affordable Care Act to allow for certain third party payments. HR 5410 a bill to amend the Patient Protection and Affordable Care Act to better align the grace period required for non-payment of premiums before discontinuing certain health coverage with such grace periods under state law. HR 5589 a bill to amend the Patient Protection and Affordable Care Act to require verification for eligibility for enrollment during special enrollment periods. HR 5904 a bill requiring the Secretary of Health and Human Services to deposit funds into the general fund of Treasury under the Patient Protection and Affordable Care Act Transitional Reinsurance Program. S 83 a bill to repeal the annual fee on health insurance providers under the Patient Protection and Affordable Care Act.

Client expense: $297,932 · Firm income: Not reported

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

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. 928, To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act. S. 183, Jobs and Premium Protection Act. Affordable Care Act Implementation. Federal Budget issues. Cybersecurity policy. H.R. 6, 21st Century Cures Act. H.R. 221 and S. 123, Obamacare Taxpayer Bailout Protection Act. H.R. 724 and S. 359, Taxpayer Bailout Protection Act. H.R. 5921, State Age Rating Flexibility Act. H.R. 5410, Health Coverage State Flexibility Act. H.R. 5589, Plan Verification and Fairness Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 815 and S.1661: Legislation which removes broker commissions from the MLR calculation in the health reform law. H.R. 30 and S. 40: To restore the traditional 40-hour workweek from 30-hours H.R. 762 and S. 379: To increase the eligibility and effectiveness of the small business tax credit H.R. 928 and S.183: Legislation to eliminate the new national premium tax H.R. 588: Legislation to restore the open-enrollment period for Medicare beneficiaries to make a one-time plan switch to another Medicare Advantage plan or return to traditional Medicare for 90 days after the beginning of each calendar year. H.R. 290: the CARES act, which would change the three-day inpatient hospital admission requirement for Medicare beneficiaries who are in need of skilled nursing facility services to also allow hospital stays under observation status to count. H.R. 2: Medicare Access and CHIP Reauthorization Act of 2015 H.R. 1624: To amend title I of the Patient Protection and Affordable Care Act and title XXVII of the Public Health Service Act to revise the definition of small employer. Senator Burr, Hatch, and Uptons Patient Choice, Affordability, Responsibility, and Empowerment (CARE) Act which would replace the Affordable Care Act H.R. 876: Amends title XVIII (Medicare) of the Social Security Act to require a hospital with an agreement with the Secretary of Health and Human Services to give each individual entitled to benefits under Medicare part A (Hospital Insurance), whom the hospital classifies for more than 24 hours as an outpatient under observation status or any other similar status, an adequate oral and written notification within 36 hours of that classification. H.R. 1533: To amend the Internal Revenue Code of 1986 to repeal the excise tax on medical devices, and for other purposes. S. 620 and H.R. 1189: The Preserving Employee Wellness Programs Act, looks to reaffirm existing law allowing employee wellness programs tied to financial awards H.R. 1547: To amend the Internal Revenue Code of 1986 to repeal certain limitations on health care benefits enacted as part of the Patient Protection and Affordable Care Act. H.R. 887: Electronic Health Fairness Act of 2015, Amends title XVIII (Medicare) of the Social Security Act to prohibit any patient encounter of an eligible professional occurring at an ambulatory surgical center from being treated as such an encounter in determining whether an eligible professional qualifies as a meaningful electronic health record (EHR) user. H.R. 1570: To provide for greater transparency and information with respect to Federal expenditures under the Medicaid and CHIP programs in the territories of the United States, and for other purposes. S. 254: Small Business Health Relief Act of 2015 H.R. 1270: Repeals provisions of the Internal Revenue Code, as added by the Patient Protection and Affordable Care Act, that limit payments for medications from health savings accounts, medical savings accounts, and health flexible spending arrangements to only prescription drugs or insulin (thus allowing distributions from such accounts for over-the-counter drugs). S. 884: A bill to improve access to emergency medical services, and for other purposes. S. 836: A bill to amend the Internal Revenue Code of 1986 to repeal certain limitations on health care benefits enacted by the Patient Protection and Affordable Care Act. S. 839: A bill to amend title XVIII of the Social Security Act to extend the rural add-on payment in the Medicare home health benefit, and for other purposes. S. 844: A bill to repeal the medical device excise tax, and for other purposes. S. 861: A bill to amend titles XVIII and XIX of the Social Security Act to curb waste, fraud, and abuse in the Medicare and Medicaid programs. H.R. 2712 and S. 1996: Commonsense Reporting and Verification Act of 2015, bill to ease PPACA employer reporting requirements. S. 1099: To amend the Patient Protection and Affordable Care Act to provide States with flexibility in determining the size of employers in the small group market. S. 1415: To amend the Internal Revenue Code of 1986 to modify the definition of large employer for purposes of applying the employer mandate. H.R. 879: This bill repeals, effective for taxable years beginning after 2017, the excise tax on the excess benefit portion of high-cost employer-sponsored health care plans. H.R. 2050: Amends the Internal Revenue Code to repeal, beginning with taxable years beginning after December 31, 2017, the excise tax on employer-sponsored health care coverage for which there is an excess benefit (high-cost plans). H.R.2570: Strengthening Medicare Advantage through Innovation and Transparency for Seniors of 2015 H.R. 2911 and S. 1697: 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. House passed budget resolution for upcoming fiscal year S. 2045: Amends the Internal Revenue Code to repeal, beginning with taxable years beginning after December 31, 2017, the excise tax on employer-sponsored health care coverage for which there is an excess benefit (high-cost plans). S. 2075: This bill amends the Internal Revenue Code to repeal, for taxable years beginning after December 31, 2017, the excise tax on employer-sponsored health care coverage for which there is an excess benefit (high-cost plans). The bill expresses the sense of the Senate that the revenue loss resulting from the repeal of such excise tax should be offset by corresponding revenue. -H.R.3762: Restoring Americans' Healthcare Freedom Reconciliation Act of 2015 -H.R.2029: The Omnibus Appropriations bill -2015 Reconciliation bill -H.R. 5447 and S. 3060: Small Business Health Care Relief Act of 2016 -H.R. 3463: Aligning Children's Dental Coverage Act (ACDC) -H.R. 5589: 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. 3244: The legislation clarifies that people outside the public Exchanges can have the same choices for dental coverage as people inside the public Exchanges. -H.R. 2488: Medicare Beneficiary Preservation of Choice Act of 2015 -H.R. 6184: legislation that would allow seniors enrolled in COBRA coverage to transition to Medicare Part B without a penalty -H.R 2581: Preservation of Access for Seniors in Medicare Advantage Act of 2015

Client expense: $330,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Treasury, Dept of, White House Office

HR928; HR2646; Insurance Market stabilization (HR5410, HR5589); CMS Notice of Benefit & Payment Parameters; Healthcare Quality: Delivery System Incentives to Promote Better Care; Patient Safety and Quality Improvement; Patient-Centered Primary/Medical Home; Bundled Payments; Employer Wellness; Chronic Care & Medical Management; Childhood Obesity; Infant Mortality; 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 (H.R. 779; President's Budget); S. 1486, Postal Reform Act of 2013; Risk Mitigation Legislation (S. 123, H.R. 221); mental health reform (HR2646/S1945); ACA Implementation and back-end issues; Small Business Health Options Program (SHOP) implementation; ICD-10 implementation; ACA small group definition (S. 1099/H.R. 1624.

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

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

HR 5243- Zika Response Appropriations Act, 2016 Amendments to HR 2577, related to Zika Virus Workplace Violence in Health Care Settings HR 4723- repayments of Affordable Care Act tax credits when income/family situation changes HR 5122- CMS' Medicare Part B proposed regulation HR 5589 and related bills- proposals to amend the ACA by increasing age-rating, limiting the enrollment period, and reducing the grace period for non-payment ACA and tax treatment of health care, alternatives to the ACA, ending the tax exclusion for employer-provided health care, policies to rein in prescription drug costs S 2579- Funding for water infrastructure and other aid to address lead crisis in Flint, MI NIH march-in rights under Dole-Bayh Act HR 1270- bill to increase repayments of ACA tax credits and expand health savings accounts Federal income tax exclusion for employer-sponsored health care HR 2050, HR 879, S 2045, S 2075- Federal 40% tax on high-cost employer sponsored health benefits HR 2635, S 1961- Improving the Treatment of the US Territories Under Federal Health Program Act

Client expense: $660,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), SENATE, Social Security Administration (SSA), Treasury, Dept of, U.S. Trade Representative (USTR), White House Office

P.L. 111-148 Patient Protection and Affordable Care Act: Employer responsibility requirements premium and cost sharing subsidies, treatment of excepted benefits P.L. 111-152 Health Care and Education Reconciliation Act of 2010: Employer responsibility requirements premium and cost sharing subsidies, treatment of excepted benefits H.R. 3999 FMLA 2014, FMLA Enhancement Act of 2014 H.R.2050/S. 2045 Middle Class Health Benefits Tax Repeal Act of 2015: Provisions repealing the tax on high cost health care plans H.R.2712 Commonsense Reporting and Verification Act of 2015: Provisions reducing employers' requirements to report compliance with the ACA employer responsibility requirement S. 2075: American Worker Health Care Tax Relief Act of 2015 S. 1697: Small Business Healthcare Relief Act S. 2698: Preserving Consumer Health Accounts Act of 2016: Provisions that exempt health savings accounts S. 2499/H.R. 4469: Health Savings Act of 2016: Provisions that permit expanded use of Health S. 1809, H.R. 863 (STARS Act): Provisions affecting definition of seasonal employment for purposes of ACA employer responsibility H.R. 2911, H.R. 5447: Small Business Healthcare Relief Act H.R. 5458: Veterans TRICARE Choice Act S. 3056: CREATES Act of 2016, prescription drug approvals, provisions H.R. 5445: Healthcare Security Act of 2016 H.R. 879: Ax the Tax on Middle Class Americans' health plans Act: Provisions repealing the tax on high cost health care plans H.R. 1270: Restoring access to medication and improving health savings act of 2016: provisions H.R. 210: Student worker exemption act: provisions H.R. 5573: PRICED Act: provisions H.R. 5410: Health Coverage state flexibility act of 2016: provisions H.R. 5589: Plan verification & fairness act of 2016: provisions

Client expense: $760,000 · Firm income: Not reported

Government targets: Defense, Dept of (DOD), Election Assistance Commission (EAC), Energy, Dept of, Equal Employment Opportunity Commission (EEOC), Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Labor Relations Board (NLRB), Occupational Safety & Health Administration (OSHA), Office of Management & Budget (OMB), SENATE, Securities & Exchange Commission (SEC), Social Security Administration (SSA), State, Dept of (DOS), Treasury, Dept of, U.S. Trade Representative (USTR), White House Office

H.R. 30, Save American Workers Act (Young) - definition of full-time employee H.R. 117, Reclaiming Individual Liberty Act (Garrett) - ACA individual mandate H.R. 221, ACA Taxpayer Bailout Prevention Act (Harris) - risk corridors program H.R. 371, Care for All Act (Fortenberry) - catastrophic plans H.R. 494, Competitive Health Insurance Reform Act (Gosar) - antitrust policy H.R. 543, Health Care Choice Act (Blackburn) - national marketplace for individual health insurance H.R. 724, Taxpayer Bailout Protection Act (Lance) - risk corridors program H.R. 815, Access to Independent Health Insurance Advisors Act (Long-Schrader) - treatment of broker compensation in MLR calculation H.R. 1770, Data Security and Breach Notification Act (Blackburn-Welch) - data security H.R. 2205, Data Security Act (Neugebauer) - data security H.R. 2739, Cancer Drug Coverage Parity Act (Lance) - coverage of oral anti-cancer drugs H.R. 2868, Small Business Health Fairness Act (Johnson) - association health plans H.R. 3323, Dental and Optometric Care Access Act (Carter) - dental and vision benefits H.R. 3727, Health Insurance Rate Review Act (Schakowsky) - rate review H.R. 4299, Patient Opportunity Protection Act (Blum) - HIPAA excepted benefits H.R. 5410, Health Coverage State Flexibility Act (Flores) - grace period for recipients of advanced premium tax credits H.R. 5485, Financial Services and General Government Appropriations Act (Crenshaw) - risk corridors amendment H.R. 5589, Plan Verification and Fairness Act (Blackburn) - pre-enrollment verification process Draft Bill on Age Variation in Health Insurance Premium Rates (Brooks) S. 30, Forty Hours Is Full Time Act (Collins) - definition of full-time employee S. 123, ACA Taxpayer Bailout Prevention Act (Rubio) - risk corridors program S. 158, Employee Health Care Protection Act (Cassidy) - grandfathering of health coverage S. 359, Taxpayer Bailout Protection Act (Cassidy) - risk corridors program S. 1099, Protecting Affordable Coverage for Employees Act (Scott-Shaheen) - ACA definition of small employer S. 1532, Affordability is Access Act (Murray) - coverage of OTC birth control S. 1566, Cancer Drug Coverage Parity Act (Kirk) - coverage of oral anti-cancer drugs S. 1661, Access to Independent Health Insurance Advisors Act (Isakson-Coons) - treatment of broker compensation in MLR calculation S. 2172, Health Insurance Rate Review Act (Feinstein) - rate review S. 2803, Taxpayers Before Insurers Act (Sasse) - ACA reinsurance program Regulatory Issues: Insurance regulatory reform; issues related to the coordination of private and public disability income benefits; disability risk management; disability income insurance enrollment and awareness; issues related to encouraging impaired workers to stay in/return to the workforce; issues relating to the coordination of benefits between private health insurance plans and Medicaid; Medigap claims processing and crossover fees; Medigap cross-over claim issues, Medigap coverage, implementation of Medigap standardized plan offerings; Medigap carrier recoveries related to CMS fraud and abuse enforcement activities, and issues related to Medigap educational materials, and other Medigap issues; fraud and abuse issues affecting public and private insurance coverage; issues relating to antitrust; implementation of the Mental Health Parity Act requirements; summary of benefits and coverage disclosures; pre-existing condition insurance plans; accountable care organizations; coverage of preventive services; preexisting condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; dependent coverage; treatment of expatriate plans; compliance with the transitional reinsurance program; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations, non-discriminatory wellness programs; issues related to supplemental products; issues related to implementation of the Telephone Consumer Protection Act; 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), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of Personnel Management (OPM), SENATE, Treasury, Dept of, White House Office

(1) Issues related to Public Law 111-148 - The Patient Protection and Affordable Care Act (2) Issues related to Public Law 111-152 - Health Care and Education Reconciliation Act of 2010 (3) Issues related to the Health Information Technology for Economic and Clinical Health (HITECH) Act (4) Issues related to implementation of the Affordable Care Act, including Exchanges, Essential Health Benefits, affordability, health information technology, transparency, employer regulations, and taxes and fees (5) Issues related to S. 30 - The Forty Hours is Full-Time Act (6) Issues related to H.R. 879 - Ax the Tax On Middle Class Americans Health Plans Act (7) Issues related to Public Law No: 114-60 - The Protecting Affordable Coverage for Employees Act (8) Issues related to H.R. 2712 - Commonsense Reporting and Verification Act of 2015 (9) Issues related to H.R. 3112 - Be Open Act (10) Issues related to H.R. 5589 - Plan Verification and Fairness Act of 2016

Client expense: $610,000 · 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), Labor, Dept of (DOL), SENATE, Treasury, Dept of

Affordable Care Act Issues: Chronic Care Innovations; Payment Reform; Small Group Expansion; Payment Reform; 2017 Notice of Benefit and Payment Parameters (NBPP); ACA Regulations; Co-ops; Implementation; Cyber Security; Open Enrollment; Market Stability; Department of Labor Conflict of Interest Rule; Grace Periods; Special Enrollment Periods (SEPs); Department of Labor Fiduciary Rule; 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 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. 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. 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 1624 Introduced March 25, 2015 by Brett Guthrie (R-KY) To amend Title I of the Patient Protection and Affordable Care Act and Title XXVII of the Public Health Service Act to revise the definition of small employer.

Client expense: $8,000 · 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.

Client expense: $2,180,000 · 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

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; Grace Periods; Special Enrollment Periods (SEPs); Reinsurance; Taskforce; Premiums; Health Reimbursement Arrangements (HRAs) Legislation; Individual Market Reform; Tobacco Cessation Programs Other Health Care Issues - Mental Health Parity; Opioid Education; End Stage Renal Disease (ESRD) 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 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 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 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 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 5589 Plan Verification and Fairness Act of 2016 Introduced 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.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.2646, "Helping Families in Mental Health Crisis Act of 2015", regarding all provisions. S.1945, "Mental Health Reform Act of 2015", regarding all provisions. H.R. 5410, "Health Coverage State Flexibility Act of 2016", regarding all provisions. H.R. 5659, "ESRD Choice Act of 2016", regarding all provisions. S. 2803, "Taxpayers Before Insurers Act", regarding all provisions. S. 524, "Comprehensive Addiction and Recovery Act of 2016", regarding all provisions. H.R. 5589, "Plan Verification and Fairness Act of 2016", regarding all provisions. H.R. 3742, "Access to Marketplace Insurance Act", regarding all provisions. Issues related to Mental Health Parity. Issues related to the Federal Employee Health Benefit Program (FEHBP). Issues related to the Affordable Care Act including Chronic Care Innovations; Payment reform; 2017 Notice of Benefit and Payment Parameters (NBPP); ACA Regulations; Co-ops; Implementation; Cyber Security; Open Enrollment; Market Stability; Department of Labor Conflict of Interest Rule; Grace Periods; Special Enrollment Periods.

Client expense: $1,240,000 · Firm income: Not reported

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