Taxpayers Before Insurers Act

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)

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

HR 5904 / S 2803 "Taxpayers Before Insurers Act," all provisions.

Client expense: $70,000 · 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. 5904, S. 2803 - Taxpayers Before Insurers Act Correspondence with United States Congress in support of the Taxpayers Before Insurers Act (S. 2803, H.R. 5904) to recover $5 billion illegally given to insurance companies through federal reinsurance programs and prevent future occurrences of a similar nature; Research relating thereto.

Client expense: $10,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, President of the U.S., SENATE

HR 5904 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 Acts Transitional Reinsurance Program.

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

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

Issues related to the Affordable Care Act. Commercial Insurance. Medicare Advantage. Medicaid and CHIP Issues. ACA Taxes and Fees. HR 5904/S 2803 - Taxpayers Before Insurers Act HR 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 Public Law 111-48, Patient Protection and Affordable Care Act and Public Law 111-52, Health Care and Education Reconciliation Act of 2010

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

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

Discussed H.R. 5053 with Deputy Staff Director from Representative Dan Coates office Discussed H.R. 5053 with Senior Staff Policy Advisor from Representative John Thune's office Discussed gas tax with Legislative Director from Representative Sam graves office Discussed tax extenders with Legislative Director and Deputy Chief of Staff from Representative Ryan Costellos office Discussed opposition of green tax extenders with Legislative Director from Representative Lamar Smiths office Discussed tax extenders and tax reform with Chief of Staff of Tom Emmers office Discussed the supporting of H.R. 5904 obamacare bailout legislation with Chief of Staff of Representative Jason Smiths office Discussed support of AFPs tax extenders with Chief of Staff from Representative Peter Roskams office Discussed tax extenders and tax reform with Legislative Aid from Mike Kellys office Discussed Taxpayer Termination Act with Legal Counsel from Representative Ben Sasses office Discussed online sales tax issues with house judiciary Discussed online sales tax issue with Dan Huff (House Judiciary Committee)

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

Discussed VA Healthcare with Senior Legislative Aid from Representative Dan Benisheks Office Discussed opposition of obamacare bailouts H.R. 5904 with Chief of Staff from Marsha Blackburns office Discussed opposition of obamacare bailouts H.R. 5904 with Counsel from Kevin Bradys office Supported Walker's Taxpayers before Insurers bill (H.R. 5904) Supported Restoring Access to Medication Act of 2015 (H.R. 1270) Supported CO-OP Consumer Protection Act and Regulatory Relief for Small Business, Schools, and Nonprofits Act (H.R. 954, H.R.6094) Opposed Obamacare bailouts for insurance companies (S. 2803, H.R. 5904)

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

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

HR 5904 / S2803 "Taxpayers Before Insurers Act," all provisions. HR 670 "Special Needs Trust Fairness and Medicaid Improvement Act," all provisions. HR 6 "21st Century Cures Act," all provisions.

Client expense: $110,000 · 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; 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

General health care issues, including, implementation of the "Affordable Care Act" and payment policies (contact regarding H.R. 5410, the "Health Coverage State Flexibility Act of 2016" and H.R. 5904/S. 2802, the "Taxpayers Before Insurers Act"

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE