Permanent Investment in Health Research Act of 2015

Presidents Budget, FY 2017 P.L. 114-113, Consolidated Appropriations Act, 2016, Division H, Title II Draft House and Senate Labor, HHS, Education and Related Agencies Act, 2017, Title II Issues: Support funding for National Institutes of Health (NIH), Title VII and Title VIII health professions and nursing education programs, Agency for Healthcare Research and Quality (AHRQ), National Health Service Corps (NHSC), Childrens Hospitals Graduate Medical Education (CHGME), Health Resources and Services Administration (HRSA), the Prevention and Public Health Fund (PPHF), Hospital Preparedness Program, and biodefense and public health preparedness programs. Maintain NIH salary cap at Executive Level II. Encourage the highest possible allocation for the Labor-HHS Subcommittee. President's Budget, FY 2017 Issues: Oppose proposed reductions in Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments; oppose use of Medicare GME funding for creation of new GME grant program. Oppose Independent Payment Advisory Panel (IPAB) and site-neutral payment policy. President's Budget, FY 2017 Draft House and Senate Military Construction and Veterans Affairs and Related Agencies Appropriations Act, 2017 Issues: Support funding for Veterans Affairs medical research, research infrastructure, and health care. S. 289/H.R. 2104, American Cures Act Issue: Increases budget authority for National Institutes of Health (NIH), Center for Disease Control and Prevention, Department of Defense Health Program, and the VA Medical and Prosthetics Research Program S. 318/H.R. 531, Accelerating Biomedical Research Act Issue: Increases discretionary spending cap to increase funding for the National Institutes of Health (NIH). H.R. 777, Permanent Investment in Health Research Act Issue: Creates mandatory appropriation for the National Institutes of Health (NIH), adjusted annually for inflation. S. 2624, National Biomedical Research Act. Issue: Support establishment of a Biomedical Innovation Fund to support the National Institutes of Health (NIH) and the Food and Drug Administration (FDA). Issue: Oppose Medicare payment reductions as offsets for non-Medicare spending. P.L. 114-74, H.R. 1314, Bipartisan Budget Act of 2015 Issue: Oppose Medicare site-neutral payment policy. Oppose extension of Medicare sequester Issue: Support mandatory funding for the National Health Service Corps (NHSC) authorized under P.L. 114-10, the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Issue: Support supplemental funding to prevent and combat Zika virus.

Client expense: $822,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Education, Dept of, Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Veterans Affairs, Dept of (VA), White House Office

S 318, HR 531 Accelerating Biomedical Research Act HR 744, S 320 Medical Innovation Act (Swear Jar bill) HR 777 Permanent Investment in Health Research Act HR 6 21st Century Cures S 289, HR 2104 American Cures Act HR 2101 Research for All Act S 1077 Advancing Breakthrough Devices for Patients HR 2337 To amend the Federal Food, Drug, and Cosmetic Act to authorize priority review for breakthrough devices HR 160 Protect Medical Innovation Act of 2015 (to repeal the ACA medical device tax) S2014 HR3466 Next Generation Researchers Act HR 3171 HR 3215 HR 3429 S 1917 legislation relating to the regulation of fetal tissue research HR639 Improving Regulatory Transparency for New Medical Therapies Act (signed into law) HR 2820 Stem Cell Therapeutic and Research Reauthorization Act of 2015 (signed into law) HR 2646 S1945 Helping Families in Mental Health Crisis Act of 2015 HR 3731, S 2030 Rare Disease Fund Act of 2015 HR 3729 Limit Fetal Tissue Research S 2141 Transparent Ratings on Usability and Security to Transform Information Technology Act of 2015 or TRUST It Act (with respect to health information technology) S 2624 National Biomedical Research Act S 1878 Advancing Hope Act of 2015 S 2512 Adding Zika Virus to the FDA Priority Review Voucher Program Act S 1101 Medical Electronic Data Technology Enhancement for Consumers' Health Act S 1767 Combination Product Regulatory Fairness Act of 2015 S 1597 Patient-Focused Impact Assessment Act of 2015 S 2055 Medical Countermeasure Innovation Act of 2016 S 1945 Mental Health Reform Act of 2015 S 1622 FDA Device Accountability Act S 849 Advancing Research for Neurological Diseases Act of 2015 S 800 Enhancing the Stature and Visibility of Medical Rehabilitation Research at the NIH Act S 2700 FDA and NIH Workforce Authorities Modernization Act S 2713 Advancing Precision Medicine Act of 2016 S 2745 NIH Strategic Plan and Inclusion in Clinical Research S 2472 Promoting Biomedical Research and Public Health for Patients Act (to reduce regulatory burden on NIH-funded researchers)

S 318, HR 531 Accelerating Biomedical Research Act HR 744, S 320 Medical Innovation Act (Swear Jar bill) HR 777 Permanent Investment in Health Research Act HR 6 21st Century Cures S 289, HR 2104 American Cures Act HR 2101 Research for All Act S 1077 Advancing Breakthrough Devices for Patients HR 2337 To amend the Federal Food, Drug, and Cosmetic Act to authorize priority review for breakthrough devices HR 160 Protect Medical Innovation Act of 2015 (to repeal the ACA medical device tax) S2014 HR3466 Next Generation Researchers Act HR 3171 HR 3215 HR 3429 S 1917 legislation relating to the regulation of fetal tissue research HR639 Improving Regulatory Transparency for New Medical Therapies Act (signed into law) HR 2820 Stem Cell Therapeutic and Research Reauthorization Act of 2015 (signed into law) HR 2646 S1945 Helping Families in Mental Health Crisis Act of 2015 HR 3731 Rare Disease Fund Act of 2015 (Andrew Los brainchild) HR 3729 Limit Fetal Tissue Research S 2141 Transparent Ratings on Usability and Security to Transform Information Technology Act of 2015 or TRUST It Act (with respect to health information technology)

Client expense: $58,549 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Presidents Budget, FY 2017 Issue: Funding for Agency for Healthcare Research and Quality (AHRQ), NIH Presidents Budget, FY 2016 H.R. 3020/S. 1695, Labor, HHS, Education and Related Agencies Act, 2016, Title II P.L. 114-113, H.R. 2029, Consolidated Appropriations Act, 2016, Division H, Title II Issues: Support funding for National Institutes of Health (NIH), Agency for Healthcare Research and Quality (AHRQ), biodefense and public health preparedness programs, Maintain NIH salary cap at Executive Level II. Encourage the highest possible allocation for the Labor-HHS Subcommittee. Oppose House proposal to eliminate AHRQ. Oppose rescissions from CMMI and PCORI. President's Budget, FY 2017 H.R. 2029 and draft Senate Military Construction and Veterans Affairs and Related Agencies Appropriations Act, 2016 P.L. 114-113, Consolidated Appropriations Act, 2016, Division J, Title II Issues: Support funding for Veterans Affairs medical research, research infrastructure, and health care. Issue: Support the use of animals in medical research. Issue: Oppose discretionary spending cuts through sequestration, including NIH and other science programs. Issue: Funding for pandemic preparedness and biodefense programs Issue: Draft legislation on protections for human subjects in research S. 289/H.R. 2104, American Cures Act Issue: Increases budget authority for National Institutes of Health NIH), Center for Disease Control and Prevention, Department of Defense Health Program, and the VA Medical and Prosthetics Research Program S. 320/H.R. 744, Medical Innovation Act Issue: Requires covered manufacturers of blockbuster drugs developed, in whole or in part, through federal investments in medical research that enter settlement agreements with a federal agency to pay 1 percent of net income over five years to increase congressional investments in biomedical research. S. 318/H.R. 531, Accelerating Biomedical Research Act Issue: Increases discretionary spending cap to increase funding for the National Institutes of Health (NIH). H.R. 777, Permanent Investment in Health Research Act Issue: Creates mandatory appropriation for the National Institutes of Health (NIH), adjusted annually for inflation. H.R. 6, 21st Century Cures Act Senate HELP Committee Innovation Initiative Issue: Support increased funding for medical research, reduce administrative and regulatory burden on scientists and research institutions, and support young investigators. H.R. 2102, Research for All Act of 2015 Issue: Support inclusion of male and female cells and animals in basic research, and NIH updating its guidelines on inclusion of women in clinical research. Issue: FDA regulation of Laboratory Developed Tests (LDTs) Issue: Support federal funding for research using human fetal tissue. H.R. 3466/S. 2014, Next Generation Research Act Issue: Support National Institutes of Health programs for new and young scientists. H.R. 3119, draft Senate legislation, Palliative Care and Hospice Education and Training Act Issue: Health professions education on palliative care Submitted comments to: -HRSA on Proposed Omnibus Guidance on 340B Drug Pricing Program -FDA on International Scheduling of Ketamine -NIH on its strategic plan to advance research on the health and well-being of sexual and gender minorities

Presidents Budget, FY 2017 Issue: Funding for Agency for Healthcare Research and Quality (AHRQ), NIH Presidents Budget, FY 2016 H.R. 3020/S. 1695, Labor, HHS, Education and Related Agencies Act, 2016, Title II P.L. 114-113, H.R. 2029, Consolidated Appropriations Act, 2016, Division H, Title II Issues: Support funding for National Institutes of Health (NIH), Agency for Healthcare Research and Quality (AHRQ), biodefense and public health preparedness programs. Maintain NIH salary cap at Executive Level II. Encourage the highest possible allocation for the Labor-HHS Subcommittee. Oppose House proposal to eliminate AHRQ. Oppose rescissions from CMMI and PCORI. President's Budget, FY 2017 H.R. 2029 and draft Senate Military Construction and Veterans Affairs and Related Agencies Appropriations Act, 2016 P.L. 114-113, Consolidated Appropriations Act, 2016, Division J, Title II Issues: Support funding for Veterans Affairs medical research, research infrastructure, and health care. Issue: Oppose discretionary spending cuts through sequestration, including NIH and other science programs. Issue: Supporting the use of animals in medical research. Issue: Funding for pandemic preparedness and biodefense programs. Issue: Draft legislation on protections for human subjects in research. S. 289/H.R. 2104, American Cures Act Issue: Increases budget authority for National Institutes of Health (NIH), Center for Disease Control and Prevention, Department of Defense Health Program, and the VA Medical and Prosthetics Research Program S. 320/H.R. 744, Medical Innovation Act Issue: Requires covered manufacturers of blockbuster drugs developed, in whole or in part, through federal investments in medical research that enter settlement agreements with a federal agency to pay 1 percent of net income over five years to increase congressional investments in biomedical research. S. 318/H.R. 531, Accelerating Biomedical Research Act Issue: Increases discretionary spending cap to increase funding for the National Institutes of Health (NIH). H.R. 777, Permanent Investment in Health Research Act Issue: Creates mandatory appropriation for the National Institutes of Health (NIH), adjusted annually for inflation. H.R. 6, 21st Century Cures Act Senate HELP Committee Innovation Initiative Issue: Support increased funding for medical research, reduce administrative and regulatory burden on scientists and research institutions, and support young investigators. H.R. 2102, Research for All Act of 2015 Issue: Support inclusion of male and female cells and animals in basic research, and NIH updating its guidelines on inclusion of women in clinical research. Issue: FDA regulation of Laboratory Developed Tests (LDTs) H.R. 3466/S. 2014, Next Generation Research Act Issue: Support National Institutes of Health programs for new and young scientists. H.R. 1806, The America COMPETES Act of 2015 Issue: Support increased funding for the National Science Foundation (NSF) Issue: Support federal funding for research using human fetal tissue. Submitted comments to: -FDA on International Scheduling of Ketamine -NIH on strategies to enhance diversity in the physician�scientist workforce -NIH on its strategic plan to advance research on the health and well-being of sexual and gender minorities

Presidents Budget, FY 2017 Issue: Funding for Agency for Healthcare Research and Quality (AHRQ), Hospital Preparedness Program, NIH, Title VII & VIII Presidents Budget, FY 2016 H.R. 3020/S. 1695, Labor, HHS, Education and Related Agencies Act, 2016, Title II P.L. 114-113, H.R. 2029, Consolidated Appropriations Act, 2016, Division H, Title II Issues: Support funding for National Institutes of Health (NIH), Title VII and Title VIII health professions and nursing education programs, Agency for Healthcare Research and Quality (AHRQ), National Health Service Corps (NHSC), Childrens Hospitals Graduate Medical Education (CHGME), Health Resources and Services Administration (HRSA), the Prevention and Public Health Fund (PPHF), biodefense and public health preparedness programs,. Maintain NIH salary cap at Executive Level II. Encourage the highest possible allocation for the Labor-HHS Subcommittee. Oppose House proposal to eliminate AHRQ. Oppose rescissions from CMMI and PCORI. President's Budget, FY 2017 H.R. 2029 and draft Senate Military Construction and Veterans Affairs and Related Agencies Appropriations Act, 2016 P.L. 114-113, Consolidated Appropriations Act, 2016, Division J, Title II Issues: Support funding for Veterans Affairs medical research, research infrastructure, and health care. Issue: Support mandatory funding for Community Health Centers and the National Health Service Corps (NHSC) authorized under P.L. 111-148, the Patient Protection and Affordable Care Act, Title V and Section 10503. Draft Debt in Health Education Loan Programs (DebtHELP) legislative proposal Issues: Expand National Health Service Corps State Loan Repayment program, and align Department of Education and HRSA student loan programs. H.R. 2124/S. 1148, Resident Physician Shortage Reduction Act of 2015 Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments and increase Graduate Medical Education (GME) accountability and transparency. Issue: Funding and reporting requirements for Teaching Health Center Graduate Medical Education program under section 340G of the Public Health Service Act. H.R. 3288, Strengthening DSH and Medicare through Subsidy Recapture and Payment Reform Act of 2015 Issue: Alter DSH payment methodology and increase DSH spending in non-Medicaid expansion states H.R. 3292, Medicare IME Pool Act of 2015 Issue: Oppose redesign of Medicare Indirect Medical Education financing and redistribution. H.R. 3291, Medicare Crosswalk Hospital Code Development Act of 2015 Issue: Create a crosswalk between Medicare Part A and Part B payments P.L. 114-10, Medicare Access and CHIP Reauthorization Act of 2015. Issues: Support repeal of Medicare's sustainable growth rate (SGR) formula; Medicare physician payment reform; extension of the Childrens Health Insurance Program (CHIP); and extension of mandatory funding for the National Health Service Corps (NHSC). Issue: Support the use of animals in medical research. Issue: Promote interprofessional education and training of the health care workforce. Issue: Support funding for the National Healthcare Workforce Commission. Issue: Oppose reduction in Medicare hospital outpatient department reimbursement. P.L. 114-74, H.R. 1314, Bipartisan Budget Act of 2015 Issue: Oppose Medicare site-neutral payment policy. Oppose extension of Medicare sequester S. 2107/H.R. 1006, Building A Health Care Workforce for the Future Act Issue: Support bill to increase scholarship opportunities for medical students and encourage primary care workforce development. Issue: Oppose inclusion of Medicare add-on payments in Hospital-Acquired Condition (HAC) program. Issue: Support delay of enforcement of new CMS inpatient criteria (e.g., "Two-Midnight" rule) in FY 2016 Inpatient Prospective Payment System (IPPS) final rule. Issue: Support Medicare GME per Resident Amount and cap trigger technical corrections and administrative relief. H.R. 1343, Establishing Beneficiary Equity in the Hospital Readmissions Program Act of 2015. S. 688, Hospital Readmission Accuracy and Accountability Act. Issue: Support inclusion of socioeconomic status as part of hospital readmissions program, including support for adoption of National Quality Forum (NQF) recommendations. President's Budget, FY 2016 Issues: Oppose proposed reductions in Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments; oppose use of Medicare GME funding for creation of new GME grant program; oppose elimination of Children's Hospitals GME program. Issue: Legislation on educating health professionals regarding appropriate use of antibiotics, prescription drug abuse, pain management, female genital mutilation, and sepsis. Issue: Implementation of the 340B drug pricing program. Oppose efforts to restrict the program. Issue: Oppose Medicare payment reductions as offsets for non-Medicare spending. Issue: Oppose extension of Medicare sequester Issue: Oppose Medicare hospital cuts as offsets for physician payment reform. Issue: Preserve funding for the Primary Care Residency Expansion program. P.L. 114-41, Surface Transportation and Veterans Health Care Choice Improvement Act of 2015 Issue: Support improved contracting with academic affiliates and increased VA GME funding. H.R.1272, Doctors Helping Heroes Act of 2015 Issue: Support expansion of the Conrad 30 J-1 visa waiver program and physician immigration to address VA workforce shortages S. 289/H.R. 2104, American Cures Act Issue: Increases budget authority for National Institutes of Health NIH), Center for Disease Control and Prevention, Department of Defense Health Program, and the VA Medical and Prosthetics Research Program S. 320/H.R. 744, Medical Innovation Act Issue: Requires covered manufacturers of blockbuster drugs developed, in whole or in part, through federal investments in medical research that enter settlement agreements with a federal agency to pay 1 percent of net income over five years to increase congressional investments in biomedical research. S. 318/H.R. 531, Accelerating Biomedical Research Act Issue: Increases discretionary spending cap to increase funding for the National Institutes of Health (NIH). H.R. 777, Permanent Investment in Health Research Act Issue: Creates mandatory appropriation for the National Institutes of Health (NIH), adjusted annually for inflation. H.R. 6, 21st Century Cures Act Senate HELP Committee Innovation Initiative Issue: Support increased funding for medical research, reduce administrative and regulatory burden on scientists and research institutions, and support young investigators. H.R. 2102, Research for All Act of 2015 Issue: Support inclusion of male and female cells and animals in basic research, and NIH updating its guidelines on inclusion of women in clinical research. Issue: FDA regulation of Laboratory Developed Tests (LDTs) Draft Community Based Medical Education Act of 2014 Issue: Oppose reduction of Medicare GME/IME payments S. 1455, Recovery Enhancement for Addiction Treatment (TREAT) Act Issue: Support legislation to increase access to care for patients addicted to opioids Draft Hospital Improvements for Payment (HIP) Act of 2014 Issues: Support repeal of CMS Two-Midnights Rule, extending RAC audit moratorium for short stays, and permanent bundle program. Issue: Oppose further delays in the implementation of the ICD-10 system H.R. 1411, Expanding Nutrition's Role in Curricula and Healthcare Act (ENRICH Act) Issue: Support grants for medical schools to develop or expand nutrition and physical activity curricula. Issue: Funding for Ebola Treatment Centers and hospital preparedness Issue: Educate congressional staff on academic medicines missions, including education, research, patient care, GME, workforce, and physician shortages in rural and urban communities. H.R. 2513, Promoting Access, Competition, and Equity Act of 2015 Issue: Oppose easing restrictions on physician owned hospitals Issue: Senate Finance Committee Chronic Care Workgroup, support and send comments on efforts to improve care for Medicare patients with chronic conditions. H.R. 3285, Reducing Disparities Using Care Models and Education Act of 2015 Issue: Studying and developing guidelines to reduce health disparities Draft Health Equity and Accountability Act Issue: Addressing health equity through health care workforce programs Issue: Support federal funding for research using human fetal tissue. H.R. 3119, draft Senate legislation, Palliative Care and Hospice Education and Training Act Issue: Health professions education on palliative care Submitted comments to: -HRSA on Proposed Omnibus Guidance on 340B Drug Pricing Program -FDA on International Scheduling of Ketamine -CMS on implementation of the Medicare Access and CHIP Reauthorization Act of 2015 -NIH on its strategic plan to advance research on the health and well-being of sexual and gender minorities -HHS on nondiscrimination in heath programs and activities

Presidents Budget, FY 2017 Issue: Funding for Agency for Healthcare Research and Quality (AHRQ), Hospital Preparedness Program, National Institutes of Health (NIH), Title VII & VIII health professions and nursing education programs Presidents Budget, FY 2016 H.R. 3020/S. 1695, Labor, HHS, Education and Related Agencies Act, 2016, Title II P.L. 114-113, H.R. 2029, Consolidated Appropriations Act, 2016, Division H, Title II Issues: Support funding for National Institutes of Health (NIH), Title VII and Title VIII health professions and nursing education programs, Agency for Healthcare Research and Quality (AHRQ), National Health Service Corps (NHSC), Childrens Hospitals Graduate Medical Education (CHGME), Health Resources and Services Administration (HRSA), the Prevention and Public Health Fund (PPHF), Hospital Preparedness Program, and biodefense and public health preparedness programs. Maintain NIH salary cap at Executive Level II. Encourage the highest possible allocation for the Labor-HHS Subcommittee. Oppose House proposal to eliminate AHRQ. Oppose rescissions from Center for Medicare & Medicaid Innovation (CMMI) and Patient-Centered Outcomes Research Institute (PCORI). President's Budget, FY 2017 H.R. 2029 and draft Senate Military Construction and Veterans Affairs and Related Agencies Appropriations Act, 2016 P.L. 114-113, Consolidated Appropriations Act, 2016, Division J, Title II Issues: Support funding for Veterans Affairs medical research, research infrastructure, and health care. Issue: Support mandatory funding for Community Health Centers and the National Health Service Corps (NHSC) authorized under P.L. 111-148, the Patient Protection and Affordable Care Act, Title V and Section 10503. Issue: Funding for the National Health Care Workforce Commission. Issue: Funding for Teaching Health Centers under Section 340H of the Public Health Service Act. Issue: Oppose Medicare payment reductions as offsets for non-Medicare spending. P.L. 114-74, H.R. 1314, Bipartisan Budget Act of 2015 Issue: Oppose Medicare site-neutral payment policy. Oppose extension of Medicare sequester President's Budget, FY 2016 Issues: Oppose proposed reductions in Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments; oppose use of Medicare GME funding for creation of new GME grant program; oppose cuts to Children's Hospitals GME program and Title VII health professions education and training programs. Issue: Preserve funding for the Primary Care Residency Expansion program. Issue: Implementation of HRSA's 340B Drug Pricing Program. S. 289/H.R. 2104, American Cures Act Issue: Increases budget authority for National Institutes of Health (NIH), Center for Disease Control and Prevention, Department of Defense Health Program, and the VA Medical and Prosthetics Research Program S. 318/H.R. 531, Accelerating Biomedical Research Act Issue: Increases discretionary spending cap to increase funding for the National Institutes of Health (NIH). H.R. 777, Permanent Investment in Health Research Act Issue: Creates mandatory appropriation for the National Institutes of Health (NIH), adjusted annually for inflation. Issue: Educate congressional staff on Academic Medicine's missions including education, research, patient care, GME, workforce, and physician shortage. H.R. 1006/S. 2107, Building A Health Care Workforce for the Future Act Issue: Support bill to increase scholarship opportunities for medical students and encourage primary care workforce development. H.R. 1411, Expanding Nutrition's Role in Curricula and Healthcare Act (ENRICH Act) Issue: Support grants for medical schools to develop or expand nutrition and physical activity curricula. Draft, Community Based Medical Education Act of 2014 Issue: Oppose reduction of Medicare GME/IME payments Issue: Support funding for Ebola Treatment Centers and hospital preparedness Issue: Support funding for interprofessional education H.R. 1806, The America COMPETES Act of 2015 Issue: Support increased funding for the National Science Foundation (NSF) H.R. 6, 21st Century Cures Act Senate HELP Committee Innovation Initiative Issue: Support increased funding for medical research, reduce administrative and regulatory burden on scientists and research institutions, and support young investigators. Issue: Support federal funding for research using fetal tissue.

Presidents Budget, FY 2017 Issue: Funding for Agency for Healthcare Research and Quality (AHRQ), Hospital Preparedness Program, NIH, Title VII & VIII Presidents Budget, FY 2016 H.R. 3020/S. 1695, Labor, HHS, Education and Related Agencies Act, 2016, Title II Issues: Support funding for National Institutes of Health (NIH), Title VII and Title VIII health professions and nursing education programs, Agency for Healthcare Research and Quality (AHRQ), National Health Service Corps (NHSC), Childrens Hospitals Graduate Medical Education (CHGME), Health Resources and Services Administration (HRSA), the Prevention and Public Health Fund (PPHF), biodefense and public health preparedness programs,. Maintain NIH salary cap at Executive Level II. Encourage the highest possible allocation for the Labor-HHS Subcommittee. Oppose House proposal to eliminate AHRQ. Oppose rescissions from CMMI and PCORI. President's Budget, FY 2016 H.R. 4486 and draft Senate House Military Construction and Veterans Affairs and Related Agencies Appropriations Act, 2015 Issues: Support funding for Veterans Affairs medical research, research infrastructure, and health care. Issue: Support Obama Administrations position on King v Burwell Issue: Support mandatory funding for Community Health Centers and the National Health Service Corps (NHSC) authorized under P.L. 111-148, the Patient Protection and Affordable Care Act, Title V and Section 10503. Draft Debt in Health Education Loan Programs (DebtHELP) legislative proposal Issues: Expand National Health Service Corps State Loan Repayment program, and align Department of Education and HRSA student loan programs. H.R. 2124/S. 1148, Resident Physician Shortage Reduction Act of 2015 Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments and increase Graduate Medical Education (GME) accountability and transparency. Issue: Funding and reporting requirements for Teaching Health Center Graduate Medical Education program under section 340G of the Public Health Service Act. H.R. 3288, Strengthening DSH and Medicare through Subsidy Recapture and Payment Reform Act of 2015 Issue: Alter DSH payment methodology and increase DSH spending in non-Medicaid expansion states H.R. 3292, Medicare IME Pool Act of 2015 Issue: Oppose redesign of Medicare Indirect Medical Education financing and redistribution. H.R. 3291, Medicare Crosswalk Hospital Code Development Act of 2015 Issue: Create a crosswalk between Medicare Part A and Part B payments P.L. 114-10, Medicare Access and CHIP Reauthorization Act of 2015. Issues: Support repeal of Medicare's sustainable growth rate (SGR) formula; Medicare physician payment reform; extension of the Childrens Health Insurance Program (CHIP); and extension of mandatory funding for the National Health Service Corps (NHSC). Issue: Support the use of animals in medical research. Issue: Promote interprofessional education and training of the health care workforce. Issue: Support funding for the National Healthcare Workforce Commission. Issue: Oppose reduction in Medicare hospital outpatient department reimbursement. S. 2107/H.R. 1006, Building A Health Care Workforce for the Future Act Issue: Support bill to increase scholarship opportunities for medical students and encourage primary care workforce development. Issue: Oppose inclusion of Medicare add-on payments in Hospital-Acquired Condition (HAC) program. Issue: Support delay of enforcement of new CMS inpatient criteria (e.g., "Two-Midnight" rule) in FY 2016 Inpatient Prospective Payment System (IPPS) final rule. Issue: Support Medicare GME per Resident Amount and cap trigger technical corrections and administrative relief. H.R. 1343, Establishing Beneficiary Equity in the Hospital Readmissions Program Act of 2015. S. 688, Hospital Readmission Accuracy and Accountability Act. Issue: Support inclusion of socioeconomic status as part of hospital readmissions program, including support for adoption of National Quality Forum (NQF) recommendations. President's Budget, FY 2016 Issues: Oppose proposed reductions in Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments; oppose use of Medicare GME funding for creation of new GME grant program; oppose elimination of Children's Hospitals GME program. Issue: Legislation on educating health professionals regarding appropriate use of antibiotics, prescription drug abuse, pain management, female genital mutilation, and sepsis. Issue: Implementation of the 340B drug pricing program. Oppose efforts to restrict the program. Issue: Oppose Medicare payment reductions as offsets for non-Medicare spending. Issue: Oppose Medicare hospital cuts as offsets for physician payment reform. Issue: Preserve funding for the Primary Care Residency Expansion program. P.L. 114-41, Surface Transportation and Veterans Health Care Choice Improvement Act of 2015 Issue: Support improved contracting with academic affiliates and increased VA GME funding. H.R.1272, Doctors Helping Heroes Act of 2015 Issue: Support expansion of the Conrad 30 J-1 visa waiver program and physician immigration to address VA workforce shortages S. 289/H.R. 2104, American Cures Act Issue: Increases budget authority for National Institutes of Health NIH), Center for Disease Control and Prevention, Department of Defense Health Program, and the VA Medical and Prosthetics Research Program S. 320/H.R. 744, Medical Innovation Act Issue: Requires covered manufacturers of blockbuster drugs developed, in whole or in part, through federal investments in medical research that enter settlement agreements with a federal agency to pay 1 percent of net income over five years to increase congressional investments in biomedical research. S. 318/H.R. 531, Accelerating Biomedical Research Act Issue: Increases discretionary spending cap to increase funding for the National Institutes of Health (NIH). H.R. 777, Permanent Investment in Health Research Act Issue: Creates mandatory appropriation for the National Institutes of Health (NIH), adjusted annually for inflation. H.R. 6, 21st Century Cures Act Senate HELP Committee Innovation Initiative Issue: Support increased funding for medical research, reduce administrative and regulatory burden on scientists and research institutions, and support young investigators. H.R. 2102, Research for All Act of 2015 Issue: Support inclusion of male and female cells and animals in basic research, and NIH updating its guidelines on inclusion of women in clinical research. Issue: FDA regulation of Laboratory Developed Tests (LDTs) Draft Community Based Medical Education Act of 2014 Issue: Oppose reduction of Medicare GME/IME payments S. 1455, Recovery Enhancement for Addiction Treatment (TREAT) Act Issue: Support legislation to increase access to care for patients addicted to opioids Draft Hospital Improvements for Payment (HIP) Act of 2014 Issues: Support repeal of CMS Two-Midnights Rule, extending RAC audit moratorium for short stays, and permanent bundle program. Issue: Oppose further delays in the implementation of the ICD-10 system H.R. 1411, Expanding Nutrition's Role in Curricula and Healthcare Act (ENRICH Act) Issue: Support grants for medical schools to develop or expand nutrition and physical activity curricula. Issue: Funding for Ebola Treatment Centers and hospital preparedness Issue: Educate congressional staff on academic medicines missions, including education, research, patient care, GME, workforce, and physician shortages in rural and urban communities. H.R. 2513, Promoting Access, Competition, and Equity Act of 2015 Issue: Oppose easing restrictions on physician owned hospitals Issue: Senate Finance Committee Chronic Care Workgroup, support and send comments on efforts to improve care for Medicare patients with chronic conditions. H.R. 3285, Reducing Disparities Using Care Models and Education Act of 2015 Issue: Studying and developing guidelines to reduce health disparities Draft Health Equity and Accountability Act Issue: Addressing health equity through health care workforce programs Issue: Support federal funding for research using human fetal tissue. Submitted comments to: Department of Veterans Affairs on VA health care contracting and potential risks to VA-academic affiliations Centers for Medicare & Medicaid Services (CMS) on CY 2016 Physician Fee Schedule proposed rule CMS on the on the Comprehensive Care for Joint Replacement (CCJR) proposed rule CMS on CY 2016 Outpatient Prospective Payment System (OPPS) proposed rule CMS on the methodology of overall Hospital Quality Star Ratings technical expert panel report CMS on the Medicaid and CHIP Managed Care proposed rule

Presidents Budget, FY 2017 Issue: Funding for Agency for Healthcare Research and Quality (AHRQ), NIH Presidents Budget, FY 2016 H.R. 3020/S. 1695, House Labor, HHS, Education and Related Agencies Act, 2016, Title II Issues: Support funding for National Institutes of Health (NIH), Title VII and Title VIII health professions and nursing education programs, Agency for Healthcare Research and Quality (AHRQ), National Health Service Corps (NHSC), Childrens Hospitals Graduate Medical Education (CHGME), Health Resources and Services Administration (HRSA), the Prevention and Public Health Fund (PPHF), biodefense and public health preparedness programs, Maintain NIH salary cap at Executive Level II. Encourage the highest possible allocation for the Labor-HHS Subcommittee. Oppose House proposal to eliminate AHRQ. Oppose rescissions from CMMI and PCORI. President's Budget, FY 2016 H.R. 4486 and draft Senate House Military Construction and Veterans Affairs and Related Agencies Appropriations Act, 2015 Issues: Support funding for Veterans Affairs medical research, research infrastructure, and health care. Issue: Support the use of animals in medical research. Issue: Oppose discretionary spending cuts through sequestration, including NIH and other science programs. Issue: Funding for pandemic preparedness and biodefense programs Issue: Draft legislation on protections for human subjects in research S. 289/H.R. 2104, American Cures Act Issue: Increases budget authority for National Institutes of Health NIH), Center for Disease Control and Prevention, Department of Defense Health Program, and the VA Medical and Prosthetics Research Program S. 320/H.R. 744, Medical Innovation Act Issue: Requires covered manufacturers of blockbuster drugs developed, in whole or in part, through federal investments in medical research that enter settlement agreements with a federal agency to pay 1 percent of net income over five years to increase congressional investments in biomedical research. S. 318/H.R. 531, Accelerating Biomedical Research Act Issue: Increases discretionary spending cap to increase funding for the National Institutes of Health (NIH). H.R. 777, Permanent Investment in Health Research Act Issue: Creates mandatory appropriation for the National Institutes of Health (NIH), adjusted annually for inflation. H.R. 6, 21st Century Cures Act Senate HELP Committee Innovation Initiative Issue: Support increased funding for medical research, reduce administrative and regulatory burden on scientists and research institutions, and support young investigators. H.R. 2102, Research for All Act of 2015 Issue: Support inclusion of male and female cells and animals in basic research, and NIH updating its guidelines on inclusion of women in clinical research. Issue: FDA regulation of Laboratory Developed Tests (LDTs) Issue: Support federal funding for research using human fetal tissue. H.R. 3466/S. 2014, Next Generation Research Act Issue: Support National Institutes of Health programs for new and young scientists. Submitted comments to: National Institute on Minority Health and Health Disparities (NIMHD) on interdisciplinary training in health disparities science The White House on the Precision Medicine Initiatives proposed privacy and trust principles National Institutes of Health (NIH) on the framework for the NIH-wide Strategic Plan NIMHD on the NIH Science Vision for health disparities research

Presidents Budget, FY 2017 Issue: Funding for Agency for Healthcare Research and Quality (AHRQ), NIH Presidents Budget, FY 2016 H.R. 3020/S. 1695, House Labor, HHS, Education and Related Agencies Act, 2016, Title II Issues: Support funding for National Institutes of Health (NIH), Title VII and Title VIII health professions and nursing education programs, Agency for Healthcare Research and Quality (AHRQ), National Health Service Corps (NHSC), Childrens Hospitals Graduate Medical Education (CHGME), Health Resources and Services Administration (HRSA), the Prevention and Public Health Fund (PPHF), biodefense and public health preparedness programs. Maintain NIH salary cap at Executive Level II. Encourage the highest possible allocation for the Labor-HHS Subcommittee. Oppose House proposal to eliminate AHRQ. Oppose rescissions from CMMI and PCORI. President's Budget, FY 2016 H.R. 4486 and draft Senate House Military Construction and Veterans Affairs and Related Agencies Appropriations Act, 2015 Issues: Support funding for Veterans Affairs medical research, research infrastructure, and health care. Issue: Oppose discretionary spending cuts through sequestration, including NIH and other science programs. Issue: Supporting the use of animals in medical research. Issue: Funding for pandemic preparedness and biodefense programs. Issue: Draft legislation on protections for human subjects in research. S. 289/H.R. 2104, American Cures Act Issue: Increases budget authority for National Institutes of Health (NIH), Center for Disease Control and Prevention, Department of Defense Health Program, and the VA Medical and Prosthetics Research Program S. 320/H.R. 744, Medical Innovation Act Issue: Requires covered manufacturers of blockbuster drugs developed, in whole or in part, through federal investments in medical research that enter settlement agreements with a federal agency to pay 1 percent of net income over five years to increase congressional investments in biomedical research. S. 318/H.R. 531, Accelerating Biomedical Research Act Issue: Increases discretionary spending cap to increase funding for the National Institutes of Health (NIH). H.R. 777, Permanent Investment in Health Research Act Issue: Creates mandatory appropriation for the National Institutes of Health (NIH), adjusted annually for inflation. H.R. 6, 21st Century Cures Act Senate HELP Committee Innovation Initiative Issue: Support increased funding for medical research, reduce administrative and regulatory burden on scientists and research institutions, and support young investigators. H.R. 2102, Research for All Act of 2015 Issue: Support inclusion of male and female cells and animals in basic research, and NIH updating its guidelines on inclusion of women in clinical research. Issue: FDA regulation of Laboratory Developed Tests (LDTs) H.R. 3466/S. 2014, Next Generation Research Act Issue: Support National Institutes of Health programs for new and young scientists. H.R. 1806, The America COMPETES Act of 2015 Issue: Support increased funding for the National Science Foundation (NSF) Issue: Support federal funding for research using human fetal tissue. Submitted comments to: National Institute on Minority Health and Health Disparities (NIMHD) on interdisciplinary training in health disparities science The White House on the Precision Medicine Initiatives proposed privacy and trust principles National Institutes of Health (NIH) on the framework for the NIH-wide Strategic Plan NIMHD on the NIH Science Vision for health disparities research

Presidents Budget, FY 2017 Issue: Funding for Agency for Healthcare Research and Quality (AHRQ), Hospital Preparedness Program, National Institutes of Health (NIH), Title VII & VIII health professions and nursing education programs Presidents Budget, FY 2016 H.R. 3020/S. 1695, Labor, HHS, Education and Related Agencies Act, 2016, Title II Issues: Support funding for National Institutes of Health (NIH), Title VII and Title VIII health professions and nursing education programs, Agency for Healthcare Research and Quality (AHRQ), National Health Service Corps (NHSC), Childrens Hospitals Graduate Medical Education (CHGME), Health Resources and Services Administration (HRSA), the Prevention and Public Health Fund (PPHF), and biodefense and public health preparedness programs. Maintain NIH salary cap at Executive Level II. Encourage the highest possible allocation for the Labor-HHS Subcommittee. Oppose House proposal to eliminate AHRQ. Oppose rescissions from Center for Medicare & Medicaid Innovation (CMMI) and Patient-Centered Outcomes Research Institute (PCORI). President's Budget, FY 2016 H.R. 4486 and draft Senate Military Construction and Veterans Affairs and Related Agencies Appropriations Act, 2015 Issues: Support funding for Veterans Affairs medical research, research infrastructure, and health care. Issue: Support mandatory funding for Community Health Centers and the National Health Service Corps (NHSC) authorized under P.L. 111-148, the Patient Protection and Affordable Care Act, Title V and Section 10503. Issue: Funding for the National Health Care Workforce Commission. Issue: Funding for Teaching Health Centers under Section 340H of the Public Health Service Act. Issue: Oppose Medicare payment reductions as offsets for non-Medicare spending. President's Budget, FY 2016 Issues: Oppose proposed reductions in Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments; oppose use of Medicare GME funding for creation of new GME grant program; oppose cuts to Children's Hospitals GME program and Title VII health professions education and training programs. Issue: Preserve funding for the Primary Care Residency Expansion program. Issue: Implementation of HRSA's 340B Drug Pricing Program. S. 289/H.R. 2104, American Cures Act Issue: Increases budget authority for National Institutes of Health (NIH), Center for Disease Control and Prevention, Department of Defense Health Program, and the VA Medical and Prosthetics Research Program S. 318/H.R. 531, Accelerating Biomedical Research Act Issue: Increases discretionary spending cap to increase funding for the National Institutes of Health (NIH). H.R. 777, Permanent Investment in Health Research Act Issue: Creates mandatory appropriation for the National Institutes of Health (NIH), adjusted annually for inflation. Issue: Educate congressional staff on Academic Medicine's missions including education, research, patient care, GME, workforce, and physician shortage. H.R. 1006/S. 2107, Building A Health Care Workforce for the Future Act Issue: Support bill to increase scholarship opportunities for medical students and encourage primary care workforce development. H.R. 1411, Expanding Nutrition's Role in Curricula and Healthcare Act (ENRICH Act) Issue: Support grants for medical schools to develop or expand nutrition and physical activity curricula. Draft, Community Based Medical Education Act of 2014 Issue: Oppose reduction of Medicare GME/IME payments Issue: Support funding for Ebola Treatment Centers and hospital preparedness Issue: Support funding for interprofessional education H.R. 1806, The America COMPETES Act of 2015 Issue: Support increased funding for the National Science Foundation (NSF) H.R. 6, 21st Century Cures Act Senate HELP Committee Innovation Initiative Issue: Support increased funding for medical research, reduce administrative and regulatory burden on scientists and research institutions, and support young investigators. Issue: Support federal funding for research using fetal tissue.

S 318, HR 531 Accelerating Biomedical Research Act HR 744, S 320 Medical Innovation Act (Swear Jar bill) HR 777 Permanent Investment in Health Research Act HR 6 21st Century Cures S 289, HR 2104 American Cures Act HR 2101 Research for All Act S 1077 Advancing Breakthrough Devices for Patients HR 2337 To amend the Federal Food, Drug, and Cosmetic Act to authorize priority review for breakthrough devices HR 160 Protect Medical Innovation Act of 2015 (to repeal the ACA medical device tax) S2014 HR3466 Next Generation Researchers Act HR 3171 HR 3215 HR 3429 S 1917 legislation relating to the regulation of fetal tissue research

Client expense: $58,549 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Presidents Budget, FY 2017 Issue: Funding for Agency for Healthcare Research and Quality (AHRQ) Presidents Budget, FY 2016 S. 1695 and draft House Labor, HHS, Education and Related Agencies Act, 2016, Title II Issues: Support funding for National Institutes of Health (NIH), Title VII and Title VIII health professions and nursing education programs, Agency for Healthcare Research and Quality (AHRQ), National Health Service Corps (NHSC), Childrens Hospitals Graduate Medical Education (CHGME), Health Resources and Services Administration (HRSA), the Prevention and Public Health Fund (PPHF), biodefense and public health preparedness programs, and CDC's National Healthcare Safety Network (NHSN) and the Prevention Epicenters Program. Maintain NIH salary cap at Executive Level II. Encourage the highest possible allocation for the Labor-HHS Subcommittee. Oppose House proposal to eliminate AHRQ. Oppose rescissions from CMMI and PCORI. President's Budget, FY 2016 H.R. 4486 and draft Senate House Military Construction and Veterans Affairs and Related Agencies Appropriations Act, 2015 Issues: Support funding for Veterans Affairs medical research, research infrastructure, and health care. Issue: Support the use of animals in medical research. Issue: Oppose discretionary spending cuts through sequestration, including NIH and other science programs. Issue: Funding for pandemic preparedness and biodefense programs Issue: Draft legislation on protections for human subjects in research S. 289/H.R. 2104, American Cures Act Issue: Increases budget authority for National Institutes of Health NIH), Center for Disease Control and Prevention, Department of Defense Health Program, and the VA Medical and Prosthetics Research Program S. 320/H.R. 744, Medical Innovation Act Issue: Requires covered manufacturers of blockbuster drugs developed, in whole or in part, through federal investments in medical research that enter settlement agreements with a federal agency to pay 1 percent of net income over five years to increase congressional investments in biomedical research. S. 318/H.R. 531, Accelerating Biomedical Research Act Issue: Increases discretionary spending cap to increase funding for the National Institutes of Health (NIH). H.R. 777, Permanent Investment in Health Research Act Issue: Creates mandatory appropriation for the National Institutes of Health (NIH), adjusted annually for inflation. H.R. 6, 21st Century Cures Act Senate HELP Committee Innovation Initiative Issue: Support increased funding for medical research, reduce administrative and regulatory burden on scientists and research institutions, and support young investigators. H.R. 2102, Research for All Act of 2015 Issue: Support inclusion of male and female cells and animals in basic research, and NIH updating its guidelines on inclusion of women in clinical research. Issue: FDA regulation of Laboratory Developed Tests (LDTs) Draft Next Generation Research Act Issue: Support National Institutes of Health programs for new and young scientists. Submitted comments to: NIH on precision medicine and community engagement NIH on policies and strategies to improve the sustainability of biomedical research HHS Office for Human Research Protections (OHRP) on draft guidance for electronic informed consent in clinical investigations FDA on draft guidance for electronic informed consent in clinical investigations

Presidents Budget, FY 2017 Issue: Funding for Agency for Healthcare Research and Quality (AHRQ) Presidents Budget, FY 2016 S. 1695 and draft House Labor, HHS, Education and Related Agencies Act, 2016, Title II Issues: Support funding for National Institutes of Health (NIH), Title VII and Title VIII health professions and nursing education programs, Agency for Healthcare Research and Quality (AHRQ), National Health Service Corps (NHSC), Childrens Hospitals Graduate Medical Education (CHGME), Health Resources and Services Administration (HRSA), the Prevention and Public Health Fund (PPHF), biodefense and public health preparedness programs, and CDC's National Healthcare Safety Network (NHSN) and the Prevention Epicenters Program. Maintain NIH salary cap at Executive Level II. Encourage the highest possible allocation for the Labor-HHS Subcommittee. Oppose House proposal to eliminate AHRQ. Oppose rescissions from CMMI and PCORI. President's Budget, FY 2016 H.R. 4486 and draft Senate Military Construction and Veterans Affairs and Related Agencies Appropriations Act, 2015 Issues: Support funding for Veterans Affairs medical research, research infrastructure, and health care. Issue: Support mandatory funding for Community Health Centers and the National Health Service Corps (NHSC) authorized under P.L. 111-148, the Patient Protection and Affordable Care Act, Title V and Section 10503. Issue: Funding for the National Health Care Workforce Commission. Issue: Funding for Teaching Health Centers under Section 340H of the Public Health Service Act. Issue: Oppose Medicare payment reductions as offsets for non-Medicare spending. President's Budget, FY 2016 Issues: Oppose proposed reductions in Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments; oppose use of Medicare GME funding for creation of new GME grant program; oppose cuts to Children's Hospitals GME program and Title VII health professions education and training programs. Issue: Preserve funding for the Primary Care Residency Expansion program. Issue: Implementation of HRSA's 340B Drug Pricing Program. S. 289/H.R. 2104, American Cures Act Issue: Increases budget authority for National Institutes of Health (NIH), Center for Disease Control and Prevention, Department of Defense Health Program, and the VA Medical and Prosthetics Research Program S. 318/H.R. 531, Accelerating Biomedical Research Act Issue: Increases discretionary spending cap to increase funding for the National Institutes of Health (NIH). H.R. 777, Permanent Investment in Health Research Act Issue: Creates mandatory appropriation for the National Institutes of Health (NIH), adjusted annually for inflation. Issue: Educate congressional staff on Academic Medicine's missions including education, research, patient care, GME, workforce, and physician shortage. H.R. 1006, Building A Health Care Workforce for the Future Act Issue: Support bill to increase scholarship opportunities for medical students and encourage primary care workforce development. H.R. 1411, Expanding Nutrition's Role in Curricula and Healthcare Act (ENRICH Act) Issue: Support grants for medical schools to develop or expand nutrition and physical activity curricula. Draft, Community Based Medical Education Act of 2014 Issue: Oppose reduction of Medicare GME/IME payments Issue: Funding for Ebola Treatment Centers and hospital preparedness Issue: Support funding for interprofessional education H.R. 1806, The America COMPETES Act of 2015 Issue: Support increased funding for the National Science Foundation (NSF)

Presidents Budget, FY 2017 Issue: Funding for Agency for Healthcare Research and Quality (AHRQ) Presidents Budget, FY 2016 S. 1695 and draft House Labor, HHS, Education and Related Agencies Act, 2016, Title II Issues: Support funding for National Institutes of Health (NIH), Title VII and Title VIII health professions and nursing education programs, Agency for Healthcare Research and Quality (AHRQ), National Health Service Corps (NHSC), Childrens Hospitals Graduate Medical Education (CHGME), Health Resources and Services Administration (HRSA), the Prevention and Public Health Fund (PPHF), biodefense and public health preparedness programs, and CDC's National Healthcare Safety Network (NHSN) and the Prevention Epicenters Program. Maintain NIH salary cap at Executive Level II. Encourage the highest possible allocation for the Labor-HHS Subcommittee. Oppose House proposal to eliminate AHRQ. Oppose rescissions from CMMI and PCORI. President's Budget, FY 2016 H.R. 4486 and draft Senate House Military Construction and Veterans Affairs and Related Agencies Appropriations Act, 2015 Issues: Support funding for Veterans Affairs medical research, research infrastructure, and health care. Issue: Oppose discretionary spending cuts through sequestration, including NIH and other science programs. Issue: Supporting the use of animals in medical research. Issue: Funding for pandemic preparedness and biodefense programs. Issue: Draft legislation on protections for human subjects in research. S. 289/H.R. 2104, American Cures Act Issue: Increases budget authority for National Institutes of Health (NIH), Center for Disease Control and Prevention, Department of Defense Health Program, and the VA Medical and Prosthetics Research Program S. 320/H.R. 744, Medical Innovation Act Issue: Requires covered manufacturers of blockbuster drugs developed, in whole or in part, through federal investments in medical research that enter settlement agreements with a federal agency to pay 1 percent of net income over five years to increase congressional investments in biomedical research. S. 318/H.R. 531, Accelerating Biomedical Research Act Issue: Increases discretionary spending cap to increase funding for the National Institutes of Health (NIH). H.R. 777, Permanent Investment in Health Research Act Issue: Creates mandatory appropriation for the National Institutes of Health (NIH), adjusted annually for inflation. H.R. 6, 21st Century Cures Act Senate HELP Committee Innovation Initiative Issue: Support increased funding for medical research, reduce administrative and regulatory burden on scientists and research institutions, and support young investigators. H.R. 2102, Research for All Act of 2015 Issue: Support inclusion of male and female cells and animals in basic research, and NIH updating its guidelines on inclusion of women in clinical research. Issue: FDA regulation of Laboratory Developed Tests (LDTs) Draft Next Generation Research Act Issue: Support National Institutes of Health programs for new and young scientists. H.R. 1806, The America COMPETES Act of 2015 Issue: Support increased funding for the National Science Foundation (NSF) Submitted comments to: NIH on precision medicine and community engagement NIH on policies and strategies to improve the sustainability of biomedical research HHS Office for Human Research Protections (OHRP) on draft guidance for electronic informed consent in clinical investigations FDA on draft guidance for electronic informed consent in clinical investigations

Presidents Budget, FY 2017 Issue: Funding for Agency for Healthcare Research and Quality (AHRQ) Presidents Budget, FY 2016 S. 1695 and draft House Labor, HHS, Education and Related Agencies Act, 2016, Title II Issues: Support funding for National Institutes of Health (NIH), Title VII and Title VIII health professions and nursing education programs, Agency for Healthcare Research and Quality (AHRQ), National Health Service Corps (NHSC), Childrens Hospitals Graduate Medical Education (CHGME), Health Resources and Services Administration (HRSA), the Prevention and Public Health Fund (PPHF), biodefense and public health preparedness programs, and CDC's National Healthcare Safety Network (NHSN) and the Prevention Epicenters Program. Maintain NIH salary cap at Executive Level II. Encourage the highest possible allocation for the Labor-HHS Subcommittee. Oppose House proposal to eliminate AHRQ. Oppose rescissions from CMMI and PCORI. President's Budget, FY 2016 H.R. 4486 and draft Senate House Military Construction and Veterans Affairs and Related Agencies Appropriations Act, 2015 Issues: Support funding for Veterans Affairs medical research, research infrastructure, and health care. Issue: Support Obama Administrations position on King v Burwell Issue: Support mandatory funding for Community Health Centers and the National Health Service Corps (NHSC) authorized under P.L. 111-148, the Patient Protection and Affordable Care Act, Title V and Section 10503. Draft Debt in Health Education Loan Programs (DebtHELP) legislative proposal Issues: Expand National Health Service Corps State Loan Repayment program, and align Department of Education and HRSA student loan programs. H.R. 2124/S. 1148, Resident Physician Shortage Reduction Act of 2015 Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments and increase Graduate Medical Education (GME) accountability and transparency. Issue: Funding and reporting requirements for Teaching Health Center Graduate Medical Education program under section 340G of the Public Health Service Act. H.R. 2, Medicare Access and CHIP Reauthorization Act of 2015. H.R. 810/S. 1871, SGR Repeal and Medicare Beneficiary Access Improvement Act of 2015. Issues: Support repeal of Medicare's sustainable growth rate (SGR) formula; Medicare physician payment reform; extension of the Childrens Health Insurance Program (CHIP); and extension of mandatory funding for the National Health Service Corps (NHSC). Issue: Support the use of animals in medical research. Issue: Promote interprofessional education and training of the health care workforce. Issue: Support funding for the National Healthcare Workforce Commission. Issue: Oppose reduction in Medicare hospital outpatient department reimbursement. H.R. 1006, Building A Health Care Workforce for the Future Act Issue: Support bill to increase scholarship opportunities for medical students and encourage primary care workforce development. Issue: Oppose inclusion of Medicare add-on payments in Hospital-Acquired Condition (HAC) program. Issue: Support delay of enforcement of new CMS inpatient criteria (e.g., "Two-Midnight" rule) in FY 2014 Inpatient Prospective Payment System (IPPS) final rule. Issue: Support Medicare GME per Resident Amount and cap trigger technical corrections and administrative relief. H.R. 1343, Establishing Beneficiary Equity in the Hospital Readmissions Program Act of 2015. S. 688, Hospital Readmission Accuracy and Accountability Act. Issue: Support inclusion of socioeconomic status as part of hospital readmissions program, including support for adoption of National Quality Forum (NQF) recommendations. President's Budget, FY 2016 Issues: Oppose proposed reductions in Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments; oppose use of Medicare GME funding for creation of new GME grant program; oppose elimination of Children's Hospitals GME program. Issue: Legislation on educating health professionals regarding appropriate use of antibiotics. Issue: Implementation of the 340B drug pricing program. Oppose efforts to restrict the program. Issue: Oppose Medicare payment reductions as offsets for non-Medicare spending. Issue: Oppose Medicare hospital cuts as offsets for physician payment reform. Issue: Preserve funding for the Primary Care Residency Expansion program. P.L. 113-564, Veterans Access, Choice, and Accountability Act of 2014 Issues: Support improved contracting with academic affiliates and increased VA GME funding. H.R.1272, Doctors Helping Heroes Act of 2015 Issue: Support expansion of the Conrad 30 J-1 visa waiver program and physician immigration to address VA workforce shortages S. 289/H.R. 2104, American Cures Act Issue: Increases budget authority for National Institutes of Health NIH), Center for Disease Control and Prevention, Department of Defense Health Program, and the VA Medical and Prosthetics Research Program S. 320/H.R. 744, Medical Innovation Act Issue: Requires covered manufacturers of blockbuster drugs developed, in whole or in part, through federal investments in medical research that enter settlement agreements with a federal agency to pay 1 percent of net income over five years to increase congressional investments in biomedical research. S. 318/H.R. 531, Accelerating Biomedical Research Act Issue: Increases discretionary spending cap to increase funding for the National Institutes of Health (NIH). H.R. 777, Permanent Investment in Health Research Act Issue: Creates mandatory appropriation for the National Institutes of Health (NIH), adjusted annually for inflation. H.R. 6, 21st Century Cures Act Senate HELP Committee Innovation Initiative Issue: Support increased funding for medical research, reduce administrative and regulatory burden on scientists and research institutions, and support young investigators. H.R. 2102, Research for All Act of 2015 Issue: Support inclusion of male and female cells and animals in basic research, and NIH updating its guidelines on inclusion of women in clinical research. Issue: FDA regulation of Laboratory Developed Tests (LDTs) Draft Community Based Medical Education Act of 2014 Issue: Oppose reduction of Medicare GME/IME payments S. 1455, Recovery Enhancement for Addiction Treatment (TREAT) Act Issue: Support legislation to increase access to care for patients addicted to opioids Draft Hospital Improvements for Payment (HIP) Act of 2014 Issues: Support repeal of CMS Two-Midnights Rule, extending RAC audit moratorium for short stays, and permanent bundle program. Issue: Oppose further delays in the implementation of the ICD-10 system H.R. 1411, Expanding Nutrition's Role in Curricula and Healthcare Act (ENRICH Act) Issue: Support grants for medical schools to develop or expand nutrition and physical activity curricula. Issue: Funding for Ebola Treatment Centers and hospital preparedness Issue: Educate congressional staff on academic medicines missions, including education, research, patient care, GME, workforce, and physician shortages in rural and urban communities. H.R. 2513, Promoting Access, Competition, and Equity Act of 2015 Issue: Oppose easing restrictions on physician owned hospitals Issue: Senate Finance Committee Chronic Care Workgroup, support and send comments on efforts to improve care for Medicare patients with chronic conditions. Submitted comments to: CMS on the FY 2016 Inpatient Prospective Payment System (IPPS) proposed rule CMS on the modifications on meaningful use 2015-2017 proposed rule HHS on the CMS short-stay inpatient admission policy, the Two Midnights rule The Office of the National Coordinator for Health Information Technology (ONC) on the 2015 Edition Health Information Technology Certification Criteria proposed rule CMS on the Meaningful Use Stage 3 proposed rule FDA on public health concerns of demographic subgroups The White House on AAMCs commitment to the effective use and management of antibiotic treatment

S 318, HR 531 Accelerating Biomedical Research Act HR 744, S 320 Medical Innovation Act (Swear Jar bill) HR 777 Permanent Investment in Health Research Act HR 6 21st Century Cures S 289, HR 2104 American Cures Act HR 2101 Research for All Act S 1077 Advancing Breakthrough Devices for Patients HR 2337 To amend the Federal Food, Drug, and Cosmetic Act to authorize priority review for breakthrough devices HR 160 Protect Medical Innovation Act of 2015 (to repeal the ACA medical device tax)

Client expense: $29,766 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S 153 I-Squared Act of 2015 S 341 Start-up Jobs and Innovation Act HR 962 Startup Act HR 213 Fairness for High-Skilled Immigrants Act of 2015 Health (Bill) S 318, HR 531 Accelerating Biomedical Research Act HR 744, S 320 Medical Innovation Act (Swear Jar bill) HR 777 Permanent Investment in Health Research Act HR 6 21st Century Cures S 289, HR 2104 American Cures Act HR 2101 Research for All Act S 1077 Advancing Breakthrough Devices for Patients HR 2337 To amend the Federal Food, Drug, and Cosmetic Act to authorize priority review for breakthrough devices HR 160 Protect Medical Innovation Act of 2015 (to repeal the ACA medical device tax)

Client expense: $29,766 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S 318, HR 531 Accelerating Biomedical Research Act HR 744, S 320 Medical Innovation Act (Swear Jar bill) HR 777 Permanent Investment in Health Research Act 21st Century Cures (House discussion draft) from Energy and Commerce Committee S 289 American Cures Act

Client expense: $56,235 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Presidents Budget, FY 2016 Issues: Support funding for National Institutes of Health (NIH), Title VII and Title VIII health professions and nursing education programs, Agency for Healthcare Research and Quality (AHRQ), National Health Service Corps (NHSC), Childrens Hospitals Graduate Medical Education (CHGME), Health Resources and Services Administration (HRSA), the Prevention and Public Health Fund (PPHF), biodefense and public health preparedness programs, and CDC's National Healthcare Safety Network (NHSN) and the Prevention Epicenters Program. Maintain NIH salary cap at Executive Level II. Encourage the highest possible allocation for the Labor-HHS Subcommittee. President's Budget, FY 2016 Draft House Military Construction and Veterans Affairs and Related Agencies Appropriations bill Issues: Support funding for Veterans Affairs medical research, research infrastructure, and health care. Issue: Oppose discretionary spending cuts through sequestration, including NIH and other science programs. Issue: Supporting the use of animals in medical research. Issue: Funding for pandemic preparedness and biodefense programs. Issue: Draft legislation on protections for human subjects in research. S. 289, American Cures Act Issue: Increases budget authority for National Institutes of Health, Center for Disease Control and Prevention, Department of Defense Health Program, and the VA Medical and Prosthetics Research Program S. 320/H.R. 744, Medical Innovation Act Issue: Requires covered manufacturers of blockbuster drugs developed, in whole or in part, through federal investments in medical research that enter settlement agreements with a federal agency to pay 1 percent of net income over five years to increase congressional investments in biomedical research. S. 318/H.R. 531, Accelerating Biomedical Research Act Issue: Increases discretionary spending cap to increase funding for the National Institutes of Health (NIH). H.R. 777, Permanent Investment in Health Research Act Issue: Creates mandatory appropriation for the National Institutes of Health, adjusted annually for inflation. 21st Century Cures Initiative discussion draft Senate HELP Committee Innovation Initiative Issue: Support increased funding for medical research, reduce administrative and regulatory burden on scientists and research institutions, and support young investigators. Issue: FDA regulation of Laboratory Developed Tests (LDTs) Submitted comments to: HHS Office for Human Research Protections (OHRP) on draft guidance regarding standard of care research NIH on the use of a single Institutional Review Board (IRB) for multi-site research NIH Advisory Committee to the Director (ACD) on the strategic vision for the National Library of Medicine NIH and HHS on clinical trials registrations and results submission to ClinicalTrials.gov FDA on Laboratory Developed Tests (LDTs)

Presidents Budget, FY 2016 Issues: Support funding for National Institutes of Health (NIH), Title VII and Title VIII health professions and nursing education programs, Agency for Healthcare Research and Quality (AHRQ), National Health Service Corps (NHSC), Childrens Hospitals Graduate Medical Education (CHGME), Health Resources and Services Administration (HRSA), the Prevention and Public Health Fund (PPHF), biodefense and public health preparedness programs, CDC's National Healthcare Safety Network (NHSN) and the Prevention Epicenters Program, funding for Ebola Treatment Centers and hospital preparedness, and trauma and emergency care programs. Maintain NIH salary cap at Executive Level II. Encourage the highest possible allocation for the Labor-HHS Subcommittee. President's Budget, FY 2016 Draft House Military Construction and Veterans Affairs and Related Agencies Appropriations bill Issues: Support funding for Veterans Affairs medical research, research infrastructure, and health care. Issue: Support mandatory funding for Community Health Centers and the National Health Service Corps (NHSC) authorized under P.L. 111-148, the Patient Protection and Affordable Care Act, Title V and Section 10503. Draft Debt in Health Education Loan Programs (DebtHELP) legislative proposal Issues: Expand National Health Service Corps State Loan Repayment program, and align Department of Education and HRSA student loan programs. Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments and increase Graduate Medical Education (GME) accountability and transparency. Issue: Support funding and reporting requirements for Teaching Health Center Graduate Medical Education program under section 340G of the Public Health Service Act. H.R. 2, Medicare Access and CHIP Reauthorization Act of 2015. H.R. 810/S. 1871, SGR Repeal and Medicare Beneficiary Access Improvement Act of 2015. Issues: Support repeal of Medicare's sustainable growth rate (SGR) formula; Medicare physician payment reform; extension of the Childrens Health Insurance Program (CHIP); and extension of mandatory funding for the National Health Service Corps (NHSC). Issue: Support the use of animals in medical research. Issue: Promote interprofessional education and training of the health care workforce. Issue: Support funding for the National Healthcare Workforce Commission. Issue: Oppose reduction in Medicare hospital outpatient department reimbursement. S. 1006, Building A Health Care Workforce for the Future Act Issue: Support bill to increase scholarship opportunities for medical students and encourage primary care workforce development. Issue: Oppose inclusion of Medicare add-on payments in Hospital-Acquired Condition (HAC) program. Issue: Support delay of enforcement of new CMS inpatient criteria (e.g., "Two-Midnight" rule) in FY 2014 Inpatient Prospective Payment System (IPPS) final rule. Issue: Support Medicare GME per Resident Amount and cap trigger technical corrections and administrative relief. H.R. 1343, Establishing Beneficiary Equity in the Hospital Readmissions Program Act of 2015. S. 688, Hospital Readmission Accuracy and Accountability Act. Issue: Support inclusion of socioeconomic status as part of hospital readmissions program, including support for adoption of National Quality Forum (NQF) recommendations. President's Budget, FY 2016 Issues: Oppose proposed reductions in Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments; oppose use of Medicare GME funding for creation of new GME grant program; oppose elimination of Children's Hospitals GME program. Issue: Legislation on educating health professionals regarding appropriate use of antibiotics. Issue: Support report language and efforts of HHS agencies to support efforts of urban-based institutions to improve health equity. Support use of holistic review in admissions. Issue: Implementation of the 340B drug pricing program. Issue: Oppose Medicare payment reductions as offsets for non-Medicare spending. Issue: Oppose Medicare hospital cuts as offsets for physician payment reform. Issue: Preserve funding for the Primary Care Residency Expansion program. P.L. 113-564, Veterans Access, Choice, and Accountability Act of 2014 Issues: Support improved contracting with academic affiliates and increased VA GME funding. H.R.1272, Doctors Helping Heroes Act of 2015 Issue: Support expansion of the Conrad 30 J-1 visa waiver program and physician immigration to address VA workforce shortages S. 289, American Cures Act Issue: Increases budget authority for National Institutes of Health, Center for Disease Control and Prevention, Department of Defense Health Program, and the VA Medical and Prosthetics Research Program S. 320/H.R. 744, Medical Innovation Act Issue: Requires covered manufacturers of blockbuster drugs developed, in whole or in part, through federal investments in medical research that enter settlement agreements with a federal agency to pay 1 percent of net income over five years to increase congressional investments in biomedical research. S. 318/H.R. 531, Accelerating Biomedical Research Act Issue: Increases discretionary spending cap to increase funding for the National Institutes of Health (NIH). H.R. 777, Permanent Investment in Health Research Act Issue: Creates mandatory appropriation for the National Institutes of Health, adjusted annually for inflation. 21st Century Cures Initiative discussion draft Senate HELP Committee Innovation Initiative Issue: Support increased funding for medical research, reduce administrative and regulatory burden on scientists and research institutions, and support young investigators. Issue: FDA regulation of Laboratory Developed Tests (LDTs) Issue: Provide comments to House Energy and Commerce Committee on GME financing Draft Community Based Medical Education Act of 2014 Issue: Oppose reduction of Medicare GME/IME payments Draft Recovery Enhancement for Addiction Treatment (TREAT) Act Issue: Support legislation to increase access to care for patients addicted to opioids Draft Hospital Improvements for Payment (HIP) Act of 2015 Issues: Support repeal of CMS Two-Midnights Rule, extending RAC audit moratorium for short stays, and permanent bundle program. Issue: Oppose further delays in the implementation of the ICD-10 system H.R. 1411, Expanding Nutrition's Role in Curricula and Healthcare Act (ENRICH Act) Issue: Support grants for medical schools to develop or expand nutrition and physical activity curricula. Issue: Educate congressional staff on academic medicines missions, including education, research, patient care, GME, workforce, and physician shortages Submitted comments to: FDA on Laboratory Developed Tests (LDTs) White House Ebola Response Coordinator offering to work with federal and state officials to prepare and respond to Ebola cases. CMS on measure selection for Hospital Compare Star Ratings Technical Expert Panel Report CMS on Notice of Proposed Rulemaking for Medicare Share Savings Program/Accountable Care Organizations CMS on the Medicare Advantage and Medicare Part D 2016 Advance Notice and Draft Call Letter CMS on policy priorities for FY 2016 Hospital Inpatient Prospective Payment System (IPPS) NIH and HHS on clinical trials registrations and results submission to ClinicalTrials.gov National Quality Forum (NQF) on the Measure Applications Partnership (MAP) pre-rulemaking draft report HHS Office for Human Research Protections (OHRP) on draft guidance regarding standard of care research NIH on the use of a single Institutional Review Board (IRB) for multi-site research NIH Advisory Committee to the Director (ACD) on the strategic vision for the National Library of Medicine

Presidents Budget, FY 2016 Issues: Support funding for National Institutes of Health (NIH), Title VII and Title VIII health professions and nursing education programs, Agency for Healthcare Research and Quality (AHRQ), National Health Service Corps (NHSC), Childrens Hospitals Graduate Medical Education (CHGME), Health Resources and Services Administration (HRSA), the Prevention and Public Health Fund (PPHF), biodefense and public health preparedness programs, CDC's National Healthcare Safety Network (NHSN) and the Prevention Epicenters Program, funding for Ebola Treatment Centers and hospital preparedness, and trauna and emergency care programs. Maintain NIH salary cap at Executive Level II. Encourage the highest possible allocation for the Labor-HHS Subcommittee. President's Budget, FY 2016 Draft House Military Construction and Veterans Affairs and Related Agencies Appropriations bill Issues: Support funding for Veterans Affairs medical research, research infrastructure, and health care. Issue: Support mandatory funding for Community Health Centers and the National Health Service Corps (NHSC) authorized under P.L. 111-148, the Patient Protection and Affordable Care Act, Title V and Section 10503. Issue: Funding for the National Health Care Workforce Commission. Issue: Funding for Teaching Health Centers under Section 340H of the Public Health Service Act. Issue: Oppose Medicare payment reductions as offsets for non-Medicare spending. President's Budget, FY 2016 Issues: Oppose proposed reductions in Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments; oppose use of Medicare GME funding for creation of new GME grant program; oppose cuts to Children's Hospitals GME program and Title VII health professions education and training programs. Issue: Preserve funding for the Primary Care Residency Expansion program. Issue: Implementation of HRSA's 340B Drug Pricing Program. S. 289, American Cures Act Issue: Increases budget authority for National Institutes of Health, Center for Disease Control and Prevention, Department of Defense Health Program, and the VA Medical and Prosthetics Research Program S. 318/H.R. 531, Accelerating Biomedical Research Act Issue: Increases discretionary spending cap to increase funding for the National Institutes of Health (NIH). H.R. 777, Permanent Investment in Health Research Act Issue: Creates mandatory appropriation for the National Institutes of Health, adjusted annually for inflation. Issue: Educate congressional staff on Academic Medicine's missions including education, research, patient care, GME, workforce, and physician shortage. S. 1006, Building A Health Care Workforce for the Future Act Issue: Support bill to increase scholarship opportunities for medical students and encourage primary care workforce development. H.R. 1411, Expanding Nutrition's Role in Curricula and Healthcare Act (ENRICH Act) Issue: Support grants for medical schools to develop or expand nutrition and physical activity curricula. Draft, Community Based Medical Education Act of 2014 Issue: Oppose reduction of Medicare GME/IME payments

Presidents Budget, FY 2016 Issues: Support funding for National Institutes of Health (NIH), Title VII and Title VIII health professions and nursing education programs, Agency for Healthcare Research and Quality (AHRQ), National Health Service Corps (NHSC), Childrens Hospitals Graduate Medical Education (CHGME), Health Resources and Services Administration (HRSA), the Prevention and Public Health Fund (PPHF), biodefense and public health preparedness programs, and CDC's National Healthcare Safety Network (NHSN) and the Prevention Epicenters Program and funding for pandemic preparedness and biodefense programs . Maintain NIH salary cap at Executive Level II. Encourage the highest possible allocation for the Labor-HHS Subcommittee. President's Budget, FY 2016 Draft House Military Construction and Veterans Affairs and Related Agencies Appropriations bill Issues: Support funding for Veterans Affairs medical research, research infrastructure, and health care. Issue: Support the use of animals in medical research. Issue: Oppose discretionary spending cuts through sequestration, including NIH and other science programs. Issue: Draft legislation on protections for human subjects in research S. 289, American Cures Act Issue: Increases budget authority for National Institutes of Health, Center for Disease Control and Prevention, Department of Defense Health Program, and the VA Medical and Prosthetics Research Program S. 320/H.R. 744, Medical Innovation Act Issue: Requires covered manufacturers of blockbuster drugs developed, in whole or in part, through federal investments in medical research that enter settlement agreements with a federal agency to pay 1 percent of net income over five years to increase congressional investments in biomedical research. S. 318/H.R. 531, Accelerating Biomedical Research Act Issue: Increases discretionary spending cap to increase funding for the National Institutes of Health (NIH). H.R. 777, Permanent Investment in Health Research Act Issue: Creates mandatory appropriation for the National Institutes of Health, adjusted annually for inflation. 21st Century Cures Initiative discussion draft Senate HELP Committee Innovation Initiative Issue: Support increased funding for medical research, reduce administrative and regulatory burden on scientists and research institutions, and support young investigators. Issue: FDA regulation of Laboratory Developed Tests (LDTs)