Pre-existing Conditions Protection Act of 2017

PL 111-148 - The Patient Protection and Affordable Care Act, implementation H.R. 1628 - American Health Care Act of 2017 H.R. 246 - health insurance tax repeal H.R. 1101 - Small Business Health Care Fairness Act H.R. 372 - Competitive Health Insurance Reform Act H.R. 1121 - Pre-existing Conditions Protection Act of 2017 H.R. 708- State Age Rating Flexibility Act H.R. 6 - SUPPORT for Patients and Communities Act S. 3120 - HEAL Substance Use Disorders Act S. 2680 - Opioid Crisis Response Act ***, no specific bill(s), Health Savings Accounts/Medical Savings Accounts, Transparency, Interoperability, Health Information Technology, Electronic Prescribing, Insurance Market Reform, Uninsured, Employer Based Health System, Exchanges, Risk Corridors and Reinsurance, Federal employees and regional PPOs, Cybersecurity, telehealth, Co-ops, special enrollment periods, Risk Mitigation, mental health, opioid abuse, market stabilization, out of network billing, risk adjustment, value based purchasing, NBPP

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

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

S 3702/HR 7223 - Tax legislation, provisions regarding generic drugs S 3738/HR 7251 - Patent legislation regarding inter partes review HR 302 - FAA Re-authorization (provisions related to air ambulance services HR 7217 - IMPROVE Act Blueprint on Drug Pricing State Reinsurance Program H.R. 6 - The Support for Patients and Communities Act S 1835 - Lower Premiums through Reinsurance Act of 2017. Collins (R-ME) HR 3545 - Overdose Prevention and Patient Safety Act. Murphy (R-PA) S 1850 - Protecting Jessica Grubbs Legacy Act. Manchin (D-WV) HR 4200 & S 2052 - To provide for temporary funding for health insurance cost-sharing reduction payments and provide targeted tax relief, and for other purposes. HR 2212 & S 974 - Creating and Restoring Equal Access To Equivalent Samples Act of 2017: A bill to promote competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products. Marino (R-PA) & Leahy (D-VT) S 1354 - Individual Health Insurance Marketplace Improvement Act: A bill to establish an individual market reinsurance fund to provide funding for state individual market stabilization reinsurance programs. Carper (D-DE) S 1859 - Healthcare Tax Relief Act: A bill to extend the moratorium on the annual fee on health insurance providers. Gardner (R-CO) H.R. 1215 - Protecting Access to Care Act of 2017: To improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system. King (R-IA) H.R.1101 - Small Business Health Fairness Act of 2017: To amend title I of the Employee Retirement Income Security Act of 1974 to improve access and choice for entrepreneurs with small businesses with respect to medical care for their employees. Johnson (R-TX). S. 974 and H.R. 2212 - Creates Act of 2017: To promote competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products. Leahy (D-VT) & Marino (R-PA). HR 173 and S 40 - Middle Class Health Benefits Tax Repeal Act of 2017: To amend the Internal Revenue Code of 1986 to repeal the excise tax on high cost employer-sponsored health coverage. Kelly (R-PA) & Heller (R-NV). HR 708 - State Age Rating Flexibility Act of 2017: To amend title XXVII of the Public Health Service Act to change the permissible age variation in health insurance premium rates. Buschon (R-IN). HR 710 -Health Coverage State Flexibility Act of 2017: 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. Flores (R-TX). HR 749 - Lower Drug Costs through Competition Act: To increase competition in the pharmaceutical industry. Schrader (D-OR) H.R.1121 - Pre-existing Conditions Protection Act of 2017: To amend the Public Health Service Act to prohibit application of pre-existing condition exclusions and to guarantee availability of health insurance coverage in the individual and group market, contingent on the enactment of legislation repealing the Patient Protection and Affordable Care Act, and for other purposes. Walden (R-OR). HR 1175 and S 403 - Health Savings Act of 2017: To amend the Internal Revenue Code of 1986 to improve access to health care through expanded health savings accounts, and for other purposes. Paulsen (R-MN) & Hatch (R-UT). HR 1304 - Self-Insurance Protection Act: To amend the Employee Retirement Income Security Act of 1974, the Public Health Service Act, and the Internal Revenue Code of 1986 to exclude from the definition of health insurance coverage certain medical stop-loss insurance obtained by certain plan sponsors of group health plans. Roe (R-TN) HR 1776 & S 771 Improving Access To Affordable Prescription Drugs Act: To improve access to affordable prescription drugs. Schakowsky (D-IL) & Franken (D-MN) HR 2051 - To amend the Federal Food, Drug, and Cosmetic Act to ensure that eligible product developers have competitive access to approved drugs and licensed biological products, so as to enable eligible product developers to develop and test new products, and for other purposes. McKinley (R-WV) S 191 - Patient Freedom Act of 2017: To improve patient choice by allowing States to adopt market based alternatives to the Affordable Care Act that increase access to affordable health insurance and reduce costs while ensuring important consumer protections and improving patient care. Cassidy (R-LA) S 637 - Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2017: To amend titles XI and XVIII of the Social Security Act to provide greater transparency of discounts provided by drug manufacturers. Wyden (D-OR) HR - 6082 Overdose Prevention and Patient Safety Act S 2554 Patient Right to Know Drug Prices Act

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

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

Issues related to lung disease treatment, prevention and research; public health; Issues related asthma; COPD; influenza; lung cancer; pneumonia; tuberculosis and other lung diseases; Issues related to tobacco cessation; Issues related to the Affordable Care Act; Issues related to the Childrens Health Insurance Program; Issues related to the President's Budget; H.R.774 Medicaid Coverage of Tobacco Cessation Nonprescription Drugs Act H.R.1121 Pre-existing Conditions Protection Act of 2017; H.R.2550 Medicare Telehealth Parity Act of 2017; H.R.4695 Bipartisan Market Stabilization and Innovation Act of 2017; H.R.4897 Women and Lung Cancer Research and Preventive Services Act of 2018; H.RES.827 Expressing support for the designation of April 2018 as "National Donate Life Month"; S.974 CREATES Act of 2017; S.1462 Marketplace Certainty Act; S.2494 Fair Care Act; S.2507 Improving Choices in Health Care Coverage Act;S. 2507, Improving Choices in Health Care Coverage Act (Codification of Short Term Limited Duration Health Plans); House Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2019; S.3158 - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2019; H.Con.Res.128 - Establishing the congressional budget for the United States Government for fiscal year 2019 and setting forth the appropriate budgetary levels for fiscal years 2020 through 2028H.R.6157 - Department of Defense and Labor, Health and Human Services, and Education Appropriations Act, 2019 and Continuing Appropriations Act, 2019; H.R.2 Agriculture and Nutrition Act of 2018; S.3388 - Ensuring Coverage for Patients with Pre-Existing Conditions Act; S.J.Res.63 - A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Secretary of the Treasury, Secretary of Labor, and Secretary of Health and Human Services relating to "Short-Term, Limited Duration Insurance

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), Natl Highway Traffic Safety Administration (NHTSA), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Postal Regulatory Commission, SENATE, Transportation, Dept of (DOT), Veterans Affairs, Dept of (VA), White House Office

Bipartisan Health Care Stabilization Act (Alexander-Murray) - funding for cost sharing reduction benefits, stabilization of individual market Bipartisan Health Care Stabilization Act; updated version (Alexander-Walden-Collins-Costello) - funding for cost sharing reduction benefits and reinsurance, stabilization of individual market S. 147, Obamacare Taxpayer Bailout Prevention Act (Rubio) - ACA risk corridors program S. 581, Jessies Law (Manchin-Capito) - patient history of opioid use disorder S. 1201, Health Care Options for All Act (McCaskill) - coverage options in bare counties S. 1354, Individual Health Insurance Marketplace Improvement Act (Carper-Kaine) - individual market reinsurance fund, outreach and enrollment activities S. 1462, Marketplace Certainty Act (Shaheen) - funding for cost-sharing reduction benefits S. 1516, Coverage Across State Lines (Heller) S. 1667, Protecting Consumers from Unreasonable Rates Act (Feinstein) - rate review S. 1835, Lower Premiums Through Reinsurance Act (Collins-Nelson) - invisible high risk pool and reinsurance programs S. 1850, Legacy Act (Manchin-Capito) -- confidentiality of drug and alcohol treatment and prevention records S. 1976, Increasing Access to Care Act (Scott) - copper plan S. 1985, Protect Access to Birth Control Act (Murray) - coverage of contraceptive services S. 2052, Healthcare Market Certainty and Mandate Relief Act (Hatch) - funding for cost sharing reduction benefits, HSA improvements, ACA individual mandate S. 2241 (King) - fees on excepted benefits and standalone dental plans S. 2303, Access to Independent Health Insurance Advisors Act (Isakson-Coons) - calculation of medical loss ratios S. 3388, Ensuring Coverage for Patients with Pre-Existing Conditions Act (Tillis) - protections for individuals with pre-existing conditions H.R. 2, Agriculture and Nutrition Act (Conaway) - agricultural association health plans H.R. 314, Health Care Choice Act (Blackburn) - selling insurance across state lines H.R. 372, Competitive Health Insurance Reform Act (Gosar) - McCarran-Ferguson Act H.R. 421, Allowing Greater Access to Safe and Effective Contraception Act (Love) - non-prescription contraceptives, HSA flexibility H.R. 706, Plan Verification and Fairness Act (Blackburn) - verifying eligibility for special enrollment periods H.R. 708, State Age Rating Flexibility Act (Buchson) - age rating bands H.R. 710, Health Coverage State Flexibility Act (Flores) - grace period for premium payments H.R. 1101, Small Business Health Fairness Act (Johnson) - association health plans H.R. 1121, Pre-existing Conditions Protection Act (Walden) - protections for patients with pre-existing conditions H.R. 1304, Self-Insurance Protection Act (Roe) - medical stop-loss insurance H.R. 1409, Cancer Drug Parity Act (Lance) - coverage of oral anti-cancer drugs H.R. 1606, DOC Access Act (Carter) - reimbursement for dental and vision providers H.R. 3450, Protecting Consumers from Unreasonable Rates Act (Schakowsky) - rate review H.R. 3545, Overdose Prevention and Patient Safety Act (Murphy- Blumenauer) -- confidentiality of drug and alcohol treatment and prevention records H.R. 3976, Access to Marketplace Insurance Act (Cramer) - third party payments H.R. 4082, Protect Access to Birth Control Act (DeGette) - coverage of contraceptive services H.R. 4200, Healthcare Market Certainty and Mandate Relief Act (Brady) - funding for cost sharing reduction benefits, HSA improvements H.R. 4225 (Hudson) - fees on excepted benefits and standalone dental plans H.R. 4575, Access to Independent Health Insurance Advisors Act (Long-Schrader) - calculation of medical loss ratios H.R. 4666, Premium Relief Act (Costello) - Patient and State Stability Fund H.R. 4695, Bipartisan Market Stabilization and Innovation Act (Schrader) - stabilization of individual market H.R. 6311, Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act (Roskam) - access to catastrophic plans, definition of qualified health plans H.R. 6314, Health Savings Act (Burgess) - definition of high-deductible health plan H.R. 6496, Continuing Coverage for Preexisting Conditions Act (Joyce) - protections for individuals with pre-existing conditions H.R. 7003, Federal Invisible Risk Sharing Program (Schweikert) Regulatory Issues: Insurance regulatory reform; issues related to the coordination of private and public disability income benefits; disability risk management; disability income insurance enrollment and awareness; issues related to encouraging impaired workers to stay in/return to the workforce; issues related to expanding long-term care insurance coverage; issues relating to the coordination of benefits between private health insurance plans and Medicaid; Medigap claims processing and crossover fees; Medigap cross-over claim issues, Medigap coverage, implementation of Medigap standardized plan offerings; Medigap carrier recoveries related to CMS fraud and abuse enforcement activities, and issues related to Medigap educational materials, and other Medigap issues; fraud and abuse issues affecting public and private insurance coverage; issues relating to antitrust; implementation of the Mental Health Parity Act requirements; implementation of the 21st Century Cures Act requirements; summary of benefits and coverage disclosures; pre-existing condition insurance plans; accountable care organizations; coverage of preventive services; preexisting condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; dependent coverage; treatment of expatriate plans; issues related to all payor claims databases; issues related to association health plans; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations, non-discriminatory wellness programs; issues related to supplemental products; issues relating to dental coverage; issues relating to proposals for single-payer and Medicare/Medicaid buy-in options; issues related to implementation of the Telephone Consumer Protection Act; issues relating to third party payment of premiums; issues related to cost-sharing reductions (CSRs); issues relating to the individual market; and other issues relating to health care reform implementation.

Client expense: $1,500,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Treasury, Dept of

Bipartisan Health Care Stabilization Act (Alexander-Murray) - funding for cost sharing reduction benefits, stabilization of individual market Bipartisan Health Care Stabilization Act; updated version (Alexander-Walden-Collins-Costello) - funding for cost sharing reduction benefits and reinsurance, stabilization of individual market S. 147, Obamacare Taxpayer Bailout Prevention Act (Rubio) - ACA risk corridors program S. 581, Jessies Law (Manchin-Capito) - patient history of opioid use disorder S. 1201, Health Care Options for All Act (McCaskill) - coverage options in bare counties S. 1354, Individual Health Insurance Marketplace Improvement Act (Carper-Kaine) - individual market reinsurance fund, outreach and enrollment activities S. 1405, FAA Reauthorization Act (Thune) - air ambulance issues S. 1462, Marketplace Certainty Act (Shaheen) - funding for cost-sharing reduction benefits S. 1516, Coverage Across State Lines (Heller) S. 1667, Protecting Consumers from Unreasonable Rates Act (Feinstein) - rate review S. 1835, Lower Premiums Through Reinsurance Act (Collins-Nelson) - invisible high risk pool and reinsurance programs S. 1850, Legacy Act (Manchin-Capito) -- confidentiality of drug and alcohol treatment and prevention records S. 1976, Increasing Access to Care Act (Scott) - copper plan S. 1985, Protect Access to Birth Control Act (Murray) - coverage of contraceptive services S. 2052, Healthcare Market Certainty and Mandate Relief Act (Hatch) - funding for cost sharing reduction benefits, HSA improvements, ACA individual mandate S. 2241 (King) - fees on excepted benefits and standalone dental plans S. 2303, Access to Independent Health Insurance Advisors Act (Isakson-Coons) - calculation of medical loss ratios H.R. 2, Agriculture and Nutrition Act (Conaway) - agricultural association health plans H.R. 4, FAA Reauthorization Act (Shuster) - air ambulance issues H.R. 314, Health Care Choice Act (Blackburn) - selling insurance across state lines H.R. 372, Competitive Health Insurance Reform Act (Gosar) - McCarran-Ferguson Act H.R. 421, Allowing Greater Access to Safe and Effective Contraception Act (Love) - non-prescription contraceptives, HSA flexibility H.R. 706, Plan Verification and Fairness Act (Blackburn) - verifying eligibility for special enrollment periods H.R. 708, State Age Rating Flexibility Act (Buchson) - age rating bands H.R. 710, Health Coverage State Flexibility Act (Flores) - grace period for premium payments H.R. 1101, Small Business Health Fairness Act (Johnson) - association health plans H.R. 1121, Pre-existing Conditions Protection Act (Walden) - protections for patients with pre-existing conditions H.R. 1304, Self-Insurance Protection Act (Roe) - medical stop-loss insurance H.R. 1409, Cancer Drug Parity Act (Lance) - coverage of oral anti-cancer drugs H.R. 3450, Protecting Consumers from Unreasonable Rates Act (Schakowsky) - rate review H.R. 3545, Overdose Prevention and Patient Safety Act (Murphy- Blumenauer) -- confidentiality of drug and alcohol treatment and prevention records H.R. 3922, CHAMPION Act (Walden) - extension of federal CHIP funding, ACA grace periods, community health center funding H.R. 3976, Access to Marketplace Insurance Act (Cramer) - third party payments H.R. 4082, Protect Access to Birth Control Act (DeGette) - coverage of contraceptive services H.R. 4200, Healthcare Market Certainty and Mandate Relief Act (Brady) - funding for cost sharing reduction benefits, HSA improvements H.R. 4225 (Hudson) - fees on excepted benefits and standalone dental plans H.R. 4575, Access to Independent Health Insurance Advisors Act (Long-Schrader) - calculation of medical loss ratios H.R. 4666, Premium Relief Act (Costello) - Patient and State Stability Fund H.R. 4695, Bipartisan Market Stabilization and Innovation Act (Schrader) - stabilization of individual market H.R. 6314, Health Savings Act (Burgess) - definition of high-deductible health plan Regulatory Issues: Insurance regulatory reform; issues related to the coordination of private and public disability income benefits; disability risk management; disability income insurance enrollment and awareness; issues related to encouraging impaired workers to stay in/return to the workforce; issues relating to the coordination of benefits between private health insurance plans and Medicaid; Medigap claims processing and crossover fees; Medigap cross-over claim issues, Medigap coverage, implementation of Medigap standardized plan offerings; Medigap carrier recoveries related to CMS fraud and abuse enforcement activities, and issues related to Medigap educational materials, and other Medigap issues; fraud and abuse issues affecting public and private insurance coverage; issues relating to antitrust; implementation of the Mental Health Parity Act requirements; implementation of the 21st Century Cures Act requirements; summary of benefits and coverage disclosures; pre-existing condition insurance plans; accountable care organizations; coverage of preventive services; preexisting condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; dependent coverage; treatment of expatriate plans; issues related to all payor claims databases; issues related to association health plans; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations, non-discriminatory wellness programs; issues related to supplemental products; issues relating to dental coverage; issues relating to proposals for single-payer and Medicare/Medicaid buy-in options; issues related to implementation of the Telephone Consumer Protection Act; issues relating to third party payment of premiums; issues related to cost-sharing reductions (CSRs); issues relating to the individual market; and other issues relating to health care reform implementation.

Client expense: $1,410,000 · Firm income: Not reported

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

Blueprint on Drug Pricing State Reinsurance Program H.R. 6 - The Support for Patients and Communities Act HR 4666 - Relief Act of 2017. Costello (R-PA) S 1835 - Lower Premiums through Reinsurance Act of 2017. Collins (R-ME) HR 3545 - Overdose Prevention and Patient Safety Act. Murphy (R-PA) S 1850 - Protecting Jessica Grubbs Legacy Act. Manchin (D-WV) HR 4200 & S 2052 - To provide for temporary funding for health insurance cost-sharing reduction payments and provide targeted tax relief, and for other purposes. HR 2212 & S 974 - Creating and Restoring Equal Access To Equivalent Samples Act of 2017: A bill to promote competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products. Marino (R-PA) & Leahy (D-VT) HR 3922 - Community Health And Medical Professionals Improve Our Nation Act of 2017: To extend funding for certain public health programs, and for other purposes. Walden (R-OR) S 1354 - Individual Health Insurance Marketplace Improvement Act: A bill to establish an individual market reinsurance fund to provide funding for state individual market stabilization reinsurance programs. Carper (D-DE) S 1859 - Healthcare Tax Relief Act: A bill to extend the moratorium on the annual fee on health insurance providers. Gardner (R-CO) H.R. 1215 - Protecting Access to Care Act of 2017: To improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system. King (R-IA) H.R.1101 - Small Business Health Fairness Act of 2017: To amend title I of the Employee Retirement Income Security Act of 1974 to improve access and choice for entrepreneurs with small businesses with respect to medical care for their employees. Johnson (R-TX). S. 974 and H.R. 2212 - Creates Act of 2017: To promote competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products. Leahy (D-VT) & Marino (R-PA). HR 173 and S 40 - Middle Class Health Benefits Tax Repeal Act of 2017: To amend the Internal Revenue Code of 1986 to repeal the excise tax on high cost employer-sponsored health coverage. Kelly (R-PA) & Heller (R-NV). HR 708 - State Age Rating Flexibility Act of 2017: To amend title XXVII of the Public Health Service Act to change the permissible age variation in health insurance premium rates. Buschon (R-IN). HR 710 -Health Coverage State Flexibility Act of 2017: 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. Flores (R-TX). HR 749 - Lower Drug Costs through Competition Act: To increase competition in the pharmaceutical industry. Schrader (D-OR) H.R.1121 - Pre-existing Conditions Protection Act of 2017: To amend the Public Health Service Act to prohibit application of pre-existing condition exclusions and to guarantee availability of health insurance coverage in the individual and group market, contingent on the enactment of legislation repealing the Patient Protection and Affordable Care Act, and for other purposes. Walden (R-OR). HR 1175 and S 403 - Health Savings Act of 2017: To amend the Internal Revenue Code of 1986 to improve access to health care through expanded health savings accounts, and for other purposes. Paulsen (R-MN) & Hatch (R-UT). HR 1304 - Self-Insurance Protection Act: To amend the Employee Retirement Income Security Act of 1974, the Public Health Service Act, and the Internal Revenue Code of 1986 to exclude from the definition of health insurance coverage certain medical stop-loss insurance obtained by certain plan sponsors of group health plans. Roe (R-TN) HR 1776 & S 771 Improving Access To Affordable Prescription Drugs Act: To improve access to affordable prescription drugs. Schakowsky (D-IL) & Franken (D-MN) HR 2051 - To amend the Federal Food, Drug, and Cosmetic Act to ensure that eligible product developers have competitive access to approved drugs and licensed biological products, so as to enable eligible product developers to develop and test new products, and for other purposes. McKinley (R-WV) S 191 - Patient Freedom Act of 2017: To improve patient choice by allowing States to adopt market based alternatives to the Affordable Care Act that increase access to affordable health insurance and reduce costs while ensuring important consumer protections and improving patient care. Cassidy (R-LA) S 637 - Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2017: To amend titles XI and XVIII of the Social Security Act to provide greater transparency of discounts provided by drug manufacturers. Wyden (D-OR) HR - 6082 Overdose Prevention and Patient Safety Act S 2554 Patient Right to Know Drug Prices Act

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

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

PL 111-148 - The Patient Protection and Affordable Care Act, implementation H.R. 1628 - American Health Care Act of 2017 H.R. 246 - health insurance tax repeal H.R. 1101 - Small Business Health Care Fairness Act H.R. 372 - Competitive Health Insurance Reform Act H.R. 1121 - Pre-existing Conditions Protection Act of 2017 H.R. 708- State Age Rating Flexibility Act H.R. 6 - SUPPORT for Patients and Communities Act S. 3120 - HEAL Substance Use Disorders Act S. 2680 - Opioid Crisis Response Act ***, no specific bill(s), Health Savings Accounts/Medical Savings Accounts, Transparency, Interoperability, Health Information Technology, Electronic Prescribing, Insurance Market Reform, Uninsured, Employer Based Health System, Exchanges, Risk Corridors and Reinsurance, Federal employees and regional PPOs, Cybersecurity, telehealth, Co-ops, special enrollment periods, Risk Mitigation, mental health, opioid abuse, market stabilization, out of network billing, risk adjustment, value based purchasing

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

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

H. Res. 142/S. Res. 63 National Obesity Care Week Resolution S. Res. 325 National Obesity Care Week Resolution S. J. Res. 16 a joint resolution approving the discontinuation of the process for consideration and automatic implementation of the annual proposal of the independent payment Medicare advisory board H.J. Res 51/S. J. Res 17 Independent Payment Advisory Board Repeal H.R 1995 Value Based Insurance Design for Better Care Act H.R. 1004 Regulatory Integrity Act H.R. 1009/S. 676 OIRA Insight, Reform, and Accountability Act H.R. 1038/S. 413 Improving Transparency and Accuracy in Medicare Part D Spending H.R. 1072/S. 222 Obamacare Replacement Act H.R. 1101 Small Business Health Fairness Act H.R. 1121 Pre-Existing Conditions Protection Act H.R. 1148/S. 431 Furthering Access to Stroke Telemedicine (FAST) Act H.R. 1215 Protecting Access to Care Act H.R. 1267/S. 482 Personal Health Investment Today Act H.R. 1304 Self-Insurance Protection Act H.R. 1313 Preserving Employee Wellness Programs Act H.R. 1554 Jessie's Law H.R. 1565 Saving Lives, Saving Costs Act H.R. 1628 American Health Care Act H.R. 1703 Medical Product Communications Act H.R. 184 Protect Medical Innovation Act H.R. 1953/S. 830 Treat and Reduce Obesity Act H.R. 2267/S. 1301 Resident Physician Shortage Reduction Act H.R. 246/S. 183 Jobs and Premium Protection Act H.R. 2550 Medicare Telehealth Parity Act H.R. 2556/S. 1016 CONNECT for Health Act H.R. 2797/S. 1334 Patient Choice and Quality Care Act H.R. 2824 Increasing Opportunity and Success for Children and Parents Through Evidence-Based Home Visiting Act H.R. 284 Advancing Medical Resident Training in Community Hospitals Act H.R. 2953/S. 2164 Preventive Health Savings Act H.R. 3044 to expand supplemental benefits to meet the needs of chronically ill Medicare Advantage enrollees H.R. 3059/S. 1441 Community Health Center and Primary Care Workforce Expansion Act H.R. 3120 to reduce the volume of future electronic health record-related significant hardship requests H.R. 3124/S. 1299 Preventing Diabetes in Medicare Act H.R. 3168 to provide continued access to Medicare Advantage plans for special needs H.R. 3224 Critical Access and Rural Equity Act H.R. 3245 Medicare Civil and Criminal Penalties Act H.R. 3263 to extend the Medicare independence at home medical demonstration program H.R. 3358/S. 1771 Fiscal Year 2018 Labor-Health and Human Services-Education Appropriations Bill H.R. 3394 Teaching Health Centers Graduate Medical Education Extension Act H.R. 3447 Furthering Access to Coordinated Treatment for Seniors Act H.R. 3545 Overdoes Prevention and Patient Safety Act H.R. 3726 Stark Administrative Simplification Act of 2017 H.R. 3728 Empowering Medical Professionals and Optimizing Workforce Efficiency and Readiness Act H.R. 3820/S. 977 Medicare Home Health Flexibility Act H.R. 3862 National Health Service Corps Strengthening Act H.R. 3921 Helping Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable Act H.R. 3922 Continuing Community Health and Medical Professional Programs to Improve Our Nation, Increase National Gains, and Help Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable Act H.R. 4541 Continuing Community Health and Medical Professional Programs to Improve Our Nation and Keep Insurance Delivery Stable H.R. 4613 Ensuring Patient Access to Healthcare Records Act H.R. 4616 to provide for a temporary moratorium on the employer mandate and to provide for a delay in the implementation of the excise tax on high cost employer-sponsored health coverage H.R. 4617 to provide for a temporary moratorium on the medical device excise tax H.R. 4618 to provide for a temporary moratorium on certain taxes affecting purchases of prescription medication H.R. 4619 to provide temporary relief from the annual fee imposed on health insurance providers, to the extent that such fee is due to Puerto Rican health insurance H.R. 4620 Protecting Families and Small Businesses Act H.R. 4006 Community-Based Independence for Seniors Act of 2017 H.R. 4200/S. 2052 Healthcare Market Certainty and Mandate Relief Act H.R. 4520 to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2017 H.R. 4552/S. 1291 Advancing Medical Training in Community Hospitals Act H.R. 4105 to extend the health professions workforce demonstration project H.R. 592/S. 109 Pharmacy and Medically Underserved Areas Enhancement Act H.R. 706 Plan Verification and Fairness Act H.R. 741/S. 243 Rural Hospital Regulatory Relief Act H.R. 749 Lower Drug Costs Through Competition Act H.R. 766 Amend Title XVII of the Social Security Act to expand telehealth in Medicare H.R. 849/S. 260 Protecting Seniors' Access to Medicare Act H.R. 908 Medicare Advantage Quality Payment Relief Act H.R. 998 Searching for and Cutting Regulations that are Unnecessarily Burdensome (SCRUB) Act H.R.3545 Overdose Prevention and Patient Safety Act H.R.3727 To amend title XVIII of the Social Security Act to include additional telehealth services for purposes of MA organization bids, and for other purposes H.R. 4206/S. 2051 Medicare Care Coordination Improvement Act Introduction of the Healthcare Cybersecurity Improvement Act Introduction of the Stark Law Modernization Act of 2017 Pub L. 114-198 Comprehensive Addiction and Recovery Act Pub L. 115-31 Fiscal Year 2017 Consolidated Appropriations Act Pub L. 115-80 National Clinical Care Commission Act Pub. L. 102-143 Telephone Consumer Protection Act Pub. L. 111-148 Patient Protection and Affordable Care Act (PPACA) Pub. L. 111-5 The American Recovery and Reinvestment Act Pub. L. 114-10 Medicare Access and CHIP Reauthorization Act (MACRA) Pub. L. 114-255, 21st Century Cures Act Pub. L. 114-270 Expanding Capacity for Health Outcomes Act (ECHO) Pub. L. 114-328 National Defense Authorization Act for Fiscal Year Pub. L. 114-329 American Innovation and Competitiveness Act Pub L. 115-63 Disaster Relief and Airway Extension Act Pub. L. 115-96 2018 Continuing Resolution Pub. L. 115-97 Tax Cuts and Jobs Act Reintroduction of TELE-MED Act of 2015 S. 108 Medical Device Access and Innovation Protection Act S. 297 Increasing Competition in Pharmaceuticals Act S. 1754 Training the Next Generation of Primary Care Doctors Act S. 1827 Keep Kids' Insurance Dependable and Secure Act S. 1829 Strong Families Act S. 1850 Protecting Jessica Grubbs Legacy Act (The Legacy Act) S. 1859 Healthcare Tax Relief Act S. 1899 to reauthorize and extend funding for community health centers and the National Health Service Corps S. 1967 Mandate Relief Act S. 191 Patient Freedom Act S. 251 Protecting Medicare from Executive Action Act S. 309 Community Based Independence for Seniors Act S. 464 Independence at Home Act H .R. 1933/S. 761 Health Care Options Act of 2017 S. 787 Telehealth Innovation and Improvement Act S. 870 Creating High-Quality Results and Outcomes Necessary to Improve Chronic Care Act S. 1978 Small Business and Family Health Tax Relief Act S. Con. Res. 3 Budget Resolution

Client expense: $190,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Blueprint on Drug Pricing State Reinsurance Program H.R. 6 - The Support for Patients and Communities Act HR 4666 - Relief Act of 2017. Costello (R-PA) S 1835 - Lower Premiums through Reinsurance Act of 2017. Collins (R-ME) HR 3545 - Overdose Prevention and Patient Safety Act. Murphy (R-PA) S 1850 - Protecting Jessica Grubbs Legacy Act. Manchin (D-WV) HR 4200 & S 2052 - To provide for temporary funding for health insurance cost-sharing reduction payments and provide targeted tax relief, and for other purposes. HR 2212 & S 974 - Creating and Restoring Equal Access To Equivalent Samples Act of 2017: A bill to promote competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products. Marino (R-PA) & Leahy (D-VT) HR 3922 - Community Health And Medical Professionals Improve Our Nation Act of 2017: To extend funding for certain public health programs, and for other purposes. Walden (R-OR) S 1354 - Individual Health Insurance Marketplace Improvement Act: A bill to establish an individual market reinsurance fund to provide funding for state individual market stabilization reinsurance programs. Carper (D-DE) S 1859 - Healthcare Tax Relief Act: A bill to extend the moratorium on the annual fee on health insurance providers. Gardner (R-CO) H.R. 1215 - Protecting Access to Care Act of 2017: To improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system. King (R-IA) H.R.1101 - Small Business Health Fairness Act of 2017: To amend title I of the Employee Retirement Income Security Act of 1974 to improve access and choice for entrepreneurs with small businesses with respect to medical care for their employees. Johnson (R-TX). S. 974 and H.R. 2212 - Creates Act of 2017: To promote competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products. Leahy (D-VT) & Marino (R-PA). HR 173 and S 40 - Middle Class Health Benefits Tax Repeal Act of 2017: To amend the Internal Revenue Code of 1986 to repeal the excise tax on high cost employer-sponsored health coverage. Kelly (R-PA) & Heller (R-NV). HR 708 - State Age Rating Flexibility Act of 2017: To amend title XXVII of the Public Health Service Act to change the permissible age variation in health insurance premium rates. Buschon (R-IN). HR 710 -Health Coverage State Flexibility Act of 2017: 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. Flores (R-TX). HR 749 - Lower Drug Costs through Competition Act: To increase competition in the pharmaceutical industry. Schrader (D-OR) H.R.1121 - Pre-existing Conditions Protection Act of 2017: To amend the Public Health Service Act to prohibit application of pre-existing condition exclusions and to guarantee availability of health insurance coverage in the individual and group market, contingent on the enactment of legislation repealing the Patient Protection and Affordable Care Act, and for other purposes. Walden (R-OR). HR 1175 and S 403 - Health Savings Act of 2017: To amend the Internal Revenue Code of 1986 to improve access to health care through expanded health savings accounts, and for other purposes. Paulsen (R-MN) & Hatch (R-UT). HR 1304 - Self-Insurance Protection Act: To amend the Employee Retirement Income Security Act of 1974, the Public Health Service Act, and the Internal Revenue Code of 1986 to exclude from the definition of health insurance coverage certain medical stop-loss insurance obtained by certain plan sponsors of group health plans. Roe (R-TN) HR 1776 & S 771 Improving Access To Affordable Prescription Drugs Act: To improve access to affordable prescription drugs. Schakowsky (D-IL) & Franken (D-MN) HR 2051 - To amend the Federal Food, Drug, and Cosmetic Act to ensure that eligible product developers have competitive access to approved drugs and licensed biological products, so as to enable eligible product developers to develop and test new products, and for other purposes. McKinley (R-WV) S 191 - Patient Freedom Act of 2017: To improve patient choice by allowing States to adopt market based alternatives to the Affordable Care Act that increase access to affordable health insurance and reduce costs while ensuring important consumer protections and improving patient care. Cassidy (R-LA) S 637 - Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2017: To amend titles XI and XVIII of the Social Security Act to provide greater transparency of discounts provided by drug manufacturers. Wyden (D-OR)

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

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

Issues related to lung disease treatment, prevention and research; public health; Issues related asthma; COPD; influenza; lung cancer; pneumonia; tuberculosis and other lung diseases; Issues related to tobacco cessation; Issues related to the Affordable Care Act; Issues related to the Childrens Health Insurance Program; Issues related to the President's Budget; H.R.774 Medicaid Coverage of Tobacco Cessation Nonprescription Drugs Act H.R.1121 Pre-existing Conditions Protection Act of 2017; H.R.2550 Medicare Telehealth Parity Act of 2017; H.R.4695 Bipartisan Market Stabilization and Innovation Act of 2017; H.R.4897 Women and Lung Cancer Research and Preventive Services Act of 2018; H.RES.827 Expressing support for the designation of April 2018 as "National Donate Life Month"; S.974 CREATES Act of 2017; S.1462 Marketplace Certainty Act; S.2494 Fair Care Act; S.2507 Improving Choices in Health Care Coverage Act; S.RES.152 A resolution expressing support for the designation of April 2017 as "National Donate Life Month";S. 2507, Improving Choices in Health Care Coverage Act (Codification of Short Term Limited Duration Health Plans); S.204 - Trickett Wendler, Frank Mongiello, Jordan McLinn, and Matthew Bellina Right to Try Act of 2017; H.R.878 - Right to Try Act of 2017; House Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2019; S.3158 - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2019; H.Con.Res.128 - Establishing the congressional budget for the United States Government for fiscal year 2019 and setting forth the appropriate budgetary levels for fiscal years 2020 through 2028

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), Natl Highway Traffic Safety Administration (NHTSA), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Postal Regulatory Commission, SENATE, Transportation, Dept of (DOT), Veterans Affairs, Dept of (VA), White House Office

PL 111-148 - The Patient Protection and Affordable Care Act, implementation H.R. 1628 - American Health Care Act of 2017 H.R. 246 - health insurance tax repeal H.R. 1101 - Small Business Health Care Fairness Act H.R. 372 - Competitive Health Insurance Reform Act H.R. 1121 - Pre-existing Conditions Protection Act of 2017 H.R. 708- State Age Rating Flexibility Act H.R. 6 - SUPPORT for Patients and Communities Act S. 3120 - HEAL Substance Use Disorders Act S. 2680 - Opioid Crisis Response Act ***, no specific bill(s), Health Savings Accounts/Medical Savings Accounts, Transparency, Interoperability, Health Information Technology, Electronic Prescribing, Insurance Market Reform, Uninsured, Employer Based Health System, Exchanges, Risk Corridors and Reinsurance, Federal employees and regional PPOs, Cybersecurity, telehealth, Co-ops, special enrollment periods, Risk Mitigation, mental health, opioid abuse, market stabilization, out of network billing, risk adjustment

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

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

Bipartisan Health Care Stabilization Act (Alexander-Murray) - funding for cost sharing reduction benefits, stabilization of individual market Bipartisan Health Care Stabilization Act; updated version (Alexander-Walden-Collins-Costello) - funding for cost sharing reduction benefits and reinsurance, stabilization of individual market S. 147, Obamacare Taxpayer Bailout Prevention Act (Rubio) - ACA risk corridors program S. 581, Jessies Law (Manchin-Capito) - patient history of opioid use disorder S. 1201, Health Care Options for All Act (McCaskill) - coverage options in bare counties S. 1354, Individual Health Insurance Marketplace Improvement Act (Carper-Kaine) - individual market reinsurance fund, outreach and enrollment activities S. 1405, FAA Reauthorization Act (Thune) - air ambulance issues S. 1462, Marketplace Certainty Act (Shaheen) - funding for cost-sharing reduction benefits S. 1516, Coverage Across State Lines (Heller) S. 1667, Protecting Consumers from Unreasonable Rates Act (Feinstein) - rate review S. 1835, Lower Premiums Through Reinsurance Act (Collins-Nelson) - invisible high risk pool and reinsurance programs S. 1850, Legacy Act (Manchin-Capito) -- confidentiality of drug and alcohol treatment and prevention records S. 1976, Increasing Access to Care Act (Scott) - copper plan S. 1985, Protect Access to Birth Control Act (Murray) - coverage of contraceptive services S. 2052, Healthcare Market Certainty and Mandate Relief Act (Hatch) - funding for cost sharing reduction benefits, HSA improvements, ACA individual mandate S. 2241 (King) - fees on excepted benefits and standalone dental plans S. 2303, Access to Independent Health Insurance Advisors Act (Isakson-Coons) - calculation of medical loss ratios H.R. 2, Agriculture and Nutrition Act (Conaway) - agricultural association health plans H.R. 4, FAA Reauthorization Act (Shuster) - air ambulance issues H.R. 314, Health Care Choice Act (Blackburn) - selling insurance across state lines H.R. 372, Competitive Health Insurance Reform Act (Gosar) - McCarran-Ferguson Act H.R. 421, Allowing Greater Access to Safe and Effective Contraception Act (Love) - non-prescription contraceptives, HSA flexibility H.R. 706, Plan Verification and Fairness Act (Blackburn) - verifying eligibility for special enrollment periods H.R. 708, State Age Rating Flexibility Act (Buchson) - age rating bands H.R. 710, Health Coverage State Flexibility Act (Flores) - grace period for premium payments H.R. 1101, Small Business Health Fairness Act (Johnson) - association health plans H.R. 1121, Pre-existing Conditions Protection Act (Walden) - protections for patients with pre-existing conditions H.R. 1304, Self-Insurance Protection Act (Roe) - medical stop-loss insurance H.R. 1409, Cancer Drug Parity Act (Lance) - coverage of oral anti-cancer drugs H.R. 3450, Protecting Consumers from Unreasonable Rates Act (Schakowsky) - rate review H.R. 3545, Overdose Prevention and Patient Safety Act (Murphy- Blumenauer) -- confidentiality of drug and alcohol treatment and prevention records H.R. 3922, CHAMPION Act (Walden) - extension of federal CHIP funding, ACA grace periods, community health center funding H.R. 3976, Access to Marketplace Insurance Act (Cramer) - third party payments H.R. 4082, Protect Access to Birth Control Act (DeGette) - coverage of contraceptive services H.R. 4200, Healthcare Market Certainty and Mandate Relief Act (Brady) - funding for cost sharing reduction benefits, HSA improvements H.R. 4225 (Hudson) - fees on excepted benefits and standalone dental plans H.R. 4575, Access to Independent Health Insurance Advisors Act (Long-Schrader) - calculation of medical loss ratios H.R. 4666, Premium Relief Act (Costello) - Patient and State Stability Fund H.R. 4695, Bipartisan Market Stabilization and Innovation Act (Schrader) - stabilization of individual market H.R. 6314, Health Savings Act (Burgess) - definition of high-deductible health plan Regulatory Issues: Insurance regulatory reform; issues related to the coordination of private and public disability income benefits; disability risk management; disability income insurance enrollment and awareness; issues related to encouraging impaired workers to stay in/return to the workforce; issues relating to the coordination of benefits between private health insurance plans and Medicaid; Medigap claims processing and crossover fees; Medigap cross-over claim issues, Medigap coverage, implementation of Medigap standardized plan offerings; Medigap carrier recoveries related to CMS fraud and abuse enforcement activities, and issues related to Medigap educational materials, and other Medigap issues; fraud and abuse issues affecting public and private insurance coverage; issues relating to antitrust; implementation of the Mental Health Parity Act requirements; implementation of the 21st Century Cures Act requirements; summary of benefits and coverage disclosures; pre-existing condition insurance plans; accountable care organizations; coverage of preventive services; preexisting condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; dependent coverage; treatment of expatriate plans; issues related to all payor claims databases; issues related to association health plans; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations, non-discriminatory wellness programs; issues related to supplemental products; issues relating to dental coverage; issues relating to proposals for single-payer and Medicare/Medicaid buy-in options; issues related to implementation of the Telephone Consumer Protection Act; issues relating to third party payment of premiums; issues related to cost-sharing reductions (CSRs); issues relating to the individual market; and other issues relating to health care reform implementation.

Client expense: $1,410,000 · Firm income: Not reported

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

Issues related to lung disease treatment, prevention and research; public health; Issues related asthma; COPD; influenza; lung cancer; pneumonia; tuberculosis and other lung diseases; Issues related to tobacco cessation; Issues related to the Affordable Care Act; Issues related to the Childrens Health Insurance Program; Issues related to the President's Budget; Issues related to FY 2019 Appropriations;H.J.RES.123, Making further continuing appropriations for fiscal year 2018, and for other purposes; H.R.878, Right to Try Act of 2017; H.R.1121, Pre-existing Conditions Protection Act of 2017; H.R.1625, Consolidated Appropriations Act, 2018; H.R.2368, Right to Try Act; H.R.2550, Medicare Telehealth Parity Act of 2017; H.R.2810, National Defense Authorization Act for Fiscal Year 2018; H.R.3258, Marketplace Certainty Act; H.R.3267, Commerce, Justice, Science, and Related Agencies Appropriations Act, 2018; H.R.3358, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2018; H.R.3362, Department of State, Foreign Operations, and Related Programs Appropriations Act, 2018; H.R.4667, Making further supplemental appropriations for the fiscal year ending September 30, 2018, for disaster assistance for Hurricanes Harvey, Irma, and Maria, and calendar year 2017 wildfires, and for other purposes.; H.R.4695, Bipartisan Market Stabilization and Innovation Act of 2017; H.R.4897, Women and Lung Cancer Research and Preventive Services Act of 2018; H.RES.827, Expressing support for the designation of April 2018 as "National Donate Life Month".; S.204, Trickett Wendler, Frank Mongiello, Jordan McLinn, and Matthew Bellina Right to Try Act of 2017; S.974, CREATES Act of 2017; S.1462, Marketplace Certainty Act; S.1519, National Defense Authorization Act for Fiscal Year 2018; S.1557, Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2018; S.1662, Commerce, Justice, Science, and Related Agencies Appropriations Act, 2018; S.1771, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2018; S.1780, Department of State, Foreign Operations, and Related Programs Appropriations Act, 2018; S. 1835, Lower Premiums Through Reinsurance Act of 2017; S.2494, Fair Care Act; S.2507, Improving Choices in Health Care Coverage Act; S.RES.152, A resolution expressing support for the designation of April 2017 as "National Donate Life Month".;  

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Postal Regulatory Commission, SENATE, Veterans Affairs, Dept of (VA), White House Office

PL 111-148 - The Patient Protection and Affordable Care Act, implementation H.R. 1628 - American Health Care Act of 2017 H.R. 246 - health insurance tax repeal H.R. 1101 - Small Business Health Care Fairness Act H.R. 372 - Competitive Health Insurance Reform Act H.R. 1121 - Pre-existing Conditions Protection Act of 2017 H.R. 708- State Age Rating Flexibility Act ***, no specific bill(s), Health Savings Accounts/Medical Savings Accounts, Transparency, Interoperability, Health Information Technology, Electronic Prescribing, Insurance Market Reform, Uninsured, Employer Based Health System, Exchanges, Risk Corridors and Reinsurance, Federal employees and regional PPOs, Cybersecurity, telehealth, Co-ops, special enrollment periods, Risk Mitigation, mental health, opioid abuse, market stabilization, out of network billing

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

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

Bipartisan Health Care Stabilization Act (Alexander-Murray) - funding for cost sharing reduction benefits, stabilization of individual market Bipartisan Health Care Stabilization Act; updated version (Alexander-Walden-Collins-Costello) - funding for cost sharing reduction benefits and reinsurance, stabilization of individual market S. 147, Obamacare Taxpayer Bailout Prevention Act (Rubio) - ACA risk corridors program S. 581, Jessies Law (Manchin-Capito) - patient history of opioid use disorder S. 1201, Health Care Options for All Act (McCaskill) - coverage options in bare counties S. 1354, Individual Health Insurance Marketplace Improvement Act (Carper-Kaine) - individual market reinsurance fund, outreach and enrollment activities S. 1462, Marketplace Certainty Act (Shaheen) - funding for cost-sharing reduction benefits S. 1516, Coverage Across State Lines (Heller) S. 1667, Protecting Consumers from Unreasonable Rates Act (Feinstein) - rate review S. 1771, FY 2018 Labor-HHS Appropriations Act (Blunt) - risk corridors and other ACA issues, funding for HHS programs and agencies S. 1835, Lower Premiums Through Reinsurance Act (Collins-Nelson) - invisible high risk pool and reinsurance programs S. 1850, Legacy Act (Manchin-Capito) -- confidentiality of drug and alcohol treatment and prevention records S. 1976, Increasing Access to Care Act (Scott) - copper plan S. 1985, Protect Access to Birth Control Act (Murray) - coverage of contraceptive services S. 2052, Healthcare Market Certainty and Mandate Relief Act (Hatch) - funding for cost sharing reduction benefits, HSA improvements, ACA individual mandate S. 2241 (King) - fees on excepted benefits and standalone dental plans S. 2303, Access to Independent Health Insurance Advisors Act (Isakson-Coons) - calculation of medical loss ratios S. 2410, Chronic Disease Management Act (Thune) - flexibility for high-deductible health plans H.R. 314, Health Care Choice Act (Blackburn) - selling insurance across state lines H.R. 372, Competitive Health Insurance Reform Act (Gosar) - McCarran-Ferguson Act H.R. 421, Allowing Greater Access to Safe and Effective Contraception Act (Love) - non-prescription contraceptives, HSA flexibility H.R. 706, Plan Verification and Fairness Act (Blackburn) - verifying eligibility for special enrollment periods H.R. 708, State Age Rating Flexibility Act (Buchson) - age rating bands H.R. 710, Health Coverage State Flexibility Act (Flores) - grace period for premium payments H.R. 1101, Small Business Health Fairness Act (Johnson) - association health plans H.R. 1121, Pre-existing Conditions Protection Act (Walden) - protections for patients with pre-existing conditions H.R. 1304, Self-Insurance Protection Act (Roe) - medical stop-loss insurance H.R. 1409, Cancer Drug Parity Act (Lance) - coverage of oral anti-cancer drugs H.R. 3354, FY 2018 Appropriations Act (Calvert) - risk corridors and other ACA issues, funding for HHS programs and agencies H.R. 3358, FY 2018 Labor-HHS Appropriations Act (Cole) - risk corridors and other ACA issues, funding for HHS programs and agencies H.R. 3450, Protecting Consumers from Unreasonable Rates Act (Schakowsky) - rate review H.R. 3545, Overdose Prevention and Patient Safety Act (Murphy- Blumenauer) -- confidentiality of drug and alcohol treatment and prevention records H.R. 3922, CHAMPION Act (Walden) - extension of federal CHIP funding, ACA grace periods, community health center funding H.R. 3976, Access to Marketplace Insurance Act (Cramer) - third party payments H.R. 4082, Protect Access to Birth Control Act (DeGette) - coverage of contraceptive services H.R. 4200, Healthcare Market Certainty and Mandate Relief Act (Brady) - funding for cost sharing reduction benefits, HSA improvements H.R. 4225 (Hudson) - fees on excepted benefits and standalone dental plans H.R. 4575, Access to Independent Health Insurance Advisors Act (Long-Schrader) - calculation of medical loss ratios H.R. 4666, Premium Relief Act (Costello) - Patient and State Stability Fund H.R. 4695, Bipartisan Market Stabilization and Innovation Act (Schrader) - stabilization of individual market H.R. 4978, Chronic Disease Management Act (Black) - flexibility for high-deductible health plans Regulatory Issues: Insurance regulatory reform; issues related to the coordination of private and public disability income benefits; disability risk management; disability income insurance enrollment and awareness; issues related to encouraging impaired workers to stay in/return to the workforce; issues relating to the coordination of benefits between private health insurance plans and Medicaid; Medigap claims processing and crossover fees; Medigap cross-over claim issues, Medigap coverage, implementation of Medigap standardized plan offerings; Medigap carrier recoveries related to CMS fraud and abuse enforcement activities, and issues related to Medigap educational materials, and other Medigap issues; fraud and abuse issues affecting public and private insurance coverage; issues relating to antitrust; implementation of the Mental Health Parity Act requirements; implementation of the 21st Century Cures Act requirements; summary of benefits and coverage disclosures; pre-existing condition insurance plans; accountable care organizations; coverage of preventive services; preexisting condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; dependent coverage; treatment of expatriate plans; issues related to all payor claims databases; issues related to association health plans; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations, non-discriminatory wellness programs; issues related to supplemental products; issues relating to dental coverage; issues relating to proposals for single-payer and Medicare/Medicaid buy-in options; issues related to implementation of the Telephone Consumer Protection Act; issues relating to third party payment of premiums; issues related to cost-sharing reductions (CSRs); issues relating to the individual market; and other issues relating to health care reform implementation.

Client expense: $2,280,000 · Firm income: Not reported

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

HR 4666 - Relief Act of 2017. Costello (R-PA) S 1835 - Lower Premiums through Reinsurance Act of 2017. Collins (R-ME) HR 3545 - Overdose Prevention and Patient Safety Act. Murphy (R-PA) S 1850 - Protecting Jessica Grubbs Legacy Act. Manchin (D-WV) HR 4200 & S 2052 - To provide for temporary funding for health insurance cost-sharing reduction payments and provide targeted tax relief, and for other purposes. HR 2212 & S 974 - Creating and Restoring Equal Access To Equivalent Samples Act of 2017: A bill to promote competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products. Marino (R-PA) & Leahy (D-VT) HR 3922 - Community Health And Medical Professionals Improve Our Nation Act of 2017: To extend funding for certain public health programs, and for other purposes. Walden (R-OR) S 1354 - Individual Health Insurance Marketplace Improvement Act: A bill to establish an individual market reinsurance fund to provide funding for state individual market stabilization reinsurance programs. Carper (D-DE) S 1859 - Healthcare Tax Relief Act: A bill to extend the moratorium on the annual fee on health insurance providers. Gardner (R-CO) H.R. 1215 - Protecting Access to Care Act of 2017: To improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system. King (R-IA) H.R.1101 - Small Business Health Fairness Act of 2017: To amend title I of the Employee Retirement Income Security Act of 1974 to improve access and choice for entrepreneurs with small businesses with respect to medical care for their employees. Johnson (R-TX). S. 974 and H.R. 2212 - Creates Act of 2017: To promote competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products. Leahy (D-VT) & Marino (R-PA). HR 173 and S 40 - Middle Class Health Benefits Tax Repeal Act of 2017: To amend the Internal Revenue Code of 1986 to repeal the excise tax on high cost employer-sponsored health coverage. Kelly (R-PA) & Heller (R-NV). HR 708 - State Age Rating Flexibility Act of 2017: To amend title XXVII of the Public Health Service Act to change the permissible age variation in health insurance premium rates. Buschon (R-IN). HR 710 -Health Coverage State Flexibility Act of 2017: 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. Flores (R-TX). HR 749 - Lower Drug Costs through Competition Act: To increase competition in the pharmaceutical industry. Schrader (D-OR) H.R.1121 - Pre-existing Conditions Protection Act of 2017: To amend the Public Health Service Act to prohibit application of pre-existing condition exclusions and to guarantee availability of health insurance coverage in the individual and group market, contingent on the enactment of legislation repealing the Patient Protection and Affordable Care Act, and for other purposes. Walden (R-OR). HR 1175 and S 403 - Health Savings Act of 2017: To amend the Internal Revenue Code of 1986 to improve access to health care through expanded health savings accounts, and for other purposes. Paulsen (R-MN) & Hatch (R-UT). HR 1304 - Self-Insurance Protection Act: To amend the Employee Retirement Income Security Act of 1974, the Public Health Service Act, and the Internal Revenue Code of 1986 to exclude from the definition of health insurance coverage certain medical stop-loss insurance obtained by certain plan sponsors of group health plans. Roe (R-TN) HR 1776 & S 771 Improving Access To Affordable Prescription Drugs Act: To improve access to affordable prescription drugs. Schakowsky (D-IL) & Franken (D-MN) HR 2051 - To amend the Federal Food, Drug, and Cosmetic Act to ensure that eligible product developers have competitive access to approved drugs and licensed biological products, so as to enable eligible product developers to develop and test new products, and for other purposes. McKinley (R-WV) S 191 - Patient Freedom Act of 2017: To improve patient choice by allowing States to adopt market based alternatives to the Affordable Care Act that increase access to affordable health insurance and reduce costs while ensuring important consumer protections and improving patient care. Cassidy (R-LA) S 637 - Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2017: To amend titles XI and XVIII of the Social Security Act to provide greater transparency of discounts provided by drug manufacturers. Wyden (D-OR)

Client expense: $570,000 · Firm income: Not reported

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

S. J. Res. 16 a joint resolution approving the discontinuation of the process for consideration and automatic implementation of the annual proposal of the independent payment Medicare advisory board H.J. Res 51/S. J. Res 17 Independent Payment Advisory Board Repeal H.R 1995 Value Based Insurance Design for Better Care Act H.R. 1004 Regulatory Integrity Act H.R. 1009/S. 676 OIRA Insight, Reform, and Accountability Act H.R. 1038/S. 413 Improving Transparency and Accuracy in Medicare Part D Spending H.R. 1101 Small Business Health Fairness Act H.R. 1121 Pre-Existing Conditions Protection Act H.R. 1148/S. 431 Furthering Access to Stroke Telemedicine (FAST) Act H.R. 1215 Protecting Access to Care Act H.R. 1267/S. 482 Personal Health Investment Today Act H.R. 1304 Self-Insurance Protection Act H.R. 1313 Preserving Employee Wellness Programs Act H.R. 1554 Jessie's Law H.R. 1565 Saving Lives, Saving Costs Act H.R. 1628 American Health Care Act H.R. 1703 Medical Product Communications Act H.R. 184 Protect Medical Innovation Act H.R. 1876 Good Samaritan Health Professionals Act H.R. 1953/S. 830 Treat and Reduce Obesity Act H.R. 2267/S. 1301 Resident Physician Shortage Reduction Act H.R. 246/S. 183 Jobs and Premium Protection Act H.R. 2550 Medicare Telehealth Parity Act H.R. 2556/S. 1016 CONNECT for Health Act H.R. 2797/S. 1334 Patient Choice and Quality Care Act H.R. 284 Advancing Medical Resident Training in Community Hospitals Act H.R. 2953/S. 2164 Preventive Health Savings Act H.R. 3044 to expand supplemental benefits to meet the needs of chronically ill Medicare Advantage enrollees H.R. 3059/S. 1441 Community Health Center and Primary Care Workforce Expansion Act H.R. 3120 to reduce the volume of future electronic health record-related significant hardship requests H.R. 3124/S. 1299 Preventing Diabetes in Medicare Act H.R. 3168 to provide continued access to Medicare Advantage plans for special needs H.R. 3224 Critical Access and Rural Equity Act H.R. 3245 Medicare Civil and Criminal Penalties Act H.R. 3263 to extend the Medicare independence at home medical demonstration program H.R. 3394 Teaching Health Centers Graduate Medical Education Extension Act H.R. 3447 Furthering Access to Coordinated Treatment for Seniors Act H.R. 3726 Stark Administrative Simplification Act of 2017 H.R. 3728 Empowering Medical Professionals and Optimizing Workforce Efficiency and Readiness Act H.R. 3820/S. 977 Medicare Home Health Flexibility Act H.R. 3862 National Health Service Corps Strengthening Act H.R. 3921 Helping Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable Act H.R. 3922 Continuing Community Health and Medical Professional Programs to Improve Our Nation, Increase National Gains, and Help Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable Act H.R. 4541 Continuing Community Health and Medical Professional Programs to Improve Our Nation and Keep Insurance Delivery Stable H.R. 4613 Ensuring Patient Access to Healthcare Records Act H.R. 4616 to provide for a temporary moratorium on the employer mandate and to provide for a delay in the implementation of the excise tax on high cost employer-sponsored health coverage H.R. 4617 to provide for a temporary moratorium on the medical device excise tax H.R. 4618 to provide for a temporary moratorium on certain taxes affecting purchases of prescription medication H.R. 4619 to provide temporary relief from the annual fee imposed on health insurance providers, to the extent that such fee is due to Puerto Rican health insurance H.R. 4620 Protecting Families and Small Businesses Act H.R. 4006 Community-Based Independence for Seniors Act of 2017 H.R. 4200/S. 2052 Healthcare Market Certainty and Mandate Relief Act H.R. 4520 to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2017 H.R. 4552/S. 1291 Advancing Medical Training in Community Hospitals Act H.R. 4105 to extend the health professions workforce demonstration project H.R. 4841 Standardizing Electronic Prior Authorization for Safe Prescribing Act H.R. 592/S. 109 Pharmacy and Medically Underserved Areas Enhancement Act H.R. 706 Plan Verification and Fairness Act H.R. 741/S. 243 Rural Hospital Regulatory Relief Act H.R. 749 Lower Drug Costs Through Competition Act H.R. 766 Amend Title XVII of the Social Security Act to expand telehealth in Medicare H.R. 849/S. 260 Protecting Seniors' Access to Medicare Act H.R. 908 Medicare Advantage Quality Payment Relief Act H.R. 998 Searching for and Cutting Regulations that are Unnecessarily Burdensome (SCRUB) Act H.R. 2687/S. 1169 Medicaid Coverage for Addiction Recovery Expansion Act H.R.3727 To amend title XVIII of the Social Security Act to include additional telehealth services for purposes of MA organization bids, and for other purposes H.R. 4206/S. 2051 Medicare Care Coordination Improvement Act H.R. 5138 Bipartisan Health Savings Accounts Improvement Act Introduction of the Healthcare Cybersecurity Improvement Act Introduction of the Stark Law Modernization Act Pub L. 114-198 Comprehensive Addiction and Recovery Act Pub. L. 115-120 Fiscal Year 2018 Continuing Resolution Pub L. 115-80 National Clinical Care Commission Act Pub L. 115-123 Bipartisan Budget Act Pub L. 115-141 Fiscal Year 2018 Omnibus Appropriations Act Pub. L. 102-143 Telephone Consumer Protection Act Pub. L. 111-148 Patient Protection and Affordable Care Act (PPACA) Pub. L. 111-5 The American Recovery and Reinvestment Act Pub. L. 114-10 Medicare Access and CHIP Reauthorization Act (MACRA) Pub. L. 114-255 21st Century Cures Act Pub. L. 114-270 Expanding Capacity for Health Outcomes Act (ECHO) Pub. L. 114-329 American Innovation and Competitiveness Act Pub L. 115-63 Disaster Relief and Airway Extension Act Pub. L. 115-97 Tax Cuts and Jobs Act Reintroduction of TELE-MED Act of 2015 S. 108 Medical Device Access and Innovation Protection Act S. 297 Increasing Competition in Pharmaceuticals Act S. 1754 Training the Next Generation of Primary Care Doctors Act S. 1827 Keep Kids' Insurance Dependable and Secure Act S. 1829 Strong Families Act S. 1859 Healthcare Tax Relief Act S. 1899 to reauthorize and extend funding for community health centers and the National Health Service Corps S. 1967 Mandate Relief Act S. 251 Protecting Medicare from Executive Action Act S. 2278 State Offices of Rural Health Reauthorization Act S. 309 Community Based Independence for Seniors Act S. 464 Independence at Home Act H .R. 1933/S. 761 Health Care Options Act S. 787 Telehealth Innovation and Improvement Act S. 870 Creating High-Quality Results and Outcomes Necessary to Improve Chronic Care Act S. 1978 Small Business and Family Health Tax Relief Act S. Con. Res. 3 Budget Resolution H.R. 3545 Overdose Prevention and Patient Safety Act H.R. 4613 Ensuring Patient Access to Healthcare Records Act S.1850 Jessie's Law H.R. 4206/S.2501 Medicare Care Coordination Improvement Act

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

HR 2212 & S 974 - Creating and Restoring Equal Access To Equivalent Samples Act of 2017: A bill to promote competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products. Marino (R-PA) & Leahy (D-VT) HR 3120 - To amend title XVIII of the Social Security Act to reduce the volume of future electronic health record-related significant hardship requests. Burgess (R-TX) HR 3245 - Medicare Civil and Criminal Penalties Update Act: To amend title XI of the Social Security Act to increase civil money penalties and criminal fines for Federal health care program fraud and abuse, and for other purposes. Bilirakis (R-FL). HR 3263 - To amend title XVIII of the Social Security Act to extend the Medicare independence at home medical practice demonstration program. Burgess (R-TX) HR 3921 - Helping Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable Act of 2017: To extend funding for the Children's Health Insurance Program, and for other purposes. Burgess (R-TX) HR 3922 - Community Health And Medical Professionals Improve Our Nation Act of 2017: To extend funding for certain public health programs, and for other purposes. Walden (R-OR) S 1354 - Individual Health Insurance Marketplace Improvement Act: A bill to establish an individual market reinsurance fund to provide funding for state individual market stabilization reinsurance programs. Carper (D-DE) S 1827 - Keep Kids' Insurance Dependable and Secure Act of 2017: A bill to extend funding for the Children's Health Insurance Program, and for other purposes. Hatch (R-UT) S 1859 - Healthcare Tax Relief Act: A bill to extend the moratorium on the annual fee on health insurance providers. Gardner (R-CO) H.R. 1215 - Protecting Access to Care Act of 2017: To improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system. King (R-IA) H.R.1101 - Small Business Health Fairness Act of 2017: To amend title I of the Employee Retirement Income Security Act of 1974 to improve access and choice for entrepreneurs with small businesses with respect to medical care for their employees. Johnson (R-TX). H.R.3120 - To amend title XVIII of the Social Security Act to reduce the volume of future electronic health record-related significant hardship requests. Burgess (R-TX). S. 934 and H.R. 2430 - FDA Reauthorization Act of 2017: To amend the Federal Food, Drug, and Cosmetic Act to revise and extend the user-fee programs for prescription drugs, medical devices, generic drugs, and biosimilar biological products, and for other purposes. Alexander (R-TN) & Walden (R-OR). S. 974 and H.R. 2212 - Creates Act of 2017: To promote competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products. Leahy (D-VT) & Marino (R-PA). HR 173 and S 40 - Middle Class Health Benefits Tax Repeal Act of 2017: To amend the Internal Revenue Code of 1986 to repeal the excise tax on high cost employer-sponsored health coverage. Kelly (R-PA) & Heller (R-NV). HR 314 - Health Care Choice Act of 2017: To repeal title I of the Patient Protection and Affordable Care Act and to amend the Public Health Service Act to provide for cooperative governing of individual health insurance coverage offered in interstate commerce. Blackburn (R-TN). HR 706 - Plan Verification and Fairness Act of 2017: 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. Blackburn (R-TN). HR 708 - State Age Rating Flexibility Act of 2017: To amend title XXVII of the Public Health Service Act to change the permissible age variation in health insurance premium rates. Buschon (R-IN). HR 710 -Health Coverage State Flexibility Act of 2017: 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. Flores (R-TX). HR 749 - Lower Drug Costs through Competition Act: To increase competition in the pharmaceutical industry. Schrader (D-OR) H.R.1121 - Pre-existing Conditions Protection Act of 2017: To amend the Public Health Service Act to prohibit application of pre-existing condition exclusions and to guarantee availability of health insurance coverage in the individual and group market, contingent on the enactment of legislation repealing the Patient Protection and Affordable Care Act, and for other purposes. Walden (R-OR). HR 1175 and S 403 - Health Savings Act of 2017: To amend the Internal Revenue Code of 1986 to improve access to health care through expanded health savings accounts, and for other purposes. Paulsen (R-MN) & Hatch (R-UT). HR 1304 - Self-Insurance Protection Act: To amend the Employee Retirement Income Security Act of 1974, the Public Health Service Act, and the Internal Revenue Code of 1986 to exclude from the definition of health insurance coverage certain medical stop-loss insurance obtained by certain plan sponsors of group health plans. Roe (R-TN) HR 1628 - American Health Care Act of 2017: To provide for reconciliation pursuant to title II of the concurrent resolution on the budget for fiscal year 2017. Black (R-TN). HR 1776 & S 771 Improving Access To Affordable Prescription Drugs Act: To improve access to affordable prescription drugs. Schakowsky (D-IL) & Franken (D-MN) HR 2051 - To amend the Federal Food, Drug, and Cosmetic Act to ensure that eligible product developers have competitive access to approved drugs and licensed biological products, so as to enable eligible product developers to develop and test new products, and for other purposes. McKinley (R-WV) S 191 - Patient Freedom Act of 2017: To improve patient choice by allowing States to adopt market based alternatives to the Affordable Care Act that increase access to affordable health insurance and reduce costs while ensuring important consumer protections and improving patient care. Cassidy (R-LA) S 637 - Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2017: To amend titles XI and XVIII of the Social Security Act to provide greater transparency of discounts provided by drug manufacturers. Wyden (D-OR)

Client expense: $1,043,000 · Firm income: Not reported

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

HR 1 - An act to provide for reconciliation pursuant to titles II and V of the concurrent resolution on the budget for fiscal year 2018. HJ Res 123 - Making further continuing appropriations for fiscal year 2018 and for other purposes. HR 4200 & S 2052 - To provide for temporary funding for health insurance cost-sharing reduction payments and provide targeted tax relief, and for other purposes. HR 2212 & S 974 - Creating and Restoring Equal Access To Equivalent Samples Act of 2017: A bill to promote competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products. Marino (R-PA) & Leahy (D-VT) HR 3921 - Helping Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable Act of 2017: To extend funding for the Children's Health Insurance Program, and for other purposes. Burgess (R-TX) HR 3922 - Community Health And Medical Professionals Improve Our Nation Act of 2017: To extend funding for certain public health programs, and for other purposes. Walden (R-OR) S 1354 - Individual Health Insurance Marketplace Improvement Act: A bill to establish an individual market reinsurance fund to provide funding for state individual market stabilization reinsurance programs. Carper (D-DE) S 1827 - Keep Kids' Insurance Dependable and Secure Act of 2017: A bill to extend funding for the Children's Health Insurance Program, and for other purposes. Hatch (R-UT) S 1859 - Healthcare Tax Relief Act: A bill to extend the moratorium on the annual fee on health insurance providers. Gardner (R-CO) H.R. 1215 - Protecting Access to Care Act of 2017: To improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system. King (R-IA) H.R.1101 - Small Business Health Fairness Act of 2017: To amend title I of the Employee Retirement Income Security Act of 1974 to improve access and choice for entrepreneurs with small businesses with respect to medical care for their employees. Johnson (R-TX). S. 974 and H.R. 2212 - Creates Act of 2017: To promote competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products. Leahy (D-VT) & Marino (R-PA). HR 173 and S 40 - Middle Class Health Benefits Tax Repeal Act of 2017: To amend the Internal Revenue Code of 1986 to repeal the excise tax on high cost employer-sponsored health coverage. Kelly (R-PA) & Heller (R-NV). HR 706 - Plan Verification and Fairness Act of 2017: 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. Blackburn (R-TN). HR 708 - State Age Rating Flexibility Act of 2017: To amend title XXVII of the Public Health Service Act to change the permissible age variation in health insurance premium rates. Buschon (R-IN). HR 710 -Health Coverage State Flexibility Act of 2017: 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. Flores (R-TX). HR 749 - Lower Drug Costs through Competition Act: To increase competition in the pharmaceutical industry. Schrader (D-OR) H.R.1121 - Pre-existing Conditions Protection Act of 2017: To amend the Public Health Service Act to prohibit application of pre-existing condition exclusions and to guarantee availability of health insurance coverage in the individual and group market, contingent on the enactment of legislation repealing the Patient Protection and Affordable Care Act, and for other purposes. Walden (R-OR). HR 1175 and S 403 - Health Savings Act of 2017: To amend the Internal Revenue Code of 1986 to improve access to health care through expanded health savings accounts, and for other purposes. Paulsen (R-MN) & Hatch (R-UT). HR 1304 - Self-Insurance Protection Act: To amend the Employee Retirement Income Security Act of 1974, the Public Health Service Act, and the Internal Revenue Code of 1986 to exclude from the definition of health insurance coverage certain medical stop-loss insurance obtained by certain plan sponsors of group health plans. Roe (R-TN) HR 1628 - American Health Care Act of 2017: To provide for reconciliation pursuant to title II of the concurrent resolution on the budget for fiscal year 2017. Black (R-TN). HR 1776 & S 771 Improving Access To Affordable Prescription Drugs Act: To improve access to affordable prescription drugs. Schakowsky (D-IL) & Franken (D-MN) HR 2051 - To amend the Federal Food, Drug, and Cosmetic Act to ensure that eligible product developers have competitive access to approved drugs and licensed biological products, so as to enable eligible product developers to develop and test new products, and for other purposes. McKinley (R-WV) S 191 - Patient Freedom Act of 2017: To improve patient choice by allowing States to adopt market based alternatives to the Affordable Care Act that increase access to affordable health insurance and reduce costs while ensuring important consumer protections and improving patient care. Cassidy (R-LA) S 637 - Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2017: To amend titles XI and XVIII of the Social Security Act to provide greater transparency of discounts provided by drug manufacturers. Wyden (D-OR)

Client expense: $155,000 · Firm income: Not reported

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

Issues related to lung disease treatment, prevention and research; public health; Issues related to tobacco cessation; Issues related to the President's Budget; Issues related to Medicaid waivers; Issues related to the Affordable Care Act; H.R.774 Medicaid Coverage of Tobacco Cessation Nonprescription Drugs Act; H.R.1121 Pre-existing Conditions Protection Act of 2017; H.R.1628 American Health Care Act of 2017; Better Care Reconciliation Act, H.R.2550 - Medicare Telehealth Parity Act of 2017; H.R.3354 - Interior and Environment, Agriculture and Rural Development, Commerce, Justice, Science, Financial Services and General Government, Homeland Security, Labor, Health and Human Services, Education, State and Foreign Operations, Transportation, Housing and Urban Development, Defense, Military Construction and Veterans Affairs, Legislative Branch, and Energy and Water Development Appropriations Act, 2018; H.R.3358 - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2018 S.1771 - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2018; H.Con.Res.71 - Establishing the congressional budget for the United States Government for fiscal year 2018 and setting forth the appropriate budgetary levels for fiscal years 2019 through 2027. H.R.1 An Act to provide for reconciliation pursuant to titles II and V of the concurrent resolution on the budget for fiscal year 2018. H.J.Res.123 Continuing Resolution through December 22, 2017; H.R.1370 Continuing Resolution through January 19, 2018; continuing resolutions to extend appropriations funding; H.R.4667 Making further supplemental appropriations for the fiscal year ending September 30, 2018, for disaster assistance for Hurricanes Harvey, Irma, and Maria, and calendar year 2017 wildfires, and for other purposes.

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Postal Regulatory Commission, SENATE, Transportation, Dept of (DOT), Veterans Affairs, Dept of (VA), White House Office

Issues related to lung disease treatment, prevention and research; public health; Issues related asthma; COPD; influenza; lung cancer; pneumonia; tuberculosis and other lung diseases; Issues related to tobacco cessation; Issues related to the Affordable Care Act; Issues related to the Childrens Health Insurance Program; Issues related to the President's Budget; H.R.774 Medicaid Coverage of Tobacco Cessation Nonprescription Drugs Act; H.R.1121 Pre-existing Conditions Protection Act of 2017; H.R. 1628 American Health Care Act of 2017; Better Care Reconciliation Act; S. 1462 Marketplace Certainty Act; S. 934 FDA Reauthorization Act of 2017; H.R.2430 - FDA Reauthorization Act of 2017; H.R.3921 - HEALTHY KIDS Act; H.R.3922 - CHAMPION Act; S.204 - Trickett Wendler, Frank Mongiello, Jordan McLinn, and Matthew Bellina Right to Try Act of 2017; H.R.878 - Right to Try Act of 2017; S.1519 - National Defense Authorization Act for Fiscal Year 2018 H.R.2810 - National Defense Authorization Act for Fiscal Year 2018 H.R.2550 - Medicare Telehealth Parity Act of 2017; H.R.3258 - Marketplace Certainty Act; H.R.3354 - Interior and Environment, Agriculture and Rural Development, Commerce, Justice, Science, Financial Services and General Government, Homeland Security, Labor, Health and Human Services, Education, State and Foreign Operations, Transportation, Housing and Urban Development, Defense, Military Construction and Veterans Affairs, Legislative Branch, and Energy and Water Development Appropriations Act, 2018; H.R.3219 - Make America Secure Appropriations Act, 2018; HH.R.3268 - Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, 2018; S.1603 - Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, 2018; H.R.3358 - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2018; S.1771 - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2018; H.R.2998 - Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2018; S.1557 - Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2018; H.Con.Res.71 - Establishing the congressional budget for the United States Government for fiscal year 2018 and setting forth the appropriate budgetary levels for fiscal years 2019 through 2027 S.1827 - KIDS Act of 2017; H.R.1 An Act to provide for reconciliation pursuant to titles II and V of the concurrent resolution on the budget for fiscal year 2018. H.J.Res.123 Continuing Resolution through December 22, 2017; H.R.1370 Continuing Resolution through January 19, 2018; continuing resolutions to extend appropriations funding; H.R.4667 Making further supplemental appropriations for the fiscal year ending September 30, 2018, for disaster assistance for Hurricanes Harvey, Irma, and Maria, and calendar year 2017 wildfires, and for other purposes.  

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Postal Regulatory Commission, SENATE, Transportation, Dept of (DOT), Veterans Affairs, Dept of (VA), White House Office

Bipartisan Health Care Stabilization Act (Alexander-Murray) - funding for cost sharing reduction benefits, stabilization of individual market Better Care Reconciliation Act (Enzi) - ACA repeal and replace issues; coverage provisions; market stabilization; McConnell Substitute Amendment; Cruz Consumer Freedom Option; Portman Medicaid Option for Cost Sharing; Paul Repeal Only Amendment; Graham-Cassidy-Heller-Johnson Block Grant Amendment S. 147, Obamacare Taxpayer Bailout Prevention Act (Rubio) - ACA risk corridors program S. 581, Jessies Law (Manchin-Capito) - patient history of opioid use disorder S. 1201, Health Care Options for All Act (McCaskill) - coverage options in bare counties S. 1354, Individual Health Insurance Marketplace Improvement Act (Carper-Kaine) - individual market reinsurance fund, outreach and enrollment activities S. 1462, Marketplace Certainty Act (Shaheen) - funding for cost-sharing reduction benefits S. 1516, Coverage Across State Lines (Heller) S. 1667, Protecting Consumers from Unreasonable Rates Act (Feinstein) - rate review S. 1749, American Liberty Restoration Act (Hatch) - ACA individual coverage requirement S. 1771, FY 2018 Labor-HHS Appropriations Act (Blunt) - risk corridors and other ACA issues, funding for HHS programs and agencies S. 1835, Lower Premiums Through Reinsurance Act (Collins-Nelson) - invisible high risk pool and reinsurance programs S. 1850, Legacy Act (Manchin-Capito) -- confidentiality of drug and alcohol treatment and prevention records S. 1898 (Daines) - ACA individual coverage requirement S. 1976, Increasing Access to Care Act (Scott) - copper plan S. 1985, Protect Access to Birth Control Act (Murray) - coverage of contraceptive services S. 2052, Healthcare Market Certainty and Mandate Relief Act (Hatch) - funding for cost sharing reduction benefits, HSA improvements, ACA individual mandate S. 2241 (King) - fees on excepted benefits and standalone dental plans H.R. 314, Health Care Choice Act (Blackburn) - selling insurance across state lines H.R. 372, Competitive Health Insurance Reform Act (Gosar) - McCarran-Ferguson Act H.R. 421, Allowing Greater Access to Safe and Effective Contraception Act (Love) - non-prescription contraceptives, HSA flexibility H.R. 706, Plan Verification and Fairness Act (Blackburn) - verifying eligibility for special enrollment periods H.R. 708, State Age Rating Flexibility Act (Buchson) - age rating bands H.R. 710, Health Coverage State Flexibility Act (Flores) - grace period for premium payments H.R. 1101, Small Business Health Fairness Act (Johnson) - association health plans H.R. 1121, Pre-existing Conditions Protection Act (Walden) - protections for patients with pre-existing conditions H.R. 1304, Self-Insurance Protection Act (Roe) - medical stop-loss insurance H.R. 1409, Cancer Drug Parity Act (Lance) - coverage of oral anti-cancer drugs H.R. 1628, American Health Care Act (Black) - ACA repeal and replace issues; coverage provisions; market stabilization H.R. 2086, No Coverage, No Penalty Act (Blackburn) - waiving ACA individual mandate in areas with no QHPs H.R. 2516, Freedom from the ACA Tax Penalty Act (Young) - waiving ACA individual mandate in areas with no QHPs H.R. 3280, Financial Services and General Government Appropriations Act (Graves) - enforcement of ACA individual mandate H.R. 3354, FY 2018 Appropriations Act (Calvert) - risk corridors and other ACA issues, funding for HHS programs and agencies H.R. 3358, FY 2018 Labor-HHS Appropriations Act (Cole) - risk corridors and other ACA issues, funding for HHS programs and agencies H.R. 3450, Protecting Consumers from Unreasonable Rates Act (Schakowsky) - rate review H.R. 3545, Overdose Prevention and Patient Safety Act (Murphy- Blumenauer) -- confidentiality of drug and alcohol treatment and prevention records H.R. 3725, (Tiberi-Burgess) - ACA individual coverage requirement H.R. 3922, CHAMPION Act (Walden) - extension of federal CHIP funding, ACA grace periods, community health center funding H.R. 3976, Access to Marketplace Insurance Act (Cramer) - third party payments H.R. 4082, Protect Access to Birth Control Act (DeGette) - coverage of contraceptive services H.R. 4200, Healthcare Market Certainty and Mandate Relief Act (Brady) - funding for cost sharing reduction benefits, HSA improvements, ACA individual mandate H.R. 4225 (Hudson) - fees on excepted benefits and standalone dental plans H.R. 4575, Access to Independent Health Insurance Advisors Act (Long-Schrader) - calculation of medical loss ratios H.R. 4666, Premium Relief Act (Costello) - Patient and State Stability Fund H.R. 4695, Bipartisan Market Stabilization and Innovation Act (Schrader) - stabilization of individual market H.Con.Res. 71, Budget Resolution for FY 2018 (Black) - funding for federal health programs Regulatory Issues: Insurance regulatory reform; issues related to the coordination of private and public disability income benefits; disability risk management; disability income insurance enrollment and awareness; issues related to encouraging impaired workers to stay in/return to the workforce; issues relating to the coordination of benefits between private health insurance plans and Medicaid; Medigap claims processing and crossover fees; Medigap cross-over claim issues, Medigap coverage, implementation of Medigap standardized plan offerings; Medigap carrier recoveries related to CMS fraud and abuse enforcement activities, and issues related to Medigap educational materials, and other Medigap issues; fraud and abuse issues affecting public and private insurance coverage; issues relating to antitrust; implementation of the Mental Health Parity Act requirements; implementation of the 21st Century Cures Act requirements; summary of benefits and coverage disclosures; pre-existing condition insurance plans; accountable care organizations; coverage of preventive services; preexisting condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; dependent coverage; treatment of expatriate plans; issues related to all payor claims databases; issues related to association health plans; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations, non-discriminatory wellness programs; issues related to supplemental products; issues relating to dental coverage; issues relating to proposals for single-payer and Medicare/Medicaid buy-in options; issues related to implementation of the Telephone Consumer Protection Act; issues relating to third party payment of premiums; issues related to cost-sharing reductions (CSRs); issues relating to the individual market; and other issues relating to health care reform implementation.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Council of Economic Advisers (CEA), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Economic Council (NEC), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), SENATE, Treasury, Dept of, White House Office

PL 111-148 - The Patient Protection and Affordable Care Act, implementation H.R. 1628 - American Health Care Act of 2017 H.R. 246 - health insurance tax repeal H.R. 1101 - Small Business Health Care Fairness Act H.R. 372 - Competitive Health Insurance Reform Act H.R. 1121 - Pre-existing Conditions Protection Act of 2017 H.R. 708- State Age Rating Flexibility Act ***, no specific bill(s), Health Savings Accounts/Medical Savings Accounts, Transparency, Interoperability, Health Information Technology, Electronic Prescribing, Insurance Market Reform, Uninsured, Employer Based Health System, Exchanges, Risk Corridors and Reinsurance, Federal employees and regional PPOs, Cybersecurity, telehealth, Co-ops, special enrollment periods, Risk Mitigation, mental health, opioid abuse, market stabilization, out of network billing

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

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

HR 1 - An act to provide for reconciliation pursuant to titles II and V of the concurrent resolution on the budget for fiscal year 2018. HJ Res 123 - Making further continuing appropriations for fiscal year 2018 and for other purposes. HR 392 - The HEALTHY Kids Act to reauthorize CHIP. HR 4200 & S 2052 - To provide for temporary funding for health insurance cost-sharing reduction payments and provide targeted tax relief, and for other purposes. HR 2212 & S 974 - Creating and Restoring Equal Access To Equivalent Samples Act of 2017: A bill to promote competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products. Marino (R-PA) & Leahy (D-VT) HR 3921 - Helping Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable Act of 2017: To extend funding for the Children's Health Insurance Program, and for other purposes. Burgess (R-TX) HR 3922 - Community Health And Medical Professionals Improve Our Nation Act of 2017: To extend funding for certain public health programs, and for other purposes. Walden (R-OR) S 1354 - Individual Health Insurance Marketplace Improvement Act: A bill to establish an individual market reinsurance fund to provide funding for state individual market stabilization reinsurance programs. Carper (D-DE) S 1827 - Keep Kids' Insurance Dependable and Secure Act of 2017: A bill to extend funding for the Children's Health Insurance Program, and for other purposes. Hatch (R-UT) S 1859 - Healthcare Tax Relief Act: A bill to extend the moratorium on the annual fee on health insurance providers. Gardner (R-CO) H.R. 1215 - Protecting Access to Care Act of 2017: To improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system. King (R-IA) H.R.1101 - Small Business Health Fairness Act of 2017: To amend title I of the Employee Retirement Income Security Act of 1974 to improve access and choice for entrepreneurs with small businesses with respect to medical care for their employees. Johnson (R-TX). S. 974 and H.R. 2212 - Creates Act of 2017: To promote competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products. Leahy (D-VT) & Marino (R-PA). HR 173 and S 40 - Middle Class Health Benefits Tax Repeal Act of 2017: To amend the Internal Revenue Code of 1986 to repeal the excise tax on high cost employer-sponsored health coverage. Kelly (R-PA) & Heller (R-NV). HR 706 - Plan Verification and Fairness Act of 2017: 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. Blackburn (R-TN). HR 708 - State Age Rating Flexibility Act of 2017: To amend title XXVII of the Public Health Service Act to change the permissible age variation in health insurance premium rates. Buschon (R-IN). HR 710 -Health Coverage State Flexibility Act of 2017: 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. Flores (R-TX). HR 749 - Lower Drug Costs through Competition Act: To increase competition in the pharmaceutical industry. Schrader (D-OR) H.R.1121 - Pre-existing Conditions Protection Act of 2017: To amend the Public Health Service Act to prohibit application of pre-existing condition exclusions and to guarantee availability of health insurance coverage in the individual and group market, contingent on the enactment of legislation repealing the Patient Protection and Affordable Care Act, and for other purposes. Walden (R-OR). HR 1175 and S 403 - Health Savings Act of 2017: To amend the Internal Revenue Code of 1986 to improve access to health care through expanded health savings accounts, and for other purposes. Paulsen (R-MN) & Hatch (R-UT). HR 1304 - Self-Insurance Protection Act: To amend the Employee Retirement Income Security Act of 1974, the Public Health Service Act, and the Internal Revenue Code of 1986 to exclude from the definition of health insurance coverage certain medical stop-loss insurance obtained by certain plan sponsors of group health plans. Roe (R-TN) HR 1628 - American Health Care Act of 2017: To provide for reconciliation pursuant to title II of the concurrent resolution on the budget for fiscal year 2017. Black (R-TN). HR 1776 & S 771 Improving Access To Affordable Prescription Drugs Act: To improve access to affordable prescription drugs. Schakowsky (D-IL) & Franken (D-MN) HR 2051 - To amend the Federal Food, Drug, and Cosmetic Act to ensure that eligible product developers have competitive access to approved drugs and licensed biological products, so as to enable eligible product developers to develop and test new products, and for other purposes. McKinley (R-WV) S 191 - Patient Freedom Act of 2017: To improve patient choice by allowing States to adopt market based alternatives to the Affordable Care Act that increase access to affordable health insurance and reduce costs while ensuring important consumer protections and improving patient care. Cassidy (R-LA) S 637 - Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2017: To amend titles XI and XVIII of the Social Security Act to provide greater transparency of discounts provided by drug manufacturers. Wyden (D-OR)

Client expense: $155,000 · Firm income: Not reported

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

H. Res. 142/S. Res. 63 National Obesity Care Week Resolution S. Res. 325 National Obesity Care Week Resolution S. J. Res. 16 a joint resolution approving the discontinuation of the process for consideration and automatic implementation of the annual proposal of the independent payment Medicare advisory board H.J. Res 51/S. J. Res 17 Independent Payment Advisory Board Repeal H.R 1995 Value Based Insurance Design for Better Care Act H.R. 1004 Regulatory Integrity Act H.R. 1009/S. 676 OIRA Insight, Reform, and Accountability Act H.R. 1038/S. 413 Improving Transparency and Accuracy in Medicare Part D Spending H.R. 1072/S. 222 Obamacare Replacement Act H.R. 1101 Small Business Health Fairness Act H.R. 1121 Pre-Existing Conditions Protection Act H.R. 1148/S. 431 Furthering Access to Stroke Telemedicine (FAST) Act H.R. 1215 Protecting Access to Care Act H.R. 1267/S. 482 Personal Health Investment Today Act H.R. 1304 Self-Insurance Protection Act H.R. 1313 Preserving Employee Wellness Programs Act H.R. 1554 Jessie's Law H.R. 1565 Saving Lives, Saving Costs Act H.R. 1628 American Health Care Act H.R. 1703 Medical Product Communications Act H.R. 184 Protect Medical Innovation Act H.R. 1953/S. 830 Treat and Reduce Obesity Act H.R. 2267/S. 1301 Resident Physician Shortage Reduction Act H.R. 246/S. 183 Jobs and Premium Protection Act H.R. 2550 Medicare Telehealth Parity Act H.R. 2556/S. 1016 CONNECT for Health Act H.R. 2797/S. 1334 Patient Choice and Quality Care Act H.R. 2824 Increasing Opportunity and Success for Children and Parents Through Evidence-Based Home Visiting Act H.R. 284 Advancing Medical Resident Training in Community Hospitals Act H.R. 2953/S. 2164 Preventive Health Savings Act H.R. 3044 to expand supplemental benefits to meet the needs of chronically ill Medicare Advantage enrollees H.R. 3059/S. 1441 Community Health Center and Primary Care Workforce Expansion Act H.R. 3120 to reduce the volume of future electronic health record-related significant hardship requests H.R. 3124/S. 1299 Preventing Diabetes in Medicare Act H.R. 3168 to provide continued access to Medicare Advantage plans for special needs H.R. 3224 Critical Access and Rural Equity Act H.R. 3245 Medicare Civil and Criminal Penalties Act H.R. 3263 to extend the Medicare independence at home medical demonstration program H.R. 3358/S. 1771 Fiscal Year 2018 Labor-Health and Human Services-Education Appropriations Bill H.R. 3394 Teaching Health Centers Graduate Medical Education Extension Act H.R. 3447 Furthering Access to Coordinated Treatment for Seniors Act H.R. 3545 Overdoes Prevention and Patient Safety Act H.R. 3726 Stark Administrative Simplification Act of 2017 H.R. 3728 Empowering Medical Professionals and Optimizing Workforce Efficiency and Readiness Act H.R. 3820/S. 977 Medicare Home Health Flexibility Act H.R. 3862 National Health Service Corps Strengthening Act H.R. 3921 Helping Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable Act H.R. 3922 Continuing Community Health and Medical Professional Programs to Improve Our Nation, Increase National Gains, and Help Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable Act H.R. 4541 Continuing Community Health and Medical Professional Programs to Improve Our Nation and Keep Insurance Delivery Stable H.R. 4613 Ensuring Patient Access to Healthcare Records Act H.R. 4616 to provide for a temporary moratorium on the employer mandate and to provide for a delay in the implementation of the excise tax on high cost employer-sponsored health coverage H.R. 4617 to provide for a temporary moratorium on the medical device excise tax H.R. 4618 to provide for a temporary moratorium on certain taxes affecting purchases of prescription medication H.R. 4619 to provide temporary relief from the annual fee imposed on health insurance providers, to the extent that such fee is due to Puerto Rican health insurance H.R. 4620 Protecting Families and Small Businesses Act H.R. 4006 Community-Based Independence for Seniors Act of 2017 H.R. 4200/S. 2052 Healthcare Market Certainty and Mandate Relief Act H.R. 4520 to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2017 H.R. 4552/S. 1291 Advancing Medical Training in Community Hospitals Act H.R. 4105 to extend the health professions workforce demonstration project H.R. 592/S. 109 Pharmacy and Medically Underserved Areas Enhancement Act H.R. 706 Plan Verification and Fairness Act H.R. 741/S. 243 Rural Hospital Regulatory Relief Act H.R. 749 Lower Drug Costs Through Competition Act H.R. 766 Amend Title XVII of the Social Security Act to expand telehealth in Medicare H.R. 849/S. 260 Protecting Seniors' Access to Medicare Act H.R. 908 Medicare Advantage Quality Payment Relief Act H.R. 998 Searching for and Cutting Regulations that are Unnecessarily Burdensome (SCRUB) Act H.R.3545 Overdose Prevention and Patient Safety Act H.R.3727 To amend title XVIII of the Social Security Act to include additional telehealth services for purposes of MA organization bids, and for other purposes H.R. 4206/S. 2051 Medicare Care Coordination Improvement Act Introduction of the Healthcare Cybersecurity Improvement Act Introduction of the Stark Law Modernization Act of 2017 Pub L. 114-198 Comprehensive Addiction and Recovery Act Pub L. 115-31 Fiscal Year 2017 Consolidated Appropriations Act Pub L. 115-80 National Clinical Care Commission Act Pub. L. 102-143 Telephone Consumer Protection Act Pub. L. 111-148 Patient Protection and Affordable Care Act (PPACA) Pub. L. 111-5 The American Recovery and Reinvestment Act Pub. L. 114-10 Medicare Access and CHIP Reauthorization Act (MACRA) Pub. L. 114-255, 21st Century Cures Act Pub. L. 114-270 Expanding Capacity for Health Outcomes Act (ECHO) Pub. L. 114-328 National Defense Authorization Act for Fiscal Year Pub. L. 114-329 American Innovation and Competitiveness Act Pub L. 115-63 Disaster Relief and Airway Extension Act Pub. L. 115-96 2018 Continuing Resolution Pub. L. 115-97 Tax Cuts and Jobs Act Reintroduction of TELE-MED Act of 2015 S. 108 Medical Device Access and Innovation Protection Act S. 297 Increasing Competition in Pharmaceuticals Act S. 1754 Training the Next Generation of Primary Care Doctors Act S. 1827 Keep Kids' Insurance Dependable and Secure Act S. 1829 Strong Families Act S. 1850 Protecting Jessica Grubbs Legacy Act (The Legacy Act) S. 1859 Healthcare Tax Relief Act S. 1899 to reauthorize and extend funding for community health centers and the National Health Service Corps S. 1967 Mandate Relief Act S. 191 Patient Freedom Act S. 251 Protecting Medicare from Executive Action Act S. 309 Community Based Independence for Seniors Act S. 464 Independence at Home Act H .R. 1933/S. 761 Health Care Options Act of 2017 S. 787 Telehealth Innovation and Improvement Act S. 870 Creating High-Quality Results and Outcomes Necessary to Improve Chronic Care Act S. 1978 Small Business and Family Health Tax Relief Act S. Con. Res. 3 Budget Resolution

Client expense: $190,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Issues related to lung disease treatment, prevention and research; public health; Issues related to tobacco cessation; Issues related to the President's Budget; Issues related to Medicaid waivers; Issues related to the Affordable Care Act; H.R.774 Medicaid Coverage of Tobacco Cessation Nonprescription Drugs Act; H.R.1121 Pre-existing Conditions Protection Act of 2017; H.R.1628 American Health Care Act of 2017; Better Care Reconciliation Act, H.R.2550 - Medicare Telehealth Parity Act of 2017; H.R.3354 - Interior and Environment, Agriculture and Rural Development, Commerce, Justice, Science, Financial Services and General Government, Homeland Security, Labor, Health and Human Services, Education, State and Foreign Operations, Transportation, Housing and Urban Development, Defense, Military Construction and Veterans Affairs, Legislative Branch, and Energy and Water Development Appropriations Act, 2018; H.R.601 - Continuing Appropriations Act, 2018 and Supplemental Appropriations for Disaster Relief Requirements Act, 2017; H.R.3358 - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2018 S.1771 - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2018; H.Con.Res.71 - Establishing the congressional budget for the United States Government for fiscal year 2018 and setting forth the appropriate budgetary levels for fiscal years 2019 through 2027

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Postal Regulatory Commission, SENATE, Transportation, Dept of (DOT), Veterans Affairs, Dept of (VA), White House Office

Issues related to lung disease treatment, prevention and research; public health; Issues related asthma; COPD; influenza; lung cancer; pneumonia; tuberculosis and other lung diseases; Issues related to tobacco cessation; Issues related to the Affordable Care Act; Issues related to the Childrens Health Insurance Program; Issues related to the President's Budget; H.R.774 Medicaid Coverage of Tobacco Cessation Nonprescription Drugs Act; H.R.1121 Pre-existing Conditions Protection Act of 2017; H.R. 1628 American Health Care Act of 2017; Better Care Reconciliation Act; S. 1462 Marketplace Certainty Act; S. 934 FDA Reauthorization Act of 2017; H.R.2430 - FDA Reauthorization Act of 2017; H.R.3921 - HEALTHY KIDS Act; H.R.3922 - CHAMPION Act; S.204 - Trickett Wendler, Frank Mongiello, Jordan McLinn, and Matthew Bellina Right to Try Act of 2017; H.R.878 - Right to Try Act of 2017; S.1519 - National Defense Authorization Act for Fiscal Year 2018 H.R.2810 - National Defense Authorization Act for Fiscal Year 2018 H.R.2550 - Medicare Telehealth Parity Act of 2017; H.R.3258 - Marketplace Certainty Act; H.R.3354 - Interior and Environment, Agriculture and Rural Development, Commerce, Justice, Science, Financial Services and General Government, Homeland Security, Labor, Health and Human Services, Education, State and Foreign Operations, Transportation, Housing and Urban Development, Defense, Military Construction and Veterans Affairs, Legislative Branch, and Energy and Water Development Appropriations Act, 2018; H.R.3219 - Make America Secure Appropriations Act, 2018; H.R.601 - Continuing Appropriations Act, 2018 and Supplemental Appropriations for Disaster Relief Requirements Act, 2017; H.R.3268 - Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, 2018; S.1603 - Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, 2018; H.R.3358 - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2018; S.1771 - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2018; H.R.2998 - Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2018; S.1557 - Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2018; H.Con.Res.71 - Establishing the congressional budget for the United States Government for fiscal year 2018 and setting forth the appropriate budgetary levels for fiscal years 2019 through 2027

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Postal Regulatory Commission, SENATE, Transportation, Dept of (DOT), Veterans Affairs, Dept of (VA), White House Office

Better Care Reconciliation Act (Enzi) - ACA repeal and replace issues; coverage provisions; market stabilization; McConnell Substitute Amendment; Cruz Consumer Freedom Option; Portman Medicaid Option for Cost Sharing; Paul Repeal Only Amendment; Graham-Cassidy-Heller-Johnson Block Grant Amendment S. 147, Obamacare Taxpayer Bailout Prevention Act (Rubio) - ACA risk corridors program S. 191, Patient Freedom Act (Cassidy-Collins) - replacement reforms; state options S. 581, Jessies Law (Manchin-Capito) - patient history of opioid use disorder S. 1201, Health Care Options for All Act (McCaskill) - coverage options in bare counties S. 1354, Individual Health Insurance Marketplace Improvement Act (Carper-Kaine) - individual market reinsurance fund, outreach and enrollment activities S. 1462, Marketplace Certainty Act (Shaheen) - funding for cost-sharing reduction (CSR) payments S. 1516, Coverage Across State Lines (Heller) S. 1667, Protecting Consumers from Unreasonable Rates Act (Feinstein) - rate review S. 1749, American Liberty Restoration Act (Hatch) - ACA individual coverage requirement S. 1771, FY 2018 Labor-HHS Appropriations Act (Blunt) - risk corridors and other ACA issues, funding for HHS programs and agencies S. 1835, Lower Premiums Through Reinsurance Act (Collins-Nelson) - invisible high risk pool and reinsurance programs S. 1850, Legacy Act (Manchin-Capito) -- confidentiality of drug and alcohol treatment and prevention records S. 1898 (Daines) - ACA individual coverage requirement H.R. 314, Health Care Choice Act (Blackburn) - selling insurance across state lines H.R. 372, Competitive Health Insurance Reform Act (Gosar) - McCarran-Ferguson Act H.R. 421, Allowing Greater Access to Safe and Effective Contraception Act (Love) - non-prescription contraceptives, HSA flexibility H.R. 706, Plan Verification and Fairness Act (Blackburn) - verifying eligibility for special enrollment periods H.R. 708, State Age Rating Flexibility Act (Buchson) - age rating bands H.R. 710, Health Coverage State Flexibility Act (Flores) - grace period for premium payments H.R. 1101, Small Business Health Fairness Act (Johnson) - association health plans H.R. 1121, Pre-existing Conditions Protection Act (Walden) - protections for patients with pre-existing conditions H.R. 1304, Self-Insurance Protection Act (Roe) - medical stop-loss insurance H.R. 1409, Cancer Drug Parity Act (Lance) - coverage of oral anti-cancer drugs H.R. 1628, American Health Care Act (Black) - ACA repeal and replace issues; coverage provisions; market stabilization H.R. 2086, No Coverage, No Penalty Act (Blackburn) - waiving ACA individual mandate in areas with no QHPs H.R. 2516, Freedom from the ACA Tax Penalty Act (Young) - waiving ACA individual mandate in areas with no QHPs H.R. 3280, Financial Services and General Government Appropriations Act (Graves) - enforcement of ACA individual mandate H.R. 3354, FY 2018 Appropriations Act (Calvert) - risk corridors and other ACA issues, funding for HHS programs and agencies H.R. 3358, FY 2018 Labor-HHS Appropriations Act (Cole) - risk corridors and other ACA issues, funding for HHS programs and agencies H.R. 3450, Protecting Consumers from Unreasonable Rates Act (Schakowsky) - rate review H.R. 3545, Overdose Prevention and Patient Safety Act (Murphy- Blumenauer) -- confidentiality of drug and alcohol treatment and prevention records H.R. 3725, (Tiberi-Burgess) - ACA individual coverage requirement H.R. 3922, CHAMPION Act (Walden) - ACA grace periods, community health center funding FY 2018 Budget Resolution (Black) - Medicaid and Medicare funding Regulatory Issues: Insurance regulatory reform; issues related to the coordination of private and public disability income benefits; disability risk management; disability income insurance enrollment and awareness; issues related to encouraging impaired workers to stay in/return to the workforce; issues relating to the coordination of benefits between private health insurance plans and Medicaid; Medigap claims processing and crossover fees; Medigap cross-over claim issues, Medigap coverage, implementation of Medigap standardized plan offerings; Medigap carrier recoveries related to CMS fraud and abuse enforcement activities, and issues related to Medigap educational materials, and other Medigap issues; fraud and abuse issues affecting public and private insurance coverage; issues relating to antitrust; implementation of the Mental Health Parity Act requirements; implementation of the 21st Century Cures Act requirements; summary of benefits and coverage disclosures; pre-existing condition insurance plans; accountable care organizations; coverage of preventive services; preexisting condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; dependent coverage; treatment of expatriate plans; compliance with the transitional reinsurance program; issues related to all payor claims databases; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations, non-discriminatory wellness programs; issues related to supplemental products; issues related to implementation of the Telephone Consumer Protection Act; issues relating to third party payment of premiums; issues related to cost-sharing reductions (CSRs); issues relating to the individual market; and other issues relating to health care reform implementation.

Client expense: $1,470,000 · Firm income: Not reported

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

PL 111-148 - The Patient Protection and Affordable Care Act, implementation H.R. 1628 - American Health Care Act of 2017 H.R. 246 - health insurance tax repeal Better Care Reconciliation Act of 2017 H.R. 1101 - Small Business Health Care Fairness Act H.R. 372 - Competitive Health Insurance Reform Act H.R. 1121 - Pre-existing Conditions Protection Act of 2017 H.R. 708- State Age Rating Flexibility Act Graham-Cassidy Amendment ***, no specific bill(s), Health Savings Accounts/Medical Savings Accounts, Transparency, Interoperability, Health Information Technology, Electronic Prescribing, Insurance Market Reform, Uninsured, Employer Based Health System, Exchanges, Risk Corridors and Reinsurance, Federal employees and regional PPOs, Cybersecurity, telehealth, Co-ops, special enrollment periods, Risk Mitigation, mental health, opioid abuse, market stabilization, out of network billing

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

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

HR 2212 & S 974 - Creating and Restoring Equal Access To Equivalent Samples Act of 2017: A bill to promote competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products. Marino (R-PA) & Leahy (D-VT) HR 3120 - To amend title XVIII of the Social Security Act to reduce the volume of future electronic health record-related significant hardship requests. Burgess (R-TX) HR 3245 - Medicare Civil and Criminal Penalties Update Act: To amend title XI of the Social Security Act to increase civil money penalties and criminal fines for Federal health care program fraud and abuse, and for other purposes. Bilirakis (R-FL). HR 3263 - To amend title XVIII of the Social Security Act to extend the Medicare independence at home medical practice demonstration program. Burgess (R-TX) HR 3921 - Helping Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable Act of 2017: To extend funding for the Children's Health Insurance Program, and for other purposes. Burgess (R-TX) HR 3922 - Community Health And Medical Professionals Improve Our Nation Act of 2017: To extend funding for certain public health programs, and for other purposes. Walden (R-OR) S 1354 - Individual Health Insurance Marketplace Improvement Act: A bill to establish an individual market reinsurance fund to provide funding for state individual market stabilization reinsurance programs. Carper (D-DE) S 1827 - Keep Kids' Insurance Dependable and Secure Act of 2017: A bill to extend funding for the Children's Health Insurance Program, and for other purposes. Hatch (R-UT) S 1859 - Healthcare Tax Relief Act: A bill to extend the moratorium on the annual fee on health insurance providers. Gardner (R-CO) H.R. 1215 - Protecting Access to Care Act of 2017: To improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system. King (R-IA) H.R.1101 - Small Business Health Fairness Act of 2017: To amend title I of the Employee Retirement Income Security Act of 1974 to improve access and choice for entrepreneurs with small businesses with respect to medical care for their employees. Johnson (R-TX). H.R.3120 - To amend title XVIII of the Social Security Act to reduce the volume of future electronic health record-related significant hardship requests. Burgess (R-TX). S. 934 and H.R. 2430 - FDA Reauthorization Act of 2017: To amend the Federal Food, Drug, and Cosmetic Act to revise and extend the user-fee programs for prescription drugs, medical devices, generic drugs, and biosimilar biological products, and for other purposes. Alexander (R-TN) & Walden (R-OR). S. 974 and H.R. 2212 - Creates Act of 2017: To promote competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products. Leahy (D-VT) & Marino (R-PA). HR 173 and S 40 - Middle Class Health Benefits Tax Repeal Act of 2017: To amend the Internal Revenue Code of 1986 to repeal the excise tax on high cost employer-sponsored health coverage. Kelly (R-PA) & Heller (R-NV). HR 314 - Health Care Choice Act of 2017: To repeal title I of the Patient Protection and Affordable Care Act and to amend the Public Health Service Act to provide for cooperative governing of individual health insurance coverage offered in interstate commerce. Blackburn (R-TN). HR 706 - Plan Verification and Fairness Act of 2017: 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. Blackburn (R-TN). HR 708 - State Age Rating Flexibility Act of 2017: To amend title XXVII of the Public Health Service Act to change the permissible age variation in health insurance premium rates. Buschon (R-IN). HR 710 -Health Coverage State Flexibility Act of 2017: 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. Flores (R-TX). HR 749 - Lower Drug Costs through Competition Act: To increase competition in the pharmaceutical industry. Schrader (D-OR) H.R.1121 - Pre-existing Conditions Protection Act of 2017: To amend the Public Health Service Act to prohibit application of pre-existing condition exclusions and to guarantee availability of health insurance coverage in the individual and group market, contingent on the enactment of legislation repealing the Patient Protection and Affordable Care Act, and for other purposes. Walden (R-OR). HR 1175 and S 403 - Health Savings Act of 2017: To amend the Internal Revenue Code of 1986 to improve access to health care through expanded health savings accounts, and for other purposes. Paulsen (R-MN) & Hatch (R-UT). HR 1304 - Self-Insurance Protection Act: To amend the Employee Retirement Income Security Act of 1974, the Public Health Service Act, and the Internal Revenue Code of 1986 to exclude from the definition of health insurance coverage certain medical stop-loss insurance obtained by certain plan sponsors of group health plans. Roe (R-TN) HR 1628 - American Health Care Act of 2017: To provide for reconciliation pursuant to title II of the concurrent resolution on the budget for fiscal year 2017. Black (R-TN). HR 1776 & S 771 Improving Access To Affordable Prescription Drugs Act: To improve access to affordable prescription drugs. Schakowsky (D-IL) & Franken (D-MN) HR 2051 - To amend the Federal Food, Drug, and Cosmetic Act to ensure that eligible product developers have competitive access to approved drugs and licensed biological products, so as to enable eligible product developers to develop and test new products, and for other purposes. McKinley (R-WV) S 191 - Patient Freedom Act of 2017: To improve patient choice by allowing States to adopt market based alternatives to the Affordable Care Act that increase access to affordable health insurance and reduce costs while ensuring important consumer protections and improving patient care. Cassidy (R-LA) S 637 - Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2017: To amend titles XI and XVIII of the Social Security Act to provide greater transparency of discounts provided by drug manufacturers. Wyden (D-OR)

Client expense: $166,896 · Firm income: Not reported

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

H.R. 173: Legislation to repeal the Cadillac/Excise tax H.R. 246: Legislation to repeal the annual fee on health insurance providers; Health Insurance Tax (HIT) H.R. 1628: The American Health Care Act of 2017 (AHCA) H.R. 175: ObamaCare Repeal Act H.R 242: Medicare Prescription Drug Price Negotiation Act of 2017 H.R. 277: American Health Care Reform Act of 2017 H.R. 314: Health Care Choice Act H.R. 352: State Health Flexibility Act of 2017 H.R. 372: Competitive Health Insurance Reform Act of 2017 H.R. 432: Small Business Tax Credit Accessibility Act H.R. 521: Protection from Insurance Exchange Monopolies Act H.R. 551: Amends the ACA to permit insurers to offer catastrophic coverage plans to anyone H.R. 552: Affordable Limited Health Coverage Act H.R. 633: Patient Fairness and Relief Act of 2017 H.R. 661: Employee Fairness and Relief Act H.R. 708: State Age Rating Flexibility Act of 2017 H.R. 710: Health Coverage State Flexibility Act of 2017 H.R. 749: Lower Drug Costs through Competition Act H.R. 1072: ObamaCare Replacement Act H.R 1101: Small Business Health Fairness Act of 2017 H.R. 1121: Pre-existing Conditions Protection Act of 2017 H.R. 1215: Protecting Access to Care Act of 2017 H.R. 1245: Affordable and Safe Prescription Drug Importation Act H.R. 1275: World's Greatest Healthcare Plan of 2017 H.R. 1304: Self-Insurance Protection Act H.R. 1313: Preserving Employee Wellness Programs Act H.R. 1314: Health Care Choice Act of 2017 H.R. 1421: Improving Access to Medicare Coverage Act of 2017 S. 58: Legislation to repeal the Cadillac/Excise tax S. 106: ObamaCare Repeal Act S. 40: Middle Class Health Benefits Tax Repeal Act S. 41: Medicare Prescription Drug Price Negotiation Act of 2017 S. 92: Safe and Affordable Drugs from Canada Act of 2017 S. 124: Preserve Access to Affordable Generics Act S. 147: Obamacare Taxpayer Bailout Prevention Act S. 191: Patient Freedom Act of 2017 S. 222: Obamacare Replacement Act S. 297: Increasing Competition in Pharmaceuticals Act S. 469: Affordable and Safe Prescription Drug Importation Act S. 568: Improving Access to Medicare Coverage Act of 2017 S. 761: Health Care Options Act of 2017 S. 870 Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017 H.R.1995 - V-BID for Better Care Act of 2017 H.R. 3044 To amend title XVIII of the Social Security Act to expand supplemental benefits to meet the needs of chronically ill Medicare Advantage enrollees under the Medicare program, and for other purposes. H.R. 3168 To amend title XVIII of the Social Security Act to provide continued access to specialized Medicare Advantage plans for special needs individuals, and for other purposes. H.R.2575 Beneficiary Enrollment Notification and Eligibility Simplification Act S.1254 Health Care for Small Business Act H.R.2823 - Affordable Retirement Advice for Savers Act S.1462, The Marketplace Certainty Act S.1354 - Individual Health Insurance Marketplace Improvement Act S.1201 - Health Care Options for All Act H.R.2770 - Health Care Options for All Act H.R.676 - Expanded & Improved Medicare For All Act H.R. 3919 - Commonsense Reporting Act of 2017 S. 1908 - Commonsense Reporting Act of 2017 S. 1804 - Medicare for All Act of 2017 S. 1835 - Lower Premiums Through Reinsurance Act of 2017 S. 1782 - Forty Hours Is Full Time Act of 2017 H.R. 3181 - Medicare Choices Empowerment and Protection Act S. 1827 - KIDS Act of 2017 S. 1681 - A bill to require persons who undertake Federally funded research and development of drugs to enter into reasonable pricing agreements with the Secretary of Health and Human Services S. 1909 - BENES Act of 2017 H.R. 3877 - Fair Billing Act of 2017 S. 1859 - Healthcare Tax Relief Act H.R. 3780 - Air Ambulance Quality and Accountability Act H.R. 3748 - Medicare Buy-In and Health Care Stabilization Act of 2017 H.R. 3378 - Ensuring Access to Air Ambulance Services Act of 2017 H.R. 3311 - Individual Health Insurance Marketplace Improvement Act H.R. 3258 - Marketplace Certainty Act S. 1546 - Commonsense Competition and Access to Health Insurance Act

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

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

H. Con. Res. 71 Fiscal Year 2018 Budget Resolution H. Res. 142/S. Res. 63 National Obesity Care Week Resolution S. J. Res. 16 a joint resolution approving the discontinuation of the process for consideration and automatic implementation of the annual proposal of the independent payment Medicare advisory board H.J. Res 51/S. J. Res 17 Independent Payment Advisory Board Repeal H.R 1995 Value Based Insurance Design for Better Care Act H.R. 1004 Regulatory Integrity Act H.R. 1009/S. 676 OIRA Insight, Reform, and Accountability Act H.R. 1038/S. 413 Improving Transparency and Accuracy in Medicare Part D Spending H.R. 1072/S. 222 Obamacare Replacement Act H.R. 1101 Small Business Health Fairness Act H.R. 1121 Pre-Existing Conditions Protection Act H.R. 1148/S. 431 Furthering Access to Stroke Telemedicine (FAST) Act H.R. 1215 Protecting Access to Care Act H.R. 1245/S. 469 Affordable and Safe Prescription Drug Importation Act H.R. 1267/S. 482 Personal Health Investment Today Act H.R. 1304 Self-Insurance Protection Act H.R. 1313 Preserving Employee Wellness Programs Act H.R. 1554/S. 581 Jessie's Law H.R. 1565 Saving Lives, Saving Costs Act H.R. 1617 Promoting Access to Diabetic Shoes Act H.R. 1628 American Health Care Act H.R. 1703 Medical Product Communications Act H.R. 1776/S. 771 Improving Access to Affordable Prescription Drugs Act H.R. 184 Protect Medical Innovation Act H.R. 1953/S. 830 Treat and Reduce Obesity Act H.R. 2192/S. 1569 to eliminate the non-application of certain state waiver provisions to members of Congress and Congressional staff H.R. 2212/S. 974 Creating and Restoring Equal Access to Equivalent Samples Act H.R. 2267/S. 1301 Resident Physician Shortage Reduction Act H.R. 2372 Veterans Equal Treatment Ensures Relief and Access Now Act H.R. 246/S. 183 Jobs and Premium Protection Act H.R. 2550 Medicare Telehealth Parity Act H.R. 2556/S. 1016 CONNECT for Health Act H.R. 2579 Broader Options for Americans Act H.R. 2581 Verify First Act H.R. 2797/S. 1334 Patient Choice and Quality Care Act H.R. 2824 Increasing Opportunity and Success for Children and Parents Through Evidence -Based Home Visiting Act H.R. 284/S. 1291 Advancing Medical Resident Training in Community Hospitals Act H.R. 2953 Preventive Health Savings Act H.R. 3044 to expand supplemental benefits to meet the needs of chronically ill Medicare Advantage enrollees H.R. 3059/S. 1441 Community Health Center and Primary Care Workforce Expansion Act H.R. 309/S. 920 National Clinical Care Commission Act H.R. 3120 to reduce the volume of future electronic health record-related significant hardship requests H.R. 3124/S. 1299 Preventing Diabetes in Medicare Act H.R. 3168 to provide continued access to Medicare Advantage plans for special needs H.R. 3224 Critical Access and Rural Equity Act H.R. 3245 Medicare Civil and Criminal Penalties Act H.R. 3263 to extend the Medicare independence at home medical demonstration program H.R. 3271/S. 1914 Protecting Access to Diabetes Supplies Act H.R. 3358/S. 1771 Fiscal Year 2018 Labor-Health and Human Services-Education Appropriations Bill H.R. 3394 Teaching Health Centers Graduate Medical Education Extension Act H.R. 3447 Furthering Access to Coordinated Treatment for Seniors Act H.R. 3536/S.1681 to require persons who undertake federally funded research and development of drugs to enter into reasonable pricing agreements H.R. 372 Competitive Health Insurance Reform Act H.R. 3726 Stark Administrative Simplification Act of 2017 H.R. 3728 Empowering Medical Professionals and Optimizing Workforce Efficiency and Readiness Act H.R. 3820/S. 977 Medicare Home Health Flexibility Act H.R. 3862 National Health Service Corps Strengthening Act H.R. 3921 Helping Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable Act H.R. 4006 Community-Based Independence for Seniors Act of 2017 H.R. 592/S. 109 Pharmacy and Medically Underserved Areas Enhancement Act H.R. 706 Plan Verification and Fairness Act H.R. 741/S. 243 Rural Hospital Regulatory Relief Act H.R. 749 Lower Drug Costs Through Competition Act H.R. 766 Amend Title XVII of the Social Security Act to expand telehealth in Medicare H.R. 849/S. 260 Protecting Seniors' Access to Medicare Act H.R. 908 Medicare Advantage Quality Payment Relief Act H.R. 998 Searching for and Cutting Regulations that are Unnecessarily Burdensome(SCRUB) Act H.R.3545 Overdose Prevention and Patient Safety Act H.R.3727 To amend title XVIII of the Social Security Act to include additional telehealth services for purposes of MA organization bids, and for other purposes Introduction of the Stark Law Modernization Act of 2017 Pub L. 114-198 Comprehensive Addiction and Recovery Act Pub L. 115-31 Fiscal Year 2017 Consolidated Appropriations Act Pub. L. 102-143 Telephone Consumer Protection Act Pub. L. 111-148 Patient Protection and Affordable Care Act (PPACA) Pub. L. 111-5 The American Recovery and Reinvestment Act Pub. L. 114-10 Medicare Access and CHIP Reauthorization Act (MACRA) Pub. L. 114-255, 21st Century Cures Act Pub. L. 114-270 Expanding Capacity for Health Outcomes Act (ECHO) Pub. L. 114-329 American Innovation and Competitiveness Act Pub L. 115-63 Disaster Relief & Airway Extension Act S. 108 Medical Device Access and Innovation Protection Act S. 297 Increasing Competition in Pharmaceuticals Act S. 1688 Empowering Medicare Seniors to Negotiate Drug Prices Act S. 1754 Training the Next Generation of Primary Care Doctors Act S. 1804 Medicare for All Act S. 1827 Keep Kids' Insurance Dependable and Secure Act S. 1829 Strong Families Act S. 1850 Protecting Jessica Grubbs Legacy Act, (The Legacy Act) S. 1859 Healthcare Tax Relief Act S. 1899 to reauthorize and extend funding for community health centers and the National Health Service Corps S. 191 Patient Freedom Act S. 251 Protecting Medicare from Executive Action Act S. 309 Community Based Independence for Seniors Act S. 464 Independence at Home Act S. 64 Safe and Affordable Drugs from Canada Act H .R. 1933/S. 761 Health Care Options Act of 2017 S. 787 Telehealth Innovation and Improvement Act S. 870 Creating High-Quality Results and Outcomes Necessary to Improve Chronic Care Act S. Con. Res. 3 Budget Resolution

Client expense: $190,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Discussion Draft Better Care Reconciliation Act (Enzi) - ACA repeal and replace issues; coverage provisions; market stabilization S.Con.Res. 3, Budget Resolution (Enzi) - ACA repeal and replace issues; coverage provisions; market stabilization S. 147, Obamacare Taxpayer Bailout Prevention Act (Rubio) - ACA risk corridors program S. 191, Patient Freedom Act (Cassidy-Collins) - replacement reforms; state options S. 1201, Health Care Options for All Act (McCaskill) - access to FEHBP in bare counties S. 1354, Individual Health Insurance Marketplace Improvement Act (Carper-Kaine) - individual market reinsurance fund, outreach and enrollment activities S. 1462, Marketplace Certainty Act (Shaheen) - funding for cost-sharing reduction (CSR) payments S. 1516, Coverage Across State Lines (Heller) H.R. 277, American Health Care Reform Act (Roe) - replacement reforms H.R. 314, Health Care Choice Act (Blackburn) - selling insurance across state lines H.R. 372, Competitive Health Insurance Reform Act (Gosar) - McCarran-Ferguson Act H.R. 706, Plan Verification and Fairness Act (Blackburn) - verifying eligibility for special enrollment periods H.R. 708, State Age Rating Flexibility Act (Buchson) - age rating bands H.R. 710, Health Coverage State Flexibility Act (Flores) - grace period for premium payments H.R. 1101, Small Business Health Fairness Act (Johnson) - association health plans H.R. 1121, Pre-existing Conditions Protection Act (Walden) - protections for patients with pre-existing conditions H.R. 1304, Self-Insurance Protection Act (Roe) - medical stop-loss insurance H.R. 1409, Cancer Drug Parity Act (Lance) - coverage of oral anti-cancer drugs H.R. 1628, American Health Care Act (Black) - ACA repeal and replace issues; coverage provisions; market stabilization H.R. 2086, No Coverage, No Penalty Act (Blackburn) - waiving ACA individual mandate in areas with no QHPs H.R. 2516, Freedom from the ACA Tax Penalty Act (Young) - waiving ACA individual mandate in areas with no QHPs Regulatory Issues: Insurance regulatory reform; issues related to the coordination of private and public disability income benefits; disability risk management; disability income insurance enrollment and awareness; issues related to encouraging impaired workers to stay in/return to the workforce; issues relating to the coordination of benefits between private health insurance plans and Medicaid; Medigap claims processing and crossover fees; Medigap cross-over claim issues, Medigap coverage, implementation of Medigap standardized plan offerings; Medigap carrier recoveries related to CMS fraud and abuse enforcement activities, and issues related to Medigap educational materials, and other Medigap issues; fraud and abuse issues affecting public and private insurance coverage; issues relating to antitrust; implementation of the Mental Health Parity Act requirements; implementation of the 21st Century Cures Act requirements; summary of benefits and coverage disclosures; pre-existing condition insurance plans; accountable care organizations; coverage of preventive services; preexisting condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; dependent coverage; treatment of expatriate plans; compliance with the transitional reinsurance program; issues related to all payor claims databases; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations, non-discriminatory wellness programs; issues related to supplemental products; issues related to implementation of the Telephone Consumer Protection Act; issues relating to third party payment of premiums; issues related to cost-sharing reductions (CSRs); issues relating to the individual market; and other issues relating to health care reform implementation.

Client expense: $1,700,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Treasury, Dept of

Issues related to lung disease treatment, prevention and research; public health; Issues related asthma; COPD; influenza; lung cancer; pneumonia; tuberculosis and other lung diseases; Issues related to tobacco cessation; Issues related to the Affordable Care Act; Issues related to the President's Budget; H.R.774 Medicaid Coverage of Tobacco Cessation Nonprescription Drugs Act; H.R.1121 Pre-existing Conditions Protection Act of 2017; H.R.1628 American Health Care Act of 2017; Better Care Reconciliation Act; S. 1462 Marketplace Certainty Act; S.934 FDA Reauthorization Act of 2017; H.R.2430 - FDA Reauthorization Act of 2017; S.Con.Res.3 A concurrent resolution setting forth the congressional budget for the United States Government for fiscal year 2017 and setting forth the appropriate budgetary levels for fiscal years 2018 through 2026; Senate Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2017; House Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2017; Senate Department of State, Foreign Operations, and Related Programs Appropriations Act, 2017; House Department of State, Foreign Operations, and Related Programs Appropriations Act, 2017; H.R.244 - Consolidated Appropriations Act, 2017; Senate Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2018; House Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2018; Senate Department of State, Foreign Operations, and Related Programs Appropriations Act, 2018; House Department of State, Foreign Operations, and Related Programs Appropriations Act, 2018; H.R.2998 Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2018; Senate Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2018

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Postal Regulatory Commission, SENATE, Veterans Affairs, Dept of (VA), White House Office

Issues related to lung disease treatment, prevention and research; public health; Issues related to tobacco cessation; Issues related to the President's Budget; Issues related to Medicaid waivers; H.R.774 Medicaid Coverage of Tobacco Cessation Nonprescription Drugs Act; H.R.1121 Pre-existing Conditions Protection Act of 2017; H.R.1628 American Health Care Act of 2017; Better Care Reconciliation Act,; S.Con.Res.3 A concurrent resolution setting forth the congressional budget for the United States Government for fiscal year 2017 and setting forth the appropriate budgetary levels for fiscal years 2018 through 2026; Senate Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2017; House Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2017; H.R.244 Consolidated Appropriations Act, 2017; Health and Human Services, and Education, and Related Agencies Appropriations Act, 2019; House Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2018;

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Postal Regulatory Commission, SENATE, Veterans Affairs, Dept of (VA), White House Office

H.R. 1215 - Protecting Access to Care Act of 2017: To improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system. King (R-IA) H.R.1101 - Small Business Health Fairness Act of 2017: To amend title I of the Employee Retirement Income Security Act of 1974 to improve access and choice for entrepreneurs with small businesses with respect to medical care for their employees. Johnson (R-TX). H.R.3120 - To amend title XVIII of the Social Security Act to reduce the volume of future electronic health record-related significant hardship requests. Burgess (R-TX). S. 934 and H.R. 2430 - FDA Reauthorization Act of 2017: To amend the Federal Food, Drug, and Cosmetic Act to revise and extend the user-fee programs for prescription drugs, medical devices, generic drugs, and biosimilar biological products, and for other purposes. Alexander (R-TN) & Walden (R-OR). S. 974 and H.R. 2212 - Creates Act of 2017: To promote competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products. Leahy (D-VT) & Marino (R-PA). HR 173 and S 40 - Middle Class Health Benefits Tax Repeal Act of 2017: To amend the Internal Revenue Code of 1986 to repeal the excise tax on high cost employer-sponsored health coverage. Kelly (R-PA) & Heller (R-NV). HR 314 - Health Care Choice Act of 2017: To repeal title I of the Patient Protection and Affordable Care Act and to amend the Public Health Service Act to provide for cooperative governing of individual health insurance coverage offered in interstate commerce. Blackburn (R-TN). HR 706 - Plan Verification and Fairness Act of 2017: 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. Blackburn (R-TN). HR 708 - State Age Rating Flexibility Act of 2017: To amend title XXVII of the Public Health Service Act to change the permissible age variation in health insurance premium rates. Buschon (R-IN). HR 710 -Health Coverage State Flexibility Act of 2017: 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. Flores (R-TX). HR 749 - Lower Drug Costs through Competition Act: To increase competition in the pharmaceutical industry. Schrader (D-OR) H.R.1121 - Pre-existing Conditions Protection Act of 2017: To amend the Public Health Service Act to prohibit application of pre-existing condition exclusions and to guarantee availability of health insurance coverage in the individual and group market, contingent on the enactment of legislation repealing the Patient Protection and Affordable Care Act, and for other purposes. Walden (R-OR). HR 1175 and S 403 - Health Savings Act of 2017: To amend the Internal Revenue Code of 1986 to improve access to health care through expanded health savings accounts, and for other purposes. Paulsen (R-MN) & Hatch (R-UT). HR 1304 - Self-Insurance Protection Act: To amend the Employee Retirement Income Security Act of 1974, the Public Health Service Act, and the Internal Revenue Code of 1986 to exclude from the definition of health insurance coverage certain medical stop-loss insurance obtained by certain plan sponsors of group health plans. Roe (R-TN) HR 1628 - American Health Care Act of 2017: To provide for reconciliation pursuant to title II of the concurrent resolution on the budget for fiscal year 2017. Black (R-TN). HR 1776 & S 771 Improving Access To Affordable Prescription Drugs Act: To improve access to affordable prescription drugs. Schakowsky (D-IL) & Franken (D-MN) HR 2051 - To amend the Federal Food, Drug, and Cosmetic Act to ensure that eligible product developers have competitive access to approved drugs and licensed biological products, so as to enable eligible product developers to develop and test new products, and for other purposes. McKinley (R-WV) S 191 - Patient Freedom Act of 2017: To improve patient choice by allowing States to adopt market based alternatives to the Affordable Care Act that increase access to affordable health insurance and reduce costs while ensuring important consumer protections and improving patient care. Cassidy (R-LA) S 637 - Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2017: To amend titles XI and XVIII of the Social Security Act to provide greater transparency of discounts provided by drug manufacturers. Wyden (D-OR)

Client expense: $208,058 · Firm income: Not reported

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

PL 111-148 - The Patient Protection and Affordable Care Act, implementation H.R. 1628 - American Health Care Act of 2017 H.R. 246 - health insurance tax repeal Better Care Reconciliation Act of 2017 H.R. 1101 - Small Business Health Care Fairness Act H.R. 372 - Competitive Health Insurance Reform Act H.R. 1121 - Pre-existing Conditions Protection Act of 2017 H.R. 708- State Age Rating Flexibility Act ***, no specific bill(s), Health Savings Accounts/Medical Savings Accounts, Transparency, Interoperability, Health Information Technology, Electronic Prescribing, Insurance Market Reform, Uninsured, Employer Based Health System, Exchanges, Risk Corridors and Reinsurance, Federal employees and regional PPOs, Cybersecurity, telehealth, Co-ops, special enrollment periods, Risk Mitigation, mental health, opioid abuse, market stabilization, out of network billing

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

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

H.R. 173: Legislation to repeal the Cadillac/Excise tax H.R. 246: Legislation to repeal the annual fee on health insurance providers; Health Insurance Tax (HIT) H.R. 1628: The American Health Care Act of 2017 (AHCA) H.R. 175: ObamaCare Repeal Act H.R 242: Medicare Prescription Drug Price Negotiation Act of 2017 H.R. 277: American Health Care Reform Act of 2017 H.R. 314: Health Care Choice Act H.R. 352: State Health Flexibility Act of 2017 H.R. 372: Competitive Health Insurance Reform Act of 2017 H.R. 432: Small Business Tax Credit Accessibility Act H.R. 521: Protection from Insurance Exchange Monopolies Act H.R. 551: Amends the ACA to permit insurers to offer catastrophic coverage plans to anyone H.R. 552: Affordable Limited Health Coverage Act H.R. 633: Patient Fairness and Relief Act of 2017 H.R. 661: Employee Fairness and Relief Act H.R. 708: State Age Rating Flexibility Act of 2017 H.R. 710: Health Coverage State Flexibility Act of 2017 H.R. 749: Lower Drug Costs through Competition Act H.R. 1072: ObamaCare Replacement Act H.R 1101: Small Business Health Fairness Act of 2017 H.R. 1121: Pre-existing Conditions Protection Act of 2017 H.R. 1215: Protecting Access to Care Act of 2017 H.R. 1245: Affordable and Safe Prescription Drug Importation Act H.R. 1275: World's Greatest Healthcare Plan of 2017 H.R. 1304: Self-Insurance Protection Act H.R. 1313: Preserving Employee Wellness Programs Act H.R. 1314: Health Care Choice Act of 2017 H.R. 1421: Improving Access to Medicare Coverage Act of 2017 S. 58: Legislation to repeal the Cadillac/Excise tax S. 106: ObamaCare Repeal Act S. 40: Middle Class Health Benefits Tax Repeal Act S. 41: Medicare Prescription Drug Price Negotiation Act of 2017 S. 92: Safe and Affordable Drugs from Canada Act of 2017 S. 124: Preserve Access to Affordable Generics Act S. 147: Obamacare Taxpayer Bailout Prevention Act S. 191: Patient Freedom Act of 2017 S. 222: Obamacare Replacement Act S. 297: Increasing Competition in Pharmaceuticals Act S. 469: Affordable and Safe Prescription Drug Importation Act S. 568: Improving Access to Medicare Coverage Act of 2017 S. 761: Health Care Options Act of 2017 S. 870 Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017 H.R.1995 - V-BID for Better Care Act of 2017 H.R. 3044 To amend title XVIII of the Social Security Act to expand supplemental benefits to meet the needs of chronically ill Medicare Advantage enrollees under the Medicare program, and for other purposes. H.R. 3168 To amend title XVIII of the Social Security Act to provide continued access to specialized Medicare Advantage plans for special needs individuals, and for other purposes. H.R.2575 Beneficiary Enrollment Notification and Eligibility Simplification Act S.1254 Health Care for Small Business Act H.R.2823 - Affordable Retirement Advice for Savers Act S.1462, The Marketplace Certainty Act S.1354 - Individual Health Insurance Marketplace Improvement Act S.1201 - Health Care Options for All Act H.R.2770 - Health Care Options for All Act H.R.676 - Expanded & Improved Medicare For All Act

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

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

H.R. 2938 Removing Barriers to Medicaid and CHIP Addiction Treatment Act of 2017 H. Res. 142 Expressing support for "National Obesity Care Week" S. Res. 63 Expressing support for "National Obesity Care Week" H.R. 181 Close Annuity Loopholes in Medicaid Act H.R. 184 Protect Medical Innovation Act H.R. 244 Consolidated Appropriations Act, 2017 H.R. 284 Advancing Medical Resident Training in Community Hospitals Act H.R. 309 National Clinical Care Commission Act S. 920 National Clinical Care Commission Act H.R. 372 Competitive Health Insurance Reform Act H.R. 592 Pharmacy and Medically Underserved Areas Enhancement Act S. 109 Pharmacy and Medically Underserved Areas Enhancement Act H.R. 706 Plan Verification and Fairness Act H.R. 741 Rural Hospital Regulatory Relief Act S. 243 Rural Hospital Regulatory Relief Act H.R. 749 Lower Drug Costs through Competition Act H.R. 766 Amend Title XVII of the Social Security Act to Expand Telehealth in Medicare H.R. 829 Prioritizing the Most Vulnerable Over Lottery Winners Act H.R. 849 Protecting Seniors' Access to Medicare Act S. 260 Protecting Seniors' Access to Medicare Act H.R. 908 Medicare Advantage Quality Payment Relief Act H.R. 998 Searching for and Cutting Regulations that are Unnecessarily Burdensome (SCRUB) Act H.R. 1004 Regulatory Integrity Act H.R. 1009 OIRA Insight, Reform, and Accountability Act S. 676 OIRA Insight, Reform, and Accountability Act H.R. 1038 Improving Transparency and Accuracy in Medicare Part D Spending H.R. 1072 Obamacare Replacement Act S. 222 Obamacare Replacement Act H.R. 1101 Small Business Health Fairness Act H.R. 1121 Pre-Existing Conditions Protection Act H.R. 1148 Furthering Access to Stroke Telemedicine (FAST) Act S. 431 Furthering Access to Stroke Telemedicine (FAST) Act H.R. 1215 Protecting Access to Care Act H.R. 1245 Affordable and Safe Prescription Drug Importation Act S. 469 Affordable and Safe Prescription Drug Importation Act H.R. 1267 Personal Health Investment Today (PHIT) Act S. 482 Personal Health Investment Today (PHIT) Act H.R. 1304 Self-Insurance Protection Act H.R. 1313 Preserving Employee Wellness Programs Act H.R. 1554 Jessie's Law S. 581 Jessie's Law H.R. 1565 Saving Lives, Saving Costs Act H.R. 1628 American Health Care Act H.R. 1703 Medical Product Communications Act H.R. 1776 Improving Access to Affordable Prescription Drugs Act S. 771 Improving Access to Affordable Prescription Drugs Act H.R. 1922 Foreign Medical School Accountability Fairness Act S. 850 Foreign Medical School Accountability Fairness Act H.R. 1953 Treat and Reduce Obesity Act (TROA) S. 830 Treat and Reduce Obesity Act (TROA) H.R. 2141 Conrad State 30 and Physician Access Reauthorization Act S. 898 Conrad State 30 and Physician Access Reauthorization Act H.R. 2192 To Amend the Public Health Service Act to Eliminate the Non-Application of Certain State Waiver Provisions to Members of Congress and Congressional Staff H.R. 2212 Creating and Restoring Equal Access to Equivalent Samples (CREATES) Act S. 974 Creating and Restoring Equal Access to Equivalent Samples (CREATES) Act H.R. 2267 Resident Physician Reduction Shortage Act H.R. 246 Jobs and Premium Protection Act H.R. 2550 Medicare Telehealth Parity Act H.R. 2556 CONNECT for Health Act S. 1016 CONNECT for Health Act H.R. 2953 Amend the Congressional Budget Act of 1974 Respecting the Scoring of Preventive Health Savings S. 108 Medical Device Access and Innovation Protection Act S. 183 Jobs and Premium Protection Act S. 191 Patient Freedom Act S. 251 Protecting Medicare from Executive Action Act S. 309 Community-Based Independence for Seniors Act S. 413 Improving Transparency and Accuracy in Medicare Part D Spending S. 464 Independence at Home Act S. 469 Affordable and Safe Prescription Drug Importation Act S. 64 Safe and Affordable Drugs from Canada Act S. 761 Health Care Options Act S. 771 Improving Access to Affordable Prescription Drugs Act S. 787, Telehealth Innovation and Improvement Act S. 870 Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act

Client expense: $180,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H.R.1628, American Health Care Act of 2017 - Lobbied in opposition to the bill. Discussed support for medical expense deduction. H.R. 708, State Age Rating Flexibility Act of 2017 - Discussed opposition to bill. Sent letter to House Energy and Commerce Committee. H.R. 1121, Pre-Existing Conditions Protection Act of 2017 - Discussed bill. H.R. 708/H.R.1628 - Provided information on the age tax and its impact on older adults. Discussed priorities for older adults in health care reform legislation including Medicare, private health insurance/age tax, Medicaid, and prescription drugs. S. 191, Patient Freedom Act of 2017 - Discussed bill. Discussed health care reform generally. H.R. 2028 (Public Law 114-254) - Further Continuing and Security Assistance Appropriations Act, 2017 - Lobbied in support of increased funding for CMS' state survey and certification program and opposition to hostile policy riders re Patient Protection and Affordable Care Act. H.R. 1313, Preserving Employee Wellness Programs Act - Opposed bill. Discussed health care tax provisions - Sent letter to House and Senate committee leadership addressing preservation of tax exempt status of employer sponsored insurance coverage, maintenance of tax subsidies for lower- and moderate-income Americans to purchase health insurance coverage in health care marketplaces, the creation of a new, non-refundable tax credit for working family caregivers, and the retention of the medical expense itemized deduction.

Client expense: $2,010,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Equal Employment Opportunity Commission (EEOC), Federal Transit Administration (FTA), HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Social Security Administration (SSA), Transportation, Dept of (DOT)

H.R. 708, State Age Rating Flexibility Act of 2017 - Discussed opposition to bill. H.R. 1121, Pre-Existing Conditions Protection Act of 2017 - Discussed bill. H.R. 708/H.R.1628 - Provided information on the age tax and its impact on older adults. H.R. 1628, American Health Care Act - Discussed health care reform and opposition to the bill including because of "age tax" and changes to Medicaid. Discussed priorities for older adults in health care reform legislation including Medicare, private health insurance/age tax, Medicaid, and prescription drugs. S. 191, Patient Freedom Act of 2017 - Discussed bill. Discussed health care reform generally.

Client expense: $2,010,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Equal Employment Opportunity Commission (EEOC), Federal Transit Administration (FTA), HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Social Security Administration (SSA), Transportation, Dept of (DOT)

ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (reconciliation, individual mandate, cost sharing reduction subsidies) ACA transitional policies Proposed HHS Market Stabilization Regulation The American Health Care Act (H.R. 1628 and H. Res. 154) The Small Business Health Fairness Act of 2017 (H.R. 1101) The Competitive Health Insurance Reform Act (H.R. 372) The Protecting Access to Care Act (H.R. 1215) The Self-Insurance Protection Act (H.R. 1304) The Pre-existing Conditions Protection Act of 2017 (H.R. 1121) The Patient Fairness and Relief Act of 2017 (H.R. 633) The Employee Fairness and Relief Act of 2017 (H.R. 661) The Plan Verification and Fairness Act of 2017 (H.R. 706) The State Age Rating Flexibility Act of 2017 (H.R. 708) The Health Coverage State Flexibility Act of 2017 (H.R. 710) The Lower Drug Costs through Competition Act (H.R. 749) Out of network Billing ACA third party payments Telehealth Price of prescription drugs

Client expense: $1,700,000 · 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

ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (reconciliation, individual mandate, cost sharing reduction subsidies) ACA transitional policies Proposed HHS Market Stabilization Regulation The American Health Care Act (H.R. 1628 and H. Res. 154) The Small Business Health Fairness Act of 2017 (H.R. 1101) The Competitive Health Insurance Reform Act (H.R. 372) The Protecting Access to Care Act (H.R. 1215) The Self-Insurance Protection Act (H.R. 1304) The Pre-existing Conditions Protection Act of 2017 (H.R. 1121) The Patient Fairness and Relief Act of 2017 (H.R. 633) The Employee Fairness and Relief Act of 2017 (H.R. 661) The Plan Verification and Fairness Act of 2017 (H.R. 706) The State Age Rating Flexibility Act of 2017 (H.R. 708) The Health Coverage State Flexibility Act of 2017 (H.R. 710) The Lower Drug Costs through Competition Act (H.R. 749) Out of network Billing ACA third party payments Telehealth Price of prescription drugs

Client expense: $1,700,000 · 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

Legislation and policies related to: Physician/nurse practitioner reimbursement Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Implementation of the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 (P.L. 114-10) including policies related to the Quality Payment Program Adoption of recommendations of the Institute of Medicine report, The Future of Nursing: Leading Change, Advancing Health Medicare Shared Savings Program beneficiary assignment requirements Medicare-Medicaid hospital conditions of participation Evaluation of the Medicare Graduate Nurse Education demonstration Medicare-Medicaid Program Integrity policies Medicaid maintenance of effort requirements Medicaid eligibility expansion and state options Medicaid waiver application procedures Medicaid per capita cap policy options H.R. 181 - Close Annuity Loopholes in Medicaid Act H.R. 365 - Primary Care Enhancement Act of 2017 H.R. 829 - Prioritizing the Most Vulnerable Over Lottery Winners Act of 2017 H.R. 1121 - Pre-Existing Conditions Protection Act H.R. 1160 - ACO Assignment Improvement Act of 2017 H.R. 1617 - Promoting Access to Diabetic Shoes Act H.R. 1628 - American Health Care Act of 2017 S. 191 - Patient Freedom Act S. 222/H.R. 1072 - Obamacare Replacement Act S. 251 - Protecting Medicare from Executive Action Act of 2017 S. 260/H.R. 849 - Protecting Seniors' Access to Medicare Act of 2017 S. 403/H.R. 1175 - Health Savings Act of 2017 S. 445/H.R. 1825 - Home Health Care Planning Improvement Act of 2017 S. 428 - Advancing Care for Exceptional Kids (ACE Kids) Act

Client expense: Not reported · Firm income: $23,450

Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Justice, Dept of (DOJ), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, U.S. Immigration & Customs Enforcement (ICE), Veterans Affairs, Dept of (VA)

Issues related to lung disease treatment, prevention and research; public health; Issues related to tobacco cessation; Issues related to the President's Budget; H.R.774 Medicaid Coverage of Tobacco Cessation Nonprescription Drugs Act; H.R.1121 Pre-existing Conditions Protection Act of 2017; H.R.1628 American Health Care Act of 2017; S.Con.Res.3 A concurrent resolution setting forth the congressional budget for the United States Government for fiscal year 2017 and setting forth the appropriate budgetary levels for fiscal years 2018 through 2026; Senate Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2017; House Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2017; Issues related to FY 2018 Appropriations;

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Postal Regulatory Commission, SENATE, Veterans Affairs, Dept of (VA), White House Office