Protecting Access to Care Act of 2017

S.3548, CARES Act: To provide emergency assistance and health care response for individuals, families, and businesses affected by the 2020 coronavirus pandemic; Practice Support/Grants to Practice S.3201, Temporary Reauthorization and Study of the Emergency Scheduling of Fentanyl Analogues Act: Letter to Congressional Leadership regarding Fentanyl Surprise Medical Bills S.2723, Mitigating Emergency Drug Shortages Act: reducing drug shortages H.R. 3502, Protecting People From Surprise Medical Bills Act H.R. 2500, National Defense Authorization Act for Fiscal Year 2020: Krishnamoorthi amdt on drug shortages H.R. 3107, Improving Seniors' Timely Access to Care Act of 2019: pre-authorization S. 1895, Lower Health Care Costs Act H.R. 3692, Addiction Treatment Access Improvement Act of 2017: Medically assisted treatment; opioids H.R. 5761, Ending Maternal Mortality Act of 2018: Maternal mortality H.R. 5718, Perioperative Reduction of Opioids Act: Opioids H.R. 5197, Alternatives to Opioids (ALTO) in the Emergency Department Act: Medically assisted treatment; opioids S. 2516, Alternatives to Opioids (ALTO) in the Emergency Department Act: Medically assisted treatment; opioids S.2680, Opioid Crisis Response Act of 2018: Medically assisted treatment; opioids S.2456, CARA 2.0 Act of 2018: Medically assisted treatment; opioids H.R. 1565, Saving Lives, Saving Costs S.1475, Saving Lives, Saving Costs Comprehensive Addiction and Recovery Act of 2016 (PL 114-198) FY 2021 LHHS Appropriations: Fiscal Year 2021 Appropriations for Subcommittee on Labor, Health and Human Services Outside Witness Testimony Affordable Care Act reform efforts H.R. 1628, American Health Care Act of 2017 S. Amdt. 1030 to H.R. 1628, "Graham-Cassidy" Better Care Reconciliation Act of 2017 H.R. 1492, Medical Controlled Substances Transportation Act of 2017 H.R. 1215, Protecting Access to Care Act of 2017 H.R. 3545, Overdose Prevention and Patient Safety Act H.R. 3446, Restoring Board Immunity Act of 2017: Professional Licensing S.2260, Opioids and STOP Pain Initiative ACT:opioids 42 CFR Part 2, Confidentiality of Substance Use Disorder Patient Records: appropriate access to patient information essential for providing whole-person care H.R.3928, Truth in Healthcare Marketing Act of 2017 H.R. 1554, REDI Act: student loan debt repayment for residents 21st Century Cures Initiative Drug Shortages - FDA, DEA, HHS, CMS, GAO, House Energy and Commerce Committee, Senate HELP Committee DEA Scheduling Propofol Comparative Effectiveness Research - PCORI HITECH Implementation, Electronic Health Records, Final and Proposed Rules, HIT Meaningful Use HHS/OIG Anesthesia Practice Arrangements, Company Model FDA Safe Use Initiative Pain Management FTC Letters to States re: Interventional Pain Medicine & Advanced Practice Nurses & Competition in Healthcare Anesthesia Research Funding (Pediatric and others) Scope of Practice FDA Operating Room Fires Naloxone FDA Opioids Prescription Drug Abuse FDA Network of Experts NIH Interagency Pain Research Coordinating Committee FDA SMART TOTS - pediatric anesthesia research USP - US Pharmacopeia National Pain Strategy Nondiscrimination Compounding FDA Nominations to Advisory Committees (Anesthesia Drugs, Anesthesia Devices, Compounding) Agency for Healthcare Research and Quality (AHRQ) funding Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Sequestration Opioids and opioid abuse; Brain health Anesthesiologist Assistants Blood management Immigration: Foreign Physician Immigration Status COVID-19: Increased supply of PPE and ventilators,Funding for physician practices impacted by the cancellation of elective surgeries, unique role of anesthesiologists in responding to COVID-19 pandemic, medical liability, Scope of Practice (Waiver of federal supervision requirement under the Emergency Declaration)

Client expense: $340,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Natl Institutes of Health (NIH), Occupational Safety & Health Administration (OSHA), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA)

Surprise Medical Bills S.2723, Mitigating Emergency Drug Shortages Act: reducing drug shortages H.R. 3502, Protecting People From Surprise Medical Bills Act H.R. 2500, National Defense Authorization Act for Fiscal Year 2020: Krishnamoorthi amdt on drug shortages H.R. 3107, Improving Seniors' Timely Access to Care Act of 2019: pre-authorization S. 1895, Lower Health Care Costs Act H.R. 3692, Addiction Treatment Access Improvement Act of 2017: Medically assisted treatment; opioids H.R. 5761, Ending Maternal Mortality Act of 2018: Maternal mortality H.R. 5718, Perioperative Reduction of Opioids Act: Opioids H.R. 5197, Alternatives to Opioids (ALTO) in the Emergency Department Act: Medically assisted treatment; opioids S. 2516, Alternatives to Opioids (ALTO) in the Emergency Department Act: Medically assisted treatment; opioids S.2680, Opioid Crisis Response Act of 2018: Medically assisted treatment; opioids S.2456, CARA 2.0 Act of 2018: Medically assisted treatment; opioids H.R. 1565, Saving Lives, Saving Costs S.1475, Saving Lives, Saving Costs Comprehensive Addiction and Recovery Act of 2016 (PL 114-198) Affordable Care Act reform efforts H.R. 1628, American Health Care Act of 2017 S. Amdt. 1030 to H.R. 1628, "Graham-Cassidy" Better Care Reconciliation Act of 2017 H.R. 1492, Medical Controlled Substances Transportation Act of 2017 H.R. 1215, Protecting Access to Care Act of 2017 H.R. 3545, Overdose Prevention and Patient Safety Act H.R. 3446, Restoring Board Immunity Act of 2017: Professional Licensing S.2260, Opioids and STOP Pain Initiative ACT:opioids 42 CFR Part 2, Confidentiality of Substance Use Disorder Patient Records: appropriate access to patient information essential for providing whole-person care H.R.3928, Truth in Healthcare Marketing Act of 2017 H.R. 1554, REDI Act: student loan debt repayment for residents 21st Century Cures Initiative Drug Shortages - FDA, DEA, HHS, CMS, GAO, House Energy and Commerce Committee, Senate HELP Committee DEA Scheduling Propofol Comparative Effectiveness Research - PCORI HITECH Implementation, Electronic Health Records, Final and Proposed Rules, HIT Meaningful Use HHS/OIG Anesthesia Practice Arrangements, Company Model FDA Safe Use Initiative Pain Management FTC Letters to States re: Interventional Pain Medicine & Advanced Practice Nurses & Competition in Healthcare Anesthesia Research Funding (Pediatric and others) Scope of Practice FDA Operating Room Fires Naloxone FDA Opioids Prescription Drug Abuse FDA Network of Experts NIH Interagency Pain Research Coordinating Committee FDA SMART TOTS - pediatric anesthesia research USP - US Pharmacopeia National Pain Strategy Nondiscrimination Compounding FDA Nominations to Advisory Committees (Anesthesia Drugs, Anesthesia Devices, Compounding) Agency for Healthcare Research and Quality (AHRQ) funding Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Sequestration Opioids and opioid abuse; Brain health Anesthesiologist Assistants Blood management

Client expense: $300,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Natl Institutes of Health (NIH), Occupational Safety & Health Administration (OSHA), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA)

Surprise Medical Bills H.R. 3502, Protecting People From Surprise Medical Bills Act H.R. 2500, National Defense Authorization Act for Fiscal Year 2020: Krishnamoorthi amdt on drug shortages H.R. 3107, Improving Seniors' Timely Access to Care Act of 2019: pre-authorization S. 1895, Lower Health Care Costs Act H.R. 3692, Addiction Treatment Access Improvement Act of 2017: Medically assisted treatment; opioids H.R. 5761, Ending Maternal Mortality Act of 2018: Maternal mortality H.R. 5718, Perioperative Reduction of Opioids Act: Opioids H.R. 5197, Alternatives to Opioids (ALTO) in the Emergency Department Act: Medically assisted treatment; opioids S. 2516, Alternatives to Opioids (ALTO) in the Emergency Department Act: Medically assisted treatment; opioids S.2680, Opioid Crisis Response Act of 2018: Medically assisted treatment; opioids S.2456, CARA 2.0 Act of 2018: Medically assisted treatment; opioids H.R. 1565, Saving Lives, Saving Costs S.1475, Saving Lives, Saving Costs Comprehensive Addiction and Recovery Act of 2016 (PL 114-198) Affordable Care Act reform efforts H.R. 1628, American Health Care Act of 2017 S. Amdt. 1030 to H.R. 1628, "Graham-Cassidy" Better Care Reconciliation Act of 2017 H.R. 1492, Medical Controlled Substances Transportation Act of 2017 H.R. 1215, Protecting Access to Care Act of 2017 H.R. 3545, Overdose Prevention and Patient Safety Act H.R. 3446, Restoring Board Immunity Act of 2017: Professional Licensing S.2260, Opioids and STOP Pain Initiative ACT:opioids 42 CFR Part 2, Confidentiality of Substance Use Disorder Patient Records: appropriate access to patient information essential for providing whole-person care H.R.3928, Truth in Healthcare Marketing Act of 2017 H.R. 1554, REDI Act: student loan debt repayment for residents 21st Century Cures Initiative Drug Shortages - FDA, DEA, HHS, CMS, GAO, House Energy and Commerce Committee, Senate HELP Committee DEA Scheduling Propofol Comparative Effectiveness Research - PCORI HITECH Implementation, Electronic Health Records, Final and Proposed Rules, HIT Meaningful Use HHS/OIG Anesthesia Practice Arrangements, Company Model FDA Safe Use Initiative Pain Management FTC Letters to States re: Interventional Pain Medicine & Advanced Practice Nurses & Competition in Healthcare Anesthesia Research Funding (Pediatric and others) Scope of Practice FDA Operating Room Fires Naloxone FDA Opioids Prescription Drug Abuse FDA Network of Experts NIH Interagency Pain Research Coordinating Committee FDA SMART TOTS - pediatric anesthesia research USP - US Pharmacopeia National Pain Strategy Nondiscrimination Compounding FDA Nominations to Advisory Committees (Anesthesia Drugs, Anesthesia Devices, Compounding) Agency for Healthcare Research and Quality (AHRQ) funding Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Sequestration Opioids and opioid abuse; Brain health Anesthesiologist Assistants Blood management

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Natl Institutes of Health (NIH), Occupational Safety & Health Administration (OSHA), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA)

Surprise Medical Bills H.R. 3502, Protecting People From Surprise Medical Bills Act S. 1895, Lower Health Care Costs Act H.R. 3692, Addiction Treatment Access Improvement Act of 2017: Medically assisted treatment; opioids H.R. 5761, Ending Maternal Mortality Act of 2018: Maternal mortality H.R. 5718, Perioperative Reduction of Opioids Act: Opioids H.R. 5197, Alternatives to Opioids (ALTO) in the Emergency Department Act: Medically assisted treatment; opioids S. 2516, Alternatives to Opioids (ALTO) in the Emergency Department Act: Medically assisted treatment; opioids S.2680, Opioid Crisis Response Act of 2018: Medically assisted treatment; opioids S.2456, CARA 2.0 Act of 2018: Medically assisted treatment; opioids H.R. 1565, Saving Lives, Saving Costs S.1475, Saving Lives, Saving Costs Comprehensive Addiction and Recovery Act of 2016 (PL 114-198) Affordable Care Act reform efforts H.R. 1628, American Health Care Act of 2017 S. Amdt. 1030 to H.R. 1628, "Graham-Cassidy" Better Care Reconciliation Act of 2017 H.R. 1492, Medical Controlled Substances Transportation Act of 2017 H.R. 1215, Protecting Access to Care Act of 2017 H.R. 3545, Overdose Prevention and Patient Safety Act H.R. 3446, Restoring Board Immunity Act of 2017: Professional Licensing S.2260, Opioids and STOP Pain Initiative ACT:opioids 42 CFR Part 2, Confidentiality of Substance Use Disorder Patient Records: appropriate access to patient information essential for providing whole-person care H.R.3928, Truth in Healthcare Marketing Act of 2017 H.R. 1554, REDI Act: student loan debt repayment for residents 21st Century Cures Initiative Drug Shortages - FDA, DEA, HHS, CMS, GAO, House Energy and Commerce Committee, Senate HELP Committee DEA Scheduling Propofol Comparative Effectiveness Research - PCORI HITECH Implementation, Electronic Health Records, Final and Proposed Rules, HIT Meaningful Use HHS/OIG Anesthesia Practice Arrangements, Company Model FDA Safe Use Initiative Pain Management FTC Letters to States re: Interventional Pain Medicine & Advanced Practice Nurses & Competition in Healthcare Anesthesia Research Funding (Pediatric and others) Scope of Practice FDA Operating Room Fires Naloxone FDA Opioids Prescription Drug Abuse FDA Network of Experts NIH Interagency Pain Research Coordinating Committee FDA SMART TOTS - pediatric anesthesia research USP - US Pharmacopeia National Pain Strategy Nondiscrimination Compounding FDA Nominations to Advisory Committees (Anesthesia Drugs, Anesthesia Devices, Compounding) Agency for Healthcare Research and Quality (AHRQ) funding Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Sequestration Opioids and opioid abuse; Brain health Anesthesiologist Assistants

Client expense: $310,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Natl Institutes of Health (NIH), Occupational Safety & Health Administration (OSHA), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA)

H.R. 3692, Addiction Treatment Access Improvement Act of 2017: Medically assisted treatment; opioids H.R. 5761, Ending Maternal Mortality Act of 2018: Maternal mortality H.R. 5718, Perioperative Reduction of Opioids Act: Opioids H.R. 5197, Alternatives to Opioids (ALTO) in the Emergency Department Act: Medically assisted treatment; opioids S. 2516, Alternatives to Opioids (ALTO) in the Emergency Department Act: Medically assisted treatment; opioids S.2680, Opioid Crisis Response Act of 2018: Medically assisted treatment; opioids S.2456, CARA 2.0 Act of 2018: Medically assisted treatment; opioids H.R. 1565, Saving Lives, Saving Costs S.1475, Saving Lives, Saving Costs Comprehensive Addiction and Recovery Act of 2016 (PL 114-198) Affordable Care Act reform efforts H.R. 1628, American Health Care Act of 2017 S. Amdt. 1030 to H.R. 1628, "Graham-Cassidy" Better Care Reconciliation Act of 2017 H.R. 1492, Medical Controlled Substances Transportation Act of 2017 H.R. 1215, Protecting Access to Care Act of 2017 H.R. 3545, Overdose Prevention and Patient Safety Act H.R. 3446, Restoring Board Immunity Act of 2017: Professional Licensing S.2260, Opioids and STOP Pain Initiative ACT:opioids 42 CFR Part 2, Confidentiality of Substance Use Disorder Patient Records: appropriate access to patient information essential for providing whole-person care H.R.3928, Truth in Healthcare Marketing Act of 2017 H.R. 5734, Resident Education Deferred Interest Act: student loan debt repayment for residents 21st Century Cures Initiative Drug Shortages - FDA, DEA, HHS, CMS, GAO, House Energy and Commerce Committee, Senate HELP Committee DEA Scheduling Propofol Comparative Effectiveness Research - PCORI HITECH Implementation, Electronic Health Records, Final and Proposed Rules, HIT Meaningful Use HHS/OIG Anesthesia Practice Arrangements, Company Model FDA Safe Use Initiative Pain Management FTC Letters to States re: Interventional Pain Medicine & Advanced Practice Nurses & Competition in Healthcare Anesthesia Research Funding (Pediatric and others) Scope of Practice FDA Operating Room Fires Naloxone FDA Opioids Prescription Drug Abuse FDA Network of Experts NIH Interagency Pain Research Coordinating Committee FDA SMART TOTS - pediatric anesthesia research USP - US Pharmacopeia National Pain Strategy Nondiscrimination Compounding FDA Nominations to Advisory Committees (Anesthesia Drugs, Anesthesia Devices, Compounding) Agency for Healthcare Research and Quality (AHRQ) funding Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Sequestration Opioids and Opioid abuse; Brain health

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Natl Institutes of Health (NIH), Occupational Safety & Health Administration (OSHA), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA)

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: $210,000 · Firm income: Not reported

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

Legislation H.R. 469/S. 119 - Sunshine for Regulatory Decrees and Settlements Act of 2017 H.R. 10 - Financial CHOICE Act of 2017 H.R. 725 - The Innocent Party Protection Act H.R. 720/S. 237 - Lawsuit Abuse Reduction Act of 2017 H.R. 26/S. 21 - Regulations from the Executive in Need of Scrutiny Act of 2017 H.R. 985 - Fairness in Class Action Litigation and Furthering Asbestos Claim Transparency Act of 2017 H.R. 906 - Furthering Asbestos Claim Transparency Act of 2017 H.R. 953 - Reducing Regulatory Burdens Act of 2017 H.R 725 - Innocent Party Protection Act H.R. 1215 - Protecting Access to Care Act of 2017 H.R. 1704 - ACCESS Act of 2017 H.R. 1179 - Discouraging Frivolous Lawsuits Act H.R 1004 - Regulatory Integrity Act of 2017 HR 1009 - OIRA Insight, Reform, and Accountability Act H.R. 5 - Regulatory Accountability Act of 2017 H.R. 21/S. 34 - Midnight Rules Relief Act of 2017 H.R. 998 - Searching for and Cutting Regulations that are Unnecessarily Burdensome (SCRUB) Act H.R. 1430 - Honest and Open New EPA Science Treatment (HONEST) Act of 2017 H.R. 1 - Tax Cuts and Jobs Act (115th Congress, 2017-2018), Public law no. 115-97 HR 3117 - Transparency and Honesty in Energy Regulations Act of 2017 HR 732/ S. 333 - Stop Settlement Slush Funds Act of 2017 H.J. Res. 111/S.J. Res. 47 - CFPB Arbitration Rule CRA H.R. 2359 - FCRA Liability Harmonization Act H.R. 3141 - Taxpayer Transparency Act of 2017 H.R. 2233 - American Jobs First Act of 2017 H.R. 2437/ S. 1134 - Back the Blue Act H.R. 620 - the ADA Education and Reform Act of 2017 H.R. 4396 - the ME TOO Congress Act H.R. 4423 - N. Texas Water Supply Security Act H.R. 4809 - Guidance Out of Darkness (GOOD) Act H.R. 5468 - Permitting Litigation Efficiency Act of 2018 H.R. 6754 - CIRCUIT Act of 2018 S. 1609 - Energy and Water Development and Related Agencies Appropriations Act, 2018 S. 584 - Small Business Regulatory Flexibility Improvements Act S. 580 - Truth in Regulations Act of 2017 S. 579 - Early Participation in Regulations Act of 2017 S. 578 - Better Evaluation of Science and Technology (BEST) Act S. 577 - Providing Accountability through Transparency Act of 2017 S. 951 - Regulatory Accountability Act of 2017 S. 1615 - Dream Act of 2017 S. 2014 - Prove it Act of 2017 S. 565 - Judgment Fund Transparency Act S. 386 - Judgment Fund Transparency and Terrorism Financing Prevention Act of 2017 S. 276 - Judicial Administration and Improvement Act of 2017 Rulemakings EO 13781 - Presidential Executive Order on a Comprehensive Plan for Reorganizing the Executive Branch, 82 FR 13959 (March 13, 2017) EO 13777 - Enforcing the Regulatory Reform Agenda, 82 FR 12285 (March 1, 2017) EO 13783 - Presidential Executive Order on Promoting Energy Independence and Economic Growth, 82 FR 16093 (March 28, 2017) Environmental Protection Agency, Environmental Justice Action Agenda 2016-2020 (EJ 2020) Environmental Protection Agency, Evaluation of Existing Regulations, 82 Fed. Reg. 17,793 (Apr. 13, 2017) (Docket ID EPA-HQ-OA-2017-0190). Centers for Medicare & Medicaid Services (CMS), Health and Human Services, Proposed Changes to Strip Legal Rights from Vulnerable Residents in Long-Term Care Facilities, CMS-3342-P, 82 FR 26649, (June 8, 2017) Nominations Jeffrey Clark for Assistant Attorney General, Department of Justice Mike Pompeo for Secretary of State Andrew Oldham for United States Court of Appeals for the Fifth Circuit Damien Schiff for United States Court of Federal Claims Andrew Brasher for United States Court for the Middle District of Alabama Patrick Wyrick for United States District Judge for the Western District of Oklahoma Brett Kavanaugh for United States Supreme Court Jonathan Kobes for United States Court of Appeals for the Eight Circuit William Barr for U.S. Attorney General, Department of Justice Thomas Farr for United States District Judge for the Eastern District of NC Eric Miller for United States Court of Appeals for the Ninth Circuit

Client expense: $74,132 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Army, Dept of (Corps of Engineers), Bureau of Land Management (BLM), Centers For Medicare and Medicaid Services (CMS), Consumer Product Safety Commission (CPSC), Council on Environmental Quality (CEQ), Defense, Dept of (DOD), Energy, Dept of, Environmental Protection Agency (EPA), HOUSE OF REPRESENTATIVES, Interior, Dept of (DOI), Natl Oceanic & Atmospheric Administration (NOAA), SENATE, Transportation, Dept of (DOT), U.S. Fish & Wildlife Service (USFWS)

Essential emergency medication shortages Mental health services for emergency psychiatric patients Price transparency, out-of-network reimbursement of emergency medical services H.Res.906-Congratulating the American College of Emergency Physicians on its 50th anniversary H.R.6-Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act H.R.372-Competetive Health Insurance Reform Act of 2017 H.R.548-Health Care Safety Net Enhancement Act of 2017 H.R.767-Stop, Observe, Ask, and Respond (SOAR) to Health and Wellness Act of 2017 H.R.817-End Surprise Billing Act of 2017 H.R.880-Military Injury Surgical Systems Integrated Operationally Nationwide to Achieve ZERO Preventable Deaths Act H.R.1057-Synthetics Trafficking and Overdose Prevention Act of 2017 H.R.1215-Protecting Access to Care Act of 2017 H.R.1323-Reducing Unnecessary Emergency Room Visits under Medicaid Act H.R.1492-Medical Controlled Substances Transportation Act of 2017 H.R.1565-Saving Lives, Saving Costs Act H.R.1822-Good Samaritan Health Professionals Act of 2017 H.R.1876-Good Samaritan Health Professionals Act of 2017 H.R.2200-Frederick Douglass Trafficking Victims Prevention and Protection Reauthorization Act of 2017 H.R.2410-Sickle Cell Disease Research, Surveillance, Prevention, and Treatment Act of 2017 H.R.2851-Stop the Importation and Trafficking of Synthetic Analogues (SITSA) Act of 2017 H.R.2957-Save Rural Hospitals Act H.R.3181-Medicare Choices Empowerment and Protection Act H.R.3258-Marketplace Certainty Act H.R.3545-Overdose Prevention and Patient Safety (OPPS) Act H.R.4922-Stopping Overdoses of Fentanyl Analogues Act H.R.5176-Preventing Overdoses While in Emergency Rooms Act of 2018 H.R.5197-Alternatives to Opioids (ALTO) in the Emergency Department Act H.R.5531-Opioid Emergency Response Act H.R.5558-Alternatives to Opioids Prescribing Act H.R.5678-Rural Emergency Medical Center Act of 2018 H.R.5734-Resident Education Deferred Interest Act H.R.6082-Overdose Prevention and Patient Safety (OPPS) Act H.R.6143-Patient Right to Know Drug Prices Act H.R.6144-Know the Lowest Price Act of 2018 H.R.6372-To require the Secretary of Health and Human Services issue regulations to ensure due process rights for physicians furnishing emergency medical services H.R.6502-Reducing Unnecessary Senior Hospitalizations Act of 2018 H.R.6615-Traumatic Brain Injury Program Reauthorization Act of 2018 H.R.6733-Know the Cost Act of 2018 H.R.6748-Emergency Medical Services for Children Program Reauthorization Act of 2018 H.R.7223-Right Rebate Act of 2018 Senate resolution congratulating the American College of Emergency Physicians on its 50th anniversary S.191-Patient Freedom Act of 2017 S.256-SOAR to Health and Wellness Act of 2017 S.284-End Surprise Billing Act of 2017 S.372- Synthetics Trafficking and Overdose Prevention Act of 2017 S.527-Health Care Safety Net Enhancement Act of 2017 S.568-Improving Access to Medicare Coverage Act of 2017 S.781-Good Samaritan Health Professionals Act of 2017 S.1016-Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2017 S.1022-Military Injury Surgical Systems Integrated Operationally Nationwide to Achieve ZERO Preventable Deaths Act S.1130-Rural Emergency Acute Care Hospital (REACH) Act S.1462-Marketplace Certainty Act S.1530- Medicare Choices Empowerment and Protection Act S.1553-Stopping Overdoses of Fentanyl Analogues Act S.1835-Lower Premiums Through Reinsurance Act of 2017 S.2465-Sickle Cell Disease Research, Surveillance, Prevention, and Treatment Act of 2018 S.2516-Alternatives to Opioids (ALTO) in the Emergency Department Act S.2544-Patient Right to Know Drug Prices Act S.2553-Know the Lowest Price Act of 2018 S.2609-Recovery Coaches Offer Addiction Counseling and Healing (COACH) Act S.2610-Preventing Overdoses While in Emergency Departments Act of 2018 S.2680-Opioid Crisis Response Act of 2018 S.3482-Emergency Medical Services for Children Program Reauthorization Act of 2018 S.3531-Emergency Care Improvement Act S.3657-Traumatic Brain Injury Program Reauthorization Act of 2018 S.3702-Right Rebate Act of 2018

Client expense: $549,617 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA)

H.R.548-Health Care Safety Net Enhancement Act of 2017 H.R.720-Lawsuit Abuse Reduction Act H.R.1215-Protecting Access to Care Act of 2017 H.R.1565-Saving Lives, Saving Costs Act H.R.1822-Good Samaritan Health Professionals Act of 2017 H.R.1876-Good Samaritan Health Professionals Act of 2017 S.527-Health Care Safety Net Enhancement Act of 2017 S.781-Good Samaritan Health Professionals Act of 2017

Client expense: $549,617 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA)

S. 1850, Legacy Act (Manchin-Capito) -- confidentiality of drug and alcohol treatment and prevention records S. 2460, Every Prescription Conveyed Securely Act (Bennet) - opioid issues S. 2680, Opioid Crisis Response Act (Alexander) - opioid initiatives, mental health parity S. 2789, Substance Abuse Prevention Act (Cornyn) - opioid initiatives, restrictions on step therapy S. 2812, Air Ambulance Consumer Protection Act (McCaskill) - air ambulance S. 2828, Sober Home Fraud Detection Act (Rubio) - best practices for identifying fraud in recovery housing S. 2891, Fighting the Opioid Epidemic with Sunshine Act (Grassley) - opioid issues S. 2892, Peer Support Enhancement and Evaluation Review Act (Cardin) - opioid issues S. 2898, Medication-Assisted Treatment Improvement Act (Casey) - opioid issues S. 2899, Caring Recovery for Infants and Babies Act (Brown) - opioid issues S. 2900, Comprehensive Screenings for Seniors Act (Brown) - opioid issues S. 2902, Better Data Sharing to Combat the Opioid Crisis Act (Cassidy) - opioid issues S. 2905, Strengthening Partnerships to Prevent Opioid Abuse Act (Toomey) - opioid issues S. 2910, Telehealth for Childrens Access to Services and Treatment Act (Roberts) - opioid issues S. 2911, Enhancing Patient Access to Non-Opioid Treatment Options (Heller) - opioid issues S. 2912, Opioid Addiction Treatment Programs Enhancement Act (Cassidy) - opioid issues S. 2920, Commit to Opioid Medical Prescriber Accountability and Safety for Seniors Act (McCaskill) - opioid issues S. 2922, Help for Moms and Babies Act (Stabenow) - opioid issues S. 2923, Building Capacity for Family-Focused Residential Treatment Act (Grassley) - opioid issues S. 2924, Supporting Family-Focused Residential Treatment Act (Scott) - opioid issues S. 3016, Action for Dental Health Act (Booker) - grants for oral health programs S. 3120, the HEAL Substance Use Disorders Act (Hatch) - opioid initiatives S. 3158, Labor-HHS-Education Appropriations Act (Blunt) - HHS funding S. 3254, Eliminating Kickbacks in Recovery Act (Rubio) - anti-kickback penalties for body brokers Draft Bill: Protecting Patients From Surprise Medical Bills Act (Cassidy) - surprise medical bills H.R. 6, SUPPORT Patients and Families Act (Walden) - opioid initiatives, Medicare and Medicaid issues, budget offsets H.R. 302, FAA Reauthorization Act - air ambulance issues H.R. 1215, Protecting Access to Care Act (King) - medical liability reform H.R. 1313, Preserving Employee Wellness Programs Act (Foxx) - employee wellness programs H.R. 2422, Action for Dental Health Act (Kelly) - oral health services and education for underserved populations H.R. 3331, adoption and use of EHR technology by behavioral health providers (Jenkins) - opioid issues H.R. 3528, Every Prescription Conveyed Securely Act (Clark) - opioid issues H.R. 4684, Ensuring Access to Quality Sober Living Act (Chu) - best practices for recovery housing H.R. 4841, Standardizing Electronic Prior Authorization for Safe Prescribing Act (Schweikert) - opioid issues H.R. 4998, Health Insurance for Former Foster Youth Act (Bass) - opioid issues H.R. 5100, Recovery Home Certification Act (Knight) -- anti-kickback penalties for body brokers H.R. 5477, Rural DOCS Act (O'Halleran) - opioid issues H.R. 5515, National Defense Authorization Act (Thornberry) H.R. 5562, Protecting NAS Babies Act (Jenkins) - opioid issues H.R. 5582, Abuse Deterrent Access Act (Carter) - opioid issues H.R. 5583, State reporting on certain adult health quality measures (Clarke) - opioid issues H.R. 5590, CMS Action Plan (Kinzinger) - opioid issues H.R. 5714, Education for Disposal of Unused Opioids Act (Black) - opioid issues H.R. 5715, Strengthening Partnerships to Prevent Opioid Abuse Act (Renacci) - opioid issues H.R. 5716, COMPASS Act (Roskam) - opioid issues H.R. 5723, Expanding Oversight of Opioid Prescribing and Payment Act (Tenney) - opioid issues H.R. 5725, BEST Act (Roskam) - opioid issues H.R. 5774, Combating Opioid Abuse for Care in Hospitals Act (Curbelo) - opioid issues H.R. 5775, Providing Reliable Options for Patients and Educational Resources Act (Paulsen) - opioid issues H.R. 5776, MOST Act (Neal) - opioid issues H.R. 5789, protections for pregnant and post-partum women (Foster) - opioid issues H.R. 5795, Overdose Prevention and Patient Safety Act (Blumenauer) - confidential sharing of substance use disorder information H.R. 5796, Responsible Education Achieves Care and Healthy Outcomes for Users' Treatment Act (Fitzpatrick) - opioid issues H.R. 5801, PARTNERSHIP Act (Griffith) - opioid issues H.R. 6082, Overdose Prevention and Patient Safety Act (Mullin) - confidential sharing of substance use disorder information H.R. 6147, Interior, Environment, Financial Services, Agriculture, FDA, Transportation, and Housing Appropriations Act (Calvert) - FDA funding H.R. 6157, Defense-Labor-HHS-Education Appropriations Act (Granger) - HHS funding H.R. 6753, Strengthening the Health Care Fraud Prevention Task Force Act (Walden) - codification of Healthcare Fraud Prevention Partnership H.R. 6878, Eliminating Kickbacks in Recovery Act (Deutch) - anti-kickback penalties for body brokers H.R. 6902, Eliminating Kickbacks in Recovery Act (Knight) - anti-kickback penalties for body brokers Regulatory Issues: HIPAA administrative simplification issues, including standards for privacy, security, and electronic transactions and code sets (including ICD-10), identifiers including the health plan identifier, enforcement; cybersecurity; FEHBP enrollment data clearinghouse initiative, the enrollment reconciliation process, and a related OPM reimbursement factor for records that cannot be reconciled; issues relating to health insurance plan participation in FEHBP, including contract requirements; issues relating to similarly sized subscriber group (SSSG) and MLR requirements under the FEHBP; implementation of the health savings account provisions of the Medicare Act; issues related to Medicare Secondary Payer requirements; issues related to implementation of the National Health Information Infrastructure; electronic health records, personal health records, and similar technologies; issues relating to market consolidation; issues related to hospital consolidation; issues relating to quality improvement; issues relating to the national health data stewardship; issues relating to hospital outpatient measurement and reporting; prescription drug pricing; issues related to the collection of race and ethnicity data; issues related to medical loss ratios; reference pricing; review of rates for reasonableness; preexisting condition insurance plans; issues relating to antitrust; accountable care organizations; provider non-discrimination; coverage of preventive services; contraceptive coverage; pre-existing condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; issues relating to the annual fee on health insurance providers; health plan automatic enrollment requirements; issues related to qualified health plans including certification and rate filing templates; health insurance market rules; reinsurance, risk corridors, and risk adjustment; dependent coverage; summary of benefits and coverage disclosures; benefit and payment parameters; essential health benefits, actuarial value, and accreditation; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations; issues related to supplemental products; issues related to HIPAA excepted benefits; issues related to short term limited duration products; issues related to the federally-facilitated marketplaces (i.e., Exchanges/formerly referred to as the web portal); issues related to business continuity in relation to pandemics or natural events (e.g., hurricane, tornado, etc.); issues related to association health plans; issues related to cost-sharing reductions (CSRs); issues related to the refundable credit for coverage under a qualified health plan; issues related to small employer group size; issues related to Certificate of Public Advantage; issues relating to veterans health care; issues relating to family caregivers; and other issues relating to health care reform implementation.

Client expense: $1,550,000 · 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

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: $1,190,000 · Firm income: Not reported

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

H.R. 906 - The Furthering Asbestos Claims Transparency Act , ALL PROVISIONS H.R. 985; H.Res.180 - The Fairness in Class Action Litigation Act , ALL PROVISIONS H.R. 720; H.Res 180; S.237 - The Lawsuit Abuse Reduction Act , ALL PROVISIONS H.R. 1215; H.Res.382 - The Protecting Access to Care Act , ALL PROVISIONS H.R. 1118 - The Innocent Sellers Fairness Act , ALL PROVISIONS S. 2815 - Litigation Funding Transparency Act of 2018 , ALL PROVISIONS

Client expense: $560,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Federal Aviation Administration (FAA), Federal Election Commission (FEC), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Highway Traffic Safety Administration (NHTSA), SENATE, Treasury, Dept of, U.S. Trade Representative (USTR)

H.R.548-Health Care Safety Net Enhancement Act of 2017 H.R.720-Lawsuit Abuse Reduction Act H.R.1215-Protecting Access to Care Act of 2017 H.R.1565-Saving Lives, Saving Costs Act H.R.1822-Good Samaritan Health Professionals Act of 2017 H.R.1876-Good Samaritan Health Professionals Act of 2017 S.527-Health Care Safety Net Enhancement Act of 2017 S.781-Good Samaritan Health Professionals Act of 2017

Client expense: $402,721 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Essential emergency medication shortages Mental health services for emergency psychiatric patients Price transparency, out-of-network reimbursement of emergency medical services H.Res.906-Congratulating the American College of Emergency Physicians on its 50th anniversary H.R.6-Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act H.R.372-Competetive Health Insurance Reform Act of 2017 H.R.548-Health Care Safety Net Enhancement Act of 2017 H.R.767-Stop, Observe, Ask, and Respond (SOAR) to Health and Wellness Act of 2017 H.R.817-End Surprise Billing Act of 2017 H.R.880-Military Injury Surgical Systems Integrated Operationally Nationwide to Achieve ZERO Preventable Deaths Act H.R.1057-Synthetics Trafficking and Overdose Prevention Act of 2017 H.R.1215-Protecting Access to Care Act of 2017 H.R.1323-Reducing Unnecessary Emergency Room Visits under Medicaid Act H.R.1492-Medical Controlled Substances Transportation Act of 2017 H.R.1565-Saving Lives, Saving Costs Act H.R.1822-Good Samaritan Health Professionals Act of 2017 H.R.1876-Good Samaritan Health Professionals Act of 2017 H.R.2200-Frederick Douglass Trafficking Victims Prevention and Protection Reauthorization Act of 2017 H.R.2410-Sickle Cell Disease Research, Surveillance, Prevention, and Treatment Act of 2017 H.R.2851-Stop the Importation and Trafficking of Synthetic Analogues (SITSA) Act of 2017 H.R.2957-Save Rural Hospitals Act H.R.3181-Medicare Choices Empowerment and Protection Act H.R.3258-Marketplace Certainty Act H.R.3545-Overdose Prevention and Patient Safety (OPPS) Act H.R.4922-Stopping Overdoses of Fentanyl Analogues Act H.R.5176-Preventing Overdoses While in Emergency Rooms Act of 2018 H.R.5197-Alternatives to Opioids (ALTO) in the Emergency Department Act H.R.5531-Opioid Emergency Response Act H.R.5558-Alternatives to Opioids Prescribing Act H.R.5678-Rural Emergency Medical Center Act of 2018 H.R.5734-Resident Education Deferred Interest Act H.R.6082-Overdose Prevention and Patient Safety (OPPS) Act H.R.6143-Patient Right to Know Drug Prices Act H.R.6144-Know the Lowest Price Act of 2018 H.R.6372-To require the Secretary of Health and Human Services issue regulations to ensure due process rights for physicians furnishing emergency medical services H.R.6502-Reducing Unnecessary Senior Hospitalizations Act of 2018 H.R.6733-Know the Cost Act of 2018 Senate resolution congratulating the American College of Emergency Physicians on its 50th anniversary S.191-Patient Freedom Act of 2017 S.256-SOAR to Health and Wellness Act of 2017 S.284-End Surprise Billing Act of 2017 S.372- Synthetics Trafficking and Overdose Prevention Act of 2017 S.527-Health Care Safety Net Enhancement Act of 2017 S.568-Improving Access to Medicare Coverage Act of 2017 S.781-Good Samaritan Health Professionals Act of 2017 S.1016-Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2017 S.1022-Military Injury Surgical Systems Integrated Operationally Nationwide to Achieve ZERO Preventable Deaths Act S.1130-Rural Emergency Acute Care Hospital (REACH) Act S.1462-Marketplace Certainty Act S.1530- Medicare Choices Empowerment and Protection Act S.1553-Stopping Overdoses of Fentanyl Analogues Act S.1835-Lower Premiums Through Reinsurance Act of 2017 S.2465-Sickle Cell Disease Research, Surveillance, Prevention, and Treatment Act of 2018 S.2516-Alternatives to Opioids (ALTO) in the Emergency Department Act S.2544-Patient Right to Know Drug Prices Act S.2553-Know the Lowest Price Act of 2018 S.2609-Recovery Coaches Offer Addiction Counseling and Healing (COACH) Act S.2610-Preventing Overdoses While in Emergency Departments Act of 2018 S.2680-Opioid Crisis Response Act of 2018 S.3531-Emergency Care Improvement Act

Client expense: $402,721 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Protecting Access to Care Act (regarding federal medical liability reform), H.R. 1215, entire bill; Accessible Care by Curbing Excessive lawSuitS Act (ACCESS Act) (regarding federal medical liability reform), H.R. 1704, entire bill.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Liability protection for providers who prescribe, or dispense pursuant to a prescription, a medical product subject to a product liability or class action lawsuit. H.R. 1215-Protecting Access to Care Act of 2017

Client expense: $530,000 · Firm income: Not reported

Government targets: Drug Enforcement Administration (DEA), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), Office of Natl Drug Control Policy (NDCP), SENATE, Treasury, Dept of

Legislation and policies relating to: Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Reauthorization of funding for the Childrens Health Insurance Program Reauthorization of the Child Nutrition Act Section 2706 of the ACA regarding provider non-discrimination Policies related to health insurance market stabilization Policies affecting nurse practitioner education and workforce Definition, evaluation and enforcement of essential health benefits and provider network adequacy Health information technology and electronic health records Mental health services and violence prevention Human and child trafficking H.R. 315/S. 783 - Improving Access to Maternity Care Act H.R. 767/S. 256 - Stop, Observe, Ask, and Respond (SOAR) to Health and Wellness Act of 2017 H.R. 772/S. 261 - Common Sense Nutrition Disclosure Act H.R. 959/S. 1109 - Title VIII Nursing Workforce Reauthorization Act of 2017 H.R. 1168 - United States Cadet Nurse Corps Equity Act H.R. 1174/S. 1497 - Fairness For Breastfeeding Mothers Act of 2017 H.R. 1215 - Protecting Access to Care Act of 2017 H.R. 1318 - Preventing Maternal Deaths Act of 2017 H.R. 1865 - Allow States and Victims to Fight Online Sex Trafficking Act of 2017 H.R. 2742/S. 1257 - Modernizing the Interstate Placement of Children in Foster Care Act H.R. 2824 - Increasing Opportunity through Evidence-Based Home Visiting Act H.R. 2857 - Supporting Families in Substance Abuse Treatment Act H.R. 2834 - Partnership Grants to Strengthen Families Affected by Parental Substance Abuse Act H.R. 2866 - Reducing Barriers for Relative Foster Parents Act H.R. 2847 - Improving Services for Older Youth in Foster Care Act H.R. 3192 - CHIP Mental Health Parity Act H.R. 3291 - Alleviating Adverse Childhood Experiences (ACES) Act H.R. 3387 - Drinking Water System Improvement Act of 2017 H.R. 3525 - Home Visiting Works Act of 2017 H.R. 3728 - Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness (EMPOWER) Act of 2017 H.R. 3921 - Helping Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable (HEALTHY KIDS) 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 (CHAMPIONING HEALTHY KIDS) Act of 2017 H.R. 3928 - Truth in Healthcare Marketing Act of 2017 H.R. 4695 - Bipartisan Market Stabilization and Innovation Act of 2017 H.R. 4978/S. 2410 - Chronic Disease Management Act of 2018 H.R. 4998 - Health Insurance for Former Foster Youth Act H.R. 5385/S. 2597 - Childrens Hospital GME Support Reauthorization Act of 2018 H.R. 5425/S. 2647 - Food Labeling Modernization Act of 2018 H.R. 5977 - Mothers and Offspring Mortality and Morbidity Awareness (MOMMAs) Act H.R. 6199 - Restoring Access to Medication and Modernizing Health Savings Accounts Act of 2018 H.R. 6560 - ChiPACC Act of 2018 H.R. 7141 - Workplace Violence Prevention for Health Care and Social Service Workers Act S. 761/H.R. 1933 - Health Care Options Act of 2017 S. 920 - National Clinical Care Commission Act S. 1016/H.R. 2556 - Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2017 S. 1028 - Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act S. 1091/H.R. 3105 - Supporting Grandparents Raising Grandchildren Act S. 1112 - Maternal Health Accountability Act of 2017 S. 1268 - Child Protection and Family Support Act of 2017 S. 1377 - Reaching Underserved Rural Areas to Lead on Telehealth Act S. 1441/H.R. 3059 - Community Health Center and Primary Care Workforce Expansion Act of 2017 S. 1522/H.R. 3186 - Every Kid Outdoors Act S. 1630/H.R. 3381 - Child Poverty Reduction Act of 2017 S. 1693 - Stop Enabling Sex Traffickers Act of 2017 S. 1827 - Keeping Kids Insurance Dependable and Secure (KIDS) Act S. 1829 - Strong Families Act of 2017 S. 2415 - Accelerating Kids Access to Care Act S. 2582 - Consumer Health Insurance Protection Act of 2018 S. 2852/H.R. 3678 - Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018 S. 3029 - Prematurity Research Expansion and Education for Mothers who deliver Infants Early (PREEMIE) Reauthorization Act of 2018 S. 3074 - Focus on Children Act S. 3075 - Childrens Budget Act S. 3319 - Stopping Appealing Flavors in E-Cigarettes (SAFE) for Kids Act S. 3388 - Ensuring Coverage for Patients with Pre-Existing Conditions Act S. 3482/H.R. 6748 - Emergency Medical Services for Children Program Reauthorization Act of 2018 S. 3685 - Nursing Where It's Needed (Nurse WIN) Act S. 3729 - United States Cadet Nurse Corps Service Recognition Act of 2018 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: Not reported · Firm income: $23,450

Government targets: Agriculture, Dept of (USDA), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Justice, Dept of (DOJ), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA)

Legislative proposals affecting Medicare and Medicaid hospital reimbursement policies Health Information Technology Health Care Reform Implementation Medicare Graduate Medical Education Payments S. 2597/H.R. 5385, Children's Hospital GME Support Reauthorization Act of 2018 H.R. 959/S. 1109, Title VIII Nursing Workforce Reauthorization Act S. 781/ H.R. 1876, Good Samaritan Health Professional Act of 2017 - provisions related to limiting the liability of health care professionals who volunteer to provide health care services in response to a disaster H.R. 1215, "Protecting Access to Care Act" - provisions related to medical liability system reform 42 CFR Part 2 alignment with HIPAA S. 2852/H.R. 6378, Pandemic and All-Hazards Preparedness & Advancing Innovation Act - provisions related to hospitals

Client expense: Not reported · Firm income: $110,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Health care quality; physician and hospital quality; health care innovation; Patient Protection and Affordable Care Act/health care reform implementation; Affordable Care Act repeal/replace/reform efforts; medical liability reform, including HR 1215, the Protecting Access to Care Act; unique device identifier policy and post-market surveillance for medical devices; clinical trial design; clinical data registries; the Common Rule and registries; HIPAA and registries; federal funding/appropriations for HHS, NIH, AHRQ, CDC, FDA, HRSA and the Childrens Hospital Graduate Medical Education payment program, including H.R. 5385, the Prevention & Public Health Fund, medical research, and prevention; HR 3592, the South Asian Heart Health Awareness and Research Act of 2017; research and scholarly communication policy, including S 1701/HR 3427, the Fair Access to Science and Technology Research Act of 2017; healthy diet/lifestyle; implementation and oversight of 21st Century Cures Act; data blocking/interoperability of electronic data; health disparities; S 477/HR 1222, the Congenital Heart Futures Reauthorization Act of 2017; National Clinical Care Commission Act implementation; Senate price transparency workgroup; reduction/oversight of prior authorization and other administrative burdens; shared decision-making; medical isotope production and supply; digital health/FDA pre-certification; cardiomyopathy education and awareness; peripheral arterial disease (PAD) education and awareness.

Client expense: $480,000 · 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), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, White House Office

Support H.R. 304/S. 916, The Protecting Patient Access to Emergency Medications Act of 2017, a bill to amend the Controlled Substances Act with regard to the provision of emergency medical services and discussed companion legislation with the Senate; Support H.R. 372, The Competitive Health Insurance Reform Act of 2017, a bill to repeal McCarran-Ferguson with respect to the business of health insurance; Discussed with members of congress working on legislation that maintains coverage and improves Americas health care system through patient-centered care; Oppose HR 1156/ S 1133 , Patient Access to Higher Quality Health Care Act of 2017, a bill to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals; Support HR 1215, Protecting Access to Care Act, a bill 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; Urged CMS to release guidance pertaining to hospital co-location arrangements and to provide flexibility in the agencys co-location policies; Support HR 2141/ S 898, the Conrad State 30 and Physician Access Act of 2017, a bill that would reauthorize the Conrad State 30 Program and make other changes to improve patient access to care; Support S.781/ HR 1876. Good Samaritan Health Professional Act of 2017, a bill to amend the Public Health Service Act to limit the liability of health care professionals who volunteer to provide health care services in response to a disaster; Support HR 2212/ S 974Creating and Restoring Equal Access to Equivalent Samples (CREATES) 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; Meet with HRSA Administrator and senior staff on 340B drug pricing program; Discussed marketplace stabilization solutions with Hill staff; Support and Recommend changes to HR 1253, Mental Health and Substance Abuse Treatment Accessibility Act of 2017 a bill to authorize the Secretary of Health and Human Services to make loans and loan guarantees for constructing or renovating, or planning construction or renovation of, qualified psychiatric and substance abuse treatment facilities, and for other purposes: advocated for changes to clarify/expand the entities that can be loan applicants/recipients; Urged the Administration to suspend the faulty star ratings from the Hospital Compare website; Eliminate barriers to care with the creation of an Anti-Kickback safe harbor for clinical integration arrangements that establishes the basic accountabilities for the use of incentive payment or shared savings programs among hospitals, physicians and other providers, along with a safe-harbor for assistance to patients that would protect providers from financial penalties under the Civil Monetary Penalties (CMPs) for providing an inducement to a patient; Advocated for changes including: eliminating geographic and setting locations requirements so patients outside of rural areas can benefit from telehealth; expanding the types of technology that can be used, including remote monitoring; and covering all services that are safe to provide, rather than a small list of approved services; Submit Statement Stabilizing Premiums and Helping Individuals in the Individual Insurance Market for 2018: Health Care Stakeholders about the importance of stabilizing the Health Insurance Marketplaces for 2018 and beyond; We urged Congress to pass legislation to fund the ACA cost-sharing reductions; Urged Senators to oppose the Graham-Cassidy proposal being considered in the Senate because this proposal would make significant changes to health care coverage and health care financing; Review of H.R. 3528, Every Prescription Conveyed Securely Act, a bill to amend title XVIII of the Social Security Act to require e-prescribing for coverage under part D of the Medicare program of prescription drugs that are controlled substances; Discussions with Congress on prescription drug monitoring programs, the dispensing of controlled substances, and clinical workflow; Discussions with Congress on draft legislation related to prescription drug monitoring programs; Urged Congress to consider advancing solutions aimed at making our health care system stronger, protecting access and coverage, and exploring new delivery system reforms that have the potential to make care both more affordable and safer; Review of The Combating the Opioid Epidemic Act, a bill to provide funding to combat the opioid epidemic; Discussions with the White House/Office of National Drug Control Policy about the opioid epidemic, including concerns about regulations that prohibit the sharing of substance use disorder records among health care providers; Support H.R. 4392 a bill to prevent cuts to the 340B drug savings program, which would provide relief from deep cuts to payments to hospitals participating in the 340B program; Letter to congress outlining AHA opposition to a potential policy that would cut payments to hospitals treating hospice patients; Oppose H.R. 4710, 340B Protecting Access for the Underserved and Safety-Net Entities (PAUSE) Act, a bill to amend the Public Health Service Act to establish a moratorium on the registration of certain new 340B hospitals and associated site; Sent comments to the Energy and Commerce Subcommittee on Oversight and Investigations for its hearing on Examining the Impact of Health Care Consolidation.; Letter sent to the Energy & Commerce Subcommittee for its hearing on, "Combating the Opioid Crisis: Helping Communities Balance Enforcement and Patient Safety"; Letter submitted to the Ways and Means Committee on policy recommendations to address the opioid epidemic; Sent letter to discuss the current state of health care costs, and efforts to increase transparency in the pricing of health care services and the quality of care; Addressed our concerns with the MedPAC Commissions draft recommendation to substantially reduce payments for off-campus stand-alone emergency departments (EDs) that are within 6 miles of an on-campus hospital ED; Support HR 4776, Hospital Preparedness Reauthorization Act of 2018, a bill to amend the Public Health Service Act to reauthorize a program of partnerships for State and regional hospital preparedness to improve surge capacity and would increase the level of authorized funding for the Hospital Preparedness Program to $515 million; Submitted statement to the Senate HELP Committee on the Hearing on How to Reduce Health Care Costs: Understanding the Cost of Health Care in America; Submitted a Statement for the HELP hearing on Effective Administration of the 340B Drug Pricing Program; Support certain provisions in Helping to End Addiction and Lesson (HEAL) Substance Use Disorders Act of 2018; Support HR 6071, Stretching Entity Resources for Vulnerable Communities Act or the SERV Communities Act, A bill to amend the Public Health Service Act to clarify the intent of the 340B program and provide for enhanced 340B program integrity; Support S 2597Childrens Hospital GME Support Reauthorization Act of 2018, A bill to amend the Public Health Service Act to reauthorize the program of payments to children's hospitals that operate graduate medical education programs; Support HR 3545, Overdose Prevention and Patient Safety ActA bill to amend the Public Health Service Act to protect the confidentiality of substance use disorder patient records; Support S 2516, Alternatives to Opioids (ALTO) in the Emergency Department ActA bill to direct the Secretary of Health and Human Services to conduct a demonstration program to test alternative pain management protocols to limit the use of opioids in emergency departments; Support HR 5176/ S 2610, Preventing Overdoses While in Emergency Rooms Act of 2018 A bill to require the Secretary of Health and Human Services to provide coordinated care to patients who have experienced a non-fatal overdose after emergency room discharge; Submit statement to the Ways and Means Subcommittee on Health on the hearing Identifying Innovative Practices and Technology in Health Care; Support S 1845 Lead-Safe Housing for Kids Act" To amend the Lead-Based Paint Poisoning Prevention Act to provide for additional procedures for families with children under the age of 6; Submitted statement to the Energy & Commerce Health Subcommittee for the hearing "Improving the Coordination and Quality of Substance Use Disorder Treatment." The statement focuses on 42 CFR Part 2; Comments to HELP Committee's discussion draft of the Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018; The current Pandemic and All-Hazards Preparedness Act (PAHPA) will sunset on October 1, 2018 so this is "must-do" legislation; Support S 2852, the Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018 (PAHPAI), A bill to reauthorize certain programs under the Pandemic and All-Hazards Preparedness Reauthorization Act; Supports S. 2372, VA Maintaining Internal Systems and Strengthening Integrated Outside Networks Act of 2018 (VA MISSION Act of 2018).A bill to establish a permanent community care program for veterans, to establish a commission for the purpose of making recommendations regarding the modernization or realignment of facilities of the Veterans Health Administration, to improve construction of the Department of Veterans Affairs, to make certain improvements in the laws administered by the Secretary of Veterans Affairs relating to the home loan program of the Department of Veterans Affairs,Submitted a statement to the Ways and Means Committee hearing on "Lowering Costs and Expanding Access to Health Care through Consumer-Directed Health Plans;" Submitted a statement to the Senate HELP Subcommittee on "Primary Health and Retirement Security on Health Care in Rural America: Examining Experiences and Costs"; Submitted a statement to the Senate HELP Committee on "Reducing Health Care Costs: Eliminating Excess Health Care Spending and Improving Quality and Value for Patients"; Submitted comments on the consumer-directed health plan legislation to the Committee on Ways & Means; Submitted a statement to the Energy and Commerce Subcommittee on Health on "Opportunities to Improve the 340B Drug Pricing Program"; Discussions about maternal health issues sent by the majority oversight and health subcommittee chairs; Discussions about the Megan Rondini Act; Surprise billing letter to congressional and committee leadership and discussions with members on the same issue; Letter on short-term limited duration plan rule; Meeting with Committee to discuss clarification of Anti-Kickback Statute provisions in the SUPPORT Act.

Client expense: $5,460,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA), White House Office

S. 1850, Legacy Act (Manchin-Capito) -- confidentiality of drug and alcohol treatment and prevention records S. 2460, Every Prescription Conveyed Securely Act (Bennet) - opioid issues S. 2680, Opioid Crisis Response Act (Alexander) - opioid initiatives, mental health parity S. 2789, Substance Abuse Prevention Act (Cornyn) - opioid initiatives, restrictions on step therapy S. 2812, Air Ambulance Consumer Protection Act (McCaskill) - air ambulance S. 2828, Sober Home Fraud Detection Act (Rubio) - best practices for identifying fraud in recovery housing S. 2891, Fighting the Opioid Epidemic with Sunshine Act (Grassley) - opioid issues S. 2892, Peer Support Enhancement and Evaluation Review Act (Cardin) - opioid issues S. 2898, Medication-Assisted Treatment Improvement Act (Casey) - opioid issues S. 2899, Caring Recovery for Infants and Babies Act (Brown) - opioid issues S. 2900, Comprehensive Screenings for Seniors Act (Brown) - opioid issues S. 2902, Better Data Sharing to Combat the Opioid Crisis Act (Cassidy) - opioid issues S. 2905, Strengthening Partnerships to Prevent Opioid Abuse Act (Toomey) - opioid issues S. 2910, Telehealth for Childrens Access to Services and Treatment Act (Roberts) - opioid issues S. 2911, Enhancing Patient Access to Non-Opioid Treatment Options (Heller) - opioid issues S. 2912, Opioid Addiction Treatment Programs Enhancement Act (Cassidy) - opioid issues S. 2920, Commit to Opioid Medical Prescriber Accountability and Safety for Seniors Act (McCaskill) - opioid issues S. 2922, Help for Moms and Babies Act (Stabenow) - opioid issues S. 2923, Building Capacity for Family-Focused Residential Treatment Act (Grassley) - opioid issues S. 2924, Supporting Family-Focused Residential Treatment Act (Scott) - opioid issues S. 3016, Action for Dental Health Act (Booker) - grants for oral health programs S. 3120, the HEAL Substance Use Disorders Act (Hatch) - opioid initiatives S. 3158, Labor-HHS-Education Appropriations Act (Blunt) - HHS funding S. 3254, Eliminating Kickbacks in Recovery Act (Rubio) - anti-kickback penalties for body brokers Draft Bill: Protecting Patients From Surprise Medical Bills Act (Cassidy) - surprise medical bills H.R. 6, SUPPORT Patients and Families Act (Walden) - opioid initiatives, Medicare and Medicaid issues, budget offsets H.R. 302, FAA Reauthorization Act - air ambulance issues H.R. 1215, Protecting Access to Care Act (King) - medical liability reform H.R. 1313, Preserving Employee Wellness Programs Act (Foxx) - employee wellness programs H.R. 2422, Action for Dental Health Act (Kelly) - oral health services and education for underserved populations H.R. 3331, adoption and use of EHR technology by behavioral health providers (Jenkins) - opioid issues H.R. 3528, Every Prescription Conveyed Securely Act (Clark) - opioid issues H.R. 4684, Ensuring Access to Quality Sober Living Act (Chu) - best practices for recovery housing H.R. 4841, Standardizing Electronic Prior Authorization for Safe Prescribing Act (Schweikert) - opioid issues H.R. 4998, Health Insurance for Former Foster Youth Act (Bass) - opioid issues H.R. 5100, Recovery Home Certification Act (Knight) -- anti-kickback penalties for body brokers H.R. 5477, Rural DOCS Act (O'Halleran) - opioid issues H.R. 5515, National Defense Authorization Act (Thornberry) H.R. 5562, Protecting NAS Babies Act (Jenkins) - opioid issues H.R. 5582, Abuse Deterrent Access Act (Carter) - opioid issues H.R. 5583, State reporting on certain adult health quality measures (Clarke) - opioid issues H.R. 5590, CMS Action Plan (Kinzinger) - opioid issues H.R. 5714, Education for Disposal of Unused Opioids Act (Black) - opioid issues H.R. 5715, Strengthening Partnerships to Prevent Opioid Abuse Act (Renacci) - opioid issues H.R. 5716, COMPASS Act (Roskam) - opioid issues H.R. 5723, Expanding Oversight of Opioid Prescribing and Payment Act (Tenney) - opioid issues H.R. 5725, BEST Act (Roskam) - opioid issues H.R. 5774, Combating Opioid Abuse for Care in Hospitals Act (Curbelo) - opioid issues H.R. 5775, Providing Reliable Options for Patients and Educational Resources Act (Paulsen) - opioid issues H.R. 5776, MOST Act (Neal) - opioid issues H.R. 5789, protections for pregnant and post-partum women (Foster) - opioid issues H.R. 5795, Overdose Prevention and Patient Safety Act (Blumenauer) - confidential sharing of substance use disorder information H.R. 5796, Responsible Education Achieves Care and Healthy Outcomes for Users' Treatment Act (Fitzpatrick) - opioid issues H.R. 5801, PARTNERSHIP Act (Griffith) - opioid issues H.R. 6082, Overdose Prevention and Patient Safety Act (Mullin) - confidential sharing of substance use disorder information H.R. 6147, Interior, Environment, Financial Services, Agriculture, FDA, Transportation, and Housing Appropriations Act (Calvert) - FDA funding H.R. 6157, Defense-Labor-HHS-Education Appropriations Act (Granger) - HHS funding H.R. 6753, Strengthening the Health Care Fraud Prevention Task Force Act (Walden) - codification of Healthcare Fraud Prevention Partnership H.R. 6878, Eliminating Kickbacks in Recovery Act (Deutch) - anti-kickback penalties for body brokers H.R. 6902, Eliminating Kickbacks in Recovery Act (Knight) - anti-kickback penalties for body brokers Regulatory Issues: HIPAA administrative simplification issues, including standards for privacy, security, and electronic transactions and code sets (including ICD-10), identifiers including the health plan identifier, enforcement; cybersecurity; FEHBP enrollment data clearinghouse initiative, the enrollment reconciliation process, and a related OPM reimbursement factor for records that cannot be reconciled; issues relating to health insurance plan participation in FEHBP, including contract requirements; issues relating to similarly sized subscriber group (SSSG) and MLR requirements under the FEHBP; implementation of the health savings account provisions of the Medicare Act; issues related to Medicare Secondary Payer requirements; issues related to implementation of the National Health Information Infrastructure; electronic health records, personal health records, and similar technologies; issues relating to market consolidation; issues related to hospital consolidation; issues relating to quality improvement; issues relating to the national health data stewardship; issues relating to hospital outpatient measurement and reporting; prescription drug pricing; issues related to the collection of race and ethnicity data; issues related to medical loss ratios; reference pricing; review of rates for reasonableness; preexisting condition insurance plans; issues relating to antitrust; accountable care organizations; provider non-discrimination; coverage of preventive services; contraceptive coverage; pre-existing condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; issues relating to the annual fee on health insurance providers; health plan automatic enrollment requirements; issues related to qualified health plans including certification and rate filing templates; health insurance market rules; reinsurance, risk corridors, and risk adjustment; dependent coverage; summary of benefits and coverage disclosures; benefit and payment parameters; essential health benefits, actuarial value, and accreditation; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations; issues related to supplemental products; issues related to HIPAA excepted benefits; issues related to short term limited duration products; issues related to the federally-facilitated marketplaces (i.e., Exchanges/formerly referred to as the web portal); issues related to business continuity in relation to pandemics or natural events (e.g., hurricane, tornado, etc.); issues related to association health plans; issues related to cost-sharing reductions (CSRs); issues related to the refundable credit for coverage under a qualified health plan; issues related to small employer group size; issues related to Certificate of Public Advantage; issues relating to veterans health care; issues relating to family caregivers; and other issues relating to health care reform implementation.

Client expense: $1,540,000 · 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

H.R. 1215 (Protecting Access to Care Act); establishes provisions governing health care lawsuits, including limiting noneconomic damages to $250,000. S. 808/H.R. 302 (Sports Medicine Licensure Clarity Act); provides protections for certain sports medicine professionals who provide certain medical services in a secondary State. H.R. 1565 (Saving Lives, Saving Costs Act); establishes a framework for health care liability lawsuits to undergo review by independent medical review panels if health care professionals (practicing physicians or their agents or employees) allege adherence to applicable clinical practice guidelines in the provision of health care goods or services. H.R. 1704 (ACCESS Act of 2017); affects healthcare lawsuits by limiting liability and capping noneconomic damages, among other measures. H.R. 1118 (Innocent Sellers Fairness Act); limits liability for personal injury, monetary loss, or damage to property arising out of an accident or transaction involving a seller's products during the regular course of trade or business. S. 781/H.R. 1876 (Good Samaritan Health Professionals Act); limits the liability of health care professionals who volunteer to provide health care services in response to a disaster. S. 1134/H.R. 2437 (Back the Blue Act); alters rules governing criminal and civil rights cases against government entities. H.R. 1103 (Child Abuse Accountability Enhancement Act); amends title 10, United States Code, to provide for garnishment pursuant to a court order to satisfy a judgment against a retired member of the uniformed services for physically, sexually, or emotionally abusing a child. S. 1693 (Stop Enabling Sex Traffickers Act of 2017); amends the Communications Act of 1934 to clarify that section 230 of that Act does not prohibit the enforcement against providers and users of interactive computer services of Federal and State criminal and civil law relating to sex trafficking. H.R. 1865 (Allow States and Victims to Fight Online Sex Trafficking Act of 2017); amends the Communications Act of 1934 to clarify that section 230 of such Act does not prohibit the enforcement against providers and users of interactive computer services of Federal and State criminal and civil law relating to sexual exploitation of children or sex trafficking, and for other purposes. H.R. 459 (Trafficking Survivors Relief Act of 2017); provides for the vacating of certain convictions and expungement of certain arrests of victims of human trafficking. S. 1426 (United States Center for Safe Sport Authorization Act of 2017); amends the Ted Stevens Olympic and Amateur Sports Act to expand the purposes of the corporation, to designate the United States Center for Safe Sport. H.R. 3808 (Infrastructure Expansion Act of 2017); preempts New York state law and precludes absolute liability in any action against a property owner or contractor for projects receiving federal financial assistance. S. 2815 (Litigation Funding Transparency Act); requries one-sided disclosure of plaintiff use of litigation funding. H.R. 5856 (Good Samaritan Charitable Physicians Services Act of 2018); creates limited liability for volunteer health care professionals. General lobbying with regard to federal preemption of state common law.

Client expense: $1,300,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE, Securities & Exchange Commission (SEC)

Advocate for legislation to enact medical liability reforms. Support H.R. 1704, Accessible Care by Curbing Excessive lawSuitS (ACCESS) Act. Support H.R. 1215, Protecting Access to Care Act. Support H.R. 1876, Good Samaritans Health Professionals Act

Client expense: $360,000 · Firm income: Not reported

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

H.R. 6, Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act H.R. 35, Health Savings Act of 2017 H.R. 143, Health Insurance Industry Antitrust Enforcement Act of 2017 H.R. 173/S. 40/S. 58, Middle Class Health Benefits Tax Repeal Act of 2017 H.R. 184, Protect Medical Innovation Act of 2017 H.R. 195, Making further continuing appropriations for the fiscal year ending September 30, 2018, and for other purposes H.R. 246, To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act H.R. 394/S. 85, Restoring Access to Medication Act of 2017 H.R. 620, ADA Education and Reform Act of 2017 H.R. 849/S. 260, Protecting Seniors Access to Medicare Act H.R. 1101, Small Business Health Fairness Act of 2017 H.R. 1175/S. 403, Health Savings Act of 2017 H.R. 1215, Protecting Access to Care Act of 2017 H.R. 1313, Preserving Employee Wellness Programs Act H.R. 1625, Consolidated Appropriations Act, 2018 H.R. 1892, Bipartisan Budget Act of 2018 H.R. 3331, To amend title XI of the Social Security Act to promote testing of incentive payments for behavioral health providers for adoption and use of certified electronic health record technology H.R. 3798, Save American Workers Act of 2017 H.R. 4284, Indexing Narcotics, Fentanyl, and Opioids (INFO) Act of 2018 H.R. 4616, To amend the Patient Protection and Affordable Care Act 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 amend the Internal Revenue Code of 1986 to provide for a temporary moratorium on the medical device excise tax H.R. 4618, To amend the Internal Revenue Code of 1986 to provide for a temporary moratorium on certain taxes affecting purchases of prescription medication H.R. 4619, To amend the Patient Protection and Affordable Care Act 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 of 2017 H.R. 4978/S. 2410, Chronic Disease Management Act of 2018 H.R. 5009, Jessies Law H.R. 5041, Safe Disposal of Unused Medication Act H.R. 5138, Bipartisan HSA Improvement Act of 2018 H.R. 5272, To provide additional guidance to grantees seeking funding to treat or prevent mental health or substance use disorders H.R. 5582, Abuse Deterrent Access Act of 2018 H.R. 5788, Synthetics Trafficking and Overdose Prevention (STOP) Act of 2018 H.R. 5892, To establish an Advisory Committee on Opioids and the Workplace to advise the Secretary of Labor on actions the Department of Labor can take to address the impact of opioid abuse on the workplace H.R. 6199, Restoring Access to Medication and Modernizing Health Savings Accounts Act of 2018 H.R. 6311, Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act of 2018 S. 108, Medical Device Access and Innovation Protection Act S. 191, Patient Freedom Act of 2017 S. 222, Obamacare Replacement Act S. 251, Protecting Medicare from Executive Action Act of 2017 S. 974, Creating and Restoring Equal Access To Equivalent Samples (CREATES) Act of 2017 S. 1835, Lower Premiums Through Reinsurance Act of 2017 S. 1850, Protecting Jessica Grubb's Legacy Act S. 1859, Healthcare Tax Relief Act S. 1978, Small Business and Family Health Tax Relief Act of 2017 S. 2004, Combating the Opioid Epidemic Act S. 2164, To amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings S. 3057, Synthetics Trafficking and Overdose Prevention (STOP) Act of 2018 Draft legislation to stabilize individual market premiums for the 2018 and 2019 plan years and provide meaningful State flexibility (Alexander-Murray) Proposed regulation on health reimbursement arrangements and other account-based group health plans (83 Fed. Reg. 54,420-54,477, October 29, 2018) Final Regulation, definition of employer under Section 3(5) of ERISA - association health plans (83 Fed. Reg. 28912-28964, June 21, 2018) Various issues relating to Patient Protection and Affordable Care Act (P.L. 111-148) and the Health Care and Education Affordability Reconciliation Act of 2010 (P.L. 111-152), including the employer-sponsored health care system, implementation of regulatory process, provider network adequacy, delivery system reform, health savings account (HSAs), health reimbursement account (HRAs), and flexible spending account (FSAs) changes, IPAB, employer mandate, reporting requirements for issuers and applicable large employers, premium stabilization programs, medical loss ratio, medical malpractice reform, exchanges, the impact on small business, the Small Business Tax Credit, section 1332 waivers, section 1557 on nondiscrimination, caps on compensation deductibility required under section 9014, incompleteness or inaccuracy of cost impact analysis, lack of quantified benefit analysis, and need for empirical data sources on which to base costs and benefits, the Cost Sharing Reduction (CSR) program, the section 9010 Health Insurance Providers Fee or Health Insurance Tax (HIT), 40% excise tax on high-cost employer-sponsored health coverage (Cadillac tax); medical device tax; protect Medicare Part D's Non-Interference Clause from repeal Public Health Services Act (P.L.78-410), Internal Revenue Code and the Employee Retirement Income Security Act (ERISA) (P.L. 93-406), regarding regulatory process and legislative corrections to ERISA preemption, changes to Medicare Advantage and Parts B, C, and D, including rebates and non-interference with prescription drug prices, entitlement reform, health information technology, telemedicine services in Medicare, and coordination and disease management programs; House Republican Taskforce on Health Care report; A Better Way to Fix Health Care; association health plans; importation of foreign pharmaceuticals into the United States and preemptive authority of federal food and drug regulations; Executive Order 13813, Promoting Healthcare Choice and Competition; addressing the opioids crisis, including end-stage renal disease; balance or surprise billing; single-payer health care options; aligning 42 CFR Part 2 with the Health Insurance Portability and Accountability Act (P.L. 104-191) for the purposes of treatment, payment, and health car operation (TPO); inclusion of prescription drug pricing on 2019 congressional agenda; general advocacy for Congress to reach a working quorum for the board of the Export-Import Bank; section 301 of the Trade Act of 1974; U.N. Convention on the Assignment of Receivables in Int'l Trade

Client expense: $15,950,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Army, Dept of (Corps of Engineers), Commerce, Dept of (DOC), Commodity Futures Trading Commission (CFTC), Consumer Financial Protection Bureau (CFPB), Council on Environmental Quality (CEQ), Defense, Dept of (DOD), Education, Dept of, Energy, Dept of, Environmental Protection Agency (EPA), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Federal Communications Commission (FCC), Federal Deposit Insurance Corporation (FDIC), Federal Energy Regulatory Commission (FERC), Federal Reserve System, Federal Trade Commission (FTC), General Services Administration (GSA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Interior, Dept of (DOI), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Economic Council (NEC), Natl Labor Relations Board (NLRB), Natl Security Council (NSC), Natl Telecommunications & Information Administration (NTIA), Office of Management & Budget (OMB), Office of the Comptroller of the Currency (OCC), Office of the Vice President of the United States, Patent & Trademark Office (PTO), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Small Business Administration (SBA), Social Security Administration (SSA), State, Dept of (DOS), Transportation Security Administration (TSA), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Copyright Office, U.S. Customs & Border Protection, U.S. Trade Representative (USTR), White House Office

American Health Care Act of 2017 (HR 1628) Health Care Safety Net Enhancement Act (HR 548) Congenital Heart Futures Reauthorization Act (S 477/HR 1222) USPSTF Transparency and Accountability Act (HR 539) Protecting Access to Care Act of 2017 (HR 1215) Resident Physician Shortage Reduction Act of 2017 (HR2267/S.1301) Prohibit Smoking in VA Facilities Act (H.R.1662) The Veterans Affairs Medical Scribe Pilot Act of 2017 (H.R. 1848) Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Medicare Access and CHIP Reauthorization Act of 2015 Implementation, Medicare Physician Payment Reform, MEDPAC, surgical global payments, Affordable Care Act Implementation, Affordable Care Act Repeal & Replace, health care reform, health care quality improvement, physician workforce, comparative effectiveness research, health information technology, EHR meaningful use, EHR data blocking, Patient-Centered Outcomes Research Institute, MEDCAC, Centers for Medicare & Medicaid Innovation, registry access to Medicare claims data, Social Security Death Master File, lung cancer screenings, AHRQ funding, USPSTF, Graduate Medical Education, electronic cigarette and cigar regulation, Physician-Focused Payment Model Technical Advisory Committee (PTAC), Proposed Medical Device Surveillance System, Meaningful Use, Congenital Heart Disease Funding, Unique Device Identifiers, Medical Liability Reform, essential health benefits, tobacco riders in appropriations bills, tobacco regulation in the FDA, Evaluation and Management coding collapse, price transparency, ECMO coding

Client expense: $84,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), 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), Medicare Payment Advisory Commission (MedPAC), SENATE, Social Security Administration (SSA)

Legislation H.R. 469/S. 119 - Sunshine for Regulatory Decrees and Settlements Act of 2017 H.R. 10 - Financial CHOICE Act of 2017 H.R. 725 - The Innocent Party Protection Act H.R. 720/S. 237 - Lawsuit Abuse Reduction Act of 2017 H.R. 26/S. 21 - Regulations from the Executive in Need of Scrutiny Act of 2017 H.R. 985 - Fairness in Class Action Litigation and Furthering Asbestos Claim Transparency Act of 2017 H.R. 906 - Furthering Asbestos Claim Transparency Act of 2017 H.R. 953 - Reducing Regulatory Burdens Act of 2017 H.R 725 - Innocent Party Protection Act H.R. 1215 - Protecting Access to Care Act of 2017 H.R. 1704 - ACCESS Act of 2017 H.R. 1179 - Discouraging Frivolous Lawsuits Act H.R 1004 - Regulatory Integrity Act of 2017 HR 1009 - OIRA Insight, Reform, and Accountability Act H.R. 5 - Regulatory Accountability Act of 2017 H.R. 21/S. 34 - Midnight Rules Relief Act of 2017 H.R. 998 - Searching for and Cutting Regulations that are Unnecessarily Burdensome (SCRUB) Act H.R. 1430 - Honest and Open New EPA Science Treatment (HONEST) Act of 2017 H.R. 1 - Tax Cuts and Jobs Act (115th Congress, 2017-2018), Public law no. 115-97 HR 3117 - Transparency and Honesty in Energy Regulations Act of 2017 HR 732/ S. 333 - Stop Settlement Slush Funds Act of 2017 H.J. Res. 111/S.J. Res. 47 - CFPB Arbitration Rule CRA H.R. 2359 - FCRA Liability Harmonization Act H.R. 3141 - Taxpayer Transparency Act of 2017 H.R. 2233 - American Jobs First Act of 2017 H.R. 2437/ S. 1134 - Back the Blue Act H.R. 620 - the ADA Education and Reform Act of 2017 H.R. 4396 - the ME TOO Congress Act H.R. 4423 - N. Texas Water Supply Security Act H.R. 4809 - Guidance Out of Darkness (GOOD) Act H.R. 5468 - Permitting Litigation Efficiency Act of 2018 H.R. 6754 - CIRCUIT Act of 2018 S. 1609 - Energy and Water Development and Related Agencies Appropriations Act, 2018 S. 584 - Small Business Regulatory Flexibility Improvements Act S. 580 - Truth in Regulations Act of 2017 S. 579 - Early Participation in Regulations Act of 2017 S. 578 - Better Evaluation of Science and Technology (BEST) Act S. 577 - Providing Accountability through Transparency Act of 2017 S. 951 - Regulatory Accountability Act of 2017 S. 1615 - Dream Act of 2017 S. 2014 - Prove it Act of 2017 S. 565 - Judgment Fund Transparency Act S. 386 - Judgment Fund Transparency and Terrorism Financing Prevention Act of 2017 S. 276 - Judicial Administration and Improvement Act of 2017 Rulemakings EO 13781 - Presidential Executive Order on a Comprehensive Plan for Reorganizing the Executive Branch, 82 FR 13959 (March 13, 2017) EO 13777 - Enforcing the Regulatory Reform Agenda, 82 FR 12285 (March 1, 2017) EO 13783 - Presidential Executive Order on Promoting Energy Independence and Economic Growth, 82 FR 16093 (March 28, 2017) Environmental Protection Agency, Environmental Justice Action Agenda 2016-2020 (EJ 2020) Environmental Protection Agency, Evaluation of Existing Regulations, 82 Fed. Reg. 17,793 (Apr. 13, 2017) (Docket ID EPA-HQ-OA-2017-0190). Centers for Medicare & Medicaid Services (CMS), Health and Human Services, Proposed Changes to Strip Legal Rights from Vulnerable Residents in Long-Term Care Facilities, CMS-3342-P, 82 FR 26649, (June 8, 2017) Nominations Jeffrey Clark for Assistant Attorney General, Department of Justice Mike Pompeo for Secretary of State Andrew Oldham for United States Court of Appeals for the Fifth Circuit Damien Schiff for United States Court of Federal Claims Andrew Brasher for United States Court for the Middle District of Alabama Patrick Wyrick for United States District Judge for the Western District of Oklahoma Brett Kavanaugh for United States Supreme Court Jonathan Kobes for United States Court of Appeals for the Eight Circuit William Barr for U.S. Attorney General, Department of Justice Thomas Farr for United States District Judge for the Eastern District of NC Eric Miller for United States Court of Appeals for the Ninth Circuit

Client expense: $77,132 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Army, Dept of (Corps of Engineers), Bureau of Land Management (BLM), Centers For Medicare and Medicaid Services (CMS), Consumer Product Safety Commission (CPSC), Council on Environmental Quality (CEQ), Defense, Dept of (DOD), Energy, Dept of, Environmental Protection Agency (EPA), HOUSE OF REPRESENTATIVES, Interior, Dept of (DOI), Natl Oceanic & Atmospheric Administration (NOAA), SENATE, Transportation, Dept of (DOT), U.S. Fish & Wildlife Service (USFWS)

RAISE Health Benefits Act Health Savings Act Dental and Optometric Care Access Act or the DOC Access Act Student Loan Refinancing Issue The Competitive Health Insurance Reform Act of 2017 H.R.1215 - Protecting Access to Care Act of 2017 H.R.4001 - Student Loan Refinancing and Recalculation Act Insurance Coverage for Craniofacial Anomalies Opioid Abuse Issues Opioid Crisis Response Act of 2018 Ensuring Lasting Smiles Act ( HR 6689 / S 3369 REDI Act HR 5734

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

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

H.R. 906 - The Furthering Asbestos Claims Transparency Act , ALL PROVISIONS H.R. 985; H.Res.180 - The Fairness in Class Action Litigation Act , ALL PROVISIONS H.R. 720; H.Res 180; S.237 - The Lawsuit Abuse Reduction Act , ALL PROVISIONS H.R. 1215; H.Res.382 - The Protecting Access to Care Act , ALL PROVISIONS H.R. 1118 - The Innocent Sellers Fairness Act , ALL PROVISIONS S. 2815 - Litigation Funding Transparency Act of 2018 , ALL PROVISIONS

Client expense: $560,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Federal Aviation Administration (FAA), Federal Election Commission (FEC), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Highway Traffic Safety Administration (NHTSA), SENATE, Treasury, Dept of, U.S. Trade Representative (USTR)

In support of the RAISE Health Benefits Act (HR 1204) - expanding the use of FSAs In support of the Health Savings Act (HR 35) - expanding the use of HSAs In support of the Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act of 2018 (HR 6311) In support of the Protecting Access to Care Act (HR 1215) - medical malpractice reform In support of Action for Dental Health Act (HR 2422/S 3016)

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

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

H.R. 938 Medicaid Medical Assistance Third Party Payer Liability H.R. 1215 Patient Access To Care Act of 2017 H.R. 3450 Premium Rate Increases H.R. 4284 INFO Act

Client expense: $1,030,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Executive Office of the President (EOP), Federal Deposit Insurance Corporation (FDIC), Federal Emergency Management Agency (FEMA), HOUSE OF REPRESENTATIVES, Natl Credit Union Administration (NCUA), Natl Economic Council (NEC), Natl Security Council (NSC), SENATE, Transportation, Dept of (DOT), Treasury, Dept of, U.S. Trade Representative (USTR)

H.R. 1215, the "Protecting Access to Care Act," all provisions. H.R. 1704, the "Accessible Care by Curbing Excessive lawSuitS (ACCESS) Act," all provisions. H.R. 1876, the "Good Samaritan Health Professionals Act of 2017," all provisions. Comments urging floor action in regards to the Good Samaritan Health Professionals Act of 2018 (H.R. 1876). Coalition letter to the Speaker of the House in support of the Good Samaritan Health Professionals Act of 2018 (H.R. 1876). Coalition letter to leaders of the U.S. House Committee on Energy & Commerce requesting inclusion of H.R. 1876 in the Pandemic and All Hazards Preparedness Re-authorization Act of 2018 (S. 2852). S. 2852, the Pandemic All Hazards Preparedness and Advancing Innovation Act of 2018; provisions related to malpractice/tort reform and H.R. 1876.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, U.S. Trade Representative (USTR), Veterans Affairs, Dept of (VA)

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

H.R. 3692, Addiction Treatment Access Improvement Act of 2017: Medically assisted treatment; opioids H.R. 5761, Ending Maternal Mortality Act of 2018: Maternal mortality H.R. 5718, Perioperative Reduction of Opioids Act: Opioids H.R. 5197, Alternatives to Opioids (ALTO) in the Emergency Department Act: Medically assisted treatment; opioids S. 2516, Alternatives to Opioids (ALTO) in the Emergency Department Act: Medically assisted treatment; opioids S.2680, Opioid Crisis Response Act of 2018: Medically assisted treatment; opioids S.2456, CARA 2.0 Act of 2018: Medically assisted treatment; opioids H.R. 1565, Saving Lives, Saving Costs S.1475, Saving Lives, Saving Costs Comprehensive Addiction and Recovery Act of 2016 (PL 114-198) Affordable Care Act reform efforts H.R. 1628, American Health Care Act of 2017 S. Amdt. 1030 to H.R. 1628, "Graham-Cassidy" Better Care Reconciliation Act of 2017 H.R. 1492, Medical Controlled Substances Transportation Act of 2017 H.R. 1215, Protecting Access to Care Act of 2017 H.R. 3545, Overdose Prevention and Patient Safety Act H.R. 3446, Restoring Board Immunity Act of 2017: Professional Licensing S.2260, Opioids and STOP Pain Initiative ACT:opioids 42 CFR Part 2, Confidentiality of Substance Use Disorder Patient Records: appropriate access to patient information essential for providing whole-person care H.R.3928, Truth in Healthcare Marketing Act of 2017 H.R. 5734, Resident Education Deferred Interest Act: student loan debt repayment for residents 21st Century Cures Initiative Drug Shortages - FDA, DEA, HHS, CMS, GAO, House Energy and Commerce Committee, Senate HELP Committee DEA Scheduling Propofol Comparative Effectiveness Research - PCORI HITECH Implementation, Electronic Health Records, Final and Proposed Rules, HIT Meaningful Use HHS/OIG Anesthesia Practice Arrangements, Company Model FDA Safe Use Initiative Pain Management FTC Letters to States re: Interventional Pain Medicine & Advanced Practice Nurses & Competition in Healthcare Anesthesia Research Funding (Pediatric and others) Scope of Practice FDA Operating Room Fires Naloxone FDA Opioids Prescription Drug Abuse FDA Network of Experts NIH Interagency Pain Research Coordinating Committee FDA SMART TOTS - pediatric anesthesia research USP - US Pharmacopeia National Pain Strategy Nondiscrimination Compounding FDA Nominations to Advisory Committees (Anesthesia Drugs, Anesthesia Devices, Compounding) Agency for Healthcare Research and Quality (AHRQ) funding Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Sequestration Opioids and Opioid abuse; Brain health

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Natl Institutes of Health (NIH), Occupational Safety & Health Administration (OSHA), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA)

S. 2155, Economic Growth, Regulatory Relief, and Consumer Protection Act--Implementation and regulatory reform of the financial services industry. H.R. 3861, Federal Insurance Office Reform Act of 2017-- FIO reform. H.R. 4061, Financial Stability Oversight Council Improvement Act of 2017--Reform of FSOC non-bank SIFI designation process. S.1360, International Insurance Capital Standards Accountability Act of 2017--International capital standards H.R.4537, International Insurance Standards Act of 2017--International Capital Standards H.R. 10, Financial CHOICE Act--Dodd Frank Act reforms S. 1157, H.B. 2481, PATCH Act of 2017-A bill to establish the Vulnerabilities Equities Review Board Tort Reform H.R. 906 - The Furthering Asbestos Claims Transparency Act H.R. 985; H.Res.180 - The Fairness in Class Action Litigation Act H.R. 720; H.Res 180; S.237 - The Lawsuit Abuse Reduction Act H.R. 1215; H.Res.382 - The Protecting Access to Care Act H.R. 1118 - The Innocent Sellers Fairness Act Trade Recently concluded bilateral covered agreement with the EU Disaster Relief S. 161, A bill to improve hurricane forecasting and for other purposes. S. 153, A bill to ensure reliable observation of hurricanes. H.R.1423 - National Flood Insurance Program Reauthorization and Improvement Act of 2017 S.600 - Fairness in Federal Disaster Declarations Act of 2017 H.R. 1422 - Flood Insurance Market Parity and Modernization Act H.R.1183 - To amend the Robert T. Stafford Disaster Relief and Emergency Assistance Act to improve mitigation assistance. H.R.1481 - To amend the Internal Revenue Code of 1986 to include automated fire sprinkler system retrofits as section 179 property and classify certain automated fire sprinkler system retrofits as 15-year property for purposes of depreciation. H.R. 1558 - Repeatedly Flooded Communities Preparation Act H.R.1665 - To ensure that Administrator of the Federal Emergency Management Agency considers severe local impact in making a recommendation to the President for a major disaster declaration. H.R.1679 - To ensure that the Federal Emergency Management Agency's current efforts to modernize its grant management system includes applicant accessibility and transparency, and for other purposes. H.R. 1789 H.R.1691 - To amend the Internal Revenue Code of 1986 to exclude from gross income amounts received from State-based earthquake loss mitigation programs. H.R. 2246 - Taxpayer Exposure Mitigation Act of 2017 H.R. 2548 - FEMA Reauthorization Act of 2017 H.R. 2565 - a bill to require the use of replacement cost value in determining the premium rates for flood insurance coverage under the National Flood Insurance Act, and for other purposes. H.R. 2818 - Disaster Savings Accounts Act of 2017 H.R. 2868 - National Flood Insurance Program Policyholder Protection Act of 2017 H.R. 2874 - 21st Century Flood Reform Act H.R. 2875 - National Flood Insurance Program Administrative Reform Act of 2017 S. 1368 - Sustainable, Affordable, Fair, and Efficient (SAFE) National Flood Insurance Program Reauthorization Act of 2017 H.R.3672 - Making supplemental appropriations for disaster relief requirements for the fiscal year ending September 30, 2017. S.1768 - National Earthquake Hazards Reduction Program Reauthorization Act of 2017 H.R.3732 - Emergency Aid to American Survivors of Hurricanes Irma and Jose Overseas Act S.1798 - Federal Flood Management Act of 2017 S.1823 - Federal Disaster Assistance Nonprofit Fairness Act of 2017 S.1842 - Wildfire Disaster Funding Act S.1853 - Small Business Disaster Relief Act of 2017 H.R.3823 - Disaster Tax Relief and Airport and Airway Extension Act of 2017 H.R.3824 - Texas Flood Accountability Act of 2017 H.R.3854 - Federal Infrastructure Flood Resiliency Act of 2017 H.R. 601 - Continuing Appropriations Act, 2018 and Supplemental Appropriations for Disaster Relief Requirements Act, 2017 H.R.3936 - National Flood Insurance Program Debt Forgiveness Act of 2017 S.1932 - Wildfire Mitigation Assistance Act H.R.4056 - Disaster Insurance Risk Equality Act H.R.4008 - Additional Supplemental Appropriations for Disaster Relief Requirements Act of 2017 S.1991 - Wildland Fires Act of 2017 H.R.4148 - Small Business Disaster Relief Act of 2017 S.2104 - Earthquake Mitigation Incentive and Tax Parity Act of 2017 S.2092 - Flood Insurance Continuing Education and Training Act H.R.4397 - California Wildfire Disaster Tax Relief Act of 2017 S.1907 - National Disaster Tax Relief Act of 2017 H.R.4460 - Disaster Recovery Reform Act H.R.4455 - SMART Rebuilding Act 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.J.Res.123 - Making further continuing appropriations for fiscal year 2018, and for other purposes. H.R.1370 - An Act to amend the Homeland Security Act of 2002 to require the Secretary of Homeland Security to issue Department of Homeland Security-wide guidance and develop training programs as part of the Department of Homeland Security Blue Campaign, and for other purposes. H.R.4739 - Build America Act of 2018 H.R.4995 - Due Diligence for FEMA Disaster Contractors Act of 2018 H.R.4905 - IMAGES Act of 2018 (NFIP) H.R.5200 - Hardest Hit Housing Act of 2018 S.2447 - Smart Building Acceleration Act H.R.5069 - Smart Building Acceleration Act of 2018 H.R.4845 - Connecting Communities Post Disasters Act of 2018 H.R.5016 - Revitalize Rural America Act of 2018 Regulation of the insurance industry H.R.1708 - To prohibit the sale of a firearm to, and the purchase of a firearm by, a person who is not covered by appropriate liability insurance coverage. Monitor implementation of (Pub. L. 114-1), the Terrorism Risk Insurance Program Reauthorization Act of 2015 Monitor implementation of Pub. L. 114-113, Consolidated Appropriations Act, 2016 (contains the Policyholder Protection Act) Monitor the Federal Insurance Offices activities at the International Association of Insurance Supervisors Recently concluded bilateral covered agreement with the EU H.R. 10 - Financial CHOICE Act of 2017 S. 1360 - International Insurance Capital Standards Accountability Act of 2017 S.1579 - Bureau of Consumer Financial Protection Advisory Board Enhancement Act H.R. 3110 - Financial Stability Oversight Council Insurance Member Continuity Act H.R.3312 - Systemic Risk Designation Improvement Act of 2017 H.J.Res.111 - Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by Bureau of Consumer Financial Protection relating to "Arbitration Agreements" H.R.3363 - CLAIM Act S.1773/H.R. 3698 - A bill to amend the Federal Crop Insurance Act to limit the overall rate of return for crop insurance providers and remove the requirement of budget neutrality in the Standard Reinsurance Agreement. H.R.3746 - Business of Insurance Regulatory Reform Act of 2017 S.1835 - Lower Premiums Through Reinsurance Act of 2017 S.1893 - Systemic Risk Designation Improvement Act of 2017 H.R.3762 - International Insurance Standards Act of 2017 H.R.4309 - Regulatory Relief Act of 2017 H.R.4483 - Federal Insurance Office Abolishment Act of 2017 H.R.4537 - International Insurance Standards Act of 2017 H.R.4755 - Federal Reserve Regulatory Oversight Act S.2299 - Wildfire Regulatory Relief Act of 2018 S.2512 - A bill to amend the Agricultural Act of 2014 to require producers to elect to receive price loss coverage or agriculture risk coverage under that Act or Federal crop insurance under the Federal Crop Insurance Act. H.R.5203 - To amend the Agricultural Act of 2014 to require producers to elect to receive price loss coverage or agriculture risk coverage under that Act or Federal crop insurance under the Federal Crop Insurance Act. (related bill to above) H.R.4865 - Crop Insurance Modernization Act of 2018 H.R.4771 - Small Bank Holding Company Relief Act of 2018 H.R.5076 - Small Bank Exam Cycle Improvement Act of 2018 (to amend the Federal Deposit Insurance Act to extend the examination cycle for certain insured depository institutions) H.R.5266 - Financial Product Safety Commission Act of 2018 (to amend the Consumer Financial Protection Act of 2010 to make the Bureau of Consumer Financial Protection an independent Financial Product Safety Commission, and for other purposes) H.R.5381 - GRATER Act of 2018 (To reduce and minimize the credit, guarantee, and insurance risk of all Federal Government programs by transferring such risk to the private sector at market terms, and for other purposes) Automotive H.R. 1266 - To authorize the Secretary of Transportation to make grants to assist units of local government in developing and implementing plans, known as Vision Zero plans, to H.R.1568 - To enhance interstate commerce by creating a national hiring standard for motor carriers, and for other purposes. H.R.3388 - SELF DRIVE Act H.R.3404 - To provide for the establishment in the National Highway Traffic Safety Administration of a Highly Automated Vehicle Advisory Council. H.R.3411 - To establish in the National Highway Traffic Safety Administration an Automated Driving System Cybersecurity Advisory Council to make recommendations regarding cybersecurity for the testing, deployment, and updating of automated driving systems. H.R.3412 - LEAD'R Act H.R.3421 - INFORM Act H.R.3407 - To amend chapter 301 of subtitle VI of title 49, United States Code, to require a cybersecurity plan for highly automated vehicles, and for other purposes. H.R.3430 - SHARES Act S.1666 - HOT CARS Act of 2017 H.R.3449 - Used Car Safety Recall Repair Act H.Res.493 - Recognizing the dangers of distracted driving. S.1885 - AV START Act S.2017/H.R. 4156 - Driver Fatigue Prevention Act H.R.4542 - Distracted Driving Education Act of 2017 H.R.5131 - Surface Transportation Security Improvement Act of 2018 H.R.5358 - DRIVE-Safe Act Aviation/Aircraft/Airlines (House, Senate) S. 631 - A bill to amend the FAA Modernization and Reform Act of 2012 to provide guidance and limitations regarding the integration of unmanned aircraft systems into United States airspace, and for other purposes. Monitor implementation of (Pub. L. 114-190), FAA Extension, Safety, and Security Act of 2016 H.R. 2997 - 21st Century AIRR Act H.R. 2930 - Drone Innovation Act of 2017 S.1272 - Drone Federalism Act of 2017 H.R. 3644/S.1755 - Drone Operator Safety Act of 2017 H.R.3823 - Disaster Tax Relief and Airport and Airway Extension Act of 2017 Postal Reform (House, Senate) H.R. 756 - Postal Service Reform Act of 2017 H.R. 760 - Postal Service Financial Improvement Act of 2017 H.R. 5666, S. 3177 the Primary Regulators of Insurance Vote Act-a bill to allow for a state insurance member to have a vote on FSOC H.R. 5881, S. _____, PAID ACT-- Provide Accurate Information Directly Act--A bill to improve claim resolution through CMS systems related to Medicare part C, D and Medicaid. H.R. 4219 Workflex in the 21st Century Act- Federal uniformity on paid leave requirements (HR) Public Law 111-203, H.R. 4173- Dodd-Frank Wall Street Reform and Consumer Protection Act. Issue: Implementation and Regulatory reform. Captive Reinsurance Transactions, Insurance Capital Standards and Global Capital Standards. Implementation of S. 2270 - Insurance Capital Standards Clarification Act of 2014. The bill would give the Federal Reserve the authority to tailor capital standards for insurance companies subject to Fed supervision. Issue: Capital Standards, Basel III H.R. 372 - Competitive Health Insurance Reform Act of 2017. This bill would restore the application of the Federal antitrust laws to the business of health insurance to protect competition and consumers. Issue: McCarran-Ferguson Act. H.R. 1270 - Living Donor Protection Act of 2017. The bill would promote and protect from discrimination living organ donors. Issue: underwriting. Tort Reform HR 3808, New York Scaffold Law-- This bill precludes absolute liability in any action against a property owner or contractor for projects receiving federal financial assistance for infrastructure and transportation development for any injury associated with an elevation or gravity related risk occurring on those projects S. 2815 - Litigation Funding Transparency Act of 2018 Trade Disaster Relief H.R.4177 - PREPARE Act of 2017 - To enhance the Federal Governments planning and preparation for extreme weather and the Federal Governments dissemination of best practices to respond to extreme weather, thereby increasing resilience, improving regional coordination, and mitigating the financial risk to the Federal Government from such extreme weather, and for other purposes. S. 2701 - A bill to require the Administrator of the Federal Emergency Management Agency to carry out a pilot program to enhance the mapping of urban flooding and associated property damage and the availability of that mapped data to homeowners, businesses, and localities to help understand and mitigate the risk of such flooding, and for other purposes. H.R. 5559 - To transfer functions related to the preparation of flood maps from the Administrator of the Federal Emergency Management Agency to the Director of the United States Geological Survey, and for other purposes. H.R. 5543 - To amend the Internal Revenue Code of 1986 to allow for a credit against tax for certain flood insurance expenses. S.2767 - A bill to make improvements to certain wildfire and disaster recovery programs of the Federal Government, and for other purposes. H.R.5618 - To exempt properties located in flood hazard areas that are participating in an approved buy-out program from the mandatory purchase requirement under the National Flood Insurance Program, and for other purposes. H.R.5973 - Disaster Assistance Risk Transfer Act of 2018 - To amend the Robert T. Stafford Disaster Relief and Emergency Assistance Act to require a report on risk transfer, and for other purposes Regulation of the insurance industry Public Law 111-203, H.R. 4173 - Dodd-Frank Wall Street Reform and Consumer Protection Act. Issue: Implementation and Regulatory reform. Captive Reinsurance Transactions, Insurance Capital Standards and Global Capital Standards. Roles of federal and state agencies at the International Association of Insurance Supervisors and the Financial Stability Board. Implementation of S. 2270 - Insurance Capital Standards Clarification Act of 2014. The bill would give the Federal Reserve the authority to tailor capital standards for insurance companies subject to Fed supervision. Issue: Capital Standards, Basel III H.R.___ - Financial Services and General Government Appropriations Act. Making appropriations for financial services and general government for the fiscal year ending September 30, 2018, and for other purposes. Issue: Global insurance standards; SIFI de-risking. H.R. 4537 Insurance Capital Standards Accountability Act of 2017. Issue: international insurance standards. H.R. 4483 - Federal Insurance Office Abolishment Act of 2017. Issue: FIO reform. H.R. 5323 - Derivatives Fairness Act. Issue: establish an exemption from the credit valuation adjustment calculation for uncleared derivatives transactions with end-users. H.R. 1625 - Consolidated Appropriations Act of 2018. Issue: postal reform. H.R.___/S.___ - Financial Services and General Government Appropriations Act. Making appropriations for financial services and general government for the fiscal year ending September 30, 2019, and for other purposes. Issue: Global insurance standards; SIFI de-risking. H.R.__ - Draft legislation regarding the designations or titles of financial professionals. Issue: Unclaimed life insurance products. No bill number assigned. Issue: Covered agreement on prudential measures with respect to the business of insurance and reinsurance. No bill number assigned. Issue: Whole or universal life insurance premiums. Issue: Swap margin rule. The rule establishes margin requirements for swaps not cleared through a clearinghouse. No bill number assigned. H.R. 1303/S. 180 - H-1B and L-1 Visa Reform Act of 2017. This bill would amend the Immigration and Nationality Act to reform and reduce fraud and abuse in certain visa programs for aliens working temporarily in the U.S. Issue: immigration reform. H.R. 1226/S. 447 - Justice for Uncompensated Survivors Today (JUST) Act of 2017. This bill would require reporting on acts of certain foreign countries on Holocaust era assets and related issues. Issue: Holocaust era insurance claims. H.R. 762/S.258 - Holocaust Insurance Accountability Act of 2017. This bill would provide for the restoration of legal rights for claimants under holocaust-era insurance policies. S. 2702 - A bill to amend the Consumer Financial Protection Act of 2010 to clarify authority of the Bureau of Consumer Financial Protection with respect to persons regulated by a State insurance regulator, and for other purposes H.R. 4061 - Financial Stability Oversight Council Improvement Act of 2017 - To amend the Financial Stability Act of 2010 to improve the transparency of the Financial Stability Oversight Council, to improve the SIFI designation process, and for other purposes. S.3177 - A bill to amend the Financial Stability Act of 2010 to include the State insurance commissioner as a voting member of the Financial Stability Oversight Council, and for other purposes Automotive H.R.5502 - Prohibit Auto Insurance Discrimination Act - To prohibit private passenger automobile insurers from using certain income proxies to determine insurance rates and eligibility. Aviation/Aircraft/Airlines (House, Senate) Postal Reform (House, Senate) S.2755 - A bill to amend title 39, United States Code, to provide that the United States Postal Service may provide certain basic financial services, and for other purposes. H.R.6076 - To restore the financial solvency and improve the governance of the United States Postal Service in order to ensure the efficient and affordable nationwide delivery of mail, and for other purposes Primary Regulators of Insurance Vote Act of 2018, S. 3177-allow for the state representative to be a voting member of FSOC S. 488, the JOBS and Investor Confidence Act (JOBS 3.0)-Including Duffy-Heck International Capital Standard bill. oH.R. 6321, the Investment Adviser Regulatory Flexibility Improvement Act-- require the SEC to revise its definition of a "small business," requiring the SEC to look beyond assets under management and include other factors, such as employment at an advisory firm. oH.R.6323, the National Senior Investor Initiative Act, would require the SEC to set up an interagency task force to focus on challenges facing senior investors. HR 1585, the Fair Investment Opportunities for Professional Experts Act. It would Amends the Securities Act of 1933 to modify the definition of accredited investor H.R. 6021, the Small Business Audit Correction Act of 2018 H.R. 6743, the Consumer Information Notification Requirement Act-a preemptive federal standard for data breach and cyber security applied to financial services companies H.R. 6021, the Small Business Audit Correction Act. the legislation would ease audit requirements for small broker-dealers Disaster H.R.6379 - National Flood Insurance Program Extension Act of 2018 - Passed House H.R.6402 - National Flood Insurance Program Extension and Enhanced Consumer and Community Protections Act of 2018 H.R.6499 - To amend the Small Business Act to authorize the Administrator of the Small Business Administration to issue loans to homeowners in areas at risk for disasters to carry out pre-disaster mitigation activities, and for other purposes H.R.6650 - To reauthorize and amend the National Earthquake Hazards Reduction Program, and for other purposes S.3265 - A bill to require the Secretary of Commerce to undertake certain activities to support waterfront community revitalization and resiliency, and for other purposes (Tammy Baldwin) H.R.6826 - To amend the Small Business Act to provide for disaster loans to repair, rehabilitate, or replace property damaged or destroyed by hurricane Harvey, Irma, or Maria, and for other purposes H.R.6799 - To authorize disaster recovery assistance for areas affected by wildfires on Federal Lands, and for other purposes H.R.6944 - To establish centers of excellence for innovative stormwater control infrastructure, and for other purposes Auto (House, Senate) S.3491 - A bill to require the Secretary of Transportation to carry out a pilot program to develop and provide to States and transportation planning organizations accessibility data sets, and for other purposes S.3215 - A bill to amend title 49, United States Code, to require the development of a bus operations safety risk reduction program, and for other purposes S.3432 - A bill to direct the Secretary of Transportation to issue rules requiring the inclusion of new safety equipment in school buses, and for other purposes Aviation/Aircraft/Airlines (House, Senate) H.R.6438 - To amend the Homeland Security Act of 2002 to establish in the Department of Homeland Security an Unmanned Aircraft Systems Coordinator, and for other purposes S.3511 - A bill to broaden unmanned aircraft systems safety awareness, and for other purposes S.3513 - A bill to establish a deadline for the establishment of a process to allow applicants to petition the Administrator of the Federal Aviation Administration to prohibit or restrict the operation of an unmanned aircraft in close proximity to a fixed site facility Homeland Security (House, Senate) H.R.6864 - Information Transparency & Personal Data Control Act - To require the Federal Trade Commission to promulgate regulations related to sensitive personal information or behavioral data, and for other purposes H.R.6913 - To direct the Secretary of Commerce to establish a working group to recommend to Congress a definition of blockchain technology, and for other purposes S.3437 - A bill to establish a Federal rotational cyber workforce program for the Federal cyber workforce PAID FAMILY LEAVE H.R. 4219 Workflex in the 21st C. Act-- This bill amends the Employee Retirement Income Security Act of 1974 (ERISA) to establish a voluntary workflex option under which employers who provide flexible workplace arrangement plans that include a combination of paid leave and flexible work options are exempt from certain state and local laws regarding employee benefits. S.3345 - Economic Security for New Parents Act - Parental leave only. Allows new parents to drawdown on future Social Security benefits. Rubio Introduced bill week of 7/31, Rep. Ann Wagner to intro companion in Sept. H.R. 1516 Healthy Families Act--Mandate paid sick leave S. 337/H.R 847 FAMILY (Family and Medical Insurance Leave) Act-- Creates a new trust fund within Social Security Admin. For sick leave. H.R. 2282/S. 1006, Equality Act--This bill amends the Civil Rights Act of 1964 to include sex, sexual orientation, and gender identity among the prohibited categories of discrimination or segregation in places of public accommodation. H.R.7037 - State Flood Mitigation Revolving Fund Act of 2018- To amend the National Flood Insurance Act of 1968 to allow the Administrator of the Federal Emergency Management Agency to provide capitalization grants to States to establish revolving funds to provide funding assistance to reduce flood risks, and for other purposes (Charlie Crist, D-FL) H.R.7166 - Hurricane Michael Tax Relief Act - To provide tax relief for the victims of Hurricane Michael, and for other purposes (Neal Dunn, R-FL) S.3679 - A bill to ensure that older adults and individuals with disabilities are prepared for disasters, and for other purposes (Bob Casey) H.R.7200 - To extend indemnity for wildfires and hurricanes, and for other purposes (Austin Scott, R-GA) S.3648 - Hurricanes Florence and Michael and California Wildfire Tax Relief Act - To provide tax relief for the victims of Hurricane Florence, Hurricane Michael, and certain California wildfires (Richard Burr, NC) H.R.7024 - Federal Flood Management Act of 2018 - To establish a Federal standard in order to improve the Nations resilience to current and future flood risk (Jamie Raskin, D-MD) H.R.7315 - To protect American communities from wildfire, and for other purposes (Bruce Westerman, R-AR) H.R.7242 - Disaster Recovery and Opportunity Act of 2018 - To amend the Internal Revenue Code of 1986 to allow certain areas affected by certain Federally declared disasters to be designated as opportunity zones (Mark Meadows, R-NC) H.R.7333 - FEMA Modernization Act of 2018- To provide for reform and reorganization of the Federal Emergency Management Agency, and for other purposes (Sheila Jackson Lee, D-TX) H.R.7322 - H.R 7133,H.R.7192,H.R.7260, H.R.7357,S.3744,S.ConsumerProtectionAct Wyden,H.R.7343,H.R.7392,S.3655,S.3577,H.R. 7383,H.R. 7394

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

Government targets: Federal Deposit Insurance Corporation (FDIC), Federal Emergency Management Agency (FEMA), Federal Reserve System, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Labor, Dept of (DOL), SENATE, Securities & Exchange Commission (SEC), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Copyright Office, U.S. Postal Service (USPS)

H.R. 985 - Fairness in Class Action Litigation and Furthering Asbestos Claim Transparency Act - SUPPORT H.R. 720 / S. 237 - Lawsuit Abuse Reduction Act (LARA) - SUPPORT H.R. 725 - Innocent Party Protection Act (formally Fraudulent Joinder Prevention Act) - SUPPORT H.R. 1215 - Protecting Access to Care Act - SUPPORT H.R. 1876 - Good Samaritan Health Professionals Act - SUPPORT H.R. 732 / H.R. 522 / S. 333 - Stop Settlement Slush Funds Act - SUPPORT H.R. 1033 / S. 378 - Open Book on Equal Access to Justice Act - SUPPORT H.R. 469 / S. 119 - Congressional Article I Powers Strengthening Act (formally called Sunshine for Regulatory Decrees and Settlements Act) - SUPPORT H.R. 4570 / H.R. 4734 / S. 2203 - Ending Forced Arbitration of Sexual Harassment Act - OPPOSE H.R. 1396 / S. 550 - Restoring Statutory Rights and Interests of the States Act - OPPOSE S. 542 - Safety Over Arbitration Act - OPPOSE H.R. 832 - Arbitration Transparency Act - OPPOSE H.R. 1414 / S. 552 - Justice for Victims of Fraud Act - OPPOSE H.R. 2631 / S. 646 - Justice for Service Members and Veterans Act - OPPOSE S. 647 - Mandatory Arbitration Transparency Act - OPPOSE H.R. 1374 / S. 537 - Arbitration Fairness Act - OPPOSE

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Work to modify proposed CMS regulation that would apply the Medicare Secondary Payer Act to liability settlements. Work in opposition to H.R. 1215, the Protecting Access to Care Act, legislation that would impose federal caps on non-economic damages available in medical malpractice cases.

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

Government targets: Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, Transportation, Dept of (DOT)

Supporting Independent Payment Advisory Board Repeal - H.R.849/S.260, Protecting Seniors' Access to Medicare Act and S.251, Protecting Medicare from Executive Action, enacted into law Supporting Medical Liability Reform - H.R.1215, Protecting Access to Care Act ACA Repeal and Replace - not supporting Supporting H.R.4206, Medicare Care Coordination Improvement Act Comments on FY 2018 Hospital Outpatient Prospective Payment System Final Rule submitted to CMS, the agency corrected placement of vascular ultrasound codes Supporting H.R.2267, Resident Physician Shortage Reduction Act Supporting H.R.1876/S.781 - Good Samaritan Health Professionals Act Opposing Medicare Payment Advisory Commission's proposal to rebalance the physician fee schedule towards primary care Following opioid legislation, Stark Act Reform to allow for physician self referral under alternative payment models

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA)

H.R. 1215 (Protecting Access to Care Act); establishes provisions governing health care lawsuits, including limiting noneconomic damages to $250,000. S. 808/H.R. 302 (Sports Medicine Licensure Clarity Act); provides protections for certain sports medicine professionals who provide certain medical services in a secondary State. H.R. 1565 (Saving Lives, Saving Costs Act); establishes a framework for health care liability lawsuits to undergo review by independent medical review panels if health care professionals (practicing physicians or their agents or employees) allege adherence to applicable clinical practice guidelines in the provision of health care goods or services. H.R. 1704 (ACCESS Act of 2017); affects healthcare lawsuits by limiting liability and capping noneconomic damages, among other measures. H.R. 1118 (Innocent Sellers Fairness Act); limits liability for personal injury, monetary loss, or damage to property arising out of an accident or transaction involving a seller's products during the regular course of trade or business. S. 781/H.R. 1876 (Good Samaritan Health Professionals Act); limits the liability of health care professionals who volunteer to provide health care services in response to a disaster. S. 1134/H.R. 2437 (Back the Blue Act); alters rules governing criminal and civil rights cases against government entities. H.R. 1103 (Child Abuse Accountability Enhancement Act); amends title 10, United States Code, to provide for garnishment pursuant to a court order to satisfy a judgment against a retired member of the uniformed services for physically, sexually, or emotionally abusing a child. S. 1693 (Stop Enabling Sex Traffickers Act of 2017); amends the Communications Act of 1934 to clarify that section 230 of that Act does not prohibit the enforcement against providers and users of interactive computer services of Federal and State criminal and civil law relating to sex trafficking. H.R. 1865 (Allow States and Victims to Fight Online Sex Trafficking Act of 2017); amends the Communications Act of 1934 to clarify that section 230 of such Act does not prohibit the enforcement against providers and users of interactive computer services of Federal and State criminal and civil law relating to sexual exploitation of children or sex trafficking, and for other purposes. H.R. 459 (Trafficking Survivors Relief Act of 2017); provides for the vacating of certain convictions and expungement of certain arrests of victims of human trafficking. S. 1426 (United States Center for Safe Sport Authorization Act of 2017); amends the Ted Stevens Olympic and Amateur Sports Act to expand the purposes of the corporation, to designate the United States Center for Safe Sport. H.R. 3808 (Infrastructure Expansion Act of 2017); preempts New York state law and precludes absolute liability in any action against a property owner or contractor for projects receiving federal financial assistance. S. 2815 (Litigation Funding Transparency Act); requries one-sided disclosure of plaintiff use of litigation funding. H.R. 5856 (Good Samaritan Charitable Physicians Services Act of 2018); creates limited liability for volunteer health care professionals. General lobbying with regard to preemption of state common law.

Client expense: $1,430,000 · Firm income: Not reported

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

Supporting Independent Payment Advisory Board Repeal - H.R.849/S.260, Protecting Seniors' Access to Medicare Act and S.251, Protecting Medicare from Executive Action, enacted into law Supporting Medical Liability Reform - H.R.1215, Protecting Access to Care Act ACA Repeal and Replace - not supporting Supporting H.R.4206, Medicare Care Coordination Improvement Act Comments on FY 2018 Hospital Outpatient Prospective Payment System Final Rule submitted to CMS, the agency corrected placement of vascular ultrasound codes Supporting H.R.2267, Resident Physician Shortage Reduction Act Supporting H.R.1876/S.781 - Good Samaritan Health Professionals Act Opposing Medicare Payment Advisory Commission's proposal to rebalance the physician fee schedule towards primary care Following opioid legislation, Stark Act Reform to allow for physician self referral under alternative payment models

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA)

Protecting Access to Care Act (regarding federal medical liability reform), H.R. 1215, entire bill; Accessible Care by Curbing Excessive lawSuitS Act (ACCESS Act) (regarding federal medical liability reform), H.R. 1704, entire bill.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation and policies relating to: Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Reauthorization of funding for the Childrens Health Insurance Program Reauthorization of the Child Nutrition Act Section 2706 of the ACA regarding provider non-discrimination Policies related to health insurance market stabilization Policies affecting nurse practitioner education and workforce Definition, evaluation and enforcement of essential health benefits and provider network adequacy Health information technology and electronic health records Mental health services and violence prevention Human and child trafficking H.R. 315/S. 783 - Improving Access to Maternity Care Act H.R. 767/S. 256 - Stop, Observe, Ask, and Respond (SOAR) to Health and Wellness Act of 2017 H.R. 772/S. 261 - Common Sense Nutrition Disclosure Act H.R. 959/S. 1109 - Title VIII Nursing Workforce Reauthorization Act of 2017 H.R. 1174/S. 1497 - Fairness For Breastfeeding Mothers Act of 2017 H.R. 1215 - Protecting Access to Care Act of 2017 H.R. 1318 - Preventing Maternal Deaths Act of 2017 H.R. 1865 - Allow States and Victims to Fight Online Sex Trafficking Act of 2017 H.R. 2742/S. 1257 - Modernizing the Interstate Placement of Children in Foster Care Act H.R. 2824 - Increasing Opportunity through Evidence-Based Home Visiting Act H.R. 2857 - Supporting Families in Substance Abuse Treatment Act H.R. 2834 - Partnership Grants to Strengthen Families Affected by Parental Substance Abuse Act H.R. 2866 - Reducing Barriers for Relative Foster Parents Act H.R. 2847 - Improving Services for Older Youth in Foster Care Act H.R. 3192 - CHIP Mental Health Parity Act H.R. 3291 - Alleviating Adverse Childhood Experiences (ACES) Act H.R. 3387 - Drinking Water System Improvement Act of 2017 H.R. 3525 - Home Visiting Works Act of 2017 H.R. 3728 - Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness (EMPOWER) Act of 2017 H.R. 3921 - Helping Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable (HEALTHY KIDS) 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 (CHAMPIONING HEALTHY KIDS) Act of 2017 H.R. 3928 - Truth in Healthcare Marketing Act of 2017 H.R. 4695 - Bipartisan Market Stabilization and Innovation Act of 2017 H.R. 4978/S. 2410 - Chronic Disease Management Act of 2018 H.R. 4998 - Health Insurance for Former Foster Youth Act H.R. 5385/S. 2597 - Childrens Hospital GME Support Reauthorization Act of 2018 H.R. 5425/S. 2647 - Food Labeling Modernization Act of 2018 H.R. 5977 - Mothers and Offspring Mortality and Morbidity Awareness (MOMMAs) Act H.R. 6199 - Restoring Access to Medication and Modernizing Health Savings Accounts Act of 2018 H.R. 6560 - ChiPACC Act of 2018 S. 761/H.R. 1933 - Health Care Options Act of 2017 S. 920 - National Clinical Care Commission Act S. 1016/H.R. 2556 - Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2017 S. 1028 - Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act S. 1091/H.R. 3105 - Supporting Grandparents Raising Grandchildren Act S. 1112 - Maternal Health Accountability Act of 2017 S. 1268 - Child Protection and Family Support Act of 2017 S.1377 - Reaching Underserved Rural Areas to Lead on Telehealth Act S. 1441/H.R. 3059 - Community Health Center and Primary Care Workforce Expansion Act of 2017 S. 1693 - Stop Enabling Sex Traffickers Act of 2017 S. 1827 - Keeping Kids Insurance Dependable and Secure (KIDS) Act S. 1829 - Strong Families Act of 2017 S. 2415 - Accelerating Kids Access to Care Act S. 2852/H.R. 3678 - Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018 S. 3029 - Prematurity Research Expansion and Education for Mothers who deliver Infants Early (PREEMIE) Reauthorization Act of 2018 S. 3319 - Stopping Appealing Flavors in E-Cigarettes (SAFE) for Kids Act 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: Not reported · Firm income: $23,450

Government targets: Agriculture, Dept of (USDA), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Justice, Dept of (DOJ), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA)

H.R. 985, the Fairness in Class Action Litigation Act of 2017 H.R. 1215, the Protecting Access to Care Act of 2017

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

Government targets: Commerce, Dept of (DOC), Congressional Budget Office (CBO), Consumer Financial Protection Bureau (CFPB), Education, Dept of, Federal Deposit Insurance Corporation (FDIC), Federal Emergency Management Agency (FEMA), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Office of Management & Budget (OMB), SENATE, State, Dept of (DOS), Treasury, Dept of, U.S. Trade Representative (USTR), White House Office

Health care quality; physician and hospital quality; health care innovation; Patient Protection and Affordable Care Act/health care reform implementation; Affordable Care Act repeal/replace/reform efforts; medical liability reform, including HR 1215, the Protecting Access to Care Act; unique device identifier policy and post-market surveillance for medical devices; clinical trial design; clinical data registries; the Common Rule and registries; HIPAA and registries; federal funding/appropriations for HHS, NIH, AHRQ, CDC, FDA, HRSA and the Childrens Hospital Graduate Medical Education payment program, including H.R. 5385, the Prevention & Public Health Fund, medical research, and prevention; HR 3592, the South Asian Heart Health Awareness and Research Act of 2017; research and scholarly communication policy, including S 1701/HR 3427, the Fair Access to Science and Technology Research Act of 2017; healthy diet/lifestyle; implementation and oversight of 21st Century Cures Act; data blocking/interoperability of electronic data; health disparities; S 477/HR 1222, the Congenital Heart Futures Reauthorization Act of 2017; National Clinical Care Commission Act implementation; Senate price transparency workgroup; reduction/oversight of prior authorization and other administrative burdens; shared decision-making; medical isotope production and supply; digital health/FDA pre-certification; cardiomyopathy education and awareness.

Client expense: $750,000 · 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), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, White House Office

Support H.R. 304/S. 916, The Protecting Patient Access to Emergency Medications Act of 2017, a bill to amend the Controlled Substances Act with regard to the provision of emergency medical services and discussed companion legislation with the Senate; Support H.R. 372, The Competitive Health Insurance Reform Act of 2017, a bill to repeal McCarran-Ferguson with respect to the business of health insurance; Discussed with members of congress working on legislation that maintains coverage and improves Americas health care system through patient-centered care; Oppose HR 1156/ S 1133 , Patient Access to Higher Quality Health Care Act of 2017, a bill to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals; Support HR 1215, Protecting Access to Care Act, a bill 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; Urged CMS to release guidance pertaining to hospital co-location arrangements and to provide flexibility in the agencys co-location policies; Support HR 2141/ S 898, the Conrad State 30 and Physician Access Act of 2017, a bill that would reauthorize the Conrad State 30 Program and make other changes to improve patient access to care; Support S.781/ HR 1876. Good Samaritan Health Professional Act of 2017, a bill to amend the Public Health Service Act to limit the liability of health care professionals who volunteer to provide health care services in response to a disaster; Support HR 2212/ S 974Creating and Restoring Equal Access to Equivalent Samples (CREATES) 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; Meet with HRSA Administrator and senior staff on 340B drug pricing program; Discussed marketplace stabilization solutions with Hill staff; Support and Recommend changes to HR 1253, Mental Health and Substance Abuse Treatment Accessibility Act of 2017a bill to authorize the Secretary of Health and Human Services to make loans and loan guarantees for constructing or renovating, or planning construction or renovation of, qualified psychiatric and substance abuse treatment facilities, and for other purposes: advocated for changes to clarify/expand the entities that can be loan applicants/recipients; Urged the Administration to suspend the faulty star ratings from the Hospital Compare website; Eliminate barriers to care with the creation of an Anti-Kickback safe harbor for clinical integration arrangements that establishes the basic accountabilities for the use of incentive payment or shared savings programs among hospitals, physicians and other providers, along with a safe-harbor for assistance to patients that would protect providers from financial penalties under the Civil Monetary Penalties (CMPs) for providing an inducement to a patient; Advocated for changes including: eliminating geographic and setting locations requirements so patients outside of rural areas can benefit from telehealth; expanding the types of technology that can be used, including remote monitoring; and covering all services that are safe to provide, rather than a small list of approved services; Submit Statement Stabilizing Premiums and Helping Individuals in the Individual Insurance Market for 2018: Health Care Stakeholders about the importance of stabilizing the Health Insurance Marketplaces for 2018 and beyond; We urged Congress to pass legislation to fund the ACA cost-sharing reductions; Urged Senators to oppose the Graham-Cassidy proposal being considered in the Senate because this proposal would make significant changes to health care coverage and health care financing; Review of H.R. 3528, Every Prescription Conveyed Securely Act, a bill to amend title XVIII of the Social Security Act to require e-prescribing for coverage under part D of the Medicare program of prescription drugs that are controlled substances; Discussions with Congress on prescription drug monitoring programs, the dispensing of controlled substances, and clinical workflow; Discussions with Congress on draft legislation related to prescription drug monitoring programs; Urged Congress to consider advancing solutions aimed at making our health care system stronger, protecting access and coverage, and exploring new delivery system reforms that have the potential to make care both more affordable and safer; Review of The Combating the Opioid Epidemic Act, a bill to provide funding to combat the opioid epidemic; Discussions with the White House/Office of National Drug Control Policy about the opioid epidemic, including concerns about regulations that prohibit the sharing of substance use disorder records among health care providers; Support H.R. 4392 a bill to prevent cuts to the 340B drug savings program, which would provide relief from deep cuts to payments to hospitals participating in the 340B program; Letter to congress outlining AHA opposition to a potential policy that would cut payments to hospitals treating hospice patients; Oppose H.R. 4710, 340B Protecting Access for the Underserved and Safety-Net Entities (PAUSE) Act, a bill to amend the Public Health Service Act to establish a moratorium on the registration of certain new 340B hospitals and associated site; Sent comments to the Energy and Commerce Subcommittee on Oversight and Investigations for its hearing on Examining the Impact of Health Care Consolidation.; Letter sent to the Energy & Commerce Subcommittee for its hearing on, "Combating the Opioid Crisis: Helping Communities Balance Enforcement and Patient Safety"; Letter submitted to the Ways and Means Committee on policy recommendations to address the opioid epidemic; Sent letter to discuss the current state of health care costs, and efforts to increase transparency in the pricing of health care services and the quality of care; Addressed our concerns with the MedPAC Commissions draft recommendation to substantially reduce payments for off-campus stand-alone emergency departments (EDs) that are within 6 miles of an on-campus hospital ED; Addressed our concerns with the Commissions draft recommendation to substantially reduce payments for off-campus stand-alone emergency departments (EDs) that are within 6 miles of an on-campus hospital ED; Support HR4776, Hospital Preparedness Reauthorization Act of 2018, a bill to amend the Public Health Service Act to reauthorize a program of partnerships for State and regional hospital preparedness to improve surge capacity and would increase the level of authorized funding for the Hospital Preparedness Program to $515 million; Submitted statement to the Senate HELP Committee on the Hearing on How to Reduce Health Care Costs: Understanding the Cost of Health Care in America; Submitted a Statement for the HELP hearing on Effective Administration of the 340B Drug Pricing Program; Support certain provisions in Helping to End Addiction and Lesson (HEAL) Substance Use Disorders Act of 2018; Support HR 6071, Stretching Entity Resources for Vulnerable Communities Act or the SERV Communities Act, A bill to amend the Public Health Service Act to clarify the intent of the 340B program and provide for enhanced 340B program integrity; Support S 2597Childrens Hospital GME Support Reauthorization Act of 2018, A bill to amend the Public Health Service Act to reauthorize the program of payments to children's hospitals that operate graduate medical education programs; Support HR 3545, Overdose Prevention and Patient Safety ActA bill to amend the Public Health Service Act to protect the confidentiality of substance use disorder patient records; Support S 2516, Alternatives to Opioids (ALTO) in the Emergency Department ActA bill to direct the Secretary of Health and Human Services to conduct a demonstration program to test alternative pain management protocols to limit the use of opioids in emergency departments; Support HR 5176/ S 2610, Preventing Overdoses While in Emergency Rooms Act of 2018 A bill to require the Secretary of Health and Human Services to provide coordinated care to patients who have experienced a non-fatal overdose after emergency room discharge; Submit statement to the Ways and Means Subcommittee on Health on the hearing Identifying Innovative Practices and Technology in Health Care; Support S 1845 Lead-Safe Housing for Kids Act" To amend the Lead-Based Paint Poisoning Prevention Act to provide for additional procedures for families with children under the age of 6; Submitted statement to the Energy & Commerce Health Subcommittee for the hearing "Improving the Coordination and Quality of Substance Use Disorder Treatment." The statement focuses on 42 CFR Part 2; Comments to HELP Committee's discussion draft of the Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018; The current Pandemic and All-Hazards Preparedness Act (PAHPA) will sunset on October 1, 2018 so this is "must-do" legislation; Support S 2852, the Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018 (PAHPAI), A bill to reauthorize certain programs under the Pandemic and All-Hazards Preparedness Reauthorization Act; Supports S. 2372, VA Maintaining Internal Systems and Strengthening Integrated Outside Networks Act of 2018 (VA MISSION Act of 2018).A bill to establish a permanent community care program for veterans, to establish a commission for the purpose of making recommendations regarding the modernization or realignment of facilities of the Veterans Health Administration, to improve construction of the Department of Veterans Affairs, to make certain improvements in the laws administered by the Secretary of Veterans Affairs relating to the home loan program of the Department of Veterans Affairs,Submitted a statement to the Ways and Means Committee hearing on "Lowering Costs and Expanding Access to Health Care through Consumer-Directed Health Plans;" Submitted a statement to the Senate HELP Subcommittee on "Primary Health and Retirement Security on Health Care in Rural America: Examining Experiences and Costs"; Submitted a statement to the Senate HELP Committee on "Reducing Health Care Costs: Eliminating Excess Health Care Spending and Improving Quality and Value for Patients"; Submitted comments on the consumer-directed health plan legislation to the Committee on Ways & Means; Submitted a statement to the Energy and Commerce Subcommittee on Health on "Opportunities to Improve the 340B Drug Pricing Program".

Client expense: $5,220,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA), White House Office

H.R. 1215 (Protecting Access to Care Act); establishes provisions governing health care lawsuits, including limiting noneconomic damages to $250,000. S. 808/H.R. 302 (Sports Medicine Licensure Clarity Act); provides protections for certain sports medicine professionals who provide certain medical services in a secondary State. H.R. 1565 (Saving Lives, Saving Costs Act); establishes a framework for health care liability lawsuits to undergo review by independent medical review panels if health care professionals (practicing physicians or their agents or employees) allege adherence to applicable clinical practice guidelines in the provision of health care goods or services. H.R. 1704 (ACCESS Act of 2017); affects healthcare lawsuits by limiting liability and capping noneconomic damages, among other measures. H.R. 1118 (Innocent Sellers Fairness Act); limits liability for personal injury, monetary loss, or damage to property arising out of an accident or transaction involving a seller's products during the regular course of trade or business. S. 781/H.R. 1876 (Good Samaritan Health Professionals Act); limits the liability of health care professionals who volunteer to provide health care services in response to a disaster. S. 1134/H.R. 2437 (Back the Blue Act); alters rules governing criminal and civil rights cases against government entities. H.R. 1103 (Child Abuse Accountability Enhancement Act); amends title 10, United States Code, to provide for garnishment pursuant to a court order to satisfy a judgment against a retired member of the uniformed services for physically, sexually, or emotionally abusing a child. S. 1693 (Stop Enabling Sex Traffickers Act of 2017); amends the Communications Act of 1934 to clarify that section 230 of that Act does not prohibit the enforcement against providers and users of interactive computer services of Federal and State criminal and civil law relating to sex trafficking. H.R. 1865 (Allow States and Victims to Fight Online Sex Trafficking Act of 2017); amends the Communications Act of 1934 to clarify that section 230 of such Act does not prohibit the enforcement against providers and users of interactive computer services of Federal and State criminal and civil law relating to sexual exploitation of children or sex trafficking, and for other purposes. H.R. 459 (Trafficking Survivors Relief Act of 2017); provides for the vacating of certain convictions and expungement of certain arrests of victims of human trafficking. S. 1426 (United States Center for Safe Sport Authorization Act of 2017); amends the Ted Stevens Olympic and Amateur Sports Act to expand the purposes of the corporation, to designate the United States Center for Safe Sport. H.R. 3808 (Infrastructure Expansion Act of 2017); preempts New York state law and precludes absolute liability in any action against a property owner or contractor for projects receiving federal financial assistance. S. 2815 (Litigation Funding Transparency Act); requries one-sided disclosure of plaintiff use of litigation funding. H.R. 5856 (Good Samaritan Charitable Physicians Services Act of 2018); creates limited liability for volunteer health care professionals. General lobbying with regard to federal preemption of state common law.

Client expense: $1,510,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE, Securities & Exchange Commission (SEC)