Self-Insurance Protection Act

HR.3798, Save American Workers Act HR.1304, Self Insurance Protection Act HR.246, Jobs & Premium Protection Act HR.173, Middle Class Health Benefits Tax Repeal Act HR.1628, American Healthcare Act HR.1101, Small Business Fairness Act S.1859, Healthcare Tax Relief Act S.1979, Small Business & Family Health Tax Relief Act S.1908 and HR.3919, Commonsense Reporting Act to streamline IRG reporting process HR.5138, Bipartisan HSA Improvement Act Repeal Cadillac Tax Authorize small business health plans; preserve employee exclusion Preserve ERISA preemption Better Care Reconciliation Act American Health Care Act of 2017 Health Insurance Tax (HIT) Cost-sharing reduction payments under ACA Affordable Care Act Net Investment Income (NII) Tax

Client expense: $121,523 · Firm income: Not reported

Government targets: Federal Aviation Administration (FAA), General Services Administration (GSA), HOUSE OF REPRESENTATIVES, Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Labor Relations Board (NLRB), SENATE, Small Business Administration (SBA), Transportation, Dept of (DOT), Treasury, Dept of

HR 1304, the Self-Insurance Protection Act. Matters related to self-insurance and stop-loss coverage, association health plans, medical billing, captive insurance and the IRC 831(b)election.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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

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

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

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

HR.1304, Self Insurance Protection Act HR.246, Jobs & Premium Protection Act HR.173, Middle Class Health Benefits Tax Repeal Act HR.1628, American Healthcare Act HR.1101, Small Business Fairness Act S.1859, Healthcare Tax Relief Act S.1979, Small Business & Family Health Tax Relief Act of 2017 S.1908 + HR.3919, Commonsense Reporting Act to streamline IRS reporting process HR.5138, Bipartisan HSA Improvement Act Repeal Cadillac Tax Authorize small business health plans; preserve employee exclusion; Preserve ERISA preemption Better Care Reconciliation Act; American Health Care Act of 2017 Health Insurance Tax (HIT) Cost-Sharing reduction payments under ACA Affordable Care Act Net Investment Income (NII) Tax

Client expense: $102,243 · Firm income: Not reported

Government targets: Federal Aviation Administration (FAA), General Services Administration (GSA), HOUSE OF REPRESENTATIVES, Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Labor Relations Board (NLRB), SENATE, Small Business Administration (SBA), Transportation, Dept of (DOT), Treasury, Dept of

HR 1304, the Self-Insurance Protection Act. Matters related to self-insurance and stop-loss coverage, association health plans, captive insurance and the IRC 831(b)election.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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

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

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

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

HR.1304, Self Insurance Protection Act; HR.246, Jobs & Premium Protection Act; HR.173, Middle Class Health Benefits Tax Repeal Act; HR.1628, American Healthcare Act; HR.1101, Small Business Fairness Act; Repeal Cadillac Tax; Authorize small business health plans; Preserve employee exclusion; Preserve ERISA preemption; Better Care Reconciliation Act; American Health Care Act of 2017; Health Insurance Tax (HIT); Cost-Sharing reduction payments under ACA; Affordable Care Act Net Investment Income (NII) Tax; S.1859, Healthcare Tax Relief Act; S.1978, Small Business & Family Health Tax Relief Act of 2017; S.1908/HR.3919, Commonsense Reporting Act to streamline IRS reporting process; HR.5138, Bipartisan HSA Improvement Act; Comments to DOL re Definition of Employer Under Sec 3(5) of ERISA

Client expense: $128,835 · Firm income: Not reported

Government targets: Federal Aviation Administration (FAA), General Services Administration (GSA), HOUSE OF REPRESENTATIVES, Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Labor Relations Board (NLRB), SENATE, Small Business Administration (SBA), Transportation, Dept of (DOT), Treasury, Dept of

HR 1304, the Self-Insurance Protection Act. Matters related to self-insurance and stop-loss coverage, captive insurance and the IRC 831(b)election.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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

H.R. 1 - Tax Cuts and Jobs Act (Reduces ACA individual mandate penalty.) - House and Senate H.R. 1101 - The Small Business Health Fairness Act (Improve access to health care coverage for small business.) H.R. 1215 - Protecting Access to Health Care Act (Medical malpractice reform.) H.R. 1304 - The Self-Insurance Protection Act (Medical stop-loss insurance.) H.R. 1313 - The Preserving Employee Wellness Programs Act (Clarification of wellness programs.) H.R. 1628 - The American Health Care Act (Repeal ACA tax provisions through reconciliation.) H.R. 1628 / Sen. Substitute - The Better Care Reconciliation Act (Repeal ACA tax provisions through reconciliation.) H.R. 3798 - Save American Workers Act (Amends the ACA definition of full-time.) H.R. 173 and S. 58 - The Middle-Class Health Benefits Tax Repeal Act (Repeals the health care excise tax.) H.R. 3919 and S. 1908 - Commonsense Reporting Act (Clarifies the ACA employer reporting requirements.) S. 1782 -Forty Hours is Full-Time Act (Amends the ACA definition of full-time.) Graham-Cassidy-Heller-Johnson (GCHJ) proposal (Repeals ACA tax provisions through reconciliation.) - Senate Health Care Reform - White House Wellness Programs (Clarification of wellness programs.) - House and Senate / EEOC Health Care Stabilization Bill (Increases HSA limits and provides ACA employer mandate penalty relief.) House and Senate Bipartisan Health Care Stabilization Act (Bipartisan agreement to stabilize ACA markets.) - Senate

Client expense: $660,364 · Firm income: Not reported

Government targets: Bureau of Citizenship & Immigration Services (BCIS), Equal Employment Opportunity Commission (EEOC), HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), Labor, Dept of (DOL), Natl Labor Relations Board (NLRB), Office of Management & Budget (OMB), SENATE, Small Business Administration (SBA), White House Office

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

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

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

HR.1304, Self Insurance Protection Act; HR.246, The Jobs & Premium Protection Act; HR.173, Middle Class Health Benefits Tax Repeal Act; HR.1628, American Healthcare Act; HR.1101, Small Business Fairness Act; Repeal Cadillac Tax; Authorize small business health plans; Preserve employee exclusion; Preserve ERISA preemption; Better Care Reconciliation Act; American Health Care Act of 2017; Health Insurance Tax (HIT); Cost-Sharing reduction payments under ACA; Affordable Care Act Net Investment Income (NII) Tax; S.1859, The Healthcare Tax Relief Act; S.1978, Small Business & Family Health Tax Relief Act of 2017

Client expense: $244,100 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Labor Relations Board (NLRB), Occupational Safety & Health Administration (OSHA), SENATE, Treasury, Dept of

HR 1304, the Self-Insurance Protection Act. Matters related to self-insurance and stop-loss coverage, captive insurance and the IRC 831(b)election.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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

H.R. 1101 - The Small Business Health Fairness Act (Improve access to health care coverage for small business.) H.R. 1215 - Protecting Access to Health Care Act (Medical malpractice reform.) H.R. 1304 - The Self-Insurance Protection Act (Medical stop-loss insurance.) H.R. 1313 - The Preserving Employee Wellness Programs Act (Clarification of wellness programs.) H.R. 1628 - The American Health Care Act (Repeal ACA tax provisions through reconciliation.) H.R. 1628 / Sen. Substitute - The Better Care Reconciliation Act (Repeal ACA tax provisions through reconciliation.) H.R. 3798 - Save American Workers Act (Amends the ACA definition of full-time.) H.R. 173 and S. 58 - The Middle-Class Health Benefits Tax Repeal Act (Repeals the health care excise tax.) S. 1782 -Forty Hours is Full-Time Act (Amends the ACA definition of full-time.) Graham-Cassidy-Heller-Johnson (GCHJ) proposal (Repeals ACA tax provisions through reconciliation.) - Senate Health Care Reform - White House Wellness Programs (Clarification of wellness programs.) - EEOC

Client expense: $559,530 · Firm income: Not reported

Government targets: Equal Employment Opportunity Commission (EEOC), HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), Labor, Dept of (DOL), Natl Labor Relations Board (NLRB), SENATE, Small Business Administration (SBA), White House Office

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

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

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

HR.1304, Self Insurance Protection Act; HR.246, Repeal annual fee on health insurance providers enacted by the Patient Protection Act; HR.173, Middle Class Health Benefits Tax Repeal Act; HR.1628, American Healthcare Act; HR.1101, Small Business Fairness Act; Repeal Cadillac Tax; Authorize small business health plans; Preserve employee exclusion; Preserve ERISA preemption; Better Care Reconciliation Act of 2017; American Health Care Act of 2017; Health Insurance Tax (HIT); Cost-Sharing reduction payments under ACA; Affordable Care Act Net Investment Income (NII) Tax

Client expense: $187,910 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Labor Relations Board (NLRB), Occupational Safety & Health Administration (OSHA), SENATE, Treasury, Dept of

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

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

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

HR 1304, the Self-Insurance Protection Act. Matters related to self-insurance and stop-loss coverage, captive insurance and the IRC 831(b)election.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Access to Capital Supporting America's Innovators Act, H.R. 1219 - Supported House passage. The Financial CHOICE Act, H.R. 10 - supported House passage. Other issues: Continue to advocate for reforms to improve the rules governing equity and debt-based crowdfunding, and policies that lighten the regulatory burden on community banks and the financial system in general to improve capital formation and capital access for startups and entrepreneurs. This includes major changes to Dodd-Frank, reform of the Consumer Financial Protection Bureau, and SEC regulatory reforms to reduce red tape and costs for small firms. Tax Relief and Reform Continue to support fundamental reform of the U.S. tax code to make it fair, less complex and more competitive for small businesses and startups. SBE Council focuses on lower rates, elimination of death and AMT taxes, lower individual and corporate rates, lower capital gains taxes and full expensing, and a territorial system. Regulatory Reform, Relief and Transparency Continue to support reforms that make the regulatory process more transparent, accountable and that provides a voice and meaningful input for small businesses. Also support: cost-benefit analysis, look-back provisions, and sunsetting. Have provided feedback to U.S. Treasury under their regulatory review process as required by President Trump's executive orders on regulatory reform on regulatory relief measures that would unleash and lower the cost of capital for small businesses. Small Business Regulatory Flexibility Improvements Act, S. 584: Support the legislation Regulatory Accountability Act, S.951: Support Midnight Rules Relief Act, S. 34: Support Regulations from the Executive in Need of Scrutiny Act, S. 21: Support Provide Accountability Through Transparency Act, S. 577: Support Early Participation in Regulations Act, S.579: Support Health Care Reform Continue to support legislative efforts to reform and repeal major parts of the Affordable Care Act (Obamacare) including repeal of the tax increases and new taxes imposed by the law, mandates such as the individual and employer mandates, and other regulations that are driving up costs and eliminating choice in the marketplace. Support a national marketplace for health insurance, broad efforts to improve and strengthen HSAs so that small businesses and their employees have flexible, affordable choices in insurance coverage, expanding health reimbursement accounts, restoring strong Flexible Savings Accounts, tax credits for health coverage and other reforms that allow for innovation and new market entrants into the health insurance marketplace. Self-Insurance Protection Act, H.R. 1304: Supported House passage Good Government and Reform Intellectual Property: Continue to educate and advocate on the importance of protecting and strengthening IP. Fair and Open Competition Act, S. 622/H.R. 1552: Support the legislation Access to Broadband Have voiced support on Federal Communications Commission efforts that give small business and ISPs a voice in the regulatory process and broader efforts to accelerate the deployment of broadband to rural and underserved markets. Voiced support for the FCC Restoring Internet Freedom order. Legal Reform Stop Settlement Slush Funds Act, H.R. 372: Support the legislation Workforce Issues Encouraging Employee Ownership Act, H.R. 1343: Supported House passage Confirmation of Federal Department and Agency Heads HHS Secretary Nominee Tom Price. M.D.: Supported Senate confirmation SBA Administrator Nominee Linda McMahon: Supported Senate confirmation U.S. Labor Secretary Nominee Andrew Puzder: Supported nomination prior to Mr. Puzder withdrawing from consideration Trade and Global Markets Continue to support trade expansion and trade agreements to open overseas markets to small businesses. Have pointed out the benefits of NAFTA to Congress and the Administration.

Client expense: $55,000 · Firm income: Not reported

Government targets: Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, President of the U.S., SENATE, Small Business Administration (SBA), Treasury, Dept of

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

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

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

H.R. 1101 - The Small Business Health Fairness Act (Improve access to health care coverage for small business.) H.R. 1215 - Protecting Access to Health Care Act (Medical malpractice reform.) H.R. 1304 - The Self-Insurance Protection Act (Medical stop-loss insurance.) H.R. 1313 - The Preserving Employee Wellness Programs Act (Clarification of wellness programs.) H.R. 1628 - The American Health Care Act (Bill to repeal ACA tax provisions through reconciliation.) H.R. 1628 - The Better Care Reconciliation Act (Bill to repeal ACA tax provisions through reconciliation. This is the Senate substitute amendment to the House- passed H.R. 1628, the American Health Care Act.) H.R. 173 and S. 58 - The Middle-Class Health Benefits Tax Repeal Act (Repeal of the excise tax.) Health Care Reform - White House

Client expense: $654,902 · Firm income: Not reported

Government targets: Equal Employment Opportunity Commission (EEOC), HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), Labor, Dept of (DOL), Natl Labor Relations Board (NLRB), SENATE, Small Business Administration (SBA), White House Office

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

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

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

HR.1304, Self Insurance Protection Act; HR.246, Repeal annual fee on health insurance providers enacted by the Patient Protection Act; HR.173, Middle Class Health Benefits Tax Repeal Act; HR.1628, American Healthcare Act, HR.1101, Small Business Fairness Act; Repeal Cadillac Tax; Authorize small business health plans; Preserve employee exclusion; Preserve ERISA preemption; Better Care Reconciliation Act of 2017; American Health Care Act of 2017

Client expense: $138,489 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Labor Relations Board (NLRB), Occupational Safety & Health Administration (OSHA), SENATE, Treasury, Dept of, White House Office

HR 1304, the Self-Insurance Protection Act. Matters related to self-insurance and stop-loss coverage, captive insurance and the IRC 831(b)election.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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

Access to Capital Helping Angels Lead Our Startups Act (HALOS Act), H.R. 79: Supported House passage SEC Regulatory Accountability Act, H.R. 5: Supported House passage Supporting Americas Innovators Act, H.R. 1219: Support the legislation Other issues: Continue to advocate for reforms to improve the rules governing equity and debt-based crowdfunding, and policies that lighten the regulatory burden on community banks and the financial system in general to improve capital formation and capital access for startups and entrepreneurs. This includes major changes to Doff-Frank, reform of the Consumer Financial Protection Bureau, and SEC regulatory reforms to reduce red tape and costs for small firms. Tax Relief and Reform Continue to support fundamental reform of the U.S. tax code to make it fair, less complex and more competitive for small businesses and startups. SBE Council focuses on lower rates, elimination of death and AMT taxes, lower individual and corporate rates, lower capital gains taxes and full expensing. Mobile Workforce State Income Tax Simplification Act, H.R. 1393: Supported House passage Regulatory Reform, Relief and Transparency Continue to support reforms that make the regulatory process more transparent, accountable and that provides a voice and meaningful input for small businesses. Also support: cost-benefit analysis, look-back provisions, and sunsetting. Midnight Rules Relief Act, H.R. 21: Supported House passage. Regulations from the Executive in Need of Scrutiny Act (REINS Act), H.R. 26: Supported House passage. Small Business Regulatory Flexibility Improvements Act, H.R. 33: Support the legislation Regulatory Integrity Act, H.R. 1004: Support the legislation Federal Communications Process Reform Act, H.R. 290: Supported House passage Searching for and Cutting Regulations that are Unnecessarily Burdensome Act (SCRUB ACT), H.R. 988: Support the legislations CRA to Disapprove of the FCC Duplicative Privacy Rule, S.J. 34: Supported Senate and House passage Honest and Open EPA New Science Treatment Act, H.R. 1430: Supported House passage Regulatory Accountability Act, H.R. 5: Supported House passage Health Care Reform Continue to support legislative efforts to reform and repeal major parts of the Affordable Care Act (Obamacare) including repeal of the tax increases and new taxes imposed by the law, mandates such as the individual and employer mandates, and other regulations that are driving up costs and eliminating choice in the marketplace. Support a national marketplace for health insurance, broad efforts to improve and strengthen HSAs so that small businesses and their employees have flexible, affordable choices in insurance coverage, expanding health reimbursement accounts, tax credits for health coverage and other reforms that allow for innovation and new market entrants into the health insurance marketplace. Competitive Health Insurance Reform Act, H.R. 372: Supported House passage Small Business Health Fairness Act, H.R. 1101: Supported House passage American Health Care Act, H.R. 277: Supported the legislation Self-Insurance Protection Act, H.R. 1304: Supported House passage Good Government and Reform Taxpayers Right to Know Act, H.R. 71: Supported House passage Intellectual Property: Continue to educate and advocate on the importance of protecting and strengthening IP. Fair and Open Competition Act, S. 622/H.R. 1552: Support the legislation Promoting Women in Entrepreneurship Act, H.R. 255: Supported House and Senate passage Access to Broadband Small Business Broadband Deployment Act, H.R. 288: Supported House passage Legal Reform Stop Settlement Slush Funds Act, H.R. 372: Support the legislation Fairness in Class Action Litigation Act, H.R. 985: Supported House passage Workforce Issues Encouraging Employee Ownership Act, H.R. 1343: Supported House passage Confirmation of Federal Department and Agency Heads HHS Secretary Nominee Tom Price. M.D.: Supported Senate confirmation SBA Administrator Nominee Linda McMahon: Supported Senate confirmation U.S. Labor Secretary Nominee Andrew Puzder: Supported nomination prior to Mr. Puzder withdrawing from consideration

Client expense: $45,000 · Firm income: Not reported

Government targets: Council of Economic Advisers (CEA), Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, President of the U.S., SENATE, Treasury, Dept of

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

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

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

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

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

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

Legislation and policies 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 Lead contamination of drinking water H.R. 315/S. 783 - Improving Access to Maternity Care Act H.R. 372 - Competitive Health Insurance Reform Act of 2017 H.R. 959 - Title VIII Nursing Workforce Reauthorization Act of 2017 H.R. 1101 - Small Business Health Fairness Act of 2017 H.R. 1174 - Fairness For Breastfeeding Mothers Act of 2017 H.R. 1215 - Protecting Access to Care Act of 2017 H.R. 1267/S. 482 - Personal Health Investment Today (PHIT) Act H.R. 1304 - Self-Insurance Protection Act H.R. 1313 - Preserving Employee Wellness Programs Act H.R. 1704 - Accessible Care by Curbing Excessive lawSuitS (ACCESS) Act of 2017 H.R. 2086 - No Coverage, No Penalty Act S. 761 - Health Care Options Act of 2017

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

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

HR 372 - The competitive Health Insurance Reform Act of 2017: Urge passage of repeal of McCarran-Ferguson Act. HR 1101 Small Business Health Fairness Act: Association health plans may not meet standard of health care coverage. HR 1215 Protecting Access to Care Act of 2017: Urge reform of medical liability law HR 1304 Self Insurance Protection Act: ERISA plans should be held responsible for medical outcomes just like other plans. HR 1313 Preserving Employee Wellness Programs: Opposition to employer inquiries on genetic/medical info of workers. HR 1628 - American Health Care Act (Repeal and Replace Obamacare): educate members and staff on AAFP's positions on Health Care for all; advocate for changes to the AHCA and ultimately lobby against the bill; protecting the ACA coverage gains from being lost; urge defeat of HR 1628. HR 5926 & S 3068 - HHS FY 2017 appropriations priorities: AHRQ, Health Resources & Services Admin, Title VII, Title X NHSC: Federal spending priorities to support workforce, research; AAFP federal spending priorities for primary care training research and access. SConRes 3 - FY17 Budget Resolution: Health Care Coverage, Prevention & Public Health fund. No Bill No: Introductions to offer new legislators with a family medicine contact: AAFP policy on healthcare coverage for all highlighting primary care. No Bill No. - Direct Primary Care: Advocate for introduction and c0-sponsorship of a bill to allow more patient access to the DPC model. No Bill No. - President Obama's plan to address the prescription opioid abuse and heroin use epidemic. No Bill No. - National Advisory Council on the National Health Service Corps: NHSC scholarships & loans, physician workforce distribution. No Bill No. - Primary Care Briefings; promoting the value of primary care. No Bill No: FY2018 appropriations for AHRQ, HRSA Title VII, section 747, THCGME, NHSC, CMS CDC, SAMHSA: AAFP federal spending priorities for primary care training research and access. No Bill No - Agency for Healthcare Research & Quality: Primary care research. No Bill No.: Advisory Committee on Training in Primary Care Medicine and Dentistry: Title VII Health Professions Sec. 474 Primary Care Training and Enhancement Grants. No Bill No: Draft bill to limit opioid prescribing: oppose limits on patients' access to pharmaceuticals prescribed by a physician using appropriate clinical training and knowledge. No Bill No. - Nominations to USDA committee: maternal, infant, fetal nutrition. No Bill No. - Sign on letter in support of vaccines; vaccines. No Bill No. - Improvement of EHRs and HIT: Meaningful use, EHR, HIT. No Bill No. - Adult Vaccines: Advocating for health care reform provisions that support vaccine access. No Bill No. - Expressing concerns about legislation that interferes with the doctor-patient relationship or access to family planning services. No Bill No. Congressional Primary Care Caucus: Urge Members to join the caucus and support primary care to achieve the triple aim in healthcare. No Bill No. - Health Insurance Marketplace Issues and Provider Involvement with Patient Enrollment: Network adequacy, patient enrollment in marketplaces.

Client expense: $696,905 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE, White House Office

HR 372 - The competitive Health Insurance Reform Act of 2017: Urge passage of repeal of McCarran-Ferguson Act. HR 1215 Protecting Access to Care Act of 2017: Urge reform of medical liability law HR 1304 Self Insurance Protection Act: ERISA plans should be held responsible for medical outcomes just like other plans. HR 1628 - American Health Care Act (Repeal and Replace Obamacare): educate members and staff on AAFP's positions on Health Care for all; advocate for changes to the AHCA and ultimately lobby against the bill; protecting the ACA coverage gains from being lost; urge defeat of HR 1628. HR 1101 Small Business Health Fairness Act: Association health plans may not meet standard of health care coverage. No Bill No - Primary Care Briefings: Promoting the value of primary care. No Bill No: FY2018 appropriations for AHRQ, HRSA Title VII, section 747, THCGME, NHSC, CMS CDC, SAMHSA: AAFP federal spending priorities for primary care training research and access.

Client expense: $696,905 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE, White House Office

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

Client expense: $1,640,000 · Firm income: Not reported

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

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

Client expense: $1,640,000 · Firm income: Not reported

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

S.Con.Res. 3, Budget Resolution (Enzi) - ACA repeal and replace issues; coverage provisions; market stabilization S. 147, Obamacare Taxpayer Bailout Prevention Act (Rubio) - ACA risk corridors program S. 191, Patient Freedom Act (Cassidy-Collins) - replacement reforms; state options H.R. 277, American Health Care Reform Act (Roe) - replacement reforms H.R. 314, Health Care Choice Act (Blackburn) - selling insurance across state lines H.R. 372, Competitive Health Insurance Reform Act (Gosar) - McCarran-Ferguson Act H.R. 1101, Small Business Health Fairness Act (Johnson) - association health plans H.R. 1121, Pre-existing Conditions Protection Act (Walden) - protections for patients with pre-existing conditions H.R. 1304, Self-Insurance Protection Act (Roe) - medical stop-loss insurance H.R. 1409, Cancer Drug Parity Act (Lance) - coverage of oral anti-cancer drugs H.R. 1628, American Health Care Act (Black) - ACA repeal and replace issues; coverage provisions; market stabilization Draft: Plan Verification and Fairness Act (Blackburn) - verifying eligibility for special enrollment periods Draft: State Age Rating Flexibility Act (Buchson) - age rating bands Draft: Health Coverage State Flexibility Act (Flores) - grace period for premium payments Regulatory Issues: Insurance regulatory reform; issues related to the coordination of private and public disability income benefits; disability risk management; disability income insurance enrollment and awareness; issues related to encouraging impaired workers to stay in/return to the workforce; issues relating to the coordination of benefits between private health insurance plans and Medicaid; Medigap claims processing and crossover fees; Medigap cross-over claim issues, Medigap coverage, implementation of Medigap standardized plan offerings; Medigap carrier recoveries related to CMS fraud and abuse enforcement activities, and issues related to Medigap educational materials, and other Medigap issues; fraud and abuse issues affecting public and private insurance coverage; issues relating to antitrust; implementation of the Mental Health Parity Act requirements; summary of benefits and coverage disclosures; pre-existing condition insurance plans; accountable care organizations; coverage of preventive services; preexisting condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; dependent coverage; treatment of expatriate plans; compliance with the transitional reinsurance program; issues related to all payor claims databases; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations, non-discriminatory wellness programs; issues related to supplemental products; issues related to implementation of the Telephone Consumer Protection Act; issues relating to third party payment of premiums; issues relating to the individual market; and other issues relating to health care reform implementation.

Client expense: $1,650,000 · Firm income: Not reported

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

H.R. 1101 - The Small Business Health Fairness Act (Improve access to health care coverage for small business.) H.R. 1215 - Protecting Access to Health Care Act (Medical malpractice reform.) H.R. 1304 - The Self-Insurance Protection Act (Medical stop-loss insurance.) H.R. 1313 - The Preserving Employee Wellness Programs Act (Clarification of wellness programs.) H.R. 1628 - The American Health Care Act (Bill to repeal ACA tax provisions through reconciliation.) H.R. 173 and S. 58 - The Middle-Class Health Benefits Tax Repeal Act (Excise tax.) Health Care Reform - White House

Client expense: $662,570 · Firm income: Not reported

Government targets: Equal Employment Opportunity Commission (EEOC), HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), Labor, Dept of (DOL), Natl Labor Relations Board (NLRB), SENATE, Small Business Administration (SBA), White House Office

-Affordable Care Act: Analysis, Review, Summary Prep -Prescription Drug & Health Improvement Act -Children's health insurance program: need to extend the authorization for funding of the program -HR 1313: Preserving Employee Wellness Programs Act -HR 1101: Small Business Health Fairness Act of 2017: provisions -HR 1304: Self-insurance protection act -HR 1215: Protecting Access to Care Act of 2017 -Medicare: opposing benefit cuts -S. Con. Res.3: Amendment # 107 for permanent repeal of excise tax on high cost health plans: provisions allowing repeal of ACA insurance coverage policies -Cap on tax exclusion for employer-based health insurance -Tom Price nomination -H.R. 173/S.58: Middle Class Health Benefits Tax Repeal Act of 2017

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

Government targets: Defense, Dept of (DOD), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, U.S. Trade Representative (USTR), White House Office

H.R. 173: Legislation to repeal the Cadillac/Excise tax H.R. 246: Legislation to repeal the annual fee on health insurance providers; Health Insurance Tax (HIT) H.R. 1628: The American Health Care Act of 2017 (AHCA) H.R. 175: ObamaCare Repeal Act H.R 242: Medicare Prescription Drug Price Negotiation Act of 2017 H.R. 277: American Health Care Reform Act of 2017 H.R. 314: Health Care Choice Act H.R. 352: State Health Flexibility Act of 2017 H.R. 372: Competitive Health Insurance Reform Act of 2017 H.R. 432: Small Business Tax Credit Accessibility Act H.R. 521: Protection from Insurance Exchange Monopolies Act H.R. 551: Amends the ACA to permit insurers to offer catastrophic coverage plans to anyone H.R. 552: Affordable Limited Health Coverage Act H.R. 633: Patient Fairness and Relief Act of 2017 H.R. 661: Employee Fairness and Relief Act H.R. 708: State Age Rating Flexibility Act of 2017 H.R. 710: Health Coverage State Flexibility Act of 2017 H.R. 749: Lower Drug Costs through Competition Act H.R. 1072: ObamaCare Replacement Act H.R 1101: Small Business Health Fairness Act of 2017 H.R. 1121: Pre-existing Conditions Protection Act of 2017 H.R. 1215: Protecting Access to Care Act of 2017 H.R. 1245: Affordable and Safe Prescription Drug Importation Act H.R. 1275: World's Greatest Healthcare Plan of 2017 H.R. 1304: Self-Insurance Protection Act H.R. 1313: Preserving Employee Wellness Programs Act H.R. 1314: Health Care Choice Act of 2017 H.R. 1421: Improving Access to Medicare Coverage Act of 2017 S. 58: Legislation to repeal the Cadillac/Excise tax S. 106: ObamaCare Repeal Act S. 40: Middle Class Health Benefits Tax Repeal Act S. 41: Medicare Prescription Drug Price Negotiation Act of 2017 S. 92: Safe and Affordable Drugs from Canada Act of 2017 S. 124: Preserve Access to Affordable Generics Act S. 147: Obamacare Taxpayer Bailout Prevention Act S. 191: Patient Freedom Act S. 222: Obamacare Replacement Act S. 297: Increasing Competition in Pharmaceuticals Act S. 469: Affordable and Safe Prescription Drug Importation Act S. 568: Improving Access to Medicare Coverage Act of 2017 S. 761: Health Care Options Act of 2017

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

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

H.R. 181 Close Annuity Loopholes in Medicaid Act H.R. 184 Protect Medical Innovation Act H.R. 246 Jobs and Premium Protection Act S. 183 Jobs and Premium Protection Act H.R. 284 Advancing Medical Resident Training in Community Hospitals Act H.R. 309 National Clinical Care Commission Act H.R. 372 Competitive Health Insurance Reform Act H.R. 592 Pharmacy and Medically Underserved Areas Enhancement Act S. 109 Pharmacy and Medically Underserved Areas Enhancement Act H.R. 741 Rural Hospital Regulatory Relief Act S. 243 Rural Hospital Regulatory Relief Act H.R. 766 Amend Title XVII of the Social Security Act to expand telehealth in Medicare H.R. 829 Prioritizing the Most Vulnerable Over Lottery Winners Act H.R. 849/ S. 260 Protecting Seniors' Access to Medicare Act H.R. 998 Searching for and Cutting Regulations that are Unnecessarily Burdensome (SCRUB) Act H.R. 1004 Regulatory Integrity Act H.R. 1009 OIRA Insight, Reform, and Accountability Act S. 676 OIRA Insight, Reform, and Accountability Act H.R. 1038 Improving Transparency and Accuracy in Medicare Part D Spending S. 413 Improving Transparency and Accuracy in Medicare Part D Spending H.R. 1072/ S. 222 Obamacare Replacement Act H.R. 1101 Small Business Health Fairness Act of 2017 H.R. 1121 Pre-Existing Conditions Protection Act of 2017 H.R. 1148/S. 431 Furthering Access to Stroke Telemedicine (FAST) Act H.R. 1215 Protecting Access to Care Act H.R. 1245/S. 469 Affordable and Safe Prescription Drug Importation Act H.R. 1267/S. 482 (PHIT Act) H.R. 1304 Self-Insurance Protection Act H.R. 1313 Preserving Employee Wellness Programs Act H.R. 1554/S. 581 Jessie's Law H.R. 1565 Saving Lives, Saving Costs Act H.R. 1628 American Health Care Act H.R. 1776/ S. 771 Improving Access to Affordable Prescription Drugs Act Pub. L. 102-143 Telephone Consumer Protection Act Pub. L. 111-5, The American Recovery and Reinvestment Act Pub. L. 111-148 Patient Protection and Affordable Care Act (PPACA) Pub. L. 114-10 Medicare Access and CHIP Reauthorization Act (MACRA) P.L. 114-198 Comprehensive Addiction and Recovery Act Pub. L. 114-255, 21st Century Cures Act Pub. L. 114-270 Expanding Capacity for Health Outcomes Act (ECHO) Pub. L. 114-328, National Defense Authorization Act for Fiscal Year Pub. L. 114-329 American Innovation and Competitiveness Act S. 870 Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act S. 64 Safe and Affordable Drugs from Canada Act S. 108 Medical Debvice Access and Innovation Protection Act S. 191 Patient Freedom Act S. 251 Protecting Medicare from Executive Action Act S. 464 Independence at Home Act S. 761 Health Care Options Act of 2017 S. 787, Telehealth Innovation and Improvement Act

Client expense: $170,000 · Firm income: Not reported

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

HR.1304, Self Insurance Protection Act; HR.246, Repeal annual fee on health insurance providers enacted by the Patient Protection Act; HR.173, Middle Class Health Benefits Tax Repeal Act; HR.1628, American Healthcare Act; HR.1101, Small Business Health Fairness Act; S.Con.Res.3, Healthcare-related legislative recommendations included in FY2017 reconciliation bill; Repeal Cadillac Tax

Client expense: $136,154 · Firm income: Not reported

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), Natl Economic Council (NEC), Natl Labor Relations Board (NLRB), Occupational Safety & Health Administration (OSHA), SENATE, Securities & Exchange Commission (SEC), White House Office

HR 1304, the Self-Insurance Protection Act. Matters related to self-insurance and stop-loss coverage, captive insurance and the 831(b)election.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE