PIMA of 2017

H.R. 1017 / S. 479 - Removing Barriers to Colorectal Cancer Screening Act of 2017. Opposition to H.R. 2066 - PIMA of 2017. Support for H.R. 4206 / S. 2051 Medicare Care Coordination Improvement Act of 2017. Opposition to step therapy requirement in Medicare Advantage.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Support for H.R. 4206 / S. 2051 - Medicare Care Coordination Improvement Act of 2017. Opposition to H.R. 2066 - PIMA of 2017. Opposition to step therapy requirement in Medicare Advantage. CY 2019 OPPS/ ASC Proposed Payment Rule, (83 Fed. Reg. 37046). Lobbied against the International Pricing Index model (83 FR 54546).

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

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

H.R.5812 - Creating Opportunities that Necessitate New and Enhanced Connections That Improve Opioid Navigation Strategies Act of 2018 H.R. 6 - Opioid Package S.2680 - Opioid Crisis Response Act of 2018 H.R.3635 - Local Coverage Determination Clarification Act of 2017 Local Coverage Determination (LCD) Clarification Act (S. 794) Promoting Integrity in Medicare Act (HR 2066) Protecting Seniors' Access to Medicare Act (HR 849) Protecting Access to Medicare Act Protecting Patients from Surprise Medical Bills (Cassidy Language) FDA Technical Assistance to DAIA S. 2582 - Consumer Health Insurance Protection Act S. 284 - End Surprise Billing Act CMS Physician Fee Schedule Registry Measures

Client expense: $325,721 · Firm income: Not reported

Advocate for adequate and accurate network coverage for dermatologic care within Medicare Advantage. Advocate for Congressional support for relief from Medicare regulations under Medicare Access and CHIP Reauthorization Act (MACRA P.L. 114-110), including the Quality Payment Program (QPP) and specifically the development of advanced alternative payment models (APMs) and implementation of the Merit-Based Incentive Payment System (MIPS). Advocate for increased funding and reforms to Graduate Medical Education. Advocate for a new study on physician shortage to be conducted by the Health Resources and Services Administration. Lobby members of Congress regarding improvements to Health Information Technology implementation. Support provisions to allow Medicare Advantage plans to include telehealth as a benefit. Advocate for improving disease management and care coordination for patients with chronic diseases. Support preservation of the In-Offices Ancillary Services Exemption (IOASE) under Stark Law regarding physician self-referral and oppose repeal of the in-office ancillary and physician services exception. Advocate regarding possible changes to IOASE and Stark Law relative to implementation of Medicare Access and CHIP Reauthorization Act (MACRA P.L. 114-110) Support H.R. 4206/S.2051 Medicare Care Coordination Improvement Act of 2017 Advocate for Congressional support for relief from Medicare regulations under Medicare Access and CHIP Reauthorization Act (MACRA P.L. 114-110), including the Quality Payment Program (QPP) and specifically the development of advanced alternative payment models (APMs) and implementation of the Merit-Based Incentive Payment System (MIPS). Oppose elimination of a Merit-Based Incentive Payment System. Advocate allowing further appeals process within the Quality Payment Program. Advocate against H.R. 2066, Promoting Integrity in Medicare Act of 2017. Advocate for relief for from prior authorization requirements under Medicare Advantage and Medicare Part D plans. Support H.R. 4841/H.R. 5773/Section 6062 of H.R. 6 (SUPPORT for Patients & Communities Act), Standardizing Electronic Prior Authorization for Safe Prescribing Act and S. 2908, Electronic Prior Authorization in Medicare Part D Act Advocate expanding the period for reporting and returning overpayments beyond the 60 days statutorily required under audits by Recovery Audit Contractors (RACs). Lobby Congress to urge CMS to withdraw evaluation and management (E/M) coding and payment proposals, including the Modifier 25 proposal or what is also sometimes referred to as the multiple procedure payment reduction (MPPR), from 2019 Medicare Physician Fee Schedule. Lobby Congress to urge CMS to strengthen Qualified Clinical Data Registries (QCDRs) by removing barriers that restrict access to data from EHRs. Lobby Congress to urge CMS to maintain oversight for correct implementation and calculation of QCDR measures and to ensure QCDRs intellectual property is protected. Lobby Congress to urge CMS to pause implementation of a new policy that allows Medicare Advantage plans to implement step therapy protocols, and to work with stakeholders to find an alternative solution.

Implementation/Expansion of CDC Falls Program Implementation of Affordable Care Act - provisions pertaining to Essential Health Benefits & Health Insurance Exchanges AHRQ provisions pertaining to PT Physician self-referra/Stark Law American Cures Act H.R. 930/S.497 Lymphadema Treatment Act Health Information Technology Nominations to PCORI Methodology Committees Medicaid Expansion HR. 1639/S.619 Physical Therapist Workforce & Patient Access Act Physician owned distributerships H.R. 302/S.808 Sports Medicine Licensure Clarity Act MACRA/MIPS APMS IMPACT/PAC reform Network adequacy Insurance Benefit parameters H.R. 1361/S.486 Ensuring Access to Quality CRT Medicare Telehealth Parity Act HR2550 American Healthcare Act of 2017/CONNECT - H.R. 2556/S1016 H.R. 1628 - American Health Care Action of 2017 Opioid Epidemic/Pain Management Better Care Reconciliation Act of 2017 H.R.2066 Promoting Integrity in Medicare H.R. 2063 Opioid Pace Act of 2017 H.R. 5261 Teach Act H.R. 5197 Alto Act H.R. 5686, Medicare Clear Health Options in Care for Enrollees Act H.R. 5773, Preventing Addiction for Susceptible Seniors Act H.R. 5774, Combating Opioid Abuse for Care in Hospitals Act H.R. 5718, Perioperative Reduction for Opioids Act H.R. 5719, Reduce Overprescribing Opioids in Treatment Act H.R. 5722, Dr. Todd Graham Pain Management Improvement Act H.R. 6, Substance-Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act S. 3120, the HEAL Act S. 2680, Opioid Crisis Response Act Association Retirement Plans State Relief and Empowerment Waivers D.O.L Information Collection Request Extensions Health Reimbursement Accounts HR 7217: Improve Act

Client expense: $252,000 · Firm income: Not reported

HR 6836, Clinical Treatment Act HR 3635, Local Coverage Determinations Act Prior Authorization S.2425-Patient Access and Medicare Protection Act (PAMPA) implementation. Support for legislation to freeze radiation therapy payments through the end of 2019, increase funding for the NIH for FY 2018 and FY 2019, and simplify the MIPS program; Balanced Budget Act of 2018 (HR 1892). Support for legislation to ensure patient safety and preserve the integrity of the Medicare program by ending abuses of the physician self-referral law for radiation therapy services; Protecting Integrity in Medicare Act (H.R. 2066) Support for structural changes that lead to delivering high-quality care for patients while increasing efficiencies and promoting Medicare sustainability; oppose radiation oncology benefit managers. Support for ensuring radiation oncologists participation in the Medicare electronic health record incentive program. Support for reforming the way Medicare pays for radiation oncology services by tying payments to quality and value. Implementation of H.R. 2, the Medicare Access and CHIP Reauthorization Act of 2015 Support the elimination of abuse to the Medicare program by closing the in-office ancillary services exception to the Stark Law for radiation oncology services. S. 794 Local Coverage Determination Clarification Act of 2017

Client expense: $189,038 · Firm income: Not reported

FY2019 LHHS Appropriations bill-funding for NIH/NCI HR 4675, Low Dose Radiation Research Act Access to radioactive isotopes Support to ensure that patient care advances in biomedical research impacting patient care are not compromised by any policies imposed on the medical use and research applications of cesium chloride. Support for NRC Commissioner nominee to have medical background. Support patient choice in treatment options by closing the in-office ancillary services exception to the Stark Law for radiation oncology services; Protecting Integrity in Medicare Act (H.R. 2066) Oppose Non-Burning Sunshine Report Language Oppose HR 1150, Tanning Tax Repeal Act of 2017 Radiation Oncology reimbursement Radiation Oncology safety Cancer Moonshot Initiative S. 794 Local Coverage Determination Clarification Act of 2016 HR 1629, Oppose American Health Care Act and Senate Better Care Reconciliation Amendment Oppose Graham-Cassidy Amendment Support Children's Health Insurance Re authorization Act Support Medicare Red Tape Initiative Supplemental Appropriations for Disaster Relief for Puerto Rico

Client expense: $189,038 · Firm income: Not reported

Medicare physician payment; new/alternative payment models; Medicare coverage, including coverage policies pertaining to implantable cardioverter-defibrillators and transcatheter aortic valve replacement; Medicare hospital payment; access to Medicare claims data; Ways & Means Committee hospital payment project; physician and hospital quality; electronic health record incentive program; clinical data registries; health care quality; medical imaging and prior authorization, including HR 4841, Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018; the Stark Law and the in-office ancillary services exception, including HR 4206/S 2051, the Medicare Care Coordination Improvement Act; Promoting Integrity in Medicare Act, HR 2066; Medicare Access and CHIP Reauthorization Act implementation and oversight; Bipartisan Budget Act of 2015 and Medicare site of service policy; HR 1155/S 1361, a bill to amend title XVIII of the Social Security Act to allow physician assistants, nurse practitioners, and clinical nurse specialists to supervise cardiac, intensive cardiac, and pulmonary rehabilitation programs; S 46, the Strengthening Medicare Intensive Cardiac Rehabilitation Programs Act of 2017; HR 3325/S 428, The Advancing Care for Exceptional Kids Act of 2017 (or ACE Kids Act), a bill to allow a state, at its option, to elect to provide medical assistance for items and services furnished to eligible children with medically complex conditions enrolled in a Medicaid Children's Care Coordination (MCCC) program; Senate Finance Committee chronic care project; graduate medical education policy including HR 2267/S 1301, Resident Physician Shortage Reduction Act of 2017; end of life care, including HR 2797/S 1334, the Patient Choice and Quality Care Act of 2017; Puerto Rico Oversight, Management, and Economic Stability Act (PROMESA) implementation; oversight and implementation of the Protecting Access to Medicare Act of 2014, including Appropriate Use Criteria; physician-owned hospital policy, including HR 1156/S 1133, the Patient Access to High Quality Care Act of 2017; Medicaid coverage and eligibility, including HR 829, Prioritizing the Most Vulnerable Over Lottery Winners Act of 2017, HR 181, Close Annuity Loopholes in Medicaid Act, and HR 705, Verify Eligibility Coverage Act; HR 3163, Medicare Part B Home Infusion Services Temporary Transitional Payment Act; Affordable Care Act repeal/replace/reform efforts; HR 3767 and S 989, the Ensuring Childrens Access to Specialty Care Act of 2017; HR 3635, the Local Coverage Determination Clarification Act of 2017; Ways and Means Committee Medicare extenders policy/legislation.

Advocate for adequate and accurate network coverage for dermatologic care within Medicare Advantage. Advocate for Congressional support for relief from Medicare regulations under Medicare Access and CHIP Reauthorization Act (MACRA P.L. 114-110), including the Quality Payment Program (QPP) and specifically the development of advanced alternative payment models (APMs) and implementation of the Merit-Based Incentive Payment System (MIPS). Advocate for increased funding and reforms to Graduate Medical Education. Advocate for a new study on physician shortage to be conducted by the Health Resources and Services Administration. Lobby members of Congress regarding improvements to Health Information Technology implementation. Support provisions to allow Medicare Advantage plans to include telehealth as a benefit. Advocate for improving disease management and care coordination for patients with chronic diseases. Support preservation of the In-Offices Ancillary Services Exemption (IOASE) under Stark Law regarding physician self-referral and oppose repeal of the in-office ancillary and physician services exception. Advocate regarding possible changes to IOASE and Stark Law relative to implementation of Medicare Access and CHIP Reauthorization Act (MACRA P.L. 114-110) Support H.R. 4206/S.2051 Medicare Care Coordination Improvement Act of 2017 Advocate for Congressional support for relief from Medicare regulations under Medicare Access and CHIP Reauthorization Act (MACRA P.L. 114-110), including the Quality Payment Program (QPP) and specifically the development of advanced alternative payment models (APMs) and implementation of the Merit-Based Incentive Payment System (MIPS). Oppose elimination of a Merit-Based Incentive Payment System. Advocate allowing further appeals process within the Quality Payment Program. Advocate against H.R. 2066, Promoting Integrity in Medicare Act of 2017. Advocate for relief for from prior authorization requirements under Medicare Advantage and Medicare Part D plans. Support H.R. 4841/H.R. 5773/Section 6062 of H.R. 6 (SUPPORT for Patients & Communities Act), Standardizing Electronic Prior Authorization for Safe Prescribing Act and S. 2908, Electronic Prior Authorization in Medicare Part D Act Advocate expanding the period for reporting and returning overpayments beyond the 60 days statutorily required under audits by Recovery Audit Contractors (RACs). Support S. 2553, Know the Lowest Price Act. Lobby Congress to urge CMS to withdraw evaluation and management (E/M) coding and payment proposals, including the Modifier 25 proposal or what is also sometimes referred to as the multiple procedure payment reduction (MPPR), from 2019 Medicare Physician Fee Schedule. Lobby Congress to urge CMS to strengthen Qualified Clinical Data Registries (QCDRs) by removing barriers that restrict access to data from EHRs.

H.R. 1017 / S. 479 - Removing Barriers to Colorectal Cancer Screening Act of 2017. Opposition to H.R. 2066 - PIMA of 2017. Support for H.R. 4206 / S. 2051 Medicare Care Coordination Improvement Act of 2017. Opposition to step therapy requirement in Medicare Advantage.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Support for H.R. 4206 / S. 2051 - Medicare Care Coordination Improvement Act of 2017. Opposition to H.R. 2066 - PIMA of 2017. Opposition to step therapy requirement in Medicare Advantage. CY 2019 OPPS/ ASC Proposed Payment Rule, 83 Fed. Reg. 37046.

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

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

H.R.5812 - Creating Opportunities that Necessitate New and Enhanced Connections That Improve Opioid Navigation Strategies Act of 2018 H.R. 6 - Opioid Package S.2680 - Opioid Crisis Response Act of 2018 H.R.3635 - Local Coverage Determination Clarification Act of 2017 Local Coverage Determination (LCD) Clarification Act (S. 794) Promoting Integrity in Medicare Act (HR 2066) Protecting Seniors' Access to Medicare Act (HR 849) Protecting Access to Medicare Act Protecting Patients from Surprise Medical Bills (Cassidy Language) FDA Technical Assistance to DAIA S. 2582 - Consumer Health Insurance Protection Act S. 284 - End Surprise Billing Act CMS Physician Fee Schedule Registry Measures

Client expense: $371,117 · Firm income: Not reported

HR 3635, Local coverage Determinations Act Prior Authorization S.2425-Patient Access and Medicare Protection Act (PAMPA) implementation. Support for legislation to freeze radiation therapy payments through the end of 2019, increase funding for the NIH for FY 2018 and FY 2019, and simplify the MIPS program; Balanced Budget Act of 2018 (HR 1892). Support for legislation to ensure patient safety and preserve the integrity of the Medicare program by ending abuses of the physician self-referral law for radiation therapy services; Protecting Integrity in Medicare Act (H.R. 2066) Support for structural changes that lead to delivering high-quality care for patients while increasing efficiencies and promoting Medicare sustainability; oppose radiation oncology benefit managers. Support for ensuring radiation oncologists participation in the Medicare electronic health record incentive program. Support for reforming the way Medicare pays for radiation oncology services by tying payments to quality and value. Implementation of H.R. 2, the Medicare Access and CHIP Reauthorization Act of 2015 Support the elimination of abuse to the Medicare program by closing the in-office ancillary services exception to the Stark Law for radiation oncology services. S. 794 Local Coverage Determination Clarification Act of 2017

Client expense: $197,287 · Firm income: Not reported

FY2019 LHHS Appropriations bill-funding for NIH/NCI HR 4675, Low Dose Radiation Research Act Access to radioactive isotopes Support to ensure that patient care advances in biomedical research impacting patient care are not compromised by any policies imposed on the medical use and research applications of cesium chloride. Support for NRC Commissioner nominee to have medical background. Support patient choice in treatment options by closing the in-office ancillary services exception to the Stark Law for radiation oncology services; Protecting Integrity in Medicare Act (H.R. 2066) Oppose Non-Burning Sunshine Report Language Oppose HR 1150, Tanning Tax Repeal Act of 2017 Radiation Oncology reimbursement Radiation Oncology safety Cancer Moonshot Initiative S. 794 Local Coverage Determination Clarification Act of 2016 HR 1629, Oppose American Health Care Act and Senate Better Care Reconciliation Amendment Oppose Graham-Cassidy Amendment Support Children's Health Insurance Re authorization Act Support Medicare Red Tape Initiative Supplemental Appropriations for Disaster Relief for Puerto Rico

Client expense: $197,287 · Firm income: Not reported

Implementation/Expansion of CDC Falls Program Implementation of Affordable Care Act - provisions pertaining to Essential Health Benefits & Health Insurance Exchanges AHRQ provisions pertaining to PT Physician self-referra/Stark Law American Cures Act H.R. 930/S.497 Lymphadema Treatment Act Health Information Technology Nominations to PCORI Methodology Committees Medicaid Expansion HR. 1639/S.619 Physical Therapist Workforce & Patient Access Act Physician owned distributerships H.R. 302/S.808 Sports Medicine Licensure Clarity Act MACRA/MIPS APMS IMPACT/PAC reform Network adequacy Insurance Benefit parameters H.R. 1361/S.486 Ensuring Access to Quality CRT Medicare Telehealth Parity Act HR2550 American Healthcare Act of 2017/CONNECT - H.R. 2556/S1016 H.R. 1628 - American Health Care Action of 2017 Opioid Epidemic/Pain Management Better Care Reconciliation Act of 2017 H.R.2066 Promoting Integrity in Medicare H.R. 2063 Opioid Pace Act of 2017 H.R. 5261 Teach Act H.R. 5197 Alto Act H.R. 5686, Medicare Clear Health Options in Care for Enrollees Act H.R. 5773, Preventing Addiction for Susceptible Seniors Act H.R. 5774, Combating Opioid Abuse for Care in Hospitals Act H.R. 5718, Perioperative Reduction for Opioids Act H.R. 5719, Reduce Overprescribing Opioids in Treatment Act H.R. 5722, Dr. Todd Graham Pain Management Improvement Act H.R. 6, Substance-Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act S. 3120, the HEAL Act S. 2680, Opioid Crisis Response Act

Client expense: $251,000 · Firm income: Not reported

Medicare physician payment; new/alternative payment models; Medicare coverage, including coverage policies pertaining to implantable cardioverter-defibrillators and transcatheter aortic valve replacement; Medicare hospital payment; access to Medicare claims data; Ways & Means Committee hospital payment project; physician and hospital quality; electronic health record incentive program; clinical data registries; health care quality; medical imaging and prior authorization, including HR 4841, Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018; the Stark Law and the in-office ancillary services exception, including HR 4206/S 2051, the Medicare Care Coordination Improvement Act; Promoting Integrity in Medicare Act, HR 2066; Medicare Access and CHIP Reauthorization Act implementation and oversight; Bipartisan Budget Act of 2015 and Medicare site of service policy; HR 1155/S 1361, a bill to amend title XVIII of the Social Security Act to allow physician assistants, nurse practitioners, and clinical nurse specialists to supervise cardiac, intensive cardiac, and pulmonary rehabilitation programs; S 46, the Strengthening Medicare Intensive Cardiac Rehabilitation Programs Act of 2017; HR 3325/S 428, The Advancing Care for Exceptional Kids Act of 2017 (or ACE Kids Act), a bill to allow a state, at its option, to elect to provide medical assistance for items and services furnished to eligible children with medically complex conditions enrolled in a Medicaid Children's Care Coordination (MCCC) program; Senate Finance Committee chronic care project; graduate medical education policy including HR 2267/S 1301, Resident Physician Shortage Reduction Act of 2017; end of life care, including HR 2797/S 1334, the Patient Choice and Quality Care Act of 2017; Puerto Rico Oversight, Management, and Economic Stability Act (PROMESA) implementation; oversight and implementation of the Protecting Access to Medicare Act of 2014, including Appropriate Use Criteria; physician-owned hospital policy, including HR 1156/S 1133, the Patient Access to High Quality Care Act of 2017; Medicaid coverage and eligibility, including HR 829, Prioritizing the Most Vulnerable Over Lottery Winners Act of 2017, HR 181, Close Annuity Loopholes in Medicaid Act, and HR 705, Verify Eligibility Coverage Act; HR 3163, Medicare Part B Home Infusion Services Temporary Transitional Payment Act; Affordable Care Act repeal/replace/reform efforts; HR 3767 and S 989, the Ensuring Childrens Access to Specialty Care Act of 2017; HR 3635, the Local Coverage Determination Clarification Act of 2017; Ways and Means Committee Medicare extenders policy/legislation.

Support for H.R. 4206 / S. 2051 - Medicare Care Coordination Improvement Act of 2017. Opposition to H.R. 2066 - PIMA of 2017.

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

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

H.R. 1017 / S. 479 - Removing Barriers to Colorectal Cancer Screening Act of 2017. Opposition to H.R. 2066 - PIMA of 2017. Support for H.R. 4206 / S. 2051 Medicare Care Coordination Improvement Act of 2017.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Advocate for adequate and accurate network coverage for dermatologic care within Medicare Advantage. Advocate for Congressional support for relief from Medicare regulations under Medicare Access and CHIP Reauthorization Act (MACRA P.L. 114-110), including the Quality Payment Program (QPP) and specifically the development of advanced alternative payment models (APMs) and implementation of the Merit-Based Incentive Payment System (MIPS). Advocate for increased funding and reforms to Graduate Medical Education. Advocate for a new study on physician shortage to be conducted by the Health Resources and Services Administration. Lobby members of Congress regarding improvements to Health Information Technology implementation. Support provisions to allow Medicare Advantage plans to include telehealth as a benefit. Advocate for improving disease management and care coordination for patients with chronic diseases. Support preservation of the In-Offices Ancillary Services Exemption (IOASE) under Stark Law regarding physician self-referral and oppose repeal of the in-office ancillary and physician services exception. Advocate regarding possible changes to IOASE and Stark Law relative to implementation of Medicare Access and CHIP Reauthorization Act (MACRA P.L. 114-110) Support H.R. 4206/S.2051 Medicare Care Coordination Improvement Act of 2017 Advocate for Congressional support for relief from Medicare regulations under Medicare Access and CHIP Reauthorization Act (MACRA P.L. 114-110), including the Quality Payment Program (QPP) and specifically the development of advanced alternative payment models (APMs) and implementation of the Merit-Based Incentive Payment System (MIPS). Oppose elimination of a Merit-Based Incentive Payment System. Advocate allowing further appeals process within the Quality Payment Program. Advocate against H.R. 2066, Promoting Integrity in Medicare Act of 2017. Advocate for relief for from pior authorization requirements under Medicare Advantage and Medicare Part D plans. Support H.R. 4841/H.R. 5773/Section 6062 of H.R. 6 (SUPPORT for Patients & Communities Act), Standardizing Electronic Prior Authorization for Safe Prescribing Act and S. 2908, Electronic Prior Authorization in Medicare Part D Act Advocate expanding the period for reporting and returning overpayments beyond the 60 days statutorily required under audits by Recovery Audit Contractors (RACs). Support S. 2553, Know the Lowest Price Act. Lobby for support of nomination of Michael Bigby, MD to serve as Commissioner on Medicare Payment Advisory Commission (MedPAC).

H.R.5812 - Creating Opportunities that Necessitate New and Enhanced Connections That Improve Opioid Navigation Strategies Act of 2018 S.2680 - Opioid Crisis Response Act of 2018 H.R.3635 - Local Coverage Determination Clarification Act of 2017 Local Coverage Determination (LCD) Clarification Act (S. 794) Promoting Integrity in Medicare Act (HR 2066) Protecting Seniors' Access to Medicare Act (HR 849) Protecting Access to Medicare Act (HR 3635)

Client expense: $259,965 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Support to ensure that patient care advances in biomedical research impacting patient care are not compromised by any policies imposed on the medical use and research applications of cesium chloride. Support for NRC Commissioner nominee to have medical background. Support patient choice in treatment options by closing the in-office ancillary services exception to the Stark Law for radiation oncology services; Protecting Integrity in Medicare Act (H.R. 2066) Oppose Non-Burning Sunshine Report Language Oppose HR 1150, Tanning Tax Repeal Act of 2017 Radiation Oncology reimbursement Radiation Oncology safety Cancer Moonshot Initiative S. 794 Local Coverage Determination Clarification Act of 2016 HR 1629, Oppose American Health Care Act and Senate Better Care Reconciliation Amendment Oppose Graham-Cassidy Amendment Support Children's Health Insurance Re authorization Act Support Medicare Red Tape Initiative Supplemental Appropriations for Disaster Relief for Puerto Rico

Client expense: $235,969 · Firm income: Not reported

S.2425-Patient Access and Medicare Protection Act (PAMPA) implementation. Support for legislation to freeze radiation therapy payments through the end of 2019, increase funding for the NIH for FY 2018 and FY 2019, and simplify the MIPS program; Balanced Budget Act of 2018 (HR 1892). Support for legislation to ensure patient safety and preserve the integrity of the Medicare program by ending abuses of the physician self-referral law for radiation therapy services; Protecting Integrity in Medicare Act (H.R. 2066) Support for structural changes that lead to delivering high-quality care for patients while increasing efficiencies and promoting Medicare sustainability; oppose radiation oncology benefit managers. Support for ensuring radiation oncologists participation in the Medicare electronic health record incentive program. Support for reforming the way Medicare pays for radiation oncology services by tying payments to quality and value. Implementation of H.R. 2, the Medicare Access and CHIP Reauthorization Act of 2015 Support the elimination of abuse to the Medicare program by closing the in-office ancillary services exception to the Stark Law for radiation oncology services. S. 794 Local Coverage Determination Clarification Act of 2017

Client expense: $235,969 · Firm income: Not reported

Implementation/Expansion of CDC Falls Program Implementation of Affordable Care Act - provisions pertaining to Essential Health Benefits & Health Insurance Exchanges AHRQ provisions pertaining to PT Physician self-referra/Stark Law American Cures Act H.R. 930/S.497 Lymphadema Treatment Act Health Information Technology Nominations to PCORI Methodology Committees Medicaid Expansion HR. 1639/S.619 Physical Therapist Workforce & Patient Access Act Physician owned distributerships H.R. 302/S.808 Sports Medicine Licensure Clarity Act MACRA/MIPS APMS IMPACT/PAC reform Network adequacy Insurance Benefit parameters H.R. 1361/S.486 Ensuring Access to Quality CRT Medicare Telehealth Parity Act HR2550 American Healthcare Act of 2017/CONNECT - H.R. 2556/S1016 H.R. 1628 - American Health Care Action of 2017 Opioid Epidemic/Pain Management Better Care Reconciliation Act of 2017 H.R.2066 Promoting Integrity in Medicare H.R. 2063 Opioid Pace Act of 2017 H.R. 5261 Teach Act H.R. 5197 Alto Act H.R. 5686, Medicare Clear Health Options in Care for Enrollees Act H.R. 5773, Preventing Addiction for Susceptible Seniors Act H.R. 5774, Combating Opioid Abuse for Care in Hospitals Act H.R. 5718, Perioperative Reduction for Opioids Act H.R. 5719, Reduce Overprescribing Opioids in Treatment Act H.R. 5722, Dr. Todd Graham Pain Management Improvement Act H.R. 6, Substance-Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act S. 3120, the HEAL Act S. 2680, Opioid Crisis Response Act

Client expense: $292,000 · Firm income: Not reported

Advocate for adequate and accurate network coverage for dermatologic care within Medicare Advantage. Support legislation to eliminate the Independent Payment Advisory Board (H.R. 849, Protecting Seniors Access to Medicare Act, , S.251, Protecting Medicare from Executive Action Act, S. 260, Protecting Seniors Access to Medicare Act) Advocate for Congressional support for relief from Medicare regulations under Medicare Access and CHIP Reauthorization Act (MACRA P.L. 114-110), including the Quality Payment Program (QPP) and specifically the development of advanced alternative payment models (APMs) and implementation of the Merit-Based Incentive Payment System (MIPS) in the Bipartisan Budget Act of 2018, HR. 1892. Advocate for the expansion of telehealth coverage under Medicare Advantage Plan B, beginning in 2020 in the Bipartisan Budget Act of 2018, H.R. 1892. Advocate for the repeal of the Independent Payment Advisory Board (IPAB) as part of the Bipartisan Budget Act of 2018, H.R. 1892. Advocate for the elimination of the requirement that make electronic health record (EHR) meaningful use (MU) standards more stringent over time as part of the Bipartisan Budget Act of 2018, H.R. 1892. Oppose extension of the Medicare misvalued codes policy as part of the Bipartisan Budget Act of 2018, H.R. 1892. Oppose extension of 2 percent sequestration cuts to Medicare through 2027 as part of the Bipartisan Budget Act of 2018, H.R. 1892. Advocate for increased funding and reforms to Graduate Medical Education. Advocate for a new study on physician shortage to be conducted by the Health Resources and Services Administration. Lobby members of Congress regarding improvements to Health Information Technology implementation. Support H.R. 2556/ S. 1016, CONNECT for Health Act of 2017. Lobby members of Congress regarding issues related to telemedicine and Medicare reimbursement, including regarding provisions in H.R. 2556/S.1016, CONNECT for Health Act of 2017 and S. 2870, Creating High-Quality Results and Outcomes Necessary to Improve (CHRONIC) Care Act of 2017. Support provisions to allow Medicare Advantage plans to include telehealth as a benefit. Advocate for improving disease management and care coordination for patients with chronic diseases. Support preservation of the In-Offices Ancillary Services Exemption (IOASE) under Stark Law regarding physician self-referral and oppose repeal of the in-office ancillary and physician services exception. Advocate regarding possible changes to IOASE and Stark Law relative to implementation of Medicare Access and CHIP Reauthorization Act (MACRA P.L. 114-110) Support H.R. 4206/S.2051 Medicare Care Coordination Improvement Act of 2017 Advocate for Congressional support for relief from Medicare regulations under Medicare Access and CHIP Reauthorization Act (MACRA P.L. 114-110), including the Quality Payment Program (QPP) and specifically the development of advanced alternative payment models (APMs) and implementation of the Merit-Based Incentive Payment System (MIPS). Oppose elimination of a Merit-Based Incentive Payment System. Advocate allowing further appeals process within the Quality Payment Program. Advocate against H.R. 2066, Promoting Integrity in Medicare Act of 2017. Advocate for relief for from prior authorization requirements under Medicare Advantage and Medicare Part D plans. Support H.R. 4841, Standardizing Electronic Prior Authorization for Safe Prescribing Act Advocate expanding the period for reporting and returning overpayments beyond the 60 days statutorily required under audits by Recovery Audit Contractors (RACs). Support S. 2553, Know the Lowest Price Act. Lobby for support of nomination of Michael Bigby, MD to serve as Commissioner on Medicare Payment Advisory Commission (MedPAC).

Local Coverage Determination (LCD) Clarification Act (S. 794) Promoting Integrity in Medicare Act (HR 2066) Protecting Seniors' Access to Medicare Act (HR 849) Protecting Access to Medicare Act (HR 3635)

Client expense: $343,246 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

regulation and oversight of clinical laboratories, including laboratory developed test services, the Diagnostic Accuracy and Innovation Act; reimbursement and coverage issues for and related to clinical laboratory services, including the Medicare clinical laboratory fee schedule, physician fee schedule, new test coding and pricing, TRICARE coverage and reimbursement, and implementation of the Protecting Access to Medicare Act (P.L. 113-93); reauthorization of FDA user fees, FDA Reauthorization Act of 2017 (HR 2430/S 934); narrowing the in-office ancillary services exception to the federal self-referral statute to remove anatomic pathology, advanced diagnostic imaging, physical therapy, and radiation therapy, Promoting Integrity in Medicare Act of 2017 (HR 2066); Preventive Health Savings Act (HR 2953); Medicare physician signature documentation requirements; Creating High Quality Results and Outcomes Necessary to Improve Chronic Care (CHRONIC) Act of 2017 (S. 870); National Diabetes Prevention Program; commercial laboratory surge capacity issues for response to pandemic/epidemic/public health crises; H.R.3268/S.1603, Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, FY2018; H.R.3358/S.1771, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, FY2018, Medicare reimbursement of clinical labatory services

Client expense: $139,350 · Firm income: Not reported

reimbursement and coverage issues for and related to clinical laboratory services, including the Medicare clinical laboratory fee schedule, physician fee schedule, new test coding and pricing, and implementation of the Protecting Access to Medicare Act (P.L. 113-93); narrowing the in-office ancillary services exception to the federal self-referral statute to remove anatomic pathology, advanced diagnostic imaging, physical therapy, and radiation therapy, Promoting Integrity in Medicare Act of 2017 (HR 2066); Preventive Health Savings Act (HR 2953); Medicare physician signature documentation requirements; Medicare Laboratory Date of Service Policy; Creating High Quality Results and Outcomes Necessary to Improve Chronic Care (CHRONIC) Act of 2017 (S. 870); National Diabetes Prevention Program; FY2018; H.R.3358/S.1771, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, FY2018, Medicare reimbursement of clinical labatory services

Client expense: $139,350 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, White House Office

regulation and oversight of clinical laboratories, including laboratory developed test services, the Diagnostic Accuracy and Innovation Act; reimbursement and coverage issues for and related to clinical laboratory services, including the Medicare clinical laboratory fee schedule, physician fee schedule, new test coding and pricing, TRICARE coverage and reimbursement, and implementation of the Protecting Access to Medicare Act (P.L. 113-93); reauthorization of FDA user fees, FDA Reauthorization Act of 2017 (HR 2430/S 934); narrowing the in-office ancillary services exception to the federal self-referral statute to remove anatomic pathology, advanced diagnostic imaging, physical therapy, and radiation therapy, Promoting Integrity in Medicare Act of 2017 (HR 2066); Preventive Health Savings Act (HR 2953); Medicare physician signature documentation requirements; Medicare Laboratory Date of Service Policy; Creating High Quality Results and Outcomes Necessary to Improve Chronic Care (CHRONIC) Act of 2017 (S. 870); National Diabetes Prevention Program; commercial laboratory surge capacity issues for response to pandemic/epidemic/public health crises; H.R.3268/S.1603, Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, FY2018; H.R.3358/S.1771, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, FY2018, Medicare reimbursement of clinical labatory services, FY19 federal appropriations for FDA, CMS, and HHS related to clinical laboratory service issues

Client expense: $139,350 · Firm income: Not reported

regulation and oversight of clinical laboratories, including laboratory developed test services, the Diagnostic Accuracy and Innovation Act; reimbursement and coverage issues for and related to clinical laboratory services, including the Medicare clinical laboratory fee schedule, physician fee schedule, new test coding and pricing, TRICARE coverage and reimbursement, and implementation of the Protecting Access to Medicare Act (P.L. 113-93); reauthorization of FDA user fees, FDA Reauthorization Act of 2017 (HR 2430/S 934); narrowing the in-office ancillary services exception to the federal self-referral statute to remove anatomic pathology, advanced diagnostic imaging, physical therapy, and radiation therapy, Promoting Integrity in Medicare Act of 2017 (HR 2066); Preventive Health Savings Act (HR 2953); Medicare physician signature documentation requirements; Medicare Laboratory Date of Service Policy; Creating High Quality Results and Outcomes Necessary to Improve Chronic Care (CHRONIC) Act of 2017 (S. 870); National Diabetes Prevention Program; commercial laboratory surge capacity issues for response to pandemic/epidemic/public health crises; H.R.3268/S.1603, Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, FY2018; H.R.3358/S.1771, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, FY2018, Medicare reimbursement of clinical labatory services, FY19 federal appropriations for FDA, CMS, and HHS related to clinical laboratory service issues

Client expense: $139,350 · Firm income: Not reported

H.R. 1017 / S. 479 - Removing Barriers to Colorectal Cancer Screening Act of 2017. Opposition to H.R. 2066 - PIMA of 2017. Support for H.R. 4206 / S. 2051 Medicare Care Coordination Improvement Act of 2017.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Support for H.R. 4206 / S. 2051 - Medicare Care Coordination Improvement Act of 2017. Opposition to H.R. 2066 - PIMA of 2017

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare physician payment; new/alternative payment models; Medicare coverage; Medicare hospital payment; access to Medicare claims data; Ways & Means Committee hospital payment project; physician and hospital quality; electronic health record incentive program; clinical data registries; health care quality; medical imaging and prior authorization, including HR 4841, Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018; the Stark Law and the in-office ancillary services exception, including HR 4206/S 2051, the Medicare Care Coordination Improvement Act; Promoting Integrity in Medicare Act, HR 2066; Medicare Access and CHIP Reauthorization Act implementation and oversight; Bipartisan Budget Act of 2015 and Medicare site of service policy; HR 1155/S 1361, a bill to amend title XVIII of the Social Security Act to allow physician assistants, nurse practitioners, and clinical nurse specialists to supervise cardiac, intensive cardiac, and pulmonary rehabilitation programs; S 46, the Strengthening Medicare Intensive Cardiac Rehabilitation Programs Act of 2017; HR 3325/S 428, The Advancing Care for Exceptional Kids Act of 2017 (or ACE Kids Act), a bill to allow a state, at its option, to elect to provide medical assistance for items and services furnished to eligible children with medically complex conditions enrolled in a Medicaid Children's Care Coordination (MCCC) program; Senate Finance Committee chronic care project; graduate medical education policy including HR 2267/S 1301, Resident Physician Shortage Reduction Act of 2017; end of life care, including HR 2797/S 1334, the Patient Choice and Quality Care Act of 2017; Children's Health Insurance Program (CHIP) extension, including HR 3922, the CHAMPIONING HEALTHY KIDS Act; Puerto Rico Oversight, Management, and Economic Stability Act (PROMESA) implementation; oversight and implementation of the Protecting Access to Medicare Act of 2014, including Appropriate Use Criteria; repeal of the Independent Payment Advisory Board (IPAB), including S 251, the Protecting Medicare from Executive Action Act, S 260, the Protecting Seniors' Access to Medicare Act, SJ Res 16, SJ Res 17, and HR Res 51, joint resolutions approving the discontinuation of the process for consideration and automatic implementation of the annual proposal of the Independent Payment Advisory Board, and HR 849, a bill to repeal the IPAB; physician-owned hospital policy, including HR 1156/S 1133, the Patient Access to High Quality Care Act of 2017; Medicaid coverage and eligibility, including HR 829, Prioritizing the Most Vulnerable Over Lottery Winners Act of 2017, HR 181, Close Annuity Loopholes in Medicaid Act, and HR 705, Verify Eligibility Coverage Act; HR 3163, Medicare Part B Home Infusion Services Temporary Transitional Payment Act; Affordable Care Act repeal/replace/reform efforts, including the American Health Care Act, the Better Care Reconciliation Act, S 1835, the Lower Premiums Through Reinsurance Act of 2017, and the Graham/Cassidy amendment to the American Health Care Act; HR 3120, a bill to amend title XVIII of the Social Security Act to reduce the volume of future electronic health record-related significant hardship requests; HR 3767 and S 989, the Ensuring Childrens Access to Specialty Care Act of 2017; HR 3635, the Local Coverage Determination Clarification Act of 2017; Ways and Means Committee Medicare extenders policy/legislation; above-mentioned issues included in HR 1892, the Bipartisan Budget Act of 2018.

Advocate for adequate and accurate network coverage for dermatologic care within Medicare Advantage. Support legislation to eliminate the Independent Payment Advisory Board (H.R. 849, Protecting Seniors Access to Medicare Act, , S.251, Protecting Medicare from Executive Action Act, S. 260, Protecting Seniors Access to Medicare Act) Advocate for Congressional support for relief from Medicare regulations under Medicare Access and CHIP Reauthorization Act (MACRA P.L. 114-110), including the Quality Payment Program (QPP) and specifically the development of advanced alternative payment models (APMs) and implementation of the Merit-Based Incentive Payment System (MIPS) in the Bipartisan Budget Act of 2018, HR. 1892. Advocate for the expansion of telehealth coverage under Medicare Advantage Plan B, beginning in 2020 in the Bipartisan Budget Act of 2018, H.R. 1892. Advocate for the repeal of the Independent Payment Advisory Board (IPAB) as part of the Bipartisan Budget Act of 2018, H.R. 1892. Advocate for the elimination of the requirement that make electronic health record (EHR) meaningful use (MU) standards more stringent over time as part of the Bipartisan Budget Act of 2018, H.R. 1892. Oppose extension of the Medicare misvalued codes policy as part of the Bipartisan Budget Act of 2018, H.R. 1892. Oppose extension of 2 percent sequestration cuts to Medicare through 2027 as part of the Bipartisan Budget Act of 2018, H.R. 1892. Advocate for increased funding and reforms to Graduate Medical Education. Advocate for a new study on physician shortage to be conducted by the Health Resources and Services Administration. Lobby members of Congress regarding improvements to Health Information Technology implementation. Support H.R. 2556/ S. 1016, CONNECT for Health Act of 2017. Lobby members of Congress regarding issues related to telemedicine and Medicare reimbursement, including regarding provisions in H.R. 2556/S.1016, CONNECT for Health Act of 2017 and S. 2870, Creating High-Quality Results and Outcomes Necessary to Improve (CHRONIC) Care Act of 2017. Support provisions to allow Medicare Advantage plans to include telehealth as a benefit. Advocate for improving disease management and care coordination for patients with chronic diseases. Support preservation of the In-Offices Ancillary Services Exemption (IOASE) under Stark Law regarding physician self-referral and oppose repeal of the in-office ancillary and physician services exception. Advocate regarding possible changes to IOASE and Stark Law relative to implementation of Medicare Access and CHIP Reauthorization Act (MACRA P.L. 114-110) Support H.R. 4206/S.2051 Medicare Care Coordination Improvement Act of 2017 Advocate for Congressional support for relief from Medicare regulations under Medicare Access and CHIP Reauthorization Act (MACRA P.L. 114-110), including the Quality Payment Program (QPP) and specifically the development of advanced alternative payment models (APMs) and implementation of the Merit-Based Incentive Payment System (MIPS). Oppose elimination of a Merit-Based Incentive Payment System. Advocate allowing further appeals process within the Quality Payment Program. Advocate against H.R. 2066, Promoting Integrity in Medicare Act of 2017. Advocate for relief for from prior authorization requirements under Medicare Advantage and Medicare Part D plans. Support H.R. 4841, Standardizing Electronic Prior Authorization for Safe Prescribing Act Advocate expanding the period for reporting and returning overpayments beyond the 60 days statutorily required under audits by Recovery Audit Contractors (RACs). Support S. 2553, Know the Lowest Price Act.

S.2425-Patient Access and Medicare Protection Act (PAMPA) implementation. Support for legislation to freeze radiation therapy payments through the end of 2019, increase funding for the NIH for FY 2018 and FY 2019, and simplify the MIPS program; Balanced Budget Act of 2018 (HR 1892). Support for legislation to ensure patient safety and preserve the integrity of the Medicare program by ending abuses of the physician self-referral law for radiation therapy services; Protecting Integrity in Medicare Act (H.R. 2066) Support for structural changes that lead to delivering high-quality care for patients while increasing efficiencies and promoting Medicare sustainability; oppose radiation oncology benefit managers. Support for ensuring radiation oncologists participation in the Medicare electronic health record incentive program. Support for reforming the way Medicare pays for radiation oncology services by tying payments to quality and value. Implementation of H.R. 2, the Medicare Access and CHIP Reauthorization Act of 2015 Support the elimination of abuse to the Medicare program by closing the in-office ancillary services exception to the Stark Law for radiation oncology services. S. 794 Local Coverage Determination Clarification Act of 2017

Client expense: $174,676 · Firm income: Not reported

Support to ensure that patient care advances in biomedical research impacting patient care are not compromised by any policies imposed on the medical use and research applications of cesium chloride. Support for NRC Commissioner nominee to have medical background. Support patient choice in treatment options by closing the in-office ancillary services exception to the Stark Law for radiation oncology services; Protecting Integrity in Medicare Act (H.R. 2066) Oppose Non-Burning Sunshine Report Language Oppose HR 1150, Tanning Tax Repeal Act of 2017 Radiation Oncology reimbursement Radiation Oncology safety Cancer Moonshot Initiative S. 794 Local Coverage Determination Clarification Act of 2016 HR 1629, Oppose American Health Care Act and Senate Better Care Reconciliation Amendment Oppose Graham-Cassidy Amendment Support Children's Health Insurance Re authorization Act Support Medicare Red Tape Initiative Supplemental Appropriations for Disaster Relief for Puerto Rico

Client expense: $174,676 · Firm income: Not reported

Implementation/Expansion of CDC Falls Program Implementation of Affordable Care Act - provisions pertaining to Essential Health Benefits & Health Insurance Exchanges AHRQ provisions pertaining to PT Physician self-referra/Stark Law American Cures Act H.R. 930/S.497 Lymphadema Treatment Act Health Information Technology Nominations to PCORI Methodology Committees Medicaid Expansion HR. 1639/S.619 Physical Therapist Workforce & Patient Access Act Physician owned distributerships H.R. 302/S.808 Sports Medicine Licensure Clarity Act MACRA/MIPS APMS IMPACT/PAC reform Network adequacy Insurance Benefit parameters H.R. 1361/S.486 Ensuring Access to Quality CRT Medicare Telehealth Parity Act HR2550 American Healthcare Act of 2017/CONNECT - H.R. 2556/S1016 H.R. 1628 - American Health Care Action of 2017 Opioid Epidemic/Pain Management Better Care Reconciliation Act of 2017 H.R.2066 Promoting Integrity in Medicare H.R. 2063 Opioid Pace Act of 2017 H.R. 5261 Teach Act H.R. 5197 Alto Act

Client expense: $252,000 · Firm income: Not reported

Implementation/Expansion of CDC Falls Program Implementation of Affordable Care Act - provisions pertaining to Essential Health Benefits & Health Insurance Exchanges AHRQ provisions pertaining to PT Physician self-referra/Stark Law American Cures Act H.R. 930/S.497 Lymphadema Treatment Act Health Information Technology Nominations to PCORI Methodology Committees Medicaid Expansion HR. 1639/S.619 Physical Therapist Workforce & Patient Access Act Physician owned distributerships H.R. 302/S.808 Sports Medicine Licensure Clarity Act MACRA/MIPS APMS IMPACT/PAC reform Network adequacy Insurance Benefit parameters H.R. 1361/S.486 Ensuring Access to Quality CRT Medicare Telehealth Parity Act HR2550 American Healthcare Act of 2017/CONNECT - H.R. 2556/S1016 H.R. 1628 - American Health Care Action of 2017 Opioid Epidemic/Pain Management Better Care Reconciliation Act of 2017 H.R.2066 Promoting Integrity in Medicare

Client expense: $254,609 · Firm income: Not reported

Advocate for adequate and accurate network coverage for dermatologic care within Medicare Advantage. Support legislation to eliminate the Independent Payment Advisory Board (H.R. 849, Protecting Seniors Access to Medicare Act, H.J. Res. 51, S.251, Protecting Medicare from Executive Action Act, S. 260, Protecting Seniors Access to Medicare Act, S.J. Res. 16 and S.J. Res. 17) Advocate for increased funding and reforms to Graduate Medical Education. Advocate for a new study on physician shortage to be conducted by the Health Resources and Services Administration. Lobby members of Congress regarding improvements to Health Information Technology implementation. Support H.R. 2556/ S. 1016, CONNECT for Health Act of 2017. Lobby members of Congress regarding issues related to telemedicine and Medicare reimbursement, including regarding provisions in H.R. 2556/S.1016, CONNECT for Health Act of 2017 and S. 2870, Creating High-Quality Results and Outcomes Necessary to Improve (CHRONIC) Care Act of 2017. Advocate for improving disease management and care coordination for patients with chronic diseases. Support preservation of the In-Offices Ancillary Services Exemption (IOASE) under Stark Law regarding physician self-referral and oppose repeal of the in-office ancillary and physician services exception. Advocate regarding possible changes to IOASE and Stark Law relative to implementation of Medicare Access and CHIP Reauthorization Act (MACRA P.L. 114-110) Advocate for Congressional support for relief from Medicare regulations under Medicare Access and CHIP Reauthorization Act (MACRA P.L. 114-110), including the Quality Payment Program (QPP) and specifically the development of advanced alternative payment models (APMs) and implementation of the Merit-Based Incentive Payment System (MIPS). Advocate allowing further appeals process within the Quality Payment Program. Advocate against H.R. 2066, Promoting Integrity in Medicare Act of 2017. Advocate for reform of insurers prior authorization practices within Medicare Advantage and Medicare prescription drug plans (Medicare Parts C and D). Advocate expanding the period for reporting and returning overpayments beyond the 60 days statutorily required under audits by Recovery Audit Contractors (RACs).

Local Coverage Determination (LCD) Clarification Act (S. 794) Promoting Integrity in Medicare Act (HR 2066) Protecting Seniors' Access to Medicare Act (HR 849)

Client expense: $367,171 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

reimbursement and coverage issues for and related to clinical laboratory services, including the Medicare clinical laboratory fee schedule, physician fee schedule, new test coding and pricing, and implementation of the Protecting Access to Medicare Act (P.L. 113-93); narrowing the in-office ancillary services exception to the federal self-referral statute to remove anatomic pathology, advanced diagnostic imaging, physical therapy, and radiation therapy, Promoting Integrity in Medicare Act of 2017 (HR 2066); Preventive Health Savings Act (HR 2953); Medicare physician signature documentation requirements; Medicare Laboratory Date of Service Policy; Creating High Quality Results and Outcomes Necessary to Improve Chronic Care (CHRONIC) Act of 2017 (S. 870); National Diabetes Prevention Program; FY2018; H.R.3358/S.1771, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, FY2018, Medicare reimbursement of clinical labatory services

Client expense: $195,339 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, White House Office

regulation and oversight of clinical laboratories, including laboratory developed test services, the Diagnostic Accuracy and Innovation Act; reimbursement and coverage issues for and related to clinical laboratory services, including the Medicare clinical laboratory fee schedule, physician fee schedule, new test coding and pricing, TRICARE coverage and reimbursement, and implementation of the Protecting Access to Medicare Act (P.L. 113-93); reauthorization of FDA user fees, FDA Reauthorization Act of 2017 (HR 2430/S 934); narrowing the in-office ancillary services exception to the federal self-referral statute to remove anatomic pathology, advanced diagnostic imaging, physical therapy, and radiation therapy, Promoting Integrity in Medicare Act of 2017 (HR 2066); Preventive Health Savings Act (HR 2953); Medicare physician signature documentation requirements; Medicare Laboratory Date of Service Policy; Creating High Quality Results and Outcomes Necessary to Improve Chronic Care (CHRONIC) Act of 2017 (S. 870); National Diabetes Prevention Program; commercial laboratory surge capacity issues for response to pandemic/epidemic/public health crises; H.R.3268/S.1603, Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, FY2018; H.R.3358/S.1771, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, FY2018, Medicare reimbursement of clinical labatory services

Client expense: $195,339 · Firm income: Not reported

regulation and oversight of clinical laboratories, including laboratory developed test services, the Diagnostic Accuracy and Innovation Act; reimbursement and coverage issues for and related to clinical laboratory services, including the Medicare clinical laboratory fee schedule, physician fee schedule, new test coding and pricing, TRICARE coverage and reimbursement, and implementation of the Protecting Access to Medicare Act (P.L. 113-93); reauthorization of FDA user fees, FDA Reauthorization Act of 2017 (HR 2430/S 934); narrowing the in-office ancillary services exception to the federal self-referral statute to remove anatomic pathology, advanced diagnostic imaging, physical therapy, and radiation therapy, Promoting Integrity in Medicare Act of 2017 (HR 2066); Preventive Health Savings Act (HR 2953); Medicare physician signature documentation requirements; Medicare Laboratory Date of Service Policy; Creating High Quality Results and Outcomes Necessary to Improve Chronic Care (CHRONIC) Act of 2017 (S. 870); National Diabetes Prevention Program; commercial laboratory surge capacity issues for response to pandemic/epidemic/public health crises; H.R.3268/S.1603, Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, FY2018; H.R.3358/S.1771, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, FY2018, Medicare reimbursement of clinical labatory services

Client expense: $195,339 · Firm income: Not reported

S. 251, Protecting Medicare from Executive Action Act: Repeal the Independent Payment Advisory Board S. 260, Protecting Seniors Access to Medicare Act: Repeal the Independent Payment Advisory Board Implementation of the annual proposal of the Independent Payment Advisory Board (IPAB) S.794, Local Coverage Determination Clarification Act: Medicare coverage policy process S.1301, Resident Physician Shortage Reduction Act: Graduate Medicare Education residency training support H.R. 849, Protecting Seniors Access to Medicare Act: Repeal the Independent Payment Advisory Board H.R.1156, Patient Access to Higher Quality Health Care Act: Allowing for the expansion of physician-owned specialty hospitals H.R. 2066, Promoting Integrity in Medicare Act: imaging self-referral H.R.2267, Resident Physician Shortage Reduction Act: Graduate Medicare Education residency training support H.R. 2373, accreditation of osteopathic and medical residency training programs H.R.3635, Local Coverage Determination Clarification Act of 2017: Medicare coverage policy process H.R. 4133, the Medicare Patient Empowerment Act: Private contracting under Medicare No Bill: Medicare regulatory relief, including delay of global surgery data collection and delay of appropriate use criteria for advanced diagnostic imaging No Bill: Medicare Access and CHIP Reauthorization Act's Quality Payment Program modifications No Bill: Medicare extenders, including opposition to extending the Medicare sequester and misvalued code cuts No Bill: Prior authorization in Medicare Advantage

Client expense: $25,000 · Firm income: Not reported

S. 251, Protecting Medicare from Executive Action Act: Repeal the Independent Payment Advisory Board S. 260, Protecting Seniors Access to Medicare Act: Repeal the Independent Payment Advisory Board Implementation of the annual proposal of the Independent Payment Advisory Board (IPAB) S.794, Local Coverage Determination Clarification Act: Medicare coverage policy process S.1301, Resident Physician Shortage Reduction Act: Graduate Medicare Education residency training support H.R. 849, Protecting Seniors Access to Medicare Act: Repeal the Independent Payment Advisory Board H.R.1156, Patient Access to Higher Quality Health Care Act: Allowing for the expansion of physician-owned specialty hospitals H.R. 2066, Promoting Integrity in Medicare Act: imaging self-referral H.R.2267, Resident Physician Shortage Reduction Act: Graduate Medicare Education residency training support H.R. 2373, accreditation of osteopathic and medical residency training programs H.R.3635, Local Coverage Determination Clarification Act of 2017: Medicare coverage policy process H.R. 4133, the Medicare Patient Empowerment Act: Private contracting under Medicare No Bill: Medicare regulatory relief, including delay of global surgery data collection and delay of appropriate use criteria for advanced diagnostic imaging No Bill: Medicare Access and CHIP Reauthorization Act's Quality Payment Program modifications No Bill: Medicare extenders, including opposition to extending the Medicare sequester and misvalued code cuts No Bill: Prior authorization in Medicare Advantage

Client expense: $25,000 · Firm income: Not reported

Medicare physician payment; new/alternative payment models; Medicare coverage; Medicare hospital payment; access to Medicare claims data; Ways & Means Committee hospital payment project; physician and hospital quality; electronic health record incentive program; clinical data registries; health care quality; medical imaging and prior authorization; the Stark Law and the in-office ancillary services exception including HR 4206/S 2051, the Medicare Care Coordination Improvement Act; Promoting Integrity in Medicare Act, HR 2066; Medicare Access and CHIP Reauthorization Act implementation and oversight; Bipartisan Budget Act of 2015 and Medicare site of service policy; HR 1155/S 1361, a bill to amend title XVIII of the Social Security Act to allow physician assistants, nurse practitioners, and clinical nurse specialists to supervise cardiac, intensive cardiac, and pulmonary rehabilitation programs; S 46, the Strengthening Medicare Intensive Cardiac Rehabilitation Programs Act of 2017; S 428, The Advancing Care for Exceptional Kids Act of 2017, a bill to allow a state, at its option, to elect to provide medical assistance for items and services furnished to eligible children with medically complex conditions enrolled in a Medicaid Children's Care Coordination (MCCC) program; Senate Finance Committee chronic care project; graduate medical education policy including HR 2267/S 1301, Resident Physician Shortage Reduction Act of 2017; end of life care, including HR 2797/S 1334, the Patient Choice and Quality Care Act of 2017; Children's Health Insurance Program (CHIP) extension, including HR 3922, the CHAMPIONING HEALTHY KIDS Act; Puerto Rico Oversight, Management, and Economic Stability Act (PROMESA) implementation; oversight and implementation of the Protecting Access to Medicare Act of 2014, including Appropriate Use Criteria; repeal of the Independent Payment Advisory Board (IPAB), including S 251, the Protecting Medicare from Executive Action Act, S 260, the Protecting Seniors' Access to Medicare Act, SJ Res 16, SJ Res 17, and HR Res 51, joint resolutions approving the discontinuation of the process for consideration and automatic implementation of the annual proposal of the Independent Payment Advisory Board, and HR 849, a bill to repeal the IPAB; physician-owned hospital policy, including HR 1156/S 1133, the Patient Access to High Quality Care Act of 2017; Medicaid eligibility: HR 829, Prioritizing the Most Vulnerable Over Lottery Winners Act of 2017, HR 181, Close Annuity Loopholes in Medicaid Act, and HR 705, Verify Eligibility Coverage Act; HR 3163, Medicare Part B Home Infusion Services Temporary Transitional Payment Act; Affordable Care Act repeal/replace/reform efforts, including the American Health Care Act, the Better Care Reconciliation Act, S 1835, the Lower Premiums Through Reinsurance Act of 2017, and the Graham/Cassidy amendment to the American Health Care Act; HR 3120, a bill to amend title XVIII of the Social Security Act to reduce the volume of future electronic health record-related significant hardship requests; HR 3767 and S 989, the Ensuring Childrens Access to Specialty Care Act of 2017; HR 3635, the Local Coverage Determination Clarification Act of 2017; Ways and Means Committee Medicare extenders policy/legislation.

Support for H.R. 4206 / S. 2051 - Medicare Care Coordination Improvement Act of 2017. Opposition to H.R. 2066 - PIMA of 2017

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE