Audiology Patient Choice Act of 2017

PL 109-417 - Pandemic and All-Hazards Preparedness Act (PAHPA) PL 114-10 - Medicare and CHIP Reauthorization Act of 2017 Implementation H.R. 6 - SUPPORT for Patients and Communities Act H.R. 5507 - Critical Access Hospital Relief Act of 2018 H. R. 5809 - Postoperative Opioid Prevention Act of 2018 H.R 4143/S. 2065 - Dialysis PATIENTS Demonstration Act of 2017 S. 2852/H.R. 6378 - Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018 (PAHPAI) H.R. 5385 - Children's Hospital GME Support Reauthorization Act of 2018 S. 2809 - A bill to amend title XVIII of the Social Security Act to provide for electronic prior authorization under Medicare part D for covered part D drugs, and for other purposes. H.R. 5106 - Investor Choice Against Gun Proliferation Act H.R.1057 - STOP Act of 2017 H.R. 1822, 1876/S. 781 - Good Samaritan Health Professionals Act of 2017 H.R. 880/S. 1022 - Mission Zero Act H.R. 1017/S. 479 - Removing Barriers to Colorectal Cancer Screening Act of 2017 H.R. 820/S. 292 - Childhood Cancer STAR Act H.R. 5160 - Cancer Care Planning and Communications Act of 2018 H.R. 1704 - ACCESS Act of 2017 H.R. 2267 - Resident Physician Shortage Reduction Act of 2017 H.R. 1676/S. 693 - Palliative Care and Hospice Education and Training Act H.R. 4909/S. 2495 - STOP School Violence Act of 2018 H.R. 4841 - Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018 H.R. 4206/S. 2051 - Medicare Care Coordination Improvement Act H.R. 1892 - Bipartisan Budget Act of 2018 H.R. 1625 - Omnibus H.R. 2906/S. 1351 - Ensuring Access to General Surgery Act of 2017 H.R. 4434/S.2135 - Fix NICS Act of 2017 H.R. 548/S. 527 - Health Care Safety Net Enhancement Act of 2017 H.R. 849/S. 260, S. 251 - Protecting Seniors' Access to Medicare Act of 2017 H.R. 2843/S.1317 - Medicaid and CHIP Quality Improvement Act of 2017 H.R. 3120 - Electronic Health Record Meaningful Use H.R. 2276/S.2575 - Audiology Patient Choice Act of 2018 H.R. 6157 - Department of Defense and Labor, Health and Human Services, and Education Appropriations Act, 2019 and Continuing Appropriations Act, 2019 H.R. 6545 - Violence Against Women Reauthorization Act of 2018 H.R. 6808 - Patient Navigation Assistance Act of 2018 H.R.4897 - Women and Lung Cancer Research and Preventive Services Act of 2018 H.R. 930/S. 497 - Lymphedema Treatment Act H.R. 7083 - Access to Genetic Counselor Services Act of 2018 H.R. 1318 - Preventing Maternal Deaths Act of 2018 Medicaid GME Transparency Act Bleeding Control for the Injured (Stop The Bleed campaign) Injury Prevention Initiatives Childrens Health Insurance Program Reauthorization Cancer Research and Funding Opioids EHR Clinician Burden/Administrative Burden Mis-valued Codes Medicare Sequestration Congenital Anomalies Global Codes Qualified clinical data registry (QCDR) Consumer Assessment of Healthcare Providers and Systems Surgical Care Survey (S-CAHPS) VA Health Issues DOD Health Issues The Emergency Medical Services for Children Program MIPS cost measure development E-Prior Authorization Digital health systems Sports Medicine Firearms Research Hospital-based violence intervention programs National Trauma System (Military-Civilian Trauma Care) Visa Denial Medicare Fraud Surprise Billing Draft Legislation Stark Law Reform and Medicare Administrative Burden relief Alternative Payment Models (APMs) Physician Fee Schedule Quality Payment Program (QPP) Out-of-Network billing Narrow networks/Network Adequacy Hospital-based Violence Intervention Programs Out of the Crucible: U.S. Military Combat Casualty Care principles

Client expense: $16,092 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Veterans Affairs, Dept of (VA)

PL 109-417 - Pandemic and All-Hazards Preparedness Act (PAHPA) PL 114-10 - Medicare and CHIP Reauthorization Act of 2017 Implementation H.R. 6 - SUPPORT for Patients and Communities Act H.R. 5507 - Critical Access Hospital Relief Act of 2018 H. R. 5809 - Postoperative Opioid Prevention Act of 2018 H.R 4143/S. 2065 - Dialysis PATIENTS Demonstration Act of 2017 S. 2852/H.R. 6378 - Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018 (PAHPAI) H.R. 5385 - Children's Hospital GME Support Reauthorization Act of 2018 S. 2809 - A bill to amend title XVIII of the Social Security Act to provide for electronic prior authorization under Medicare part D for covered part D drugs, and for other purposes. H.R. 5106 - Investor Choice Against Gun Proliferation Act H.R.1057 - STOP Act of 2017 H.R. 1822, 1876/S. 781 - Good Samaritan Health Professionals Act of 2017 H.R. 880/S. 1022 - Mission Zero Act H.R. 1017/S. 479 - Removing Barriers to Colorectal Cancer Screening Act of 2017 H.R. 820/S. 292 - Childhood Cancer STAR Act H.R. 5160 - Cancer Care Planning and Communications Act of 2018 H.R. 1704 - ACCESS Act of 2017 H.R. 2267 - Resident Physician Shortage Reduction Act of 2017 H.R. 1676/S. 693 - Palliative Care and Hospice Education and Training Act H.R. 4909/S. 2495 - STOP School Violence Act of 2018 H.R. 4841 - Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018 H.R. 4206/S. 2051 - Medicare Care Coordination Improvement Act H.R. 1892 - Bipartisan Budget Act of 2018 H.R. 1625 - Omnibus H.R. 2906/S. 1351 - Ensuring Access to General Surgery Act of 2017 H.R. 4434/S.2135 - Fix NICS Act of 2017 H.R. 548/S. 527 - Health Care Safety Net Enhancement Act of 2017 H.R. 849/S. 260, S. 251 - Protecting Seniors' Access to Medicare Act of 2017 H.R. 2843/S.1317 - Medicaid and CHIP Quality Improvement Act of 2017 H.R. 3120 - Electronic Health Record Meaningful Use H.R. 2276/S.2575 - Audiology Patient Choice Act of 2018 H.R. 6157 - Department of Defense and Labor, Health and Human Services, and Education Appropriations Act, 2019 and Continuing Appropriations Act, 2019 H.R. 6545 - Violence Against Women Reauthorization Act of 2018 H.R. 6808 - Patient Navigation Assistance Act of 2018 H.R.4897 - Women and Lung Cancer Research and Preventive Services Act of 2018 H.R. 930/S. 497 - Lymphedema Treatment Act H.R. 7083 - Access to Genetic Counselor Services Act of 2018 H.R. 1318 - Preventing Maternal Deaths Act of 2018 Medicaid GME Transparency Act Bleeding Control for the Injured (Stop The Bleed campaign) Injury Prevention Initiatives Childrens Health Insurance Program Reauthorization Cancer Research and Funding Opioids EHR Clinician Burden/Administrative Burden Mis-valued Codes Medicare Sequestration Congenital Anomalies Global Codes Qualified clinical data registry (QCDR) Consumer Assessment of Healthcare Providers and Systems Surgical Care Survey (S-CAHPS) VA Health Issues DOD Health Issues The Emergency Medical Services for Children Program MIPS cost measure development E-Prior Authorization Digital health systems Sports Medicine Firearms Research Hospital-based violence intervention programs National Trauma System (Military-Civilian Trauma Care) Visa Denial Medicare Fraud Surprise Billing Draft Legislation Stark Law Reform and Medicare Administrative Burden relief Alternative Payment Models (APMs) Physician Fee Schedule Quality Payment Program (QPP) Out-of-Network billing Narrow networks/Network Adequacy Hospital-based Violence Intervention Programs Out of the Crucible: U.S. Military Combat Casualty Care principles

Client expense: $16,092 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Veterans Affairs, Dept of (VA)

PL 109-417 - Pandemic and All-Hazards Preparedness Act (PAHPA) PL 114-10 - Medicare and CHIP Reauthorization Act of 2017 Implementation H.R. 6 - SUPPORT for Patients and Communities Act H.R. 5507 - Critical Access Hospital Relief Act of 2018 H. R. 5809 - Postoperative Opioid Prevention Act of 2018 H.R 4143/S. 2065 - Dialysis PATIENTS Demonstration Act of 2017 S. 2852/H.R. 6378 - Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018 (PAHPAI) H.R. 5385 - Children's Hospital GME Support Reauthorization Act of 2018 S. 2809 - A bill to amend title XVIII of the Social Security Act to provide for electronic prior authorization under Medicare part D for covered part D drugs, and for other purposes. H.R. 5106 - Investor Choice Against Gun Proliferation Act H.R.1057 - STOP Act of 2017 H.R. 1822, 1876/S. 781 - Good Samaritan Health Professionals Act of 2017 H.R. 880/S. 1022 - Mission Zero Act H.R. 1017/S. 479 - Removing Barriers to Colorectal Cancer Screening Act of 2017 H.R. 820/S. 292 - Childhood Cancer STAR Act H.R. 5160 - Cancer Care Planning and Communications Act of 2018 H.R. 1704 - ACCESS Act of 2017 H.R. 2267 - Resident Physician Shortage Reduction Act of 2017 H.R. 1676/S. 693 - Palliative Care and Hospice Education and Training Act H.R. 4909/S. 2495 - STOP School Violence Act of 2018 H.R. 4841 - Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018 H.R. 4206/S. 2051 - Medicare Care Coordination Improvement Act H.R. 1892 - Bipartisan Budget Act of 2018 H.R. 1625 - Omnibus H.R. 2906/S. 1351 - Ensuring Access to General Surgery Act of 2017 H.R. 4434/S.2135 - Fix NICS Act of 2017 H.R. 548/S. 527 - Health Care Safety Net Enhancement Act of 2017 H.R. 849/S. 260, S. 251 - Protecting Seniors' Access to Medicare Act of 2017 H.R. 2843/S.1317 - Medicaid and CHIP Quality Improvement Act of 2017 H.R. 3120 - Electronic Health Record Meaningful Use H.R. 2276/S.2575 - Audiology Patient Choice Act of 2018 H.R. 6157 - Department of Defense and Labor, Health and Human Services, and Education Appropriations Act, 2019 and Continuing Appropriations Act, 2019 H.R. 6545 - Violence Against Women Reauthorization Act of 2018 H.R. 6808 - Patient Navigation Assistance Act of 2018 H.R.4897 - Women and Lung Cancer Research and Preventive Services Act of 2018 H.R. 930/S. 497 - Lymphedema Treatment Act H.R. 7083 - Access to Genetic Counselor Services Act of 2018 H.R. 1318 - Preventing Maternal Deaths Act of 2018 Medicaid GME Transparency Act Bleeding Control for the Injured (Stop The Bleed campaign) Injury Prevention Initiatives Childrens Health Insurance Program Reauthorization Cancer Research and Funding Opioids EHR Clinician Burden/Administrative Burden Mis-valued Codes Medicare Sequestration Congenital Anomalies Global Codes Qualified clinical data registry (QCDR) Consumer Assessment of Healthcare Providers and Systems Surgical Care Survey (S-CAHPS) VA Health Issues DOD Health Issues The Emergency Medical Services for Children Program MIPS cost measure development E-Prior Authorization Digital health systems Sports Medicine Firearms Research Hospital-based violence intervention programs National Trauma System (Military-Civilian Trauma Care) Visa Denial Medicare Fraud Surprise Billing Draft Legislation Stark Law Reform and Medicare Administrative Burden relief Alternative Payment Models (APMs) Physician Fee Schedule Quality Payment Program (QPP) Out-of-Network billing Narrow networks/Network Adequacy Hospital-based Violence Intervention Programs Out of the Crucible: U.S. Military Combat Casualty Care principles

Client expense: $169,817 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Veterans Affairs, Dept of (VA)

PL 109-417 - Pandemic and All-Hazards Preparedness Act (PAHPA) PL 114-10 - Medicare and CHIP Reauthorization Act of 2017 Implementation H.R. 6 - SUPPORT for Patients and Communities Act H.R. 5507 - Critical Access Hospital Relief Act of 2018 H. R. 5809 - Postoperative Opioid Prevention Act of 2018 H.R 4143/S. 2065 - Dialysis PATIENTS Demonstration Act of 2017 S. 2852/H.R. 6378 - Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018 (PAHPAI) H.R. 5385 - Children's Hospital GME Support Reauthorization Act of 2018 S. 2809 - A bill to amend title XVIII of the Social Security Act to provide for electronic prior authorization under Medicare part D for covered part D drugs, and for other purposes. H.R. 5106 - Investor Choice Against Gun Proliferation Act H.R.1057 - STOP Act of 2017 H.R. 1822, 1876/S. 781 - Good Samaritan Health Professionals Act of 2017 H.R. 880/S. 1022 - Mission Zero Act H.R. 1017/S. 479 - Removing Barriers to Colorectal Cancer Screening Act of 2017 H.R. 820/S. 292 - Childhood Cancer STAR Act H.R. 5160 - Cancer Care Planning and Communications Act of 2018 H.R. 1704 - ACCESS Act of 2017 H.R. 2267 - Resident Physician Shortage Reduction Act of 2017 H.R. 1676/S. 693 - Palliative Care and Hospice Education and Training Act H.R. 4909/S. 2495 - STOP School Violence Act of 2018 H.R. 4841 - Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018 H.R. 4206/S. 2051 - Medicare Care Coordination Improvement Act H.R. 1892 - Bipartisan Budget Act of 2018 H.R. 1625 - Omnibus H.R. 2906/S. 1351 - Ensuring Access to General Surgery Act of 2017 H.R. 4434/S.2135 - Fix NICS Act of 2017 H.R. 548/S. 527 - Health Care Safety Net Enhancement Act of 2017 H.R. 849/S. 260, S. 251 - Protecting Seniors' Access to Medicare Act of 2017 H.R. 2843/S.1317 - Medicaid and CHIP Quality Improvement Act of 2017 H.R. 3120 - Electronic Health Record Meaningful Use H.R. 2276/S.2575 - Audiology Patient Choice Act of 2018 H.R. 6157 - Department of Defense and Labor, Health and Human Services, and Education Appropriations Act, 2019 and Continuing Appropriations Act, 2019 H.R. 6545 - Violence Against Women Reauthorization Act of 2018 H.R. 6808 - Patient Navigation Assistance Act of 2018 H.R.4897 - Women and Lung Cancer Research and Preventive Services Act of 2018 H.R. 930/S. 497 - Lymphedema Treatment Act H.R. 7083 - Access to Genetic Counselor Services Act of 2018 H.R. 1318 - Preventing Maternal Deaths Act of 2018 Medicaid GME Transparency Act Bleeding Control for the Injured (Stop The Bleed campaign) Injury Prevention Initiatives Childrens Health Insurance Program Reauthorization Cancer Research and Funding Opioids EHR Clinician Burden/Administrative Burden Mis-valued Codes Medicare Sequestration Congenital Anomalies Global Codes Qualified clinical data registry (QCDR) Consumer Assessment of Healthcare Providers and Systems Surgical Care Survey (S-CAHPS) VA Health Issues DOD Health Issues The Emergency Medical Services for Children Program MIPS cost measure development E-Prior Authorization Digital health systems Sports Medicine Firearms Research Hospital-based violence intervention programs National Trauma System (Military-Civilian Trauma Care) Visa Denial Medicare Fraud Surprise Billing Draft Legislation Stark Law Reform and Medicare Administrative Burden relief Alternative Payment Models (APMs) Physician Fee Schedule Quality Payment Program (QPP) Out-of-Network billing Narrow networks/Network Adequacy Hospital-based Violence Intervention Programs Out of the Crucible: U.S. Military Combat Casualty Care principles

Client expense: $169,817 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Veterans Affairs, Dept of (VA)

H.R. 2276/S. 2575, the "Audiology Patient Choice Act," all provisions. Medicare physician payment reform and implementation of the Medicare and CHIP Reauthorization Act of 2015, in general. Medicare physician payment reform and implementation of the Medicare and CHIP Reauthorization Act of 2015 related to the cost domain of the Merit-based Incentive Payment System. H.R. 1156, the "Patient Access to Higher Quality Health Care Act of 2017," all provisions. H.R. 849/S. 260, the "Protecting Seniors' Access to Medicare Act of 2017," all provisions. Comments outlining concern with the November 2017 Medicare Payment Advisory Commission (MedPAC) discussion titled, "Rebalancing the physician fee schedule towards primary care services." Issues pertaining to scope of practice, in general. Comments urging the Centers for Medicare and Medicaid Services (CMS) to reduce the 2018 Merit-based Incentive Payment System (MIPS) reporting period from a calendar year to a minimum of 90 consecutive days. Comments on the Medicare Hospital IPPS FY 2019 Proposed Rule communicating concerns about the agencys plans to remove the Public Health and Clinical Data Exchange objective by 2022. Comments urging leaders of the U.S. Senate Committee on Finance not to co-sponsor and oppose any efforts to advance the "Audiology Patient Choice Act" (S. 2575). Comments to the Centers for Medicare and Medicaid Services (CMS) regarding Medicare's designation of CPT Code 31241 Nasal/sinus endoscopy, surgical; with ligation of sphenopalatine artery. Coalition letter to leaders of the U.S. House Committees on Ways & Means and Energy & Commerce regarding the Medicare Appropriate Use Criteria (AUC) Program for Advanced Diagnostic Imaging. Coalition letter to leaders of the U.S. Senate Committee on Finance regarding the Medicare Appropriate Use Criteria (AUC) Program for Advanced Diagnostic Imaging. Coalition letter to U.S. House Committees on Ways & Means and Energy and Commerce and U.S. Senate Committee on Finance regarding payment cuts for clinical lab tests in the Medicare program. Coalition letter to the CMS Administrator urging HHS to allow eligible clinicians utilizing a certified electronic health record to participate in a clinician-led qualified clinical data registry to qualify them as fully achieving all points from the MIPS program. Coalition letter to the CMS Administrator regarding the Evaluation and Management coding and payment recommendations included in the CY19 Medicare Physician Fee Schedule Proposed Rule. Coalition letter to U.S. House of Representatives requesting support of a letter to HHS Secretary Alex Azar regarding data information blocking guidelines as related to Qualified Clinical Data Registries. Comments on the CY19 Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System proposed rule communicating support for proposed changes to reduce site of service disparities, as well as removal of CPT 31241 (Nasal/sinus endoscopy, surgical; with ligation of sphenopalatine artery) from the Inpatient Only List. Comments on the CY19 Medicare Physician Fee Schedule Proposed Rule regarding the proposed changes to documentation requirements, coding and payment for Evaluation and Management (E/M) services, application of the MPPR to E/M services, and the pricing and composition of balloon sinus surgery kits. Coalition Letter to leaders of the U.S. Senate Committee on Finance and U.S. House Committees on Ways and Means and Energy and Commerce regarding cuts to clinical laboratory services implemented by the Protecting Access to Medicare Act (PAMA) of 2014. Coalition letter to U.S. Senate Finance Committee and U.S. House Committees on Ways and Means and Energy and Commerce expressing concerns with CMS proposal to require Qualified Clinical Data Registry (QCDR) measure owners to enter into licensing agreements with CMS that would permit any other approved QCDR to submit data on the licensed measure for purposes of MIPS reporting. Comments on the CY19 Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Final Rule regarding changes to reduce site of service disparities, as well as removal of CPT 31241 (Nasal/sinus endoscopy, surgical; with ligation of sphenopalatine artery) from the Inpatient Only List. Comments on the CY 2019 Physician Fee Schedule Final Rule regarding the changes to documentation requirements, coding and payment for Evaluation and Management (E/M) services, application of the MPPR to E/M services, and the pricing and composition of balloon sinus surgery kits. Coalition letter to CMS expressing several concerns with Qualified Clinical Data Registries and MIPS. Coalition letter to CMS in response to an RFI regarding reporting requirements under the Open Payments Program for educational materials.

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

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

General Medicare Protection, Prevention of Fraud, Waste, and Abuse: H.R. 2460 and H.R. 4841 and H.R. 4704, Prescription Drug Re-Importation: S. 92 and S. 469 and H.R. 1245, Negotiation of Prescription Drug Prices: H.R. 242 and S. 41, General Prescription Drug Affordability: S. 124 and S. 771 and H.R. 1776 and H.R. 4138 and H.R. 4116 and H.R. 4117 and S. 2011 and S. 974 and H.R. 2212 and S. 2553, Medicare Enrollment Simplification: H.R. 2575 and S. 1909, Expanding Medicare Coverage: H.R. 5083 and H.R. 4957 and S. 2387 and H.R. 807 and H.R. 3098 and H.R. 4701 and H.R. 508 and H.R. 2276 and S. 2575 and H.R. 5083.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to implementation of the 21st Century Cures Act (Public Law No: 114-255); in general H.R. 5311/S. 2456, the CARA 2.0 Act of 2018 H.R. 2556/S. 1016, the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act S. 1850, the Protecting Jessica Grubbs Legacy Act H.R. 3545, the Overdose Prevention and Patient Safety Act Docket ID: SAMHSA-4162-20, Confidentiality of Substance Use Disorder Patient Records Issues relating to the reauthorization of the Childrens Health Insurance Program H.R. 3192/S. 2253, the CHIP Mental Health Parity Act S. 774, the Trauma-Informed Care for Children and Families Act H.R. 4778/S. 2301, the Behavioral Health Coverage Transparency Act S. 2406/H.R. 5002, the Advancing Cutting-Edge (ACE) Research Act H.R. 5102/S. 2524, the Substance use Disorder Workforce Loan Repayment Act Issues relating to market stabilization for the Affordable Care Act Issues related to opioids. Issues related to gun violence and mental health, in general H.R. 2276/S. 2575, the Audiology Patient Choice Act H.R. 6, SUPPORT for Patients and Communities Act S. 2680, the Opioid Crisis Response Act H.R. 994, the Examining Opioid Treatment Infrastructure Act H.R. 1375, a bill to amend the Public Health Service Act to authorize the Secretary of Health of Human Services to award grants to States (or collaborations of States) to establish, expand, or maintain a comprehensive regional, State, or municipal system to provide training, education, consultation, and other resources to prescribers relating to patient pain, substance misuse, and substance abuse disorders, and for other purposes. S. 581/H.R. 5009, Jessie's Law H.R. 2077, theRestoring the Patient's Voice Act H.R. 2345, the National Suicide Hotline Improvement Act S. 1354, a bill to establish an Individual Market Reinsurance fund to provide funding for State individual market stabilization reinsurance programs. H.R. 3692, the Addiction Treatment Access Improvement Act H.R. 3931/S.1905, the Excellence in Mental Health and Addiction Treatment Expansion Act H.R. 4733/S. 2260, the Opioids and STOP Pain Initiative Act S. 2317, a bill to amend the Controlled Substances Act to provide for additional flexibility with respect to medication-assisted treatment for opioid use disorders, and for other purposes. H.R. 4903, Combating Opioid Misuse By Advancing Treatment (COMBAT) Act H.R. 5083, the Expanding Access to Evidence-Based Opioid Treatment for Seniors Act H.R. 5327, the Comprehensive Opioid Recovery Centers Act H.R. 5385/S. 2597, the Children's Hospital GME Support Reauthorization Act S. 2606, the Opioid ECHO Act H.R. 5795, the Overdose Prevention and Patient Safety Act H.R. 5483, the Special Registration for Telemedicine Clarification Act H.R. 6082, the Overdose Prevention and Patient Safety Act S.3337, the Mental Health Services for Students Act H.R.6597, the Mental Health Professionals Workforce Shortage Loan Repayment Act Issues relating to suicide prevention; in general Issues relating to the enforcement of mental health parity; in general

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Justice, Dept of (DOJ), Natl Institutes of Health (NIH), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), U.S. Immigration & Customs Enforcement (ICE), Veterans Affairs, Dept of (VA)

H.R. 1173/S. 448, the Medicare Mental Health Access Act H.R. 849, the Protecting Seniors Access to Medicare Act S. 1301/H.R. 2267, the Resident Physician Shortage Reduction Act H.R. 2276/S. 2575, the Audiology Patient Choice Act H.R. 5594, the Improving Access to Remote Behavioral Health Treatment Act of 2018 S. 2680, the Opioid Crisis Response Act of 2018 H.R. 6, the SUPPORT for Patients and Communities Act H.R. 1925, the At-Risk Youth Medicaid Protection Act H.R. 2509, the Medicare Mental Health Inpatient Equity Act S. 1169, the Medicaid Coverage for Addiction Recovery Expansion Act H.R. 2687, the Medicaid Coverage for Addiction Recovery Expansion Act H.R. 4005, the Medicaid Reentry Act H.R. 4097, the Medicare Beneficiary Opioid Addiction Treatment Act S. 2843/H.R. 5818, the Opioid Workforce Act of 2018 Comments re: the Centers for Medicare & Medicaid Services (CMS) decision to suspend the risk adjustment payments to insurers participating in the individual and small-group marketplaces, as mandated by the Affordable Care Act Support for S.J.Res.63, a joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Secretary of the Treasury, Secretary of Labor, and Secretary of Health and Human Services relating to "Short-Term, Limited Duration Insurance. Comments re: CMSs proposed rule, Revisions to Payment Policies under the Medicare Physician Fee Schedule, Quality Payment Program and Other Revisions to Part B for CY 2019. CMS-1693-P Comments re: CMSs proposed rule, Medicare Program; Medicare Shared Savings Program; Accountable Care Organizations-Pathways to Success. Issue relating to suicide prevention; in general Issues relating to the enforcement of mental health parity; in general

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Justice, Dept of (DOJ), Natl Institutes of Health (NIH), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), U.S. Immigration & Customs Enforcement (ICE), Veterans Affairs, Dept of (VA)

H.R. 2276/S. 2575, the "Audiology Patient Choice Act," all provisions. Medicare physician payment reform and implementation of the Medicare and CHIP Reauthorization Act of 2015, in general. Medicare physician payment reform and implementation of the Medicare and CHIP Reauthorization Act of 2015 related to the cost domain of the Merit-based Incentive Payment System. H.R. 1156, the "Patient Access to Higher Quality Health Care Act of 2017," all provisions. H.R. 849/S. 260, the "Protecting Seniors' Access to Medicare Act of 2017," all provisions. Comments outlining concern with the November 2017 Medicare Payment Advisory Commission (MedPAC) discussion titled, "Rebalancing the physician fee schedule towards primary care services." Issues pertaining to scope of practice, in general. Comments urging the Centers for Medicare and Medicaid Services (CMS) to reduce the 2018 Merit-based Incentive Payment System (MIPS) reporting period from a calendar year to a minimum of 90 consecutive days. Comments on the Medicare Hospital IPPS FY 2019 Proposed Rule communicating concerns about the agencys plans to remove the Public Health and Clinical Data Exchange objective by 2022. Comments urging leaders of the U.S. Senate Committee on Finance not to co-sponsor and oppose any efforts to advance the "Audiology Patient Choice Act" (S. 2575). Comments to the Centers for Medicare and Medicaid Services (CMS) regarding Medicare's designation of CPT Code 31241 Nasal/sinus endoscopy, surgical; with ligation of sphenopalatine artery. Coalition letter to leaders of the U.S. House Committees on Ways & Means and Energy & Commerce regarding the Medicare Appropriate Use Criteria (AUC) Program for Advanced Diagnostic Imaging. Coalition letter to leaders of the U.S. Senate Committee on Finance regarding the Medicare Appropriate Use Criteria (AUC) Program for Advanced Diagnostic Imaging. Coalition letter to U.S. House Committees on Ways & Means and Energy and Commerce and U.S. Senate Committee on Finance regarding payment cuts for clinical lab tests in the Medicare program. Coalition letter to the CMS Administrator urging HHS to allow eligible clinicians utilizing a certified electronic health record to participate in a clinician-led qualified clinical data registry to qualify them as fully achieving all points from the MIPS program. Coalition letter to the CMS Administrator regarding the Evaluation and Management coding and payment recommendations included in the CY19 Medicare Physician Fee Schedule Proposed Rule. Coalition letter to U.S. House of Representatives requesting support of a letter to HHS Secretary Alex Azar regarding data information blocking guidelines as related to Qualified Clinical Data Registries. Comments on the CY19 Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System proposed rule communicating support for proposed changes to reduce site of service disparities, as well as removal of CPT 31241 (Nasal/sinus endoscopy, surgical; with ligation of sphenopalatine artery) from the Inpatient Only List. Comments on the CY19 Medicare Physician Fee Schedule Proposed Rule regarding the proposed changes to documentation requirements, coding and payment for Evaluation and Management (E/M) services, application of the MPPR to E/M services, and the pricing and composition of balloon sinus surgery kits.

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

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

PL 109-417 - Pandemic and All-Hazards Preparedness Act (PAHPA) PL 114-10 - Medicare and CHIP Reauthorization Act of 2017 Implementation H.R. 6 - SUPPORT for Patients and Communities Act H.R. 5507 - Critical Access Hospital Relief Act of 2018 H. R. 5809 - Postoperative Opioid Prevention Act of 2018 H.R 4143/S. 2065 - Dialysis PATIENTS Demonstration Act of 2017 S. 2852/H.R. 6378 - Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018 H.R. 5385 - Children's Hospital GME Support Reauthorization Act of 2018 S. 2809 - A bill to amend title XVIII of the Social Security Act to provide for electronic prior authorization under Medicare part D for covered part D drugs, and for other purposes. H.R. 5106 - Investor Choice Against Gun Proliferation Act H.R.1057 - STOP Act of 2017 H.R. 1822, 1876/S. 781 - Good Samaritan Health Professionals Act of 2017 H.R. 880/S. 1022 - Mission Zero Act H.R. 1017/S. 479 - Removing Barriers to Colorectal Cancer Screening Act of 2017 H.R. 820/S. 292 - Childhood Cancer STAR Act H.R. 5160 - Cancer Care Planning and Communications Act of 2018 H.R. 1704 - ACCESS Act of 2017 H.R. 2267 - Resident Physician Shortage Reduction Act of 2017 H.R. 1676/S. 693 - Palliative Care and Hospice Education and Training Act H.R. 4909/S. 2495 - STOP School Violence Act of 2018 H.R. 4841 - Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018 H.R. 4206/S. 2051 - Medicare Care Coordination Improvement Act H.R. 1892 - Bipartisan Budget Act of 2018 H.R. 1625 - Omnibus H.R. 2906/S. 1351 - Ensuring Access to General Surgery Act of 2017 H.R. 4434/S.2135 - Fix NICS Act of 2017 H.R. 548/S. 527 - Health Care Safety Net Enhancement Act of 2017 H.R. 849/S. 260, S. 251 - Protecting Seniors' Access to Medicare Act of 2017 H.R. 2843/S.1317 - Medicaid and CHIP Quality Improvement Act of 2017 H.R. 3120 - Electronic Health Record Meaningful Use H.R. 2276/S.2575 - Audiology Patient Choice Act of 2018 H.R. 6157 - Department of Defense and Labor, Health and Human Services, and Education Appropriations Act, 2019 and Continuing Appropriations Act, 2019 H.R. 6545 - Violence Against Women Reauthorization Act of 2018 H.R. 6808 - Patient Navigation Assistance Act of 2018 Medicaid GME Transparency Act Bleeding Control for the Injured (Stop The Bleed campaign) Injury Prevention Initiatives Childrens Health Insurance Program Reauthorization Cancer Research and Funding Opioids EHR Clinician Burden/Administrative Burden Mis-valued Codes Medicare Sequestration Congenital Anomalies Global Codes Qualified clinical data registry (QCDR) Consumer Assessment of Healthcare Providers and Systems Surgical Care Survey (S-CAHPS) VA Health Issues DOD Health Issues The Emergency Medical Services for Children Program MIPS cost measure development E-Prior Authorization Digital health systems Sports Medicine Firearms Research Hospital-based violence intervention programs National Trauma System (Military-Civilian Trauma Care) Visa Denial Medicare Fraud Surprise Billing Draft Legislation Stark Law Reform and Medicare Administrative Burden relief Alternative Payment Models (APMs) Physician Fee Schedule

Client expense: $28,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Veterans Affairs, Dept of (VA)

PL 109-417 - Pandemic and All-Hazards Preparedness Act (PAHPA) PL 114-10 - Medicare and CHIP Reauthorization Act of 2017 Implementation H.R. 6 - SUPPORT for Patients and Communities Act H.R. 5507 - Critical Access Hospital Relief Act of 2018 H. R. 5809 - Postoperative Opioid Prevention Act of 2018 H.R 4143/S. 2065 - Dialysis PATIENTS Demonstration Act of 2017 S. 2852/H.R. 6378 - Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018 H.R. 5385 - Children's Hospital GME Support Reauthorization Act of 2018 S. 2809 - A bill to amend title XVIII of the Social Security Act to provide for electronic prior authorization under Medicare part D for covered part D drugs, and for other purposes. H.R. 5106 - Investor Choice Against Gun Proliferation Act H.R.1057 - STOP Act of 2017 H.R. 1822, 1876/S. 781 - Good Samaritan Health Professionals Act of 2017 H.R. 880/S. 1022 - Mission Zero Act H.R. 1017/S. 479 - Removing Barriers to Colorectal Cancer Screening Act of 2017 H.R. 820/S. 292 - Childhood Cancer STAR Act H.R. 5160 - Cancer Care Planning and Communications Act of 2018 H.R. 1704 - ACCESS Act of 2017 H.R. 2267 - Resident Physician Shortage Reduction Act of 2017 H.R. 1676/S. 693 - Palliative Care and Hospice Education and Training Act H.R. 4909/S. 2495 - STOP School Violence Act of 2018 H.R. 4841 - Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018 H.R. 4206/S. 2051 - Medicare Care Coordination Improvement Act H.R. 1892 - Bipartisan Budget Act of 2018 H.R. 1625 - Omnibus H.R. 2906/S. 1351 - Ensuring Access to General Surgery Act of 2017 H.R. 4434/S.2135 - Fix NICS Act of 2017 H.R. 548/S. 527 - Health Care Safety Net Enhancement Act of 2017 H.R. 849/S. 260, S. 251 - Protecting Seniors' Access to Medicare Act of 2017 H.R. 2843/S.1317 - Medicaid and CHIP Quality Improvement Act of 2017 H.R. 3120 - Electronic Health Record Meaningful Use H.R. 2276/S.2575 - Audiology Patient Choice Act of 2018 H.R. 6157 - Department of Defense and Labor, Health and Human Services, and Education Appropriations Act, 2019 and Continuing Appropriations Act, 2019 H.R. 6545 - Violence Against Women Reauthorization Act of 2018 H.R. 6808 - Patient Navigation Assistance Act of 2018 Medicaid GME Transparency Act Bleeding Control for the Injured (Stop The Bleed campaign) Injury Prevention Initiatives Childrens Health Insurance Program Reauthorization Cancer Research and Funding Opioids EHR Clinician Burden/Administrative Burden Mis-valued Codes Medicare Sequestration Congenital Anomalies Global Codes Qualified clinical data registry (QCDR) Consumer Assessment of Healthcare Providers and Systems Surgical Care Survey (S-CAHPS) VA Health Issues DOD Health Issues The Emergency Medical Services for Children Program MIPS cost measure development E-Prior Authorization Digital health systems Sports Medicine Firearms Research Hospital-based violence intervention programs National Trauma System (Military-Civilian Trauma Care) Visa Denial Medicare Fraud Surprise Billing Draft Legislation Stark Law Reform and Medicare Administrative Burden relief Alternative Payment Models (APMs) Physician Fee Schedule

Client expense: $28,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Veterans Affairs, Dept of (VA)

PL 109-417 - Pandemic and All-Hazards Preparedness Act (PAHPA) PL 114-10 - Medicare and CHIP Reauthorization Act of 2017 Implementation H.R. 6 - SUPPORT for Patients and Communities Act H.R. 5507 - Critical Access Hospital Relief Act of 2018 H. R. 5809 - Postoperative Opioid Prevention Act of 2018 H.R 4143/S. 2065 - Dialysis PATIENTS Demonstration Act of 2017 S. 2852/H.R. 6378 - Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018 H.R. 5385 - Children's Hospital GME Support Reauthorization Act of 2018 S. 2809 - A bill to amend title XVIII of the Social Security Act to provide for electronic prior authorization under Medicare part D for covered part D drugs, and for other purposes. H.R. 5106 - Investor Choice Against Gun Proliferation Act H.R.1057 - STOP Act of 2017 H.R. 1822, 1876/S. 781 - Good Samaritan Health Professionals Act of 2017 H.R. 880/S. 1022 - Mission Zero Act H.R. 1017/S. 479 - Removing Barriers to Colorectal Cancer Screening Act of 2017 H.R. 820/S. 292 - Childhood Cancer STAR Act H.R. 5160 - Cancer Care Planning and Communications Act of 2018 H.R. 1704 - ACCESS Act of 2017 H.R. 2267 - Resident Physician Shortage Reduction Act of 2017 H.R. 1676/S. 693 - Palliative Care and Hospice Education and Training Act H.R. 4909/S. 2495 - STOP School Violence Act of 2018 H.R. 4841 - Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018 H.R. 4206/S. 2051 - Medicare Care Coordination Improvement Act H.R. 1892 - Bipartisan Budget Act of 2018 H.R. 1625 - Omnibus H.R. 2906/S. 1351 - Ensuring Access to General Surgery Act of 2017 H.R. 4434/S.2135 - Fix NICS Act of 2017 H.R. 548/S. 527 - Health Care Safety Net Enhancement Act of 2017 H.R. 849/S. 260, S. 251 - Protecting Seniors' Access to Medicare Act of 2017 H.R. 2843/S.1317 - Medicaid and CHIP Quality Improvement Act of 2017 H.R. 3120 - Electronic Health Record Meaningful Use H.R. 2276/S.2575 - Audiology Patient Choice Act of 2018 H.R. 6157 - Department of Defense and Labor, Health and Human Services, and Education Appropriations Act, 2019 and Continuing Appropriations Act, 2019 H.R. 6545 - Violence Against Women Reauthorization Act of 2018 H.R. 6808 - Patient Navigation Assistance Act of 2018 Medicaid GME Transparency Act Bleeding Control for the Injured (Stop The Bleed campaign) Injury Prevention Initiatives Childrens Health Insurance Program Reauthorization Cancer Research and Funding Opioids EHR Clinician Burden/Administrative Burden Mis-valued Codes Medicare Sequestration Congenital Anomalies Global Codes Qualified clinical data registry (QCDR) Consumer Assessment of Healthcare Providers and Systems Surgical Care Survey (S-CAHPS) VA Health Issues DOD Health Issues The Emergency Medical Services for Children Program MIPS cost measure development E-Prior Authorization Digital health systems Sports Medicine Firearms Research Hospital-based violence intervention programs National Trauma System (Military-Civilian Trauma Care) Visa Denial Medicare Fraud Surprise Billing Draft Legislation Stark Law Reform and Medicare Administrative Burden relief Alternative Payment Models (APMs) Physician Fee Schedule

Client expense: $182,400 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Veterans Affairs, Dept of (VA)

PL 109-417 - Pandemic and All-Hazards Preparedness Act (PAHPA) PL 114-10 - Medicare and CHIP Reauthorization Act of 2017 Implementation H.R. 6 - SUPPORT for Patients and Communities Act H.R. 5507 - Critical Access Hospital Relief Act of 2018 H. R. 5809 - Postoperative Opioid Prevention Act of 2018 H.R 4143/S. 2065 - Dialysis PATIENTS Demonstration Act of 2017 S. 2852/H.R. 6378 - Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018 H.R. 5385 - Children's Hospital GME Support Reauthorization Act of 2018 S. 2809 - A bill to amend title XVIII of the Social Security Act to provide for electronic prior authorization under Medicare part D for covered part D drugs, and for other purposes. H.R. 5106 - Investor Choice Against Gun Proliferation Act H.R.1057 - STOP Act of 2017 H.R. 1822, 1876/S. 781 - Good Samaritan Health Professionals Act of 2017 H.R. 880/S. 1022 - Mission Zero Act H.R. 1017/S. 479 - Removing Barriers to Colorectal Cancer Screening Act of 2017 H.R. 820/S. 292 - Childhood Cancer STAR Act H.R. 5160 - Cancer Care Planning and Communications Act of 2018 H.R. 1704 - ACCESS Act of 2017 H.R. 2267 - Resident Physician Shortage Reduction Act of 2017 H.R. 1676/S. 693 - Palliative Care and Hospice Education and Training Act H.R. 4909/S. 2495 - STOP School Violence Act of 2018 H.R. 4841 - Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018 H.R. 4206/S. 2051 - Medicare Care Coordination Improvement Act H.R. 1892 - Bipartisan Budget Act of 2018 H.R. 1625 - Omnibus H.R. 2906/S. 1351 - Ensuring Access to General Surgery Act of 2017 H.R. 4434/S.2135 - Fix NICS Act of 2017 H.R. 548/S. 527 - Health Care Safety Net Enhancement Act of 2017 H.R. 849/S. 260, S. 251 - Protecting Seniors' Access to Medicare Act of 2017 H.R. 2843/S.1317 - Medicaid and CHIP Quality Improvement Act of 2017 H.R. 3120 - Electronic Health Record Meaningful Use H.R. 2276/S.2575 - Audiology Patient Choice Act of 2018 H.R. 6157 - Department of Defense and Labor, Health and Human Services, and Education Appropriations Act, 2019 and Continuing Appropriations Act, 2019 H.R. 6545 - Violence Against Women Reauthorization Act of 2018 H.R. 6808 - Patient Navigation Assistance Act of 2018 Medicaid GME Transparency Act Bleeding Control for the Injured (Stop The Bleed campaign) Injury Prevention Initiatives Childrens Health Insurance Program Reauthorization Cancer Research and Funding Opioids EHR Clinician Burden/Administrative Burden Mis-valued Codes Medicare Sequestration Congenital Anomalies Global Codes Qualified clinical data registry (QCDR) Consumer Assessment of Healthcare Providers and Systems Surgical Care Survey (S-CAHPS) VA Health Issues DOD Health Issues The Emergency Medical Services for Children Program MIPS cost measure development E-Prior Authorization Digital health systems Sports Medicine Firearms Research Hospital-based violence intervention programs National Trauma System (Military-Civilian Trauma Care) Visa Denial Medicare Fraud Surprise Billing Draft Legislation Stark Law Reform and Medicare Administrative Burden relief Alternative Payment Models (APMs) Physician Fee Schedule

Client expense: $182,400 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Veterans Affairs, Dept of (VA)

Hearing Health Care Services. S. 2575/H.R. 2276, Audiology Patient Choice Act of 2018: Proposal to expand access to hearing health care services for Medicare beneficiaries. Hearing Aids. H.R. 3426, Medicare Hearing Aid Coverage Act: Proposal to provide Medicare coverage of hearing aids. Medicare Dental, Vision, and Hearing Coverage. H.R. 508, Seniors Have Eyes, Ears and Teeth Act and H.R. 3111, Medicare Dental, Vision, and Hearing Benefit Act of 2017: Proposals to expand Medicare coverage to include comprehensive coverage of dental, vision, and hearing care. Medicare Observation Status. S. 568/H.R. 1421, Improving Access to Medicare Coverage Act of 2017: Proposal to count days in the hospital in observation status toward meeting the three-day prior hospitalization requirement for skilled nursing facility care eligibility. Dementia and Alzheimers. S. 2076/H.R. 4256, Building Our Largest Dementia Infrastructure for Alzheimers Act (BOLD Act): Proposal to apply a public health approach to combat Alzheimers disease and related dementias. Alzheimers Disease. S. 2387/H.R. 4957, Concentrating on High-Value Alzheimers Needs to Get to an End (CHANGE) Act of 2018: Proposal to aid Alzheimers disease suffers, their families and caregivers, including authorization of a cognitive impairment detection benefit in the Medicare annual wellness visit and initial preventive physical examination. Drug Price Negotiation. S. 2011/H.R. 4138, Medicare Drug Price Negotiation Act: Proposals to lower prescription drug prices in the Medicare Part D program, including allowing Medicare to negotiate directly with prescription drug manufacturers and requiring drug manufacturers to rebate to the federal government for drugs covered under Medicare Part D for low-income Medicare beneficiaries. Generic Drug Introduction. S. 974/H.R. 2212, CREATES Act: Proposal to speed the introduction of generic competition by curbing brand drug maker abuses of safety procedures as a means to limit generic manufacturer access to the drug samples needed to obtain Food and Drug Administration approval. Opioid Treatment. H.R. 6, SUPPORT for Patients and Communities Act: Section 2005 proposals related to Medicare coverage of certain services furnished by opioid treatment programs. Medicare Beneficiary Equitable Relief. (No bill): Efforts to extend and make permanent the Centers for Medicare and Medicaid Services policy for equitable relief for select individuals currently or previously enrolled in Marketplace plans who delayed Medicare enrollment during their Initial Enrollment Period or during a qualifying Special Enrollment Period. Medicare Physician Payment. (No bill): Proposal to collapse the current five levels of payments for office visits (Evaluation and Management) into two levels. Medicare and Medicaid Protection. S. 3330, Medicare and Medicaid Protection Act: Proposed changes to budget reconciliation legislation affecting Medicare and Medicaid program protections. Medicaid Protection. (No bill): Proposals requiring Medicaid recipients to work and ending homecare workers rights to make deductions from their pay for health care and union dues. Medicare Prescription Drug Costs. (May be attached to several legislative vehicles.) Proposals to reduce amount drug manufacturers must contribute to closing the donut hole. Medicare Prescription Drug Costs. S. 2553, Know the Lowest Price Act of 2018: Proposal to prohibit Medicare Advantage plans from putting clauses in contracts with pharmacists prohibiting them from disclosing to beneficiaries when a drug is less expensive if the beneficiary doesnt use his or her insurance. Medicare Part B Drug Costs. H.R. 5150, Protecting Medicare from Excessive Price Increases Act of 2018: Proposal to reduce Medicare Part B drug costs by requiring Medicare to rebate to the government the amount by which a drug price increase exceeds an inflation limit. Medicare Open Enrollment. (No bill). Efforts to ensure the Centers for Medicare and Medicaid Services conducts open enrollment in a way that is unbiased toward the traditional program.

Client expense: $210,000 · Firm income: Not reported

Government targets: Administration on Aging, Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Economic Council (NEC), Office of Management & Budget (OMB), SENATE, Social Security Administration (SSA), Treasury, Dept of

Medicare reform; HR2276; S.2575; audiology patient choice act

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), SENATE

General Medicare Protection, Prevention of Fraud, Waste, and Abuse: H.R. 2460 and H.R. 4841 and H.R. 4704, Prescription Drug Re-Importation: S. 92 and S. 469 and H.R. 1245, Negotiation of Prescription Drug Prices: H.R. 242 and S. 41, General Prescription Drug Affordability: S. 124 and S. 771 and H.R. 1776 and H.R. 4138 and H.R. 4116 and H.R. 4117 and S. 2011 and S. 974 and H.R. 2212 and S. 2553, Medicare Enrollment Simplification: H.R. 2575 and S. 1909, Expanding Medicare Coverage: H.R. 5083 and H.R. 4957 and S. 2387 and H.R. 807 and H.R. 3098 and H.R. 4701 and H.R. 508 and H.R. 2276 and S. 2575 and H.R. 5083.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1173/S. 448, the Medicare Mental Health Access Act H.R. 849, the Protecting Seniors Access to Medicare Act S. 1301/H.R. 2267, the Resident Physician Shortage Reduction Act H.R. 2276/S. 2575, the Audiology Patient Choice Act H.R. 5594, the Improving Access to Remote Behavioral Health Treatment Act of 2018 S. 2680, the Opioid Crisis Response Act of 2018 H.R. 6, the SUPPORT for Patients and Communities Act H.R. 1925, the At-Risk Youth Medicaid Protection Act H.R. 2509, the Medicare Mental Health Inpatient Equity Act S. 1169, the Medicaid Coverage for Addiction Recovery Expansion Act H.R. 2687, the Medicaid Coverage for Addiction Recovery Expansion Act H.R. 4005, the Medicaid Reentry Act H.R. 4097, the Medicare Beneficiary Opioid Addiction Treatment Act

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Natl Institutes of Health (NIH), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), U.S. Immigration & Customs Enforcement (ICE), Veterans Affairs, Dept of (VA)

Issues related to implementation of the 21st Century Cures Act (Public Law No: 114-255); in general H.R. 5311/S. 2456, the CARA 2.0 Act of 2018 H.R. 2556/S. 1016, the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act S. 1850, the Protecting Jessica Grubbs Legacy Act H.R. 3545, the Overdose Prevention and Patient Safety Act Docket ID: SAMHSA-4162-20, Confidentiality of Substance Use Disorder Patient Records Issues relating to the reauthorization of the Childrens Health Insurance Program H.R. 3192/S. 2253, the CHIP Mental Health Parity Act S. 774, the Trauma-Informed Care for Children and Families ActH.R. 4778/S. 2301, the Behavioral Health Coverage Transparency Act S. 2406/H.R. 5002, the Advancing Cutting-Edge (ACE) Research Act H.R. 5102/S. 2524, the Substance use Disorder Workforce Loan Repayment Act Issues relating to market stabilization for the Affordable Care Act Issues related to opioids. Issues related to gun violence and mental health, in general H.R. 2276/S. 2575, the Audiology Patient Choice Act H.R. 6, SUPPORT for Patients and Communities Act S. 2680, the Opioid Crisis Response Act of 2018 H.R. 994, the Examining Opioid Treatment Infrastructure Act H.R. 1375, a bill to amend the Public Health Service Act to authorize the Secretary of Health of Human Services to award grants to States (or collaborations of States) to establish, expand, or maintain a comprehensive regional, State, or municipal system to provide training, education, consultation, and other resources to prescribers relating to patient pain, substance misuse, and substance abuse disorders, and for other purposes. S. 581/H.R. 5009, Jessie's Law H.R. 2077, theRestoring the Patient's Voice Act H.R. 2345, the National Suicide Hotline Improvement Act S. 1354, a bill to establish an Individual Market Reinsurance fund to provide funding for State individual market stabilization reinsurance programs. H.R. 3692, the Addiction Treatment Access Improvement Act H.R. 3931/S.1905, the Excellence in Mental Health and Addiction Treatment Expansion Act H.R. 4733/S. 2260, the Opioids and STOP Pain Initiative Act H.R. 4778/S. 2301, Behavioral Health Coverage Transparency Act S. 2317, a bill to amend the Controlled Substances Act to provide for additional flexibility with respect to medication-assisted treatment for opioid use disorders, and for other purposes. H.R. 4903, Combating Opioid Misuse By Advancing Treatment (COMBAT) Act H.R. 5083, the Expanding Access to Evidence-Based Opioid Treatment for Seniors Act H.R. 5327, the Comprehensive Opioid Recovery Centers Act H.R. 5385/S. 2597, the Children's Hospital GME Support Reauthorization Act S. 2606, the Opioid ECHO Act H.R. 5795, the Overdose Prevention and Patient Safety Act H.R. 5483, the Special Registration for Telemedicine Clarification Act H.R. 6082, the Overdose Prevention and Patient Safety Act

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Natl Institutes of Health (NIH), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), U.S. Immigration & Customs Enforcement (ICE), Veterans Affairs, Dept of (VA)

Communication with CMS regarding the potential effects to audiology should the Audiology Patient Choice Act (S. 2575 and H.R. 2276) be enacted into law.

Client expense: Not reported · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS)

H.R. 2276/S. 2575, the "Audiology Patient Choice Act," all provisions. Medicare physician payment reform and implementation of the Medicare and CHIP Reauthorization Act of 2015, in general. Medicare physician payment reform and implementation of the Medicare and CHIP Reauthorization Act of 2015 related to the cost domain of the Merit-based Incentive Payment System. H.R. 1156, the "Patient Access to Higher Quality Health Care Act of 2017," all provisions. H.R. 849/S. 260, the "Protecting Seniors' Access to Medicare Act of 2017," all provisions. Comments outlining concern with the November 2017 Medicare Payment Advisory Commission (MedPAC) discussion titled, "Rebalancing the physician fee schedule towards primary care services." Issues pertaining to scope of practice, in general. Comments urging the Centers for Medicare and Medicaid Services (CMS) to reduce the 2018 Merit-based Incentive Payment System (MIPS) reporting period from a calendar year to a minimum of 90 consecutive days. Comments on the Medicare Hospital IPPS FY 2019 Proposed Rule communicating concerns about the agencys plans to remove the Public Health and Clinical Data Exchange objective by 2022. Comments urging leaders of the U.S. Senate Committee on Finance not to co-sponsor and oppose any efforts to advance the "Audiology Patient Choice Act" (S. 2575). Comments to the Centers for Medicare and Medicaid Services (CMS) regarding Medicare's designation of CPT Code 31241 Nasal/sinus endoscopy, surgical; with ligation of sphenopalatine artery.

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

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

PL 109-417 - Pandemic and All-Hazards Preparedness Act (PAHPA) PL 114-10 - Medicare and CHIP Reauthorization Act of 2017 Implementation H.R. 6 - SUPPORT for Patients and Communities Act H.R. 5507 - Critical Access Hospital Relief Act of 2018 H. R. 5809 - Postoperative Opioid Prevention Act of 2018 H.R 4143/S. 2065 - Dialysis PATIENTS Demonstration Act of 2017 S. 2852 - Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018 H.R. 5385 - Children's Hospital GME Support Reauthorization Act of 2018 S. 2809 - A bill to amend title XVIII of the Social Security Act to provide for electronic prior authorization under Medicare part D for covered part D drugs, and for other purposes. H.R. 5106 - Investor Choice Against Gun Proliferation Act H.R.1057 - STOP Act of 2017 H.R. 1822, 1876/S. 781 - Good Samaritan Health Professionals Act of 2017 H.R. 880/S. 1022 - Mission Zero Act H.R. 1017/S. 479 - Removing Barriers to Colorectal Cancer Screening Act of 2017 H.R. 820/S. 292 - Childhood Cancer STAR Act H.R. 5160 - Cancer Care Planning and Communications Act of 2018 H.R. 1704 - ACCESS Act of 2017 H.R. 2267 - Resident Physician Shortage Reduction Act of 2017 H.R. 1676/S. 693 - Palliative Care and Hospice Education and Training Act H.R. 4909/S. 2495 - STOP School Violence Act of 2018 H.R. 4841 - Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018 H.R. 4206/S. 2051 - Medicare Care Coordination Improvement Act H.R. 1892 - Bipartisan Budget Act of 2018 H.R. 1625 - Omnibus H.R. 2906/S. 1351 - Ensuring Access to General Surgery Act of 2017 H.R. 4434/S.2135 - Fix NICS Act of 2017 H.R. 548/S. 527 - Health Care Safety Net Enhancement Act of 2017 H.R. 849/S. 260, S. 251 - Protecting Seniors' Access to Medicare Act of 2017 H.R. 2843/S.1317 - Medicaid and CHIP Quality Improvement Act of 2017 H.R. 3120 - Electronic Health Record Meaningful Use H.R. 2276/S.2575 - Audiology Patient Choice Act of 2018 Medicaid GME Transparency Act Bleeding Control for the Injured (Stop The Bleed campaign) Injury Prevention Initiatives Childrens Health Insurance Program Reauthorization Cancer Research and Funding Opioids EHR Clinician Burden/Administrative Burden Mis-valued Codes Medicare Sequestration Congenital Anomalies Global Codes Qualified clinical data registry (QCDR) Consumer Assessment of Healthcare Providers and Systems Surgical Care Survey (S-CAHPS) VA Health Issues DOD Health Issues The Emergency Medical Services for Children Program MIPS cost measure development E-Prior Authorization Digital health systems Sports Medicine Firearms Research Hospital-based violence intervention programs

Client expense: $27,440 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Veterans Affairs, Dept of (VA)

PL 109-417 - Pandemic and All-Hazards Preparedness Act (PAHPA) PL 114-10 - Medicare and CHIP Reauthorization Act of 2017 Implementation H.R. 6 - SUPPORT for Patients and Communities Act H.R. 5507 - Critical Access Hospital Relief Act of 2018 H. R. 5809 - Postoperative Opioid Prevention Act of 2018 H.R 4143/S. 2065 - Dialysis PATIENTS Demonstration Act of 2017 S. 2852 - Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018 H.R. 5385 - Children's Hospital GME Support Reauthorization Act of 2018 S. 2809 - A bill to amend title XVIII of the Social Security Act to provide for electronic prior authorization under Medicare part D for covered part D drugs, and for other purposes. H.R. 5106 - Investor Choice Against Gun Proliferation Act H.R.1057 - STOP Act of 2017 H.R. 1822, 1876/S. 781 - Good Samaritan Health Professionals Act of 2017 H.R. 880/S. 1022 - Mission Zero Act H.R. 1017/S. 479 - Removing Barriers to Colorectal Cancer Screening Act of 2017 H.R. 820/S. 292 - Childhood Cancer STAR Act H.R. 5160 - Cancer Care Planning and Communications Act of 2018 H.R. 1704 - ACCESS Act of 2017 H.R. 2267 - Resident Physician Shortage Reduction Act of 2017 H.R. 1676/S. 693 - Palliative Care and Hospice Education and Training Act H.R. 4909/S. 2495 - STOP School Violence Act of 2018 H.R. 4841 - Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018 H.R. 4206/S. 2051 - Medicare Care Coordination Improvement Act H.R. 1892 - Bipartisan Budget Act of 2018 H.R. 1625 - Omnibus H.R. 2906/S. 1351 - Ensuring Access to General Surgery Act of 2017 H.R. 4434/S.2135 - Fix NICS Act of 2017 H.R. 548/S. 527 - Health Care Safety Net Enhancement Act of 2017 H.R. 849/S. 260, S. 251 - Protecting Seniors' Access to Medicare Act of 2017 H.R. 2843/S.1317 - Medicaid and CHIP Quality Improvement Act of 2017 H.R. 3120 - Electronic Health Record Meaningful Use H.R. 2276/S.2575 - Audiology Patient Choice Act of 2018 Medicaid GME Transparency Act Bleeding Control for the Injured (Stop The Bleed campaign) Injury Prevention Initiatives Childrens Health Insurance Program Reauthorization Cancer Research and Funding Opioids EHR Clinician Burden/Administrative Burden Mis-valued Codes Medicare Sequestration Congenital Anomalies Global Codes Qualified clinical data registry (QCDR) Consumer Assessment of Healthcare Providers and Systems Surgical Care Survey (S-CAHPS) VA Health Issues DOD Health Issues The Emergency Medical Services for Children Program MIPS cost measure development E-Prior Authorization Digital health systems Sports Medicine Firearms Research Hospital-based violence intervention programs

Client expense: $27,440 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Veterans Affairs, Dept of (VA)

PL 109-417 - Pandemic and All-Hazards Preparedness Act (PAHPA) PL 114-10 - Medicare and CHIP Reauthorization Act of 2017 Implementation H.R. 6 - SUPPORT for Patients and Communities Act H.R. 5507 - Critical Access Hospital Relief Act of 2018 H. R. 5809 - Postoperative Opioid Prevention Act of 2018 H.R 4143/S. 2065 - Dialysis PATIENTS Demonstration Act of 2017 S. 2852 - Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018 H.R. 5385 - Children's Hospital GME Support Reauthorization Act of 2018 S. 2809 - A bill to amend title XVIII of the Social Security Act to provide for electronic prior authorization under Medicare part D for covered part D drugs, and for other purposes. H.R. 5106 - Investor Choice Against Gun Proliferation Act H.R.1057 - STOP Act of 2017 H.R. 1822, 1876/S. 781 - Good Samaritan Health Professionals Act of 2017 H.R. 880/S. 1022 - Mission Zero Act H.R. 1017/S. 479 - Removing Barriers to Colorectal Cancer Screening Act of 2017 H.R. 820/S. 292 - Childhood Cancer STAR Act H.R. 5160 - Cancer Care Planning and Communications Act of 2018 H.R. 1704 - ACCESS Act of 2017 H.R. 2267 - Resident Physician Shortage Reduction Act of 2017 H.R. 1676/S. 693 - Palliative Care and Hospice Education and Training Act H.R. 4909/S. 2495 - STOP School Violence Act of 2018 H.R. 4841 - Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018 H.R. 4206/S. 2051 - Medicare Care Coordination Improvement Act H.R. 1892 - Bipartisan Budget Act of 2018 H.R. 1625 - Omnibus H.R. 2906/S. 1351 - Ensuring Access to General Surgery Act of 2017 H.R. 4434/S.2135 - Fix NICS Act of 2017 H.R. 548/S. 527 - Health Care Safety Net Enhancement Act of 2017 H.R. 849/S. 260, S. 251 - Protecting Seniors' Access to Medicare Act of 2017 H.R. 2843/S.1317 - Medicaid and CHIP Quality Improvement Act of 2017 H.R. 3120 - Electronic Health Record Meaningful Use H.R. 2276/S.2575 - Audiology Patient Choice Act of 2018 Medicaid GME Transparency Act Bleeding Control for the Injured (Stop The Bleed campaign) Injury Prevention Initiatives Childrens Health Insurance Program Reauthorization Cancer Research and Funding Opioids EHR Clinician Burden/Administrative Burden Mis-valued Codes Medicare Sequestration Congenital Anomalies Global Codes Qualified clinical data registry (QCDR) Consumer Assessment of Healthcare Providers and Systems Surgical Care Survey (S-CAHPS) VA Health Issues DOD Health Issues The Emergency Medical Services for Children Program MIPS cost measure development E-Prior Authorization Digital health systems Sports Medicine Firearms Research Hospital-based violence intervention programs

Client expense: $205,500 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Veterans Affairs, Dept of (VA)

PL 109-417 - Pandemic and All-Hazards Preparedness Act (PAHPA) PL 114-10 - Medicare and CHIP Reauthorization Act of 2017 Implementation H.R. 6 - SUPPORT for Patients and Communities Act H.R. 5507 - Critical Access Hospital Relief Act of 2018 H. R. 5809 - Postoperative Opioid Prevention Act of 2018 H.R 4143/S. 2065 - Dialysis PATIENTS Demonstration Act of 2017 S. 2852 - Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018 H.R. 5385 - Children's Hospital GME Support Reauthorization Act of 2018 S. 2809 - A bill to amend title XVIII of the Social Security Act to provide for electronic prior authorization under Medicare part D for covered part D drugs, and for other purposes. H.R. 5106 - Investor Choice Against Gun Proliferation Act H.R.1057 - STOP Act of 2017 H.R. 1822, 1876/S. 781 - Good Samaritan Health Professionals Act of 2017 H.R. 880/S. 1022 - Mission Zero Act H.R. 1017/S. 479 - Removing Barriers to Colorectal Cancer Screening Act of 2017 H.R. 820/S. 292 - Childhood Cancer STAR Act H.R. 5160 - Cancer Care Planning and Communications Act of 2018 H.R. 1704 - ACCESS Act of 2017 H.R. 2267 - Resident Physician Shortage Reduction Act of 2017 H.R. 1676/S. 693 - Palliative Care and Hospice Education and Training Act H.R. 4909/S. 2495 - STOP School Violence Act of 2018 H.R. 4841 - Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018 H.R. 4206/S. 2051 - Medicare Care Coordination Improvement Act H.R. 1892 - Bipartisan Budget Act of 2018 H.R. 1625 - Omnibus H.R. 2906/S. 1351 - Ensuring Access to General Surgery Act of 2017 H.R. 4434/S.2135 - Fix NICS Act of 2017 H.R. 548/S. 527 - Health Care Safety Net Enhancement Act of 2017 H.R. 849/S. 260, S. 251 - Protecting Seniors' Access to Medicare Act of 2017 H.R. 2843/S.1317 - Medicaid and CHIP Quality Improvement Act of 2017 H.R. 3120 - Electronic Health Record Meaningful Use H.R. 2276/S.2575 - Audiology Patient Choice Act of 2018 Medicaid GME Transparency Act Bleeding Control for the Injured (Stop The Bleed campaign) Injury Prevention Initiatives Childrens Health Insurance Program Reauthorization Cancer Research and Funding Opioids EHR Clinician Burden/Administrative Burden Mis-valued Codes Medicare Sequestration Congenital Anomalies Global Codes Qualified clinical data registry (QCDR) Consumer Assessment of Healthcare Providers and Systems Surgical Care Survey (S-CAHPS) VA Health Issues DOD Health Issues The Emergency Medical Services for Children Program MIPS cost measure development E-Prior Authorization Digital health systems Sports Medicine Firearms Research Hospital-based violence intervention programs

Client expense: $205,500 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Veterans Affairs, Dept of (VA)

Increased funding and focus on the social determinants of health, including food - No specific bill Opposition to proposed cuts to the Supplemental Nutrition Assistance Program - No specific bill HR 496 - S 128 The Bridge Act - DACA protections Separation of Immigrant Children From Their Families - No specific bill Prescription Drug Prices S. 771 - Improving Access to Affordable Prescription Drugs - Legislation that seeks to address prescription drug costs by increasing transparency and accountability, boosting access and affordability of key drugs, spurring innovation, and increasing choice and competition by allowing Medicare to negotiate the price of drugs, among other provisions. Efforts to address the cost of prescription drugs, including proposals to include the manufacturers suggested retail price in direct to consumer advertising of prescription drugs - no specific bill Opioids HR 6 - SUPPORT for Patients and Communities Act HR 1375 - Prescriber Support Act - Grants to states for programs to help prescribers (1) treat and manage patient pain; and (2) prevent, identify, and respond to patient substance misuse and substance abuse disorder HR 3528 - Every Prescription Conveyed Securely Act - mandated eprescribing of controlled substances S. 1554 - Safer Prescribing of Controlled Substances Act - Federal Mandates for Opioid Prescriber Education H.R.5102 - Substance Use Disorder Workforce Loan Repayment Act of 2018 - Federal Student Loan forgiveness for substance abuse prevention and treatment professionals HR 4097 - Medicare Beneficiary Opioid Addiction Treatment Act - access for Medicare beneficiaries to MAT Safe Injection Facilities - no specific bill HR 4778 - S. 2301 Behavioral Health Coverage Transparency Act- requirements for transparency in behavioral health coverage Expanded Access to MAT, Naloxone, treatment, prevention and recovery programs for substance abuse disorder - no specific bill HR 5545/S. 5102 Comprehensive Addiction Resources Emergency (Care) Act of 2018 HR 5311/S. 2456 CARA 2.0 Act of 2018 Physician Burnout & Wellness - no specific bill Gun Violence HR 1832, S.834 - A bill to authorize the appropriation of funds to the Centers for Disease Control and Prevention for conducting or supporting research on firearms safety or gun violence prevention. S. 2546 - Making America Safe and Secure Act of 2018 - MASS Act S. 1701 - Fair Access to Science and Technology Act - changes to copyright protections for publications Changes to Sunshine Act Regarding Patient education materials - no specific bill Telemedicine S. 870 - Creating High Quality Results and Outcomes Necessary to Improve Chronic Care HR 2556 - Connect for Health Act of 2017 S. 2574/HR 2276 - Audiology Patient Choice - oppose changing Medicare reimbursement to include audiologists in definition of physician Regulatory Issues Electronic medical records - efforts to streamline and improve interoperability DEA issues Updated regulations to implement Partial Fill law Updated regulations for Eprescribing of Controlled Substances Department of Labor : Definition of Employer Under Section 3(5) of ERISA - Association Health Plans (RIN 1210-AB85): Proposal creating association health plans Department of Health and Human Services: Protecting Statutory Conscience Rights in Health care, Delegations of Authority. 45 CFR, Part 88, HHS-OCR-2018-0002; RIN 0945-ZA03 Proposed Rule on Short-Term, Limited-Duration Insurance (CMS-9923-P; RIN 0938-AT48) Opposition to Medicaid Point of Care Testing Cuts as part of the Clinical Laboratory Fee Schedule The Office of Population Affairs (OPA), in the Office of the Assistant Secretary for Health, proposes to revise its Title X regulations (Title X of the Public Health Service Act) to ensure compliance with, and enhance implementation of, the statutory requirement that none of the funds appropriated for Title X may be used in programs where abortion is a method of family planning and related statutory requirements. (Docket No.: HHS-OS-2018-0008;42 CFR Part 59; RIN 0937-ZA00 Compliance with Statutory Program Integrity Requirements)

Client expense: $70,000 · Firm income: Not reported

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

Increased funding and focus on the social determinants of health, including food - No specific bill S. 771 - Improving Access to Affordable Prescription Drugs - Legislation that seeks to address prescription drug costs by increasing transparency and accountability, boosting access and affordability of key drugs, spurring innovation, and increasing choice and competition by allowing Medicare to negotiate the price of drugs, among other provisions. Efforts to address the cost of prescription drugs, including proposals to include the manufacturers suggested retail price in direct to consumer advertising of prescription drugs - no specific bill Opioids HR 6 - SUPPORT for Patients and Communities Act HR 1375 - Prescriber Support Act - Grants to states for programs to help prescribers (1) treat and manage patient pain; and (2) prevent, identify, and respond to patient substance misuse and substance abuse disorder HR 3528 - Every Prescription Conveyed Securely Act - mandated eprescribing of controlled substances S. 1554 - Safer Prescribing of Controlled Substances Act - Federal Mandates for Opioid Prescriber Education H.R.5102 - Substance Use Disorder Workforce Loan Repayment Act of 2018 - Federal Student Loan forgiveness for substance abuse prevention and treatment professionals HR 4097 - Medicare Beneficiary Opioid Addiction Treatment Act - access for Medicare beneficiaries to MAT Safe Injection Facilities - no specific bill HR 4778 - S. 2301 Behavioral Health Coverage Transparency Act- requirements for transparency in behavioral health coverage Expanded Access to MAT, Naloxone, treatment, prevention and recovery programs for substance abuse disorder - no specific bill HR 5545/S. 5102 Comprehensive Addiction Resources Emergency (Care) Act of 2018 HR 5311/S. 2456 CARA 2.0 Act of 2018 Physician Burnout & Wellness - no specific bill Telemedicine S. 870 - Creating High Quality Results and Outcomes Necessary to Improve Chronic Care HR 2556 - Connect for Health Act of 2017 S. 2574/HR 2276 - Audiology Patient Choice - oppose changing Medicare reimbursement to include audiologists in definition of physician Regulatory Issues Electronic medical records - efforts to streamline and improve interoperability DEA issues Updated regulations to implement Partial Fill law Updated regulations for Eprescribing of Controlled Substances Department of Health and Human Services: Protecting Statutory Conscience Rights in Health care, Delegations of Authority. 45 CFR, Part 88, HHS-OCR-2018-0002; RIN 0945-ZA03 Opposition to Medicaid Point of Care Testing Cuts as part of the Clinical Laboratory Fee Schedule The Office of Population Affairs (OPA), in the Office of the Assistant Secretary for Health, proposes to revise its Title X regulations (Title X of the Public Health Service Act) to ensure compliance with, and enhance implementation of, the statutory requirement that none of the funds appropriated for Title X may be used in programs where abortion is a method of family planning and related statutory requirements. (Docket No.: HHS-OS-2018-0008;42 CFR Part 59; RIN 0937-ZA00 Compliance with Statutory Program Integrity Requirements)

Client expense: $70,000 · Firm income: Not reported

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

Medicare reform; HR2276; S.2575; audiology patient choice act

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

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

Supported H.R. 2550, the Medicare Telehealth Parity Act which would allow audiologists to be reimbursed by Medicare for services administered via telehealth. The Academy has met with congressional offices on the Access to Frontline Health Care Act (H.R. 2042). This legislation would allow for medical practitioners in certain fields to have some of their student loans covered by the Department of Health and Human Services in exchange for practicing for two years in federally-defined frontline shortage areas. Met with offices on H.R. 2276 and S. 2575, the Audiology Patient Choice Act, to gather information on the legislation and on viability of provisions found within the bill. Contacted CMS to explore effects of regulatory implementation of the Audiology Patient Choice Act on the practice of audiology.

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

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

Hearing Health Care Services. S. 2575/H.R. 2276, Audiology Patient Choice Act of 2018: Proposal to expand access to hearing health care services for Medicare beneficiaries. Hearing Aids. H.R. 3426, Medicare Hearing Aid Coverage Act: Proposal to provide Medicare coverage of hearing aids. Medicare Dental, Vision, and Hearing Coverage. H.R. 508, Seniors Have Eyes, Ears and Teeth Act and H.R. 3111, Medicare Dental, Vision, and Hearing Benefit Act of 2017: Proposals to expand Medicare coverage to include comprehensive coverage of dental, vision, and hearing care. Medicare Observation Status. S. 568/H.R. 1421, Improving Access to Medicare Coverage Act of 2017: Proposal to count days in the hospital in observation status toward meeting the three-day prior hospitalization requirement for skilled nursing facility care eligibility. Opioid Treatment. S. 2704/H.R. 4097, Medicare Beneficiary Opioid Addiction Treatment Act: Proposal to provide for coverage of methadone under Medicare Part B. Dementia and Alzheimers. S. 2076/H.R. 4256, Building Our Largest Dementia Infrastructure for Alzheimers Act (BOLD Act): Proposal to apply a public health approach to combat Alzheimers disease and related dementias; Alzheimers Disease. S. 2387/H.R. 4957, Concentrating on High-Value Alzheimers Needs to Get to an End (CHANGE) Act of 2018: Proposal to aid Alzheimers disease suffers, their families and caregivers, including authorization of a cognitive impairment detection benefit in the Medicare annual wellness visit and initial preventive physical examination. Drug Price Negotiation. S. 2011/H.R. 4138, Medicare Drug Price Negotiation Act: Proposals to lower prescription drug prices in the Medicare Part D program, including allowing Medicare to negotiate directly with prescription drug manufacturers and requiring drug manufacturers to rebate to the federal government for drugs covered under Medicare Part D for low-income Medicare beneficiaries. Generic Drug Introduction. S. 974/H.R. 2212, CREATES Act: Proposal to speed the introduction of generic competition by curbing brand drug maker abuses of safety procedures as a means to limit generic manufacturer access to the drug samples needed to obtain Food and Drug Administration approval. Prescription Drug costs. S. 2553/H.R. 6144, the Know the Lowest Price Act: Proposal to prohibit health plans and pharmacy benefits managers from utilizing contract gag clauses prohibiting pharmacists from disclosing to consumers when it costs less to pay out-of-pocket for a prescription than it would using their insurance coverage. Medicare Part B Drug Costs . H.R. 5150, Protecting Medicare from Excessive Price Increases Act of 2018: Proposal to reduce Medicare Part B drug costs by requiring Medicare to rebate to the government the amount by which a drug price increase exceeds an inflation limit. Medicare Beneficiary Education. (No bill): Efforts to improve the Centers for Medicare and Medicaid outreach and education during open enrollment.

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

Government targets: Administration on Aging, Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Economic Council (NEC), Office of Management & Budget (OMB), President of the U.S., SENATE, Social Security Administration (SSA), Treasury, Dept of, Vice President of the U.S.

General Medicare Protection, Prevention of Fraud, Waste, and Abuse: H.R. 2460 and H.R. 4841 and H.R. 4704, Prescription Drug Re-Importation: S. 92 and S. 469 and H.R. 1245, Negotiation of Prescription Drug Prices: H.R. 242 and S. 41, General Prescription Drug Affordability: S. 124 and S. 771 and H.R. 1776 and H.R. 4138 and H.R. 4116 and H.R. 4117 and S. 2011 and S. 974 and H.R. 2212 and S. 2553, Medicare Enrollment Simplification: H.R. 2575 and S. 1909, Expanding Medicare Coverage: H.R. 5083 and H.R. 4957 and S. 2387 and H.R. 807 and H.R. 3098 and H.R. 4701 and H.R. 508 and H.R. 2276 and S. 2575 and H.R. 5083.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3767/S. 989 - Ensuring Children's Access to Specialty Care Act of 2017 H.R. 2141/S.898 - Conrad State 30 and Physician Access Reauthorization Act H.R.449 - Synthetic Drug Awareness Act of 2017 H.R. 2276 - Audiology Patient Choice Act of 2017 H.R. 2913 - Mental Health in Schools Act H.R. 2290/S. 1357 - The family based care services act H.R. 3552 - Cady Housh and Jason Flatt Teen Suicide Prevention Act of 2017 Legislation opposing the repeal and replacement of the Patient Protection and Affordable Care Act Continued full funding for stabilizing the health insurance marketplace Continued full funding for substance use disorder services programs Protection of Mental Health Parity requirements Safety of vaccines H.R. 3192/S. 2253 The CHIP Mental Health Parity Act H.R. 3931/S. 1950 Excellence in Mental Health and Addiction Treatment Act Funding of the infant and early childhood mental health grant program H.R. 2345 - The National Suicide Hotline Improvement Act of 2017 H.R. 4778/S. 2301 - The Behavioral Health Coverage Transparency Act of 2018 Funding of the Title V Maternal and Child Health (MCH) Service block grant S.1357/H.R. 2290 The Family Based Care Service Act Opposing the policy of separating immigrant children from families

Client expense: $31,250 · Firm income: Not reported

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Natl Institutes of Health (NIH), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), White House Office

H.R. 3767/S. 989 - Ensuring Children's Access to Specialty Care Act of 2017 H.R. 2141/S.898 - Conrad State 30 and Physician Access Reauthorization Act H.R.449 - Synthetic Drug Awareness Act of 2017 H.R. 2276 - Audiology Patient Choice Act of 2017 H.R. 2913 - Mental Health in Schools Act H.R. 2290/S. 1357 - The family based care services act H.R. 3552 - Cady Housh and Jason Flatt Teen Suicide Prevention Act of 2017 Legislation opposing the repeal and replacement of the Patient Protection and Affordable Care Act Continued full funding for stabilizing the health insurance marketplace Continued full funding for substance use disorder services programs Protection of Mental Health Parity requirements Safety of vaccines H.R. 3192/S. 2253 The CHIP Mental Health Parity Act H.R. 3931/S. 1950 Excellence in Mental Health and Addiction Treatment Act Funding of the infant and early childhood mental health grant program H.R. 2345 - The National Suicide Hotline Improvement Act of 2017 H.R. 4778/S. 2301 - The Behavioral Health Coverage Transparency Act of 2018 Funding of the Title V Maternal and Child Health (MCH) Service block grant S.1357/H.R. 2290 The Family Based Care Service Act Opposing the policy of separating immigrant children from families

Client expense: $31,250 · Firm income: Not reported

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Natl Institutes of Health (NIH), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), White House Office

H.R. 1173/S. 448, the "Medicare Mental Health Access Act" H.R. 849, the "Protecting Seniors Access to Medicare Act" S. 1301/H.R. 2267, the Resident Physician Shortage Reduction Act H.R. 2276/S. 2575, the Audiology Patient Choice Act

Client expense: $187,300 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Natl Institutes of Health (NIH), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Veterans Affairs, Dept of (VA)

H.R. 2276/S. 2575, the "Audiology Patient Choice Act," all provisions. Medicare physician payment reform and implementation of the Medicare and CHIP Reauthorization Act of 2015, in general. Medicare physician payment reform and implementation of the Medicare and CHIP Reauthorization Act of 2015 related to the cost domain of the Merit-based Incentive Payment System. H.R. 1156, the "Patient Access to Higher Quality Health Care Act of 2017," all provisions. H.R. 849/S. 260, the "Protecting Seniors' Access to Medicare Act of 2017," all provisions. Comments outlining concern with the November 2017 Medicare Payment Advisory Commission (MedPAC) discussion titled, "Rebalancing the physician fee schedule towards primary care services." Issues pertaining to scope of practice, in general.

Client expense: $160,000 · Firm income: Not reported

Government targets: Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE

PL 109-417 - Pandemic and All-Hazards Preparedness Act (PAHPA) PL 114-10 - Medicare and CHIP Reauthorization Act of 2017 Implementation H.R.1057 - STOP Act of 2017 H.R. 1822, 1876/S. 781 - Good Samaritan Health Professionals Act of 2017 H.R. 880/S. 1022 - Mission Zero Act H.R. 1017/S. 479 - Removing Barriers to Colorectal Cancer Screening Act of 2017 H.R. 820/S. 292 - Childhood Cancer STAR Act H.R. 5160 - Cancer Care Planning and Communications Act of 2018 H.R. 1704 - ACCESS Act of 2017 H.R. 2267 - Resident Physician Shortage Reduction Act of 2017 H.R. 1676/S. 693 - Palliative Care and Hospice Education and Training Act H.R. 4909/S. 2495 - STOP School Violence Act of 2018 H.R. 4841 - Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018 H.R. 4206/S. 2051 - Medicare Care Coordination Improvement Act H.R. 1892 - Bipartisan Budget Act of 2018 H.R. 1625 - Omnibus H.R. 2906/S. 1351 - Ensuring Access to General Surgery Act of 2017 H.R. 4434/S.2135 - Fix NICS Act of 2017 H.R. 548/S. 527 - Health Care Safety Net Enhancement Act of 2017 H.R. 849/S. 260, S. 251 - Protecting Seniors' Access to Medicare Act of 2017 H.R. 2843/S.1317 - Medicaid and CHIP Quality Improvement Act of 2017 H.R. 3120 - Electronic Health Record Meaningful Use H.R. 2276/S.2575 - Audiology Patient Choice Act of 2018 Bleeding Control for the Injured (Stop The Bleed campaign) Injury Prevention Initiatives Childrens Health Insurance Program Reauthorization Cancer Research and Funding Opioids EHR Clinician Burden/Administrative Burden Mis-valued Codes Medicare Sequestration Congenital Anomalies Global Codes Qualified clinical data registry (QCDR) Consumer Assessment of Healthcare Providers and Systems Surgical Care Survey (S-CAHPS) VA Health Issues DOD Health Issues The Emergency Medical Services for Children Program

Client expense: $20,587 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Veterans Affairs, Dept of (VA)

PL 109-417 - Pandemic and All-Hazards Preparedness Act (PAHPA) PL 114-10 - Medicare and CHIP Reauthorization Act of 2017 Implementation H.R.1057 - STOP Act of 2017 H.R. 1822, 1876/S. 781 - Good Samaritan Health Professionals Act of 2017 H.R. 880/S. 1022 - Mission Zero Act H.R. 1017/S. 479 - Removing Barriers to Colorectal Cancer Screening Act of 2017 H.R. 820/S. 292 - Childhood Cancer STAR Act H.R. 5160 - Cancer Care Planning and Communications Act of 2018 H.R. 1704 - ACCESS Act of 2017 H.R. 2267 - Resident Physician Shortage Reduction Act of 2017 H.R. 1676/S. 693 - Palliative Care and Hospice Education and Training Act H.R. 4909/S. 2495 - STOP School Violence Act of 2018 H.R. 4841 - Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018 H.R. 4206/S. 2051 - Medicare Care Coordination Improvement Act H.R. 1892 - Bipartisan Budget Act of 2018 H.R. 1625 - Omnibus H.R. 2906/S. 1351 - Ensuring Access to General Surgery Act of 2017 H.R. 4434/S.2135 - Fix NICS Act of 2017 H.R. 548/S. 527 - Health Care Safety Net Enhancement Act of 2017 H.R. 849/S. 260, S. 251 - Protecting Seniors' Access to Medicare Act of 2017 H.R. 2843/S.1317 - Medicaid and CHIP Quality Improvement Act of 2017 H.R. 3120 - Electronic Health Record Meaningful Use H.R. 2276/S.2575 - Audiology Patient Choice Act of 2018 Bleeding Control for the Injured (Stop The Bleed campaign) Injury Prevention Initiatives Childrens Health Insurance Program Reauthorization Cancer Research and Funding Opioids EHR Clinician Burden/Administrative Burden Mis-valued Codes Medicare Sequestration Congenital Anomalies Global Codes Qualified clinical data registry (QCDR) Consumer Assessment of Healthcare Providers and Systems Surgical Care Survey (S-CAHPS) VA Health Issues DOD Health Issues The Emergency Medical Services for Children Program

Client expense: $20,587 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Veterans Affairs, Dept of (VA)

PL 109-417 - Pandemic and All-Hazards Preparedness Act (PAHPA) PL 114-10 - Medicare and CHIP Reauthorization Act of 2017 Implementation H.R.1057 - STOP Act of 2017 H.R. 1822, 1876/S. 781 - Good Samaritan Health Professionals Act of 2017 H.R. 880/S. 1022 - Mission Zero Act H.R. 1017/S. 479 - Removing Barriers to Colorectal Cancer Screening Act of 2017 H.R. 820/S. 292 - Childhood Cancer STAR Act H.R. 5160 - Cancer Care Planning and Communications Act of 2018 H.R. 1704 - ACCESS Act of 2017 H.R. 2267 - Resident Physician Shortage Reduction Act of 2017 H.R. 1676/S. 693 - Palliative Care and Hospice Education and Training Act H.R. 4909/S. 2495 - STOP School Violence Act of 2018 H.R. 4841 - Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018 H.R. 4206/S. 2051 - Medicare Care Coordination Improvement Act H.R. 1892 - Bipartisan Budget Act of 2018 H.R. 1625 - Omnibus H.R. 2906/S. 1351 - Ensuring Access to General Surgery Act of 2017 H.R. 4434/S.2135 - Fix NICS Act of 2017 H.R. 548/S. 527 - Health Care Safety Net Enhancement Act of 2017 H.R. 849/S. 260, S. 251 - Protecting Seniors' Access to Medicare Act of 2017 H.R. 2843/S.1317 - Medicaid and CHIP Quality Improvement Act of 2017 H.R. 3120 - Electronic Health Record Meaningful Use H.R. 2276/S.2575 - Audiology Patient Choice Act of 2018 Bleeding Control for the Injured (Stop The Bleed campaign) Injury Prevention Initiatives Childrens Health Insurance Program Reauthorization Cancer Research and Funding Opioids EHR Clinician Burden/Administrative Burden Mis-valued Codes Medicare Sequestration Congenital Anomalies Global Codes Qualified clinical data registry (QCDR) Consumer Assessment of Healthcare Providers and Systems Surgical Care Survey (S-CAHPS) VA Health Issues DOD Health Issues The Emergency Medical Services for Children Program

Client expense: $185,387 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Veterans Affairs, Dept of (VA)

PL 109-417 - Pandemic and All-Hazards Preparedness Act (PAHPA) PL 114-10 - Medicare and CHIP Reauthorization Act of 2017 Implementation H.R.1057 - STOP Act of 2017 H.R. 1822, 1876/S. 781 - Good Samaritan Health Professionals Act of 2017 H.R. 880/S. 1022 - Mission Zero Act H.R. 1017/S. 479 - Removing Barriers to Colorectal Cancer Screening Act of 2017 H.R. 820/S. 292 - Childhood Cancer STAR Act H.R. 5160 - Cancer Care Planning and Communications Act of 2018 H.R. 1704 - ACCESS Act of 2017 H.R. 2267 - Resident Physician Shortage Reduction Act of 2017 H.R. 1676/S. 693 - Palliative Care and Hospice Education and Training Act H.R. 4909/S. 2495 - STOP School Violence Act of 2018 H.R. 4841 - Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018 H.R. 4206/S. 2051 - Medicare Care Coordination Improvement Act H.R. 1892 - Bipartisan Budget Act of 2018 H.R. 1625 - Omnibus H.R. 2906/S. 1351 - Ensuring Access to General Surgery Act of 2017 H.R. 4434/S.2135 - Fix NICS Act of 2017 H.R. 548/S. 527 - Health Care Safety Net Enhancement Act of 2017 H.R. 849/S. 260, S. 251 - Protecting Seniors' Access to Medicare Act of 2017 H.R. 2843/S.1317 - Medicaid and CHIP Quality Improvement Act of 2017 H.R. 3120 - Electronic Health Record Meaningful Use H.R. 2276/S.2575 - Audiology Patient Choice Act of 2018 Bleeding Control for the Injured (Stop The Bleed campaign) Injury Prevention Initiatives Childrens Health Insurance Program Reauthorization Cancer Research and Funding Opioids EHR Clinician Burden/Administrative Burden Mis-valued Codes Medicare Sequestration Congenital Anomalies Global Codes Qualified clinical data registry (QCDR) Consumer Assessment of Healthcare Providers and Systems Surgical Care Survey (S-CAHPS) VA Health Issues DOD Health Issues The Emergency Medical Services for Children Program

Client expense: $185,387 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Veterans Affairs, Dept of (VA)

H.R. 3767/S. 989 - Ensuring Children's Access to Specialty Care Act of 2017 H.R. 2141/S.898 - Conrad State 30 and Physician Access Reauthorization Act H.R.449 - Synthetic Drug Awareness Act of 2017 S. 934 - FDA Reauthorization Act of 2017 H.R. 2430 - FDA Reauthorization Act of 2017 H.R. 2276 - Audiology Patient Choice Act of 2017 H.R. 2913 - Mental Health in Schools Act H.R. 2290/S. 1357 - The family based care services act H.R. 3552 - Cady Housh and Jason Flatt Teen Suicide Prevention Act of 2017 Legislation opposing the repeal and replace of the Patient Protection and Affordable Care Act Continued full funding for stabilizing the health insurance marketplace Continued full funding for substance use disorder services programs Protection of Mental Health Parity requirements Safety of vaccines H.R. 3192/S. 2253 The CHIP Mental Health Parity Act H.R. 3931/S. 1950 Excellence in Mental Health and Addiction Treatment Act Funding of the infant and early childhood mental health grant program H.R. 2345 - The National Suicide Hotline Improvement Act of 2017 H.R. 4778/S. 2301 - The Behavioral Health Coverage Transparency Act of 2018

Client expense: $99,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Natl Institutes of Health (NIH), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), White House Office

Medicare reform; HR2276; S.2575; audiology patient choice act

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

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

S. 260 / H.R. 849: Protecting Seniors Access to Medicare Act S. 431 / H.R. 1148: Furthering Access to Stroke Telemedicine (FAST) Act S. 794 / H.R. 3635: Local Coverage Determination Clarification Act S. 870: CHRONIC Care Act S. 1016 / H.R. 2556: CONNECT for Health Act H.R. 1628: American Health Care Act, an amendment in the nature of a substitute [LYN17744] H.R. 2276: Audiology Patient Choice Act Preservation of the in-office ancillary exception to the Stark law; Medicare Red Tape Relief Project; appropriate use criteria for imaging services; Medicare coverage of Oxygen therapy for cluster headaches; urging changes to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).

Client expense: $210,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 92: Safe and Affordable Drugs from Canada Act of 2017 S. 469: Affordable and Safe Prescription Drug Importation Act H.R. 714: Legitimate Use of Medicinal Marijuana Act S. 794: Local Coverage Determination Act of 2017 H.R. 2276: Audiology Patient Choice Act of 2017 H.R. 2439/S. 1131: FAIR Drug Pricing Act H.R. 1776/S. 771: Improving Access to Affordable Prescription Drugs Act Maintenance/expansion of Graduate Medical Education (GME); NIH funding including the BRAIN Initiative; concussion related issues.

Client expense: $380,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare physician payment reform and implementation of the Medicare Access and CHIP Reauthorization Act of 2015, in general. Comments to CMS requesting a deferment from implementing 2015 Edition certified electronic health record technology (CEHRT) until such technology is widely available, and, in no event, sooner than January 2019. Comments re: Advance Notice of Methodological Changes for Calendar Year (CY) 2018 for Medicare Advantage (MA) Capitation Rates, Part C and Part D Payment Policies and 2018 Call Letter (Call Letter). H.R.1156, the "Patient Access to Higher Quality Health Care Act of 2017," all provisions. H.R.849/S. 260, the "Protecting Seniors' Access to Medicare Act of 2017," all provisions. S.251, the "Protecting Medicare from Executive Action Act of 2017," all provisions. Comments requesting relief from 2018 penalties to be imposed on physicians pursuant to the Value Modifier (VM), Meaningful Use (MU) and Physician Quality Reporting System (PQRS) programs. Comments Final Rule re: Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2017; Medicare Advantage Bid Pricing Data Release; Medicare Advantage and Part D Medical Loss Ratio Data Release; Medicare Advantage Provider Network Requirements; Expansion of Medicare Diabetes Prevention Program Model; Medicare Shared Savings Program Requirements. Topics included: 1.) Practice Expense; 2.) Potentially Misvalued Services under the Fee Schedule; 3.) Improving Valuation of the Global Surgical Package; 4.) Reducing Administrative Burden and Improving Payment Accuracy for Chronic Care Management Services; 5.) Valuation of Specific Codes; 6.) Appropriate Use Criteria for Advanced Imaging Screening; 7.) Accountable Care Organizations (ACO) Participants Who Report Physician Quality Reporting System (PQRS) Quality Measures Separately; and 8.) Value-Based Payment Modifier and Physician Feedback Program. Issues pertaining to scope of practice; in general. Comments re: Collecting Data on Resources Used in Furnishing Global Services per the calendar year (CY) 2017 Medicare Physician Fee Schedule (MPFS) Final Rule. Comments re: the Centers for Medicare & Medicaid Services (CMS) planned enactment of the Social Security Number Removal Initiative (SSNRI). Comments re: relief from the administrative burdens and significant financial penalties slated to be imposed on physicians in 2018 as part of the Medicare physician fee schedule. H.R. 2276, the "Audiology Patient Choice Act," all provisions. Comments re: Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Hospital Prospective Payment System and Proposed Policy Changes and Fiscal Year 2018 Rate. Support for allowing eligible clinicians utilizing an electronic health record to participate in a qualified clinical data registry to qualify them as fully achieving all points for the Advancing Care Information category of the Quality Payment Programs Merit Based Incentive Payment System. Concerns regarding the difficulty Qualified Clinical Data Registries (QCDRs) have experienced with the QCDR measure review and self-nomination process under the Merit-based Incentive Payment System (MIPS), which was established by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Support for efforts to improve the transparency regarding Medicare Advantage (MA) plan prior authorization requirements. Support for the implementation of the Unique Device Identifier (UDI) through electronic health records (EHRs) and clinical registries in order to achieve the congressional intent of promoting patient safety by ensuring all patients and their healthcare providers as well as public health officials and researchers have accurate and complete information on medical devices. Comments re: "Medicare Program; CY 2018 Updates to the Quality Payment Program (QPP)," published in the Federal Register on June 30, 2017. Topics included: changes in reporting requirements, classification of measures, ACI performance category credit, APMs, and the use of QCDRs and certified EHR technology (CEHRT) for reporting measures under the Quality performance category of the Merit-Based Incentive Payment System (MIPS). Comments on the "Medicare Program; Revisions to Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY 2018; Medicare Shared Savings Program Requirements; and Medicare Diabetes Prevention Program," published in the Federal Register on July 21, 2017. Topics included: 1.) Practice Expense; 2.) Crosswalking PLI for Non-Physicians; 3.) Potentially Misvalued Services under the Fee Schedule; 4.) Valuation of Specific Codes; 5.) Appropriate Use Criteria for Advanced Imaging Screening; 6.) Physician Quality Reporting System Criteria for Satisfactory Reporting for Individual EPs and Group Practices for the 2018 PQRS Payment Adjustment; 7.) Clinical Quality Measurement for Eligible Professionals Participating in the Electronic Health Records (EHR) Incentive Program for 2016; 8.) Value-Based Payment Modifier and Physician Feedback Program; and 9.) MACRA Patient Relationship Categories and Codes. Comments re: FY 2018 Medicare Hospital Inpatient Prospective Payment System and Long-Term Acute Care Hospital Prospective Payment System Final Rule, published in the Federal Register as a proposed rule on August 2, 2017. Comments re: the CY 2018 Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs, published in the Federal Register as a proposed rule. Topics included: 1.) CY 2018 Comprehensive Ambulatory Payment Classifications (C-APCs); 2.) Imaging APCs; and 3.) Changes for Computed Tomography (CT) under the Protecting Access to Medicare Act of 2014 (PAMA); and 4.) New Bundled Sinus Codes Payment in the Ambulatory Surgical Center (ASC). Concerns with new methodology for updating malpractice (MP) relative value units (RVUs) as discussed in the calendar year (CY) 2018 Medicare Physician Fee Schedule (PFS) proposed rule. Comments to the House Ways & Means Committee in response to its "Medicare Red Tape Relief Project." Topics included: scope of practice, the Quality Payment Program (QPP) and clinical data registries. Support for statutory changes to MACRA that will allow CMS to provide an additional three years of flexibility as necessary program elements are put in place. Comments outlining concerns re: the commercial misuse of quality measures developed for the Merit-based Incentive Payment System (MIPS), which was established by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), and requests that CMS issue sub-regulatory guidance about the ownership and licensing of MIPS measures as it has issued for QCDR measures. Opposition to the inclusion of Medicare cuts (in general) in the tax bill, an end of year spending package, or other legislation, that could threaten patient access to quality care. Comments via the Physician Clinical Registry Coalition re: CMS-5522-FC - Medicare Programs: CY 2018 Updates to the Quality Payment Program. Comments to CMS re: the Innovation Center New Direction Request for Information, posted on the CMS Innovation Center website on September 20, 2017. The AAO-HNS urged CMMI to adopt several strategies to design and implement new APMs consistent with the guiding principles, including support for physician-driven approaches to APM models. Comments to CMS re: Medicare; CY 2018 Updates to the Quality Payment Program; and Quality Payment Program: Extreme and Uncontrollable Circumstance Policy for the Transition Year. Comments to MedPAC highlighting the significant benefits of clinical data registries and the role they should play in achieving the goals of the Quality Payment Program (QPP). Opposition to current methodologies used to survey and assess values associated with Global Surgical Services.

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), SENATE, Treasury, Dept of, U.S. Trade Representative (USTR)

Medicare reform; HR2276; audiology patient choice act

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

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

H.R. 1628 The American Health Care Act of 2017 H.R. 1628 The Better Care Reconciliation Act of 2017 H.R. 3767/S. 989 - Ensuring Children's Access to Specialty Care Act of 2017 H.R. 2141/S.898 - Conrad State 30 and Physician Access Reauthorization Act H.R.449 - Synthetic Drug Awareness Act of 2017 S. 934 - FDA Reauthorization Act of 2017 H.R. 2430 - FDA Reauthorization Act of 2017 H.R. 2276 - Audiology Patient Choice Act of 2017 H.R. 2913 - Mental Health in Schools Act H.R. 2290/S. 1357 - The family based care services act H.R. 3552 - Cady Housh and Jason Flatt Teen Suicide Prevention Act of 2017 Legislation in regard to the repeal and replace of the Patient Protection and Affordable Care Act Continued full funding for stabilizing the health insurance marketplace Continued full funding for substance use disorder services programs Protection of Mental Health Parity requirements Safety of vaccines H.R. 3192/S. 2253 The CHIP Mental Health Parity Act H.R. 3931/S. 1950 Excellence in Mental Health and Addiction Treatment Act

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

Government targets: HOUSE OF REPRESENTATIVES, Natl Institutes of Health (NIH), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), White House Office