To amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings.

P.L. 111-375 National Alzheimer's Project Act, All Sections P.L. 115-119 Recognize, Assist, Include, Support and Engage (RAISE) Family Caregivers Act S.311/H.R.2972 Alzheimer's Caregiver Support Act H.R. 1676/S. 693 The Palliative Care and Hospice Education and Training Act S. Res 49 A resolution declaring that achieving the primary goal of the National Plan to Address Alzheimer's Disease of the Department of Health and Human Services to prevent and effectively treat Alzheimer's disease by 2025 is an urgent national priority H.R.2953/S.2164 Preventive Health Savings Act S. 464 the Independence at Home Act of 2017 S. 547 Senior Financial Empowerment Act of 2017 S. 1606 In-Home CARE Act H.R.2505/S.1151 Credit for Caring Act H.R.2797/S.1334 Patient Choice and Quality Care Act H.R.2973/S.2208 Alzheimer's Disease Semipostal Stamp Act S.2076/H.R.4256 BOLD Infrastructure for Alzheimer's Act S.1188/H.R.2535 Lifespan Respite Care Reauthorization Act H.R.5191 Medical Improvement of Neurodegenerative Diseases (MIND) Act of 2018 S.2387/H.R.4957 Concentrating on High-Value Alzheimer's Needs to Get to an End (CHANGE) Act of 2018 H.R.3493/S.3608 Care Corps Demonstration Act The CY 2018 Revisions to Payment Policies under the Physician Fee Schedule and Other Revisions to Medicare Part B H.R.6561 Comprehensive Care for Seniors Act of 2018 H.R.6646 Younger-Onset Alzheimer's Disease Parity Act H.R.6502 Reducing Unnecessary Senior Hospitalizations (RUSH) Act of 2018 S.3412 Paid Family Leave Pilot Act

Client expense: $480,000 · Firm income: Not reported

Government targets: Administration on Aging, Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Indian Health Service, Interior, Dept of (DOI), Justice, Dept of (DOJ), Natl Institutes of Health (NIH), SENATE, Veterans Affairs, Dept of (VA)

H.R. 2953/S. 2164, Preventive Health Savings Act (CBO scoring of preventive health); National Diabetes Prevention Program and other CDC diabetes prevention activities in P.L. 115-96 (CR of FY18 Labor, Health and Human Services, and Education Appropriations), and FY19 Labor, Health and Human Services, and Education Appropriations.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 2953/S. 2164 - Preventive Health Savings Act H.R. 5963 - To delay the reimposition of the annual fee on health insurance providers until after 2020 H.R. 6082- Overdose Prevention and Safety (OPPS) act H.R. 6, SUPPORT for Patients and Communities Act H.R.184, the Protect Medical Innovation Act of 2017 H.R. 6378, the Pandemic and All-Hazards Preparedness and Advancing Innovation Act (PAHPA) of 2018 H.R. 1822, the Good Samaritan Health Professionals Act S. 3496, the Improving Seniors Access to Quality Benefits Act S. 3497, the Medicare Advantage Quality Payment Relief Act

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

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

H.R. 2953/S. 2164 - Preventive Health Savings Act H.R. 5963 - To delay the reimposition of the annual fee on health insurance providers until after 2020 H.R. 6082- Overdose Prevention and Safety (OPPS) act H.R. 6, SUPPORT for Patients and Communities Act H.R.184, the Protect Medical Innovation Act of 2017 H.R. 6378, the Pandemic and All-Hazards Preparedness and Advancing Innovation Act (PAHPA) of 2018 H.R. 1822, the Good Samaritan Health Professionals Act S. 3496, the Improving Seniors Access to Quality Benefits Act S. 3497, the Medicare Advantage Quality Payment Relief Act

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

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

Support for permanent business deduction for sole proprietors on insurance premiums. Support implementation and expansion of HRA availability. Continued addressing of ACA implementation and analysis of new health care bills. Support HRA's as a tool for micro-business. Advocacy against the classification of HRAs as health insurance. Support protection of Essential health Benefits. Support robust individual health insurance markets. Regulatory action regarding HSA's at Health and Human Services. Support small business and self-employed issues in American Health Care Act of 2017 (H.R. 1628). Support H.R. 2953 scoring amendments. Support favorable treatment of HRA and AHIP in Executive Orders affecting the ACA. Support H.R. 6314 The Health Savings Act of 2018.

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

Government targets: Commerce, Dept of (DOC), Consumer Financial Protection Bureau (CFPB), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Securities & Exchange Commission (SEC), Small Business Administration (SBA), Treasury, Dept of

Efforts to keep business deduction of health insurance costs for sole proprietors going forward. Support for favorable regulations and interpretations of the home office deduction. Support for favorable and expanded treatment of HRA accounts. Support favorable elements of the American Health Care Act. Support tax credits for health insurance. Support for H.R. 2953 to revise CBO scoring of preventative health measures. Support for simplifying small business income tax (H.R. 3717).Support favorable tax treatment for self-employed and microbusiness in Executive Orders affecting the ACA. Support fair tax treatment for self-employed in tax rate changes. Monitoring potential legislation affecting online sales tax. Support for the Online Sales Simplicity and Small Business Relief Act of 2018 (H.R. 6814).

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

Government targets: Commerce, Dept of (DOC), Consumer Financial Protection Bureau (CFPB), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Securities & Exchange Commission (SEC), Small Business Administration (SBA), Treasury, Dept of

H.R. 2953/S. 2164 Preventative Health Savings Act (CBO scoring of preventive health); National Diabetes Prevention Program and other CDC diabetes prevention activities in P.L. 115-96 (CR of FY18 Labor, Health and Human Services, and Education Appropriations)and FY19 Labor, Health and Human Services, and Education Appropriations.

Client expense: $870,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Economic Council (NEC), SENATE, Veterans Affairs, Dept of (VA)

H.R.2953 Preventive Health Savings Act and S.2164 H.R.3124/S.1299 Preventing Diabetes in Medicare Act H.R. 5768 Expanding Access to DSMT Act H.R.1953/S.830 TROA H.R. 1413 Enrich Act H.R. 1634 Eat for Health Act H.R. 1628 American Healthcare Act H.R. 772 Common Sense Nutrition Disclosure Act H.R. 5942 Health Equity and Accountability Act of 2018

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

Government targets: Agriculture, Dept of (USDA), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Office of Management & Budget (OMB), SENATE

National Institutes of Health, Alzheimer's Disease, and the Cures Acceleration Network P.L. 112-25 Budget Control Act of 2011, provisions related to funding for non-defense discretionary programs; entitlements reform The fiscal year 2019 Labor, Health & Human Services, Education and Related Agencies Appropriations Bill, All sections related to the National Institutes of Health, Alzheimer's Disease and the Cures Acceleration Network Fiscal Year 2019 Defense Appropriations Bill; provisions relating to the Peer Reviewed Alzheimer's Research Program H.R. 6157, Department of Defense and Labor, Health and Human Services, and Education Appropriations Act, 2019 Fiscal Year 2019 Agriculture Appropriations Bill, All sections related to the Food and Drug Administration Fiscal Year 2019 Interior and Environment Appropriations Bill; provisions related to the Indian Health Service and Alzheimer's disease Fiscal Year 2019 Military Construction, Veterans Affairs and Related Agencies Appropriations Bill; provisions related to the Department of Veterans Affairs, specifically Medical and Prosthetic Research and Alzheimer's research Fiscal Year 2019 Commerce, Justice, Science, and Related Agencies Appropriations Act; provisions related to grant program established by Kevin and Avonte's Law S.2076/H.R.4256 Building Our Largest Dementia (BOLD) Infrastructure for Alzheimer's Act H.R.2953/S.2164 Preventive Health Savings Act

Client expense: $480,000 · Firm income: Not reported

Government targets: Administration on Aging, Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Indian Health Service, Interior, Dept of (DOI), Justice, Dept of (DOJ), Natl Institutes of Health (NIH), SENATE, Veterans Affairs, Dept of (VA)

P.L. 111-375 National Alzheimer's Project Act, All Sections S.311/H.R.2972 Alzheimer's Caregiver Support Act H.R. 1676/S. 693 The Palliative Care and Hospice Education and Training Act S. Res 49 A resolution declaring that achieving the primary goal of the National Plan to Address Alzheimer's Disease of the Department of Health and Human Services to prevent and effectively treat Alzheimer's disease by 2025 is an urgent national priority H.R.2953/S.2164 Preventive Health Savings Act S. 464 the Independence at Home Act of 2017 S. 547 Senior Financial Empowerment Act of 2017 S. 1606 In-Home CARE Act H.R.2505/S.1151 Credit for Caring Act H.R.2797/S.1334 Patient Choice and Quality Care Act H.R.2973/S.2208 Alzheimer's Disease Semipostal Stamp Act S.2076/H.R.4256 BOLD Infrastructure for Alzheimer's Act S.1188/H.R.2535 Lifespan Respite Care Reauthorization Act H.R.5191 Medical Improvement of Neurodegenerative Diseases (MIND) Act of 2018 S.2387/H.R.4957 Concentrating on High-Value Alzheimer's Needs to Get to an End (CHANGE) Act of 2018 H.R.3493 Care Corps Demonstration Act The CY 2018 Revisions to Payment Policies under the Physician Fee Schedule and Other Revisions to Medicare Part B H.R.6561 Comprehensive Care for Seniors Act of 2018 H.R.6646 Younger-Onset Alzheimer's Disease Parity Act H.R.6502 Reducing Unnecessary Senior Hospitalizations (RUSH) Act of 2018

Client expense: $480,000 · Firm income: Not reported

Government targets: Administration on Aging, Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Indian Health Service, Interior, Dept of (DOI), Justice, Dept of (DOJ), Natl Institutes of Health (NIH), SENATE, Veterans Affairs, Dept of (VA)

Preventative Health Savings Act (H.R. 2953/S. 216); CBO scoring of preventive health, generally

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Support for permanent business deduction for sole proprietors on insurance premiums. Support implementation and expansion of HRA availability. Continued addressing of ACA implementation and analysis of new health care bills. Support HRA's as a tool for micro-business. Advocacy against the classification of HRAs as health insurance. Support protection of Essential health Benefits. Support robust individual health insurance markets. Regulatory action regarding HSA's at Health and Human Services. Support small business and self-employed issues in American Health Care Act of 2017 (H.R. 1628). Support H.R. 2953 scoring amendments. Support favorable treatment of HRA and AHIP in Executive Orders affecting the ACA. Support H.R. 6314 The Health Savings Act of 2018.

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

Government targets: Commerce, Dept of (DOC), Consumer Financial Protection Bureau (CFPB), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Securities & Exchange Commission (SEC), Small Business Administration (SBA), Treasury, Dept of

Efforts to keep business deduction of health insurance costs for sole proprietors going forward. Support for favorable regulations and interpretations of the home office deduction. Support for favorable and expanded treatment of HRA accounts. Support favorable elements of the American Health Care Act. Support tax credits for health insurance. Support for H.R. 2953 to revise CBO scoring of preventative health measures. Support for simplifying small business income tax (H.R. 3717).Support favorable tax treatment for self-employed and microbusiness in Executive Orders affecting the ACA. Support fair tax treatment for self-employed in tax rate changes. Monitoring potential legislation affecting online sales tax. Support for the Online Sales Simplicity and Small Business Relief Act of 2018 (H.R. 6814).

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

Government targets: Commerce, Dept of (DOC), Consumer Financial Protection Bureau (CFPB), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Securities & Exchange Commission (SEC), Small Business Administration (SBA), Treasury, Dept of

H.R.2953/S. 2164, Preventive Health Savings Act (CBO scoring of preventive health); National Diabetes Prevention Program and other CDC diabetes prevention activities in P.L. 115-96 (CR of FY18 Labor, Health and Human Services, and Education Appropriations), and FY19 Labor, Health and Human Services, and Education Appropriations.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.1016, the CONNECT for Health Act S. 445, the Home Health Planning Improvement Act H.R. 592 the Pharmacy and Medically Underserved Areas Enhancement Act S. 109, the Pharmacy and Medically Underserved Areas Enhancement Act H.R. 6, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act H.R. 6082, the Overdose Prevention and Patient Safety (OPPS) Act S. 1850, the Protecting Jessica Grubbs Legacy Act (The Legacy Act) H.R. 5483, the Special Registration for Telemedicine Clarification Act H.R. 6378, the Pandemic and All-Hazards Preparedness and Advancing Innovation Act (PAHPA) of 2018 H.R. 1822, the Good Samaritan Health Professionals Act H.R. 4952, the Improving Seniors Access to Quality Benefits Act H.R. 6311, the Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act, H.R. 6199, the Restoring Access to Medication and Modernizing Health Savings Accounts Act H.R. 6312, the Personal Health Investment Today (PHIT) Act H.R. 1267, the PHIT Act S. 2901, the Expanding Telehealth Response to Ensure Addiction Treatment Act (eTREAT) H.R. 1953 , the Treat and Reduce Obesity Act S. 830, the Treat and Reduce Obesity Act H.R. 2953, the Preventive Health Savings Act H.R. 4006, the Community-Based Independence for Seniors Act of 2017 H.R. 1565, the Saving Lives, Saving Costs Act H.R. 959, the Nursing Workforce Reauthorization Act H.R. 1676, the Palliative Care and Hospice Education and Training Act H.R. 5385, the Childrens Hospital GME Support Reauthorization Act H.R. 3728, the Education Medical Professionals and Optimizing Workforce Efficiency Readiness (EMPOWER) Act H.R. 676, the Expanded and Improved Medicare for All Act

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

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

S.1016, the CONNECT for Health Act S. 445, the Home Health Planning Improvement Act H.R. 592 the Pharmacy and Medically Underserved Areas Enhancement Act S. 109, the Pharmacy and Medically Underserved Areas Enhancement Act H.R. 6, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act H.R. 6082, the Overdose Prevention and Patient Safety (OPPS) Act S. 1850, the Protecting Jessica Grubbs Legacy Act (The Legacy Act) H.R. 5483, the Special Registration for Telemedicine Clarification Act H.R. 6378, the Pandemic and All-Hazards Preparedness and Advancing Innovation Act (PAHPA) of 2018 H.R. 1822, the Good Samaritan Health Professionals Act H.R. 4952, the Improving Seniors Access to Quality Benefits Act H.R. 6311, the Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act, H.R. 6199, the Restoring Access to Medication and Modernizing Health Savings Accounts Act H.R. 6312, the Personal Health Investment Today (PHIT) Act H.R. 1267, the PHIT Act S. 2901, the Expanding Telehealth Response to Ensure Addiction Treatment Act (eTREAT) H.R. 1953 , the Treat and Reduce Obesity Act S. 830, the Treat and Reduce Obesity Act H.R. 2953, the Preventive Health Savings Act H.R. 4006, the Community-Based Independence for Seniors Act of 2017 H.R. 1565, the Saving Lives, Saving Costs Act H.R. 959, the Nursing Workforce Reauthorization Act H.R. 1676, the Palliative Care and Hospice Education and Training Act H.R. 5385, the Childrens Hospital GME Support Reauthorization Act H.R. 3728, the Education Medical Professionals and Optimizing Workforce Efficiency Readiness (EMPOWER) Act H.R. 676, the Expanded and Improved Medicare for All Act

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

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

H.R. 2953/S. 2164 Preventative Health Savings Act (CBO scoring of preventive health); National Diabetes Prevention Program and other CDC diabetes prevention activities in P.L. 115-96 (CR of FY18 Labor, Health and Human Services, and Education Appropriations)and FY19 Labor, Health and Human Services, and Education Appropriations.

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

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Economic Council (NEC), SENATE, Veterans Affairs, Dept of (VA)

H.R.2953 Preventive Health Savings Act and S.2164 H.R.3124/S.1299 Preventing Diabetes in Medicare Act H.R. 5768 Expanding Access to DSMT Act H.R.1953/S.830 TROA H.R. 1413 Enrich Act H.R. 1634 Eat for Health Act H.R. 1628 American Healthcare Act H.R. 772 Common Sense Nutrition Disclosure Act H.R. 5942 Health Equity and Accountability Act of 2018

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

Government targets: Agriculture, Dept of (USDA), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Office of Management & Budget (OMB), SENATE

S. J. Res. 16 a joint resolution approving the discontinuation of the process for consideration and automatic implementation of the annual proposal of the independent payment Medicare advisory board H.J. Res 51/S. J. Res 17 Independent Payment Advisory Board Repeal H.R 1995 Value Based Insurance Design for Better Care Act H.R. 1038/S. 413 Improving Transparency and Accuracy in Medicare Part D Spending H.R. 1072/S. 222 Obamacare Replacement Act H.R. 1148/S. 431 Furthering Access to Stroke Telemedicine (FAST) Act H.R. 1628 American Health Care Act H.R. 1953/S. 830 Treat and Reduce Obesity Act H.R. 2267/S. 1301 Resident Physician Shortage Reduction Act H.R. 2550 Medicare Telehealth Parity Act H.R. 2556/S. 1016 CONNECT for Health Act H.R. 2797/S. 1334 Patient Choice and Quality Care Act H.R. 2824 Increasing Opportunity and Success for Children and Parents Through Evidence-Based Home Visiting Act H.R. 284 Advancing Medical Resident Training in Community Hospitals Act H.R. 2953/S. 2164 Preventive Health Savings Act H.R. 3044 to expand supplemental benefits to meet the needs of chronically ill Medicare Advantage enrollees H.R. 3059/S. 1441 Community Health Center and Primary Care Workforce Expansion Act H.R. 3124/S. 1299 Preventing Diabetes in Medicare Act H.R. 3168 to provide continued access to Medicare Advantage plans for special needs H.R. 3224 Critical Access and Rural Equity Act H.R. 3245 Medicare Civil and Criminal Penalties Act H.R. 3263 to extend the Medicare independence at home medical demonstration program H.R. 3358/S. 1771 Fiscal Year 2018 Labor-Health and Human Services-Education Appropriations Bill H.R. 3394 Teaching Health Centers Graduate Medical Education Extension Act H.R. 3447 Furthering Access to Coordinated Treatment for Seniors Act H.R. 3726 Stark Administrative Simplification Act of 2017 H.R. 3728 Empowering Medical Professionals and Optimizing Workforce Efficiency and Readiness Act H.R. 3820/S. 977 Medicare Home Health Flexibility Act H.R. 3862 National Health Service Corps Strengthening Act H.R. 3921 Helping Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable Act H.R. 3922 Continuing Community Health and Medical Professional Programs to Improve Our Nation, Increase National Gains, and Help Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable Act H.R. 4541 Continuing Community Health and Medical Professional Programs to Improve Our Nation and Keep Insurance Delivery Stable H.R. 4613 Ensuring Patient Access to Healthcare Records Act H.R. 4619 to provide temporary relief from the annual fee imposed on health insurance providers, to the extent that such fee is due to Puerto Rican health insurance H.R. 4620 Protecting Families and Small Businesses Act H.R. 4006 Community-Based Independence for Seniors Act of 2017 H.R. 4520 to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2017 H.R. 4552/S. 1291 Advancing Medical Training in Community Hospitals Act H.R. 4105 to extend the health professions workforce demonstration project H.R. 592/S. 109 Pharmacy and Medically Underserved Areas Enhancement Act H.R. 741/S. 243 Rural Hospital Regulatory Relief Act H.R. 766 Amend Title XVII of the Social Security Act to expand telehealth in Medicare H.R. 849/S. 260 Protecting Seniors' Access to Medicare Act H.R. 908 Medicare Advantage Quality Payment Relief Act H.R.3727 To amend title XVIII of the Social Security Act to include additional telehealth services for purposes of MA organization bids, and for other purposes H.R. 4206/S. 2051 Medicare Care Coordination Improvement Act Introduction of the Healthcare Cybersecurity Improvement Act Introduction of the Stark Law Modernization Act of 2017 Pub L. 114-198 Comprehensive Addiction and Recovery Act Pub L. 115-31 Fiscal Year 2017 Consolidated Appropriations Act Pub L. 115-80 National Clinical Care Commission Act Pub. L. 102-143 Telephone Consumer Protection Act Pub. L. 111-148 Patient Protection and Affordable Care Act (PPACA) Pub. L. 111-5 The American Recovery and Reinvestment Act Pub. L. 114-10 Medicare Access and CHIP Reauthorization Act (MACRA) Pub. L. 114-255, 21st Century Cures Act Pub. L. 114-270 Expanding Capacity for Health Outcomes Act (ECHO) Pub L. 115-63 Disaster Relief and Airway Extension Act Pub. L. 115-96 2018 Continuing Resolution Reintroduction of TELE-MED Act of 2015 S. 1754 Training the Next Generation of Primary Care Doctors Act S. 1827 Keep Kids' Insurance Dependable and Secure Act S. 1829 Strong Families Act S. 1859 Healthcare Tax Relief Act S. 1899 to reauthorize and extend funding for community health centers and the National Health Service Corps S. 1967 Mandate Relief Act S. 191 Patient Freedom Act S. 251 Protecting Medicare from Executive Action Act S. 309 Community Based Independence for Seniors Act S. 464 Independence at Home Act S. 787 Telehealth Innovation and Improvement Act S. 870 Creating High-Quality Results and Outcomes Necessary to Improve Chronic Care Act S. 1978 Small Business and Family Health Tax Relief Act

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

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

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

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

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

National Institutes of Health, Alzheimer's Disease, and the Cures Acceleration Network P.L. 112-25 Budget Control Act of 2011, provisions related to funding for non-defense discretionary programs; entitlements reform The fiscal year 2019 Labor, Health & Human Services, Education and Related Agencies Appropriations Bill, All sections related to the National Institutes of Health, Alzheimer's Disease and the Cures Acceleration Network Fiscal Year 2019 Agriculture Appropriations Bill, All sections related to the Food and Drug Administration Fiscal Year 2019 Defense Appropriations Bill; provisions relating to the Peer Reviewed Alzheimer's Research Program Fiscal Year 2019 Interior and Environment Appropriations Bill; provisions related to the Indian Health Service and Alzheimer's disease Fiscal Year 2019 Military Construction, Veterans Affairs and Related Agencies Appropriations Bill; provisions related to the Department of Veterans Affairs, specifically Medical and Prosthetic Research and Alzheimer's research S.2076/H.R.4256 Building Our Largest Dementia (BOLD) Infrastructure for Alzheimer's Act H.R.2953/S.2164 Preventive Health Savings Act

Client expense: $400,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Indian Health Service, Interior, Dept of (DOI), Natl Institutes of Health (NIH), SENATE, Veterans Affairs, Dept of (VA)

P.L. 111-375 National Alzheimer's Project Act, All Sections S.311/H.R.2972 Alzheimer's Caregiver Support Act H.R. 1676/S. 693 The Palliative Care and Hospice Education and Training Act S. Res 49 A resolution declaring that achieving the primary goal of the National Plan to Address Alzheimer's Disease of the Department of Health and Human Services to prevent and effectively treat Alzheimer's disease by 2025 is an urgent national priority H.R.2953/S.2164 Preventive Health Savings Act S. 464 the Independence at Home Act of 2017 S. 547 Senior Financial Empowerment Act of 2017 S. 1606 In-Home CARE Act H.R.2505/S.1151 Credit for Caring Act H.R.2797/S.1334 Patient Choice and Quality Care Act H.R.2973/S.2208 Alzheimer's Disease Semipostal Stamp Act S.2076/H.R.4256 BOLD Infrastructure for Alzheimer's Act S.1188/H.R.2535 Lifespan Respite Care Reauthorization Act H.R.5191 Medical Improvement of Neurodegenerative Diseases (MIND) Act of 2018 S.2387/H.R.4957 Concentrating on High-Value Alzheimer's Needs to Get to an End (CHANGE) Act of 2018 H.R.3493 Care Corps Demonstration Act

Client expense: $400,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Indian Health Service, Interior, Dept of (DOI), Natl Institutes of Health (NIH), SENATE, Veterans Affairs, Dept of (VA)

H.R.2953/S. 2164, Preventive Health Savings Act (CBO scoring of preventive health); National Diabetes Prevention Program and other CDC diabetes prevention activities in P.L. 115-96 (CR of FY18 Labor, Health and Human Services, and Education Appropriations).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

- Preventative Health Savings Act (H.R. 2953/S. 216); CBO scoring of preventive health, generally - National Diabetes Prevention Program and other CDC diabetes prevention activities in Pub.L. 115-96 (CR of FY18 Labor, Health and Human Services, and Education Appropriations)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 2953/S. 2164 Preventative Health Savings Act (CBO scoring of preventive health); National Diabetes Prevention Program and other CDC diabetes prevention activities in P.L. 115-96 (CR of FY18 Labor, Health and Human Services, and Education Appropriations)and FY19 Labor, Health and Human Services, and Education Appropriations.

Client expense: $977,600 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Economic Council (NEC), SENATE, Veterans Affairs, Dept of (VA)

Support for permanent business deduction for sole proprietors on insurance premiums. Support implementation and expansion of HRA availability. Continued addressing of ACA implementation and analysis of new health care bills. Support HRA's as a tool for micro-business. Advocacy against the classification of HRAs as health insurance. Support protection of Essential health Benefits. Support robust individual health insurance markets. Regulatory action regarding HSA's at Health and Human Services. Support small business and self-employed issues in American Health Care Act of 2017 (H.R. 1628). Support H.R. 2953 scoring amendments. Support favorable treatment of HRA and AHIP in Executive Orders affecting the ACA. Support H.R. 6314 The Health Savings Act of 2018.

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

Government targets: Commerce, Dept of (DOC), Consumer Financial Protection Bureau (CFPB), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Securities & Exchange Commission (SEC), Small Business Administration (SBA), Treasury, Dept of

Efforts to keep business deduction of health insurance costs for sole proprietors going forward. Support for favorable regulations and interpretations of the home office deduction. Support for favorable and expanded treatment of HRA accounts. Support favorable elements of the American Health Care Act. Support tax credits for health insurance. Support for H.R. 2953 to revise CBO scoring of preventative health measures. Support for simplifying small business income tax (H.R. 3717).Support favorable tax treatment for self-employed and microbusiness in Executive Orders affecting the ACA. Support fair tax treatment for self-employed in tax rate changes. Monitoring potential legislation affecting online sales tax.

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

Government targets: Commerce, Dept of (DOC), Consumer Financial Protection Bureau (CFPB), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Securities & Exchange Commission (SEC), Small Business Administration (SBA), Treasury, Dept of

H.R.2953 Preventive Health Savings Act and S.2164 H.R.3124/S.1299 Preventing Diabetes in Medicare Act H.R. 5768 Expanding Access to DSMT Act H.R.1953/S.830 TROA H.R. 1413 Enrich Act H.R. 1634 Eat for Health Act H.R. 1628 American Healthcare Act H.R. 772 Common Sense Nutrition Disclosure Act H.R. 5942 Health Equity and Accountability Act of 2018

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

Government targets: Agriculture, Dept of (USDA), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Office of Management & Budget (OMB), SENATE

P.L. 111-375 National Alzheimer's Project Act, All Sections S.311/H.R.2972 Alzheimer's Caregiver Support Act H.R. 1676/S. 693 The Palliative Care and Hospice Education and Training Act S. Res 49 A resolution declaring that achieving the primary goal of the National Plan to Address Alzheimer's Disease of the Department of Health and Human Services to prevent and effectively treat Alzheimer's disease by 2025 is an urgent national priority S. 464 the Independence at Home Act of 2016 S. 547 Senior Financial Empowerment Act of 2017 S. 1606 In-Home CARE Act H.R.2953/S.2164 Preventive Health Savings Act H.R.2505/S.1151 Credit for Caring Act H.R.2797/S.1334 Patient Choice and Quality Care Act H.R.2973/S.2208 Alzheimer's Disease Semipostal Stamp Act H.R.3263 To amend title XVIII of the Social Security Act to extend the Medicare independence at home medical practice demonstration program S.870/H.R.4579 CHRONIC Care Act S.2070/H.R.4221 Kevin and Avonte's Law of 2017 S.2076/H.R.4256 BOLD Infrastructure for Alzheimer's Act S.1188/H.R.2535 Lifespan Respite Care Reauthorization Act H.R.5191 Medical Improvement of Neurodegenerative Diseases (MIND) Act of 2018 S.2387/H.R.4957 Concentrating on High-Value Alzheimer's Needs to Get to an End (CHANGE) Act of 2018

Client expense: $316,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Indian Health Service, Interior, Dept of (DOI), Natl Institutes of Health (NIH), SENATE, Veterans Affairs, Dept of (VA)

- Preventative Health Savings Act (H.R. 2953/S. 216); CBO scoring of preventive health, generally - National Diabetes Prevention Program and other CDC diabetes prevention activities in Pub.L. 115-96 (CR of FY18 Labor, Health and Human Services, and Education Appropriations)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.2953/S. 2164, Preventive Health Savings Act (CBO scoring of preventive health); National Diabetes Prevention Program and other CDC diabetes prevention activities in P.L. 115-96 (CR of FY18 Labor, Health and Human Services, and Education Appropriations).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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

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

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

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

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

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

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

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

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

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

H.R.2953 Preventive Health Savings Act and S.2164 H.R.3124/S.1299 Preventing Diabetes in Medicare Act H.R.1953/S.830 TROA H.R. 1413 Enrich Act H.R. 1634 Eat for Health Act H.R. 1628 American Healthcare Act

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

Government targets: Agriculture, Dept of (USDA), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE

Support for permanent business deduction for sole proprietors on insurance premiums. Support implementation and expansion of HRA availability. Continued addressing of ACA implementation and analysis of new health care bills. Support HRA's as a tool for micro-business. Advocacy against the classification of HRAs as health insurance. Support protection of Essential health Benefits. Support robust individual health insurance markets. Regulatory action regarding HSA's at Health and Human Services. Support small business and self-employed issues in American Health Care Act of 2017 (H.R. 1628). Support H.R. 2953 scoring amendments. Support favorable treatment of HRA and AHIP in Executive Orders affecting the ACA.

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

Government targets: Commerce, Dept of (DOC), Consumer Financial Protection Bureau (CFPB), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Securities & Exchange Commission (SEC), Small Business Administration (SBA), Treasury, Dept of

Efforts to keep business deduction of health insurance costs for sole proprietors going forward. Support for favorable regulations and interpretations of the home office deduction. Support for favorable and expanded treatment of HRA accounts. Support favorable elements of the American Health Care Act. Support tax credits for health insurance. Support for H.R. 2953 to revise CBO scoring of preventative health measures. Support for simplifying small business income tax (H.R. 3717).Support favorable tax treatment for self-employed and microbusiness in Executive Orders affecting the ACA. Support fair tax treatment for self-employed in tax rate changes.

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

Government targets: Commerce, Dept of (DOC), Consumer Financial Protection Bureau (CFPB), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Securities & Exchange Commission (SEC), Small Business Administration (SBA), Treasury, Dept of

H.R. 2953/S. 2164 Preventative Health Savings Act (CBO scoring of preventive health); National Diabetes Prevention Program and other CDC diabetes prevention activities in P.L. 115-96 (CR of FY18 Labor, Health and Human Services, and Education Appropriations).

Client expense: $1,460,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Economic Council (NEC), SENATE, Veterans Affairs, Dept of (VA)

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

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

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

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

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

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

H.R.2953 Preventive Health Savings Act H.Res.161/S.Res.75 Centennial Resolution-Academy of Nutrition and Dietetics H.R.3124/S.1299 Preventing Diabetes H.R.1953/S.830 TROA H.R. 1413 Enrich Act H.R. 1634 Eat for Health Act H.R. 1628 American Health Act

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

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

P.L. 111-375 National Alzheimer's Project Act, All Sections S.311/H.R.2972 Alzheimer's Caregiver Support Act H.R. 1676/S. 693 The Palliative Care and Hospice Education and Training Act S. Res 49 A resolution declaring that achieving the primary goal of the National Plan to Address Alzheimer's Disease of the Department of Health and Human Services to prevent and effectively treat Alzheimer's disease by 2025 is an urgent national priority S. 464 the Independence at Home Act of 2016 S. 178 the Elder Abuse Prevention and Prosecution Act S. 547 Senior Financial Empowerment Act of 2017 S. 1606 In-Home CARE Act H.R.2953/S.2164 Preventive Health Savings Act S.1028/H.R.3759 RAISE Family Caregivers Act H.R.2505/S.1151 Credit for Caring Act H.R.2797/S.1334 Patient Choice and Quality Care Act H.R.2973/S.2208 Alzheimer's Disease Semipostal Stamp Act H.R.3263 To amend title XVIII of the Social Security Act to extend the Medicare independence at home medical practice demonstration program S.870/H.R.4579 CHRONIC Care Act S.2070/H.R.4221 Kevin and Avonte's Law of 2017 S.2076/H.R.4256 BOLD Infrastructure for Alzheimer's Act H.R.1 An Act to provide for reconciliation pursuant to titles II and V of the concurrent resolution on the budget for fiscal year 2018 (Tax Cuts and Jobs Act)

Client expense: $316,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Indian Health Service, Interior, Dept of (DOI), Natl Institutes of Health (NIH), SENATE, Veterans Affairs, Dept of (VA)

Agriculture Appropriations: Provisions relating to Summer Food Service Program; Child and Adult Care Food Program. Interior Appropriations: Provisions relating to the Land and Water Conservation Fund; Urban Park and Recreation Recovery Program; Environmental Protection Agency's National Environmental Education Act and Environmental Justice Small Grant Programs; and US Forest Service Community Forest and Open Space and Urban and Community Forestry programs. Labor, HHS, Education Appropriations: Provisions relating to Title IV of the Primary and Secondary Education Act; Prevention and Public Health Fund and other public health prevention programs. Transportation, Housing and Urban Development Appropriations: Provisions relating to Transportation Alternatives Program; Recreational Trails Program; Congestion Mitigation; TIGER Grants; and Community Development Block Grants (CDBG). Preventative Health Savings Act (H.R. 2953)

Client expense: Not reported · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Education, Dept of, Federal Highway Administration (FHA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), Interior, Dept of (DOI), Natl Park Service (NPS), SENATE

Agriculture Appropriations: Provisions relating to Summer Food Service Program; Child and Adult Care Food Program. Interior Appropriations: Provisions relating to the Land and Water Conservation Fund; Urban Park and Recreation Recovery Program; Environmental Protection Agency's National Environmental Education Act and Environmental Justice Small Grant Programs; and US Forest Service Community Forest and Open Space and Urban and Community Forestry programs. Labor, HHS, Education Appropriations: Provisions relating to Title IV of the Primary and Secondary Education Act; Prevention and Public Health Fund and other public health prevention programs. Transportation, Housing and Urban Development Appropriations: Provisions relating to Transportation Alternatives Program; Recreational Trails Program; Congestion Mitigation; TIGER Grants; and Community Development Block Grants (CDBG). Preventative Health Savings Act (H.R. 2953)

Client expense: $9,125 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Education, Dept of, Federal Highway Administration (FHA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), Interior, Dept of (DOI), Natl Park Service (NPS), SENATE