Medicare Choices Empowerment and Protection Act

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Insurance-related issues pertaining to reconciliation legislation are reported under BUD (Budget/Appropriations). Insurance-related provisions pertaining to health-care ("Obamacare replacement") legislation are reported on the HCR (Health Issues) page. Contacts in support of the Medicare Choices Empowerment and Protection Act (S. 1530/H.R. 3181), to give beneficiaries and others online access to model advance directives that choose life-saving treatment, food and fluids equally with those that reject them in order to offset widespread efforts to nudge patients to agree to forego life-saving treatment.

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

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

Discussed importance of high-quality electronic advance medical directives for all adults over the age of 18 years that can be digitally accessed 24 hours/day, 7 days/week in the cloud by qualified medical health professionals, hospitals and other providers, and consumers anywhere in the world as part of a consumer's electronic medical record. Seeking consideration of ADs as a required, or at minimum strongly encouraged, added benefit to Medicare Advantage (MA) plans. Support proposals to incentivize Medicare/Medicaid beneficiaries and federal employees through FEHBP to create and store a digital AD. Endorsed legislation, the Medicare Choices Empowerment & Protection Act (S. 1503/HR 3181), introduced by Senators Coons & Cassidy & Reps Black, Thompson, Welch, and Collins, to provide a one-time financial incentive to Medicare beneficiaries who voluntarily register an advance care plan.

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

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

Furthering Access to Coordinated Treatment for Seniors Act of 2017(H.R.3447) Medicare Choice Empowerment and Protection Act(H.R.3181/S.1530) Palliative Care and Hospital Education and Training Act(H.R.1676/S.693) Patient Choice and Quality Care Act of 2017(S.1334/H.R.2797) S.3028- Americans Giving Care to Elders(AGE)Act of 2018

Client expense: $110,535 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Education, Dept of, Environmental Protection Agency (EPA), 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), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Transportation, Dept of (DOT), Treasury, Dept of, U.S. Trade Representative (USTR), White House Office

Insurance-related issues pertaining to reconciliation legislation are reported under BUD (Budget/Appropriations). Insurance-related provisions pertaining to health-care ("Obamacare replacement") legislation are reported on the HCR (Health Issues) page. Contacts in support of the Medicare Choices Empowerment and Protection Act (S. 1530/H.R. 3181), to give beneficiaries and others online access to model advance directives that choose life-saving treatment, food and fluids equally with those that reject them in order to offset widespread efforts to nudge patients to agree to forego life-saving treatment.

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

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

Discussed importance of high-quality electronic advance medical directives for all adults over the age of 18 years that can be digitally accessed 24 hours/day, 7 days/week in the cloud by qualified medical health professionals, hospitals and other providers, and consumers anywhere in the world as part of a consumer's electronic medical record. Seeking consideration of ADs as a required, or at minimum strongly encouraged, added benefit to Medicare Advantage (MA) plans. Support proposals to incentivize Medicare/Medicaid beneficiaries and federal employees through FEHBP to create and store a digital AD. Endorsed legislation, the Medicare Choices Empowerment & Protection Act (S. 1503/HR 3181), introduced by Senators Coons & Cassidy & Reps Black, Thompson, Welch, and Collins, to provide a one-time financial incentive to Medicare beneficiaries who voluntarily register an advance care plan.

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

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

H.R.817-End Surprise Billing Act of 2017 H.R.1323-Reducing Unnecessary Emergency Room Visits under Medicaid Act H.R.2957-Save Rural Hospitals Act H.R.3181-Medicare Choices Empowerment and Protection Act H.R.5678-Rural Emergency Medical Center Act of 2018 S.260-Protecting Seniors' Access to Medicare Act of 2017 S.284-End Surprise Billing Act of 2017 S.568-Improving Access to Medicare Coverage Act of 2017 S.1130-Rural Emergency Acute Care Hospital (REACH) Act S.1530- Medicare Choices Empowerment and Protection Act

Client expense: $702,392 · Firm income: Not reported

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

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

Insurance-related issues pertaining to reconciliation legislation are reported under BUD (Budget/Appropriations). Insurance-related provisions pertaining to health-care ("Obamacare replacement") legislation are reported on the HCR (Health Issues) page. Contacts in support of the Medicare Choices Empowerment and Protection Act (S. 1530/H.R. 3181), to give beneficiaries and others online access to model advance directives that choose life-saving treatment, food and fluids equally with those that reject them in order to offset widespread efforts to nudge patients to agree to forego life-saving treatment.

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

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

Discussed importance of high-quality electronic advance medical directives for all adults over the age of 18 years that can be digitally accessed 24 hours/day, 7 days/week in the cloud by qualified medical health professionals, hospitals and other providers, and consumers anywhere in the world as part of a consumer's electronic medical record. Seeking consideration of ADs as a required, or at minimum strongly encouraged, added benefit to Medicare Advantage (MA) plans. Support proposals to incentivize Medicare/Medicaid beneficiaries and federal employees through FEHBP to create and store a digital AD. Endorsed legislation, the Medicare Choices Empowerment & Protection Act (S. 1503/HR 3181), introduced by Senators Coons & Cassidy & Reps Black, Thompson, Welch, and Collins, to provide a one-time financial incentive to Medicare beneficiaries who voluntarily register an advance care plan.

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

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

Furthering Access to Coordinated Treatment for Seniors Act of 2017(H.R.3447) Klobuchar Age Act 5.879 Medicare Choice Empowerment and Protection Act(H.R.3181/S.1530) Palliative Care and Hospital Education and Training Act(H.R.1676/S.693) Patient Choice and Quality Care Act of 2017(S.1334/H.R.2797)

Client expense: $102,265 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Education, Dept of, Environmental Protection Agency (EPA), 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), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Transportation, Dept of (DOT), Treasury, Dept of, U.S. Trade Representative (USTR), White House Office

Medicare and Other Health and Human Services Extender Provisions H.R.817-End Surprise Billing Act of 2017 H.R.849-Protecting Seniors' Access to Medicare Act of 2017 H.R.1148-Furthering Access to Stroke Telemedicine (FAST) Act H.R.1323-Reducing Unnecessary Emergency Room Visits under Medicaid Act H.R.1421-Improving Access to Medicare Coverage Act of 2017 H.R.2392-Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2017 H.R.2957-Save Rural Hospitals Act H.R.3181-Medicare Choices Empowerment and Protection Act H.R.3729-Comprehensive Operations, Sustainability, and Transport Act of 2017 S.251-Protecting Medicare from Executive Action Act of 2017 S.260-Protecting Seniors' Access to Medicare Act of 2017 S.284-End Surprise Billing Act of 2017 S.568-Improving Access to Medicare Coverage Act of 2017 S.1063-Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2017 S.1130-Rural Emergency Acute Care Hospital (REACH) Act S.1530- Medicare Choices Empowerment and Protection Act

Client expense: $520,414 · Firm income: Not reported

Essential emergency medication shortages Bipartisan Health Care Stabilization Act of 2017 H.R.372-Competetive Health Insurance Reform Act of 2017 H.R.548-Health Care Safety Net Enhancement Act of 2017 H.R.582-Kari's Law Act of 2017 H.R.767-Stop, Observe, Ask, and Respond (SOAR) to Health and Wellness Act of 2017 H.R.817-End Surprise Billing Act of 2017 H.R.849-Protecting Seniors' Access to Medicare Act of 2017 H.R.880-Military Injury Surgical Systems Integrated Operationally Nationwide to Achieve ZERO Preventable Deaths Act H.R.1057-Synthetics Trafficking and Overdose Prevention Act of 2017 H.R.1148-Furthering Access to Stroke Telemedicine (FAST) Act of 2017 H.R.1215-Protecting Access to Care Act of 2017 H.R.1323-Reducing Unnecessary Emergency Room Visits under Medicaid Act H.R.1421-Improving Access to Medicare Coverage Act of 2017 H.R.1492-Medical Controlled Substances Transportation Act of 2017 H.R.1565-Saving Lives, Saving Costs Act H.R.1628-American Health Care Act of 2017 H.R.1822-Good Samaritan Health Professionals Act of 2017 H.R.1876-Good Samaritan Health Professionals Act of 2017 H.R.2200-Frederick Douglass Trafficking Victims Prevention and Protection Reauthorization Act of 2017 H.R.2392-Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2017 HR 2843-Medicaid and Chip Quality Improvement Act of 2017 H.R.2851-Stop the Importation and Trafficking of Synthetic Analogues (SITSA) Act of 2017 H.R.2957-Save Rural Hospitals Act H.R.3181-Medicare Choices Empowerment and Protection Act H.R.3258-Marketplace Certainty Act H.R.3545-Overdose Prevention and Patient Safety (OPPS) Act H.R.3729-Comprehensive Operations, Sustainability, and Transport Act of 2017 H.R.3922-Continuing Community Health And Medical Professional Programs to Improve Our Nation, Increase National Gains, and Help Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable (CHAMPIONING HEALTHY KIDS) Act of 2017 H.R.5176-Preventing Overdoses While in Emergency Rooms Act of 2018 H.R.5197-Alternatives to Opioids (ALTO) in the Emergency Department Act P.L.111-148-Patient Protection and Affordable Care Act S.191-Patient Freedom Act of 2017 S.251-Protecting Medicare from Executive Action Act of 2017 S.256-SOAR to Health and Wellness Act of 2017 S.260-Protecting Seniors' Access to Medicare Act of 2017 S.284-End Surprise Billing Act of 2017 S.372- Synthetics Trafficking and Overdose Prevention Act of 2017 S.527-Health Care Safety Net Enhancement Act of 2017 S.568-Improving Access to Medicare Coverage Act of 2017 S.781-Good Samaritan Health Professionals Act of 2017 S.1016-Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2017 S.1022-Military Injury Surgical Systems Integrated Operationally Nationwide to Achieve ZERO Preventable Deaths Act S.1063-Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2017 S.1130-Rural Emergency Acute Care Hospital (REACH) Act H.R.1148-Furthering Access to Stroke Telemedicine (FAST) Act S.1462-Marketplace Certainty Act S.1530- Medicare Choices Empowerment and Protection Act S.1827-Keep Kids Insurance Dependable and Secure (KIDS) Act of 2017 S.1835-Lower Premiums Through Reinsurance Act of 2017 S.2516-Alternatives to Opioids (ALTO) in the Emergency Department Act S.2609-Recovery Coaches Offer Addiction Counseling and Healing (COACH) Act S.2610-Preventing Overdoses While in Emergency Departments Act of 2018

Furthering Access to Coordinated Treatment for Seniors Act of 2017(H.R.3447) Furthering Access to Stroke Telemedicine Act(S.431/H.R.1148) Medicare Access to Rehabilitation Services Act(H.R.807/S.253) Medicare Cardiac Rehab Supervision Bill(H.R.1155/S.1361) Medicare Choice Empowerment and Protection Act(H.R.3181/S.1530) Palliative Care and Hospital Education and Training Act(H.R.1676/S.693) Patient Choice and Quality Care Act of 2017(S.1334/H.R.2797) Senate Finance CHRONIC Care Bill(S.870)

Client expense: $45,380 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Education, Dept of, Environmental Protection Agency (EPA), 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), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Transportation, Dept of (DOT), Treasury, Dept of, U.S. Trade Representative (USTR), White House Office

Insurance-related issues pertaining to reconciliation legislation are reported under BUD (Budget/Appropriations). Insurance-related provisions pertaining to health-care ("Obamacare replacement") legislation are reported on the HCR (Health Issues) page. Contacts in support of the Medicare Choices Empowerment and Protection Act (S. 1530/H.R. 3181), to give beneficiaries and others online access to model advance directives that choose life-saving treatment, food and fluids equally with those that reject them in order to offset widespread efforts to nudge patients to agree to forego life-saving treatment.

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

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

Discussed importance of high-quality electronic advance medical directives for all adults over the age of 18 years that can be digitally accessed 24 hours/day, 7 days/week in the cloud by qualified medical health professionals, hospitals and other providers, and consumers anywhere in the world as part of a consumer's electronic medical record. Seeking consideration of ADs as a required, or at minimum strongly encouraged, added benefit to Medicare Advantage (MA) plans. Support proposals to incentivize Medicare/Medicaid beneficiaries and federal employees through FEHBP to create and store a digital AD. Endorsed legislation, the Medicare Choices Empowerment & Protection Act (S. 1503/HR 3181), introduced by Senators Coons & Cassidy & Reps Black, Thompson, Welch, and Collins, to provide a one-time financial incentive to Medicare beneficiaries who voluntarily register an advance care plan.

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

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

Alternatives to Opiates (ALTO) Bipartisan Health Care Stabilization Act of 2017 H.R.304-Protecting Patient Access to Emergency Medications Act of 2017 H.R.372-Competetive Health Insurance Reform Act of 2017 H.R.548-Health Care Safety Net Enhancement Act of 2017 H.R.582-Kari's Law Act of 2017 H.R.817-End Surprise Billing Act of 2017 H.R.849-Protecting Seniors' Access to Medicare Act of 2017 H.R.880-Military Injury Surgical Systems Integrated Operationally Nationwide to Achieve ZERO Preventable Deaths Act H.R.1057-Synthetics Trafficking and Overdose Prevention Act of 2017 H.R.1215-Protecting Access to Care Act of 2017 H.R.1323-Reducing Unnecessary Emergency Room Visits under Medicaid Act H.R.1421-Improving Access to Medicare Coverage Act of 2017 H.R.1492-Medical Controlled Substances Transportation Act of 2017 H.R.1565-Saving Lives, Saving Costs Act H.R.1628-American Health Care Act of 2017 H.R.1822-Good Samaritan Health Professionals Act of 2017 H.R.1876-Good Samaritan Health Professionals Act of 2017 H.R.2200-Frederick Douglass Trafficking Victims Prevention and Protection Reauthorization Act of 2017 H.R.2392-Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2017 H.R.2430-FDA Reauthorization Act of 2017 HR 2843-Medicaid and Chip Quality Improvement Act of 2017 H.R.2851-Stop the Importation and Trafficking of Synthetic Analogues (SITSA) Act of 2017 H.R.2957-Save Rural Hospitals Act H.R.3181-Medicare Choices Empowerment and Protection Act H.R.3258-Marketplace Certainty Act H.R.3545-Overdose Prevention and Patient Safety (OPPS) Act H.R.3729-Comprehensive Operations, Sustainability, and Transport Act of 2017 H.R.3922-Continuing Community Health And Medical Professional Programs to Improve Our Nation, Increase National Gains, and Help Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable (CHAMPIONING HEALTHY KIDS) Act of 2017 H.J.Res.51-Approving the discontinuation of the process for consideration and automatic implementation of the annual proposal of the Independent Medicare Advisory Board under section 1899A of the Social Security Act P.L.111-148-Patient Protection and Affordable Care Act S.191-Patient Freedom Act of 2017 S.222-Obamacare Replacement Act S.251-Protecting Medicare from Executive Action Act of 2017 S.260-Protecting Seniors' Access to Medicare Act of 2017 S.284-End Surprise Billing Act of 2017 S.372- Synthetics Trafficking and Overdose Prevention Act of 2017 S.527-Health Care Safety Net Enhancement Act of 2017 S.568-Improving Access to Medicare Coverage Act of 2017 S.781-Good Samaritan Health Professionals Act of 2017 S.916-Protecting Patient Access to Emergency Medications Act of 2017 S.934-FDA Reauthorization Act of 2017 S.1016-Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2017 S.1022-Military Injury Surgical Systems Integrated Operationally Nationwide to Achieve ZERO Preventable Deaths Act S.1063-Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2017 S.1130-Rural Emergency Acute Care Hospital (REACH) Act H.R.1148-Furthering Access to Stroke Telemedicine (FAST) Act S.1462-Marketplace Certainty Act S.1530- Medicare Choices Empowerment and Protection Act S.1827-Keep Kids Insurance Dependable and Secure (KIDS) Act of 2017 S.1835-Lower Premiums Through Reinsurance Act of 2017 S.Amdt.667 to S.Amdt.267 to H.R.1628-Better Care Reconciliation Act 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 Medicare Advisory Board under section 1899A of the Social Security Act S.J.Res.17-A joint resolution approving the discontinuation of the process for consideration and automatic implementation of the annual proposal of the Independent Medicare Advisory Board under section 1899A of the Social Security Act

Medicare and Other Health and Human Services Extender Provisions H.R.817-End Surprise Billing Act of 2017 H.R.849-Protecting Seniors' Access to Medicare Act of 2017 H.R.1148-Furthering Access to Stroke Telemedicine (FAST) Act H.R.1323-Reducing Unnecessary Emergency Room Visits under Medicaid Act H.R.1421-Improving Access to Medicare Coverage Act of 2017 H.R.2392-Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2017 H.R.2957-Save Rural Hospitals Act H.R.3181-Medicare Choices Empowerment and Protection Act H.R.3729-Comprehensive Operations, Sustainability, and Transport Act of 2017 H.J.Res.51-Approving the discontinuation of the process for consideration and automatic implementation of the annual proposal of the Independent Medicare Advisory Board under section 1899A of the Social Security Act S.251-Protecting Medicare from Executive Action Act of 2017 S.260-Protecting Seniors' Access to Medicare Act of 2017 S.284-End Surprise Billing Act of 2017 S.568-Improving Access to Medicare Coverage Act of 2017 S.1063-Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2017 S.1130-Rural Emergency Acute Care Hospital (REACH) Act S.1530- Medicare Choices Empowerment and Protection Act S.Amdt.667 to S.Amdt.267 to H.R.1628-Better Care Reconciliation Act 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 Medicare Advisory Board under section 1899A of the Social Security Act S.J.Res.17-A joint resolution approving the discontinuation of the process for consideration and automatic implementation of the annual proposal of the Independent Medicare Advisory Board under section 1899A of the Social Security Act

Client expense: $672,362 · Firm income: Not reported

Furthering Access to Coordinated Treatment for Seniors Act of 2017(H.R.3447) Furthering Access to Stroke Telemedicine Act(S.431/H.R.1148) Independence at Home Act(S.464) Medicare Access to Rehabilitation Services Act(H.R.807/S.253) Medicare Cardiac Rehab Supervision Bill(H.R.1155/S.1361) Medicare Choice Empowerment and Protection Act(H.R.3181/S.1530) Palliative Care and Hospital Education and Training Act(H.R.1676/S.693) Patient Choice and Quality Care Act of 2017(S.1334/H.R.2797) Senate Finance CHRONIC Care Bill(S.870)

Client expense: $40,713 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Education, Dept of, Environmental Protection Agency (EPA), 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), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Transportation, Dept of (DOT), Treasury, Dept of, U.S. Trade Representative (USTR), White House Office

Insurance-related issues pertaining to reconciliation legislation are reported under BUD (Budget/Appropriations). Insurance-related provisions pertaining to health-care ("Obamacare replacement") legislation are reported on the HCR (Health Issues) page. Contacts in support of the Medicare Choices Empowerment and Protection Act (S. 1530/H.R. 3181), to give beneficiaries and others online access to model advance directives that choose life-saving treatment, food and fluids equally with those that reject them in order to offset widespread efforts to nudge patients to agree to forego life-saving treatment.

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

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

Discussed importance of high-quality electronic advance medical directives for all adults over the age of 18 years that can be digitally accessed 24 hrs/day, 7 days/ week in the cloud by physicians, hospitals and consumers anywhere in the world as part of the patient's electronic medical record. Seeking consideration of ADs as a required, or at minimum strongly encouraged, added benefit to Medicare Advantage (MA) plans. Support proposals to incentivize all Medicare/Medicaid beneficiaries and federal employees through FEHBP to create and store a digital AD. Endorsed legislation, the Medicare Choices Empowerment & Protection Act (S. 1530/HR 3181), introduced by Senators Coons/Cassidy & Reps. Black, Thompson, Welch and Collins, to provide a one-time financial incentive to Medicare beneficiaries that voluntarily register an advance care plan.

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

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

Discussed importance of high-quality electronic advance medical directives for all adults over the age of 18 years that can be digitally accessed 24 hours/day, 7 days/week in the cloud by qualified medical health professionals, hospitals and other providers, and consumers anywhere in the world as part of a consumer's electronic medical record. Seeking consideration of ADs as a required, or at minimum strongly encouraged, added benefit to Medicare Advantage (MA) plans. Support proposals to incentivize Medicare/Medicaid beneficiaries and federal employees through FEHBP to create and store a digital AD. Endorsed legislation, the Medicare Choices Empowerment & Protection Act (S. 1503/HR 3181), introduced by Senators Coons & Cassidy & Reps Black, Thompson, Welch, and Collins, to provide a one-time financial incentive to Medicare beneficiaries who voluntarily register an advance care plan.

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

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

H.R.817-End Surprise Billing Act of 2017 H.R.849-Protecting Seniors' Access to Medicare Act of 2017 H.R.1148-Furthering Access to Stroke Telemedicine (FAST) Act H.R.1323-Reducing Unnecessary Emergency Room Visits under Medicaid Act H.R.1421-Improving Access to Medicare Coverage Act of 2017 H.R.2392-Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2017 H.R.2957-Save Rural Hospitals Act H.R.3181-Medicare Choices Empowerment and Protection Act H.R.3729-Comprehensive Operations, Sustainability, and Transport Act of 2017 H.J.Res.51-Approving the discontinuation of the process for consideration and automatic implementation of the annual proposal of the Independent Medicare Advisory Board under section 1899A of the Social Security Act S.251-Protecting Medicare from Executive Action Act of 2017 S.260-Protecting Seniors' Access to Medicare Act of 2017 S.284-End Surprise Billing Act of 2017 S.568-Improving Access to Medicare Coverage Act of 2017 S.1063-Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2017 S.1130-Rural Emergency Acute Care Hospital (REACH) Act S.1530- Medicare Choices Empowerment and Protection Act S.Amdt.667 to S.Amdt.267 to H.R.1628-Better Care Reconciliation Act 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 Medicare Advisory Board under section 1899A of the Social Security Act S.J.Res.17-A joint resolution approving the discontinuation of the process for consideration and automatic implementation of the annual proposal of the Independent Medicare Advisory Board under section 1899A of the Social Security Act

Client expense: $568,275 · Firm income: Not reported

Alternatives to Opiates (ALTO) H.R.304-Protecting Patient Access to Emergency Medications Act of 2017 H.R.372-Competetive Health Insurance Reform Act of 2017 H.R.548-Health Care Safety Net Enhancement Act of 2017 H.R.582-Kari's Law Act of 2017 H.R.817-End Surprise Billing Act of 2017 H.R.849-Protecting Seniors' Access to Medicare Act of 2017 H.R.880-Military Injury Surgical Systems Integrated Operationally Nationwide to Achieve ZERO Preventable Deaths Act H.R.1057-Synthetics Trafficking and Overdose Prevention Act of 2017 H.R.1215-Protecting Access to Care Act of 2017 H.R.1323-Reducing Unnecessary Emergency Room Visits under Medicaid Act H.R.1421-Improving Access to Medicare Coverage Act of 2017 H.R.1492-Medical Controlled Substances Transportation Act of 2017 H.R.1565-Saving Lives, Saving Costs Act H.R.1628-American Health Care Act of 2017 H.R.1822-Good Samaritan Health Professionals Act of 2017 H.R.1876-Good Samaritan Health Professionals Act of 2017 H.R.2200-Frederick Douglass Trafficking Victims Prevention and Protection Reauthorization Act of 2017 H.R.2392-Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2017 H.R.2430-FDA Reauthorization Act of 2017 H.R.2851-Stop the Importation and Trafficking of Synthetic Analogues (SITSA) Act of 2017 H.R.2957-Save Rural Hospitals Act H.R.3181-Medicare Choices Empowerment and Protection Act H.R.3258-Marketplace Certainty Act H.R.3545-Overdose Prevention and Patient Safety (OPPS) Act H.R.3729-Comprehensive Operations, Sustainability, and Transport Act of 2017 H.J.Res.51-Approving the discontinuation of the process for consideration and automatic implementation of the annual proposal of the Independent Medicare Advisory Board under section 1899A of the Social Security Act P.L.111-148-Patient Protection and Affordable Care Act S.191-Patient Freedom Act of 2017 S.222-Obamacare Replacement Act S.251-Protecting Medicare from Executive Action Act of 2017 S.260-Protecting Seniors' Access to Medicare Act of 2017 S.284-End Surprise Billing Act of 2017 S.372- Synthetics Trafficking and Overdose Prevention Act of 2017 S.527-Health Care Safety Net Enhancement Act of 2017 S.568-Improving Access to Medicare Coverage Act of 2017 S.781-Good Samaritan Health Professionals Act of 2017 S.916-Protecting Patient Access to Emergency Medications Act of 2017 S.934-FDA Reauthorization Act of 2017 S.1016-Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2017 S.1022-Military Injury Surgical Systems Integrated Operationally Nationwide to Achieve ZERO Preventable Deaths Act S.1063-Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2017 S.1130-Rural Emergency Acute Care Hospital (REACH) Act H.R.1148-Furthering Access to Stroke Telemedicine (FAST) Act S.1462-Marketplace Certainty Act S.1530- Medicare Choices Empowerment and Protection Act S.Amdt.667 to S.Amdt.267 to H.R.1628-Better Care Reconciliation Act 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 Medicare Advisory Board under section 1899A of the Social Security Act S.J.Res.17-A joint resolution approving the discontinuation of the process for consideration and automatic implementation of the annual proposal of the Independent Medicare Advisory Board under section 1899A of the Social Security Act

Insurance-related issues pertaining to reconciliation legislation are reported under BUD (Budget/Appropriations). Insurance-related provisions pertaining to health-care ("Obamacare replacement") legislation are reported on the HCR (Health Issues) page. Contacts in support of the Medicare Choices Empowerment and Protection Act (S. 1530/H.R. 3181), to give beneficiaries and others online access to model advance directives that choose life-saving treatment, food and fluids equally with those that reject them in order to offset widespread efforts to nudge patients to agree to forego life-saving treatment.

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

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

Furthering Access to Coordinated Treatment for Seniors Act of 2017(H.R.3447) Furthering Access to Stroke Telemedicine Act(S.431/H.R.1148) Independence at Home Act(S.464) Medicare Access to Rehabilitation Services Act(H.R.807/S.253) Medicare Cardiac Rehab Supervision Bill(H.R.1155/S.1361) Medicare Choice Empowerment and Protection Act(H.R.3181/S.1530) Palliative Care and Hospital Education and Training Act(H.R.1676/S.693) Patient Choice and Quality Care Act of 2017(S.1334/H.R.2797) Senate Finance CHRONIC Care Bill(S.870)

Client expense: $41,981 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Education, Dept of, 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), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Transportation, Dept of (DOT), Treasury, Dept of, U.S. Trade Representative (USTR), White House Office

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

Discussed importance of high-quality electronic advance medical directives for all adults over the age of 18 years that can be digitally accessed 24 hrs/day, 7 days/ week in the cloud by physicians, hospitals and consumers anywhere in the world as part of the patient's electronic medical record. Seeking consideration of ADs as a required, or at minimum strongly encouraged, added benefit to Medicare Advantage (MA) plans. Support proposals to incentivize all Medicare/Medicaid beneficiaries and federal employees through FEHBP to create and store a digital AD. Endorsed legislation, the Medicare Choices Empowerment & Protection Act (S. 1530/HR 3181), introduced by Senators Coons/Cassidy & Reps. Black, Thompson, Welch and Collins, to provide a one-time financial incentive to Medicare beneficiaries that voluntarily register an advance care plan.

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

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