Every Prescription Conveyed Securely Act

Implementation of Comprehensive Addiction and Recovery Act (CARA) PL 114-198 and education regarding opioid treatment and prevention; Implementation of 21st Century Cures (H.R. 34), advocacy related to healthcare technology and innovation issues; E-Rx (H.R.3528), advocacy related to electronic prescriptions of medications; Implementation of FY'2018 NDAA provision related to e-Commerce portals; education about potential improvements to Prescription Drug Monitoring Programs; H.R. 6 Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act; Education about improvements to Prescription Drug Monitoring programs that would promote greater efficiency and utility at the pharmacy and other issues related to opioid abuse.

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

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

Support H.R. 304/S. 916, The Protecting Patient Access to Emergency Medications Act of 2017, a bill to amend the Controlled Substances Act with regard to the provision of emergency medical services and discussed companion legislation with the Senate; Support H.R. 372, The Competitive Health Insurance Reform Act of 2017, a bill to repeal McCarran-Ferguson with respect to the business of health insurance; Discussed with members of congress working on legislation that maintains coverage and improves Americas health care system through patient-centered care; Oppose HR 1156/ S 1133 , Patient Access to Higher Quality Health Care Act of 2017, a bill to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals; Support HR 1215, Protecting Access to Care Act, a bill to improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system; Urged CMS to release guidance pertaining to hospital co-location arrangements and to provide flexibility in the agencys co-location policies; Support HR 2141/ S 898, the Conrad State 30 and Physician Access Act of 2017, a bill that would reauthorize the Conrad State 30 Program and make other changes to improve patient access to care; Support S.781/ HR 1876. Good Samaritan Health Professional Act of 2017, a bill to amend the Public Health Service Act to limit the liability of health care professionals who volunteer to provide health care services in response to a disaster; Support HR 2212/ S 974Creating and Restoring Equal Access to Equivalent Samples (CREATES) Act of 2017, a bill to promote competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products; Meet with HRSA Administrator and senior staff on 340B drug pricing program; Discussed marketplace stabilization solutions with Hill staff; Support and Recommend changes to HR 1253, Mental Health and Substance Abuse Treatment Accessibility Act of 2017 a bill to authorize the Secretary of Health and Human Services to make loans and loan guarantees for constructing or renovating, or planning construction or renovation of, qualified psychiatric and substance abuse treatment facilities, and for other purposes: advocated for changes to clarify/expand the entities that can be loan applicants/recipients; Urged the Administration to suspend the faulty star ratings from the Hospital Compare website; Eliminate barriers to care with the creation of an Anti-Kickback safe harbor for clinical integration arrangements that establishes the basic accountabilities for the use of incentive payment or shared savings programs among hospitals, physicians and other providers, along with a safe-harbor for assistance to patients that would protect providers from financial penalties under the Civil Monetary Penalties (CMPs) for providing an inducement to a patient; Advocated for changes including: eliminating geographic and setting locations requirements so patients outside of rural areas can benefit from telehealth; expanding the types of technology that can be used, including remote monitoring; and covering all services that are safe to provide, rather than a small list of approved services; Submit Statement Stabilizing Premiums and Helping Individuals in the Individual Insurance Market for 2018: Health Care Stakeholders about the importance of stabilizing the Health Insurance Marketplaces for 2018 and beyond; We urged Congress to pass legislation to fund the ACA cost-sharing reductions; Urged Senators to oppose the Graham-Cassidy proposal being considered in the Senate because this proposal would make significant changes to health care coverage and health care financing; Review of H.R. 3528, Every Prescription Conveyed Securely Act, a bill to amend title XVIII of the Social Security Act to require e-prescribing for coverage under part D of the Medicare program of prescription drugs that are controlled substances; Discussions with Congress on prescription drug monitoring programs, the dispensing of controlled substances, and clinical workflow; Discussions with Congress on draft legislation related to prescription drug monitoring programs; Urged Congress to consider advancing solutions aimed at making our health care system stronger, protecting access and coverage, and exploring new delivery system reforms that have the potential to make care both more affordable and safer; Review of The Combating the Opioid Epidemic Act, a bill to provide funding to combat the opioid epidemic; Discussions with the White House/Office of National Drug Control Policy about the opioid epidemic, including concerns about regulations that prohibit the sharing of substance use disorder records among health care providers; Support H.R. 4392 a bill to prevent cuts to the 340B drug savings program, which would provide relief from deep cuts to payments to hospitals participating in the 340B program; Letter to congress outlining AHA opposition to a potential policy that would cut payments to hospitals treating hospice patients; Oppose H.R. 4710, 340B Protecting Access for the Underserved and Safety-Net Entities (PAUSE) Act, a bill to amend the Public Health Service Act to establish a moratorium on the registration of certain new 340B hospitals and associated site; Sent comments to the Energy and Commerce Subcommittee on Oversight and Investigations for its hearing on Examining the Impact of Health Care Consolidation.; Letter sent to the Energy & Commerce Subcommittee for its hearing on, "Combating the Opioid Crisis: Helping Communities Balance Enforcement and Patient Safety"; Letter submitted to the Ways and Means Committee on policy recommendations to address the opioid epidemic; Sent letter to discuss the current state of health care costs, and efforts to increase transparency in the pricing of health care services and the quality of care; Addressed our concerns with the MedPAC Commissions draft recommendation to substantially reduce payments for off-campus stand-alone emergency departments (EDs) that are within 6 miles of an on-campus hospital ED; Support HR 4776, Hospital Preparedness Reauthorization Act of 2018, a bill to amend the Public Health Service Act to reauthorize a program of partnerships for State and regional hospital preparedness to improve surge capacity and would increase the level of authorized funding for the Hospital Preparedness Program to $515 million; Submitted statement to the Senate HELP Committee on the Hearing on How to Reduce Health Care Costs: Understanding the Cost of Health Care in America; Submitted a Statement for the HELP hearing on Effective Administration of the 340B Drug Pricing Program; Support certain provisions in Helping to End Addiction and Lesson (HEAL) Substance Use Disorders Act of 2018; Support HR 6071, Stretching Entity Resources for Vulnerable Communities Act or the SERV Communities Act, A bill to amend the Public Health Service Act to clarify the intent of the 340B program and provide for enhanced 340B program integrity; Support S 2597Childrens Hospital GME Support Reauthorization Act of 2018, A bill to amend the Public Health Service Act to reauthorize the program of payments to children's hospitals that operate graduate medical education programs; Support HR 3545, Overdose Prevention and Patient Safety ActA bill to amend the Public Health Service Act to protect the confidentiality of substance use disorder patient records; Support S 2516, Alternatives to Opioids (ALTO) in the Emergency Department ActA bill to direct the Secretary of Health and Human Services to conduct a demonstration program to test alternative pain management protocols to limit the use of opioids in emergency departments; Support HR 5176/ S 2610, Preventing Overdoses While in Emergency Rooms Act of 2018 A bill to require the Secretary of Health and Human Services to provide coordinated care to patients who have experienced a non-fatal overdose after emergency room discharge; Submit statement to the Ways and Means Subcommittee on Health on the hearing Identifying Innovative Practices and Technology in Health Care; Support S 1845 Lead-Safe Housing for Kids Act" To amend the Lead-Based Paint Poisoning Prevention Act to provide for additional procedures for families with children under the age of 6; Submitted statement to the Energy & Commerce Health Subcommittee for the hearing "Improving the Coordination and Quality of Substance Use Disorder Treatment." The statement focuses on 42 CFR Part 2; Comments to HELP Committee's discussion draft of the Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018; The current Pandemic and All-Hazards Preparedness Act (PAHPA) will sunset on October 1, 2018 so this is "must-do" legislation; Support S 2852, the Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018 (PAHPAI), A bill to reauthorize certain programs under the Pandemic and All-Hazards Preparedness Reauthorization Act; Supports S. 2372, VA Maintaining Internal Systems and Strengthening Integrated Outside Networks Act of 2018 (VA MISSION Act of 2018).A bill to establish a permanent community care program for veterans, to establish a commission for the purpose of making recommendations regarding the modernization or realignment of facilities of the Veterans Health Administration, to improve construction of the Department of Veterans Affairs, to make certain improvements in the laws administered by the Secretary of Veterans Affairs relating to the home loan program of the Department of Veterans Affairs,Submitted a statement to the Ways and Means Committee hearing on "Lowering Costs and Expanding Access to Health Care through Consumer-Directed Health Plans;" Submitted a statement to the Senate HELP Subcommittee on "Primary Health and Retirement Security on Health Care in Rural America: Examining Experiences and Costs"; Submitted a statement to the Senate HELP Committee on "Reducing Health Care Costs: Eliminating Excess Health Care Spending and Improving Quality and Value for Patients"; Submitted comments on the consumer-directed health plan legislation to the Committee on Ways & Means; Submitted a statement to the Energy and Commerce Subcommittee on Health on "Opportunities to Improve the 340B Drug Pricing Program"; Discussions about maternal health issues sent by the majority oversight and health subcommittee chairs; Discussions about the Megan Rondini Act; Surprise billing letter to congressional and committee leadership and discussions with members on the same issue; Letter on short-term limited duration plan rule; Meeting with Committee to discuss clarification of Anti-Kickback Statute provisions in the SUPPORT Act.

Client expense: $5,460,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA), White House Office

Medicare Advantage Policy and Reimbursement Part D Policy and Reimbursement Medicaid and Dual Eligible Issues Pharmacy Reimbursement Issues Medicare Access and CHIP Reauthorization Act Implementation HHS Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs Opioid Issues H.R. 6, Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act S. 3120, HEAL Act of 2018 S. 637, Creating Transparency to Have Drug Rebates Unlocked Act H.R. 3528, Every Prescription Conveyed Securely Act H.R. 6733, Know the Cost Act of 2018 S. 2553, Know the Lowest Price Act of 2018

Client expense: $320,000 · Firm income: Not reported

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

Monitor legislative and administrative action related to health care policy; Monitor legislative activity related to H.R. 1628, the American Health Care Act; H.R. 592 and S. 109, The Pharmacy and Medically Underserved Areas Enhancement Act; H.R. 3528 and S. 2460, Every Prescription Conveyed Securely Act; H.R. 6 SUPPORT for Patients and Communities Act; and H.R. 4190, House Provider Status Bill.

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

Government targets: Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, Internal Revenue Service (IRS), Labor, Dept of (DOL), Pension Benefit Guaranty Corporation (PBGC), SENATE, Treasury, Dept of

S. 483 (114th Congress) legislation to prevent and reduce prescription drug abuse. H.R. 592 & S. 109, provide for coverage under Medicare program of pharmacist services. Medication Therapy Management. H.R. 1038 and S. 413, legislation to prohibit prescription drug plan sponsors and MAPD organizations under Medicare program from retroactively reducing payment on clean claims submitted by pharmacies. Pharmaceutical compounding and the implementation of Drug Quality Security Act; FDA implementation of Section 503B of the Food, Drug, and Cosmetic Act; House & Senate Agriculture, FDA & Related Agency Appropriations bills; H.R. 2871, Preserving Patient Access to Compounded Medications Act of 2017. Prescription Drug Importation including S. 771 and H.R. 1776, the Improving Access to Affordable Prescription Drugs Act and S.469, the Affordable and Safe Prescription Drug Importation Act. E-Prescribing bills including H.R. 3528 and S. 2460, the Every Prescription Conveyed Securely (EPCS) Act. H.R. 5958, Phair Pricing Act of 2018. HHS Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs. S. 3282 and H.R. 6600, the DEA Order Clearinghouse Act of 2018. H.R. 6, SUPPORT for Patients and Communities Act.

Client expense: $450,000 · Firm income: Not reported

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

H.R. 6, Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act, all provisions H.R. 930, Lymphedema Treatment Act, all provisions S. 497, Lymphedema Treatment Act, all provisions H.R. 6836, CLINICAL TREATMENT Act, all provisions S. 3592, No More Surprise Medical Bills Act of 2018, all provisions H.R. 7122, Shared Accountability for Improved Patient Outcomes Act of 2018, all provisions H.R. 6, SUPPORT for Patients and Communities Act, all provisions S. 3120, HEAL Act of 2018, all provisions H.R.3528 - Every Prescription Conveyed Securely Act, all provisions S. 2460, Every Prescription Conveyed Securely Act, all provisions H.R. 2687, Medicaid Coverage for Addiction Recovery Expansion Act, all provisions S. 1169, Medicaid Coverage for Addiction Recovery Expansion Act, all provisions S. 1016, CONNECT for Health Act of 2017, provisions relating to telehealth Medicare program: Protecting Patients from Surprise Medical Bills Act Medicare program: Protecting Access to Medicare Act (PAMA)/physician office labs Medicare program: Medicare Access and Chip Reauthorization Act (MACRA) implementation Medicare program: Merit-based Incentive Payment System (MIPS) Medicare program: MIPS cost measures Medicare program: MIPS impact on Part B drugs and DME Medicare program: Physician-Focused Payment Model Technical Advisory Committee (PTAC) Medicare program: Diabetes Prevention Program/virtual coverage Medicare program: Evaluation and Management Codes/documentation Medicare program: Medicare physician fee schedule Medicare program: Medicare Advantage (MA) and Part D Medicare program: Quality Payment Program Medicare program: Shared Savings Program Medicare program: Health IT burdens Medicare program: Surprise billing Medicare program: Graduate Medical Education (GME) Medicare program: Alternative Payment Models (APMs) Medicare program: Appropriate Use Criteria Medicare program: Cybersecurity Medicare program: Interoperability Medicare program: Stark/Anti-kickback Medicare program: Privacy Medicare program: Regulatory relief Medicare program: Step therapy Medicare program: Residents/minor procedures Medicare program: Prior authorization and utilization management Medicare program: Medicare for all Medicare program: Open Payments Medicare program: PECOS/Medicare Enrollment/Revocations/Revalidations Medicare program: Pharmacy Benefit Manager (PBM)/drug price transparency Medicare program: Misvalued codes Medicare program: List price for drugs Medicare program: Drug pricing transparency

Client expense: $4,740,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Bureau of Citizenship & Immigration Services (BCIS), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Natl Drug Control Policy (NDCP), SENATE, U.S. Customs & Border Protection, U.S. Trade Representative (USTR), Veterans Affairs, Dept of (VA), White House Office

S. 1850, Legacy Act (Manchin-Capito) -- confidentiality of drug and alcohol treatment and prevention records S. 2460, Every Prescription Conveyed Securely Act (Bennet) - opioid issues S. 2680, Opioid Crisis Response Act (Alexander) - opioid initiatives, mental health parity S. 2789, Substance Abuse Prevention Act (Cornyn) - opioid initiatives, restrictions on step therapy S. 2812, Air Ambulance Consumer Protection Act (McCaskill) - air ambulance S. 2828, Sober Home Fraud Detection Act (Rubio) - best practices for identifying fraud in recovery housing S. 2891, Fighting the Opioid Epidemic with Sunshine Act (Grassley) - opioid issues S. 2892, Peer Support Enhancement and Evaluation Review Act (Cardin) - opioid issues S. 2898, Medication-Assisted Treatment Improvement Act (Casey) - opioid issues S. 2899, Caring Recovery for Infants and Babies Act (Brown) - opioid issues S. 2900, Comprehensive Screenings for Seniors Act (Brown) - opioid issues S. 2902, Better Data Sharing to Combat the Opioid Crisis Act (Cassidy) - opioid issues S. 2905, Strengthening Partnerships to Prevent Opioid Abuse Act (Toomey) - opioid issues S. 2910, Telehealth for Childrens Access to Services and Treatment Act (Roberts) - opioid issues S. 2911, Enhancing Patient Access to Non-Opioid Treatment Options (Heller) - opioid issues S. 2912, Opioid Addiction Treatment Programs Enhancement Act (Cassidy) - opioid issues S. 2920, Commit to Opioid Medical Prescriber Accountability and Safety for Seniors Act (McCaskill) - opioid issues S. 2922, Help for Moms and Babies Act (Stabenow) - opioid issues S. 2923, Building Capacity for Family-Focused Residential Treatment Act (Grassley) - opioid issues S. 2924, Supporting Family-Focused Residential Treatment Act (Scott) - opioid issues S. 3016, Action for Dental Health Act (Booker) - grants for oral health programs S. 3120, the HEAL Substance Use Disorders Act (Hatch) - opioid initiatives S. 3158, Labor-HHS-Education Appropriations Act (Blunt) - HHS funding S. 3254, Eliminating Kickbacks in Recovery Act (Rubio) - anti-kickback penalties for body brokers Draft Bill: Protecting Patients From Surprise Medical Bills Act (Cassidy) - surprise medical bills H.R. 6, SUPPORT Patients and Families Act (Walden) - opioid initiatives, Medicare and Medicaid issues, budget offsets H.R. 302, FAA Reauthorization Act - air ambulance issues H.R. 1215, Protecting Access to Care Act (King) - medical liability reform H.R. 1313, Preserving Employee Wellness Programs Act (Foxx) - employee wellness programs H.R. 2422, Action for Dental Health Act (Kelly) - oral health services and education for underserved populations H.R. 3331, adoption and use of EHR technology by behavioral health providers (Jenkins) - opioid issues H.R. 3528, Every Prescription Conveyed Securely Act (Clark) - opioid issues H.R. 4684, Ensuring Access to Quality Sober Living Act (Chu) - best practices for recovery housing H.R. 4841, Standardizing Electronic Prior Authorization for Safe Prescribing Act (Schweikert) - opioid issues H.R. 4998, Health Insurance for Former Foster Youth Act (Bass) - opioid issues H.R. 5100, Recovery Home Certification Act (Knight) -- anti-kickback penalties for body brokers H.R. 5477, Rural DOCS Act (O'Halleran) - opioid issues H.R. 5515, National Defense Authorization Act (Thornberry) H.R. 5562, Protecting NAS Babies Act (Jenkins) - opioid issues H.R. 5582, Abuse Deterrent Access Act (Carter) - opioid issues H.R. 5583, State reporting on certain adult health quality measures (Clarke) - opioid issues H.R. 5590, CMS Action Plan (Kinzinger) - opioid issues H.R. 5714, Education for Disposal of Unused Opioids Act (Black) - opioid issues H.R. 5715, Strengthening Partnerships to Prevent Opioid Abuse Act (Renacci) - opioid issues H.R. 5716, COMPASS Act (Roskam) - opioid issues H.R. 5723, Expanding Oversight of Opioid Prescribing and Payment Act (Tenney) - opioid issues H.R. 5725, BEST Act (Roskam) - opioid issues H.R. 5774, Combating Opioid Abuse for Care in Hospitals Act (Curbelo) - opioid issues H.R. 5775, Providing Reliable Options for Patients and Educational Resources Act (Paulsen) - opioid issues H.R. 5776, MOST Act (Neal) - opioid issues H.R. 5789, protections for pregnant and post-partum women (Foster) - opioid issues H.R. 5795, Overdose Prevention and Patient Safety Act (Blumenauer) - confidential sharing of substance use disorder information H.R. 5796, Responsible Education Achieves Care and Healthy Outcomes for Users' Treatment Act (Fitzpatrick) - opioid issues H.R. 5801, PARTNERSHIP Act (Griffith) - opioid issues H.R. 6082, Overdose Prevention and Patient Safety Act (Mullin) - confidential sharing of substance use disorder information H.R. 6147, Interior, Environment, Financial Services, Agriculture, FDA, Transportation, and Housing Appropriations Act (Calvert) - FDA funding H.R. 6157, Defense-Labor-HHS-Education Appropriations Act (Granger) - HHS funding H.R. 6753, Strengthening the Health Care Fraud Prevention Task Force Act (Walden) - codification of Healthcare Fraud Prevention Partnership H.R. 6878, Eliminating Kickbacks in Recovery Act (Deutch) - anti-kickback penalties for body brokers H.R. 6902, Eliminating Kickbacks in Recovery Act (Knight) - anti-kickback penalties for body brokers Regulatory Issues: HIPAA administrative simplification issues, including standards for privacy, security, and electronic transactions and code sets (including ICD-10), identifiers including the health plan identifier, enforcement; cybersecurity; FEHBP enrollment data clearinghouse initiative, the enrollment reconciliation process, and a related OPM reimbursement factor for records that cannot be reconciled; issues relating to health insurance plan participation in FEHBP, including contract requirements; issues relating to similarly sized subscriber group (SSSG) and MLR requirements under the FEHBP; implementation of the health savings account provisions of the Medicare Act; issues related to Medicare Secondary Payer requirements; issues related to implementation of the National Health Information Infrastructure; electronic health records, personal health records, and similar technologies; issues relating to market consolidation; issues related to hospital consolidation; issues relating to quality improvement; issues relating to the national health data stewardship; issues relating to hospital outpatient measurement and reporting; prescription drug pricing; issues related to the collection of race and ethnicity data; issues related to medical loss ratios; reference pricing; review of rates for reasonableness; preexisting condition insurance plans; issues relating to antitrust; accountable care organizations; provider non-discrimination; coverage of preventive services; contraceptive coverage; pre-existing condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; issues relating to the annual fee on health insurance providers; health plan automatic enrollment requirements; issues related to qualified health plans including certification and rate filing templates; health insurance market rules; reinsurance, risk corridors, and risk adjustment; dependent coverage; summary of benefits and coverage disclosures; benefit and payment parameters; essential health benefits, actuarial value, and accreditation; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations; issues related to supplemental products; issues related to HIPAA excepted benefits; issues related to short term limited duration products; issues related to the federally-facilitated marketplaces (i.e., Exchanges/formerly referred to as the web portal); issues related to business continuity in relation to pandemics or natural events (e.g., hurricane, tornado, etc.); issues related to association health plans; issues related to cost-sharing reductions (CSRs); issues related to the refundable credit for coverage under a qualified health plan; issues related to small employer group size; issues related to Certificate of Public Advantage; issues relating to veterans health care; issues relating to family caregivers; and other issues relating to health care reform implementation.

Client expense: $1,540,000 · Firm income: Not reported

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

General education about the pharmacy benefit manager/pharmacy industry, including S.637, The Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act. Issues related to Risk Evaluation and Mitigation Strategies (REMS) program, including S.974 and H. R. 2212, The CREATES Act. Proactive measures to curb opioid abuse, including H. R. 3528, Every Prescription Conveyed Securely Act, and H. R. 4841, Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018, as well as H.R. 6, the SUPPORT for Patients and Communities Act.

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

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

General education about the pharmacy benefit manager/pharmacy industry, including S.637, The Creating Transparency to Have Drug Rebates Unlocked (C-THRU)Act. Issues related to access and affordability of health care for veterans. Issues related to the proposed CVS-Aetna merger. Legislative efforts to address the opioid epidemic, including H. R. 3528, Every Prescription Conveyed Securely Act, and H. R. 4841, Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018, as well as H.R. 6, the SUPPORT for Patients and Communities Act.

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

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

Implementation of Public Law 114-198 pharmacy provisions; Implementation of Public Law 114-255 pharmacy provisions; H.R. 1854/S. 778, Prescription Drug Monitoring Act of 2017; S 892 / H.R. 4408, Opioid Addiction Prevention Act of 2017; HR 3528 / S.2460, Every Prescription Conveyed Securely Act; H.R. 3545, Overdose Prevention and Patient Safety Act; S. 1850, Protecting Jessica Grubbs Legacy Act; H.R. 1271, DXM Abuse Prevention Act of 2017; H.R. 1375, Prescriber Support Act of 2017; S. 523, Budgeting for Opioid Addiction Treatment Act; S. 581 / H.R. 5009, Jessies Law; S 1079, Protecting Americans from Dangerous Opioids Act; H.R. 4236, MONITOR Act of 2017; H.R. 3991, Expanded Access to Opioid Abuse Treatment Act of 2017; H.R. 4275, Empowering Pharmacists in the Fight Against Opioid Abuse Act; H.R. 5219, Opioid Prescription Verification Act of 2018; H.R. 5676, SENIOR Communities Protection Act of 2018; H.R. 5773, PASS Act of 2018; Draft legislation, Medicare Care Coordination Improvement Act of 2017; Draft legislation, Pain Care Coordination Act of 2018; S. 2456/H.R. 5311, CARA 2.0 Act of 2018; H.R. 5687, SOUND Disposal and Packaging Act; H.R. 5202, Ensuring Patient Access to Substance Use Disorder Treatments Act of 2018; H.R. 5812, CONNECTIONS Act; H.R. 5801, Medicaid PARTNERSHIP Act; H.R. 6, SUPPORT for Patients and Communities Act; H.R. 5808, Medicaid Pharmaceutical Home Act of 2018; H.R. 5675, To amend title XVIII of the Social Security Act to require prescription drug plan sponsors under the Medicare program to establish drug management programs for at-risk beneficiaries; S. 2680, Opioid Crisis Response Act of 2018; S. 2645 / H.R. 5628, Access to Increased Drug Disposal Act of 2018; H.R. 6600 / S. 3282, the DEA Order Clearinghouse Act of 2018; H.R. 6688, ALERT Act of 2018

Client expense: $240,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), Office of Personnel Management (OPM), SENATE, Small Business Administration (SBA), Substance Abuse & Mental Health Services Administration (SAMHSA), White House Office

H.R. 592/S. 109, The Pharmacy and Medically Underserved Areas Enhancement Act, all provisions. H.R. 1038/S. 413, Improving Transparency and Accuracy in Medicare Part D Spending Act, all provisions. H.R. 6 - Support for Patients and Communities Act, provisions related to pharmacy operations S. 2460/H.R. 3528, Every Prescription Conveyed Securely Act, all provisions. H.R. 6199 - Restoring Access to Medication and Modernizing Health Savings Accounts Act of 2018, provisions related to over-the-counter medications Implementation of 2017 NDAA Tricare Pilot. CMS Medicare Part D Final Rule, provisions related to DIR fees.

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

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

Implementation of the 21st Century Cures Act (P.L.114-255); Patient Matching issues. H.R.3528/S.2460, Every Prescription Conveyed Securely Act; Electronic Prescribing of Controlled Substances issues. Cybersecurity issues. Health Information Technology issues. H.R.6, SUPPORT for Patients and Communities Act (P.L.115-271).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 592 / S. 109 - The Pharmacy and Medically Underserved Areas Enhancement Act, all provisions related to amending the Social Security Act to allow pharmacists to be reimbursed under Medicare Part B for services provided to patients in medically underserved communities, consistent with state scope of practice laws. H.R. 3528 / S. 2460 and H.R. 6 - These bills would amend title XVIII of the Social Security Act to require e-prescribing under Part D of the Medicare program of prescription drugs that are controlled substances. Issues related to American Patients First: The Trump Administration Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs; no legislation.

Client expense: $560,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 592/S. 109, Pharmacy and Medically Underserved Areas Enhancement Act. H.R. 6, SUPPORT for Patients and Communities Act. H.R. 5684, Protecting Seniors from Opioid Abuse Act. H.R. 3528/S. 2460, Every Prescription Conveyed Securely Act.

Client expense: $440,000 · Firm income: Not reported

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, SENATE, Treasury, Dept of

H.R. 1776/S. 771 - Improving Access To Affordable Prescription Drugs Act H.R. 592/S. 109 - Pharmacy and Medically Underserved Areas Enhancement Act H.R. 394/S. 85 - Restoring Access to Medication Act H.R.3528 - Every Prescription Conveyed Securely Act S.2460- Every Prescription Conveyed Securely Act H.R. 5799, Medicaid DRUG Improvement Act H.R. 5801, Medicaid PARTNERSHIP Act H.R. 5808, Medicaid Pharmaceutical Home Act of 2018 H.R. 3325 - Advancing Care for Exceptional (ACE) Kids Act

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, SENATE

S.892 Opioid Addiction Prevention Act of 2017 H.R.4408 - Opioid Addiction Prevention Act of 2017 H.R.3964 - Opioid Addiction Prevention Act of 2017 H.R. 5219 - Opioid Prescription Verification Act H.R. 4275 - Empowering Pharmacists in the Fight Against Opioids Act H.R. 4275 - Safe Disposal of Unused Medication Act H.R. 2063 - Opioid Preventing Abuse through Continuing Education Act S. 3120 Helping to End Addiction and Lessen (HEAL) Substance Use Disorders Act of 2018 S. 2789, Substance Abuse Prevention Act of 2018 S. 2838, Using Data to Prevent Opioid Diversion Act of 2018 S. 2460, Every Prescription Conveyed Security Act of 2018 H.R. 5812, Creating Opportunities that Necessitate New and Enhanced Connections That Improve Opioid Navigation Strategies Act (CONNECTIONS) Act H.R. 4275, Empowering Pharmacists in the Fight Against Opioid Abuse Act H.R. 3528, Every Prescription Conveyed Securely Act H.R. 4841, Standardizing Electronic Prior Authorization for Safe Prescribing Act H.R. 5675, To amend title XVIII of the Social Security Act to require prescription drug plan sponsors under the Medicare program to establish drug management programs for at-risk beneficiaries H.R. 5333, Over-the-Counter Monograph Safety, Innovation, and Reform Act H.R. 5687, Securing Opioids and Unused Narcotics with Deliberate Disposal and Packaging Act H.R.6 - SUPPORT for Patients and Communities Act S. 2465 - AIDD Act S 2837 - Preventing Drug Diversion Act S. 3282 - DEA Order Clearinghouse Act S. 2383 - Using Data to Prevent Opioid Diversion Act

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, SENATE

Meaningful Use; 21st Century Cures implementation and oversight; Innovation for Healthier Americans - identifying opportunities for meaningful reform to our nation's Medicare product discovery and development; patient access to data; The "Access to Telehealth Services for Opioid Use Disorders" Act; the "Every Prescription Conveyed Securely" Act, H.R. 3528; "Overdose Prevention and Patient Safety (OPPS)" Act, H.R. 3545 and H.R. 6082; the "Standardizing Electronic Prior Authorization for Safe Prescribing" Act of 2018, H.R. 4841; the "Protecting Jessica Grub's Legacy" Act S. 1850; The "Ensuring Patient Access to Healthcare Records" Act of 2017, H.R. 4613; the "Support for Patient and Communities Act," H.R. 6; the "Preventing Addiction for Susceptible Seniors Issues(PASS) Act," H.R. 5773; Issues related to Prescription Drug Monitoring Programs; The "Reducing Unnecessary Senior Hospitalization Act" H.R. 6502; The "Streamline Small Cell Deployment Act" S.3157; The "Analyzing and Leveraging Existing Rx Transactions Act" HR 6688. )

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

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

H.R. 6 - Support for Patients and Communities Act - Support for policies that help to fight the opioid epidemic with a focus on safe prescriptions. S. 3120 - Helping to End Addiction and Lessen Substance Use Disorders Act - Support for policies that help to fight the opioid epidemic with a focus on safe prescriptions. H.R. 3528/S. 2460 - Every Prescription Conveyed Securely Act - Support for electronic prescribing of opioids to enhance patient safety. S. 2553 - Know the Lowest Price Act of 2018 - Support for the elimination of " gag clauses" in the Medicare Part D program. S. 2554 - Patient Right to Know Act Drug Prices Act of 2018 - Support for for the elimination of "gag clauses" in the private insurance market. CMS Regulations related to the Medicare Part D program and Prescription Drug Plans(PDPs). FDA work on addressing drug shortages in the U.S. S. 637 - Creating Transparency to Have Prescription Drug Rebates Unlocked - Issues related to the alleged relationship between rebates and drug prices. S. 771 - A Bill to Improve Access to Affordable Prescription Drugs - Issues related to bringing drug prices down including strengthening policies in the Part D coverage gap, couponing and advancing biosimilars. Education activities for Members and staff related to Direct and Indirect Renumeration(DIR)policies. Education activities related to the cross referencing of certain data related to Medicare Parts A, B and D. Trump Administration's Blueprint for lowering the price of prescription medications in the United States and the role that PBMs can play in doing so.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, SENATE

H.R. 6 - Support for Patients and Communities Act - Support for policies that help to fight the opioid epidemic with a focus on safe prescriptions. S. 3120 - Helping to End Addiction and Lessen Substance Use Disorders Act - Support for policies that help to fight the opioid epidemic with a focus on safe prescriptions. H.R. 3528/S. 2460 - Every Prescription Conveyed Securely Act - Support for electronic prescribing of opioids to enhance patient safety. S. 2553 - Know the Lowest Price Act of 2018 - Support for the elimination of " gag clauses" in the Medicare Part D program. S. 2554 - Patient Right to Know Act Drug Prices Act of 2018 - Support for for the elimination of "gag clauses" in the private insurance market. CMS Regulations related to the Medicare Part D program and Prescription Drug Plans(PDPs). FDA work on drug shortages and solutions. S. 637 - Creating Transparency to Have Prescription Drug Rebates Unlocked - Issues related to the alleged relationship between rebates and drug prices. S. 771 - A Bill to Improve Access to Affordable Prescription Drugs - Issues related to bringing drug prices down including strengthening policies in the Part D coverage gap, couponing and advancing biosimilars. Education activities for Members and staff related to Direct and Indirect Renumeration(DIR)policies. Education activities related to the cross referencing of certain data related to Medicare Parts A, B and D. Trump Administration's Blueprint for lowering the price of prescription medications in the United States and the role that PBMs can play in doing so.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, SENATE

H.R. 6 - Support for Patients and Communities Act - Support for policies that help to fight the opioid epidemic with a focus on safe prescriptions in the Medicare program. S. 3120 - Helping to End Addiction and Lessen Substance Use Disorders Act - Support for policies that help to fight the opioid epidemic with a focus on safe prescriptions in the Medicare program. H.R. 3528/S. 2460 - Every Prescription Conveyed Securely Act - Support for electronic prescribing of opioids to enhance patient safety. S. 2553 - Know the Lowest Price Act of 2018 - Support for the elimination of " gag clauses" in the Medicare Part D program. CMS Regulations related to the Medicare Part D program and Prescription Drug Plans(PDPs). S. 637 - Creating Transparency to Have Prescription Drug Rebates Unlocked - Issues related to the alleged relationship between rebates and drug prices. S. 771 - A Bill to Improve Access to Affordable Prescription Drugs - Issues related to bringing drug prices down including strengthening policies in the Part D coverage gap, couponing and advancing biosimilars. Education activities for Members and staff related to Direct and Indirect Renumeration(DIR)policies. Education activities related to the cross referencing of certain data related to Medicare Parts A, B and D. Trump Administration's Blueprint for lowering the price of prescription medications in the United States and the role that PBMs can play in doing so.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, SENATE

S. 2553 - Know the Lowest Price Act of 2018- Support of the elimination of "gag clauses" in Medicare Part D. H.R. 6 - Support for Patients and Communities Act - Issues related to ensuring safe prescribing of opioids and other pharmaceuticals that can drive addiction. S. 3120 - Helping to End Addition and Lessen Substance Use Disorders Act - Issues related to ensuring safe prescribing of opioids and other pharmaceuticals that can drive addiction. S. 2460/H.R. 3528 - Every Prescription Conveyed Securely Act - support for a bill that would require electronic prescribing for opioids. CMS regulations related to the Medicare Part D program and role of Prescription Drug Plans. S. 637 - Creating Transparency to have Prescription Drug Rebates Unlocked - Issues related to the alleged relationship between rebates and drug prices. S. 771 - A bill to Improve Access to Affordable Prescription Drugs - Issues related to bringing drug pricing down including better policies in the Part D coverage gap, couponing and advancing biosimilars. H.R. 3447 - Furthering Access to Coordinated Treatment for Seniors (FACTS) Act of 2017 - Working to explain the need for safe and confidential data sharing between Medicare part A, B, and D to ensure better coordination of patient care. Issues related to Direct and Indirect Renumeration policies and their impact on consumers. The Trump Administration's Blueprint for Controlling Prescription Drug Prices - Issues related to the role PBMs can play in controlling the price of prescription medications in the United States.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 2553 - Know the Lowest Price Act of 2018- Support of the elimination of "gag clauses" in Medicare Part D. S. 2554 - Patient Right to Know Act - Support of the elimination of "gag clauses" in private market drug benefits. H.R. 6 - Support for Patients and Communities Act - Issues related to ensuring safe prescribing of opioids and other pharmaceuticals that can drive addiction. S. 3120 - Helping to End Addition and Lessen Substance Use Disorders Act - Issues related to ensuring safe prescribing of opioids and other pharmaceuticals that can drive addiction. S. 2460/H.R. 3528 - Every Prescription Conveyed Securely Act - support for a bill that would require electronic prescribing for opioids. CMS regulations related to the Medicare Part D program and role of Prescription Drug Plans. S. 637 - Creating Transparency to have Prescription Drug Rebates Unlocked - Issues related to the alleged relationship between rebates and drug prices. S. 771 - A bill to Improve Access to Affordable Prescription Drugs - Issue related to bringing drug pricing down including better policies in the Part D coverage gap, couponing and advancing biosimilars. H.R. 3447 - Furthering Access to Coordinated Treatment for Seniors (FACTS) Act of 2017 - Working to explain the need for safe and confidential data sharing between Medicare part A, B, and D to ensure better coordination of patient care. Issues related to Direct and Indirect Renumeration policies and their impact on consumers. The Trump Administration's Blueprint for Controlling Prescription Drug Prices - Issues related to the role PBMs can play in controlling the price of prescription medications in the United States.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 2553 - Know the Lowest Price Act of 2018- Support of the elimination of "gag clauses" in Medicare Part D. S. 2554 - Patient Right to Know Act - Support of the elimination of "gag clauses" in private market drug benefits. H.R. 6 - Support for Patients and Communities Act - Issues related to ensuring safe prescribing of opioids and other pharmaceuticals that can drive addiction. S. 3120 - Helping to End Addition and Lessen Substance Use Disorders Act - Issues related to ensuring safe prescribing of opioids and other pharmaceuticals that can drive addiction. S. 2460/H.R. 3528 - Every Prescription Conveyed Securely Act - support for a bill that would require electronic prescribing for opioids. CMS regulations related to the Medicare Part D program and role of Prescription Drug Plans. S. 637 - Creating Transparency to have Prescription Drug Rebates Unlocked - Issues related to the alleged relationship between rebates and drug prices. S. 771 - A bill to Improve Access to Affordable Prescription Drugs - Issue related to bringing drug pricing down including better policies in the Part D coverage gap, couponing and advancing biosimilars. H.R. 3447 - Furthering Access to Coordinated Treatment for Seniors (FACTS) Act of 2017 - Working to explain the need for safe and confidential data sharing between Medicare part A, B, and D to ensure better coordination of patient care. Issues related to Direct and Indirect Renumeration policies and their impact on consumers. The Trump Administration's Blueprint for Controlling Prescription Drug Prices - Issues related to the role PBMs can play in controlling the price of prescription medications in the United States.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 1316 To amend title XVIII of the Social Security Act to provide for pharmacy benefits manager standards under the Medicare prescription drug program and Medicare Advantage program to further transparency of payment methodologies to pharmacies, and for other purposes. HR 1939 To amend title XVIII of the Social Security Act to ensure equal access of Medicare beneficiaries to community pharmacies in underserved areas as network pharmacies under Medicare prescription drug coverage, and for other purposes. HR 592, S 109 To amend title XVIII of the Social Security Act to provide for coverage under the Medicare program of pharmacist services. HR 3528/S 2460 Every Prescription Conveyed Securely Act -- To amend title XVIII of the Social Security Act to require e-prescribing for coverage under part D of the Medicare program of prescription drugs that are controlled substances. HR 7083 This Act may be cited as the Access to Genetic Counselor Services Act of 2018. To amend title XVIII of the Social Security Act to provide for expanded coverage of services furnished by genetic counselors under part B of the Medicare program, and for other purposes.

Client expense: $34,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 1038, S 413 Improving Transparency and Accuracy in Medicare Part D Spending Act HR 1939 To amend title XVIII of the Social Security Act to ensure equal access of Medicare beneficiaries to community pharmacies in underserved areas as network pharmacies under Medicare prescription drug coverage, and for other purposes. HR 592/S 109 To amend title XVIII of the Social Security Act to provide for coverage under the Medicare program of pharmacist services. HR 2871 Preserving Patient Access to Compounded Medications Act of 2017 HR 1939/S 1044 Ensuring Seniors Access to Local Pharmacies Act of 2017 HR 3528/S 2460 Every Prescription Conveyed Securely Act HR 6 Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act HR 4275 To provide for the development and dissemination of programs and materials for training pharmacists, health care providers, and patients on indicators that a prescription is fraudulent, forged, or otherwise indicative of abuse or diversion, and for other purposes. S 3120 Helping to End Addiction and Lessen Substance Use Disorders Act of 2018

Client expense: $34,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to pharmaceutical manufacturer and pharmacy contracting with respect to drug pricing. Issues included in the Proposed Part D Rule and accompanying RFI and the Administrations Blueprint on drug pricing RFI . Issues related to Medicaid Provider Enrollment. Issues related to prescription drug abuse. Issues related to the Medicare Coverage Gap Discount. Regulatory design and coverage of pharmacy benefits in health reform exchanges and the commercial market (essential health benefits, e-prescribing, PBM disclosure requirements, specialty pharmacy, mail-service pharmacy, formulary transparency, and medical loss ratio). H.R.749/S.297, Lower Drug Costs through Competition Act HR.1038/S.413, Improving Transparency and Accuracy in Part D Spending Act H.R.1316, Prescription Drug Price Transparency Act S.637, Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2017 S.771, Improving Access to Affordable Prescription Drug Act H.R.1939/S.1044, Ensuring Seniors Access to Local Pharmacies Act H.R. 2026, Pharmaceutical Information Exchange Act H.R.2051, FAST Generics Act H.R.2212/S.974, Creating and Restoring Equal Access To Equivalent Samples Act of 2017 H.R.2077 Restoring the Patient's Voice Act of 2017 S.2553/H.R.6144, Know the Lowest Price Act of 2018 S.2554/H.R.6143, Patient Right to Know Drug Prices Act H.R.3528/S.2460, The Every Prescription Carried Safely Act H.R.5343, Prescription Transparency Act of 2018 H.R.4841, Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018 Issues related to the affordability of prescription drugs and competitive marketplace, including: pedigree, manufacturer market and data exclusivity, REMS, accelerated generic approval, biosimilars.

Client expense: $656,680 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE

Issues related to pharmacy contracting with respect to drug pricing and pharmacy networks. Regulatory and proposed legislative changes to Medicare Part D pharmacy contracting, Direct and Indirect Remuneration (DIR), pharmacy networks, and mail-service pharmacy. Issues included in the Part D Rule and accompanying RFI. Issues related to the management of Medicaid prescription drug benefits. Issues related to prescription drug abuse. Issues related to pharmacy gag clauses. HR.1038/S.413, Improving Transparency and Accuracy in Part D Spending Act H.R.1316, Prescription Drug Price Transparency Act S.637, Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2017 S.771, Improving Access to Affordable Prescription Drug Act H.R.1939/S.1044, Ensuring Seniors Access to Local Pharmacies Act H.R.3528, The Every Prescription Carried Safely Act S.2553/H.R.6144, Know the Lowest Price Act of 2018 S.2554/H.R.6143, Patient Right to Know Drug Prices Act H.R.5343, Prescription Transparency Act of 2018 H.R.4841, Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018

Client expense: $656,680 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE

H.R. 3528/S. 2460, Every Prescription Conveyed Securely Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Monitor legislative and administrative action related to health care policy; Monitor legislative activity related to H.R. 1628, the American Health Care Act; H.R. 592 and S. 109, The Pharmacy and Medically Underserved Areas Enhancement Act; H.R. 3528 and S. 2460, Every Prescription Conveyed Securely Act; H.R. 6 SUPPORT for Patients and Communities Act; and H.R. 4190, House Provider Status Bill.

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

Government targets: Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, Internal Revenue Service (IRS), Labor, Dept of (DOL), Pension Benefit Guaranty Corporation (PBGC), SENATE, Treasury, Dept of

Implementation of Comprehensive Addiction and Recovery Act (CARA) PL 114-198 and education regarding opioid treatment and prevention; Implementation of 21st Century Cures (H.R. 34), advocacy related to healthcare technology and innovation issues; E-Rx (H.R.3528), advocacy related to electronic prescriptions of medications; Implementation of FY'2018 NDAA provision related to e-Commerce portals; education about potential improvements to Prescription Drug Monitoring Programs; H.R. 6 Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act.

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

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

Support H.R. 304/S. 916, The Protecting Patient Access to Emergency Medications Act of 2017, a bill to amend the Controlled Substances Act with regard to the provision of emergency medical services and discussed companion legislation with the Senate; Support H.R. 372, The Competitive Health Insurance Reform Act of 2017, a bill to repeal McCarran-Ferguson with respect to the business of health insurance; Discussed with members of congress working on legislation that maintains coverage and improves Americas health care system through patient-centered care; Oppose HR 1156/ S 1133 , Patient Access to Higher Quality Health Care Act of 2017, a bill to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals; Support HR 1215, Protecting Access to Care Act, a bill to improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system; Urged CMS to release guidance pertaining to hospital co-location arrangements and to provide flexibility in the agencys co-location policies; Support HR 2141/ S 898, the Conrad State 30 and Physician Access Act of 2017, a bill that would reauthorize the Conrad State 30 Program and make other changes to improve patient access to care; Support S.781/ HR 1876. Good Samaritan Health Professional Act of 2017, a bill to amend the Public Health Service Act to limit the liability of health care professionals who volunteer to provide health care services in response to a disaster; Support HR 2212/ S 974Creating and Restoring Equal Access to Equivalent Samples (CREATES) Act of 2017, a bill to promote competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products; Meet with HRSA Administrator and senior staff on 340B drug pricing program; Discussed marketplace stabilization solutions with Hill staff; Support and Recommend changes to HR 1253, Mental Health and Substance Abuse Treatment Accessibility Act of 2017a bill to authorize the Secretary of Health and Human Services to make loans and loan guarantees for constructing or renovating, or planning construction or renovation of, qualified psychiatric and substance abuse treatment facilities, and for other purposes: advocated for changes to clarify/expand the entities that can be loan applicants/recipients; Urged the Administration to suspend the faulty star ratings from the Hospital Compare website; Eliminate barriers to care with the creation of an Anti-Kickback safe harbor for clinical integration arrangements that establishes the basic accountabilities for the use of incentive payment or shared savings programs among hospitals, physicians and other providers, along with a safe-harbor for assistance to patients that would protect providers from financial penalties under the Civil Monetary Penalties (CMPs) for providing an inducement to a patient; Advocated for changes including: eliminating geographic and setting locations requirements so patients outside of rural areas can benefit from telehealth; expanding the types of technology that can be used, including remote monitoring; and covering all services that are safe to provide, rather than a small list of approved services; Submit Statement Stabilizing Premiums and Helping Individuals in the Individual Insurance Market for 2018: Health Care Stakeholders about the importance of stabilizing the Health Insurance Marketplaces for 2018 and beyond; We urged Congress to pass legislation to fund the ACA cost-sharing reductions; Urged Senators to oppose the Graham-Cassidy proposal being considered in the Senate because this proposal would make significant changes to health care coverage and health care financing; Review of H.R. 3528, Every Prescription Conveyed Securely Act, a bill to amend title XVIII of the Social Security Act to require e-prescribing for coverage under part D of the Medicare program of prescription drugs that are controlled substances; Discussions with Congress on prescription drug monitoring programs, the dispensing of controlled substances, and clinical workflow; Discussions with Congress on draft legislation related to prescription drug monitoring programs; Urged Congress to consider advancing solutions aimed at making our health care system stronger, protecting access and coverage, and exploring new delivery system reforms that have the potential to make care both more affordable and safer; Review of The Combating the Opioid Epidemic Act, a bill to provide funding to combat the opioid epidemic; Discussions with the White House/Office of National Drug Control Policy about the opioid epidemic, including concerns about regulations that prohibit the sharing of substance use disorder records among health care providers; Support H.R. 4392 a bill to prevent cuts to the 340B drug savings program, which would provide relief from deep cuts to payments to hospitals participating in the 340B program; Letter to congress outlining AHA opposition to a potential policy that would cut payments to hospitals treating hospice patients; Oppose H.R. 4710, 340B Protecting Access for the Underserved and Safety-Net Entities (PAUSE) Act, a bill to amend the Public Health Service Act to establish a moratorium on the registration of certain new 340B hospitals and associated site; Sent comments to the Energy and Commerce Subcommittee on Oversight and Investigations for its hearing on Examining the Impact of Health Care Consolidation.; Letter sent to the Energy & Commerce Subcommittee for its hearing on, "Combating the Opioid Crisis: Helping Communities Balance Enforcement and Patient Safety"; Letter submitted to the Ways and Means Committee on policy recommendations to address the opioid epidemic; Sent letter to discuss the current state of health care costs, and efforts to increase transparency in the pricing of health care services and the quality of care; Addressed our concerns with the MedPAC Commissions draft recommendation to substantially reduce payments for off-campus stand-alone emergency departments (EDs) that are within 6 miles of an on-campus hospital ED; Addressed our concerns with the Commissions draft recommendation to substantially reduce payments for off-campus stand-alone emergency departments (EDs) that are within 6 miles of an on-campus hospital ED; Support HR4776, Hospital Preparedness Reauthorization Act of 2018, a bill to amend the Public Health Service Act to reauthorize a program of partnerships for State and regional hospital preparedness to improve surge capacity and would increase the level of authorized funding for the Hospital Preparedness Program to $515 million; Submitted statement to the Senate HELP Committee on the Hearing on How to Reduce Health Care Costs: Understanding the Cost of Health Care in America; Submitted a Statement for the HELP hearing on Effective Administration of the 340B Drug Pricing Program; Support certain provisions in Helping to End Addiction and Lesson (HEAL) Substance Use Disorders Act of 2018; Support HR 6071, Stretching Entity Resources for Vulnerable Communities Act or the SERV Communities Act, A bill to amend the Public Health Service Act to clarify the intent of the 340B program and provide for enhanced 340B program integrity; Support S 2597Childrens Hospital GME Support Reauthorization Act of 2018, A bill to amend the Public Health Service Act to reauthorize the program of payments to children's hospitals that operate graduate medical education programs; Support HR 3545, Overdose Prevention and Patient Safety ActA bill to amend the Public Health Service Act to protect the confidentiality of substance use disorder patient records; Support S 2516, Alternatives to Opioids (ALTO) in the Emergency Department ActA bill to direct the Secretary of Health and Human Services to conduct a demonstration program to test alternative pain management protocols to limit the use of opioids in emergency departments; Support HR 5176/ S 2610, Preventing Overdoses While in Emergency Rooms Act of 2018 A bill to require the Secretary of Health and Human Services to provide coordinated care to patients who have experienced a non-fatal overdose after emergency room discharge; Submit statement to the Ways and Means Subcommittee on Health on the hearing Identifying Innovative Practices and Technology in Health Care; Support S 1845 Lead-Safe Housing for Kids Act" To amend the Lead-Based Paint Poisoning Prevention Act to provide for additional procedures for families with children under the age of 6; Submitted statement to the Energy & Commerce Health Subcommittee for the hearing "Improving the Coordination and Quality of Substance Use Disorder Treatment." The statement focuses on 42 CFR Part 2; Comments to HELP Committee's discussion draft of the Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018; The current Pandemic and All-Hazards Preparedness Act (PAHPA) will sunset on October 1, 2018 so this is "must-do" legislation; Support S 2852, the Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018 (PAHPAI), A bill to reauthorize certain programs under the Pandemic and All-Hazards Preparedness Reauthorization Act; Supports S. 2372, VA Maintaining Internal Systems and Strengthening Integrated Outside Networks Act of 2018 (VA MISSION Act of 2018).A bill to establish a permanent community care program for veterans, to establish a commission for the purpose of making recommendations regarding the modernization or realignment of facilities of the Veterans Health Administration, to improve construction of the Department of Veterans Affairs, to make certain improvements in the laws administered by the Secretary of Veterans Affairs relating to the home loan program of the Department of Veterans Affairs,Submitted a statement to the Ways and Means Committee hearing on "Lowering Costs and Expanding Access to Health Care through Consumer-Directed Health Plans;" Submitted a statement to the Senate HELP Subcommittee on "Primary Health and Retirement Security on Health Care in Rural America: Examining Experiences and Costs"; Submitted a statement to the Senate HELP Committee on "Reducing Health Care Costs: Eliminating Excess Health Care Spending and Improving Quality and Value for Patients"; Submitted comments on the consumer-directed health plan legislation to the Committee on Ways & Means; Submitted a statement to the Energy and Commerce Subcommittee on Health on "Opportunities to Improve the 340B Drug Pricing Program".

Client expense: $5,220,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA), White House Office

H.R. 592 / S. 109 - The Pharmacy and Medically Underserved Areas Enhancement Act, all provisions related to amending the Social Security Act to allow pharmacists to be reimbursed under Medicare Part B for services provided to patients in medically underserved communities, consistent with state scope of practice laws. H.R. 3528 / S. 2460 and H.R. 6 - These bills would amend title XVIII of the Social Security Act to require e-prescribing under Part D of the Medicare program of prescription drugs that are controlled substances. Issues related to American Patients First: The Trump Administration Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs; no legislation.

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

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

S. 2460, Every Prescription Conveyed Securely Act (Bennet) - opioid issues S. 2680, Opioid Crisis Response Act (Alexander) - opioid initiatives, mental health parity S. 2789, Substance Abuse Prevention Act (Cornyn) - opioid initiatives, restrictions on step therapy S. 2812, Air Ambulance Consumer Protection Act (McCaskill) - air ambulance S. 2828, Sober Home Fraud Detection Act (Rubio) - best practices for identifying fraud in recovery housing S. 2891, Fighting the Opioid Epidemic with Sunshine Act (Grassley) - opioid issues S. 2892, Peer Support Enhancement and Evaluation Review Act (Cardin) - opioid issues S. 2898, Medication-Assisted Treatment Improvement Act (Casey) - opioid issues S. 2899, Caring Recovery for Infants and Babies Act (Brown) - opioid issues S. 2900, Comprehensive Screenings for Seniors Act (Brown) - opioid issues S. 2902, Better Data Sharing to Combat the Opioid Crisis Act (Cassidy) - opioid issues S. 2905, Strengthening Partnerships to Prevent Opioid Abuse Act (Toomey) - opioid issues S. 2910, Telehealth for Childrens Access to Services and Treatment Act (Roberts) - opioid issues S. 2911, Enhancing Patient Access to Non-Opioid Treatment Options (Heller) - opioid issues S. 2912, Opioid Addiction Treatment Programs Enhancement Act (Cassidy) - opioid issues S. 2920, Commit to Opioid Medical Prescriber Accountability and Safety for Seniors Act (McCaskill) - opioid issues S. 2922, Help for Moms and Babies Act (Stabenow) - opioid issues S. 2923, Building Capacity for Family-Focused Residential Treatment Act (Grassley) - opioid issues S. 2924, Supporting Family-Focused Residential Treatment Act (Scott) - opioid issues S. 3016, Action for Dental Health Act (Booker) - grants for oral health programs S. 3120, the HEAL Substance Use Disorders Act (Hatch) - opioid initiatives S. 3158, Labor-HHS-Education Appropriations Act (Blunt) - HHS funding S. 3254, Eliminating Kickbacks in Recovery Act (Rubio) - anti-kickback penalties for body brokers Draft Bill: Protecting Patients From Surprise Medical Bills Act (Cassidy) - surprise medical bills H.R. 6, SUPPORT Patients and Families Act (Walden) - opioid initiatives, Medicare and Medicaid issues, budget offsets H.R. 302, FAA Reauthorization Act - air ambulance issues H.R. 1215, Protecting Access to Care Act (King) - medical liability reform H.R. 1313, Preserving Employee Wellness Programs Act (Foxx) - employee wellness programs H.R. 2422, Action for Dental Health Act (Kelly) - oral health services and education for underserved populations H.R. 3331, adoption and use of EHR technology by behavioral health providers (Jenkins) - opioid issues H.R. 3528, Every Prescription Conveyed Securely Act (Clark) - opioid issues H.R. 4684, Ensuring Access to Quality Sober Living Act (Chu) - best practices for recovery housing H.R. 4841, Standardizing Electronic Prior Authorization for Safe Prescribing Act (Schweikert) - opioid issues H.R. 4998, Health Insurance for Former Foster Youth Act (Bass) - opioid issues H.R. 5100, Recovery Home Certification Act (Knight) -- anti-kickback penalties for body brokers H.R. 5477, Rural DOCS Act (O'Halleran) - opioid issues H.R. 5515, National Defense Authorization Act (Thornberry) H.R. 5562, Protecting NAS Babies Act (Jenkins) - opioid issues H.R. 5582, Abuse Deterrent Access Act (Carter) - opioid issues H.R. 5583, State reporting on certain adult health quality measures (Clarke) - opioid issues H.R. 5590, CMS Action Plan (Kinzinger) - opioid issues H.R. 5714, Education for Disposal of Unused Opioids Act (Black) - opioid issues H.R. 5715, Strengthening Partnerships to Prevent Opioid Abuse Act (Renacci) - opioid issues H.R. 5716, COMPASS Act (Roskam) - opioid issues H.R. 5723, Expanding Oversight of Opioid Prescribing and Payment Act (Tenney) - opioid issues H.R. 5725, BEST Act (Roskam) - opioid issues H.R. 5774, Combating Opioid Abuse for Care in Hospitals Act (Curbelo) - opioid issues H.R. 5775, Providing Reliable Options for Patients and Educational Resources Act (Paulsen) - opioid issues H.R. 5776, MOST Act (Neal) - opioid issues H.R. 5789, protections for pregnant and post-partum women (Foster) - opioid issues H.R. 5795, Overdose Prevention and Patient Safety Act (Blumenauer) - confidential sharing of substance use disorder information H.R. 5796, Responsible Education Achieves Care and Healthy Outcomes for Users' Treatment Act (Fitzpatrick) - opioid issues H.R. 5801, PARTNERSHIP Act (Griffith) - opioid issues H.R. 6082, Overdose Prevention and Patient Safety Act (Mullin) - confidential sharing of substance use disorder information H.R. 6147, Interior, Environment, Financial Services, Agriculture, FDA, Transportation, and Housing Appropriations Act (Calvert) - FDA funding H.R. 6157, Defense-Labor-HHS-Education Appropriations Act (Granger) - HHS funding H.R. 6753, Strengthening the Health Care Fraud Prevention Task Force Act (Walden) - codification of Healthcare Fraud Prevention Partnership H.R. 6878, Eliminating Kickbacks in Recovery Act (Deutch) - anti-kickback penalties for body brokers H.R. 6902, Eliminating Kickbacks in Recovery Act (Knight) - anti-kickback penalties for body brokers Regulatory Issues: HIPAA administrative simplification issues, including standards for privacy, security, and electronic transactions and code sets (including ICD-10), identifiers including the health plan identifier, enforcement; cybersecurity; FEHBP enrollment data clearinghouse initiative, the enrollment reconciliation process, and a related OPM reimbursement factor for records that cannot be reconciled; issues relating to health insurance plan participation in FEHBP, including contract requirements; issues relating to similarly sized subscriber group (SSSG) and MLR requirements under the FEHBP; implementation of the health savings account provisions of the Medicare Act; issues related to Medicare Secondary Payer requirements; issues related to implementation of the National Health Information Infrastructure; electronic health records, personal health records, and similar technologies; issues relating to market consolidation; issues related to hospital consolidation; issues relating to quality improvement; issues relating to the national health data stewardship; issues relating to hospital outpatient measurement and reporting; prescription drug pricing; issues related to the collection of race and ethnicity data; issues related to medical loss ratios; reference pricing; review of rates for reasonableness; preexisting condition insurance plans; issues relating to antitrust; accountable care organizations; provider non-discrimination; coverage of preventive services; contraceptive coverage; pre-existing condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; issues relating to the annual fee on health insurance providers; health plan automatic enrollment requirements; issues related to qualified health plans including certification and rate filing templates; health insurance market rules; reinsurance, risk corridors, and risk adjustment; dependent coverage; summary of benefits and coverage disclosures; benefit and payment parameters; essential health benefits, actuarial value, and accreditation; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations; issues related to supplemental products; issues related to HIPAA excepted benefits; issues related to short term limited duration products; issues related to the federally-facilitated marketplaces (i.e., Exchanges/formerly referred to as the web portal); issues related to business continuity in relation to pandemics or natural events (e.g., hurricane, tornado, etc.); issues related to association health plans; issues related to cost-sharing reductions (CSRs); issues related to the refundable credit for coverage under a qualified health plan; issues related to small employer group size; issues related to Certificate of Public Advantage; issues relating to veterans health care; issues relating to family caregivers; and other issues relating to health care reform implementation.

Client expense: $1,500,000 · Firm income: Not reported

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

S. 1625, FY 2018 Consolidated Appropriations Act (Royce) - funding for HHS programs and agencies, opioid initiatives, ACA risk corridors S. 2460, Every Prescription Conveyed Securely Act (Bennet) - opioid issues S. 2680, Opioid Crisis Response Act (Alexander) - opioid initiatives, mental health parity S. 2789, Substance Abuse Prevention Act (Cornyn) - opioid initiatives, restrictions on step therapy S. 2812, Air Ambulance Consumer Protection Act (McCaskill) - air ambulance S. 2891, Fighting the Opioid Epidemic with Sunshine Act (Grassley) - opioid issues S. 2892, Peer Support Enhancement and Evaluation Review Act (Cardin) - opioid issues S. 2898, Medication-Assisted Treatment Improvement Act (Casey) - opioid issues S. 2899, Caring Recovery for Infants and Babies Act (Brown) - opioid issues S. 2900, Comprehensive Screenings for Seniors Act (Brown) - opioid issues S. 2902, Better Data Sharing to Combat the Opioid Crisis Act (Cassidy) - opioid issues S. 2905, Strengthening Partnerships to Prevent Opioid Abuse Act (Toomey) - opioid issues S. 2910, Telehealth for Childrens Access to Services and Treatment Act (Roberts) - opioid issues S. 2911, Enhancing Patient Access to Non-Opioid Treatment Options (Heller) - opioid issues S. 2912, Opioid Addiction Treatment Programs Enhancement Act (Cassidy) - opioid issues S. 2920, Commit to Opioid Medical Prescriber Accountability and Safety for Seniors Act (McCaskill) - opioid issues S. 2922, Help for Moms and Babies Act (Stabenow) - opioid issues S. 2923, Building Capacity for Family-Focused Residential Treatment Act (Grassley) - opioid issues S. 2924, Supporting Family-Focused Residential Treatment Act (Scott) - opioid issues S. 2987, National Defense Authorization Act (Inhofe) S. 3120, the HEAL Substance Use Disorders Act (Hatch) - opioid initiatives S. 3158, FY 2019 Labor, HHS, Education Appropriations Act (Blunt) - HHS funding, ACA issues House version of FY 2019 Labor, HHS, Education Appropriations Act (Cole) - HHS funding, ACA issues H.R. 6, SUPPORT Patients and Families Act (Walden) - opioid initiatives, budget offsets H.R. 1215, Protecting Access to Care Act (King) - medical liability reform H.R. 1313, Preserving Employee Wellness Programs Act (Foxx) - employee wellness programs H.R. 2422, Action for Dental Health Act (Kelly) - oral health services and education for underserved populations H.R. 3331, adoption and use of EHR technology by behavioral health providers (Jenkins) - opioid issues H.R. 3528, Every Prescription Conveyed Securely Act (Clark) - opioid issues H.R. 3759, RAISE Family Caregivers Act (Harper-Castor) - support for family caregivers H.R. 4841, Standardizing Electronic Prior Authorization for Safe Prescribing Act (Schweikert) - opioid issues H.R. 4998, Health Insurance for Former Foster Youth Act (Bass) - opioid issues H.R. 5477, Rural DOCS Act (O'Halleran) - opioid issues H.R. 5562, Protecting NAS Babies Act (Jenkins) - opioid issues H.R. 5582, Abuse Deterrent Access Act (Carter) - opioid issues H.R. 5583, State reporting on certain adult health quality measures (Clarke) - opioid issues H.R. 5590, CMS Action Plan (Kinzinger) - opioid issues H.R. 5515, National Defense Authorization Act (Thornberry) H.R. 5714, Education for Disposal of Unused Opioids Act (Black) - opioid issues H.R. 5715, Strengthening Partnerships to Prevent Opioid Abuse Act (Renacci) - opioid issues H.R. 5716, COMPASS Act (Roskam) - opioid issues H.R. 5723, Expanding Oversight of Opioid Prescribing and Payment Act (Tenney) - opioid issues H.R. 5725, BEST Act (Roskam) - opioid issues H.R. 5774, Combating Opioid Abuse for Care in Hospitals Act (Curbelo) - opioid issues H.R. 5775, Providing Reliable Options for Patients and Educational Resources Act (Paulsen) - opioid issues H.R. 5776, MOST Act (Neal) - opioid issues H.R. 5789, protections for pregnant and post-partum women (Foster) - opioid issues H.R. 5795, Overdose Prevention and Patient Safety Act (Blumenauer) - confidential sharing of substance use disorder information H.R. 5796, Responsible Education Achieves Care and Healthy Outcomes for Users' Treatment Act (Fitzpatrick) - opioid issues H.R. 5801, PARTNERSHIP Act (Griffith) - opioid issues H.R. 6082, Overdose Prevention and Patient Safety Act (Mullin) - confidential sharing of substance use disorder information Regulatory Issues: HIPAA administrative simplification issues, including standards for privacy, security, and electronic transactions and code sets (including ICD-10), identifiers including the health plan identifier, enforcement; cybersecurity; FEHBP enrollment data clearinghouse initiative, the enrollment reconciliation process, and a related OPM reimbursement factor for records that cannot be reconciled; issues relating to health insurance plan participation in FEHBP, including contract requirements; issues relating to similarly sized subscriber group (SSSG) and MLR requirements under the FEHBP; implementation of the health savings account provisions of the Medicare Act; issues related to Medicare Secondary Payer requirements; issues related to implementation of the National Health Information Infrastructure; electronic health records, personal health records, and similar technologies; issues relating to market consolidation; issues related to hospital consolidation; issues relating to quality improvement; issues relating to the national health data stewardship; issues relating to hospital outpatient measurement and reporting; prescription drug pricing; issues related to the collection of race and ethnicity data; issues related to medical loss ratios; reference pricing; review of rates for reasonableness; preexisting condition insurance plans; issues relating to antitrust; accountable care organizations; provider non-discrimination; coverage of preventive services; contraceptive coverage; pre-existing condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; issues relating to the annual fee on health insurance providers; health plan automatic enrollment requirements; issues related to qualified health plans including certification and rate filing templates; health insurance market rules; reinsurance, risk corridors, and risk adjustment; dependent coverage; summary of benefits and coverage disclosures; benefit and payment parameters; essential health benefits, actuarial value, and accreditation; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations; issues related to supplemental products; issues related to HIPAA excepted benefits; issues related to short term limited duration products; issues related to the federally-facilitated marketplaces (i.e., Exchanges/formerly referred to as the web portal); issues related to business continuity in relation to pandemics or natural events (e.g., hurricane, tornado, etc.); issues related to association health plans; issues related to cost-sharing reductions (CSRs); issues related to the refundable credit for coverage under a qualified health plan; issues related to small employer group size; issues related to Certificate of Public Advantage; issues relating to veterans health care; issues relating to family caregivers; and other issues relating to health care reform implementation.

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

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

H.R.6, SUPPORT for Patients and Communities Act H.R.3528, the Every Prescription Conveyed Securely Act S.2680, the Opioid Crisis Response Act of 2018

Client expense: $1,380,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), HOUSE OF REPRESENTATIVES, Natl Economic Council (NEC), SENATE, Treasury, Dept of, U.S. Trade Representative (USTR)

S. 483 (114th Congress) legislation to prevent and reduce prescription drug abuse. H.R. 592 & S. 109, provide for coverage under Medicare program of pharmacist services. Medication Therapy Management. H.R. 1038 and S. 413, legislation to prohibit prescription drug plan sponsors and MAPD organizations under Medicare program from retroactively reducing payment on clean claims submitted by pharmacies. Pharmaceutical compounding and the implementation of Drug Quality Security Act; FDA implementation of Section 503B of the Food, Drug, and Cosmetic Act; House & Senate Agriculture, FDA & Related Agency Appropriations bills; H.R. 2871, Preserving Patient Access to Compounded Medications Act of 2017. Prescription Drug Importation including S. 771 and H.R. 1776, the Improving Access to Affordable Prescription Drugs Act and S.469, the Affordable and Safe Prescription Drug Importation Act. E-Prescribing bills including H.R. 3528 and S. 2460, the Every Prescription Conveyed Securely (EPCS) Act. H.R. 5958, Phair Pricing Act of 2018. HHS Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs. S. 3282 and H.R. 6600, the DEA Order Clearinghouse Act of 2018.

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

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

Medicare Advantage Policy and Reimbursement Part D Policy and Reimbursement Medicaid and Dual Eligible Issues Pharmacy Reimbursement Issues Medicare Access and CHIP Reauthorization Act Implementation HHS Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs Opioid Issues H.R. 6, Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act S. 3120, HEAL Act of 2018 S. 637, Creating Transparency to Have Drug Rebates Unlocked Act H.R. 3528, Every Prescription Conveyed Securely Act H.R. 6733, Know the Cost Act of 2018 S. 2553, Know the Lowest Price Act of 2018

Client expense: $310,000 · Firm income: Not reported

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

H.R. 592/S. 109, The Pharmacy and Medically Underserved Areas Enhancement Act, all provisions. H.R. 1038/S. 413, Improving Transparency and Accuracy in Medicare Part D Spending Act, all provisions. H.R. 6 - Support Patients and Communities Act, provisions related to pharmacy operations S. 2460/H.R. 3528, Every Prescription Conveyed Securely Act, all provisions. H.R. 6199 - Restoring Access to Medication and Modernizing Health Savings Accounts Act of 2018, provisions related to over-the-counter medications Implementation of 2017 NDAA Tricare Pilot. CMS Medicare Part D Final Rule, provisions related to DIR fees.

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

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

Implementation of the 21st Century Cures Act (P.L.114-255); Patient Matching issues. H.R.3528/S.2460, Every Prescription Conveyed Securely Act; Electronic Prescribing of Controlled Substances issues. Cybersecurity issues. Health Information Technology issues. H.R.6, SUPPORT for Patients and Communities Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 6, Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act, all provisions H.R. 4143, Dialysis Patient Access To Integrated-care, Empowerment, Nephrologists, Treatment, and Services (PATIENTS) Demonstration Act of 2017, all provisions S. 2065, Dialysis Patient Access To Integrated-care, Empowerment, Nephrologists, Treatment, and Services (PATIENTS) Demonstration Act of 2017, all provisions H.R. 4554, Medicare Common Access Card Act of 2017, all provisions H.R. 6309, Allowing Working Seniors to Keep Their Health Savings Accounts Act of 2018, all provisions H.R. 6733, Know the Cost Act of 2018, all provisions S. 2553, Know the Lowest Price Act of 2018, all provisions S. 3120, Helping to End Addiction and Lessen (HEAL) Substance Use Disorders Act of 2018, provisions relating to Medicare and Medicaid S. 2904, Medicaid Substance Use Disorder Treatment via Telehealth Act, provision relating to telehealth definition S. 2910, Telehealth for Children's Access to Services and Treatment (TeleCAST) Act, provision relating to telehealth definition H.R. 3528, Every Prescription Conveyed Securely Act, all provisions S. 2460, Every Prescription Conveyed Securely Act, all provisions H.R. 2687, Medicaid Coverage for Addiction Recovery Expansion Act, all provisions S. 1169, Medicaid Coverage for Addiction Recovery Expansion Act, all provisions S. 1291, Advancing Medical Resident Training in Community Hospitals Act of 2017, all provisions S. 1016, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2017, provisions relating to telehealth Medicare program: Medicare Access and Chip Reauthorization (MACRA) implementation Medicare program: Merit-based Incentive Payment System (MIPS) Medicare program: Regulatory Relief Medicare program: Quality Payment Program (QPP)/Interoperability Medicare program: QPP cost measures Medicare program: Protecting Access to Medicare Act (PAMA) clinical lab issues/physician office labs Medicare program: Part B drug reimbursement Medicare program: Outpatient Prospective Payment System (OPPS)/Ambulatory Surgical Center (ASC) Payment System Medicare program: Appropriate Use Criteria Medicare program: Health IT Medicare program: Office visit codes Medicare program: Alternative Payment Models (APMs) Medicare program: Accountable Care Organization (ACO)/Medicare Shared Savings Program (MSSP) Medicare program: Graduate Medical Education (GME) Medicare program: 2019 Medicare Physician Fee Schedule Medicare program: Drug pricing/Competitive Acquisition Program, Part B to Part D, Medicare Advantage Step Therapy Medicare program: Open Payments Medicare program: Clinical laboratory fee schedule cuts Medicare program: Evaluation & Management Codes Medicare program: Misvalued codes Medicare program: Outpatient Prospective Payment System (OPPS)/Ambulatory Surgical Centers (ASC) Payment System Medicare program: Prior Authorization Medicare program: Electronic Health Records (EHR) Medicare program: Inpatient Prospective Payment System Medicare program: Diabetes/payment Medicare program: Diabetes Prevention Program Medicare program: Opioids Medicare program: Smart Cards Medicare program: Value-based arrangements Medicare program: Evaluation and Management proposals Medicare program: Payment Model Technical Advisory Committee (PTAC)/model approval process Medicare program: Medicare Advantage Qualifying Payment Arrangement Incentive (MAQI) demonstration Medicare program: Pharmacy Benefit Managers (PBMs) Medicare and Medicaid programs: Appropriate Use Criteria Medicare and Medicaid programs: Cybersecurity Medicare and Medicaid programs: Stark/Anti-Kickback/Value-based arrangements Medicare and Medicaid programs: Electronic Health Records/certification Medicare and Medicaid programs: Provider Enrollment, Chain and Ownership System (PECOS)/Medicare Enrollment/Revocations/Revalidations Medicaid program: Marylands Medicaid Demonstration Waiver Amendment

Client expense: $4,120,000 · Firm income: Not reported

Government targets: Bureau of Citizenship & Immigration Services (BCIS), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), SENATE, Veterans Affairs, Dept of (VA), White House Office

HR 1038, S 413 Improving Transparency and Accuracy in Medicare Part D Spending Act HR 1939 To amend title XVIII of the Social Security Act to ensure equal access of Medicare beneficiaries to community pharmacies in underserved areas as network pharmacies under Medicare prescription drug coverage, and for other purposes. HR 592, S 109 To amend title XVIII of the Social Security Act to provide for coverage under the Medicare program of pharmacist services. HR 1480 Safe and Affordable Drugs from Canada Act of 2017 S 778 Prescription Drug Monitoring Act of 2017 HR 934 Personal Drug Importation Fairness Act of 2017 HR 2871 Preserving Patient Access to Compounded Medications Act of 2017 HR 1939/S 1044 Ensuring Seniors Access to Local Pharmacies Act of 2017 S 469 Affordable and Safe Prescription Drug Importation Act HR 3528/S 2460 Every Prescription Conveyed Securely Act HR 6 Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act HR 4275 To provide for the development and dissemination of programs and materials for training pharmacists, health care providers, and patients on indicators that a prescription is fraudulent, forged, or otherwise indicative of abuse or diversion, and for other purposes. S 3120 Helping to End Addiction and Lessen Substance Use Disorders Act of 2018

Client expense: $34,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 1316 To amend title XVIII of the Social Security Act to provide for pharmacy benefits manager standards under the Medicare prescription drug program and Medicare Advantage program to further transparency of payment methodologies to pharmacies, and for other purposes. HR 1038, S 413 Improving Transparency and Accuracy in Medicare Part D Spending Act HR 1939 To amend title XVIII of the Social Security Act to ensure equal access of Medicare beneficiaries to community pharmacies in underserved areas as network pharmacies under Medicare prescription drug coverage, and for other purposes. HR 592, S 109 To amend title XVIII of the Social Security Act to provide for coverage under the Medicare program of pharmacist services. HR 3528/S 2460 Every Prescription Conveyed Securely Act -- To amend title XVIII of the Social Security Act to require e-prescribing for coverage under part D of the Medicare program of prescription drugs that are controlled substances.

Client expense: $34,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

General education about the pharmacy benefit manager/pharmacy industry, including S.637, The Creating Transparency to Have Drug Rebates Unlocked (C-THRU)Act. Issues related to access and affordability of health care for veterans. Issues related to the proposed CVS-Aetna merger. Legislative efforts to address the opioid epidemic, including H. R. 3528, Every Prescription Conveyed Securely Act, and H. R. 4841, Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018, as well as H.R. 6, the SUPPORT for Patients and Communities Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

General education about the pharmacy benefit manager/pharmacy industry, including S.637, The Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act. Issues related to Risk Evaluation and Mitigation Strategies (REMS) program, including S.974 and H. R. 2212, The CREATES Act. Proactive measures to curb opioid abuse, including H. R. 3528, Every Prescription Conveyed Securely Act, and H. R. 4841, Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018, as well as H.R. 6, the SUPPORT for Patients and Communities Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3528/S. 2460, Every Prescription Conveyed Securely Act.

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

Government targets: Environmental Protection Agency (EPA), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, Treasury, Dept of