Competitive Health Insurance Reform Act of 2017

Bipartisan Health Care Stabilization Act (Alexander-Murray) - funding for cost sharing reduction benefits, stabilization of individual market Bipartisan Health Care Stabilization Act; updated version (Alexander-Walden-Collins-Costello) - funding for cost sharing reduction benefits and reinsurance, stabilization of individual market S. 147, Obamacare Taxpayer Bailout Prevention Act (Rubio) - ACA risk corridors program S. 581, Jessies Law (Manchin-Capito) - patient history of opioid use disorder S. 1201, Health Care Options for All Act (McCaskill) - coverage options in bare counties S. 1354, Individual Health Insurance Marketplace Improvement Act (Carper-Kaine) - individual market reinsurance fund, outreach and enrollment activities S. 1462, Marketplace Certainty Act (Shaheen) - funding for cost-sharing reduction benefits S. 1516, Coverage Across State Lines (Heller) S. 1667, Protecting Consumers from Unreasonable Rates Act (Feinstein) - rate review S. 1835, Lower Premiums Through Reinsurance Act (Collins-Nelson) - invisible high risk pool and reinsurance programs S. 1976, Increasing Access to Care Act (Scott) - copper plan S. 1985, Protect Access to Birth Control Act (Murray) - coverage of contraceptive services S. 2052, Healthcare Market Certainty and Mandate Relief Act (Hatch) - funding for cost sharing reduction benefits, HSA improvements, ACA individual mandate S. 2241 (King) - fees on excepted benefits and standalone dental plans S. 2303, Access to Independent Health Insurance Advisors Act (Isakson-Coons) - calculation of medical loss ratios S. 3388, Ensuring Coverage for Patients with Pre-Existing Conditions Act (Tillis) - protections for individuals with pre-existing conditions S. 3541, Reducing Costs for Out-of-Network Services Act (Shaheen) -cost-sharing for out-of-network services S. 3592, No More Surprise Medical Bills Act (Hassan) - surprise medical bills S. 3742, Cancer Drug Parity Act (Smith) - cost sharing for cancer drugs H.R. 2, Agriculture and Nutrition Act (Conaway) - agricultural association health plans H.R. 314, Health Care Choice Act (Blackburn) - selling insurance across state lines H.R. 372, Competitive Health Insurance Reform Act (Gosar) - McCarran-Ferguson Act H.R. 421, Allowing Greater Access to Safe and Effective Contraception Act (Love) - non-prescription contraceptives, HSA flexibility H.R. 706, Plan Verification and Fairness Act (Blackburn) - verifying eligibility for special enrollment periods H.R. 708, State Age Rating Flexibility Act (Buchson) - age rating bands H.R. 710, Health Coverage State Flexibility Act (Flores) - grace period for premium payments H.R. 1101, Small Business Health Fairness Act (Johnson) - association health plans H.R. 1121, Pre-existing Conditions Protection Act (Walden) - protections for patients with pre-existing conditions H.R. 1304, Self-Insurance Protection Act (Roe) - medical stop-loss insurance H.R. 1409, Cancer Drug Parity Act (Lance) - coverage of oral anti-cancer drugs H.R. 1606, DOC Access Act (Carter) - reimbursement for dental and vision providers H.R. 3450, Protecting Consumers from Unreasonable Rates Act (Schakowsky) - rate review H.R. 3545, Overdose Prevention and Patient Safety Act (Murphy- Blumenauer) -- confidentiality of drug and alcohol treatment and prevention records H.R. 3976, Access to Marketplace Insurance Act (Cramer) - third party payments H.R. 4082, Protect Access to Birth Control Act (DeGette) - coverage of contraceptive services H.R. 4200, Healthcare Market Certainty and Mandate Relief Act (Brady) - funding for cost sharing reduction benefits, HSA improvements H.R. 4225 (Hudson) - fees on excepted benefits and standalone dental plans H.R. 4575, Access to Independent Health Insurance Advisors Act (Long-Schrader) - calculation of medical loss ratios H.R. 4666, Premium Relief Act (Costello) - Patient and State Stability Fund H.R. 4695, Bipartisan Market Stabilization and Innovation Act (Schrader) - stabilization of individual market H.R. 6311, Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act (Roskam) - access to catastrophic plans, definition of qualified health plans H.R. 6314, Health Savings Act (Burgess) - definition of high-deductible health plan H.R. 6496, Continuing Coverage for Preexisting Conditions Act (Joyce) - protections for individuals with pre-existing conditions H.R. 7003, Federal Invisible Risk Sharing Program (Schweikert) Regulatory Issues: Insurance regulatory reform; issues related to the coordination of private and public disability income benefits; disability risk management; disability income insurance enrollment and awareness; issues related to encouraging impaired workers to stay in/return to the workforce; issues related to expanding long-term care insurance coverage; issues relating to the coordination of benefits between private health insurance plans and Medicaid; Medigap claims processing and crossover fees; Medigap cross-over claim issues, Medigap coverage, implementation of Medigap standardized plan offerings; Medigap carrier recoveries related to CMS fraud and abuse enforcement activities, and issues related to Medigap educational materials, and other Medigap issues; fraud and abuse issues affecting public and private insurance coverage; issues relating to antitrust; implementation of the Mental Health Parity Act requirements; implementation of the 21st Century Cures Act requirements; summary of benefits and coverage disclosures; pre-existing condition insurance plans; accountable care organizations; coverage of preventive services; preexisting condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; health reimbursement accounts; dependent coverage; treatment of expatriate plans; issues related to all payor claims databases; issues related to association health plans; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations, non-discriminatory wellness programs; issues related to supplemental products; issues relating to dental coverage; issues relating to proposals for single-payer and Medicare/Medicaid buy-in options; issues related to implementation of the Telephone Consumer Protection Act; issues relating to third party payment of premiums; issues related to cost-sharing reductions (CSRs); issues relating to the individual market; and other issues relating to health care reform implementation.

Client expense: $1,550,000 · 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

Public Law 111-203, H.R. 4173- Dodd-Frank Wall Street Reform and Consumer Protection Act. Issue: Implementation and Regulatory reform. Captive Reinsurance Transactions, Insurance Capital Standards and Global Capital Standards. H.R. 372 - Competitive Health Insurance Reform Act of 2017. This bill would restore the application of the Federal antitrust laws to the business of health insurance to protect competition and consumers. Issue: McCarran-Ferguson Act. H.R. 1270 - Living Donor Protection Act of 2017. The bill would promote and protect from discrimination living organ donors. Issue: underwriting. H.R. 3746/S.2702 - Business of Insurance Regulatory Reform Act. Issue: Insurance exclusion from CFPB jurisdiction. H.R. 5059 - State Insurance Regulation Preservation Act. Issue: Federal Reserve Board supervision of insurance companies. H.R. 5666/S. 3177 - Primary Regulators of Insurance Vote Act of 2018. Issue: FSOC reform. S.__ - Draft legislation regarding Federal Reserve Board supervision of insurance companies. Implementation of S. 2270 - Insurance Capital Standards Clarification Act of 2014. The bill would give the Federal Reserve the authority to tailor capital standards for insurance companies subject to Fed supervision. Issue: Capital Standards, Basel III H.R. 5666/S. 3177 - Primary Regulators of Insurance Vote Act of 2018. Issue: FSOC reform.

Client expense: $510,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE, Securities & Exchange Commission (SEC)

H.Res.116 - Providing for consideration of the joint resolution (H.J. Res. 66) disapproving the rule submitted by the Department of Labor relating to savings arrangements established by States for non-governmental employees, and providing for consideration of the joint resolution (H.J. Res. 67) disapproving the rule submitted by the Department of Labor relating to savings arrangements established by qualified State political subdivisions for non-governmental employees , ALL PROVISIONS H.R. 372, the Competitive Health Insurance Reform Act of 2017 , ALL PROVISIONS

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

Government targets: Commerce, Dept of (DOC), Federal Aviation Administration (FAA), Federal Election Commission (FEC), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Highway Traffic Safety Administration (NHTSA), SENATE, Treasury, Dept of, U.S. Trade Representative (USTR)

H.R. 372, the Competitive Health Insurance Reform Act of 2017 Discussions with members of Congress and the Department of Labor regarding the Department of Labors disability insurance claims rule Department of Labor rule on Association Health Plans

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

Government targets: HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Treasury, Dept of

H.R. 4575/S.2303, the Access to Independent Health Insurance Advisors Act; H.R. 173/S. 58 the Middle Class Americans' Health Plans Act; H.R. 372, the Competitive Health Insurance Reform Act of 2017; H.R. 1628, American Health Care Act of 2017; Issues related to the Federally-facilitated marketplaces;S. 191, the Patient Freedom Act of 2017; H.R. 1626, the Better Care Reconciliation Act of 2017; H.R. 3798, the Save American Workers Act of 2018; H.R.4616, the Employer Relief Act of 2018; Comments on the Cooperative Agreement to Support Navigators in Federally Facilitated Exchanges, Funding Opportunity Number: CA-NAV-18-001

Client expense: $90,632 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Emergency Management Agency (FEMA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Risk Management Agency, SENATE, Treasury, Dept of

H.R.372-Competetive Health Insurance Reform Act of 2017 H.R.817-End Surprise Billing Act of 2017 H.R.1628-American Health Care Act of 2017 H.R.3258-Marketplace Certainty Act H.R.6143-Patient Right to Know Drug Prices Act H.R.6144-Know the Lowest Price Act of 2018 H.R.6733-Know the Cost Act of 2018 S.191-Patient Freedom Act of 2017 S.1462-Marketplace Certainty Act S.1835-Lower Premiums Through Reinsurance Act of 2017 S.2544-Patient Right to Know Drug Prices Act S.2553-Know the Lowest Price Act of 2018

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.372 - Competitive Health Insurance Reform Act of 2017 H.R.1606 - DOC Access Act

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), SENATE

Reforming parts of the ERISA and McCarran-Ferguson laws to foster a more competition in the health insurance marketplace. H.R. 372-Competitive Health Insurance Reform Act H.R. 65-Responsible Additions and Increases to Sustain Employee (RAISE) Health Benefits Act of 2017 H.R. 1313-Preserving Employee Wellness Programs Act S. 155-Responsible Additions and Increases to Sustain Employee (RAISE) Health Benefits Act of 2017

Client expense: $530,000 · Firm income: Not reported

Government targets: Drug Enforcement Administration (DEA), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), Office of Natl Drug Control Policy (NDCP), SENATE, Treasury, Dept of

Health care payment and delivery system reform Health Information Technology and the implementation of EHR meaningful use Implementation of the Affordable Care Act Policy related to the ACA's health exchange risk corridors Policy related to cost-sharing reduction payments Support H.R. 372, The Competitive Health Insurance Reform Act of 2017, - provisions related to repeal McCarran-Ferguson with respect to the business of health insurance 42 CFR Part 2 alignment with HIPAA S. 2852/H.R. 6378, Pandemic and All-Hazards Preparedness & Advancing Innovation Act - provisions related to hospitals

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

Government targets: 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

H.R. 302 - FAA Reauthorization Act of 2018; provisions relating to drones H.R. 372 - Competitive Health Insurance Reform Act of 2017; provisions relating to McCarran-Ferguson Act coverage for life, annuities, disability income insurance, long-term care insurance, and P/C insurance H.R. 2997 - The 21st Century Aviation Innovation, Reform, and Reauthorization Act (AIRRACT); provisions relating to use of drones H.R. 3746 - Business of Insurance Regulatory Reform Act of 2017; entire bill H.R. 3762 - International Insurance Standards Act of 2017; entire bill H.R. 3861 - Federal Insurance Office Reform Act of 2017; entire bill H.R. 5059 - State Insurance Regulation Preservation Act; entire bill H.R. 5666 - Primary Regulators of Insurance Vote of 2018; entire bill S. 488 - JOBS and Investor Confidence Act of 2018; provisions relating to international insurance standards S. 1360 - International Insurance Capital Standards Accountability Act of 2017; entire bill S. 2702 - Business of Insurance Regulatory Reform Act of 2018; entire bill S. 3177 - Primary Regulators of Insurance Vote Act of 2018; entire bill

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 4575/S.2303, the Access to Independent Health Insurance Advisors Act; H.R. 173/S. 58 the Middle Class Americans' Health Plans Act; H.R. 372, the Competitive Health Insurance Reform Act of 2017; H.R. 1628, American Health Care Act of 2017; Issues related to the Federally-facilitated marketplaces;S. 191, the Patient Freedom Act of 2017; H.R. 1626, the Better Care Reconciliation Act of 2017; H.R. 3798, the Save American Workers Act of 2018; H.R.4616, the Employer Relief Act of 2018; Comments on the Cooperative Agreement to Support Navigators in Federally Facilitated Exchanges, Funding Opportunity Number: CA-NAV-18-001

Client expense: $90,632 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Emergency Management Agency (FEMA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Risk Management Agency, SENATE, Treasury, Dept of

HR 372 Competitive Health Insurance Reform Act of 2017 (all sections of full text)(support) S 3782 Competitive Health Insurance Reform Act of 2018 (all sections of full text)(support)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 372, the Competitive Health Insurance Reform Act of 2017 Discussions with members of Congress and the Department of Labor regarding the Department of Labors disability insurance claims rule Department of Labor rule on Association Health Plans

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

Government targets: HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Treasury, Dept of

Bipartisan Health Care Stabilization Act (Alexander-Murray) - funding for cost sharing reduction benefits, stabilization of individual market Bipartisan Health Care Stabilization Act; updated version (Alexander-Walden-Collins-Costello) - funding for cost sharing reduction benefits and reinsurance, stabilization of individual market S. 147, Obamacare Taxpayer Bailout Prevention Act (Rubio) - ACA risk corridors program S. 581, Jessies Law (Manchin-Capito) - patient history of opioid use disorder S. 1201, Health Care Options for All Act (McCaskill) - coverage options in bare counties S. 1354, Individual Health Insurance Marketplace Improvement Act (Carper-Kaine) - individual market reinsurance fund, outreach and enrollment activities S. 1462, Marketplace Certainty Act (Shaheen) - funding for cost-sharing reduction benefits S. 1516, Coverage Across State Lines (Heller) S. 1667, Protecting Consumers from Unreasonable Rates Act (Feinstein) - rate review S. 1835, Lower Premiums Through Reinsurance Act (Collins-Nelson) - invisible high risk pool and reinsurance programs S. 1976, Increasing Access to Care Act (Scott) - copper plan S. 1985, Protect Access to Birth Control Act (Murray) - coverage of contraceptive services S. 2052, Healthcare Market Certainty and Mandate Relief Act (Hatch) - funding for cost sharing reduction benefits, HSA improvements, ACA individual mandate S. 2241 (King) - fees on excepted benefits and standalone dental plans S. 2303, Access to Independent Health Insurance Advisors Act (Isakson-Coons) - calculation of medical loss ratios S. 3388, Ensuring Coverage for Patients with Pre-Existing Conditions Act (Tillis) - protections for individuals with pre-existing conditions S. 3541, Reducing Costs for Out-of-Network Services Act (Shaheen) -cost-sharing for out-of-network services S. 3592, No More Surprise Medical Bills Act (Hassan) - surprise medical bills S. 3742, Cancer Drug Parity Act (Smith) - cost sharing for cancer drugs H.R. 2, Agriculture and Nutrition Act (Conaway) - agricultural association health plans H.R. 314, Health Care Choice Act (Blackburn) - selling insurance across state lines H.R. 372, Competitive Health Insurance Reform Act (Gosar) - McCarran-Ferguson Act H.R. 421, Allowing Greater Access to Safe and Effective Contraception Act (Love) - non-prescription contraceptives, HSA flexibility H.R. 706, Plan Verification and Fairness Act (Blackburn) - verifying eligibility for special enrollment periods H.R. 708, State Age Rating Flexibility Act (Buchson) - age rating bands H.R. 710, Health Coverage State Flexibility Act (Flores) - grace period for premium payments H.R. 1101, Small Business Health Fairness Act (Johnson) - association health plans H.R. 1121, Pre-existing Conditions Protection Act (Walden) - protections for patients with pre-existing conditions H.R. 1304, Self-Insurance Protection Act (Roe) - medical stop-loss insurance H.R. 1409, Cancer Drug Parity Act (Lance) - coverage of oral anti-cancer drugs H.R. 1606, DOC Access Act (Carter) - reimbursement for dental and vision providers H.R. 3450, Protecting Consumers from Unreasonable Rates Act (Schakowsky) - rate review H.R. 3545, Overdose Prevention and Patient Safety Act (Murphy- Blumenauer) -- confidentiality of drug and alcohol treatment and prevention records H.R. 3976, Access to Marketplace Insurance Act (Cramer) - third party payments H.R. 4082, Protect Access to Birth Control Act (DeGette) - coverage of contraceptive services H.R. 4200, Healthcare Market Certainty and Mandate Relief Act (Brady) - funding for cost sharing reduction benefits, HSA improvements H.R. 4225 (Hudson) - fees on excepted benefits and standalone dental plans H.R. 4575, Access to Independent Health Insurance Advisors Act (Long-Schrader) - calculation of medical loss ratios H.R. 4666, Premium Relief Act (Costello) - Patient and State Stability Fund H.R. 4695, Bipartisan Market Stabilization and Innovation Act (Schrader) - stabilization of individual market H.R. 6311, Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act (Roskam) - access to catastrophic plans, definition of qualified health plans H.R. 6314, Health Savings Act (Burgess) - definition of high-deductible health plan H.R. 6496, Continuing Coverage for Preexisting Conditions Act (Joyce) - protections for individuals with pre-existing conditions H.R. 7003, Federal Invisible Risk Sharing Program (Schweikert) Regulatory Issues: Insurance regulatory reform; issues related to the coordination of private and public disability income benefits; disability risk management; disability income insurance enrollment and awareness; issues related to encouraging impaired workers to stay in/return to the workforce; issues related to expanding long-term care insurance coverage; issues relating to the coordination of benefits between private health insurance plans and Medicaid; Medigap claims processing and crossover fees; Medigap cross-over claim issues, Medigap coverage, implementation of Medigap standardized plan offerings; Medigap carrier recoveries related to CMS fraud and abuse enforcement activities, and issues related to Medigap educational materials, and other Medigap issues; fraud and abuse issues affecting public and private insurance coverage; issues relating to antitrust; implementation of the Mental Health Parity Act requirements; implementation of the 21st Century Cures Act requirements; summary of benefits and coverage disclosures; pre-existing condition insurance plans; accountable care organizations; coverage of preventive services; preexisting condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; health reimbursement accounts; dependent coverage; treatment of expatriate plans; issues related to all payor claims databases; issues related to association health plans; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations, non-discriminatory wellness programs; issues related to supplemental products; issues relating to dental coverage; issues relating to proposals for single-payer and Medicare/Medicaid buy-in options; issues related to implementation of the Telephone Consumer Protection Act; issues relating to third party payment of premiums; issues related to cost-sharing reductions (CSRs); issues relating to the individual market; 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

Public Law 111-203, H.R. 4173- Dodd-Frank Wall Street Reform and Consumer Protection Act. Issue: Implementation and Regulatory reform. Captive Reinsurance Transactions, Insurance Capital Standards and Global Capital Standards. H.R. 372 - Competitive Health Insurance Reform Act of 2017. This bill would restore the application of the Federal antitrust laws to the business of health insurance to protect competition and consumers. Issue: McCarran-Ferguson Act. H.R. 1270 - Living Donor Protection Act of 2017. The bill would promote and protect from discrimination living organ donors. Issue: underwriting. H.R. 3746/S.2702 - Business of Insurance Regulatory Reform Act. Issue: Insurance exclusion from CFPB jurisdiction. H.R. 5059 - State Insurance Regulation Preservation Act. Issue: Federal Reserve Board supervision of insurance companies. H.R. 5666/S. 3177 - Primary Regulators of Insurance Vote Act of 2018. Issue: FSOC reform. S.__ - Draft legislation regarding Federal Reserve Board supervision of insurance companies. Implementation of S. 2270 - Insurance Capital Standards Clarification Act of 2014. The bill would give the Federal Reserve the authority to tailor capital standards for insurance companies subject to Fed supervision. Issue: Capital Standards, Basel III H.R. 5666/S. 3177 - Primary Regulators of Insurance Vote Act of 2018. Issue: FSOC reform.

Client expense: $510,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 372 - Competitive Health Insurance Reform Act - issues related to McCarran Ferguson Act H.R. 1422/S.563 - Flood Market Parity and Modernization Act (entire bill) H.R. 1423 - The National Flood Insurance Programs and Reauthroization Act of 2017 (entire) H.R. 1558 - The Repeatedly Flooded Communities preparation Act (entire) H.R. 10 - Financial CHOICE Act (titles I, VI, VII, X, and XI) H.R. 1558, the Repeatedly Flooded Communities Preparation Act (entire) H.R. 2246, the Taxpayer Exposure Mitigation Act of 2017 (entire) H.R. 2565, National Flood Insurance Act (entire) S. 3528, National Flood Insurance Program Extension Act (entire) H.R. 2868, the National Flood Insurance Program Policyholder Protection Act of 2017 (entire) H.R. 2875 the National Flood Insurance Program Administrative Reform Act of 2017 (entire) H.R. 2874, the 21st Century Flood Reform Act of 2017 H.R. 2874 (entire) S. 1368 - Sustainable, Affordable, Fair, and Efficient (SAFE) National Flood Insurance Program Reauthorization Act of 2017 (entire) H.R. 3746 - Business of Insurance Regulatory Reform Act, to clarify the authority of the Bureau of Consumer Financial Protection with respect to persons regulated by a state insurance regulator, and for other purposes. H.R. 3861, Federal Insurance Office Reform Act (entire) H.R. 4537, International Insurance Standards Act (entire) H.R. 4483 - Federal Insurance Office Abolishment Act (entire) Issues related to the imposition of capital standards to non-banks Issues related to the U.S. - E.U. Insurance Covered Agreement Issues related to international insurance standards Issues related to the implementation of Dodd-Frank Act (PL 111-203), the provisions which may impact insurance regulation Issues related to Financial Services and General Government Appropriations Issues related to the Systematic Risk Designation process pursuant to the Dodd-Frank Wall Street Reform and Consumer Protection Act Issues related to U.S. Department of Treasury regulations regarding approval and listing of Certified Sureties. (T-List) H.R. 5666, Primary Regulations of Insurance Vote Act of 2018 (entire) H.R. 6292, Nonprofit Property Protection Act (entire) H.R. 3353, Claims Licensing Advancement for Interstate Matters Act (CLAIM)-entire S.488, Jobs and Investor Confidence Act (title XIV)

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

Government targets: Federal Emergency Management Agency (FEMA), Federal Reserve System, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Internal Revenue Service (IRS), SENATE, Treasury, Dept of

General discussions related to the modernization of the Medicare secondary payer process (specific to workers compensation liability). General discussion related to ERISA disability claim procedures. General discussions on apprenticeships, including specific Illinois program, DOL's American Apprenticeship Initiative Grant program, and certified apprenticeship status. H.R. 372, Competitive Health Insurance Reform Act of 2017. S. 3079, Medicare Secondary Payer and Workers' Compensation Settlement Agreements Act of 2018. H.R. 5881, PAID Act.

Client expense: $390,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Commerce, Dept of (DOC), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), Labor, Dept of (DOL), Risk Management Agency, SENATE, State, Dept of (DOS), Treasury, Dept of

HR1628; HR372; HR3922; HR3921; S1827; HR1825 / S445; S1362; HR4392; S292 / HR820 STAR Childhood Cancer Act; HR6;

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

PL 111-148 - The Patient Protection and Affordable Care Act, implementation H.R. 1628 - American Health Care Act of 2017 H.R. 246 - health insurance tax repeal H.R. 1101 - Small Business Health Care Fairness Act H.R. 372 - Competitive Health Insurance Reform Act H.R. 1121 - Pre-existing Conditions Protection Act of 2017 H.R. 708- State Age Rating Flexibility Act H.R. 6 - SUPPORT for Patients and Communities Act S. 3120 - HEAL Substance Use Disorders Act S. 2680 - Opioid Crisis Response Act ***, no specific bill(s), Health Savings Accounts/Medical Savings Accounts, Transparency, Interoperability, Health Information Technology, Electronic Prescribing, Insurance Market Reform, Uninsured, Employer Based Health System, Exchanges, Risk Corridors and Reinsurance, Federal employees and regional PPOs, Cybersecurity, telehealth, Co-ops, special enrollment periods, Risk Mitigation, mental health, opioid abuse, market stabilization, out of network billing, risk adjustment, value based purchasing, NBPP

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

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

H.Res.116 - Providing for consideration of the joint resolution (H.J. Res. 66) disapproving the rule submitted by the Department of Labor relating to savings arrangements established by States for non-governmental employees, and providing for consideration of the joint resolution (H.J. Res. 67) disapproving the rule submitted by the Department of Labor relating to savings arrangements established by qualified State political subdivisions for non-governmental employees , ALL PROVISIONS H.R. 372, the Competitive Health Insurance Reform Act of 2017 , ALL PROVISIONS

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

Government targets: Commerce, Dept of (DOC), Federal Aviation Administration (FAA), Federal Election Commission (FEC), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Highway Traffic Safety Administration (NHTSA), SENATE, Treasury, Dept of, U.S. Trade Representative (USTR)

H.R. 372, Competitive Health Insurance Reform Act of 2017, all sections.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 372 Competitive Health Insurance Reform Act of 2017 (all sections of full text)(support)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Public Law 111-203, H.R. 4173- Dodd-Frank Wall Street Reform and Consumer Protection Act. Issue: Implementation and Regulatory reform. Captive Reinsurance Transactions, Insurance Capital Standards and Global Capital Standards. Implementation of S. 2270 - Insurance Capital Standards Clarification Act of 2014. The bill would give the Federal Reserve the authority to tailor capital standards for insurance companies subject to Fed supervision. Issue: Capital Standards, Basel III H.R. 372 - Competitive Health Insurance Reform Act of 2017. This bill would restore the application of the Federal antitrust laws to the business of health insurance to protect competition and consumers. Issue: McCarran-Ferguson Act. H.R. 1270 - Living Donor Protection Act of 2017. The bill would promote and protect from discrimination living organ donors. Issue: underwriting. H.R. 3746/S.2702 - Business of Insurance Regulatory Reform Act. Issue: Insurance exclusion from CFPB jurisdiction. H.R. 5059 - State Insurance Regulation Preservation Act. Issue: Federal Reserve Board supervision of insurance companies. H.R. 5666/S. 3177 - Primary Regulators of Insurance Vote Act of 2018. Issue: FSOC reform. S.__ - Draft legislation regarding Federal Reserve Board supervision of insurance companies.

Client expense: $1,024,543 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

In support of the Competitive Health Insurance Reform Act of 2017 (HR 372) - antitrust reform In support of legislation to require insurance coverage for patients with craniofacial anomalies (S 3369/HR 6639)

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

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

INS - Fourth Quarter Report - 2018 Public Law 111-203, H.R. 4173 - Dodd-Frank Wall Street Reform and Consumer Protection Act. Issue: Implementation and Regulatory reform. Captive Reinsurance Transactions, Insurance Capital Standards and Global Capital Standards. H.R. 372 - Competitive Health Insurance Reform Act of 2017. This bill would restore the application of the Federal antitrust laws to the business of health insurance to protect competition and consumers. Issue: McCarran-Ferguson Act. H.R. 1270 - Living Donor Protection Act of 2017. The bill would promote and protect from discrimination living organ donors. Issue: underwriting. H.R. 3746/S.2702 - Business of Insurance Regulatory Reform Act. Issue: Insurance exclusion from CFPB jurisdiction. H.R. 5059 - State Insurance Regulation Preservation Act. Issue: Federal Reserve Board supervision of insurance companies. Implementation of S. 2270 - Insurance Capital Standards Clarification Act of 2014. The bill would give the Federal Reserve the authority to tailor capital standards for insurance companies subject to Fed supervision. Issue: Capital Standards, Basel III S.__ - Draft legislation regarding Federal Reserve Board supervision of insurance companies.

Client expense: $620,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 143 Anticompetitive Activities H.R. 372 Health Insurance Antitrust Law Application H.R. 617 Application of the Federal Antitrust Laws H.R. 906 Asbestos Exposure Claims Reports Public Disclosure H.R. 985 Federal Court Procedures H.R. 1637 Compel Sanctions by Filing Civil Actions H.R. 1667 Insolvent Financial Institution Bankruptcy Resolution H.R. 4432 Residential Lead-Based Paint Hazards Violations S. 2564 Fraudulent Claims Against Trusts S. 237 Lawsuit Abuse Reduction Act of 2017 H.R. 6773 Attorney Accountability **Issues lobbied without specific bill numbers: Disparate Impact rule

Client expense: $1,030,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Executive Office of the President (EOP), Federal Deposit Insurance Corporation (FDIC), Federal Emergency Management Agency (FEMA), HOUSE OF REPRESENTATIVES, Natl Credit Union Administration (NCUA), Natl Economic Council (NEC), Natl Security Council (NSC), SENATE, Transportation, Dept of (DOT), Treasury, Dept of, U.S. Trade Representative (USTR)

H.R. 372: Competitive Health Insurance Reform Act of 2017 -(Sec. 2) This bill amends the McCarran-Ferguson Act to declare that nothing in that Act modifies, impairs, or supersedes the operation of antitrust laws with respect to the business of health insurance, including the business of dental insurance. This declaration does not apply to a contract, combination, or conspiracy to: (1) collect, compile, or disseminate historical loss data; (2) determine a loss development factor for historical loss data; (3) perform actuarial services if the collaboration does not involve a restraint of trade; or (4) develop or disseminate a standard insurance policy form if adherence to the form is not required. H.R. 3746/S. 2702: Business of Insurance Regulatory Reform Act - the bill would clarify the insurance exclusion from CFPB jurisdiction and reaffirm that enforcement is broadly construed in favor of the authority of the state insurance regulator. H.R. 3762:International Insurance Standards Act of 2017 -the bill would provide Congress a more active role in monitoring and reviewing international insurance agreements. H.R. 3861: Federal Insurance Office Reform Act of 2017 - the bill would eliminate the FIO's ability to subpoena information from insurers, block the office from participating on insurance companies regulatory oversight panels, and weaken the agency's authority in negotiating insurance deals with foreign governments. H.R. 4537: would require negotiators of international insurance agreements to oppose any proposal that is inconsistent with existing federal and state laws. The bill would require negotiators to consult with state insurance commissioners and the Congress. The bill also would provide the Congress with a process to disapprove of any international insurance agreement. H.R. 5666/S. 3177: Primary Regulators of Insurance Vote Act of 2018 - This bill would allow the President to appoint a state insurance commissioner as a voting member of the Financial Stability Oversight Council (FSOC).

Client expense: $580,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 2155, Economic Growth, Regulatory Relief, and Consumer Protection Act--Implementation and regulatory reform of the financial services industry. H.R. 3861, Federal Insurance Office Reform Act of 2017-- FIO reform. H.R. 4061, Financial Stability Oversight Council Improvement Act of 2017--Reform of FSOC non-bank SIFI designation process. S.1360, International Insurance Capital Standards Accountability Act of 2017--International capital standards H.R.4537, International Insurance Standards Act of 2017--International Capital Standards H.R. 10, Financial CHOICE Act--Dodd Frank Act reforms S. 1157, H.B. 2481, PATCH Act of 2017-A bill to establish the Vulnerabilities Equities Review Board Tort Reform H.R. 906 - The Furthering Asbestos Claims Transparency Act H.R. 985; H.Res.180 - The Fairness in Class Action Litigation Act H.R. 720; H.Res 180; S.237 - The Lawsuit Abuse Reduction Act H.R. 1215; H.Res.382 - The Protecting Access to Care Act H.R. 1118 - The Innocent Sellers Fairness Act Trade Recently concluded bilateral covered agreement with the EU Disaster Relief S. 161, A bill to improve hurricane forecasting and for other purposes. S. 153, A bill to ensure reliable observation of hurricanes. H.R.1423 - National Flood Insurance Program Reauthorization and Improvement Act of 2017 S.600 - Fairness in Federal Disaster Declarations Act of 2017 H.R. 1422 - Flood Insurance Market Parity and Modernization Act H.R.1183 - To amend the Robert T. Stafford Disaster Relief and Emergency Assistance Act to improve mitigation assistance. H.R.1481 - To amend the Internal Revenue Code of 1986 to include automated fire sprinkler system retrofits as section 179 property and classify certain automated fire sprinkler system retrofits as 15-year property for purposes of depreciation. H.R. 1558 - Repeatedly Flooded Communities Preparation Act H.R.1665 - To ensure that Administrator of the Federal Emergency Management Agency considers severe local impact in making a recommendation to the President for a major disaster declaration. H.R.1679 - To ensure that the Federal Emergency Management Agency's current efforts to modernize its grant management system includes applicant accessibility and transparency, and for other purposes. H.R. 1789 H.R.1691 - To amend the Internal Revenue Code of 1986 to exclude from gross income amounts received from State-based earthquake loss mitigation programs. H.R. 2246 - Taxpayer Exposure Mitigation Act of 2017 H.R. 2548 - FEMA Reauthorization Act of 2017 H.R. 2565 - a bill to require the use of replacement cost value in determining the premium rates for flood insurance coverage under the National Flood Insurance Act, and for other purposes. H.R. 2818 - Disaster Savings Accounts Act of 2017 H.R. 2868 - National Flood Insurance Program Policyholder Protection Act of 2017 H.R. 2874 - 21st Century Flood Reform Act H.R. 2875 - National Flood Insurance Program Administrative Reform Act of 2017 S. 1368 - Sustainable, Affordable, Fair, and Efficient (SAFE) National Flood Insurance Program Reauthorization Act of 2017 H.R.3672 - Making supplemental appropriations for disaster relief requirements for the fiscal year ending September 30, 2017. S.1768 - National Earthquake Hazards Reduction Program Reauthorization Act of 2017 H.R.3732 - Emergency Aid to American Survivors of Hurricanes Irma and Jose Overseas Act S.1798 - Federal Flood Management Act of 2017 S.1823 - Federal Disaster Assistance Nonprofit Fairness Act of 2017 S.1842 - Wildfire Disaster Funding Act S.1853 - Small Business Disaster Relief Act of 2017 H.R.3823 - Disaster Tax Relief and Airport and Airway Extension Act of 2017 H.R.3824 - Texas Flood Accountability Act of 2017 H.R.3854 - Federal Infrastructure Flood Resiliency Act of 2017 H.R. 601 - Continuing Appropriations Act, 2018 and Supplemental Appropriations for Disaster Relief Requirements Act, 2017 H.R.3936 - National Flood Insurance Program Debt Forgiveness Act of 2017 S.1932 - Wildfire Mitigation Assistance Act H.R.4056 - Disaster Insurance Risk Equality Act H.R.4008 - Additional Supplemental Appropriations for Disaster Relief Requirements Act of 2017 S.1991 - Wildland Fires Act of 2017 H.R.4148 - Small Business Disaster Relief Act of 2017 S.2104 - Earthquake Mitigation Incentive and Tax Parity Act of 2017 S.2092 - Flood Insurance Continuing Education and Training Act H.R.4397 - California Wildfire Disaster Tax Relief Act of 2017 S.1907 - National Disaster Tax Relief Act of 2017 H.R.4460 - Disaster Recovery Reform Act H.R.4455 - SMART Rebuilding Act H.R.4667 - Making further supplemental appropriations for the fiscal year ending September 30, 2018, for disaster assistance for Hurricanes Harvey, Irma, and Maria, and calendar year 2017 wildfires, and for other purposes. H.J.Res.123 - Making further continuing appropriations for fiscal year 2018, and for other purposes. H.R.1370 - An Act to amend the Homeland Security Act of 2002 to require the Secretary of Homeland Security to issue Department of Homeland Security-wide guidance and develop training programs as part of the Department of Homeland Security Blue Campaign, and for other purposes. H.R.4739 - Build America Act of 2018 H.R.4995 - Due Diligence for FEMA Disaster Contractors Act of 2018 H.R.4905 - IMAGES Act of 2018 (NFIP) H.R.5200 - Hardest Hit Housing Act of 2018 S.2447 - Smart Building Acceleration Act H.R.5069 - Smart Building Acceleration Act of 2018 H.R.4845 - Connecting Communities Post Disasters Act of 2018 H.R.5016 - Revitalize Rural America Act of 2018 Regulation of the insurance industry H.R.1708 - To prohibit the sale of a firearm to, and the purchase of a firearm by, a person who is not covered by appropriate liability insurance coverage. Monitor implementation of (Pub. L. 114-1), the Terrorism Risk Insurance Program Reauthorization Act of 2015 Monitor implementation of Pub. L. 114-113, Consolidated Appropriations Act, 2016 (contains the Policyholder Protection Act) Monitor the Federal Insurance Offices activities at the International Association of Insurance Supervisors Recently concluded bilateral covered agreement with the EU H.R. 10 - Financial CHOICE Act of 2017 S. 1360 - International Insurance Capital Standards Accountability Act of 2017 S.1579 - Bureau of Consumer Financial Protection Advisory Board Enhancement Act H.R. 3110 - Financial Stability Oversight Council Insurance Member Continuity Act H.R.3312 - Systemic Risk Designation Improvement Act of 2017 H.J.Res.111 - Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by Bureau of Consumer Financial Protection relating to "Arbitration Agreements" H.R.3363 - CLAIM Act S.1773/H.R. 3698 - A bill to amend the Federal Crop Insurance Act to limit the overall rate of return for crop insurance providers and remove the requirement of budget neutrality in the Standard Reinsurance Agreement. H.R.3746 - Business of Insurance Regulatory Reform Act of 2017 S.1835 - Lower Premiums Through Reinsurance Act of 2017 S.1893 - Systemic Risk Designation Improvement Act of 2017 H.R.3762 - International Insurance Standards Act of 2017 H.R.4309 - Regulatory Relief Act of 2017 H.R.4483 - Federal Insurance Office Abolishment Act of 2017 H.R.4537 - International Insurance Standards Act of 2017 H.R.4755 - Federal Reserve Regulatory Oversight Act S.2299 - Wildfire Regulatory Relief Act of 2018 S.2512 - A bill to amend the Agricultural Act of 2014 to require producers to elect to receive price loss coverage or agriculture risk coverage under that Act or Federal crop insurance under the Federal Crop Insurance Act. H.R.5203 - To amend the Agricultural Act of 2014 to require producers to elect to receive price loss coverage or agriculture risk coverage under that Act or Federal crop insurance under the Federal Crop Insurance Act. (related bill to above) H.R.4865 - Crop Insurance Modernization Act of 2018 H.R.4771 - Small Bank Holding Company Relief Act of 2018 H.R.5076 - Small Bank Exam Cycle Improvement Act of 2018 (to amend the Federal Deposit Insurance Act to extend the examination cycle for certain insured depository institutions) H.R.5266 - Financial Product Safety Commission Act of 2018 (to amend the Consumer Financial Protection Act of 2010 to make the Bureau of Consumer Financial Protection an independent Financial Product Safety Commission, and for other purposes) H.R.5381 - GRATER Act of 2018 (To reduce and minimize the credit, guarantee, and insurance risk of all Federal Government programs by transferring such risk to the private sector at market terms, and for other purposes) Automotive H.R. 1266 - To authorize the Secretary of Transportation to make grants to assist units of local government in developing and implementing plans, known as Vision Zero plans, to H.R.1568 - To enhance interstate commerce by creating a national hiring standard for motor carriers, and for other purposes. H.R.3388 - SELF DRIVE Act H.R.3404 - To provide for the establishment in the National Highway Traffic Safety Administration of a Highly Automated Vehicle Advisory Council. H.R.3411 - To establish in the National Highway Traffic Safety Administration an Automated Driving System Cybersecurity Advisory Council to make recommendations regarding cybersecurity for the testing, deployment, and updating of automated driving systems. H.R.3412 - LEAD'R Act H.R.3421 - INFORM Act H.R.3407 - To amend chapter 301 of subtitle VI of title 49, United States Code, to require a cybersecurity plan for highly automated vehicles, and for other purposes. H.R.3430 - SHARES Act S.1666 - HOT CARS Act of 2017 H.R.3449 - Used Car Safety Recall Repair Act H.Res.493 - Recognizing the dangers of distracted driving. S.1885 - AV START Act S.2017/H.R. 4156 - Driver Fatigue Prevention Act H.R.4542 - Distracted Driving Education Act of 2017 H.R.5131 - Surface Transportation Security Improvement Act of 2018 H.R.5358 - DRIVE-Safe Act Aviation/Aircraft/Airlines (House, Senate) S. 631 - A bill to amend the FAA Modernization and Reform Act of 2012 to provide guidance and limitations regarding the integration of unmanned aircraft systems into United States airspace, and for other purposes. Monitor implementation of (Pub. L. 114-190), FAA Extension, Safety, and Security Act of 2016 H.R. 2997 - 21st Century AIRR Act H.R. 2930 - Drone Innovation Act of 2017 S.1272 - Drone Federalism Act of 2017 H.R. 3644/S.1755 - Drone Operator Safety Act of 2017 H.R.3823 - Disaster Tax Relief and Airport and Airway Extension Act of 2017 Postal Reform (House, Senate) H.R. 756 - Postal Service Reform Act of 2017 H.R. 760 - Postal Service Financial Improvement Act of 2017 H.R. 5666, S. 3177 the Primary Regulators of Insurance Vote Act-a bill to allow for a state insurance member to have a vote on FSOC H.R. 5881, S. _____, PAID ACT-- Provide Accurate Information Directly Act--A bill to improve claim resolution through CMS systems related to Medicare part C, D and Medicaid. H.R. 4219 Workflex in the 21st Century Act- Federal uniformity on paid leave requirements (HR) Public Law 111-203, H.R. 4173- Dodd-Frank Wall Street Reform and Consumer Protection Act. Issue: Implementation and Regulatory reform. Captive Reinsurance Transactions, Insurance Capital Standards and Global Capital Standards. Implementation of S. 2270 - Insurance Capital Standards Clarification Act of 2014. The bill would give the Federal Reserve the authority to tailor capital standards for insurance companies subject to Fed supervision. Issue: Capital Standards, Basel III H.R. 372 - Competitive Health Insurance Reform Act of 2017. This bill would restore the application of the Federal antitrust laws to the business of health insurance to protect competition and consumers. Issue: McCarran-Ferguson Act. H.R. 1270 - Living Donor Protection Act of 2017. The bill would promote and protect from discrimination living organ donors. Issue: underwriting. Tort Reform HR 3808, New York Scaffold Law-- This bill precludes absolute liability in any action against a property owner or contractor for projects receiving federal financial assistance for infrastructure and transportation development for any injury associated with an elevation or gravity related risk occurring on those projects S. 2815 - Litigation Funding Transparency Act of 2018 Trade Disaster Relief H.R.4177 - PREPARE Act of 2017 - To enhance the Federal Governments planning and preparation for extreme weather and the Federal Governments dissemination of best practices to respond to extreme weather, thereby increasing resilience, improving regional coordination, and mitigating the financial risk to the Federal Government from such extreme weather, and for other purposes. S. 2701 - A bill to require the Administrator of the Federal Emergency Management Agency to carry out a pilot program to enhance the mapping of urban flooding and associated property damage and the availability of that mapped data to homeowners, businesses, and localities to help understand and mitigate the risk of such flooding, and for other purposes. H.R. 5559 - To transfer functions related to the preparation of flood maps from the Administrator of the Federal Emergency Management Agency to the Director of the United States Geological Survey, and for other purposes. H.R. 5543 - To amend the Internal Revenue Code of 1986 to allow for a credit against tax for certain flood insurance expenses. S.2767 - A bill to make improvements to certain wildfire and disaster recovery programs of the Federal Government, and for other purposes. H.R.5618 - To exempt properties located in flood hazard areas that are participating in an approved buy-out program from the mandatory purchase requirement under the National Flood Insurance Program, and for other purposes. H.R.5973 - Disaster Assistance Risk Transfer Act of 2018 - To amend the Robert T. Stafford Disaster Relief and Emergency Assistance Act to require a report on risk transfer, and for other purposes Regulation of the insurance industry Public Law 111-203, H.R. 4173 - Dodd-Frank Wall Street Reform and Consumer Protection Act. Issue: Implementation and Regulatory reform. Captive Reinsurance Transactions, Insurance Capital Standards and Global Capital Standards. Roles of federal and state agencies at the International Association of Insurance Supervisors and the Financial Stability Board. Implementation of S. 2270 - Insurance Capital Standards Clarification Act of 2014. The bill would give the Federal Reserve the authority to tailor capital standards for insurance companies subject to Fed supervision. Issue: Capital Standards, Basel III H.R.___ - Financial Services and General Government Appropriations Act. Making appropriations for financial services and general government for the fiscal year ending September 30, 2018, and for other purposes. Issue: Global insurance standards; SIFI de-risking. H.R. 4537 Insurance Capital Standards Accountability Act of 2017. Issue: international insurance standards. H.R. 4483 - Federal Insurance Office Abolishment Act of 2017. Issue: FIO reform. H.R. 5323 - Derivatives Fairness Act. Issue: establish an exemption from the credit valuation adjustment calculation for uncleared derivatives transactions with end-users. H.R. 1625 - Consolidated Appropriations Act of 2018. Issue: postal reform. H.R.___/S.___ - Financial Services and General Government Appropriations Act. Making appropriations for financial services and general government for the fiscal year ending September 30, 2019, and for other purposes. Issue: Global insurance standards; SIFI de-risking. H.R.__ - Draft legislation regarding the designations or titles of financial professionals. Issue: Unclaimed life insurance products. No bill number assigned. Issue: Covered agreement on prudential measures with respect to the business of insurance and reinsurance. No bill number assigned. Issue: Whole or universal life insurance premiums. Issue: Swap margin rule. The rule establishes margin requirements for swaps not cleared through a clearinghouse. No bill number assigned. H.R. 1303/S. 180 - H-1B and L-1 Visa Reform Act of 2017. This bill would amend the Immigration and Nationality Act to reform and reduce fraud and abuse in certain visa programs for aliens working temporarily in the U.S. Issue: immigration reform. H.R. 1226/S. 447 - Justice for Uncompensated Survivors Today (JUST) Act of 2017. This bill would require reporting on acts of certain foreign countries on Holocaust era assets and related issues. Issue: Holocaust era insurance claims. H.R. 762/S.258 - Holocaust Insurance Accountability Act of 2017. This bill would provide for the restoration of legal rights for claimants under holocaust-era insurance policies. S. 2702 - A bill to amend the Consumer Financial Protection Act of 2010 to clarify authority of the Bureau of Consumer Financial Protection with respect to persons regulated by a State insurance regulator, and for other purposes H.R. 4061 - Financial Stability Oversight Council Improvement Act of 2017 - To amend the Financial Stability Act of 2010 to improve the transparency of the Financial Stability Oversight Council, to improve the SIFI designation process, and for other purposes. S.3177 - A bill to amend the Financial Stability Act of 2010 to include the State insurance commissioner as a voting member of the Financial Stability Oversight Council, and for other purposes Automotive H.R.5502 - Prohibit Auto Insurance Discrimination Act - To prohibit private passenger automobile insurers from using certain income proxies to determine insurance rates and eligibility. Aviation/Aircraft/Airlines (House, Senate) Postal Reform (House, Senate) S.2755 - A bill to amend title 39, United States Code, to provide that the United States Postal Service may provide certain basic financial services, and for other purposes. H.R.6076 - To restore the financial solvency and improve the governance of the United States Postal Service in order to ensure the efficient and affordable nationwide delivery of mail, and for other purposes Primary Regulators of Insurance Vote Act of 2018, S. 3177-allow for the state representative to be a voting member of FSOC S. 488, the JOBS and Investor Confidence Act (JOBS 3.0)-Including Duffy-Heck International Capital Standard bill. oH.R. 6321, the Investment Adviser Regulatory Flexibility Improvement Act-- require the SEC to revise its definition of a "small business," requiring the SEC to look beyond assets under management and include other factors, such as employment at an advisory firm. oH.R.6323, the National Senior Investor Initiative Act, would require the SEC to set up an interagency task force to focus on challenges facing senior investors. HR 1585, the Fair Investment Opportunities for Professional Experts Act. It would Amends the Securities Act of 1933 to modify the definition of accredited investor H.R. 6021, the Small Business Audit Correction Act of 2018 H.R. 6743, the Consumer Information Notification Requirement Act-a preemptive federal standard for data breach and cyber security applied to financial services companies H.R. 6021, the Small Business Audit Correction Act. the legislation would ease audit requirements for small broker-dealers Disaster H.R.6379 - National Flood Insurance Program Extension Act of 2018 - Passed House H.R.6402 - National Flood Insurance Program Extension and Enhanced Consumer and Community Protections Act of 2018 H.R.6499 - To amend the Small Business Act to authorize the Administrator of the Small Business Administration to issue loans to homeowners in areas at risk for disasters to carry out pre-disaster mitigation activities, and for other purposes H.R.6650 - To reauthorize and amend the National Earthquake Hazards Reduction Program, and for other purposes S.3265 - A bill to require the Secretary of Commerce to undertake certain activities to support waterfront community revitalization and resiliency, and for other purposes (Tammy Baldwin) H.R.6826 - To amend the Small Business Act to provide for disaster loans to repair, rehabilitate, or replace property damaged or destroyed by hurricane Harvey, Irma, or Maria, and for other purposes H.R.6799 - To authorize disaster recovery assistance for areas affected by wildfires on Federal Lands, and for other purposes H.R.6944 - To establish centers of excellence for innovative stormwater control infrastructure, and for other purposes Auto (House, Senate) S.3491 - A bill to require the Secretary of Transportation to carry out a pilot program to develop and provide to States and transportation planning organizations accessibility data sets, and for other purposes S.3215 - A bill to amend title 49, United States Code, to require the development of a bus operations safety risk reduction program, and for other purposes S.3432 - A bill to direct the Secretary of Transportation to issue rules requiring the inclusion of new safety equipment in school buses, and for other purposes Aviation/Aircraft/Airlines (House, Senate) H.R.6438 - To amend the Homeland Security Act of 2002 to establish in the Department of Homeland Security an Unmanned Aircraft Systems Coordinator, and for other purposes S.3511 - A bill to broaden unmanned aircraft systems safety awareness, and for other purposes S.3513 - A bill to establish a deadline for the establishment of a process to allow applicants to petition the Administrator of the Federal Aviation Administration to prohibit or restrict the operation of an unmanned aircraft in close proximity to a fixed site facility Homeland Security (House, Senate) H.R.6864 - Information Transparency & Personal Data Control Act - To require the Federal Trade Commission to promulgate regulations related to sensitive personal information or behavioral data, and for other purposes H.R.6913 - To direct the Secretary of Commerce to establish a working group to recommend to Congress a definition of blockchain technology, and for other purposes S.3437 - A bill to establish a Federal rotational cyber workforce program for the Federal cyber workforce PAID FAMILY LEAVE H.R. 4219 Workflex in the 21st C. Act-- This bill amends the Employee Retirement Income Security Act of 1974 (ERISA) to establish a voluntary workflex option under which employers who provide flexible workplace arrangement plans that include a combination of paid leave and flexible work options are exempt from certain state and local laws regarding employee benefits. S.3345 - Economic Security for New Parents Act - Parental leave only. Allows new parents to drawdown on future Social Security benefits. Rubio Introduced bill week of 7/31, Rep. Ann Wagner to intro companion in Sept. H.R. 1516 Healthy Families Act--Mandate paid sick leave S. 337/H.R 847 FAMILY (Family and Medical Insurance Leave) Act-- Creates a new trust fund within Social Security Admin. For sick leave. H.R. 2282/S. 1006, Equality Act--This bill amends the Civil Rights Act of 1964 to include sex, sexual orientation, and gender identity among the prohibited categories of discrimination or segregation in places of public accommodation. H.R.7037 - State Flood Mitigation Revolving Fund Act of 2018- To amend the National Flood Insurance Act of 1968 to allow the Administrator of the Federal Emergency Management Agency to provide capitalization grants to States to establish revolving funds to provide funding assistance to reduce flood risks, and for other purposes (Charlie Crist, D-FL) H.R.7166 - Hurricane Michael Tax Relief Act - To provide tax relief for the victims of Hurricane Michael, and for other purposes (Neal Dunn, R-FL) S.3679 - A bill to ensure that older adults and individuals with disabilities are prepared for disasters, and for other purposes (Bob Casey) H.R.7200 - To extend indemnity for wildfires and hurricanes, and for other purposes (Austin Scott, R-GA) S.3648 - Hurricanes Florence and Michael and California Wildfire Tax Relief Act - To provide tax relief for the victims of Hurricane Florence, Hurricane Michael, and certain California wildfires (Richard Burr, NC) H.R.7024 - Federal Flood Management Act of 2018 - To establish a Federal standard in order to improve the Nations resilience to current and future flood risk (Jamie Raskin, D-MD) H.R.7315 - To protect American communities from wildfire, and for other purposes (Bruce Westerman, R-AR) H.R.7242 - Disaster Recovery and Opportunity Act of 2018 - To amend the Internal Revenue Code of 1986 to allow certain areas affected by certain Federally declared disasters to be designated as opportunity zones (Mark Meadows, R-NC) H.R.7333 - FEMA Modernization Act of 2018- To provide for reform and reorganization of the Federal Emergency Management Agency, and for other purposes (Sheila Jackson Lee, D-TX) H.R.7322 - H.R 7133,H.R.7192,H.R.7260, H.R.7357,S.3744,S.ConsumerProtectionAct Wyden,H.R.7343,H.R.7392,S.3655,S.3577,H.R. 7383,H.R. 7394

Client expense: $1,070,000 · Firm income: Not reported

Government targets: Federal Deposit Insurance Corporation (FDIC), Federal Emergency Management Agency (FEMA), Federal Reserve System, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Labor, Dept of (DOL), SENATE, Securities & Exchange Commission (SEC), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Copyright Office, U.S. Postal Service (USPS)

H.R. 372 - Competitive Health Insurance Reform Act - issues related to McCarran Ferguson Act H.R. 1422/S.563 - Flood Market Parity and Modernization Act (entire bill) H.R. 1423 - The National Flood Insurance Programs and Reauthroization Act of 2017 (entire) H.R. 1558 - The Repeatedly Flooded Communities preparation Act (entire) H.R. 10 - Financial CHOICE Act (titles I, VI, VII, X, and XI) H.R. 1558, the Repeatedly Flooded Communities Preparation Act (entire) H.R. 2246, the Taxpayer Exposure Mitigation Act of 2017 (entire) H.R. 2565, National Flood Insurance Act (entire) S. 3528, National Flood Insurance Program Extension Act (entire) H.R. 2868, the National Flood Insurance Program Policyholder Protection Act of 2017 (entire) H.R. 2875 the National Flood Insurance Program Administrative Reform Act of 2017 (entire) H.R. 2874, the 21st Century Flood Reform Act of 2017 H.R. 2874 (entire) S. 1368 - Sustainable, Affordable, Fair, and Efficient (SAFE) National Flood Insurance Program Reauthorization Act of 2017 (entire) H.R. 3746 - Business of Insurance Regulatory Reform Act, to clarify the authority of the Bureau of Consumer Financial Protection with respect to persons regulated by a state insurance regulator, and for other purposes. H.R. 3861, Federal Insurance Office Reform Act (entire) H.R. 4537, International Insurance Standards Act (entire) H.R. 4483 - Federal Insurance Office Abolishment Act (entire) Issues related to the imposition of capital standards to non-banks Issues related to the U.S. - E.U. Insurance Covered Agreement Issues related to international insurance standards Issues related to the implementation of Dodd-Frank Act (PL 111-203), the provisions which may impact insurance regulation Issues related to Financial Services and General Government Appropriations Issues related to the Systematic Risk Designation process pursuant to the Dodd-Frank Wall Street Reform and Consumer Protection Act Issues related to U.S. Department of Treasury regulations regarding approval and listing of Certified Sureties. (T-List) H.R. 5666, Primary Regulations of Insurance Vote Act of 2018 (entire) H.R. 6292, Nonprofit Property Protection Act (entire) H.R. 3353, Claims Licensing Advancement for Interstate Matters Act (CLAIM)-entire S.488, Jobs and Investor Confidence Act (title XIV)

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

Government targets: Federal Emergency Management Agency (FEMA), Federal Reserve System, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Internal Revenue Service (IRS), SENATE, Treasury, Dept of

Issues related to agent compensation. Issues related to the implementation of the Patient Protection and Affordable Care Act: H.R. 246, H.R. 394 and S. 761. Issues related to HSA/FSA reform including S. 28 and H.R. 247. Issues related to the McCarran Ferguson antitrust exemption including H.R. 372. Issues with respect to the small employer health care insurance taxes including S. 58 and H.R. 173. Issues relating to the establishment and governance of association health plans (AHPs) including H.R. 1101. Issues related to the American Health Care Act H.R. 1628. Issues related to short-term limited duration insurance.

Client expense: $624,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Securities & Exchange Commission (SEC), Treasury, Dept of

H.R. 372: Competitive Health Insurance Reform Act of 2017 provisions relating to the McCarran-Ferguson Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.445/H.R.1825 - Home Health Care Planning Improvement Act of 2017 H.R.1617/S.3067 - Promoting Access to Diabetic Shoes Act S.1109/H.R.959 - Title VIII Nursing Workforce Reauthorization Act of 2017 H.R.1160 - ACO Assignment Improvement Act of 2017 H.R. 1155 - To amend title XVIII of the Social Security Act to allow physician assistants, nurse practitioners, and clinical nurse specialists to supervise cardiac, intensive cardiac, and pulmonary rehabilitation programs. S.1361 - Improving Access to Cardiac and Pulmonary Rehabilitation Act of 2017 S.783/H.R.315 [P.L. No: 115-320] - Improving Access to Maternity Care Act H.R.3692 - Addiction Treatment Access Improvement Act of 2017 S. 2317 - Addiction Treatment Access Improvement Act of 2018 S.2004 / H.R. 4501- Combating the Opioid Epidemic Act S. 2456/H.R. 5311 - CARA 2.0 Act of 2018 S.2524/H.R. 5102 - Substance Use Disorder Workforce Loan Repayment Act of 2018 H.R. 3922 - CHAMPIONING HEALTHY KIDS Act S. 1827: KIDS Act of 2017 Alexander-Murray Bipartisan Health Care Stabilization Act of 2017 S.1835 - Lower Premiums Through Reinsurance Act of 2017 H.R. 1478 - Gun Violence Research Act Graham-Cassidy-Heller-Johnson Amendment in the nature of a substitute to H.R. 1628 - American Health Care Act of 2017 H.R. 1628 - American Health Care Act of 2017 Better Care Reconciliation Act Discussion Draft S. 222 - Obamacare Replacement Act H.R. 372 - Competitive Health Insurance Reform Act of 2017 S. 934 - FDA Reauthorization Act of 2017 S. 870 - Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017 H.R. 449 - The Synthetic Drug Awareness Act of 2017 S. 191 - Patient Freedom Act of 2017 S. 403 - Health Savings Act of 2017 H.R. 1136 - FDA Deeming Authority Clarification Act of 2017 S.2680 - Opioid Crisis Response Act of 2018 S. 2891 - Fighting the Opioid Epidemic with Sunshine Act of 2018 H.R. 6 [P.L. No: 115-271] - SUPPORT for Patients and Communities Act H.R. 5605 - Advancing High Quality Treatment for Opioid Use Disorders in Medicare Act H.R. 3331/S.1732 - To amend title XI of the Social Security Act to promote testing of incentive payments for behavioral health providers for adoption and use of certified electronic health record technology H.R. 5002/S.2406 - Advancing Cutting-Edge (ACE) Research Act H.R. 5796 - Responsible Education Achieves Care and Healthy Outcomes for Users Treatment Act H.R. 5798 - Opioid Screening and Chronic Pain Management Alternatives for Seniors Act S.3120 - Helping to End Addiction and Lessen (HEAL) Substance Use Disorders Act of 2018 H.Res 1099 - Providing for the concurrence by the House in the Senate amendment to H.R. 6, with an amendment H.R. 6310/H.R. 6317 - Primary Care Enhancement Act of 2018 H.R. 6199 - Restoring Access to Medication and Modernizing Health Savings Accounts Act of 2018 H.R. 6502 - Reducing Unnecessary Senior Hospitalizations Act of 2018 Medical Record Documentation Medicare Extenders Home Infusion Therapy Medication-Assisted Therapies (MATs) Opioid Abuse Epidemic Medicare Carrier Advisory Committees Reducing Regulatory Burdens

Client expense: $206,455 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Justice, Dept of (DOJ), SENATE, Veterans Affairs, Dept of (VA), White House Office

H.R. - 1628 American Health Care Act S.Con.Res.3 - Concurrent Resolution Setting Forth Budgetary Levels for FY 18-26 H.R. 1378 - National Health Service Corps Improvement Act H.R. 372 - Competitive Health Insurance Reform Act H.R. 302 - Sports Medicine Licensure Clarity Act S. 808 Sports Medicine Licensure Clarity Act H.R. 1628 Better Care Reconciliation Act H.R. 2202 Chiropractic Membership in the Public Health Service Commissioned Corps Act H.R. 1370 Continuing Resolution H.J. Res. 123 Continuing Resolution H.R. 1625 Vehicle for Consolidated Appropriations Act 2018 H.R. 2042 Access to Frontline Health Act H.R. 5722 Dr. Todd Graham Pain Management Improvement Act S. 3008 Dr. Todd Graham Pain Management Improvement Act H.R. 5776 MOST Act H.R. 4508 PROSPER Act H.R. 6157 Appropriations for DOD, Labor/HHS/Education and Continuing Appropriations for all other agencies

Client expense: $72,063 · Firm income: Not reported

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

H.R.372 - Competitive Health Insurance Reform Act of 2017 H.R.1606 - DOC Access Act

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), SENATE

H.R. 372, the Competitive Health Insurance Reform Act of 2017 Discussions with members of Congress and the Department of Labor regarding the Department of Labors disability insurance claims rule Department of Labor rule on Association Health Plans

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

Government targets: HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Treasury, Dept of

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. 302 - FAA Reauthorization Act of 2018; provisions relating to drones H.R. 372 - Competitive Health Insurance Reform Act of 2017; provisions relating to McCarran-Ferguson Act coverage for life, annuities, disability income insurance, long-term care insurance, and P/C insurance H.R. 2997 - The 21st Century Aviation Innovation, Reform, and Reauthorization Act (AIRRACT); provisions relating to use of drones H.R. 3746 - Business of Insurance Regulatory Reform Act of 2017; entire bill H.R. 3762 - International Insurance Standards Act of 2017; entire bill H.R. 3861 - Federal Insurance Office Reform Act of 2017; entire bill H.R. 4537 - International Insurance Standards Act; entire bill H.R. 5059 - State Insurance Regulation Preservation Act; entire bill H.R. 5666 - Primary Regulators of Insurance Vote of 2018; entire bill S. 488 - JOBS and Investor Confidence Act of 2018; provisions relating to international insurance standards S. 1360 - International Insurance Capital Standards Accountability Act of 2017; entire bill S. 2702 - Business of Insurance Regulatory Reform Act of 2018; entire bill S. 3177 - Primary Regulators of Insurance Vote Act of 2018; entire bill

Client expense: $130,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Public Law 111-203, H.R. 4173- Dodd-Frank Wall Street Reform and Consumer Protection Act. Issue: Implementation and Regulatory reform. Captive Reinsurance Transactions, Insurance Capital Standards and Global Capital Standards. H.R. 372 - Competitive Health Insurance Reform Act of 2017. This bill would restore the application of the Federal antitrust laws to the business of health insurance to protect competition and consumers. Issue: McCarran-Ferguson Act. H.R. 1270 - Living Donor Protection Act of 2017. The bill would promote and protect from discrimination living organ donors. Issue: underwriting. H.R. 3746/S.___ - Business of Insurance Regulatory Reform Act. Issue: Insurance exclusion from CFPB jurisdiction. H.R. 5059 - State Insurance Regulation Preservation Act. Issue: Federal Reserve Board supervision of insurance companies. S.__ - Draft legislation regarding Federal Reserve Board supervision of insurance companies. Implementation of S. 2270 - Insurance Capital Standards Clarification Act of 2014. The bill would give the Federal Reserve the authority to tailor capital standards for insurance companies subject to Fed supervision. Issue: Capital Standards, Basel III H.R. 5666/S. 3177 - Primary Regulators of Insurance Vote Act of 2018. Issue: FSOC reform.

Client expense: $430,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Bipartisan Health Care Stabilization Act (Alexander-Murray) - funding for cost sharing reduction benefits, stabilization of individual market Bipartisan Health Care Stabilization Act; updated version (Alexander-Walden-Collins-Costello) - funding for cost sharing reduction benefits and reinsurance, stabilization of individual market S. 147, Obamacare Taxpayer Bailout Prevention Act (Rubio) - ACA risk corridors program S. 581, Jessies Law (Manchin-Capito) - patient history of opioid use disorder S. 1201, Health Care Options for All Act (McCaskill) - coverage options in bare counties S. 1354, Individual Health Insurance Marketplace Improvement Act (Carper-Kaine) - individual market reinsurance fund, outreach and enrollment activities S. 1462, Marketplace Certainty Act (Shaheen) - funding for cost-sharing reduction benefits S. 1516, Coverage Across State Lines (Heller) S. 1667, Protecting Consumers from Unreasonable Rates Act (Feinstein) - rate review S. 1835, Lower Premiums Through Reinsurance Act (Collins-Nelson) - invisible high risk pool and reinsurance programs S. 1850, Legacy Act (Manchin-Capito) -- confidentiality of drug and alcohol treatment and prevention records S. 1976, Increasing Access to Care Act (Scott) - copper plan S. 1985, Protect Access to Birth Control Act (Murray) - coverage of contraceptive services S. 2052, Healthcare Market Certainty and Mandate Relief Act (Hatch) - funding for cost sharing reduction benefits, HSA improvements, ACA individual mandate S. 2241 (King) - fees on excepted benefits and standalone dental plans S. 2303, Access to Independent Health Insurance Advisors Act (Isakson-Coons) - calculation of medical loss ratios S. 3388, Ensuring Coverage for Patients with Pre-Existing Conditions Act (Tillis) - protections for individuals with pre-existing conditions H.R. 2, Agriculture and Nutrition Act (Conaway) - agricultural association health plans H.R. 314, Health Care Choice Act (Blackburn) - selling insurance across state lines H.R. 372, Competitive Health Insurance Reform Act (Gosar) - McCarran-Ferguson Act H.R. 421, Allowing Greater Access to Safe and Effective Contraception Act (Love) - non-prescription contraceptives, HSA flexibility H.R. 706, Plan Verification and Fairness Act (Blackburn) - verifying eligibility for special enrollment periods H.R. 708, State Age Rating Flexibility Act (Buchson) - age rating bands H.R. 710, Health Coverage State Flexibility Act (Flores) - grace period for premium payments H.R. 1101, Small Business Health Fairness Act (Johnson) - association health plans H.R. 1121, Pre-existing Conditions Protection Act (Walden) - protections for patients with pre-existing conditions H.R. 1304, Self-Insurance Protection Act (Roe) - medical stop-loss insurance H.R. 1409, Cancer Drug Parity Act (Lance) - coverage of oral anti-cancer drugs H.R. 1606, DOC Access Act (Carter) - reimbursement for dental and vision providers H.R. 3450, Protecting Consumers from Unreasonable Rates Act (Schakowsky) - rate review H.R. 3545, Overdose Prevention and Patient Safety Act (Murphy- Blumenauer) -- confidentiality of drug and alcohol treatment and prevention records H.R. 3976, Access to Marketplace Insurance Act (Cramer) - third party payments H.R. 4082, Protect Access to Birth Control Act (DeGette) - coverage of contraceptive services H.R. 4200, Healthcare Market Certainty and Mandate Relief Act (Brady) - funding for cost sharing reduction benefits, HSA improvements H.R. 4225 (Hudson) - fees on excepted benefits and standalone dental plans H.R. 4575, Access to Independent Health Insurance Advisors Act (Long-Schrader) - calculation of medical loss ratios H.R. 4666, Premium Relief Act (Costello) - Patient and State Stability Fund H.R. 4695, Bipartisan Market Stabilization and Innovation Act (Schrader) - stabilization of individual market H.R. 6311, Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act (Roskam) - access to catastrophic plans, definition of qualified health plans H.R. 6314, Health Savings Act (Burgess) - definition of high-deductible health plan H.R. 6496, Continuing Coverage for Preexisting Conditions Act (Joyce) - protections for individuals with pre-existing conditions H.R. 7003, Federal Invisible Risk Sharing Program (Schweikert) Regulatory Issues: Insurance regulatory reform; issues related to the coordination of private and public disability income benefits; disability risk management; disability income insurance enrollment and awareness; issues related to encouraging impaired workers to stay in/return to the workforce; issues related to expanding long-term care insurance coverage; issues relating to the coordination of benefits between private health insurance plans and Medicaid; Medigap claims processing and crossover fees; Medigap cross-over claim issues, Medigap coverage, implementation of Medigap standardized plan offerings; Medigap carrier recoveries related to CMS fraud and abuse enforcement activities, and issues related to Medigap educational materials, and other Medigap issues; fraud and abuse issues affecting public and private insurance coverage; issues relating to antitrust; implementation of the Mental Health Parity Act requirements; implementation of the 21st Century Cures Act requirements; summary of benefits and coverage disclosures; pre-existing condition insurance plans; accountable care organizations; coverage of preventive services; preexisting condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; dependent coverage; treatment of expatriate plans; issues related to all payor claims databases; issues related to association health plans; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations, non-discriminatory wellness programs; issues related to supplemental products; issues relating to dental coverage; issues relating to proposals for single-payer and Medicare/Medicaid buy-in options; issues related to implementation of the Telephone Consumer Protection Act; issues relating to third party payment of premiums; issues related to cost-sharing reductions (CSRs); issues relating to the individual market; 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

Bipartisan Health Care Stabilization Act (Alexander-Murray) - funding for cost sharing reduction benefits, stabilization of individual market Bipartisan Health Care Stabilization Act; updated version (Alexander-Walden-Collins-Costello) - funding for cost sharing reduction benefits and reinsurance, stabilization of individual market S. 147, Obamacare Taxpayer Bailout Prevention Act (Rubio) - ACA risk corridors program S. 581, Jessies Law (Manchin-Capito) - patient history of opioid use disorder S. 1201, Health Care Options for All Act (McCaskill) - coverage options in bare counties S. 1354, Individual Health Insurance Marketplace Improvement Act (Carper-Kaine) - individual market reinsurance fund, outreach and enrollment activities S. 1405, FAA Reauthorization Act (Thune) - air ambulance issues S. 1462, Marketplace Certainty Act (Shaheen) - funding for cost-sharing reduction benefits S. 1516, Coverage Across State Lines (Heller) S. 1667, Protecting Consumers from Unreasonable Rates Act (Feinstein) - rate review S. 1835, Lower Premiums Through Reinsurance Act (Collins-Nelson) - invisible high risk pool and reinsurance programs S. 1850, Legacy Act (Manchin-Capito) -- confidentiality of drug and alcohol treatment and prevention records S. 1976, Increasing Access to Care Act (Scott) - copper plan S. 1985, Protect Access to Birth Control Act (Murray) - coverage of contraceptive services S. 2052, Healthcare Market Certainty and Mandate Relief Act (Hatch) - funding for cost sharing reduction benefits, HSA improvements, ACA individual mandate S. 2241 (King) - fees on excepted benefits and standalone dental plans S. 2303, Access to Independent Health Insurance Advisors Act (Isakson-Coons) - calculation of medical loss ratios H.R. 2, Agriculture and Nutrition Act (Conaway) - agricultural association health plans H.R. 4, FAA Reauthorization Act (Shuster) - air ambulance issues H.R. 314, Health Care Choice Act (Blackburn) - selling insurance across state lines H.R. 372, Competitive Health Insurance Reform Act (Gosar) - McCarran-Ferguson Act H.R. 421, Allowing Greater Access to Safe and Effective Contraception Act (Love) - non-prescription contraceptives, HSA flexibility H.R. 706, Plan Verification and Fairness Act (Blackburn) - verifying eligibility for special enrollment periods H.R. 708, State Age Rating Flexibility Act (Buchson) - age rating bands H.R. 710, Health Coverage State Flexibility Act (Flores) - grace period for premium payments H.R. 1101, Small Business Health Fairness Act (Johnson) - association health plans H.R. 1121, Pre-existing Conditions Protection Act (Walden) - protections for patients with pre-existing conditions H.R. 1304, Self-Insurance Protection Act (Roe) - medical stop-loss insurance H.R. 1409, Cancer Drug Parity Act (Lance) - coverage of oral anti-cancer drugs H.R. 3450, Protecting Consumers from Unreasonable Rates Act (Schakowsky) - rate review H.R. 3545, Overdose Prevention and Patient Safety Act (Murphy- Blumenauer) -- confidentiality of drug and alcohol treatment and prevention records H.R. 3922, CHAMPION Act (Walden) - extension of federal CHIP funding, ACA grace periods, community health center funding H.R. 3976, Access to Marketplace Insurance Act (Cramer) - third party payments H.R. 4082, Protect Access to Birth Control Act (DeGette) - coverage of contraceptive services H.R. 4200, Healthcare Market Certainty and Mandate Relief Act (Brady) - funding for cost sharing reduction benefits, HSA improvements H.R. 4225 (Hudson) - fees on excepted benefits and standalone dental plans H.R. 4575, Access to Independent Health Insurance Advisors Act (Long-Schrader) - calculation of medical loss ratios H.R. 4666, Premium Relief Act (Costello) - Patient and State Stability Fund H.R. 4695, Bipartisan Market Stabilization and Innovation Act (Schrader) - stabilization of individual market H.R. 6314, Health Savings Act (Burgess) - definition of high-deductible health plan Regulatory Issues: Insurance regulatory reform; issues related to the coordination of private and public disability income benefits; disability risk management; disability income insurance enrollment and awareness; issues related to encouraging impaired workers to stay in/return to the workforce; issues relating to the coordination of benefits between private health insurance plans and Medicaid; Medigap claims processing and crossover fees; Medigap cross-over claim issues, Medigap coverage, implementation of Medigap standardized plan offerings; Medigap carrier recoveries related to CMS fraud and abuse enforcement activities, and issues related to Medigap educational materials, and other Medigap issues; fraud and abuse issues affecting public and private insurance coverage; issues relating to antitrust; implementation of the Mental Health Parity Act requirements; implementation of the 21st Century Cures Act requirements; summary of benefits and coverage disclosures; pre-existing condition insurance plans; accountable care organizations; coverage of preventive services; preexisting condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; dependent coverage; treatment of expatriate plans; issues related to all payor claims databases; issues related to association health plans; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations, non-discriminatory wellness programs; issues related to supplemental products; issues relating to dental coverage; issues relating to proposals for single-payer and Medicare/Medicaid buy-in options; issues related to implementation of the Telephone Consumer Protection Act; issues relating to third party payment of premiums; issues related to cost-sharing reductions (CSRs); issues relating to the individual market; 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. 4575/S.2303, the Access to Independent Health Insurance Advisors Act; H.R. 173/S. 58 the Middle Class Americans' Health Plans Act; H.R. 372, the Competitive Health Insurance Reform Act of 2017; H.R. 1628, American Health Care Act of 2017; Issues related to the Federally-facilitated marketplaces;S. 191, the Patient Freedom Act of 2017; H.R. 1626, the Better Care Reconciliation Act of 2017; H.R. 3798, the Save American Workers Act of 2018; H.R.4616, the Employer Relief Act of 2018; Comments on the Cooperative Agreement to Support Navigators in Federally Facilitated Exchanges, Funding Opportunity Number: CA-NAV-18-001

Client expense: $87,356 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Emergency Management Agency (FEMA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Risk Management Agency, SENATE, Treasury, Dept of

General discussions related to the modernization of the Medicare secondary payer process (specific to workers compensation liability). General discussion related to ERISA disability claim procedures. General discussions on apprenticeships, including specific Illinois program, DOL's American Apprenticeship Initiative Grant program, and certified apprenticeship status. H.R. 372, Competitive Health Insurance Reform Act of 2017. S. 3079, Medicare Secondary Payer and Workers' Compensation Settlement Agreements Act of 2018. H.R. 5881, PAID Act.

Client expense: $300,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Commerce, Dept of (DOC), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), Labor, Dept of (DOL), Risk Management Agency, SENATE, Treasury, Dept of

Health care payment and delivery system reform Health Information Technology and the implementation of EHR meaningful use Implementation of the Affordable Care Act Policy related to the ACA's health exchange risk corridors Policy related to cost-sharing reduction payments Support H.R. 372, The Competitive Health Insurance Reform Act of 2017, - provisions related to repeal McCarran-Ferguson with respect to the business of health insurance S. 2680, Opioid Crisis Response Act H.R. 6, Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act - provisions related to IMD exclusion, alignment of 42 CFR Part 2 regulations with HIPAA and medication-assisted treatment Proposals to address opioid abuse

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE