To provide that the provision of the Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs final regulation relating to changes in the payment amount for certain drugs and biologicals purchased under the 340B drug discount program shall have no force or effect, and for other purposes.

OSHA Covid-19 Health Care Emergency Temporary Standard (ETS) Bill That Extends Moratorium on 2% Medicare Sequester Cuts Through End of 2021 Healthcare Price Transparency Rules for Hospitals 340B Medicare DSH Medicare Physician Payment (MACRA) H.R. 365 The Primary Care Enhancement Act S. 898/H.R. 2141 Conrad State 30 and Physician Access Reauthorization Act S. 1130 Rural Emergency Acute Care Hospital (REACH) Act S. 257 / H.R. 1611: Protecting Access to Rural Therapy Services Act S. 258 / H.R. 169: Critical Access Hospital Relief Act of 2015 H.R. 672 / S. 607: Rural Community Hospital Demonstration Extension Act of 2015 S. 1135: Hospital Payment Fairness Act H.R. 1479: Repeal of the Obamacare Bay State Boondoggle Act S. 1648: Rural Emergency Acute Care Hospital Act H.R. 3225: Save Rural Hospitals Act H.R. 1343 / S. 688: Establishing Beneficiary Equity in the Hospital Readmission Program Act S. 1148 / H.R. 2124: Resident Physician Shortage Reduction Act S. 2484 / H.R. 4442: CONNECT for Health Act H.R. 2156: Medicare Audit Improvement Act H.R. 5164: Rural Hospital Regulatory Relief Act S. 3435: Craig Thomas Rural Hospital and Provider Equity Act of 2016 H.R. 5406: Helping Ensure Accountability, Leadership, and Trust in Tribal Healthcare Act H.R. 34: 21st Century Cures Act H.R. 3298: Medicare Post-Acute Care Value-Based Purchasing Act H.R 1628: American Health Care Act S. 872 / H.R. 1955: Rural Hospital Access Act S. 377: Medicare Ambulance Access, Fraud Prevention and Reform Act H.R. 1156: Patient Access to Higher Quality Health Care Act of 2017 H.R. 2: Medicare Access and CHIP Reauthorization Act of 2016 H.R. 1628 Better Care Reconciliation Act (BCRA) H.R. 4392 To provide that the provision of the Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs final regulation relating to changes in the payment amount for certain drugs and biologicals purchased under the 340B drug discount program shall have no force or effect, and for other purposes. The Senate Committee on Health, Education, Labor and Pensions (HELP) June 26 passed the Lower Health Care Costs Act of 2019 (S.1895) Congress should act now to delay the Medicaid DSH cuts that are scheduled to go into effect Nov. 22. The Coronavirus Aid, Relief, and Economic Security (CARES) Act.

Client expense: Not reported · Firm income: Not reported

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

OSHA Covid-19 Health Care Emergency Temporary Standard (ETS) Bill That Extends Moratorium on 2% Medicare Sequester Cuts Through End of 2021 Healthcare Price Transparency Rules for Hospitals 340B Medicare DSH Medicare Physician Payment (MACRA) H.R. 365 The Primary Care Enhancement Act S. 898/H.R. 2141 Conrad State 30 and Physician Access Reauthorization Act S. 1130 Rural Emergency Acute Care Hospital (REACH) Act S. 257 / H.R. 1611: Protecting Access to Rural Therapy Services Act S. 258 / H.R. 169: Critical Access Hospital Relief Act of 2015 H.R. 672 / S. 607: Rural Community Hospital Demonstration Extension Act of 2015 S. 1135: Hospital Payment Fairness Act H.R. 1479: Repeal of the Obamacare Bay State Boondoggle Act S. 1648: Rural Emergency Acute Care Hospital Act H.R. 3225: Save Rural Hospitals Act H.R. 1343 / S. 688: Establishing Beneficiary Equity in the Hospital Readmission Program Act S. 1148 / H.R. 2124: Resident Physician Shortage Reduction Act S. 2484 / H.R. 4442: CONNECT for Health Act H.R. 2156: Medicare Audit Improvement Act H.R. 5164: Rural Hospital Regulatory Relief Act S. 3435: Craig Thomas Rural Hospital and Provider Equity Act of 2016 H.R. 5406: Helping Ensure Accountability, Leadership, and Trust in Tribal Healthcare Act H.R. 34: 21st Century Cures Act H.R. 3298: Medicare Post-Acute Care Value-Based Purchasing Act H.R 1628: American Health Care Act S. 872 / H.R. 1955: Rural Hospital Access Act S. 377: Medicare Ambulance Access, Fraud Prevention and Reform Act H.R. 1156: Patient Access to Higher Quality Health Care Act of 2017 H.R. 2: Medicare Access and CHIP Reauthorization Act of 2016 H.R. 1628 Better Care Reconciliation Act (BCRA) H.R. 4392 To provide that the provision of the Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs final regulation relating to changes in the payment amount for certain drugs and biologicals purchased under the 340B drug discount program shall have no force or effect, and for other purposes. The Senate Committee on Health, Education, Labor and Pensions (HELP) June 26 passed the Lower Health Care Costs Act of 2019 (S.1895) Congress should act now to delay the Medicaid DSH cuts that are scheduled to go into effect Nov. 22. The Coronavirus Aid, Relief, and Economic Security (CARES) Act.

Client expense: Not reported · Firm income: Not reported

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

Bill That Extends Moratorium on 2% Medicare Sequester Cuts Through End of 2021 Healthcare Price Transparency Rules for Hospitals 340B Medicare DSH Medicare Physician Payment (MACRA) H.R. 365 The Primary Care Enhancement Act S. 898/H.R. 2141 Conrad State 30 and Physician Access Reauthorization Act S. 1130 Rural Emergency Acute Care Hospital (REACH) Act S. 257 / H.R. 1611: Protecting Access to Rural Therapy Services Act S. 258 / H.R. 169: Critical Access Hospital Relief Act of 2015 H.R. 672 / S. 607: Rural Community Hospital Demonstration Extension Act of 2015 S. 1135: Hospital Payment Fairness Act H.R. 1479: Repeal of the Obamacare Bay State Boondoggle Act S. 1648: Rural Emergency Acute Care Hospital Act H.R. 3225: Save Rural Hospitals Act H.R. 1343 / S. 688: Establishing Beneficiary Equity in the Hospital Readmission Program Act S. 1148 / H.R. 2124: Resident Physician Shortage Reduction Act S. 2484 / H.R. 4442: CONNECT for Health Act H.R. 2156: Medicare Audit Improvement Act H.R. 5164: Rural Hospital Regulatory Relief Act S. 3435: Craig Thomas Rural Hospital and Provider Equity Act of 2016 H.R. 5406: Helping Ensure Accountability, Leadership, and Trust in Tribal Healthcare Act H.R. 34: 21st Century Cures Act H.R. 3298: Medicare Post-Acute Care Value-Based Purchasing Act H.R 1628: American Health Care Act S. 872 / H.R. 1955: Rural Hospital Access Act S. 377: Medicare Ambulance Access, Fraud Prevention and Reform Act H.R. 1156: Patient Access to Higher Quality Health Care Act of 2017 H.R. 2: Medicare Access and CHIP Reauthorization Act of 2016 H.R. 1628 Better Care Reconciliation Act (BCRA) H.R. 4392 To provide that the provision of the Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs final regulation relating to changes in the payment amount for certain drugs and biologicals purchased under the 340B drug discount program shall have no force or effect, and for other purposes. The Senate Committee on Health, Education, Labor and Pensions (HELP) June 26 passed the Lower Health Care Costs Act of 2019 (S.1895) Congress should act now to delay the Medicaid DSH cuts that are scheduled to go into effect Nov. 22. The Coronavirus Aid, Relief, and Economic Security (CARES) Act.

Client expense: Not reported · Firm income: Not reported

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

Healthcare Price Transparency Rules for Hospitals 340B Medicare DSH Medicare Physician Payment (MACRA) H.R. 365 The Primary Care Enhancement Act S. 898/H.R. 2141 Conrad State 30 and Physician Access Reauthorization Act S. 1130 Rural Emergency Acute Care Hospital (REACH) Act S. 257 / H.R. 1611: Protecting Access to Rural Therapy Services Act S. 258 / H.R. 169: Critical Access Hospital Relief Act of 2015 H.R. 672 / S. 607: Rural Community Hospital Demonstration Extension Act of 2015 S. 1135: Hospital Payment Fairness Act H.R. 1479: Repeal of the Obamacare Bay State Boondoggle Act S. 1648: Rural Emergency Acute Care Hospital Act H.R. 3225: Save Rural Hospitals Act H.R. 1343 / S. 688: Establishing Beneficiary Equity in the Hospital Readmission Program Act S. 1148 / H.R. 2124: Resident Physician Shortage Reduction Act S. 2484 / H.R. 4442: CONNECT for Health Act H.R. 2156: Medicare Audit Improvement Act H.R. 5164: Rural Hospital Regulatory Relief Act S. 3435: Craig Thomas Rural Hospital and Provider Equity Act of 2016 H.R. 5406: Helping Ensure Accountability, Leadership, and Trust in Tribal Healthcare Act H.R. 34: 21st Century Cures Act H.R. 3298: Medicare Post-Acute Care Value-Based Purchasing Act H.R 1628: American Health Care Act S. 872 / H.R. 1955: Rural Hospital Access Act S. 377: Medicare Ambulance Access, Fraud Prevention and Reform Act H.R. 1156: Patient Access to Higher Quality Health Care Act of 2017 H.R. 2: Medicare Access and CHIP Reauthorization Act of 2016 H.R. 1628 Better Care Reconciliation Act (BCRA) H.R. 4392 To provide that the provision of the Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs final regulation relating to changes in the payment amount for certain drugs and biologicals purchased under the 340B drug discount program shall have no force or effect, and for other purposes. The Senate Committee on Health, Education, Labor and Pensions (HELP) June 26 passed the Lower Health Care Costs Act of 2019 (S.1895) Congress should act now to delay the Medicaid DSH cuts that are scheduled to go into effect Nov. 22. The Coronavirus Aid, Relief, and Economic Security (CARES) Act.

Client expense: Not reported · Firm income: Not reported

HR 4392- To provide that the provision of the Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs final regulation relating to changes in the payment amount for certain drugs and biologicals purchased under the 340B drug discount program shall have no force or effect, and for other purposes; Opposition to any provision in any bill to reduce the scope and use of the 340B Drug Discount benefit; HR 4710 340B PAUSE Act Any provision(s) reducing or changing the 340B Drug Discount Program or benefits to hospitals limiting hospital access to the benefit and or improving or updating the program's guidelines. H.R. 3. Lower Prescription Drug Costs Now Act - legislation that would make a series of changes to the Medicare program in an effort to lower the price of prescription drugs.

Client expense: $252,758 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Healthcare Price Transparency Rules for Hospitals 340B Medicare DSH Medicare Physician Payment (MACRA) H.R. 365 The Primary Care Enhancement Act S. 898/H.R. 2141 Conrad State 30 and Physician Access Reauthorization Act S. 1130 Rural Emergency Acute Care Hospital (REACH) Act S. 257 / H.R. 1611: Protecting Access to Rural Therapy Services Act S. 258 / H.R. 169: Critical Access Hospital Relief Act of 2015 H.R. 672 / S. 607: Rural Community Hospital Demonstration Extension Act of 2015 S. 1135: Hospital Payment Fairness Act H.R. 1479: Repeal of the Obamacare Bay State Boondoggle Act S. 1648: Rural Emergency Acute Care Hospital Act H.R. 3225: Save Rural Hospitals Act H.R. 1343 / S. 688: Establishing Beneficiary Equity in the Hospital Readmission Program Act S. 1148 / H.R. 2124: Resident Physician Shortage Reduction Act S. 2484 / H.R. 4442: CONNECT for Health Act H.R. 2156: Medicare Audit Improvement Act H.R. 5164: Rural Hospital Regulatory Relief Act S. 3435: Craig Thomas Rural Hospital and Provider Equity Act of 2016 H.R. 5406: Helping Ensure Accountability, Leadership, and Trust in Tribal Healthcare Act H.R. 34: 21st Century Cures Act H.R. 3298: Medicare Post-Acute Care Value-Based Purchasing Act H.R 1628: American Health Care Act S. 872 / H.R. 1955: Rural Hospital Access Act S. 377: Medicare Ambulance Access, Fraud Prevention and Reform Act H.R. 1156: Patient Access to Higher Quality Health Care Act of 2017 H.R. 2: Medicare Access and CHIP Reauthorization Act of 2016 H.R. 1628 Better Care Reconciliation Act (BCRA) H.R. 4392 To provide that the provision of the Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs final regulation relating to changes in the payment amount for certain drugs and biologicals purchased under the 340B drug discount program shall have no force or effect, and for other purposes. The Senate Committee on Health, Education, Labor and Pensions (HELP) June 26 passed the Lower Health Care Costs Act of 2019 (S.1895) Congress should act now to delay the Medicaid DSH cuts that are scheduled to go into effect Nov. 22. The Coronavirus Aid, Relief, and Economic Security (CARES) Act.

Client expense: Not reported · Firm income: Not reported

Healthcare Price Transparency Rules for Hospitals 340B Medicare DSH Medicare Physician Payment (MACRA) H.R. 365 The Primary Care Enhancement Act S. 898/H.R. 2141 Conrad State 30 and Physician Access Reauthorization Act S. 1130 Rural Emergency Acute Care Hospital (REACH) Act S. 257 / H.R. 1611: Protecting Access to Rural Therapy Services Act S. 258 / H.R. 169: Critical Access Hospital Relief Act of 2015 H.R. 672 / S. 607: Rural Community Hospital Demonstration Extension Act of 2015 S. 1135: Hospital Payment Fairness Act H.R. 1479: Repeal of the Obamacare Bay State Boondoggle Act S. 1648: Rural Emergency Acute Care Hospital Act H.R. 3225: Save Rural Hospitals Act H.R. 1343 / S. 688: Establishing Beneficiary Equity in the Hospital Readmission Program Act S. 1148 / H.R. 2124: Resident Physician Shortage Reduction Act S. 2484 / H.R. 4442: CONNECT for Health Act H.R. 2156: Medicare Audit Improvement Act H.R. 5164: Rural Hospital Regulatory Relief Act S. 3435: Craig Thomas Rural Hospital and Provider Equity Act of 2016 H.R. 5406: Helping Ensure Accountability, Leadership, and Trust in Tribal Healthcare Act H.R. 34: 21st Century Cures Act H.R. 3298: Medicare Post-Acute Care Value-Based Purchasing Act H.R 1628: American Health Care Act S. 872 / H.R. 1955: Rural Hospital Access Act S. 377: Medicare Ambulance Access, Fraud Prevention and Reform Act H.R. 1156: Patient Access to Higher Quality Health Care Act of 2017 H.R. 2: Medicare Access and CHIP Reauthorization Act of 2016 H.R. 1628 Better Care Reconciliation Act (BCRA) H.R. 4392 To provide that the provision of the Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs final regulation relating to changes in the payment amount for certain drugs and biologicals purchased under the 340B drug discount program shall have no force or effect, and for other purposes. The Senate Committee on Health, Education, Labor and Pensions (HELP) June 26 passed the Lower Health Care Costs Act of 2019 (S.1895) Congress should act now to delay the Medicaid DSH cuts that are scheduled to go into effect Nov. 22. The Coronavirus Aid, Relief, and Economic Security (CARES) Act.

Client expense: Not reported · Firm income: Not reported

Healthcare Price Transparency Rules for Hospitals 340B Medicare DSH Medicare Physician Payment (MACRA) H.R. 365 The Primary Care Enhancement Act S. 898/H.R. 2141 Conrad State 30 and Physician Access Reauthorization Act S. 1130 Rural Emergency Acute Care Hospital (REACH) Act S. 257 / H.R. 1611: Protecting Access to Rural Therapy Services Act S. 258 / H.R. 169: Critical Access Hospital Relief Act of 2015 H.R. 672 / S. 607: Rural Community Hospital Demonstration Extension Act of 2015 S. 1135: Hospital Payment Fairness Act H.R. 1479: Repeal of the Obamacare Bay State Boondoggle Act S. 1648: Rural Emergency Acute Care Hospital Act H.R. 3225: Save Rural Hospitals Act H.R. 1343 / S. 688: Establishing Beneficiary Equity in the Hospital Readmission Program Act S. 1148 / H.R. 2124: Resident Physician Shortage Reduction Act S. 2484 / H.R. 4442: CONNECT for Health Act H.R. 2156: Medicare Audit Improvement Act H.R. 5164: Rural Hospital Regulatory Relief Act S. 3435: Craig Thomas Rural Hospital and Provider Equity Act of 2016 H.R. 5406: Helping Ensure Accountability, Leadership, and Trust in Tribal Healthcare Act H.R. 34: 21st Century Cures Act H.R. 3298: Medicare Post-Acute Care Value-Based Purchasing Act H.R 1628: American Health Care Act S. 872 / H.R. 1955: Rural Hospital Access Act S. 377: Medicare Ambulance Access, Fraud Prevention and Reform Act H.R. 1156: Patient Access to Higher Quality Health Care Act of 2017 H.R. 2: Medicare Access and CHIP Reauthorization Act of 2016 H.R. 1628 Better Care Reconciliation Act (BCRA) H.R. 4392 To provide that the provision of the Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs final regulation relating to changes in the payment amount for certain drugs and biologicals purchased under the 340B drug discount program shall have no force or effect, and for other purposes. The Senate Committee on Health, Education, Labor and Pensions (HELP) June 26 passed the Lower Health Care Costs Act of 2019 (S.1895) Congress should act now to delay the Medicaid DSH cuts that are scheduled to go into effect Nov. 22.

Client expense: Not reported · Firm income: Not reported

HR 4392- To provide that the provision of the Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs final regulation relating to changes in the payment amount for certain drugs and biologicals purchased under the 340B drug discount program shall have no force or effect, and for other purposes; Opposition to any provision in any bill to reduce the scope and use of the 340B Drug Discount benefit; HR 4710 340B PAUSE Act Any provision(s) reducing or changing the 340B Drug Discount Program or benefits to hospitals limiting hospital access to the benefit and or improving or updating the program's guidelines. H.R. 3. Lower Prescription Drug Costs Now Act - legislation that would make a series of changes to the Medicare program in an effort to lower the price of prescription drugs.

Client expense: $252,275 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Healthcare Price Transparency Rules for Hospitals 340B Medicare DSH Medicare Physician Payment (MACRA) H.R. 365 The Primary Care Enhancement Act S. 898/H.R. 2141 Conrad State 30 and Physician Access Reauthorization Act S. 1130 Rural Emergency Acute Care Hospital (REACH) Act S. 257 / H.R. 1611: Protecting Access to Rural Therapy Services Act S. 258 / H.R. 169: Critical Access Hospital Relief Act of 2015 H.R. 672 / S. 607: Rural Community Hospital Demonstration Extension Act of 2015 S. 1135: Hospital Payment Fairness Act H.R. 1479: Repeal of the Obamacare Bay State Boondoggle Act S. 1648: Rural Emergency Acute Care Hospital Act H.R. 3225: Save Rural Hospitals Act H.R. 1343 / S. 688: Establishing Beneficiary Equity in the Hospital Readmission Program Act S. 1148 / H.R. 2124: Resident Physician Shortage Reduction Act S. 2484 / H.R. 4442: CONNECT for Health Act H.R. 2156: Medicare Audit Improvement Act H.R. 5164: Rural Hospital Regulatory Relief Act S. 3435: Craig Thomas Rural Hospital and Provider Equity Act of 2016 H.R. 5406: Helping Ensure Accountability, Leadership, and Trust in Tribal Healthcare Act H.R. 34: 21st Century Cures Act H.R. 3298: Medicare Post-Acute Care Value-Based Purchasing Act H.R 1628: American Health Care Act S. 872 / H.R. 1955: Rural Hospital Access Act S. 377: Medicare Ambulance Access, Fraud Prevention and Reform Act H.R. 1156: Patient Access to Higher Quality Health Care Act of 2017 H.R. 2: Medicare Access and CHIP Reauthorization Act of 2016 H.R. 1628 Better Care Reconciliation Act (BCRA) H.R. 4392 To provide that the provision of the Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs final regulation relating to changes in the payment amount for certain drugs and biologicals purchased under the 340B drug discount program shall have no force or effect, and for other purposes. The Senate Committee on Health, Education, Labor and Pensions (HELP) June 26 passed the Lower Health Care Costs Act of 2019 (S.1895) Congress should act now to delay the Medicaid DSH cuts that are scheduled to go into effect Nov. 22.

Client expense: Not reported · Firm income: Not reported

HR 4392- To provide that the provision of the Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs final regulation relating to changes in the payment amount for certain drugs and biologicals purchased under the 340B drug discount program shall have no force or effect, and for other purposes; Opposition to any provision in any bill to reduce the scope and use of the 340B Drug Discount benefit; HR 4710 340B PAUSE Act Any provision(s) reducing or changing the 340B Drug Discount Program or benefits to hospitals limiting hospital access to the benefit and or improving or updating the program's guidelines. H.R. 3. Lower Prescription Drug Costs Now Act - legislation that would make a series of changes to the Medicare program in an effort to lower the price of prescription drugs.

Client expense: $8,905 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 4392- To provide that the provision of the Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs final regulation relating to changes in the payment amount for certain drugs and biologicals purchased under the 340B drug discount program shall have no force or effect, and for other purposes; Opposition to any provision in any bill to reduce the scope and use of the 340B Drug Discount benefit; HR 4710 340B PAUSE Act Any provision(s) reducing or changing the 340B Drug Discount Program or benefits to hospitals limiting hospital access to the benefit and or improving or updating the program's guidelines. H.R. 3. Lower Prescription Drug Costs Now Act - legislation that would make a series of changes to the Medicare program in an effort to lower the price of prescription drugs.

Client expense: $6,852 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Healthcare Price Transparency Rules for Hospitals 340B Medicare DSH Medicare Physician Payment (MACRA) H.R. 365 The Primary Care Enhancement Act S. 898/H.R. 2141 Conrad State 30 and Physician Access Reauthorization Act S. 1130 Rural Emergency Acute Care Hospital (REACH) Act S. 257 / H.R. 1611: Protecting Access to Rural Therapy Services Act S. 258 / H.R. 169: Critical Access Hospital Relief Act of 2015 H.R. 672 / S. 607: Rural Community Hospital Demonstration Extension Act of 2015 S. 1135: Hospital Payment Fairness Act H.R. 1479: Repeal of the Obamacare Bay State Boondoggle Act S. 1648: Rural Emergency Acute Care Hospital Act H.R. 3225: Save Rural Hospitals Act H.R. 1343 / S. 688: Establishing Beneficiary Equity in the Hospital Readmission Program Act S. 1148 / H.R. 2124: Resident Physician Shortage Reduction Act S. 2484 / H.R. 4442: CONNECT for Health Act H.R. 2156: Medicare Audit Improvement Act H.R. 5164: Rural Hospital Regulatory Relief Act S. 3435: Craig Thomas Rural Hospital and Provider Equity Act of 2016 H.R. 5406: Helping Ensure Accountability, Leadership, and Trust in Tribal Healthcare Act H.R. 34: 21st Century Cures Act H.R. 3298: Medicare Post-Acute Care Value-Based Purchasing Act H.R 1628: American Health Care Act S. 872 / H.R. 1955: Rural Hospital Access Act S. 377: Medicare Ambulance Access, Fraud Prevention and Reform Act H.R. 1156: Patient Access to Higher Quality Health Care Act of 2017 H.R. 2: Medicare Access and CHIP Reauthorization Act of 2016 H.R. 1628 Better Care Reconciliation Act (BCRA) H.R. 4392 To provide that the provision of the Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs final regulation relating to changes in the payment amount for certain drugs and biologicals purchased under the 340B drug discount program shall have no force or effect, and for other purposes. The Senate Committee on Health, Education, Labor and Pensions (HELP) June 26 passed the Lower Health Care Costs Act of 2019 (S.1895) Congress should act now to delay the Medicaid DSH cuts that are scheduled to go into effect Nov. 22.

Client expense: Not reported · Firm income: Not reported

HR 4392- To provide that the provision of the Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs final regulation relating to changes in the payment amount for certain drugs and biologicals purchased under the 340B drug discount program shall have no force or effect, and for other purposes; Opposition to any provision in any bill to reduce the scope and use of the 340B Drug Discount benefit; HR 4710 340B PAUSE Act Any provision(s) reducing or changing the 340B Drug Discount Program or benefits to hospitals limiting hospital access to the benefit and or improving or updating the program's guidelines.

Client expense: $22,245 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Healthcare Price Transparency Rules for Hospitals 340B Medicare DSH Medicare Physician Payment (MACRA) H.R. 365 The Primary Care Enhancement Act S. 898/H.R. 2141 Conrad State 30 and Physician Access Reauthorization Act S. 1130 Rural Emergency Acute Care Hospital (REACH) Act S. 257 / H.R. 1611: Protecting Access to Rural Therapy Services Act S. 258 / H.R. 169: Critical Access Hospital Relief Act of 2015 H.R. 672 / S. 607: Rural Community Hospital Demonstration Extension Act of 2015 S. 1135: Hospital Payment Fairness Act H.R. 1479: Repeal of the Obamacare Bay State Boondoggle Act S. 1648: Rural Emergency Acute Care Hospital Act H.R. 3225: Save Rural Hospitals Act H.R. 1343 / S. 688: Establishing Beneficiary Equity in the Hospital Readmission Program Act S. 1148 / H.R. 2124: Resident Physician Shortage Reduction Act S. 2484 / H.R. 4442: CONNECT for Health Act H.R. 2156: Medicare Audit Improvement Act H.R. 5164: Rural Hospital Regulatory Relief Act S. 3435: Craig Thomas Rural Hospital and Provider Equity Act of 2016 H.R. 5406: Helping Ensure Accountability, Leadership, and Trust in Tribal Healthcare Act H.R. 34: 21st Century Cures Act H.R. 3298: Medicare Post-Acute Care Value-Based Purchasing Act H.R 1628: American Health Care Act S. 872 / H.R. 1955: Rural Hospital Access Act S. 377: Medicare Ambulance Access, Fraud Prevention and Reform Act H.R. 1156: Patient Access to Higher Quality Health Care Act of 2017 H.R. 2: Medicare Access and CHIP Reauthorization Act of 2016 H.R. 1628 Better Care Reconciliation Act (BCRA) H.R. 4392 To provide that the provision of the Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs final regulation relating to changes in the payment amount for certain drugs and biologicals purchased under the 340B drug discount program shall have no force or effect, and for other purposes

Client expense: Not reported · Firm income: Not reported

HR 4392- To provide that the provision of the Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs final regulation relating to changes in the payment amount for certain drugs and biologicals purchased under the 340B drug discount program shall have no force or effect, and for other purposes; Opposition to any provision in any bill to reduce the scope and use of the 340B Drug Discount benefit; HR 4710 340B PAUSE Act Any provision(s) reducing or changing the 340B Drug Discount Program or benefits to hospitals limiting hospital access to the benefit and or improving or updating the program's guidelines.

Client expense: $275,279 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Healthcare Price Transparency Rules for Hospitals 340B Medicare DSH Medicare Physician Payment (MACRA) H.R. 365 The Primary Care Enhancement Act S. 898/H.R. 2141 Conrad State 30 and Physician Access Reauthorization Act S. 1130 Rural Emergency Acute Care Hospital (REACH) Act S. 257 / H.R. 1611: Protecting Access to Rural Therapy Services Act S. 258 / H.R. 169: Critical Access Hospital Relief Act of 2015 H.R. 672 / S. 607: Rural Community Hospital Demonstration Extension Act of 2015 S. 1135: Hospital Payment Fairness Act H.R. 1479: Repeal of the Obamacare Bay State Boondoggle Act S. 1648: Rural Emergency Acute Care Hospital Act H.R. 3225: Save Rural Hospitals Act H.R. 1343 / S. 688: Establishing Beneficiary Equity in the Hospital Readmission Program Act S. 1148 / H.R. 2124: Resident Physician Shortage Reduction Act S. 2484 / H.R. 4442: CONNECT for Health Act H.R. 2156: Medicare Audit Improvement Act H.R. 5164: Rural Hospital Regulatory Relief Act S. 3435: Craig Thomas Rural Hospital and Provider Equity Act of 2016 H.R. 5406: Helping Ensure Accountability, Leadership, and Trust in Tribal Healthcare Act H.R. 34: 21st Century Cures Act H.R. 3298: Medicare Post-Acute Care Value-Based Purchasing Act H.R 1628: American Health Care Act S. 872 / H.R. 1955: Rural Hospital Access Act S. 377: Medicare Ambulance Access, Fraud Prevention and Reform Act H.R. 1156: Patient Access to Higher Quality Health Care Act of 2017 H.R. 2: Medicare Access and CHIP Reauthorization Act of 2016 H.R. 1628 Better Care Reconciliation Act (BCRA) H.R. 4392 To provide that the provision of the Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs final regulation relating to changes in the payment amount for certain drugs and biologicals purchased under the 340B drug discount program shall have no force or effect, and for other purposes

Client expense: Not reported · Firm income: Not reported

HR 4392- To provide that the provision of the Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs final regulation relating to changes in the payment amount for certain drugs and biologicals purchased under the 340B drug discount program shall have no force or effect, and for other purposes; Opposition to any provision in any bill to reduce the scope and use of the 340B Drug Discount benefit; HR 4710 340B PAUSE Act Any provision(s) reducing or changing the 340B Drug Discount Program or benefits to hospitals limiting hospital access to the benefit and or improving or updating the program's guidelines.

Client expense: $13,972 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Outreach and monitoring related to health, Medicaid and Medicare issues. H.R. 4710, 340B PAUSE Act. H.R. 4392, To provide that the provision of the Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs final regulation relating to changes in the payment amount for certain drugs and biologicals purchased under the 340B drug discount program shall have no force or effect, and for other purposes. H.R. 541, Improving Oversight and Accountability in Medicaid Non-DSH Supplemental Payments Act. H.R. 1892, Bipartisan Budget Act of 2018 (P.L. 115-123). H.R. 195, Extension of Continuing Appropriations Act, 2018 (P.L. 115-120). S. 2183, CHIP Stability Act. S. 2312, HELP Act.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Outreach and monitoring related to health, Medicaid and Medicare issues. H.R. 4710, 340B PAUSE Act. H.R. 4392, To provide that the provision of the Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs final regulation relating to changes in the payment amount for certain drugs and biologicals purchased under the 340B drug discount program shall have no force or effect, and for other purposes. H.R. 541, Improving Oversight and Accountability in Medicaid Non-DSH Supplemental Payments Act. H.R. 1892, Bipartisan Budget Act of 2018 (P.L. 115-123). H.R. 195, Extension of Continuing Appropriations Act, 2018 (P.L. 115-120). S. 2183, CHIP Stability Act. S. 2312, HELP Act.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

ACE Kids: Support for the ACE Kids Act, S 428 and HR 3325, which seeks to make it easier for children with medical complexity to seek treatment across state lines. 340B: Sought the reversal of cuts to 340B reimbursements in the final Medicare Outpatient Prospective Payment System - H.R. 4392. Opposed measures that would limit expansions of the 340B program and require burdensome, irrelevant and unnecessary reporting by 340B covered entities - H.R. 4710, S. 2312, and S. 2453. Supported H.R. 6071 (Matsui) to require HHS to audit drug manufacturers and publish 340B ceiling prices. Opposed the proposed public charge rule and adding Medi-Cal to the list of programs that would be considered in making a public charge determination.

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

Government targets: HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), SENATE

ACE Kids: Support for the ACE Kids Act, S 428 and HR 3325, which seeks to make it easier for children with medical complexity to seek treatment across state lines. 340B: Sought the reversal of cuts to 340B reimbursements in the final Medicare Outpatient Prospective Payment System - H.R. 4392. Opposed measures that would limit expansions of the 340B program and require burdensome, irrelevant and unnecessary reporting by 340B covered entities - H.R. 4710, S. 2312, and S. 2453. Supported H.R. 6071 (Matsui) to require HHS to audit drug manufacturers and publish 340B ceiling prices. Opposed proposed public charge rule, which would punish children with disabilities and complex medical conditions, and make it harder for them to pursue lawful citizenship.

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

Government targets: HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), SENATE

Issues affecting the 340B drug pricing program; HR 6071 - SERV Communities Act; HR 4392 - To provide that the provision of the Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs final regulation relating to changes in the payment amount for certain drugs and biologicals purchased under the 340B drug discount program shall have no force or effect, and for other purposes; H.R.6157 - Department of Defense and Labor, Health and Human Services, and Education Appropriations Act, 2019 and Continuing Appropriations Act, 2019

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues affecting the 340B drug pricing program; HR 6071 - SERV Communities Act; HR 4392 - To provide that the provision of the Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs final regulation relating to changes in the payment amount for certain drugs and biologicals purchased under the 340B drug discount program shall have no force or effect, and for other purposes; H.R.6157 - Department of Defense and Labor, Health and Human Services, and Education Appropriations Act, 2019 and Continuing Appropriations Act, 2019

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 128/H.R. 496, the Bar Removal of Individuals Who Dream and Grow Our Economy (BRIDGE) Act - entire bill H.R. 165, the Restoring the Partnership for County Health Care Costs Act - entire bill S. 745, to Reauthorize the SCAAP Program - entire bill H.R. 496/S. 128, the Bar Removal of Individuals who Dream and Grow our Economy Act or BRIDGE Act - entire bill S. 548, the Affordable Housing Credit Improvement Act - entire bill S. 611/H.R. 1511, the Homeless Children and Youth Act - entire bill H.R. 731/S. 31 the California Clean Coast Act, - entire bill S. 860, the Juvenile Justice and Delinquency Prevention Reauthorization Act - entire bill H.R. 1138, the Wildfire Airspace Protection Act - entire bill H.R. 1352, the Preparing More Welfare Recipients for Work Act - entire bill H.R. 1491, the Santa Ynez Band of Chumash Indians Land Affirmation Act - entire bill H.R. 1628, the American Health Care Act - funding for local health care and public health responsibilities H.R. 1809, the Juvenile Justice Reform Act - entire bill H.R. 2639, the Elder Justice Reauthorization Act - entire bill H.R. 3212, Reauthorization of the State Criminal Alien Assistance Program (SCAAP) - entire bill H.R. 3682, the Blue Whales and Blue Skies Act - entire bill H.R. 4392, 340B Drug Pricing Program CAP funding for debris basins Channel Islands National Marine Sanctuary H.R. 2/S. 3042, Farm Bill reauthorization - Pest detection and prevention; Assistance to producers of Specialty Crops; Border inspection/detection; use of detector dogs; SNAP; WIC Infrastructure funding Lake Cachuma - bureau of Reclamation funding Land-Into-Trust process Mission Creek Flood Control Project - Federal resources Outer Continental Shelf issues Payments in Lieu of Taxes; Secure Rural Schools H.R. 5861 - Jobs and Opportunity with Benefits and Services for Success Act; TANF reauthorization, employment training Tax Exempt municipal bonds H.R. 5952/S. 3072, FY 2019 Commerce, Justice, State Appropriations - funding for local law enforcement activities, including youth delinquency prevention, local law enforcement technology needs, domestic abuse programs, drug treatment, SCAAP, and the Southwest Border Prosecution Initiative S. 3109, FY 2019 Energy and Water Appropriations- Funding for: Lower Mission Creek; Lake Cachuma Recreation Area; Goleta Beach FY 2019 Homeland Security Appropriations - local homeland security and disaster preparedness activities, including public safety, public health, emergency management personnel, communications infrastructure, Assistance to Firefighters Grant program, and Emergency Management Performance Grants H.R. 6147/S. 3073, FY 2019 Interior Appropriations - Funding for EPA Section 103 & 105 grants to State and Local Agencies; National Endowment for the Arts S. 3158, FY 2019 Labor, Health and Human Services Appropriations - funding for CDC State & Local Capacity, Bioterrorism Hospital Program, MMRS, MCH, ADAP, TB Control, family planning, substance abuse block grants, preventative health, safety net grants, nutrition services for older Americans, LSTA. Funding for Community Services and Social Services Block Grants H.R. 6072/S. 3023, FY 2019 Transportation, HUD Appropriations bill - transportation program funding; funding for CDBG, HOME Investment Partnerships, homeless assistance grants, HOPWA, Elderly housing S. 2800 - America's Water Infrastructure Act of 2018; Army Corps funding and policies H.R. 8 - Water Resources Development Act of 2018; Army Corps funding and policies H.R. 5861 - Jobs and Opportunity with Benefits and Services for Success Act; TANF reauthorization, employment training Violence Against Women Act reauthorization

Client expense: Not reported · Firm income: $24,000

Government targets: Army, Dept of (Corps of Engineers), Bureau of Reclamation, HOUSE OF REPRESENTATIVES, SENATE, Transportation, Dept of (DOT)

S. 128/H.R. 496, the Bar Removal of Individuals Who Dream and Grow Our Economy (BRIDGE) Act - entire bill H.R. 165, the Restoring the Partnership for County Health Care Costs Act - entire bill S. 178, the Elder Abuse Prevention and Prosecution Act - entire bill S. 745, to Reauthorize the SCAAP Program - entire bill H.R. 506/S. 150, the Preventing Crimes Against Veterans Act - entire bill S. 548, the Affordable Housing Credit Improvement Act, S. 611/H.R. 1511, the Homeless Children and Youth Act - entire bill H.R. 731, the California Clean Coast Act - entire bill S. 745, to reauthorize and update the State Criminal Alien Assistance Program (SCAAP) - entire bill S. 860, the Juvenile Justice and Delinquency Prevention Reauthorization Act - entire bill H.R. 1138, the Wildfire Airspace Protection Act - entire bill H.R. 1352, the Preparing More Welfare Recipients for Work Act - entire bill H.R. 1809, the Juvenile Justice Reform Act - entire bill S. 1993, the Rim of the Valley Corridor Preservation Act, H.R. 2156, Saint Francis Dam Disaster National Memorial Act - entire bill H.R. 2524, to provide for conveyance of a former immigration and customs facility from the Department of Homeland Security to Ventura County - entire bill H.R. 2639, the Elder Justice Reauthorization Act - entire bill H.R. 2899, the Second Chance Reauthorization Act - entire bill H.R. 3212, Reauthorization of the State Criminal Alien Assistance Program (SCAAP) - entire bill H.R. 2997/S. 1405, the 21st Century AIRR Act (FAA Reauthorization) - Airport Improvement Program/Contract Tower Program reauthorization, passenger facility charge, air traffic privatization, pilot safety, viable service for non-hub airports H.R. 4 - FAA Reauthorization Act of 2018; Airport Improvement Program/Contract Tower Program reauthorization, passenger facility charge, air traffic privatization, pilot safety, viable service for non-hub airports H.R. 3682, the Blue Whales and Blue Skies Act - entire bill S. 548, the Affordable Housing Credit Improvement Act - entire bill H.R. 4072, the Central Coast Heritage Protection Act - entire bill H.R. 4082 - repeal of Ensuring Patient Access and Effective Drug Enforcement Act provisions limiting DEA enforcement H.R. 4086, the Rim of the Valley Corridor Preservation Act - entire bill H.R. 4392 - Cuts to 340B Drug Purchasing Program 340B Drug Purchase program Channel Islands National Marine Sanctuary H.R. 2/S. 3042, Farm Bill reauthorization - Pest exclusion, detection and eradication; support for specialty crops; SNAP; WIC; honeybee health; food safety; rural housing Infrastructure funding NRCS Emergency Watershed Protection Program Outer Continental Shelf issues Payments in Lieu of Taxes; Secure Rural Schools Temporary Assistance for Needy Families (TANF) Reauthorization Tax Exempt municipal bonds H.R. 5952/S. 3072, FY 2019 Commerce, Justice, State Appropriations - funding for local law enforcement activities, including youth delinquency prevention, local law enforcement technology needs, domestic abuse programs, drug treatment, SCAAP, and the Southwest Border Prosecution Initiative S. 3109, FY 2019 Energy and Water Appropriations - Funding for Army Corps of Engineers projects FY 2019 Homeland Security Appropriations - local homeland security and disaster preparedness activities, including public safety, public health, emergency management personnel, communications infrastructure, Assistance to Firefighters Grant program, and Emergency Management Performance Grants H.R. 6147/S. 3073, FY 2019 Interior Appropriations - Funding for EPA Section 103 & 105 grants to State and Local Agencies; National Endowment for the Arts S. 3158, FY 2019 Labor, Health and Human Services Appropriations - funding for CDC State & Local Capacity, Bioterrorism Hospital Program, MMRS, MCH, ADAP, TB Control, family planning, substance abuse block grants, preventative health, safety net grants, nutrition services for older Americans, LSTA. Funding for Community Services and Social Services Block Grants H.R. 6072/S. 3023, FY 2019 Transportation, HUD Appropriations bill - transportation program funding; funding for CDBG, HOME Investment Partnerships, homeless assistance grants, HOPWA, Elderly housing Federal gun control CDC research into gun violence S. 2800 - America's Water Infrastructure Act of 2018; Army Corps funding and policies H.R. 8 - Water Resources Development Act of 2018; Army Corps funding and policies H.R. 5861 - Jobs and Opportunity with Benefits and Services for Success Act; TANF reauthorization, employment training Violence Against Women Act reauthorization Land and Water Conservation Fund reauthorization H.R. 6, the SUPPORT for Patients and Communities Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare payments for Graduate Medical Education H.R. 2267/S. 1301, "Resident Physician Shortage Reduction Act" - provisions related to increasing the number of Medicare-funded residency positions Proposed changes to Medicare hospital reimbursement policies Proposed cuts and policy changes to Medicare Advantage insurance plans 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 Opposed H.R. 4710, a bill to implement reporting requirement for certain 340B participants and to establish a 2-year moratorium on new 340B program participants H.R. 6071, Stretching Entity Resources for Vulnerable Communities Act - provisions related to rescinding Medicare reimbursements cuts and codifying the definition of patient Additional legislative proposals modifying the 340B program

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislative proposals affecting Medicare and Medicaid hospital reimbursement policies Health Information Technology Health Care Reform Implementation Medicare Graduate Medical Education Payments H.R. 2267/S. 1301, "Resident Physician Shortage Reduction Act" - provisions related to increasing the number of Medicare-funded residency positions S. 568/H.R.1421, "Improving Access to Medicare Coverage Act" - provisions related to counting outpatient observation services toward satisfying the 3-day inpatient hospital requirement for coverage of skilled nursing facility services under Medicare H.R. 1130/S. 397, Fair Medicare Hospital Payments Act of 2017 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 Opposed H.R. 4710, a bill to implement reporting requirement for certain 340B participants and to establish a 2-year moratorium on new 340B program participants H.R. 6071, Stretching Entity Resources for Vulnerable Communities Act - provisions related to rescinding Medicare reimbursements cuts and codifying the definition of patient Additional legislative proposals modifying the 340B program

Client expense: Not reported · Firm income: $110,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Drug pricing; 340B Drug Discount Program; Program for All Inclusive Care of the Elderly (PACE);HR 4392, to provide that the provisions of the Hospital OPPS final rule provisions related to changes in payment for certain 340B drugs have no force or effect; alignment of 42 CFR Part 2 with HIPAA by co-sponsoring, S.1850, the Protecting Jessica Grubb's Legacy Act and H.R.3545, the Opioid Prevention and Patient Safety Act, federal response to the opioid crisis; Medicare bad debt reporting; Medicare Outpatient PPS proposed rule

Client expense: $352,000 · Firm income: Not reported

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

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

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

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

Medicare Graduate Medical Education H.R. 2267/S. 1301, "Resident Physician Shortage Reduction Act" - provisions related to increasing the number of Medicare-funded residency positions Health Care Delivery and Payment Reform Proposals 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 Opposed H.R. 4710, a bill to implement reporting requirement for certain 340B participants and to establish a 2-year moratorium on new 340B program participants H.R. 6071, Stretching Entity Resources for Vulnerable Communities Act - provisions related to rescinding Medicare reimbursements cuts, codifying the definition of patient Additional legislative proposals modifying the 340B program

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Repeal of the Affordable Care Act H.R. 1628 The American Health Care Act Development of legislation to protect essential hospitals Issues related to telehealth Mental Health Essential Health Benefits created by the Affordable Care Act Access to hospital emergency services Issues related to the 340B Drug Pricing Program HR1628 Better Care Reconciliation Act ACA Cost Sharing Reduction Subsidies Graham-Cassidy Amendment to HR 1628 340B drug pricing program HR3545-Overdose, Prevention and Patient Advocacy Act HR4392 CMS OPPS 340b rule moratorium HR4710 340b PAUSE Act Bipartisan Healthcare Stabilization Act of 2017 Opioid Crisis Response Act of 2018 42 CFR Part 2 IMD Exclusion Prescription drug monitoring programs H.R. 5197, S. 2516, Alternatives to opioids in the emergency dept Act H.R. 5102, Substance Use Disorder Workforce Loan Repayment Act H.R. 5261, Treatment, Education, and Community Help to Combat Opioid Addiction Act Poison Center Network Enhancement Act A Bill to support the peer support specialist workforce HR6 Support for Patients and Communities Act H.R. 4710 PAUSE Act HELP Act S. 2312 HR6378 Pandemic and All Hazards Preparedness and Advancing Innovation Act S.974 CREATES Act S.2843 Opioid Workforce Act HEAL Act S.3120 SERV Communities Act H. R. 6071 S.428, H.R. 3325 The Advancing Care for Exceptional (ACE) Kids Act Cassidy Surprise Billing Draft H.R.6 Support for Patients and Communities Act Protecting Patients from Surprise Medical Bills Hassan Surprise Billing-S. 3592, No more Surprise Medical Bills Act H.R. 7328, Pandemic and All-Hazards Preparedness and Advancing Innovation Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE, White House Office

Proposed changes to Medicare hospital reimbursement policy Issues related to the Hospital Compare Star Ratings S. 568/H.R.1421, "Improving Access to Medicare Coverage Act" - provisions related to counting outpatient observation services toward satisfying the 3-day inpatient hospital requirement for coverage of skilled nursing facility services under Medicare H.R. 2267/S. 1301, "Resident Physician Shortage Reduction Act" - provisions related to increasing the number of Medicare-funded residency positions 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 Opposed H.R. 4710, a bill to implement reporting requirement for certain 340B participants and to establish a 2-year moratorium on new 340B program participants H.R. 6071, Stretching Entity Resources for Vulnerable Communities Act - provisions related to rescinding Medicare reimbursements cuts, codify the definition of patient Additional legislative proposals modifying the 340B program

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

340B Drug Discount Program Resident Physician Shortage Reduction Act Graduate Medical Education Disproportionate Share Hospital payments Childrens Health Insurance Program Medicare Dependent Hospital Program (MDH) Medicaid Low Volume Payments (LV) H.R. 1955, S. 872 - Rural Hospital Access Act H.R. 2889, Closing Loopholes for Orphan Drugs Act Medicare Wage Index Federal Medical Assistance Percentage Extension Inpatient Prospective Payment System Outpatient Prospective Payment System Bad debt/charity care Hospital Outpatient Department payments H.R. 4392, Medicare Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems 340B Drug Discount program legislation H.R. 4710, 340B PAUSE Act S. 2453, Ensuring the Value of the 340B Program Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 4710 - 340B Protecting Access for the Underserved and Safety-Net Entities Act (340B PAUSE Act) S. 2312 - The Helping Ensure Low-income Patients have Access to Care and Treatment Act S. 2453 - Ensuring the Value of the 340B Program Act of 2018 Part D Medicare Program (including Coverage Gap and other offsets in H.R.1892/P.L.115-123, Bipartisan Budget Act of 2018). HR 4392 - reversing the HOPPS rule reimbursement cut to 340B hospitals HR 5598 - 340B Optimization Act HR 2889 - Closing Loopholes for Orphan Drugs Act HR 6071 - SERV Communities Act HR 6240 - Drug Discount Accountability Act (user fees) S.3787 - DISARM Act of 2018 H.R. 7077, the Restoring the Patients Voice Act - Issues related to Medicare and Medicaid coverage and reimbursement - Issues related to the 340B Drug Discount Program - Issues related to drug pricing - Medicare reimbursement for biosimilars - MACRA treatment and reimbursement of Part B drugs - Medicare payments for inpatient antimicrobials - Issues related to Right to Try - Issues related to drug importation - Issues related to Part D Medicare Program including coverage gap and other offsets

Client expense: $1,480,000 · Firm income: Not reported

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

H.R. 4710 - 340B Protecting Access for the Underserved and Safety-Net Entities (PAUSE) Act S. 2312 - The Helping Ensure Low-income Patients have Access to Care and Treatment Act S. 2453 - Ensuring the Value of the 340B Program Act of 2018 HR 4392 - Reversing the HOPPS rule reimbursement cut to 340B hospitals HR 5598 - 340B Optimization Act HR 2889 - Closing Loopholes for Orphan Drugs Act HR 6240 - Drug Discount Accountability Act (user fees) H.R.6071 - SERV Communities Act of 2018 S.204/H.R.878, Trickett-Wendler Right to Try Act of 2017 P.L.109-417, Pandemic and All-Hazards Preparedness Act (PAHPA) S.2852 - Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018 H.R.6294 - Re-Valuing Anti-Microbial Products (REVAMP) Act of 2018 S.974 - CREATES Act of 2017 - Issues related to the 340B Drug Discount Program - Issues relating to drug pricing - Development of policies to advance antimicrobial research, antiviral research, and novel product development environment, including advancing new market incentives. - Issues and policies relating to the Food and Drug Administration including biopharmaceutical development, drug safety and counterfeiting, and biosimilars. - General education about policies impacting pharmaceutical development, approval, reimbursement and pricing. - Issues related to healthcare legislation

Client expense: $1,480,000 · Firm income: Not reported

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

Graduate Medical Education, 340B Drug Discount Program Disproportionate Share Payments Care Coordination Reimbursement CMS OPPS Proposed Rule Graduate Nursing Education HR 4392 CMS Proposed Revisions to the Physician Fee Schedule

Client expense: $104,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 4710 - 340B PAUSE Act; provisions relating to 340B drug pricing S. 2453 - Ensuring the Value of the 340B Program Act of 2018; provisions relating to 340B drug pricing S. 2312 - HELP Act; provisions relating to 340B drug pricing H.R. 6071 - SERV Communities Act; provisions relating to 340B drug pricing H.R. 4392 - To provide that the provision of the Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs final regulation relating to changes in the payment amount for certain drugs and biologicals purchased under the 340B drug discount program shall have no force or effect, and for other purposes; provisions related to 340B drug pricing. Centers for Medicare and Medicaid Services' FY2019 Inpatient Prospective Payment System (IPPS) Final Rule comments/CAR-T therapy reimbursement Medicare Hospital Outpatient Prospective Payment System (OPPS) Final Rule/Physician Fee Schedule proposed rule comments Medicare and Medicaid Programs; Regulatory Provisions to Promote Program Efficiency, Transparency and Burden Reduction, CMS-3346-P, proposed rule comments Medicare Program; Medicare Shared Savings Program; Accountable Care Organizations - Pathways to Success, CMS-1701-P, proposed rule comments

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

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

Issue: Educate congressional staff on academic medicines missions, including education, research, patient care, GME, workforce, and physician shortages in rural and urban communities. Issue: Support continuation of high-quality affordable health insurance through preservation of current levels of health care coverage. Support programs and funds for safety-net providers. H.R. 3728, Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness (EMPOWER) Act of 2017 Issue: Support reauthorization of Title VII health professions programs P.L. 115-241, Childrens Hospital GME Support Reauthorization Act Issue: Support reauthorization of the Childrens Hospital GME program H.R. 959/S. 1109 Title VIII Nursing Workforce Reauthorization Act of 2017 Issue: Support reauthorization of Title VIII nursing workforce development programs S.3095 / H.R. 2574, Building a Health Care Workforce for the Future Act Issue: Support bill to increase scholarship opportunities for medical students and encourage primary care workforce development S. 3660 / H.R. 5942, Health Equity and Accountability Act Issue: Support workforce grants to medical schools to improve health equity Issue: Oppose regulatory proposals to narrow the definition of sex Issue: Educate Congress and the administration, support training on substance use disorders, pain management, and safe prescribing practices. Strategies to prevent, identify, and treat opioid addiction Issue: Support reauthorization of the Patient Centered Outcomes Research Institute (PCORI) and the Patient Centered Outcomes Research Trust Fund Issue: Promote resilience of health professionals Issue: Support policies to address IV fluid shortages exacerbated by hurricanes, and educate Congress on the shortage of IV saline fluid and injectable drug shortage. Issue: Oppose restrictions on fetal tissue and embryonic stem cell research. P.L. 115-176/H.R. 5247, Trickett Wendler, Frank Mongiello, Jordan McLinn, and Matthew Bellina Right to Try Act. Issue: Oppose Right to Try legislation that removes safety measures under FDAs current expanded access program. P.L. 115-271 SUPPORT for Patients and Communities Act H.R. 5261, Treatment, Education, and Community Help to Combat Addiction Act of 2018 S.2680, Opioid Crisis Response Act of 2018 S.2711, Enhancing Access to Addiction Treatment Act of 2018 Issue: Support policies to address the opioid epidemic including improving coverage and payment for non-opioid therapies, enhancing usability of PDMPs, addressing physician shortages, promoting medication assisted treatment, eliminating Medicare limits on in-patient psychiatric hospital treatment, eliminating Medicaid IMD exclusion, aligning privacy regulations, and investing in research and education, and reauthorizing the Patient Centered Outcomes Research Institute. Provide grants to regional Centers of Excellence in substance use disorder education. Support policy eliminating Medicaid IMD exclusion and revising 42 Code of Federal Regulations (CFR) Part 2 to amend the Public Health Service Act to align federal privacy standards for substance use disorder (SUD) patient records more closely with standards under the Health Insurance Portability and Accountability Act (HIPAA). Issue: Amend Controlled Substances Act to improve MAT waiver process for qualified health professionals. H.R. 6082, the Overdose Prevention and Patient Safety Act Issue: Support legislation revising 42 Code of Federal Regulations (CFR) Part 2 to amend the Public Health Service Act to align federal privacy standards for substance use disorder (SUD) patient records more closely with standards under the Health Insurance Portability and Accountability Act (HIPAA). H.R. 7328/ H.R. 6378/S.2852, Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018 Issue: Support the Hospital Preparedness Program and the reauthorization of the Pandemic and All-Hazards Preparedness Act. Support increased funding authorization levels. H.R.4776 Hospital Preparedness Reauthorization Act of 2018. Issue: Support reauthorization of the Hospital Preparedness Program Issue: Support legislative solutions to fire arm related injuries and fatalities including research, public health surveillance, and firearm background checks. H.R. 4392, To provide that the provision of the Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs final regulation relating to changes in the payment amount for certain drugs and biologicals purchased under the 340B drug discount program shall have no force or effect, and for other purposes. Issue: Support rescission of Medicare cuts to hospitals that participate in 340B Drug Pricing Program H.R. 4710, 340B PAUSE Act Issue: Oppose bill that would impose a moratorium on 340B hospitals and other issues S. 2312, 340B HELP Act Issue: Oppose bill that would impose a moratorium and add additional reporting requirements for 340B hospitals S.2453, Ensuring the Value of the 340B Program Act of 2018 Issue: Oppose bill that would require hospitals to report total 340B acquisition costs H.R. 6071, Stretching Entity Resources for Vulnerable Communities Act Issue: Support bill to rescind Medicare cuts to 340B hospitals and improve program integrity H.R. 5598: 340B Optimization Act Issue: Oppose bill that would change eligibility metrics in the 340B program H.R. 6240, Drug Discount Accountability Act Issue: Oppose bill that would impose a user fee on hospitals that participate in the 340B program S. 3366, Maternal CARE Act Issue: Support efforts to reduce preventable maternal mortality Issue: Support national preparedness infrastructure.

Client expense: $892,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Bureau of Citizenship & Immigration Services (BCIS), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Natl Science Foundation (NSF), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), Office of Science & Technology Policy (OSTP), Patent & Trademark Office (PTO), SENATE, State, Dept of (DOS), Substance Abuse & Mental Health Services Administration (SAMHSA), Veterans Affairs, Dept of (VA), Vice President of the U.S., White House Office

Discussions pertinent to health care group purchasing organizations (GPOs) role in helping to prevent drug shortages Monitored HR 277 American Health Care Reform Act of 2017 Monitored S 297 Increasing Competition in Pharmaceuticals Act Monitored HR 749 Lower Drug Costs trough Competition Act Monitored HR 208 Ensuring Health Care Opportunities Act Monitored S 1115 Making Pharmaceutical Markets More Competitive Act Monitored HR 2562 Making Pharmaceutical Markets More Competitive Act Monitored S191 Patient Freedom Act of 2017 Monitored S761 Health Care Options Act of 2017 Monitored HR1933 Health Care Options Act of 2017 Monitored HR 1628 American Health Care Act of 2017 Monitored Bipartisan Health Care Stabilization Act of 2017 (proposed Alexander-Murray legislation) Monitored S 2312 Helping Ensure Low-income patients have Access to Care and Treatment (HELP) Act Monitored S 3158 Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2019 Monitored HR 4191 HHS Cybersecurity Modernization Act Monitored HR 4710 340B PAUSE Act Monitored S 2453 Ensuring the Value of the 340B Program Act of 2018 Monitored HR 4392 To provide that the provision of the Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs final regulation relating to changes in the payment amount for certain drugs and biologicals purchased under the 340B drug discount program shall have no force or effect, and for other purposes. Monitored HR6 SUPPORT for Patients and Communities Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Expressed support for legislation to preserve the 340b drug pricing program (HR 4392). Expressed support for legislation to reauthorize Title VII health professions programs (HR 3728).

Client expense: $110,000 · Firm income: Not reported

Government targets: Defense Advanced Research Projects Agency (DARPA), Defense, Dept of (DOD), HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), Natl Institutes of Health (NIH), SENATE

Support for Graduate Medical Education (GME) funding including the Resident Physician Shortage Reduction Act (S. 1301/H.R. 2267) and the Opioid Workforce Act of 2018 (H.R. 5818/S. 2843) Support for legislation to address opioid epidemic (SUPPORT for Patients and Communities Act (H.R. 6)) including bills to modify to institute of mental disease exclusion (H.R. 5797) and to align 42 CFR Part 2 with the Health Insurance Portability and Accountability Act (H.R. 6082) and policies to expand ability to prescribe buprenorphine treatment Support for full protection of Critical Access Hospital payments Support for REMC Act of 2018 (H.R. 5678) Support for Fairness in Liver Allocation Act (H.R. 6517) Support for changes to Medicare Volume Decrease Adjustment calculation Support for correction of erroneous reductions of GME residency positions Opposition to 340B program reductions in Centers for Medicare and Medicaid Services (CMS) 2018 Outpatient Prospective Payment System (OPPS) proposed rule [CMS-1678-P] and support for legislation (H.R. 4392, H.R. 6071) to halt these payment cut Opposition to changes to 340B program (H.R. 4710, H.R. 6240) Opposition to site-neutral payment reductions to hospital outpatient departments proposed in CMS 2019 OPPS proposed rule [CMS-1695-P] Support for policies to preserve Medicare Disproportionate Share Hospital funding as part of CMS 2019 Inpatient Prospective Payment System proposed rule [CMS-1694-P] Opposition to Department of Homeland Security Proposed Rule on Inadmissibility on Public Charge Grounds [DHS Docket No. USCIS-2010-0012]

Client expense: $150,000 · Firm income: Not reported

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

Support for the 340b program, HR 4392. Support for continued funding for the Rural Health Care telemedicine program. Support for new models of care, HR 5678 and appropriations report language contained in H.R. 6157 by inference to S.Rpt. 115-289

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

Government targets: Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE

H.R. 4392, a bill to restore cuts to hospitals as part of the 340b drug reimbursement program that were made in the final OPPS rule, particularly regarding Congressional cosponsorship and support of the measure. Support for eliminating sequestration for Medicare. Support for H.R. 5678, a bill that would establish a new model of Medicare reimbursement for rural hospitals that operate as rural emergency medical centers. Support for language included in S.Rpt. 115-289 related to new models of care and reimbursement including speaking with staff at Health and Human Services about the pilot project contained therein.

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

Government targets: Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE

Health care reform, Hospital related issues and initiatives. Medicaid 1115 Waiver S.2051/H.R.4206, Medicare Care Coordinator Improvement Act H.R.4392, To provide that the provision of the Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs final regulation relating to changes in the payment amount for certain drugs and biologicals purchased under the 340B drug discount program shall have no force or effect, and for other purposes. S.1301/H.R.2267, Resident Physician Shortage Reduction Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE