SERV Communities Act

H.R.3 - Lower Drug Costs Now Act of 2019 Prescription Drug Pricing Reduction Act (PDPRA) of 2019 S.977 - Transparent Drug Pricing Act of 2019 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 S.551, REFUND Act of 2019 H.R. 1520, the Purple Book Continuity Act H.R. 1503, the Orange Book Transparency Act; H.R. 1499, the Protecting Consumer Access to Generic Drugs Act H.R. 965, the CREATES Act H.R.269/S.1379, Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019 (P.L.116-22). S.1895, Lower Health Care Costs Act of 2019. -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 drug importation

Client expense: $2,610,000 · 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

S.977 - Transparent Drug Pricing Act of 2019 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 S.551, REFUND Act of 2019 H.R. 1520, the Purple Book Continuity Act H.R. 1503, the Orange Book Transparency Act; H.R. 1499, the Protecting Consumer Access to Generic Drugs Act H.R. 965, the CREATES Act H.R.269/S.1379, Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019 (P.L.116-22). S.1895, Lower Health Care Costs Act of 2019. - 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 drug importation - Issues related to the International Pricing Index for Medicare Part D

Client expense: $1,610,000 · 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 H.R. 2113 - The Prescription Drug STAR Act H.R. 1520, the Purple Book Continuity Act; H.R. 1503, the Orange Book Transparency Act; H.R. 1499, the Protecting Consumer Access to Generic Drugs Act; and H.R. 965, the CREATES Act; - 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.

Client expense: $1,610,000 · 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 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 S.551, REFUND Act of 2019 H.R. 1520, the Purple Book Continuity Act H.R. 1503, the Orange Book Transparency Act; H.R. 1499, the Protecting Consumer Access to Generic Drugs Act H.R. 965, the CREATES 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 the International Pricing Index for Medicare Part D

Client expense: $2,950,000 · 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 H.R. 2113 - The Prescription Drug STAR Act H.R. 1520, the Purple Book Continuity Act; H.R. 1503, the Orange Book Transparency Act; H.R. 1499, the Protecting Consumer Access to Generic Drugs Act; and H.R. 965, the CREATES Act; - 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: $2,950,000 · 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

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

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

Outreach and monitoring related to health, Medicaid and Medicare issues. Monitor legislative activity on issues related to the Presidents Budget FY 2019. H.R. 3325, ACE Kids Act. H.R. 5598, 340B Optimization Act. H.R. 5985, To amend title XVIII of the Social Security Act to permit review of certain Medicare payment determinations for disproportionate share hospitals and for other purposes. H.R. 6071, SERV Communities Act. S. 2690, To amend title XVIII of the Social Security Act to permit review of certain Medicare payment determinations for disproportionate share hospitals and for other purposes.

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

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

Outreach and monitoring related to health, Medicaid and Medicare issues. Monitor legislative activity on issues related to the Presidents Budget FY 2019. H.R. 3325, ACE Kids Act. H.R. 5598, 340B Optimization Act. H.R. 5985, To amend title XVIII of the Social Security Act to permit review of certain Medicare payment determinations for disproportionate share hospitals and for other purposes. H.R. 6071, SERV Communities Act. S. 2690, To amend title XVIII of the Social Security Act to permit review of certain Medicare payment determinations for disproportionate share hospitals and for other purposes.

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

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

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

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

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

H.R. 4710: 340B Protecting Access for the Underserved and Safety-net Entities Act or PAUSE Act - Provisions related to the 340B program H.R. 5598: 340B Optimization Act - Provisions related to transparency in the 340B program H.R. 6071: SERV Communities Act - Provisions related to transparency in the 340B program S. 1131: Fair Accountability and Innovative Research Drug Pricing Act of 2017 - Provisions related to drug pricing S. 2312: HELP Act - Provisions related to 340B program S. 2453: Ensuring the Value of the 340B Program Act of 2018 - Provisions to increase transparency in the 340B program Drug cost and pricing policy issues Transparency policy issues Drug importation and counterfeiting policy issues 340B drug discount program policy issues

Client expense: $1,820,000 · Firm income: Not reported

Government targets: Council of Economic Advisers (CEA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Vice President of the U.S.

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

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

340B drug pricing program HR 6071 HR 6082 S 1850 Site Neutral Payment Policy Transparency CMS Coding Sole Community Hospital Designation Rural Health

Client expense: $15,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), 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

Issues related to the implementation of PL 111-148 "Patient Protection and Affordable Care Act," all provisions pertaining to the Center for Medicare and Medicaid Innovation (CMMI) and federal programs. Issues related to the implementation of PL 97-414 "Orphan Drug Act," all provisions. HR 4710 "340B Protecting Access for the Underserved and Safety-net Entities Act," all provisions. S 2312 "Helping Ensure Low-income Patients have Access to Care and Treatment" (HELP Act), all provisions. S 2453 "Ensuring the Value of the 340B Program Act of 2018," all provisions. HR 5598 "340B Optimization Act," all provisions. HR 6071 "SERV Communities Act," all provisions. HR 6240 "Drug Discount Accountability Act," all provisions.

Client expense: $1,400,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, 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

Monitor and advocate on legislative and regulatory issues regarding healthcare. Legislative monitoring and outreach related to the H.R. 6, SUPPORT for Patients and Communities Act (P.L. 115-271). H.R. 6071, SERV Communities Act. H.R. 6082, Overdose Prevention and Patient Safety Act. Legislative monitoring and outreach related to the H.R. 6157, Department of Defense and Labor, Health and Human Services, and Education Appropriations Act, 2019 and Continuing Appropriations Act, 2019 (P.L. 115-245). H.R. 6733, Know the Cost Act of 2018. H.R. 7052, No Federal Funds for Public Charge Act of 2018. H.R. 7217, IMPROVE Act. S. 2553, Know the Lowest Price Act of 2018. S. 2554, Patient Right to Know Drug Prices Act. S. 2680, Opioid Crisis Response Act of 2018. S. 3120, HEAL Act of 2018. S. 3702, Right Rebate Act of 2018.

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

Government targets: HOUSE OF REPRESENTATIVES

P.L. 111-148/H.R. 3590, Patient Protection and Affordable Care Act; P.L. 111-152, Health Care and Education Reconciliation Act of 2010; H.R. 4392; 340B issues, Stark reform issues; Accelerating Access to Kids Care Act (S. 2415); ACE Kids Act (S. 298/H.R. 546); Bipartisan Budget Act of 2018; FY 2018 Consolidated Appropriations Act; SERV Communities Act (H.R.6071).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 5818 Opioid Workforce Act of 2018 H.R. 6071 The SERV Communities Act (2018)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 4710, 340B Protecting Access for the Underserved and Safety-net Entities Act (the PAUSE Act) HR 5634, Medical Cannabis Research Act of 2018 H.R. 6071, Stretching Entity Resources for Vulnerable Communities Act (SERV Communities Act) U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services (CMS), 42 CFR Parts 414 and 425, CMS-1701-P, RIN 0938-AT45, Docket ID: CMS-2018-0101, Medicare Program; Medicare Shared Savings Program; Accountable Care Organizations Pathways to Success CMS-1701-P Liver and Intestine Distribution Using Distance from Donor Hospital- US HHS OPTN Policy Notice U.S. Department of Homeland Security; U.S. Citizenship and Immigration Services; Inadmissibility on Public Charge Grounds; Notice of Proposed Rulemaking, 83 FR 51114; RIN 1615-AA22; DHS Docket No.: USCIS-2010-0012

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

Government targets: Army, Dept of (Corps of Engineers), Bureau of Citizenship & Immigration Services (BCIS), Commerce, Dept of (DOC), Defense, Dept of (DOD), Education, Dept of, HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), Natl Aeronautics & Space Administration (NASA), Natl Institutes of Health (NIH), Natl Science Foundation (NSF), Office of Management & Budget (OMB), SENATE, U.S. Coast Guard (USCG)

Preserving access to group purchasing organizations (GPOs) and protecting the GPO safe harbor; educating policymakers on hospital drug shortages and significant drug price increases, including raising awareness about saline and local anesthetic shortages. Oppose legislation that would harm the 340B Drug Discount Program for safety net hospitals and support legislation to prevents the implementation of the cuts in CMS Final 2017 OPPS Rule (CMS-2017-0091), the SERV Communities Act (support) (H.R. 6071) and H.R. 4392 (support). Support reforms aimed at creating more competition in the generic drug market, including ending pay for delay (S.124), and support other pro-competition policies, including legislation that would prohibit evergreening and abuse of citizen petitions, and promote the growth of biosimilars. Supported legislation to increase competition in the drug marketplace and prevent REMS abuses, the CREATES Act (S. 974/H.R.2214) (support). Raise awareness about generic injectable opioid shortages, urge engagement by the Food & Drug Administration Office of Drug Shortages and approval by the Drug Enforcement Agency of CII quota requests to increase production of injectable opioid products in short supply. Submitted comments to DEA urging the revision of its quota allocation process to recognize the unique institutional needs for injectable opioids. Submitted comments to DEA opposing proposed aggregate quota reductions for CY 2018 Schedule II controlled substances.

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Office of Management & Budget (OMB), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), White House Office

Hospital and Medicaid issues related to repeal and replace of the Affordable Care Act (ACA), including opposition to the American Health Care Act (House), the Better Care Reconciliation Act (Senate), the Graham-Cassidy-Heller-Johnson bill, and President Trumps FY 2019 Budget Proposal. Graduate Medical Education (GME) issues, including the Resident Physician Shortage Reduction Act of 2017 (support) (H.R. 2267/S. 1301), the Opioid Workforce Act of 2018 (support) (H.R. 5818/S. 2843), and the cuts and changes to Medicare and Medicaid GME programs in President Trumps FY 2019 budget proposal (oppose). Medicaid Disproportionate Share Hospital (DSH) cuts issues, including supporting the inclusion of a DSH cut delay in the Bipartisan Budget Act of 2018 (support) (H.R. 1892) and the continuation of DSH cuts in President Trumps FY 2019 Budget Proposal (oppose). Provide comments to CMS and OMB to advocate for a delay in further use of S-10 data for allocation of the Medicare DSH uncompensated care pool. Oppose legislation and regulations that would harm the 340B Drug Discount Program, including the cuts outlined in President Trumps FY 2019 Budget Proposal. Provide comments to CMS addressing payments to off-campus hospital outpatient departments. Support legislation to reverse the cuts to the 340B Drug Discount Program in CMS Final 2017 OPPS Rule, the SERV Communities Act (support) (H.R. 6071) and H.R. 4392 (support) Support Federal funding for Puerto Ricos Medicaid program and for Medicaid for individuals and families displaced by hurricanes. Oppose legislation that would harm Medicaid GME programs including the Medicaid Graduate Medical Education Transparency Act (oppose). Support legislation to repeal the Medicaid IMD exclusion, the Individuals in Medicaid Deserve Care that is Appropriate and Responsible in its Execution Act (support) (H.R. 5797), and support the inclusion of the legislation in the SUPPORT for Patients and Communities Act (support) (H.R. 6) and the Opioid Crisis Response Act of 2018 (support) (S. 2680). Support the inclusion of legislation to increase GME funding, the Opioid Workforce Act of 2018 (support) (H.R. 5818/S. 2843), in the SUPPORT for Patients and Communities Act (support) (H.R. 6) and the Opioid Crisis Response Act of 2018 (support) (S. 2680). Oppose the FY 2020-2025 Medicaid DSH cuts, and support proposals that would delay or repeal the scheduled cuts. Support legislative proposals to reverse the site-neutral provisions in the CMS OPPS final rule for 2019. Oppose 340b and site-neutral provisions in the CMS OPPS proposed and final rules for 2019. Sent comment letter to HHS regarding its OPPS proposed rule for CY 2019. The letter addressed issues related to site-neutral policies, 340B, WAC-based payments, packaging for non-opioid pain treatments, and changes to the IPO list, among other topics.

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Office of Management & Budget (OMB), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), White House Office

The 340B Drug Pricing Program; FY19 LHHS Appropriations; final 2018 and proposed 2019 Outpatient Prospective Payment System Rule; proposed and final rules regarding 340B ceiling price calculations and manufacturer civil monetary penalties; delay of 340B ceiling price database; S.2312, S.2453, H.R.4710, H.R.4392, H.R.5598, H.R.6071, H.R.6240, H.R.6273, and other legislation relevant to the 340B drug pricing program

Client expense: $231,609 · Firm income: Not reported

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

340B Drug Pricing Program - Opposed Medicare reimbursement reductions for hospitals eligible for the 340B drug pricing program. Supported passage of H.R. 4392, H.R 6071. Opposed H.R. 4710, H.R. 6240, S. 2312 and S.2453. Outpatient Prospective Payment System Site-Neutral Payment Reductions - Opposed implementation of Medicare payment changes that would reduce reimbursement for hospital outpatient facilities.

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

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

Group Purchasing - Conducted education and outreach efforts about the value hospital group purchasing organizations deliver the U.S. health care system. 340B Drug Pricing Program - Opposed changes to eligibility and the structure of the 340B Drug Pricing Program. Supported passage of H.R. 4392 and H.R 6071. Opposed H.R. 4710, H.R. 6240, S. 2312 and S.2453. Drug Shortages - Engaged in discussions around how ongoing shortages of prescription drugs are impacting hospitals and possible solutions. Advocated for the Drug Enforcement Agency to modify total annual production quotas to address hospital shortage of injectable opioid solutions. Drug Pricing - Supported the CREATES Act (S. 974), The Fair Access to Safe and Timely Generics Act (H.R. 2051), The Preserving Access to Affordable Generics (S.124), The Increasing Competition in Pharmaceuticals Act (S.297) and The Lower Drug Costs through Competition Act (H.R. 749). Biosimilar Drug adoption - Supported administrative proposals that would expand the adoption of biosimilar medications. Urged the Food and Drug Administration to finalize guidance related biosimilar interchangeability. Opioid Abuse - Supported changes to privacy requirements under 42 CFR Part 2 to better support coordinated care for patients. Supported H.R. 6082. Children's Hospital GME Support Reauthorization Act (H.R.5385, S.2597) - Endorsed passage of legislation to reauthorize the Children's Hospital GME program. Overall Hospital Quality Star Ratings - Urged modifications to the methodology used to calculate Overall Hospital Quality Star Ratings Program. Stark Law Reform - Monitored discussions in the House and Senate seeking reforms to the Stark Law. Voiced support for reforms that ease barriers to value-based care arrangements.

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

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

H.R.6261 - Improving Choices in Health Care Coverage Act S.3095 - Building a Health Care Workforce for the Future Act H.R.6128 - HSA Employer Flexibility Act H.R.6110 - Dr. Todd Graham Pain Management, Treatment, and Recovery Act of 2018 H.R.6098 - Family Medical Leave Modernization Act H.R.6097 - State-Based Universal Health Care Act of 2018 H.R.6082 - Overdose Prevention and Patient Safety Act H.R.6 - SUPPORT for Patients and Communities Act S.3063 - Health Insurance Tax Relief Act of 2018 H.R.6071 - SERV Communities Act S.3053 - CHIP Mental Health and Addiction Parity Act S.3048 - Examining Opioid Treatment Infrastructure Act of 2018 H.R.6050 - Increasing Access to Care Act S.3016 - Action for Dental Health Act of 2018 S.3000 - Patient Advocacy Transparency Act H.R.5997 - Ensuring Patient Access to Critical Breakthrough Products Act of 2018 H.Res.915 - Expressing the sense of the Congress in support of protecting patients' access to medically appropriate, evidence-based healthcare and information, and the ethical and professional obligations of healthcare professionals to provide that care and information H.R.5966 - Women Veterans Access to Quality Care Act of 2018 H.R.5965 - Access to Infertility Treatment and Care Act H.R.5963 - To delay the reimposition of the annual fee on health insurance providers until after 2020 S.2960 - Access to Infertility Treatment and Care Act S.Res.526 - A resolution expressing the sense of the Senate that politicians should not interfere with a woman's personal health care decisions or attempt to prevent providers from offering their full medical recommendations to their patients H.R.5942 - Health Equity and Accountability Act of 2018 H.R.5933 - Substance Abuse Prevention Act of 2018 H.R.5932 - Increasing Access to Mental Health in Schools Act H.R.5925 - CRISIS Act S.2934 - Increasing Access to Mental Health in Schools Act H.R.5917 - Professional's Access to Health Workforce Integration Act of 2018 H.R.5914 - To require a study and report on policy and regulatory changes that may have contributed to the opioid epidemic S.2920 - Commit to Opioid Medical Prescriber Accountability and Safety for Seniors Act of 2018 S.2912 - Opioid Addiction Treatment Programs Enhancement Act H.R.6144 - Know the Lowest Price Act of 2018 S.204 - Trickett Wendler, Frank Mongiello, Jordan McLinn, and Matthew Bellina Right to Try Act of 2017 S.2680 - Opioid Crisis Response Act of 2018 H.R.5511 - Healthy Communities Act of 2018 H.R.5491 - Rural Health Insurance Act of 2018 H.R.5455 - Accelerating Biomedical Research Act H.R.5641 - State Offices of Rural Health Reauthorization Act of 2018 H.R.5625 - Easy Enrollment Act of 2018 H.R.5624 - Pathway to Universal Coverage Act of 2018 H.R.5603 - Access to Telehealth Services for Substance Use Disorders Act S.2732 - Defending Access to Mental Health Care Act H.R.5699 - HOST Act of 2018 S.2802 - Responsible Additions and Increases to Sustain Employee Health Benefits Act of 2018 H.R.5725 - BEST Act S.2902 - Better Data Sharing to Combat the Opioid Crisis Act S.2901 - eTREAT Act H.R.5892 - To establish an Advisory Committee on Opioids and the Workplace to advise the Secretary of Labor on actions the Department of Labor can take to address the impact of opioid abuse on the workplace H.R.5858 - Primary Care Patient Protection Act of 2018 S.2875 - COMBAT Act of 2018 H.R.5795 - Overdose Prevention and Patient Safety Act S.2851 - Regional Health Care Emergency Preparedness and Response Systems Act H.R.5775 - Providing Reliable Options for Patients and Educational Resources Act of 2018 H.R.5769 - Expanding Access to Treatment Act S. 2608 - Reducing Opioid Risk Act S. 2589 - Comprehensive Opioid Recovery Centers Act of 2018 S. 2582 - Consumer Health Insurance Protection Act of 2018 S. 2554 - Patient Right to Know Drug Prices Act H.R. 5258 - Affordable Health Insurance for the Middle Class Act H.R. 5254 - To direct the Secretary of HHS to conduct a study on the feasibility of expanding eligibility for enrollment in Medicare Advantage plans to individuals enrolled under the Medicaid program or enrolled under a group health plan H.R. 5223 - Health Care Workplace Violence Prevention Act S. 2507 - Improving Choice in Health Care Coverage Act H.R. 5155 - Undo Sabotage and Expand Affordability of Health Insurance Act of 2018 S. 2496 - Small Business Health Account Act of 2018 S. 2494 - Fair Care Act H.R. 5138 - Bipartisan HSA Improvement Act of 2018 H.R. 5124 - Community Action Opioid Response Act of 2018 H.R. 5097 - PAVE Act of 2018 H.R. 5080 - COMBAT Act of 2018 H.R. 5062 - Advancing Access to Precision Medicine Act H.R. 5047 - VA Community Care Enhancement Act S. 2437 - Opioid Response Enhancement Act S. 2415 - Accelerating Kids Access to Care Act H.R. 4978 - Chronic Disease Management Act of 2018 S. 2410 - Chronic Disease Management Act of 2018 H.R. 4952 - To direct the Secretary of HHS to conduct a study and submit a report on the effects of the inclusion of quality increases in the determination of blended benchmark amounts under part C of the Medicare program H.R. 4938 - Respond NOW Act H.R. 4894 - Harmful Tax Prevention Act H.R. 4841 - Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018 H.R. 4831 - Healthcare Tax Relief Act H.R. 4820 - ASK Act S. 2315 - Over-the-Counter Drug Safety, Innovation, and Reform Act H.R. 4808 - Transparent Health Care Pricing Act of 2018 S. 2312 - HELP Act H.R. 4784 - ACA OUTREACH Act H.R. 4778 - Behavioral Health Coverage Transparency Act of 2018 S. 2302 - Access to Independent Health Insurance Advisors Act of 2018 S. 2301 - Behavioral Health Coverage Transparency Act of 2018 H.R. 4575 - A bill to amend title XXVII of the Public Health Service Act to preserve consumer and employer access to licensed independent insurance producers. S. 2303 - A bill to amend title XXVII of the Public Health Service Act to preserve consumer and employer access to licensed independent insurance producers. H.R. 1625 - Consolidated Appropriations Act, 2018 S. 2553 - Know the Lowest Price Act of 2018 H.R. 5343 - Prescription Transparency Act of 2018 H.R. 5150 - Protecting Medicare from Excessive Price Increases Act of 2018 H.R. 4874 - End The Shutdown Act of 2018 H.R. 4872 - End The Shutdown Act of 2018 H.R. 5104 - A bill to amend title XVIII of the Social Security Act to provide for a special enrollment period under Medicare for individuals enrolled in COBRA continuation coverage, and for other purposes H.R. 6 - SUPPORT for Patients and Communities Act S. 2554 - Patient Right to Know Drug Prices Act S. 2553 - Know the Lowest Price Act of 2018 H.R. 302 - FAA Re authorization Act of 2018 H. R. 6662 - Empowering Seniors Enrollment Decision Act of 2018 H.R. 6305 - Bipartisan HSA Improvement Act of 2018 H.R. 6312 - Personal Health Investment Today (PHIT) Act H.R. 6309 - To amend the Internal Revenue Code of 1986 to allow individuals entitled to Medicare Part A by reason of being over age 65 to contribute to health savings accounts H.R. 4616 - To amend the Patient Protection and Affordable Care Act to provide for a temporary moratorium on the employer mandate and to provide for a delay in the implementation of the excise tax on high cost employer-sponsored health coverage H.R. 6311 - To amend the Internal Revenue Code of 1986 and the Patient Protection and Affordable Care Act to modify the definition of qualified health plan for purposes of the health insurance premium tax credit and to allow individuals purchasing health insurance in the individual market to purchase a lower premium copper plan

Client expense: $330,000 · Firm income: Not reported

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

No bill, lobbied to raise awareness about Atrial Fibrillation and stroke prevention. No bill, lobbied regarding biosimilars issues including naming, labeling and interchangeability. H.R. 1245 and S. 469, Affordable and Safe Prescription Drug Importation Act, lobbied regarding all biopharmaceutical provisions. H.R. 1703, Medical Product Communications Act of 2017, regarding all biopharmaceutical related provisions H.R. 2851, Stop the Importation and Trafficking of Synthetic Analogues Act of 2017, regarding all biopharmaceutical related provisions No bill, lobbied for changes to the 340B Drug Discount Program. H.R. 4710, 340B PAUSE Act, lobbied regarding all biopharmaceutical provisions. H.R. 4392, a bill to repeal the HOPPS final regulation related to changes in the payment amount for certain drugs under the 340B program, lobbied regarding all biopharmaceutical provisions. H.R. 2026, the Pharmaceutical Information Exchange (PIE) Act of 2017, lobbied regarding all biopharmaceutical provisions. S. 2312, Helping Ensure Low-Income Patients have Access to Care and Treatment (HELP) Act, regarding all biopharmaceutical related provisions. S.2453, Ensuring the Value of the 340B Program Act of 2018, regarding all biopharmaceutical related provisions. H.R. 5598 340B Optimization Act, regarding all biopharmaceutical related provisions. H.R. 6071 SERV Communities Act, regarding all biopharmaceutical related provisions. H.R. 6240, Drug Discount Accountability Act, regarding all biopharmaceutical related provisions. H.R. 6143, S. 2554, Patient Right to Know Drug Prices Act, regarding all biopharmaceutical related provisions. H.R. 6, SUPPORT for Patients and Communities Act, regarding all biopharmaceutical related provisions.

Client expense: $940,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE, U.S. Trade Representative (USTR)

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

340B drug discount program; Serv Communities Act (HR 6071); pending Telemedicine legislation; Access to Telehealth Services (HR 5603); Opioids legislation sections 2001, 1009, 3232 regarding telemedicine.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

FY19 Labor-HHS appropriations bill funding for Children's Hospital Graduate Medical Education (CHGME); 340B drug discount program; ACE Kids Act of 2017 (S.428/HR 3325/HR 7217); Serv Communities Act (HR6071)

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

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 Medicare Hospital Inpatient Prospective Payment System (IPPS) Proposed Rule comments/CAR-T therapy reimbursement

Client expense: $70,000 · 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. 5598, 340B Optimization Act. H.R. 6071, SERV Communities Act.

Client expense: Not reported · Firm income: Not reported

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. 5598, 340B Optimization Act. H.R. 6071, SERV Communities Act.

Client expense: Not reported · Firm income: Not reported

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 Issue: Educate Congress and 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. 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. Issue: Amend Controlled Substances Act to improve MAT waiver process for qualified health professionals. H.R. 5261, Treatment, Education, and Community Help to Combat Addiction Act of 2018 Issue: Provide grants to regional Centers of Excellence in substance use disorder education. 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. 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 H.R. 6, SUPPORT for Patients and Communities Act Issue: 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: 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.

Client expense: $857,000 · 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), 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

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 - regarding cuts to 340B program (entire bill) H.R.4710 - 340B PAUSE Act -- To amend the Public Health Service Act to establish a moratorium on the registration of certain new 340B hospitals and associated sites, and for other purposes (entire bill) S.2453 - To require hospitals to provide the Secretary with information on the hospital's acquisition costs for 340B drugs and the total revenues received by the hospital for such drugs (entire bill) S. 2312 - The HELP Act, to provide a moratorium on registration of new non-rural section 340B hospitals and associated sites, and for other purposes (entire bill) H.R. 5598 - 340B Optimization Act (entire bill) H.R. 6071 - Stretching Entity Resources for Vulnerable Communities Act (entire bill) H.R.6273 - To amend the Public Health Service Act to ensure appropriate care by certain 340B covered entities for victims of sexual assault, and for other purposes (entire bill) H.R.6240 - Drug Discount Accountability Act (entire bill) H.R. 6506 - Medicare Negotiation and Competitive Licensing Act of 2018 (entire bill)

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

Government targets: HOUSE OF REPRESENTATIVES, Natl Institute of Standards & Technology (NIST), Patent & Trademark Office (PTO), SENATE