Primary Care Enhancement Act of 2018

Health Savings Act of 2017 - S. 403/H.R. 1175 Chronic Disease Management Act - S. 2410/H.R. 4978 Bipartisan HSA Improvement Act of 2018 - H.R. 5138/H.R. 6305 H.R. 6301, to provide high deductible health plans with first dollar coverage flexibility H.R. 6317, to provide that direct primary care service arrangements do not disqualify deductible health savings account contributions H.R. 6309, to allow individuals entitled to Medicare Part A by reason of being over age 65 to contribute to health savings accounts H.R. 6306, to increase the contribution limitation for health savings accounts, and for other purposes H.R. 6199, Restoring Access to Medication and Modernizing Health Savings Accounts Act H.R. 6311, Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act

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

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Natl Economic Council (NEC), SENATE, Treasury, Dept of

Health Savings Act of 2017 - S. 403/H.R. 1175 Chronic Disease Management Act - S. 2410/H.R. 4978 Bipartisan HSA Improvement Act of 2018 - H.R. 5138/H.R. 6305 H.R. 6301, to provide high deductible health plans with first dollar coverage flexibility H.R. 6317, to provide that direct primary care service arrangements do not disqualify deductible health savings account contributions H.R. 6309, to allow individuals entitled to Medicare Part A by reason of being over age 65 to contribute to health savings accounts H.R. 6306, to increase the contribution limitation for health savings accounts, and for other purposes H.R. 6199, Restoring Access to Medication and Modernizing Health Savings Accounts Act H.R. 6311, Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act

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

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Natl Economic Council (NEC), SENATE, Treasury, Dept of

S. 3014 Rural Physician Workforce Production Act of 2018: Seek co-sponsors to amend title XVIII of the Social Security Act to support rural residency training funding. HR 2 - Farm Bill: Advocating for SNAP funding, nutrition assistance, and other relevant priorities. HR 6 - Support for patients and communities Act: Supported HR 6, the comprehensive opioids bill. HR 1318/ S. 1112: Preventing Maternal Deaths Act: Seek co-sponsors on legislation to amend title XVII of the Social Security Act to support rural residency training funding. HR 2553: Know the Lowest Price Act: Supported legislation to prohibit pharmacy contact gag rules. HR 5858 - Primary Care Patient Protection Act: Seek co-sponsors for legislation to require coverage without a deductible of certain primary care services by high deductible health plans. H.R. 6310; H.R. 6317 - Direct Primary Care: Supported testimony to the promoting legislation to allow Americans with HSAs to use their accounts to pay for DPC arrangements. No Bill No.- Congressional Primary Care Caucus: Urge members to join the Primary Care Caucus to achieve the triple aim in healthcare; Increase membership in the bipartisan caucus to increase awareness of primary care value. No Bill No. - Administrative simplification: Promote reduced administrative burden on family physicians of prior authorization, EMR. No Bill No.- National Health Service Corps: Medical Student Debt Relief and Rural and Underserved area access to Family Physicians. No Bill No. - Patient Centered Outcomes Research Institute: Patient Centered, primary care research, AHRQ funding. No Bill No. - Social Determinants of Health: Advancing Health Equity by addressing SDOH. No Bill No. - Advisory Committee on Training in Primary Care Medicine and Dentistry: Health professions training grants for family medicine. No Bill No. - Rural Health: Eliminate disparities to access to quality care for rural populations. No Bill No. - AHRQ National Guidelines Clearinghouse: Closure of the NGC. No Bill No. - CPC+ reports: Timing, usefulness of reports. No Bill No. - MSSP/ACO proposed rule: Changes to accountable care organizations. No Bill No. - RFI on the EHR reporting period: Usefulness of EHR. No Bill No. - Medicare fraud and abuse:CMS fraud and abuse programs. No Bill No. - Physician focused payment model process: How the PTAC process is working. No Bill No. - Social risk factors in Medicare Programs: How SoDH should be reported. No Bill No. - Drug pricing transparency: Support for drug transparency. No Bill No. - State waivers granted through HHS: How state waivers should support primary care. No Bill No. - Medicare Part C/D changes: Telehealth benefits. No Bill No. - Medicare 2019 payments: E/M payment changes in 2019 and beyond. No Bill No. - Administrative Burden: Shared the AAFP's principles. No Bill No. - Teaching Health Center Graduate Medical Education Program Reauthorization: Meeting with staff to discuss THCGME reauthorization. No Bill No. - Advanced Primary Care Alternative Payment Model: seek co-signors on letter to HHS on APC-APM model. No Bill No. - Administrative Burden: Advocate for end to E/M documentation guidelines, AUC, etc. in WM Red Tape Initiative.

HR 5858 - Primary Care Patient Protection Act: Seek co-sponsors for legislation to require coverage without a deductible of certain primary care services by high deductible health plans. H.R. 6310; H.R. 6317 - Direct Primary Care: Advocate for co-sponsorship of bill to allow Americans with HSAs to use their accounts to pay for DPC arrangements. No Bill No. - MSSP/ACO proposed rule: Changes to accountable care organizations.

Client expense: $1,334,107 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE

Affordable Care Act, all provisions; HR1101 - Small Business Health Fairness Act, all provisions; HR173/S58 - Middle Class Health Benefits Tax Repeal Act, all provisions; H.R. 246 Jobs and Premium Protection Act; S.1859 - Healthcare Tax Relief Act; S.1978 - Small Business and Family Health Tax Relief Act; HR 4616 - Cadillac Tax; Employer Mandate Delay; H.R.4620 - Protecting Families and Small Businesses Act; HR4200/S.2052 - Healthcare Market Certainty and Mandate Relief Act; S. 1996/HR 2919 Commonsense Reporting Act; Cadillac Tax; ERISA; Opioids Legislation - mental health parity enforcement. HR 5138, Bipartisan HSA Improvement Act, all provisions. DOL rule on Association Health Plans; surprise billing. H.R.6 - Support for Patients and Communities Act, Mental health parity; ESRD HR 6301 - All Provisions HR 6317 - All Provisions HR 6305 - All Provisions, Bipartisan HSA Improvement Act HR 6312 - All Provisions, PHIT Act HR 6309 - All Provisions HR 6199 - All Provisions HR 6306 - All Provisions HR 6313 - All Provisions, Responsible Additions And Increases To Sustain Employee Health Benefits HR 6314 - All Provisions, Health Savings Act HR 6311 - All Provisions HR 3919 - All Provisions, Commonsense Reporting Act S.1908 - Commonsense Reporting Act H.R. 3798-Save American Workers Act - all provisions

Client expense: $2,540,000 · Firm income: Not reported

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

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

HR 1318 - Maternal Accountability Act/Preventing Maternal Deaths: Promoted preventing maternal mortality. HR 5961, HR 6147, HR 6470, HR 6157, S 3158, S 2976 - Oppose tobacco riders in Ag bill & cut to CDC's Office on Smoking and Health: Public Health/Tobacco control. HR 6157 - Increased funding for HHS, AHRQ, HRSA, CMS, CDC, SAMSHA in FY 19: AAFP FY 2019 federal spending priorities for primary care training, research & access. H.R. 6310; H.R. 6317 - Direct Primary Care: Advocate for co-sponsorship of bill to allow Americans with HSAs to use their accounts to pay for DPC arrangements. S. 3014 - Rural Physician Workforce Production Act of 2018: Graduate Medical Education reform, rural physician workforce; Seek House sponsors; GME Reform to support rural residency training; Seek co-sponsors on legislation to amend title XVII of the Social Security Act to support rural residency training funding. HR 5858 - Primary Care Patient Protection Act: Seek co-sponsors for legislation to require coverage without a deductible of certain primary care services by high deductible health plans. No Bill No.- Congressional Primary Care Caucus: Urge members to join the Primary Care Caucus to achieve the triple aim in healthcare; Increase membership in the bipartisan caucus to increase awareness of primary care value. No Bill No. - Direct Primary Care: work with members and staff on language of DPC legislation that passed the House. No Bill No. - Administrative Burden: Advocate for end to E/M documentation guidelines, AUC, etc. in WM Red Tape Initiative; Advocate for AAFP's administration burden principles. No Bill No. - Administrative simplification: Promote reduced administrative burden on family physicians of prior authorization, EMR. No Bill No.- National Health Service Corps: Medical Student Debt Relief and Rural and Underserved area access to Family Physicians. No Bill No. - Advisory Committee on Training in Primary Care Medicine and Dentistry: Health professions training grants for family medicine. No Bill No. - Opioid Epidemic: Support evidence-based approaches to curb opioid abuse. No Bill No. - AHRQ National Guidelines Clearinghouse: Closure of the NGC. No Bill No. - Blueprint to Lower Drug Prices: Reducing out of pocket costs. No Bill No. - Title X regulations: interference in the practice of medicine and access to evidence-based care. No Bill No. - Asbestos new use: Any form of asbestos exposure is a threat to health. No Bill No. - Physician self referral law: Transforming practices and collaborating with others to provide team-based, patient-centered care. Physician practice and flexibility. No Bill No. - Physician fee schedule: 2019 Medicare payment rates and the quality payment program. No Bill No. - Physician focused payment model process: How the PTAC process is working. No Bill No. - 2019 outpatient prospective payment system: Site of Service Neutrality. No Bill No. - Advanced Primary Care Alternative Payment Model: Seek co-signors on letter to HHS on APC-APM payment model. No Bill No. - Farm Bill/Nutrition: Advocating against the Farm Bill's SNAP cuts, as included withing the AAFP's Farm Bill Letter.

HR 5858 - Primary Care Patient Protection Act: Seek co-sponsors for legislation to require coverage without a deductible of certain primary care services by high deductible health plans. H.R. 6310; H.R. 6317 - Direct Primary Care: Advocate for co-sponsorship of bill to allow Americans with HSAs to use their accounts to pay for DPC arrangements. No Bill No. - Direct Primary Care: work with members and staff on language of DPC legislation that passed the House. No Bill No. - Administrative simplification: Promote reduced administrative burden on family physicians of prior authorization, EMR. No Bill No. - Blueprint to Lower Drug Prices: Reducing out of pocket costs. No Bill No. - Title X regulations: interference in the practice of medicine and access to evidence-based care. No Bill No. - Physician self referral law: Transforming practices and collaborating with others to provide team-based, patient-centered care. Physician practice and flexibility.

Client expense: $865,582 · Firm income: Not reported

Insurance market policies (Bipartisan Health Care Stabilization Act; Short-term, Limited Duration Health Insurance rule; Association Health Plans rule) Risk adjustment payments Cost sharing reduction payments Insurance navigator funding 340B Drug Pricing Program (H.R. 4392; H.R. 4710, 340B PAUSE Act; S. 2453, Ensuring the Value of the 340B Program Act; H.R. 6071, Stretching Entity Resources for Vulnerable Communities Act; H.R. 2889, Closing Loopholes for Orphan Drugs Act; H.R. 5598, 340B Optimization Act; H.R. 6240, Drug Discount Accountability Act; H.R. 6273, Creating Access to Rape Kit Exams (CARE) for Survivors Act) Opioid issues (S. 2680, the Opioid Crisis Response Act of 2018; H.R. 5176, Preventing Overdoses While in Emergency Rooms (POWER) Act; H.R. 5197, Alternatives to Opioids (ALTO) in the Emergency Department Act; H.R. 5009, Jessies Law; H.R. 5818 / S. 2843, the Opioid Workforce Act; H.R. 5797, the IMD CARE Act; H.R. 6082/H.R. 5795, the Overdose Prevention and Patient Safety Act; S. 2905, Strengthening Partnerships to Prevent Opioid Abuse Act; S. 2460, Every Prescription Conveyed Securely Act; S. 2920, Commit to Opioid Medical Prescriber Accountability and Safety for Seniors Act; H.R. 5582, the Abuse Deterrent Access Act; H.R. 5685, the Medicare Opioid Safety Education Act; Helping to End Addiction and Lessen (HEAL) Substance Use Disorders Act of 2018; H.R. 6, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act; S. 2899, Caring Recovery for Infants and Babies Act; S. 2898, Medication-Assisted Treatment Improvement Act; S.2911, Enhancing Patient Access to Non-Opioid Treatment Options) IV and medication shortages Drug prices (American Patients First, Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs; S. 2554 / H.R. 6143, Patient Right to Know Drug Prices Act; S. 2553, Know the Lowest Price Act; H.R. 6733, Know the Cost Act) Draft Protecting Patients from Surprise Medical Bills Act HIPAA policy in mental and behavioral health information sharing 21st Century Cures Act implementation Pandemic and All Hazards Preparedness Reauthorization, including Hospital Preparedness Program (S. 2852, the Pandemic and All-Hazards Preparedness and Advancing Innovation Act (PAHPAI) of 2018) S.781/ HR 1876. Good Samaritan Health Professional Act of 2017 Health workforce reauthorizations (H.R. 959, the Title VIII Nursing Workforce Reauthorization Act; H.R. 3728, the Educating Medical Professionals and Optimizing Workforce Efficiency Readiness (EMPOWER) Act; H.R. 1676, the Palliative Care and Hospice Education and Training Act Consumer Directed Health Plans Legislation (H.R. 6311 would modify the definition of a qualified health plan and allow individuals purchasing health insurance in the individual market to purchase a "copper" plan or use the premium tax credit to buy off-marketplace coverage; H.R. 6301 to allow CDHPs to provide coverage for services like telehealth, chronic disease management, or primary care visits below the minimum deductible; H.R. 6317 to allow coverage of direct primary care service arrangements; H.R. 6305 to permit use of CDHPs to receive certain employment-related health services like onsite clinics; H.R. 6309 to allow individuals only enrolled in Medicare Part A to contribute to health savings accounts; H.R. 6199 to include certain over-the-counter medical products as qualified medical expenses; H.R. 6306 to increase the current contribution limits for HSAs; H.R. 6312, Personal Health Investment Today (PHIT) Act to count sports equipment and exercise costs toward medical expenses; H.R. 6313 to allow carry-forward of flexible spending account balances each year; H.R. 6314 to allow bronze and catastrophic plans in connection with health savings accounts, allowing plans categorized as catastrophic and bronze in the individual and small group markets to qualify for HSA contributions) H.R. 4616 to delay the implementation of the excise tax on high cost employer-sponsored health coverage; and place a moratorium on the employer mandate Liver allocation policy

S. 28, Health Savings Account Expansion Act (Flake) - HSA improvements S. 85, Restoring Access to Medications Act (Roberts) - paying for OTC products with HSA funds S. 403, Health Savings Act (Hatch) - HSA and FSA improvements S. 761, Health Care Options Act (Alexander) - using premiums for off-Exchange plans S. 1859, Healthcare Tax Relief Act (Gardner) - suspension of ACA health insurance tax S. 1978, Small Business and Family Health Tax Relief Act (Heitkamp) - suspension of ACA health insurance tax S. 2410, Chronic Disease Management Act (Thune) - flexibility for high-deductible health plans S. 3063, Health Insurance Tax Relief Act (Barrasso) - suspension of ACA health insurance tax H.R. 246, Jobs and Premium Protection Act (Noem-Sinema) - repeal of ACA health insurance tax H.R. 247, Health Savings Account Expansion Act (Brat) - HSA improvements H.R. 394, Restoring Access to Medications Act (Jenkins) - paying for OTC products with HSA funds H.R. 1175, Health Savings Act (Paulsen) - HSA and FSA improvements H.R. 3798, Save American Workers Act (Walorski) - delay in Cadillac tax H.R. 4616 (Nunes) - delay in ACA excise tax on employer-provided health coverage H.R. 4618 (Jenkins) - use of HSA funds for OTC medications H.R. 4620, Protecting Families and Small Businesses Act (Noem) - relief from ACA health insurance tax H.R. 4894, Harmful Tax Prevention Act (Noem) - relief from ACA health insurance tax H.R. 4978, Chronic Disease Management Act (Black) - flexibility for high-deductible health plans H.R. 5138, Bipartisan HSA Improvement Act (Kelly) - HSA changes H.R. 5963, Health Insurance Premium Reduction Act (Noem) - suspension of ACA health insurance tax H.R. 6199, Restoring Access to Medication Act (Jenkins) - OTC medical products as qualified medical expense, HSA improvements H.R. 6301, Promoting High-Value Health Care Through Flexibility for High Deductible Health Plans Act (Roskam) - flexibility on first dollar coverage for HSA plans H.R. 6305, Bipartisan HSA Improvement Act (Kelly) - HSA flexibility; treatment of certain employment-related services; FSA and HRA conversions H.R. 6306, Health Care Security Act (Paulsen) - HSA contribution limits, spousal catch-up contributions, grace period for medical expenses H.R. 6309, Allowing Working Seniors to Keep Their Health Savings Accounts Act (Paulsen) - HSA contributions by Medicare-eligible individuals H.R. 6311, Increasing Access to Lower Premium Plans and Expanding HSAs Act (Roskam) - suspension of health insurance tax, HSA improvements H.R. 6312, Personal Health Investment Today Act (Smith) - medical care tax deduction for qualified sports and fitness expenses H.R. 6313, RAISE Health Benefits Act (Stivers) - Health FSA rollovers H.R. 6314, Health Savings Act (Burgess) - definition of high-deductible health plan H.R. 6317, Primary Care Enhancement Act (Paulsen) - participation by HSA-eligible individuals in direct primary care (DPC) arrangements Regulatory Issues: Annual insurer provider fees; issues concerning the patient-centered outcomes research fee; employer and individual coverage mandate; W-2 reporting requirements; health reimbursement accounts; deductibility limits for insurer compensation; health insurer and employer reporting of health coverage; issues related to implementation of health insurance tax; issues related to the refundable credit for coverage under a qualified health plan; issues related to coverage of chronic conditions in high deductible health plans; issues related to health savings accounts; issues related to the deductibility of employer-sponsored health coverage; issues related to enhancing tax treatment of long-term care insurance; issues related to qualified small employer health reimbursement accounts (QSEHRAs); issues related to implementation of the excise tax on high cost employer-sponsored health coverage; and other issues relating to health care reform implementation.

Legislation related to the taxation of employer-provided health benefits: Health Savings Act of 2017 - S. 403/H.R. 1175 Chronic Disease Management Act - S. 2410/H.R. 4978 Bipartisan HSA Improvement Act of 2018 - H.R. 5138/H.R. 6305 H.R. 6301, to provide high deductible health plans with first dollar coverage flexibility H.R. 6317, to provide that direct primary care service arrangements do not disqualify deductible health savings account contributions H.R. 6309, to allow individuals entitled to Medicare Part A by reason of being over age 65 to contribute to health savings accounts H.R. 6306, to increase the contribution limitation for health savings accounts, and for other purposes H.R. 6199, Restoring Access to Medication and Modernizing Health Savings Accounts Act H.R. 6311, Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act

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

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Natl Economic Council (NEC), SENATE, Treasury, Dept of

Legislation related to the taxation of employer-provided health benefits: Health Savings Act of 2017 - S. 403/H.R. 1175 Chronic Disease Management Act - S. 2410/H.R. 4978 Bipartisan HSA Improvement Act of 2018 - H.R. 5138/H.R. 6305 H.R. 6301, to provide high deductible health plans with first dollar coverage flexibility H.R. 6317, to provide that direct primary care service arrangements do not disqualify deductible health savings account contributions H.R. 6309, to allow individuals entitled to Medicare Part A by reason of being over age 65 to contribute to health savings accounts H.R. 6306, to increase the contribution limitation for health savings accounts, and for other purposes H.R. 6199, Restoring Access to Medication and Modernizing Health Savings Accounts Act H.R. 6311, Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act

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

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Natl Economic Council (NEC), SENATE, Treasury, Dept of

Legislative and regulatory issues including: Health care reform Implementation of the Affordable Care Act -- PL 111-148 Bipartisan Budget Act of 2018 -- H.R. 1892/PL 115-123 Middle Class Health Benefits Tax Repeal Act of 2017 - S. 58/H.R. 173 Save American Workers Act -- H.R. 3798 Restoring Access to Medication and Modernizing Health Savings Accounts Act (H.R. 6199) Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act (H.R. 6311) Health Savings Act of 2017 - S. 403/H.R. 1175 Chronic Disease Management Act - S. 2410/H.R. 4978 Bipartisan HSA Improvement Act of 2018 - H.R. 5138/H.R. 6305 Mental Health Parity H.R. 6301, to provide high deductible health plans with first dollar coverage flexibility H.R. 6317, to provide that direct primary care service arrangements do not disqualify deductible health savings account contributions H.R. 6309, to allow individuals entitled to Medicare Part A by reason of being over age 65 to contribute to health savings accounts H.R. 6306, to increase the contribution limitation for health savings accounts, and for other purposes H.R. 4616, 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. 6, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act S. 2554, the Patient Right to Know Drug Prices Act S. 2553, the Know the Lowest Price Act HHS Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs, RIN 0991-ZA49

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

Legislative and regulatory issues including: Health care reform Implementation of the Affordable Care Act -- PL 111-148 Bipartisan Budget Act of 2018 -- H.R. 1892/PL 115-123 Middle Class Health Benefits Tax Repeal Act of 2017 - S. 58/H.R. 173 Save American Workers Act -- H.R. 3798 Restoring Access to Medication and Modernizing Health Savings Accounts Act (H.R. 6199) Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act (H.R. 6311) Health Savings Act of 2017 - S. 403/H.R. 1175 Chronic Disease Management Act - S. 2410/H.R. 4978 Bipartisan HSA Improvement Act of 2018 - H.R. 5138/H.R. 6305 Mental Health Parity H.R. 6301, to provide high deductible health plans with first dollar coverage flexibility H.R. 6317, to provide that direct primary care service arrangements do not disqualify deductible health savings account contributions H.R. 6309, to allow individuals entitled to Medicare Part A by reason of being over age 65 to contribute to health savings accounts H.R. 6306, to increase the contribution limitation for health savings accounts, and for other purposes H.R. 4616, 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. 6, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act S. 2554, the Patient Right to Know Drug Prices Act S. 2553, the Know the Lowest Price Act HHS Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs, RIN 0991-ZA49

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

H.R. 1267, Personal Health Investment Today (PHIT) Act, all provisions H.R. 4240, Public Safety and Second Amendment Rights Protection Act of 2017, all provisions H.R. 6142, Reducing Drug Waste Act of 2018, all provisions H.R. 6301, Promoting High-Value Health Care Through Flexibility for High Deductible Health Plans Act of 2018, all provisions H.R. 6199, Restoring Access to Medication and Modernizing Health Savings Accounts Act of 2018, all provisions H.R. 6305, Bipartisan HSA Improvement Act of 2018, all provisions H.R. 6306, Health Care Security Act of 2018, all provisions H.R. 6313, Responsible Additions and Increases to Sustain Employee Health Benefits Act of 2018, all provisions H.R. 6314, Health Savings Act of 2018, all provisions H.R. 6317, Primary Care Enhancement Act of 2018, all provisions H.R. 6082, Overdose Prevention and Patient Safety Act, all provisions H.R. 6, Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act, all provisions S. 2680, Opioid Crisis Response Act of 2018, all provisions S. 3120, Helping to End Addiction and Lessen (HEAL) Substance Use Disorders Act of 2018, provisions relating to human services H.R. 6733, Know the Cost Act of 2018, all provisions S. 2554, Patient Right to Know Drug Prices Act, all provisions S. 2020, Cyber Shield Act of 2017, all provisions H.R. 394, Restoring Access to Medication Act of 2017, all provisions S. 85, Restoring Access to Medication Act of 2017, all provisions H.R. 1375, Prescriber Support Act of 2017, all provisions S. 1016, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2017, provisions relating to telehealth S. 2456, CARA 2.0 Act of 2018, all provisions H.R. 4825, Marijuana Effective Drug Studies (MEDS) Act of 2018, all provisions S. 1112, Maternal Health Accountability Act of 2017, all provisions Diagnostic Accuracy and Innovation Prescription Drug Pricing Affordable Care Act (ACA) risk-adjustment program 42 CFR Part 2/Substance abuse confidentiality regulations Software as a Medical Device (SaMD) SaMD Transparency Certificate-of-Need Reform Physician-Owned Hospitals Augmented Intelligence (AI) Cybersecurity ACA Navigator program funding cuts Electronic Health Records (EHR) EHR Vendor Reporting Program EHR Interoperability In-Office Compounding Opioids Consent2Share demonstration Prescription drug costs and pricing Substance use disorder Medical price transparency Administrative burdens and simplification Telehealth Laboratory developed tests (LDTs) Health Savings Accounts - Prescription requirement for over-the-counter medications Electronic prescribing of controlled substances Prescription Drug Monitoring Program (PDMP) Federal prescription limits Sunshine Act Regulation - Journal reprints and textbooks Direct-to-consumer (DTC) advertising - prescription drug price disclosure Biosimilar Regulations Generic Drug Regulations Pharmacy Benefit Managers (PBMs) Surprise billing

Affordable Care Act, all provisions; HR1101 - Small Business Health Fairness Act, all provisions; HR173/S58 - Middle Class Health Benefits Tax Repeal Act, all provisions; H.R. 246 Jobs and Premium Protection Act; S.1859 - Healthcare Tax Relief Act; S.1978 - Small Business and Family Health Tax Relief Act; HR 4616 - Cadillac Tax; Employer Mandate Delay; H.R.4620 - Protecting Families and Small Businesses Act; HR4200/S.2052 - Healthcare Market Certainty and Mandate Relief Act; S. 1996/HR 2919 Commonsense Reporting Act; Cadillac Tax; ERISA; Opioids Legislation - mental health parity enforcement. HR 5138, Bipartisan HSA Improvement Act, all provisions. DOL rule on Association Health Plans; H.R.6 - Support for Patients and Communities Act, Mental health parity; ESRD HR 6301 - All Provisions HR 6317 - All Provisions HR 6305 - All Provisions, Bipartisan HSA Improvement Act HR 6312 - All Provisions, PHIT Act HR 6309 - All Provisions HR 6199 - All Provisions HR 6306 - All Provisions HR 6313 - All Provisions, Responsible Additions And Increases To Sustain Employee Health Benefits HR 6314 - All Provisions, Health Savings Act HR 6311 - All Provisions HR 3919 - All Provisions, Commonsense Reporting Act S.1908 - Commonsense Reporting Act H.R. 3798-Save American Workers Act - all provisions

Client expense: $1,892,000 · Firm income: Not reported

S.445/H.R.1825 - Home Health Care Planning Improvement Act of 2017 H.R.1617/S.3067 - Promoting Access to Diabetic Shoes Act S.1109/H.R.959 - Title VIII Nursing Workforce Reauthorization Act of 2017 H.R.1160 - ACO Assignment Improvement Act of 2017 H.R. 1155 - To amend title XVIII of the Social Security Act to allow physician assistants, nurse practitioners, and clinical nurse specialists to supervise cardiac, intensive cardiac, and pulmonary rehabilitation programs. S.1361 - Improving Access to Cardiac and Pulmonary Rehabilitation Act of 2017 S.783/H.R.315 - Improving Access to Maternity Care Act H.R.3692 - Addiction Treatment Access Improvement Act of 2017 S. 2317 - Addiction Treatment Access Improvement Act of 2018 S.2004 / H.R. 4501- Combating the Opioid Epidemic Act S. 2456/H.R. 5311 - CARA 2.0 Act of 2018 S.2524/H.R. 5102 - Substance Use Disorder Workforce Loan Repayment Act of 2018 H.R. 3922 - CHAMPIONING HEALTHY KIDS Act S. 1827: KIDS Act of 2017 Alexander-Murray Bipartisan Health Care Stabilization Act of 2017 S.1835 - Lower Premiums Through Reinsurance Act of 2017 H.R. 1478 - Gun Violence Research Act Graham-Cassidy-Heller-Johnson Amendment in the nature of a substitute to H.R. 1628 - American Health Care Act of 2017 H.R. 1628 - American Health Care Act of 2017 Better Care Reconciliation Act Discussion Draft S. 222 - Obamacare Replacement Act H.R. 372 - Competitive Health Insurance Reform Act of 2017 S. 934 - FDA Reauthorization Act of 2017 S. 870 - Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017 H.R. 449 - The Synthetic Drug Awareness Act of 2017 S. 191 - Patient Freedom Act of 2017 S. 403 - Health Savings Act of 2017 H.R. 1136 - FDA Deeming Authority Clarification Act of 2017 S.2680 - Opioid Crisis Response Act of 2018 S. 2891 - Fighting the Opioid Epidemic with Sunshine Act of 2018 H.R. 6 - SUPPORT for Patients and Communities Act H.R. 5605 - Advancing High Quality Treatment for Opioid Use Disorders in Medicare Act H.R. 3331/S.1732 - To amend title XI of the Social Security Act to promote testing of incentive payments for behavioral health providers for adoption and use of certified electronic health record technology H.R. 5002/S.2406 - Advancing Cutting-Edge (ACE) Research Act H.R. 5796 - Responsible Education Achieves Care and Healthy Outcomes for Users Treatment Act H.R. 5798 - Opioid Screening and Chronic Pain Management Alternatives for Seniors Act S.3120 - Helping to End Addiction and Lessen (HEAL) Substance Use Disorders Act of 2018 H.Res 1099 - Providing for the concurrence by the House in the Senate amendment to H.R. 6, with an amendment H.R. 6310/H.R. 6317 - Primary Care Enhancement Act of 2018 H.R. 6199 - Restoring Access to Medication and Modernizing Health Savings Accounts Act of 2018 Medical Record Documentation Medicare Extenders Home Infusion Therapy Medication-Assisted Therapies (MATs) Opioid Abuse Epidemic Medicare Carrier Advisory Committees Reducing Regulatory Burdens

* 445/ H.R.1825 - Home Health Care Planning Improvement Act of 2017 H.R.1617/S.3067 - Promoting Access to Diabetic Shoes Act S.1109/H.R.959 - Title VIII Nursing Workforce Reauthorization Act of 2017 H.R.1160 - ACO Assignment Improvement Act of 2017 H.R. 1155 - To amend title XVIII of the Social Security Act to allow physician assistants, nurse practitioners, and clinical nurse specialists to supervise cardiac, intensive cardiac, and pulmonary rehabilitation programs. S.1361 - Improving Access to Cardiac and Pulmonary Rehabilitation Act of 2017 S.783/H.R. 315 - Improving Access to Maternity Care Act S. 2317 - Addiction Treatment Access Improvement Act of 2018 S.2004 / H.R. 4501- Combating the Opioid Epidemic Act S. 2456/H.R. 5311 - CARA 2.0 Act of 2018 H.R. 3922 - CHAMPIONING HEALTHY KIDS Act S. 1827: KIDS Act of 2017 S.1835 - Lower Premiums Through Reinsurance Act of 2017 H.R. 1478 - Gun Violence Research Act Medicare Extenders Home Infusion Therapy Medication-Assisted Therapies (MATs) Opioid Abuse Epidemic S.2680 - Opioid Crisis Response Act of 2018 S. 2891 - Fighting the Opioid Epidemic with Sunshine Act of 2018 S.2524/H.R. 5102 - Substance Use Disorder Workforce Loan Repayment Act of 2018 H.R.3692 - Addiction Treatment Access Improvement Act of 2017 H.R. 6 - SUPPORT for Patients and Communities Act H.Res.1099 - Providing for the concurrence by the House in the Senate amendment to H.R. 6, with an amendment H.R. 5605 - Advancing High Quality Treatment for Opioid Use Disorders in Medicare Act H.R. 3331 - To amend title XI of the Social Security Act to promote testing of incentive payments for behavioral health providers for adoption and use of certified electronic health record technology H.R. 449 - Synthetic Drug Awareness Act of 2017 H.R. 5002/S.2406 - Advancing Cutting-Edge (ACE) Research Act H.R. 5796 - Responsible Education Achieves Care and Healthy Outcomes for Users Treatment Act H.R. 5798 - Opioid Screening and Chronic Pain Management Alternatives for Seniors Act S.3120 - Helping to End Addiction and Lessen (HEAL) Substance Use Disorders Act of 2018 Medicare Carrier Advisory Committees Reducing Regulatory Burdens H.R.6310 - Primary Care Enhancement Act of 2018 H.R.6317 - Primary Care Enhancement Act of 2018 H.R.6199 - Restoring Access to Medication and Modernizing Health Savings Accounts Act of 2018

Affordable Care Act, all provisions; HR1628 - all provisions; HR1101 - Small Business Health Fairness Act, all provisions; HR173/S58 - Middle Class Health Benefits Tax Repeal Act, all provisions; H.R. 246 Jobs and Premium Protection Act; S.1859 - Healthcare Tax Relief Act; S.1978 - Small Business and Family Health Tax Relief Act; S.1818 - Small Business Health Plans Act; HR 4616 - Cadillac Tax; Employer Mandate Delay; H.R.4620 - Protecting Families and Small Businesses Act; HR4200/S.2052 - H.R. 4200: Healthcare Market Certainty and Mandate Relief Act; S. 1996/HR 2919 Commonsense Reporting Act; Cadillac Tax; ERISA; Alexander - Murray - Individual Market Stabilization; Opioids Legislation - mental health parity enforcement. HR 5138, Bipartisan HSA Improvement Act, all provisions. DOL proposed rule on Association Health Plans; H.R.6 - Support for Patients and Communities Act, Mental health parity HR 6301 - All Provisions HR 6317 - All Provisions HR 6305 - All Provisions, Bipartisan HSA Improvement Act HR 6312 - All Provisions, PHIT Act HR 6309 - All Provisions HR 6199 - All Provisions HR 6306 - All Provisions HR 6313 - All Provisions, Responsible Additions And Increases To Sustain Employee Health Benefits HR 6314 - All Provisions, Health Savings Act HR 6311 - All Provisions HR 3919 - All Provisions, Commonsense Reporting Act S.1908 - Commonsense Reporting Act

Client expense: $1,467,000 · Firm income: Not reported

Affordable Care Act, all provisions; HR1628 - all provisions; HR1101 - Small Business Health Fairness Act, all provisions; HR173/S58 - Middle Class Health Benefits Tax Repeal Act, all provisions; H.R. 246 Jobs and Premium Protection Act; S.1859 - Healthcare Tax Relief Act; S.1978 - Small Business and Family Health Tax Relief Act; S.1818 - Small Business Health Plans Act; HR 4616 - Cadillac Tax; Employer Mandate Delay; H.R.4620 - Protecting Families and Small Businesses Act; HR4200/S.2052 - H.R. 4200: Healthcare Market Certainty and Mandate Relief Act; S. 1996/HR 2919 Commonsense Reporting Act; Cadillac Tax; ERISA; Alexander - Murray - Individual Market Stabilization; Opioids Legislation - mental health parity enforcement. HR 5138, Bipartisan HSA Improvement Act, all provisions. DOL proposed rule on Association Health Plans; H.R.6 - Support for Patients and Communities Act, Mental health parity HR 6301 - All Provisions HR 6317 - All Provisions HR 6305 - All Provisions, Bipartisan HSA Improvement Act HR 6312 - All Provisions, PHIT Act HR 6309 - All Provisions HR 6199 - All Provisions HR 6306 - All Provisions HR 6313 - All Provisions, Responsible Additions And Increases To Sustain Employee Health Benefits HR 6314 - All Provisions, Health Savings Act HR 6311 - All Provisions HR 3919 - All Provisions, Commonsense Reporting Act S.1908 - Commonsense Reporting Act

Client expense: $1,467,000 · Firm income: Not reported

Legislation related to the taxation of employer-provided health benefits: Middle Class Health Benefits Tax Repeal Act of 2017 - S. 58/H.R. 173 Health Savings Act of 2017 - S. 403/H.R. 1175 Chronic Disease Management Act - S. 2410/H.R. 4978 Bipartisan HSA Improvement Act of 2018 - H.R. 5138/H.R. 6305 H.R. 6301, to provide high deductible health plans with first dollar coverage flexibility H.R. 6317, to provide that direct primary care service arrangements do not disqualify deductible health savings account contributions H.R. 6309, to allow individuals entitled to Medicare Part A by reason of being over age 65 to contribute to health savings accounts H.R. 6306, to increase the contribution limitation for health savings accounts, and for other purposes

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

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Natl Economic Council (NEC), SENATE, Treasury, Dept of

Legislation related to the taxation of employer-provided health benefits: Middle Class Health Benefits Tax Repeal Act of 2017 - S. 58/H.R. 173 Health Savings Act of 2017 - S. 403/H.R. 1175 Chronic Disease Management Act - S. 2410/H.R. 4978 Bipartisan HSA Improvement Act of 2018 - H.R. 5138/H.R. 6305 H.R. 6301, to provide high deductible health plans with first dollar coverage flexibility H.R. 6317, to provide that direct primary care service arrangements do not disqualify deductible health savings account contributions H.R. 6309, to allow individuals entitled to Medicare Part A by reason of being over age 65 to contribute to health savings accounts H.R. 6306, to increase the contribution limitation for health savings accounts, and for other purposes

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

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Natl Economic Council (NEC), SENATE, Treasury, Dept of

Legislative and regulatory issues including: Health care reform Implementation of the Affordable Care Act -- PL 111-148 Bipartisan Budget Act of 2018 -- H.R. 1892/PL 115-123 Middle Class Health Benefits Tax Repeal Act of 2017 - S. 58/H.R. 173 Health Savings Act of 2017 - S. 403/H.R. 1175 Chronic Disease Management Act - S. 2410/H.R. 4978 Bipartisan HSA Improvement Act of 2018 - H.R. 5138/H.R. 6305 Mental Health Parity H.R. 6301, to provide high deductible health plans with first dollar coverage flexibility H.R. 6317, to provide that direct primary care service arrangements do not disqualify deductible health savings account contributions H.R. 6309, to allow individuals entitled to Medicare Part A by reason of being over age 65 to contribute to health savings accounts H.R. 6306, to increase the contribution limitation for health savings accounts, and for other purposes H.R. 4616, 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. 6, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act S. 2680, The Opioid Crisis Response Act of 2018 S. 3120, Helping to End Addiction and Lessen (HEAL) Substance Use Disorders Act of 2018

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

Legislative and regulatory issues including: Health care reform Implementation of the Affordable Care Act -- PL 111-148 Bipartisan Budget Act of 2018 -- H.R. 1892/PL 115-123 Middle Class Health Benefits Tax Repeal Act of 2017 - S. 58/H.R. 173 Health Savings Act of 2017 - S. 403/H.R. 1175 Chronic Disease Management Act - S. 2410/H.R. 4978 Bipartisan HSA Improvement Act of 2018 - H.R. 5138/H.R. 6305 Mental Health Parity H.R. 6301, to provide high deductible health plans with first dollar coverage flexibility H.R. 6317, to provide that direct primary care service arrangements do not disqualify deductible health savings account contributions H.R. 6309, to allow individuals entitled to Medicare Part A by reason of being over age 65 to contribute to health savings accounts H.R. 6306, to increase the contribution limitation for health savings accounts, and for other purposes H.R. 4616, 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. 6, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act S. 2680, The Opioid Crisis Response Act of 2018 S. 3120, Helping to End Addiction and Lessen (HEAL) Substance Use Disorders Act of 2018

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

S. 1112/HR 1318 - Maternal Accountability Act/Preventing Maternal Deaths: Promoted preventing maternal mortality. S. 2691 - Opioid Crisis Accountability Act - Responding to Senate inquiry on restricting the marketing and distribution of opioids. S. 2704 - Medicare Beneficiary Opioid Addiction Treatment: Responding to senate inquiry in support of Opioid treatment. S 2852, S. 2852 & House Draft: ASPR & Pandemic & All Hazards Preparedness Act reauthorization: Public Health preparedness. S. 3014 - Rural Physician Workforce Production Act: Graduate Medical Education reform, rural physician workforce; seek co-sponsors on rural GME bill; seek House sponsors; Seek Co-sponsors on legislation to amend the title XVIII of the Social Security Act to support rural residency training funding. S 3158 - HRSA funding-FY 2019 HHS Appropriations: Funding for access to primary care, health professional training grants, Title X family planning. S. 3158 - CDC funding-FY 2019 HHS Appropriations: Chronic Disease Prevention & Health Promotion, Immunization. S. 3158 - Increased overall spending FY19 HHS Appropriations: AAFP FY 2019 federal spending priorities for primary care training, research & access. S. 3158 - Rural Health programs funding-FY 2019 HHS Appropriations: Eliminate disparities of access to quality care for all populations. S. 3158 - Gun Violence Prevention CDC funding-FY 2019 HHS Appropriation:Gun violence is a public health emergency. S 3158 - AHRQ funding-FY 2019 HHS Appropriations:Primary Care Research, US Preventive Services Task Force. S. 3158 - SAMHSA funding-FY 2019 HHS Appropriations: Provide adequate resources for substance abuse treatment. S. 3158 - CMS funding-FY 2019 HHS Appropriations S 3158 & House draft: Support effective, efficient management of Medicare, Medicaid, CHIP & Marketplaces. HR 2 - Agriculture Improvement Act: Issued concerns about the SNAP cuts and health care policies. HR 5858 - Primary Care Patient Protection Act: Seek co-sponsors for legislation to require coverage without a deductible of certain primary care services by high deductible health plans. H.R. 6310; H.R. 6317 - Direct Primary Care: Advocate for co-sponsorship of bill to allow Americans with HSAs to use their accounts to pay for DPC arrangements. No Bill No. - Opioid Epidemic: Support evidence based approaches to curb opioid abuse; Commented on E&C Bills. Advocated for the ACE Research Act and CONNECTIONS Act. No Bill No. - Overcoming Gaps in the Treatment of Mental Illness Research: Improved mental health services. No Bill No. - Shoulder Injury Related to Vaccine Administration: Responding to Senate inquiry on vaccine injury prevention. No Bill No. - Paid sick leave to benefit American workers: Public Health. No Bill No. - Oppose tobacco riders in Ag bill & cut to CDCs Office on Smoking and Health: Public Health/Tobacco Control. No Bill No. - National Health Services Corps.: Sustainable funding for NHSC to provide access and debt relief. No Bill No. - Administrative Burden: Administrative simplification to stem physician burnout; Advocate for end to E/M documentation guidelines, AUC, etc. in WM Red Tape Initiative. No Bill No. - Advanced Primary Care Alternative Payment Model: New Medicare alternative payment model; Seek co-signors on letter to HHS on APC-APM payment model. No Bill No. - HHS on the HPV draft paper: How to improve HPV vaccination rates. No Bill No.- Congressional Primary Care Caucus: Urge members to join the Primary Care Caucus to achieve the triple aim in healthcare. No Bill No. - Direct Primary Care:advocate for co-sponsorship of bill to allow Americans with HSAs to use DPCs. No Bill No. - Insurance Market Stabilization: Outreach on ACA policies and possible market stabilization. No Bill No. - Drug Pricing: Provided feedback ont he CREATES Act and PACED Act. Drafted a drug pricing letter.

No Bill No. - Respond to HHS on short-term, limited duration insurance: Meaningful insurance isn't short term. HR 5858 - Primary Care Patient Protection Act: Seek co-sponsors for legislation to require coverage without a deductible of certain primary care services by high deductible health plans. H.R. 6310; H.R. 6317 - Direct Primary Care: Advocate for co-sponsorship of bill to allow Americans with HSAs to use their accounts to pay for DPC arrangements. No Bill No. - Direct Primary Care:advocate for co-sponsorship of bill to allow Americans with HSAs to use DPCs.

Client expense: $795,726 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE