Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018

General issues related to Puerto Rico hurricane recovery. H.R. 6378, H.R. 7328, H.R. 269, & S. 2852, Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018 and 2019

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

Government targets: Federal Emergency Management Agency (FEMA), General Services Administration (GSA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), SENATE

PL 109-417 - Pandemic and All-Hazards Preparedness Act (PAHPA) H. R. 8 - Bipartisan Background Checks Act of 2019 H. R. 1418 - Competitive Health Insurance Reform Act of 2019 S. 668/H.R. 1570 - Removing Barriers to Colorectal Cancer Screening Act of 2019 S. 966 - Medicare Care Coordination Improvement Act of 2019 S. 741/H. R. 1730 - Cancer Drug Parity Act of 2019 H. R. 1379 - Ensuring Lasting Smiles Act H. R. 207 - Stop the Violence Act of 2019 H. R. 1841 - Ensuring Access to General Surgery Act of 2019 (and Senate version reintroduction) H. R. 1041 - Critical Access Hospital Relief Act of 2019 H.R. 3656/S. 1350 - ACCESS Act of 2019 S. 2852/H.R. 6378 - Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018 (PAHPAI) H.R. 880/S. 1022 - Mission Zero Act H.R. 861 End Surprise Billing Act H.R. 3630 No Surprises Act H.R. 3502 Protecting People from Surprise Medical Bills Act H.R. 2550 - Prevent BLEEDing Act of 2019 H. R. 2143 - Promoting Integrity in Medicare Act of 2019 H. R. 3107 - Improving Seniors' Timely Access to Care Act of 2019 H. R. 1332 - Fair Care Act of 2019 H.R. 2464 - End the Cycle of Violence Act of 2019 S. 1895 Lower Health Care Costs Act S. 967 Reducing Costs for Out of Network Services Act S. 1266 Protecting Patients from Surprise Medical Bills Act S. 1531 Stopping the Outrageous Practice of Surprise Bills Act S. 1607 Medical Billing Fairness Act H. R. 1763/S. 348 - Resident's Physician Shortage Reduction Act S. 1350 - Good Samaritan Health Professionals Act H. R. 2689/S. 1438 - Breast Cancer Research Stamp reauthorization Bleeding Control for the Injured (Stop The Bleed campaign) Qualified clinical data registry (QCDR) Firearms Safety and Research MACRA Implementation Merit-based Incentive Payment Systems (MIPS) Alternative Payment Models (APM) Common Rule Medicare for All National Trauma Systems Legislation Drug Pricing HIT/UPI Ban Removal Patient-Centered Outcomes Research Institute (PCORI) Measuring Surgical Quality Medicare Physician Reimbursement Cancer Research and Funding Trauma Research and Funding Opioid Legislation ACS THRIVE (Transforming Health care Resources to Increase Value and Efficiency) Reauthorization of Patient-Centered Outcomes Research Institute (PCORI) 2020 CMS Proposed Fee Schedule

Client expense: $30,813 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Veterans Affairs, Dept of (VA)

PL 109-417 - Pandemic and All-Hazards Preparedness Act (PAHPA) H. R. 8 - Bipartisan Background Checks Act of 2019 H. R. 1418 - Competitive Health Insurance Reform Act of 2019 S. 668/H.R. 1570 - Removing Barriers to Colorectal Cancer Screening Act of 2019 S. 966 - Medicare Care Coordination Improvement Act of 2019 S. 741/H. R. 1730 - Cancer Drug Parity Act of 2019 H. R. 1379 - Ensuring Lasting Smiles Act H. R. 207 - Stop the Violence Act of 2019 H. R. 1841 - Ensuring Access to General Surgery Act of 2019 (and Senate version reintroduction) H. R. 1041 - Critical Access Hospital Relief Act of 2019 H.R. 3656/S. 1350 - ACCESS Act of 2019 S. 2852/H.R. 6378 - Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018 (PAHPAI) H.R. 880/S. 1022 - Mission Zero Act H.R. 861 End Surprise Billing Act H.R. 3630 No Surprises Act H.R. 3502 Protecting People from Surprise Medical Bills Act H.R. 2550 - Prevent BLEEDing Act of 2019 H. R. 2143 - Promoting Integrity in Medicare Act of 2019 H. R. 3107 - Improving Seniors' Timely Access to Care Act of 2019 H. R. 1332 - Fair Care Act of 2019 H.R. 2464 - End the Cycle of Violence Act of 2019 S. 1895 Lower Health Care Costs Act S. 967 Reducing Costs for Out of Network Services Act S. 1266 Protecting Patients from Surprise Medical Bills Act S. 1531 Stopping the Outrageous Practice of Surprise Bills Act S. 1607 Medical Billing Fairness Act H. R. 1763/S. 348 - Resident's Physician Shortage Reduction Act S. 1350 - Good Samaritan Health Professionals Act H. R. 2689/S. 1438 - Breast Cancer Research Stamp reauthorization Bleeding Control for the Injured (Stop The Bleed campaign) Qualified clinical data registry (QCDR) Firearms Safety and Research MACRA Implementation Merit-based Incentive Payment Systems (MIPS) Alternative Payment Models (APM) Common Rule Medicare for All National Trauma Systems Legislation Drug Pricing HIT/UPI Ban Removal Patient-Centered Outcomes Research Institute (PCORI) Measuring Surgical Quality Medicare Physician Reimbursement Cancer Research and Funding Trauma Research and Funding Opioid Legislation ACS THRIVE (Transforming Health care Resources to Increase Value and Efficiency) Reauthorization of Patient-Centered Outcomes Research Institute (PCORI) 2020 CMS Proposed Fee Schedule

Client expense: $30,813 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Veterans Affairs, Dept of (VA)

PL 109-417 - Pandemic and All-Hazards Preparedness Act (PAHPA) H. R. 8 - Bipartisan Background Checks Act of 2019 H. R. 1418 - Competitive Health Insurance Reform Act of 2019 S. 668/H.R. 1570 - Removing Barriers to Colorectal Cancer Screening Act of 2019 S. 966 - Medicare Care Coordination Improvement Act of 2019 S. 741/H. R. 1730 - Cancer Drug Parity Act of 2019 H. R. 1379 - Ensuring Lasting Smiles Act H. R. 207 - Stop the Violence Act of 2019 H. R. 1841 - Ensuring Access to General Surgery Act of 2019 (and Senate version reintroduction) H. R. 1041 - Critical Access Hospital Relief Act of 2019 H.R. 3656/S. 1350 - ACCESS Act of 2019 S. 2852/H.R. 6378 - Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018 (PAHPAI) H.R. 880/S. 1022 - Mission Zero Act H.R. 861 End Surprise Billing Act H.R. 3630 No Surprises Act H.R. 3502 Protecting People from Surprise Medical Bills Act H.R. 2550 - Prevent BLEEDing Act of 2019 H. R. 2143 - Promoting Integrity in Medicare Act of 2019 H. R. 3107 - Improving Seniors' Timely Access to Care Act of 2019 H. R. 1332 - Fair Care Act of 2019 H.R. 2464 - End the Cycle of Violence Act of 2019 S. 1895 Lower Health Care Costs Act S. 967 Reducing Costs for Out of Network Services Act S. 1266 Protecting Patients from Surprise Medical Bills Act S. 1531 Stopping the Outrageous Practice of Surprise Bills Act S. 1607 Medical Billing Fairness Act H. R. 1763/S. 348 - Resident's Physician Shortage Reduction Act S. 1350 - Good Samaritan Health Professionals Act H. R. 2689/S. 1438 - Breast Cancer Research Stamp reauthorization Bleeding Control for the Injured (Stop The Bleed campaign) Qualified clinical data registry (QCDR) Firearms Safety and Research MACRA Implementation Merit-based Incentive Payment Systems (MIPS) Alternative Payment Models (APM) Common Rule Medicare for All National Trauma Systems Legislation Drug Pricing HIT/UPI Ban Removal Patient-Centered Outcomes Research Institute (PCORI) Measuring Surgical Quality Medicare Physician Reimbursement Cancer Research and Funding Trauma Research and Funding Opioid Legislation ACS THRIVE (Transforming Health care Resources to Increase Value and Efficiency) Reauthorization of Patient-Centered Outcomes Research Institute (PCORI) 2020 CMS Proposed Fee Schedule

Client expense: $226,707 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Veterans Affairs, Dept of (VA)

PL 109-417 - Pandemic and All-Hazards Preparedness Act (PAHPA) H. R. 8 - Bipartisan Background Checks Act of 2019 H. R. 1418 - Competitive Health Insurance Reform Act of 2019 S. 668/H.R. 1570 - Removing Barriers to Colorectal Cancer Screening Act of 2019 S. 966 - Medicare Care Coordination Improvement Act of 2019 S. 741/H. R. 1730 - Cancer Drug Parity Act of 2019 H. R. 1379 - Ensuring Lasting Smiles Act H. R. 207 - Stop the Violence Act of 2019 H. R. 1841 - Ensuring Access to General Surgery Act of 2019 (and Senate version reintroduction) H. R. 1041 - Critical Access Hospital Relief Act of 2019 H.R. 3656/S. 1350 - ACCESS Act of 2019 S. 2852/H.R. 6378 - Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018 (PAHPAI) H.R. 880/S. 1022 - Mission Zero Act H.R. 861 End Surprise Billing Act H.R. 3630 No Surprises Act H.R. 3502 Protecting People from Surprise Medical Bills Act H.R. 2550 - Prevent BLEEDing Act of 2019 H. R. 2143 - Promoting Integrity in Medicare Act of 2019 H. R. 3107 - Improving Seniors' Timely Access to Care Act of 2019 H. R. 1332 - Fair Care Act of 2019 H.R. 2464 - End the Cycle of Violence Act of 2019 S. 1895 Lower Health Care Costs Act S. 967 Reducing Costs for Out of Network Services Act S. 1266 Protecting Patients from Surprise Medical Bills Act S. 1531 Stopping the Outrageous Practice of Surprise Bills Act S. 1607 Medical Billing Fairness Act H. R. 1763/S. 348 - Resident's Physician Shortage Reduction Act S. 1350 - Good Samaritan Health Professionals Act H. R. 2689/S. 1438 - Breast Cancer Research Stamp reauthorization Bleeding Control for the Injured (Stop The Bleed campaign) Qualified clinical data registry (QCDR) Firearms Safety and Research MACRA Implementation Merit-based Incentive Payment Systems (MIPS) Alternative Payment Models (APM) Common Rule Medicare for All National Trauma Systems Legislation Drug Pricing HIT/UPI Ban Removal Patient-Centered Outcomes Research Institute (PCORI) Measuring Surgical Quality Medicare Physician Reimbursement Cancer Research and Funding Trauma Research and Funding Opioid Legislation ACS THRIVE (Transforming Health care Resources to Increase Value and Efficiency) Reauthorization of Patient-Centered Outcomes Research Institute (PCORI) 2020 CMS Proposed Fee Schedule

Client expense: $226,707 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Veterans Affairs, Dept of (VA)

Lobbying Issues Description: Budget and appropriations for disease and injury prevention, including obesity and related diseases; pandemic influenza and emerging infectious diseases; physical activity; public health bioterrorism preparedness; food safety, environmental health; paid sick days; womens and childrens health; community-based public health interventions, and substance misuse/behavioral health issues. Specific Legislation: 1.Implementation of the Patient Protection and Affordable Care Act (Public Law 111-148) 2.Implementation of the FDA Food Safety Modernization Act (Public Law 111-353) 3.Implementation of Pandemic and All-Hazards Preparedness Reauthorization Act and Pandemic and All-Hazards Preparedness and Advancing Innovation Act (Public Law 113-5, 116-22) 4.Implementation of Healthy, Hunger-Free Kids Act of 2010 (Public Law 111-296) 5.Implementation of the Budget Control Act of 2011 (Public Law 112-25) 6.Implementation of Child Care and Development Block Grant Act of 2014 (Public Law 113-186) 7.Implementation of Every Student Succeeds Act (Public Law 114-95) 8.Implementation of the Comprehensive Addition and Recovery Act (Public Law 114-98) 9.FY 2020 Departments of Labor, Health and Human Services, and Education and Related Agencies Appropriations (H.R. 2740/Not Yet Introduced)) 10.FY 2020 Departments of Agriculture, Rural Development, Food and Drug Administration and Related Agencies Appropriations (H.R. 3164/Not yet introduced) 11.FY2020 Departments of Transportation, HUD and related agencies Appropriations (H.R. 3163/Not Yet Introduced) 12.Midnight Rules Relief Act (S.34/H.R. 21) 13.Regulations from the Executive in Need of Scrutiny Act (S. 21/H.R. 26) 14.Regulatory Accountability Act (S.951/H.R. 5/H.R. 45/H.Res.33) 15.Searching for and Cutting Regulations that are Unnecessarily Burdensome (SCRUB) Act (H.R. 998) 16.Regulatory Integrity Act (H.R. 1004) 17.OIRA Insight, Reform, and Accountability Act (S. 676/H.R. 1009) 18.A concurrent resolution setting forth the congressional budget for the United States Government for fiscal year 2017 and setting forth the appropriate budgetary levels for fiscal years 2018 through 2026 (S.Con.Res. 3) 19.American Health Care Act (H.R. 1628/H.Res. 228) 20.Ozone Standards Implementation Act (S. 263/H.R. 806) 21.Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the final rule of the Bureau of Land Management relating to "Waste Prevention, Production Subject to Royalties, and Resource Conservation" (S.J. Res. 11/H.J.Res.36) 22.Common Sense Nutrition Disclosure Act (S. 261/H.R. 772) 23.Reinvigorating Antibiotic and Diagnostic Innovation (READI) Act (H.R. 1840) 24.Preservation of Antibiotics for Medical Treatment Act (H.R. 1587) 25.Preventing Antibiotic Resistance Act (S. 629) 26.Better Care Reconciliation Act (H.R. 1628) and related amendments 27.Public Health Emergency Response Act (S. 196) 28.Recognizing the importance of vaccinations and immunizations in the United States (H.Res.327) 29.Consolidated Appropriations Act, 2017 (Public Law 115-31) 30.Treat and Reduce Obesity Act (S. 830/H.R. 1953) 31.Community Health and Medical Professionals Improve Our Nation (CHAMPION) Act (H.R. 3922) 32.Community Health Investment, Modernization, and Excellence Act of 2017 (S. 1899) 33.Tobacco Tax Equity Act (S. 1837) 34.Healthy Kids Act (S. 1821/H.R. 3921) 35.Implementation of the Drug Quality and Security Act (P.S. 113-54) 36.Continuing Appropriations Act, 2018 and Supplemental Appropriations for Disaster Relief Requirements Act, 2017 (Public Law 115-56) 37.Friendly Airports for Mothers Act (S. 1110/H.R. 2375) 38.Lead-Safe Housing for Kids Act (S. 1845) 39.Supporting Working Moms Act (S. 2122/H.R. 3255) 40.Championing Healthy Kids Act (H.R. 3922) 41.Making further continuing appropriations for fiscal year 2018, and for other purposes (Public Law 115-90) 42.An Act to amend the Homeland Security Act of 2002 to require the Secretary of Homeland Security to issue Department of Homeland Security-wide guidance and develop training programs as part of the Department of Homeland Security Blue Campaign, and for other purposes (Public Law 115-96) 43.Tax Cuts and Jobs Act (Public Law 115-97) 44.Pandemic and All-Hazards Preparedness Advancing Innovation Act (S. 2852/H.R. 6378/H.R. 7328/S. 1379/H.R. 269) 45.Vaccine Access Improvement Act (H.R. 4993) 46.Relief from New Source Performance Standards Act (H.R. 453) 47.Strategies to Address Antimicrobial Resistance (S. 2469) 48.Opioid Quota Reform Act (S. 2535) 49.Hospital Preparedness Program Reauthorization Act (H.R. 4776) 50.Blocking Regulatory Interference from Closing Kilns Act (H.R. 1917) 51.Health Equity and Accountability Act (H.R. 5942) 52.Opioid Crisis Response Act of 2018 (S. 2680) 53.Agriculture and Nutrition Act (H.R. 2) 54.Agriculture Improvement Act (S. 3042) 55.SECURE Act (H.R. 5998) 56.Trauma-Informed Care for Children and Families Act (S. 774) 57.SUPPORT for Patients and Communities Act (H.R. 6) 58.Centers for Disease Control Emergency Response Act (S. 3161) 59.LABEL Opioids Act (S. 3428) 60.Relief from New Source Performance Standards Act (S. 1857) 61.Outdoors for All Act (S. 3499) 62.The MOMMA Act (H.R. 5977) 63.Preventing Maternal Deaths Act (H.R. 1318) 64.Medicare Access to Vaccines Equity Act (note yet introduced) 65.The Support Act (H.R. 6) 66.Climate Change Health Protection and Promotion Act (S. 529) 67.FY 2020 Departments of the Interior, Environment, and Related Agencies Appropriations Act (H.R. 3052/Not Yet Introduced) 68.NURSE Act (H.R. 1597) 69.Investing for the People Act (H.R. 2021) 70.Child Care for Working Families Act (H.R. 365/S. 568) 71.FAMILY Act (H.R. 1185/S. 463) 72.Transportation Alternatives Enhancement Act (S. 1098) 73.Lower Health Care Costs Act (S. 1895) 74.LIFT America Act (H.R 2479) 75.Public Health Funding Restoration Act (H.R. 3447/S. 1944) 76.Older Americans Act reauthorization (not yet introduced) 77.Campus Prevention and Recovery Services for Students Act (H.R. 3591) 78.Healthier Students for Stronger Campuses Act (S. 1281) 79.Saving Lives Through Better Data Act (S. 1793) 80.VACCINES Act (H.R. 2862) 81.DISARM Act (S. 1712/not yet introduced) 82.Community Access, Resources, and Education for Families Act (H.R. 3117) 83.Protecting Seniors Through Immunization Act (S. 1872) 84.Tobacco-Free Youth Act (S. 1541) 85.Tobacco to 21 Act (H.R. 2411/S. 1258) 86.Investing for People Act (H.R. 2021) 87.School Based Health Centers Reauthorization Act (H.R.2075/S.1013) 88.Reversing the Youth Tobacco Epidemic Act of 2019 (H.R. 2339) House(s) of Congress and Federal Agencies lobbied during the quarter: House, Senate, Exec Office of Pres, HHS, CDC, FDA, CMS, OMB, DOT, HUD, EPA, Education, USDA, DHS, FEMA, and SAMHSA.

Client expense: $38,304 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Environmental Protection Agency (EPA), Executive Office of the President (EOP), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Office of Management & Budget (OMB), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Transportation, Dept of (DOT)

PL 109-417 - Pandemic and All-Hazards Preparedness Act (PAHPA) H. R. 8 - Bipartisan Background Checks Act of 2019 H. R. 1418 - Competitive Health Insurance Reform Act of 2019 S. 668 - Removing Barriers to Colorectal Cancer Screening Act of 2019 S. 966 - Medicare Care Coordination Improvement Act of 2019 S. 741/H. R. 1730 - Cancer Drug Parity Act of 2019 H. R. 1379 - Ensuring Lasting Smiles Act H. R. 207 - Stop the Violence Act of 2019 H. R. 1841 - Ensuring Access to General Surgery Act of 2019 (and Senate version reintroduction) H. R. 1041 - Critical Access Hospital Relief Act of 2019 S. 2852/H.R. 6378 - Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018 (PAHPAI) H.R. 880/S. 1022 - Mission Zero Act H.R. 861 End Surprise Billing Act H.R. 3630 No Surprises Act H.R. 3502 Protecting People from Surprise Medical Bills Act H.R. 2550 - Prevent BLEEDing Act of 2019 H. R. 2143 - Promoting Integrity in Medicare Act of 2019 H. R. 3107 - Improving Seniors' Timely Access to Care Act of 2019 H. R. 1332 - Fair Care Act of 2019 H.R. 2464 - End the Cycle of Violence Act of 2019 S. 1895 Lower Health Care Costs Act S. 967 Reducing Costs for Out of Network Services Act S. 1266 Protecting Patients from Surprise Medical Bills Act S. 1531 Stopping the Outrageous Practice of Surprise Bills Act S. 1607 Medical Billing Fairness Act Resident's Physician Shortage Reduction Act Good Samaritan Health Professionals Act Bleeding Control for the Injured (Stop The Bleed campaign) Qualified clinical data registry (QCDR) Firearms Safety and Research MACRA Implementation Merit-based Incentive Payment Systems (MIPS) Alternative Payment Models (APM) Common Rule Breast Cancer Research Stamp reauthorization Medicare for All Prior Authorization National Trauma Systems Legislation Drug Pricing Unique Patient Identifiers Out of Network Penalty/Payment Patient-Centered Outcomes Research Institute (PCORI) Measuring Surgical Quality Surprise/Unanticipated Billing Medicare Physician Reimbursement Cancer Research and Funding Trauma Research and Funding Opioid Legislation

Client expense: $24,009 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Veterans Affairs, Dept of (VA)

PL 109-417 - Pandemic and All-Hazards Preparedness Act (PAHPA) H. R. 8 - Bipartisan Background Checks Act of 2019 H. R. 1418 - Competitive Health Insurance Reform Act of 2019 S. 668 - Removing Barriers to Colorectal Cancer Screening Act of 2019 S. 966 - Medicare Care Coordination Improvement Act of 2019 S. 741/H. R. 1730 - Cancer Drug Parity Act of 2019 H. R. 1379 - Ensuring Lasting Smiles Act H. R. 207 - Stop the Violence Act of 2019 H. R. 1841 - Ensuring Access to General Surgery Act of 2019 (and Senate version reintroduction) H. R. 1041 - Critical Access Hospital Relief Act of 2019 S. 2852/H.R. 6378 - Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018 (PAHPAI) H.R. 880/S. 1022 - Mission Zero Act H.R. 861 End Surprise Billing Act H.R. 3630 No Surprises Act H.R. 3502 Protecting People from Surprise Medical Bills Act H.R. 2550 - Prevent BLEEDing Act of 2019 H. R. 2143 - Promoting Integrity in Medicare Act of 2019 H. R. 3107 - Improving Seniors' Timely Access to Care Act of 2019 H. R. 1332 - Fair Care Act of 2019 H.R. 2464 - End the Cycle of Violence Act of 2019 S. 1895 Lower Health Care Costs Act S. 967 Reducing Costs for Out of Network Services Act S. 1266 Protecting Patients from Surprise Medical Bills Act S. 1531 Stopping the Outrageous Practice of Surprise Bills Act S. 1607 Medical Billing Fairness Act Resident's Physician Shortage Reduction Act Good Samaritan Health Professionals Act Bleeding Control for the Injured (Stop The Bleed campaign) Qualified clinical data registry (QCDR) Firearms Safety and Research MACRA Implementation Merit-based Incentive Payment Systems (MIPS) Alternative Payment Models (APM) Common Rule Breast Cancer Research Stamp reauthorization Medicare for All Prior Authorization National Trauma Systems Legislation Drug Pricing Unique Patient Identifiers Out of Network Penalty/Payment Patient-Centered Outcomes Research Institute (PCORI) Measuring Surgical Quality Surprise/Unanticipated Billing Medicare Physician Reimbursement Cancer Research and Funding Trauma Research and Funding Opioid Legislation

Client expense: $24,009 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Veterans Affairs, Dept of (VA)

PL 109-417 - Pandemic and All-Hazards Preparedness Act (PAHPA) H. R. 8 - Bipartisan Background Checks Act of 2019 H. R. 1418 - Competitive Health Insurance Reform Act of 2019 S. 668 - Removing Barriers to Colorectal Cancer Screening Act of 2019 S. 966 - Medicare Care Coordination Improvement Act of 2019 S. 741/H. R. 1730 - Cancer Drug Parity Act of 2019 H. R. 1379 - Ensuring Lasting Smiles Act H. R. 207 - Stop the Violence Act of 2019 H. R. 1841 - Ensuring Access to General Surgery Act of 2019 (and Senate version reintroduction) H. R. 1041 - Critical Access Hospital Relief Act of 2019 S. 2852/H.R. 6378 - Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018 (PAHPAI) H.R. 880/S. 1022 - Mission Zero Act H.R. 861 End Surprise Billing Act H.R. 3630 No Surprises Act H.R. 3502 Protecting People from Surprise Medical Bills Act H.R. 2550 - Prevent BLEEDing Act of 2019 H. R. 2143 - Promoting Integrity in Medicare Act of 2019 H. R. 3107 - Improving Seniors' Timely Access to Care Act of 2019 H. R. 1332 - Fair Care Act of 2019 H.R. 2464 - End the Cycle of Violence Act of 2019 S. 1895 Lower Health Care Costs Act S. 967 Reducing Costs for Out of Network Services Act S. 1266 Protecting Patients from Surprise Medical Bills Act S. 1531 Stopping the Outrageous Practice of Surprise Bills Act S. 1607 Medical Billing Fairness Act Resident's Physician Shortage Reduction Act Good Samaritan Health Professionals Act Bleeding Control for the Injured (Stop The Bleed campaign) Qualified clinical data registry (QCDR) Firearms Safety and Research MACRA Implementation Merit-based Incentive Payment Systems (MIPS) Alternative Payment Models (APM) Common Rule Breast Cancer Research Stamp reauthorization Medicare for All Prior Authorization National Trauma Systems Legislation Drug Pricing Unique Patient Identifiers Out of Network Penalty/Payment Patient-Centered Outcomes Research Institute (PCORI) Measuring Surgical Quality Surprise/Unanticipated Billing Medicare Physician Reimbursement Cancer Research and Funding Trauma Research and Funding Opioid Legislation

Client expense: $218,921 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Veterans Affairs, Dept of (VA)

PL 109-417 - Pandemic and All-Hazards Preparedness Act (PAHPA) H. R. 8 - Bipartisan Background Checks Act of 2019 H. R. 1418 - Competitive Health Insurance Reform Act of 2019 S. 668 - Removing Barriers to Colorectal Cancer Screening Act of 2019 S. 966 - Medicare Care Coordination Improvement Act of 2019 S. 741/H. R. 1730 - Cancer Drug Parity Act of 2019 H. R. 1379 - Ensuring Lasting Smiles Act H. R. 207 - Stop the Violence Act of 2019 H. R. 1841 - Ensuring Access to General Surgery Act of 2019 (and Senate version reintroduction) H. R. 1041 - Critical Access Hospital Relief Act of 2019 S. 2852/H.R. 6378 - Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018 (PAHPAI) H.R. 880/S. 1022 - Mission Zero Act H.R. 861 End Surprise Billing Act H.R. 3630 No Surprises Act H.R. 3502 Protecting People from Surprise Medical Bills Act H.R. 2550 - Prevent BLEEDing Act of 2019 H. R. 2143 - Promoting Integrity in Medicare Act of 2019 H. R. 3107 - Improving Seniors' Timely Access to Care Act of 2019 H. R. 1332 - Fair Care Act of 2019 H.R. 2464 - End the Cycle of Violence Act of 2019 S. 1895 Lower Health Care Costs Act S. 967 Reducing Costs for Out of Network Services Act S. 1266 Protecting Patients from Surprise Medical Bills Act S. 1531 Stopping the Outrageous Practice of Surprise Bills Act S. 1607 Medical Billing Fairness Act Resident's Physician Shortage Reduction Act Good Samaritan Health Professionals Act Bleeding Control for the Injured (Stop The Bleed campaign) Qualified clinical data registry (QCDR) Firearms Safety and Research MACRA Implementation Merit-based Incentive Payment Systems (MIPS) Alternative Payment Models (APM) Common Rule Breast Cancer Research Stamp reauthorization Medicare for All Prior Authorization National Trauma Systems Legislation Drug Pricing Unique Patient Identifiers Out of Network Penalty/Payment Patient-Centered Outcomes Research Institute (PCORI) Measuring Surgical Quality Surprise/Unanticipated Billing Medicare Physician Reimbursement Cancer Research and Funding Trauma Research and Funding Opioid Legislation

Client expense: $218,921 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Veterans Affairs, Dept of (VA)

General issues related to Puerto Rico hurricane recovery. H.R. 6378, H.R. 7328, H.R. 269, & S. 2852, Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018 and 2019

Client expense: $550,000 · Firm income: Not reported

Government targets: Federal Emergency Management Agency (FEMA), General Services Administration (GSA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), SENATE

Lobbying Issues Description: Budget and appropriations for disease and injury prevention, including obesity and related diseases; pandemic influenza and emerging infectious diseases; physical activity; public health bioterrorism preparedness; food safety, environmental health; paid sick days; womens and childrens health; community-based public health interventions, and substance misuse/behavioral health issues. Specific Legislation: 1. Implementation of the Patient Protection and Affordable Care Act (Public Law 111-148) 2. Implementation of the FDA Food Safety Modernization Act (Public Law 111-353) 3. Implementation of Pandemic and All-Hazards Preparedness Reauthorization Act (Public Law 113-5) 4. Implementation of Healthy, Hunger-Free Kids Act of 2010 (Public Law 111-296) 5. Implementation of the Budget Control Act of 2011 (Public Law 112-25) 6. Implementation of the Drug Quality and Security Act of 2013 (Public Law 113-54) 7. Implementation of Animal Drug and Animal Generic Drug User Fee Act (Public Law 113-14) 8. Implementation of Child Care and Development Block Grant Act of 2014 (Public Law 113-186) 9. Implementation of Every Student Succeeds Act (Public Law 114-95) 10. Implementation of the Comprehensive Addition and Recovery Act (Public Law 114-98) 11. FY 2018 Departments of Labor, Health and Human Services, and Education and Related Agencies Appropriations (S. 1771/H.R. 3358) 12. FY 2018 Departments of Agriculture, Rural Development, Food and Drug Administration and Related Agencies Appropriations (S. 1603/H.R. 3268) 13. Consolidated Appropriations Act 2018 (Public Law 115-141) 14. Midnight Rules Relief Act (S.34/H.R. 21) 15. Regulations from the Executive in Need of Scrutiny Act (S. 21/H.R. 26) 16. Regulatory Accountability Act (S.951/H.R. 5/H.R. 45/H.Res.33) 17. Searching for and Cutting Regulations that are Unnecessarily Burdensome (SCRUB) Act (H.R. 998) 18. Regulatory Integrity Act (H.R. 1004) 19. OIRA Insight, Reform, and Accountability Act (S. 676/H.R. 1009) 20. A concurrent resolution setting forth the congressional budget for the United States Government for fiscal year 2017 and setting forth the appropriate budgetary levels for fiscal years 2018 through 2026 (S.Con.Res. 3) 21. American Health Care Act (H.R. 1628/H.Res. 228) 22. Ozone Standards Implementation Act (S. 263/H.R. 806) 23. Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the final rule of the Bureau of Land Management relating to "Waste Prevention, Production Subject to Royalties, and Resource Conservation" (S.J. Res. 11/H.J.Res.36) 24. Common Sense Nutrition Disclosure Act (S. 261/H.R. 772) 25. Reinvigorating Antibiotic and Diagnostic Innovation (READI) Act (H.R. 1840) 26. Preservation of Antibiotics for Medical Treatment Act (H.R. 1587) 27. Preventing Antibiotic Resistance Act (S. 629) 28. Better Care Reconciliation Act (H.R. 1628) and related amendments 29. Public Health Emergency Response Act (S. 196) 30. Recognizing the importance of vaccinations and immunizations in the United States (H.Res.327) 31. Consolidated Appropriations Act, 2017 (Public Law 115-31) 32. Treat and Reduce Obesity Act (S. 830/H.R. 1953) 33. Community Health and Medical Professionals Improve Our Nation (CHAMPION) Act (H.R. 3922) 34. Community Health Investment, Modernization, and Excellence Act of 2017 (S. 1899) 35. Tobacco Tax Equity Act (S. 1837) 36. Healthy Kids Act (S. 1821/H.R. 3921) 37. Implementation of the Drug Quality and Security Act (P.S. 113-54) 38. Continuing Appropriations Act, 2018 and Supplemental Appropriations for Disaster Relief Requirements Act, 2017 (Public Law 115-56) 39. Friendly Airports for Mothers Act (S. 1110/H.R. 2375) 40. Lead-Safe Housing for Kids Act (S. 1845) 41. Supporting Working Moms Act (S. 2122/H.R. 3255) 42. Championing Healthy Kids Act (H.R. 3922) 43. Making further continuing appropriations for fiscal year 2018, and for other purposes (Public Law 115-90) 44. An Act to amend the Homeland Security Act of 2002 to require the Secretary of Homeland Security to issue Department of Homeland Security-wide guidance and develop training programs as part of the Department of Homeland Security Blue Campaign, and for other purposes (Public Law 115-96) 45. Tax Cuts and Jobs Act (Public Law 115-97) 46. Pandemic and All-Hazards Preparedness Advancing Innovation Act (S. 2852/H.R. 6378/H.R. 7328) 47. Vaccine Access Improvement Act (H.R. 4993) 48. Relief from New Source Performance Standards Act (H.R. 453) 49. Strategies to Address Antimicrobial Resistance (S. 2469) 50. Opioid Quota Reform Act (S. 2535) 51. Hospital Preparedness Program Reauthorization Act (H.R. 4776) 52. Blocking Regulatory Interference from Closing Kilns Act (H.R. 1917) 53. Health Equity and Accountability Act (H.R. 5942) 54. Opioid Crisis Response Act of 2018 (S. 2680) 55. Agriculture and Nutrition Act (H.R. 2) 56. Agriculture Improvement Act (S. 3042) 57. SECURE Act (H.R. 5998) 58. FY 2019 Departments of Labor, Health and Human Services, and Education and Related Agencies Appropriations (S. 3158) 59. FY 2019 Departments of the Interior, Environment, and Related Agencies Appropriations Act (H.R. 6147/S. 3073) 60. FY 2019 Departments of Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations (H.R. 5961/ S. 2976) 61. Trauma-Informed Care for Children and Families Act (S. 774) 62. SUPPORT for Patients and Communities Act (H.R. 6) 63. Centers for Disease Control Emergency Response Act (S. 3161) 64. LABEL Opioids Act (S. 3428) 65. Relief from New Source Performance Standards Act (S. 1857) 66. Outdoors for All Act (S. 3499) 67. The MOMMA Act (H.R. 5977) 68. The WIC Act (not yet introduced) 69. Preventing Maternal Deaths Act (H.R. 1318) 70. Medicare Access to Vaccines Equity Act (note yet introduced) 71. The Support Act (H.R. 6) 72. Climate Change Health Protection and Promotion Act (S. 529) 73. FY 2020 Departments of the Interior, Environment, and Related Agencies Appropriations Act 74. NURSE Act (H.R. 1597) 75. Investing for the People Act (H.R. 2021) 76. Child Care for Working Families Act (H.R. 365/S. 568) 77. FAMILY Act (H.R. 1185/S. 463) 78. Transportation Alternatives Enhancement Act (S. 1098) House(s) of Congress and Federal Agencies lobbied during the quarter: House, Senate, Exec Office of Pres, HHS, CDC, FDA, CMS, OMB, DOT, HUD, EPA, Education, USDA, DHS, FEMA, and SAMHSA

Client expense: $33,373 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Environmental Protection Agency (EPA), Executive Office of the President (EOP), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Office of Management & Budget (OMB), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Transportation, Dept of (DOT)

Issue: Educate Congress and the administration on academic medicines missions, including education, research, patient care, GME, workforce, and physician shortages in rural and urban communities. Issue: Support the reauthorization of Health Resources and Services Administrations Title VII health professions workforce programs. S. 192, Community and Public Health Programs Extension Act S. 106, Community Health Investment, Modernization, and Excellence Act of 2019 S. 692, Community Health Center and Primary Care Workforce Expansion Act of 2019 Issue: Support the reauthorization of the National Health Service Corps, Community Health Centers, and Teaching Health Centers mandatory appropriation fund. Issue: Support initiatives of hospitals to promote affordable housing in local communities and eliminate other social determinants of health to improve health equity. Issue: Educate Congress and the administration about academic medicines response to the opioid epidemic. Support funding for training on substance use disorders, pain management, and safe prescribing practices. Issue: Support reauthorization of the Patient Centered Outcomes Research Institute (PCORI) and the Patient Centered Outcomes Research Trust Fund Issue: Oppose restrictions on fetal tissue research. Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018 (H.R. 7328/ H.R. 6378/S.2852/H.R. 4776 of the 115th congress) Issue: Support the Hospital Preparedness Program and the reauthorization of the Pandemic and All-Hazards Preparedness Act. Support increased funding authorization levels. 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. Issue: Support measures to preserve and strengthen the 340B Drug Pricing Program and oppose efforts to reduce the scope of the program, including instituting a moratorium, increasing reporting requirements on covered entities, and imposing user fees Draft, Verifying Accurate Leading-edge IVCT Development (VALID) Act of 2018 Draft, Diagnostic Accuracy and Innovation Act (DAIA) Issue: Oppose burdensome regulation of Laboratory Developed Tests Issue: Educate Congress on surprise medical bills and price transparency. Support general principles for surprise medical bills draft legislation.

Client expense: $1,081,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Bureau of Citizenship & Immigration Services (BCIS), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Education, Dept of, 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), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Veterans Affairs, Dept of (VA), White House Office

General issues related to Puerto Rico hurricane recovery. H.R. 6378, H.R. 7328, H.R. 269, & S. 2852, Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018 and 2019

Client expense: $780,000 · Firm income: Not reported

Government targets: Federal Emergency Management Agency (FEMA), General Services Administration (GSA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), SENATE

PL 109-417 - Pandemic and All-Hazards Preparedness Act (PAHPA) H. R. 8 - Bipartisan Background Checks Act of 2019 H. R. 1418 - Competitive Health Insurance Reform Act of 2019 S. 668 - Removing Barriers to Colorectal Cancer Screening Act of 2019 S. 966 - Medicare Care Coordination Improvement Act of 2019 S. 741/H. R. 1730 - Cancer Drug Parity Act of 2019 H. R. 1379 - Ensuring Lasting Smiles Act H. R. 207 - Stop the Violence Act of 2019 H. R. 1841 - Ensuring Access to General Surgery Act of 2019 (and Senate version reintroduction) H. R. 1041 - Critical Access Hospital Relief Act of 2019 S. 2852/H.R. 6378 - Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018 (PAHPAI) H.R. 880/S. 1022 - Mission Zero Act Good Samaritan Health Professionals Act Bleeding Control for the Injured (Stop The Bleed campaign) Qualified clinical data registry (QCDR) Firearms Safety and Research MACRA Implementation Merit-based Incentive Payment Systems (MIPS) Alternative Payment Models (APM) Common Rule Breast Cancer Research Stamp reauthorization Medicare for All Prior Authorization National Trauma Systems Legislation Drug Pricing Measuring Surgical Quality Surprise/Unanticipated Billing Medicare Physician Reimbursement Cancer Research and Funding Trauma Research and Funding Opioid Legislation

Client expense: $20,600 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Veterans Affairs, Dept of (VA)

PL 109-417 - Pandemic and All-Hazards Preparedness Act (PAHPA) H. R. 8 - Bipartisan Background Checks Act of 2019 H. R. 1418 - Competitive Health Insurance Reform Act of 2019 S. 668 - Removing Barriers to Colorectal Cancer Screening Act of 2019 S. 966 - Medicare Care Coordination Improvement Act of 2019 S. 741/H. R. 1730 - Cancer Drug Parity Act of 2019 H. R. 1379 - Ensuring Lasting Smiles Act H. R. 207 - Stop the Violence Act of 2019 H. R. 1841 - Ensuring Access to General Surgery Act of 2019 (and Senate version reintroduction) H. R. 1041 - Critical Access Hospital Relief Act of 2019 S. 2852/H.R. 6378 - Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018 (PAHPAI) H.R. 880/S. 1022 - Mission Zero Act Good Samaritan Health Professionals Act Bleeding Control for the Injured (Stop The Bleed campaign) Qualified clinical data registry (QCDR) Firearms Safety and Research MACRA Implementation Merit-based Incentive Payment Systems (MIPS) Alternative Payment Models (APM) Common Rule Breast Cancer Research Stamp reauthorization Medicare for All Prior Authorization National Trauma Systems Legislation Drug Pricing Measuring Surgical Quality Surprise/Unanticipated Billing Medicare Physician Reimbursement Cancer Research and Funding Trauma Research and Funding Opioid Legislation

Client expense: $20,600 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Veterans Affairs, Dept of (VA)

PL 109-417 - Pandemic and All-Hazards Preparedness Act (PAHPA) H. R. 8 - Bipartisan Background Checks Act of 2019 H. R. 1418 - Competitive Health Insurance Reform Act of 2019 S. 668 - Removing Barriers to Colorectal Cancer Screening Act of 2019 S. 966 - Medicare Care Coordination Improvement Act of 2019 S. 741/H. R. 1730 - Cancer Drug Parity Act of 2019 H. R. 1379 - Ensuring Lasting Smiles Act H. R. 207 - Stop the Violence Act of 2019 H. R. 1841 - Ensuring Access to General Surgery Act of 2019 (and Senate version reintroduction) H. R. 1041 - Critical Access Hospital Relief Act of 2019 S. 2852/H.R. 6378 - Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018 (PAHPAI) H.R. 880/S. 1022 - Mission Zero Act Good Samaritan Health Professionals Act Bleeding Control for the Injured (Stop The Bleed campaign) Qualified clinical data registry (QCDR) Firearms Safety and Research MACRA Implementation Merit-based Incentive Payment Systems (MIPS) Alternative Payment Models (APM) Common Rule Breast Cancer Research Stamp reauthorization Medicare for All Prior Authorization National Trauma Systems Legislation Drug Pricing Measuring Surgical Quality Surprise/Unanticipated Billing Medicare Physician Reimbursement Cancer Research and Funding Trauma Research and Funding Opioid Legislation

Client expense: $181,090 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Veterans Affairs, Dept of (VA)

PL 109-417 - Pandemic and All-Hazards Preparedness Act (PAHPA) H. R. 8 - Bipartisan Background Checks Act of 2019 H. R. 1418 - Competitive Health Insurance Reform Act of 2019 S. 668 - Removing Barriers to Colorectal Cancer Screening Act of 2019 S. 966 - Medicare Care Coordination Improvement Act of 2019 S. 741/H. R. 1730 - Cancer Drug Parity Act of 2019 H. R. 1379 - Ensuring Lasting Smiles Act H. R. 207 - Stop the Violence Act of 2019 H. R. 1841 - Ensuring Access to General Surgery Act of 2019 (and Senate version reintroduction) H. R. 1041 - Critical Access Hospital Relief Act of 2019 S. 2852/H.R. 6378 - Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018 (PAHPAI) H.R. 880/S. 1022 - Mission Zero Act Good Samaritan Health Professionals Act Bleeding Control for the Injured (Stop The Bleed campaign) Qualified clinical data registry (QCDR) Firearms Safety and Research MACRA Implementation Merit-based Incentive Payment Systems (MIPS) Alternative Payment Models (APM) Common Rule Breast Cancer Research Stamp reauthorization Medicare for All Prior Authorization National Trauma Systems Legislation Drug Pricing Measuring Surgical Quality Surprise/Unanticipated Billing Medicare Physician Reimbursement Cancer Research and Funding Trauma Research and Funding Opioid Legislation

Client expense: $181,090 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Veterans Affairs, Dept of (VA)

Health insurance market stabilization, including the Bipartisan Health Care Stabilization Act of 2017, Lower Premiums Through Reinsurance Act of 2017 (S. 1835), and provisions to encourage automatic enrollment as alternative to Affordable Care Act individual mandate. Combatting the national opioids crisis, including the S. 2680, The Opioid Crisis Response Act of 2018 and S. 3120, the HEAL Act of 2018 Improving nutrition in the Supplemental Nutrition Assistance Program (SNAP) authorized under the Farm Bill (Agriculture and Nutrition Act of 2018 (H.R. 2)) Reauthorization of the Pandemic and All-Hazards Preparedness and Advancing Innovation Act (S. 2852/H.R. 6378) Reauthorization of the Presidents Emergency Plan for AIDS Relief (PEPFAR) EMPOWER Care Act (S.2227 and H.R.5306)

Client expense: $250,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Health insurance market stabilization, including the Bipartisan Health Care Stabilization Act of 2017, Lower Premiums Through Reinsurance Act of 2017 (S. 1835), and provisions to encourage automatic enrollment as alternative to Affordable Care Act individual mandate. Combatting the national opioids crisis, including the S. 2680, The Opioid Crisis Response Act of 2018 and S. 3120, the HEAL Act of 2018 Improving nutrition in the Supplemental Nutrition Assistance Program (SNAP) authorized under the Farm Bill (Agriculture and Nutrition Act of 2018 (H.R. 2)) Reauthorization of the Pandemic and All-Hazards Preparedness and Advancing Innovation Act (S. 2852/H.R. 6378) Reauthorization of the Presidents Emergency Plan for AIDS Relief (PEPFAR)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Essential emergency medication shortages H.R.880-Military Injury Surgical Systems Integrated Operationally Nationwide to Achieve ZERO Preventable Deaths Act H.R.1822-Good Samaritan Health Professionals Act of 2017 H.R.1876-Good Samaritan Health Professionals Act of 2017 H.R.6378-Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018 S.781-Good Samaritan Health Professionals Act of 2017 S.1022- Military Injury Surgical Systems Integrated Operationally Nationwide to Achieve ZERO Preventable Deaths Act S.2852-Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018

Client expense: $549,617 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA)

H.R. 5961 & S. 2976, FY19 Appropriations for Agriculture, Rural Development, Food and Drug Administration, and Related Agencies, provisions to fund FDA; H.R. 6470 & S. 3158 FY19 Appropriations for Labor, Health and Human Services, and Education, and Related Agencies, provisions to fund NIH; H.R. 6378, Section 302 & S. 2852, Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018.

Client expense: $170,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 6378, Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018

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

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

Reauthorization of the Pandemic and All-Hazards Preparedness Act. (S.2852, H.R.6378). Specific support for Section 406 of H.R. 6378 and Section 505 of the Senate substitute amendment to H.R. 6378 that would guarantee the continued work of the Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria (PACCARB) by setting the Advisory Council into law rather than relying on future executive orders for its continuation.

Client expense: Not reported · Firm income: $13,500

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Lobbying Issues Description: Budget and appropriations for disease and injury prevention, including obesity and related diseases; pandemic influenza and emerging infectious diseases; physical activity; public health bioterrorism preparedness; food safety, environmental health; paid sick days; womens and childrens health; community-based public health interventions, and substance misuse/behavioral health issues. Specific Legislation: 1. Implementation of the Patient Protection and Affordable Care Act (Public Law 111-148) 2. Implementation of the FDA Food Safety Modernization Act (Public Law 111-353) 3. Implementation of Pandemic and All-Hazards Preparedness Reauthorization Act (Public Law 113-5) 4. Implementation of Healthy, Hunger-Free Kids Act of 2010 (Public Law 111-296) 5. Implementation of the Budget Control Act of 2011 (Public Law 112-25) 6. Implementation of the Drug Quality and Security Act of 2013 (Public Law 113-54) 7. Implementation of Animal Drug and Animal Generic Drug User Fee Act (Public Law 113-14) 8. Implementation of Child Care and Development Block Grant Act of 2014 (Public Law 113-186) 9. Implementation of Every Student Succeeds Act (Public Law 114-95) 10. Implementation of the Comprehensive Addition and Recovery Act (Public Law 114-98) 11. FY 2018 Departments of Labor, Health and Human Services, and Education and Related Agencies Appropriations (S. 1771/H.R. 3358) 12. FY 2018 Departments of Agriculture, Rural Development, Food and Drug Administration and Related Agencies Appropriations (S. 1603/H.R. 3268) 13. Consolidated Appropriations Act 2018 (Public Law 115-141) 14. Midnight Rules Relief Act (S.34/H.R. 21) 15. Regulations from the Executive in Need of Scrutiny Act (S. 21/H.R. 26) 16. Regulatory Accountability Act (S.951/H.R. 5/H.R. 45/H.Res.33) 17. Searching for and Cutting Regulations that are Unnecessarily Burdensome (SCRUB) Act (H.R. 998) 18. Regulatory Integrity Act (H.R. 1004) 19. OIRA Insight, Reform, and Accountability Act (S. 676/H.R. 1009) 20. A concurrent resolution setting forth the congressional budget for the United States Government for fiscal year 2017 and setting forth the appropriate budgetary levels for fiscal years 2018 through 2026 (S.Con.Res. 3) 21. American Health Care Act (H.R. 1628/H.Res. 228) 22. Ozone Standards Implementation Act (S. 263/H.R. 806) 23. Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the final rule of the Bureau of Land Management relating to "Waste Prevention, Production Subject to Royalties, and Resource Conservation" (S.J. Res. 11/H.J.Res.36) 24. Common Sense Nutrition Disclosure Act (S. 261/H.R. 772) 25. Reinvigorating Antibiotic and Diagnostic Innovation (READI) Act (H.R. 1840) 26. Preservation of Antibiotics for Medical Treatment Act (H.R. 1587) 27. Preventing Antibiotic Resistance Act (S. 629) 28. Better Care Reconciliation Act (H.R. 1628) and related amendments 29. Public Health Emergency Response Act (S. 196) 30. Recognizing the importance of vaccinations and immunizations in the United States (H.Res.327) 31. Consolidated Appropriations Act, 2017 (Public Law 115-31) 32. Treat and Reduce Obesity Act (S. 830/H.R. 1953) 33. Community Health and Medical Professionals Improve Our Nation (CHAMPION) Act (H.R. 3922) 34. Community Health Investment, Modernization, and Excellence Act of 2017 (S. 1899) 35. Tobacco Tax Equity Act (S. 1837) 36. Healthy Kids Act (S. 1821/H.R. 3921) 37. Implementation of the Drug Quality and Security Act (P.S. 113-54) 38. Continuing Appropriations Act, 2018 and Supplemental Appropriations for Disaster Relief Requirements Act, 2017 (Public Law 115-56) 39. Friendly Airports for Mothers Act (S. 1110/H.R. 2375) 40. Lead-Safe Housing for Kids Act (S. 1845) 41. Supporting Working Moms Act (S. 2122/H.R. 3255) 42. Championing Healthy Kids Act (H.R. 3922) 43. Making further continuing appropriations for fiscal year 2018, and for other purposes (Public Law 115-90) 44. An Act to amend the Homeland Security Act of 2002 to require the Secretary of Homeland Security to issue Department of Homeland Security-wide guidance and develop training programs as part of the Department of Homeland Security Blue Campaign, and for other purposes (Public Law 115-96) 45. Tax Cuts and Jobs Act (Public Law 115-97) 46. Pandemic and All-Hazards Preparedness Advancing Innovation Act (S. 2852/H.R. 6378/H.R. 7328) 47. Vaccine Access Improvement Act (H.R. 4993) 48. Relief from New Source Performance Standards Act (H.R. 453) 49. Strategies to Address Antimicrobial Resistance (S. 2469) 50. Opioid Quota Reform Act (S. 2535) 51. Hospital Preparedness Program Reauthorization Act (H.R. 4776) 52. Blocking Regulatory Interference from Closing Kilns Act (H.R. 1917) 53. Health Equity and Accountability Act (H.R. 5942) 54. Opioid Crisis Response Act of 2018 (S. 2680) 55. Agriculture and Nutrition Act (H.R. 2) 56. Agriculture Improvement Act (S. 3042) 57. SECURE Act (H.R. 5998) 58. FY 2019 Departments of Labor, Health and Human Services, and Education and Related Agencies Appropriations (S. 3158) 59. FY 2019 Departments of the Interior, Environment, and Related Agencies Appropriations Act (H.R. 6147/S. 3073) 60. FY 2019 Departments of Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations (H.R. 5961/ S. 2976) 61. Trauma-Informed Care for Children and Families Act (S. 774) 62. SUPPORT for Patients and Communities Act (H.R. 6) 63. Centers for Disease Control Emergency Response Act (S. 3161) 64. LABEL Opioids Act (S. 3428) 65. Relief from New Source Performance Standards Act (S. 1857) 66. Outdoors for All Act (S. 3499) 67. The MOMMA Act (H.R. 5977) 68. The WIC Act (not yet introduced) 69. Preventing Maternal Deaths Act (H.R. 1318) 70. Medicare Access to Vaccines Equity Act (note yet introduced) 71. The Support Act (H.R. 6) House(s) of Congress and Federal Agencies lobbied during the quarter: House, Senate, Exec Office of Pres, HHS, CDC, FDA, CMS, OMB, DOT, HUD, EPA, Education, USDA, DHS, FEMA, and SAMHSA.

Client expense: $28,207 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Environmental Protection Agency (EPA), Executive Office of the President (EOP), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Office of Management & Budget (OMB), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Transportation, Dept of (DOT)

Essential emergency medication shortages H.R.880-Military Injury Surgical Systems Integrated Operationally Nationwide to Achieve ZERO Preventable Deaths Act H.R.1822-Good Samaritan Health Professionals Act of 2017 H.R.1876-Good Samaritan Health Professionals Act of 2017 H.R.6378-Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018 S.781-Good Samaritan Health Professionals Act of 2017 S.1022- Military Injury Surgical Systems Integrated Operationally Nationwide to Achieve ZERO Preventable Deaths Act S.2852-Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Good Samaritan Health Professionals Act (regarding ensuring access to care by protecting certain medical volunteers from lawsuits), H.R. 1876, entire bill; Good Samaritan Health Professionals Act (regarding ensuring access to care by protecting certain medical volunteers from lawsuits), S. 781, entire bill; Pandemic and All-Hazards Preparedness and Advancing Innovation Act, H.R. 6378, Sec. 209 (regarding ensuring access to care by protecting certain medical volunteers from lawsuits); Pandemic and All-Hazards Preparedness Reauthorization Act, S. 2852, Sec. 207 (regarding healthcare volunteer registration systems) and Sec. 208 (liability related to healthcare volunteers); Pandemic and All-Hazards Preparedness and Advancing Innovation Act, H.R. 7328, Sec. 207 (regarding healthcare volunteer registration systems) and Sec. 208 (liability related to healthcare volunteers).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Health Information Technology, Interoperability, Clinical Quality Measures, Patient Identification/Patient Data Matching, Healthcare Cybersecurity, Telehealth, Electronic Health Records and the EHR Incentive Program, H.R. 3120 - bill to reduce Meaningful Use hardship exemptions, S. 2059 - EHR Regulatory Relief Act, opioids, H.R. 3545 - Overdose Prevention and Patient Safety (OPPS) Act, H.R. 6082 -Overdose Prevention and Patient Safety Act, H.R. 6378 - Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018, HIPAA, H.R. 6 - SUPPORT for Patients and Communities Act, H.R. 3528 - Every Prescription Conveyed Securely Act

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Federal Bureau of Investigation (FBI), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Natl Institute of Standards & Technology (NIST), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), White House Office

Healthcare Cybersecurity, medical device cybersecurity, cybersecurity threat information sharing, Ransomware/Malware, Breach notification, NIST Cybersecurity Framework, S. 770 - MAIN STREET Cybersecurity Act, S.1656 - Medical Device Cybersecurity Act, H.R. 4191 - HHS Cybersecurity Modernization Act, H.R. 6378 - Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Federal Bureau of Investigation (FBI), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Natl Institute of Standards & Technology (NIST), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), White House Office

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislative proposals affecting Medicare and Medicaid hospital reimbursement policies Health Information Technology Health Care Reform Implementation Medicare Graduate Medical Education Payments S. 2597/H.R. 5385, Children's Hospital GME Support Reauthorization Act of 2018 H.R. 959/S. 1109, Title VIII Nursing Workforce Reauthorization Act S. 781/ H.R. 1876, Good Samaritan Health Professional Act of 2017 - provisions related to limiting the liability of health care professionals who volunteer to provide health care services in response to a disaster H.R. 1215, "Protecting Access to Care Act" - provisions related to medical liability system reform 42 CFR Part 2 alignment with HIPAA S. 2852/H.R. 6378, Pandemic and All-Hazards Preparedness & Advancing Innovation Act - provisions related to hospitals

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.3392, Modernizing Obstetric Medicine Standards Act of 2018 (MOMS Act), all provisions relating to preventing obstetric hemorrhage. H.R.6378 / S.2852, Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018, all provisions relating to blood supply.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to the distribution of health care products, competitive bidding, and medical device licensure; issues related to pandemic preparedness, including S. 2852 and H.R. 6378, Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018; and issues related to the impact of P.L. 115-91 (National Defense Authorization Act), Section 801, on health industry distribution.

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

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

H.R. 749: Lower Drug Costs through Competition Act - Provisions related to generic drug approvals H.R. 1245: Affordable and Safe Prescription Drug Importation Act - Provisions related to importation H.R. 1480: Safe and Affordable Drugs from Canada Act of 2017 - Provisions related to importation H.R. 1628: American Health Care Act of 2017 - Provisions related to the biopharmaceutical industry including repeal of brand pharmaceutical manufacturer fee and individual and employer mandates, insurance affordability provisions, and Medicaid reforms H.R. 1776: Improving Access to Affordable Prescription Drugs Act - Provisions related to drug pricing H.R. 2051: FAST Generics Act of 2017 - Provisions related to REMS and limited distribution systems H.R. 2212: CREATES Act of 2017 - Provisions related to Risk Evaluation and Mitigation Strategies (REMS) and limited distribution systems 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. 5041: The Safe Disposal of Unused Medication Act - Provisions related to drug disposal H.R. 5228: SCREEN Act - Provisions related to drug recall authority H.R. 5311: CARA 2.0 Act of 2018 - Provisions to reauthorize and expand the Comprehensive Addiction and Recovery Act H.R. 5598: 340B Optimization Act - Provisions related to transparency in the 340B program H.R. 6574: Medicare Fair Drug Pricing Act of 2018 - Provisions related to drug pricing HR 5333 - Over-the-Counter Monograph Safety, Innovation, and Reform Act of 2018 S 2315 - Over-the-Counter Drug Safety, Innovation, and Reform Act HR 7328 - Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018 HR 394/S85 - Restoring Access to Medication Ac HR 6199 - Restoring Access to Medication and Modernizing Health Savings Accounts Act of 2018 Medicare Doughnjt hole -House/Senate Labor HHS AppropriationsHouse/Senate DoD AppropriationsDoggett bill Trump Administration IPI proposal, Trump Administration proposed changes to six protected classes. HR6378, Pandemic and All Hazards Preparedness and Advancing Innovation Act; HR4993/S3253, Vaccine Access Improvement Act; HR 4297/S2103, Protecting Seniors Through Immunization Act; H.R.4710 - 340B PAUSE ActH.R.4297 - Protecting Seniors Through Immunization Act of 2017 S. 3477 - Protecting Seniors through Immunization Act S. 64: Safe and Affordable Drugs from Canada Act of 2017 - Provisions related to importation S. 92: Safe and Affordable Drugs from Canada Act of 2017 - Provisions related to importation S. 469: Affordable and Safe Prescription Drug Importation Act - Provisions related to importation S. 771: Improving Access to Affordable Prescription Drugs Act - Provisions related to drug pricing S. 974: CREATES Act of 2017 - Provisions related to Risk Evaluation and Mitigation Strategies (REMS) and limited distribution systems 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 S. 2553: Know the Lowest Price Act of 2018 - Provisions related to drug pricing S. 2554: Patient Right to Know Drug Prices Act - To ensure that health insurance issuers and group health plans do not prohibit pharmacy providers from providing certain information to enrollees -Know the Lowest Price Act of 2018Medicare Part D Six Protected Classes HHS Proposal on Medicare Part B International Pricing Index (IPI)340B Drug Discount Program S. 3519: A bill to establish a process for the Food and Drug Administration to determine whether to modify the labeling of drugs whose labeling may be outdated, including drugs with accepted uses that are not reflected in the approved labeling S. 3775: Affordable Drug Manufacturing Act of 2018 Drug cost and pricing policy issues Transparency policy issues Drug importation and counterfeiting policy issues Prescription drug take back and secure disposal policy issues Expanded access policy issues Generic drug approval process policy issues High deductible health plans/HSA policy issues Sharing of truthful and non-misleading information about medicines with healthcare professionals and payors Risk Evaluation and Mitigation Strategy (REMS) policy issues Compulsory licensing policy issues Foreign reference pricing policy issues 340B drug discount program policy issues Bipartisan Budget Act of 2018 (Public Law 115-123) - Part D provisions Biosimilar approval and reimbursement policy issues Drug compounding policy issues including federal oversight of compounded drugs Cancer drug vial size policy issues TRICARE pharmacy pilot program Drug shortages policy issues Reauthorization of the Pandemic and All-Hazards Preparedness Act Request for Information: HHS Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs (RIN 0991-ZA49)

Client expense: $920,000 · 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), Office of Management & Budget (OMB), SENATE, U.S. Trade Representative (USTR)

H.R. 6378, To reauthorize certain programs under the Pandemic and All-Hazards, Preparedness Reauthorization Act, issues relating to medical countermeasures. Issues relating to drug pricing.

Client expense: $490,000 · Firm income: Not reported

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

HR6378/HR7328/S2851 Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018

Client expense: $323,071 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Re-authorization of the Pandemic and All-Hazards Preparedness Act. H.R. 6378, Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018. FDA regulatory issues. Issues related to Priority Voucher Review programs. Opioid and heroin addiction legislation. Naloxone access, co-prescribing opioid guidelines.

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

Government targets: Centers For Disease Control & Prevention (CDC), Defense, Dept of (DOD), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Issues related to S.2315 "Over-the-Counter Drug Safety, Innovation, and Reform Act; general issues related to drug pricing;issues related to cosmetic regulations; issues related to insulin pricing;issues related H.R. 6378 "Pandemic and All Hazards Preparedness (PAHPA)Advancing Innovation Act"; issues related to Medicare Part D; issues related to flu and Veterans Affairs; issues related to seasonal influenza vaccination; issues related to 340B Reform; issues related to Drug Importation; issues related to vaccine safety;issues related to HR5333 "Over-the-Counter Monograph Safety, Innovation, and reform Act of 2018; issues related to HR2212 "CREATES Act of 2017";issues related to HR 2439 "Fair Accountability and Innovation Research Drug Act of 2017"; issues related S. 2852 "Pandemic and All-Hazards Preparedness and Advancing Innovation Act (PAHPA) of 2018"; issues related to PAHPA reauthorization; and issues related to S.2465 "Sickle Cell Disease and other Heritable Blood Disorders Research, Surveillance, Prevention and Treatment Act of 2018"

Client expense: $790,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Security Council (NSC), Office of Management & Budget (OMB), 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 Health care policy H.R. 959/S. 1109, Title VIII Nursing Workforce Reauthorization Act Support S.781/H.R. 1876, Good Samaritan Health Professional Act of 2017 - provisions related to limiting the liability of health care professionals who volunteer to provide health care services in response to a disaster 42 CFR Part 2 alignment with HIPAA S. 2852/H.R. 6378, Pandemic and All-Hazards Preparedness & Advancing Innovation Act - provisions related to hospitals

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Monitor reauthorization of H.R. 6378 / S. 2852, the Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018, and discuss issues related to liability protection.

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

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Health insurance market stabilization, including the Bipartisan Health Care Stabilization Act of 2017, Lower Premiums Through Reinsurance Act of 2017 (S. 1835), and provisions to encourage automatic enrollment as alternative to Affordable Care Act individual mandate. Combatting the national opioids crisis, including the S. 2680, The Opioid Crisis Response Act of 2018 and S. 3120, the HEAL Act of 2018 Improving nutrition in the Supplemental Nutrition Assistance Program (SNAP) authorized under the Farm Bill (Agriculture and Nutrition Act of 2018 (H.R. 2)) Reauthorization of the Pandemic and All-Hazards Preparedness and Advancing Innovation Act (S. 2852/H.R. 6378) Reauthorization of the Presidents Emergency Plan for AIDS Relief (PEPFAR) EMPOWER Care Act (S.2227 and H.R.5306)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

1. Supporting the Affordable Care Act 2. Supporting Medicaid, opposing cuts, changing structure to capped system or block grant to states 3. Supporting delaying cuts to Medicaid disproportionate share hospital payments 4. Supporting the Prevention and Public Health Fund 5. Supporting H.R.6378 - To reauthorize certain programs under the Pandemic and All-Hazards Preparedness Reauthorization Act (with enhanced authorization)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 527, the Health Care Safety Net Enhancement Act of 2017: Medical liability protections for physicians providing EMTALA mandated care S. 781, the Good Samaritan Health Professionals Act: Medical liability protections for physicians volunteering during a national disaster S.1022, MISSION ZERO Act: Military Injury Surgical Systems Integrated Operationally Nationwide to Achieve ZERO Preventable Deaths Act: To facilitate assignment of military trauma care providers to civilian trauma centers in order to maintain military trauma readiness and to support such centers S.2852 - Pandemic and All-Hazards Preparedness and Advancing Innovation Act: Including Good Samaritan liability protections H.R. 6, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act or the SUPPORT for Patients and Communities Act: Opioid prescription limits and reporting requirements H.R. 880, Military Injury Surgical Systems Integrated Operationally Nationwide to Achieve ZERO Preventable Deaths Act: To facilitate assignment of military trauma care providers to civilian trauma centers in order to maintain military trauma readiness and to support such centers H.R. 1876, the Good Samaritan Health Professionals Act: Medical liability protections for physicians volunteering during a national disaster H.R.6378: Pandemic and All-Hazards Preparedness Reauthorization Act, including adding the Good Samaritan Bill provisions to PAHPA No BilL: Surprise medical bills No Bill: Pediatric loan repayment program

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 6378/S. 2852, Pandemic and All-Hazards Preparedness and Advancing Innovation Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE