Know the Cost Act of 2018

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.5515-John S. McCain National Defense Authorization Act for Fiscal Year 2019 H.R.6143-Patient Right to Know Drug Prices Act H.R.6144-Know the Lowest Price Act of 2018 H.R.6733-Know the Cost Act of 2018 S.2544-Patient Right to Know Drug Prices Act S.2553-Know the Lowest Price Act of 2018 S.2987-John S. McCain National Defense Authorization Act for Fiscal Year 2019

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Advantage Policy and Reimbursement Part D Policy and Reimbursement Medicaid and Dual Eligible Issues Pharmacy Reimbursement Issues Medicare Access and CHIP Reauthorization Act Implementation HHS Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs Opioid Issues H.R. 6, Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act S. 3120, HEAL Act of 2018 S. 637, Creating Transparency to Have Drug Rebates Unlocked Act H.R. 3528, Every Prescription Conveyed Securely Act H.R. 6733, Know the Cost Act of 2018 S. 2553, Know the Lowest Price Act of 2018

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

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

Affordable Care Act (ACA); ACA Regulations; ACA Stabilization; Health Reform; Rural Healthcare; Risk Adjustment; State Flexibility; Point of Sale; Fall Priorities; Opioids; Sober Homes; Marketplace Stability; Individual Market Reform; FAA (Air Ambulance); CREATES Act; Sec. 1332 Waivers; Short Term Limited Duration (STLD): AHPs; Value-based Care; Health Care Costs; Mental Health; Small Business Plans; Single Payer; Reinsurance; CSRs; SNPs; Health Savings Accounts (HSAs); Postal Reform; FEHBP Options; 42 CFR Part 2; Transparency; Silverloading; Health IT Interoperability; Urban Affairs/Deterrence (Opioid epidemic); Texas lawsuit; Air Ambulance; Surprise billing, Transparency, Small Business, State Flexibility; Lyme Disease HR 6 SUPPORT for Patients and Communities Act Introduced June 13, 2018 by Greg Walden (R-OR) includes Medicaid, Medicare, and public health reforms to combat the opioid crisis by advancing treatment and recovery initiatives, improving prevention, protecting communities, and bolstering efforts to combat illicit synthetic drugs like fentanyl. The policies contained in the legislation were advanced through regular order by the House Energy and Commerce Committee and the Ways and Means Committee. HR 2051 FAST Generics Act Introduced April 6, 2017 by David McKinley (R-WV) To amend the Federal Food, Drug, and Cosmetic Act to ensure that eligible product developers have competitive access to approved drugs and licensed biological products, so as to enable eligible product developers to develop and test new products, and for other purposes. HR 2212 CREATES Act Introduced April 27, 2017 by Tom Marino (R-PA) To promote competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products. HR 3325 ACE Kids Act Introduced July 20, 2017 by Joe Barton (R-TX) To amend title XIX of the Social Security Act to provide States with the option of providing coordinated care for children with complex medical conditions through a health home, and for other purposes. HR 6294 REVAMP Act Introduced June 28, 2018 by John Shimkus (R-IL) To amend the Federal Food, Drug, and Cosmetic Act to encourage the development of priority antimicrobial products through the award of a transferable exclusivity extension period, and for other purposes. HR 6733 Know the Cost Act of 2018 Introduced September 7, 2018 by Buddy Carter (R-GA) To amend title XXVII of the Public Health Service Act and title XVIII of the Social Security Act to prohibit group health plans, health insurance issuers, prescription drug plan sponsors, and Medicare Advantage organizations from limiting certain information on drug prices.

Client expense: $1,590,000 · Firm income: Not reported

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

S. 297, Increasing Competition in Pharmaceuticals Act (Collins-McCaskill) - prescription drug costs S. 974, CREATES Act (Leahy-Grassley) - access to generic drugs and biosimilars S. 1115, Making Pharmaceutical Markets More Competitive Act (Collins-McCaskill) - accelerated approval of generic therapies S. 1131, FAIR Drug Pricing Act (Baldwin-McCain) - transparency in prescription drug pricing S. 2553, Know the Lowest Price Act (Stabenow) - pharmacist-patient communications S. 2554, Patient Right to Know Drug Prices Act (Collins) - pharmacist-patient communications, reporting of biosimilar pay-for-delay settlements S. 3194, Capping Prescription Costs Act (Warren) - capping prescription copays S. 3738, Hatch-Waxman Integrity Act (Hatch) - inter partes review process S. 3792, Preserve Access to Affordable Generics and Biosimilars Act (Klobuchar-Grassley) - pay-for-delay settlements H.R. 749, Lower Drug Costs Through Competition Act (Schrader-Bilirakis) - prescription drug costs H.R. 1703, Medical Product Communication Act (Griffith) - off-label exchange of information H.R. 2026, Pharmaceutical Information Exchange Act (Guthrie) - pre-approval health care economic information to payors H.R. 2051, Fair Access for Safe and Timely Generics Act (McKinley-Welch) - access to generic drugs H.R. 2212, CREATES Act (Marino-Cicilline) - access to generic drugs and biosimilars H.R. 2439, FAIR Drug Pricing Act (Schakowsky) - transparency in prescription drug pricing H.R. 2562, Making Pharmaceutical Markets More Competitive Act (Kelly) - accelerated approval of generic therapies H.R. 2999, Patients' Access to Treatments Act (McKinley) - limiting cost sharing in specialty drug tiers H.R. 5247, Right to Try Act (Fitzpatrick) - use of unapproved investigational drugs by patients with life-threatening conditions H.R. 6142, Reducing Drug Waste Act (Doggett) - packaging of medications H.R. 6157, Defense-Labor-HHS-Education Appropriations Act (Granger) -pharmaceutical price transparency in DTC advertising H.R. 6340, Capping Prescription Costs Act (Rosen) - capping prescription copays H.R. 6478, Biosimilars Competition Act (Sarbanes) - reporting of pay-for-delay settlements H.R. 6576, Drug-Price Transparency in Communications Act (Schakowsky) - disclosure of drug prices in DTC advertising H.R. 6733, Know the Cost Act (Carter) - pharmacist-patient communications H.R. 7251, Hatch-Waxman Integrity Act (Flores) - inter partes review process Regulatory Issues: Issues relating to long term safety and effectiveness of medical devices and drugs, including registries; issues relating to post-market surveillance of drugs and medical devices; issues relating to price of drugs and biologics; issues related to pharmacy benefit managers; issues related to biosimilars; issues related to approval of drugs and biologics; issues relating to opioids; issues relating to prescription drug rebates; issues relating to prescription drug price blueprint; direct-to-consumer advertising for prescription drugs; issues relating to access for investigational drugs; and other issues relating to health care reform implementation.

Client expense: $1,540,000 · Firm income: Not reported

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

H.R. 1316, Prescription Drug Price Transparency Act; H.R. 1038, Improving Transparency and Accuracy in Medicare Part D Spending Act; S. 413, Improving Transparency and Accuracy in Medicare Part D Spending Act; H.R. 592, Pharmacy and Medically Underserved Areas Enhancement Act; S. 109, Pharmacy and Medically Underserved Areas Enhancement Act; H.R.1939 - To amend title XVIII of the Social Security Act to ensure equal access of Medicare beneficiaries to community pharmacies in underserved areas as network pharmacies under Medicare prescription drug coverage, and for other purposes; S.637 Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2017; HR 394/ S 85, Restoring Access to Medication Act; HR 3921/S 1827, KIDS Act of 2017; HR 3271, Protecting Access to Diabetes Supplies Act of 2017; S. 870, Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017; Centers for Medicare and Medicaid Services (CMS) Proposed Rule for the 2019 Medicare Part D Plan Year, pharmacy provisions; S.2553 / H.R. 6144, Know the Lowest Price Act of 2018; S.2554 / H.R. 6143, Patient Right to Know Drug Prices Act; H.R. 5343, Prescription Transparency Act of 2018; H.R. 5958, Phair Pricing Act of 2018; CMS Call Letter for 2019 Medicare Part D and Medicare Advantage Plans; H.R. 6733, Know the Cost Act of 2018; H.R. 6641, COST Act; H.R. 7339, Medicare for America Act of 2018; Proposed Rule, "Modernizing Part D and Medicare Advantage to Lower Drug Prices and Reduce Out-of-Pocket Expenses, CMS-4180-P"

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

Government targets: Agriculture, Dept of (USDA), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), 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), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), Office of Personnel Management (OPM), SENATE, Small Business Administration (SBA), Substance Abuse & Mental Health Services Administration (SAMHSA), White House Office

H.R. 1408, Access to Insurance for All Americans Act H.R. 1628, American Health Care Reform Act H.R. 2400, to Allow Persons not Federal Employees to enroll in FEHBP H.R. 5965, Access to Infertility Treatment and Care Act S. 2960, Access to Infertility Treatment and Care Act H.R. 6143, Patient Right to Know Drug Prices Act S. 2554, Patient Right to Know Drug Prices Act H.R. 6733, Know the Cost Act of 2018

Client expense: $200,000 · Firm income: Not reported

Government targets: Commodity Futures Trading Commission (CFTC), Consumer Financial Protection Bureau (CFPB), Federal Communications Commission (FCC), Federal Retirement Thrift Investment Board, Food & Drug Administration (FDA), General Services Administration (GSA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Merit Systems Protection Board, Natl Park Service (NPS), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Office of Special Counsel, Office of the Comptroller of the Currency (OCC), Patent & Trademark Office (PTO), SENATE, Securities & Exchange Commission (SEC), Treasury, Dept of, U.S. Customs & Border Protection

H.R. 2051: "FAST Generics Act of 2017", To amend the Federal Food, Drug, and Cosmetic Act to ensure that eligible product developers have competitive access to approved drugs and licensed biological products, so as to enable eligible product developers to develop and test new products, issues pertaining to drug pricing. S. 974, H.R. 2212: "CREATES Act of 2017", regarding all provisions. H.R. 3976: "Access to Marketplace Insurance Act", issues pertaining to Third Party Payment Premiums (TPPs). S. 2680, H.R. 6: "The Opioid Crisis Response Act of 2018", regarding all provisions. S. 3042, H.R. 2: "Agriculture Improvement Act of 2018", issues pertaining to federal funding for AHPs. H.R. 302, FAA Reauthorization Act of 2018, issues pertaining to air ambulance pricing transparency. H.R. 6294: "REVAMP Act" - To amend the Federal Food, Drug and Cosmetic Act to encourage the development of priority antimicrobial products through the award of transferable exclusivity extension period, regarding all provisions. H.R. 6733: "Know the Cost Act" - To amend title XXVII of the Public Health Service Act and title XVIII of the Social Security Act to prohibit group health plans, health insurance issuers, prescription drug plan sponsors and Medicare Advantage organizations from limiting certain information on drug prices, regarding all provisions. Issues pertaining to the Affordable Care Act; Annual Appropriations; Reinsurance; Cost Sharing Reductions (CSRs); Individual Market; Short Term Limited Duration Plans; Part D Donut Hole fix; Free standing ERs; ESRD coverage by private health plans; Risk adjustment.

Client expense: $1,280,000 · Firm income: Not reported

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

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

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

Government targets: HOUSE OF REPRESENTATIVES

Affordable Care Act (ACA); ACA Regulations; ACA Stabilization; Health Reform; Rural Healthcare; Risk Adjustment; State Flexibility; Point of Sale; Opioids; Sober Homes; Marketplace Stability; Individual Market Reform; FAA (Air Ambulance); CREATES Act; Sec. 1332 Waivers; Short Term Limited Duration (STLD): AHPs; Value-based Care; Health Care Costs; Mental Health; Small Business Plans; Single Payer; Reinsurance; CSRs; SNPs; Health Savings Accounts (HSAs); Postal Reform; 42 CFR Part 2; Transparency; Fall Priorities. HR 6 SUPPORT for Patients and Communities Act Introduced June 13, 2018 by Greg Walden (R-OR) includes Medicaid, Medicare, and public health reforms to combat the opioid crisis by advancing treatment and recovery initiatives, improving prevention, protecting communities, and bolstering efforts to combat illicit synthetic drugs like fentanyl. The policies contained in the legislation were advanced through regular order by the House Energy and Commerce Committee and the Ways and Means Committee. HR 2051 FAST Generics Act Introduced April 6, 2017 by David McKinley (R-WV) To amend the Federal Food, Drug, and Cosmetic Act to ensure that eligible product developers have competitive access to approved drugs and licensed biological products, so as to enable eligible product developers to develop and test new products, and for other purposes. HR 2212 CREATES Act Introduced April 27, 2017 by Tom Marino (R-PA) To promote competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products. HR 3325 ACE Kids Act Introduced July 20, 2017 by Joe Barton (R-TX) To amend title XIX of the Social Security Act to provide States with the option of providing coordinated care for children with complex medical conditions through a health home, and for other purposes. HR 6733 Know the Cost Act of 2018 Introduced September 7, 2018 by Buddy Carter (R-GA) To amend title XXVII of the Public Health Service Act and title XVIII of the Social Security Act to prohibit group health plans, health insurance issuers, prescription drug plan sponsors, and Medicare Advantage organizations from limiting certain information on drug prices.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Affordable Care Act (ACA); ACA Regulations; ACA Stabilization; Health Reform; Rural Healthcare; Risk Adjustment; State Flexibility; Opioids; Marketplace Stability; Individual Market Reform; FAA (Air Ambulance); CREATES Act; Sec. 1332 Waivers; Short Term Limited Duration (STLD); AHPs; Value-Based Care; Health Care Costs; Mental Health; Small Business Plans; Single Payer; Reinsurance; CSRs; SNPs; Health Savings Accounts (HSAs); 42 CFR Part 2; Transparency; Silverloading; Texas Lawsuit; Air Ambulance; Surprise Billing HR 6 SUPPORT for Patients and Communities Act Introduced June 13, 2018 by Greg Walden (R-OR) includes Medicaid, Medicare, and public health reforms to combat the opioid crisis by advancing treatment and recovery initiatives, improving prevention, protecting communities, and bolstering efforts to combat illicit synthetic drugs like fentanyl. The policies contained in the legislation were advanced through regular order by the House Energy and Commerce Committee and the Ways and Means Committee. HR 2051 FAST Generics Act Introduced April 6, 2017 by David McKinley (R-WV) To amend the Federal Food, Drug, and Cosmetic Act to ensure that eligible product developers have competitive access to approved drugs and licensed biological products, so as to enable eligible product developers to develop and test new products, and for other purposes. HR 2212 CREATES Act Introduced April 27, 2017 by Tom Marino (R-PA) To promote competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products. HR 6733 Know the Cost Act of 2018 Introduced September 7, 2018 by Buddy Carter (R-GA) To amend title XXVII of the Public Health Service Act and title XVIII of the Social Security Act to prohibit group health plans, health insurance issuers, prescription drug plan sponsors, and Medicare Advantage organizations from limiting certain information on drug prices.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1038/S. 413 - Improving Transparency and Accuracy in Medicare Part D Spending Act H.R.592/S. 109 - Pharmacy and Medically Underserved Areas Enhancement Act H.R. 1316 - Prescription Drug Price Transparency Act H.R. 623 - Fairness to Pet Owners Act Letter to HHS/CMS on direct and indirect remuneration (DIR) fees Discussions with House committees on pharmacy benefit managers (PBMs) H.R.6 - SUPPORT for Patients and Communities Act - FDA Guidelines Section 3004 Letter S. 2680 - Opioid Crisis Response Act of 2018 H.R. 6733, Know the Cost Act of 2018 S. 2553, Know the Lowest Price Act S. 2554, the Patient Right to Know Drug Prices Act H.R. 5333, the Over-the-Counter Monograph Safety, Innovation, and Reform Act of 2018

Client expense: $160,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Commerce, Dept of (DOC), Federal Reserve System, HOUSE OF REPRESENTATIVES, SENATE

Affordable Care Act (ACA) Regulations; ACA Stabilization; Health Reform; Risk Adjustment; State Flexibility; Opioids; Sober Homes, Marketplace Stability; Individual Market Reform; FAA (Air Ambulance); CREATES Act; Section 1332 Waivers; Short Term Limited Duration Insurance (STLDI); Association Health Plans (AHPs); Value-based Care; Health Care Costs; Mental Health; Single Payer; Reinsurance; Cost Sharing Reductions (CSRs); Health Savings Accounts (HSAs); Silver Loading; Texas v. U.S. Lawsuit; Surprise Billing HR 6 Introduced June 13, 2018 by Greg Walden (R-OR). The SUPPORT for Patients and Communities Act includes Medicaid, Medicare, and public health reforms to combat the opioid crisis by advancing treatment and recovery initiatives, improving prevention, protecting communities, and bolstering efforts to combat illicit synthetic drugs like fentanyl. The policies contained in the legislation were advanced through regular order by the House Energy and Commerce Committee and the Ways and Means Committee. HR 2051 Introduced April 6, 2017 by David McKinley (R-WV). The FAST Generics Act amends the Federal Food, Drug, and Cosmetic Act to ensure that eligible product developers have competitive access to approved drugs and licensed biological products, so as to enable eligible product developers to develop and test new products, and for other purposes. HR 2212 Introduced April 27, 2017 by Tom Marino (R-PA). The CREATES Act promotes competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products. HR 3325 Introduced July 20, 2017 by Joe Barton (R-TX). This bill amends title XIX of the Social Security Act to provide states with the option of providing coordinated care for children with complex medical conditions through a health home, and for other purposes. HR 6294 Introduced June 28, 2018 by John Shimkus (R-IL). The REVAMP Act would amend the Federal Food, Drug, and Cosmetic Act to encourage the development of priority antimicrobial products through the award of a transferable exclusivity extension period, and for other purposes. HR 6733 Introduced September 7,2018 by Buddy Carter (R-GA). The Know the Cost Act of 2018 amends title XXVII of the Public Health Service Act and title XVIII of the Social Security Act to prohibit group health plans, health insurance issuers, prescription drug plan sponsors, and Medicare Advantage organizations from limiting certain information on drug prices.

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

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

Real World Evidence Patient Reported Outcomes Medical Product Communications Act of 2017, HR 1703 Prescription Drug Price Transparency Act, HR 1316 Drug Pricing Biosimilars Patient Right to Know Drug Pricing Act, S.2554 Know the Lowest Price Act of 2018, S. 2553 Know the Cost Act of 2018, H.R. 6733 Medicare Part B coverage policy Health Reimbursement Arrangements

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

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

Affordable Care Act (ACA); ACA Regulations; ACA Stabilization; Health Reform; Rural Healthcare; Risk Adjustment; State Flexibility; Point of Sale; Fall Priorities; Opioids; Sober Homes; Marketplace Stability; Individual Market Reform; FAA (Air Ambulance); CREATES Act; Sec. 1332 Waivers; Short Term Limited Duration (STLD); AHP's; Value Based Care; Health Care Costs; Mental Health; Small Business Plans; Single Payer; Reinsurance; CSRs; SNPs; Health Savings Accounts (HSAs); Postal Reform; 42 CFR Part 2; Transparancy;Silverloading; Health IT Interoperability; Urban Affairs/Deterrence (Opioid Epidemic) Texas lawsuit; Air Ambulance; Surprise billing, Transparency, Small Business, State Flexibility HR 6 SUPPORT for Patients and Communities Act Introduced June 13, 2018 by Greg Walden (R-OR) includes Medicaid, Medicare, and public health reforms to combat the opioid crisis by advancing treatment and recovery initiatives, improving prevention, protecting communities, bolstering efforts to combat illicit synthetic drugs like fentanyl. The policies contained in the legislation were advanced through regular order by the House Energy and Commerce Committee and the Ways and Means Committee. HR 2051 FAST Generics Act Introduced April 6, 2017 by David McKinley (R-WV) to amend the Federal Food, Drug and Cosmetic Act to ensure that eligible product developers have competitive access to approved drugs and licensed biological products, so as to enable eligible product developers to develop and test new products and for other purposes. HR 2212 CREATES Act Introduced April 27, 2017 by Tom Marino (R-PA) to promote competition in the market for drugs and biological products by facilitating the timely entry of lower cost generic and biosimilar versions of those drugs and biological products. HR 3325 ACE Kids Act Introduced July 20, 2017by Joe Barton (R-TX) to amend title XIX of the Social Security Act to provide States with the option of providing coordinated care for children with complex medical conditions through a health home, and for other purposes. HR 6733 Know the Cost Act of 2018 Introduced September 7, 2018 by Buddy Carter (R-GA) To amend title XXVII of the Public Health Service Act and title XVIII of the Social Security Act to prohibit group health plans, health insurance issurers, prescription drug plan sponsors, and Medicare Advantage organizations from limiting certain information on drug prices.

Client expense: $92,595 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1245/S. 469 The Affordable and Safe Prescription Drug Importation Act H.R. 1316 - Prescription Drug Price Transparency Act H.R. 749 Lower Drug Costs Through Competition H.R.2430/S. 934 - FDA Reauthorization Act of 2017 H.R. 4841 - Standardizing Electronic Prior Authorization for Safe Prescribing Act H.R. 6733 - Know the Cost Act H.R. 6143/ S. 2554 - Patient Right to Know Drug Prices Act H.R. 6144/ S. 2553 - Know the Lowest Price Act H.R. 6641 - True Cost-sharing of Seniors Drugs Transparency (True COST) Act H.R. 5958 - Phair Pricing Act

Client expense: $640,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, SENATE

HR 1316 To amend title XVIII of the Social Security Act to provide for pharmacy benefits manager standards under the Medicare prescription drug program and Medicare Advantage program to further transparency of payment methodologies to pharmacies, and for other purposes. HR 1245/S 469 To amend the Federal Food, Drug, and Cosmetic Act to allow for the importation of affordable and safe drugs by wholesale distributors, pharmacies, and individuals. S 2553 Know the Lowest Price Act of 2018 -- prohibits health plans and pharmacy benefit managers from restricting pharmacies from informing individuals regarding the prices for certain drugs and biologicals S 2554 Patient Right to Know Drug Prices Act -- ensure that health insurance issuers and group health plans do not prohibit pharmacy providers from providing certain information to enrollees S 2645 To establish a demonstration program under which the Drug Enforcement Administration provides grants to certain States to enable those States to increase participation in drug take-back programs. HR 6733 This Act may be cited as the Know the Cost Act of 2018. To amend title XXVII of the Public Health Service Act and title XVIII of the Social Security Act to prohibit group health plans, health insurance issuers, prescription drug plan sponsors, and Medicare Advantage organizations from limiting certain information on drug prices.

Client expense: $34,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation H.R. 5343 - Prescription Transparency Act of 2018. (Lobbying activities related to pharmacy benefit managers.) H.R. 6470 - Making appropriations for the Departments of Labor, Health and Human Services, and Education, and related agencies for the fiscal year ending September 30, 2019, and for other purposes. (Lobbying activities related to DIR fees.) H.R. 6157 - Making consolidated appropriations for the Departments of Defense, Labor, Health and Human Services, and Education, and Related Agencies for the fiscal year ending September 30, 2019, and for other purposes. (Lobbying activities related to DIR fees.) S. 413 - To amend title XVIII of the Social Security Act to prohibit prescription drug plan sponsors and MA-PD organizations under the Medicare program from retroactively reducing payment on clean claims submitted by pharmacies. (Lobbying activities related to pharmacy benefit managers.) H.R. 1038 - To amend title XVIII of the Social Security Act to prohibit prescription drug plan sponsors and MA-PD organizations under the Medicare program from retroactively reducing payment on clean claims submitted by pharmacies. (Lobbying activities related to pharmacy benefit managers.) S. 2553 - To amend title XVIII of the Social Security Act to prohibit health plans and pharmacy benefit managers from restricting pharmacies from informing individuals regarding the prices for certain drugs and biologicals. (Lobbying activities related to pharmacy benefit managers.) S. 2554 - To ensure that health insurance issuers and group health plans do not prohibit pharmacy providers from providing certain information to enrollees. (Lobbying activities related to pharmacy benefit managers.) H.R. 6733 - To amend title XXVII of the Public Health Service Act and title XVIII of the Social Security Act to prohibit group health plans, health insurance issuers, prescription drug plan sponsors, and Medicare Advantage organizations from limiting certain information on drug prices. (Lobbying activities related to pharmacy benefit managers.) Issues Prescription drug prices Pharmacy benefit managers DIR Fees

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation H.R. 5343 - Prescription Transparency Act of 2018. (Lobbying activities related to pharmacy benefit managers.) H.R. 6470 - Making appropriations for the Departments of Labor, Health and Human Services, and Education, and related agencies for the fiscal year ending September 30, 2019, and for other purposes. (Lobbying activities related to DIR fees.) H.R. 6157 - Making consolidated appropriations for the Departments of Defense, Labor, Health and Human Services, and Education, and Related Agencies for the fiscal year ending September 30, 2019, and for other purposes. (Lobbying activities related to DIR fees.) S. 413 - To amend title XVIII of the Social Security Act to prohibit prescription drug plan sponsors and MA-PD organizations under the Medicare program from retroactively reducing payment on clean claims submitted by pharmacies. (Lobbying activities related to pharmacy benefit managers.) H.R. 1038 - To amend title XVIII of the Social Security Act to prohibit prescription drug plan sponsors and MA-PD organizations under the Medicare program from retroactively reducing payment on clean claims submitted by pharmacies. (Lobbying activities related to pharmacy benefit managers.) S. 2553 - To amend title XVIII of the Social Security Act to prohibit health plans and pharmacy benefit managers from restricting pharmacies from informing individuals regarding the prices for certain drugs and biologicals. (Lobbying activities related to pharmacy benefit managers.) S. 2554 - To ensure that health insurance issuers and group health plans do not prohibit pharmacy providers from providing certain information to enrollees. (Lobbying activities related to pharmacy benefit managers.) H.R. 6733 - To amend title XXVII of the Public Health Service Act and title XVIII of the Social Security Act to prohibit group health plans, health insurance issuers, prescription drug plan sponsors, and Medicare Advantage organizations from limiting certain information on drug prices. (Lobbying activities related to pharmacy benefit managers.) Issues Prescription drug prices Pharmacy benefit managers DIR Fees

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 592/S. 109, Pharmacy and Medically Underserved Areas Enhancement Act. H.R. 6, SUPPORT for Patients and Communities Act. H.R. 5684, Protecting Seniors from Opioid Abuse Act. H.R. 5773, Preventing Addiction for Susceptible Seniors Act of 2018. H.R. 5801, Medicaid PARTNERSHIP Act. S. 3120, Helping End Addiction and Lessen Substance Use Disorders Act of 2018. H.R. 6733, Know the Cost Act. S. 2553, Know the Lowest Price Act. S. 2554, Patient Right to Know Prices Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 297, Increasing Competition in Pharmaceuticals Act (Collins-McCaskill) - prescription drug costs S. 974, CREATES Act (Leahy-Grassley) - access to generic drugs and biosimilars S. 1115, Making Pharmaceutical Markets More Competitive Act (Collins-McCaskill) - accelerated approval of generic therapies S. 1131, FAIR Drug Pricing Act (Baldwin-McCain) - transparency in prescription drug pricing S. 2553, Know the Lowest Price Act (Stabenow) - pharmacist-patient communications, S. 2554, Patient Right to Know Drug Prices Act (Collins) - pharmacist-patient communications, reporting of biosimilar pay-for-delay settlements S. 3194, Capping Prescription Costs Act (Warren) - capping prescription copays H.R. 749, Lower Drug Costs Through Competition Act (Schrader-Bilirakis) - prescription drug costs H.R. 1703, Medical Product Communication Act (Griffith) - off-label exchange of information H.R. 2026, Pharmaceutical Information Exchange Act (Guthrie) - pre-approval health care economic information to payors H.R. 2051, Fair Access for Safe and Timely Generics Act (McKinley-Welch) - access to generic drugs H.R. 2212, CREATES Act (Marino-Cicilline) - access to generic drugs and biosimilars H.R. 2439, FAIR Drug Pricing Act (Schakowsky) - transparency in prescription drug pricing H.R. 2562, Making Pharmaceutical Markets More Competitive Act (Kelly) - accelerated approval of generic therapies H.R. 2999, Patients' Access to Treatments Act (McKinley) - limiting cost sharing in specialty drug tiers H.R. 5247, Right to Try Act (Fitzpatrick) - use of unapproved investigational drugs by patients with life-threatening conditions H.R. 6142, Reducing Drug Waste Act (Doggett) - packaging of medications H.R. 6157, Defense-Labor-HHS-Education Appropriations Act (Granger) -pharmaceutical price transparency in DTC advertising H.R. 6340, Capping Prescription Costs Act (Rosen) - capping prescription copays H.R. 6478, Biosimilars Competition Act (Sarbanes) - reporting of pay-for-delay settlements H.R. 6576, Drug-Price Transparency in Communications Act (Schakowsky) - disclosure of drug prices in DTC advertising H.R. 6733, Know the Cost Act (Carter) - pharmacist-patient communications Regulatory Issues: Issues relating to long term safety and effectiveness of medical devices and drugs, including registries; issues relating to post-market surveillance of drugs and medical devices; issues relating to price of drugs and biologics; issues relating to opioids; issues relating to prescription drug price blueprint; issues relating to access for investigational drugs; and other issues relating to health care reform implementation.

Client expense: $1,500,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Treasury, Dept of

H.R. 1038/S. 413 - Improving Transparency and Accuracy in Medicare Part D Spending Act H.R.592/S. 109 - Pharmacy and Medically Underserved Areas Enhancement Act H.R. 1316 - Prescription Drug Price Transparency Act H.R. 623 - Fairness to Pet Owners Act Letter to HHS/CMS on direct and indirect remuneration (DIR) fees Discussions with House committees on pharmacy benefit managers (PBMs) H.R.6 - SUPPORT for Patients and Communities Act - FDA Guidelines Section 3004 Letter S. 2680 - Opioid Crisis Response Act of 2018 H.R. 6733, Know the Cost Act of 2018 S. 2553, Know the Lowest Price Act S. 2554, the Patient Right to Know Drug Prices Act H.R. 5333, the Over-the-Counter Monograph Safety, Innovation, and Reform Act of 2018

Client expense: $180,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Commerce, Dept of (DOC), Federal Reserve System, HOUSE OF REPRESENTATIVES, SENATE

H.R. 1408, Access to Insurance for All Americans Act H.R. 1628, American Health Care Reform Act H.R. 2400, to Allow Persons not Federal Employees to enroll in FEHBP H.R. 5965, Access to Infertility Treatment and Care Act S. 2960, Access to Infertility Treatment and Care Act H.R. 6143, Patient Right to Know Drug Prices Act S. 2554, Patient Right to Know Drug Prices Act H.R. 6733, Know the Cost Act of 2018

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

Government targets: Commodity Futures Trading Commission (CFTC), Consumer Financial Protection Bureau (CFPB), Federal Communications Commission (FCC), Federal Retirement Thrift Investment Board, Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Merit Systems Protection Board, Natl Park Service (NPS), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Office of Special Counsel, Office of the Comptroller of the Currency (OCC), Patent & Trademark Office (PTO), SENATE, Securities & Exchange Commission (SEC), Treasury, Dept of, U.S. Customs & Border Protection

Affordable Care Act (ACA); ACA Regulations; ACA Stabilization; Health Reform; Rural Healthcare; Risk Adjustment; State Flexibility; Point of Sale; Opioids; Sober Homes; Marketplace Stability; Individual Market Reform; FAA (Air Ambulance); CREATES Act; Sec. 1332 Waivers; Short Term Limited Duration (STLD): AHPs; Value-based Care; Health Care Costs; Mental Health; Small Business Plans; Single Payer; Reinsurance; CSRs; SNPs; Health Savings Accounts (HSAs); Postal Reform; 42 CFR Part 2; Transparency. HR 4 FAA Reauthorization Act of 2018 Introduced April 13, 2018 by Bill Shuster (R-PA) Air Ambulance issues. HR 6 SUPPORT for Patients and Communities Act Introduced June 13, 2018 by Greg Walden (R-OR) includes Medicaid, Medicare, and public health reforms to combat the opioid crisis by advancing treatment and recovery initiatives, improving prevention, protecting communities, and bolstering efforts to combat illicit synthetic drugs like fentanyl. The policies contained in the legislation were advanced through regular order by the House Energy and Commerce Committee and the Ways and Means Committee. HR 2051 FAST Generics Act Introduced April 6, 2017 by David McKinley (R-WV) To amend the Federal Food, Drug, and Cosmetic Act to ensure that eligible product developers have competitive access to approved drugs and licensed biological products, so as to enable eligible product developers to develop and test new products, and for other purposes. HR 2212 CREATES Act Introduced April 27, 2017 by Tom Marino (R-PA) To promote competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products. HR 6082 Overdose Prevention and Patient Safety Act Introduced June 13, 2018 by Markwayne Mullin (R-OK) Amends the Public Health Service Act to permit substance use disorder (SUD) records to be shared among covered entities and Part 2 programs in accordance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA), for the purposes of treatment, payment, and healthcare operations. In order to protect individuals seeking and receiving SUD treatment, the bill enhances the protections on the disclosure of SUD treatment records to non-covered entities and non-Part 2 programs by, except for authorization by court order or by consent of the patient, prohibiting the use of these records in any criminal, civil, or administrative investigations, actions, or proceedings. The legislation increases the penalties in the event of unlawful disclosure of SUD treatment records and establishes breach notification requirements in accordance with the Health Information Technology for Economic and Clinical Health (HITECH) Act. Finally, the bill requires the Secretary of Health and Human Services to issue regulations prohibiting discrimination based on data disclosed from such medical records, to issue regulations requiring covered entities to provide written notice of privacy practices, and to develop model training programs and materials for health care providers and patients and their families. HR 6733 Know the Cost Act of 2018 Introduced September 7, 2018 by Buddy Carter (R-GA) To amend title XXVII of the Public Health Service Act and title XVIII of the Social Security Act to prohibit group health plans, health insurance issuers, prescription drug plan sponsors, and Medicare Advantage organizations from limiting certain information on drug prices. S 974 Creating and Restoring Equal Access to Equivalent Samples Act of 2018 Introduced April 27, 2017 by Patrick Leahy (D-VT). A bill to promote competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products. S 1354 Individual Health Insurance Marketplace Improvement Act introduced June 14, 2017 by Thomas Carper (D-DE) A bill to establish an Individual Market Reinsurance fund to provide funding for State individual market stabilization reinsurance programs.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Advantage Policy and Reimbursement Part D Policy and Reimbursement Medicaid and Dual Eligible Issues Pharmacy Reimbursement Issues Medicare Access and CHIP Reauthorization Act Implementation HHS Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs Opioid Issues H.R. 6, Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act S. 3120, HEAL Act of 2018 S. 637, Creating Transparency to Have Drug Rebates Unlocked Act H.R. 3528, Every Prescription Conveyed Securely Act H.R. 6733, Know the Cost Act of 2018 S. 2553, Know the Lowest Price Act of 2018

Client expense: $310,000 · Firm income: Not reported

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

Real World Evidence Patient Reported Outcomes Medical Product Communications Act of 2017, HR 1703 Prescription Drug Price Transparency Act, HR 1316 Drug Pricing Biosimilars Patient Right to Know Drug Pricing Act, S.2554 Know the Lowest Price Act of 2018, S. 2553 Know the Cost Act of 2018, H.R. 6733

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

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

H.R. 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

Client expense: $4,120,000 · Firm income: Not reported

Government targets: Bureau of Citizenship & Immigration Services (BCIS), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), SENATE, Veterans Affairs, Dept of (VA), White House Office

H.R. 6, Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act, all provisions H.R. 4143, Dialysis Patient Access To Integrated-care, Empowerment, Nephrologists, Treatment, and Services (PATIENTS) Demonstration Act of 2017, all provisions S. 2065, Dialysis Patient Access To Integrated-care, Empowerment, Nephrologists, Treatment, and Services (PATIENTS) Demonstration Act of 2017, all provisions H.R. 4554, Medicare Common Access Card Act of 2017, all provisions H.R. 6309, Allowing Working Seniors to Keep Their Health Savings Accounts Act of 2018, all provisions H.R. 6733, Know the Cost Act of 2018, all provisions S. 2553, Know the Lowest Price Act of 2018, all provisions S. 3120, Helping to End Addiction and Lessen (HEAL) Substance Use Disorders Act of 2018, provisions relating to Medicare and Medicaid S. 2904, Medicaid Substance Use Disorder Treatment via Telehealth Act, provision relating to telehealth definition S. 2910, Telehealth for Children's Access to Services and Treatment (TeleCAST) Act, provision relating to telehealth definition H.R. 3528, Every Prescription Conveyed Securely Act, all provisions S. 2460, Every Prescription Conveyed Securely Act, all provisions H.R. 2687, Medicaid Coverage for Addiction Recovery Expansion Act, all provisions S. 1169, Medicaid Coverage for Addiction Recovery Expansion Act, all provisions S. 1291, Advancing Medical Resident Training in Community Hospitals 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 Medicare program: Medicare Access and Chip Reauthorization (MACRA) implementation Medicare program: Merit-based Incentive Payment System (MIPS) Medicare program: Regulatory Relief Medicare program: Quality Payment Program (QPP)/Interoperability Medicare program: QPP cost measures Medicare program: Protecting Access to Medicare Act (PAMA) clinical lab issues/physician office labs Medicare program: Part B drug reimbursement Medicare program: Outpatient Prospective Payment System (OPPS)/Ambulatory Surgical Center (ASC) Payment System Medicare program: Appropriate Use Criteria Medicare program: Health IT Medicare program: Office visit codes Medicare program: Alternative Payment Models (APMs) Medicare program: Accountable Care Organization (ACO)/Medicare Shared Savings Program (MSSP) Medicare program: Graduate Medical Education (GME) Medicare program: 2019 Medicare Physician Fee Schedule Medicare program: Drug pricing/Competitive Acquisition Program, Part B to Part D, Medicare Advantage Step Therapy Medicare program: Open Payments Medicare program: Clinical laboratory fee schedule cuts Medicare program: Evaluation & Management Codes Medicare program: Misvalued codes Medicare program: Outpatient Prospective Payment System (OPPS)/Ambulatory Surgical Centers (ASC) Payment System Medicare program: Prior Authorization Medicare program: Electronic Health Records (EHR) Medicare program: Inpatient Prospective Payment System Medicare program: Diabetes/payment Medicare program: Diabetes Prevention Program Medicare program: Opioids Medicare program: Smart Cards Medicare program: Value-based arrangements Medicare program: Evaluation and Management proposals Medicare program: Payment Model Technical Advisory Committee (PTAC)/model approval process Medicare program: Medicare Advantage Qualifying Payment Arrangement Incentive (MAQI) demonstration Medicare program: Pharmacy Benefit Managers (PBMs) Medicare and Medicaid programs: Appropriate Use Criteria Medicare and Medicaid programs: Cybersecurity Medicare and Medicaid programs: Stark/Anti-Kickback/Value-based arrangements Medicare and Medicaid programs: Electronic Health Records/certification Medicare and Medicaid programs: Provider Enrollment, Chain and Ownership System (PECOS)/Medicare Enrollment/Revocations/Revalidations Medicaid program: Marylands Medicaid Demonstration Waiver Amendment

Client expense: $4,120,000 · Firm income: Not reported

Government targets: Bureau of Citizenship & Immigration Services (BCIS), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), SENATE, Veterans Affairs, Dept of (VA), White House Office

Affordable Care Act (ACA); ACA Regulations; ACA Stabilization; Health Reform; Rural Healthcare; Risk Adjustment; State Flexibility; Point of Sale; Fall Priorities; Opioids; Sober Homes; Marketplace Stability; Individual Market Reform; TCPA (Robocalls); FAA (Air Ambulance); CREATES Act; Sec. 1332 Waivers; Short Term Limited Duration (STLD): AHPs; Value-based Care; Health Care Costs; Mental Health; Small Business Plans; Single Payer; Reinsurance; CSRs; SNPs; Health Savings Accounts (HSAs); Postal Reform; 42 CFR Part 2; Transparency; HR 4 FAA Reauthorization Act of 2018 Introduced April 13, 2018 by Bill Shuster (R-PA) Air Ambulance HR 6 SUPPORT for Patients and Communities Act Introduced June 13, 2018 by Greg Walden (R-OR) includes Medicaid, Medicare, and public health reforms to combat the opioid crisis by advancing treatment and recovery initiatives, improving prevention, protecting communities, and bolstering efforts to combat illicit synthetic drugs like fentanyl. The policies contained in the legislation were advanced through regular order by the House Energy and Commerce Committee and the Ways and Means Committee. HR 2051 FAST Generics Act Introduced April 6, 2017 by David McKinley (R-WV) To amend the Federal Food, Drug, and Cosmetic Act to ensure that eligible product developers have competitive access to approved drugs and licensed biological products, so as to enable eligible product developers to develop and test new products, and for other purposes. HR 2212 CREATES Act Introduced April 27, 2017 by Tom Marino (R-PA) To promote competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products. HR 3325 ACE Kids Act Introduced July 20, 2017 by Joe Barton (R-TX) To amend title XIX of the Social Security Act to provide States with the option of providing coordinated care for children with complex medical conditions through a health home, and for other purposes. HR 6082 Overdose Prevention and Patient Safety Act Introduced June 13, 2018 by Markwayne Mullin (R-OK) Amends the Public Health Service Act to permit substance use disorder (SUD) records to be shared among covered entities and Part 2 programs in accordance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA), for the purposes of treatment, payment, and healthcare operations. In order to protect individuals seeking and receiving SUD treatment, the bill enhances the protections on the disclosure of SUD treatment records to non-covered entities and non-Part 2 programs by, except for authorization by court order or by consent of the patient, prohibiting the use of these records in any criminal, civil, or administrative investigations, actions, or proceedings. The legislation increases the penalties in the event of unlawful disclosure of SUD treatment records and establishes breach notification requirements in accordance with the Health Information Technology for Economic and Clinical Health (HITECH) Act. Finally, the bill requires the Secretary of Health and Human Services to issue regulations prohibiting discrimination based on data disclosed from such medical records, to issue regulations requiring covered entities to provide written notice of privacy practices, and to develop model training programs and materials for health care providers and patients and their families. HR 6294 REVAMP Act Introduced June 28, 2018 by John Shimkus (R-IL) To amend the Federal Food, Drug, and Cosmetic Act to encourage the development of priority antimicrobial products through the award of a transferable exclusivity extension period, and for other purposes. HR 6733 Know the Cost Act of 2018 Introduced September 7, 2018 by Buddy Carter (R-GA) To amend title XXVII of the Public Health Service Act and title XVIII of the Social Security Act to prohibit group health plans, health insurance issuers, prescription drug plan sponsors, and Medicare Advantage organizations from limiting certain information on drug prices. S 974 Creating and Restoring Equal Access to Equivalent Samples Act of 2018 Introduced April 27, 2017 by Patrick Leahy (D-VT). A bill to promote competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products. S 1354 Individual Health Insurance Marketplace Improvement Act introduced June 14, 2017 by Thomas Carper (D-DE) A bill to establish an Individual Market Reinsurance fund to provide funding for State individual market stabilization reinsurance programs.

Client expense: $1,700,000 · Firm income: Not reported

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

Affordable Care Act; Health Care Reform; Reinsurance; Cost Sharing Reduction Subsidies; Drug Pricing; Individual Market Reform; Market Stabilization; Association Health Plans; Waivers; Short-Term Limited Duration Policies; issues related to delivery system and payment reforms; Part 2 substance use disorder regulation; HSAs; Risk Adjustment; Air Ambulance; HR. 6 Support for Patients and Communities Act of 2018 (Walden) HR. 6082 - Overdose Prevention and Patient Safety Act (Mullin) - 42 CFR Part 2 HR. 6733 - Know the Cost Act (Carter) - pharmacy gag rule HR. 4 - FAA Reauthorization (air ambulance)

Client expense: $140,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Monitor and advocate on legislative and regulatory issues regarding healthcare. H.R. 6, SUPPORT for Patients and Communities Act. H.R. 541, Improving Oversight and Accountability in Medicaid Non-DSH Supplemental Payments Act. H.R. 1038, Improving Transparency and Accuracy in Medicare Part D Spending Act. H.R. 2038, Budgeting for Opioid Addiction Treatment Act. H.R. 2843, Medicaid and CHIP Quality Improvement Act of 2017. H.R. 5795, Overdose Prevention and Patient Safety Act. H.R. 5797, Individuals in Medicaid Deserve Care that is Appropriate and Responsible in its Execution Act. H.R. 6071, SERV Communities Act. H.R. 6082, Overdose Prevention and Patient Safety Act. H.R. 6157, Department of Defense and Labor, Health and Human Services, and Education Appropriations Act, 2019 and Continuing Appropriations Act, 2019 H.R. 6470, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2019. H.R. 6733, Know the Cost Act of 2018. S.413, Improving Transparency and Accuracy in Medicare Part D Spending Act. S. 523, Budgeting for Opioid Addiction Treatment Act. S. 1079, Protecting Americans from Dangerous Opioids Act. S. 1123, Office of National Drug Control Policy Reauthorization Act of 2017. S. 2553, Know the Lowest Price Act of 2018. S. 2554, Patient Right to Know Drug Prices Act. S. 2680, Opioid Crisis Response Act of 2018. S. 3120, HEAL Act of 2018.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 592/S. 109, Pharmacy and Medically Underserved Areas Enhancement Act. H.R. 6, SUPPORT for Patients and Communities Act. H.R. 5684, Protecting Seniors from Opioid Abuse Act. H.R. 5773, Preventing Addiction for Susceptible Seniors Act of 2018. H.R. 5801, Medicaid PARTNERSHIP Act. S. 3120, Helping End Addiction and Lessen Substance Use Disorders Act of 2018. H.R. 6733, Know the Cost Act. S. 2553, Know the Lowest Price Act. S. 2554, Patient Right to Know Prices Act.

Client expense: $160,000 · Firm income: Not reported

Government targets: Environmental Protection Agency (EPA), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, Treasury, Dept of

Affordable Care Act (ACA) Regulations; ACA Stabilization; Health Reform; Risk Adjustment; State Flexibility; Opioids; Sober Homes, Marketplace Stability; Individual Market Reform; FAA (Air Ambulance); CREATES Act; Section 1332 Waivers; Short Term Limited Duration Insurance (STLDI); Association Health Plans (AHPs); Value-based Care; Health Care Costs; Mental Health; Single Payer; Reinsurance; Cost Sharing Reductions (CSRs); Health Savings Accounts (HSAs) HR 4 Introduced April 13, 2018 by Bill Shuster (R-PA). The FAA Reauthorization Act of 2018 includes several provisions addressing air ambulance issues. The bill would establish an Advisory Committee on Air Ambulance and Patient Billing (including representatives of health insurance providers and other stakeholders) to make recommendations on the disclosure of charges and fees for air ambulance services and insurance coverage, consumer protections, the enforcement authorities of both the Department of Transportation and state authorities, and the prevention of balance billing to consumers; direct the Secretary of Transportation to consider the Advisory Committees recommendations and then issue regulations or guidance on specific issues, including consumer protections for customers of air ambulance providers; and provide an avenue through which consumers may submit complaints to the Secretary of Transportation about unfair and deceptive practices or unfair methods of competition by air ambulances. HR 6 Introduced June 13, 2018 by Greg Walden (R-OR). The SUPPORT for Patients and Communities Act includes Medicaid, Medicare, and public health reforms to combat the opioid crisis by advancing treatment and recovery initiatives, improving prevention, protecting communities, and bolstering efforts to combat illicit synthetic drugs like fentanyl. The policies contained in the legislation were advanced through regular order by the House Energy and Commerce Committee and the Ways and Means Committee. HR 2051 Introduced April 6, 2017 by David McKinley (R-WV). The FAST Generics Act amends the Federal Food, Drug, and Cosmetic Act to ensure that eligible product developers have competitive access to approved drugs and licensed biological products, so as to enable eligible product developers to develop and test new products, and for other purposes. HR 2212 Introduced April 27, 2017 by Tom Marino (R-PA). The CREATES Act promotes competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products. HR 3325 Introduced July 20, 2017 by Joe Barton (R-TX). This bill amends title XIX of the Social Security Act to provide states with the option of providing coordinated care for children with complex medical conditions through a health home, and for other purposes. HR 6082 Introduced June 13, 2018 by Markwayne Mullin (R-OK). The Overdose Prevention and Patient Safety Act amends the Public Health Service Act to permit substance use disorder (SUD) records to be shared among covered entities and Part 2 programs in accordance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA), for the purposes of treatment, payment, and healthcare operations. In order to protect individuals seeking and receiving SUD treatment, the bill enhances the protections on the disclosure of SUD treatment records to non-covered entities and non-Part 2 programs, except for authorization by court order or by consent of the patient, by prohibiting the use of these records in any criminal, civil, or administrative investigations, actions, or proceedings. The legislation increases the penalties in the event of unlawful disclosure of SUD treatment records and establishes breach notification requirements in accordance with the Health Information Technology for Economic and Clinical Health (HITECH) Act. Finally, the bill requires the Secretary of Health and Human Services to issue regulations prohibiting discrimination based on data disclosed from such medical records, to issue regulations requiring covered entities to provide written notice of privacy practices, and to develop model training programs and materials for health care providers and patients and their families. HR 6294 Introduced June 28, 2018 by John Shimkus (R-IL). The REVAMP Act would amend the Federal Food, Drug, and Cosmetic Act to encourage the development of priority antimicrobial products through the award of a transferable exclusivity extension period, and for other purposes. HR 6733 Introduced September 7,2018 by Buddy Carter (R-GA). The Know the Cost Act of 2018 amends title XXVII of the Public Health Service Act and title XVIII of the Social Security Act to prohibit group health plans, health insurance issuers, prescription drug plan sponsors, and Medicare Advantage organizations from limiting certain information on drug prices. S 974 Introduced April 27, 2017 by Patrick Leahy (D-VT). The Creating and Restoring Equal Access to Equivalent Samples Act of 2018 promotes competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products. S 1354 Introduced June 14, 2017 by Thomas Carper (D-DE). The Individual Health Insurance Marketplace Improvement Act would establish an individual market reinsurance fund to provide funding for state individual market stabilization reinsurance programs.

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

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

H.R. 1316, Prescription Drug Price Transparency Act; H.R. 1038, Improving Transparency and Accuracy in Medicare Part D Spending Act; S. 413, Improving Transparency and Accuracy in Medicare Part D Spending Act; H.R. 592, Pharmacy and Medically Underserved Areas Enhancement Act; S. 109, Pharmacy and Medically Underserved Areas Enhancement Act; H.R.1939 - To amend title XVIII of the Social Security Act to ensure equal access of Medicare beneficiaries to community pharmacies in underserved areas as network pharmacies under Medicare prescription drug coverage, and for other purposes; S.637 Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2017; HR 394/ S 85, Restoring Access to Medication Act; HR 3921/S 1827, KIDS Act of 2017; HR 3271, Protecting Access to Diabetes Supplies Act of 2017; S. 870, Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017; Centers for Medicare and Medicaid Services (CMS) Proposed Rule for the 2019 Medicare Part D Plan Year, pharmacy provisions; S.2553 / H.R. 6144, Know the Lowest Price Act of 2018; S.2554 / H.R. 6143, Patient Right to Know Drug Prices Act; H.R. 5343, Prescription Transparency Act of 2018; H.R. 5958, Phair Pricing Act of 2018; CMS Call Letter for 2019 Medicare Part D and Medicare Advantage Plans; H.R. 6733, Know the Cost Act of 2018; H.R. 6641, COST Act

Client expense: $290,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), 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), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), Office of Personnel Management (OPM), SENATE, Small Business Administration (SBA), Substance Abuse & Mental Health Services Administration (SAMHSA), White House Office

H.R. 1245/S. 469 The Affordable and Safe Prescription Drug Importation Act H.R. 1316 - Prescription Drug Price Transparency Act H.R. 749 Lower Drug Costs Through Competition H.R.2430/S. 934 - FDA Reauthorization Act of 2017 H.R. 4841 - Standardizing Electronic Prior Authorization for Safe Prescribing Act H.R. 6733 - Know the Cost Act H.R. 6143/ S. 2554 - Patient Right to Know Drug Prices Act H.R. 6144/ S. 2553 - Know the Lowest Price Act H.R. 6641 - True Cost-sharing of Seniors Drugs Transparency (True COST) Act H.R. 5989 - Fair Pricing Act

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, SENATE

Legislation H.R. 5343 - Prescription Transparency Act of 2018. (Lobbying activities related to pharmacy benefit managers.) H.R. 6470 - Making appropriations for the Departments of Labor, Health and Human Services, and Education, and related agencies for the fiscal year ending September 30, 2019, and for other purposes. (Lobbying activities related to DIR fees.) H.R. 6157 - Making consolidated appropriations for the Departments of Defense, Labor, Health and Human Services, and Education, and Related Agencies for the fiscal year ending September 30, 2019, and for other purposes. (Lobbying activities related to DIR fees.) S. 413 - To amend title XVIII of the Social Security Act to prohibit prescription drug plan sponsors and MA-PD organizations under the Medicare program from retroactively reducing payment on clean claims submitted by pharmacies. (Lobbying activities related to pharmacy benefit managers.) H.R. 1038 - To amend title XVIII of the Social Security Act to prohibit prescription drug plan sponsors and MA-PD organizations under the Medicare program from retroactively reducing payment on clean claims submitted by pharmacies. (Lobbying activities related to pharmacy benefit managers.) S. 2553 - To amend title XVIII of the Social Security Act to prohibit health plans and pharmacy benefit managers from restricting pharmacies from informing individuals regarding the prices for certain drugs and biologicals. (Lobbying activities related to pharmacy benefit managers.) S. 2554 - To ensure that health insurance issuers and group health plans do not prohibit pharmacy providers from providing certain information to enrollees. (Lobbying activities related to pharmacy benefit managers.) H.R. 6733 - To amend title XXVII of the Public Health Service Act and title XVIII of the Social Security Act to prohibit group health plans, health insurance issuers, prescription drug plan sponsors, and Medicare Advantage organizations from limiting certain information on drug prices. (Lobbying activities related to pharmacy benefit managers.) Issues Prescription drug prices Pharmacy benefit managers DIR Fees

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation H.R. 5343 - Prescription Transparency Act of 2018. (Lobbying activities related to pharmacy benefit managers.) H.R. 6470 - Making appropriations for the Departments of Labor, Health and Human Services, and Education, and related agencies for the fiscal year ending September 30, 2019, and for other purposes. (Lobbying activities related to DIR fees.) H.R. 6157 - Making consolidated appropriations for the Departments of Defense, Labor, Health and Human Services, and Education, and Related Agencies for the fiscal year ending September 30, 2019, and for other purposes. (Lobbying activities related to DIR fees.) S. 413 - To amend title XVIII of the Social Security Act to prohibit prescription drug plan sponsors and MA-PD organizations under the Medicare program from retroactively reducing payment on clean claims submitted by pharmacies. (Lobbying activities related to pharmacy benefit managers.) H.R. 1038 - To amend title XVIII of the Social Security Act to prohibit prescription drug plan sponsors and MA-PD organizations under the Medicare program from retroactively reducing payment on clean claims submitted by pharmacies. (Lobbying activities related to pharmacy benefit managers.) S. 2553 - To amend title XVIII of the Social Security Act to prohibit health plans and pharmacy benefit managers from restricting pharmacies from informing individuals regarding the prices for certain drugs and biologicals. (Lobbying activities related to pharmacy benefit managers.) S. 2554 - To ensure that health insurance issuers and group health plans do not prohibit pharmacy providers from providing certain information to enrollees. (Lobbying activities related to pharmacy benefit managers.) H.R. 6733 - To amend title XXVII of the Public Health Service Act and title XVIII of the Social Security Act to prohibit group health plans, health insurance issuers, prescription drug plan sponsors, and Medicare Advantage organizations from limiting certain information on drug prices. (Lobbying activities related to pharmacy benefit managers.) Issues Prescription drug prices Pharmacy benefit managers DIR Fees

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE