Plan Verification and Fairness Act of 2017

Bipartisan Health Care Stabilization Act (Alexander-Murray) - funding for cost sharing reduction benefits, stabilization of individual market Bipartisan Health Care Stabilization Act; updated version (Alexander-Walden-Collins-Costello) - funding for cost sharing reduction benefits and reinsurance, stabilization of individual market S. 147, Obamacare Taxpayer Bailout Prevention Act (Rubio) - ACA risk corridors program S. 581, Jessies Law (Manchin-Capito) - patient history of opioid use disorder S. 1201, Health Care Options for All Act (McCaskill) - coverage options in bare counties S. 1354, Individual Health Insurance Marketplace Improvement Act (Carper-Kaine) - individual market reinsurance fund, outreach and enrollment activities S. 1405, FAA Reauthorization Act (Thune) - air ambulance issues S. 1462, Marketplace Certainty Act (Shaheen) - funding for cost-sharing reduction benefits S. 1516, Coverage Across State Lines (Heller) S. 1667, Protecting Consumers from Unreasonable Rates Act (Feinstein) - rate review S. 1835, Lower Premiums Through Reinsurance Act (Collins-Nelson) - invisible high risk pool and reinsurance programs S. 1850, Legacy Act (Manchin-Capito) -- confidentiality of drug and alcohol treatment and prevention records S. 1976, Increasing Access to Care Act (Scott) - copper plan S. 1985, Protect Access to Birth Control Act (Murray) - coverage of contraceptive services S. 2052, Healthcare Market Certainty and Mandate Relief Act (Hatch) - funding for cost sharing reduction benefits, HSA improvements, ACA individual mandate S. 2241 (King) - fees on excepted benefits and standalone dental plans S. 2303, Access to Independent Health Insurance Advisors Act (Isakson-Coons) - calculation of medical loss ratios H.R. 2, Agriculture and Nutrition Act (Conaway) - agricultural association health plans H.R. 4, FAA Reauthorization Act (Shuster) - air ambulance issues H.R. 314, Health Care Choice Act (Blackburn) - selling insurance across state lines H.R. 372, Competitive Health Insurance Reform Act (Gosar) - McCarran-Ferguson Act H.R. 421, Allowing Greater Access to Safe and Effective Contraception Act (Love) - non-prescription contraceptives, HSA flexibility H.R. 706, Plan Verification and Fairness Act (Blackburn) - verifying eligibility for special enrollment periods H.R. 708, State Age Rating Flexibility Act (Buchson) - age rating bands H.R. 710, Health Coverage State Flexibility Act (Flores) - grace period for premium payments H.R. 1101, Small Business Health Fairness Act (Johnson) - association health plans H.R. 1121, Pre-existing Conditions Protection Act (Walden) - protections for patients with pre-existing conditions H.R. 1304, Self-Insurance Protection Act (Roe) - medical stop-loss insurance H.R. 1409, Cancer Drug Parity Act (Lance) - coverage of oral anti-cancer drugs H.R. 3450, Protecting Consumers from Unreasonable Rates Act (Schakowsky) - rate review H.R. 3545, Overdose Prevention and Patient Safety Act (Murphy- Blumenauer) -- confidentiality of drug and alcohol treatment and prevention records H.R. 3922, CHAMPION Act (Walden) - extension of federal CHIP funding, ACA grace periods, community health center funding H.R. 3976, Access to Marketplace Insurance Act (Cramer) - third party payments H.R. 4082, Protect Access to Birth Control Act (DeGette) - coverage of contraceptive services H.R. 4200, Healthcare Market Certainty and Mandate Relief Act (Brady) - funding for cost sharing reduction benefits, HSA improvements H.R. 4225 (Hudson) - fees on excepted benefits and standalone dental plans H.R. 4575, Access to Independent Health Insurance Advisors Act (Long-Schrader) - calculation of medical loss ratios H.R. 4666, Premium Relief Act (Costello) - Patient and State Stability Fund H.R. 4695, Bipartisan Market Stabilization and Innovation Act (Schrader) - stabilization of individual market H.R. 6314, Health Savings Act (Burgess) - definition of high-deductible health plan Regulatory Issues: Insurance regulatory reform; issues related to the coordination of private and public disability income benefits; disability risk management; disability income insurance enrollment and awareness; issues related to encouraging impaired workers to stay in/return to the workforce; issues relating to the coordination of benefits between private health insurance plans and Medicaid; Medigap claims processing and crossover fees; Medigap cross-over claim issues, Medigap coverage, implementation of Medigap standardized plan offerings; Medigap carrier recoveries related to CMS fraud and abuse enforcement activities, and issues related to Medigap educational materials, and other Medigap issues; fraud and abuse issues affecting public and private insurance coverage; issues relating to antitrust; implementation of the Mental Health Parity Act requirements; implementation of the 21st Century Cures Act requirements; summary of benefits and coverage disclosures; pre-existing condition insurance plans; accountable care organizations; coverage of preventive services; preexisting condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; dependent coverage; treatment of expatriate plans; issues related to all payor claims databases; issues related to association health plans; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations, non-discriminatory wellness programs; issues related to supplemental products; issues relating to dental coverage; issues relating to proposals for single-payer and Medicare/Medicaid buy-in options; issues related to implementation of the Telephone Consumer Protection Act; issues relating to third party payment of premiums; issues related to cost-sharing reductions (CSRs); issues relating to the individual market; and other issues relating to health care reform implementation.

Client expense: $1,410,000 · 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), Internal Revenue Service (IRS), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE, Treasury, Dept of, White House Office

Bipartisan Health Care Stabilization Act (Alexander-Murray) - funding for cost sharing reduction benefits, stabilization of individual market Bipartisan Health Care Stabilization Act; updated version (Alexander-Walden-Collins-Costello) - funding for cost sharing reduction benefits and reinsurance, stabilization of individual market S. 147, Obamacare Taxpayer Bailout Prevention Act (Rubio) - ACA risk corridors program S. 581, Jessies Law (Manchin-Capito) - patient history of opioid use disorder S. 1201, Health Care Options for All Act (McCaskill) - coverage options in bare counties S. 1354, Individual Health Insurance Marketplace Improvement Act (Carper-Kaine) - individual market reinsurance fund, outreach and enrollment activities S. 1462, Marketplace Certainty Act (Shaheen) - funding for cost-sharing reduction benefits S. 1516, Coverage Across State Lines (Heller) S. 1667, Protecting Consumers from Unreasonable Rates Act (Feinstein) - rate review S. 1771, FY 2018 Labor-HHS Appropriations Act (Blunt) - risk corridors and other ACA issues, funding for HHS programs and agencies S. 1835, Lower Premiums Through Reinsurance Act (Collins-Nelson) - invisible high risk pool and reinsurance programs S. 1850, Legacy Act (Manchin-Capito) -- confidentiality of drug and alcohol treatment and prevention records S. 1976, Increasing Access to Care Act (Scott) - copper plan S. 1985, Protect Access to Birth Control Act (Murray) - coverage of contraceptive services S. 2052, Healthcare Market Certainty and Mandate Relief Act (Hatch) - funding for cost sharing reduction benefits, HSA improvements, ACA individual mandate S. 2241 (King) - fees on excepted benefits and standalone dental plans S. 2303, Access to Independent Health Insurance Advisors Act (Isakson-Coons) - calculation of medical loss ratios S. 2410, Chronic Disease Management Act (Thune) - flexibility for high-deductible health plans H.R. 314, Health Care Choice Act (Blackburn) - selling insurance across state lines H.R. 372, Competitive Health Insurance Reform Act (Gosar) - McCarran-Ferguson Act H.R. 421, Allowing Greater Access to Safe and Effective Contraception Act (Love) - non-prescription contraceptives, HSA flexibility H.R. 706, Plan Verification and Fairness Act (Blackburn) - verifying eligibility for special enrollment periods H.R. 708, State Age Rating Flexibility Act (Buchson) - age rating bands H.R. 710, Health Coverage State Flexibility Act (Flores) - grace period for premium payments H.R. 1101, Small Business Health Fairness Act (Johnson) - association health plans H.R. 1121, Pre-existing Conditions Protection Act (Walden) - protections for patients with pre-existing conditions H.R. 1304, Self-Insurance Protection Act (Roe) - medical stop-loss insurance H.R. 1409, Cancer Drug Parity Act (Lance) - coverage of oral anti-cancer drugs H.R. 3354, FY 2018 Appropriations Act (Calvert) - risk corridors and other ACA issues, funding for HHS programs and agencies H.R. 3358, FY 2018 Labor-HHS Appropriations Act (Cole) - risk corridors and other ACA issues, funding for HHS programs and agencies H.R. 3450, Protecting Consumers from Unreasonable Rates Act (Schakowsky) - rate review H.R. 3545, Overdose Prevention and Patient Safety Act (Murphy- Blumenauer) -- confidentiality of drug and alcohol treatment and prevention records H.R. 3922, CHAMPION Act (Walden) - extension of federal CHIP funding, ACA grace periods, community health center funding H.R. 3976, Access to Marketplace Insurance Act (Cramer) - third party payments H.R. 4082, Protect Access to Birth Control Act (DeGette) - coverage of contraceptive services H.R. 4200, Healthcare Market Certainty and Mandate Relief Act (Brady) - funding for cost sharing reduction benefits, HSA improvements H.R. 4225 (Hudson) - fees on excepted benefits and standalone dental plans H.R. 4575, Access to Independent Health Insurance Advisors Act (Long-Schrader) - calculation of medical loss ratios H.R. 4666, Premium Relief Act (Costello) - Patient and State Stability Fund H.R. 4695, Bipartisan Market Stabilization and Innovation Act (Schrader) - stabilization of individual market H.R. 4978, Chronic Disease Management Act (Black) - flexibility for high-deductible health plans Regulatory Issues: Insurance regulatory reform; issues related to the coordination of private and public disability income benefits; disability risk management; disability income insurance enrollment and awareness; issues related to encouraging impaired workers to stay in/return to the workforce; issues relating to the coordination of benefits between private health insurance plans and Medicaid; Medigap claims processing and crossover fees; Medigap cross-over claim issues, Medigap coverage, implementation of Medigap standardized plan offerings; Medigap carrier recoveries related to CMS fraud and abuse enforcement activities, and issues related to Medigap educational materials, and other Medigap issues; fraud and abuse issues affecting public and private insurance coverage; issues relating to antitrust; implementation of the Mental Health Parity Act requirements; implementation of the 21st Century Cures Act requirements; summary of benefits and coverage disclosures; pre-existing condition insurance plans; accountable care organizations; coverage of preventive services; preexisting condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; dependent coverage; treatment of expatriate plans; issues related to all payor claims databases; issues related to association health plans; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations, non-discriminatory wellness programs; issues related to supplemental products; issues relating to dental coverage; issues relating to proposals for single-payer and Medicare/Medicaid buy-in options; issues related to implementation of the Telephone Consumer Protection Act; issues relating to third party payment of premiums; issues related to cost-sharing reductions (CSRs); issues relating to the individual market; and other issues relating to health care reform implementation.

Client expense: $2,280,000 · 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

HR1; The American Health Care Act of 2017; HR706; HR710; HR1628; Insurance Market stabilization; CMS Notice of Benefit & Payment Parameters; reinsurance; cost-sharing reductions; 3rd party payment of premiums; special enrollment periods; grace periods; age rate bands; delivery system reform; Patient Safety and Quality Improvement; Patient-Centered Primary/Medical Home; Bundled Payments; Employer Wellness; Chronic Care & Medical Management; Childhood Obesity; mental health reform; ACA Implementation and back-end issues; Executive Orders related to short-term limited duration plans and association health plans.

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

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

S. J. Res. 16 a joint resolution approving the discontinuation of the process for consideration and automatic implementation of the annual proposal of the independent payment Medicare advisory board H.J. Res 51/S. J. Res 17 Independent Payment Advisory Board Repeal H.R 1995 Value Based Insurance Design for Better Care Act H.R. 1004 Regulatory Integrity Act H.R. 1009/S. 676 OIRA Insight, Reform, and Accountability Act H.R. 1038/S. 413 Improving Transparency and Accuracy in Medicare Part D Spending H.R. 1101 Small Business Health Fairness Act H.R. 1121 Pre-Existing Conditions Protection Act H.R. 1148/S. 431 Furthering Access to Stroke Telemedicine (FAST) Act H.R. 1215 Protecting Access to Care Act H.R. 1267/S. 482 Personal Health Investment Today Act H.R. 1304 Self-Insurance Protection Act H.R. 1313 Preserving Employee Wellness Programs Act H.R. 1554 Jessie's Law H.R. 1565 Saving Lives, Saving Costs Act H.R. 1628 American Health Care Act H.R. 1703 Medical Product Communications Act H.R. 184 Protect Medical Innovation Act H.R. 1876 Good Samaritan Health Professionals Act H.R. 1953/S. 830 Treat and Reduce Obesity Act H.R. 2267/S. 1301 Resident Physician Shortage Reduction Act H.R. 246/S. 183 Jobs and Premium Protection Act H.R. 2550 Medicare Telehealth Parity Act H.R. 2556/S. 1016 CONNECT for Health Act H.R. 2797/S. 1334 Patient Choice and Quality Care Act H.R. 284 Advancing Medical Resident Training in Community Hospitals Act H.R. 2953/S. 2164 Preventive Health Savings Act H.R. 3044 to expand supplemental benefits to meet the needs of chronically ill Medicare Advantage enrollees H.R. 3059/S. 1441 Community Health Center and Primary Care Workforce Expansion Act H.R. 3120 to reduce the volume of future electronic health record-related significant hardship requests H.R. 3124/S. 1299 Preventing Diabetes in Medicare Act H.R. 3168 to provide continued access to Medicare Advantage plans for special needs H.R. 3224 Critical Access and Rural Equity Act H.R. 3245 Medicare Civil and Criminal Penalties Act H.R. 3263 to extend the Medicare independence at home medical demonstration program H.R. 3394 Teaching Health Centers Graduate Medical Education Extension Act H.R. 3447 Furthering Access to Coordinated Treatment for Seniors Act H.R. 3726 Stark Administrative Simplification Act of 2017 H.R. 3728 Empowering Medical Professionals and Optimizing Workforce Efficiency and Readiness Act H.R. 3820/S. 977 Medicare Home Health Flexibility Act H.R. 3862 National Health Service Corps Strengthening Act H.R. 3921 Helping Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable Act H.R. 3922 Continuing Community Health and Medical Professional Programs to Improve Our Nation, Increase National Gains, and Help Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable Act H.R. 4541 Continuing Community Health and Medical Professional Programs to Improve Our Nation and Keep Insurance Delivery Stable H.R. 4613 Ensuring Patient Access to Healthcare Records Act H.R. 4616 to provide for a temporary moratorium on the employer mandate and to provide for a delay in the implementation of the excise tax on high cost employer-sponsored health coverage H.R. 4617 to provide for a temporary moratorium on the medical device excise tax H.R. 4618 to provide for a temporary moratorium on certain taxes affecting purchases of prescription medication H.R. 4619 to provide temporary relief from the annual fee imposed on health insurance providers, to the extent that such fee is due to Puerto Rican health insurance H.R. 4620 Protecting Families and Small Businesses Act H.R. 4006 Community-Based Independence for Seniors Act of 2017 H.R. 4200/S. 2052 Healthcare Market Certainty and Mandate Relief Act H.R. 4520 to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2017 H.R. 4552/S. 1291 Advancing Medical Training in Community Hospitals Act H.R. 4105 to extend the health professions workforce demonstration project H.R. 4841 Standardizing Electronic Prior Authorization for Safe Prescribing Act H.R. 592/S. 109 Pharmacy and Medically Underserved Areas Enhancement Act H.R. 706 Plan Verification and Fairness Act H.R. 741/S. 243 Rural Hospital Regulatory Relief Act H.R. 749 Lower Drug Costs Through Competition Act H.R. 766 Amend Title XVII of the Social Security Act to expand telehealth in Medicare H.R. 849/S. 260 Protecting Seniors' Access to Medicare Act H.R. 908 Medicare Advantage Quality Payment Relief Act H.R. 998 Searching for and Cutting Regulations that are Unnecessarily Burdensome (SCRUB) Act H.R. 2687/S. 1169 Medicaid Coverage for Addiction Recovery Expansion Act H.R.3727 To amend title XVIII of the Social Security Act to include additional telehealth services for purposes of MA organization bids, and for other purposes H.R. 4206/S. 2051 Medicare Care Coordination Improvement Act H.R. 5138 Bipartisan Health Savings Accounts Improvement Act Introduction of the Healthcare Cybersecurity Improvement Act Introduction of the Stark Law Modernization Act Pub L. 114-198 Comprehensive Addiction and Recovery Act Pub. L. 115-120 Fiscal Year 2018 Continuing Resolution Pub L. 115-80 National Clinical Care Commission Act Pub L. 115-123 Bipartisan Budget Act Pub L. 115-141 Fiscal Year 2018 Omnibus Appropriations Act Pub. L. 102-143 Telephone Consumer Protection Act Pub. L. 111-148 Patient Protection and Affordable Care Act (PPACA) Pub. L. 111-5 The American Recovery and Reinvestment Act Pub. L. 114-10 Medicare Access and CHIP Reauthorization Act (MACRA) Pub. L. 114-255 21st Century Cures Act Pub. L. 114-270 Expanding Capacity for Health Outcomes Act (ECHO) Pub. L. 114-329 American Innovation and Competitiveness Act Pub L. 115-63 Disaster Relief and Airway Extension Act Pub. L. 115-97 Tax Cuts and Jobs Act Reintroduction of TELE-MED Act of 2015 S. 108 Medical Device Access and Innovation Protection Act S. 297 Increasing Competition in Pharmaceuticals Act S. 1754 Training the Next Generation of Primary Care Doctors Act S. 1827 Keep Kids' Insurance Dependable and Secure Act S. 1829 Strong Families Act S. 1859 Healthcare Tax Relief Act S. 1899 to reauthorize and extend funding for community health centers and the National Health Service Corps S. 1967 Mandate Relief Act S. 251 Protecting Medicare from Executive Action Act S. 2278 State Offices of Rural Health Reauthorization Act S. 309 Community Based Independence for Seniors Act S. 464 Independence at Home Act H .R. 1933/S. 761 Health Care Options Act S. 787 Telehealth Innovation and Improvement Act S. 870 Creating High-Quality Results and Outcomes Necessary to Improve Chronic Care Act S. 1978 Small Business and Family Health Tax Relief Act S. Con. Res. 3 Budget Resolution H.R. 3545 Overdose Prevention and Patient Safety Act H.R. 4613 Ensuring Patient Access to Healthcare Records Act S.1850 Jessie's Law H.R. 4206/S.2501 Medicare Care Coordination Improvement Act

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

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

HR 2212 & S 974 - Creating and Restoring Equal Access To Equivalent Samples Act of 2017: A bill to promote competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products. Marino (R-PA) & Leahy (D-VT) HR 3120 - To amend title XVIII of the Social Security Act to reduce the volume of future electronic health record-related significant hardship requests. Burgess (R-TX) HR 3245 - Medicare Civil and Criminal Penalties Update Act: To amend title XI of the Social Security Act to increase civil money penalties and criminal fines for Federal health care program fraud and abuse, and for other purposes. Bilirakis (R-FL). HR 3263 - To amend title XVIII of the Social Security Act to extend the Medicare independence at home medical practice demonstration program. Burgess (R-TX) HR 3921 - Helping Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable Act of 2017: To extend funding for the Children's Health Insurance Program, and for other purposes. Burgess (R-TX) HR 3922 - Community Health And Medical Professionals Improve Our Nation Act of 2017: To extend funding for certain public health programs, and for other purposes. Walden (R-OR) S 1354 - Individual Health Insurance Marketplace Improvement Act: A bill to establish an individual market reinsurance fund to provide funding for state individual market stabilization reinsurance programs. Carper (D-DE) S 1827 - Keep Kids' Insurance Dependable and Secure Act of 2017: A bill to extend funding for the Children's Health Insurance Program, and for other purposes. Hatch (R-UT) S 1859 - Healthcare Tax Relief Act: A bill to extend the moratorium on the annual fee on health insurance providers. Gardner (R-CO) H.R. 1215 - Protecting Access to Care Act of 2017: To improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system. King (R-IA) H.R.1101 - Small Business Health Fairness Act of 2017: To amend title I of the Employee Retirement Income Security Act of 1974 to improve access and choice for entrepreneurs with small businesses with respect to medical care for their employees. Johnson (R-TX). H.R.3120 - To amend title XVIII of the Social Security Act to reduce the volume of future electronic health record-related significant hardship requests. Burgess (R-TX). S. 934 and H.R. 2430 - FDA Reauthorization Act of 2017: To amend the Federal Food, Drug, and Cosmetic Act to revise and extend the user-fee programs for prescription drugs, medical devices, generic drugs, and biosimilar biological products, and for other purposes. Alexander (R-TN) & Walden (R-OR). S. 974 and H.R. 2212 - Creates Act of 2017: 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. Leahy (D-VT) & Marino (R-PA). HR 173 and S 40 - Middle Class Health Benefits Tax Repeal Act of 2017: To amend the Internal Revenue Code of 1986 to repeal the excise tax on high cost employer-sponsored health coverage. Kelly (R-PA) & Heller (R-NV). HR 314 - Health Care Choice Act of 2017: To repeal title I of the Patient Protection and Affordable Care Act and to amend the Public Health Service Act to provide for cooperative governing of individual health insurance coverage offered in interstate commerce. Blackburn (R-TN). HR 706 - Plan Verification and Fairness Act of 2017: To amend title I of the Patient Protection and Affordable Care Act to require verification for eligibility for enrollment during special enrollment periods in PPACA insurance plans, and for other purposes. Blackburn (R-TN). HR 708 - State Age Rating Flexibility Act of 2017: To amend title XXVII of the Public Health Service Act to change the permissible age variation in health insurance premium rates. Buschon (R-IN). HR 710 -Health Coverage State Flexibility Act of 2017: To amend the Patient Protection and Affordable Care Act to better align the grace period required for non-payment of premiums before discontinuing coverage under qualified health plans with such grace periods provided for under State law. Flores (R-TX). HR 749 - Lower Drug Costs through Competition Act: To increase competition in the pharmaceutical industry. Schrader (D-OR) H.R.1121 - Pre-existing Conditions Protection Act of 2017: To amend the Public Health Service Act to prohibit application of pre-existing condition exclusions and to guarantee availability of health insurance coverage in the individual and group market, contingent on the enactment of legislation repealing the Patient Protection and Affordable Care Act, and for other purposes. Walden (R-OR). HR 1175 and S 403 - Health Savings Act of 2017: To amend the Internal Revenue Code of 1986 to improve access to health care through expanded health savings accounts, and for other purposes. Paulsen (R-MN) & Hatch (R-UT). HR 1304 - Self-Insurance Protection Act: To amend the Employee Retirement Income Security Act of 1974, the Public Health Service Act, and the Internal Revenue Code of 1986 to exclude from the definition of health insurance coverage certain medical stop-loss insurance obtained by certain plan sponsors of group health plans. Roe (R-TN) HR 1628 - American Health Care Act of 2017: To provide for reconciliation pursuant to title II of the concurrent resolution on the budget for fiscal year 2017. Black (R-TN). HR 1776 & S 771 Improving Access To Affordable Prescription Drugs Act: To improve access to affordable prescription drugs. Schakowsky (D-IL) & Franken (D-MN) HR 2051 - 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. McKinley (R-WV) S 191 - Patient Freedom Act of 2017: To improve patient choice by allowing States to adopt market based alternatives to the Affordable Care Act that increase access to affordable health insurance and reduce costs while ensuring important consumer protections and improving patient care. Cassidy (R-LA) S 637 - Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2017: To amend titles XI and XVIII of the Social Security Act to provide greater transparency of discounts provided by drug manufacturers. Wyden (D-OR)

Client expense: $1,043,000 · Firm income: Not reported

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

HR 1 - An act to provide for reconciliation pursuant to titles II and V of the concurrent resolution on the budget for fiscal year 2018. HJ Res 123 - Making further continuing appropriations for fiscal year 2018 and for other purposes. HR 4200 & S 2052 - To provide for temporary funding for health insurance cost-sharing reduction payments and provide targeted tax relief, and for other purposes. HR 2212 & S 974 - Creating and Restoring Equal Access To Equivalent Samples Act of 2017: A bill to promote competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products. Marino (R-PA) & Leahy (D-VT) HR 3921 - Helping Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable Act of 2017: To extend funding for the Children's Health Insurance Program, and for other purposes. Burgess (R-TX) HR 3922 - Community Health And Medical Professionals Improve Our Nation Act of 2017: To extend funding for certain public health programs, and for other purposes. Walden (R-OR) S 1354 - Individual Health Insurance Marketplace Improvement Act: A bill to establish an individual market reinsurance fund to provide funding for state individual market stabilization reinsurance programs. Carper (D-DE) S 1827 - Keep Kids' Insurance Dependable and Secure Act of 2017: A bill to extend funding for the Children's Health Insurance Program, and for other purposes. Hatch (R-UT) S 1859 - Healthcare Tax Relief Act: A bill to extend the moratorium on the annual fee on health insurance providers. Gardner (R-CO) H.R. 1215 - Protecting Access to Care Act of 2017: To improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system. King (R-IA) H.R.1101 - Small Business Health Fairness Act of 2017: To amend title I of the Employee Retirement Income Security Act of 1974 to improve access and choice for entrepreneurs with small businesses with respect to medical care for their employees. Johnson (R-TX). S. 974 and H.R. 2212 - Creates Act of 2017: 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. Leahy (D-VT) & Marino (R-PA). HR 173 and S 40 - Middle Class Health Benefits Tax Repeal Act of 2017: To amend the Internal Revenue Code of 1986 to repeal the excise tax on high cost employer-sponsored health coverage. Kelly (R-PA) & Heller (R-NV). HR 706 - Plan Verification and Fairness Act of 2017: To amend title I of the Patient Protection and Affordable Care Act to require verification for eligibility for enrollment during special enrollment periods in PPACA insurance plans, and for other purposes. Blackburn (R-TN). HR 708 - State Age Rating Flexibility Act of 2017: To amend title XXVII of the Public Health Service Act to change the permissible age variation in health insurance premium rates. Buschon (R-IN). HR 710 -Health Coverage State Flexibility Act of 2017: To amend the Patient Protection and Affordable Care Act to better align the grace period required for non-payment of premiums before discontinuing coverage under qualified health plans with such grace periods provided for under State law. Flores (R-TX). HR 749 - Lower Drug Costs through Competition Act: To increase competition in the pharmaceutical industry. Schrader (D-OR) H.R.1121 - Pre-existing Conditions Protection Act of 2017: To amend the Public Health Service Act to prohibit application of pre-existing condition exclusions and to guarantee availability of health insurance coverage in the individual and group market, contingent on the enactment of legislation repealing the Patient Protection and Affordable Care Act, and for other purposes. Walden (R-OR). HR 1175 and S 403 - Health Savings Act of 2017: To amend the Internal Revenue Code of 1986 to improve access to health care through expanded health savings accounts, and for other purposes. Paulsen (R-MN) & Hatch (R-UT). HR 1304 - Self-Insurance Protection Act: To amend the Employee Retirement Income Security Act of 1974, the Public Health Service Act, and the Internal Revenue Code of 1986 to exclude from the definition of health insurance coverage certain medical stop-loss insurance obtained by certain plan sponsors of group health plans. Roe (R-TN) HR 1628 - American Health Care Act of 2017: To provide for reconciliation pursuant to title II of the concurrent resolution on the budget for fiscal year 2017. Black (R-TN). HR 1776 & S 771 Improving Access To Affordable Prescription Drugs Act: To improve access to affordable prescription drugs. Schakowsky (D-IL) & Franken (D-MN) HR 2051 - 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. McKinley (R-WV) S 191 - Patient Freedom Act of 2017: To improve patient choice by allowing States to adopt market based alternatives to the Affordable Care Act that increase access to affordable health insurance and reduce costs while ensuring important consumer protections and improving patient care. Cassidy (R-LA) S 637 - Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2017: To amend titles XI and XVIII of the Social Security Act to provide greater transparency of discounts provided by drug manufacturers. Wyden (D-OR)

Client expense: $155,000 · Firm income: Not reported

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

Bipartisan Health Care Stabilization Act (Alexander-Murray) - funding for cost sharing reduction benefits, stabilization of individual market Better Care Reconciliation Act (Enzi) - ACA repeal and replace issues; coverage provisions; market stabilization; McConnell Substitute Amendment; Cruz Consumer Freedom Option; Portman Medicaid Option for Cost Sharing; Paul Repeal Only Amendment; Graham-Cassidy-Heller-Johnson Block Grant Amendment S. 147, Obamacare Taxpayer Bailout Prevention Act (Rubio) - ACA risk corridors program S. 581, Jessies Law (Manchin-Capito) - patient history of opioid use disorder S. 1201, Health Care Options for All Act (McCaskill) - coverage options in bare counties S. 1354, Individual Health Insurance Marketplace Improvement Act (Carper-Kaine) - individual market reinsurance fund, outreach and enrollment activities S. 1462, Marketplace Certainty Act (Shaheen) - funding for cost-sharing reduction benefits S. 1516, Coverage Across State Lines (Heller) S. 1667, Protecting Consumers from Unreasonable Rates Act (Feinstein) - rate review S. 1749, American Liberty Restoration Act (Hatch) - ACA individual coverage requirement S. 1771, FY 2018 Labor-HHS Appropriations Act (Blunt) - risk corridors and other ACA issues, funding for HHS programs and agencies S. 1835, Lower Premiums Through Reinsurance Act (Collins-Nelson) - invisible high risk pool and reinsurance programs S. 1850, Legacy Act (Manchin-Capito) -- confidentiality of drug and alcohol treatment and prevention records S. 1898 (Daines) - ACA individual coverage requirement S. 1976, Increasing Access to Care Act (Scott) - copper plan S. 1985, Protect Access to Birth Control Act (Murray) - coverage of contraceptive services S. 2052, Healthcare Market Certainty and Mandate Relief Act (Hatch) - funding for cost sharing reduction benefits, HSA improvements, ACA individual mandate S. 2241 (King) - fees on excepted benefits and standalone dental plans H.R. 314, Health Care Choice Act (Blackburn) - selling insurance across state lines H.R. 372, Competitive Health Insurance Reform Act (Gosar) - McCarran-Ferguson Act H.R. 421, Allowing Greater Access to Safe and Effective Contraception Act (Love) - non-prescription contraceptives, HSA flexibility H.R. 706, Plan Verification and Fairness Act (Blackburn) - verifying eligibility for special enrollment periods H.R. 708, State Age Rating Flexibility Act (Buchson) - age rating bands H.R. 710, Health Coverage State Flexibility Act (Flores) - grace period for premium payments H.R. 1101, Small Business Health Fairness Act (Johnson) - association health plans H.R. 1121, Pre-existing Conditions Protection Act (Walden) - protections for patients with pre-existing conditions H.R. 1304, Self-Insurance Protection Act (Roe) - medical stop-loss insurance H.R. 1409, Cancer Drug Parity Act (Lance) - coverage of oral anti-cancer drugs H.R. 1628, American Health Care Act (Black) - ACA repeal and replace issues; coverage provisions; market stabilization H.R. 2086, No Coverage, No Penalty Act (Blackburn) - waiving ACA individual mandate in areas with no QHPs H.R. 2516, Freedom from the ACA Tax Penalty Act (Young) - waiving ACA individual mandate in areas with no QHPs H.R. 3280, Financial Services and General Government Appropriations Act (Graves) - enforcement of ACA individual mandate H.R. 3354, FY 2018 Appropriations Act (Calvert) - risk corridors and other ACA issues, funding for HHS programs and agencies H.R. 3358, FY 2018 Labor-HHS Appropriations Act (Cole) - risk corridors and other ACA issues, funding for HHS programs and agencies H.R. 3450, Protecting Consumers from Unreasonable Rates Act (Schakowsky) - rate review H.R. 3545, Overdose Prevention and Patient Safety Act (Murphy- Blumenauer) -- confidentiality of drug and alcohol treatment and prevention records H.R. 3725, (Tiberi-Burgess) - ACA individual coverage requirement H.R. 3922, CHAMPION Act (Walden) - extension of federal CHIP funding, ACA grace periods, community health center funding H.R. 3976, Access to Marketplace Insurance Act (Cramer) - third party payments H.R. 4082, Protect Access to Birth Control Act (DeGette) - coverage of contraceptive services H.R. 4200, Healthcare Market Certainty and Mandate Relief Act (Brady) - funding for cost sharing reduction benefits, HSA improvements, ACA individual mandate H.R. 4225 (Hudson) - fees on excepted benefits and standalone dental plans H.R. 4575, Access to Independent Health Insurance Advisors Act (Long-Schrader) - calculation of medical loss ratios H.R. 4666, Premium Relief Act (Costello) - Patient and State Stability Fund H.R. 4695, Bipartisan Market Stabilization and Innovation Act (Schrader) - stabilization of individual market H.Con.Res. 71, Budget Resolution for FY 2018 (Black) - funding for federal health programs Regulatory Issues: Insurance regulatory reform; issues related to the coordination of private and public disability income benefits; disability risk management; disability income insurance enrollment and awareness; issues related to encouraging impaired workers to stay in/return to the workforce; issues relating to the coordination of benefits between private health insurance plans and Medicaid; Medigap claims processing and crossover fees; Medigap cross-over claim issues, Medigap coverage, implementation of Medigap standardized plan offerings; Medigap carrier recoveries related to CMS fraud and abuse enforcement activities, and issues related to Medigap educational materials, and other Medigap issues; fraud and abuse issues affecting public and private insurance coverage; issues relating to antitrust; implementation of the Mental Health Parity Act requirements; implementation of the 21st Century Cures Act requirements; summary of benefits and coverage disclosures; pre-existing condition insurance plans; accountable care organizations; coverage of preventive services; preexisting condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; dependent coverage; treatment of expatriate plans; issues related to all payor claims databases; issues related to association health plans; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations, non-discriminatory wellness programs; issues related to supplemental products; issues relating to dental coverage; issues relating to proposals for single-payer and Medicare/Medicaid buy-in options; issues related to implementation of the Telephone Consumer Protection Act; issues relating to third party payment of premiums; issues related to cost-sharing reductions (CSRs); issues relating to the individual market; and other issues relating to health care reform implementation.

Client expense: $1,710,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Council of Economic Advisers (CEA), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Economic Council (NEC), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), SENATE, Treasury, Dept of, White House Office

Implementation of health care payment and coverage reforms in the Affordable Care Act (ACA), including related provisions in H.R. 1628, the American Health Care Act, and proposed Senate substitute amendments, including the Health Care Freedom Act and Senators Graham and Cassidy proposed block grant substitute amendment, legislation to repeal and replace the ACA; ACA exchange enrollment and payment restrictions, including related provisions in H.R. 710, the Health Coverage State Flexibility Act, and H.R. 706, the Plan Verification and Fairness Act; and third party payment of premiums.

Client expense: Not reported · Firm income: $90,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR1; The American Health Care Act of 2017; HR706; HR710; HR1628; Insurance Market stabilization; CMS Notice of Benefit & Payment Parameters; reinsurance; cost-sharing reductions; 3rd party payment of premiums; special enrollment periods; grace periods; age rate bands; delivery system reform; Patient Safety and Quality Improvement; Patient-Centered Primary/Medical Home; Bundled Payments; Employer Wellness; Chronic Care & Medical Management; Childhood Obesity; mental health reform; ACA Implementation and back-end issues; Executive Orders related to short-term limited duration plans and association health plans.

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

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

HR 1 - An act to provide for reconciliation pursuant to titles II and V of the concurrent resolution on the budget for fiscal year 2018. HJ Res 123 - Making further continuing appropriations for fiscal year 2018 and for other purposes. HR 392 - The HEALTHY Kids Act to reauthorize CHIP. HR 4200 & S 2052 - To provide for temporary funding for health insurance cost-sharing reduction payments and provide targeted tax relief, and for other purposes. HR 2212 & S 974 - Creating and Restoring Equal Access To Equivalent Samples Act of 2017: A bill to promote competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products. Marino (R-PA) & Leahy (D-VT) HR 3921 - Helping Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable Act of 2017: To extend funding for the Children's Health Insurance Program, and for other purposes. Burgess (R-TX) HR 3922 - Community Health And Medical Professionals Improve Our Nation Act of 2017: To extend funding for certain public health programs, and for other purposes. Walden (R-OR) S 1354 - Individual Health Insurance Marketplace Improvement Act: A bill to establish an individual market reinsurance fund to provide funding for state individual market stabilization reinsurance programs. Carper (D-DE) S 1827 - Keep Kids' Insurance Dependable and Secure Act of 2017: A bill to extend funding for the Children's Health Insurance Program, and for other purposes. Hatch (R-UT) S 1859 - Healthcare Tax Relief Act: A bill to extend the moratorium on the annual fee on health insurance providers. Gardner (R-CO) H.R. 1215 - Protecting Access to Care Act of 2017: To improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system. King (R-IA) H.R.1101 - Small Business Health Fairness Act of 2017: To amend title I of the Employee Retirement Income Security Act of 1974 to improve access and choice for entrepreneurs with small businesses with respect to medical care for their employees. Johnson (R-TX). S. 974 and H.R. 2212 - Creates Act of 2017: 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. Leahy (D-VT) & Marino (R-PA). HR 173 and S 40 - Middle Class Health Benefits Tax Repeal Act of 2017: To amend the Internal Revenue Code of 1986 to repeal the excise tax on high cost employer-sponsored health coverage. Kelly (R-PA) & Heller (R-NV). HR 706 - Plan Verification and Fairness Act of 2017: To amend title I of the Patient Protection and Affordable Care Act to require verification for eligibility for enrollment during special enrollment periods in PPACA insurance plans, and for other purposes. Blackburn (R-TN). HR 708 - State Age Rating Flexibility Act of 2017: To amend title XXVII of the Public Health Service Act to change the permissible age variation in health insurance premium rates. Buschon (R-IN). HR 710 -Health Coverage State Flexibility Act of 2017: To amend the Patient Protection and Affordable Care Act to better align the grace period required for non-payment of premiums before discontinuing coverage under qualified health plans with such grace periods provided for under State law. Flores (R-TX). HR 749 - Lower Drug Costs through Competition Act: To increase competition in the pharmaceutical industry. Schrader (D-OR) H.R.1121 - Pre-existing Conditions Protection Act of 2017: To amend the Public Health Service Act to prohibit application of pre-existing condition exclusions and to guarantee availability of health insurance coverage in the individual and group market, contingent on the enactment of legislation repealing the Patient Protection and Affordable Care Act, and for other purposes. Walden (R-OR). HR 1175 and S 403 - Health Savings Act of 2017: To amend the Internal Revenue Code of 1986 to improve access to health care through expanded health savings accounts, and for other purposes. Paulsen (R-MN) & Hatch (R-UT). HR 1304 - Self-Insurance Protection Act: To amend the Employee Retirement Income Security Act of 1974, the Public Health Service Act, and the Internal Revenue Code of 1986 to exclude from the definition of health insurance coverage certain medical stop-loss insurance obtained by certain plan sponsors of group health plans. Roe (R-TN) HR 1628 - American Health Care Act of 2017: To provide for reconciliation pursuant to title II of the concurrent resolution on the budget for fiscal year 2017. Black (R-TN). HR 1776 & S 771 Improving Access To Affordable Prescription Drugs Act: To improve access to affordable prescription drugs. Schakowsky (D-IL) & Franken (D-MN) HR 2051 - 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. McKinley (R-WV) S 191 - Patient Freedom Act of 2017: To improve patient choice by allowing States to adopt market based alternatives to the Affordable Care Act that increase access to affordable health insurance and reduce costs while ensuring important consumer protections and improving patient care. Cassidy (R-LA) S 637 - Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2017: To amend titles XI and XVIII of the Social Security Act to provide greater transparency of discounts provided by drug manufacturers. Wyden (D-OR)

Client expense: $155,000 · Firm income: Not reported

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

H. Res. 142/S. Res. 63 National Obesity Care Week Resolution S. Res. 325 National Obesity Care Week Resolution S. J. Res. 16 a joint resolution approving the discontinuation of the process for consideration and automatic implementation of the annual proposal of the independent payment Medicare advisory board H.J. Res 51/S. J. Res 17 Independent Payment Advisory Board Repeal H.R 1995 Value Based Insurance Design for Better Care Act H.R. 1004 Regulatory Integrity Act H.R. 1009/S. 676 OIRA Insight, Reform, and Accountability Act H.R. 1038/S. 413 Improving Transparency and Accuracy in Medicare Part D Spending H.R. 1072/S. 222 Obamacare Replacement Act H.R. 1101 Small Business Health Fairness Act H.R. 1121 Pre-Existing Conditions Protection Act H.R. 1148/S. 431 Furthering Access to Stroke Telemedicine (FAST) Act H.R. 1215 Protecting Access to Care Act H.R. 1267/S. 482 Personal Health Investment Today Act H.R. 1304 Self-Insurance Protection Act H.R. 1313 Preserving Employee Wellness Programs Act H.R. 1554 Jessie's Law H.R. 1565 Saving Lives, Saving Costs Act H.R. 1628 American Health Care Act H.R. 1703 Medical Product Communications Act H.R. 184 Protect Medical Innovation Act H.R. 1953/S. 830 Treat and Reduce Obesity Act H.R. 2267/S. 1301 Resident Physician Shortage Reduction Act H.R. 246/S. 183 Jobs and Premium Protection Act H.R. 2550 Medicare Telehealth Parity Act H.R. 2556/S. 1016 CONNECT for Health Act H.R. 2797/S. 1334 Patient Choice and Quality Care Act H.R. 2824 Increasing Opportunity and Success for Children and Parents Through Evidence-Based Home Visiting Act H.R. 284 Advancing Medical Resident Training in Community Hospitals Act H.R. 2953/S. 2164 Preventive Health Savings Act H.R. 3044 to expand supplemental benefits to meet the needs of chronically ill Medicare Advantage enrollees H.R. 3059/S. 1441 Community Health Center and Primary Care Workforce Expansion Act H.R. 3120 to reduce the volume of future electronic health record-related significant hardship requests H.R. 3124/S. 1299 Preventing Diabetes in Medicare Act H.R. 3168 to provide continued access to Medicare Advantage plans for special needs H.R. 3224 Critical Access and Rural Equity Act H.R. 3245 Medicare Civil and Criminal Penalties Act H.R. 3263 to extend the Medicare independence at home medical demonstration program H.R. 3358/S. 1771 Fiscal Year 2018 Labor-Health and Human Services-Education Appropriations Bill H.R. 3394 Teaching Health Centers Graduate Medical Education Extension Act H.R. 3447 Furthering Access to Coordinated Treatment for Seniors Act H.R. 3545 Overdoes Prevention and Patient Safety Act H.R. 3726 Stark Administrative Simplification Act of 2017 H.R. 3728 Empowering Medical Professionals and Optimizing Workforce Efficiency and Readiness Act H.R. 3820/S. 977 Medicare Home Health Flexibility Act H.R. 3862 National Health Service Corps Strengthening Act H.R. 3921 Helping Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable Act H.R. 3922 Continuing Community Health and Medical Professional Programs to Improve Our Nation, Increase National Gains, and Help Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable Act H.R. 4541 Continuing Community Health and Medical Professional Programs to Improve Our Nation and Keep Insurance Delivery Stable H.R. 4613 Ensuring Patient Access to Healthcare Records Act H.R. 4616 to provide for a temporary moratorium on the employer mandate and to provide for a delay in the implementation of the excise tax on high cost employer-sponsored health coverage H.R. 4617 to provide for a temporary moratorium on the medical device excise tax H.R. 4618 to provide for a temporary moratorium on certain taxes affecting purchases of prescription medication H.R. 4619 to provide temporary relief from the annual fee imposed on health insurance providers, to the extent that such fee is due to Puerto Rican health insurance H.R. 4620 Protecting Families and Small Businesses Act H.R. 4006 Community-Based Independence for Seniors Act of 2017 H.R. 4200/S. 2052 Healthcare Market Certainty and Mandate Relief Act H.R. 4520 to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2017 H.R. 4552/S. 1291 Advancing Medical Training in Community Hospitals Act H.R. 4105 to extend the health professions workforce demonstration project H.R. 592/S. 109 Pharmacy and Medically Underserved Areas Enhancement Act H.R. 706 Plan Verification and Fairness Act H.R. 741/S. 243 Rural Hospital Regulatory Relief Act H.R. 749 Lower Drug Costs Through Competition Act H.R. 766 Amend Title XVII of the Social Security Act to expand telehealth in Medicare H.R. 849/S. 260 Protecting Seniors' Access to Medicare Act H.R. 908 Medicare Advantage Quality Payment Relief Act H.R. 998 Searching for and Cutting Regulations that are Unnecessarily Burdensome (SCRUB) Act H.R.3545 Overdose Prevention and Patient Safety Act H.R.3727 To amend title XVIII of the Social Security Act to include additional telehealth services for purposes of MA organization bids, and for other purposes H.R. 4206/S. 2051 Medicare Care Coordination Improvement Act Introduction of the Healthcare Cybersecurity Improvement Act Introduction of the Stark Law Modernization Act of 2017 Pub L. 114-198 Comprehensive Addiction and Recovery Act Pub L. 115-31 Fiscal Year 2017 Consolidated Appropriations Act Pub L. 115-80 National Clinical Care Commission Act Pub. L. 102-143 Telephone Consumer Protection Act Pub. L. 111-148 Patient Protection and Affordable Care Act (PPACA) Pub. L. 111-5 The American Recovery and Reinvestment Act Pub. L. 114-10 Medicare Access and CHIP Reauthorization Act (MACRA) Pub. L. 114-255, 21st Century Cures Act Pub. L. 114-270 Expanding Capacity for Health Outcomes Act (ECHO) Pub. L. 114-328 National Defense Authorization Act for Fiscal Year Pub. L. 114-329 American Innovation and Competitiveness Act Pub L. 115-63 Disaster Relief and Airway Extension Act Pub. L. 115-96 2018 Continuing Resolution Pub. L. 115-97 Tax Cuts and Jobs Act Reintroduction of TELE-MED Act of 2015 S. 108 Medical Device Access and Innovation Protection Act S. 297 Increasing Competition in Pharmaceuticals Act S. 1754 Training the Next Generation of Primary Care Doctors Act S. 1827 Keep Kids' Insurance Dependable and Secure Act S. 1829 Strong Families Act S. 1850 Protecting Jessica Grubbs Legacy Act (The Legacy Act) S. 1859 Healthcare Tax Relief Act S. 1899 to reauthorize and extend funding for community health centers and the National Health Service Corps S. 1967 Mandate Relief Act S. 191 Patient Freedom Act S. 251 Protecting Medicare from Executive Action Act S. 309 Community Based Independence for Seniors Act S. 464 Independence at Home Act H .R. 1933/S. 761 Health Care Options Act of 2017 S. 787 Telehealth Innovation and Improvement Act S. 870 Creating High-Quality Results and Outcomes Necessary to Improve Chronic Care Act S. 1978 Small Business and Family Health Tax Relief Act S. Con. Res. 3 Budget Resolution

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

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

Better Care Reconciliation Act (Enzi) - ACA repeal and replace issues; coverage provisions; market stabilization; McConnell Substitute Amendment; Cruz Consumer Freedom Option; Portman Medicaid Option for Cost Sharing; Paul Repeal Only Amendment; Graham-Cassidy-Heller-Johnson Block Grant Amendment S. 147, Obamacare Taxpayer Bailout Prevention Act (Rubio) - ACA risk corridors program S. 191, Patient Freedom Act (Cassidy-Collins) - replacement reforms; state options S. 581, Jessies Law (Manchin-Capito) - patient history of opioid use disorder S. 1201, Health Care Options for All Act (McCaskill) - coverage options in bare counties S. 1354, Individual Health Insurance Marketplace Improvement Act (Carper-Kaine) - individual market reinsurance fund, outreach and enrollment activities S. 1462, Marketplace Certainty Act (Shaheen) - funding for cost-sharing reduction (CSR) payments S. 1516, Coverage Across State Lines (Heller) S. 1667, Protecting Consumers from Unreasonable Rates Act (Feinstein) - rate review S. 1749, American Liberty Restoration Act (Hatch) - ACA individual coverage requirement S. 1771, FY 2018 Labor-HHS Appropriations Act (Blunt) - risk corridors and other ACA issues, funding for HHS programs and agencies S. 1835, Lower Premiums Through Reinsurance Act (Collins-Nelson) - invisible high risk pool and reinsurance programs S. 1850, Legacy Act (Manchin-Capito) -- confidentiality of drug and alcohol treatment and prevention records S. 1898 (Daines) - ACA individual coverage requirement H.R. 314, Health Care Choice Act (Blackburn) - selling insurance across state lines H.R. 372, Competitive Health Insurance Reform Act (Gosar) - McCarran-Ferguson Act H.R. 421, Allowing Greater Access to Safe and Effective Contraception Act (Love) - non-prescription contraceptives, HSA flexibility H.R. 706, Plan Verification and Fairness Act (Blackburn) - verifying eligibility for special enrollment periods H.R. 708, State Age Rating Flexibility Act (Buchson) - age rating bands H.R. 710, Health Coverage State Flexibility Act (Flores) - grace period for premium payments H.R. 1101, Small Business Health Fairness Act (Johnson) - association health plans H.R. 1121, Pre-existing Conditions Protection Act (Walden) - protections for patients with pre-existing conditions H.R. 1304, Self-Insurance Protection Act (Roe) - medical stop-loss insurance H.R. 1409, Cancer Drug Parity Act (Lance) - coverage of oral anti-cancer drugs H.R. 1628, American Health Care Act (Black) - ACA repeal and replace issues; coverage provisions; market stabilization H.R. 2086, No Coverage, No Penalty Act (Blackburn) - waiving ACA individual mandate in areas with no QHPs H.R. 2516, Freedom from the ACA Tax Penalty Act (Young) - waiving ACA individual mandate in areas with no QHPs H.R. 3280, Financial Services and General Government Appropriations Act (Graves) - enforcement of ACA individual mandate H.R. 3354, FY 2018 Appropriations Act (Calvert) - risk corridors and other ACA issues, funding for HHS programs and agencies H.R. 3358, FY 2018 Labor-HHS Appropriations Act (Cole) - risk corridors and other ACA issues, funding for HHS programs and agencies H.R. 3450, Protecting Consumers from Unreasonable Rates Act (Schakowsky) - rate review H.R. 3545, Overdose Prevention and Patient Safety Act (Murphy- Blumenauer) -- confidentiality of drug and alcohol treatment and prevention records H.R. 3725, (Tiberi-Burgess) - ACA individual coverage requirement H.R. 3922, CHAMPION Act (Walden) - ACA grace periods, community health center funding FY 2018 Budget Resolution (Black) - Medicaid and Medicare funding Regulatory Issues: Insurance regulatory reform; issues related to the coordination of private and public disability income benefits; disability risk management; disability income insurance enrollment and awareness; issues related to encouraging impaired workers to stay in/return to the workforce; issues relating to the coordination of benefits between private health insurance plans and Medicaid; Medigap claims processing and crossover fees; Medigap cross-over claim issues, Medigap coverage, implementation of Medigap standardized plan offerings; Medigap carrier recoveries related to CMS fraud and abuse enforcement activities, and issues related to Medigap educational materials, and other Medigap issues; fraud and abuse issues affecting public and private insurance coverage; issues relating to antitrust; implementation of the Mental Health Parity Act requirements; implementation of the 21st Century Cures Act requirements; summary of benefits and coverage disclosures; pre-existing condition insurance plans; accountable care organizations; coverage of preventive services; preexisting condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; dependent coverage; treatment of expatriate plans; compliance with the transitional reinsurance program; issues related to all payor claims databases; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations, non-discriminatory wellness programs; issues related to supplemental products; issues related to implementation of the Telephone Consumer Protection Act; issues relating to third party payment of premiums; issues related to cost-sharing reductions (CSRs); issues relating to the individual market; and other issues relating to health care reform implementation.

Client expense: $1,470,000 · Firm income: Not reported

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

Implementation of health care payment and coverage reforms in the Affordable Care Act (ACA), including related provisions in H.R. 1628, the American Health Care Act, and proposed Senate substitute amendments, including the Health Care Freedom Act and Senators Graham and Cassidy proposed block grant substitute amendment, legislation to repeal and replace the ACA; ACA exchange enrollment and payment restrictions, including related provisions in H.R. 710, the Health Coverage State Flexibility Act, and H.R. 706, the Plan Verification and Fairness Act; and third party payment of premiums.

Client expense: Not reported · Firm income: $90,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 2212 & S 974 - Creating and Restoring Equal Access To Equivalent Samples Act of 2017: A bill to promote competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products. Marino (R-PA) & Leahy (D-VT) HR 3120 - To amend title XVIII of the Social Security Act to reduce the volume of future electronic health record-related significant hardship requests. Burgess (R-TX) HR 3245 - Medicare Civil and Criminal Penalties Update Act: To amend title XI of the Social Security Act to increase civil money penalties and criminal fines for Federal health care program fraud and abuse, and for other purposes. Bilirakis (R-FL). HR 3263 - To amend title XVIII of the Social Security Act to extend the Medicare independence at home medical practice demonstration program. Burgess (R-TX) HR 3921 - Helping Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable Act of 2017: To extend funding for the Children's Health Insurance Program, and for other purposes. Burgess (R-TX) HR 3922 - Community Health And Medical Professionals Improve Our Nation Act of 2017: To extend funding for certain public health programs, and for other purposes. Walden (R-OR) S 1354 - Individual Health Insurance Marketplace Improvement Act: A bill to establish an individual market reinsurance fund to provide funding for state individual market stabilization reinsurance programs. Carper (D-DE) S 1827 - Keep Kids' Insurance Dependable and Secure Act of 2017: A bill to extend funding for the Children's Health Insurance Program, and for other purposes. Hatch (R-UT) S 1859 - Healthcare Tax Relief Act: A bill to extend the moratorium on the annual fee on health insurance providers. Gardner (R-CO) H.R. 1215 - Protecting Access to Care Act of 2017: To improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system. King (R-IA) H.R.1101 - Small Business Health Fairness Act of 2017: To amend title I of the Employee Retirement Income Security Act of 1974 to improve access and choice for entrepreneurs with small businesses with respect to medical care for their employees. Johnson (R-TX). H.R.3120 - To amend title XVIII of the Social Security Act to reduce the volume of future electronic health record-related significant hardship requests. Burgess (R-TX). S. 934 and H.R. 2430 - FDA Reauthorization Act of 2017: To amend the Federal Food, Drug, and Cosmetic Act to revise and extend the user-fee programs for prescription drugs, medical devices, generic drugs, and biosimilar biological products, and for other purposes. Alexander (R-TN) & Walden (R-OR). S. 974 and H.R. 2212 - Creates Act of 2017: 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. Leahy (D-VT) & Marino (R-PA). HR 173 and S 40 - Middle Class Health Benefits Tax Repeal Act of 2017: To amend the Internal Revenue Code of 1986 to repeal the excise tax on high cost employer-sponsored health coverage. Kelly (R-PA) & Heller (R-NV). HR 314 - Health Care Choice Act of 2017: To repeal title I of the Patient Protection and Affordable Care Act and to amend the Public Health Service Act to provide for cooperative governing of individual health insurance coverage offered in interstate commerce. Blackburn (R-TN). HR 706 - Plan Verification and Fairness Act of 2017: To amend title I of the Patient Protection and Affordable Care Act to require verification for eligibility for enrollment during special enrollment periods in PPACA insurance plans, and for other purposes. Blackburn (R-TN). HR 708 - State Age Rating Flexibility Act of 2017: To amend title XXVII of the Public Health Service Act to change the permissible age variation in health insurance premium rates. Buschon (R-IN). HR 710 -Health Coverage State Flexibility Act of 2017: To amend the Patient Protection and Affordable Care Act to better align the grace period required for non-payment of premiums before discontinuing coverage under qualified health plans with such grace periods provided for under State law. Flores (R-TX). HR 749 - Lower Drug Costs through Competition Act: To increase competition in the pharmaceutical industry. Schrader (D-OR) H.R.1121 - Pre-existing Conditions Protection Act of 2017: To amend the Public Health Service Act to prohibit application of pre-existing condition exclusions and to guarantee availability of health insurance coverage in the individual and group market, contingent on the enactment of legislation repealing the Patient Protection and Affordable Care Act, and for other purposes. Walden (R-OR). HR 1175 and S 403 - Health Savings Act of 2017: To amend the Internal Revenue Code of 1986 to improve access to health care through expanded health savings accounts, and for other purposes. Paulsen (R-MN) & Hatch (R-UT). HR 1304 - Self-Insurance Protection Act: To amend the Employee Retirement Income Security Act of 1974, the Public Health Service Act, and the Internal Revenue Code of 1986 to exclude from the definition of health insurance coverage certain medical stop-loss insurance obtained by certain plan sponsors of group health plans. Roe (R-TN) HR 1628 - American Health Care Act of 2017: To provide for reconciliation pursuant to title II of the concurrent resolution on the budget for fiscal year 2017. Black (R-TN). HR 1776 & S 771 Improving Access To Affordable Prescription Drugs Act: To improve access to affordable prescription drugs. Schakowsky (D-IL) & Franken (D-MN) HR 2051 - 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. McKinley (R-WV) S 191 - Patient Freedom Act of 2017: To improve patient choice by allowing States to adopt market based alternatives to the Affordable Care Act that increase access to affordable health insurance and reduce costs while ensuring important consumer protections and improving patient care. Cassidy (R-LA) S 637 - Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2017: To amend titles XI and XVIII of the Social Security Act to provide greater transparency of discounts provided by drug manufacturers. Wyden (D-OR)

Client expense: $166,896 · Firm income: Not reported

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

The American Health Care Act of 2017 (AHCA); The Better Care Reconciliation Act of 2017 (BCRA); HR706; HR710; HR1628; Insurance Market stabilization; CMS Notice of Benefit & Payment Parameters; reinsurance; cost-sharing reductions; 3rd party payment of premiums; special enrollment periods; grace periods; age rate bands; delivery system reform; Patient Safety and Quality Improvement; Patient-Centered Primary/Medical Home; Bundled Payments; Employer Wellness; Chronic Care & Medical Management; Childhood Obesity; Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM; Postal Reform Act; Risk Mitigation Legislation; mental health reform; ACA Implementation and back-end issues; Small Business Health Options Program (SHOP)implementation.

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

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

H. Con. Res. 71 Fiscal Year 2018 Budget Resolution H. Res. 142/S. Res. 63 National Obesity Care Week Resolution S. J. Res. 16 a joint resolution approving the discontinuation of the process for consideration and automatic implementation of the annual proposal of the independent payment Medicare advisory board H.J. Res 51/S. J. Res 17 Independent Payment Advisory Board Repeal H.R 1995 Value Based Insurance Design for Better Care Act H.R. 1004 Regulatory Integrity Act H.R. 1009/S. 676 OIRA Insight, Reform, and Accountability Act H.R. 1038/S. 413 Improving Transparency and Accuracy in Medicare Part D Spending H.R. 1072/S. 222 Obamacare Replacement Act H.R. 1101 Small Business Health Fairness Act H.R. 1121 Pre-Existing Conditions Protection Act H.R. 1148/S. 431 Furthering Access to Stroke Telemedicine (FAST) Act H.R. 1215 Protecting Access to Care Act H.R. 1245/S. 469 Affordable and Safe Prescription Drug Importation Act H.R. 1267/S. 482 Personal Health Investment Today Act H.R. 1304 Self-Insurance Protection Act H.R. 1313 Preserving Employee Wellness Programs Act H.R. 1554/S. 581 Jessie's Law H.R. 1565 Saving Lives, Saving Costs Act H.R. 1617 Promoting Access to Diabetic Shoes Act H.R. 1628 American Health Care Act H.R. 1703 Medical Product Communications Act H.R. 1776/S. 771 Improving Access to Affordable Prescription Drugs Act H.R. 184 Protect Medical Innovation Act H.R. 1953/S. 830 Treat and Reduce Obesity Act H.R. 2192/S. 1569 to eliminate the non-application of certain state waiver provisions to members of Congress and Congressional staff H.R. 2212/S. 974 Creating and Restoring Equal Access to Equivalent Samples Act H.R. 2267/S. 1301 Resident Physician Shortage Reduction Act H.R. 2372 Veterans Equal Treatment Ensures Relief and Access Now Act H.R. 246/S. 183 Jobs and Premium Protection Act H.R. 2550 Medicare Telehealth Parity Act H.R. 2556/S. 1016 CONNECT for Health Act H.R. 2579 Broader Options for Americans Act H.R. 2581 Verify First Act H.R. 2797/S. 1334 Patient Choice and Quality Care Act H.R. 2824 Increasing Opportunity and Success for Children and Parents Through Evidence -Based Home Visiting Act H.R. 284/S. 1291 Advancing Medical Resident Training in Community Hospitals Act H.R. 2953 Preventive Health Savings Act H.R. 3044 to expand supplemental benefits to meet the needs of chronically ill Medicare Advantage enrollees H.R. 3059/S. 1441 Community Health Center and Primary Care Workforce Expansion Act H.R. 309/S. 920 National Clinical Care Commission Act H.R. 3120 to reduce the volume of future electronic health record-related significant hardship requests H.R. 3124/S. 1299 Preventing Diabetes in Medicare Act H.R. 3168 to provide continued access to Medicare Advantage plans for special needs H.R. 3224 Critical Access and Rural Equity Act H.R. 3245 Medicare Civil and Criminal Penalties Act H.R. 3263 to extend the Medicare independence at home medical demonstration program H.R. 3271/S. 1914 Protecting Access to Diabetes Supplies Act H.R. 3358/S. 1771 Fiscal Year 2018 Labor-Health and Human Services-Education Appropriations Bill H.R. 3394 Teaching Health Centers Graduate Medical Education Extension Act H.R. 3447 Furthering Access to Coordinated Treatment for Seniors Act H.R. 3536/S.1681 to require persons who undertake federally funded research and development of drugs to enter into reasonable pricing agreements H.R. 372 Competitive Health Insurance Reform Act H.R. 3726 Stark Administrative Simplification Act of 2017 H.R. 3728 Empowering Medical Professionals and Optimizing Workforce Efficiency and Readiness Act H.R. 3820/S. 977 Medicare Home Health Flexibility Act H.R. 3862 National Health Service Corps Strengthening Act H.R. 3921 Helping Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable Act H.R. 4006 Community-Based Independence for Seniors Act of 2017 H.R. 592/S. 109 Pharmacy and Medically Underserved Areas Enhancement Act H.R. 706 Plan Verification and Fairness Act H.R. 741/S. 243 Rural Hospital Regulatory Relief Act H.R. 749 Lower Drug Costs Through Competition Act H.R. 766 Amend Title XVII of the Social Security Act to expand telehealth in Medicare H.R. 849/S. 260 Protecting Seniors' Access to Medicare Act H.R. 908 Medicare Advantage Quality Payment Relief Act H.R. 998 Searching for and Cutting Regulations that are Unnecessarily Burdensome(SCRUB) Act H.R.3545 Overdose Prevention and Patient Safety Act H.R.3727 To amend title XVIII of the Social Security Act to include additional telehealth services for purposes of MA organization bids, and for other purposes Introduction of the Stark Law Modernization Act of 2017 Pub L. 114-198 Comprehensive Addiction and Recovery Act Pub L. 115-31 Fiscal Year 2017 Consolidated Appropriations Act Pub. L. 102-143 Telephone Consumer Protection Act Pub. L. 111-148 Patient Protection and Affordable Care Act (PPACA) Pub. L. 111-5 The American Recovery and Reinvestment Act Pub. L. 114-10 Medicare Access and CHIP Reauthorization Act (MACRA) Pub. L. 114-255, 21st Century Cures Act Pub. L. 114-270 Expanding Capacity for Health Outcomes Act (ECHO) Pub. L. 114-329 American Innovation and Competitiveness Act Pub L. 115-63 Disaster Relief & Airway Extension Act S. 108 Medical Device Access and Innovation Protection Act S. 297 Increasing Competition in Pharmaceuticals Act S. 1688 Empowering Medicare Seniors to Negotiate Drug Prices Act S. 1754 Training the Next Generation of Primary Care Doctors Act S. 1804 Medicare for All Act S. 1827 Keep Kids' Insurance Dependable and Secure Act S. 1829 Strong Families Act S. 1850 Protecting Jessica Grubbs Legacy Act, (The Legacy Act) S. 1859 Healthcare Tax Relief Act S. 1899 to reauthorize and extend funding for community health centers and the National Health Service Corps S. 191 Patient Freedom Act S. 251 Protecting Medicare from Executive Action Act S. 309 Community Based Independence for Seniors Act S. 464 Independence at Home Act S. 64 Safe and Affordable Drugs from Canada Act H .R. 1933/S. 761 Health Care Options Act of 2017 S. 787 Telehealth Innovation and Improvement Act S. 870 Creating High-Quality Results and Outcomes Necessary to Improve Chronic Care Act S. Con. Res. 3 Budget Resolution

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

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

Discussion Draft Better Care Reconciliation Act (Enzi) - ACA repeal and replace issues; coverage provisions; market stabilization S.Con.Res. 3, Budget Resolution (Enzi) - ACA repeal and replace issues; coverage provisions; market stabilization S. 147, Obamacare Taxpayer Bailout Prevention Act (Rubio) - ACA risk corridors program S. 191, Patient Freedom Act (Cassidy-Collins) - replacement reforms; state options S. 1201, Health Care Options for All Act (McCaskill) - access to FEHBP in bare counties S. 1354, Individual Health Insurance Marketplace Improvement Act (Carper-Kaine) - individual market reinsurance fund, outreach and enrollment activities S. 1462, Marketplace Certainty Act (Shaheen) - funding for cost-sharing reduction (CSR) payments S. 1516, Coverage Across State Lines (Heller) H.R. 277, American Health Care Reform Act (Roe) - replacement reforms H.R. 314, Health Care Choice Act (Blackburn) - selling insurance across state lines H.R. 372, Competitive Health Insurance Reform Act (Gosar) - McCarran-Ferguson Act H.R. 706, Plan Verification and Fairness Act (Blackburn) - verifying eligibility for special enrollment periods H.R. 708, State Age Rating Flexibility Act (Buchson) - age rating bands H.R. 710, Health Coverage State Flexibility Act (Flores) - grace period for premium payments H.R. 1101, Small Business Health Fairness Act (Johnson) - association health plans H.R. 1121, Pre-existing Conditions Protection Act (Walden) - protections for patients with pre-existing conditions H.R. 1304, Self-Insurance Protection Act (Roe) - medical stop-loss insurance H.R. 1409, Cancer Drug Parity Act (Lance) - coverage of oral anti-cancer drugs H.R. 1628, American Health Care Act (Black) - ACA repeal and replace issues; coverage provisions; market stabilization H.R. 2086, No Coverage, No Penalty Act (Blackburn) - waiving ACA individual mandate in areas with no QHPs H.R. 2516, Freedom from the ACA Tax Penalty Act (Young) - waiving ACA individual mandate in areas with no QHPs Regulatory Issues: Insurance regulatory reform; issues related to the coordination of private and public disability income benefits; disability risk management; disability income insurance enrollment and awareness; issues related to encouraging impaired workers to stay in/return to the workforce; issues relating to the coordination of benefits between private health insurance plans and Medicaid; Medigap claims processing and crossover fees; Medigap cross-over claim issues, Medigap coverage, implementation of Medigap standardized plan offerings; Medigap carrier recoveries related to CMS fraud and abuse enforcement activities, and issues related to Medigap educational materials, and other Medigap issues; fraud and abuse issues affecting public and private insurance coverage; issues relating to antitrust; implementation of the Mental Health Parity Act requirements; implementation of the 21st Century Cures Act requirements; summary of benefits and coverage disclosures; pre-existing condition insurance plans; accountable care organizations; coverage of preventive services; preexisting condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; dependent coverage; treatment of expatriate plans; compliance with the transitional reinsurance program; issues related to all payor claims databases; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations, non-discriminatory wellness programs; issues related to supplemental products; issues related to implementation of the Telephone Consumer Protection Act; issues relating to third party payment of premiums; issues related to cost-sharing reductions (CSRs); issues relating to the individual market; and other issues relating to health care reform implementation.

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), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Treasury, Dept of

Implementation of health care payment and coverage reforms in the Affordable Care Act (ACA), including related provisions in H.R. 1628, the American Health Care Act, and Senate Discussion Draft of the Better Care Reconciliation Act, legislation to repeal and replace the ACA; ACA exchange enrollment and payment restrictions, including related provisions in H.R. 710, the Health Coverage State Flexibility Act, and H.R. 706, the Plan Verification and Fairness Act; and third party payment of premiums.

Client expense: Not reported · Firm income: $90,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1215 - Protecting Access to Care Act of 2017: To improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system. King (R-IA) H.R.1101 - Small Business Health Fairness Act of 2017: To amend title I of the Employee Retirement Income Security Act of 1974 to improve access and choice for entrepreneurs with small businesses with respect to medical care for their employees. Johnson (R-TX). H.R.3120 - To amend title XVIII of the Social Security Act to reduce the volume of future electronic health record-related significant hardship requests. Burgess (R-TX). S. 934 and H.R. 2430 - FDA Reauthorization Act of 2017: To amend the Federal Food, Drug, and Cosmetic Act to revise and extend the user-fee programs for prescription drugs, medical devices, generic drugs, and biosimilar biological products, and for other purposes. Alexander (R-TN) & Walden (R-OR). S. 974 and H.R. 2212 - Creates Act of 2017: 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. Leahy (D-VT) & Marino (R-PA). HR 173 and S 40 - Middle Class Health Benefits Tax Repeal Act of 2017: To amend the Internal Revenue Code of 1986 to repeal the excise tax on high cost employer-sponsored health coverage. Kelly (R-PA) & Heller (R-NV). HR 314 - Health Care Choice Act of 2017: To repeal title I of the Patient Protection and Affordable Care Act and to amend the Public Health Service Act to provide for cooperative governing of individual health insurance coverage offered in interstate commerce. Blackburn (R-TN). HR 706 - Plan Verification and Fairness Act of 2017: To amend title I of the Patient Protection and Affordable Care Act to require verification for eligibility for enrollment during special enrollment periods in PPACA insurance plans, and for other purposes. Blackburn (R-TN). HR 708 - State Age Rating Flexibility Act of 2017: To amend title XXVII of the Public Health Service Act to change the permissible age variation in health insurance premium rates. Buschon (R-IN). HR 710 -Health Coverage State Flexibility Act of 2017: To amend the Patient Protection and Affordable Care Act to better align the grace period required for non-payment of premiums before discontinuing coverage under qualified health plans with such grace periods provided for under State law. Flores (R-TX). HR 749 - Lower Drug Costs through Competition Act: To increase competition in the pharmaceutical industry. Schrader (D-OR) H.R.1121 - Pre-existing Conditions Protection Act of 2017: To amend the Public Health Service Act to prohibit application of pre-existing condition exclusions and to guarantee availability of health insurance coverage in the individual and group market, contingent on the enactment of legislation repealing the Patient Protection and Affordable Care Act, and for other purposes. Walden (R-OR). HR 1175 and S 403 - Health Savings Act of 2017: To amend the Internal Revenue Code of 1986 to improve access to health care through expanded health savings accounts, and for other purposes. Paulsen (R-MN) & Hatch (R-UT). HR 1304 - Self-Insurance Protection Act: To amend the Employee Retirement Income Security Act of 1974, the Public Health Service Act, and the Internal Revenue Code of 1986 to exclude from the definition of health insurance coverage certain medical stop-loss insurance obtained by certain plan sponsors of group health plans. Roe (R-TN) HR 1628 - American Health Care Act of 2017: To provide for reconciliation pursuant to title II of the concurrent resolution on the budget for fiscal year 2017. Black (R-TN). HR 1776 & S 771 Improving Access To Affordable Prescription Drugs Act: To improve access to affordable prescription drugs. Schakowsky (D-IL) & Franken (D-MN) HR 2051 - 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. McKinley (R-WV) S 191 - Patient Freedom Act of 2017: To improve patient choice by allowing States to adopt market based alternatives to the Affordable Care Act that increase access to affordable health insurance and reduce costs while ensuring important consumer protections and improving patient care. Cassidy (R-LA) S 637 - Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2017: To amend titles XI and XVIII of the Social Security Act to provide greater transparency of discounts provided by drug manufacturers. Wyden (D-OR)

Client expense: $208,058 · Firm income: Not reported

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

The American Health Care Act of 2017 (AHCA); The Better Care Reconciliation Act of 2017 (BCRA); HR706; HR710; Insurance Market stabilization; CMS Notice of Benefit & Payment Parameters; reinsurance; cost-sharing reductions; 3rd party payment of premiums; special enrollment periods; grace periods; age rate bands; delivery system reform; Patient Safety and Quality Improvement; Patient-Centered Primary/Medical Home; Bundled Payments; Employer Wellness; Chronic Care & Medical Management; Childhood Obesity; Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM; Postal Reform Act; Risk Mitigation Legislation; mental health reform; ACA Implementation and back-end issues; Small Business Health Options Program (SHOP)implementation.

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

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

H.R. 2938 Removing Barriers to Medicaid and CHIP Addiction Treatment Act of 2017 H. Res. 142 Expressing support for "National Obesity Care Week" S. Res. 63 Expressing support for "National Obesity Care Week" H.R. 181 Close Annuity Loopholes in Medicaid Act H.R. 184 Protect Medical Innovation Act H.R. 244 Consolidated Appropriations Act, 2017 H.R. 284 Advancing Medical Resident Training in Community Hospitals Act H.R. 309 National Clinical Care Commission Act S. 920 National Clinical Care Commission Act H.R. 372 Competitive Health Insurance Reform Act H.R. 592 Pharmacy and Medically Underserved Areas Enhancement Act S. 109 Pharmacy and Medically Underserved Areas Enhancement Act H.R. 706 Plan Verification and Fairness Act H.R. 741 Rural Hospital Regulatory Relief Act S. 243 Rural Hospital Regulatory Relief Act H.R. 749 Lower Drug Costs through Competition Act H.R. 766 Amend Title XVII of the Social Security Act to Expand Telehealth in Medicare H.R. 829 Prioritizing the Most Vulnerable Over Lottery Winners Act H.R. 849 Protecting Seniors' Access to Medicare Act S. 260 Protecting Seniors' Access to Medicare Act H.R. 908 Medicare Advantage Quality Payment Relief Act H.R. 998 Searching for and Cutting Regulations that are Unnecessarily Burdensome (SCRUB) Act H.R. 1004 Regulatory Integrity Act H.R. 1009 OIRA Insight, Reform, and Accountability Act S. 676 OIRA Insight, Reform, and Accountability Act H.R. 1038 Improving Transparency and Accuracy in Medicare Part D Spending H.R. 1072 Obamacare Replacement Act S. 222 Obamacare Replacement Act H.R. 1101 Small Business Health Fairness Act H.R. 1121 Pre-Existing Conditions Protection Act H.R. 1148 Furthering Access to Stroke Telemedicine (FAST) Act S. 431 Furthering Access to Stroke Telemedicine (FAST) Act H.R. 1215 Protecting Access to Care Act H.R. 1245 Affordable and Safe Prescription Drug Importation Act S. 469 Affordable and Safe Prescription Drug Importation Act H.R. 1267 Personal Health Investment Today (PHIT) Act S. 482 Personal Health Investment Today (PHIT) Act H.R. 1304 Self-Insurance Protection Act H.R. 1313 Preserving Employee Wellness Programs Act H.R. 1554 Jessie's Law S. 581 Jessie's Law H.R. 1565 Saving Lives, Saving Costs Act H.R. 1628 American Health Care Act H.R. 1703 Medical Product Communications Act H.R. 1776 Improving Access to Affordable Prescription Drugs Act S. 771 Improving Access to Affordable Prescription Drugs Act H.R. 1922 Foreign Medical School Accountability Fairness Act S. 850 Foreign Medical School Accountability Fairness Act H.R. 1953 Treat and Reduce Obesity Act (TROA) S. 830 Treat and Reduce Obesity Act (TROA) H.R. 2141 Conrad State 30 and Physician Access Reauthorization Act S. 898 Conrad State 30 and Physician Access Reauthorization Act H.R. 2192 To Amend the Public Health Service Act to Eliminate the Non-Application of Certain State Waiver Provisions to Members of Congress and Congressional Staff H.R. 2212 Creating and Restoring Equal Access to Equivalent Samples (CREATES) Act S. 974 Creating and Restoring Equal Access to Equivalent Samples (CREATES) Act H.R. 2267 Resident Physician Reduction Shortage Act H.R. 246 Jobs and Premium Protection Act H.R. 2550 Medicare Telehealth Parity Act H.R. 2556 CONNECT for Health Act S. 1016 CONNECT for Health Act H.R. 2953 Amend the Congressional Budget Act of 1974 Respecting the Scoring of Preventive Health Savings S. 108 Medical Device Access and Innovation Protection Act S. 183 Jobs and Premium Protection Act S. 191 Patient Freedom Act S. 251 Protecting Medicare from Executive Action Act S. 309 Community-Based Independence for Seniors Act S. 413 Improving Transparency and Accuracy in Medicare Part D Spending S. 464 Independence at Home Act S. 469 Affordable and Safe Prescription Drug Importation Act S. 64 Safe and Affordable Drugs from Canada Act S. 761 Health Care Options Act S. 771 Improving Access to Affordable Prescription Drugs Act S. 787, Telehealth Innovation and Improvement Act S. 870 Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act

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

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

ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (reconciliation, individual mandate, cost sharing reduction subsidies) ACA transitional policies Proposed HHS Market Stabilization Regulation The American Health Care Act (H.R. 1628 and H. Res. 154) The Small Business Health Fairness Act of 2017 (H.R. 1101) The Competitive Health Insurance Reform Act (H.R. 372) The Protecting Access to Care Act (H.R. 1215) The Self-Insurance Protection Act (H.R. 1304) The Pre-existing Conditions Protection Act of 2017 (H.R. 1121) The Patient Fairness and Relief Act of 2017 (H.R. 633) The Employee Fairness and Relief Act of 2017 (H.R. 661) The Plan Verification and Fairness Act of 2017 (H.R. 706) The State Age Rating Flexibility Act of 2017 (H.R. 708) The Health Coverage State Flexibility Act of 2017 (H.R. 710) The Lower Drug Costs through Competition Act (H.R. 749) Out of network Billing ACA third party payments Telehealth Price of prescription drugs

Client expense: $1,700,000 · 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

ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (reconciliation, individual mandate, cost sharing reduction subsidies) ACA transitional policies Proposed HHS Market Stabilization Regulation The American Health Care Act (H.R. 1628 and H. Res. 154) The Small Business Health Fairness Act of 2017 (H.R. 1101) The Competitive Health Insurance Reform Act (H.R. 372) The Protecting Access to Care Act (H.R. 1215) The Self-Insurance Protection Act (H.R. 1304) The Pre-existing Conditions Protection Act of 2017 (H.R. 1121) The Patient Fairness and Relief Act of 2017 (H.R. 633) The Employee Fairness and Relief Act of 2017 (H.R. 661) The Plan Verification and Fairness Act of 2017 (H.R. 706) The State Age Rating Flexibility Act of 2017 (H.R. 708) The Health Coverage State Flexibility Act of 2017 (H.R. 710) The Lower Drug Costs through Competition Act (H.R. 749) Out of network Billing ACA third party payments Telehealth Price of prescription drugs

Client expense: $1,700,000 · 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

HR 246, "To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act", regarding all provisions. HR 633, "Patient Fairness and Relief Act of 2017", regarding all provisions. HR 708, "State Age Rating Flexibility Act of 2017", regarding all provisions. HR 710, "Health Coverage State Flexibility Act of 2017", regarding all provisions. HR 706, "Plan Verification and Fairness Act of 2017", regarding all provisions. HR 661, "Employee Fairness and Relief Act of 2017", regarding all provisions. HR 749, "Lower Drug Costs through Competition Act", regarding all provisions. HR 1101, "Small Business Health Fairness Act of 2017", regarding all provisions.

Client expense: $1,080,000 · Firm income: Not reported

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

ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (reconciliation, individual mandate, cost sharing reduction subsidies) ACA transitional policies Proposed HHS Market Stabilization Regulation The American Health Care Act (H.R. 1628 and H. Res. 154) The Small Business Health Fairness Act of 2017 (H.R. 1101) The Competitive Health Insurance Reform Act (H.R. 372) The Protecting Access to Care Act (H.R. 1215) The Self-Insurance Protection Act (H.R. 1304) The Pre-existing Conditions Protection Act of 2017 (H.R. 1121) The Patient Fairness and Relief Act of 2017 (H.R. 633) The Employee Fairness and Relief Act of 2017 (H.R. 661) The Plan Verification and Fairness Act of 2017 (H.R. 706) The State Age Rating Flexibility Act of 2017 (H.R. 708) The Health Coverage State Flexibility Act of 2017 (H.R. 710) The Lower Drug Costs through Competition Act (H.R. 749) Out of network Billing ACA third party payments Telehealth Price of prescription drugs

Client expense: $1,640,000 · 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

ACA implementation (exchange operations and functionality, risk mitigation programs, risk adjustment) ACA reform (reconciliation, individual mandate, cost sharing reduction subsidies) ACA transitional policies Proposed HHS Market Stabilization Regulation The American Health Care Act (H.R. 1628 and H. Res. 154) The Small Business Health Fairness Act of 2017 (H.R. 1101) The Competitive Health Insurance Reform Act (H.R. 372) The Protecting Access to Care Act (H.R. 1215) The Self-Insurance Protection Act (H.R. 1304) The Pre-existing Conditions Protection Act of 2017 (H.R. 1121) The Patient Fairness and Relief Act of 2017 (H.R. 633) The Employee Fairness and Relief Act of 2017 (H.R. 661) The Plan Verification and Fairness Act of 2017 (H.R. 706) The State Age Rating Flexibility Act of 2017 (H.R. 708) The Health Coverage State Flexibility Act of 2017 (H.R. 710) The Lower Drug Costs through Competition Act (H.R. 749) Out of network Billing ACA third party payments Telehealth Price of prescription drugs

Client expense: $1,640,000 · 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

Affordable Healthcare Act (ACA) Regulations; American Health Care Act (AHCA); Health Care Reform; Implementation; Cost Sharing Reduction (CSR); Reinsurance; Health Savings Accounts (HSAs); Repeal and Replace; Grace Periods; SEPs; Marketplace Stability; Individual Marketplace Reform; Antitrust; Medical Malpractice Reform; Association Health Plans HR 246 Introduced January 4, 2017 by Kristi Noem (R-SD) This bill repeals a provision of the Patient Protection and Affordable Care Act that imposes an annual fee on a health insurance provider based on its net premium income. HR 633 Patient Fairness and Relief Act of 2017 Introduced January 24, 2017 by Gregg Harper (R-MS) To authorize health insurance issuers to continue to offer for sale health insurance coverage offered in the individual market before the enactment of the Patient Protection and Affordable Care Act in satisfaction of the minimum essential health insurance coverage requirement, and for other purposes. HR 708 State Age Rating Flexibility Act of 2017 Introduced by Larry Bucshon (R-IN) This bill amends the Public Health Service Act to increase the permissible variation based on age for health insurance premiums for coverage offered in the individual or small group market from a factor of three to a factor of five, or to a factor determined by the state. This applies to plan years starting on or after January 1, 2018. HR 710 Health Coverage State Flexibility Act of 2017 Introduced January 17, 2017 by Bill Flores (R-TX) This bill amends the Patient Protection and Affordable Care Act to revise the grace period that health insurers must provide to recipients of premium subsidies before discontinuing health coverage for nonpayment of premiums. The grace period is shortened from 3 months to 30 days unless state law includes an applicable grace period. HR 706 Plan Verification and Fairness Act of 2017 Introduced January 27, 2017 by Marsha Blackburn (R-TN) This bill amends the Patient Protection and Affordable Care Act to require health insurance exchanges to verify an individual's eligibility for a special enrollment period before coverage is made effective. Individuals seeking coverage through an exchange during a special enrollment period must submit to the exchange the documents necessary to verify their eligibility for the special enrollment period. HR 661 Employee Fairness and Relief Act of 2017 Introduced January 24, 2017 by Brett Guthrie (R-KY) To authorize health insurance issuers to offer for sale previously available health insurance coverage in the small group market in satisfaction of the minimum essential health insurance coverage requirement, and for other purposes. HR 749 Lower Drug Costs Through Competition Act Introduced January 30, 2017 by Kurt Schrader (D-OR) To increase competition in the pharmaceutical industry. HR 1101 Small Business Health Fairness Act of 2017 Introduced February 16, 2017 by Sam Johnson (R-TX) To amend Title I of the Employee Retirement Income Security Act of 1974 to improve access and choice for entrepreneurs with small businesses with respect to medical care for their employees.

Client expense: $22,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 173 and S 40 - Middle Class Health Benefits Tax Repeal Act of 2017: To amend the Internal Revenue Code of 1986 to repeal the excise tax on high cost employer-sponsored health coverage. Kelly (R-PA) & Heller (R-NV). HR 314 - Health Care Choice Act of 2017: To repeal title I of the Patient Protection and Affordable Care Act and to amend the Public Health Service Act to provide for cooperative governing of individual health insurance coverage offered in interstate commerce. Blackburn (R-TN). HR 706 - Plan Verification and Fairness Act of 2017: To amend title I of the Patient Protection and Affordable Care Act to require verification for eligibility for enrollment during special enrollment periods in PPACA insurance plans, and for other purposes. Blackburn (R-TN). HR 708 - State Age Rating Flexibility Act of 2017: To amend title XXVII of the Public Health Service Act to change the permissible age variation in health insurance premium rates. Buschon (R-IN). HR 710 -Health Coverage State Flexibility Act of 2017: To amend the Patient Protection and Affordable Care Act to better align the grace period required for non-payment of premiums before discontinuing coverage under qualified health plans with such grace periods provided for under State law. Flores (R-TX). HR 749 - Lower Drug Costs through Competition Act: To increase competition in the pharmaceutical industry. Schrader (D-OR) H.R.1121 - Pre-existing Conditions Protection Act of 2017: To amend the Public Health Service Act to prohibit application of pre-existing condition exclusions and to guarantee availability of health insurance coverage in the individual and group market, contingent on the enactment of legislation repealing the Patient Protection and Affordable Care Act, and for other purposes. Walden (R-OR). HR 1175 and S 403 - Health Savings Act of 2017: To amend the Internal Revenue Code of 1986 to improve access to health care through expanded health savings accounts, and for other purposes. Paulsen (R-MN) & Hatch (R-UT). HR 1304 - Self-Insurance Protection Act: To amend the Employee Retirement Income Security Act of 1974, the Public Health Service Act, and the Internal Revenue Code of 1986 to exclude from the definition of health insurance coverage certain medical stop-loss insurance obtained by certain plan sponsors of group health plans. Roe (R-TN) HR 1628 - American Health Care Act of 2017: To provide for reconciliation pursuant to title II of the concurrent resolution on the budget for fiscal year 2017. Black (R-TN). HR 1776 & S 771 Improving Access To Affordable Prescription Drugs Act: To improve access to affordable prescription drugs. Schakowsky (D-IL) & Franken (D-MN) HR 2051 - 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. McKinley (R-WV) S 191 - Patient Freedom Act of 2017: To improve patient choice by allowing States to adopt market based alternatives to the Affordable Care Act that increase access to affordable health insurance and reduce costs while ensuring important consumer protections and improving patient care. Cassidy (R-LA) S 637 - Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2017: To amend titles XI and XVIII of the Social Security Act to provide greater transparency of discounts provided by drug manufacturers. Wyden (D-OR)

Client expense: $660,000 · Firm income: Not reported

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

H.R. 706 Plan Verification and Fairness Act of 2017; H.R. 708 State Age Rating Flexibility Act of 2017; H.R. 710 Health Coverage State Flexibility Act of 2017; H.R. 1121 Preexisting Conditions Protection and Continuous Coverage Incentive Act of 2017; H.R. 1101 The Small Business Health Fairness Act of 2017; H.R. 1628 American Health Care Act (AHCA).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Postal Reform: Affordable Healthcare Act (ACA) Regulations; Amendment of the Food, Drug and Cosmetic Act; American Health care Act (AHCA); Health Care Reform; Implementation, Cost Sharing Reduction(CSR); Reinsurance; Health Savings Accounts (HSA's); Repeal and Replace; Grace periods; SEPs; Marketplace Stability; Individual Marketplace Reform; Anti-Trust; Automated Calls and Telephone Consumer Protection Act; Medical Malpractice Reform; Association Health Plans. HR 246 Introduced January 4, 2017 by Kristi Noem (R-SD). This bill repeals a provision of the Patient Protection and Affordable Care Act imposes an annual fee on a health insurance provider based on its net premium income. HR 633 Patient Fairness and Relief Act of 2017 introduced January 24, 2017 by Gregg Harper (R-MS)to authorize health insurance issuers to continue to offer for sale health insurance coverage offered in the individual market before the enactment of the Patient Protection and Affordable Care Act in satisfaction of the minimum essential health insurance coverage requirement and for other purposes. HR 710 Health Coverage State Flexibility Act of 2017 introduced January 17, 2017 by Bill Flores (R-TX). This bill amends the Patient Protection and Affordable Care Act to revise the grace period that health insurers must provide to recipients of premium subsidies before discontinuing health coverage for nonpayment of premiums. The grace period is shortened from 3 months to 30 days unless state law includes an applicable grace period. HR 706 Plan Verification and Fairness Act of 2017 Introduced January 27, 2017 by Marsha Blackburn f(R-TN). This bill amends the Patient Protection and Affordable Care Act to require health insurance exchanges to verify and individual's eligibility for a special enrollment period before coverage is made effective. Individuals seeking coverage through an exchange during a special enrollment period must submit to the exchange the documents necessary to verify their eligibility for the special enrollment period. HR 749 Lower Drug Costs Through competition Act introduced January 30, 2017 by Kurt Schrader (D-OR) to increase competition in the pharmaceutical industry. HR 756 Postal Service Reform Act of 2017 introduced January 30, 2017 by Jason Chaffetz (R-UT) to restore the financial solvency and improve the governance of the United States Postal Service in order to ensure the efficient and affordable nationwide delivery of mail and for other purposes.

Client expense: $66,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Postal Reform; Affordable Healthcare Act (ACA) Regulations; Amendment of the Food, Drug, and Cosmetic Act; American Health Care Act (AHCA); Health Care Reform; Implementation; Cost Sharing Reduction (CSR); Reinsurance; Health Savings Accounts (HSAs); Repeal and Replace; Grace Periods; SEPs; Marketplace Stability; Individual Marketplace Reform; Anti-trust; Automated Calls and Telephone Consumer Protection Act; Medical Malpractice Reform; Association Health Plans HR 246 Introduced January 4, 2017 by Kristi Noem (R-SD) This bill repeals a provision of the Patient Protection and Affordable Care Act that imposes an annual fee on a health insurance provider based on its net premium income. HR 633 Patient Fairness and Relief Act of 2017 Introduced January 24, 2017 by Gregg Harper (R-MS) To authorize health insurance issuers to continue to offer for sale health insurance coverage offered in the individual market before the enactment of the Patient Protection and Affordable Care Act in satisfaction of the minimum essential health insurance coverage requirement, and for other purposes. HR 708 State Age Rating Flexibility Act of 2017 Introduced by Larry Bucshon (R-IN) This bill amends the Public Health Service Act to increase the permissible variation based on age for health insurance premiums for coverage offered in the individual or small group market from a factor of three to a factor of five, or to a factor determined by the state. This applies to plan years starting on or after January 1, 2018. HR 710 Health Coverage State Flexibility Act of 2017 Introduced January 17, 2017 by Bill Flores(R-TX) This bill amends the Patient Protection and Affordable Care Act to revise the grace period that health insurers must provide to recipients of premium subsidies before discontinuing health coverage for nonpayment of premiums. The grace period is shortened from 3 months to 30 days unless state law includes an applicable grace period. HR 706 Plan Verification and Fairness Act of 2017 Introduced January 27, 2017 by Marsha Blackburn (R-TN) This bill amends the Patient Protection and Affordable Care Act to require health insurance exchanges to verify an individual's eligibility for a special enrollment period before coverage is made effective. Individuals seeking coverage through an exchange during a special enrollment period must submit to the exchange the documents necessary to verify their eligibility for the special enrollment period. HR 661 Employee Fairness and Relief Act of 2017 Introduced January 24, 2017 by Brett Guthrie (R-KY) To authorize health insurance issuers to offer for sale previously available health insurance coverage in the small group market in satisfaction of the minimum essential health insurance coverage requirement, and for other purposes. HR 749 Lower Drug Costs Through Competition Act Introduced January 30, 2017 by Kurt Schrader (D-OR) To increase competition in the pharmaceutical industry. HR 756 Postal Service Reform Act of 2017 Introduced January 31, 2017by Jason Chaffetz (R-UT) To restore the financial solvency and improve the governance of the United States Postal Service in order to ensure the efficient and affordable nationwide delivery of mail, and for other purposes. HR 1101 Small Business Health Fairness Act of 2017 Introduced February 16, 2017 by Sam Johnson (R-TX) To amend title I of the Employee Retirement Income Security Act of 1974 to improve access and choice for entrepreneurs with small businesses with respect to medical care for their employees.

Client expense: $2,150,000 · Firm income: Not reported

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

Affordable Care Act (ACA); ACA Regulations, HCR Implementation; American Health Care Act (AHCA); Market Stability; Health Savings Accounts (HSAs); Special Enrollment Periods (SEPs); Cost-sharing Reduction (CSR); Re-insurance; Repeal/Replace; Grace Periods; Healthcare Reform; Individual Market Reform; Exchanges; Age Bands; Association Health Plans. HR 246 Introduces January 4, 2017 by Kristi Noem (R-SD This bill repeals a provision of the Patient Protection and Affordable Care Act that imposes an annual fee on a health insurance provider based on its net premium income. HR 633 Patient Fairness and Relief Act of 2017 Introduced January 24, 2017 by Gregg Harper (R-MS) To authorize health insurance issuers to continue to offer for sale health insurance coverage offered in the individual market before the enactment of the Patient Protection and Affordable Care Act in satisfaction of the minimum essential health insurance coverage requirement, and for other purposes. HR 661 Employer Fairness and Relief Act of 2017 Introduced January 27, 2017 Introduced January 24, 2017 by Brett Guthrie (R-KY) To authorize health insurance issuers to offer for sale previously available health insurance coverage in the small group market in satisfaction of the minimum essential health insurance coverage requirement and for other purposes. HR 708 State Age Rating Flexibility Act of 2017 Introduced by Larry Bucshon (R-IN) This bill amends the Public Health Service Act to increase the permissible variation based on age for health insurance premiums for coverage offered in the individual or small group market from a factor of three to a factor of five, or to a factor determined by the state. This applies to plan years starting on or after January 1, 2018. HR 710 Health Coverage State Flexibility Act 2017 Introduced January 17, 2017 by Bill Flores (R-TX) This bill amends the Patient Protection and Affordable Care Act to revise the grace period that health insurers must provide to recipients of premium subsidies before discontinuing health coverage for nonpayment of premiums. The grace period is shortened from 3 months to 30 days unless state law includes an applicable grace period. HR 706 Plan Verification and Fairness Act of 2017 Introduced January 27, 2017 by Marsha Blackburn (R-TN) This bill amends the Patient Protection and Affordable Care Act to require health insurance exchanges to verify an individual's eligibility for a special enrollment period before coverage is made effective. Individuals seeking coverage through an exchange during a special enrollment period must submit to the exchange the documents necessary to verify their eligibility for the special enrollment period. HR 749 Lower Drug Costs Through Competition Act Introduced January 30, 2017 by Kurt Schrader (D-OR) To increase competition in the pharmaceutical industry. HR 1101 Small Business Health Fairness Act of 2017 Introduced February 16, 2017 by Sam Johnson (R-TX) to amend title I of the Employee Retirement Income Security Act of 1974 to improve access and choice for entrepreneurs with small businesses with respect to medical care for their employees.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Affordable Care Act (ACA) Regulations; American Health Care Act (AHCA); Health Care Reform; Implementation; Cost Sharing Reduction (CSR); Reinsurance; Health Savings Accounts (HSAs); Repeal and Replace; Grace Periods; SEPs; Marketplace Stability; Individual Marketplace Reform; Anti-trust; Medical Malpractice Reform; Association Health Plans, Selling across state lines HR 246 Introduced January 4, 2017 by Kristi Noem (R-SD) This bill repeals a provision of the Patient Protection and Affordable Care Act that imposes an annual fee on a health insurance provider based on its net premium income. HR 633 Patient Fairness and Relief Act of 2017 Introduced January 24, 2017 by Gregg Harper (R-MS) To authorize health insurance issuers to continue to offer for sale health insurance coverage offered in the individual market before the enactment of the Patient Protection and Affordable Care Act in satisfaction of the minimum essential health insurance coverage requirement, and for other purposes. HR 708 State Age Rating Flexibility Act of 2017 Introduced by Larry Bucshon (R-IN) This bill amends the Public Health Service Act to increase the permissible variation based on age for health insurance premiums for coverage offered in the individual or small group market from a factor of three to a factor of five, or to a factor determined by the state. This applies to plan years starting on or after January 1, 2018. HR 710 Health Coverage State Flexibility Act of 2017 Introduced January 17, 2017 by Bill Flores(R-TX) This bill amends the Patient Protection and Affordable Care Act to revise the grace period that health insurers must provide to recipients of premium subsidies before discontinuing health coverage for nonpayment of premiums. The grace period is shortened from 3 months to 30 days unless state law includes an applicable grace period. HR 706 Plan Verification and Fairness Act of 2017 Introduced January 27, 2017 by Marsha Blackburn (R-TN) This bill amends the Patient Protection and Affordable Care Act to require health insurance exchanges to verify an individual's eligibility for a special enrollment period before coverage is made effective. Individuals seeking coverage through an exchange during a special enrollment period must submit to the exchange the documents necessary to verify their eligibility for the special enrollment period. HR 661 Employee Fairness and Relief Act of 2017 Introduced January 24, 2017 by Brett Guthrie (R-KY) To authorize health insurance issuers to offer for sale previously available health insurance coverage in the small group market in satisfaction of the minimum essential health insurance coverage requirement, and for other purposes. HR 1101 Small Business Health Fairness Act of 2017 Introduced February 16, 2017 by Sam Johnson (R-TX) To amend title I of the Employee Retirement Income Security Act of 1974 to improve access and choice for entrepreneurs with small businesses with respect to medical care for their employees.

Client expense: $350,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Repeal and Replace, American Health Care Act (AHCA) regulations, Cost Sharing Reductions (CSRs), Reinsurance, Health Savings Accounts (HSAs), Grace Periods, Special Enrollment Periods (SEPs), Marketplace Stability HR 246 Introduced January 4, 2017 by Kristi Noem (R-SD). This bill repeals a provision of the Patient Protection and Affordable Care Act (PPACA) that imposes an annual fee on a health insurance provider based on its net premium income. HR 633 Patient Fairness and Relief Act of 2017 Introduced January 24, 2017 by Gregg Harper (R-MS). To authorize health insurance issuers to continue to offer for sale health insurance coverage offered in the individual market before the enactment of the PPACA in satisfaction of the minimum essential health insurance coverage requirement, and for other purposes. HR 708 State Age Rating Flexibility Act of 2017 Introduced by Larry Bucshon (R-TN). This bill amends the Public Health Service Act (PHSA) to increase the permissible variation based on age for health insurance premiums for coverage offered in the individual or small group market from a factor of three to a factor of five, or a factor to be determined by the state, for plan years starting on or after January 1, 2018. HR 710 Health Coverage State Flexibility Act of 2017 Introduced January 17, 2017 by Bill Flores (R-TX). This bill amends the PPACA to revise the grace period that health insurers must provide to recipients of premium subsidies before discontinuing health coverage for nonpayment of premiums. The grace period is shortened from 3 months to 30 days unless state law defines an applicable grace period. HR 706 Plan Verification and Fairness Act of 2017 Introduced January 27, 2017 by Marsha Blackburn (R-TN). This bill amends the PPACA to require health insurance exchanges to verify an individual's eligibility for a special enrollment period (SEP) before coverage is made effective. Individuals seeking coverage through an exchange during a SEP must submit to the exchange the documentation necessary to verify their eligibility for the SEP.

Client expense: $360,000 · Firm income: Not reported

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

American Health Care Act; HR706; HR710; Insurance Market stabilization; CMS Notice of Benefit & Payment Parameters; reinsurance; cost-sharing reductions; 3rd party payment of premiums; special enrollment periods; grace periods; age rate bands; delivery system reform; Patient Safety and Quality Improvement; Patient-Centered Primary/Medical Home; Bundled Payments; Employer Wellness; Chronic Care & Medical Management; Childhood Obesity; Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM; President's Budget; Postal Reform Act; Risk Mitigation Legislation; mental health reform; ACA Implementation and back-end issues; Small Business Health Options Program (SHOP)implementation.

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

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

Implementation of health care payment and coverage reforms in the Affordable Care Act (ACA), including implementation of ACA grace period for nonpayment of premiums under advanced premium tax credit and eligibility and enrollment issues; mental health reform related issues; ACA exchange enrollment and payment restrictions, including related provisions in H.R. 710, the Health Coverage State Flexibility Act, and H.R. 706, the Plan Verification and Fairness Act; and third party payment of premiums.

Client expense: Not reported · Firm income: $90,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE