Responsible Additions and Increases to Sustain Employee Health Benefits Act of 2019

S.692 & H.R.2207 - Protect Medical Innovation Act of 2019 S.503 & H.R.1366 - Responsible Additions & Increases to Sustain Employee Health Benefits Act of 2019 S.684 - Middle Class Health Benefits Tax Repeal Act of 2019

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

Government targets: Centers For Disease Control & Prevention (CDC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Occupational Safety & Health Administration (OSHA), SENATE, Treasury, Dept of

HR 1366 "Responsible Additions and Increases to Sustain Employee Health Benefits Act of 2019," all provisions. HR 1425 "Patient Protection and Affordable Care Enhancement Act," all provisions. Issues pertaining to "surprise" medical billing, a truth in advertising solution, and arbitration/bench-marking proposals.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Health savings accounts, flexible spending accounts, expand and make permanent the 199A/pass through deduction for small businesses. H.R. 1366, Responsible Additions and Increases to Sustain Employee Health Benefits Act of 2019 (RAISE ACT) (health savings accounts, flexible spending accounts) S. 503, Responsible Additions and Increases to Sustain Employee Health Benefits Act of 2019 (RAISE ACT) (health savings accounts, flexible spending accounts) H.R. 6886/H.R. 7001 Paycheck Protection Program Flexibility Act. S. 3833 Paycheck Protection Program Extension Act H.R. 7216 Small Business Personal Protective Equipment (PPE) Tax Credit Act S. 3716 Main Street Enhancement and Safety Act Deductibility of expenses paid for with funds from Paycheck Protection Program loans. H.R. 6776 JOBS Credit Act of 2020 H.R. 266 Paycheck Protection Program and Health Care Enhancement Act H.R. 6433, Helping Emergency Responders Overcome Emergency Situations (HEROES) Act Deductibility of Expenses paid for with Paycheck Protection Program loan funds S. 2871/H.R. 6448 Indian Health Service Health Professions Tax Fairness Act

Client expense: $600,000 · Firm income: Not reported

-In support of the RAISE Health Benefits Act (S 503/HR 1366) - expanding the use of FSAs -In support of the Health Savings Act (S 12) - expanding the use of HSAs -In support of the Oral Health Literacy and Awareness Act of 2019 (H.R.4678) - authorizes HRSA to develop a 5-year evidence-based oral health literacy campaign across the agencys relevant program. -Asking for assistance in securing access for OMSs to N95 masks during COVID-19 pandemic -Asking HHS to provide federal authorization for licensed dentists to conduct FDA authorized point-of-case testing for COVID-19. -Asking CDC to consider AAOMS's comments on their May 19 Interim Infection Prevention and Control Guidance for Dental Settings During the COVID-19 Response

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

Government targets: Centers For Disease Control & Prevention (CDC), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), SENATE, Small Business Administration (SBA), Treasury, Dept of, White House Office

S.692 & H.R.2207 - Protect Medical Innovation Act of 2019 S.503 & H.R.1366 - Responsible Additions & Increases to Sustain Employee Health Benefits Act of 2019 S.684 - Middle Class Health Benefits Tax Repeal Act of 2019

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

Government targets: Centers For Disease Control & Prevention (CDC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), SENATE, Treasury, Dept of

-In support of the RAISE Health Benefits Act (S 503/HR 1366) - expanding the use of FSAs -In support of the Health Savings Act (S 12) - expanding the use of HSAs -In support of the Oral Health Literacy and Awareness Act of 2019 (H.R.4678) - authorizes HRSA to develop a 5-year evidence-based oral health literacy campaign across the agencys relevant program. -Asking for assistance in securing access for OMSs to N95 masks during COVID-19 pandemic

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

Government targets: Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), SENATE, White House Office

Expansion of health savings accounts, flexible spending accounts, expand and make permanent the 199A/pass through deduction for small businesses. H.R. 1366, Responsible Additions and Increases to Sustain Employee Health Benefits Act of 2019 (RAISE ACT) (health savings accounts, flexible spending accounts) S. 503, Responsible Additions and Increases to Sustain Employee Health Benefits Act of 2019 (RAISE ACT) (health savings accounts, flexible spending accounts) H.R. 216, Main Street Tax Certainty Act Medical Device Tax Repeal H.R. 748, Middle Class Health Benefits Tax Repeal Act S. 684, Middle Class Health Benefits Tax Repeal Act H.R. 748 Coronavirus Aid, Relief, and Economic Security Act or the CARES Act H.R. 6201 Families First Coronavirus Response Act.

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Indian Health Service, Labor, Dept of (DOL), Natl Institutes of Health (NIH), SENATE, Small Business Administration (SBA), White House Office

Issues related to medical device excise tax (Protect Medical Innovation Act, S. 692/H.R. 2207); flexible spending account limits and treasury rulings on rollovers; RAISE Act (H.R. 1366/S. 503); tax policy proposals and implementation of comprehensive tax reform, including small business tax issues, pass-throughs, student loan interest deduction, higher education tax credits and benefits, dental faculty loan repayment assistance (H.R. 996/S. 359), ACA tax implementation; and student loan debt on medical professional small business owners. Middle Class Health Benefits Tax Repeal Act of 2019 (H.R. 748). Policy issues related to tax, small business and the federal response to the COVID-19 virus.

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

Issues related to medical device tax repeal (Protect Medical Innovation Act, H.R. 2207/S. 692) and expanded use of flexible spending accounts, health savings accounts, and association health plans (H.R. 2294/S. 1170), market stabilization efforts, issues related to oral health care, and health care workforce issues. Responsible Additions and Increases to Sustain Employee Health Benefits Act of 2019 (H.R. 1366/S. 503). Legislation to repeal Affordable Care Act limits on flexible spending accounts. Issues related to small business health care providers, including the Small Business Health Account Act. Ensuring Lasting Smiles Act (H.R. 1379/S. 560). FY 2021 Labor-HHS-Education appropriations; Policy issues related to health care and the federal response to the COVID-19 virus.

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

RAISE Act (H.R. 1366/S. 503) and issues related to oral health care, ACA regulations, McCarran-Ferguson Act repeal, small business insurance regulations. Association Health Plans Act of 2019 (H.R. 2294/S. 1170); policy issues related to insurance and the federal response to the COVID-19 virus.

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

S.692 & H.R.2207 - Protect Medical Innovation Act of 2019 S.503 & H.R.1366 - Responsible Additions & Increases to Sustain Employee Health Benefits Act of 2019 S.684 & H.R.748 - Middle Class Health Benefits Tax Repeal Act of 2019

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), SENATE

In support of the RAISE Health Benefits Act (S 503/HR 1366) - expanding the use of FSAs In support of the Health Savings Act (S 12) - expanding the use of HSAs

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

Government targets: Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Natl Institutes of Health (NIH), SENATE

Expansion of health savings accounts, flexible spending accounts, expand and make permanent the 199A/pass through deduction for small businesses. H.R. 1366, Responsible Additions and Increases to Sustain Employee Health Benefits Act of 2019 (RAISE ACT) (health savings accounts, flexible spending accounts) S. 503, Responsible Additions and Increases to Sustain Employee Health Benefits Act of 2019 (RAISE ACT) (health savings accounts, flexible spending accounts) H.R. 216, Main Street Tax Certainty Act Medical Device Tax Repeal H.R. 748, Middle Class Health Benefits Tax Repeal Act S. 684, Middle Class Health Benefits Tax Repeal Act

Client expense: $480,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Environmental Protection Agency (EPA), Federal Communications Commission (FCC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Indian Health Service, Labor, Dept of (DOL), Natl Institutes of Health (NIH), SENATE, White House Office

Issues related to medical device excise tax (Protect Medical Innovation Act, S. 692/H.R. 2207); flexible spending account limits and treasury rulings on rollovers; RAISE Act (H.R. 1366/S. 503); tax policy proposals and implementation of comprehensive tax reform, including small business tax issues, pass-throughs, student loan interest deduction, higher education tax credits and benefits, dental faculty loan repayment assistance (H.R. 996/S. 359), ACA tax implementation; and student loan debt on medical professional small business owners. Middle Class Health Benefits Tax Repeal Act of 2019 (H.R. 748). Further Consolidated Appropriations Act, 2020 (H.R. 1865).

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

Issues related to medical device tax repeal (Protect Medical Innovation Act, H.R. 2207/S. 692) and expanded use of flexible spending accounts, health savings accounts, and association health plans (H.R. 2294/S. 1170), market stabilization efforts, issues related to oral health care, and health care workforce issues. Responsible Additions and Increases to Sustain Employee Health Benefits Act of 2019 (H.R. 1366/S. 503). Legislation to repeal Affordable Care Act limits on flexible spending accounts. Issues related to small business health care providers, including the Small Business Health Account Act, and dental tourism (H.R. 951, The United States-Mexico Tourism Improvement Act). Ensuring Lasting Smiles Act (H.R. 1379/S. 560). Further Consolidated Appropriations Act, 2020 (H.R. 1865).

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

RAISE Act (H.R. 1366/S. 503) and issues related to oral health care, ACA regulations, McCarran-Ferguson Act repeal, small business insurance regulations. Association Health Plans Act of 2019 (H.R. 2294/S. 1170) .

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

The Senate Committee on Finance introduced S. 2543 on September 25, the Prescription Drug Pricing Reduction Act of 2019. Senator Lamar Alexander (R-TN), Chairman, and Senator Patty Murray (D-WA), Ranking Member, of the Senate Committee on Health, Education and Labor (HELP) introduced S.1895, the Lower Health Care Costs Act of 2019, on June 19, a bipartisan piece of legislation to deliver better health care at lower cost. Rep. Joe Courtney (D-CT) introduced a bill to repeal the Cadillac tax, the Affordable Care Act's forty percent tax on high-cost health plans. H.R. 748, entitled the Middle Class Health Benefits Tax Repeal Act would amend the Internal Revenue Code of 1986 to repeal the excise tax on high cost employer-sponsored health coverage. A bill, S.61, the Safe and Affordable Drugs from Canada Act of 2019, sponsored by Senator Chuck Grassley (R-IA), was introduced. The bill would amend the Federal Food, Drug, and Cosmetic Act to allow for the personal importation of safe and affordable drugs from approved pharmacies in Canada. S. 489, a bill to establish a State public option through Medicaid to provide Americans with the choice of a high-quality, low-cost health insurance plan, was introduced by Senator Brian Schatz (D-HI). A companion bill has been introduced in the House, which is H.R. 1277. Rep. Marcia Fudge (D-OH) is a cosponsor. S.692, a bill to amend the Internal Revenue Code of 1986 to repeal the excise tax on medical devices, was introduced by Senator Pat Toomey. S.684, a bill to amend the Internal Revenue Code of 1986 to repeal the excise tax on high cost employer-sponsored health coverage, the Cadillac Tax was introduced by Senator Martin Heinrich (D-NM). A similar House bill has been introduced. H.R. 1398, a bipartisan bill to delay the re-imposition of the annual fee on health insurance providers, aka the Health Insurance Tax (HIT) until after 2021 was introduced. The bill was introduced by Rep. Ami Bera. (D-CA). Rep. Steve Stivers (R-OH) introduced H.R. 1366, the Responsible Additions and Increases to Sustain Employee Health Benefits Act, RAISE Act to put flexibility back in Flexible Spending Accounts and to help families pay for out of pocket health care costs. H.R. 965, the CREATES Act, was reintroduced in Congress by Rep. David Cicilline (D-RI). The bill would 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. Senator Rob Portman (R-OH) introduced the Biologic Patent Transparency Act. The bill would require companies to publicly disclose the web of patents that protect their biologics, making it easier for competitors to evaluate and plan for the development of generic versions of these drugs. S.516, the Prescription Drug Monitoring Act of 2019, was introduced by Senator Amy Klobuchar (D-MN). The bill would require the use of prescription drug monitoring programs. Senator Sherrod Brown (D-OH) introduced S. 378, the Stop Price Gouging Act. The bill would penalize pharmaceutical companies that engage in price gouging without cause, leading to price spikes for patients who rely on medication to treat illnesses. H.R. 1091 is the companion House bill, which has been cosponsored by Rep. Marcy Kaptur (D-OH). Senator Sherrod Brown introduced legislation to address prescription drug affordability. The bill, S. 377, entitled, "The Medicare Negotiation and Competitive Licensing Act," would authorize the Secretary of Health and Human Services to negotiate drug prices and if a drug company refuses to negotiate in good faith, the secretary would be enabled to issue a competitive, compulsory license to another company that is willing and able to produce the medication as a generic. H.R. 965, the CREATES Act of 2019, which aims to increase competition by cracking down on brand-name drug manufacturers using tactics to keep generic manufacturers from entering the market, was advanced out of the Committee on Energy and Commerce and will be considered by the Committee on the Judiciary. Members of the Ohio delegation are co-sponsors.

Issues related to medical device tax repeal (Protect Medical Innovation Act, S. 692) and expanded use of flexible spending accounts, health savings accounts, and association health plans, market stabilization efforts, issues related to oral health care, and health care workforce issues. Responsible Additions and Increases to Sustain Employee Health Benefits Act of 2019 (H.R. 1366/S. 503). Legislation to repeal Affordable Care Act limits on flexible spending accounts. Issues related to small business health care providers, including the Small Business Health Account Act, and dental tourism (H.R. 951, The United States-Mexico Tourism Improvement Act).

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

RAISE Act (H.R. 1366/S. 503) and issues related to oral health care, ACA regulations, McCarran-Ferguson Act repeal, small business insurance regulations.

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

Issues related to medical device excise tax (Protect Medical Innovation Act, S. 692); flexible spending account limits and treasury rulings on rollovers; RAISE Act (H.R. 1366/S. 503); tax policy proposals and implementation of comprehensive tax reform, including small business tax issues, pass-throughs, student loan interest deduction, higher education tax credits and benefits, dental faculty loan repayment assistance (H.R. 996/S. 359), ACA tax implementation; and student loan debt on medical professional small business owners.

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

Expansion of health savings accounts, flexible spending accounts, expand and make permanent the 199A/pass through deduction for small businesses. H.R. 1366, Responsible Additions and Increases to Sustain Employee Health Benefits Act of 2019 (RAISE ACT) (health savings accounts, flexible spending accounts) S. 503, Responsible Additions and Increases to Sustain Employee Health Benefits Act of 2019 (RAISE ACT) (health savings accounts, flexible spending accounts) H.R. 216, Main Street Tax Certainty Act Medical Device Tax Repeal H.R. 748, Middle Class Health Benefits Tax Repeal Act S. 684, Middle Class Health Benefits Tax Repeal Act

Client expense: $510,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Federal Communications Commission (FCC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Indian Health Service, Labor, Dept of (DOL), Natl Institutes of Health (NIH), SENATE, State, Dept of (DOS), White House Office

In support of the RAISE Health Benefits Act (S 503/HR 1366) - expanding the use of FSAs In support of the Health Savings Act (S 12) - expanding the use of HSAs Sent letter to HHS in support of notice of proposed rulemaking related to Section 1557.

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

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

Senator Lamar Alexander (R-TN), Chairman, and Senator Patty Murray (D-WA), Ranking Member, of the Senate Committee on Health, Education and Labor (HELP) introduced S.1895, the Lower Health Care Costs Act of 2019, on June 19, a bipartisan piece of legislation to deliver better health care at lower cost. Rep. Joe Courtney (D-CT) introduced a bill to repeal the Cadillac tax, the Affordable Care Act's forty percent tax on high-cost health plans. H.R. 748, entitled the Middle Class Health Benefits Tax Repeal Act would amend the Internal Revenue Code of 1986 to repeal the excise tax on high cost employer-sponsored health coverage. A bill, S.61, the Safe and Affordable Drugs from Canada Act of 2019, sponsored by Senator Chuck Grassley (R-IA), was introduced. The bill would amend the Federal Food, Drug, and Cosmetic Act to allow for the personal importation of safe and affordable drugs from approved pharmacies in Canada. S. 489, a bill to establish a State public option through Medicaid to provide Americans with the choice of a high-quality, low-cost health insurance plan, was introduced by Senator Brian Schatz (D-HI). A companion bill has been introduced in the House, which is H.R. 1277. Rep. Marcia Fudge (D-OH) is a cosponsor. S.692, a bill to amend the Internal Revenue Code of 1986 to repeal the excise tax on medical devices, was introduced by Senator Pat Toomey. S.684, a bill to amend the Internal Revenue Code of 1986 to repeal the excise tax on high cost employer-sponsored health coverage, the Cadillac Tax was introduced by Senator Martin Heinrich (D-NM). A similar House bill has been introduced. H.R. 1398, a bipartisan bill to delay the re-imposition of the annual fee on health insurance providers, aka the Health Insurance Tax (HIT) until after 2021 was introduced. The bill was introduced by Rep. Ami Bera. (D-CA). Rep. Steve Stivers (R-OH) introduced H.R. 1366, the Responsible Additions and Increases to Sustain Employee Health Benefits Act, RAISE Act to put flexibility back in Flexible Spending Accounts and to help families pay for out of pocket health care costs. H.R. 965, the CREATES Act, was reintroduced in Congress by Rep. David Cicilline (D-RI). The bill would 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. Senator Rob Portman (R-OH) introduced the Biologic Patent Transparency Act. The bill would require companies to publicly disclose the web of patents that protect their biologics, making it easier for competitors to evaluate and plan for the development of generic versions of these drugs. S.516, the Prescription Drug Monitoring Act of 2019, was introduced by Senator Amy Klobuchar (D-MN). The bill would require the use of prescription drug monitoring programs. Senate bill, S.475, the RxCAP Act of 2019, was introduced by Senator Ron Wyden (D-OR). The bill would amend title XVIII of the Social Security Act to prevent catastrophic out-of-pocket spending on prescription drugs for seniors and individuals with disabilities. Senator Sherrod Brown (D-OH) introduced S. 378, the Stop Price Gouging Act. The bill would penalize pharmaceutical companies that engage in price gouging without cause, leading to price spikes for patients who rely on medication to treat illnesses. H.R. 1091 is the companion House bill, which has been cosponsored by Rep. Marcy Kaptur (D-OH). Senator Sherrod Brown introduced legislation to address prescription drug affordability. The bill, S. 377, entitled, "The Medicare Negotiation and Competitive Licensing Act," would authorize the Secretary of Health and Human Services to negotiate drug prices and if a drug company refuses to negotiate in good faith, the secretary would be enabled to issue a competitive, compulsory license to another company that is willing and able to produce the medication as a generic. Senator Ron Wyden (D-OR) introduced S.476, a bill for Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2019. Senator Sherrod Brown (D-OH) is one of the cosponsors. The bill would amend titles XI and XVIII of the Social Security Act to provide greater transparency of discounts provided by drug manufacturers. At the end of January 2019, the Health and Human Services Department issued a proposed rule, Fraud and Abuse; Removal of Safe Harbor Protection for Rebates Involving Prescription Pharmaceuticals and Creation of New Safe Harbor Protection for Certain Point-of-Sale Reductions in Price on Prescription Pharmaceuticals and Certain Pharmacy Benefit Manager Service Fees. The proposed rule has been interpreted to eliminate safe harbor protection for rebates paid by drug manufacturers to pharmacy benefit managers (PBMs), Medicare Part D plans and Medicaid managed care plans; create a new safe harbor for drug discounts offered to patients at the point of sale, and create a new safe harbor for PBM fees charged to drug manufacturers. The proposed rule would cost the federal government over $170 billion and approximately $20 million for a plan sponsor. EGWPS plans were excluded from the proposal. A meeting with HHS occured to ask questions and provide background and a letter was sent to CMS Administrator Verma. H.R. 965, the CREATES Act of 2019, which aims to increase competition by cracking down on brand-name drug manufacturers using tactics to keep generic manufacturers from entering the market, was advanced out of the Committee on Energy and Commerce and will be considered by the Committee on the Judiciary. Members of the Ohio delegation are co-sponsors.

Issues related to medical device tax repeal (Protect Medical Innovation Act, S. 692) and expanded use of flexible spending accounts, health savings accounts, and association health plans, market stabilization efforts, issues related to oral health care, and health care workforce issues. Responsible Additions and Increases to Sustain Employee Health Benefits Act of 2019 (H.R. 1366/S. 503). Legislation to repeal Affordable Care Act limits on flexible spending accounts. Issues related to small business health care providers, including the Small Business Health Account Act, and dental tourism (H.R. 951, The United States-Mexico Tourism Improvement Act).

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

Issues related to medical device excise tax (Protect Medical Innovation Act, S. 692); flexible spending account limits and treasury rulings on rollovers; RAISE Act (H.R. 1366/S. 503); tax policy proposals and implementation of comprehensive tax reform, including small business tax issues, pass-throughs, student loan interest deduction, higher education tax credits and benefits, dental faculty loan repayment assistance (H.R. 996/S. 359), ACA tax implementation; and student loan debt on medical professional small business owners.

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

RAISE Act (H.R. 1366/S. 503) and issues related to oral health care, ACA regulations, McCarran-Ferguson Act repeal, small business insurance regulations.

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

In support of the RAISE Health Benefits Act (S 503/HR 1366) - expanding the use of FSAs In support of the Health Savings Act (S 12) - expanding the use of HSAs Commented to HHS in response to the ONC's March 4, 2019 proposed rule on health information technology

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

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

Expansion of health savings accounts, flexible spending accounts, medical device tax repeal, expand and make permanent the 199A/pass through deduction for small businesses. H.R. 1366, Responsible Additions and Increases to Sustain Employee Health Benefits Act of 2019 (RAISE ACT) (health savings accounts, flexible spending accounts) S. 503, Responsible Additions and Increases to Sustain Employee Health Benefits Act of 2019 (RAISE ACT) (health savings accounts, flexible spending accounts)

Client expense: $510,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Federal Communications Commission (FCC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Indian Health Service, Labor, Dept of (DOL), Natl Institutes of Health (NIH), SENATE

Health savings accounts, flexible spending accounts. H.R. 1366, Responsible Additions and Increases to Sustain Employee Health Benefits Act of 2019 (RAISE ACT) (health savings accounts, flexible spending accounts) S. 503, Responsible Additions and Increases to Sustain Employee Health Benefits Act of 2019 (RAISE ACT) (health savings accounts, flexible spending accounts)

Client expense: $560,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Indian Health Service, Labor, Dept of (DOL), Natl Institutes of Health (NIH), SENATE

The partial shutdown impacted the ability of key regulatory agencies, DOL, HHS and Treasury/IRS to move forward on reviewing comment letters pertaining to the proposed HRA Excepted Benefits Rule and decide whether to extend Limited Wraparound Plans. Discussions were held to understand the status of the comments received and when decisions might be made. Rep. David Joyce introduced H.R.383, a bill called, the Continuing Coverage for Preexisting Conditions Act of 2019, on January 9. The bill would amend the Patient Protection and Affordable Care Act to ensure that preexisting condition exclusions with respect to enrollment in health insurance coverage and group health plans continue to be prohibited. Rep. Joe Courtney (D-CT) introduced a bill on January 24 to repeal the Cadillac tax, the Affordable Care Act's forty percent tax on high-cost health plans. H.R. 748, entitled the Middle Class Health Benefits Tax Repeal Act would amend the Internal Revenue Code of 1986 to repeal the excise tax on high cost employer-sponsored health coverage. A bill, S.61, the Safe and Affordable Drugs from Canada Act of 2019, sponsored by Senator Chuck Grassley (R-IA), was introduced on January 9. The bill would amend the Federal Food, Drug, and Cosmetic Act to allow for the personal importation of safe and affordable drugs from approved pharmacies in Canada. S. 489, a bill to establish a State public option through Medicaid to provide Americans with the choice of a high-quality, low-cost health insurance plan, was introduced on February 14 by Senator Brian Schatz (D-HI). A companion bill has been introduced in the House, which is H.R. 1277. Rep. Marcia Fudge (D-OH) is a cosponsor. S.692, a bill to amend the Internal Revenue Code of 1986 to repeal the excise tax on medical devices, was introduced by Senator Pat Toomey (R-PA) on March 7. S.684, a bill to amend the Internal Revenue Code of 1986 to repeal the excise tax on high cost employer-sponsored health coverage, the Cadillac Tax was introduced on March 6 by Senator Martin Heinrich (D-NM). H.R. 1398, a bipartisan bill to delay the re-imposition of the annual fee on health insurance providers, aka the Health Insurance Tax (HIT) until after 2021 was introduced on February 27. The bill was introduced by Rep. Ami Bera (D-CA). Rep. Steve Stivers (R-OH) introduced H.R. 1366, the Responsible Additions and Increases to Sustain Employee Health Benefits Act, RAISE Act to put flexibility back in Flexible Spending Accounts and to help families pay for out of pocket health care costs. On February 5, H.R. 965, the CREATES Act, was reintroduced in Congress by Rep. David Cicilline (D-RI). The bill would 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. Senator Rob Portman (R-OH) introduced the Biologic Patent Transparency Act. The bill would require companies to publicly disclose the web of patents that protect their biologics, making it easier for competitors to evaluate and plan for the development of generic versions of these drugs. S.516, the Prescription Drug Monitoring Act of 2019, was introduced by Senator Amy Klobuchar (D-MN) on February 14. The bill would require the use of prescription drug monitoring programs. Another Senate bill, S.475, the RxCAP Act of 2019, was introduced by Senator Ron Wyden (D-OR) on February 13. The bill would amend title XVIII of the Social Security Act to prevent catastrophic out-of-pocket spending on prescription drugs for seniors and individuals with disabilities. Senator Sherrod Brown introduced S. 378, the Stop Price Gouging Act. The bill would penalize pharmaceutical companies that engage in price gouging without cause, leading to price spikes for patients who rely on medication to treat illnesses. H.R. 1091 is the companion House bill, which has been cosponsored by Rep. Marcy Kaptur (D-OH). On February 7, Senator Sherrod Brown introduced legislation to address prescription drug affordability. The bill, S. 377, entitled, "The Medicare Negotiation and Competitive Licensing Act," would authorize the Secretary of Health and Human Services to negotiate drug prices and if a drug company refuses to negotiate in good faith, the secretary would be enabled to issue a competitive, compulsory license to another company that is willing and able to produce the medication as a generic. On February 13, Senator Ron Wyden (D-OR) introduced S.476, a bill for Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2019. Senator Sherrod Brown is one of the cosponsors. The bill would amend titles XI and XVIII of the Social Security Act to provide greater transparency of discounts provided by drug manufacturers. At the end of January 2019, the Health and Human Services Department issued a proposed rule, Fraud and Abuse; Removal of Safe Harbor Protection for Rebates Involving Prescription Pharmaceuticals and Creation of New Safe Harbor Protection for Certain Point-of-Sale Reductions in Price on Prescription Pharmaceuticals and Certain Pharmacy Benefit Manager Service Fees. The proposed rule has been interpreted to eliminate safe harbor protection for rebates paid by drug manufacturers to pharmacy benefit managers (PBMs), Medicare Part D plans and Medicaid managed care plans; create a new safe harbor for drug discounts offered to patients at the point of sale, and create a new safe harbor for PBM fees charged to drug manufacturers.

RAISE Act (H.R. 1366/S. 503) and issues related to oral health care, ACA regulations, McCarran-Ferguson Act repeal, small business insurance regulations.

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

Issues related to medical device excise tax (Protect Medical Innovation Act, S. 692); flexible spending account limits and treasury rulings on rollovers; RAISE Act (H.R. 1366/S. 503); tax policy proposals and implementation of comprehensive tax reform, including small business tax issues, pass-throughs, student loan interest deduction, higher education tax credits and benefits, dental faculty loan repayment assistance (H.R. 996/S. 359), and ACA tax implementation.

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

Issues related to medical device tax repeal (Protect Medical Innovation Act, S. 692) and expanded use of flexible spending accounts, health savings accounts, and association health plans, market stabilization efforts, issues related to oral health care, and health care workforce issues. Responsible Additions and Increases to Sustain Employee Health Benefits Act of 2019 (H.R. 1366/S. 503). Legislation to repeal Affordable Care Act limits on flexible spending accounts. Issues related to small business health care providers, including the Small Business Health Account Act.

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

In support of the RAISE Health Benefits Act (S 503/HR 1366) - expanding the use of FSAs In support of the Health Savings Act (S 12) - expanding the use of HSAs Comments to the National Institutes of Health about the Surgeon General's 2020 Report on Oral HEalth

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

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