ENROLL Act of 2019

: Issues related to lung disease treatment, prevention and research; public health; Issues related asthma; COPD; influenza; lung cancer; pneumonia; tuberculosis and other lung diseases; Issues related to tobacco cessation; Issues related to the Affordable Care Act; Issues related to the Childrens Health Insurance Program; Issues related to the President's Budget; Issues related to telehealth; Issues related to changing federal poverty line calculation; Issues related to COVID-19 Response;; H.R.986 Protecting Americans with Preexisting Conditions Act of 2019 H.R.987 Strengthening Health Care and Lowering Prescription Drug Costs Act H.R.1010 To provide that the rule entitled "Short-Term, Limited Duration Insurance" shall have no force or effect. H.R.1385 SAVE Act H.R.1386 ENROLL Act of 2019 H.R.1425 State Health Care Premium Reduction Act H.R.1499 Protecting Consumer Access to Generic Drugs Act of 2019 H.R.1884 Protecting Pre-Existing Conditions and Making Health Care More Affordable Act of 2019 H.R.2508 Better Respiration through Expanding Access to Tele-Health Act;H.R.2862 VACCINES Act of 2019; H.R.3630 No Surprises Act H.R.4622 Family Asthma Act S.466 Protecting Americans with Pre-existing Conditions Act of 2019 S.946 Henrietta Lacks Enhancing Cancer Research Act of 2019 S.1125 Protect Act S.1895 Lower Health Care Costs Act S.1944 Public Health Funding Restoration Act. HR 3 Elijah E. Cummings Lower Drug Costs Now Act; H.R.4716 I CAN Act; HR 5230 Elijah E. Cummings Family Asthma Act; HR 6201 - Families First Coronavirus Act; HR 6704 - Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020; HR 748 - CARES Act; S. 3548 - CARES Act; S. 1531 - Stopping the Outrageous Practice of Surprise Medical Bills Act of 2019; HR 6408 -- To extend the charitable deduction to all taxpayers regardless of whether a taxpayer itemizes deductions in order to encourage and increase charitable giving, and to provide for loans and loan guarantees to certain public charities; HR 7610 Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, 2021; HR 7667 Commerce, Justice, Science, and Related Agencies Appropriations Act, 2021; HR 7617 Department of Defense Appropriations Act, 2021; HR 7612 Department of the Interior, Environment, and Related Agencies Appropriations Act, 2021; HR 2468 School-Based Allergies and Asthma Management Program Act; HR 7614 Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2021; HR 7609 Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2021; HR 7616 Transportation, Housing and Urban Development, and Related Agencies Appropriations Act, 2021; HR 7608 Department of State, Foreign Operations, and Related Programs Appropriations Act, 2021; H.R.5076 Protecting Seniors Through Immunization Act of 2019; H.R.6561 Improving Social Determinants of Health Act of 2020; HR 6800 HEROES Act; H.R.6935 Protecting the Health of America's Older Adults During COVID-19 and Beyond Act; HR 7286 Quit Because of COVID-19 Act; S. 4775 Delivering Immediate Relief to Americas Families, Schools and Small Businesses Act; S. 4321 The Continuing Small Business Recovery and Paycheck Protection Program Act; S. 4318 The American Workers, Families, and Employers Assistance Act; S. 4317 SAFE TO WORK Act; S. 4322 The Safely Back to School and Back to Work Act; S. 4320 Coronavirus Response Additional Supplemental Appropriations Act, 2020; ;H.R.8061 Community Immunity During COVID-19 Act of 2020;H.R.8406 The Heroes Act; H.R.925 The Heroes Act; S.4557 COVER Act; S.4740 A bill to support public health infrastructure; H.RES.957 Expressing support for the designation of May as "National Asthma and Allergy Awareness Month"; H.R.7011 Pandemic Risk Insurance Act of 2020; H.R.8261 Presumptive Benefits for War Fighters Exposed to Burn Pits and Other Toxins Act of 2020; S.4572 Presumptive Benefits for War Fighters Exposed to Burn Pits and Other Toxins Act of 2020; S.4355 Katherine's Lung Cancer Early Detection and Survival Act of 2020; H.RES.1192 Expressing support for the goals of November National Lung Cancer Awareness Month and for the early detection of lung cancer; H.R.8158 To amend title XVIII of the Social Security Act to waive budget neutrality for oxygen under the Medicare program, and for other purposes.;H.R.7481 RESTART Act; S.4737 A bill to amend the Public Health Service Act to direct the Secretary of Health and Human Services to make grants to covered health departments to increase the rate of recommended immunizations, and for other purposes; S.Res.780 A resolution designating November 2020 as "National Lung Cancer Awareness Month" and expressing support for the early detection of lung cancer; H.R.8623 SAVE for Seniors Act; S.4864 HAPI Act; H.R.8725 HAPI Act; H.R.8595 To nullify the effect of Executive Order 13950 relating to combating race and sex stereotyping; Senate Labor HHS Appropriations bill; Senate Defense Appropriations bill; Senate Transportation, Housing and Urban Development and Related Agencies Appropriations bill; Senate Agriculture, Rural Development, FDA, and Related Agencies Appropriations bill; Senate Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2021H.R.133 Consolidated Appropriations Act, 2021; H.J.Res.110 - Extension of Continuing Appropriations Act, 2021

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Environmental Protection Agency (EPA), Federal Reserve System, Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Postal Regulatory Commission, SENATE, Small Business Administration (SBA), Treasury, Dept of, White House Office

H.R. 985, Fair Access for Safe and Timely Generics Act of 2019 (FAST Generics Act), support passage. H.R. 2035/S. 995, Lifespan Respite Care Reauthorization Act, support reauthorization H.R. 3208/ S.1755 - Real Emergency Access for Aging and Disability Inclusion for Disasters Act, support passage H.R. 2781 - Empower for Health Act of 2019, support passage H.R. 2296/S.1391 - FAIR Drug Pricing Act of 2019, support passage H.R. 3630 - No Surprises Act, support passage H.R. 1010, To provide that the rule entitled Short-Term, Limited Duration Insurance shall have no force or effect, support passage. H.R. 986, The Protecting Americans with Preexisting Conditions Act of 2019, support passage. H.R.1386, Expand Navigators Resources for Outreach, Learning, and Longevity (ENROLL) Act of 2019, support passage. H.R. 2408, the Ensuring Access to Quality Complex Rehabilitation technology Act, support passage. H.R 3 - Lower Drug Costs Now Act of 2019, support passage H.R. 19 - Lower Costs, More Cures Act of 2019, support passage H.R. 2387, the Stop The Overuse of Petitions and Get Affordable Medicines to Enter Soon (STOP GAMES) Act of 2019, support passage H.R. 6417, Protecting Cures Act of 2020, support passage H.R. 5800, Ban Surprise Billing Act, support passage H.R. 1595, Secure and Fair Enforcement Banking Act (SAFE Banking Act), support passage S. 1935, Family Coverage Act, support passage. S.1556, No Junk Plans Act, support passage. S.475, Reducing Existing Costs Associated with Pharmaceuticals for Seniors Act of 2019 (RX Cap Act), support passage S. 637, Combatting Unreasonable Rises and Excessively High Drug Prices Act (CURE High Drug Prices Act), support passage S.366, Forcing Limits on Abusive and Tumultuous Prices (FLAT Prices) Act, support passage S. 63, Preserve Access to Affordable Generics and Biosimilars Act, support passage S. 659, Biologic Patent Transparency Act, support passage S.1895 - Lower Health Care Costs Act, support passage S. 2543 - Prescription Drug Price Reduction Act of 2019 - support passage S. 1801, Low Cost Generics Act of 2019, support passage H.R. 1425 Patient Protection and Affordable Care Enhancement Act, support H.R. 6514, Worker Health Coverage Protection Act, Support H.R. 3832, S. 1257, Legacy IRA Act, Support H.R. 6408 - Save the Organizations that Serve America Act S.3544/H.R.6305 - Coronavirus Relief for Seniors and People with Disabilities Act of 2020, support S. 3815, RESTART Act, Oppose S. 3833/H.R. 7010/H.R.6886, Paycheck Protection Program Flexibility Act of 2020, Support S. 4032/H.R. 7324, Universal Giving Pandemic Response Act. Support passage H.R. 6892-Help Charities Protect Communities Act, Support - S.Amdt. 1566 to the CARES Act, Charitable Giving oAmendment Increases the $300 limit on the charitable giving deduction to one-third of the standard deduction ($4,000 for an individual filer/$8,000 for married joint filers) for the remainder of 2020. Support. H.R. 7663-Protecting Access to Post-COVID-19 Telehealth Act, support passage H.R. 6644/S. 3741 - Health Care At Home Act, support passage H.R. 7391- the Protect Telehealth Access Act, support passage S. 3998- the Enhancing Preparedness Through Telehealth Act, support passage

Client expense: $48,803 · Firm income: Not reported

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

H.R. 1389 - Safe Home Act of 2019 H.R. 1386 - the Enroll Act of 2019 H.R. 987 - the MORE Health Education Act of 2019 HR 1010 - a bill to provide that the rule entitled Short-Term, Limited Duration Insurance shall have no force or effect H.R. 986 - Protecting Americans with Preexisting Conditions Act of 2019 H.R. 1425 - State Health Care Premium Reduction Act H.R. 1398/S. 172 - Health Insurance Tax Relief Act of 2019 S. 1895 - Lower Health Care Costs Act H.R. 4378 - Continuing Appropriations Act and Health Extenders Act H.R. 861 - End Surprise Billing Act H.R. 3502 - Protecting People from Surprise Medical Bills Act S. 1531 - Stopping Surprise Medical Bills Act H.R. 6074 - Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 H.R. 6201 - Families First Coronavirus Response Act S. 3548 - CARES Act H.R. 6800 - The Heroes Act H.R. 133 - Consolidated Appropriations Act, 2021 no specific bills, health care reform, health savings accounts, reinsurance, cost sharing reductions (CSRs), special needs plans, third party payment, Risk ratios, individual market reform, market stability, Grace periods, Special Enrollment Period, opioids, surprise billing, transparency, all provider claims database, testing

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

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

H.R. 938, Bringing Low-cost Options and Competition while Keeping Incentives for New Generics (BLOCKING) Act of 2019, regarding all bio-pharmaceutical related provisions. H.R. 985, Fair Access for Safe and Timely (FAST) Generics Act of 2019, regarding all bio-pharmaceutical related provisions. H.R. 986, Protecting American with Preexisting Conditions Act of 2019, regarding all bio-pharmaceutical related provisions. H.R. 987, Marketing and Outreach Restoration to Empower Health Education Act of 2019, regarding all bio-pharmaceutical related provisions. H.R. 1010, Short-Term, Limited Duration Insurance (STLDI), regarding all bio-pharmaceutical related provisions. H.R. 1323, Rural Hospital Frontier Fairness Act, regarding all bio-pharmaceutical related provisions. H.R. 1385, State Allowance for a Variety of Exchanges (SAVE) Act, regarding all bio-pharmaceutical related provisions. H.R. 1386, Expanded Navigators Resources for Outreach, Learning, and Longevity (ENROLL) Act, regarding all bio-pharmaceutical related provisions. H.R. 1409, Transparency in All Health Care Pricing Act, regarding all bio-pharmaceutical related provisions. H.R. 1425, State Health Care Premium Reduction Act, regarding all bio-pharmaceutical related provisions. H.R. 1478, Insulin importation, regarding all bio-pharmaceutical related provisions. H.R. 1503, Orange Book Transparency Act, regarding all bio-pharmaceutical related provisions. H.R. 1506, Fair and Immediate Release (FAIR) of Generics Act, regarding all bio-pharmaceutical related provisions. H.R. 1520, Purple Book Continuity Act, regarding all bio-pharmaceutical related provisions. H.R. 2011, Protecting Access to Biosimilars Act of 2019, regarding all bio-pharmaceutical related provisions. H.R. 2038, State-based , Market-Oriented, Prescription Drug Negotiations Act of 2019, regarding all bio-pharmaceutical related provisions. H.R. 2064, Product Sample reporting, regarding all bio-pharmaceutical related provisions. S. 61, Safe and Affordable Drugs from Canada Act, regarding all bio-pharmaceutical related provisions. S. 97, Affordable and Safe Drug Importation Act, regarding all bio-pharmaceutical related provisions. S. 102, Prescription Drug Price Relief Act, regarding all bio-pharmaceutical related provisions. S. 344/H.R. 990, Hatch-Waxman Integrity Act, regarding all bio-pharmaceutical related provisions. S. 366/H.R. 1188, FLAT Prices Act- Reduced exclusivity period for certain price hikes, regarding all bio-pharmaceutical related provisions. S. 418, FDA Accountability for Public Safety Act, regarding all bio-pharmaceutical related provisions. S. 419, Protecting Americans from Dangerous Opioids Act, regarding all bio-pharmaceutical related provisions. S. 637, CURE High Drug Prices Act, regarding all bio-pharmaceutical related provisions. S. 657, Drug Price Transparency Act, regarding all bio-pharmaceutical related provisions. S. 658, Accelerated Drug Approval for Prescription Therapies Act, regarding all bio-pharmaceutical related provisions. S. 659, Biologic Patent Transparency Act, regarding all bio-pharmaceutical related provisions. S. 660, Transparency in Petitions Act, regarding all bio-pharmaceutical related provisions. S. 709, Establishes public dashboard for price and utilization of drugs purchased by federal programs, regarding all bio-pharmaceutical related provisions. S. 741 /H.R. 1730, Cancer Drug Parity Act, regarding all bio-pharmaceutical related provisions. S. 844, Short Competition Act, regarding all bio-pharmaceutical related provisions. S. 977, Transparent Drug Pricing Act of 2019, regarding all bio-pharmaceutical related provisions. S. 989, STEER Act, regarding all bio-pharmaceutical related provisions. S. 1140, A bill to amend the Public Health Service Act with respect to the treatment under section 351(k)(7) of such Act (relating to exclusivity for reference products) of certain products deemed to have a biological product license pursuant to section 7002 of the Biologics Price Competition and Innovation Act of 2009, regarding all bio-pharmaceutical related provisions. S.1169, FDA citizen petition, regarding all bio-pharmaceutical related provisions. S. 1209, A bill to amend the Federal Food, Drug, and Cosmetic Act with respect to approval of abbreviated new drug applications, regarding all bio-pharmaceutical related provisions. H.R. 2115, Public Disclosure of Drug Discounts Act, regarding all bio-pharmaceutical related provisions H.R.2296/S.1391, FAIR Drug Pricing Act, regarding all bio-pharmaceutical related provisions H.R.2700, Lowering Prescription Drug Costs and Extending Community Health Centers and other Health Priorities Act, regarding all bio-pharmaceutical related provisions H.R. 3223, Pharmacy Benefit Manager Accountability Study Act, regarding all bio-pharmaceutical related provisions S. 1361/H.R.2584, Preventive Health Savings Act, regarding all bio-pharmaceutical related provisions S. 1437, DTC Act, regarding all bio-pharmaceutical related provisions S.1532, Pharmacy Benefit Managers Accountability Study Act, regarding all bio-pharmaceutical related provisions S.1636, Ensuring Innovation Act, regarding all bio-pharmaceutical related provisions S. 1664, Prescription Drug Price Reporting Act, regarding all bio-pharmaceutical related provisions S. 1801, Affordable Medications Act, regarding all bio-pharmaceutical related provisions S. 1895, Lowering Health Costs Act, regarding all bio-pharmaceutical related provisions S. 1897, a bill to establish a process for updating the labeling of certain drugs with outdated labeling, regarding all bio-pharmaceutical related provisions S. 1897/H.R. 3523, End Price Gouging for Medications Act, regarding all bio-pharmaceutical related provisions S. 2004, Emergency Access to Insulin Act, regarding all bio-pharmaceutical related provisions H.R. 2279/S. 2546, Safe Step Act of 2019, regarding all bio-pharmaceutical related provisions H.R 748/S. 3548, Coronavirus Aid, Relief and Economic Security Act (CARES Act), regarding all bio-pharmaceutical provisions. H.R. 1425, State Health Care Premium Reduction Act, regarding all bio-pharmaceutical related provisions H.R. 6800, Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act, regarding all bio-pharmaceutical related provisions

Client expense: $1,090,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE, U.S. Trade Representative (USTR)

Ban Surprise Billing Act (H.R. 5800) Consumer Protections Against Surprise Medical Bills Act of 2020 (H.R. 5826) Dependent Income Exclusion Act of 2019 (H.R.4417/S.2497) Educating Consumers on the Risks of Short-Term Plans Act of 2019 (H.R.1143) ENROLL Act of 2019 (H.R.1386/S.1905) Family Coverage Act (S.1935) HEARTS Act of 2020 (H.R. 6166) The Heroes Act (H.R. 6800) Home Visiting to Reduce Maternal Mortality and Morbidity Act (H.R.4768) Lower Health Care Costs Act (S.1895) Marketing & Outreach Restoration to Empower Health Education Act (MORE) (H.R.987) No Surprises Act (H.R.3630) The Patient Protection and Affordable Care Enhancement Act (H.R. 1425) Personal Health Investment Today Act (PHIT) (S.680/H.R.1679) Physical Activity Recommendations (PAR) for Americans Act (S.1608/H.R.2891) Pre-existing Conditions Protection Act of 2019 (H.R.692) Protect Act (S.1125) Protecting Access to Post COVID-19 Telehealth Act of 2020 (H.R. 7663) Protecting Americans with Pre-existing Conditions Act of 2019 (H.R.986) Public Health Funding Restoration Act (S.1944/H.R.3447) Quit Because of COVID-19 Act (H.R. 7286) A Resolution Supporting the Designation of April 2019 as "National Donate Life Month"(H.Res 315/S.Res 162) South Asian Heart Health Awareness and Research Act of 2019 (H.R.3131) State Allowance for a Variety of Exchanges Act (SAVE Act) (H.R.1385) States Achieve Medicaid Expansion (S.585) State Health Care Premium Reduction Act (H.R.1425) Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019 (S.1531) Sustaining Outpatient Services Act (H.R. 4838/S.4151) Implementation of: Menu Labeling Physical Activity Guidelines Recommendations Prevention and Public Health Fund (PL 111-148, Sec 4002)

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

Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Federal Reserve System, Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Interior, Dept of (DOI), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Transportation, Dept of (DOT), Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

Support HR 1763/ S 348, Resident Physician Shortage Reduction Act of 2019, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; Oppose HR 506,Hospital Competition Act of 2019, a bill to amend title XVIII of the Social Security Act to increase hospital competition; Statement submitted to the House Judiciary on the hearing "Diagnosing the Problem: Exploring the Effects of Consolidation and Anticompetitive Conduct in Health Care Markets";Letter of support for the Senate Workgroups efforts to ensure consumer protections by addressing surprise medical bills and comments on the development of legislation to protect patients from surprise medical bills; Letter urging Congress and the Administration to take further action to help reduce input and administrative costs, as well as maximize the number of insured patients; Support HR 965/ S340, Creating and Restoring Equal Access to Equivalent Samples Act of 2019 or the CREATES Act of 2019, 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; Support HR 986/ S466 Protecting Americans with Preexisting Conditions Act of 2019, a bill provide that certain guidance related to waivers for State innovation under the Patient Protection and Affordable Care Act shall have no force or effect; Support HR 987 Strengthening Health Care and Lowering Prescription Drug Costs Act, a bill to amend the Patient Protection and Affordable Care Act to provide for Federal Exchange outreach and educational activities; Support HR 938 Bringing Low-cost Options and Competition while Keeping Incentives for New Generics Act of 2019 or the BLOCKING Act of 2019, a bill to amend the Federal Food, Drug, and Cosmetic Act, with respect to eligibility for approval of a subsequent generic drug, to remove the barrier to that approval posed by the 180-day exclusivity period afforded to a first generic applicant that has not yet received final approval, and for other purposes; Support HR 1010, a bill to provide that the rule entitled Short-Term, Limited Duration Insurance shall have no force or effect; Support HR 1499 Protecting Consumer Access to Generic Drugs Act of 2019, a bill to prohibit brand name drug manufacturers from compensating generic drug manufacturers to delay the entry of a generic drug into the market, and to prohibit biological product manufacturers from compensating biosimilar and interchangeable product manufacturers to delay entry of biosimilar and interchangeable products, and for other purposes; Support HR 1425 State Health Care Premium Reduction Act, a bill to amend the Patient Protection and Affordable Care Act to provide for a Improve Health Insurance Affordability Fund to provide for certain reinsurance payments to lower premiums in the individual health insurance market; Support HR 1386/ S 1905 Expand Navigators Resources for Outreach, Learning, and Longevity Act of 2019 or the ENROLL Act of 2019,a bill to amend the Patient Protection and Affordable Care Act to provide for additional requirements with respect to the navigator program, and for other purposes; Support HR 1520 Purple Book Continuity Act of 2019, a bill to amend the Public Health Service Act to provide for the publication of a list of licensed biological products, and for other purposes; Support HR 1503 Orange Book Transparency Act of 2019A bill that would increase transparency for the patent status of both approved biological products and approved drugs; Support HR 2439/ HR 3414 Opioid Workforce Act of 2019, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions to help combat the opioid crisis; Submitted statement to the House Committee on Ways and Means Overcoming Racial Disparities and Social Determinants in the Maternal Mortality Crisis sharing information regarding hospitals and health systems efforts to address maternal morbidity and mortality, as we seek ways to improve outcomes and reduce health inequities for expectant and new mothers, and give their children the best possible start in life; Submitted oral and written testimony to the House Committee on Ways and Means Subcommittee on Health Hearing on Protecting Patients from Surprise Medical Bills. Protecting patients from surprise medical bills is a top priority and we have adopted a set of guiding principles to use as we evaluate legislative proposals: Define surprise bills, Protect the patient financially, Ensure patient access to emergency care, Preserve the role of private negotiation, Remove the patient from health plan/provider negotiations, Educate patients about their health care coverage, Ensure patients have access to comprehensive provider networks and accurate network information, and Support state laws that work; Letters submitted to the Energy & Commerce Committee in response to the request for comments on their surprise billing discussion draft. Concerned with the Committees draft legislations approach to determining reimbursement for out-of-network providers. Once the patient is protected from surprise bills, providers and insurers should then be permitted to negotiate payment rates for services provided. We strongly oppose approaches that would impose arbitrary rates on providers. We look forward to continuing to work with the Committee on solutions to stop surprise medical bills; Letter sent to the HELP Committee in response to the Lower Health Care Costs Act of 2019 discussion draft about our concerns about several of the proposals that would allow the government to intrude into private commercial contracts between providers and insurers. For example, several of the provisions could undermine value-based purchasing arrangements aimed directly at improving the quality of care while reducing costs. We strongly urge the Committee to remove these provisions; Submitted oral and written testimony to the House Committee on Energy and Commerce, Subcommittee on Health Hearing on No More Surprises: Protecting Patients from Surprise Medical Bills asking that the Committee preserve the ability of providers and insurers to negotiate private contracts and not establish a fixed payment amount for out-of-network services; Oppose HR 1309 Workplace Violence Prevention for Health Care and Social Service Workers Act, a bill to direct the Secretary of Labor to issue an occupational safety and health standard that requires covered employers within the health care and social service industries to develop and implement a comprehensive workplace violence prevention plan, and for other purposes; Concerns about S.1531, Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019 or the STOP Surprise Medical Bills Act of 2019, to amend the Public Health Service Act to provide protections for health insurance consumers from surprise billing; Concerns about S. 1895 Lower Health Care Costs Act Letter addressed concerns about the legislative provision that sets a benchmark rate in statute for the out-of-network payments, as well as provisions that seek to change privately negotiated contracting arrangements between hospitals and insurance companies; Support HR 3425, Advancing Medical Resident Training in Community Hospitals Act of 2019, to amend title XVIII of the Social Security Act to establish rules for payment for graduate medical education (GME) costs for hospitals that establish a new medical residency training program after hosting resident rotators for short durations; Expressed concerns regarding the provisions that reduce reimbursements to providers and hospitals that administer drugs the Prescription Drug Pricing Reduction Act (PDPRA) of 2019: including about Section 107, Medicare Part B Rebate by Manufacturers for Drugs or Biologicals with Prices Increasing Faster than Inflation, Section 110, Establishment of Maximum Add-on Payment for Drugs, Biologicals, and Biosimilars, this provision would establish $1,000 as the maximum add-on amount that a provider can be paid for a separately payable drug, biological or biosimilar, Section 111, Treatment of Drug Administration Services Furnished by an Off-Campus Outpatient Department of a Provider, the site neutral payment reduction would cut aggregate hospital payments; Support S. 2091, Backlog Elimination, Legal Immigration, and Employment Visa Enhancement Act, this legislation would increase the total number of employment-based visas from 140,000 to 270,000 and ensure that critical health care workers needed in the U.S. have access to employment-based visas by carving out health care workers in designated shortage occupations from the limit; Support S 350, The Competitive Health Insurance Reform Act of 2019, a bill to restore the application of the Federal antitrust laws to the business of health insurance to protect competition and consumers; Submitted statement to Subcommittee on Health of the Committee on Energy and Commerce for the hearing on Improving Maternal Health: Legislation to Advance Prevention Efforts and Access to Care; Concerns with S. 386 and HR 1044, Fairness for High-Skilled Immigrants Act of 2019, this bill increases the per-country cap on family-based immigrant visas from 7% of the total number of such visas available that year to 15%, and eliminates the 7% cap for employment-based immigrant visas. It also removes an offset that reduced the number of visas for individuals from China; Support H.R. 4538, Closing Loopholes for Orphan Drugs Act, a bill to amend title III of the Public Health Service Act to limit the orphan drug exclusion under the drug discount program under section 340B of such title; Discussions of provisions we support and those we recommend be changes in a draft bill called the Mitigating Existing Drug Shortages (MEDS) Act; Discussions in support of the allowing states to designate hospitals as necessary providers for purposes of waiving the critical access hospital mileage requirements; Provided comments to W&M on legislation to expand Health Profession Opportunity Grants; Support S. 2723, The Mitigating Emergency Drug Shortages (MEDS) Act, a bill to amend Sec. 506C of the Federal Food, Drug, and Cosmetic Act which strengthens requirements for drug manufacturers to disclose the root causes and expected duration of shortages, extends reporting requirements to active pharmaceutical ingredients manufacturers, requires manufacturers have contingency plans to ensure ongoing supply, develops recommendations to incentivize manufacturers to enter the market for drugs in shortage and examines the national security risks of shortages; Discuss DEA reductions in annual quotas for opioid products used by hospitals for sedation and pain management; Meeting with the Office of the Assistant Secretary of Preparedness and Response (ASPR) to discuss developments in the hospital preparedness program, the pilot projects for the Regional Disaster Healthcare System and other issues; Rural access to health care, including identifying core services needed in rural communities, outlining approaches and considerations for delivering those services, and examining access and quality in the rural context; ONCs proposed rule to implement the 21st Century Cures provision on information blocking; Supported members serving on the HHS Quality Summit panel, which was convened by the Deputy Secretary to gather input regarding how to improve and energize quality and safety improvement activities across health care system; Discussion with HHS on drug pricing, 340b, and price transparency policies, as well as the International Pricing Index ANPRM; Discussion with HHS about the work of Aligning for Health to address social determinants of health; Support S 2902, Strengthening Our Rural Health Workforce Act of 2019, a bill to enhance the rural health workforce; Meetings and correspondence with staff members of Senate Financing Committee on a proposal to support rural health care access (REH, re-opening necessary provider CAH, infrastructure funding); Letter to Ways & Means committee Rural and Underserved Communities Health Task Force in response to RFI on factors that contribute to health outcomes in these areas, examples of successful models and lessons from the field that address access and outcomes, and considerations for the unique circumstances of rural and underserved communities; Letter to Energy and Commerce Members regarding health information technology priorities; Letter of Support to Senate Appropriations on funding for the Centers for Disease Control and Prevention and the National Institutes of Health to study gun violence; Support S.2741 and H.R. 4932,Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019, a bill to amend title XVIII of the Social Security Act to expand access to telehealth services, and for other purposes; Support S 2603, Resolving Extended Limbo for Immigrant Employees and Families (RELIEF) Act, a bill to amend the Immigration and Nationality Act to end the immigrant visa backlog, and for other purposes; Support HR 4995, Maternal Health Quality Improvement Act of 2019, a bill to amend the Public Health Service Act to improve obstetric care and maternal health outcomes, and for other purposes; Concerns with HR 5800,Ban Surprise Billing Act, a bill to address surprise medical bills that relies on a median in-network rate to resolve out-of-network payments and allows for an independent dispute resolution process to determine the final payment. Concerned with the Committee's legislative approach to determining reimbursement for out-of-network providers. Oppose approaches that would impose arbitrary rates on providers, which could have significant consequences far beyond the scope of surprise medical bills. It is the insurers' responsibility to maintain comprehensive provider networks, and a default payment rate would remove incentives for health plans to contract with providers or to offer fair terms; Support HR 5826, Consumer Protections Against Surprise Medical Bills Act, a bill that prohibits providers from balance billing patients for emergency services or medical care the patient reasonably could have expected to be in-network, and from charging patients more than the in-network cost-sharing amount. Rather than rely on a benchmark payment rate to determine out-of-network reimbursement, the legislation provides a period for health plans and providers to negotiate out-of-network reimbursement, followed by a mediated dispute resolution process if necessary; Letter urging HHS to take regulatory actions to help hospitals and health systems prepare and respond to COVID-19; Letter requesting $100 billion to prepare and respond to COVID-19; Letter urging the Department of Labor to accurately define health care provider when promulgating regulations implementing key sections of the Families First Coronavirus Response Act; Letter sent to the President asking for the use of the Defense Production Act to increase the production of medical supplies and equipment; Letter to HHS regarding $100 billion emergency fund, asking HHS and CMS to directly and expediently distribute to rural and urban hospitals and health systems funds from the Public Health and Social Services Emergency Fund that were designated for providers in the Coronavirus Aid, Relief, and Economic Security (CARES) Act. The CARES Act increased funding by $100 billion in order to reimburse eligible health care providers for health care-related expenses or lost revenues that are attributable to COVID-19. In the letter, we urged HHS and CMS to immediately distribute funding to all hospital types in the US - with additional funding going to COVID-19 hotspots; Letter urging Congress to modernize the Stafford Act as part of its next COVID-19 legislative package to allow all hospitals to recoup financial losses from this pandemic and future disasters; Letter to the Federal Reserve System, the Federal Deposit Insurance Corporation and the Office of the Comptroller of the Currency requesting they, as primary federal regulators for insured depository institutions, take prompt action to assist health care providers on the front line of the COVID-19 pandemic should the need to do so arise; Letter to the Secretary of the Treasury and the Federal Reserve Chair of the Board of Governors urging a supplement to the New Main Street Loan Facility term sheet with prompt guidance to ensure that access to this critically-necessary loan facility will be attainable for hospitals without delay; Letter was sent to the SBA urging it to ensure that small- and mid-size public hospitals, including those that have both nonprofit and public designations, are allowed to apply for and receive loans under the newly-authorized SBA Paycheck Protection Program; Letter in response to FEMAs request for input on establishing a voluntary agreement, under the Defense Production Act, of key private sector stakeholders relevant to responding to COVID-19, urging that such an agreement account for the full breadth of COVID-19 medical supply and equipment needs; Support H.R. 6474/S.3838 Healthcare Broadband Expansion During COVID-19 Act, a bill that would provide an additional $2 billion in funding for the FCC Rural Health Care program and increase the subsidy for health care providers from 65 to 85 percent. This legislation also simplifies the program to allow for more efficient application processes and disbursement of much needed funding; Support HR 6654 Emergency COVID-19 Telehealth Response Act, a bill that would codify an expanded list of providers to deliver and bill for telehealth services during the PHE; Support HR 7233Knowing the Efficiency and Efficacy of Permanent (KEEP) Telehealth Options Act of 2020, a bill that would require the Department of Health and Human Services and the Government Accountability Office (GAO) to conduct studies to provide information about the expanded use of telehealth during the COVID-19 pandemic; Letter to Senate HELP Committee in response to request for feedback on preparing for next pandemic; Discussion about telehealth waivers and flexibilities with HHS; Discussion about CARES provider relief fund distributions with HHS; Oppose HR 6559/ S 3677 COVID-19 Every Worker Protection Act of 2020, a bill to require the Occupational Safety and Health Administration to promulgate an emergency temporary standard to protect employees from occupational exposure to SARS-CoV-2, and for other purposes; Joint letter with ANA urging Congress to act quickly to get needed resources into the health care system, so that hospitals, nurses and physicians responding to COVID-19 are able to continue to provide treatments, front-line health care personnel are able to provide care and patients are able access health care services; Statement to Committee on Ways and Means for the hearing on The Disproportionate Impact of COVID-19 on Communities of Color urging Congress to employ the resources of the National Institute on Minority Health and Health Disparities - which is congressionally-mandated to coordinate the research of the other National Institutes of Healths centers and institutes related to minority health - to research and develop approaches to specifically address the COVID-19 needs of minority populations; Advocate with Congress for full forgiveness of COVID-19 related accelerated payments received by hospitals; Support S 3781Pharmaceutical Accountability, Responsibility, and Transparency (PART) Act, a bill to increase reporting of, help mitigate potential shortages related to, and promote, accountability and transparency for pharmaceuticals and medical devices; Support S 3780 Help Onshore Manufacturing Efficiencies (HOME) for Drugs and Devices Act, a bill to encourage domestic advanced manufacturing of critical drugs and devices in order to address economic, health, and security concerns, combat shortages of critical drugs and devices, and promote increased domestic diversification of, and independence from foreign reliance on, pharmaceutical and medical device supply chains; Support S.3763 Pandemic Responder Service Award Act, a bill to establish the Pandemic Responder Service Award program to express our gratitude to front-line health care workers; Support HR 6788/ S 3599 Healthcare Workforce Resilience Act, a bill to enhance our Nations nurse and physician workforce during the COVID-19 crisis by recapturing unused immigrant visas; Urged support for joint House and Senate letter to the Administration asking for flexibility for hospitals with respect to J-1 and H-1B visa programs; Letter to Senate Finance Committee to address the important issue of maternal health and the opportunity to provide suggestions regarding how to improve maternal health in this country; Support the Temporary Reciprocity to Ensure Access to Treatment Act, a bill that allows for the temporary reciprocity for treatment by medical professionals licensed in one state to patients in other states; Letter urging the Senate to include in the next COVID-19 relief bill provisions to strengthen the federal response for racial and ethnic minority and marginalized communities, which are disproportionately affected by the pandemic;Letter asking Congress to allocate as part of the next COVID-19 relief package at least an additional $100 billion to the emergency relief fund to provide direct funding to front line health care personnel and providers to continue to respond to this pandemic; Letter sent to HHS urging them to direct HRSA to take action to stop three drug manufacturers from limiting the distribution of 340B drugs to 340B covered entities. These drug manufacturers have taken separate actions to either limit the distribution of 340B drugs or require 340B covered entities provide claims level data for investigatory purposes if that 340B covered entity uses a contract pharmacy arrangement; Letter to the Congressional Leadership asking them to not to include in the next COVID-19 relief package any surprise medical billing legislation - such as a reimbursement rate set in statute - that would further destabilize hospitals finances during the pandemic; Support S 4507, Getting Early Treatment and Comprehensive Assessments Reduces Emergencies Act of 2020 or the GET CARE Act of 2020, a bill to amend the Public Health Service Act to provide for a national campaign to raise awareness of the importance of seeking preventive health services and the utilization of such services; Comment letter addressing concerns on the proposed rule from the Departments of the Treasury, Labor and Health and Human Services that would allow certain grandfathered health plans to increase patient cost-sharing beyond current limits, without losing their grandfathered status; Letter urging the Administration to work with the AHA and Congress to create a future for telehealth that allows not only clinicians, but also hospitals and health systems, to code and bill for virtual services. We further urge CMS and HHS to continue to provide hospitals with the flexibility for annual beneficiary consent to telehealth treatment to be obtained at the same time, and not necessarily before, services are furnished; Support HR 8061,Community Immunity During COVID-19 Act of 2020, a bill that would provide funding to state and local health departments to work with community providers and organizations to increase immunization rates for Advisory Committee on Immunization Practices (ACIP)-recommended vaccines during the COVID-19 public health emergency; Letter again expressing concern with recent actions taken by several major drug manufacturers to limit the distribution of certain 340B drugs to our hospital members. While we understand that the HRSA is further investigating these actions, we urge swift and decisive action to halt these pernicious tactics so as to prevent other manufacturers from following suit; Comment letter outlining our concerns about the ability of hospital systems to distribute provider relief funds among the parent and subsidiaries. HHS published certain FAQs that place problematic restrictions on the use of CARES Act provider relief fund dollars. Specifically, the FAQs restrict the ability of a hospital system to allocate the funds throughout its system where COVID-19 related expenses and lost revenues are occurring; Submitted comments in response to HRSAs RFI on Health Professional Shortage Area (HPSA) scoring. HPSA scores are important for rural hospitals and clinics ability to recruit physicians and other clinicians, namely from the National Health Service Corps (NHSC) program. Letter asking HHS to reinstate the COVID-19 Provider Relief Fund reporting requirements.

Client expense: $4,860,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA), White House Office

Issues related to lung disease treatment, prevention and research; public health; Issues related asthma; COPD; influenza; lung cancer; pneumonia; tuberculosis and other lung diseases; Issues related to tobacco cessation; Issues related to the Affordable Care Act; Issues related to the Childrens Health Insurance Program; Issues related to the President's Budget; Issues related to telehealth; Issues related to changing federal poverty line calculation; Issues related to COVID-19 Response;; H.R.986 Protecting Americans with Preexisting Conditions Act of 2019 H.R.987 Strengthening Health Care and Lowering Prescription Drug Costs Act H.R.1010 To provide that the rule entitled "Short-Term, Limited Duration Insurance" shall have no force or effect. H.R.1385 SAVE Act H.R.1386 ENROLL Act of 2019 H.R.1425 State Health Care Premium Reduction Act H.R.1499 Protecting Consumer Access to Generic Drugs Act of 2019 H.R.1884 Protecting Pre-Existing Conditions and Making Health Care More Affordable Act of 2019 H.R.2508 Better Respiration through Expanding Access to Tele-Health Act;H.R.2862 VACCINES Act of 2019; H.R.3630 No Surprises Act H.R.4622 Family Asthma Act S.466 Protecting Americans with Pre-existing Conditions Act of 2019 S.946 Henrietta Lacks Enhancing Cancer Research Act of 2019 S.1125 Protect Act S.1895 Lower Health Care Costs Act S.1944 Public Health Funding Restoration Act. HR 3 Elijah E. Cummings Lower Drug Costs Now Act; H.R.4716 I CAN Act; HR 5230 Elijah E. Cummings Family Asthma Act; HR 6201 - Families First Coronavirus Act; HR 6704 - Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020; HR 748 - CARES Act; S. 3548 - CARES Act; S. 1531 - Stopping the Outrageous Practice of Surprise Medical Bills Act of 2019; HR 6408 -- To extend the charitable deduction to all taxpayers regardless of whether a taxpayer itemizes deductions in order to encourage and increase charitable giving, and to provide for loans and loan guarantees to certain public charities; HR 7610 Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, 2021; HR 7667 Commerce, Justice, Science, and Related Agencies Appropriations Act, 2021; HR 7617 Department of Defense Appropriations Act, 2021; HR 7612 Department of the Interior, Environment, and Related Agencies Appropriations Act, 2021; HR 2468 School-Based Allergies and Asthma Management Program Act; HR 7614 Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2021; HR 7609 Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2021; HR 7616 Transportation, Housing and Urban Development, and Related Agencies Appropriations Act, 2021; HR 7608 Department of State, Foreign Operations, and Related Programs Appropriations Act, 2021; H.R.5076 Protecting Seniors Through Immunization Act of 2019; H.R.6561 Improving Social Determinants of Health Act of 2020; HR 6800 HEROES Act; H.R.6935 Protecting the Health of America's Older Adults During COVID-19 and Beyond Act; HR 7286 Quit Because of COVID-19 Act; S. 4775 Delivering Immediate Relief to Americas Families, Schools and Small Businesses Act; S. 4321 The Continuing Small Business Recovery and Paycheck Protection Program Act; S. 4318 The American Workers, Families, and Employers Assistance Act; S. 4317 SAFE TO WORK Act; S. 4322 The Safely Back to School and Back to Work Act; S. 4320 Coronavirus Response Additional Supplemental Appropriations Act, 2020; ;H.R.8061 Community Immunity During COVID-19 Act of 2020;H.R.8406 The Heroes Act; H.R.925 The Heroes Act; S.4557 COVER Act; S.4740 A bill to support public health infrastructure; H.RES.957 Expressing support for the designation of May as "National Asthma and Allergy Awareness Month"; H.R.7011 Pandemic Risk Insurance Act of 2020; H.R.8261 Presumptive Benefits for War Fighters Exposed to Burn Pits and Other Toxins Act of 2020; S.4572 Presumptive Benefits for War Fighters Exposed to Burn Pits and Other Toxins Act of 2020; S.4355 Katherine's Lung Cancer Early Detection and Survival Act of 2020; H.RES.1192 Expressing support for the goals of November National Lung Cancer Awareness Month and for the early detection of lung cancer; H.R.8158 To amend title XVIII of the Social Security Act to waive budget neutrality for oxygen under the Medicare program, and for other purposes.;H.R.7481 RESTART Act; S.4737 A bill to amend the Public Health Service Act to direct the Secretary of Health and Human Services to make grants to covered health departments to increase the rate of recommended immunizations, and for other purposes;

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Environmental Protection Agency (EPA), Federal Reserve System, Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Postal Regulatory Commission, SENATE, Small Business Administration (SBA), Treasury, Dept of, White House Office

H.R. 985, Fair Access for Safe and Timely Generics Act of 2019 (FAST Generics Act), support passage. H.R. 2035/S. 995, Lifespan Respite Care Reauthorization Act, support reauthorization H.R. 3208/ S.1755 - Real Emergency Access for Aging and Disability Inclusion for Disasters Act, support passage H.R. 2781 - Empower for Health Act of 2019, support passage H.R. 2296/S.1391 - FAIR Drug Pricing Act of 2019, support passage H.R. 3630 - No Surprises Act, support passage H.R. 1010, To provide that the rule entitled Short-Term, Limited Duration Insurance shall have no force or effect, support passage. H.R. 986, The Protecting Americans with Preexisting Conditions Act of 2019, support passage. H.R.1386, Expand Navigators Resources for Outreach, Learning, and Longevity (ENROLL) Act of 2019, support passage. H.R. 2408, the Ensuring Access to Quality Complex Rehabilitation technology Act, support passage. H.R 3 - Lower Drug Costs Now Act of 2019, support passage H.R. 19 - Lower Costs, More Cures Act of 2019, support passage H.R. 2387, the Stop The Overuse of Petitions and Get Affordable Medicines to Enter Soon (STOP GAMES) Act of 2019, support passage H.R. 6417, Protecting Cures Act of 2020, support passage H.R. 5800, Ban Surprise Billing Act, support passage H.R. 1595, Secure and Fair Enforcement Banking Act (SAFE Banking Act), support passage S. 1935, Family Coverage Act, support passage. S.1556, No Junk Plans Act, support passage. S.475, Reducing Existing Costs Associated with Pharmaceuticals for Seniors Act of 2019 (RX Cap Act), support passage S. 637, Combatting Unreasonable Rises and Excessively High Drug Prices Act (CURE High Drug Prices Act), support passage S.366, Forcing Limits on Abusive and Tumultuous Prices (FLAT Prices) Act, support passage S. 63, Preserve Access to Affordable Generics and Biosimilars Act, support passage S. 659, Biologic Patent Transparency Act, support passage S.1895 - Lower Health Care Costs Act, support passage S. 2543 - Prescription Drug Price Reduction Act of 2019 - support passage S. 1801, Low Cost Generics Act of 2019, support passage H.R. 1425 Patient Protection and Affordable Care Enhancement Act, support H.R. 6514, Worker Health Coverage Protection Act, Support H.R. 3832, S. 1257, Legacy IRA Act, Support H.R. 6408 - Save the Organizations that Serve America Act S.3544/H.R.6305 - Coronavirus Relief for Seniors and People with Disabilities Act of 2020, support S. 3815, RESTART Act, Oppose S. 3833/H.R. 7010/H.R.6886, Paycheck Protection Program Flexibility Act of 2020, Support S. 4032/H.R. 7324, Universal Giving Pandemic Response Act. Support passage H.R. 6892-Help Charities Protect Communities Act, Support - S.Amdt. 1566 to the CARES Act, Charitable Giving oAmendment Increases the $300 limit on the charitable giving deduction to one-third of the standard deduction ($4,000 for an individual filer/$8,000 for married joint filers) for the remainder of 2020. Support. H.R. 7663-Protecting Access to Post-COVID-19 Telehealth Act, support passage H.R. 6644/S. 3741 - Health Care At Home Act, support passage H.R. 7391- the Protect Telehealth Access Act, support passage S. 3998- the Enhancing Preparedness Through Telehealth Act, support passage

Client expense: $57,579 · Firm income: Not reported

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

H.R. 938, Bringing Low-cost Options and Competition while Keeping Incentives for New Generics (BLOCKING) Act of 2019, regarding all bio-pharmaceutical related provisions. H.R. 985, Fair Access for Safe and Timely (FAST) Generics Act of 2019, regarding all bio-pharmaceutical related provisions. H.R. 986, Protecting American with Preexisting Conditions Act of 2019, regarding all bio-pharmaceutical related provisions. H.R. 987, Marketing and Outreach Restoration to Empower Health Education Act of 2019, regarding all bio-pharmaceutical related provisions. H.R. 1010, Short-Term, Limited Duration Insurance (STLDI), regarding all bio-pharmaceutical related provisions. H.R. 1323, Rural Hospital Frontier Fairness Act, regarding all bio-pharmaceutical related provisions. H.R. 1385, State Allowance for a Variety of Exchanges (SAVE) Act, regarding all bio-pharmaceutical related provisions. H.R. 1386, Expanded Navigators Resources for Outreach, Learning, and Longevity (ENROLL) Act, regarding all bio-pharmaceutical related provisions. H.R. 1409, Transparency in All Health Care Pricing Act, regarding all bio-pharmaceutical related provisions. H.R. 1425, State Health Care Premium Reduction Act, regarding all bio-pharmaceutical related provisions. H.R. 1478, Insulin importation, regarding all bio-pharmaceutical related provisions. H.R. 1503, Orange Book Transparency Act, regarding all bio-pharmaceutical related provisions. H.R. 1506, Fair and Immediate Release (FAIR) of Generics Act, regarding all bio-pharmaceutical related provisions. H.R. 1520, Purple Book Continuity Act, regarding all bio-pharmaceutical related provisions. H.R. 2011, Protecting Access to Biosimilars Act of 2019, regarding all bio-pharmaceutical related provisions. H.R. 2038, State-based , Market-Oriented, Prescription Drug Negotiations Act of 2019, regarding all bio-pharmaceutical related provisions. H.R. 2064, Product Sample reporting, regarding all bio-pharmaceutical related provisions. S. 61, Safe and Affordable Drugs from Canada Act, regarding all bio-pharmaceutical related provisions. S. 97, Affordable and Safe Drug Importation Act, regarding all bio-pharmaceutical related provisions. S. 102, Prescription Drug Price Relief Act, regarding all bio-pharmaceutical related provisions. S. 344/H.R. 990, Hatch-Waxman Integrity Act, regarding all bio-pharmaceutical related provisions. S. 366/H.R. 1188, FLAT Prices Act- Reduced exclusivity period for certain price hikes, regarding all bio-pharmaceutical related provisions. S. 418, FDA Accountability for Public Safety Act, regarding all bio-pharmaceutical related provisions. S. 419, Protecting Americans from Dangerous Opioids Act, regarding all bio-pharmaceutical related provisions. S. 637, CURE High Drug Prices Act, regarding all bio-pharmaceutical related provisions. S. 657, Drug Price Transparency Act, regarding all bio-pharmaceutical related provisions. S. 658, Accelerated Drug Approval for Prescription Therapies Act, regarding all bio-pharmaceutical related provisions. S. 659, Biologic Patent Transparency Act, regarding all bio-pharmaceutical related provisions. S. 660, Transparency in Petitions Act, regarding all bio-pharmaceutical related provisions. S. 709, Establishes public dashboard for price and utilization of drugs purchased by federal programs, regarding all bio-pharmaceutical related provisions. S. 741 /H.R. 1730, Cancer Drug Parity Act, regarding all bio-pharmaceutical related provisions. S. 844, Short Competition Act, regarding all bio-pharmaceutical related provisions. S. 977, Transparent Drug Pricing Act of 2019, regarding all bio-pharmaceutical related provisions. S. 989, STEER Act, regarding all bio-pharmaceutical related provisions. S. 1140, A bill to amend the Public Health Service Act with respect to the treatment under section 351(k)(7) of such Act (relating to exclusivity for reference products) of certain products deemed to have a biological product license pursuant to section 7002 of the Biologics Price Competition and Innovation Act of 2009, regarding all bio-pharmaceutical related provisions. S.1169, FDA citizen petition, regarding all bio-pharmaceutical related provisions. S. 1209, A bill to amend the Federal Food, Drug, and Cosmetic Act with respect to approval of abbreviated new drug applications, regarding all bio-pharmaceutical related provisions. H.R. 2115, Public Disclosure of Drug Discounts Act, regarding all bio-pharmaceutical related provisions H.R.2296/S.1391, FAIR Drug Pricing Act, regarding all bio-pharmaceutical related provisions H.R.2700, Lowering Prescription Drug Costs and Extending Community Health Centers and other Health Priorities Act, regarding all bio-pharmaceutical related provisions H.R. 3223, Pharmacy Benefit Manager Accountability Study Act, regarding all bio-pharmaceutical related provisions S. 1361/H.R.2584, Preventive Health Savings Act, regarding all bio-pharmaceutical related provisions S. 1437, DTC Act, regarding all bio-pharmaceutical related provisions S.1532, Pharmacy Benefit Managers Accountability Study Act, regarding all bio-pharmaceutical related provisions S.1636, Ensuring Innovation Act, regarding all bio-pharmaceutical related provisions S. 1664, Prescription Drug Price Reporting Act, regarding all bio-pharmaceutical related provisions S. 1801, Affordable Medications Act, regarding all bio-pharmaceutical related provisions S. 1895, Lowering Health Costs Act, regarding all bio-pharmaceutical related provisions S. 1897, a bill to establish a process for updating the labeling of certain drugs with outdated labeling, regarding all bio-pharmaceutical related provisions S. 1897/H.R. 3523, End Price Gouging for Medications Act, regarding all bio-pharmaceutical related provisions S. 2004, Emergency Access to Insulin Act, regarding all bio-pharmaceutical related provisions H.R. 2279/S. 2546, Safe Step Act of 2019, regarding all bio-pharmaceutical related provisions H.R 748/S. 3548, Coronavirus Aid, Relief and Economic Security Act (CARES Act), regarding all bio-pharmaceutical provisions. H.R. 1425, State Health Care Premium Reduction Act, regarding all bio-pharmaceutical related provisions H.R. 6800, Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act, regarding all bio-pharmaceutical related provisions

Client expense: $1,600,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE, U.S. Trade Representative (USTR)

H.R. 1389 - Safe Home Act of 2019 H.R. 1386 - the Enroll Act of 2019 H.R. 987 - the MORE Health Education Act of 2019 HR 1010 - a bill to provide that the rule entitled Short-Term, Limited Duration Insurance shall have no force or effect H.R. 986 - Protecting Americans with Preexisting Conditions Act of 2019 H.R. 1425 - State Health Care Premium Reduction Act H.R. 1398/S. 172 - Health Insurance Tax Relief Act of 2019 S. 1895 - Lower Health Care Costs Act H.R. 4378 - Continuing Appropriations Act and Health Extenders Act H.R. 861 - End Surprise Billing Act H.R. 3502 - Protecting People from Surprise Medical Bills Act S. 1531 - Stopping Surprise Medical Bills Act H.R. 6074 - Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 H.R. 6201 - Families First Coronavirus Response Act S. 3548 - CARES Act H.R. 6800 - The Heroes Act no specific bills, health care reform, health savings accounts, reinsurance, cost sharing reductions (CSRs), special needs plans, third party payment, Risk ratios, individual market reform, market stability, Grace periods, Special Enrollment Period, opioids, surprise billing, transparency, all provider claims database, testing

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

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

Ban Surprise Billing Act (H.R. 5800) Consumer Protections Against Surprise Medical Bills Act of 2020 (H.R. 5826) Dependent Income Exclusion Act of 2019 (H.R.4417/S.2497) Educating Consumers on the Risks of Short-Term Plans Act of 2019 (H.R.1143) ENROLL Act of 2019 (H.R.1386/S.1905) Family Coverage Act (S.1935) HEARTS Act of 2020 (H.R. 6166) The Heroes Act (H.R. 6800) Home Visiting to Reduce Maternal Mortality and Morbidity Act (H.R.4768) Lower Health Care Costs Act (S.1895) Marketing & Outreach Restoration to Empower Health Education Act (MORE) (H.R.987) No Surprises Act (H.R.3630) The Patient Protection and Affordable Care Enhancement Act (H.R. 1425) Personal Health Investment Today Act (PHIT) (S.680/H.R.1679) Physical Activity Recommendations (PAR) for Americans Act (S.1608/H.R.2891) Pre-existing Conditions Protection Act of 2019 (H.R.692) Protect Act (S.1125) Protecting Americans with Pre-existing Conditions Act of 2019 (H.R.986) Public Health Funding Restoration Act (S.1944/H.R.3447) Quit Because of COVID-19 Act (H.R. 7286) A Resolution Supporting the Designation of April 2019 as "National Donate Life Month"(H.Res 315/S.Res 162) South Asian Heart Health Awareness and Research Act of 2019 (H.R.3131) State Allowance for a Variety of Exchanges Act (SAVE Act) (H.R.1385) States Achieve Medicaid Expansion (S.585) State Health Care Premium Reduction Act (H.R.1425) Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019 (S.1531) Implementation of: Menu Labeling Physical Activity Guidelines Recommendations Prevention and Public Health Fund (PL 111-148, Sec 4002)

Client expense: $582,750 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Environmental Protection Agency (EPA), 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 Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Transportation, Dept of (DOT), Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

- H.R. 985, Fair Access for Safe and Timely Generics Act of 2017 (FAST Generics Act), support passage. -H.R. 2035/S. 995, Lifespan Respite Care Reauthorization Act, support reauthorization - H.R. 3208/ S.1755 - Real Emergency Access for Aging and Disability Inclusion for Disasters Act, support passage - H.R. 3215/ S. 1754 - Disaster Relief Medicaid Act, support passage - S.2400/ H.R. 4322 - Expanding Cannabis Research and Information Act, support passage - H.R. 3439 - Reauthorization of the Patient Centered Outcomes Research Institute, support reauthorization. -H.R. 2781 - Empower for Health Act of 2019, support passage -H.R. 2296/S.1391 - FAIR Drug Pricing Act of 2019, support passage - H.R. 3630 - No Surprises Act, support passage -H.R. 1010, To provide that the rule entitled Short-Term, Limited Duration Insurance shall have no force or effect, support passage. -H.R. 986, The Protecting Americans with Preexisting Conditions Act of 2019, support passage. -H.R.1386, Expand Navigators Resources for Outreach, Learning, and Longevity (ENROLL) Act of 2019, support passage. -H.R. 2293, the Protecting Access to Wheelchairs Act, support passage. -H.R. 2408, the Ensuring Access to Quality Complex Rehabilitation technology Act, support passage. -H.R 3 - Lower Drug Costs Now Act of 2019, support passage -H.R. 19 - Lower Costs, More Cures Act of 2019, support passage - H.R. 2387, the Stop The Overuse of Petitions and Get Affordable Medicines to Enter Soon (STOP GAMES) Act of 2019, support passage - H.R. 3107, Improving Seniors Timely Access to Care Act of 2019, support passage - H.R. 6417, Protecting Cures Act of 2020, support passage - H.R. 5800, Ban Surprise Billing Act, support passage H.R. 1595, Secure and Fair Enforcement Banking Act (SAFE Banking Act), support passage -S. 1935, Family Coverage Act, support passage. -S.1556, No Junk Plans Act, support passage. -S. 1223, the Protecting Beneficiary Access to Complex Rehab Technology Act, support passage - S.475, Reducing Existing Costs Associated with Pharmaceuticals for Seniors Act of 2019 (RX Cap Act), support passage - S. 637, Combatting Unreasonable Rises and Excessively High Drug Prices Act (CURE High Drug Prices Act), support passage - S.366, Forcing Limits on Abusive and Tumultuous Prices (FLAT Prices) Act, support passage -S. 63, Preserve Access to Affordable Generics and Biosimilars Act, support passage -S. 659, Biologic Patent Transparency Act, support passage -S.1895 - Lower Health Care Costs Act, support passage - S. 1280/HR 2477 - Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act, support passage - S. 691 - Medicare Extra Rx Help Act- support passage - S. 2543 - Prescription Drug Price Reduction Act of 2019 - support passage - Menendez - Lankford- Cardin-Daines Amendment 1 Incentivizing Generic and Biosimilar Use in Medicare Part D - support adoption Menendez -Lankford - Cardin --Daines Amendment 2 Incentivizing Generic Use in Medicare Part D - support adoption S, 1801, Low Cost Generics Act of 2019, support passage S.2911, the Seniors Prescription Drug Relief Act of 2019, support passage. - H.R. 1425 Patient Protection and Affordable Care Enhancement Act, support - H.R. 6514, Worker Health Coverage Protection Act, Support - H.R. 3832, S. 1257, Legacy IRA Act, Support - H.R. 6408 - Save the Organizations that Serve America Act - S.3544/H.R.6305 - Coronavirus Relief for Seniors and People with Disabilities Act of 2020, support -RESTART Act (S. 3814), Oppose - Paycheck Protection Program Flexibility Act of 2020(S. 3833/H.R. 7010/H.R.6886) Support -Help Charities Protect Communities Act (Rep. Beatty), bill number to be determined. Support - S.Amdt. 1566 to the CARES Act,Charitable Giving Amendment.Increases the $300 limit on the charitable giving deduction to one-third of the standard deduction ($4,000 for an individual filer/$8,000 for married joint filers) for the remainder of 2020. Support.

Client expense: $85,876 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Support HR 1763/ S 348, Resident Physician Shortage Reduction Act of 2019, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; Oppose HR 506,Hospital Competition Act of 2019, a bill to amend title XVIII of the Social Security Act to increase hospital competition; Statement submitted to the House Judiciary on the hearing "Diagnosing the Problem: Exploring the Effects of Consolidation and Anticompetitive Conduct in Health Care Markets";Letter of support for the Senate Workgroups efforts to ensure consumer protections by addressing surprise medical bills and comments on the development of legislation to protect patients from surprise medical bills; Letter urging Congress and the Administration to take further action to help reduce input and administrative costs, as well as maximize the number of insured patients; Support HR 965/ S340, Creating and Restoring Equal Access to Equivalent Samples Act of 2019 or the CREATES Act of 2019, 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; Support HR 986/ S466 Protecting Americans with Preexisting Conditions Act of 2019, a bill provide that certain guidance related to waivers for State innovation under the Patient Protection and Affordable Care Act shall have no force or effect; Support HR 987 Strengthening Health Care and Lowering Prescription Drug Costs Act, a bill to amend the Patient Protection and Affordable Care Act to provide for Federal Exchange outreach and educational activities; Support HR 938 Bringing Low-cost Options and Competition while Keeping Incentives for New Generics Act of 2019 or the BLOCKING Act of 2019, a bill to amend the Federal Food, Drug, and Cosmetic Act, with respect to eligibility for approval of a subsequent generic drug, to remove the barrier to that approval posed by the 180-day exclusivity period afforded to a first generic applicant that has not yet received final approval, and for other purposes; Support HR 1010, a bill to provide that the rule entitled Short-Term, Limited Duration Insurance shall have no force or effect; Support HR 1499 Protecting Consumer Access to Generic Drugs Act of 2019, a bill to prohibit brand name drug manufacturers from compensating generic drug manufacturers to delay the entry of a generic drug into the market, and to prohibit biological product manufacturers from compensating biosimilar and interchangeable product manufacturers to delay entry of biosimilar and interchangeable products, and for other purposes; Support HR 1425 State Health Care Premium Reduction Act, a bill to amend the Patient Protection and Affordable Care Act to provide for a Improve Health Insurance Affordability Fund to provide for certain reinsurance payments to lower premiums in the individual health insurance market; Support HR 1386/ S 1905 Expand Navigators Resources for Outreach, Learning, and Longevity Act of 2019 or the ENROLL Act of 2019,a bill to amend the Patient Protection and Affordable Care Act to provide for additional requirements with respect to the navigator program, and for other purposes; Support HR 1520 Purple Book Continuity Act of 2019, a bill to amend the Public Health Service Act to provide for the publication of a list of licensed biological products, and for other purposes; Support HR 1503 Orange Book Transparency Act of 2019A bill that would increase transparency for the patent status of both approved biological products and approved drugs; Support HR 2439/ HR 3414 Opioid Workforce Act of 2019, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions to help combat the opioid crisis; Submitted statement to the House Committee on Ways and Means Overcoming Racial Disparities and Social Determinants in the Maternal Mortality Crisis sharing information regarding hospitals and health systems efforts to address maternal morbidity and mortality, as we seek ways to improve outcomes and reduce health inequities for expectant and new mothers, and give their children the best possible start in life; Submitted oral and written testimony to the House Committee on Ways and Means Subcommittee on Health Hearing on Protecting Patients from Surprise Medical Bills. Protecting patients from surprise medical bills is a top priority and we have adopted a set of guiding principles to use as we evaluate legislative proposals: Define surprise bills, Protect the patient financially, Ensure patient access to emergency care, Preserve the role of private negotiation, Remove the patient from health plan/provider negotiations, Educate patients about their health care coverage, Ensure patients have access to comprehensive provider networks and accurate network information, and Support state laws that work; Letters submitted to the Energy & Commerce Committee in response to the request for comments on their surprise billing discussion draft. Concerned with the Committees draft legislations approach to determining reimbursement for out-of-network providers. Once the patient is protected from surprise bills, providers and insurers should then be permitted to negotiate payment rates for services provided. We strongly oppose approaches that would impose arbitrary rates on providers. We look forward to continuing to work with the Committee on solutions to stop surprise medical bills; Letter sent to the HELP Committee in response to the Lower Health Care Costs Act of 2019 discussion draft about our concerns about several of the proposals that would allow the government to intrude into private commercial contracts between providers and insurers. For example, several of the provisions could undermine value-based purchasing arrangements aimed directly at improving the quality of care while reducing costs. We strongly urge the Committee to remove these provisions; Submitted oral and written testimony to the House Committee on Energy and Commerce, Subcommittee on Health Hearing on No More Surprises: Protecting Patients from Surprise Medical Bills asking that the Committee preserve the ability of providers and insurers to negotiate private contracts and not establish a fixed payment amount for out-of-network services; Oppose HR 1309 Workplace Violence Prevention for Health Care and Social Service Workers Act, a bill to direct the Secretary of Labor to issue an occupational safety and health standard that requires covered employers within the health care and social service industries to develop and implement a comprehensive workplace violence prevention plan, and for other purposes; Concerns about S.1531, Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019 or the STOP Surprise Medical Bills Act of 2019, to amend the Public Health Service Act to provide protections for health insurance consumers from surprise billing; Concerns about S. 1895 Lower Health Care Costs Act Letter addressed concerns about the legislative provision that sets a benchmark rate in statute for the out-of-network payments, as well as provisions that seek to change privately negotiated contracting arrangements between hospitals and insurance companies; Support HR 3425, Advancing Medical Resident Training in Community Hospitals Act of 2019, to amend title XVIII of the Social Security Act to establish rules for payment for graduate medical education (GME) costs for hospitals that establish a new medical residency training program after hosting resident rotators for short durations; Expressed concerns regarding the provisions that reduce reimbursements to providers and hospitals that administer drugs the Prescription Drug Pricing Reduction Act (PDPRA) of 2019: including about Section 107, Medicare Part B Rebate by Manufacturers for Drugs or Biologicals with Prices Increasing Faster than Inflation, Section 110, Establishment of Maximum Add-on Payment for Drugs, Biologicals, and Biosimilars, this provision would establish $1,000 as the maximum add-on amount that a provider can be paid for a separately payable drug, biological or biosimilar, Section 111, Treatment of Drug Administration Services Furnished by an Off-Campus Outpatient Department of a Provider, the site neutral payment reduction would cut aggregate hospital payments; Support S. 2091, Backlog Elimination, Legal Immigration, and Employment Visa Enhancement Act, this legislation would increase the total number of employment-based visas from 140,000 to 270,000 and ensure that critical health care workers needed in the U.S. have access to employment-based visas by carving out health care workers in designated shortage occupations from the limit; Support S 350, The Competitive Health Insurance Reform Act of 2019, a bill to restore the application of the Federal antitrust laws to the business of health insurance to protect competition and consumers; Submitted statement to Subcommittee on Health of the Committee on Energy and Commerce for the hearing on Improving Maternal Health: Legislation to Advance Prevention Efforts and Access to Care; Concerns with S. 386 and HR 1044, Fairness for High-Skilled Immigrants Act of 2019, this bill increases the per-country cap on family-based immigrant visas from 7% of the total number of such visas available that year to 15%, and eliminates the 7% cap for employment-based immigrant visas. It also removes an offset that reduced the number of visas for individuals from China; Support H.R. 4538, Closing Loopholes for Orphan Drugs Act, a bill to amend title III of the Public Health Service Act to limit the orphan drug exclusion under the drug discount program under section 340B of such title; Discussions of provisions we support and those we recommend be changes in a draft bill called the Mitigating Existing Drug Shortages (MEDS) Act; Discussions in support of the allowing states to designate hospitals as necessary providers for purposes of waiving the critical access hospital mileage requirements; Provided comments to W&M on legislation to expand Health Profession Opportunity Grants; Support S. 2723, The Mitigating Emergency Drug Shortages (MEDS) Act, a bill to amend Sec. 506C of the Federal Food, Drug, and Cosmetic Act which strengthens requirements for drug manufacturers to disclose the root causes and expected duration of shortages, extends reporting requirements to active pharmaceutical ingredients manufacturers, requires manufacturers have contingency plans to ensure ongoing supply, develops recommendations to incentivize manufacturers to enter the market for drugs in shortage and examines the national security risks of shortages; Discuss DEA reductions in annual quotas for opioid products used by hospitals for sedation and pain management; Meeting with the Office of the Assistant Secretary of Preparedness and Response (ASPR) to discuss developments in the hospital preparedness program, the pilot projects for the Regional Disaster Healthcare System and other issues; Rural access to health care, including identifying core services needed in rural communities, outlining approaches and considerations for delivering those services, and examining access and quality in the rural context; ONCs proposed rule to implement the 21st Century Cures provision on information blocking; Supported members serving on the HHS Quality Summit panel, which was convened by the Deputy Secretary to gather input regarding how to improve and energize quality and safety improvement activities across health care system; Discussion with HHS on drug pricing, 340b, and price transparency policies, as well as the International Pricing Index ANPRM; Discussion with HHS about the work of Aligning for Health to address social determinants of health; Support S 2902, Strengthening Our Rural Health Workforce Act of 2019, a bill to enhance the rural health workforce; Meetings and correspondence with staff members of Senate Financing Committee on a proposal to support rural health care access (REH, re-opening necessary provider CAH, infrastructure funding); Letter to Ways & Means committee Rural and Underserved Communities Health Task Force in response to RFI on factors that contribute to health outcomes in these areas, examples of successful models and lessons from the field that address access and outcomes, and considerations for the unique circumstances of rural and underserved communities; Letter to Energy and Commerce Members regarding health information technology priorities; Letter of Support to Senate Appropriations on funding for the Centers for Disease Control and Prevention and the National Institutes of Health to study gun violence; Support S.2741 and H.R. 4932,Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019, a bill to amend title XVIII of the Social Security Act to expand access to telehealth services, and for other purposes; Support S 2603, Resolving Extended Limbo for Immigrant Employees and Families (RELIEF) Act, a bill to amend the Immigration and Nationality Act to end the immigrant visa backlog, and for other purposes; Support HR 4995, Maternal Health Quality Improvement Act of 2019, a bill to amend the Public Health Service Act to improve obstetric care and maternal health outcomes, and for other purposes; Concerns with HR 5800,Ban Surprise Billing Act, a bill to address surprise medical bills that relies on a median in-network rate to resolve out-of-network payments and allows for an independent dispute resolution process to determine the final payment. Concerned with the Committee's legislative approach to determining reimbursement for out-of-network providers. Oppose approaches that would impose arbitrary rates on providers, which could have significant consequences far beyond the scope of surprise medical bills. It is the insurers' responsibility to maintain comprehensive provider networks, and a default payment rate would remove incentives for health plans to contract with providers or to offer fair terms; Support HR 5826, Consumer Protections Against Surprise Medical Bills Act, a bill that prohibits providers from balance billing patients for emergency services or medical care the patient reasonably could have expected to be in-network, and from charging patients more than the in-network cost-sharing amount. Rather than rely on a benchmark payment rate to determine out-of-network reimbursement, the legislation provides a period for health plans and providers to negotiate out-of-network reimbursement, followed by a mediated dispute resolution process if necessary; Letter urging HHS to take regulatory actions to help hospitals and health systems prepare and respond to COVID-19; Letter requesting $100 billion to prepare and respond to COVID-19; Letter urging the Department of Labor to accurately define health care provider when promulgating regulations implementing key sections of the Families First Coronavirus Response Act; Letter sent to the President asking for the use of the Defense Production Act to increase the production of medical supplies and equipment; Letter to HHS regarding $100 billion emergency fund, asking HHS and CMS to directly and expediently distribute to rural and urban hospitals and health systems funds from the Public Health and Social Services Emergency Fund that were designated for providers in the Coronavirus Aid, Relief, and Economic Security (CARES) Act. The CARES Act increased funding by $100 billion in order to reimburse eligible health care providers for health care-related expenses or lost revenues that are attributable to COVID-19. In the letter, we urged HHS and CMS to immediately distribute funding to all hospital types in the US - with additional funding going to COVID-19 hotspots; Letter urging Congress to modernize the Stafford Act as part of its next COVID-19 legislative package to allow all hospitals to recoup financial losses from this pandemic and future disasters; Letter to the Federal Reserve System, the Federal Deposit Insurance Corporation and the Office of the Comptroller of the Currency requesting they, as primary federal regulators for insured depository institutions, take prompt action to assist health care providers on the front line of the COVID-19 pandemic should the need to do so arise; Letter to the Secretary of the Treasury and the Federal Reserve Chair of the Board of Governors urging a supplement to the New Main Street Loan Facility term sheet with prompt guidance to ensure that access to this critically-necessary loan facility will be attainable for hospitals without delay; Letter was sent to the SBA urging it to ensure that small- and mid-size public hospitals, including those that have both nonprofit and public designations, are allowed to apply for and receive loans under the newly-authorized SBA Paycheck Protection Program; Letter in response to FEMAs request for input on establishing a voluntary agreement, under the Defense Production Act, of key private sector stakeholders relevant to responding to COVID-19, urging that such an agreement account for the full breadth of COVID-19 medical supply and equipment needs; Support H.R. 6474/S.3838 Healthcare Broadband Expansion During COVID-19 Act, a bill that would provide an additional $2 billion in funding for the FCC Rural Health Care program and increase the subsidy for health care providers from 65 to 85 percent. This legislation also simplifies the program to allow for more efficient application processes and disbursement of much needed funding; Support HR 6654 Emergency COVID-19 Telehealth Response Act, a bill that would codify an expanded list of providers to deliver and bill for telehealth services during the PHE; Support HR 7233Knowing the Efficiency and Efficacy of Permanent (KEEP) Telehealth Options Act of 2020, a bill that would require the Department of Health and Human Services and the Government Accountability Office (GAO) to conduct studies to provide information about the expanded use of telehealth during the COVID-19 pandemic; Letter to Senate HELP Committee in response to request for feedback on preparing for next pandemic; Discussion about telehealth waivers and flexibilities with HHS; Discussion about CARES provider relief fund distributions with HHS; Oppose HR 6559/ S 3677 COVID-19 Every Worker Protection Act of 2020, a bill to require the Occupational Safety and Health Administration to promulgate an emergency temporary standard to protect employees from occupational exposure to SARS-CoV-2, and for other purposes; Joint letter with ANA urging Congress to act quickly to get needed resources into the health care system, so that hospitals, nurses and physicians responding to COVID-19 are able to continue to provide treatments, front-line health care personnel are able to provide care and patients are able access health care services; Statement to Committee on Ways and Means for the hearing on The Disproportionate Impact of COVID-19 on Communities of Color urging Congress to employ the resources of the National Institute on Minority Health and Health Disparities - which is congressionally-mandated to coordinate the research of the other National Institutes of Healths centers and institutes related to minority health - to research and develop approaches to specifically address the COVID-19 needs of minority populations; Advocate with Congress for full forgiveness of COVID-19 related accelerated payments received by hospitals; Support S 3781Pharmaceutical Accountability, Responsibility, and Transparency (PART) Act, a bill to increase reporting of, help mitigate potential shortages related to, and promote, accountability and transparency for pharmaceuticals and medical devices; Support S 3780 Help Onshore Manufacturing Efficiencies (HOME) for Drugs and Devices Act, a bill to encourage domestic advanced manufacturing of critical drugs and devices in order to address economic, health, and security concerns, combat shortages of critical drugs and devices, and promote increased domestic diversification of, and independence from foreign reliance on, pharmaceutical and medical device supply chains; Support S.3763 Pandemic Responder Service Award Act, a bill to establish the Pandemic Responder Service Award program to express our gratitude to front-line health care workers; Support HR 6788/ S 3599 Healthcare Workforce Resilience Act, a bill to enhance our Nations nurse and physician workforce during the COVID-19 crisis by recapturing unused immigrant visas; Urged support for joint House and Senate letter to the Administration asking for flexibility for hospitals with respect to J-1 and H-1B visa programs; Letter to Senate Finance Committee to address the important issue of maternal health and the opportunity to provide suggestions regarding how to improve maternal health in this country; Support the Temporary Reciprocity to Ensure Access to Treatment Act, a bill that allows for the temporary reciprocity for treatment by medical professionals licensed in one state to patients in other states.

Client expense: $4,260,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA), White House Office

Issues related to lung disease treatment, prevention and research; public health; Issues related asthma; COPD; influenza; lung cancer; pneumonia; tuberculosis and other lung diseases; Issues related to tobacco cessation; Issues related to the Affordable Care Act; Issues related to the Childrens Health Insurance Program; Issues related to the President's Budget; Issues related to telehealth; Issues related to changing federal poverty line calculation; Issues related to COVID-19 Response; H.R.965 CREATES Act of 2019; H.R.986 Protecting Americans with Preexisting Conditions Act of 2019 H.R.987 Strengthening Health Care and Lowering Prescription Drug Costs Act H.R.1010 To provide that the rule entitled "Short-Term, Limited Duration Insurance" shall have no force or effect. H.R.1385 SAVE Act H.R.1386 ENROLL Act of 2019 H.R.1425 State Health Care Premium Reduction Act H.R.1499 Protecting Consumer Access to Generic Drugs Act of 2019 H.R.1884 Protecting Pre-Existing Conditions and Making Health Care More Affordable Act of 2019 H.R.2508 Better Respiration through Expanding Access to Tele-Health Act;H.R.2862 VACCINES Act of 2019; H.R.3630 No Surprises Act H.R.4622 Family Asthma Act S.340 CREATES Act of 2019 S.466 Protecting Americans with Pre-existing Conditions Act of 2019 S.946 Henrietta Lacks Enhancing Cancer Research Act of 2019 S.1125 Protect Act S.1895 Lower Health Care Costs Act S.1944 Public Health Funding Restoration Act. HR 3 Elijah E. Cummings Lower Drug Costs Now Act; H.R.4716 I CAN Act; HR 5230 Elijah E. Cummings Family Asthma Act; HR 6201 - Families First Coronavirus Act; HR 6704 - Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020; HR 748 - CARES Act; S. 3548 - CARES Act; S. 1531 - Stopping the Outrageous Practice of Surprise Medical Bills Act of 2019; HR 6408 -- To extend the charitable deduction to all taxpayers regardless of whether a taxpayer itemizes deductions in order to encourage and increase charitable giving, and to provide for loans and loan guarantees to certain public charities; HR 7610 Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, 2021; HR 7667 Commerce, Justice, Science, and Related Agencies Appropriations Act, 2021; HR 7617 Department of Defense Appropriations Act, 2021; HR 7612 Department of the Interior, Environment, and Related Agencies Appropriations Act, 2021; HR 2468 School-Based Allergies and Asthma Management Program Act; HR 7614 Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2021; HR 7609 Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2021; HR 7616 Transportation, Housing and Urban Development, and Related Agencies Appropriations Act, 2021; HR 7608 Department of State, Foreign Operations, and Related Programs Appropriations Act, 2021; H.R.5076 Protecting Seniors Through Immunization Act of 2019; H.R.6561 Improving Social Determinants of Health Act of 2020; HR 6800 HEROES Act; H.R.6935 Protecting the Health of America's Older Adults During COVID-19 and Beyond Act; HR 7286 Quit Because of COVID-19 Act;

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Environmental Protection Agency (EPA), Federal Reserve System, Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Postal Regulatory Commission, SENATE, Small Business Administration (SBA), Treasury, Dept of, White House Office

H.R. 938, Bringing Low-cost Options and Competition while Keeping Incentives for New Generics (BLOCKING) Act of 2019, regarding all bio-pharmaceutical related provisions. H.R. 985, Fair Access for Safe and Timely (FAST) Generics Act of 2019, regarding all bio-pharmaceutical related provisions. H.R. 986, Protecting American with Preexisting Conditions Act of 2019, regarding all bio-pharmaceutical related provisions. H.R. 987, Marketing and Outreach Restoration to Empower Health Education Act of 2019, regarding all bio-pharmaceutical related provisions. H.R. 1010, Short-Term, Limited Duration Insurance (STLDI), regarding all bio-pharmaceutical related provisions. H.R. 1323, Rural Hospital Frontier Fairness Act, regarding all bio-pharmaceutical related provisions. H.R. 1385, State Allowance for a Variety of Exchanges (SAVE) Act, regarding all bio-pharmaceutical related provisions. H.R. 1386, Expanded Navigators Resources for Outreach, Learning, and Longevity (ENROLL) Act, regarding all bio-pharmaceutical related provisions. H.R. 1409, Transparency in All Health Care Pricing Act, regarding all bio-pharmaceutical related provisions. H.R. 1425, State Health Care Premium Reduction Act, regarding all bio-pharmaceutical related provisions. H.R. 1478, Insulin importation, regarding all bio-pharmaceutical related provisions. H.R. 1503, Orange Book Transparency Act, regarding all bio-pharmaceutical related provisions. H.R. 1506, Fair and Immediate Release (FAIR) of Generics Act, regarding all bio-pharmaceutical related provisions. H.R. 1520, Purple Book Continuity Act, regarding all bio-pharmaceutical related provisions. H.R. 2011, Protecting Access to Biosimilars Act of 2019, regarding all bio-pharmaceutical related provisions. H.R. 2038, State-based , Market-Oriented, Prescription Drug Negotiations Act of 2019, regarding all bio-pharmaceutical related provisions. H.R. 2064, Product Sample reporting, regarding all bio-pharmaceutical related provisions. S. 61, Safe and Affordable Drugs from Canada Act, regarding all bio-pharmaceutical related provisions. S. 97, Affordable and Safe Drug Importation Act, regarding all bio-pharmaceutical related provisions. S. 102, Prescription Drug Price Relief Act, regarding all bio-pharmaceutical related provisions. S. 344/H.R. 990, Hatch-Waxman Integrity Act, regarding all bio-pharmaceutical related provisions. S. 366/H.R. 1188, FLAT Prices Act- Reduced exclusivity period for certain price hikes, regarding all bio-pharmaceutical related provisions. S. 418, FDA Accountability for Public Safety Act, regarding all bio-pharmaceutical related provisions. S. 419, Protecting Americans from Dangerous Opioids Act, regarding all bio-pharmaceutical related provisions. S. 637, CURE High Drug Prices Act, regarding all bio-pharmaceutical related provisions. S. 657, Drug Price Transparency Act, regarding all bio-pharmaceutical related provisions. S. 658, Accelerated Drug Approval for Prescription Therapies Act, regarding all bio-pharmaceutical related provisions. S. 659, Biologic Patent Transparency Act, regarding all bio-pharmaceutical related provisions. S. 660, Transparency in Petitions Act, regarding all bio-pharmaceutical related provisions. S. 709, Establishes public dashboard for price and utilization of drugs purchased by federal programs, regarding all bio-pharmaceutical related provisions. S. 741 /H.R. 1730, Cancer Drug Parity Act, regarding all bio-pharmaceutical related provisions. S. 844, Short Competition Act, regarding all bio-pharmaceutical related provisions. S. 977, Transparent Drug Pricing Act of 2019, regarding all bio-pharmaceutical related provisions. S. 989, STEER Act, regarding all bio-pharmaceutical related provisions. S. 1140, A bill to amend the Public Health Service Act with respect to the treatment under section 351(k)(7) of such Act (relating to exclusivity for reference products) of certain products deemed to have a biological product license pursuant to section 7002 of the Biologics Price Competition and Innovation Act of 2009, regarding all bio-pharmaceutical related provisions. S.1169, FDA citizen petition, regarding all bio-pharmaceutical related provisions. S. 1209, A bill to amend the Federal Food, Drug, and Cosmetic Act with respect to approval of abbreviated new drug applications, regarding all bio-pharmaceutical related provisions. H.R. 2115, Public Disclosure of Drug Discounts Act, regarding all bio-pharmaceutical related provisions H.R.2296/S.1391, FAIR Drug Pricing Act, regarding all bio-pharmaceutical related provisions H.R.2700, Lowering Prescription Drug Costs and Extending Community Health Centers and other Health Priorities Act, regarding all bio-pharmaceutical related provisions H.R. 3223, Pharmacy Benefit Manager Accountability Study Act, regarding all bio-pharmaceutical related provisions S. 1361/H.R.2584, Preventive Health Savings Act, regarding all bio-pharmaceutical related provisions S. 1437, DTC Act, regarding all bio-pharmaceutical related provisions S.1532, Pharmacy Benefit Managers Accountability Study Act, regarding all bio-pharmaceutical related provisions S.1636, Ensuring Innovation Act, regarding all bio-pharmaceutical related provisions S. 1664, Prescription Drug Price Reporting Act, regarding all bio-pharmaceutical related provisions S. 1801, Affordable Medications Act, regarding all bio-pharmaceutical related provisions S. 1895, Lowering Health Costs Act, regarding all bio-pharmaceutical related provisions S. 1897, a bill to establish a process for updating the labeling of certain drugs with outdated labeling, regarding all bio-pharmaceutical related provisions S. 1897/H.R. 3523, End Price Gouging for Medications Act, regarding all bio-pharmaceutical related provisions S. 2004, Emergency Access to Insulin Act, regarding all bio-pharmaceutical related provisions H.R. 2279/S. 2546, Safe Step Act of 2019, regarding all bio-pharmaceutical related provisions H.R 748/S. 3548, Coronavirus Aid, Relief and Economic Security Act (CARES Act), regarding all bio-pharmaceutical provisions. H.R. 1425, State Health Care Premium Reduction Act, regarding all bio-pharmaceutical related provisions H.R. 6800, Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act, regarding all bio-pharmaceutical related provisions

Client expense: $2,160,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE, U.S. Trade Representative (USTR)

Medicare, Medicaid, private insurance and other health care policies that impact patient access to cardiovascular care, including H.R. 1010, the "ENROLL Act (H.R. 1386)", the "State Health Care Premium Reduction Act of 2019 (H.R. 1425)", the "Protecting Americans with Pre-Existing Conditions Act of 2019 (H.R. 466)", the "Educating Consumers on the Risk of Short Term Plans Act of 2019 (H.R. 1143)", the "Strengthening Health Care and Lowering Prescription Drug Costs Act (S. 987)", the "Lowering Health Care Costs Act (S. 1895)", the "No Surprises Act (H.R. 3630)" and "Increasing Access to Quality Rehabilitation Care Act of 2019 (H.R. 3911, S.2842)", the "Coronavirus Preparedness and Response Supplemental (H.R. 6074)", the "Families First Coronavirus Response Act (H.R. 6201)", the "Coronavirus Aid, Relief and Economic Security Act (H.R. 748)", the "Ban Surprise Billing Act (H.R. 5800)" the "Consumer Protections Against Surprise Medical Bills Act (H.R. 5826)", the "Health and Economic Recovery Omnibus Emergency Solutions Act (H.R. 6800)", and the "Paycheck Protection Program and Health Care Enhancement Act (H.R. 266)".

Client expense: Not reported · Firm income: $12,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare, Medicaid, private insurance and other health care policies that impact patient access to cardiovascular care, including H.R. 1010, the "ENROLL Act (H.R. 1386)", the "State Health Care Premium Reduction Act of 2019 (H.R. 1425)", the "Protecting Americans with Pre-Existing Conditions Act of 2019 (H.R. 466)", the "Educating Consumers on the Risk of Short Term Plans Act of 2019 (H.R. 1143)", the "Strengthening Health Care and Lowering Prescription Drug Costs Act (S. 987)", the "Lowering Health Care Costs Act (S. 1895)", the "No Surprises Act (H.R. 3630)" and "Increasing Access to Quality Rehabilitation Care Act of 2019 (H.R. 3911, S.2842)", the "Coronavirus Preparedness and Response Supplemental (H.R. 6074)", the "Families First Coronavirus Response Act (H.R. 6201)", the "Coronavirus Aid, Relief and Economic Security Act (H.R. 748)", the "Ban Surprise Billing Act (H.R. 5800)" the "Consumer Protections Against Surprise Medical Bills Act (H.R. 5826)", the "Health and Economic Recovery Omnibus Emergency Solutions Act (H.R. 6800)", and the "Paycheck Protection Program and Health Care Enhancement Act (H.R. 266)".

Client expense: Not reported · Firm income: $12,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1389 - Safe Home Act of 2019 H.R. 1386 - the Enroll Act of 2019 H.R. 987 - the MORE Health Education Act of 2019 HR 1010 - a bill to provide that the rule entitled Short-Term, Limited Duration Insurance shall have no force or effect H.R. 986 - Protecting Americans with Preexisting Conditions Act of 2019 H.R. 1425 - State Health Care Premium Reduction Act H.R. 1398/S. 172 - Health Insurance Tax Relief Act of 2019 S. 1895 - Lower Health Care Costs Act H.R. 4378 - Continuing Appropriations Act and Health Extenders Act H.R. 861 - End Surprise Billing Act H.R. 3502 - Protecting People from Surprise Medical Bills Act S. 1531 - Stopping Surprise Medical Bills Act H.R. 6074 - Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 H.R. 6201 - Families First Coronavirus Response Act S. 3548 - CARES Act H.R. 6800 - The Heroes Act no specific bills, health care reform, health savings accounts, reinsurance, cost sharing reductions (CSRs), special needs plans, third party payment, Risk ratios, individual market reform, market stability, Grace periods, Special Enrollment Period, opioids, surprise billing, transparency, all provider claims database, testing

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

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

Support HR 1763/ S 348, Resident Physician Shortage Reduction Act of 2019, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; Oppose HR 506,Hospital Competition Act of 2019, a bill to amend title XVIII of the Social Security Act to increase hospital competition; Statement submitted to the House Judiciary on the hearing "Diagnosing the Problem: Exploring the Effects of Consolidation and Anticompetitive Conduct in Health Care Markets";Letter of support for the Senate Workgroups efforts to ensure consumer protections by addressing surprise medical bills and comments on the development of legislation to protect patients from surprise medical bills; Letter urging Congress and the Administration to take further action to help reduce input and administrative costs, as well as maximize the number of insured patients; Comment letter urged CMS to extend the comment period for the proposed rules related to interoperability provisions of the 21st Century Cures Act by at least 30 days; Comment letter on the Food and Drug Administrations (FDA) draft guidance on blood glucose monitoring test systems (BGMS) for prescription point-of-care (POC) use and urge FDA to consider compiling a finite list of universally acceptable disinfectant products that would apply to all medical devices or classes of device; Comment letter that urged CMS to address the substantial flaws in the star ratings methodology since the ratings inception in 2016 and to suspend the display of overall star ratings on Hospital Compare while the agency continues its important work of enhancing the validity and meaningfulness of star ratings; Comment letter to FDA on the public meeting, Identifying the Root Causes of Drug Shortages and Finding Enduring Solutions with the following legislative recommendations: Strengthen manufacturers drug shortage disclosure requirements, Incentivize manufacturing contingency plans and/or redundancies, Enhance production transparency requirements, Enact shortage disclosure notification requirements for certain medical devices needed to administer drugs, Assess drug shortages as a national security threat, Include potential risk for drug shortages as a factor in the Federal Trade Commission (FTC) reviews of drug company merger proposals, and regulatory recommendations: Establish incentives to encourage manufacturers to produce drugs in shortage, Prevent manufacturing shutdowns, Establish a quality manufacturing initiative, Enhance information on the quality of outsourcing facilities compounding, Expand and improve the FDAs drug shortages list, Develop a list of critical drugs, Consider how reducing the number of unapproved drugs1 on the market might impact shortages, Reduce drug waste, Create an Office of Clinical Affairs within the Drug Enforcement Administration (DEA); Comment letter urging the CMS to use its upcoming proposed rules for Inpatient Rehabilitation Facility (IRF) and other post-acute care providers to address several issues related to the implementation of the revised case-mix grouping (CMG) policies; Support HR 965/ S340, Creating and Restoring Equal Access to Equivalent Samples Act of 2019 or the CREATES Act of 2019, 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; Support HR 986/ S466 Protecting Americans with Preexisting Conditions Act of 2019, a bill provide that certain guidance related to waivers for State innovation under the Patient Protection and Affordable Care Act shall have no force or effect; Support HR 987 Strengthening Health Care and Lowering Prescription Drug Costs Act, a bill to amend the Patient Protection and Affordable Care Act to provide for Federal Exchange outreach and educational activities; Support HR 938 Bringing Low-cost Options and Competition while Keeping Incentives for New Generics Act of 2019 or the BLOCKING Act of 2019, a bill to amend the Federal Food, Drug, and Cosmetic Act, with respect to eligibility for approval of a subsequent generic drug, to remove the barrier to that approval posed by the 180-day exclusivity period afforded to a first generic applicant that has not yet received final approval, and for other purposes; Support HR 1010, a bill to provide that the rule entitled Short-Term, Limited Duration Insurance shall have no force or effect; Support HR 1499 Protecting Consumer Access to Generic Drugs Act of 2019, a bill to prohibit brand name drug manufacturers from compensating generic drug manufacturers to delay the entry of a generic drug into the market, and to prohibit biological product manufacturers from compensating biosimilar and interchangeable product manufacturers to delay entry of biosimilar and interchangeable products, and for other purposes; Support HR 1425 State Health Care Premium Reduction Act, a bill to amend the Patient Protection and Affordable Care Act to provide for a Improve Health Insurance Affordability Fund to provide for certain reinsurance payments to lower premiums in the individual health insurance market; Support HR 1386/ S 1905 Expand Navigators Resources for Outreach, Learning, and Longevity Act of 2019 or the ENROLL Act of 2019,a bill to amend the Patient Protection and Affordable Care Act to provide for additional requirements with respect to the navigator program, and for other purposes; Support HR 1520 Purple Book Continuity Act of 2019, a bill to amend the Public Health Service Act to provide for the publication of a list of licensed biological products, and for other purposes; Support HR 1503 Orange Book Transparency Act of 2019A bill that would increase transparency for the patent status of both approved biological products and approved drugs; Support HR 2439/ HR 3414 Opioid Workforce Act of 2019, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions to help combat the opioid crisis; Submitted statement to the House Committee on Ways and Means Overcoming Racial Disparities and Social Determinants in the Maternal Mortality Crisis sharing information regarding hospitals and health systems efforts to address maternal morbidity and mortality, as we seek ways to improve outcomes and reduce health inequities for expectant and new mothers, and give their children the best possible start in life; Submitted oral and written testimony to the House Committee on Ways and Means Subcommittee on Health Hearing on Protecting Patients from Surprise Medical Bills. Protecting patients from surprise medical bills is a top priority and we have adopted a set of guiding principles to use as we evaluate legislative proposals: Define surprise bills, Protect the patient financially, Ensure patient access to emergency care, Preserve the role of private negotiation, Remove the patient from health plan/provider negotiations, Educate patients about their health care coverage, Ensure patients have access to comprehensive provider networks and accurate network information, and Support state laws that work; Letters submitted to the Energy & Commerce Committee in response to the request for comments on their surprise billing discussion draft. Concerned with the Committees draft legislations approach to determining reimbursement for out-of-network providers. Once the patient is protected from surprise bills, providers and insurers should then be permitted to negotiate payment rates for services provided. We strongly oppose approaches that would impose arbitrary rates on providers. We look forward to continuing to work with the Committee on solutions to stop surprise medical bills; Letter sent to the HELP Committee in response to the Lower Health Care Costs Act of 2019 discussion draft about our concerns about several of the proposals that would allow the government to intrude into private commercial contracts between providers and insurers. For example, several of the provisions could undermine value-based purchasing arrangements aimed directly at improving the quality of care while reducing costs. We strongly urge the Committee to remove these provisions; Submitted oral and written testimony to the House Committee on Energy and Commerce, Subcommittee on Health Hearing on No More Surprises: Protecting Patients from Surprise Medical Bills asking that the Committee preserve the ability of providers and insurers to negotiate private contracts and not establish a fixed payment amount for out-of-network services; Oppose HR 1309 Workplace Violence Prevention for Health Care and Social Service Workers Act, a bill to direct the Secretary of Labor to issue an occupational safety and health standard that requires covered employers within the health care and social service industries to develop and implement a comprehensive workplace violence prevention plan, and for other purposes; Concerns about S.1531, Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019 or the STOP Surprise Medical Bills Act of 2019, to amend the Public Health Service Act to provide protections for health insurance consumers from surprise billing; Concerns about S. 1895 Lower Health Care Costs Act Letter addressed concerns about the legislative provision that sets a benchmark rate in statute for the out-of-network payments, as well as provisions that seek to change privately negotiated contracting arrangements between hospitals and insurance companies; Support HR 3425, Advancing Medical Resident Training in Community Hospitals Act of 2019, to amend title XVIII of the Social Security Act to establish rules for payment for graduate medical education (GME) costs for hospitals that establish a new medical residency training program after hosting resident rotators for short durations; Expressed concerns regarding the provisions that reduce reimbursements to providers and hospitals that administer drugs the Prescription Drug Pricing Reduction Act (PDPRA) of 2019: including about Section 107, Medicare Part B Rebate by Manufacturers for Drugs or Biologicals with Prices Increasing Faster than Inflation, Section 110, Establishment of Maximum Add-on Payment for Drugs, Biologicals, and Biosimilars, this provision would establish $1,000 as the maximum add-on amount that a provider can be paid for a separately payable drug, biological or biosimilar, Section 111, Treatment of Drug Administration Services Furnished by an Off-Campus Outpatient Department of a Provider, the site neutral payment reduction would cut aggregate hospital payments; Support S. 2091, Backlog Elimination, Legal Immigration, and Employment Visa Enhancement Act, this legislation would increase the total number of employment-based visas from 140,000 to 270,000 and ensure that critical health care workers needed in the U.S. have access to employment-based visas by carving out health care workers in designated shortage occupations from the limit; Support S 350, The Competitive Health Insurance Reform Act of 2019, a bill to restore the application of the Federal antitrust laws to the business of health insurance to protect competition and consumers; Support letter for the adoption of a unique patient identifier (UPI, by removing the prohibition on the use of federal funds to promulgate or adopt a national UPI would provide HHS the ability to explore solutions that link patients with their correct medical records; Submitted statement to Subcommittee on Health of the Committee on Energy and Commerce for the hearing on Improving Maternal Health: Legislation to Advance Prevention Efforts and Access to Care; Concerns with S. 386 and HR 1044, Fairness for High-Skilled Immigrants Act of 2019, this bill increases the per-country cap on family-based immigrant visas from 7% of the total number of such visas available that year to 15%, and eliminates the 7% cap for employment-based immigrant visas. It also removes an offset that reduced the number of visas for individuals from China; Support H.R. 4538, Closing Loopholes for Orphan Drugs Act, a bill to amend title III of the Public Health Service Act to limit the orphan drug exclusion under the drug discount program under section 340B of such title; Discussions of provisions we support and those we recommend be changes in a draft bill called the Mitigating Existing Drug Shortages (MEDS) Act; Discussions in support of the allowing states to designate hospitals as necessary providers for purposes of waiving the critical access hospital mileage requirements; Provided comments to W&M on legislation to expand Health Profession Opportunity Grants; Support S. 2723, The Mitigating Emergency Drug Shortages (MEDS) Act, a bill to amend Sec. 506C of the Federal Food, Drug, and Cosmetic Act which strengthens requirements for drug manufacturers to disclose the root causes and expected duration of shortages, extends reporting requirements to active pharmaceutical ingredients manufacturers, requires manufacturers have contingency plans to ensure ongoing supply, develops recommendations to incentivize manufacturers to enter the market for drugs in shortage and examines the national security risks of shortages; DEA reductions in annual quotas for opioid products used by hospitals for sedation and pain management; Meeting with the Office of the Assistant Secretary of Preparedness and Response (ASPR) to discuss developments in the hospital preparedness program, the pilot projects for the Regional Disaster Healthcare System and other issues; Rural access to health care, including identifying core services needed in rural communities, outlining approaches and considerations for delivering those services, and examining access and quality in the rural context; ONCs proposed rule to implement the 21st Century Cures provision on information blocking; Supported members serving on the HHS Quality Summit panel, which was convened by the Deputy Secretary to gather input regarding how to improve and energize quality and safety improvement activities across health care system; Discussion with HHS on drug pricing, 340b, and price transparency policies, as well as the International Pricing Index ANPRM; Discussion with HHS about the work of Aligning for Health to address social determinants of health; Support S 2902, Strengthening Our Rural Health Workforce Act of 2019, a bill to enhance the rural health workforce; Meetings and correspondence with staff members of Senate Financing Committee on a proposal to support rural health care access (REH, re-opening necessary provider CAH, infrastructure funding); Letter to Ways & Means committee Rural and Underserved Communities Health Task Force in response to RFI on factors that contribute to health outcomes in these areas, examples of successful models and lessons from the field that address access and outcomes, and considerations for the unique circumstances of rural and underserved communities; Letter to Energy and Commerce Members regarding health information technology priorities; Letter of Support to Senate Appropriations on funding for the Centers for Disease Control and Prevention and the National Institutes of Health to study gun violence; Support S.2741 and H.R. 4932,Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019, a bill to amend title XVIII of the Social Security Act to expand access to telehealth services, and for other purposes; Support S 2603, Resolving Extended Limbo for Immigrant Employees and Families (RELIEF) Act, a bill to amend the Immigration and Nationality Act to end the immigrant visa backlog, and for other purposes; Support HR 4995, Maternal Health Quality Improvement Act of 2019, a bill to amend the Public Health Service Act to improve obstetric care and maternal health outcomes, and for other purposes. Concerns with HR 5800,Ban Surprise Billing Act, a bill to address surprise medical bills that relies on a median in-network rate to resolve out-of-network payments and allows for an independent dispute resolution process to determine the final payment. Concerned with the Committee's legislative approach to determining reimbursement for out-of-network providers. Oppose approaches that would impose arbitrary rates on providers, which could have significant consequences far beyond the scope of surprise medical bills. It is the insurers' responsibility to maintain comprehensive provider networks, and a default payment rate would remove incentives for health plans to contract with providers or to offer fair terms; Support HR 5826, Consumer Protections Against Surprise Medical Bills Act, a bill that prohibits providers from balance billing patients for emergency services or medical care the patient reasonably could have expected to be in-network, and from charging patients more than the in-network cost-sharing amount. Rather than rely on a benchmark payment rate to determine out-of-network reimbursement, the legislation provides a period for health plans and providers to negotiate out-of-network reimbursement, followed by a mediated dispute resolution process if necessary; Letter urging HHS to take regulatory actions to help hospitals and health systems prepare and respond to COVID-19; Letter requesting $100 billion to prepare and respond to COVID-19; Letter urging the Department of Labor to accurately define health care provider when promulgating regulations implementing key sections of the Families First Coronavirus Response Act; Letter sent to the President today asking for the use of the Defense Production Act to increase the production of medical supplies and equipment; Letter to HHS regarding $100 billion emergency fund, asking HHS and CMS to directly and expediently distribute to rural and urban hospitals and health systems funds from the Public Health and Social Services Emergency Fund that were designated for providers in the Coronavirus Aid, Relief, and Economic Security (CARES) Act. The CARES Act increased funding by $100 billion in order to reimburse eligible health care providers for health care-related expenses or lost revenues that are attributable to COVID-19. In the letter, we urged HHS and CMS to immediately distribute funding to all hospital types in the US - with additional funding going to COVID-19 hotspots; Letter urging Congress to modernize the Stafford Act as part of its next COVID-19 legislative package to allow all hospitals to recoup financial losses from this pandemic and future disasters.

Client expense: $5,940,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA), White House Office

Ban Surprise Billing Act (H.R. 5800) Consumer Protections Against Surprise Medical Bills Act of 2020 (H.R. 5826) Dependent Income Exclusion Act of 2019 (H.R.4417/S.2497) Educating Consumers on the Risks of Short-Term Plans Act of 2019 (H.R.1143) ENROLL Act of 2019 (H.R.1386/S.1905) Family Coverage Act (S.1935) HEARTS Act of 2020 (H.R. 6166) Home Visiting to Reduce Maternal Mortality and Morbidity Act (H.R.4768) Lower Health Care Costs Act (S.1895) Marketing & Outreach Restoration to Empower Health Education Act (MORE) (H.R.987) No Surprises Act (H.R.3630) Personal Health Investment Today Act (PHIT) (S.680/H.R.1679) Physical Activity Recommendations (PAR) for Americans Act (S.1608/H.R.2891) Pre-existing Conditions Protection Act of 2019 (H.R.692) Protect Act (S.1125) Protecting Americans with Pre-existing Conditions Act of 2019 (H.R.986) Public Health Funding Restoration Act (S.1944/H.R.3447) A Resolution Supporting the Designation of April 2019 as "National Donate Life Month"(H.Res 315/S.Res 162) South Asian Heart Health Awareness and Research Act of 2019 (H.R.3131) State Allowance for a Variety of Exchanges Act (SAVE Act) (H.R.1385) States Achieve Medicaid Expansion (S.585) State Health Care Premium Reduction Act (H.R.1425) Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019 (S.1531) To provide that the rule "STLDI" shall have no force or effect (H.R.1010) 911 Saves Act (H.R.1629) Implementation of: Menu Labeling Physical Activity Guidelines Recommendations Prevention and Public Health Fund (PL 111-148, Sec 4002) Resolution to: Designating February 2020 as "American Heart Month" and February 7, 2020, as "National Wear Red Day" (S.Res.513) Recognizing the rise of cardiovascular disease as the world's leading cause of preventable death and disability and as a global public health crisis and supporting the recognition of February 2020 as "American Heart Month" (H.Res. 860)

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

Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Environmental Protection Agency (EPA), 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 Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Transportation, Dept of (DOT), Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

Issues related to lung disease treatment, prevention and research; public health; Issues related asthma; COPD; influenza; lung cancer; pneumonia; tuberculosis and other lung diseases; Issues related to tobacco cessation; Issues related to the Affordable Care Act; Issues related to the Childrens Health Insurance Program; Issues related to the President's Budget; Issues related to telehealth; Issues related to changing federal poverty line calculation; Issues related to COVID-19 Response; Issues related to FY21 appropriations including Labor, Health and Human Services, Education and Related Agencies; H.R.965 CREATES Act of 2019; H.R.986 Protecting Americans with Preexisting Conditions Act of 2019 H.R.987 Strengthening Health Care and Lowering Prescription Drug Costs Act H.R.1010 To provide that the rule entitled "Short-Term, Limited Duration Insurance" shall have no force or effect. H.R.1385 SAVE Act H.R.1386 ENROLL Act of 2019 H.R.1425 State Health Care Premium Reduction Act H.R.1499 Protecting Consumer Access to Generic Drugs Act of 2019 H.R.1884 Protecting Pre-Existing Conditions and Making Health Care More Affordable Act of 2019 H.R.2508 Better Respiration through Expanding Access to Tele-Health Act;H.R.2862 VACCINES Act of 2019; H.R.3630 No Surprises Act H.R.4622 Family Asthma Act S.340 CREATES Act of 2019 S.466 Protecting Americans with Pre-existing Conditions Act of 2019 S.946 Henrietta Lacks Enhancing Cancer Research Act of 2019 S.1125 Protect Act S.1895 Lower Health Care Costs Act S.1944 Public Health Funding Restoration Act. HR 3 Elijah E. Cummings Lower Drug Costs Now Act; H.R.4716 I CAN Act; HR 5230 Elijah E. Cummings Family Asthma Act; HR 6201 - Families First Coronavirus Act; HR 6704 - Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020; HR 748 - CARES Act; S. 3548 - CARES Act; S. 1531 - Stopping the Outrageous Practice of Surprise Medical Bills Act of 2019; HR 6408 -- To extend the charitable deduction to all taxpayers regardless of whether a taxpayer itemizes deductions in order to encourage and increase charitable giving, and to provide for loans and loan guarantees to certain public charities;

Client expense: $50,000 · 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), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Postal Regulatory Commission, SENATE, Treasury, Dept of, White House Office

H.R. 938, Bringing Low-cost Options and Competition while Keeping Incentives for New Generics (BLOCKING) Act of 2019, regarding all bio-pharmaceutical related provisions. H.R. 985, Fair Access for Safe and Timely (FAST) Generics Act of 2019, regarding all bio-pharmaceutical related provisions. H.R. 986, Protecting American with Preexisting Conditions Act of 2019, regarding all bio-pharmaceutical related provisions. H.R. 987, Marketing and Outreach Restoration to Empower Health Education Act of 2019, regarding all bio-pharmaceutical related provisions. H.R. 1010, Short-Term, Limited Duration Insurance (STLDI), regarding all bio-pharmaceutical related provisions. H.R. 1323, Rural Hospital Frontier Fairness Act, regarding all bio-pharmaceutical related provisions. H.R. 1385, State Allowance for a Variety of Exchanges (SAVE) Act, regarding all bio-pharmaceutical related provisions. H.R. 1386, Expanded Navigators Resources for Outreach, Learning, and Longevity (ENROLL) Act, regarding all bio-pharmaceutical related provisions. H.R. 1409, Transparency in All Health Care Pricing Act, regarding all bio-pharmaceutical related provisions. H.R. 1425, State Health Care Premium Reduction Act, regarding all bio-pharmaceutical related provisions. H.R. 1478, Insulin importation, regarding all bio-pharmaceutical related provisions. H.R. 1503, Orange Book Transparency Act, regarding all bio-pharmaceutical related provisions. H.R. 1506, Fair and Immediate Release (FAIR) of Generics Act, regarding all bio-pharmaceutical related provisions. H.R. 1520, Purple Book Continuity Act, regarding all bio-pharmaceutical related provisions. H.R. 2011, Protecting Access to Biosimilars Act of 2019, regarding all bio-pharmaceutical related provisions. H.R. 2038, State-based , Market-Oriented, Prescription Drug Negotiations Act of 2019, regarding all bio-pharmaceutical related provisions. H.R. 2064, Product Sample reporting, regarding all bio-pharmaceutical related provisions. S. 61, Safe and Affordable Drugs from Canada Act, regarding all bio-pharmaceutical related provisions. S. 97, Affordable and Safe Drug Importation Act, regarding all bio-pharmaceutical related provisions. S. 102, Prescription Drug Price Relief Act, regarding all bio-pharmaceutical related provisions. S. 344/H.R. 990, Hatch-Waxman Integrity Act, regarding all bio-pharmaceutical related provisions. S. 366/H.R. 1188, FLAT Prices Act- Reduced exclusivity period for certain price hikes, regarding all bio-pharmaceutical related provisions. S. 418, FDA Accountability for Public Safety Act, regarding all bio-pharmaceutical related provisions. S. 419, Protecting Americans from Dangerous Opioids Act, regarding all bio-pharmaceutical related provisions. S. 637, CURE High Drug Prices Act, regarding all bio-pharmaceutical related provisions. S. 657, Drug Price Transparency Act, regarding all bio-pharmaceutical related provisions. S. 658, Accelerated Drug Approval for Prescription Therapies Act, regarding all bio-pharmaceutical related provisions. S. 659, Biologic Patent Transparency Act, regarding all bio-pharmaceutical related provisions. S. 660, Transparency in Petitions Act, regarding all bio-pharmaceutical related provisions. S. 709, Establishes public dashboard for price and utilization of drugs purchased by federal programs, regarding all bio-pharmaceutical related provisions. S. 741 /H.R. 1730, Cancer Drug Parity Act, regarding all bio-pharmaceutical related provisions. S. 844, Short Competition Act, regarding all bio-pharmaceutical related provisions. S. 977, Transparent Drug Pricing Act of 2019, regarding all bio-pharmaceutical related provisions. S. 989, STEER Act, regarding all bio-pharmaceutical related provisions. S. 1140, A bill to amend the Public Health Service Act with respect to the treatment under section 351(k)(7) of such Act (relating to exclusivity for reference products) of certain products deemed to have a biological product license pursuant to section 7002 of the Biologics Price Competition and Innovation Act of 2009, regarding all bio-pharmaceutical related provisions. S.1169, FDA citizen petition, regarding all bio-pharmaceutical related provisions. S. 1209, A bill to amend the Federal Food, Drug, and Cosmetic Act with respect to approval of abbreviated new drug applications, regarding all bio-pharmaceutical related provisions. H.R. 2115, Public Disclosure of Drug Discounts Act, regarding all bio-pharmaceutical related provisions H.R.2296/S.1391, FAIR Drug Pricing Act, regarding all bio-pharmaceutical related provisions H.R.2700, Lowering Prescription Drug Costs and Extending Community Health Centers and other Health Priorities Act, regarding all bio-pharmaceutical related provisions H.R. 3223, Pharmacy Benefit Manager Accountability Study Act, regarding all bio-pharmaceutical related provisions S. 1361/H.R.2584, Preventive Health Savings Act, regarding all bio-pharmaceutical related provisions S. 1437, DTC Act, regarding all bio-pharmaceutical related provisions S.1532, Pharmacy Benefit Managers Accountability Study Act, regarding all bio-pharmaceutical related provisions S.1636, Ensuring Innovation Act, regarding all bio-pharmaceutical related provisions S. 1664, Prescription Drug Price Reporting Act, regarding all bio-pharmaceutical related provisions S. 1801, Affordable Medications Act, regarding all bio-pharmaceutical related provisions S. 1895, Lowering Health Costs Act, regarding all bio-pharmaceutical related provisions S. 1897, a bill to establish a process for updating the labeling of certain drugs with outdated labeling, regarding all bio-pharmaceutical related provisions S. 1897/H.R. 3523, End Price Gouging for Medications Act, regarding all bio-pharmaceutical related provisions S. 2004, Emergency Access to Insulin Act, regarding all bio-pharmaceutical related provisions H.R. 2279/S. 2546, Safe Step Act of 2019, regarding all bio-pharmaceutical related provisions H.R 748/S. 3548, Coronavirus Aid, Relief and Economic Security Act (CARES Act), regarding all bio-pharmaceutical related provisions

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE, U.S. Trade Representative (USTR)

- H.R. 985, Fair Access for Safe and Timely Generics Act of 2017 (FAST Generics Act), support passage. -H.R. 2035/S. 995, Lifespan Respite Care Reauthorization Act, support reauthorization - H.R. 3208/ S.1755 - Real Emergency Access for Aging and Disability Inclusion for Disasters Act, support passage - H.R. 3215/ S. 1754 - Disaster Relief Medicaid Act, support passage - S.2400/ H.R. 4322 - Expanding Cannabis Research and Information Act, support passage - H.R. 3439 - Reauthorization of the Patient Centered Outcomes Research Institute, support reauthorization. -H.R. 2781 - Empower for Health Act of 2019, support passage -H.R. 2296/S.1391 - FAIR Drug Pricing Act of 2019, support passage - H.R. 3630 - No Surprises Act, support passage -H.R. 1010, To provide that the rule entitled Short-Term, Limited Duration Insurance shall have no force or effect, support passage. -H.R. 986, The Protecting Americans with Preexisting Conditions Act of 2019, support passage. -H.R.1386, Expand Navigators Resources for Outreach, Learning, and Longevity (ENROLL) Act of 2019, support passage. -H.R. 2293, the Protecting Access to Wheelchairs Act, support passage. -H.R. 2408, the Ensuring Access to Quality Complex Rehabilitation technology Act, support passage. -H.R 3 - Lower Drug Costs Now Act of 2019, support passage -H.R. 19 - Lower Costs, More Cures Act of 2019, support passage - H.R. 2387, the Stop The Overuse of Petitions and Get Affordable Medicines to Enter Soon (STOP GAMES) Act of 2019, support passage - H.R. 3107, Improving Seniors Timely Access to Care Act of 2019, support passage - H.R. 6417, Protecting Cures Act of 2020, support passage - H.R. 5800, Ban Surprise Billing Act, support passage H.R. 1595, Secure and Fair Enforcement Banking Act (SAFE Banking Act), support passage -S. 1935, Family Coverage Act, support passage. -S.1556, No Junk Plans Act, support passage. -S. 1223, the Protecting Beneficiary Access to Complex Rehab Technology Act, support passage - S.475, Reducing Existing Costs Associated with Pharmaceuticals for Seniors Act of 2019 (RX Cap Act), support passage - S. 637, Combatting Unreasonable Rises and Excessively High Drug Prices Act (CURE High Drug Prices Act), support passage - S.366, Forcing Limits on Abusive and Tumultuous Prices (FLAT Prices) Act, support passage -S. 63, Preserve Access to Affordable Generics and Biosimilars Act, support passage -S. 659, Biologic Patent Transparency Act, support passage -S.1895 - Lower Health Care Costs Act, support passage - S. 1280/HR 2477 - Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act, support passage - S. 691 - Medicare Extra Rx Help Act- support passage - S. 2543 - Prescription Drug Price Reduction Act of 2019 - support passage - Menendez - Lankford- Cardin-Daines Amendment 1 Incentivizing Generic and Biosimilar Use in Medicare Part D - support adoption Menendez -Lankford - Cardin --Daines Amendment 2 Incentivizing Generic Use in Medicare Part D - support adoption S, 1801, Low Cost Generics Act of 2019, support passage S.2911, the Seniors Prescription Drug Relief Act of 2019, support passage.

Client expense: $132,919 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare, Medicaid, private insurance and other health care policies that impact patient access to cardiovascular care, including H.R. 1010, the "ENROLL Act (H.R. 1386)", the "State Health Care Premium Reduction Act of 2019 (H.R. 1425)", the "Protecting Americans with Pre-Existing Conditions Act of 2019 (H.R. 466)", the "Educating Consumers on the Risk of Short Term Plans Act of 2019 (H.R. 1143)", the "Strengthening Health Care and Lowering Prescription Drug Costs Act (S. 987)", the "Lowering Health Care Costs Act (S. 1895)", the "No Surprises Act (H.R. 3630)" and "Increasing Access to Quality Rehabilitation Care Act of 2019 (H.R. 3911, S.2842)", the "Coronavirus Preparedness and Response Supplemental (H.R. 6074)", the "Families First Coronavirus Response Act (H.R. 6201)", the "Coronavirus Aid, Relief and Economic Security Act (H.R. 748)", the "Ban Surprise Billing Act (H.R. 5800)" and the "Consumer Protections Against Surprise Medical Bills Act (H.R. 5826)".

Client expense: Not reported · Firm income: $12,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1389 - Safe Home Act of 2019 H.R. 1386 - the Enroll Act of 2019 H.R. 987 - the MORE Health Education Act of 2019 HR 1010 - a bill to provide that the rule entitled Short-Term, Limited Duration Insurance shall have no force or effect H.R. 986 - Protecting Americans with Preexisting Conditions Act of 2019 H.R. 1425 - State Health Care Premium Reduction Act H.R. 1398/S. 172 - Health Insurance Tax Relief Act of 2019 S. 1895 - Lower Health Care Costs Act H.R. 4378 - Continuing Appropriations Act and Health Extenders Act H.R. 861 - End Surprise Billing Act H.R. 3502 - Protecting People from Surprise Medical Bills Act S. 1531 - Stopping Surprise Medical Bills Act H.R. 6074 - Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 H.R. 6201 - Families First Coronavirus Response Act S. 3548 - CARES Act no specific bills, health care reform, health savings accounts, reinsurance, cost sharing reductions (CSRs), special needs plans, third party payment, Risk ratios, individual market reform, market stability, Grace periods, Special Enrollment Period, opioids, surprise billing, transparency, all provider claims database

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

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

H.R. 1781 - Payment Commission Data Act of 2019: Issues regarding providing the Medicare Payment Advisory Commission and the Medicaid and CHIP Payment and Access Commission with access to drug pricing and rebate data. H.R. 938 - Bringing Low-cost Options and Competition while Keeping Incentives for New Generics (BLOCKING) Act of 2019: Issues regarding discouraging parking of 180-day exclusivity by a first generic applicant that is blocking the approval of other generics. H.R. 1520 - Purple Book Continuity Act of 2019: Issues regarding codifying publication of the patents of approved biological products in the Purple Book in a similar format and with similar requirements to the Orange Book; Publication and regular updating of the Purple Book electronically on the FDAs website. H.R. 1503 - Orange Book Transparency Act of 2019: Issues regarding ensuring that the Orange Book is accurate and up-to-date, by requiring manufacturers to share complete and timely information with FDA, as well as ensuring that patents listed in the Orange Book are relevant to the approved drug product. H.R. 1499 - Protecting Consumer Access to Generic Drugs Act of 2019: Issues regarding brand-name and generic drug manufacturers entering into agreements in which the brand-name drug manufacturer pays the generic manufacturer to keep a generic equivalent off the market. H.R. 965, S. 340 - Creating and Restoring Equal Access to Equivalent Samples (CREATES) Act of 2019: Issues regarding processes by which generic manufacturers can obtain sufficient quantities of brand drug samples for testing. H.R. 1385 - State Allowance for a Variety of Exchanges (SAVE) Act: Issues regarding federal funds to establish state-based Marketplaces. H.R. 1386 - Expand Navigators Resources for Outreach, Learning, and Longevity (ENROLL) Act: Issues regarding funding for Federally-Facilitated Marketplace navigator program; requirements for navigator entities in each state; Health and Human Services ensuring that navigator grants are awarded to entities with demonstrated capacity to carry out the duties specified in the Affordable Care Act. H.R. 987 - Marketing and Outreach Restoration to Empower (MORE) Health Education Act of 2019: Issues related to restoring outreach and enrollment funding to assist consumers in signing up for health care. H.R. 1010 - Issues regarding Short-Term, Limited Duration Insurance. H.R. 986 - Protecting Americans with Preexisting Conditions Act of 2019: Issues regarding rescinding Section 1332 guidance of the ACA promulgated in October 2018. H.R. 1425 - State Health Care Premium Reduction Act: Issues regarding state reinsurance program and providing financial assistance to reduce out-of-pocket costs. H.R. 820 - Public Health Service Act: Issues regarding National Institutes of Health support to collect the medical specimens and information of children with selected cancers that have the least effective treatments. 657 - Drug Price Transparency (DPT) Act: Issues relating to drug and price transparency. S. 80, S. 172 - Issues regarding repeal and delay of the health insurer fee. Issues regarding surprise billing, including benchmark payments and arbitration models.

Client expense: $1,590,000 · 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

H.R. 1781 - Payment Commission Data Act of 2019: Issues regarding providing the Medicare Payment Advisory Commission and the Medicaid and CHIP Payment and Access Commission with access to drug pricing and rebate data. H.R. 938 - Bringing Low-cost Options and Competition while Keeping Incentives for New Generics (BLOCKING) Act of 2019: Issues regarding discouraging parking of 180-day exclusivity by a first generic applicant that is blocking the approval of other generics. H.R. 1520 - Purple Book Continuity Act of 2019: Issues regarding codifying publication of the patents of approved biological products in the Purple Book in a similar format and with similar requirements to the Orange Book; Publication and regular updating of the Purple Book electronically on the FDAs website. H.R. 1503 - Orange Book Transparency Act of 2019: Issues regarding ensuring that the Orange Book is accurate and up-to-date, by requiring manufacturers to share complete and timely information with FDA, as well as ensuring that patents listed in the Orange Book are relevant to the approved drug product. H.R. 1499 - Protecting Consumer Access to Generic Drugs Act of 2019: Issues regarding brand-name and generic drug manufacturers entering into agreements in which the brand-name drug manufacturer pays the generic manufacturer to keep a generic equivalent off the market. H.R. 965, S. 340 - Creating and Restoring Equal Access to Equivalent Samples (CREATES) Act of 2019: Issues regarding processes by which generic manufacturers can obtain sufficient quantities of brand drug samples for testing. H.R. 1385 - State Allowance for a Variety of Exchanges (SAVE) Act: Issues regarding federal funds to establish state-based Marketplaces. H.R. 1386 - Expand Navigators Resources for Outreach, Learning, and Longevity (ENROLL) Act: Issues regarding funding for Federally-Facilitated Marketplace navigator program; requirements for navigator entities in each state; Health and Human Services ensuring that navigator grants are awarded to entities with demonstrated capacity to carry out the duties specified in the Affordable Care Act. H.R. 987 - Marketing and Outreach Restoration to Empower (MORE) Health Education Act of 2019: Issues related to restoring outreach and enrollment funding to assist consumers in signing up for health care. H.R. 1010 - Issues regarding Short-Term, Limited Duration Insurance. H.R. 986 - Protecting Americans with Preexisting Conditions Act of 2019: Issues regarding rescinding Section 1332 guidance of the ACA promulgated in October 2018. H.R. 1425 - State Health Care Premium Reduction Act: Issues regarding state reinsurance program and providing financial assistance to reduce out-of-pocket costs. H.R. 820 - Public Health Service Act: Issues regarding National Institutes of Health support to collect the medical specimens and information of children with selected cancers that have the least effective treatments. H.R. 2069 - The SPIKE Act, H.R. 2113 - STAR Act, H.R. 2115 - Public Disclosure of Drug Discounts Act, H.R. 2296 - FAIR Drug Pricing Act, H.R. 2376 - Prescription Pricing for the People Act, H.R, 2757 - Creating Lower Cost Alternatives for Your Prescription Drugs Act, S. 657 - Drug Price Transparency (DPT) Act: Issues relating to drug and price transparency. H.R. 3253 - Empowering Beneficiaries, Ensuring Access, and Strengthening Accountability Act of 2019: Regarding all provisions. S. 1895 - The Lower Health Care Costs Act: Regarding all provisions. S. 80, S. 172 - Issues regarding repeal and delay of the health insurer fee. Issues pertaining to surprise billing, including benchmark payments and arbitration models.

Client expense: $1,710,000 · 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

H.R. 1781 - Payment Commission Data Act of 2019: Issues regarding providing the Medicare Payment Advisory Commission and the Medicaid and CHIP Payment and Access Commission with access to drug pricing and rebate data. H.R. 938 - Bringing Low-cost Options and Competition while Keeping Incentives for New Generics (BLOCKING) Act of 2019: Issues regarding discouraging parking of 180-day exclusivity by a first generic applicant that is blocking the approval of other generics. H.R. 1520 - Purple Book Continuity Act of 2019: Issues regarding codifying publication of the patents of approved biological products in the Purple Book in a similar format and with similar requirements to the Orange Book; Publication and regular updating of the Purple Book electronically on the FDAs website. H.R. 1503 - Orange Book Transparency Act of 2019: Issues regarding ensuring that the Orange Book is accurate and up-to-date, by requiring manufacturers to share complete and timely information with FDA, as well as ensuring that patents listed in the Orange Book are relevant to the approved drug product. H.R. 1499 - Protecting Consumer Access to Generic Drugs Act of 2019: Issues regarding brand-name and generic drug manufacturers entering into agreements in which the brand-name drug manufacturer pays the generic manufacturer to keep a generic equivalent off the market. H.R. 965, S. 340 - Creating and Restoring Equal Access to Equivalent Samples (CREATES) Act of 2019: Issues regarding processes by which generic manufacturers can obtain sufficient quantities of brand drug samples for testing. H.R. 1385 - State Allowance for a Variety of Exchanges (SAVE) Act: Issues regarding federal funds to establish state-based Marketplaces. H.R. 1386 - Expand Navigators Resources for Outreach, Learning, and Longevity (ENROLL) Act: Issues regarding funding for Federally-Facilitated Marketplace navigator program; requirements for navigator entities in each state; Health and Human Services ensuring that navigator grants are awarded to entities with demonstrated capacity to carry out the duties specified in the Affordable Care Act. H.R. 987 - Marketing and Outreach Restoration to Empower (MORE) Health Education Act of 2019: Issues related to restoring outreach and enrollment funding to assist consumers in signing up for health care. H.R. 1010 - Issues regarding Short-Term, Limited Duration Insurance. H.R. 986 - Protecting Americans with Preexisting Conditions Act of 2019: Issues regarding rescinding Section 1332 guidance of the ACA promulgated in October 2018. H.R. 1425 - State Health Care Premium Reduction Act: Issues regarding state reinsurance program and providing financial assistance to reduce out-of-pocket costs. H.R. 820 - Public Health Service Act: Issues regarding National Institutes of Health support to collect the medical specimens and information of children with selected cancers that have the least effective treatments. H.R. 2069 - The SPIKE Act, H.R. 2113 - STAR Act, H.R. 2115 - Public Disclosure of Drug Discounts Act, H.R. 2296 - FAIR Drug Pricing Act, H.R. 2376 - Prescription Pricing for the People Act, H.R, 2757 - Creating Lower Cost Alternatives for Your Prescription Drugs Act, S. 657 - Drug Price Transparency (DPT) Act: Issues relating to drug and price transparency. H.R. 3253 - Empowering Beneficiaries, Ensuring Access, and Strengthening Accountability Act of 2019: Regarding all provisions. S. 1895 - The Lower Health Care Costs Act: Regarding all provisions. S. 80, S. 172 - Issues regarding repeal and delay of the health insurer fee. Issues pertaining to surprise billing, including benchmark payments and arbitration models.

Client expense: $1,460,000 · 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

H.R. 1781 - Payment Commission Data Act of 2019: Issues regarding providing the Medicare Payment Advisory Commission and the Medicaid and CHIP Payment and Access Commission with access to drug pricing and rebate data. H.R. 938 - Bringing Low-cost Options and Competition while Keeping Incentives for New Generics (BLOCKING) Act of 2019: Issues regarding discouraging parking of 180-day exclusivity by a first generic applicant that is blocking the approval of other generics. H.R. 1520 - Purple Book Continuity Act of 2019: Issues regarding codifying publication of the patents of approved biological products in the Purple Book in a similar format and with similar requirements to the Orange Book; Publication and regular updating of the Purple Book electronically on the FDAs website. H.R. 1503 - Orange Book Transparency Act of 2019: Issues regarding ensuring that the Orange Book is accurate and up-to-date, by requiring manufacturers to share complete and timely information with FDA, as well as ensuring that patents listed in the Orange Book are relevant to the approved drug product. H.R. 1499 - Protecting Consumer Access to Generic Drugs Act of 2019: Issues regarding brand-name and generic drug manufacturers entering into agreements in which the brand-name drug manufacturer pays the generic manufacturer to keep a generic equivalent off the market. H.R. 965, S. 340 - Creating and Restoring Equal Access to Equivalent Samples (CREATES) Act of 2019: Issues regarding processes by which generic manufacturers can obtain sufficient quantities of brand drug samples for testing. H.R. 1385 - State Allowance for a Variety of Exchanges (SAVE) Act: Issues regarding federal funds to establish state-based Marketplaces. H.R. 1386 - Expand Navigators Resources for Outreach, Learning, and Longevity (ENROLL) Act: Issues regarding funding for Federally-Facilitated Marketplace navigator program; requirements for navigator entities in each state; Health and Human Services ensuring that navigator grants are awarded to entities with demonstrated capacity to carry out the duties specified in the Affordable Care Act. H.R. 987 - Marketing and Outreach Restoration to Empower (MORE) Health Education Act of 2019: Issues related to restoring outreach and enrollment funding to assist consumers in signing up for health care. H.R. 1010 - Issues regarding Short-Term, Limited Duration Insurance. H.R. 986 - Protecting Americans with Preexisting Conditions Act of 2019: Issues regarding rescinding Section 1332 guidance of the ACA promulgated in October 2018. H.R. 1425 - State Health Care Premium Reduction Act: Issues regarding state reinsurance program and providing financial assistance to reduce out-of-pocket costs. H.R. 820 - Public Health Service Act: Issues regarding National Institutes of Health support to collect the medical specimens and information of children with selected cancers that have the least effective treatments. 657 - Drug Price Transparency (DPT) Act: Issues relating to drug and price transparency. S. 80, S. 172 - Issues regarding repeal and delay of the health insurer fee. Issues regarding surprise billing, including benchmark payments and arbitration models.

Client expense: $1,330,000 · 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

- H.R. 965/ S. 340, Creating and Restoring Equal Access To Equivalent Samples Act of 2017 (CREATES Act), support passage. - H.R. 985, Fair Access for Safe and Timely Generics Act of 2017 (FAST Generics Act), support passage. -H.R. 2035/S. 995, Lifespan Respite Care Reauthorization Act, support reauthorization - H.R. 3208/ S.1755 - Real Emergency Access for Aging and Disability Inclusion for Disasters Act, support passage - H.R. 3215/ S. 1754 - Disaster Relief Medicaid Act, support passage - S.2400/ H.R. 4322 - Expanding Cannabis Research and Information Act, support passage - H.R. 3439 - Reauthorization of the Patient Centered Outcomes Research Institute, support reauthorization. -H.R. 2781 - Empower for Health Act of 2019, support passage -H.R. 2035, Lifespan Respite Care Reauthorization Act of 2019, support passage -H.R. 2296/S.1391 - FAIR Drug Pricing Act of 2019, support passage - H.R. 3630 - No Surprises Act, support passage -H.R. 1010, To provide that the rule entitled Short-Term, Limited Duration Insurance shall have no force or effect, support passage. -H.R. 986, The Protecting Americans with Preexisting Conditions Act of 2019, support passage. -H.R.1386, Expand Navigators Resources for Outreach, Learning, and Longevity (ENROLL) Act of 2019, support passage. -H.R. 2293, the Protecting Access to Wheelchairs Act, support passage. -H.R. 2408, the Ensuring Access to Quality Complex Rehabilitation technology Act, support passage. -H.R 3 - Lower Drug Costs Now Act of 2019, support passage - H.R. 2387, the Stop The Overuse of Petitions and Get Affordable Medicines to Enter Soon (STOP GAMES) Act of 2019, support passage - H.R. 3107, Improving Seniors Timely Access to Care Act of 2019, support passage -S. 1935, Family Coverage Act, support passage. -S.1556, No Junk Plans Act, support passage. -S. 1223, the Protecting Beneficiary Access to Complex Rehab Technology Act, support passage - S.475, Reducing Existing Costs Associated with Pharmaceuticals for Seniors Act of 2019 (RX Cap Act), support passage - S. 637, Combatting Unreasonable Rises and Excessively High Drug Prices Act (CURE High Drug Prices Act), support passage - S.366, Forcing Limits on Abusive and Tumultuous Prices (FLAT Prices) Act, support passage -S. 63, Preserve Access to Affordable Generics and Biosimilars Act, support passage -S. 659, Biologic Patent Transparency Act, support passage -S.1895 - Lower Health Care Costs Act, support passage - S. 1280/HR 2477 - Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act, support passage - S. 691 - Medicare Extra Rx Help Act- support passage - S. 2543 - Prescription Drug Price Reduction Act of 2019 - support passage - Menendez - Lankford- Cardin-Daines Amendment 1 Incentivizing Generic and Biosimilar Use in Medicare Part D - support adoption -Menendez -Lankford - Cardin --Daines Amendment 2 Incentivizing Generic Use in Medicare Part D - support adoption -S, 1801, Low Cost Generics Act of 2019, support passage -S.2911, the Seniors Prescription Drug Relief Act of 2019, support passage.

Client expense: $83,990 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Elijah E. Cummings Lower Drug Costs Now Act (H.R. 3) Prescription Drug Pricing Reduction Act (S. 2543) Put Patients First Act (H.R. 5036/S. 2836) A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Secretary of the Treasury and the Secretary of Health and Human Services relating to "State Relief and Empowerment Waivers" (S.J. Res. 52) ENROLL Act (H.R. 1386/S. 1905) Helping Medicaid Offer Maternity Service (MOMS) Act (H.R. 4996) Maternal Health Quality Improvement Act (H.R. 4995)

Client expense: $133,750 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 350, Competitive Health Insurance Reform Act (Daines) - McCarran-Ferguson Act S. 455, Marketing and Outreach Restoration to Empower Health Education Act (Shaheen) - funding for outreach and education on ACA Exchanges S. 466, Protecting Americans with Preexisting Conditions Act (Warner) - blocking updated Section 1332 guidance S. 560, Ensuring Lasting Smiles Act (Baldwin) - coverage mandate for treatment of congenital anomaly or birth defect S. 741, Cancer Drug Parity Act (Smith) -- cost sharing for oral anticancer drugs S. 913, Disclosure of Price Information to Enrollees (Braun) S. 961, Improving Health Insurance Affordability Act (Shaheen) - premium tax credits S. 964, Marketplace Certainty Act (Shaheen) - cost-sharing subsidies S. 967, Reducing Costs for Out-of-Network Services Act (Shaheen) - caps on out-of-network charges S. 981, Medicare-X Choice Act (Bennet) - public option S. 1033, CHOICE Act (Whitehouse) - public option S. 1125, Protect Act (Tillis) - pre-existing condition protections S. 1129, Medicare for All Act (Sanders) - government health insurance system S. 1170, Association Health Plans Act (Enzi) - codifying final rule for expanding AHPs S. 1266, Protecting Patients from Surprise Medical Bills Act (Scott) - surprise medical billing S. 1531, STOP Surprise Medical Bills Act (Cassidy-Bennet) - surprise medical billing S. 1576, Behavioral Health Coverage Transparency Act (Warren) - mental health parity S. 1577, Know the Price Act (Cassidy-Bennet) - restrictions on provider contracts S. 1737, Mental Health Parity Compliance Act (Murphy) - mental health parity S. 1948, Chronic Disease Management Act (Thune) - pre-deductible coverage of chronic disease prevention services S. 2546, Safe Step Act (Murkowski)-Step therapy exceptions H.R. 692, Pre-existing Conditions Protection Act (Walden) - pre-existing condition protections H.R. 986, Protecting Americans with Preexisting Conditions Act (Kuster) - blocking updated Section 1332 guidance H.R. 987, Marketing and Outreach Restoration to Empower Health Education Act (Blunt Rochester) - funding for outreach and education on ACA Exchanges, Navigator program, and establishment of state-based Health Insurance Exchanges; drug pricing proposals H.R. 1010, Short-Term Plans (Castor) - blocking final rule that expands short-term plans H.R. 1143, Educating Consumers on the Risks of Short-Term Plans Act (Eshoo) - standardized disclosures for short-term plans H.R. 1379, Ensuring Lasting Smiles Act (Peterson) - coverage mandate for treatment of congenital anomaly or birth defect H.R. 1384, Medicare for All Act (Jayapal) - government health insurance system H.R. 1385, State Allowance for a Variety of Exchanges Act (Kim) - funding for establishment of state-based Health Insurance Exchanges H.R. 1386, Expand Navigators Resources for Outreach, Learning, and Longevity Act (Castor) - funding for Navigator Program H.R. 1418, Competitive Health Insurance Reform Act (DeFazio) - McCarran-Ferguson Act H.R. 1425, State Health Care Premium Reduction Act (Craig) - funding for state reinsurance programs H.R. 1510, Premium Relief Act (Burgess) -- Patient and State Stability Fund H.R. 1730, Cancer Drug Parity Act (Higgins) -- cost sharing for oral anticancer drugs H.R. 1884, Protecting Pre-Existing Conditions and Making Health Care More Affordable Act (Pallone) - reinsurance funding, stabilization and affordability proposals H.R. 2000, Medicare-X Choice Act (Delgado) - public option H.R. 2061, Pathway to Universal Coverage Act (Bera) - auto-enrollment H.R. 2085, CHOICE Act (Schakowsky) - public option H.R. 2183, State Flexibility and Patient Choice Act (Marshall) - flexibility in state innovation waivers H.R. 2848, Parity Enforcement Act (Norcross) - mental health parity H.R. 2874, Behavioral Health Coverage Transparency Act (Kennedy) - mental health parity H.R. 3165, Mental Health Parity Compliance Act (Porter) - mental health parity H.R. 3502, Protecting People From Surprise Medical Bills Act (Ruiz) - surprise medical billing H.R. 3630, No Surprises Act (Pallone)-surprise medical billing H.R. 3784, Air Ambulance Affordability Act of 2019 (Neguse)- air ambulances H.R. 4223, Protecting Patients from Surprise Medical Bills Act (Spano)-surprise medical billing H.R. 4379, Under Performing Directories that Affect Treating Emergencies Act (Axne)-provider directories H.R. 4457, Chronic Condition Copay Elimination Act (Underwood)- Eliminating copays for services/drugs for chronic conditions H.R. 4484, Flexibility Through Lower Expenses Health Care Act (Budd)-STLDI plans H.R. 4530, Native American Health Savings Improvement Act (Moolenaar)-HSAs H.R. 4575, Improving Provider Directories Act (Schrier)-provider directories H.R. 5010, State-Based Universal Health Care Act of 2019 (Khanna) - universal health care systems H.R. 5121, Healthcare Cost Transparency Act (Beyer) - provider price comparison tool H.R. 5144, Insurance Accountability and Transparency Act (Davids) - insurance have publicly accessible self-audit information H.R. 5239 Prescription Drug Price Reporting Act (Joyce) - reporting on drug expenditures and price changes under group health plans H. Res. 271 (Allred) - resolution urging DOJ to reverse position in Texas v. United States litigation 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 related to expanding long-term care insurance coverage; 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; prior authorization; accountable care organizations; coverage of preventive services; preexisting condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; health reimbursement accounts; dependent coverage; treatment of expatriate plans; issues related to surprise medical bills; issues related to all payor claims databases; issues related to association health plans; issues related to substance abuse and provider treatment records (42 CFR Part 2); issues related to medical management; 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 related to interoperability and price transparency; issues related to the employer market; issues relating to the individual market; and other issues relating to health care reform implementation.

Client expense: $2,340,000 · 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

Issues related to lung disease treatment, prevention and research; public health; Issues related asthma; COPD; influenza; lung cancer; pneumonia; tuberculosis and other lung diseases; Issues related to tobacco cessation; Issues related to the Affordable Care Act; Issues related to the Childrens Health Insurance Program; Issues related to the President's Budget; H.R.965 CREATES Act of 2019 H.R.986 Protecting Americans with Preexisting Conditions Act of 2019 H.R.987 Strengthening Health Care and Lowering Prescription Drug Costs Act H.R.1010 To provide that the rule entitled "Short-Term, Limited Duration Insurance" shall have no force or effect. H.R.1385 SAVE Act H.R.1386 ENROLL Act of 2019 H.R.1425 State Health Care Premium Reduction Act H.R.1499 Protecting Consumer Access to Generic Drugs Act of 2019 H.R.1884 Protecting Pre-Existing Conditions and Making Health Care More Affordable Act of 2019 H.R.2508 Better Respiration through Expanding Access to Tele-Health Act H.R.2839 Department of State, Foreign Operations, and Related Programs Appropriations Act, 2020 H.R.2862 VACCINES Act of 2019 H.R.3055 Commerce, Justice, Science, Agriculture, Rural Development, Food and Drug Administration, Interior, Environment, Military Construction, Veterans Affairs, Transportation, and Housing and Urban Development Appropriations Act, 2020; S.2580, Department of the Interior, Environment, and Related Agencies Appropriations Act H.R.3630 No Surprises Act H.R.4622 Family Asthma Act S.340 CREATES Act of 2019 S.466 Protecting Americans with Pre-existing Conditions Act of 2019 S.946 Henrietta Lacks Enhancing Cancer Research Act of 2019 S.1125 Protect Act S.1895 Lower Health Care Costs Act S.1944 Public Health Funding Restoration Act. HR 3 Elijah E. Cummings Lower Drug Costs Now Act; H.R.4716 I CAN Act; HR 5230 Elijah E. Cummings Family Asthma Act

Client expense: $40,000 · 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), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, White House Office

Support HR 1763/ S 348, Resident Physician Shortage Reduction Act of 2019, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; Oppose HR 506,Hospital Competition Act of 2019, a bill to amend title XVIII of the Social Security Act to increase hospital competition; Statement submitted to the House Judiciary on the hearing "Diagnosing the Problem: Exploring the Effects of Consolidation and Anticompetitive Conduct in Health Care Markets";Letter of support for the Senate Workgroups efforts to ensure consumer protections by addressing surprise medical bills and comments on the development of legislation to protect patients from surprise medical bills; Letter urging Congress and the Administration to take further action to help reduce input and administrative costs, as well as maximize the number of insured patients; Comment letter urged CMS to extend the comment period for the proposed rules related to interoperability provisions of the 21st Century Cures Act by at least 30 days; Comment letter on the Food and Drug Administrations (FDA) draft guidance on blood glucose monitoring test systems (BGMS) for prescription point-of-care (POC) use and urge FDA to consider compiling a finite list of universally acceptable disinfectant products that would apply to all medical devices or classes of device; Comment letter that urged CMS to address the substantial flaws in the star ratings methodology since the ratings inception in 2016 and to suspend the display of overall star ratings on Hospital Compare while the agency continues its important work of enhancing the validity and meaningfulness of star ratings; Comment letter to FDA on the public meeting, Identifying the Root Causes of Drug Shortages and Finding Enduring Solutions with the following legislative recommendations: Strengthen manufacturers drug shortage disclosure requirements, Incentivize manufacturing contingency plans and/or redundancies, Enhance production transparency requirements, Enact shortage disclosure notification requirements for certain medical devices needed to administer drugs, Assess drug shortages as a national security threat, Include potential risk for drug shortages as a factor in the Federal Trade Commission (FTC) reviews of drug company merger proposals, and regulatory recommendations: Establish incentives to encourage manufacturers to produce drugs in shortage, Prevent manufacturing shutdowns, Establish a quality manufacturing initiative, Enhance information on the quality of outsourcing facilities compounding, Expand and improve the FDAs drug shortages list, Develop a list of critical drugs, Consider how reducing the number of unapproved drugs1 on the market might impact shortages, Reduce drug waste, Create an Office of Clinical Affairs within the Drug Enforcement Administration (DEA); Comment letter urging the CMS to use its upcoming proposed rules for Inpatient Rehabilitation Facility (IRF) and other post-acute care providers to address several issues related to the implementation of the revised case-mix grouping (CMG) policies; Support HR 965/ S340, Creating and Restoring Equal Access to Equivalent Samples Act of 2019 or the CREATES Act of 2019, 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; Support HR 986/ S466 Protecting Americans with Preexisting Conditions Act of 2019, a bill provide that certain guidance related to waivers for State innovation under the Patient Protection and Affordable Care Act shall have no force or effect; Support HR 987 Strengthening Health Care and Lowering Prescription Drug Costs Act, a bill to amend the Patient Protection and Affordable Care Act to provide for Federal Exchange outreach and educational activities; Support HR 938 Bringing Low-cost Options and Competition while Keeping Incentives for New Generics Act of 2019 or the BLOCKING Act of 2019, a bill to amend the Federal Food, Drug, and Cosmetic Act, with respect to eligibility for approval of a subsequent generic drug, to remove the barrier to that approval posed by the 180-day exclusivity period afforded to a first generic applicant that has not yet received final approval, and for other purposes; Support HR 1010, a bill to provide that the rule entitled Short-Term, Limited Duration Insurance shall have no force or effect; Support HR 1499 Protecting Consumer Access to Generic Drugs Act of 2019, a bill to prohibit brand name drug manufacturers from compensating generic drug manufacturers to delay the entry of a generic drug into the market, and to prohibit biological product manufacturers from compensating biosimilar and interchangeable product manufacturers to delay entry of biosimilar and interchangeable products, and for other purposes; Support HR 1425 State Health Care Premium Reduction Act, a bill to amend the Patient Protection and Affordable Care Act to provide for a Improve Health Insurance Affordability Fund to provide for certain reinsurance payments to lower premiums in the individual health insurance market; Support HR 1386/ S 1905 Expand Navigators Resources for Outreach, Learning, and Longevity Act of 2019 or the ENROLL Act of 2019,a bill to amend the Patient Protection and Affordable Care Act to provide for additional requirements with respect to the navigator program, and for other purposes; Support HR 1520 Purple Book Continuity Act of 2019, a bill to amend the Public Health Service Act to provide for the publication of a list of licensed biological products, and for other purposes; Support HR 1503 Orange Book Transparency Act of 2019A bill that would increase transparency for the patent status of both approved biological products and approved drugs; Support HR 2439/ HR 3414 Opioid Workforce Act of 2019, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions to help combat the opioid crisis; Submitted statement to the House Committee on Ways and Means Overcoming Racial Disparities and Social Determinants in the Maternal Mortality Crisis sharing information regarding hospitals and health systems efforts to address maternal morbidity and mortality, as we seek ways to improve outcomes and reduce health inequities for expectant and new mothers, and give their children the best possible start in life; Submitted oral and written testimony to the House Committee on Ways and Means Subcommittee on Health Hearing on Protecting Patients from Surprise Medical Bills. Protecting patients from surprise medical bills is a top priority and we have adopted a set of guiding principles to use as we evaluate legislative proposals: Define surprise bills, Protect the patient financially, Ensure patient access to emergency care, Preserve the role of private negotiation, Remove the patient from health plan/provider negotiations, Educate patients about their health care coverage, Ensure patients have access to comprehensive provider networks and accurate network information, and Support state laws that work; Letters submitted to the Energy & Commerce Committee in response to the request for comments on their surprise billing discussion draft. Concerned with the Committees draft legislations approach to determining reimbursement for out-of-network providers. Once the patient is protected from surprise bills, providers and insurers should then be permitted to negotiate payment rates for services provided. We strongly oppose approaches that would impose arbitrary rates on providers. We look forward to continuing to work with the Committee on solutions to stop surprise medical bills; Letter sent to the HELP Committee in response to the Lower Health Care Costs Act of 2019 discussion draft about our concerns about several of the proposals that would allow the government to intrude into private commercial contracts between providers and insurers. For example, several of the provisions could undermine value-based purchasing arrangements aimed directly at improving the quality of care while reducing costs. We strongly urge the Committee to remove these provisions; Submitted oral and written testimony to the House Committee on Energy and Commerce, Subcommittee on Health Hearing on No More Surprises: Protecting Patients from Surprise Medical Bills asking that the Committee preserve the ability of providers and insurers to negotiate private contracts and not establish a fixed payment amount for out-of-network services; Oppose HR 1309 Workplace Violence Prevention for Health Care and Social Service Workers Act, a bill to direct the Secretary of Labor to issue an occupational safety and health standard that requires covered employers within the health care and social service industries to develop and implement a comprehensive workplace violence prevention plan, and for other purposes; Concerns about S.1531, Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019 or the STOP Surprise Medical Bills Act of 2019, to amend the Public Health Service Act to provide protections for health insurance consumers from surprise billing; Concerns about S. 1895 Lower Health Care Costs Act Letter addressed concerns about the legislative provision that sets a benchmark rate in statute for the out-of-network payments, as well as provisions that seek to change privately negotiated contracting arrangements between hospitals and insurance companies; Support HR 3425, Advancing Medical Resident Training in Community Hospitals Act of 2019, to amend title XVIII of the Social Security Act to establish rules for payment for graduate medical education (GME) costs for hospitals that establish a new medical residency training program after hosting resident rotators for short durations; Expressed concerns regarding the provisions that reduce reimbursements to providers and hospitals that administer drugs the Prescription Drug Pricing Reduction Act (PDPRA) of 2019: including about Section 107, Medicare Part B Rebate by Manufacturers for Drugs or Biologicals with Prices Increasing Faster than Inflation, Section 110, Establishment of Maximum Add-on Payment for Drugs, Biologicals, and Biosimilars, this provision would establish $1,000 as the maximum add-on amount that a provider can be paid for a separately payable drug, biological or biosimilar, Section 111, Treatment of Drug Administration Services Furnished by an Off-Campus Outpatient Department of a Provider, the site neutral payment reduction would cut aggregate hospital payments; Support S. 2091, Backlog Elimination, Legal Immigration, and Employment Visa Enhancement Act, this legislation would increase the total number of employment-based visas from 140,000 to 270,000 and ensure that critical health care workers needed in the U.S. have access to employment-based visas by carving out health care workers in designated shortage occupations from the limit; Support S 350, The Competitive Health Insurance Reform Act of 2019, a bill to restore the application of the Federal antitrust laws to the business of health insurance to protect competition and consumers; Support letter for the adoption of a unique patient identifier (UPI, by removing the prohibition on the use of federal funds to promulgate or adopt a national UPI would provide HHS the ability to explore solutions that link patients with their correct medical records; Submitted statement to Subcommittee on Health of the Committee on Energy and Commerce for the hearing on Improving Maternal Health: Legislation to Advance Prevention Efforts and Access to Care; Concerns with S. 386 and HR 1044, Fairness for High-Skilled Immigrants Act of 2019, this bill increases the per-country cap on family-based immigrant visas from 7% of the total number of such visas available that year to 15%, and eliminates the 7% cap for employment-based immigrant visas. It also removes an offset that reduced the number of visas for individuals from China; Support H.R. 4538, Closing Loopholes for Orphan Drugs Act, a bill to amend title III of the Public Health Service Act to limit the orphan drug exclusion under the drug discount program under section 340B of such title; Discussions of provisions we support and those we recommend be changes in a draft bill called the Mitigating Existing Drug Shortages (MEDS) Act; Discussions in support of the allowing states to designate hospitals as necessary providers for purposes of waiving the critical access hospital mileage requirements; Provided comments to W&M on legislation to expand Health Profession Opportunity Grants; Support H.R. 2723, The Mitigating Emergency Drug Shortages (MEDS) Act, a bill to amend Sec. 506C of the Federal Food, Drug, and Cosmetic Act which strengthens requirements for drug manufacturers to disclose the root causes and expected duration of shortages, extends reporting requirements to active pharmaceutical ingredients manufacturers, requires manufacturers have contingency plans to ensure ongoing supply, develops recommendations to incentivize manufacturers to enter the market for drugs in shortage and examines the national security risks of shortages; DEA reductions in annual quotas for opioid products used by hospitals for sedation and pain management; Meeting with the Office of the Assistant Secretary of Preparedness and Response (ASPR) to discuss developments in the hospital preparedness program, the pilot projects for the Regional Disaster Healthcare System and other issues; Rural access to health care, including identifying core services needed in rural communities, outlining approaches and considerations for delivering those services, and examining access and quality in the rural context; ONCs proposed rule to implement the 21st Century Cures provision on information blocking; Supported members serving on the HHS Quality Summit panel, which was convened by the Deputy Secretary to gather input regarding how to improve and energize quality and safety improvement activities across health care system; Discussion with HHS on drug pricing, 340b, and price transparency policies, as well as the International Pricing Index ANPRM; Discussion with HHS about the work of Aligning for Health to address social determinants of health; Support S 2902, Strengthening Our Rural Health Workforce Act of 2019, a bill to enhance the rural health workforce; Meetings and correspondence with staff members of Senate Financing Committee on a proposal to support rural health care access (REH, re-opening necessary provider CAH, infrastructure funding); Letter to Ways & Means committee Rural and Underserved Communities Health Task Force in response to RFI on factors that contribute to health outcomes in these areas, examples of successful models and lessons from the field that address access and outcomes, and considerations for the unique circumstances of rural and underserved communities; Letter to Energy and Commerce Members regarding health information technology priorities; Letter of Support to Senate Appropriations on funding for the Centers for Disease Control and Prevention and the National Institutes of Health to study gun violence; Support S.2741 and H.R. 4932,Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019, a bill to amend title XVIII of the Social Security Act to expand access to telehealth services, and for other purposes; Support S 2603, Resolving Extended Limbo for Immigrant Employees and Families (RELIEF) Act, a bill to amend the Immigration and Nationality Act to end the immigrant visa backlog, and for other purposes; Support HR 4995, Maternal Health Quality Improvement Act of 2019, a bill to amend the Public Health Service Act to improve obstetric care and maternal health outcomes, and for other purposes.

Client expense: $6,610,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA), White House Office

Further Consolidated Appropriations Act, 2020 (H.R.1865) Dependent Income Exclusion Act pf 2019 (H.R.4417/S.2497) Educating Consumers on the Risks of Short-Term Plans Act of 2019 (H.R.1143) ENROLL Act of 2019 (H.R.1386/S.1905) Family Coverage Act (S.1935) Home Visiting to Reduce Maternal Mortality and Morbidity Act (H.R.4768) Lower Health Care Costs Act (S.1895) Marketing & Outreach Restoration to Empower Health Education Act (MORE) (H.R.987) No Surprises Act (H.R.3630) Personal Health Investment Today Act (PHIT) (S.680/H.R.1679) Physical Activity Recommendations (PAR) for Americans Act (S.1608/H.R.2891) Pre-existing Conditions Protection Act of 2019 (H.R.692) Protect Act (S.1125) Protecting Americans with Pre-existing Conditions Act of 2019 (H.R.986) Public Health Funding Restoration Act (S.1944/H.R.3447) A Resolution Supporting the Designation of April 2019 as "National Donate Life Month"(H.Res 315/S.Res 162) South Asian Heart Health Awareness and Research Act of 2019 (H.R.3131) State Allowance for a Variety of Exchanges Act (SAVE Act) (H.R.1385) States Achieve Medicaid Expansion (S.585) State Health Care Premium Reduction Act (H.R.1425) Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019 (S.1531) To provide that the rule "STLDI" shall have no force or effect (H.R.1010) 911 Saves Act (H.R.1629) Implementation of: Menu Labeling Physical Activity Guidelines Recommendations Prevention and public Health Fund (PL 111-148, Sec 4002)

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

Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Environmental Protection Agency (EPA), 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 Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Transportation, Dept of (DOT), Treasury, Dept of, White House Office

Affordable Care Act (ACA); ACA Regulations; ACA Stabilization; Health Reform; Rural Healthcare; Risk Adjustment; State Flexibility; Opioids; Sober Homes; Marketplace Stability; Individual Market Reform; Value-based Care; Health Care Costs; Mental Health; Small Business Plans; Reinsurance; CSRs; SNPs; FEHBP Issues; 42 CFR Part 2; Transparency; Silverloading; Health IT; Interoperability; Texas lawsuit; Surprise billing, Transparency, Small Business, State Flexibility; Health Reimbursement Arrangements (HRAs)Outreach, Education, and Enrollment; Prior Authorization; All payer claims database; Negotiated rate disclosure; Consumer-facing app disclosures; Provider directories; Medicare for All; Medicare Buy-in; Maternal health; Senior's health care; Social determinants of health; Community health; Lyme disease; Cybersecurity, NBPP (Notice Benefit and Payment Parameters) H.R.1346 - 116th Congress (2019-2020) Medicare Buy-In and Health Care Stabilization Act of 2019 Sponsor: Rep. Higgins, Brian [D-NY-26] (Introduced 02/25/2019) H.R.1384 - 116th Congress (2019-2020) Medicare for All Act of 2019 Sponsor: Rep. Jayapal, Pramila [D-WA-7] (Introduced 02/27/2019) H.R.3502 - 116th Congress (2019-2020) Protecting People From Surprise Medical Bills Act Sponsor: Rep. Ruiz, Raul [D-CA-36] (Introduced 06/26/2019) Cosponsors: (48) H.R.2003 - 116th Congress (2019-2020) Ensuring FEHBP Coverage During Shutdowns Act Sponsor: Rep. Cummings, Elijah E. [D-MD-7] (Introduced 04/01/2019) H.R.2004 - 116th Congress (2019-2020) Ensuring FEDVIP and FLTCIP Coverage During Shutdowns Act Sponsor: Rep. Cummings, Elijah E. [D-MD-7] (Introduced 04/01/2019) S.973 - 116th Congress (2019-2020) Ensuring FEDVIP and FLTCIP Coverage During Shutdowns Act Sponsor: Sen. Smith, Tina [D-MN] (Introduced 04/01/2019) S.971 - 116th Congress (2019-2020) Ensuring FEHBP Coverage During Shutdowns Act Sponsor: Sen. Smith, Tina [D-MN] (Introduced 04/01/2019) H.R.1385 - 116th Congress (2019-2020) SAVE Act Sponsor: Rep. Kim, Andy [D-NJ-3] (Introduced 02/27/2019) H.R.1386 - 116th Congress (2019-2020) ENROLL Act of 2019 Sponsor: Rep. Castor, Kathy [D-FL-14] (Introduced 02/27/2019) H.R.987 - Strengthening Health Care and Lowering Prescription Drug Costs Act 116th Congress (2019-2020) Sponsor: Rep. Blunt Rochester, Lisa [D-DE-At Large] (Introduced 02/06/2019) H.R.1010 - 116th Congress (2019-2020) To provide that the rule entitled "Short-Term, Limited Duration Insurance" shall have no force or effect. Sponsor: Rep. Castor, Kathy [D-FL-14] (Introduced 02/06/2019) H.R.986 - 116th Congress (2019-2020) Protecting Americans with Preexisting Conditions Act of 2019 Sponsor: Rep. Kuster, Ann M. [D-NH-2] (Introduced 02/06/2019) H.R.1425 - 116th Congress (2019-2020) State Health Care Premium Reduction Act Sponsor: Rep. Craig, Angie [D-MN-2] (Introduced 02/28/2019) H.R.1143 - 116th Congress (2019-2020) Educating Consumers on the Risks of Short-Term Plans Act of 2019 Sponsor: Rep. Eshoo, Anna G. [D-CA-18] (Introduced 02/11/2019) H.R.1520 - 116th Congress (2019-2020) Purple Book Continuity Act of 2019 Sponsor: Rep. Eshoo, Anna G. [D-CA-18] (Introduced 03/05/2019) S.1895 - 116th Congress (2019-2020) Lower Health Care Costs Act Sponsor: Sen. Alexander, Lamar [R-TN] (Introduced 06/19/2019) H.R.1046 - 116th Congress (2019-2020) Medicare Negotiation and Competitive Licensing Act of 2019 Sponsor: Rep. Doggett, Lloyd [D-TX-35] H.R.1897 - 116th Congress (2019-2020) MOMMA's Act Sponsor: Rep. Kelly, Robin L. [D-IL-2] (Introduced 03/27/2019) H.R.1551 - 116th Congress (2019-2020) Quality Care for Moms and Babies Act Sponsor: Rep. Engel, Eliot L. [D-NY-16] (Introduced 03/06/2019 H.R.2902 - 116th Congress (2019-2020) Maternal CARE Act Sponsor: Rep. Adams, Alma S. [D-NC-12] H.R.2602 - 116th Congress (2019-2020) Healthy MOMMIES Act Sponsor: Rep. Pressley, Ayanna [D-MA-7] H.R.3630 - 116th Congress (2019-2020) No Surprises Act Sponsor: Rep. Pallone, Frank, Jr. [D-NJ-6] H.R.4378 - 116th Congress (2019-2020) Continuing Appropriations Act, 2020, and Health Extenders Act of 2019 Sponsor: Rep. Lowey, Nita M. [D-NY-17] H.R.2328 - 116th Congress (2019-2020) Community Health Investment, Modernization, and Excellence Act of 2019 Sponsor: Rep. O'Halleran, Tom [D-AZ-1] H.R.3439 - 116th Congress (2019-2020) PATIENT Act Sponsor: Rep. Beyer, Donald S., Jr. [D-VA-8] H.R.3107 - 116th Congress (2019-2020) Improving Seniors' Timely Access to Care Act of 2019 Sponsor: Rep. DelBene, Suzan K. [D-WA-1] H.R.4004 - 116th Congress (2019-2020) Social Determinants Accelerator Act of 2019 Sponsor: Rep. Bustos, Cheri [D-IL-17] H.R.2279 - 116th Congress (2019-2020) Safe Step Act Sponsor: Rep. Ruiz, Raul [D-CA-36] H.R.360 - 116th Congress (2019-2020) Cyber Sense Act of 2019 Sponsor: Rep. Latta, Robert E. [R-OH-5] S.1895 - 116th Congress (2019-2020) Lower Health Care Costs Act Sponsor: Sen. Alexander, Lamar [R-TN] S. 2897 - 116th Congress (2019-2020) Patient-Centered Outcomes Research Institute Reauthorization Act Sponsor: Sen. Mark Warner (D-VA) S. 2546 - 116th Congress (2019-2020) Safe Step Act Sen. Lisa Murkowski (R-AK) S. 2004 - 116th Congress (2019-2020) Ensuring FEDVIP and FLTCIP Coverage During Shutdowns Act Rep. Elijah Cummings (D-MD-07) H.R. 2774 - 116th Congress (2019-2020) Primary Care Patient Protection Act of 2019 Rep. Brad Schneider (D-IL-10)

Client expense: $1,840,000 · 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, White House Office

Affordable Care Act (ACA); ACA Regulations; ACA Stabilization; Health Reform; Rural Healthcare; Risk Adjustment; State Flexibility; Point of Sale; Opioids; Marketplace Stability; Individual Market Reform; CREATES Act; Sec. 1332 Waivers; Short Term Limited Duration (STLD): AHPs; Value-based Care; Health Care Costs; Mental Health; Small Business Plans; Single Payer; Reinsurance; CSRs; SNPs; FEHBP Issues; 42 CFR Part 2; Transparency; Silverloading; Health IT; Interoperability; Texas lawsuit; Surprise billing, Transparency, Small Business, State Flexibility; Biosimilars; Provider Directories; Postal Reform; Health Reimbursement Arrangements (HRAs), Outreach, Education, and Enrollment; Prior Authorization; All-payer claims database; Negotiated rate disclosure; Consumer-facing app disclosure; Medicare for All; Medicare Buy-in; Maternal health; Seniors health care; social determinants of health; Community health, Cybersecurity. H.R.1346 - 116th Congress (2019-2020) Medicare Buy-In and Health Care Stabilization Act of 2019 Sponsor: Rep. Higgins, Brian [D-NY-26] (Introduced 02/25/2019) H.R.1384 - 116th Congress (2019-2020) Medicare for All Act of 2019 Sponsor: Rep. Jayapal, Pramila [D-WA-7] (Introduced 02/27/2019) H.R.3502 - 116th Congress (2019-2020) Protecting People From Surprise Medical Bills Act Sponsor: Rep. Ruiz, Raul [D-CA-36] (Introduced 06/26/2019) H.R.1385 - 116th Congress (2019-2020) SAVE Act Sponsor: Rep. Kim, Andy [D-NJ-3] (Introduced 02/27/2019) H.R.1386 - 116th Congress (2019-2020) ENROLL Act of 2019 Sponsor: Rep. Castor, Kathy [D-FL-14] (Introduced 02/27/2019) H.R.987 - 116th Congress (2019-2020) Strengthening Health Care and Lowering Prescription Drug Costs Act Sponsor: Rep. Blunt Rochester, Lisa [D-DE- At Large] (Introduced 02/06/2019) H.R.986 - 116th Congress (2019-2020) Protecting Americans with Preexisting Conditions Act of 2019 Sponsor: Rep. Kuster, Ann M. [D-NH-2] (Introduced 02/06/2019) H.R.1425 - 116th Congress (2019-2020) State Health Care Premium Reduction Act Sponsor: Rep. Craig, Angie [D-MN-2] (Introduced 02/28/2019) H.R.1143 - 116th Congress (2019-2020) Educating Consumers on the Risks of Short-Term Plans Act of 2019 Sponsor: Rep. Eshoo, Anna G. [D-CA-18] (Introduced 02/11/2019) H.R.1520 - 116th Congress (2019-2020) Purple Book Continuity Act of 2019 Sponsor: Rep. Eshoo, Anna G. [D-CA-18] (Introduced 03/05/2019) S.1895 - 116th Congress (2019-2020) Lower Health Care Costs Act Sponsor: Sen. Alexander, Lamar [R-TN] (Introduced 06/19/2019) H.R.1046 - 116th Congress (2019-2020) Medicare Negotiation and Competitive Licensing Act of 2019 Sponsor: Rep. Doggett, Lloyd [D-TX-35] (Introduced 02/07/2019) H.R.2902 - 116th Congress (2019-2020) Maternal CARE Act Sponsor: Rep. Adams, Alma S. [D-NC-12] (Introduced 05/22/2019) H.R.3630 - 116th Congress (2019-2020) No Surprises Act Sponsor: Rep. Pallone, Frank, Jr. [D-NJ-6] (Introduced 07/09/2019) H.R.4378 - 116th Congress (2019-2020) Continuing Appropriations Act, 2020, and Health Extenders Act of 2019 Sponsor: Rep. Lowey, Nita M. [D-NY-17] (Introduced 09/18/2019) H.R.2328 - 116th Congress (2019-2020) Community Health Investment, Modernization, and Excellence Act of 2019 Sponsor: Rep. O'Halleran, Tom [D-AZ-1] (Introduced 04/15/2019) H.R.3439 - 116th Congress (2019-2020) PATIENT Act Sponsor: Rep. Beyer, Donald S., Jr. [D-VA-8] (Introduced 06/24/2019) H.R.3107 - 116th Congress (2019-2020) Improving Seniors' Timely Access to Care Act of 2019 Sponsor: Rep. DelBene, Suzan K. [D-WA-1] (Introduced 06/05/2019) H.R.4004 - 116th Congress (2019-2020) Social Determinants Accelerator Act of 2019 Sponsor: Rep. Bustos, Cheri [D-IL-17] (Introduced 07/25/2019) H.R.2279 - 116th Congress (2019-2020) Safe Step Act Sponsor: Rep. Ruiz, Raul [D-CA-36] (Introduced 04/10/2019) S. 1895-116th Congress (2019-2020) Lower Health Care Costs Act Sponsor: Sen. Alexander, Lamar [R-TN](Introduced 06/19/2019) S2897-116th Congress (2019-2020) Patient-Centered Outcomes Research Institute Reauthorization Act Sponsor: Sen. Warner, Mark (D-VA) (Introduced 11/19/2019)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 3: A bill to establish a fair price negotiation program, protect the Medicare program from excessive price increases, and establish an out-of-pocket maximum for Medicare part D enrollees, and for other purposes. S 2543: A bill to amend titles XI, XVIII, and XIX of the Social Security Act to lower prescription drug prices in the Medicare and Medicaid programs, to improve transparency related to pharmaceutical prices and transactions, to lower patients' out-of-pocket costs, and to ensure accountability to taxpayers, and for other purposes. HR 4070: A bill to streamline the employer reporting process and strengthen the eligibility verification process for the premium assistance tax credit and cost-sharing subsidy. HR 3796: A bill to amend the Internal Revenue Code of 1986 to provide that coverage under Medicare is permissible for purposes of contributions to health savings accounts. HR 861: A bill to amend title XVIII of the Social Security Act to prevent surprise billing practices, and for other purposes. HR 3276: A bill to amend title XIX of the Social Security Act to exclude authorized generic drugs from calculation of the average manufacturer price for purposes of the Medicaid drug rebate program, and for other purposes. HR 2113: A bill to a mend titles XI and XVIII of the Social Security Act to provide for drug manufacturer price transparency, to require certain manufacturers to report on product samples provided to certain health care providers, and for other purposes. H.R. 2447: A bill to fully repeal the Health Insurance Tax S. 80: A bill to fully repeal the Health Insurance Tax H.R. 2782: This bill increases the hours of service required for an employee to be classified as a full-time employee for purposes of the employer mandate under the Patient Protection and Affordable Care Act to provide minimum essential health care coverage to full-time employees. The bill increases the hours of service threshold from an average of at least 30 hours of service a week to an average of at least 40 hours of service a week. S. 1510: This bill increases the hours of service required for an employee to be classified as a full-time employee for purposes of the employer mandate under the Patient Protection and Affordable Care Act to provide minimum essential health care coverage to full-time employees. The bill increases the hours of service threshold from an average of at least 30 hours of service a week to an average of at least 40 hours of service a week. H.R.2564: This bill creates a special Medicare enrollment period for individuals enrolled in, or transitioning out of, continuation coverage under the Consolidated Omnibus Budget Reconciliation Act (COBRA)-a federal law that allows an individual to maintain health coverage following loss of coverage due to termination of employment or another qualifying event. H.R. 1682: This bill deems an individual receiving outpatient observation services in a hospital as an inpatient for purposes of satisfying the three-day inpatient hospital-stay requirement with respect to Medicare coverage of skilled nursing facility services. H.R. 1384: This bill establishes a national health insurance program that is administered by the Department of Health and Human Services (HHS). S. 1129: This bill establishes a national health insurance program that is administered by the Department of Health and Human Services (HHS). S. 981: A bill to establish a public health plan. H.R. 1346: To amend title XVIII of the Social Security Act to provide for an option for individuals who are ages 50 to 64 to buy into Medicare, to provide for health insurance market stabilization, and for other purposes. S. 470: To amend title XVIII of the Social Security Act to provide for an option for any citizen or permanent resident of the United States age 50 to 64 to buy into Medicare. S. 1895: A bill to lower health care costs by preventing surprise medical bills, reducing prescription drug prices, improving transparency in health care, investing in public health and improving health information exchange. H.R. 3630: To amend title XXVII of the Public Health Service Act to protect health care consumers from surprise billing practices, and for other purposes. HR 1682: A bill to amend title XVIII of the Social Security Act to count a period of receipt of outpatient observation services in a hospital toward satisfying the 3-day inpatient hospital stay requirement for coverage of skilled nursing facility services under Medicare, and for other purposes. S 753: A bill to amend title XVIII of the Social Security Act to count a period of receipt of outpatient observation services in a hospital toward satisfying the 3-day inpatient hospital requirement for coverage of skilled nursing facility services under Medicare. HR 748: A bill to amend the Internal Revenue Code of 1986 to repeal the excise tax on high cost employer-sponsored health coverage. S 684: A bill to amend the Internal Revenue Code of 1986 to repeal the excise tax on high cost employer-sponsored health coverage. HR 1884: A bill to amend the Patient Protection and Affordable Care Act to improve affordability of, undo sabotage with respect to, and increase access to health insurance coverage, and for other purposes. S 172: A bill to delay the reimposition of the annual fee on health insurance providers until after 2021. HR 1398: A bill to delay the reimposition of the annual fee on health insurance providers until after 2021. S 80: A bill to repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act. HR 1385: A bill to amend the Patient Protection and Affordable Care Act to preserve the option of States to implement health care marketplaces, and for other purposes HR 1386: A bill to amend the Patient Protection and Affordable Care Act to provide for additional requirements with respect to the navigator program, and for other purposes. HR 987: A bill to amend the Patient Protection and Affordable Care Act to provide for Federal Exchange outreach and educational activities. HR 986: A bill to provide that certain guidance related to waivers for State innovation under the Patient Protection and Affordable Care Act shall have no force or effect. HR 100: A bill to provide that the rule entitled Short-Term, Limited Duration Insurance shall have no force or effect. HR 1425: A bill to amend the Patient Protection and Affordable Care Act to provide for a Improve Health Insurance Affordability Fund to provide for certain reinsurance payments to lower premiums in the individual health insurance market. HR 938: A bill to amend the Federal Food, Drug, and Cosmetic Act, with respect to eligibility for approval of a subsequent generic drug, to remove the barrier to that approval posed by the 180-day exclusivity period afforded to a first generic applicant that has not yet received final approval, and for other purposes HR 1520: A bill to amend the Public Health Service Act to provide for the publication of a list of licensed biological products, and for other purposes. HR 1503: A bill to amend the Federal Food, Drug, and Cosmetic Act regarding the list under section 505(j)(7) of the Federal Food, Drug, and Cosmetic Act, and for other purposes. HR (No Bill #) Payment Commission Data Act of 2019: A bill to amend titles XVIII and XIX of the Social Security Act to provide the Medicare Payment Advisory Commission and the Medicaid and CHIP Payment and Access Commission with access to certain drug payment information, including certain rebate information. HR 1499: A bill prohibit brand name drug manufacturers from compensating generic drug manufacturers to delay the entry of a generic drug into the market, and to prohibit biological product manufacturers from compensating biosimilar and interchangeable product manufacturers to delay entry of biosimilar and interchangeable products, and for other purposes. HR 965: 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. H.R. 1158: An act making consolidated appropriations for the fiscal year ending September 30, 2020, and for other purposes. H.R. 1865: An act making consolidated appropriations for the fiscal year ending September 30, 2020, and for other purposes. H.R. 2477: A bill to amend title XVIII of the Social Security Act to establish a system to notify individuals approaching Medicare eligibility, to simplify and modernize the eligibility enrollment process, and for other purposes. S. 1280: A bill to amend title XVIII of the Social Security Act to establish a system to notify individuals approaching Medicare eligibility, to simplify and modernize the eligibility enrollment process, and for other purposes. H.R. 3708: A bill to amend the Internal Revenue Code of 1986 to allow individuals with direct primary care service arrangements to remain eligible individuals for purposes of health savings accounts, and for other purposes. S. 2999: A bill to amend the Internal Revenue Code of 1986 to allow individuals with direct primary care service arrangements to remain eligible individuals for purposes of health savings accounts. H.R. 3: An act to establish a fair price negotiation program, protect the Medicare program from excessive price increases, and establish an out-of-pocket maximum for Medicare part D enrollees, and for other purposes. S. 2543: A bill to amend titles XI, XVIII, and XIX of the Social Security Act to lower prescription drug prices in the Medicare and Medicaid programs, to improve transparency related to pharmaceutical prices and transactions, to lower patients' out-of-pocket costs, and to ensure accountability to taxpayers, and for other purposes. H.R. 1277: 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 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 H.R. 2000: A bill to establish a public health plan H.R. 2452: A bill to amend the Social Security Act to establish a Medicare for America health program to provide for comprehensive health coverage for all Americans. H.R. 2463: A bill to provide for the establishment of Medicare part E public health plans, and for other purposes. H.R. 4527: A bill to amend title XVIII of the Social Security Act to provide an option for first responders age 50 to 64 who are separated from service due to retirement or disability to buy into Medicare. H.R. 2085: A bill to amend the Public Health Service Act to establish a public health insurance option, and for other purposes.

Client expense: $330,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Treasury, Dept of, White House Office

Affordable Care Act (ACA); ACA Regulations; ACA Stabilization; Health Reform; Rural Healthcare; Risk Adjustment; State Flexibility; Opioids; Sober Homes; Marketplace Stability; Individual Market Reform; Value-based Care; Health Care Costs; Mental Health; Small Business Plans; Reinsurance; CSRs; Transparency; Silverloading; Texas lawsuit; Surprise billing, Small Business; Outreach, Education, and Enrollment; Prior Authorization; All payer claims database; Negotiated rate disclosure; Provider directories; Medicare for All; Medicare Buy-in; Social determinants of health; NBPP (Notice Benefit and Payment Parameters); provider contracting, restrictions on steering and tiering H.R.1346 - 116th Congress (2019-2020) Medicare Buy-In and Health Care Stabilization Act of 2019 Sponsor: Rep. Higgins, Brian [D-NY-26] (Introduced 02/25/2019) H.R.1384 - 116th Congress (2019-2020) Medicare for All Act of 2019 Sponsor: Rep. Jayapal, Pramila [D-WA-7] (Introduced 02/27/2019) H.R.3502 - 116th Congress (2019-2020) Protecting People From Surprise Medical Bills Act Sponsor: Rep. Ruiz, Raul [D-CA-36] (Introduced 06/26/2019) Cosponsors: (48) H.R.1385 - 116th Congress (2019-2020) SAVE Act Sponsor: Rep. Kim, Andy [D-NJ-3] (Introduced 02/27/2019) H.R.1386 - 116th Congress (2019-2020) ENROLL Act of 2019 Sponsor: Rep. Castor, Kathy [D-FL-14] (Introduced 02/27/2019) H.R.987 - Strengthening Health Care and Lowering Prescription Drug Costs Act 116th Congress (2019-2020) Sponsor: Rep. Blunt Rochester, Lisa [D-DE-At Large] (Introduced 02/06/2019) H.R.1010 - 116th Congress (2019-2020) To provide that the rule entitled "Short-Term, Limited Duration Insurance" shall have no force or effect. Sponsor: Rep. Castor, Kathy [D-FL-14] (Introduced 02/06/2019) H.R.986 - 116th Congress (2019-2020) Protecting Americans with Preexisting Conditions Act of 2019 Sponsor: Rep. Kuster, Ann M. [D-NH-2] (Introduced 02/06/2019) H.R.1425 - 116th Congress (2019-2020) State Health Care Premium Reduction Act Sponsor: Rep. Craig, Angie [D-MN-2] (Introduced 02/28/2019) H.R.1143 - 116th Congress (2019-2020) Educating Consumers on the Risks of Short-Term Plans Act of 2019 Sponsor: Rep. Eshoo, Anna G. [D-CA-18] (Introduced 02/11/2019) S.1895 - 116th Congress (2019-2020) Lower Health Care Costs Act Sponsor: Sen. Alexander, Lamar [R-TN] (Introduced 06/19/2019) H.R.1046 - 116th Congress (2019-2020) Medicare Negotiation and Competitive Licensing Act of 2019 Sponsor: Rep. Doggett, Lloyd [D-TX-35] H.R.3630 - 116th Congress (2019-2020) No Surprises Act Sponsor: Rep. Pallone, Frank, Jr. [D-NJ-6] H.R.4378 - 116th Congress (2019-2020) Continuing Appropriations Act, 2020, and Health Extenders Act of 2019 Sponsor: Rep. Lowey, Nita M. [D-NY-17] H.R.3439 - 116th Congress (2019-2020) PATIENT Act Sponsor: Rep. Beyer, Donald S., Jr. [D-VA-8] H.R.3107 - 116th Congress (2019-2020) Improving Seniors' Timely Access to Care Act of 2019 Sponsor: Rep. DelBene, Suzan K. [D-WA-1] H.R.4004 - 116th Congress (2019-2020) Social Determinants Accelerator Act of 2019 Sponsor: Rep. Bustos, Cheri [D-IL-17] H.R.2279 - 116th Congress (2019-2020) Safe Step Act Sponsor: Rep. Ruiz, Raul [D-CA-36] S. 2897 - 116th Congress (2019-2020) Patient-Centered Outcomes Research Institute Reauthorization Act Sponsor: Sen. Mark Warner (D-VA) S. 2546 - 116th Congress (2019-2020) Safe Step Act Sen. Lisa Murkowski (R-AK)

Client expense: $330,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1389 - Safe Home Act of 2019 H.R. 1386 - the Enroll Act of 2019 H.R. 987 - the MORE Health Education Act of 2019 HR 1010 - a bill to provide that the rule entitled Short-Term, Limited Duration Insurance shall have no force or effect H.R. 986 - Protecting Americans with Preexisting Conditions Act of 2019 H.R. 1425 - State Health Care Premium Reduction Act H.R. 1398/S. 172 - Health Insurance Tax Relief Act of 2019 S. 1895 - Lower Health Care Costs Act H.R. 4378 - Continuing Appropriations Act and Health Extenders Act H.R. 861 - End Surprise Billing Act H.R. 3502 - Protecting People from Surprise Medical Bills Act S. 1531 - Stopping Surprise Medical Bills Act no specific bills, health care reform, health savings accounts, reinsurance, cost sharing reductions (CSRs), special needs plans, third party payment, Risk ratios, individual market reform, market stability, Grace periods, Special Enrollment Period, opioids, surprise billing, transparency, all provider claims database

Client expense: Not reported · Firm income: $60,000

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

H.R. 938, Bringing Low-cost Options and Competition while Keeping Incentives for New Generics (BLOCKING) Act of 2019, regarding all bio-pharmaceutical related provisions. H.R. 985, Fair Access for Safe and Timely (FAST) Generics Act of 2019, regarding all bio-pharmaceutical related provisions. H.R. 986, Protecting American with Preexisting Conditions Act of 2019, regarding all bio-pharmaceutical related provisions. H.R. 987, Marketing and Outreach Restoration to Empower Health Education Act of 2019, regarding all bio-pharmaceutical related provisions. H.R. 1010, Short-Term, Limited Duration Insurance (STLDI), regarding all bio-pharmaceutical related provisions. H.R. 1323, Rural Hospital Frontier Fairness Act, regarding all bio-pharmaceutical related provisions. H.R. 1385, State Allowance for a Variety of Exchanges (SAVE) Act, regarding all bio-pharmaceutical related provisions. H.R. 1386, Expanded Navigators Resources for Outreach, Learning, and Longevity (ENROLL) Act, regarding all bio-pharmaceutical related provisions. H.R. 1409, Transparency in All Health Care Pricing Act, regarding all bio-pharmaceutical related provisions. H.R. 1425, State Health Care Premium Reduction Act, regarding all bio-pharmaceutical related provisions. H.R. 1478, Insulin importation, regarding all bio-pharmaceutical related provisions. H.R. 1503, Orange Book Transparency Act, regarding all bio-pharmaceutical related provisions. H.R. 1506, Fair and Immediate Release (FAIR) of Generics Act, regarding all bio-pharmaceutical related provisions. H.R. 1520, Purple Book Continuity Act, regarding all bio-pharmaceutical related provisions. H.R. 2011, Protecting Access to Biosimilars Act of 2019, regarding all bio-pharmaceutical related provisions. H.R. 2038, State-based , Market-Oriented, Prescription Drug Negotiations Act of 2019, regarding all bio-pharmaceutical related provisions. H.R. 2064, Product Sample reporting, regarding all bio-pharmaceutical related provisions. S. 61, Safe and Affordable Drugs from Canada Act, regarding all bio-pharmaceutical related provisions. S. 97, Affordable and Safe Drug Importation Act, regarding all bio-pharmaceutical related provisions. S. 102, Prescription Drug Price Relief Act, regarding all bio-pharmaceutical related provisions. S. 344/H.R. 990, Hatch-Waxman Integrity Act, regarding all bio-pharmaceutical related provisions. S. 366/H.R. 1188, FLAT Prices Act- Reduced exclusivity period for certain price hikes, regarding all bio-pharmaceutical related provisions. S. 418, FDA Accountability for Public Safety Act, regarding all bio-pharmaceutical related provisions. S. 419, Protecting Americans from Dangerous Opioids Act, regarding all bio-pharmaceutical related provisions. S. 637, CURE High Drug Prices Act, regarding all bio-pharmaceutical related provisions. S. 657, Drug Price Transparency Act, regarding all bio-pharmaceutical related provisions. S. 658, Accelerated Drug Approval for Prescription Therapies Act, regarding all bio-pharmaceutical related provisions. S. 659, Biologic Patent Transparency Act, regarding all bio-pharmaceutical related provisions. S. 660, Transparency in Petitions Act, regarding all bio-pharmaceutical related provisions. S. 709, Establishes public dashboard for price and utilization of drugs purchased by federal programs, regarding all bio-pharmaceutical related provisions. S. 741 /H.R. 1730, Cancer Drug Parity Act, regarding all bio-pharmaceutical related provisions. S. 844, Short Competition Act, regarding all bio-pharmaceutical related provisions. S. 977, Transparent Drug Pricing Act of 2019, regarding all bio-pharmaceutical related provisions. S. 989, STEER Act, regarding all bio-pharmaceutical related provisions. S. 1140, A bill to amend the Public Health Service Act with respect to the treatment under section 351(k)(7) of such Act (relating to exclusivity for reference products) of certain products deemed to have a biological product license pursuant to section 7002 of the Biologics Price Competition and Innovation Act of 2009, regarding all bio-pharmaceutical related provisions. S.1169, FDA citizen petition, regarding all bio-pharmaceutical related provisions. S. 1209, A bill to amend the Federal Food, Drug, and Cosmetic Act with respect to approval of abbreviated new drug applications, regarding all bio-pharmaceutical related provisions. H.R. 2115, Public Disclosure of Drug Discounts Act, regarding all bio-pharmaceutical related provisions H.R.2296/S.1391, FAIR Drug Pricing Act, regarding all bio-pharmaceutical related provisions H.R.2700, Lowering Prescription Drug Costs and Extending Community Health Centers and other Health Priorities Act, regarding all bio-pharmaceutical related provisions H.R. 3223, Pharmacy Benefit Manager Accountability Study Act, regarding all bio-pharmaceutical related provisions S. 1361/H.R.2584, Preventive Health Savings Act, regarding all bio-pharmaceutical related provisions S. 1437, DTC Act, regarding all bio-pharmaceutical related provisions S.1532, Pharmacy Benefit Managers Accountability Study Act, regarding all bio-pharmaceutical related provisions S.1636, Ensuring Innovation Act, regarding all bio-pharmaceutical related provisions S. 1664, Prescription Drug Price Reporting Act, regarding all bio-pharmaceutical related provisions S. 1801, Affordable Medications Act, regarding all bio-pharmaceutical related provisions S. 1895, Lowering Health Costs Act, regarding all bio-pharmaceutical related provisions S. 1897, a bill to establish a process for updating the labeling of certain drugs with outdated labeling, regarding all bio-pharmaceutical related provisions S. 1897/H.R. 3523, End Price Gouging for Medications Act, regarding all bio-pharmaceutical related provisions S. 2004, Emergency Access to Insulin Act, regarding all bio-pharmaceutical related provisions H.R. 2279/S. 2546, Safe Step Act of 2019, regarding all bio-pharmaceutical related provisions

Client expense: $690,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE, U.S. Trade Representative (USTR)

Affordable Care Act (ACA); ACA Regulations; ACA Stabilization; Health Reform; Risk Adjustment; State Flexibility; Opioids; Marketplace Stability; Individual Market Reform; Value-based Care; Health Care Costs; Mental Health; Small Business Plans; Short Term Limited Duration Insurance (STLDI) Plans; Reinsurance; Cost Sharing Reductions (CSRs); Transparency; Silver Loading; Texas v. U.S. Lawsuit; Interoperability; Health Reimbursement Arrangements (HRAs); Surprise Billing; All Payer Claims Database; Negotiated Rate Disclosure; Provider Directories; Medicare for All; Medicare Buy-in; Outreach, Education, and Enrollment; Social Determinants of Health; 2021 Notice of Benefit and Payment Parameters (NBPP) HR 986 (116th Congress), Protecting Americans with Pre-existing Conditions Act of 2019, by Rep. Ann Kuster (D-NH). To provide that certain guidance related to waivers for State innovation under the Patient Protection and Affordable Care Act shall have no force or effect. HR 987 (116th Congress), MORE Health Education Act, by Rep. Lisa Blunt Rochester (D-DE). To amend the Patient Protection and Affordable Care Act to provide for Federal Exchange outreach and educational activities. HR 1010 (116th Congress) by Rep. Kathy Castor (D-FL). To provide that the rule entitled Short-Term Limited Duration Insurance shall have no force or effect. HR 1143 (116th Congress), Educating Consumers on the Risks of Short-Term Plans Act of 2019, by Rep. Anna Eshoo (D-CA). To amend title XXVII of the Public Health Service Act to require a health insurance issuer offering short-term limited duration insurance to include a standardized disclosure and certain information with respect to coverage exclusions and premium variations in marketing, application, and enrollment materials distributed in connection with such insurance and prohibiting the sale of such insurance during certain periods. HR 1346 (116th Congress), Medicare Buy-In and Health Care Stabilization Act of 2019, by Rep. Brian Higgins (D-NY). To amend title XVIII of the Social Security Act to provide for an option for individuals who are ages 50 to 64 to buy into Medicare, to provide for health insurance market stabilization, and for other purposes. HR 1384 (116th Congress), Medicare for All Act of 2019, by Rep. Pramila Jayapal (D-WA). To establish an improved Medicare for All national health insurance program. HR 1385 (116th Congress), SAVE Act, by Rep. Andy Kim (D-NJ). To amend the Patient Protection and Affordable Care Act to preserve the option of States to implement health care marketplaces. HR 1386 (116th Congress), ENROLL Act of 2019, by Rep. Kathy Castor (D-FL). To amend the Patient Protection and Affordable Care Act to provide for additional requirements with respect to the navigator program. HR 1425 (116th Congress), State Health Care Premium Reduction Act, by Rep. Angie Craig (D-MN). To amend the Patient Protection and Affordable Care Act to provide for a Improve Health Insurance Affordability Fund to provide for certain reinsurance payments to lower premiums in the individual health insurance market. HR 2274 (116th Congress), Primary Care Patient Protection Act of 2019, by Rep. Brad Schneider (D-IL). To amend the Internal Revenue Code of 1986 to require coverage without a deductible of certain primary care services by high deductible health plans. HR 2279 (116th Congress), Safe Step Act, by Rep. Raul Ruiz (D-CA). To amend the Employee Retirement Income Security Act of 1974 to require a group health plan (or health insurance coverage offered in connection with such a plan) to provide an exceptions process for any medication step therapy protocol, and for other purposes. HR 3502 (116th Congress), Protecting People from Surprise Medical Bills Act, by Rep. Raul Ruiz (D-CA). To amend the Public Health Service Act and title XI of the Social Security Act to protect health care consumers from surprise billing practices, and for other purposes. HR 3630 (116th Congress), No Surprises Act, by Rep. Frank Pallone, Jr. (D-NJ). To amend title XXVII of the Public Health Service Act to protect health care consumers from surprise billing practices, and for other purposes. HR 4004 (116th Congress), Social Determinants Accelerator Act of 2019, by Rep. Cheri Bustos (D-IL). To direct the Secretary of Health and Human Services to establish an interagency council on social determinants of health, and for other purposes. HR 4378 (116th Congress), Continuing Appropriations Act 2020, and Health Extenders Act of 2019, by Rep. Nita Lowey (D-NY). Making continuing appropriations for fiscal year 2020, and for other purposes. S 1895 (116th Congress), Lower Health Care Costs Act, by Sen. Lamar Alexander (R-TN). To lower health care costs.

Client expense: $490,000 · 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), Office of Personnel Management (OPM), SENATE, Treasury, Dept of, White House Office

Medicare, Medicaid, private insurance and other health care policies that impact patient access to cardiovascular care, including H.R. 1010, the "ENROLL Act (H.R. 1386)", the "State Health Care Premium Reduction Act of 2019 (H.R. 1425)", the "Protecting Americans with Pre-Existing Conditions Act of 2019 (H.R. 466)", the "Educating Consumers on the Risk of Short Term Plans Act of 2019 (H.R. 1143)", the "Strengthening Health Care and Lowering Prescription Drug Costs Act (S. 987)", the "Lowering Health Care Costs Act (S. 1895)", the "No Surprises Act (H.R. 3630)" and "Increasing Access to Quality Rehabilitation Care Act of 2019 (H.R. 3911, S.2842)" and the "Further Consolidated Appropriations Act, 2020".

Client expense: Not reported · Firm income: $12,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

- H.R. 965/ S. 340, Creating and Restoring Equal Access To Equivalent Samples Act of 2017 (CREATES Act), support passage. - H.R. 985, Fair Access for Safe and Timely Generics Act of 2017 (FAST Generics Act), support passage. -H.R. 2035/S. 995, Lifespan Respite Care Reauthorization Act, support reauthorization - H.R. 3208/ S.1755 - Real Emergency Access for Aging and Disability Inclusion for Disasters Act, support passage - H.R. 3215/ S. 1754 - Disaster Relief Medicaid Act, support passage - S.2400/ H.R. 4322 - Expanding Cannabis Research and Information Act, support passage - H.R. 3439 - Reauthorization of the Patient Centered Outcomes Research Institute, support reauthorization. -H.R. 2781 - Empower for Health Act of 2019, support passage -H.R. 2035, Lifespan Respite Care Reauthorization Act of 2019, support passage -H.R. 2296/S.1391 - FAIR Drug Pricing Act of 2019, support passage - H.R. 3630 - No Surprises Act, support passage -H.R. 1010, To provide that the rule entitled Short-Term, Limited Duration Insurance shall have no force or effect, support passage. -H.R. 986, The Protecting Americans with Preexisting Conditions Act of 2019, support passage. -H.R.1386, Expand Navigators Resources for Outreach, Learning, and Longevity (ENROLL) Act of 2019, support passage. -H.R. 2293, the Protecting Access to Wheelchairs Act, support passage. -H.R. 2408, the Ensuring Access to Quality Complex Rehabilitation technology Act, support passage. -H.R 3 - Lower Drug Costs Now Act of 2019, support passage - H.R. 2387, the Stop The Overuse of Petitions and Get Affordable Medicines to Enter Soon (STOP GAMES) Act of 2019, support passage - H.R. 3107, Improving Seniors Timely Access to Care Act of 2019, support passage -S. 1935, Family Coverage Act, support passage. -S.1556, No Junk Plans Act, support passage. -S. 1223, the Protecting Beneficiary Access to Complex Rehab Technology Act, support passage - S.475, Reducing Existing Costs Associated with Pharmaceuticals for Seniors Act of 2019 (RX Cap Act), support passage - S. 637, Combatting Unreasonable Rises and Excessively High Drug Prices Act (CURE High Drug Prices Act), support passage - S.366, Forcing Limits on Abusive and Tumultuous Prices (FLAT Prices) Act, support passage -S. 63, Preserve Access to Affordable Generics and Biosimilars Act, support passage -S. 659, Biologic Patent Transparency Act, support passage -S.1895 - Lower Health Care Costs Act, support passage - S. 1280/HR 2477 - Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act, support passage - S. 691 - Medicare Extra Rx Help Act- support passage - S. 2543 - Prescription Drug Price Reduction Act of 2019 - support passage - Menendez - Lankford- Cardin-Daines Amendment 1 Incentivizing Generic and Biosimilar Use in Medicare Part D - support adoption -Menendez -Lankford - Cardin --Daines Amendment 2 Incentivizing Generic Use in Medicare Part D - support adoption -S, 1801, Low Cost Generics Act of 2019, support passage -S.2911, the Seniors Prescription Drug Relief Act of 2019, support passage.

Client expense: $83,990 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Health care issues affecting individuals with neuromuscular disease including therapy development, newborn screening, adequate insurance coverage, and access to care. Advocated for the passage of the Newborn Screening Saves Lives Reauthorization Act, H.R. 2507 / S. 2158, to encourage investment in the national newborn screening program in order to detect more neuromuscular conditions early to speed appropriate interventions for patients. Advocated for increased funding for National Institutes of Health, Food and Drug Administration, Health Resources and Services Administration, and other health agencies that conduct research on neuromuscular disease and provide services to those with these conditions. Advocated for adequate, affordable, accessible health coverage for individuals with neuromuscular conditions. Cited opposition to the expansion of Section 1115 demonstration waivers that would create substantial barriers to care for patients and families who enroll in Medicaid. Advocated in opposition to proposed action on the part of the Office of Management and Budget to amend the federal poverty measure in a manner that may impact the ability of individuals with neuromuscular disease and their caregivers to access necessary safety-net supports such as Medicaid, state health programs, and other services. Advocated in favor of activities to improve outreach and enrollment for individuals to who acquire health insurance on the individual marketplace including: (1) a provision added to H.R. 987 that would require the Department of Health and Human Services to resume activities related to outreach and educational activities for open enrollment; and (2) H.R.1386, Expand Navigators Resources for Outreach, Learning, and Longevity (ENROLL) Act of 2019. Advocated for passage of H.R. 986, the Protecting Americans with Preexisting Conditions Act of 2019, which would require the Administration to rescind its Section 1332 State Relief and Empowerment Waivers Guidance, released on October 22, 2018 (1332 guidance). The guidance would allow states to let individuals use advanced premium tax credits to purchase non-compliant short-term, limited duration insurance plans-which could further draw younger, healthier people out of the risk pool for comprehensive insurance and drive up premiums for those who need comprehensive coverage, such as individuals with neuromuscular conditions. Also advocated for the passage of H.R. 1010, legislation to provide that the rule entitled Short-Term, Limited Duration Insurance shall have no force or effect. Advocated maintaining strong incentives for rare disease drug development included within the Orphan Drug Act (PL 97-414) Advocated for the continuance of the Rare Pediatric Disease Priority Review Voucher Program within the context of the Creating Hope Reauthorization Act (H.R.4439)

Client expense: $60,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Aviation Administration (FAA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Transportation, Dept of (DOT)