Improving Access to Medicare Coverage Act of 2019

Additional Coronavirus Health Care Relief. S. 178, H.R. 925, S. 4108, H.R. 6539 and H.R. 6800: Proposals to increase the Medicaid federal medical assistance percentage (FMAP), expand Medicare coverage for COVID related services, increase FMAP funding specifically for Medicaid home and community-based services; improve nursing home oversight, provide funding for COVID testing; ensure tele-visitation for nursing home residents, and eliminate cost sharing for COVID treatment. COVID Drug Database. H.R. 7288 and S. 4539, the Taxpayer Research and Coronavirus Knowledge Act of 2020: Proposals to require a single user-friendly database of federal biomedical investments in COVID-19 vaccines, drugs, therapies, medical devices, or other products. COVID Drug Pricing. H.R. 7296, the Make Medications Affordable by Preventing Pandemic Price-gouging Act: Proposals to prohibit pharmaceutical companies from exclusive licensing of drugs used to treat or prevent COVID-19. Health Care Extenders. H.R. 8337, the Continuing Appropriations Act, 2021: Proposals to extend the Medicaid Money Follows the Person Program which provides states money to keep seniors in their homes; and extend spousal impoverishment protections in Medicaid to long term care services provided in the home. Infection Control in Nursing Homes. H.R. 6698 and S. 3644, the Quality Care for Nursing Home Residents and Workers During COVID-19 Act: Proposal to authorize $500 million for states to establish expert strike teams for resident and worker safety to be deployed within 72 hours of 3+ confirmed or suspected COVID-19 cases in a facility. Medicare Coverage of Vaccines. H.R. 5076 and S. 1872, the Protecting Seniors Through Immunization Act of 2019: Proposals to expand Medicare to cover all adult vaccines recommended by the Advisory Committee on Immunization Practices without any cost-sharing for Part D. Medicare Enrollment. H.R. 2477, the BENES Act of 2020, changes the Medicare general enrollment period to October 15-December 31, and requires coverage to begin on the first day of the month following enrollment. (The general enrollment period has been January 1-March 31, and coverage begins July 1.) Medicare Enrollment. H.R. 2564, Medicare Enrollment Protection Act: Proposal to 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. Medicare Enrollment. The Consolidated Appropriations Act of 2021 (P.L. 116-260): Proposal to extending funding for enrollment assistance to help low-income seniors access the Medicare Prescription Drug Program Part D Low-Income Subsidy. Medicare Telehealth. Proposal to support efforts at Center for Medicare and Medicaid Services to continue access to telehealth during the COVID pandemic. Nursing Home Telehealth Visitation. H.R. 6487 and S. 3517, the ACCESS Act: Proposal requiring that residents have access to telehealth visitation during the pandemic. Medical Expense Deduction. The Consolidated Appropriations Act of 2021 (P.L. 116-260): Proposal to include a permanent extension of the 7.5 percent threshold for the medical expense deduction. Medicare Structure. Letter to Biden Transition team. Proposals to modify Medicare including changing to premium support model, lowering the eligibility age, furthering privatization of the program, adding hearing dental and vision coverage. Medicare Prescription Drugs: Letter to Biden transition team. Proposals to allow Medicare to negotiate prices with drug makers, cap prices at inflation in Part B and D, cap beneficiary out-of-pocket costs in Part D. Drug Pricing. Letter to Biden transition team. Proposals to allow generics to come to market earlier by limiting brand manufacturers ability to pay generics to delay entering the market. Short Term Care Coverage. H.R. 1682, Improving Access to Medicare Coverage Act of 2019: Proposal 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.

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

Government targets: Administration on Aging, 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), Justice, Dept of (DOJ), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Social Security Administration (SSA), Treasury, Dept of, U.S. Postal Service (USPS)

S. 2574 Protects Act H.R. 3398 Pathways to Health Careers Act H.R.4468- Nursing Home Workforce Quality Act Outreach to Hill on GAO Report "Federal Requirements for Oversight in Nursing Homes and Assisted Living Facilities Differ" Outreach to CMS: PDPM Implementation The Improving Access to Medicare Coverage Act of 2019 (H.R. 1682/S. 753) Observation Stays Issue Outreach to HHS/CMS/Administration Skilled Nursing Facility Requirements of Participation, RIN 0938-AR61 Survey Relief/Civil Monetary Penalties Payroll Based Journal - Section 6106 of the Affordable Care Act Outreach to HHS/ACL on Implementation of the Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (Public Law No: 115-119). Allow Secretarial discretion of CNA Training termination pertaining to Sec. 1819 (f)(2)(B)(iii)(l)(c). S. 2993- Ensuring Seniors Access to Quality Care Act S 2943/HR 5216 Quality Care for Nursing Home Residents Act of 2019 HR 5326 Fairness in Nursing Home Arbitration Act H.R.5897/S.3297 - Preventing Abuse and Neglect of Vulnerable Americans Act of 2020 Public Law 116-136, CARES Act Public Law 116-127 (H.R. 6201) Families First Coronavirus Response Act HR 6800 HEROES Act S. 3768/H.R. 6972 Nursing Home COVID-19 Protection and Prevention Act of 2020. S. 4108 A bill to amend title XIX of the Social Security Act to increase Federal support to State Medicaid programs during economic downturns, and for other purposes. S.3644 Quality Care for Nursing Home Residents and Workers During COVID-19 Act of 2020. H.R. 7048 Nursing Home Pandemic Protection Act H.R.6872 - SOS Act of 2020 H.R. 6849 Nursing Facility Quality Reporting Act of 2020 H.R. 6847 COHORT Act of 2020 Public Health Fund Distribution to HHS as agency CMS on Public Health Waiver and other waivers RUSH Act H.R. 6209/S.3447 H.R. 8574 amend titles XVIII and XIX of the Social Security Act to increase enforcement under Medicare and Medicaid for skilled nursing facilities and nursing facilities during the COVID-19 emergency period and other infectious disease outbreak periods, and for other purposes. S. 4666 National Coronavirus Commission Act of 2020 AHCA response to Ways and Means Committee report Under-Enforced and Over Prescribed: The Antipsychotic Drug Epidemic Ravings Americas Nursing Homes. BENES Act (S 1280/HR 2477) H.R.8874 - Nurses CARE Act of 2020

Client expense: $1,260,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), SENATE, Treasury, Dept of, Veterans Affairs, Dept of (VA)

Medicare Access and CHIP Reauthorization Act of 2015 implementation, Medicare physician payment reform, MEDPAC, surgical global payments, ACA implementation, health care reform, health care quality improvement, physician workforce issues, comparative clinical effectiveness research, health information technology, EHR meaningful use, EHR data blocking, Patient-Centered Outcomes Research Institute, MEDCAC, Centers for Medicare & Medicaid Innovation, registry access to Medicare claims data, lung cancer screenings, Agency for Healthcare Research & Quality, graduate medical education, electronic cigarette and cigar regulation, PTAC, meaningful use, congenital heart disease funding, unique device identifiers, medical liability reform, COVID-19 pandemic, tobacco riders in appropriations bills, tobacco regulation in the FDA, price transparency, ECMO coding, Prohibit Smoking in VA Facilities Act (S.2106/HR3700) Resident Physician Shortage Reduction Act (S.348/HR1763), Congenital Heart Futures Reauthorization Act, surprise billing, prior authorization, Women and Lung Cancer Research and Preventive Services Act (S.1107/HR2222), T21 bills, Transcatheter aortic valve replacement (TAVR), Increasing Access to Quality Cardiac Rehabilitation Act (HR.3911), Smoke-Free Schools Act of 2019 (HR.4019/S.1832), Protection for Veterans Burn Pits Exposure Act (HR.4086), The Coronavirus Aid, Relief, and Economic Security Act (H.R.748), Coronavirus Provider Protection Act (H.R.7059), Resident Physician Shortage Reduction Act of 2019 (S. 348/H.R. 1763), Quit Because of COVID-19 Act (H.R.7286), Tobacco to 21 Act (S.1258/H.R.2411), The Local Chamber, Tourism, and 501(c)(6) Protection Act (H.R.6697), Immediate Relief for Rural Facilities and Providers Act (S.3559/H.R.6365), Reversing the Youth Tobacco Epidemic Act of 2019 (H.R.2339), Vaccines Act of 2019 (H.R.2862), Investment in Tomorrow's Pediatric Health Care Workforce Act (S.2443), Protecting People from Surprise Medical Bills Act (H.R.3502), Stopping Appealing Flavors in E-Cigarettes for Kids Act (H.R.1498), Resident Education Deferred Interest (REDI) Act (H.R.1554), Improving Access to Medicare Coverage Act (H.R.1682), Traditional Cigar Manufacturing and Small Business Jobs Preservation Act of 2019 (H.R.1854), Women & Lung Cancer Research & Preventive Services Act (H.R.2222), Prevent BLEEDing Act of 2019 (H.R.2550), Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness (EMPOWER) for Health Act (H.R.2781), PCORI Reauthorization (H.R.3030), Improving Seniors Timely Access to Care Act (H.R.3107), Keep Physicians Serving Patients Act (H.R.3302), Stopping Appealing Flavors in E-Cigarettes for Kids Act (S.655), Improving Access to Medicare Coverage Act (S.753), Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020 (H.R. 8702/S.5007), Medicare Reimbursement Equity Act of 2020 (S.4932), To amend title XVIII of the Social Security Act to provide for a one-year waiver of budget neutrality adjustments under the Medicare physician fee schedule, and for other purposes (H.R. 8505)

Client expense: $86,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), SENATE, Social Security Administration (SSA)

Additional Coronavirus Health Care Relief. S. 178, H.R. 925, S. 4108, H.R. 6539 and H.R. 6800: Proposals to increase the Medicaid federal medical assistance percentage (FMAP), expand Medicare coverage for COVID related services, increase FMAP funding specifically for Medicaid home and community-based services; improve nursing home oversight, provide funding for COVID testing; ensure tele-visitation for nursing home residents, and eliminate cost sharing for COVID treatment. COVID Drug Database. H.R. 7288 and S. 4539, the Taxpayer Research and Coronavirus Knowledge Act of 2020: Proposals to require a single user-friendly database of federal biomedical investments in COVID-19 vaccines, drugs, therapies, medical devices, or other products. COVID Drug Pricing. H.R. 7296, the Make Medications Affordable by Preventing Pandemic Price-gouging Act: Proposals to prohibit pharmaceutical companies from exclusive licensing of drugs used to treat or prevent COVID-19. Health Care Extenders. H.R. 8337, the Continuing Appropriations Act, 2021: Proposals to extend the Medicaid Money Follows the Person Program which provides states money to keep seniors in their homes; and extend spousal impoverishment protections in Medicaid to long term care services provided in the home. Infection Control in Nursing Homes. H.R. 6698 and S. 3644, the Quality Care for Nursing Home Residents and Workers During COVID-19 Act: Proposal to authorize $500 million for states to establish expert strike teams for resident and worker safety to be deployed within 72 hours of 3+ confirmed or suspected COVID-19 cases in a facility. Medicare Coverage of Vaccines. H.R. 5076 and S. 1872, the Protecting Seniors Through Immunization Act of 2019: Proposals to expand Medicare to cover all adult vaccines recommended by the Advisory Committee on Immunization Practices without any cost-sharing for Part D. Medicare Enrollment. H.R. 2477, the BENES Act of 2020, changes the Medicare general enrollment period to October 15-December 31, and requires coverage to begin on the first day of the month following enrollment. (The general enrollment period has been January 1-March 31, and coverage begins July 1.) Medicare Enrollment. H.R. 2564, Medicare Enrollment Protection Act: Proposal to 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. Medicare Enrollment. The Consolidated Appropriations Act of 2021 (P.L. 116-260): Proposal to extending funding for enrollment assistance to help low-income seniors access the Medicare Prescription Drug Program Part D Low-Income Subsidy. Medicare Telehealth. Proposal to support efforts at Center for Medicare and Medicaid Services to continue access to telehealth during the COVID pandemic. Nursing Home Telehealth Visitation. H.R. 6487 and S. 3517, the ACCESS Act: Proposal requiring that residents have access to telehealth visitation during the pandemic. Medical Expense Deduction. The Consolidated Appropriations Act of 2021 (P.L. 116-260): Proposal to include a permanent extension of the 7.5 percent threshold for the medical expense deduction. Medicare Structure. Letter to Biden Transition team. Proposals to modify Medicare including changing to premium support model, lowering the eligibility age, furthering privatization of the program, adding hearing dental and vision coverage. Medicare Prescription Drugs: Letter to Biden transition team. Proposals to allow Medicare to negotiate prices with drug makers, cap prices at inflation in Part B and D, cap beneficiary out-of-pocket costs in Part D. Drug Pricing. Letter to Biden transition team. Proposals to allow generics to come to market earlier by limiting brand manufacturers ability to pay generics to delay entering the market. Short Term Care Coverage. H.R. 1682, Improving Access to Medicare Coverage Act of 2019: Proposal 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.

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

Government targets: Administration on Aging, 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), Justice, Dept of (DOJ), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Social Security Administration (SSA), Treasury, Dept of, U.S. Postal Service (USPS)

H. R. 133 (Consolidated Appropriations Act): Making consolidated appropriations for the fiscal year ending September 30, 2021, providing coronavirus emergency response and relief, and for other purposes. H.R. 2477 (Benes Act of 2020): 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. 4318: A bill to create $1,200 stimulus check, for individuals with incomes up to $75,000 the same as in the CARES Act. The bill also contains the supplemental employment benefits, with $600 per week through July 31, $200 per week through October 5th, and then becomes a payment of 70% of lost wages though December 31 S. 4317: A bill to establish a COVID-19 liability shield for employers. S. 4321: A bill which extends he Paycheck Protection Program, providing money for additional loans, while reserving loans only for companies with under 300 employees and at least a 50% reduction in gross receipts S. 4320: An appropriations bill, contains a total of $306 billion in discretionary spending S. 2733: A bill to set up committees to produce a report regarding the financial health of the various federal trust funds S. 4322: A bill to defer student loan payments for borrowers with no income, funds scholarships for students returning to and starting at private schools, includes provisions related to medical stockpiles, diagnostic testing, and disease surveillance S. 4324: A bill to decrease the United States' dependence on foreign countries for personal protective equipment manufacturing, tighten oversight of federally funded research, and others. S. 4319: A bill to allow businesses to deduct 100% of the cost of business meals in 2020, compared to the current 50% tax deduction S. 1531: A bill to amend the Public Health Service Act to provide protections for health insurance consumers from surprise billing. HR 5800: A bill to end surprise medical billing and increase transparency in health coverage. H.R. 925 (HEROES): Coronavirus Recovery Supplemental Appropriations H.R.6800 (HEROES): Making emergency supplemental appropriations for the fiscal year ending September 30, 2020, and for other purposes. HR 2477 (BENES): 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. HR 6201 (FFCRA): A bill making emergency supplemental appropriations for the fiscal year ending September 30, 2020, and for other purposes. HR 748 (CARES): This bill responds to the COVID-19 (i.e., coronavirus disease 2019) outbreak and its impact on the economy, public health, state and local governments, individuals, and businesses. S. 3548 (CARES): A bill to provide emergency assistance and health care response for individuals, families, and businesses affected by the 2020 coronavirus pandemic. 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. S. 2366: 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 amend 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. 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. 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. S. 753: 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.

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

H. R. 133 (Consolidated Appropriations Act): Making consolidated appropriations for the fiscal year ending September 30, 2021, providing coronavirus emergency response and relief, and for other purposes. H.R. 2477 (Benes Act of 2020): 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. 4318: A bill to create $1,200 stimulus check, for individuals with incomes up to $75,000 the same as in the CARES Act. The bill also contains the supplemental employment benefits, with $600 per week through July 31, $200 per week through October 5th, and then becomes a payment of 70% of lost wages though December 31 S. 4317: A bill to establish a COVID-19 liability shield for employers. S. 4321: A bill which extends he Paycheck Protection Program, providing money for additional loans, while reserving loans only for companies with under 300 employees and at least a 50% reduction in gross receipts S. 4320: An appropriations bill, contains a total of $306 billion in discretionary spending S. 2733: A bill to set up committees to produce a report regarding the financial health of the various federal trust funds S. 4322: A bill to defer student loan payments for borrowers with no income, funds scholarships for students returning to and starting at private schools, includes provisions related to medical stockpiles, diagnostic testing, and disease surveillance S. 4324: A bill to decrease the United States' dependence on foreign countries for personal protective equipment manufacturing, tighten oversight of federally funded research, and others. S. 4319: A bill to allow businesses to deduct 100% of the cost of business meals in 2020, compared to the current 50% tax deduction S. 1531: A bill to amend the Public Health Service Act to provide protections for health insurance consumers from surprise billing. HR 5800: A bill to end surprise medical billing and increase transparency in health coverage. H.R. 925 (HEROES): Coronavirus Recovery Supplemental Appropriations H.R.6800 (HEROES): Making emergency supplemental appropriations for the fiscal year ending September 30, 2020, and for other purposes. HR 2477 (BENES): 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. HR 6201 (FFCRA): A bill making emergency supplemental appropriations for the fiscal year ending September 30, 2020, and for other purposes. HR 748 (CARES): This bill responds to the COVID-19 (i.e., coronavirus disease 2019) outbreak and its impact on the economy, public health, state and local governments, individuals, and businesses. S. 3548 (CARES): A bill to provide emergency assistance and health care response for individuals, families, and businesses affected by the 2020 coronavirus pandemic. 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. S. 2366: 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 amend 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. 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. 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. S. 753: 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.

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

H. R. 133 (Consolidated Appropriations Act): Making consolidated appropriations for the fiscal year ending September 30, 2021, providing coronavirus emergency response and relief, and for other purposes. H.R. 2477 (Benes Act of 2020): 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. 2733: A bill to set up committees to produce a report regarding the financial health of the various federal trust funds S. 1531: A bill to amend the Public Health Service Act to provide protections for health insurance consumers from surprise billing. HR 5800: A bill to end surprise medical billing and increase transparency in health coverage. H.R. 925 (HEROES): Coronavirus Recovery Supplemental Appropriations HR 2477 (BENES): 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. 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 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 amend 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.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. S. 753: 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. 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.

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

Support H.R.1265 &H.R.4468 - Nursing Home Workforce Quality Act- to end the mandatory certified nursing assistant training lock out. Support H.R.1343 Protecting Married Seniors from Impoverishment Act, to extend the Money Follows the Person Act and protection against impoverishment for spouses of Medicaid beneficiaries receiving long term services and supports at home. Support H.R.1342 - EMPOWER Care Act, to reauthorize Money Follows the Person for 5 years. Support H.R 1682/S. 753- Improving Access to Medicare Coverage Act of 2019, to solve the Medicare "observation days" issue by counting all time a beneficiary spends in a hospital toward the 3-day stay requirement for coverage of post-acute care. Support H.R 6698- Quality Care for Nursing Home Residents and Workers During COVID-19 Act Support H.R.2594/ S.1190 - Rural Access to Hospice Act of 2019 Support H.R 2150, Home Health Care Planning Improvement Act Support H.R.4063 - Medicare Adult Day Services Act of 2019 Support- H.R.748 - CARES Act Support H.R.5821 - HOSPICE Act Support S. 3544 Coronavirus Relief for Seniors and People with Disabilities Act of 2020 Support H.R. 6305 Coronavirus Relief for Seniors and People with Disabilities Act of 2020 Support H.R 8727/S.4375 Telehealth Modernization Act Support H.R 7663 Protecting Access to Post COVID-19 Telehealth Act of 2020

Client expense: $31,167 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Implementation of P.L. 114-10, the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), including but not limited to issues concerning Qualifying APM Participant (QP) thresholds and H.R. 7791, Value in Health Care Act of 2020; Policies contained in H.R. 1682/S. 753, the Improving Access to Medicare Coverage Act of 2019 and S. 1260, Reducing Administrative Costs and Burdens in Health Care Act of 2019; Issues concerning changes to the Medicare Part B physician fee schedule in the proposed rule, CY2021 Payment Polices under the Physician Fee Schedule and Other Changes to Part B Payment Policies (CMS-1734-P) and H.R.8702 - Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020; Health care policies in P.L. 116-123, the Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020; P.L. 116-127, the Families First Coronavirus Response Act; P.L. 116-136, the Coronavirus Aid, Relief, and Economic Security Act of CARES Act; P.L. 116-139, the Paycheck Protection Program and Health Care Enhancement Act; H.R. 6800, the Heroes Act; H.R. 8406, the Heroes Act; Senate Amendment 2652 related to COVID-19 relief; P.L.116-159, the Continuing Appropriations Act, 2021 and Other Extensions Act.; and P.L.116-260, Consolidated Appropriations Act, 2021.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

1. Patient Protection and Affordable Health Care Act, implementation of provisions regarding Medicare Part D coverage gap assistance, preventive care services, and dual eligible Medicare and Medicare beneficiaries 2. Proposals to create a premium support or voucher program under Medicare 3. Proposals to "means test" Medicare premiums and benefits 4. Proposals to change federal and state Medicaid cost sharing 5. Proposals to raise the Medicare eligibility age 6. Proposals regarding prescription drug costs for low income Medicare beneficiaries 7. Expansion of Medicare benefits to include hearing, vision, and dental benefits 8. Administration of the Medicare State Health Insurance Assistance Programs 9. Medicare Observation Status Regulations 10. Nursing Home Arbitration Regulations 11. Medicare 340(B) drug reimbursement policy 12. Home care workers and Medicare Reassignment Policy 13. Medicare equitable relief policy 14. S. 340, CREATES Act of 2019, entire bill 15. H.R. 965, CREATES Act of 2019, entire bill 16. H.R. 1046, Medicare Negotiation and Competitive Licensing Act of 2019, entire bill 17. CMS Proposals on Part D Drug Pricing 18. S. 691, Medicare Extra Rx HELP Act of 2019, entire bill 19. H.R. 1342, EMPOWER Care Act, entire bill 20. S. 548, EMPOWER Care Act, entire bill 21. H.R. 1343, Protecting Married Seniors from Impoverishment Act, entire bill 22. S. 97, Affordable and Safe Prescription Drug Importation Act, entire bill 23. S. 99, Medicare Drug Price Negotiation Act, entire bill 24. H.R. 3, Lower Drug Costs Now Act of 2019, entire bill 25. H.R. 1393, Medicare Dental, Vision and Hearing Benefit Act of 2019, entire bill 26. H.R. 1394, Medigap Consumer Protection Act of 2019, entire bill 27. H.R. 1682, Improving Access to Medicare Coverage Act of 2019, entire bill 28. H.R. 4386, Stop the Wait Act, entire bill 29. Proposals regarding the tiering generic drugs under Medicare Part D 30. Proposals regarding the use of Medicaid waivers during the COVID-19 pandemic 31. S. 3544, Coronavirus Relief for Seniors and People with Disabilities Act of 2020, entire bill 32. H.R. 6305, Coronavirus Relief for Seniors and People with Disabilities Act of 2020, entire bill 33. Proposals to streamline Medicare enrollment during the COVID-19 pandemic 34. Proposals to expand oral health care under Medicare and Medicaid

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Pension & Welfare Benefits Administration, Pension Benefit Guaranty Corporation (PBGC), SENATE, Social Security Administration (SSA)

The Improving Access to Medicare Coverage Act of 2019 (H.R. 1682/S. 753) National Defense Authorization Act of 2018 (H.R. 2810) S. AMDT. 621 (H.R. 2810)--Authorization of Physical Therapist Assistants and Occupational Therapy Assistants to Provide Services Under the TRICARE Program Trusted Exchange Framework and Common Agreement (TEFCA) CONNECT for Health Act of 2017 (H.R. 2556/S. 1016) The Laboratory Access for Beneficiaries (LAB) Act of 2019 (H.R. 3584) The Ensuring Access to Quality Complex Rehabilitation Technology Act of 2019 (H.R. 2408) The Protecting Access to Wheelchairs Act of 2019 (H.R. 2293) The Protecting Beneficiary Access to Complex Rehab Technology Act of 2019 (S. 1223) The Beneficiary Education Tools, Telehealth, and Extenders Reauthorization (BETTER) Act of 2019 (H.R.3417) The Creating Opportunities Now and Effective Care Technologies (CONNECT) Act of 2019 (S.2741) The Safeguarding Medicare Access to Respiratory Therapy (SMART) Act of 2019 (H.R.4945) The Coronavirus Preparedness and Response Supplemental Appropriations Act of 2020(H.R.6074) The Coronavirus Aid, Relief, and Economic Security (CARES) Act of 2020 (S.3548) The Outpatient Therapy Modernization and Stabilization Act (H.R.7154) The Nursing Home COVID-19 Protection and Prevention Act (S.3768) The Infection Control Training and Support Act (H.R.7254) The Consolidated Appropriations Act of 2021 (PL 116-260) The Holding Providers Harmless from Medicare Cuts during COVID-19 Act of 2020 (H.R. 8702/S.5007)

Client expense: $39,516 · Firm income: Not reported

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

The Improving Access to Medicare Coverage Act of 2019 (H.R. 1682/S. 753) National Defense Authorization Act of 2018 (H.R. 2810) S. AMDT. 621 (H.R. 2810)--Authorization of Physical Therapist Assistants and Occupational Therapy Assistants to Provide Services Under the TRICARE Program Trusted Exchange Framework and Common Agreement (TEFCA) CONNECT for Health Act of 2017 (H.R. 2556/S. 1016) The Laboratory Access for Beneficiaries (LAB) Act of 2019 (H.R. 3584) The Ensuring Access to Quality Complex Rehabilitation Technology Act of 2019 (H.R. 2408) The Protecting Access to Wheelchairs Act of 2019 (H.R. 2293) The Protecting Beneficiary Access to Complex Rehab Technology Act of 2019 (S. 1223) The Beneficiary Education Tools, Telehealth, and Extenders Reauthorization (BETTER) Act of 2019 (H.R.3417) The Creating Opportunities Now and Effective Care Technologies (CONNECT) Act of 2019 (S.2741) The Safeguarding Medicare Access to Respiratory Therapy (SMART) Act of 2019 (H.R.4945) The Coronavirus Preparedness and Response Supplemental Appropriations Act of 2020(H.R.6074) The Coronavirus Aid, Relief, and Economic Security (CARES) Act of 2020 (S.3548) The Outpatient Therapy Modernization and Stabilization Act (H.R.7154) The Nursing Home COVID-19 Protection and Prevention Act (S.3768) The Infection Control Training and Support Act (H.R.7254)

Client expense: $39,516 · Firm income: Not reported

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

Medicare Access and CHIP Reauthorization Act of 2015 implementation, Medicare physician payment reform, MEDPAC, surgical global payments, ACA implementation, health care reform, health care quality improvement, physician workforce issues, comparative clinical effectiveness research, health information technology, EHR meaningful use, EHR data blocking, Patient-Centered Outcomes Research Institute, MEDCAC, Centers for Medicare & Medicaid Innovation, registry access to Medicare claims data, lung cancer screenings, Agency for Healthcare Research & Quality, graduate medical education, electronic cigarette and cigar regulation, PTAC, meaningful use, congenital heart disease funding, unique device identifiers, medical liability reform, COVID-19 pandemic, tobacco riders in appropriations bills, tobacco regulation in the FDA, price transparency, ECMO coding, Prohibit Smoking in VA Facilities Act (S.2106/HR3700) Resident Physician Shortage Reduction Act (S.348/HR1763), Congenital Heart Futures Reauthorization Act, surprise billing, prior authorization, Women and Lung Cancer Research and Preventive Services Act (S.1107/HR2222), T21 bills, Transcatheter aortic valve replacement (TAVR), Increasing Access to Quality Cardiac Rehabilitation Act (HR.3911), Smoke-Free Schools Act of 2019 (HR.4019/S.1832), Protection for Veterans Burn Pits Exposure Act (HR.4086), The Coronavirus Aid, Relief, and Economic Security Act (H.R.748), Coronavirus Provider Protection Act (H.R.7059), Resident Physician Shortage Reduction Act of 2019 (S. 348/H.R. 1763), Quit Because of COVID-19 Act (H.R.7286), Tobacco to 21 Act (S.1258/H.R.2411), The Local Chamber, Tourism, and 501(c)(6) Protection Act (H.R.6697), Immediate Relief for Rural Facilities and Providers Act (S.3559/H.R.6365), Reversing the Youth Tobacco Epidemic Act of 2019 (H.R.2339), Vaccines Act of 2019 (H.R.2862), Investment in Tomorrow's Pediatric Health Care Workforce Act (S.2443), Protecting People from Surprise Medical Bills Act (H.R.3502), Stopping Appealing Flavors in E-Cigarettes for Kids Act (H.R.1498), Resident Education Deferred Interest (REDI) Act (H.R.1554), Improving Access to Medicare Coverage Act (H.R.1682), Traditional Cigar Manufacturing and Small Business Jobs Preservation Act of 2019 (H.R.1854), Women & Lung Cancer Research & Preventive Services Act (H.R.2222), Prevent BLEEDing Act of 2019 (H.R.2550), Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness (EMPOWER) for Health Act (H.R.2781), PCORI Reauthorization (H.R.3030), Improving Seniors Timely Access to Care Act (H.R.3107), Keep Physicians Serving Patients Act (H.R.3302), Stopping Appealing Flavors in E-Cigarettes for Kids Act (S.655), Improving Access to Medicare Coverage Act (S.753)

Client expense: $143,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), SENATE, Social Security Administration (SSA)

S. 2574 Protects Act H.R. 3398 Pathways to Health Careers Act H.R.4468- Nursing Home Workforce Quality Act Outreach to Hill on GAO Report "Federal Requirements for Oversight in Nursing Homes and Assisted Living Facilities Differ" Outreach to CMS: PDPM Implementation The Improving Access to Medicare Coverage Act of 2019 (H.R. 1682/S. 753) Observation Stays Issue Outreach to HHS/CMS/Administration Skilled Nursing Facility Requirements of Participation, RIN 0938-AR61 Survey Relief/Civil Monetary Penalties Payroll Based Journal - Section 6106 of the Affordable Care Act Outreach to HHS/ACL on Implementation of the Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (Public Law No: 115-119). Allow Secretarial discretion of CNA Training termination pertaining to Sec. 1819 (f)(2)(B)(iii)(l)(c). S. 2993- Ensuring Seniors Access to Quality Care Act S 2943/HR 5216 Quality Care for Nursing Home Residents Act of 2019 HR 5326 Fairness in Nursing Home Arbitration Act H.R.5897/S.3297 - Preventing Abuse and Neglect of Vulnerable Americans Act of 2020 Public Law 116-136, CARES Act Public Law 116-127 (H.R. 6201) Families First Coronavirus Response Act HR 6800 HEROES Act S. 3768/H.R. 6972 Nursing Home COVID-19 Protection and Prevention Act of 2020. S. 4108 A bill to amend title XIX of the Social Security Act to increase Federal support to State Medicaid programs during economic downturns, and for other purposes. S.3644 Quality Care for Nursing Home Residents and Workers During COVID-19 Act of 2020. H.R. 7048 Nursing Home Pandemic Protection Act H.R.6872 - SOS Act of 2020 H.R. 6849 Nursing Facility Quality Reporting Act of 2020 H.R. 6847 COHORT Act of 2020 Public Health Fund Distribution to HHS as agency CMS on Public Health Waiver and other waivers RUSH Act H.R. 6209/S.3447 H.R. 8574 amend titles XVIII and XIX of the Social Security Act to increase enforcement under Medicare and Medicaid for skilled nursing facilities and nursing facilities during the COVID-19 emergency period and other infectious disease outbreak periods, and for other purposes. S. 4666 National Coronavirus Commission Act of 2020 AHCA response to Ways and Means Committee report Under-Enforced and Over Prescribed: The Antipsychotic Drug Epidemic Ravings Americas Nursing Homes. BENES Act (S 1280/HR 2477)

Client expense: $910,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), SENATE, Treasury, Dept of, Veterans Affairs, Dept of (VA)

S. 4318: A bill to create $1,200 stimulus check, for individuals with incomes up to $75,000 the same as in the CARES Act. The bill also contains the supplemental employment benefits, with $600 per week through July 31, $200 per week through October 5th, and then becomes a payment of 70% of lost wages though December 31 S. 4317: A bill to establish a COVID-19 liability shield for employers. S. 4321: A bill which extends he Paycheck Protection Program, providing money for additional loans, while reserving loans only for companies with under 300 employees and at least a 50% reduction in gross receipts S. 4320: An appropriations bill, contains a total of $306 billion in discretionary spending S. 2733: A bill to set up committees to produce a report regarding the financial health of the various federal trust funds S. 4322: A bill to defer student loan payments for borrowers with no income, funds scholarships for students returning to and starting at private schools, includes provisions related to medical stockpiles, diagnostic testing, and disease surveillance S. 4324: A bill to decrease the United States' dependence on foreign countries for personal protective equipment manufacturing, tighten oversight of federally funded research, and others. S. 4319: A bill to allow businesses to deduct 100% of the cost of business meals in 2020, compared to the current 50% tax deduction S. 1531: A bill to amend the Public Health Service Act to provide protections for health insurance consumers from surprise billing. HR 5800: A bill to end surprise medical billing and increase transparency in health coverage. H.R. 925 (HEROES): Coronavirus Recovery Supplemental Appropriations H.R.6800 (HEROES): Making emergency supplemental appropriations for the fiscal year ending September 30, 2020, and for other purposes. HR 2477 (BENES): 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. HR 6201 (FFCRA): A bill making emergency supplemental appropriations for the fiscal year ending September 30, 2020, and for other purposes. HR 748 (CARES): This bill responds to the COVID-19 (i.e., coronavirus disease 2019) outbreak and its impact on the economy, public health, state and local governments, individuals, and businesses. S. 3548 (CARES): A bill to provide emergency assistance and health care response for individuals, families, and businesses affected by the 2020 coronavirus pandemic. 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. S. 2366: 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 amend 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. 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. 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. S. 753: 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.

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

S. 4318: A bill to create $1,200 stimulus check, for individuals with incomes up to $75,000 the same as in the CARES Act. The bill also contains the supplemental employment benefits, with $600 per week through July 31, $200 per week through October 5th, and then becomes a payment of 70% of lost wages though December 31 S. 4317: A bill to establish a COVID-19 liability shield for employers. S. 4321: A bill which extends he Paycheck Protection Program, providing money for additional loans, while reserving loans only for companies with under 300 employees and at least a 50% reduction in gross receipts S. 4320: An appropriations bill, contains a total of $306 billion in discretionary spending S. 2733: A bill to set up committees to produce a report regarding the financial health of the various federal trust funds S. 4322: A bill to defer student loan payments for borrowers with no income, funds scholarships for students returning to and starting at private schools, includes provisions related to medical stockpiles, diagnostic testing, and disease surveillance S. 4324: A bill to decrease the United States' dependence on foreign countries for personal protective equipment manufacturing, tighten oversight of federally funded research, and others. S. 4319: A bill to allow businesses to deduct 100% of the cost of business meals in 2020, compared to the current 50% tax deduction S. 1531: A bill to amend the Public Health Service Act to provide protections for health insurance consumers from surprise billing. HR 5800: A bill to end surprise medical billing and increase transparency in health coverage. H.R. 925 (HEROES): Coronavirus Recovery Supplemental Appropriations H.R.6800 (HEROES): Making emergency supplemental appropriations for the fiscal year ending September 30, 2020, and for other purposes. HR 2477 (BENES): 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. HR 6201 (FFCRA): A bill making emergency supplemental appropriations for the fiscal year ending September 30, 2020, and for other purposes. HR 748 (CARES): This bill responds to the COVID-19 (i.e., coronavirus disease 2019) outbreak and its impact on the economy, public health, state and local governments, individuals, and businesses. S. 3548 (CARES): A bill to provide emergency assistance and health care response for individuals, families, and businesses affected by the 2020 coronavirus pandemic. 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. S. 2366: 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 amend 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. 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. 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. S. 753: 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.

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

S. 2733: A bill to set up committees to produce a report regarding the financial health of the various federal trust funds S. 1531: A bill to amend the Public Health Service Act to provide protections for health insurance consumers from surprise billing. HR 5800: A bill to end surprise medical billing and increase transparency in health coverage. H.R. 925 (HEROES): Coronavirus Recovery Supplemental Appropriations HR 2477 (BENES): 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. 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 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 amend 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.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. S. 753: 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. 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.

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

1. Patient Protection and Affordable Health Care Act, implementation of provisions regarding Medicare Part D coverage gap assistance, preventive care services, and dual eligible Medicare and Medicare beneficiaries 2. Proposals to create a premium support or voucher program under Medicare 3. Proposals to "means test" Medicare premiums and benefits 4. Proposals to change federal and state Medicaid cost sharing 5. Proposals to raise the Medicare eligibility age 6. Proposals regarding prescription drug costs for low income Medicare beneficiaries 7. Expansion of Medicare benefits to include hearing, vision, and dental benefits 8. Administration of the Medicare State Health Insurance Assistance Programs 9. Medicare Observation Status Regulations 10. Nursing Home Arbitration Regulations 11. Medicare 340(B) drug reimbursement policy 12. Home care workers and Medicare Reassignment Policy 13. Medicare equitable relief policy 14. S. 340, CREATES Act of 2019, entire bill 15. H.R. 965, CREATES Act of 2019, entire bill 16. H.R. 1046, Medicare Negotiation and Competitive Licensing Act of 2019, entire bill 17. CMS Proposals on Part D Drug Pricing 18. S. 691, Medicare Extra Rx HELP Act of 2019, entire bill 19. H.R. 1342, EMPOWER Care Act, entire bill 20. S. 548, EMPOWER Care Act, entire bill 21. H.R. 1343, Protecting Married Seniors from Impoverishment Act, entire bill 22. S. 97, Affordable and Safe Prescription Drug Importation Act, entire bill 23. S. 99, Medicare Drug Price Negotiation Act, entire bill 24. H.R. 3, Lower Drug Costs Now Act of 2019, entire bill 25. H.R. 1393, Medicare Dental, Vision and Hearing Benefit Act of 2019, entire bill 26. H.R. 1394, Medigap Consumer Protection Act of 2019, entire bill 27. H.R. 1682, Improving Access to Medicare Coverage Act of 2019, entire bill 28. H.R. 4386, Stop the Wait Act, entire bill 29. Proposals regarding the tiering generic drugs under Medicare Part D 30. Proposals regarding the use of Medicaid waivers during the COVID-19 pandemic 31. S. 3544, Coronavirus Relief for Seniors and People with Disabilities Act of 2020, entire bill 32. H.R. 6305, Coronavirus Relief for Seniors and People with Disabilities Act of 2020, entire bill 33. Oklahoma Medicaid waiver application 34. Proposals to streamline Medicare enrollment during the COVID-19 pandemic

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Pension & Welfare Benefits Administration, Pension Benefit Guaranty Corporation (PBGC), SENATE, Social Security Administration (SSA)

Support H.R.1265 &H.R.4468 - Nursing Home Workforce Quality Act- to end the mandatory certified nursing assistant training lock out. Support H.R.1343 Protecting Married Seniors from Impoverishment Act, to extend the Money Follows the Person Act and protection against impoverishment for spouses of Medicaid beneficiaries receiving long term services and supports at home. Support H.R.1342 - EMPOWER Care Act, to reauthorize Money Follows the Person for 5 years. Support H.R 1682/S. 753- Improving Access to Medicare Coverage Act of 2019, to solve the Medicare "observation days" issue by counting all time a beneficiary spends in a hospital toward the 3-day stay requirement for coverage of post-acute care. Support H.R 6698- Quality Care for Nursing Home Residents and Workers During COVID-19 Act Support H.R.2594/ S.1190 - Rural Access to Hospice Act of 2019 Support H.R 2150, Home Health Care Planning Improvement Act Support H.R.4063 - Medicare Adult Day Services Act of 2019 Support- H.R.748 - CARES Act Support H.R.5821 - HOSPICE Act Support S. 3544 Coronavirus Relief for Seniors and People with Disabilities Act of 2020 Support H.R. 6305 Coronavirus Relief for Seniors and People with Disabilities Act of 2020

Client expense: $65,513 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Implementation of P.L. 114-10, the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), including but not limited to issues concerning Qualifying APM Participant (QP) thresholds and H.R. 7791, Value in Health Care Act of 2020. Policies contained in H.R. 1682/S. 753, the Improving Access to Medicare Coverage Act of 2019; H.R. 2482/S. 2074, the Mainstreaming Addiction Treatment Act of 2019; and S. 1260, Reducing Administrative Costs and Burdens in Health Care Act of 2019. Issues concerning changes to the Medicare Part B physician fee schedule in the proposed rule, CY2021 Payment Polices under the Physician Fee Schedule and Other Changes to Part B Payment Policies (CMS-1734-P). Health care policies in P.L. 116-123, the Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020; P.L. 116-127, the Families First Coronavirus Response Act; P.L. 116-136, the Coronavirus Aid, Relief, and Economic Security Act of CARES Act; P.L. 116-139, the Paycheck Protection Program and Health Care Enhancement Act; H.R. 6800, the Heroes Act; H.R. 8406, the Heroes Act; Senate Amendment 2652 related to COVID-19 relief; and H.R. 8337, the Continuing Appropriations Act, 2021 and Other Extensions Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Price transparency, out-of-network reimbursement of emergency medical services, surprise medical bills Opioids, pain management Federal funding for Substance Use Disorder treatments Drug Shortages P.L.116-139-Paycheck Protection Program and Health Care Enhancement Act P.L.116-142-Paycheck Protection Program Flexibility Act of 2020 H.R.501-Poison Center Network Enhancement Act of 2019 H.R.861-End Surprise Billing Act of 2019 H.R.1301-Mental Health Telemedicine Expansion Act H.R.1309-Workplace Violence Prevention for Health Care and Social Service Workers Act H.R.1418-Competitive Health Insurance Reform Act of 2019 H.R.1554-Resident Education Deferred Interest (REDI) Act H.R.1682-Improving Access to Medicare Coverage Act of 2019 H.R.1767-Excellence in Mental Health and Addiction Treatment Expansion Act H.R.2281-Easy Medication Access and Treatment (MAT) for Opioid Addiction Act H.R.2328-Reauthorizing and Extending Americas Community Health Act H.R.2464-End the Cycle of Violence Act of 2019 H.R.2482-Mainstreaming Addiction Treatment Act of 2019 H.R.2519-Improving Mental Health Access from the Emergency Department Act of 2019 H.R.2550-Prevent Blood Loss with Emergency Equipment Devices Act of 2019 H.R.2569-Comprehensive Addiction Resources Emergency Act of 2019 H.R.3107-Improving Seniors Timely Access to Care Act of 2019 H.R.3417-Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act of 2019 H.R.3502-Protecting People From Surprise Medical Bills Act H.R.3630-No Surprises Act H.R.3984-Health Care Safety Net Enhancement Act of 2019 H.R.4861-Effective Suicide Screening and Assessment in the Emergency Department Act of 2019 H.R.4932-Creating Opportunities Now for Necessary and Effective Care Technologies for Health Act of 2019 H.R.5800-Ban Surprise Billing Act H.R.5826-Consumer Protections Against Surprise Medical Bills Act of 2020 H.R.6800-Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act H.R.6910-Emergency Room Hero and Patient Safety Act H.R.7059-Coronavirus Provider Protection Act H.R.7255-Coronavirus Health Care Worker Wellness Act of 2020 S.289-Rural Physician Workforce Production Act of 2019 S.299-Geriatrics Workforce Improvement Act S.350-Competitive Health Insurance Reform Act of 2019 S.618-Medicare Choices Empowerment and Protection Act S.753-Improving Access to Medicare Coverage Act of 2019 S.824-Excellence in Mental Health and Addiction Treatment Expansion Act S.851-Workplace Violence Prevention for Health Care and Social Service Workers Act S.1199-Poison Center Network Enhancement Act of 2019 S.1266-Protecting Patients from Surprise Medical Bills Act S.1334-Improving Mental Health Access from the Emergency Department S.1350-Good Samaritan Health Professionals Act of 2019 S.1365-Comprehensive Addiction Resources Emergency Act of 2019 S.1531-Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019 S.1895-Lower Health Care Costs Act S.2074-Mainstreaming Addiction Treatment Act of 2019 S.2741-Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019 S.3006-Effective Suicide Screening and Assessment in the Emergency Department Act of 2019 S.3143-Magnet Injury Prevention Act S.3346-Prevent Blood Loss with Emergency Equipment Devices Act of 2020

Client expense: $314,376 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.861-End Surprise Billing Act of 2019 H.R.1301-Mental Health Telemedicine Expansion Act H.R.1682-Improving Access to Medicare Coverage Act of 2019 H.R.3417-Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act of 2019 S.618-Medicare Choices Empowerment and Protection Act S.753-Improving Access to Medicare Coverage Act of 2019

Client expense: $314,376 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.861-End Surprise Billing Act of 2019 H.R.1301-Mental Health Telemedicine Expansion Act H.R.1682-Improving Access to Medicare Coverage Act of 2019 H.R.3417-Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act of 2019 S.618-Medicare Choices Empowerment and Protection Act S.753-Improving Access to Medicare Coverage Act of 2019

Client expense: $595,871 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Price transparency, out-of-network reimbursement of emergency medical services, surprise medical bills Opioids, pain management Federal funding for Substance Use Disorder treatments Drug Shortages H.R.501-Poison Center Network Enhancement Act of 2019 H.R.861-End Surprise Billing Act of 2019 H.R.1301-Mental Health Telemedicine Expansion Act H.R.1309-Workplace Violence Prevention for Health Care and Social Service Workers Act H.R.1418-Competitive Health Insurance Reform Act of 2019 H.R.1554-Resident Education Deferred Interest (REDI) Act H.R.1682-Improving Access to Medicare Coverage Act of 2019 H.R.1767-Excellence in Mental Health and Addiction Treatment Expansion Act H.R.2281-Easy Medication Access and Treatment (MAT) for Opioid Addiction Act H.R.2328-Reauthorizing and Extending Americas Community Health Act H.R.2464-End the Cycle of Violence Act of 2019 H.R.2482-Mainstreaming Addiction Treatment Act of 2019 H.R.2519-Improving Mental Health Access from the Emergency Department Act of 2019 H.R.2550-Prevent Blood Loss with Emergency Equipment Devices Act of 2019 H.R.2569-Comprehensive Addiction Resources Emergency Act of 2019 H.R.3107-Improving Seniors Timely Access to Care Act of 2019 H.R.3417-Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act of 2019 H.R.3502-Protecting People From Surprise Medical Bills Act H.R.3630-No Surprises Act H.R.3984-Health Care Safety Net Enhancement Act of 2019 H.R.4861-Effective Suicide Screening and Assessment in the Emergency Department Act of 2019 H.R.4932-Creating Opportunities Now for Necessary and Effective Care Technologies for Health Act of 2019 H.R.5800-Ban Surprise Billing Act H.R.5826-Consumer Protections Against Surprise Medical Bills Act of 2020 S.289-Rural Physician Workforce Production Act of 2019 S.299-Geriatrics Workforce Improvement Act S.350-Competitive Health Insurance Reform Act of 2019 S.618-Medicare Choices Empowerment and Protection Act S.753-Improving Access to Medicare Coverage Act of 2019 S.824-Excellence in Mental Health and Addiction Treatment Expansion Act S.851-Workplace Violence Prevention for Health Care and Social Service Workers Act S.1199-Poison Center Network Enhancement Act of 2019 S.1266-Protecting Patients from Surprise Medical Bills Act S.1334-Improving Mental Health Access from the Emergency Department S.1350-Good Samaritan Health Professionals Act of 2019 S.1365-Comprehensive Addiction Resources Emergency Act of 2019 S.1531-Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019 S.1895-Lower Health Care Costs Act S.2074-Mainstreaming Addiction Treatment Act of 2019 S.2741-Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019 S.3006-Effective Suicide Screening and Assessment in the Emergency Department Act of 2019 S.3143-Magnet Injury Prevention Act S.3346-Prevent Blood Loss with Emergency Equipment Devices Act of 2020

Client expense: $595,871 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Access and CHIP Reauthorization Act of 2015 implementation, Medicare physician payment reform, MEDPAC, surgical global payments, ACA implementation, health care reform, health care quality improvement, physician workforce issues, comparative clinical effectiveness research, health information technology, EHR meaningful use, EHR data blocking, Patient-Centered Outcomes Research Institute, MEDCAC, Centers for Medicare & Medicaid Innovation, registry access to Medicare claims data, lung cancer screenings, Agency for Healthcare Research & Quality, graduate medical education, electronic cigarette and cigar regulation, PTAC, meaningful use, congenital heart disease funding, unique device identifiers, medical liability reform, tobacco riders in appropriations bills, tobacco regulation in the FDA, price transparency, ECMO coding, Prohibit Smoking in VA Facilities Act (S.2106/HR3700) Resident Physician Shortage Reduction Act (S.348/HR1763), Congenital Heart Futures Reauthorization Act, surprise billing, prior authorization, Women and Lung Cancer Research and Preventive Services Act (S.1107/HR2222), T21 bills, Transcatheter aortic valve replacement (TAVR), Increasing Access to Quality Cardiac Rehabilitation Act (HR.3911), Smoke-Free Schools Act of 2019 (HR.4019/S.1832), Protection for Veterans Burn Pits Exposure Act (HR.4086), The Coronavirus Aid, Relief, and Economic Security Act (H.R.748), Coronavirus Provider Protection Act (H.R.7059), Resident Physician Shortage Reduction Act of 2019 (S. 348/H.R. 1763), Quit Because of COVID-19 Act (H.R.7286), Tobacco to 21 Act (S.1258/H.R.2411), The Local Chamber, Tourism, and 501(c)(6) Protection Act (H.R.6697), Immediate Relief for Rural Facilities and Providers Act (S.3559/H.R.6365), Reversing the Youth Tobacco Epidemic Act of 2019 (H.R.2339), Vaccines Act of 2019 (H.R.2862), Investment in Tomorrow's Pediatric Health Care Workforce Act (S.2443), Protecting People from Surprise Medical Bills Act (H.R.3502), Stopping Appealing Flavors in E-Cigarettes for Kids Act (H.R.1498), Resident Education Deferred Interest (REDI) Act (H.R.1554), Improving Access to Medicare Coverage Act (H.R.1682), Traditional Cigar Manufacturing and Small Business Jobs Preservation Act of 2019 (H.R.1854), Women & Lung Cancer Research & Preventive Services Act (H.R.2222), Prevent BLEEDing Act of 2019 (H.R.2550), Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness (EMPOWER) for Health Act (H.R.2781), PCORI Reauthorization (H.R.3030), Improving Seniors Timely Access to Care Act (H.R.3107), Keep Physicians Serving Patients Act (H.R.3302), Stopping Appealing Flavors in E-Cigarettes for Kids Act (S.655), Improving Access to Medicare Coverage Act (S.753)

Client expense: $186,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), SENATE, Social Security Administration (SSA)

S. 2574 Protects Act H.R. 3398 Pathways to Health Careers Act H.R.4468- Nursing Home Workforce Quality Act Outreach to Hill on GAO Report "Federal Requirements for Oversight in Nursing Homes and Assisted Living Facilities Differ" Outreach to CMS: PDPM Implementation The Improving Access to Medicare Coverage Act of 2019 (H.R. 1682/S. 753) Observation Stays Issue Outreach to HHS/CMS/Administration Medicare Post-Acute Care Value-Based Purchasing Act of 2015 H.R. 3298 Skilled Nursing Facility Payment Reform Skilled Nursing Facility Requirements of Participation, RIN 0938-AR61 Advocate on the Hill and with CMS around the release of the proposed rule on the Requirements of Participation Survey Relief/Civil Monetary Penalties Medicare Access to Rehabilitation Services Act of 2017 (S. 253/H.R. 807) Payroll Based Journal - Section 6106 of the Affordable Care Act The Improving Medicare Post-Acute Care Transformation Act of 2014 (H.R. 4994) CR: Public Law No: 115-123 Omni: Public Law No: 115-141 The Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (S. 1028 and H.R. 3759). Congress passed the legislation, and became Public Law No: 115-119 on 1/22/2018. Outreach to HHS/ACL on Implementation of the Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (Public Law No: 115-119). Allow Secretarial discretion of CNA Training termination pertaining to Sec. 1819 (f)(2)(B)(iii)(l)(c). HR 6502, the RUSH Act AHCA/NCAL supported the Building Our Largest Dementia Infrastructure for Alzheimers Act, or BOLD Infrastructure for Alzheimers Act (S. 2076/H.R. 4256), which became Public Law No. 115-406 on December 31, 2018 S. 2993- Ensuring Seniors Access to Quality Care Act S 2943/HR 5216 Quality Care for Nursing Home Residents Act of 2019 HR 5326 Fairness in Nursing Home Arbitration Act H.R.5897/S.3297 - Preventing Abuse and Neglect of Vulnerable Americans Act of 2020 Public Law 116-136, CARES Act Public Law 116-127 (H.R. 6201) Families First Coronavirus Response Act S.2943, Quality Care for Nursing Home Residents Act of 2019 HR 6800 HEROES Act S. 3768 Nursing Home COVID-19 Protection and Prevention Act of 2020. S. 4108 A bill to amend title XIX of the Social Security Act to increase Federal support to State Medicaid programs during economic downturns, and for other purposes. S.3644 Quality Care for Nursing Home Residents and Workers During COVID-19 Act of 2020. S.2943 Quality Care for Nursing Home Residents Act of 2019. H.R. 748 CARES Act H.R. 6201 Families First Coronavirus Response Act H.R. 7048 Nursing Home Pandemic Protection Act H.R.6872 - SOS Act of 2020 H.R. 6849 Nursing Facility Quality Reporting Act of 2020 H.R. 6847 COHORT Act of 2020 Public Health Fund Distribution to HHS as agency CMS on Public Health Waiver and other waivers

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), SENATE, Treasury, Dept of, Veterans Affairs, Dept of (VA)

H.R.6800 (HEROES): Making emergency supplemental appropriations for the fiscal year ending September 30, 2020, and for other purposes. HR 2477 (BENES): 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. HR 6201 (FFCRA): A bill making emergency supplemental appropriations for the fiscal year ending September 30, 2020, and for other purposes. S. 3548 (CARES): A bill to provide emergency assistance and health care response for individuals, families, and businesses affected by the 2020 coronavirus pandemic. 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 amend 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. 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. 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. S. 753: 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.

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

H.R.6800 (HEROES): Making emergency supplemental appropriations for the fiscal year ending September 30, 2020, and for other purposes. HR 2477 (BENES): 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. HR 6201 (FFCRA): A bill making emergency supplemental appropriations for the fiscal year ending September 30, 2020, and for other purposes. S. 3548 (CARES): A bill to provide emergency assistance and health care response for individuals, families, and businesses affected by the 2020 coronavirus pandemic. 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 amend 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. 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. 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. S. 753: 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.

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

HR 2477 (BENES): 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. 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 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 amend 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.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. S. 753: 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. 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.

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

Implementation of P.L. 114-10, the Medicare Access and CHIP Reauthorization Act of 2015; H.R. 1682/S. 753, the Improving Access to Medicare Coverage Act of 2019; H.R. 2482/S. 2074, the Mainstreaming Addiction Treatment Act of 2019; and S. 1260, Reducing Administrative Costs and Burdens in Health Care Act of 2019. Health care policies in P.L. 116-123, the Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020; P.L. 116-127, the Families First Coronavirus Response Act; P.L. 116-136, the Coronavirus Aid, Relief, and Economic Security Act of CARES Act; and P.L. 116-139, the Paycheck Protection Program and Health Care Enhancement Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Support H.R.1265 &H.R.4468 - Nursing Home Workforce Quality Act- to end the mandatory certified nursing assistant training lock out. Support H.R.1343 Protecting Married Seniors from Impoverishment Act, to extend the Money Follows the Person Act and protection against impoverishment for spouses of Medicaid beneficiaries receiving long term services and supports at home. Support H.R.1342 - EMPOWER Care Act, to reauthorize Money Follows the Person for 5 years. Support H.R 1682/S. 753- Improving Access to Medicare Coverage Act of 2019, to solve the Medicare "observation days" issue by counting all time a beneficiary spends in a hospital toward the 3-day stay requirement for coverage of post-acute care. Support H.R 6698- Quality Care for Nursing Home Residents and Workers During COVID-19 Act Support H.R.2594/ S.1190 - Rural Access to Hospice Act of 2019 Support H.R 2150, Home Health Care Planning Improvement Act Support H.R.4063 - Medicare Adult Day Services Act of 2019 Support- H.R.748 - CARES Act Support H.R.5821 - HOSPICE Act Support S. 3544 Coronavirus Relief for Seniors and People with Disabilities Act of 2020 Support H.R. 6305 Coronavirus Relief for Seniors and People with Disabilities Act of 2020

Client expense: $97,055 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

1. Patient Protection and Affordable Health Care Act, implementation of provisions regarding Medicare Part D coverage gap assistance, preventive care services, and dual eligible Medicare and Medicare beneficiaries 2. Proposals to create a premium support or voucher program under Medicare 3. Proposals to "means test" Medicare premiums and benefits 4. Proposals to change federal and state Medicaid cost sharing 5. Proposals to raise the Medicare eligibility age 6. Proposals regarding prescription drug costs for low income Medicare beneficiaries 7. Expansion of Medicare benefits to include hearing, vision, and dental benefits 8. Administration of the Medicare State Health Insurance Assistance Programs 9. Medicare Observation Status Regulations 10. Nursing Home Arbitration Regulations 11. Medicare 340(B) drug reimbursement policy 12. Home care workers and Medicare Reassignment Policy 13. Medicare equitable relief policy 14. S. 340, CREATES Act of 2019, entire bill 15. H.R. 965, CREATES Act of 2019, entire bill 16. H.R. 1046, Medicare Negotiation and Competitive Licensing Act of 2019, entire bill 17. CMS Proposals on Part D Drug Pricing 18. S. 691, Medicare Extra Rx HELP Act of 2019, entire bill 19. H.R. 1342, EMPOWER Care Act, entire bill 20. S. 548, EMPOWER Care Act, entire bill 21. H.R. 1343, Protecting Married Seniors from Impoverishment Act, entire bill 22. S. 97, Affordable and Safe Prescription Drug Importation Act, entire bill 23. S. 99, Medicare Drug Price Negotiation Act, entire bill 24. H.R. 3, Lower Drug Costs Now Act of 2019, entire bill 25. H.R. 1393, Medicare Dental, Vision and Hearing Benefit Act of 2019, entire bill 26. H.R. 1394, Medigap Consumer Protection Act of 2019, entire bill 27. H.R. 1682, Improving Access to Medicare Coverage Act of 2019, entire bill 28. H.R. 4386, Stop the Wait Act, entire bill 29. Proposals regarding the tiering generic drugs under Medicare Part D 30. Proposals regarding the use of Medicaid waivers during the COVID-19 pandemic 31. S. 3544, Coronavirus Relief for Seniors and People with Disabilities Act of 2020, entire bill 32. H.R. 6305, Coronavirus Relief for Seniors and People with Disabilities Act of 2020, entire bill 33. Oklahoma Medicaid waiver application 34. Proposals to streamline Medicare enrollment during the COVID-19 pandemic

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Pension & Welfare Benefits Administration, Pension Benefit Guaranty Corporation (PBGC), SENATE, Social Security Administration (SSA), U.S. Trade Representative (USTR)

The Improving Access to Medicare Coverage Act of 2019 (H.R. 1682/S. 753) National Defense Authorization Act of 2018 (H.R. 2810) S. AMDT. 621 (H.R. 2810)--Authorization of Physical Therapist Assistants and Occupational Therapy Assistants to Provide Services Under the TRICARE Program Trusted Exchange Framework and Common Agreement (TEFCA) CONNECT for Health Act of 2017 (H.R. 2556/S. 1016) The Laboratory Access for Beneficiaries (LAB) Act of 2019 (H.R. 3584) The Ensuring Access to Quality Complex Rehabilitation Technology Act of 2019 (H.R. 2408) The Protecting Access to Wheelchairs Act of 2019 (H.R. 2293) The Protecting Beneficiary Access to Complex Rehab Technology Act of 2019 (S. 1223) The Beneficiary Education Tools, Telehealth, and Extenders Reauthorization (BETTER) Act of 2019 (H.R.3417) The Creating Opportunities Now and Effective Care Technologies (CONNECT) Act of 2019 (S.2741) The Safeguarding Medicare Access to Respiratory Therapy (SMART) Act of 2019 (H.R.4945) The Coronavirus Preparedness and Response Supplemental Appropriations Act of 2020(H.R.6074) The Coronavirus Aid, Relief, and Economic Security (CARES) Act of 2020 (S.3548) The Outpatient Therapy Modernization and Stabilization Act (H.R.7154) The Nursing Home COVID-19 Protection and Prevention Act (S.3768) The Infection Control Training and Support Act (H.R.7254)

Client expense: $39,516 · Firm income: Not reported

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

Support H.R.1265 &H.R.4468 - Nursing Home Workforce Quality Act- to end the mandatory certified nursing assistant training lock out. Support H.R.1343 Protecting Married Seniors from Impoverishment Act, to extend the Money Follows the Person Act and protection against impoverishment for spouses of Medicaid beneficiaries receiving long term services and supports at home. Support H.R.1342 - EMPOWER Care Act, to reauthorize Money Follows the Person for 5 years. Support H.R 1682/S. 753- Improving Access to Medicare Coverage Act of 2019, to solve the Medicare "observation days" issue by counting all time a beneficiary spends in a hospital toward the 3-day stay requirement for coverage of post-acute care. Support H.R.2594/ S.1190 - Rural Access to Hospice Act of 2019 Support H.R 2150, Home Health Care Planning Improvement Act Support H.R.4063 - Medicare Adult Day Services Act of 2019 Support- H.R.748 - CARES Act Support H.R.5821 - HOSPICE Act

Client expense: $49,764 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 2574 Protects Act H.R. 3398 Pathways to Health Careers Act H.R.4468- Nursing Home Workforce Quality Act Outreach to Hill on GAO Report "Federal Requirements for Oversight in Nursing Homes and Assisted Living Facilities Differ" Outreach to CMS: PDPM Implementation The Improving Access to Medicare Coverage Act of 2019 (H.R. 1682/S. 753) Observation Stays Issue Outreach to HHS/CMS/Administration Medicare Post-Acute Care Value-Based Purchasing Act of 2015 H.R. 3298 Skilled Nursing Facility Payment Reform Skilled Nursing Facility Requirements of Participation, RIN 0938-AR61 Advocate on the Hill and with CMS around the release of the proposed rule on the Requirements of Participation Survey Relief/Civil Monetary Penalties Medicare Access to Rehabilitation Services Act of 2017 (S. 253/H.R. 807) Payroll Based Journal - Section 6106 of the Affordable Care Act The Improving Medicare Post-Acute Care Transformation Act of 2014 (H.R. 4994) CR: Public Law No: 115-123 Omni: Public Law No: 115-141 The Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (S. 1028 and H.R. 3759). Congress passed the legislation, and became Public Law No: 115-119 on 1/22/2018. Outreach to HHS/ACL on Implementation of the Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (Public Law No: 115-119). Allow Secretarial discretion of CNA Training termination pertaining to Sec. 1819 (f)(2)(B)(iii)(l)(c). HR 6502, the RUSH Act AHCA/NCAL supported the Building Our Largest Dementia Infrastructure for Alzheimers Act, or BOLD Infrastructure for Alzheimers Act (S. 2076/H.R. 4256), which became Public Law No. 115-406 on December 31, 2018 S. 2993- Ensuring Seniors Access to Quality Care Act S 2943/HR 5216 Quality Care for Nursing Home Residents Act of 2019 HR 5326 Fairness in Nursing Home Arbitration Act H.R.5897/S.3297 - Preventing Abuse and Neglect of Vulnerable Americans Act of 2020 Public Law 116-136, CARES Act Public Law 116-127 (H.R. 6201) Families First Coronavirus Response Act S.2943, Quality Care for Nursing Home Residents Act of 2019

Client expense: $920,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), SENATE, Treasury, Dept of, Veterans Affairs, Dept of (VA)

Drug Pricing. H.R. 3, the Lower Drug Costs Now Act: Proposals to authorize the Secretary of Health and Human Services (HHS) to negotiate drug prices on behalf of Medicare with pharmaceutical manufacturers. Create a maximum price for any negotiated drug with an international price index (Average International Market price). Require drug manufacturers that refuse to negotiate with HHS to pay a non-compliance fee of 65 percent of the gross sales of the drug in question. Require drug companies that raised the price of a drug in Medicare above the rate of inflation since 2016 to either lower the price or pay the entire price above inflation in a rebate back to the Treasury. Create a $2,000 Medicare beneficiary annual out-of-pocket cost cap for prescription drugs. Drug Pricing. S. 2543, the Prescription Drug Pricing Reduction Act of 2019: Proposals to require pharmaceutical manufacturers to rebate Medicare if they raise their prices for drugs covered by Medicare Parts B and D faster than inflation. Establish an out-of-pocket spending limit in which Medicare beneficiaries would pay no more than $3,100 a year on drug costs. Require Medicare Part D private insurers to pay 60 percent and, drug makers 20 percent, of the costs incurred over the out-of-pocket spending cap. Increase transparency into pharmacy benefit manager practices and manufacturer drug pricing decisions. Provide state Medicaid programs with more authority to contain drug prices. Medicaid Home and Community-Based Services. The Coronavirus Aid, Relief and Economic Security (CARES) Act (P.L. 116-136): Proposals to permanently extend the spousal impoverishment protections for Medicaid home and community-based services and permanently extend Money Follows the Person which provides grants to states for initiatives for people requiring long term care to receive Medicaid services and supports in their homes. Medicare Prescription Drug Costs. (No bill): Proposal to reduce the threshold for entering the catastrophic phase of the Part D benefit where seniors only pay 5 percent of their drug costs instead of 25 percent. Medicare Coverage Expansion. H.R 3, the Lower Drug Costs Now Act: Proposals to expand Medicare coverage to include, vision, dental and hearing benefits; and to expand eligibility for the Low-Income Subsidy and Medicare Savings Program which help low-income seniors pay for drug costs and Medicare premiums, deductibles and copays. Medigap Reform. H.R. 3, the Lower Drug Costs Now Act: Proposal to improve quality of coverage and access to Medigap by extending guaranteed issue to disabled people and other beneficiaries. Medical Expense Tax Deduction. Proposal to raise the threshold for the medical expense tax deduction from 7.5 percent to 10 percent of adjusted gross income. Medicare Observation Status. H.R. 1682 and S. 753, the Improving Access to Medicare Coverage Act: Proposal to allow the time patients spend in the hospital under observation status to count toward requisite three-day hospital stay for coverage of skilled nursing care. Reducing Health Care Costs. S. 1895, Lower Health Care Costs Act: Proposal to eliminate surprise medical billing including out-of-network charges in emergencies. Medicare Savings Program. (No bill): Proposal to reduce cost-sharing, aligning income and resource eligibility tests, simplifying enrollment, and other program improvements for low-income Medicare beneficiaries. Adapt Medicare and Medicaid to Improve Beneficiary Treatment and Services During the COVID-19 Pandemic. The CARES Act (P.L. 116-136) and the Families First Coronavirus Response Act (P.L. 116-127): Proposals to assist nursing homes with infection control and support states efforts to prevent the spread of coronavirus in nursing homes; make telehealth appointments more accessible to Medicare beneficiaries; eliminate beneficiary cost-sharing requirements for a COVID-19 vaccine and diagnostic tests; enable the Medicare Part D prescription drug program to provide Medicare beneficiaries with a three-month supply of their medication; provide home and community-based support services during hospital stays; increase the Federal Medical Assistance Percentages payment to state Medicaid programs; and support federal, state and local health agency coronavirus prevention, preparedness and response. Older Americans Act Reauthorization. Supporting Older Americans Act of 2020 (P.L. 116-131): Reauthorizes the Older Americans Act until September 30, 2024, modernizes programs under the Administration on Aging and improves grants for state and community programs on aging.

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

Government targets: Administration on Aging, Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Social Security Administration (SSA), Treasury, Dept of

Corona virus Preparedness And Response Act, P.L. 116-123; Families First Corona virus Response Act, P.L. 116-127; Cares Act P.L. 116-136; Surprise Billing Legislation (S. 1895); Community Health Investment, Modernization, and Excellence Act of 2019 (H.R. 2328); Medicaid DSH - Short-term delay in FY 2020 Appropriations (H.R. 1865), DSH Cut Delay Act of 2019 (H.R. 3054); Site-Neutral Payment for Outpatient Services; Delayed Bonus Payments for Alternative Payment Models (APMs); Drug Pricing - Lower Drug Costs Now Act of 2019 (H.R. 3), Prescription Drug Pricing Reduction Act of 2019 (S. 2543), CREATES Act of 2019 (S. 340); Physician Shortage - Resident Physician Shortage Reduction Act of 2019 (H.R. 1763/S. 1770), Advancing Medical Resident Training in Community Hospitals Act of 2019 (H.E. 1358); 3-Day inpatient rule for Medicare SNF coverage - Improving Access to Medicare Coverage Act of 2019 (H.R. 1682/S. 753); Medicare Area Wage Index - Imputed Rural Floor.

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

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

Issues affecting long term care ancillary service providers in H.R. 748, the CARES Act. Issues related to rehabilitation therapy providers, portable x-ray providers, and mobile clinical lab providers in responding to COVID-19. Issues related to mobile clinical lab reimbursement. Issues related to policies on evaluation and management codes in the Physician Fee Schedule CY 2020 Final Rule (84 FR 62567). Issues related to telehealth, including S. 2741/H.R. 4932, the CONNECT Act. Issues related to portable x-ray payments through Medicare Administrative Contractors. S. 753/H.R. 1682, the Improving Access to Medicare Coverage Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Corona virus Preparedness And Response Act, P.L. 116-123; Families First Corona virus Response Act, P.L. 116-127; Cares Act P.L. 116-136; Surprise Billing Legislation (S. 1895); Community Health Investment, Modernization, and Excellence Act of 2019 (H.R. 2328); Medicaid DSH - Short-term delay in FY 2020 Appropriations (H.R. 1865), DSH Cut Delay Act of 2019 (H.R. 3054); Site-Neutral Payment for Outpatient Services; Delayed Bonus Payments for Alternative Payment Models (APMs); Drug Pricing - Lower Drug Costs Now Act of 2019 (H.R. 3), Prescription Drug Pricing Reduction Act of 2019 (S. 2543), CREATES Act of 2019 (S. 340); Physician Shortage - Resident Physician Shortage Reduction Act of 2019 (H.R. 1763/S. 1770), Advancing Medical Resident Training in Community Hospitals Act of 2019 (H.E. 1358); 3-Day inpatient rule for Medicare SNF coverage - Improving Access to Medicare Coverage Act of 2019 (H.R. 1682/S. 753); Medicare Area Wage Index - Imputed Rural Floor.

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

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

Coronavirus Preparedness And Response Act, P.L. 116-123; Families First Coronavirus Response Act, P.L. 116-127; Cares Act P.L. 116-136; Surprise Billing Legislation (S. 1895); Community Health Investment, Modernization, and Excellence Act of 2019 (H.R. 2328); Medicaid DSH - Short-term delay in FY 2020 Appropriations (H.R. 1865), DSH Cut Delay Act of 2019 (H.R. 3054); Site-Neutral Payment for Outpatient Services; Delayed Bonus Payments for Alternative Payment Models (APMs); Drug Pricing - Lower Drug Costs Now Act of 2019 (H.R. 3), Prescription Drug Pricing Reduction Act of 2019 (S. 2543), CREATES Act of 2019 (S. 340); Physician Shortage - Resident Physician Shortage Reduction Act of 2019 (H.R. 1763/S. 1770), Advancing Medical Resident Training in Community Hospitals Act of 2019 (H.E. 1358); 3-Day inpatient rule for Medicare SNF coverage - Improving Access to Medicare Coverage Act of 2019 (H.R. 1682/S. 753); Medicare Area Wage Index - Imputed Rural Floor.

Client expense: Not reported · Firm income: $10,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Coronavirus Preparedness And Response Act, P.L. 116-123; Families First Coronavirus Response Act, P.L. 116-127; Cares Act P.L. 116-136; Surprise Billing Legislation (S. 1895); Community Health Investment, Modernization, and Excellence Act of 2019 (H.R. 2328); Medicaid DSH - Short-term delay in FY 2020 Appropriations (H.R. 1865), DSH Cut Delay Act of 2019 (H.R. 3054); Site-Neutral Payment for Outpatient Services; Delayed Bonus Payments for Alternative Payment Models (APMs); Drug Pricing - Lower Drug Costs Now Act of 2019 (H.R. 3), Prescription Drug Pricing Reduction Act of 2019 (S. 2543), CREATES Act of 2019 (S. 340); Physician Shortage - Resident Physician Shortage Reduction Act of 2019 (H.R. 1763/S. 1770), Advancing Medical Resident Training in Community Hospitals Act of 2019 (H.E. 1358); 3-Day inpatient rule for Medicare SNF coverage - Improving Access to Medicare Coverage Act of 2019 (H.R. 1682/S. 753); Medicare Area Wage Index - Imputed Rural Floor.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Coronavirus Preparedness And Response Act, P.L. 116-123; Families First Coronavirus Response Act, P.L. 116-127; Cares Act P.L. 116-136; Surprise Billing Legislation (S. 1895); Community Health Investment, Modernization, and Excellence Act of 2019 (H.R. 2328); Medicaid DSH - Short-term delay in FY 2020 Appropriations (H.R. 1865), DSH Cut Delay Act of 2019 (H.R. 3054); Site-Neutral Payment for Outpatient Services; Delayed Bonus Payments for Alternative Payment Models (APMs); Drug Pricing - Lower Drug Costs Now Act of 2019 (H.R. 3), Prescription Drug Pricing Reduction Act of 2019 (S. 2543), CREATES Act of 2019 (S. 340); Physician Shortage - Resident Physician Shortage Reduction Act of 2019 (H.R. 1763/S. 1770), Advancing Medical Resident Training in Community Hospitals Act of 2019 (H.E. 1358); 3-Day inpatient rule for Medicare SNF coverage - Improving Access to Medicare Coverage Act of 2019 (H.R. 1682/S. 753); Medicare Area Wage Index - Imputed Rural Floor.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Coronavirus Preparedness And Response Act, P.L. 116-123; Families First Coronavirus Response Act, P.L. 116-127; Cares Act P.L. 116-136; Surprise Billing Legislation (S. 1895); Community Health Investment, Modernization, and Excellence Act of 2019 (H.R. 2328); Medicaid DSH - Short-term delay in FY 2020 Appropriations (H.R. 1865), DSH Cut Delay Act of 2019 (H.R. 3054); Site-Neutral Payment for Outpatient Services; Delayed Bonus Payments for Alternative Payment Models (APMs); Drug Pricing - Lower Drug Costs Now Act of 2019 (H.R. 3), Prescription Drug Pricing Reduction Act of 2019 (S. 2543), CREATES Act of 2019 (S. 340); Physician Shortage - Resident Physician Shortage Reduction Act of 2019 (H.R. 1763/S. 1770), Advancing Medical Resident Training in Community Hospitals Act of 2019 (H.E. 1358); 3-Day inpatient rule for Medicare SNF coverage - Improving Access to Medicare Coverage Act of 2019 (H.R. 1682/S. 753); Medicare Area Wage Index - Imputed Rural Floor.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

1. Patient Protection and Affordable Health Care Act, implementation of provisions regarding Medicare Part D coverage gap assistance, preventive care services, and dual eligible Medicare and Medicare beneficiaries 2. Proposals to create a premium support or voucher program under Medicare 3. Proposals to "means test" Medicare premiums and benefits 4. Proposals to change federal and state Medicaid cost sharing 5. Proposals to raise the Medicare eligibility age 6. Proposals regarding prescription drug costs for low income Medicare beneficiaries 7. Expansion of Medicare benefits to include hearing, vision, and dental benefits 8. Administration of the Medicare State Health Insurance Assistance Programs 9. Medicare Observation Status Regulations 10. Nursing Home Arbitration Regulations 11. Medicare 340(B) drug reimbursement policy 12. Home care workers and Medicare Reassignment Policy 13. Medicare equitable relief policy 14. S. 340, CREATES Act of 2019, entire bill 15. H.R. 965, CREATES Act of 2019, entire bill 16. H.R. 1046, Medicare Negotiation and Competitive Licensing Act of 2019, entire bill 17. CMS Proposals on Part D Drug Pricing 18. S. 691, Medicare Extra Rx HELP Act of 2019, entire bill 19. H.R. 1342, EMPOWER Care Act, entire bill 20. S. 548, EMPOWER Care Act, entire bill 21. H.R. 1343, Protecting Married Seniors from Impoverishment Act, entire bill 22. S. 97, Affordable and Safe Prescription Drug Importation Act, entire bill 23. S. 99, Medicare Drug Price Negotiation Act, entire bill 24. H.R. 3, Lower Drug Costs Now Act of 2019, entire bill 25. H.R. 1393, Medicare Dental, Vision and Hearing Benefit Act of 2019, entire bill 26. H.R. 1394, Medigap Consumer Protection Act of 2019, entire bill 27. H.R. 1682, Improving Access to Medicare Coverage Act of 2019, entire bill 28. H.R. 4386, Stop the Wait Act, entire bill 29. Proposals regarding the tiering generic drugs under Medicare Part D 30. Proposals regarding the use of Medicaid waivers during the COVID-19 pandemic 31. S. 3544, Coronavirus Relief for Seniors and People with Disabilities Act of 2020, entire bill 32. H.R. 6305, Coronavirus Relief for Seniors and People with Disabilities Act of 2020, entire bill

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Pension & Welfare Benefits Administration, Pension Benefit Guaranty Corporation (PBGC), SENATE, Social Security Administration (SSA), U.S. Trade Representative (USTR)