Medicare-X Choice Act of 2019

H.R.7676/ S.4106 - "Health Care PRICE Transparency Act" - Oppose public disclosure of confidential hospital negotiated rates with payers H.R. 1384 - "Medicare For All Act of 2019", S.1129 - Oppose government-run national health insurance H.R. 2085/ S.1033 "Consumer Health Options and Insurance Competition Enhancement Act (CHOICE) Act", H.R. 2000/S.981 - "Medicare-X Choice Act of 2019" - Oppose public option S. 1895 - "Lower Health Care Costs Act" - Support protecting patients from surprise billing and oppose government rate setting. Advocated for appropriate transparency and contracting flexibility. S.1531 "Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019", H.R. 3630 "No Surprises Act", H.R. 3502 "Protecting People From Surprise Medical Bills Act", H.R. 5800 Ban Surprise Billing Act, H.R. 5826 "Consumer Protections Against Surprise Medical Bills Act of 2020" - Advocate to protect patients from surprise billing and oppose government rate setting. H.R. 6837/ S. 3750 "Medicare Accelerated and Advance Payments Improvement Act of 2020" - Support amended payment terms for eligible health care providers under the Medicare Accelerated and Advance Payments Program H.R. 6800 "Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act" - Support Division C, Health Provisions for Medicare and Medicaid that support health care providers and patients H.R. 6365/ S. 3559 "Immediate Relief for Rural Facilities and Providers Act of 2020" - Support expansion of access to telehealth programs for tax paying rural hospitals H.R. 7059 "Coronavirus Provider Protection Act" - Evaluated and advocated for improvements to legislation relating to liability protections during COVID-19 S. 4317 - "SAFE TO WORK Act" - Develop proposal to protect hospitals, healthcare professionals and facilities from liability due to COVID-19 H.R. 7819 / S. 4525 - " Eliminating the Provider Relief Fund Tax Penalties Act of 2020" - Support technical corrections to Provider Relief Fund to ensure funds received are not taxable H.R. 8337 - "Continuing Appropriations Act, 2021 and Other Extensions Act" - Support passage of continuing resolution, including language to improve repayment terms of Medicare Accelerated and Advance Payment Programs. H.R. 8061 - "Community Immunity During COVID-19 Act of 2020" - Support legislation that increases community access and awareness to vaccinations. S. 4421 - "The Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act" - Support legislation that provides temporary licensing reciprocity for health care professionals. H.R. 133 - "Consolidated Appropriations Act, 2021" - Advocated in support of protecting patients from surprise billing, COVID-19 response. H.Res. 1200 - "Supporting the goals and ideals of National Rural Health Day" - Support National Rural Health Day.

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

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

Monitored Congressional Proposals concerning health price transparency. H.R. 1384 - "Medicare For All Act of 2019", S.1129 - "A bill to establish a Medicare-for-all national health insurance program" - Oppose legislation to impose single payer health care delivery. H.R. 2085/ S.1033 "Consumer Health Options and Insurance Competition Enhancement Act (CHOICE) Act", H.R. 2000/S.981 - "Medicare-X Choice Act of 2019" - Oppose legislation to impose a Medicare public option. H.R. 728/S.1399 - "Title VIII Nursing Workforce Re-authorization Act of 2019" - Support legislation to provide loan repayment for nurses to practice in any care setting. S. 1895 - "Lower Health Care Costs Act" - Support protecting patients from surprise billing and oppose government rate setting. Advocated for appropriate transparency and contracting flexibility. S.1531 "Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019", H.R. 3630 "No Surprises Act", H.R. 3502 "Protecting People From Surprise Medical Bills Act", H.R. 5800 Ban Surprise Billing Act, H.R. 5826 "Consumer Protections Against Surprise Medical Bills Act of 2020" - Advocate to protect patients from surprise billing and oppose government rate setting. H.R. 2328 "Community Health Investment, Modernization, and Excellence Act of 2019", H.R. 748 "Coronavirus Aid, Relief, and Economic Security Act" - Support re-authorization of National Quality Forum. H.R. 3417 "Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act of 2019" - Supported legislation. H.R. 748 Coronavirus Aid, Relief, and Economic Security (CARES) Act, H.R. 6837/ S. 3750 "Medicare Accelerated and Advance Payments Improvement Act of 2020", H.R. 266 "Paycheck Protection Program and Health Care Enhancement Act" - Advocated in support of funding and programs for hospitals and post-acute care providers to respond to COVID-19 H.R. 6800 "Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act" - Support expanded access and affordability of COBRA and other health insurance options H.R. 6365/ S. 3559 "Immediate Relief for Rural Facilities and Providers Act of 2020" - Support expansion of access to telehealth programs for tax paying rural hospitals H.R. 7059 "Coronavirus Provider Protection Act" - Evaluated and advocated for improvements to legislation Liability Protections - Develop proposal to protect hospitals, healthcare professionals and facilities from liability due to COVID-19 Provider Relief Fund Taxability - Support technical corrections to Provider Relief Fund to ensure funds received are not taxable

Client expense: $650,000 · Firm income: Not reported

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

Proposed changes to Medicare hospital reimbursement policy Medicare hospital prospective payment system Site-neutral payment policies H.R. 1384/S. 1129, Medicare for All and other public option alternative proposals H.R. 2452, Medicare for America Act of 2010 provisions related to establishment of a Medicare for America health program to provide for comprehensive health coverage for all Americans H.R. 2463/S. 1261, Choose Medicare Act - provisions related to the establishment of Medicare part E public health plans H.R. 2000/S. 981, Medicare-X Choice Act of 2019 - provisions related to the establishment of a public health plan H.R. 2085/S. 1033, CHOICE Act - provisions amending the Public Health Service Act to establish a public health insurance option S. 470, Medicare at 50 Act - provisions related to amending 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 H.R. 1346, Medicare Buy-In and Health Care Stabilization Act of 2019 - provisions related to providing for an option for individuals who are ages 50 to 64 to buy into Medicare and to provide for health insurance market stabilization H.R. 3, Elijah E. Cummings Lower Drug Costs Now Act S.2543, the Prescription Drug Pricing Reduction Act H.R. 748, "Coronavirus Aid, Relief, and Economic Security Act" (CARES Act) - provisions related to Medicare Senate Health, Economic Assistance, Liability Protections and Schools (HEALS) Act H.R. 925, Health and Economic Recovery Omnibus Emergency Solutions Act (HEROS Act 2.0) Legislative proposals aimed at combating coronavirus impacting Medicare and Medicaid programs

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislative proposals affecting Medicare and Medicaid hospital reimbursement policies Health Information Technology Medicare Graduate Medical Education payments H.R. 1763/S. 348, "Resident Physician Shortage Reduction Act" - provisions related to increasing the number of Medicare-funded residency positions H.R. 3414, "Opioid Workforce Act" - provisions related to expanding Medicare funding for opioid or pain management residency programs Site-neutral payment policies H.R. 1384/S. 1129, Medicare for all and other public option alternative proposals H.R. 2452, Medicare for America Act of 2010 - provisions related to establishment of a Medicare for America health program to provide for comprehensive health coverage for all Americans H.R. 2463/S. 1261, Choose Medicare Act - provisions related to the establishment of Medicare part E public health plans H.R. 2000/S. 981, Medicare-X Choice Act of 2019 - provisions related to the establishment of a public health plan H.R. 2085/S. 1033, CHOICE Act - provisions amending the Public Health Service Act to establish a public health insurance option S. 470, Medicare at 50 Act - provisions related to amending 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 H.R. 1346, Medicare Buy-In and Health Care Stabilization Act of 2019 - provisions related to providing for an option for individuals who are ages 50 to 64 to buy into Medicare and to provide for health insurance market stabilization H.R. 3, "Lower Drug Costs Now Act" S. 2543, "the Prescription Drug Pricing Reduction Act" H.R. 3235, "Access to Genetic Counseling Act" H.R. 748, "Coronavirus Aid, Relief, and Economic Security Act" (CARES Act) - provisions related to Medicare Senate Health, Economic Assistance, Liability Protections and Schools (HEALS) Act H.R. 925, Health and Economic Recovery Omnibus Emergency Solutions Act (HEROS Act 2.0) Legislative proposals aimed at combating coronavirus impacting Medicare and Medicaid programs

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Proposed changes to Medicare hospital reimbursement policy Star Rating System methodology and suspension of the display of overall star ratings on Hospital Compare while the agency continues its important work of enhancing the validity and meaningfulness of star ratings H.R. 1763/S. 348, "Resident Physician Shortage Reduction Act" - provisions related to increasing the number of Medicare-funded residency positions Site-neutral payment policies Oppose H.R. 1384/S. 1129, Medicare for All - provisions related to establishment of a national health insurance program Oppose H.R. 2452, Medicare for America Act of 2010 provisions related to establishment of a Medicare for America health program to provide for comprehensive health coverage for all Americans Oppose H.R. 2463/S. 1261, Choose Medicare Act - provisions related to the establishment of Medicare part E public health plans Oppose H.R. 2000/S. 981, Medicare-X Choice Act of 2019 - provisions related to the establishment of a public health plan Oppose H.R. 2085/S. 1033, CHOICE Act - provisions amending the Public Health Service Act to establish a public health insurance option Oppose S 470, Medicare at 50 Act - provisions related to amending 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 Oppose H.R. 1346, Medicare Buy-In and Health Care Stabilization Act of 2019 - provisions related to providing 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 H.R. 3, "Elijah E. Cummings Lower Drug Costs Now Act" H.R. 748, "Coronavirus Aid, Relief, and Economic Security Act" (CARES Act) - provisions related to Medicare Senate Health, Economic Assistance, Liability Protections and Schools (HEALS) Act H.R. 925, Health and Economic Recovery Omnibus Emergency Solutions Act (HEROS Act 2.0) Legislative proposals aimed at combating coronavirus impacting Medicare and Medicaid programs

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.7676/ S.4106 - "Health Care PRICE Transparency Act" - Oppose public disclosure of confidential hospital negotiated rates with payers H.R. 1384 - "Medicare For All Act of 2019", S.1129 - Oppose government-run national health insurance H.R. 2085/ S.1033 "Consumer Health Options and Insurance Competition Enhancement Act (CHOICE) Act", H.R. 2000/S.981 - "Medicare-X Choice Act of 2019" - Oppose public option S. 1895 - "Lower Health Care Costs Act" - Support protecting patients from surprise billing and oppose government rate setting. Advocated for appropriate transparency and contracting flexibility. S.1531 "Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019", H.R. 3630 "No Surprises Act", H.R. 3502 "Protecting People From Surprise Medical Bills Act", H.R. 5800 Ban Surprise Billing Act, H.R. 5826 "Consumer Protections Against Surprise Medical Bills Act of 2020" - Advocate to protect patients from surprise billing and oppose government rate setting. H.R. 6837/ S. 3750 "Medicare Accelerated and Advance Payments Improvement Act of 2020" - Support amended payment terms for eligible health care providers under the Medicare Accelerated and Advance Payments Program H.R. 6800 "Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act" - Support Division C, Health Provisions for Medicare and Medicaid that support health care providers and patients H.R. 6365/ S. 3559 "Immediate Relief for Rural Facilities and Providers Act of 2020" - Support expansion of access to telehealth programs for tax paying rural hospitals H.R. 7059 "Coronavirus Provider Protection Act" - Evaluated and advocated for improvements to legislation relating to liability protections during COVID-19 S. 4317 - "SAFE TO WORK Act" - Develop proposal to protect hospitals, healthcare professionals and facilities from liability due to COVID-19 H.R. 7819 / S. 4525 - " Eliminating the Provider Relief Fund Tax Penalties Act of 2020" - Support technical corrections to Provider Relief Fund to ensure funds received are not taxable H.R. 8337 - "Continuing Appropriations Act, 2021 and Other Extensions Act" - Support passage of continuing resolution, including language to improve repayment terms of Medicare Accelerated and Advance Payment Programs. H.R. 8061 - "Community Immunity During COVID-19 Act of 2020" - Support legislation that increases community access and awareness to vaccinations. S. 4421 - "The Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act" - Support legislation that provides temporary licensing reciprocity for health care professionals.

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

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

Legislative proposals affecting Medicare and Medicaid hospital reimbursement policies Health Information Technology Medicare Graduate Medical Education payments H.R. 1763/S. 348, "Resident Physician Shortage Reduction Act" - provisions related to increasing the number of Medicare-funded residency positions H.R. 3414, "Opioid Workforce Act" - provisions related to expanding Medicare funding for opioid or pain management residency programs Site-neutral payment policies H.R. 1384/S. 1129, Medicare for all and other public option alternative proposals H.R. 2452, Medicare for America Act of 2010 provisions related to establishment of a Medicare for America health program to provide for comprehensive health coverage for all Americans H.R. 2463/S. 1261, Choose Medicare Act - provisions related to the establishment of Medicare part E public health plans H.R. 2000/S. 981, Medicare-X Choice Act of 2019 - provisions related to the establishment of a public health plan H.R. 2085/S. 1033, CHOICE Act - provisions amending the Public Health Service Act to establish a public health insurance option S. 470, Medicare at 50 Act - provisions related to amending 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 H.R. 1346, Medicare Buy-In and Health Care Stabilization Act of 2019 - provisions related to providing for an option for individuals who are ages 50 to 64 to buy into Medicare and to provide for health insurance market stabilization H.R. 3, "Lower Drug Costs Now Act" H.R. 3235, "Access to Genetic Counseling Act"

Client expense: $201,000 · Firm income: Not reported

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

Discussions regarding the Centers for Medicare and Medicaid (CMS) implementation and expansion of the Accelerated and Advance Payments Program under the CARES Act HR 1384 Medicare for All Act of 2019 (all sections of full text)(oppose) Disproportionate Share Hospital payments (DSH) extensions for qualifying hospitals in spending bills Discussions involving Medicare bad debt/uncompensated care payments to hospitals \ Monitored CMS Medicaid Fiscal Accountability Regulation (MFAR) rulemaking activity Monitored S 4329 Patient Access to Higher Quality Health Care Act of 2019 Monitored HR 3062 Patient Access to Higher Quality Health Care Act of 2019 Monitored S 2543 Prescription Drug Pricing Reduction Act, Sec. 109 Monitored HR 2000 Medicare-X Choice Act of 2019 Monitored S 981 Medicare-X Choice Act of 2019 Monitored S 470 Medicare at 50 Act Monitored HR 1301 The Mental Health Telemedicine Expansion Act of 2019 Monitored HR 1559 The 340B Protection and Accountability Act of 2019 Monitored CMS regulations and reporting requirements under the Emergency Medical Treatment and Labor Act

Client expense: Not reported · Firm income: $130,000

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, SENATE

Monitored Congressional Proposals concerning health price transparency. H.R. 1384 - "Medicare For All Act of 2019", S.1129 - "A bill to establish a Medicare-for-all national health insurance program" - Oppose legislation to impose single payer health care delivery. H.R. 2085/ S.1033 "Consumer Health Options and Insurance Competition Enhancement Act (CHOICE) Act", H.R. 2000/S.981 - "Medicare-X Choice Act of 2019" - Oppose legislation to impose a Medicare public option. H.R. 728/S.1399 - "Title VIII Nursing Workforce Re-authorization Act of 2019" - Support legislation to provide loan repayment for nurses to practice in any care setting. S. 1895 - "Lower Health Care Costs Act" - Support protecting patients from surprise billing and oppose government rate setting. Advocated for appropriate transparency and contracting flexibility. S.1531 "Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019", H.R. 3630 "No Surprises Act", H.R. 3502 "Protecting People From Surprise Medical Bills Act", H.R. 5800 Ban Surprise Billing Act, H.R. 5826 "Consumer Protections Against Surprise Medical Bills Act of 2020" - Advocate to protect patients from surprise billing and oppose government rate setting. H.R. 2328 "Community Health Investment, Modernization, and Excellence Act of 2019", H.R. 748 "Coronavirus Aid, Relief, and Economic Security Act" - Support re-authorization of National Quality Forum. H.R. 3417 "Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act of 2019" - Supported legislation. H.R. 748 Coronavirus Aid, Relief, and Economic Security (CARES) Act, H.R. 6837/ S. 3750 "Medicare Accelerated and Advance Payments Improvement Act of 2020", H.R. 266 "Paycheck Protection Program and Health Care Enhancement Act" - Advocated in support of funding and programs for hospitals and post-acute care providers to respond to COVID-19 H.R. 6800 "Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act" - Support expanded access and affordability of COBRA and other health insurance options H.R. 6365/ S. 3559 "Immediate Relief for Rural Facilities and Providers Act of 2020" - Support expansion of access to telehealth programs for tax paying rural hospitals H.R. 7059 "Coronavirus Provider Protection Act" - Evaluated and advocated for improvements to legislation Liability Protections - Develop proposal to protect hospitals, healthcare professionals and facilities from liability due to COVID-19 Provider Relief Fund Taxability - Support technical corrections to Provider Relief Fund to ensure funds received are not taxable

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

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

Legislative proposals affecting Medicare and Medicaid hospital reimbursement policies Health Information Technology Medicare Graduate Medical Education payments H.R. 1763/S. 348, "Resident Physician Shortage Reduction Act" - provisions related to increasing the number of Medicare-funded residency positions H.R. 3414, "Opioid Workforce Act" - provisions related to expanding Medicare funding for opioid or pain management residency programs Site-neutral payment policies H.R. 1384/S. 1129, Medicare for all and other public option alternative proposals H.R. 2452, Medicare for America Act of 2010 - provisions related to establishment of a Medicare for America health program to provide for comprehensive health coverage for all Americans H.R. 2463/S. 1261, Choose Medicare Act - provisions related to the establishment of Medicare part E public health plans H.R. 2000/S. 981, Medicare-X Choice Act of 2019 - provisions related to the establishment of a public health plan H.R. 2085/S. 1033, CHOICE Act - provisions amending the Public Health Service Act to establish a public health insurance option S. 470, Medicare at 50 Act - provisions related to amending 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 H.R. 1346, Medicare Buy-In and Health Care Stabilization Act of 2019 - provisions related to providing for an option for individuals who are ages 50 to 64 to buy into Medicare and to provide for health insurance market stabilization H.R. 3, "Lower Drug Costs Now Act" S. 2543, "the Prescription Drug Pricing Reduction Act" H.R. 3235, "Access to Genetic Counseling Act" H.R. 6201, "Families First Coronavirus Response Act" - provisions related to Medicaid and Medicare H.R. 748, "Coronavirus Aid, Relief, and Economic Security Act" (CARES Act) - provisions related to Medicare H.R. 6800, "HEROES Act" Legislative proposals aimed at combating coronavirus impacting Medicare and Medicaid programs

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Proposed changes to Medicare hospital reimbursement policy Medicare hospital prospective payment system Site-neutral payment policies H.R. 1384/S. 1129, Medicare for All and other public option alternative proposals H.R. 2452, Medicare for America Act of 2010 provisions related to establishment of a Medicare for America health program to provide for comprehensive health coverage for all Americans H.R. 2463/S. 1261, Choose Medicare Act - provisions related to the establishment of Medicare part E public health plans H.R. 2000/S. 981, Medicare-X Choice Act of 2019 - provisions related to the establishment of a public health plan H.R. 2085/S. 1033, CHOICE Act - provisions amending the Public Health Service Act to establish a public health insurance option S. 470, Medicare at 50 Act - provisions related to amending 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 H.R. 1346, Medicare Buy-In and Health Care Stabilization Act of 2019 - provisions related to providing for an option for individuals who are ages 50 to 64 to buy into Medicare and to provide for health insurance market stabilization H.R. 3, Elijah E. Cummings Lower Drug Costs Now Act S.2543, the Prescription Drug Pricing Reduction Act H.R. 6201, "Families First Coronavirus Response Act" - provisions related to Medicaid and Medicare H.R. 748, "Coronavirus Aid, Relief, and Economic Security Act" (CARES Act) - provisions related to Medicare H.R. 6800, "HEROES Act" Legislative proposals aimed at combating coronavirus impacting Medicare and Medicaid programs

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Proposed changes to Medicare hospital reimbursement policy Star Rating System methodology and suspension of the display of overall star ratings on Hospital Compare while the agency continues its important work of enhancing the validity and meaningfulness of star ratings H.R. 1763/S. 348, "Resident Physician Shortage Reduction Act" - provisions related to increasing the number of Medicare-funded residency positions Site-neutral payment policies Oppose H.R. 1384/S. 1129, Medicare for All - provisions related to establishment of a national health insurance program Oppose H.R. 2452, Medicare for America Act of 2010 provisions related to establishment of a Medicare for America health program to provide for comprehensive health coverage for all Americans Oppose H.R. 2463/S. 1261, Choose Medicare Act - provisions related to the establishment of Medicare part E public health plans Oppose H.R. 2000/S. 981, Medicare-X Choice Act of 2019 - provisions related to the establishment of a public health plan Oppose H.R. 2085/S. 1033, CHOICE Act - provisions amending the Public Health Service Act to establish a public health insurance option Oppose S 470, Medicare at 50 Act - provisions related to amending 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 Oppose H.R. 1346, Medicare Buy-In and Health Care Stabilization Act of 2019 - provisions related to providing 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 H.R. 3, "Elijah E. Cummings Lower Drug Costs Now Act" H.R. 6201, "Families First Coronavirus Response Act" - provisions related to Medicaid and Medicare H.R. 748, "Coronavirus Aid, Relief, and Economic Security Act" (CARES Act) - provisions related to Medicare H.R. 6800, "HEROES Act" Legislative proposals aimed at combating coronavirus impacting Medicare and Medicaid programs

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Discussions regarding the Centers for Medicare and Medicaid (CMS) implementation and expansion of the Accelerated and Advance Payments Program under the CARES Act HR 1384 Medicare for All Act of 2019 (all sections of full text)(oppose) Disproportionate Share Hospital payments (DSH) extensions for qualifying hospitals in spending bills Discussions pertaining to the Centers for Medicare and Medicaid (CMS) implementation and expansion of the Accelerated and Advance Payments Program under the CARES Act Monitored S 2543 Prescription Drug Pricing Reduction Act, Sec. 109 Monitored HR 3 Elijah E. Cummings Lower Drug Costs Now Act of 2019 Monitored H.R. 275 Medicare Prescription Drug Price Negotiation Act of 2019 Monitored HR 2000 Medicare-X Choice Act of 2019 Monitored S 981 Medicare-X Choice Act of 2019 Monitored S 470 Medicare at 50 Act Monitored HR 1301 The Mental Health Telemedicine Expansion Act of 2019 Monitored HR 1559 The 340B Protection and Accountability Act of 2019 Monitored HR 1332 The Fair Care Act of 2019 Monitored CMS regulations and reporting requirements under the Emergency Medical Treatment and Labor Act Monitored proposed reduction on the amount of Medicare bad debt/uncompensated care payments to hospitals for Medicare beneficiaries who fail to pay their cost-sharing obligations for treatments provided by the hospital

Client expense: Not reported · Firm income: $130,000

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, SENATE

Monitored Congressional Proposals concerning health price transparency. H.R. 1384 - "Medicare For All Act of 2019", S.1129 - "A bill to establish a Medicare-for-all national health insurance program" - Oppose legislation to impose single payer health care delivery. H.R. 2085/ S.1033 "Consumer Health Options and Insurance Competition Enhancement Act (CHOICE) Act", H.R. 2000/S.981 - "Medicare-X Choice Act of 2019" - Oppose legislation to impose a Medicare public option. H.R. 728/S.1399 - "Title VIII Nursing Workforce Re-authorization Act of 2019" - Support legislation to provide loan repayment for nurses to practice in any care setting. S. 1895 - "Lower Health Care Costs Act" - Support protecting patients from surprise billing and oppose government rate setting. Advocated for appropriate transparency and contracting flexibility. S.1531 "Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019", H.R. 3630 "No Surprises Act", H.R. 3502 "Protecting People From Surprise Medical Bills Act", H.R. 5800 Ban Surprise Billing Act, H.R. 5826 "Consumer Protections Against Surprise Medical Bills Act of 2020" - Advocate to protect patients from surprise billing and oppose government rate setting. H.R. 2328 "Community Health Investment, Modernization, and Excellence Act of 2019", H.R. 748 "Coronavirus Aid, Relief, and Economic Security Act" - Support re-authorization of National Quality Forum. H.R. 3417 "Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act of 2019" - Supported legislation. H.R. 748 Coronavirus Aid, Relief, and Economic Security (CARES) Act, H.R. 6837/ S. 3750 "Medicare Accelerated and Advance Payments Improvement Act of 2020", H.R. 266 "Paycheck Protection Program and Health Care Enhancement Act" - Advocated in support of funding and programs for hospitals and post-acute care providers to respond to COVID-19 H.R. 6800 "Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act" - Support expanded access and affordability of COBRA and other health insurance options H.R. 6365/ S. 3559 "Immediate Relief for Rural Facilities and Providers Act of 2020" - Support expansion of access to telehealth programs for tax paying rural hospitals H.R. 7059 "Coronavirus Provider Protection Act" - Evaluated and advocated for improvements to legislation Liability Protections - Develop proposal to protect hospitals, healthcare professionals and facilities from liability due to COVID-19 Provider Relief Fund Taxability - Support technical corrections to Provider Relief Fund to ensure funds received are not taxable

Client expense: $650,000 · Firm income: Not reported

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

Legislative proposals affecting Medicare and Medicaid hospital reimbursement policies Health Information Technology Medicare Graduate Medical Education payments H.R. 1763/S. 348, "Resident Physician Shortage Reduction Act" - provisions related to increasing the number of Medicare-funded residency positions H.R. 3414, "Opioid Workforce Act" - provisions related to expanding Medicare funding for opioid or pain management residency programs Site-neutral payment policies H.R. 1384/S. 1129, Medicare for all and other public option alternative proposals H.R. 2452, Medicare for America Act of 2010 provisions related to establishment of a Medicare for America health program to provide for comprehensive health coverage for all Americans H.R. 2463/S. 1261, Choose Medicare Act - provisions related to the establishment of Medicare part E public health plans H.R. 2000/S. 981, Medicare-X Choice Act of 2019 - provisions related to the establishment of a public health plan H.R. 2085/S. 1033, CHOICE Act - provisions amending the Public Health Service Act to establish a public health insurance option S. 470, Medicare at 50 Act - provisions related to amending 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 H.R. 1346, Medicare Buy-In and Health Care Stabilization Act of 2019 - provisions related to providing for an option for individuals who are ages 50 to 64 to buy into Medicare and to provide for health insurance market stabilization H.R. 3, "Lower Drug Costs Now Act" H.R. 3235, "Access to Genetic Counseling Act"

Client expense: $201,000 · Firm income: Not reported

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

Legislative proposals affecting Medicare and Medicaid hospital reimbursement policies Health Information Technology Medicare Graduate Medical Education payments H.R. 1763/S. 348, "Resident Physician Shortage Reduction Act" - provisions related to increasing the number of Medicare-funded residency positions H.R. 3414, "Opioid Workforce Act" - provisions related to expanding Medicare funding for opioid or pain management residency programs Site-neutral payment policies H.R. 1384/S. 1129, Medicare for all and other public option alternative proposals H.R. 2452, Medicare for America Act of 2010 provisions related to establishment of a Medicare for America health program to provide for comprehensive health coverage for all Americans H.R. 2463/S. 1261, Choose Medicare Act - provisions related to the establishment of Medicare part E public health plans H.R. 2000/S. 981, Medicare-X Choice Act of 2019 - provisions related to the establishment of a public health plan H.R. 2085/S. 1033, CHOICE Act - provisions amending the Public Health Service Act to establish a public health insurance option S. 470, Medicare at 50 Act - provisions related to amending 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 H.R. 1346, Medicare Buy-In and Health Care Stabilization Act of 2019 - provisions related to providing for an option for individuals who are ages 50 to 64 to buy into Medicare and to provide for health insurance market stabilization H.R. 3, "Lower Drug Costs Now Act" H.R. 3235, "Access to Genetic Counseling Act"

Client expense: $201,000 · Firm income: Not reported

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

Legislative proposals affecting Medicare and Medicaid hospital reimbursement policies Health Information Technology Medicare Graduate Medical Education payments H.R. 1763/S. 348, "Resident Physician Shortage Reduction Act" - provisions related to increasing the number of Medicare-funded residency positions H.R. 3414, "Opioid Workforce Act" - provisions related to expanding Medicare funding for opioid or pain management residency programs Site-neutral payment policies H.R. 1384/S. 1129, Medicare for all and other public option alternative proposals H.R. 2452, Medicare for America Act of 2010 provisions related to establishment of a Medicare for America health program to provide for comprehensive health coverage for all Americans H.R. 2463/S. 1261, Choose Medicare Act - provisions related to the establishment of Medicare part E public health plans H.R. 2000/S. 981, Medicare-X Choice Act of 2019 - provisions related to the establishment of a public health plan H.R. 2085/S. 1033, CHOICE Act - provisions amending the Public Health Service Act to establish a public health insurance option S. 470, Medicare at 50 Act - provisions related to amending 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 H.R. 1346, Medicare Buy-In and Health Care Stabilization Act of 2019 - provisions related to providing for an option for individuals who are ages 50 to 64 to buy into Medicare and to provide for health insurance market stabilization H.R. 3, "Lower Drug Costs Now Act" H.R. 3235, "Access to Genetic Counseling Act"

Client expense: $129,472 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

The Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 (H.R. 6074) Families First Coronavirus Response Act (H.R. 6201) The Coronavirus Aid, Relief, and Economic Security Act (S. 3548) Regulatory relief in light of coronavirus FY 2021 Labor-HHS Subcommittee Appropriations bill Market stabilization/Insurance Coverage Policies (Oversight of final rules on short-term, limited duration insurance (STLDI) and Association Health Plans) Coverage proposals (U.S. v Texas; Medicare X-Choice Proposal; H.R. 1384, the Medicare for All Act of 2019; S. 1129, Medicare-for-all national health insurance program; H.R. 1384 and H.R. 2452 to create a national health insurance program; H.R. 2000, H.R. 2463, and H.R. 2085 to create a federal public option; H.R. 1277 a Medicaid buy-in; H.R. 1346 and H.R. 4527 adults aged 50-64 or qualified first responders Medicare buy in; H.R. 584 Medicaid expansion) Hospital Price Transparency (surprise medical bills; public posting of hospital charges; Executive Order on Improving Price and Quality Transparency in American Healthcare to Put Patients First; Final Rule on Price Transparency; Transparency in Coverage Proposed Rule) Surprise Medical Bills (S. 1895 Lower Health Care Costs Act of 2019; S. 1531 Stopping the Outrageous Practice of Surprise Medical Bills Act; S. 1266 the Protecting Patients from Surprise Medical Bills Act; S. 1497, the Health Care Price Check Act; H.R.861, the End Surprise Billing Act of 2019; S. 1688 - A bill to amend the Public Health Service Act to provide for the full disclosure of billing and service information to patients; H.R. 3502 the Protecting People from Surprise Medical Bills Act; H.R. 3630, No Surprises Act; H.R. 2328, the Reauthorizing and Extending Americas Community Health Act) 340B Drug Pricing Program Drug pricing policy and drug shortages (H.R. 3, Lower Drug Costs Now Act; S. 340/H.R. 965, CREATES Act; H.R. 1499, Protecting Consumer Access to Generic Drugs Act; H.R. 2375, Preserve Access to Affordable Generics and Biosimilars Act; H.R. 2296, the More Efficient Tools to Realize Information for Consumers (METRIC) Act; H.R. 1781, the Payment Commission Data Act of 2019; H.R. 2115, requiring PBMs to report rebate data) HIPAA policy in mental and behavioral health information sharing (H.R. 2062, Overdose Prevention and Patient Safety Act) BLOCKING Act of 2019 (H.R. 938) To amend the Internal Revenue Code of 1986 and title XI of the Social Security Act to extend appropriations and transfers to the Patient-Centered Outcomes Research Trust Fund and to extend certain health insurance fees for such transfers, and for other purposes (H.R. 3439) H.R. 2781, the Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness (EMPOWER) for Health Act of 2019 H.R. 728, the Title VIII Nursing Workforce Reauthorization Act H.R. 647, the Palliative Care and Hospice Education and Training Act Hospital Star Ratings

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Proposed changes to Medicare hospital reimbursement policy Medicare hospital prospective payment system Site-neutral payment policies H.R. 1384/S. 1129, Medicare for All and other public option alternative proposals H.R. 2452, Medicare for America Act of 2010 provisions related to establishment of a Medicare for America health program to provide for comprehensive health coverage for all Americans H.R. 2463/S. 1261, Choose Medicare Act - provisions related to the establishment of Medicare part E public health plans H.R. 2000/S. 981, Medicare-X Choice Act of 2019 - provisions related to the establishment of a public health plan H.R. 2085/S. 1033, CHOICE Act - provisions amending the Public Health Service Act to establish a public health insurance option S. 470, Medicare at 50 Act - provisions related to amending 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 H.R. 1346, Medicare Buy-In and Health Care Stabilization Act of 2019 - provisions related to providing for an option for individuals who are ages 50 to 64 to buy into Medicare and to provide for health insurance market stabilization H.R. 3, Elijah E. Cummings Lower Drug Costs Now Act S.2543, the Prescription Drug Pricing Reduction Act H.R. 6201, "Families First Coronavirus Response Act" - provisions related to Medicaid and Medicare H.R. 748, "Coronavirus Aid, Relief, and Economic Security Act" (CARES Act) - provisions related to Medicare Legislative proposals aimed at combating coronavirus impacting Medicare and Medicaid programs

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislative proposals affecting Medicare and Medicaid hospital reimbursement policies Health Information Technology Medicare Graduate Medical Education payments H.R. 1763/S. 348, "Resident Physician Shortage Reduction Act" - provisions related to increasing the number of Medicare-funded residency positions H.R. 3414, "Opioid Workforce Act" - provisions related to expanding Medicare funding for opioid or pain management residency programs Site-neutral payment policies H.R. 1384/S. 1129, Medicare for all and other public option alternative proposals H.R. 2452, Medicare for America Act of 2010 - provisions related to establishment of a Medicare for America health program to provide for comprehensive health coverage for all Americans H.R. 2463/S. 1261, Choose Medicare Act - provisions related to the establishment of Medicare part E public health plans H.R. 2000/S. 981, Medicare-X Choice Act of 2019 - provisions related to the establishment of a public health plan H.R. 2085/S. 1033, CHOICE Act - provisions amending the Public Health Service Act to establish a public health insurance option S. 470, Medicare at 50 Act - provisions related to amending 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 H.R. 1346, Medicare Buy-In and Health Care Stabilization Act of 2019 - provisions related to providing for an option for individuals who are ages 50 to 64 to buy into Medicare and to provide for health insurance market stabilization H.R. 3, "Lower Drug Costs Now Act" S. 2543, "the Prescription Drug Pricing Reduction Act" H.R. 3235, "Access to Genetic Counseling Act" H.R. 6201, "Families First Coronavirus Response Act" - provisions related to Medicaid and Medicare H.R. 748, "Coronavirus Aid, Relief, and Economic Security Act" (CARES Act) - provisions related to Medicare Legislative proposals aimed at combating coronavirus impacting Medicare and Medicaid programs

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Proposed changes to Medicare hospital reimbursement policy Star Rating System methodology and suspension of the display of overall star ratings on Hospital Compare while the agency continues its important work of enhancing the validity and meaningfulness of star ratings H.R. 1763/S. 348, "Resident Physician Shortage Reduction Act" - provisions related to increasing the number of Medicare-funded residency positions Site-neutral payment policies Oppose H.R. 1384/S. 1129, Medicare for All - provisions related to establishment of a national health insurance program Oppose H.R. 2452, Medicare for America Act of 2010 provisions related to establishment of a Medicare for America health program to provide for comprehensive health coverage for all Americans Oppose H.R. 2463/S. 1261, Choose Medicare Act - provisions related to the establishment of Medicare part E public health plans Oppose H.R. 2000/S. 981, Medicare-X Choice Act of 2019 - provisions related to the establishment of a public health plan Oppose H.R. 2085/S. 1033, CHOICE Act - provisions amending the Public Health Service Act to establish a public health insurance option Oppose S 470, Medicare at 50 Act - provisions related to amending 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 Oppose HR 1346, Medicare Buy-In and Health Care Stabilization Act of 2019 - provisions related to providing 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 H.R. 3, "Elijah E. Cummings Lower Drug Costs Now Act" H.R. 6201, "Families First Coronavirus Response Act" - provisions related to Medicaid and Medicare H.R. 748, "Coronavirus Aid, Relief, and Economic Security Act" (CARES Act) - provisions related to Medicare Legislative proposals aimed at combating coronavirus impacting Medicare and Medicaid programs

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Monitored Congressional Proposals concerning health price transparency. H.R. 1384 - "Medicare For All Act of 2019" - Oppose legislation to impose single payer health care delivery. S.1129 - "A bill to establish a Medicare-for-all national health insurance program" - Oppose legislation to impose single payer health care delivery. H.R. 2000/S.981 - "Medicare-X Choice Act of 2019" - Oppose legislation to impose a Medicare public option. H.R. 728/S.1399 - "Title VIII Nursing Workforce Re-authorization Act of 2019" - Urge support for legislation to provide loan repayment for nurses to practice in any care setting. S. 1895 - "Lower Health Care Costs Act" - Support protecting patients from surprise billing and oppose government rate setting. Advocated for appropriate transparency and contracting flexibility. S.1531 "Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019", H.R. 3630 "No Surprises Act", H.R. 3502 "Protecting People From Surprise Medical Bills Act", HR 5800 Ban Surprise Billing Act, HR 5800 Ban Surprise Billing Act - Advocate to protect patients from surprise billing and oppose rate setting. H.R. 2328 - Support re-authorization of National Quality Forum. H.R. 3417 - "Health Care Extenders" - Supported legislation. H.R. 6074 Coronavirus Preparedness and Response Supplemental Appropriations Act, H.R. 6201 Families First Coronavirus Response Act, H.R. 748 Coronavirus Aid, Relief, and Economic Security (CARES) Act - Advocated in support of funding and programs for hospitals and post-acute care providers to respond to COVID-19 Advocate for appropriate requirements for 3rd party access to patient medical records.

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

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

HR 1384 Medicare for All Act of 2019 (all sections of full text)(oppose) Disproportionate Share Hospital payments (DSH) extensions for qualifying hospitals in spending bills Monitored S 2543 Prescription Drug Pricing Reduction Act, Sec. 109 Monitored HR 3 Elijah E. Cummings Lower Drug Costs Now Act of 2019 Monitored H.R. 275 Medicare Prescription Drug Price Negotiation Act of 2019 Monitored HR 2000 Medicare-X Choice Act of 2019 Monitored S 981 Medicare-X Choice Act of 2019 Monitored S 470 Medicare at 50 Act Monitored HR 1301 The Mental Health Telemedicine Expansion Act of 2019 Monitored HR 1559 The 340B Protection and Accountability Act of 2019 Monitored HR 1332 The Fair Care Act of 2019 Monitored CMS regulations and reporting requirements under the Emergency Medical Treatment and Labor Act Monitored proposed reduction on the amount of Medicare bad debt/uncompensated care payments to hospitals for Medicare beneficiaries who fail to pay their cost-sharing obligations for treatments provided by the hospital

Client expense: Not reported · Firm income: $130,000

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

HR1384 Medicare for All Act of 2019 (all sections of full text)(oppose) Disproportionate Share Hospital payments (DSH) extensions for qualifying hospitals in spending bills S 2543 Prescription Drug Pricing reduction Act, Sec. 109 Monitored HR 3 Elijah E. Cummings Lower Drug Costs Now Act of 2019 Monitored HR 275 Medicare Prescription Drug Price Negotiation Act of 2019 Monitored HR 2000 Medicare-X Choice Act of 2019 Monitored 981 Medicare-X Choice Act of 2019 Monitored S 470 Medicare at 50 Act Monitored HR1301 The Mental Health Telemedicine Expansion Act of 2019 Monitored HR1559 The 340B Protection and Accountability Act of 2019 Monitored HR1332 The Fair Care Act of 2019 Monitored CMS regulations and reporting requirements under the Emergency Medical Treatment and Labor Act Monitored proposed reduction on the amount of Medicare bad debt/uncompensated care payments to hospitals for Medicare beneficiaries who fail to pay their cost sharing obligations for treatments provided by the hospital

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

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

S. 350, Competitive Health Insurance Reform Act (Daines) - McCarran-Ferguson Act S. 455, Marketing and Outreach Restoration to Empower Health Education Act (Shaheen) - funding for outreach and education on ACA Exchanges S. 466, Protecting Americans with Preexisting Conditions Act (Warner) - blocking updated Section 1332 guidance S. 560, Ensuring Lasting Smiles Act (Baldwin) - coverage mandate for treatment of congenital anomaly or birth defect S. 741, Cancer Drug Parity Act (Smith) -- cost sharing for oral anticancer drugs S. 913, Disclosure of Price Information to Enrollees (Braun) S. 961, Improving Health Insurance Affordability Act (Shaheen) - premium tax credits S. 964, Marketplace Certainty Act (Shaheen) - cost-sharing subsidies S. 967, Reducing Costs for Out-of-Network Services Act (Shaheen) - caps on out-of-network charges S. 981, Medicare-X Choice Act (Bennet) - public option S. 1033, CHOICE Act (Whitehouse) - public option S. 1125, Protect Act (Tillis) - pre-existing condition protections S. 1129, Medicare for All Act (Sanders) - government health insurance system S. 1170, Association Health Plans Act (Enzi) - codifying final rule for expanding AHPs S. 1266, Protecting Patients from Surprise Medical Bills Act (Scott) - surprise medical billing S. 1531, STOP Surprise Medical Bills Act (Cassidy-Bennet) - surprise medical billing S. 1576, Behavioral Health Coverage Transparency Act (Warren) - mental health parity S. 1577, Know the Price Act (Cassidy-Bennet) - restrictions on provider contracts S. 1737, Mental Health Parity Compliance Act (Murphy) - mental health parity S. 1948, Chronic Disease Management Act (Thune) - pre-deductible coverage of chronic disease prevention services S. 2546, Safe Step Act (Murkowski)-Step therapy exceptions H.R. 692, Pre-existing Conditions Protection Act (Walden) - pre-existing condition protections H.R. 986, Protecting Americans with Preexisting Conditions Act (Kuster) - blocking updated Section 1332 guidance H.R. 987, Marketing and Outreach Restoration to Empower Health Education Act (Blunt Rochester) - funding for outreach and education on ACA Exchanges, Navigator program, and establishment of state-based Health Insurance Exchanges; drug pricing proposals H.R. 1010, Short-Term Plans (Castor) - blocking final rule that expands short-term plans H.R. 1143, Educating Consumers on the Risks of Short-Term Plans Act (Eshoo) - standardized disclosures for short-term plans H.R. 1379, Ensuring Lasting Smiles Act (Peterson) - coverage mandate for treatment of congenital anomaly or birth defect H.R. 1384, Medicare for All Act (Jayapal) - government health insurance system H.R. 1385, State Allowance for a Variety of Exchanges Act (Kim) - funding for establishment of state-based Health Insurance Exchanges H.R. 1386, Expand Navigators Resources for Outreach, Learning, and Longevity Act (Castor) - funding for Navigator Program H.R. 1418, Competitive Health Insurance Reform Act (DeFazio) - McCarran-Ferguson Act H.R. 1425, State Health Care Premium Reduction Act (Craig) - funding for state reinsurance programs H.R. 1510, Premium Relief Act (Burgess) -- Patient and State Stability Fund H.R. 1730, Cancer Drug Parity Act (Higgins) -- cost sharing for oral anticancer drugs H.R. 1884, Protecting Pre-Existing Conditions and Making Health Care More Affordable Act (Pallone) - reinsurance funding, stabilization and affordability proposals H.R. 2000, Medicare-X Choice Act (Delgado) - public option H.R. 2061, Pathway to Universal Coverage Act (Bera) - auto-enrollment H.R. 2085, CHOICE Act (Schakowsky) - public option H.R. 2183, State Flexibility and Patient Choice Act (Marshall) - flexibility in state innovation waivers H.R. 2848, Parity Enforcement Act (Norcross) - mental health parity H.R. 2874, Behavioral Health Coverage Transparency Act (Kennedy) - mental health parity H.R. 3165, Mental Health Parity Compliance Act (Porter) - mental health parity H.R. 3502, Protecting People From Surprise Medical Bills Act (Ruiz) - surprise medical billing H.R. 3630, No Surprises Act (Pallone)-surprise medical billing H.R. 3784, Air Ambulance Affordability Act of 2019 (Neguse)- air ambulances H.R. 4223, Protecting Patients from Surprise Medical Bills Act (Spano)-surprise medical billing H.R. 4379, Under Performing Directories that Affect Treating Emergencies Act (Axne)-provider directories H.R. 4457, Chronic Condition Copay Elimination Act (Underwood)- Eliminating copays for services/drugs for chronic conditions H.R. 4484, Flexibility Through Lower Expenses Health Care Act (Budd)-STLDI plans H.R. 4530, Native American Health Savings Improvement Act (Moolenaar)-HSAs H.R. 4575, Improving Provider Directories Act (Schrier)-provider directories H.R. 5010, State-Based Universal Health Care Act of 2019 (Khanna) - universal health care systems H.R. 5121, Healthcare Cost Transparency Act (Beyer) - provider price comparison tool H.R. 5144, Insurance Accountability and Transparency Act (Davids) - insurance have publicly accessible self-audit information H.R. 5239 Prescription Drug Price Reporting Act (Joyce) - reporting on drug expenditures and price changes under group health plans H. Res. 271 (Allred) - resolution urging DOJ to reverse position in Texas v. United States litigation Regulatory Issues: Insurance regulatory reform; issues related to the coordination of private and public disability income benefits; disability risk management; disability income insurance enrollment and awareness; issues related to encouraging impaired workers to stay in/return to the workforce; issues related to expanding long-term care insurance coverage; issues relating to the coordination of benefits between private health insurance plans and Medicaid; Medigap claims processing and crossover fees; Medigap cross-over claim issues, Medigap coverage, implementation of Medigap standardized plan offerings; Medigap carrier recoveries related to CMS fraud and abuse enforcement activities, and issues related to Medigap educational materials, and other Medigap issues; fraud and abuse issues affecting public and private insurance coverage; issues relating to antitrust; implementation of the Mental Health Parity Act requirements; implementation of the 21st Century Cures Act requirements; summary of benefits and coverage disclosures; prior authorization; accountable care organizations; coverage of preventive services; preexisting condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; health reimbursement accounts; dependent coverage; treatment of expatriate plans; issues related to surprise medical bills; issues related to all payor claims databases; issues related to association health plans; issues related to substance abuse and provider treatment records (42 CFR Part 2); issues related to medical management; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations, non-discriminatory wellness programs; issues related to supplemental products; issues relating to dental coverage; issues relating to proposals for single-payer and Medicare/Medicaid buy-in options; issues related to implementation of the Telephone Consumer Protection Act; issues relating to third party payment of premiums; issues related to cost-sharing reductions (CSRs); issues related to interoperability and price transparency; issues related to the employer market; issues relating to the individual market; and other issues relating to health care reform implementation.

Client expense: $2,340,000 · Firm income: Not reported

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

Proposed changes to Medicare hospital reimbursement policy Medicare hospital prospective payment system Site-neutral payment policies H.R. 1384/S. 1129, Medicare for All and other public option alternative proposals H.R. 2452, Medicare for America Act of 2010 provisions related to establishment of a Medicare for America health program to provide for comprehensive health coverage for all Americans H.R. 2463/S. 1261, Choose Medicare Act - provisions related to the establishment of Medicare part E public health plans H.R. 2000/S. 981, Medicare-X Choice Act of 2019 - provisions related to the establishment of a public health plan H.R. 2085/S. 1033, CHOICE Act - provisions amending the Public Health Service Act to establish a public health insurance option S. 470, Medicare at 50 Act - provisions related to amending 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 H.R. 1346, Medicare Buy-In and Health Care Stabilization Act of 2019 - provisions related to providing for an option for individuals who are ages 50 to 64 to buy into Medicare and to provide for health insurance market stabilization H.R. 3, Elijah E. Cummings Lower Drug Costs Now Act S.2543, the Prescription Drug Pricing Reduction Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislative proposals affecting Medicare and Medicaid hospital reimbursement policies Health Information Technology Medicare Graduate Medical Education payments H.R. 1763/S. 348, "Resident Physician Shortage Reduction Act" - provisions related to increasing the number of Medicare-funded residency positions H.R. 3414, "Opioid Workforce Act" - provisions related to expanding Medicare funding for opioid or pain management residency programs Site-neutral payment policies H.R. 1384/S. 1129, Medicare for all and other public option alternative proposals H.R. 2452, Medicare for America Act of 2010 - provisions related to establishment of a Medicare for America health program to provide for comprehensive health coverage for all Americans H.R. 2463/S. 1261, Choose Medicare Act - provisions related to the establishment of Medicare part E public health plans H.R. 2000/S. 981, Medicare-X Choice Act of 2019 - provisions related to the establishment of a public health plan H.R. 2085/S. 1033, CHOICE Act - provisions amending the Public Health Service Act to establish a public health insurance option S. 470, Medicare at 50 Act - provisions related to amending 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 H.R. 1346, Medicare Buy-In and Health Care Stabilization Act of 2019 - provisions related to providing for an option for individuals who are ages 50 to 64 to buy into Medicare and to provide for health insurance market stabilization H.R. 3, "Lower Drug Costs Now Act" S. 2543, the Prescription Drug Pricing Reduction Act H.R. 3235, "Access to Genetic Counseling Act"

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Proposed changes to Medicare hospital reimbursement policy Star Rating System methodology and suspension of the display of overall star ratings on Hospital Compare while the agency continues its important work of enhancing the validity and meaningfulness of star ratings H.R. 1763/S. 348, "Resident Physician Shortage Reduction Act" - provisions related to increasing the number of Medicare-funded residency positions Site-neutral payment policies Oppose H.R. 1384/S. 1129, Medicare for All - provisions related to establishment of a national health insurance program Oppose H.R. 2452, Medicare for America Act of 2010 provisions related to establishment of a Medicare for America health program to provide for comprehensive health coverage for all Americans Oppose H.R. 2463/S. 1261, Choose Medicare Act - provisions related to the establishment of Medicare part E public health plans Oppose H.R. 2000/S. 981, Medicare-X Choice Act of 2019 - provisions related to the establishment of a public health plan Oppose H.R. 2085/S. 1033, CHOICE Act - provisions amending the Public Health Service Act to establish a public health insurance option Oppose S 470, Medicare at 50 Act - provisions related to amending 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 Oppose HR 1346, Medicare Buy-In and Health Care Stabilization Act of 2019 - provisions related to providing 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 H.R. 3, "Elijah E. Cummings Lower Drug Costs Now Act"

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Monitored Congressional Proposals concerning health price transparency. H.R. 1384 - "Medicare For All Act of 2019" - Oppose legislation to impose single payer health care delivery. S.1129 - "A bill to establish a Medicare-for-all national health insurance program" - Oppose legislation to impose single payer health care delivery. H.R. 2000/S.981 - "Medicare-X Choice Act of 2019" - Oppose legislation to impose a Medicare public option. H.R. 728/S.1399 - "Title VIII Nursing Workforce Re-authorization Act of 2019" - Urge support for legislation to provide loan repayment for nurses to practice in any care setting. S. 1895 - "Lower Health Care Costs Act" - Support protecting patients from surprise billing and oppose government rate setting. Advocated for appropriate transparency and contracting flexibility. S.1531 - "Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019" - Advocate to protect patients from surprise billing. H.R. 3630 - "No Surprises Act" - Advocate to protect patients from surprise billing. H.R. 3502 - "Protecting People From Surprise Medical Bills Act" - Advocate to protect patients from surprise billing. Telehealth - Supports expanded access to telehealth services and payment parity for such services. H.R. 2328 - Support re-authorization of National Quality Forum. H.R. 3417 - "Health Care Extenders" - Supported legislation.

Client expense: $650,000 · Firm income: Not reported

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

HR 1384 Medicare for All Act of 2019 (all sections of full text)(oppose) Disproportionate Share Hospital payments (DSH) extensions for qualifying hospitals in spending bills S 2543 Prescription Drug Pricing Reduction Act, Sec. 109 Monitored HR 3 Elijah E. Cummings Lower Drug Costs Now Act of 2019 Monitored H.R. 275 Medicare Prescription Drug Price Negotiation Act of 2019 Monitored HR 2000 Medicare-X Choice Act of 2019 Monitored S 981 Medicare-X Choice Act of 2019 Monitored S 470 Medicare at 50 Act Monitored HR 1301 The Mental Health Telemedicine Expansion Act of 2019 Monitored HR 1559 The 340B Protection and Accountability Act of 2019 Monitored HR 1332 The Fair Care Act of 2019 Monitored CMS regulations and reporting requirements under the Emergency Medical Treatment and Labor Act Monitored proposed reduction on the amount of Medicare bad debt/uncompensated care payments to hospitals for Medicare beneficiaries who fail to pay their cost-sharing obligations for treatments provided by the hospital

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislative proposals affecting Medicare and Medicaid hospital reimbursement policies Health Information Technology Medicare Graduate Medical Education payments H.R. 1763/S. 348, "Resident Physician Shortage Reduction Act" - provisions related to increasing the number of Medicare-funded residency positions H.R. 3414, "Opioid Workforce Act" - provisions related to expanding Medicare funding for opioid or pain management residency programs Site-neutral payment policies H.R. 1384/S. 1129, Medicare for all and other public option alternative proposals H.R. 2452, Medicare for America Act of 2010 provisions related to establishment of a Medicare for America health program to provide for comprehensive health coverage for all Americans H.R. 2463/S. 1261, Choose Medicare Act - provisions related to the establishment of Medicare part E public health plans H.R. 2000/S. 981, Medicare-X Choice Act of 2019 - provisions related to the establishment of a public health plan H.R. 2085/S. 1033, CHOICE Act - provisions amending the Public Health Service Act to establish a public health insurance option S. 470, Medicare at 50 Act - provisions related to amending 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 H.R. 1346, Medicare Buy-In and Health Care Stabilization Act of 2019 - provisions related to providing for an option for individuals who are ages 50 to 64 to buy into Medicare and to provide for health insurance market stabilization H.R. 3, "Lower Drug Costs Now Act" H.R. 3235, "Access to Genetic Counseling Act"

Client expense: $325,590 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Market stabilization/Insurance Coverage Policies (Oversight of final rules on short-term, limited duration insurance (STLDI) and Association Health Plans) Coverage proposals (U.S. v Texas; Medicare X-Choice Proposal; H.R. 1384, the Medicare for All Act of 2019; S. 1129, Medicare-for-all national health insurance program; H.R. 1384 and H.R. 2452 to create a national health insurance program; H.R. 2000, H.R. 2463, and H.R. 2085 to create a federal public option; H.R. 1277 a Medicaid buy-in; H.R. 1346 and H.R. 4527 adults aged 50-64 or qualified first responders Medicare buy in; H.R. 584 Medicaid expansion) Hospital Price Transparency (surprise medical bills; public posting of hospital charges; Executive Order on Improving Price and Quality Transparency in American Healthcare to Put Patients First) Surprise Medical Bills (S. 1895 Lower Health Care Costs Act of 2019; S. 1531 Stopping the Outrageous Practice of Surprise Medical Bills Act; S. 1266 the Protecting Patients from Surprise Medical Bills Act; S. 1497, the Health Care Price Check Act; H.R.861, the End Surprise Billing Act of 2019; S. 1688 - A bill to amend the Public Health Service Act to provide for the full disclosure of billing and service information to patients; H.R. 3502 the Protecting People from Surprise Medical Bills Act; H.R. 3630, No Surprises Act; H.R. 2328, the Reauthorizing and Extending Americas Community Health Act) 340B Drug Pricing Program Drug pricing policy and drug shortages (H.R. 3, Lower Drug Costs Now Act; S. 340/H.R. 965, CREATES Act; H.R. 1499, Protecting Consumer Access to Generic Drugs Act; H.R. 2375, Preserve Access to Affordable Generics and Biosimilars Act; H.R. 2296, the More Efficient Tools to Realize Information for Consumers (METRIC) Act; H.R. 1781, the Payment Commission Data Act of 2019; H.R. 2115, requiring PBMs to report rebate data) HIPAA policy in mental and behavioral health information sharing (H.R. 2062, Overdose Prevention and Patient Safety Act) BLOCKING Act of 2019 (H.R. 938) To amend the Internal Revenue Code of 1986 and title XI of the Social Security Act to extend appropriations and transfers to the Patient-Centered Outcomes Research Trust Fund and to extend certain health insurance fees for such transfers, and for other purposes (H.R. 3439) H.R. 2781, the Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness (EMPOWER) for Health Act of 2019 H.R. 728, the Title VIII Nursing Workforce Reauthorization Act H.R. 647, the Palliative Care and Hospice Education and Training Act Hospital Star Ratings

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 3: A bill to establish a fair price negotiation program, protect the Medicare program from excessive price increases, and establish an out-of-pocket maximum for Medicare part D enrollees, and for other purposes. S 2543: A bill to amend titles XI, XVIII, and XIX of the Social Security Act to lower prescription drug prices in the Medicare and Medicaid programs, to improve transparency related to pharmaceutical prices and transactions, to lower patients' out-of-pocket costs, and to ensure accountability to taxpayers, and for other purposes. HR 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. 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. 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. S 753: A bill to amend title XVIII of the Social Security Act to count a period of receipt of outpatient observation services in a hospital toward satisfying the 3-day inpatient hospital requirement for coverage of skilled nursing facility services under Medicare. HR (No Bill #) Payment Commission Data Act of 2019: A bill to amend titles XVIII and XIX of the Social Security Act to provide the Medicare Payment Advisory Commission and the Medicaid and CHIP Payment and Access Commission with access to certain drug payment information, including certain rebate information. H.R. 1158: An act making consolidated appropriations for the fiscal year ending September 30, 2020, and for other purposes. H.R. 1865: An act making consolidated appropriations for the fiscal year ending September 30, 2020, and for other purposes. H.R. 2477: A bill to amend title XVIII of the Social Security Act to establish a system to notify individuals approaching Medicare eligibility, to simplify and modernize the eligibility enrollment process, and for other purposes. S. 1280: A bill to amend title XVIII of the Social Security Act to establish a system to notify individuals approaching Medicare eligibility, to simplify and modernize the eligibility enrollment process, and for other purposes. H.R. 3: An act to establish a fair price negotiation program, protect the Medicare program from excessive price increases, and establish an out-of-pocket maximum for Medicare part D enrollees, and for other purposes. S. 2543: A bill to amend titles XI, XVIII, and XIX of the Social Security Act to lower prescription drug prices in the Medicare and Medicaid programs, to improve transparency related to pharmaceutical prices and transactions, to lower patients' out-of-pocket costs, and to ensure accountability to taxpayers, and for other purposes. H.R. 1277: A bill to establish a State public option through Medicaid to provide Americans with the choice of a high-quality, low-cost health insurance plan S. 489: A bill to establish a State public option through Medicaid to provide Americans with the choice of a high-quality, low-cost health insurance plan H.R. 2000: A bill to establish a public health plan H.R. 2452: A bill to amend the Social Security Act to establish a Medicare for America health program to provide for comprehensive health coverage for all Americans. H.R. 2463: A bill to provide for the establishment of Medicare part E public health plans, and for other purposes. H.R. 4527: A bill to amend title XVIII of the Social Security Act to provide an option for first responders age 50 to 64 who are separated from service due to retirement or disability to buy into Medicare. H.R. 2085: A bill to amend the Public Health Service Act to establish a public health insurance option, and for other purposes.

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

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

HR 3: A bill to establish a fair price negotiation program, protect the Medicare program from excessive price increases, and establish an out-of-pocket maximum for Medicare part D enrollees, and for other purposes. S 2543: A bill to amend titles XI, XVIII, and XIX of the Social Security Act to lower prescription drug prices in the Medicare and Medicaid programs, to improve transparency related to pharmaceutical prices and transactions, to lower patients' out-of-pocket costs, and to ensure accountability to taxpayers, and for other purposes. HR 4070: A bill to streamline the employer reporting process and strengthen the eligibility verification process for the premium assistance tax credit and cost-sharing subsidy. HR 3796: A bill to amend the Internal Revenue Code of 1986 to provide that coverage under Medicare is permissible for purposes of contributions to health savings accounts. HR 861: A bill to amend title XVIII of the Social Security Act to prevent surprise billing practices, and for other purposes. HR 3276: A bill to amend title XIX of the Social Security Act to exclude authorized generic drugs from calculation of the average manufacturer price for purposes of the Medicaid drug rebate program, and for other purposes. HR 2113: A bill to a mend titles XI and XVIII of the Social Security Act to provide for drug manufacturer price transparency, to require certain manufacturers to report on product samples provided to certain health care providers, and for other purposes. H.R. 2447: A bill to fully repeal the Health Insurance Tax S. 80: A bill to fully repeal the Health Insurance Tax H.R. 2782: This bill increases the hours of service required for an employee to be classified as a full-time employee for purposes of the employer mandate under the Patient Protection and Affordable Care Act to provide minimum essential health care coverage to full-time employees. The bill increases the hours of service threshold from an average of at least 30 hours of service a week to an average of at least 40 hours of service a week. S. 1510: This bill increases the hours of service required for an employee to be classified as a full-time employee for purposes of the employer mandate under the Patient Protection and Affordable Care Act to provide minimum essential health care coverage to full-time employees. The bill increases the hours of service threshold from an average of at least 30 hours of service a week to an average of at least 40 hours of service a week. H.R.2564: This bill creates a special Medicare enrollment period for individuals enrolled in, or transitioning out of, continuation coverage under the Consolidated Omnibus Budget Reconciliation Act (COBRA)-a federal law that allows an individual to maintain health coverage following loss of coverage due to termination of employment or another qualifying event. H.R. 1682: This bill deems an individual receiving outpatient observation services in a hospital as an inpatient for purposes of satisfying the three-day inpatient hospital-stay requirement with respect to Medicare coverage of skilled nursing facility services. H.R. 1384: This bill establishes a national health insurance program that is administered by the Department of Health and Human Services (HHS). S. 1129: This bill establishes a national health insurance program that is administered by the Department of Health and Human Services (HHS). S. 981: A bill to establish a public health plan. H.R. 1346: To amend title XVIII of the Social Security Act to provide for an option for individuals who are ages 50 to 64 to buy into Medicare, to provide for health insurance market stabilization, and for other purposes. S. 470: To amend title XVIII of the Social Security Act to provide for an option for any citizen or permanent resident of the United States age 50 to 64 to buy into Medicare. S. 1895: A bill to lower health care costs by preventing surprise medical bills, reducing prescription drug prices, improving transparency in health care, investing in public health and improving health information exchange. H.R. 3630: To amend title XXVII of the Public Health Service Act to protect health care consumers from surprise billing practices, and for other purposes. HR 1682: A bill to amend title XVIII of the Social Security Act to count a period of receipt of outpatient observation services in a hospital toward satisfying the 3-day inpatient hospital stay requirement for coverage of skilled nursing facility services under Medicare, and for other purposes. S 753: A bill to amend title XVIII of the Social Security Act to count a period of receipt of outpatient observation services in a hospital toward satisfying the 3-day inpatient hospital requirement for coverage of skilled nursing facility services under Medicare. HR 748: A bill to amend the Internal Revenue Code of 1986 to repeal the excise tax on high cost employer-sponsored health coverage. S 684: A bill to amend the Internal Revenue Code of 1986 to repeal the excise tax on high cost employer-sponsored health coverage. HR 1884: A bill to amend the Patient Protection and Affordable Care Act to improve affordability of, undo sabotage with respect to, and increase access to health insurance coverage, and for other purposes. S 172: A bill to delay the reimposition of the annual fee on health insurance providers until after 2021. HR 1398: A bill to delay the reimposition of the annual fee on health insurance providers until after 2021. S 80: A bill to repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act. HR 1385: A bill to amend the Patient Protection and Affordable Care Act to preserve the option of States to implement health care marketplaces, and for other purposes HR 1386: A bill to amend the Patient Protection and Affordable Care Act to provide for additional requirements with respect to the navigator program, and for other purposes. HR 987: A bill to amend the Patient Protection and Affordable Care Act to provide for Federal Exchange outreach and educational activities. HR 986: A bill to provide that certain guidance related to waivers for State innovation under the Patient Protection and Affordable Care Act shall have no force or effect. HR 100: A bill to provide that the rule entitled Short-Term, Limited Duration Insurance shall have no force or effect. HR 1425: A bill to amend the Patient Protection and Affordable Care Act to provide for a Improve Health Insurance Affordability Fund to provide for certain reinsurance payments to lower premiums in the individual health insurance market. HR 938: A bill to amend the Federal Food, Drug, and Cosmetic Act, with respect to eligibility for approval of a subsequent generic drug, to remove the barrier to that approval posed by the 180-day exclusivity period afforded to a first generic applicant that has not yet received final approval, and for other purposes HR 1520: A bill to amend the Public Health Service Act to provide for the publication of a list of licensed biological products, and for other purposes. HR 1503: A bill to amend the Federal Food, Drug, and Cosmetic Act regarding the list under section 505(j)(7) of the Federal Food, Drug, and Cosmetic Act, and for other purposes. HR (No Bill #) Payment Commission Data Act of 2019: A bill to amend titles XVIII and XIX of the Social Security Act to provide the Medicare Payment Advisory Commission and the Medicaid and CHIP Payment and Access Commission with access to certain drug payment information, including certain rebate information. HR 1499: A bill prohibit brand name drug manufacturers from compensating generic drug manufacturers to delay the entry of a generic drug into the market, and to prohibit biological product manufacturers from compensating biosimilar and interchangeable product manufacturers to delay entry of biosimilar and interchangeable products, and for other purposes. HR 965: promote competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products. H.R. 1158: An act making consolidated appropriations for the fiscal year ending September 30, 2020, and for other purposes. H.R. 1865: An act making consolidated appropriations for the fiscal year ending September 30, 2020, and for other purposes. H.R. 2477: A bill to amend title XVIII of the Social Security Act to establish a system to notify individuals approaching Medicare eligibility, to simplify and modernize the eligibility enrollment process, and for other purposes. S. 1280: A bill to amend title XVIII of the Social Security Act to establish a system to notify individuals approaching Medicare eligibility, to simplify and modernize the eligibility enrollment process, and for other purposes. H.R. 3708: A bill to amend the Internal Revenue Code of 1986 to allow individuals with direct primary care service arrangements to remain eligible individuals for purposes of health savings accounts, and for other purposes. S. 2999: A bill to amend the Internal Revenue Code of 1986 to allow individuals with direct primary care service arrangements to remain eligible individuals for purposes of health savings accounts. H.R. 3: An act to establish a fair price negotiation program, protect the Medicare program from excessive price increases, and establish an out-of-pocket maximum for Medicare part D enrollees, and for other purposes. S. 2543: A bill to amend titles XI, XVIII, and XIX of the Social Security Act to lower prescription drug prices in the Medicare and Medicaid programs, to improve transparency related to pharmaceutical prices and transactions, to lower patients' out-of-pocket costs, and to ensure accountability to taxpayers, and for other purposes. H.R. 1277: A bill to establish a State public option through Medicaid to provide Americans with the choice of a high-quality, low-cost health insurance plan S. 489: A bill to establish a State public option through Medicaid to provide Americans with the choice of a high-quality, low-cost health insurance plan H.R. 2000: A bill to establish a public health plan H.R. 2452: A bill to amend the Social Security Act to establish a Medicare for America health program to provide for comprehensive health coverage for all Americans. H.R. 2463: A bill to provide for the establishment of Medicare part E public health plans, and for other purposes. H.R. 4527: A bill to amend title XVIII of the Social Security Act to provide an option for first responders age 50 to 64 who are separated from service due to retirement or disability to buy into Medicare. H.R. 2085: A bill to amend the Public Health Service Act to establish a public health insurance option, and for other purposes.

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

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

Prescription Drugs S. 340, H.R. 965 - Creating and Restoring Equal Access to Equivalent Samples Act of 2019 CREATES Act of 2019" - promote competition in the market for drugs and biological products by facilitating the timely entry of entry of lower-cost generic and biosimilar versions of those drugs and biological products. H.R. 3 - The Lower Drug Costs Now Act S. 99, H.R. 448 - Medicare Drug Price Negotiation Act Average Wholesale Price of Pharmaceuticals in Ads - no specific bill H.R. 2113 Prescription Drug STAR Act - Transparency of pharmaceutical prices across all sectors Safety of imported drug components - no specific bill Surprise Billing H.R. 3502 - Protecting People from Surprise Medical Bills Act S. 1895 - Lower Health Care Costs Act H.R. 3630 - No More Surprises Act H.R. 3502 - Protecting People From Surprise Medical Bills Act S. 967 - Resolving Unanticipated Bills Act Gun Violence H.R. 8, S. 42 Background Checks of 2019 - Legislation to close loopholes in background checks for guns S. 184, H.R. 674 Gun Violence Prevention Research Act - Legislation to authorize CDC funds into prevention gun violence research LABOR-HHS Appropriations to fund gun violence research Comprehensive gun control legislation Medicare/Medicaid S. 1129 - A bill to establish a Medicare-for-all national health insurance program H.R.1384 - Medicare for All Act of 2019 S. 470 - Medicare at 50 Act H.R. 1346 - Medicare Buy-In and Health Care Stabilization Act of 2019 H.R. 1419 - Public Option Deficit Reduction Act S. 981, H.R. 2000 - Medicare-X Choice Act of 2019 S. 296, H.R. 2150 - Home Health Care Planning Improvement Act of 2019 ACA Protections Changes to MACRA - no specific bill Social Determinants of Health Increased federal funds for community-based food programs which provide medically tailored meals to poor, sick, immobile patients and their families - no specific bill Opioids and Substance Use Disorder H.R. 2734 - Safer Prescribing of Controlled Substances Act - Federal Prescriber Education Mandates S. 1365, H.R. 2569 - Comprehensive Addiction Resources Emergency Act of 2019 Maternal Mortality H.R. 2602 - Healthy MOMMIES Act - extending Medicare ACA coverage and access to maternity care Recommendations to address racial disparities and social determinants in the national maternal mortality crisis Prior Authorization H.R. 3170 - Improving Seniors Timely Access to Care Act of 2019 Publications Open access to information based on publicly funded research Regulations Executive Order entitled, "Protecting and Improving Medicare for our Nation's Seniors." CMS- Proposed changes to Medicaid Funding

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

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

Prescription Drugs S. 340, H.R. 965 - Creating and Restoring Equal Access to Equivalent Samples Act of 2019 CREATES Act of 2019" - promote competition in the market for drugs and biological products by facilitating the timely entry of entry of lower-cost generic and biosimilar versions of those drugs and biological products. H.R. 3 - The Lower Drug Costs Now Act S. 99, H.R. 448 - Medicare Drug Price Negotiation Act Average Wholesale Price of Pharmaceuticals in Ads - no specific bill H.R. 2113 Prescription Drug STAR Act - Transparency of pharmaceutical prices across all sectors Safety of imported drug components - no specific bill Surprise Billing H.R. 3502 - Protecting People from Surprise Medical Bills Act S. 1895 - Lower Health Care Costs Act H.R. 3630 - No More Surprises Act H.R. 3502 - Protecting People From Surprise Medical Bills Act S. 967 - Resolving Unanticipated Bills Act Gun Violence H.R. 8, S. 42 Background Checks of 2019 - Legislation to close loopholes in background checks for guns S. 184, H.R. 674 Gun Violence Prevention Research Act - Legislation to authorize CDC funds into prevention gun violence research LABOR-HHS Appropriations to fund gun violence research Comprehensive gun control legislation Medicare/Medicaid S. 1129 - A bill to establish a Medicare-for-all national health insurance program H.R.1384 - Medicare for All Act of 2019 S. 470 - Medicare at 50 Act H.R. 1346 - Medicare Buy-In and Health Care Stabilization Act of 2019 H.R. 1419 - Public Option Deficit Reduction Act S. 981, H.R. 2000 - Medicare-X Choice Act of 2019 S. 296, H.R. 2150 - Home Health Care Planning Improvement Act of 2019 ACA Protections Changes to MACRA - no specific bill Social Determinants of Health Increased federal funds for community-based food programs which provide medically tailored meals to poor, sick, immobile patients and their families - no specific bill Opioids and Substance Use Disorder H.R. 2734 - Safer Prescribing of Controlled Substances Act - Federal Prescriber Education Mandates S. 1365, H.R. 2569 - Comprehensive Addiction Resources Emergency Act of 2019 Maternal Mortality H.R. 2602 - Healthy MOMMIES Act - extending Medicare ACA coverage and access to maternity care Recommendations to address racial disparities and social determinants in the national maternal mortality crisis Prior Authorization H.R. 3170 - Improving Seniors Timely Access to Care Act of 2019 Publications Open access to information based on publicly funded research Regulations Executive Order entitled, "Protecting and Improving Medicare for our Nation's Seniors." CMS- Proposed changes to Medicaid Funding

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

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

Proposed changes to Medicare hospital reimbursement policy Medicare hospital prospective payment system Site-neutral payment policies H.R. 1384/S. 1129, Medicare for All and other public option alternative proposals H.R. 2452, Medicare for America Act of 2010 provisions related to establishment of a Medicare for America health program to provide for comprehensive health coverage for all Americans H.R. 2463/S. 1261, Choose Medicare Act - provisions related to the establishment of Medicare part E public health plans H.R. 2000/S. 981, Medicare-X Choice Act of 2019 - provisions related to the establishment of a public health plan H.R. 2085/S. 1033, CHOICE Act - provisions amending the Public Health Service Act to establish a public health insurance option S. 470, Medicare at 50 Act - provisions related to amending 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 H.R. 1346, Medicare Buy-In and Health Care Stabilization Act of 2019 - provisions related to providing for an option for individuals who are ages 50 to 64 to buy into Medicare and to provide for health insurance market stabilization H.R. 3, "Lower Drug Costs Now Act"

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislative proposals affecting Medicare and Medicaid hospital reimbursement policies Health Information Technology Medicare Graduate Medical Education payments H.R. 1763/S. 348, "Resident Physician Shortage Reduction Act" - provisions related to increasing the number of Medicare-funded residency positions H.R. 3414, "Opioid Workforce Act" - provisions related to expanding Medicare funding for opioid or pain management residency programs Site-neutral payment policies H.R. 1384/S. 1129, Medicare for all and other public option alternative proposals H.R. 2452, Medicare for America Act of 2010 provisions related to establishment of a Medicare for America health program to provide for comprehensive health coverage for all Americans H.R. 2463/S. 1261, Choose Medicare Act - provisions related to the establishment of Medicare part E public health plans H.R. 2000/S. 981, Medicare-X Choice Act of 2019 - provisions related to the establishment of a public health plan H.R. 2085/S. 1033, CHOICE Act - provisions amending the Public Health Service Act to establish a public health insurance option S. 470, Medicare at 50 Act - provisions related to amending 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 H.R. 1346, Medicare Buy-In and Health Care Stabilization Act of 2019 - provisions related to providing for an option for individuals who are ages 50 to 64 to buy into Medicare and to provide for health insurance market stabilization H.R. 3, "Lower Drug Costs Now Act" H.R. 3235, "Access to Genetic Counseling Act"

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Proposed changes to Medicare hospital reimbursement policy Star Rating System methodology and suspension of the display of overall star ratings on Hospital Compare while the agency continues its important work of enhancing the validity and meaningfulness of star ratings H.R. 1763/S. 348, "Resident Physician Shortage Reduction Act" - provisions related to increasing the number of Medicare-funded residency positions Site-neutral payment policies Oppose H.R. 1384/S. 1129, Medicare for All - provisions related to establishment of a national health insurance program Oppose H.R. 2452, Medicare for America Act of 2010 provisions related to establishment of a Medicare for America health program to provide for comprehensive health coverage for all Americans Oppose H.R. 2463/S. 1261, Choose Medicare Act - provisions related to the establishment of Medicare part E public health plans Oppose H.R. 2000/S. 981, Medicare-X Choice Act of 2019 - provisions related to the establishment of a public health plan Oppose H.R. 2085/S. 1033, CHOICE Act - provisions amending the Public Health Service Act to establish a public health insurance option Oppose S 470, Medicare at 50 Act - provisions related to amending 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 Oppose HR 1346, Medicare Buy-In and Health Care Stabilization Act of 2019 - provisions related to providing 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 H.R. 3, "Lower Drug Costs Now Act"

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

___ H.R. 3: Lower Drug Costs Now Act of 2019 - Provisions related to prescription drug pricing, foreign reference pricing, Part D, manufacturer rebates, and other provisions ___ H.R. 107: To amend title XIX of the Social Security Act to sunset the limit on the maximum rebate amount for single source drugs and innovator multiple source drugs - Provisions related to Medicaid drug rebates ___ H.R. 275: Medicare Prescription Drug Price Negotiation Act of 2019 - Provisions related to Part D and drug pricing negotiation ___ H.R. 448: Medicare Drug Price Negotiation Act - Provisions related to Part D and drug pricing negotiation ___ H.R. 937: Right Rebate Act of 2019 - Provisions related to Medicaid drug rebates and drug classification ___ H.R. 1034: Phair Pricing Act of 2019 - Provisions related to Part D and manufacturer rebates ___ H.R. 1035: Prescription Drug Price Transparency Act - Provisions related to drug pricing transparency and pharmacy benefit managers ___ H.R. 1046: Medicare Negotiation and Competitive Licensing Act of 2019 - Provisions related to Part D, drug pricing negotiation and compulsory licensing ___ H.R. 1346: Medicare Buy-In and Health Care Stabilization Act of 2019 - Provisions related to Part D and drug pricing negotiation ___ H.R. 1384: Medicare for All Act of 2019 - Provisions related to Part D, drug pricing negotiation and march-in rights ___ H.R. 1839: Medicaid Services Investment and Accountability Act - Provisions related to Medicaid drug rebates and drug classification ___ H.R. 2000: Medicare-X Choice Act of 2019 - Provisions related to Part D and drug pricing negotiation ___ H.R. 2452: Medicare for America Act of 2019 - Provisions related to Part D and drug pricing negotiation ___ H.R. 2463: Choose Medicare Act - Provisions related to Part D and drug pricing negotiation ___ H.R. 2757: Creating Lower cost Alternative for Your prescription drugs Act - Provisions related to Part D and patient cost-sharing ___ H.R. 3029: Improving Low-Income Access to Prescription Drugs Act of 2019 - Provisions related to Part D prescription drug plans ___ H.R. 3523: End Price Gouging for Medications Act - Provisions related to prescription drug pricing and foreign reference pricing ___ H.R. 3910: Equality in Medicare and Medicaid Treatment Act of 2019 - Provisions related to CMMI models ___ S. 62: Empowering Medicare Seniors to Negotiate Drug Prices Act of 2019 - Provisions related to Part D and drug pricing negotiation ___ S. 99: Medicare Drug Price Negotiation Act - Provisions related to Part D and drug pricing negotiation ___ S. 205: Right Rebate Act of 2019 - Provisions related to Medicaid drug rebates and drug classification ___ S. 377: Medicare Negotiation and Competitive Licensing Act of 2019 - Provisions related to Part D, drug pricing negotiation and compulsory licensing ___ S. 475: Reducing Existing Costs Associated with Pharmaceuticals for Seniors (RxCap) Act of 2019 - Provisions related to Part D and patient cost-sharing ___ S. 470: Medicare at 50 Act - Provisions related to Part D and drug pricing negotiation ___ S. 476: Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2019 - Provisions related to transparency of prescription drug pricing and pharmacy benefit managers ___ S. 640: Phair Pricing Act of 2019 - Provisions related to Part D and manufacturer rebates ___ S. 691: Medicare Extra Rx Higher Eligibility Limits in Part D Act of 2019 - Provisions related to Part D and patient out-of-pocket costs ___ S. 801: Payment Commission Data Act - Provisions related to prescription drug pricing transparency and reporting ___ S. 981: Medicare-X Choice Act of 2019 - Provisions related to Part D and drug pricing negotiation ___ S. 1129: Medicare for All Act of 2019 - Provisions related to Part D and drug pricing negotiation ___ S. 1261: Choose Medicare Act - Provisions related to Part D and drug pricing negotiation ___ S. 1497: Health Care Price Check Act of 2019 - Provisions related to Medicare pricing transparency ___ S. 1785: Fair AMP Act - Provisions related to Medicaid drug rebates ___ S. 1801: Affordable Medications Act - Provisions relate to Part D drug pricing negotiation, importation, IP issues and pricing transparency ___ S. 1895: Lowering Health Care Costs Act - Provisions related to prescription drug pricing, transparency and patent issues ___ S. 1897: A bill to establish a process for updating the labeling of certain drugs with outdated labeling - Provisions related to prescription drug labeling ___ S. 1987: End Price Gouging for Medications Act - Provisions related to prescription drug pricing and foreign reference pricing ___ S. 1999: Improving Low-Income Access to Prescription Drugs Act of 2019 - Provisions related to Part D prescription drug plans ___ S. 2051: Strengthening Average Sales Price Reporting Act - Provisions related to Medicare pricing transparency and rebates ___ S. 2081: Stop Drug Companies from Overcharging Seniors in Medicare Part B Act of 2019 - Provisions related to prescription drug pricing and manufacturer rebates ___ S. 2247: Phair Pricing Act of 2019 - Provisions related to Part D and manufacturer rebates ___ S. 2252: Empowering States to Address Drug Costs Act - Provisions related to prescription drug pricing transparency ___ S. 2543: Prescription Drug Pricing Reduction Act of 2019 - Provisions related to prescription drug pricing, transparency, manufacturer rebates and other provisions ___ Medicare Access and Childrens Health Insurance Program (CHIP) reauthorization policy issues ___ Department of Health and Human Services (HHS) drug policy issues and regulatory policy issues ___ Part D policy issues including non-interference and rebates policy issues ___ Part B reform including MedPAC recommendations and other policy issues and local coverage decisions ___ Drug cost and pricing policy issues ___ Transparency policy issues ___ Alternative payment models policy issues ___ Value-based purchasing arrangements policy issues ___ Anti-Kickback Statute policy issues ___ Center for Medicare and Medicaid Innovation (CMMI) policy issues ___ Medicaid rebates and waiver policy issues ___ Prescription drug abuse policy issues ___ ANPRM; Medicare Program; International Pricing Index Model for Medicare Part B Drugs (CMS-5528-ANPRM) ___ Proposed Rule; Medicare and Medicaid Programs; Regulation To Require Drug Pricing Transparency (CMS-4187-P) ___ Proposed Rule; Contract Year (CY) 2020 Medicare Advantage and Part D Drug Pricing (CMS-4180-P) ___ Request for Information: Medicare and State Health Care Programs: Fraud and Abuse; Request for Information Regarding the Anti-Kickback Statute and Beneficiary Inducements CMP; 83 Fed. Reg. 43607 (Aug. 27, 2018) ___ Removal of Safe Harbor Protection for Rebates to Plans or PBMs Involving Prescription Pharmaceuticals and Creation of New Safe Harbor Protection (RIN 0936-AA08) Monograph Reform and HSA/FSAs

Client expense: $1,360,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), Patent & Trademark Office (PTO), SENATE, U.S. Trade Representative (USTR)

H.R. 3: Lower Drug Costs Now Act of 2019 - Provisions related to prescription drug pricing, foreign reference pricing, Part D, manufacturer rebates, and other provisions H.R. 107: To amend title XIX of the Social Security Act to sunset the limit on the maximum rebate amount for single source drugs and innovator multiple source drugs - Provisions related to Medicaid drug rebates H.R. 275: Medicare Prescription Drug Price Negotiation Act of 2019 - Provisions related to Part D and drug pricing negotiation H.R. 366: Insulin Access for All Act of 2019 - Provisions related to insulin cost-sharing H.R. 448: Medicare Drug Price Negotiation Act - Provisions related to Part D and drug pricing negotiation H.R. 937: Right Rebate Act of 2019 - Provisions related to Medicaid drug rebates and drug classification H.R. 1034: Phair Pricing Act of 2019 - Provisions related to Part D and manufacturer rebates H.R. 1035: Prescription Drug Price Transparency Act - Provisions related to drug pricing transparency and pharmacy benefit managers H.R. 1046: Medicare Negotiation and Competitive Licensing Act of 2019 - Provisions related to Part D, drug pricing negotiation and compulsory licensing H.R. 1346: Medicare Buy-In and Health Care Stabilization Act of 2019 - Provisions related to Part D and drug pricing negotiation H.R. 1384: Medicare for All Act of 2019 - Provisions related to Part D, drug pricing negotiation and march-in rights H.R. 1839: Medicaid Services Investment and Accountability Act - Provisions related to Medicaid drug rebates and drug classification H.R. 2000: Medicare-X Choice Act of 2019 - Provisions related to Part D and drug pricing negotiation H.R. 2452: Medicare for America Act of 2019 - Provisions related to Part D and drug pricing negotiation H.R. 2463: Choose Medicare Act - Provisions related to Part D and drug pricing negotiation H.R. 2757: Creating Lower cost Alternative for Your prescription drugs Act - Provisions related to Part D and patient cost-sharing H.R. 3029: Improving Low-Income Access to Prescription Drugs Act of 2019 - Provisions related to Part D prescription drug plans H.R. 3523: End Price Gouging for Medications Act - Provisions related to prescription drug pricing and foreign reference pricing H.R. 3910: Equality in Medicare and Medicaid Treatment Act of 2019 - Provisions related to CMMI models S. 62: Empowering Medicare Seniors to Negotiate Drug Prices Act of 2019 - Provisions related to Part D and drug pricing negotiation S. 99: Medicare Drug Price Negotiation Act - Provisions related to Part D and drug pricing negotiation S. 205: Right Rebate Act of 2019 - Provisions related to Medicaid drug rebates and drug classification S. 377: Medicare Negotiation and Competitive Licensing Act of 2019 - Provisions related to Part D, drug pricing negotiation and compulsory licensing S. 475: Reducing Existing Costs Associated with Pharmaceuticals for Seniors (RxCap) Act of 2019 - Provisions related to Part D and patient cost-sharing S. 470: Medicare at 50 Act - Provisions related to Part D and drug pricing negotiation S. 476: Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2019 - Provisions related to transparency of prescription drug pricing and pharmacy benefit managers S. 551: Recovering Excessive Funds for Unused and Needless Drugs Act of 2019 - Provisions related to prescription drug vial sizes and rebates S. 640: Phair Pricing Act of 2019 - Provisions related to Part D and manufacturer rebates S. 691: Medicare Extra Rx Higher Eligibility Limits in Part D Act of 2019 - Provisions related to Part D and patient out-of-pocket costs S. 801: Payment Commission Data Act - Provisions related to prescription drug pricing transparency and reporting S. 981: Medicare-X Choice Act of 2019 - Provisions related to Part D and drug pricing negotiation S. 1129: Medicare for All Act of 2019 - Provisions related to Part D and drug pricing negotiation S. 1261: Choose Medicare Act - Provisions related to Part D and drug pricing negotiation S. 1497: Health Care Price Check Act of 2019 - Provisions related to Medicare pricing transparency S. 1785: Fair AMP Act - Provisions related to Medicaid drug rebates S. 1801: Affordable Medications Act - Provisions related to Part D drug pricing negotiation, importation, IP issues and pricing transparency S. 1895: Lowering Health Care Costs Act - Provisions related to prescription drug pricing, transparency and patent issues S. 1897: A bill to establish a process for updating the labeling of certain drugs with outdated labeling - Provisions related to prescription drug labeling S. 1987: End Price Gouging for Medications Act - Provisions related to prescription drug pricing and foreign reference pricing S. 1999: Improving Low-Income Access to Prescription Drugs Act of 2019 - Provisions related to Part D prescription drug plans S. 2051: Strengthening Average Sales Price Reporting Act - Provisions related to Medicare pricing transparency and rebates S. 2081: Stop Drug Companies from Overcharging Seniors in Medicare Part B Act of 2019 - Provisions related to prescription drug pricing and manufacturer rebates S. 2247: Phair Pricing Act of 2019 - Provisions related to Part D and manufacturer rebates S. 2252: Empowering States to Address Drug Costs Act - Provisions related to prescription drug pricing transparency S. 2543: Prescription Drug Pricing Reduction Act of 2019 - Provisions related to prescription drug pricing, transparency, manufacturer rebates and other provisions Medicare Access and Childrens Health Insurance Program (CHIP) reauthorization policy issues Department of Health and Human Services (HHS) drug policy issues and regulatory policy issues Part D policy issues including non-interference and rebates policy issues Part B reform including MedPAC recommendations and other policy issues and local coverage decisions Drug cost and pricing policy issues Transparency policy issues Alternative payment models policy issues Policy issues related to patient medication information Value-based purchasing arrangements policy issues Anti-Kickback Statute policy issues Center for Medicare and Medicaid Innovation (CMMI) policy issues Medicaid rebates and waiver policy issues Prescription drug abuse policy issues ANPRM; Medicare Program; International Pricing Index Model for Medicare Part B Drugs (CMS-5528-ANPRM) Proposed Rule; Medicare and Medicaid Programs; Regulation To Require Drug Pricing Transparency (CMS-4187-P) Proposed Rule; Contract Year (CY) 2020 Medicare Advantage and Part D Drug Pricing (CMS-4180-P) Request for Information: Medicare and State Health Care Programs: Fraud and Abuse; Request for Information Regarding the Anti-Kickback Statute and Beneficiary Inducements CMP; 83 Fed. Reg. 43607 (Aug. 27, 2018) Removal of Safe Harbor Protection for Rebates to Plans or PBMs Involving Prescription Pharmaceuticals and Creation of New Safe Harbor Protection (RIN 0936-AA08)

Client expense: $6,230,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Economic Council (NEC), Office of Management & Budget (OMB), Patent & Trademark Office (PTO), President of the U.S., SENATE, U.S. Trade Representative (USTR)

S. 350, Competitive Health Insurance Reform Act (Daines) - McCarran-Ferguson Act S. 455, Marketing and Outreach Restoration to Empower Health Education Act (Shaheen) - funding for outreach and education on ACA Exchanges S. 466, Protecting Americans with Preexisting Conditions Act (Warner) - blocking updated Section 1332 guidance S. 560, Ensuring Lasting Smiles Act (Baldwin) - coverage mandate for treatment of congenital anomaly or birth defect S. 741, Cancer Drug Parity Act (Smith) -- cost sharing for oral anticancer drugs S. 913, Disclosure of Price Information to Enrollees (Braun) S. 961, Improving Health Insurance Affordability Act (Shaheen) - premium tax credits S. 964, Marketplace Certainty Act (Shaheen) - cost-sharing subsidies S. 967, Reducing Costs for Out-of-Network Services Act (Shaheen) - caps on out-of-network charges S. 981, Medicare-X Choice Act (Bennet) - public option S. 1033, CHOICE Act (Whitehouse) - public option S. 1125, Protect Act (Tillis) - pre-existing condition protections S. 1129, Medicare for All Act (Sanders) - government health insurance system S. 1170, Association Health Plans Act (Enzi) - codifying final rule for expanding AHPs S. 1266, Protecting Patients from Surprise Medical Bills Act (Scott) - surprise medical billing S. 1531, STOP Surprise Medical Bills Act (Cassidy-Bennet) - surprise medical billing S. 1576, Behavioral Health Coverage Transparency Act (Warren) - mental health parity S. 1577, Know the Price Act (Cassidy-Bennet) - restrictions on provider contracts S. 1737, Mental Health Parity Compliance Act (Murphy) - mental health parity S. 1948, Chronic Disease Management Act (Thune) - pre-deductible coverage of chronic disease prevention services S. 2546, Safe Step Act (Murkowski)-Step therapy exceptions H.R. 692, Pre-existing Conditions Protection Act (Walden) - pre-existing condition protections H.R. 986, Protecting Americans with Preexisting Conditions Act (Kuster) - blocking updated Section 1332 guidance H.R. 987, Marketing and Outreach Restoration to Empower Health Education Act (Blunt Rochester) - funding for outreach and education on ACA Exchanges, Navigator program, and establishment of state-based Health Insurance Exchanges; drug pricing proposals H.R. 1010, Short-Term Plans (Castor) - blocking final rule that expands short-term plans H.R. 1143, Educating Consumers on the Risks of Short-Term Plans Act (Eshoo) - standardized disclosures for short-term plans H.R. 1379, Ensuring Lasting Smiles Act (Peterson) - coverage mandate for treatment of congenital anomaly or birth defect H.R. 1384, Medicare for All Act (Jayapal) - government health insurance system H.R. 1385, State Allowance for a Variety of Exchanges Act (Kim) - funding for establishment of state-based Health Insurance Exchanges H.R. 1386, Expand Navigators Resources for Outreach, Learning, and Longevity Act (Castor) - funding for Navigator Program H.R. 1418, Competitive Health Insurance Reform Act (DeFazio) - McCarran-Ferguson Act H.R. 1425, State Health Care Premium Reduction Act (Craig) - funding for state reinsurance programs H.R. 1510, Premium Relief Act (Burgess) -- Patient and State Stability Fund H.R. 1730, Cancer Drug Parity Act (Higgins) -- cost sharing for oral anticancer drugs H.R. 1884, Protecting Pre-Existing Conditions and Making Health Care More Affordable Act (Pallone) - reinsurance funding, stabilization and affordability proposals H.R. 2000, Medicare-X Choice Act (Delgado) - public option H.R. 2061, Pathway to Universal Coverage Act (Bera) - auto-enrollment H.R. 2085, CHOICE Act (Schakowsky) - public option H.R. 2183, State Flexibility and Patient Choice Act (Marshall) - flexibility in state innovation waivers H.R. 2848, Parity Enforcement Act (Norcross) - mental health parity H.R. 2874, Behavioral Health Coverage Transparency Act (Kennedy) - mental health parity H.R. 3165, Mental Health Parity Compliance Act (Porter) - mental health parity H.R. 3502, Protecting People From Surprise Medical Bills Act (Ruiz) - surprise medical billing Discussion Draft, No Surprises Act (Pallone-Walden) - surprise medical billing H.R. 3630, No Surprises Act (Pallone)-surprise medical billing H.R. 3784, Air Ambulance Affordability Act of 2019 (Neguse)- air ambulances H.R. 4223, Protecting Patients from Surprise Medical Bills Act (Spano)-surprise medical billing H.R. 4379, Under Performing Directories that Affect Treating Emergencies Act (Axne)-provider directories H.R. 4457, Chronic Condition Copay Elimination Act (Underwood)- Eliminating copays for services/drugs for chronic conditions H.R. 4484, Flexibility Through Lower Expenses Health Care Act (Budd)-STLDI plans H.R. 4530, Native American Health Savings Improvement Act (Moolenaar)-HSAs H.R. 4575, Improving Provider Directories Act (Schrier)-provider directories H. Res. 271 (Allred) - resolution urging DOJ to reverse position in Texas v. United States litigation Regulatory Issues: Insurance regulatory reform; issues related to the coordination of private and public disability income benefits; disability risk management; disability income insurance enrollment and awareness; issues related to encouraging impaired workers to stay in/return to the workforce; issues related to expanding long-term care insurance coverage; issues relating to the coordination of benefits between private health insurance plans and Medicaid; Medigap claims processing and crossover fees; Medigap cross-over claim issues, Medigap coverage, implementation of Medigap standardized plan offerings; Medigap carrier recoveries related to CMS fraud and abuse enforcement activities, and issues related to Medigap educational materials, and other Medigap issues; fraud and abuse issues affecting public and private insurance coverage; issues relating to antitrust; implementation of the Mental Health Parity Act requirements; implementation of the 21st Century Cures Act requirements; summary of benefits and coverage disclosures; pre-existing condition insurance plans; accountable care organizations; coverage of preventive services; preexisting condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; health reimbursement accounts; dependent coverage; treatment of expatriate plans; issues related to surprise medical bills; issues related to all payor claims databases; issues related to association health plans; issues related to substance abuse and provider treatment records (42 CFR Part 2); issues related to medical management; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations, non-discriminatory wellness programs; issues related to supplemental products; issues relating to dental coverage; issues relating to proposals for single-payer and Medicare/Medicaid buy-in options; issues related to implementation of the Telephone Consumer Protection Act; issues relating to third party payment of premiums; issues related to cost-sharing reductions (CSRs); issues related to interoperability and price transparency; issues related to the employer market; issues relating to the individual market; and other issues relating to health care reform implementation.

Client expense: $2,110,000 · Firm income: Not reported

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

HR1384 Medicare for All Act of 2019 (all sections of full text)(oppose) Monitored HR 275 Medicare Prescription Drug Price Negotiation Act of 2019 Monitored HR 2000 Medicare-X Choice Act of 2019 Monitored 981 Medicare-X Choice Act of 2019 Monitored S 470 Medicare at 50 Act Monitored HR1301 The Mental Health Telemedicine Expansion Act of 2019 Monitored HR1559 The 340B Protection and Accountability Act of 2019 Monitored HR1332 The Fair Care Act of 2019 Monitored CMS regulations and reporting requirements under the Emergency Medical Treatment and Labor Act Monitored proposed reduction on the amount of Medicare bad debt/uncompensated care payments to hospitals for Medicare beneficiaries who fail to pay their cost sharing obligations for treatments provided by the hospital Monitored CMS proposed rule regarding revisions to Medicare OPPS Program

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

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

Monitored Congressional Proposals concerning health price transparency. H.R. 1384 - "Medicare For All Act of 2019" - Oppose legislation to impose single payer health care delivery. S.1129 - "A bill to establish a Medicare-for-all national health insurance program" - Oppose legislation to impose single payer health care delivery. H.R. 2000/S.981 - "Medicare-X Choice Act of 2019" - Oppose legislation to impose a Medicare public option. H.R. 728/S.1399 - "Title VIII Nursing Workforce Re-authorization Act of 2019" - Urge support for legislation to provide loan repayment for nurses to practice in any care setting. S. 1895 - "Lower Health Care Costs Act" - Support protecting patients from surprise billing and oppose government rate setting. S.1531 - "Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019" - Advocate to protect patients from surprise billing. H.R. 3630 - "No Surprises Act" - Advocate to protect patients from surprise billing. H.R. 3502 - "Protecting People From Surprise Medical Bills Act" - Advocate to protect patients from surprise billing. Telehealth - Supports expanded access to telehealth services and payment parity for such services. H.R. 2328 - Support re-authorization of National Quality Forum. H.R. 3417 - "Health Care Extenders" - Supported legislation.

Client expense: $980,000 · Firm income: Not reported

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

HR 1384 Medicare for All Act of 2019 (all sections of full text)(oppose) Monitored H.R. 275 Medicare Prescription Drug Price Negotiation Act of 2019 Monitored HR 2000 Medicare-X Choice Act of 2019 Monitored S 981 Medicare-X Choice Act of 2019 Monitored S 470 Medicare at 50 Act Monitored HR 1301 The Mental Health Telemedicine Expansion Act of 2019 Monitored HR 1559 The 340B Protection and Accountability Act of 2019 Monitored HR 1332 The Fair Care Act of 2019 Monitored CMS regulations and reporting requirements under the Emergency Medical Treatment and Labor Act Monitored proposed reduction on the amount of Medicare bad debt/uncompensated care payments to hospitals for Medicare beneficiaries who fail to pay their cost-sharing obligations for treatments provided by the hospital

Client expense: Not reported · Firm income: $130,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE