To amend the Internal Revenue Code of 1986 to permanently extend the 7.5 percent adjusted gross income floor for the medical expense deduction.

S.1443/H.R.2730 Credit for Caring Act S.110/H.R.2073 Medical Expense Savings Act H.R.2878 Homecare for Seniors Act H.R.6379 Families First Coronavirus Response Act S.3548/H.R.748 Coronavirus Aid, Relief, and Economic Security (CARES) Act; including provisions related to all nonprofits S.3544/H.R.6305 Coronavirus Relief for Seniors and People with Disabilities Act H.R.6408 Save the Organizations that Serve (SOS) America Act H.R.6800 Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act H.R.5958 Senior Health Planning Account Act H.R.3644 Independence at Home Demonstration Act of 2019 Issues related to strengthening charitable giving incentives including the universal charitable deduction (S. 4032/H.R. 7324) and Legacy IRA Act (S.1327/H.R. 3832) In forthcoming COVID-19 relief packages the Alzheimer's Association has advocated for policies which will impact charitable nonprofits including: - Expanded Nonprofit Access to Credit: To establish an exclusive fund to support nonprofit employers with between 500 and 10,000 employees, including loan forgiveness. - Expand Charitable Giving Incentives - Allow larger charitable nonprofits to be eligible to receive funds under the Paycheck Protection Program - Clarify that charitable nonprofits of all sizes are able to participate in the emergency Small Business Loan Program by using the tax-law definition of charitable organizations (Sec. 501(c)(3) public charities) and removing the language that excludes nonprofits that are eligible to receive Medicaid reimbursements.

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

Government targets: Administration on Aging, Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Indian Health Service, Interior, Dept of (DOI), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Natl Institutes of Health (NIH), SENATE, Social Security Administration (SSA), Veterans Affairs, Dept of (VA)

Charitable Giving Tax Deduction Act (H.R.651) Credit for Caring Act of 2019 (S.1443/H.R.2730) Help Charities Protect Communities Act (introduction pending) Legacy IRA Act (H.R. 3832/S.1257) Lessen Impediments from Taxes for Charities Act (LIFT for Charities Act) (S.632) Medical Expense Savings Act (S.110) Protecting Nonprofits from Catastrophic Cash Flow Strain Act of 2020 (S 4001 and S 4209) RESTART Act (S. 3814) Save the Organizations that Support (SOS) America Act (HR 6408) To amend the Internal Revenue Code of 1986 to repeal the inclusion of certain fringe benefit expenses for which a deduction is disallowed in unrelated business taxable income (H.R.1545) To amend the Internal Revenue Code of 1986 to permanently extend the 7.5 percent adjusted gross income floor for the medical expense deduction (H.R.2073) To extend the charitable deduction to all taxpayers regardless of whether a taxpayer itemizes deductions in order to encourage and increase charitable giving, and to provide for loans and loan guarantees to certain public charities (HR 6408) To include nonprofits in the Main Street Lending Program, and add Federal Reserve to list of agencies lobbied Universal Giving Pandemic Response Act (S 4032/HR 7324) WORK NOW Act (S. 3747) Implementation of: PL 115-97, Sec. 13702 unrelated business taxable income

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

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

Tax Cuts and Jobs Act, Pub. L. No. 115-97, 11011(a), 131 Stat. 2054, 2063 (2017) (codified at Internal Revenue Code 199A). Proposed tax rule for IRC 163(j) Medical Expense Savings Act (S.110) To amend the Internal Revenue Code of 1986 to permanently extend the 7.5 percent adjusted gross income floor for the medical expense deduction. (H.R.2073)

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

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

H.R. 748, the CARES Act H.R. 1814/S. 651, the ABLE Age Adjustment Act H.R. 2073/S. 110 H.R. 4045/S. 2290, the Disabled Access Credit Expansion Act H.R. 6420, the All Dependent Children Count Act H.R. 6800, the Health and Economic Recovery Omnibus Emergency Solutions Act or the HEROES Act S. 1628, the Paid Family Leave Pilot Extension Act S. 3652, the All Dependents Count Act Senate COVID Relief Package--Health, Economic Assistance, Liability Protection, and Schools (HEALS) Act Senate COVID Relief Package-- Delivering Immediate Relief to Americas Families, Schools and Small Businesses Act (ANS to S. 178) Implementation of the CARES Act (Public Law 116-136) Senate Draft Bill, Automatic Cash Assistance Act

Client expense: $78,368 · Firm income: Not reported

Government targets: AMTRAK - Natl Railroad Passenger Corporation, Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Federal Emergency Management Agency (FEMA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Institutes of Health (NIH), SENATE, Social Security Administration (SSA), Transportation Security Administration (TSA), Transportation, Dept of (DOT), U.S. Architectural & Transportation Barriers Compliance Board (ACCESS), Veterans Affairs, Dept of (VA), Veterans Employment & Training Service

H.R. 8439, To amend the Internal Revenue Code of 1986 to exclude from gross income any interest paid on an overpayment of tax. No bill number. Discussed family caregiver tax. S. 1443, Credit for Caring Act. H.R. 2073/S. 110, legislation to permanently extend the medical expense deduction at 7.5% of income. H.R. 7714, Legislation to amend IRS Code of 1986 to Reduce the Floor on Deductions for Medical Expense. H.R. 19/S. 3129, Lower Cost More Cures Act. H.R. 3, Elijah E. Cummings Lower Cost Drugs Now Act. No Bill Number. Discussed payroll tax deferral.

Client expense: $1,880,000 · Firm income: Not reported

Government targets: Administration for Children & Families (ACF), Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Consumer Financial Protection Bureau (CFPB), Corporation for Natl & Community Service, Federal Communications Commission (FCC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Indian Health Service, Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Office of the Comptroller of the Currency (OCC), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Social Security Administration (SSA), Transportation, Dept of (DOT), Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

S. 4182, Emergency Support for Nursing Homes and Elder Justice Reform Act of 2020. S. 4184/H.R. 7463, Assisted Living Facility Coronavirus Reporting Act. H.R. 6698, Quality Care for Nursing Home Residents and Workers During COVID-19 Act of 2020. H.R. 6800, Health and Economic Recovery Omnibus Emergency Solutions Act (Heroes Act). HR 925, Updated Health and Economic Recovery Omnibus Emergency Solutions Act (Updated HEROES); No bill number. Discussed funding for nursing homes, home and community-based services, and other institutional care in next COVID-19 package. S. 3768/H.R. 6972, Nursing Home COVID-19 Protection and Prevention Act. No bill number. Discussed May 8 COVID-19 interim final rule. No bill number. Discussed VA and nursing homes addressing COVID-19 and the collection of demographic data in possible COVID-19 package. H.R. 6972, Nursing Home COVID-19 Protection and Prevention Act. S. 3517/H.R. 6487, Advancing Connectivity during the Coronavirus to Ensure Support for Seniors Act (ACCESS Act). No bill number. Discussed immunity related to COVID-19 for nursing homes and other long-term care facilities. H.R. 7617, Defense, Commerce, Justice, Science, Energy and Water Development, Financial Services and General Government, Labor, Health and Human Services, Education, Transportation, Housing, and Urban Development Appropriations Act, 2021. No bill number. Submitted statement regarding nursing homes and COVID-19 to the Coronavirus Commission on Safety and Quality in Nursing Homes. No bill number. Discussed dual eligible and Medicaid. S 4318, American Workers, Families, and Employers Assistance Act (HEALS). S. 4320, Coronavirus Response Additional Supplemental Appropriations Act of 2020. No bill number. Discussed resources for Medicaid HCBS in COVID legislation. No bill number. Discussed Community Immunity During COVID-19 Act. No bill number. Discussed and provided technical assistance on draft nursing home and COVID-19 provisions/amendments. No bill number. Discussed first person account related to long-term care facilities and COVID-19. No bill number. Provided technical assistance on family caregiver tax credit. S. 1443, Credit for Caring Act. Discussed the bill and a possible COVID package. No bill number. Discussed family caregiving with RAISE Family Caregiving Advisory Council. No bill number. Discussed RAISE Family Caregiving Advisory Council report. No bill number. Discussed care transitions for Community Living staff. P.L. 116-136, CARES Act. H.R. 8114, Emergency Support for Nursing Homes and Elder Justice Reform Act of 2020. S. 4555/H.R. 8079, Elder Justice Reauthorization Act of 2020. No bill number. Nursing Home Transparency and Oversight Act. No bill number. Discussed nursing home point-of-care testing and nursing home and long-term care facility testing. No bill number. Discussed logistics for virtual aging conference. No bill number. Discussed nursing homes, COVID package, testing, health extenders, continuing resolution, home care providers, and long-term services and supports. No bill number. Discussed Fiscal 2021 Medicare home health payment proposed rule. H.R. 2073/S. 110, legislation to permanently extend the medical expense deduction at 7.5% of income. No bill number. Discussed health care affordability for Americans age 50-64. H.R. 7714, Legislation to amend IRS Code of 1986 to Reduce the Floor on Deductions for Medical Expense. H.R. 6201, Families First Coronavirus Response Act. H.R. 6074, Coronavirus Preparedness Response Supplemental Appropriations Act, 2020. S. 2543, Prescription Drug Pricing Reduction Act (Grassley-Wyden). H.R. 19/S. 3129, Lower Cost More Cures Act. H.R. 3, Elijah E. Cummings Lower Cost Drugs Now Act.

Client expense: $1,880,000 · Firm income: Not reported

Government targets: Administration for Children & Families (ACF), Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Consumer Financial Protection Bureau (CFPB), Corporation for Natl & Community Service, Federal Communications Commission (FCC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Indian Health Service, Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Office of the Comptroller of the Currency (OCC), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Social Security Administration (SSA), Transportation, Dept of (DOT), Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

S.1443/H.R.2730 Credit for Caring Act S.110/H.R.2073 Medical Expense Savings Act H.R.2878 Homecare for Seniors Act H.R.6379 Families First Coronavirus Response Act S.3548/H.R.748 Coronavirus Aid, Relief, and Economic Security (CARES) Act; including provisions related to all nonprofits S.3544/H.R.6305 Coronavirus Relief for Seniors and People with Disabilities Act H.R.6408 Save the Organizations that Serve (SOS) America Act H.R.6800 Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act Issues related to strengthening charitable giving incentives including the universal charitable deduction (S. 4032/H.R. 7324) and Legacy IRA Act (S.1327/H.R. 3832) In forthcoming COVID-19 relief packages the Alzheimer's Association has advocated for policies which will impact charitable nonprofits including: - Expanded Nonprofit Access to Credit: To establish an exclusive fund to support nonprofit employers with between 500 and 10,000 employees, including loan forgiveness. - Expand Charitable Giving Incentives - Allow larger charitable nonprofits to be eligible to receive funds under the Paycheck Protection Program - Clarify that charitable nonprofits of all sizes are able to participate in the emergency Small Business Loan Program by using the tax-law definition of charitable organizations (Sec. 501(c)(3) public charities) and removing the language that excludes nonprofits that are eligible to receive Medicaid reimbursements.

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

Government targets: Administration on Aging, Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Indian Health Service, Interior, Dept of (DOI), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Natl Institutes of Health (NIH), SENATE, Social Security Administration (SSA), Veterans Affairs, Dept of (VA)

Charitable Giving Tax Deduction Act (H.R.651) Credit for Caring Act of 2019 (S.1443/H.R.2730) Help Charities Protect Communities Act (introduction pending) Legacy IRA Act (H.R. 3832/S.1257) Lessen Impediments from Taxes for Charities Act (LIFT for Charities Act) (S.632) Medical Expense Savings Act (S.110) Protecting Nonprofits from Catastrophic Cash Flow Strain Act of 2020 (S 4001 and S 4209) RESTART Act (S. 3814) Save the Organizations that Support (SOS) America Act (HR 6408) To amend the Internal Revenue Code of 1986 to repeal the inclusion of certain fringe benefit expenses for which a deduction is disallowed in unrelated business taxable income (H.R.1545) To amend the Internal Revenue Code of 1986 to permanently extend the 7.5 percent adjusted gross income floor for the medical expense deduction (H.R.2073) To extend the charitable deduction to all taxpayers regardless of whether a taxpayer itemizes deductions in order to encourage and increase charitable giving, and to provide for loans and loan guarantees to certain public charities (HR 6408) To include nonprofits in the Main Street Lending Program, and add Federal Reserve to list of agencies lobbied Universal Giving Pandemic Response Act (S 4032/HR 7324) WORK NOW Act (S. 3747) Implementation of: PL 115-97, Sec. 13702 unrelated business taxable income

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

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

Tax Cuts and Jobs Act, Pub. L. No. 115-97, 11011(a), 131 Stat. 2054, 2063 (2017) (codified at Internal Revenue Code 199A). Proposed tax rule for IRC 163(j) Medical Expense Savings Act (S.110) To amend the Internal Revenue Code of 1986 to permanently extend the 7.5 percent adjusted gross income floor for the medical expense deduction. (H.R.2073)

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

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

S. 1443, H.R. 2730, Credit for Caring Act. No bill number. Discussed issue of nursing homes seizing residents economic impact payments. H.R. 6379, Take Responsibility for Workers and Families Act. H.R. 2073/S.110, Permanent extension of the 7.5% income threshold for the medical expense deduction. H.R. 19/S. 3129, Lower Cost More Cures Act. H.R. 3, Elijah E. Cummings Lower Cost Drugs Now Act. H.R. 748, Coronavirus Aid, Relief, and Economic Security (CARES) Act - Discussed Required Minimum Distributions (RMD)

Client expense: $1,770,000 · Firm income: Not reported

Government targets: Administration for Children & Families (ACF), Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Consumer Financial Protection Bureau (CFPB), Corporation for Natl & Community Service, Federal Communications Commission (FCC), Federal Deposit Insurance Corporation (FDIC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Indian Health Service, Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Office of the Comptroller of the Currency (OCC), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Social Security Administration (SSA), Transportation, Dept of (DOT), Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

No bill number. Participated in CMS HCBS and Nursing Home Diversification Strategies brainstorming session. H.R.7254. Infection Control Training and Support Act of 2020. No bill number. Discussed nursing homes seizing residents economic impact payments. No bill number. Discussed and provided technical assistance on draft legislation related to State Veterans Homes and COVID-19. No bill number. Discussed nursing home COVID-19 issues, AARP priorities, and COVID-19 nursing home briefing with House staff and provided contact information for possible witnesses. No bill number. Discussed AARP priorities to protect nursing home and other long-term care facilities in response to COVID-19. H.R. 6800, Health and Economic Recovery Omnibus Emergency Solutions Act H.R. 6074, Preparedness and Response Supplemental H.R. 6201, Families First Coronavirus Response Act H.R. 748, Coronavirus Aid, Relief, and Economic Security (CARES) Act H.R. 266, Paycheck Protection Program and Health Care Enhancement Act. No bill number. Discussed telehealth and waiver extensions granted for COVID-19. H.R.6698/S. 3644, Quality Care for Nursing Home Residents and Workers During COVID-19 Act of 2020. No bill number. Discussed long-term care facility issues and COVID-19. S. 3768/H.R. 6972, Nursing Home COVID-19 Protection and Prevention Act. No bill number. Discussed and shared letter to FCC urging them to take sustained action to expand the affordability and availability of communication services to address COVID-19. S. 3544, Coronavirus Relief for Seniors and People with Disabilities Act of 2020. H.R. 6379, Take Responsibility for Workers and Families Act. S. 1443, H.R. 2730, Discussed Credit for Caring Act. No bill number. Discussed use of civil money penalties to purchase technology for virtual visitation. No bill number. Submitted comments on the proposed rule regarding the Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities (SNFs); and Updates to the Value-Based Purchasing Program for FY2021. Discussed implementation of the Patient Driven Payment Model (PDPM). No bill number. Written statement submitted for House hearing on Health Care Inequality: Confronting Racial and Ethnic Disparities in COVID-19 and the Health Care System, in addition to action needed to ensure health and safety in long-term care facilities, the collection and reporting of demographic data, and testing and contact tracing. No bill number. Submitted written statement for House hearing on The Disproportionate Impact of COVID-19 on Communities of Color. No bill number. Sent letter to Senate Judiciary Committee and discussed opposition to immunity related to COVID-19 for nursing homes, assisted living facilities, and other long-term care facilities. S. 3517/H.R. 6487, Advancing Connectivity during the Coronavirus to Ensure Support for Seniors Act (ACCESS Act). H.R. 6666, the COVID-19 Testing, Reaching, And Contacting Everyone (TRACE) Act. H.R. 1425, the Patient Protection and Affordable Care Enhancement Act. H.R. 2073/S.110, Permanent extension of the 7.5% income threshold for the medical expense deduction. S. 3057, Modernization of the Older Americans Act Amendments S. 2543, Prescription Drug Pricing Reduction Act (Grassley-Wyden). H.R. 19/S. 3129, Lower Cost More Cures Act. H.R. 3, Elijah E. Cummings Lower Cost Drugs Now Act.

Client expense: $1,770,000 · Firm income: Not reported

Government targets: Administration for Children & Families (ACF), Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Consumer Financial Protection Bureau (CFPB), Corporation for Natl & Community Service, Federal Communications Commission (FCC), Federal Deposit Insurance Corporation (FDIC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Indian Health Service, Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Office of the Comptroller of the Currency (OCC), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Social Security Administration (SSA), Transportation, Dept of (DOT), Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

H.R. 748, the CARES Act H.R. 1814/S. 651, the ABLE Age Adjustment Act H.R. 2073/S. 110 H.R. 4045/S. 2290, the Disabled Access Credit Expansion Act H.R. 6420, the All Dependent Children Count Act H.R. 6800, the Health and Economic Recovery Omnibus Emergency Solutions Act or the HEROES Act S. 1628, the Paid Family Leave Pilot Extension Act S. 3652, the All Dependents Count Act Implementation of the CARES Act (Public Law 116-136) Senate Draft Bill, Automatic Cash Assistance Act

Client expense: $71,212 · Firm income: Not reported

Government targets: AMTRAK - Natl Railroad Passenger Corporation, Architectural & Transportation Barriers Compliance Board, Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Federal Emergency Management Agency (FEMA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Institutes of Health (NIH), SENATE, Social Security Administration (SSA), Transportation Security Administration (TSA), Transportation, Dept of (DOT), Veterans Affairs, Dept of (VA), Veterans Employment & Training Service

Medical Expense Deduction Extension - S.110/H.R.2073 - Medical Expense Savings Act CARES Act - Universal Charitable Deduction inclusion - HR 748 (work toward inclusion in future legislation)

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

Government targets: Centers For Disease Control & Prevention (CDC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), SENATE

S.1443/H.R.2730 Credit for Caring Act S.110/H.R.2073 Medical Expense Savings Act H.R.2878 Homecare for Seniors Act S.1257/H.R.3832 Legacy IRA Act H.R.6379 Families First Coronavirus Response Act S.3548/H.R.748 Coronavirus Aid, Relief, and Economic Security (CARES) Act; including provisions related to all nonprofits S.3544/H.R.6305 Coronavirus Relief for Seniors and People with Disabilities Act H.R.6408 Save the Organizations that Serve (SOS) America Act In forthcoming COVID-19 relief packages the Alzheimer's Association has advocated for policies which will impact charitable nonprofits including: - Expanded Nonprofit Access to Credit: To establish an exclusive fund to support nonprofit employers with between 500 and 10,000 employees, including loan forgiveness. - Expand Charitable Giving Incentives - Allow larger charitable nonprofits to be eligible to receive funds under the Paycheck Protection Program - Clarify that charitable nonprofits of all sizes are able to participate in the emergency Small Business Loan Program by using the tax-law definition of charitable organizations (Sec. 501(c)(3) public charities) and removing the language that excludes nonprofits that are eligible to receive Medicaid reimbursements.

Client expense: $400,000 · Firm income: Not reported

Government targets: Administration on Aging, Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Indian Health Service, Interior, Dept of (DOI), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Natl Institutes of Health (NIH), SENATE, Social Security Administration (SSA), Veterans Affairs, Dept of (VA)

Charitable Giving Tax Deduction Act (H.R.651) Credit for Caring Act of 2019 (S.1443/H.R.2730) Legacy IRA Act (H.R. 3832/S.1257) Lessen Impediments from Taxes for Charities Act (LIFT for Charities Act) (S.632) Medical Expense Savings Act (S.110) Save the Organizations that Support (SOS) America Act (HR 6408) To amend the Internal Revenue Code of 1986 to repeal the inclusion of certain fringe benefit expenses for which a deduction is disallowed in unrelated business taxable income (H.R.1545) To amend the Internal Revenue Code of 1986 to permanently extend the 7.5 percent adjusted gross income floor for the medical expense deduction (H.R.2073) Implementation of: PL 115-97, Sec. 13702 unrelated business taxable income

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

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

Tax Cuts and Jobs Act, Pub. L. No. 115-97, 11011(a), 131 Stat. 2054, 2063 (2017) (codified at Internal Revenue Code 199A). Proposed tax rule for IRC 163(j) Medical Expense Savings Act (S.110) To amend the Internal Revenue Code of 1986 to permanently extend the 7.5 percent adjusted gross income floor for the medical expense deduction. (H.R.2073)

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

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

H.R. 748, the CARES Act H.R. 1814/S. 651, the ABLE Age Adjustment Act H.R. 2073/S. 110 H.R. 4045/S. 2290, the Disabled Access Credit Expansion Act S. 1628, the Paid Family Leave Pilot Extension Act

Client expense: $74,586 · Firm income: Not reported

Government targets: AMTRAK - Natl Railroad Passenger Corporation, Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Federal Emergency Management Agency (FEMA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Institutes of Health (NIH), SENATE, Transportation Security Administration (TSA), Transportation, Dept of (DOT), U.S. Architectural & Transportation Barriers Compliance Board (ACCESS), Veterans Affairs, Dept of (VA), Veterans Employment & Training Service

Medical Expense Deduction Extension - S.110/H.R.2073 - Medical Expense Savings Act CARES Act - Universal Charitable Deduction inclusion - HR 748

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

Government targets: Centers For Disease Control & Prevention (CDC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), SENATE

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 - Discussed Medicare enrollment national open enrollment period, medical expense deduction, cost-sharing protections for commercial/private health insurance holders, telehealth access, nursing homes, virtual visitation, home and community-based services, Older Americans Act programs, Medicare home health care, and family caregiving, no-cost COVID-19 testing, equitable relief payments, retirement savings tax relief, suspensions of foreclosures and evictions, expanded unemployment benefits, paid sick and family leave, affordable broadband, and government operations, among other issues. S. 3517, Discussed Advancing Connectivity during the Coronavirus to Ensure Support for Seniors Act (ACCESS Act). S. 753/H.R. 1682, Improving Access to Medicare Coverage Act, discussed bill and Coronavirus legislation (no bill number). S. 296/H.R.2150, Home Health Care Planning Improvement Act, discussed bill and Coronavirus legislation. No bill number. CMS nursing home Coronavirus guidance. No bill number. Discussed nursing home virtual visitation. S. 3548/H.R. 748, P.L. 116-136, CARES Act Lobbied regarding nursing homes, virtual visitation, home and community-based services, Older Americans Act programs, Medicare home health care, and family caregiving. H.R. 6379, Take Responsibility for Workers and Families Act. Discussed virtual visitation provisions of bill and Medicaid HCBS grants. H.R. 6305, To assist older Americans and people with disabilities affected by COVID-19. S. 3544, Coronavirus Relief for Seniors and People with Disabilities Act. S. 1443, H.R. 2730, Discussed Credit for Caring Act, and inclusion of bill in Coronavirus legislation. No bill. Discussed Coronavirus disease 2019 and appropriations supplemental. S.64/H.R. 2375 - the Preserve Access to Generics and Biosimilars Act. H.R. 1499 - the Preserving Consumer Access to Generics Act. Discussed telehealth, interoperability, and data sharing with Department of Health and Human Services. H.R. 19/S. 3129, Lower Cost More Cures Act. S. 2543, the Prescription Drug Pricing Reduction Act. H.R. 2073/S. 110, Permanent Extension of the Medical Expense Deduction. H.R. 3, Elijah E. Cummings Lower Cost Drugs Now Act. S. 3057, Modernization of the Older Americans Act Amendments.

Client expense: $2,210,000 · Firm income: Not reported

Government targets: Administration for Children & Families (ACF), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Consumer Financial Protection Bureau (CFPB), Corporation for Natl & Community Service, Federal Deposit Insurance Corporation (FDIC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Indian Health Service, Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Office of the Comptroller of the Currency (OCC), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Social Security Administration (SSA), Transportation, Dept of (DOT), Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

P.L. 115-119, RAISE Family Caregivers Act. Discussed the law and the Family Caregiving Advisory Councils work, including additional funding. Lifespan Respite Care Reauthorization Act (S. 995/H.R. 2035). No bill - Assisting family caregivers in addressing the financial challenges of family caregiving S. 110, the Medical Expense Savings Act,; H.R. 2073, to extend the 7.5 percent adjusted gross income floor for the medical expense deduction. S. 3057, Modernization of the Older Americans Act Amendments. S. 299, Geriatrics Workforce Improvement Act. No bill number, drug pricing. S. 591, the Guardianship Accountability Act/guardianship, retirement security, elder justice, scams, fraud, biomedical research. H.R. 4334, Supporting Older Americans Act of 2020 and OAA reauthorization No bill number. Discussed Assisting Caregivers Today (ACT) and potential event with ACT Caucus. H.R. 1342, EMPOWER Care Act.; H.R. 1343, Protecting Married Seniors from Impoverishment Act. H.R. 2035, Lifespan Respite Care Reauthorization Act.; No bill number. Discussed Senior Guardianship Attack Force legislative proposal. S. 3517, Discussed Advancing Connectivity during the Coronavirus to Ensure Support for Seniors Act (ACCESS Act). No bill number. CMS nursing home Coronavirus guidance. No bill number. Discussed nursing home virtual visitation. S. 3548/H.R. 748, Lobbied regarding nursing homes, virtual visitation, home and community-based services, Older Americans Act programs, Medicare home health care, and family caregiving. H.R. 6379, Take Responsibility for Workers and Families Act. Discussed virtual visitation provisions and Medicaid HCBS grants. H.R. 6305, To assist older Americans and people with disabilities affected by COVID-19; S. 3544, Coronavirus Relief for Seniors and People with Disabilities Act. P.L. 115-182, VA MISSION Act. Discussed VA Caregiver Support Program and proposed rule.

Client expense: $2,210,000 · Firm income: Not reported

Government targets: Administration for Children & Families (ACF), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Consumer Financial Protection Bureau (CFPB), Corporation for Natl & Community Service, Federal Deposit Insurance Corporation (FDIC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Indian Health Service, Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Office of the Comptroller of the Currency (OCC), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Social Security Administration (SSA), Transportation, Dept of (DOT), Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

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 - Discussed Medicare enrollment national open enrollment period, medical expense deduction, cost-sharing protections for commercial/private health insurance holders, telehealth access, nursing homes, virtual visitation, home and community-based services, Older Americans Act programs, Medicare home health care, and family caregiving, no-cost COVID-19 testing, and government operations, among other issues. S. 1443, H.R. 2730, Credit for Caring Act. H.R. 6201 the Families First Coronavirus Response Act H.R. 748 (CARES Act) H.R. 19/S. 3129, Lower Cost More Cures Act. H.R. 2073/S. 110, Permanent Extension of the Medical Expense Deduction. S. 2543 the Prescription Drug Pricing Reduction Act (Grassley-Wyden).

Client expense: $2,210,000 · Firm income: Not reported

Government targets: Administration for Children & Families (ACF), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Consumer Financial Protection Bureau (CFPB), Corporation for Natl & Community Service, Federal Deposit Insurance Corporation (FDIC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Indian Health Service, Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Office of the Comptroller of the Currency (OCC), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Social Security Administration (SSA), Transportation, Dept of (DOT), Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

Letter urging Members of Congress to cosponsor H.R. 2073 and S. 110 to make permanent the 7.5% threshold for medical expense deductions, and support an extension of the 7.5% threshold in the end-of-year legislative package.

Client expense: Not reported · Firm income: Not reported

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

S.1443/H.R.2730 Credit for Caring Act S.110/H.R.2073 Medical Expense Savings Act H.R.2878 Homecare for Seniors Act

Client expense: $400,000 · Firm income: Not reported

Government targets: Administration on Aging, Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Indian Health Service, Interior, Dept of (DOI), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Natl Institutes of Health (NIH), SENATE, Social Security Administration (SSA), Veterans Affairs, Dept of (VA)

-Signed a letter supporting H.R. 2073, legislation to make the 7.5 percent threshold for medical expense deduction permanent.

Client expense: Not reported · Firm income: Not reported

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

United Spinal signed onto a Leadership Council of Aging Organizations letter to Congressional leadership urging them to reauthorize the Older Americans Act (OAA). The OAA is the authorizing vehicle for a number of important programs, including those focused on caregiving. United Spinal was invited to attend a meeting at the CDC to discuss and provide input on SCI registries. United Spinal had signed onto House and Senate Congressional letters in support of the Prescription Drug Pricing Reduction Act, which includes provisions of increased support for low-income beneficiaries and caps on out-of-pocket costs and supports preservation and improvement of the Medicare Rebate Drug Program. Personal Connected Health Alliance (United Spinal is a member) Committee on Ways & Means Rural and Underserved Communities Health Task Force - the Committees forum to convene Members and experts to discuss the delivery and financing of health care and related social determinants in urban and rural underserved areas and identify strategies to address the challenges that contribute to health inequities, issued a Request for Information (RFI) soliciting input on priority topics that affect health status and outcomes for consideration and discussion in future Member sessions of the Task Force. United Spinal supported increased Federal Government funding at NIH. United Spinal signed onto House and Senate letters, in support of extending the 7.5% threshold for the medical expense deduction, S. 110, The Medical Expense Savings Act, introduced by Sen. Susan Collins (R-ME) and a similar bill in the House, H.R. 2073, introduced by Rep. Katie Porter (D- CA 45). National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) Medstar Health Research Institute MHRI and United Spinal Association - United Spinal Association finalized an agreement in December with MHRI as a subcontracting partnership to NIDILIRRs Rehabilitation Research and Training Center (RRTC) Program which conducts research to improve rehabilitation methodology and service delivery systems; improves health and functioning; and promotes employment, independent living, family support, and economic and social self-sufficiency for individuals with disabilities. United Spinal will be assisting with recruiting participants for research projects and reviewing educational material: Rehabilitation and Research Training Center on Health and Function for People with Physical Disabilities focused on Neurogenic Lower Urinary Tract Dysfunction.

Client expense: Not reported · Firm income: $75,000

Government targets: AMTRAK - Natl Railroad Passenger Corporation, Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Federal Communications Commission (FCC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Labor, Dept of (DOL), Natl Institutes of Health (NIH), SENATE, Transportation, Dept of (DOT), U.S. Architectural & Transportation Barriers Compliance Board (ACCESS), U.S. Commission on Civil Rights

Charitable Giving Tax Deduction Act (H.R.651) Credit for Caring Act of 2019 (S.1443/H.R.2730) Legacy IRA Act (H.R. 3832/S.1257) Lessen Impediments from Taxes for Charities Act (LIFT for Charities Act) (S.632) Medical Expense Savings Act (S.110) To amend the Internal Revenue Code of 1986 to repeal the inclusion of certain fringe benefit expenses for which a deduction is disallowed in unrelated business taxable income (H.R.1545) To amend the Internal Revenue Code of 1986 to permanently extend the 7.5 percent adjusted gross income floor for the medical expense deduction (H.R.2073) Implementation of: PL 115-97, Sec. 13702 unrelated business taxable income

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

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

Tax Cuts and Jobs Act, Pub. L. No. 115-97, 11011(a), 131 Stat. 2054, 2063 (2017) (codified at Internal Revenue Code 199A). Proposed tax rule for IRC 163(j) Medical Expense Savings Act (S.110) To amend the Internal Revenue Code of 1986 to permanently extend the 7.5 percent adjusted gross income floor for the medical expense deduction. (H.R.2073)

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

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

-Signed a letter supporting H.R. 2073, legislation to make the 7.5 percent threshold for medical expense deduction permanent.

Client expense: Not reported · Firm income: Not reported

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

H.R. 1158/H.R. 1865 - The Consolidated Appropriations Act/Further Consolidated Appropriations Act. H.R. 3351/S.2524 Financial Services & General Government Appropriations bill, FY 2020 - Lobbied to protect and enhance funding levels for IRS VITA & TCE taxpayer assistance programs. H.R. 2073 - Supported bill to amend the Internal Revenue Code of 1986 to permanently extend the 7.5 percent adjusted gross income floor for the medical expense deduction. H.R. 1865/H.R. 1158- Lobbied in support of 2 year extension of 7.5% income threshold for the medical expense deduction. H.R. 2730/S. 1443, Credit for Caring Act.

Client expense: $2,140,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Transportation, Dept of (DOT), Treasury, Dept of, White House Office

H.R. 1158/H.R. 1865 - The Consolidated Appropriations Act/Further Consolidated Appropriations Act. H.R. 2740 Labor-HHS Appropriations bill, FY 2020 - Lobbied in support of increased funding for CMS' state survey and certification program and opposition to hostile policy riders re ACA, and various related medical care research and supportive services. S.340/H.R. 965 - the CREATES Act. S.64/H.R. 2375 - The Preserve Access to Generics and Biosimilars Act. H.R. 1499 - The Preserving Consumer Access to Generics Act. H.R. 3 - The Lower Drug Costs Now Act. H.R. 2073/S.110 - Lobbied in support of a permanent extension of the 7.5% income threshold for the medical expense deduction. H.R. 1865/H.R. 1158 - Lobbied in support of 2 year extension of 7.5% income threshold for the medical expense deduction in the final FY 2020 Consolidated Appropriations Act. H.R. 19/S.3129 - The Lower Costs, More Cures Act H.R. 1682/S.753 - The Improving Access to Medicare Coverage Act H.R. 1342/S. 548 - The Empower Act S. 1921, Provider Training in Palliative Care Act. S. 1399, Title VIII Nursing Workforce Reauthorization Act. P.L. 115-119, RAISE Family Caregivers Act - Discussed family caregiving in Cures 2.0.

Client expense: $2,140,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Transportation, Dept of (DOT), Treasury, Dept of, White House Office

H.R. 1814/S. 651, the ABLE Age Adjustment Act H.R. 2073/S. 110 H.R. 4045/S. 2290, the Disabled Access Credit Expansion Act S. 1628, the Paid Family Leave Pilot Extension Act

Client expense: $72,261 · Firm income: Not reported

Government targets: AMTRAK - Natl Railroad Passenger Corporation, Centers For Medicare and Medicaid Services (CMS), Federal Emergency Management Agency (FEMA), HOUSE OF REPRESENTATIVES, Housing & Urban Development, Dept of (HUD), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Institutes of Health (NIH), SENATE, Transportation, Dept of (DOT), U.S. Architectural & Transportation Barriers Compliance Board (ACCESS), Veterans Affairs, Dept of (VA)

Medical Expense Deduction Extension - S.110/H.R.2073 - Medical Expense Savings Act

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

Government targets: Centers For Disease Control & Prevention (CDC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), SENATE

S.1443/H.R.2730 Credit for Caring Act H.R.2073 7.5% Medical Expense Deduction H.R.2878 Homecare for Seniors Act

Client expense: $500,000 · Firm income: Not reported

Government targets: Administration on Aging, Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Indian Health Service, Interior, Dept of (DOI), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Natl Institutes of Health (NIH), SENATE, Social Security Administration (SSA), Veterans Affairs, Dept of (VA)

Tax Cuts and Jobs Act, Pub. L. No. 115-97, 11011(a), 131 Stat. 2054, 2063 (2017) (codified at Internal Revenue Code 199A). Proposed tax rule for IRC 163(j) Medical Expense Savings Act (S.110) To amend the Internal Revenue Code of 1986 to permanently extend the 7.5 percent adjusted gross income floor for the medical expense deduction. (H.R.2073)

Client expense: $900,000 · Firm income: Not reported

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

Charitable Giving Tax Deduction Act (H.R.651) Credit for Caring Act of 2019 (S.1443/H.R.2730) Legacy IRA Act (H.R. 3832/S.1257) Lessen Impediments from Taxes for Charities Act (LIFT for Charities Act) (S.632) Medical Expense Savings Act (S.110) To amend the Internal Revenue Code of 1986 to repeal the inclusion of certain fringe benefit expenses for which a deduction is disallowed in unrelated business taxable income (H.R.1545) To amend the Internal Revenue Code of 1986 to permanently extend the 7.5 percent adjusted gross income floor for the medical expense deduction (H.R.2073) Implementation of: PL 115-97, Sec. 13702 unrelated business taxable income

Client expense: $33,764 · Firm income: Not reported

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

H.R. 3351/S.2524 Financial Services & General Government Appropriations bill, FY 2020 - Lobbied to protect and enhance funding levels for IRS VITA & TCE taxpayer assistance programs. S.110 - Supported the Medical Expense Savings Act. H.R. 2073 - Supported bill to amend the Internal Revenue Code of 1986 to permanently extend the 7.5 percent adjusted gross income floor for the medical expense deduction. S. 1443/H.R. 2730, Discussed the Credit for Caring Act and caregiving statistics. S. 617 Tax Extenders & Disaster Relief Act. Discussed paid family leave and Social Security, including H.R. 3865 and S. 463.

Client expense: $2,140,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), General Services Administration (GSA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), Office of Personnel Management (OPM), SENATE, Securities & Exchange Commission (SEC), Transportation, Dept of (DOT), Treasury, Dept of, White House Office

H.R. 1814/S. 651, the ABLE Age Adjustment Act H.R. 2073/S. 110 H.R. 4045/S. 2290, the Disabled Access Credit Expansion Act S. 1628, the Paid Family Leave Pilot Extension Act

Client expense: $78,075 · Firm income: Not reported

Government targets: AMTRAK - Natl Railroad Passenger Corporation, Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Housing & Urban Development, Dept of (HUD), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Institutes of Health (NIH), SENATE, Transportation, Dept of (DOT), Veterans Affairs, Dept of (VA)

S.1443/H.R.2730 Credit for Caring Act H.R.2073 7.5% Medical Expense Deduction H.R.2878 Homecare for Seniors Act

Client expense: $871,000 · Firm income: Not reported

Government targets: Administration on Aging, Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Indian Health Service, Interior, Dept of (DOI), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Natl Institutes of Health (NIH), SENATE, Social Security Administration (SSA), Veterans Affairs, Dept of (VA)

Health issues impacting patients with rare diseases. H.R.2279: Safe Step Act. Rare Disease Advancement, Research, and Education Act (Legislation not yet introduced). Advancing Access to Targeted Therapies Act (Legislation not yet introduced). H.Res.242: Affirming the importance of the Orphan Drug Act, celebrating the over 750 new orphan therapies approved since its creation, and recognizing the need to continue supporting research and development for rare diseases. Pediatric subspecialty loan repayment reauthorization. H.R.2507: Newborn Screening Saves Lives Reauthorization Act of 2019. H.R. 776/S.1173: Emergency Medical Services for Children Program Reauthorization Act of 2019. H.R.1379/S.560: Ensuring Lasting Smiles Act. H.R.2862: VACCINES Act of 2019. Copay Accumulator Adjustment Programs (CAAPs). The Patient-Centered Outcomes Research Institute (PCORI) Reauthorization (Legislation not yet introduced). H.R.2501: Medical Nutrition Equity Act. H.R.1010: To provide that the rule entitled "Short-Term, Limited Duration Insurance" shall have no force or effect. H.R.986: Protecting Americans with Preexisting Conditions Act of 2019. H.R.1884: Protecting Pre-Existing Conditions and Making Health Care More Affordable Act of 2019. S.1125: Protect Act. RIN 0938-ZB45: Patient Protection and Affordable Care Act; Increasing Consumer Choice Through the Sale of Individual Health Insurance Coverage Across State Lines Through Health Care Choice Compacts. H.R.1386/S.1905: ENROLL Act of 2019. H.R.2073/S.110: Medical Expense Savings Act. Guidance on Compliance with the Congressional Review Act.

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

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

Charitable Giving Tax Deduction Act (H.R.651) Credit for Caring Act of 2019 (S.1443/H.R.2730) Implementation of Public Law 115-97, Section 13702 unrelated business taxable income Legacy IRA Act (S.1257) Lessen Impediments from Taxes for Charities Act (LIFT for Charities Act) (S.632) To amend the Internal Revenue Code of 1986 to repeal the inclusion of certain fringe benefit expenses for which a deduction is disallowed in unrelated business taxable income / Lift for Charities Act (H.R.1545/S.632) To amend the Internal Revenue Code of 1986 to permanently extend the 7.5 percent adjusted gross income floor for the medical expense deduction (H.R.2073)

Client expense: $136,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Education, Dept of, Environmental Protection Agency (EPA), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Transportation, Dept of (DOT), Treasury, Dept of, White House Office

Tax Cuts and Jobs Act, Pub. L. No. 115-97, 11011(a), 131 Stat. 2054, 2063 (2017) (codified at Internal Revenue Code 199A). Proposed tax rule for IRC 163(j) Medical Expense Savings Act (S.110) To amend the Internal Revenue Code of 1986 to permanently extend the 7.5 percent adjusted gross income floor for the medical expense deduction. (H.R.2073)

Client expense: $900,000 · Firm income: Not reported

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

The Alliance for Aging Research signed a letter of support for H.R. 2073, a bill to amend the Internal Revenue Code of 1986 to permanently extend the 7.5 percent adjusted gross income floor for the medical expense deduction. The Alliance for Aging Research signed a letter of support for S.110, the Medical Expense Savings Act which would make permanent the 7.5 percent threshold for the medical expense deduction. The Alliance for Aging Researched sent a letter to Capitol Hill in support of S. 692, the Protect Medical Innovation Act of 2019.

Client expense: Not reported · Firm income: Not reported

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

H.R. 3351 Financial Services & General Government Appropriations bill, FY 2020 - Lobbied to protect and enhance funding levels for IRS VITA & TCE taxpayer assistance programs. S. 1443/H.R. 2730, Credit for Caring Act - discussed reintroduction of the bill and AARPs support. H.R. 2073 - Support of a permanent extension of the Medical Expense Deduction at the 7.5% threshold. S. 110 - Discussed and endorsed the Medical Expense Savings Act, which makes the 7.5% income threshold permanent for all effective December 31, 2018. S. 617, Discussed legislation creating a 2 year extension for the 7.5% medical expense deduction in the Senates tax extenders bill. H.R. 2878 Homecare for Seniors Act. No bill number, Federal Interagency Task Force on Long-Term Care Insurance - discussed private long-term care insurance.

Client expense: $1,900,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), General Services Administration (GSA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Securities & Exchange Commission (SEC), Transportation, Dept of (DOT), Treasury, Dept of, White House Office

H.R. 2740 Labor-HHS Appropriations bill, FY 2020 - Lobbied in support of increased funding for CMS' state survey and certification program and opposition to hostile policy riders re ACA, and various related medical care research and supportive services. Discussed issue related to the Supplemental Nutrition Assistance Program. P.L. 114-42, NOTICE Act and no bill number, Improving Access to Medicare Coverage Act - discussed transparency/surprise medical billing, including observation issues and related prior legislation, in response to Senate request for information. S.340/H.R. 965 - the CREATES Act. S.64/H.R. 2375 - the Preserve Access to Generics and Biosimilars Act. H.R. 1499 - the Preserving Consumer Access to Generics Act. Endorsed H.R. 986, H.R. 987, and H.R. 1010, aimed at protecting the core consumer provisions of the ACA, including the prohibition on insurers engaging in an age tax and preexisting condition discrimination. S.1531- STOP Act. Discussed support for restoration and extension of the medical expense deduction. S.110/HR. 2073 Medical Expenses Permanency Legislation. S.617 Tax Extenders & Disaster Relief Act. H.R.2730/S. 1443 Credit for Caring Act. Medical Expense Deductions (included in H.R. 1628 and Better Care Reconciliation Act drafts) S.1209 REMEDY ACT. H.R.1373, Protecting Seniors from Poverty Act. H.R.2150/S. 296, Home Health Care Planning Improvement Act. H.R.1682/S.753 Improving Access to Medicare Coverage Act. H.R.1342/S.548 Empower Act. Better Care Reconciliation Act draft.

Client expense: $1,900,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), General Services Administration (GSA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Securities & Exchange Commission (SEC), Transportation, Dept of (DOT), Treasury, Dept of, White House Office

Outreach to new Members of Congress and committees of jurisdiction on the need to reform rehabilitation access, therapy and expertise for the spinal cord injury. Was asked by the Congressional Telehealth Caucus to submit comments on their RFI on telemedicine, which we did, highlighting the specific needs of access to healthcare and the challenges that our population face with reaching medical experts. Submitted appropriations requests for robust funding to the Hill for the SCI Research Program and the MS Research program at the Department of Defense. National Institutes of Health (NIH) - National Institute for Neurological Disorders and Stroke (NINDS) SCI 2020: Launching a Decade for Disruption in Spinal Cord Injury Research - Post SCI 2020 Call - Had a meaningful discussion with NIH about research priorities for the SCI population and discussed our efforts to advocate on establishing SCI Centers of Excellence. National Institute on Neurological Disorders and Strokes (NINDS) Nonprofit Forum 2019: Progress through Partnership United Spinal Policy staff participated in the Progress through Partnership Forum which provided an opportunity for nonprofit leaders to network with colleagues and to engage in discussions with NINDS staff. The agenda featured panel discussions on cell and gene therapy, data collection and storage, motivating the next generation of researchers, neuroethics and success stories. National Institute of Disability, Independent Living and Rehabilitation Research (NIDILRR) United Spinal policy staff met, along with numerous other disability organizations as members of the Disability Rehabilitation Research Coalition, to outline rehabilitation research priorities to the new director, Jim Whitehead. United Spinal policy staff emphasized fitness, exercise, nutrition and maximizing consumer outcomes from acute care and rehabilitation programs. United Spinal supports and signed onto letters to Congress on H.R.2073 and S. 110 (The Medical Expense Savings Act) - amend the Internal Revenue Code of 1986 to permanently extend the 7.5 percent adjusted gross income floor for the medical expense deduction. HHS - Administration for Community Living United Spinal signed onto CCDs letter to the U.S. Department of Health and Human Services ACL to oppose the ACL reorganization which is supposed to improve efficiency and effectiveness of the organization; strengthen infrastructure; and improve the connections between the organization and its stakeholder, grantees and consumers at the national, state and local levels. CCD is concerned that the reorganization plan may have the opposite result. HHS - Office of the National Coordinator for Health IT As a member of the Personal Connected Health Alliance (PCHAlliance), a non-profit membership association, United Spinal joined in commenting on the proposed rule, titled 21st Century Cures Act: Interoperability, Information Blocking, and the ONC Health IT Certification Program, published in the Federal Register on March 4, 2019. The letter read in part: PCHAlliance appreciates ONCs extensive work to develop consensus around interoperability standards. Consensus-based standards, certification programs, and policies comprise the essential backbone to enable interoperability and the broad sharing of health care information to support and improve health care delivery, decision-making, and operations. NIH United Spinal submitted comments addressing the National Center for Medical Rehabilitation Researchs Request for Information: Research Plan on Rehabilitation. The comments read in part: We echo the comments we joined in submitting as a member of the Disability Rehabilitation Research Consortium (DRRC), the plan should ensure an understanding of rehabilitation research that is cross-cutting, multi-disciplinary, and focused on 1) understanding the mechanisms of disability, 2) supporting efforts to restore and improve functional capacity in individuals undergoing rehabilitation, and 3) maintaining and preventing deterioration of functional skills while enhancing quality of life for people with disabilities. 21st Century Assistive Technology Bill/S. 1835. Submitted letter of support to Senator Caseys office for the introduction for the 21st Century Assistive Technology Act which would help address the need for increased education of and access to the latest assistive technology devices, particularly for people with disabilities living in rural regions. United Spinal sent in comments to Rep. Suzan DelBene (D-WA) on telemedicine restrictions regarding telehealth policies in her bill entitled Mental Health Telemedicine Expansion Act/H.R. 1301 and highlighted our opposition to in-person visit requirements.

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

Government targets: AMTRAK - Natl Railroad Passenger Corporation, Agriculture, Dept of (USDA), Centers For Medicare and Medicaid Services (CMS), Federal Communications Commission (FCC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), SENATE, Social Security Administration (SSA), Transportation, Dept of (DOT)