Strengthening Health Care and Lowering Prescription Drug Costs Act

H.R. 3502, Protecting People from Surprise Medical Bills Act, all provisions H.R. 5826, Consumer Protections Against Surprise Medical Bills Act of 2020, all provisions H.R. 3630, No Surprises Act, all provisions S. 1895, Lower Health Care Costs Act, provisions relating to surprise billing S. 1531, Stopping The Outrageous Practice of (STOP) Surprise Medical Bills Act of 2019, all provisions S. 4421, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act, all provisions H.R. 6644, To require group health plans and health insurance issuers offering group or individual health insurance coverage to provide coverage for services furnished via telehealth if such services would be covered if furnished in-person during the COVID-19 emergency, all provisions S. 3741, Health Care at Home Act of 2020, all provisions S. 4666, National Coronavirus Commission Act of 2020, all provisions S. 4507, Getting Early Treatment and Comprehensive Assessments Reduces Emergencies (GET CARE) Act of 2020, all provisions H.R. 8441, Frontline Heroes Act, all provisions S. 4317, SAFE TO WORK Act, all provisions H.R. 925, The Heroes Act, all provisions S. 3749, Public Health Emergency Privacy Act, all provisions S. 3861, Exposure Notification Privacy Act, all provisions H.R. 6585, Equitable Data Collection and Disclosure on COVID-19 Act, all provisions H.R. 7510, Assimilating Health and Equity Assessments into Decision-making (AHEAD Act) of 2020, all provisions S. 4919, Assimilating Health and Equity Assessments into Decision-making (AHEAD Act) of 2020, all provisions H.R. 6808, Health Force and Resilience Force Act of 2020, all provisions S. 3606, Health Force and Resilience Force Act of 2020, all provisions H.R. 7255, Coronavirus Health Care Worker Wellness Act of 2020, all provisions H.R. 8094, Dr. Lorna Breen Health Care Provider Protection Act, all provisions S. 4349, Dr. Lorna Breen Health Care Provider Protection Act, all provisions H.R. 3884, Marijuana Opportunity Reinvestment and Expungement (MORE) Act of 2020, all provisions S. 2032, Cannabidiol and Marihuana Research Expansion Act, all provisions H.R. 1503, Orange Book Transparency Act of 2019, provisions related to PBM and prescription drug price transparency H.R. 1520, Purple Book Continuity Act of 2019, provisions related to PBM and prescription drug price transparency H.R. 987, Strengthening Health Care and Lowering Prescription Drug Costs Act, provisions related to PBM and prescription drug price transparency H.R. 3, Elijah E. Cummings Lower Drug Costs Now Act, provisions related to PBM and prescription drug price transparency H.R. 4995, Maternal Health Quality Improvement Act of 2020, all provisions H.R. 7120, George Floyd Justice in Policing Act of 2020, provisions relating to police reform Affordable Care Act stabilization Expansion of Paycheck Protection Program for 501(c)6s Public Health and Social Services Emergency Fund Marginalized and minoritized communities/COVID-19 disproportionate impact COVID-19 long haulers COVID-19 testing/vaccines/health care prior authorization COVID-19/treatment and prescribing flexibilities COVID-19/Expanded PPE/clearinghouses E/M services Surprise medical billing executive orders Surprise Medical Billing, generally Clinical and administrative data intersection State Medical Boards/Interstate Medical Licensure Compact Pharmacists and COVID-19 testing Mental health parity Digital therapeutics Physician practice financial impact 21st Century Cures Act/health data and privacy 42 CFR Part 2, HIPAA Patent reform CPT - digital Most favored nation drug pricing Drug pricing Health Information Technology/information blocking Dietary guidelines/alcohol consumption Data privacy Cyber security best practices Race and sex stereotyping executive order

Client expense: $3,870,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Bureau of Citizenship & Immigration Services (BCIS), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), SENATE, Veterans Affairs, Dept of (VA), White House Office

Affordable prescription drugs, 340B Program; HR985 FAST Generics Act of 2019; Appropriate and accurate payment for healthcare; Site Neutral payment policies; S. 1895 - Lower Health Care Costs Act; S. 340 - CREATES Act, H.R. 987 - Strengthening Health Care and Lowering Prescription Drug Costs Act; S. 1391 - Fair Accountability and Innovative Research Drug Pricing Act of 2019; Surprise billing: S. 1531 - Stop the Outrageous Practice of Surprise Medical Bills Act of 2019; HR 3, the Lower Drug Costs Now Act; H.R.2149 - Exposing the Financing of Human Trafficking Act; H.R.508 - Trafficking Victims Housing Act of 2019; H.R. 1520 - Purple Book Continuity At of 2019; H.R. 1503 - Orange Book Transparency Act of 2019; S.2543 - Prescription Drug Pricing Reduction Act of 2019; Health care privacy; patient privacy; H.R. 647, S.2080 - Palliative Care and Hospice Education and Training Act; Conrad 30 and the Physician Access Reauthorization Act, S 948; Issues related to the Medicaid Fiscal Accountability Regulation (MFAR); HR 6074 - Coronavirus Preparedness and Response Supplemental Appropriations Act; HR 6201 - Families First Coronavirus Response Act - Public Law No: 116-127; HR 748 - Coronavirus Aid, Relief, and Economic Security (CARES) Act; response to the COVID-19 public health emergency; S. 178 - HEALS Act; H.R. 1425, Patient Protection and Affordable Care Enhancement Act; H.R. 6800 - HEROES Act; H.R. 266, Paycheck Protection Program and Health Care Enhancement Act; issues related to coverage of virtual car; Financial support for providers for diagnosis and treatment related to COVID-19, coverage of COVID-19 related conditions, and access to PPE and other materials and equipment related to the treatment of patients with COVID-19; H.R. 133 - Consolidated Appropriations Act; Issues related to social determinants of health; H.R. 6561 - Improving Social Determinants of Health Act ; S. 4421- Temporary Reciprocity to Ensure Access to Treatment Act; liability relief for health care providers

Client expense: $290,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA), Vice President of the U.S.

H.R. 1781, Payment Commission Data Act; H.R. 1503, Orange Book Transparency Act of 2019; H.R. 1520, Purple Book Continuity Act of 2019; H.R. 965 and S. 340, the CREATES Act; H.R. 2113, Prescription Drug STAR Act of 2019; H.R. 2069/S. 474, Stopping the Pharmaceutical Industry from Keeping Drugs Expensive (SPIKE) Act of 2019; H.R. 2296/S. 1391, FAIR Drug Pricing Act of 2019; S. 1895, Lower Health Care Costs Act of 2019; H.R. 2296, More Efficient Tools to Realize Information for Consumers (METRIC) Act of 2019; H.R. 987, Strengthening Health Care and Lowering Prescription Drug Costs Act; H.R. 4712, Fairness in Orphan Drug Exclusivity Act.

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

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

Support HR 1763/ S 348, Resident Physician Shortage Reduction Act of 2019, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; Oppose HR 506,Hospital Competition Act of 2019, a bill to amend title XVIII of the Social Security Act to increase hospital competition; Statement submitted to the House Judiciary on the hearing "Diagnosing the Problem: Exploring the Effects of Consolidation and Anticompetitive Conduct in Health Care Markets"; Support HR 965/ S340, Creating and Restoring Equal Access to Equivalent Samples Act of 2019 or the CREATES Act of 2019, a bill to promote competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products; Support HR 986/ S466 Protecting Americans with Preexisting Conditions Act of 2019, a bill provide that certain guidance related to waivers for State innovation under the Patient Protection and Affordable Care Act shall have no force or effect; Support HR 987 Strengthening Health Care and Lowering Prescription Drug Costs Act, a bill to amend the Patient Protection and Affordable Care Act to provide for Federal Exchange outreach and educational activities; Support HR 938 Bringing Low-cost Options and Competition while Keeping Incentives for New Generics Act of 2019 or the BLOCKING Act of 2019, a bill to amend the Federal Food, Drug, and Cosmetic Act, with respect to eligibility for approval of a subsequent generic drug, to remove the barrier to that approval posed by the 180-day exclusivity period afforded to a first generic applicant that has not yet received final approval, and for other purposes; Support HR 1010, a bill to provide that the rule entitled Short-Term, Limited Duration Insurance shall have no force or effect; Support HR 1499 Protecting Consumer Access to Generic Drugs Act of 2019, a bill to prohibit brand name drug manufacturers from compensating generic drug manufacturers to delay the entry of a generic drug into the market, and to prohibit biological product manufacturers from compensating biosimilar and interchangeable product manufacturers to delay entry of biosimilar and interchangeable products, and for other purposes; Support HR 1425 State Health Care Premium Reduction Act, a bill to amend the Patient Protection and Affordable Care Act to provide for a Improve Health Insurance Affordability Fund to provide for certain reinsurance payments to lower premiums in the individual health insurance market; Support HR 1386/ S 1905 Expand Navigators Resources for Outreach, Learning, and Longevity Act of 2019 or the ENROLL Act of 2019,a bill to amend the Patient Protection and Affordable Care Act to provide for additional requirements with respect to the navigator program, and for other purposes; Support HR 1520 Purple Book Continuity Act of 2019, a bill to amend the Public Health Service Act to provide for the publication of a list of licensed biological products, and for other purposes; Support HR 1503 Orange Book Transparency Act of 2019A bill that would increase transparency for the patent status of both approved biological products and approved drugs; Support HR 2439/ HR 3414 Opioid Workforce Act of 2019, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions to help combat the opioid crisis; Submitted statement to the House Committee on Ways and Means Overcoming Racial Disparities and Social Determinants in the Maternal Mortality Crisis sharing information regarding hospitals and health systems efforts to address maternal morbidity and mortality, as we seek ways to improve outcomes and reduce health inequities for expectant and new mothers, and give their children the best possible start in life; Submitted oral and written testimony to the House Committee on Ways and Means Subcommittee on Health Hearing on Protecting Patients from Surprise Medical Bills. Protecting patients from surprise medical bills is a top priority and we have adopted a set of guiding principles to use as we evaluate legislative proposals: Define surprise bills, Protect the patient financially, Ensure patient access to emergency care, Preserve the role of private negotiation, Remove the patient from health plan/provider negotiations, Educate patients about their health care coverage, Ensure patients have access to comprehensive provider networks and accurate network information, and Support state laws that work; Letters submitted to the Energy & Commerce Committee in response to the request for comments on their surprise billing discussion draft. Concerned with the Committees draft legislations approach to determining reimbursement for out-of-network providers. Once the patient is protected from surprise bills, providers and insurers should then be permitted to negotiate payment rates for services provided. We strongly oppose approaches that would impose arbitrary rates on providers. We look forward to continuing to work with the Committee on solutions to stop surprise medical bills; Letter sent to the HELP Committee in response to the Lower Health Care Costs Act of 2019 discussion draft about our concerns about several of the proposals that would allow the government to intrude into private commercial contracts between providers and insurers. For example, several of the provisions could undermine value-based purchasing arrangements aimed directly at improving the quality of care while reducing costs. We strongly urge the Committee to remove these provisions; Submitted oral and written testimony to the House Committee on Energy and Commerce, Subcommittee on Health Hearing on No More Surprises: Protecting Patients from Surprise Medical Bills asking that the Committee preserve the ability of providers and insurers to negotiate private contracts and not establish a fixed payment amount for out-of-network services; Oppose HR 1309 Workplace Violence Prevention for Health Care and Social Service Workers Act, a bill to direct the Secretary of Labor to issue an occupational safety and health standard that requires covered employers within the health care and social service industries to develop and implement a comprehensive workplace violence prevention plan, and for other purposes; Concerns about S.1531, Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019 or the STOP Surprise Medical Bills Act of 2019, to amend the Public Health Service Act to provide protections for health insurance consumers from surprise billing; Concerns about S. 1895 Lower Health Care Costs Act Letter addressed concerns about the legislative provision that sets a benchmark rate in statute for the out-of-network payments, as well as provisions that seek to change privately negotiated contracting arrangements between hospitals and insurance companies; Support HR 3425, Advancing Medical Resident Training in Community Hospitals Act of 2019, to amend title XVIII of the Social Security Act to establish rules for payment for graduate medical education (GME) costs for hospitals that establish a new medical residency training program after hosting resident rotators for short durations; Expressed concerns regarding the provisions that reduce reimbursements to providers and hospitals that administer drugs the Prescription Drug Pricing Reduction Act (PDPRA) of 2019: including about Section 107, Medicare Part B Rebate by Manufacturers for Drugs or Biologicals with Prices Increasing Faster than Inflation, Section 110, Establishment of Maximum Add-on Payment for Drugs, Biologicals, and Biosimilars, this provision would establish $1,000 as the maximum add-on amount that a provider can be paid for a separately payable drug, biological or biosimilar, Section 111, Treatment of Drug Administration Services Furnished by an Off-Campus Outpatient Department of a Provider, the site neutral payment reduction would cut aggregate hospital payments; Support S. 2091, Backlog Elimination, Legal Immigration, and Employment Visa Enhancement Act, this legislation would increase the total number of employment-based visas from 140,000 to 270,000 and ensure that critical health care workers needed in the U.S. have access to employment-based visas by carving out health care workers in designated shortage occupations from the limit; Support S 350, The Competitive Health Insurance Reform Act of 2019, a bill to restore the application of the Federal antitrust laws to the business of health insurance to protect competition and consumers; Submitted statement to Subcommittee on Health of the Committee on Energy and Commerce for the hearing on Improving Maternal Health: Legislation to Advance Prevention Efforts and Access to Care; Concerns with S. 386 and HR 1044, Fairness for High-Skilled Immigrants Act of 2019, this bill increases the per-country cap on family-based immigrant visas from 7% of the total number of such visas available that year to 15%, and eliminates the 7% cap for employment-based immigrant visas. It also removes an offset that reduced the number of visas for individuals from China; Support H.R. 4538, Closing Loopholes for Orphan Drugs Act, a bill to amend title III of the Public Health Service Act to limit the orphan drug exclusion under the drug discount program under section 340B of such title; Discussions of provisions we support and those we recommend be changes in a draft bill called the Mitigating Existing Drug Shortages (MEDS) Act; Discussions in support of the allowing states to designate hospitals as necessary providers for purposes of waiving the critical access hospital mileage requirements; Provided comments to W&M on legislation to expand Health Profession Opportunity Grants; Support S. 2723, The Mitigating Emergency Drug Shortages (MEDS) Act, a bill to amend Sec. 506C of the Federal Food, Drug, and Cosmetic Act which strengthens requirements for drug manufacturers to disclose the root causes and expected duration of shortages, extends reporting requirements to active pharmaceutical ingredients manufacturers, requires manufacturers have contingency plans to ensure ongoing supply, develops recommendations to incentivize manufacturers to enter the market for drugs in shortage and examines the national security risks of shortages; Discuss DEA reductions in annual quotas for opioid products used by hospitals for sedation and pain management; Meeting with the Office of the Assistant Secretary of Preparedness and Response (ASPR) to discuss developments in the hospital preparedness program, the pilot projects for the Regional Disaster Healthcare System and other issues; Rural access to health care, including identifying core services needed in rural communities, outlining approaches and considerations for delivering those services, and examining access and quality in the rural context; ONCs proposed rule to implement the 21st Century Cures provision on information blocking; Supported members serving on the HHS Quality Summit panel, which was convened by the Deputy Secretary to gather input regarding how to improve and energize quality and safety improvement activities across health care system; Discussion with HHS on drug pricing, 340b, and price transparency policies, as well as the International Pricing Index ANPRM; Discussion with HHS about the work of Aligning for Health to address social determinants of health; Support S 2902, Strengthening Our Rural Health Workforce Act of 2019, a bill to enhance the rural health workforce; Meetings and correspondence with staff members of Senate Financing Committee on a proposal to support rural health care access (REH, re-opening necessary provider CAH, infrastructure funding); Letter to Ways & Means committee Rural and Underserved Communities Health Task Force in response to RFI on factors that contribute to health outcomes in these areas, examples of successful models and lessons from the field that address access and outcomes, and considerations for the unique circumstances of rural and underserved communities; Letter to Energy and Commerce Members regarding health information technology priorities; Letter of Support to Senate Appropriations on funding for the Centers for Disease Control and Prevention and the National Institutes of Health to study gun violence; Support S.2741 and H.R. 4932,Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019, a bill to amend title XVIII of the Social Security Act to expand access to telehealth services, and for other purposes; Support S 2603, Resolving Extended Limbo for Immigrant Employees and Families (RELIEF) Act, a bill to amend the Immigration and Nationality Act to end the immigrant visa backlog, and for other purposes; Support HR 4995, Maternal Health Quality Improvement Act of 2019, a bill to amend the Public Health Service Act to improve obstetric care and maternal health outcomes, and for other purposes; Concerns with HR 5800,Ban Surprise Billing Act, a bill to address surprise medical bills that relies on a median in-network rate to resolve out-of-network payments and allows for an independent dispute resolution process to determine the final payment. Concerned with the Committee's legislative approach to determining reimbursement for out-of-network providers. Oppose approaches that would impose arbitrary rates on providers, which could have significant consequences far beyond the scope of surprise medical bills. It is the insurers' responsibility to maintain comprehensive provider networks, and a default payment rate would remove incentives for health plans to contract with providers or to offer fair terms; Support HR 5826, Consumer Protections Against Surprise Medical Bills Act, a bill that prohibits providers from balance billing patients for emergency services or medical care the patient reasonably could have expected to be in-network, and from charging patients more than the in-network cost-sharing amount. Rather than rely on a benchmark payment rate to determine out-of-network reimbursement, the legislation provides a period for health plans and providers to negotiate out-of-network reimbursement, followed by a mediated dispute resolution process if necessary; Letter urging HHS to take regulatory actions to help hospitals and health systems prepare and respond to COVID-19; Letter requesting $100 billion to prepare and respond to COVID-19; Letter urging the Department of Labor to accurately define health care provider when promulgating regulations implementing key sections of the Families First Coronavirus Response Act; Letter sent to the President asking for the use of the Defense Production Act to increase the production of medical supplies and equipment; Letter to HHS regarding $100 billion emergency fund, asking HHS and CMS to directly and expediently distribute to rural and urban hospitals and health systems funds from the Public Health and Social Services Emergency Fund that were designated for providers in the Coronavirus Aid, Relief, and Economic Security (CARES) Act. The CARES Act increased funding by $100 billion in order to reimburse eligible health care providers for health care-related expenses or lost revenues that are attributable to COVID-19. In the letter, we urged HHS and CMS to immediately distribute funding to all hospital types in the US - with additional funding going to COVID-19 hotspots; Letter urging Congress to modernize the Stafford Act as part of its next COVID-19 legislative package to allow all hospitals to recoup financial losses from this pandemic and future disasters; Letter to the Federal Reserve System, the Federal Deposit Insurance Corporation and the Office of the Comptroller of the Currency requesting they, as primary federal regulators for insured depository institutions, take prompt action to assist health care providers on the front line of the COVID-19 pandemic should the need to do so arise; Letter to the Secretary of the Treasury and the Federal Reserve Chair of the Board of Governors urging a supplement to the New Main Street Loan Facility term sheet with prompt guidance to ensure that access to this critically-necessary loan facility will be attainable for hospitals without delay; Letter was sent to the SBA urging it to ensure that small- and mid-size public hospitals, including those that have both nonprofit and public designations, are allowed to apply for and receive loans under the newly-authorized SBA Paycheck Protection Program; Letter in response to FEMAs request for input on establishing a voluntary agreement, under the Defense Production Act, of key private sector stakeholders relevant to responding to COVID-19, urging that such an agreement account for the full breadth of COVID-19 medical supply and equipment needs; Support H.R. 6474/S.3838 Healthcare Broadband Expansion During COVID-19 Act, a bill that would provide an additional $2 billion in funding for the FCC Rural Health Care program and increase the subsidy for health care providers from 65 to 85 percent. This legislation also simplifies the program to allow for more efficient application processes and disbursement of much needed funding; Support HR 6654 Emergency COVID-19 Telehealth Response Act, a bill that would codify an expanded list of providers to deliver and bill for telehealth services during the PHE; Support HR 7233Knowing the Efficiency and Efficacy of Permanent (KEEP) Telehealth Options Act of 2020, a bill that would require the Department of Health and Human Services and the Government Accountability Office (GAO) to conduct studies to provide information about the expanded use of telehealth during the COVID-19 pandemic; Letter to Senate HELP Committee in response to request for feedback on preparing for next pandemic; Discussion about telehealth waivers and flexibilities with HHS; Discussion about CARES provider relief fund distributions with HHS; Oppose HR 6559/ S 3677 COVID-19 Every Worker Protection Act of 2020, a bill to require the Occupational Safety and Health Administration to promulgate an emergency temporary standard to protect employees from occupational exposure to SARS-CoV-2, and for other purposes; Joint letter with ANA urging Congress to act quickly to get needed resources into the health care system, so that hospitals, nurses and physicians responding to COVID-19 are able to continue to provide treatments, front-line health care personnel are able to provide care and patients are able access health care services; Statement to Committee on Ways and Means for the hearing on The Disproportionate Impact of COVID-19 on Communities of Color urging Congress to employ the resources of the National Institute on Minority Health and Health Disparities - which is congressionally-mandated to coordinate the research of the other National Institutes of Healths centers and institutes related to minority health - to research and develop approaches to specifically address the COVID-19 needs of minority populations; Advocate with Congress for full forgiveness of COVID-19 related accelerated payments received by hospitals; Support S 3781Pharmaceutical Accountability, Responsibility, and Transparency (PART) Act, a bill to increase reporting of, help mitigate potential shortages related to, and promote, accountability and transparency for pharmaceuticals and medical devices; Support S 3780 Help Onshore Manufacturing Efficiencies (HOME) for Drugs and Devices Act, a bill to encourage domestic advanced manufacturing of critical drugs and devices in order to address economic, health, and security concerns, combat shortages of critical drugs and devices, and promote increased domestic diversification of, and independence from foreign reliance on, pharmaceutical and medical device supply chains; Support S.3763 Pandemic Responder Service Award Act, a bill to establish the Pandemic Responder Service Award program to express our gratitude to front-line health care workers; Support HR 6788/ S 3599 Healthcare Workforce Resilience Act, a bill to enhance our Nations nurse and physician workforce during the COVID-19 crisis by recapturing unused immigrant visas; Urged support for joint House and Senate letter to the Administration asking for flexibility for hospitals with respect to J-1 and H-1B visa programs; Letter to Senate Finance Committee to address the important issue of maternal health and the opportunity to provide suggestions regarding how to improve maternal health in this country; Support the Temporary Reciprocity to Ensure Access to Treatment Act, a bill that allows for the temporary reciprocity for treatment by medical professionals licensed in one state to patients in other states; Letter urging the Senate to include in the next COVID-19 relief bill provisions to strengthen the federal response for racial and ethnic minority and marginalized communities, which are disproportionately affected by the pandemic;Letter asking Congress to allocate as part of the next COVID-19 relief package at least an additional $100 billion to the emergency relief fund to provide direct funding to front line health care personnel and providers to continue to respond to this pandemic; Letter sent to HHS urging them to direct HRSA to take action to stop three drug manufacturers from limiting the distribution of 340B drugs to 340B covered entities. These drug manufacturers have taken separate actions to either limit the distribution of 340B drugs or require 340B covered entities provide claims level data for investigatory purposes if that 340B covered entity uses a contract pharmacy arrangement; Letter to the Congressional Leadership asking them to not to include in the next COVID-19 relief package any surprise medical billing legislation - such as a reimbursement rate set in statute - that would further destabilize hospitals finances during the pandemic; Support S 4507, Getting Early Treatment and Comprehensive Assessments Reduces Emergencies Act of 2020 or the GET CARE Act of 2020, a bill to amend the Public Health Service Act to provide for a national campaign to raise awareness of the importance of seeking preventive health services and the utilization of such services; Comment letter addressing concerns on the proposed rule from the Departments of the Treasury, Labor and Health and Human Services that would allow certain grandfathered health plans to increase patient cost-sharing beyond current limits, without losing their grandfathered status; Letter urging the Administration to work with the AHA and Congress to create a future for telehealth that allows not only clinicians, but also hospitals and health systems, to code and bill for virtual services. We further urge CMS and HHS to continue to provide hospitals with the flexibility for annual beneficiary consent to telehealth treatment to be obtained at the same time, and not necessarily before, services are furnished; Support HR 8061,Community Immunity During COVID-19 Act of 2020, a bill that would provide funding to state and local health departments to work with community providers and organizations to increase immunization rates for Advisory Committee on Immunization Practices (ACIP)-recommended vaccines during the COVID-19 public health emergency; Letter again expressing concern with recent actions taken by several major drug manufacturers to limit the distribution of certain 340B drugs to our hospital members. While we understand that the HRSA is further investigating these actions, we urge swift and decisive action to halt these pernicious tactics so as to prevent other manufacturers from following suit; Comment letter outlining our concerns about the ability of hospital systems to distribute provider relief funds among the parent and subsidiaries. HHS published certain FAQs that place problematic restrictions on the use of CARES Act provider relief fund dollars. Specifically, the FAQs restrict the ability of a hospital system to allocate the funds throughout its system where COVID-19 related expenses and lost revenues are occurring; Submitted comments in response to HRSAs RFI on Health Professional Shortage Area (HPSA) scoring. HPSA scores are important for rural hospitals and clinics ability to recruit physicians and other clinicians, namely from the National Health Service Corps (NHSC) program. Letter asking HHS to reinstate the COVID-19 Provider Relief Fund reporting requirements; Support S 4349, Dr. Lorna Breen Health Care Provider Protection Act, a bill to address behavioral health and well-being among health care professionals; Support S. 3595Ensuring Understanding of COVID-19 to Protect Public Health Act, a bill that directs the NIH to conduct a longitudinal study on mild, moderate, and severe cases of COVID-19 on a diverse patient population.

Client expense: $4,460,000 · Firm income: Not reported

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

Ban Surprise Billing Act (H.R. 5800) The Clinical Treatment Act (H.R. 913 / S. 4742) Consolidated Appropriations Act, 2021 (H.R. 133) Consumer Protections Against Surprise Medical Bills Act of 2020 (H.R. 5826) Dependent Income Exclusion Act of 2019 (H.R.4417/S.2497) Educating Consumers on the Risks of Short-Term Plans Act of 2019 (H.R.1143) ENROLL Act of 2019 (H.R.1386/S.1905) Family Coverage Act (S.1935) HEARTS Act of 2020 (H.R. 6166) The Heroes Act (H.R. 6800) Home Visiting to Reduce Maternal Mortality and Morbidity Act (H.R.4768) Lower Health Care Costs Act (S.1895) Maternal Health Quality Improvement Act of 2020 (HR 4995) Marketing & Outreach Restoration to Empower Health Education Act (MORE) (H.R.987) No Surprises Act (H.R.3630) The Patient Protection and Affordable Care Enhancement Act (H.R. 1425) Personal Health Investment Today Act (PHIT) (S.680/H.R.1679) Physical Activity Recommendations (PAR) for Americans Act (S.1608/H.R.2891) Pre-existing Conditions Protection Act of 2019 (H.R.692) Protect Act (S.1125) Protecting Access to Post COVID-19 Telehealth Act of 2020 (H.R. 7663) Protecting Americans with Pre-existing Conditions Act of 2019 (H.R.986) Public Health Funding Restoration Act (S.1944/H.R.3447) Quit Because of COVID-19 Act (H.R. 7286) A Resolution Supporting the Designation of April 2019 as "National Donate Life Month"(H.Res 315/S.Res 162) State Allowance for a Variety of Exchanges Act (SAVE Act) (H.R.1385) States Achieve Medicaid Expansion (S.585) State Health Care Premium Reduction Act (H.R.1425) Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019 (S.1531) Sustaining Outpatient Services Act (H.R. 4838/S.4151) Implementation of: Menu Labeling Physical Activity Guidelines Recommendations Prevention and Public Health Fund (PL 111-148, Sec 4002)

Client expense: $125,000 · 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

Drug safety issues; Prescription drug abuse; Monitor drug pricing legislation; H.R. 987, Strengthening Health Care and Lowering Prescription Drug Costs Act; S. 1895, Lower Health Care Costs Act; S. 1416, Affordable Prescriptions for Patients Act of 2019; H.R. 5133, Affordable Prescriptions for Patients Through Promoting Competition Act of 2019; H.R. 3, Elijah E. Cummings Lower Drug Costs Now Act; Public Law 116-136, CARES Act; H.R. 1425, Patient Protection and Affordable Care Enhancement Act (PPACEA); Issues related to Priority Review Voucher extension; H.R. 6800, The Heroes Act; H.R. 925, The Heroes Act; H.R. 133, Consolidated Appropriations Act, 2021 (Public Law 116-260)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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

The Blocking Act (H.R. 938); Strengthening Health Care and Lowering Prescription Drug Costs (H.R. 987); Lower Health Care Costs Act (Sec.205) (S. 1895).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Biopharmaceutical Intellectual Property Data exclusivity Patent Litigation Reform and Issues Related to Post Grant Proceedings at PTO BPCIA Patents Inter Partes Review at PTO Biosimilars S 1416 - Affordable Prescriptions for Patients Act of 2019 H.R.465 - Prescription Drug Price Relief Act of 2019 H.R.938 - BLOCKING Act of 2019 H.R.987 - Strengthening Health Care and Lowering Prescription Drug Costs Act H.R.1046 - Medicare Negotiation and Competitive Licensing Act of 2019 Bayh-Dole Act Section 101 H.R.3991 - Affordable Prescriptions for Patients Through Improvements to Patent Litigation Act of 2019 H.R.4398 - Affordable Prescriptions for Patients Through Promoting Competition Act of 2019 S.1617 - Second Look at Drug Patents Act of 2019 HR 4712 - Fairness in Orphan Drug Exclusivity Act HR 4850 - Biologic Patent Transparency Act - Provisions related to prescription drug patent disclosures HR 5133 - Affordable Prescriptions for Patients Through Promoting Competition Act of 2019 Intellectual Property Issues in Response to coronavirus S.2387 - We Protect American Investment in Drugs Act of 2019 S.64 - Preserve Access to Affordable Generics & Biosimilars Act of 2019

Client expense: $660,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, State, Dept of (DOS), U.S. Agency for International Development (USAID), U.S. Trade Representative (USTR), Veterans Affairs, Dept of (VA), White House Office

S.2543 - Prescription Drug Pricing Reduction Act of 2019 HR 1499: Protecting Consumer Access to Generic Drugs Act Cell, gene and radioligand therapies 340B Drug Discount Program Drug Importation Outcomes based Contracting/Value based arrangements Orphan Drugs Medicaid Payment Reform AMP Cap S 1895 - Lower Health Care Costs Act HR 987 - Strengthening Health Care and Lowering Prescription Drug Costs Act H.R.478 - Safe and Affordable Drugs from Canada Act of 2019 H.R.2011 - Protecting Access to Biosimilars Act of 2019 H.R.2296 - FAIR Drug Pricing Act of 2019 S.61 - Safe and Affordable Drugs from Canada Act of 2019 S.1140 - Protecting Access to Biosimilars Act of 2019 S.1384 - Prescription Drug Rebate Reform Act of 2019 S.1391 - Fair Accountability and Innovative Research Drug Pricing Act of 2019 S.1227 - Prescription Pricing for the People Act of 2019 H.R.447 - Affordable and Safe Prescription Drug Importation Act H.R.1922 - Restoring Access to Medication Act of 2019 H.R.2064 - To amend title XI of the Social Security Act to require manufacturers of certain drugs, devices, biologicals, and medical supplies to report on product samples provided to certain health care providers, and for other purposes H.R.5304 - PBM Transparency in Prescription Drug Costs Act S.97 - Affordable and Safe Prescription Drug Importation Act S.657 - A bill to amend title XXVII of the Public Health Service Act to establish requirements with respect to prescription drug benefits Transparency policy issues Drug cost and pricing policy issues PDUFA, BSUFA, GDUFA Drug vial size policy issues Pharmaceutical supply chain H.R. 4710 - Pharmaceutical Independence Long-Term Readiness Reform Act S. 3635 - Protecting our Pharmaceutical Supply Chain from China Act of 2020 S. 3538 - Strengthening Americas Supply Chain and Medical Security Act H.R. 6431 - Made in America Emergency Preparedness Act HR 6080 - Prevent Drug Shortages Act S. 3432 - Securing Americas Medicine Cabinet Act of 2020 H.R. 6670 - Prescription for American Drug Independence Act of 2020 H.R. 6930 - MADE in America Act HR 4439 - Creating Hope Reauthorization Act Pharmaceutical quality COVID 19 H.R 6074 - Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 H.R. 6201 - Families First Coronavirus Response Act H.R. 748 and S. 3548 - Coronavirus Aid, Relief, and Economic Security Act (CARES Act) H.R. 3772 - Medicare Diagnostic Radiopharmaceutical Payment Equity Act of 2019 S. 3370 - Coronavirus Vaccine Act CARES Act, Pub. L. 116-136 H.R. 6080 - Preventing Drug Shortages Act Buy America and other associated issues related to procurement and sourcing of finished product and active pharmaceutical ingredients Drug shortages policy issues Proposed Rule; Importation of Prescription Drugs (RIN 0910-AI45) Diversity in Clinical Trials FY 2021 Labor-HHS Appropriations Cures 2.0 Energy and Commerce RFI Part B Home Infusion Notice of Benefit Payment Parameters (NBPP) Priority Review Voucher (PRV) H.R. 4400 - The Advancing Education on Biosimilars Act of 2019 Vaccines Executive Order 13948, Lowering Drug Prices by Putting America First (September 13, 2020) - Provisions on Part B and D, Most Favored Nation, and other issues Executive Order 13944, Ensuring Essential Medicines, Medical Countermeasures, and Critical Inputs Are Made in the United States (August 6, 2020) Executive Order 13938, Increasing Drug Importation to Lower Prices for American Patients (July 24, 2020) Medicaid Generics Penalty fix HR 8337 - Continuing Appropriations Act, 2021 and Other Extensions Act H.R.2374 - Stop STALLING Act H.R. 5239 - Prescription Drug Price Reporting Act H.R. 6258 - Reciprocity Ensures Streamlined Use of Lifesaving Treatments Act of 2019 H.R. 6390 - To require the President to use authorities under the Defense Production Act of 1950 to require emergency production of medical equipment to address the COVID-19 outbreak H.R. 6410 - To direct the President to use authority under the Defense Production Act of 1950 to ensure an adequate supply equipment necessary for limiting the spread of COVID-19 H.R. 6395/S. 4049 - National Defense Authorization Act for Fiscal Year 2021 HHS PREP Act declaration relating to COVID-19 Drug importation and counterfeiting policy issues HHS Safe Importation Action Plan Expanded access policy issues FDA modernization policy issues Bipartisan Budget Act of 2018 (Public Law 115-123) - Part D provisions Patient assistance program policy issues Foreign manufacturing policy issues Biosimilar approval and reimbursement policy issues Drug shortages policy issues Regulatory efficiencies policy issues FDA mandatory recall authority policy issues COVID-19 policy issues Transparency Issues Policy Issue H.R. 2477 - Beneficiary Enrollment Notification and the Eligibility Simplification (BENES) Act of 2019 H.R. 6800 - Heroes Act

Client expense: $660,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, State, Dept of (DOS), U.S. Agency for International Development (USAID), U.S. Trade Representative (USTR), Veterans Affairs, Dept of (VA), White House Office

CMS-9115-P Interoperability and Patient Access Proposed Rule HHS ONC RIN-0955-AA01 -- 21st Century Cures Interoperability and Information Blocking Proposed Rule S. 1895, Lower Health Care Costs Act H.R. 3630, No Surprises Act H.R. 987, Strengthening Health Care and Lowering Prescription Drug Costs Act H.R. 3, Lower Drug Costs Now Act of 2019 S. 2543, Prescription Drug Pricing Reduction Act of 2019 S. 3129, Lower Cost, More Cures Act of 2019 H.R. 6074, Coronavirus Preparedness and Response Supplemental Appropriations Act of 2020 H.R. 6201, Families First Coronavirus Response Act of 2020 H.R. 748/S. 3548, Coronavirus Aid, Recovery, and Economic Security (CARES) Act of 2020 H.R. 6800, Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act Health, Economic Assistance, Liability Protection and Schools (HEALS) Act S. 4775, Delivering Immediate Relief to America's Families, Schools and Small Business Act COVID-19 Response The Senate Amendment to H.R. 133, Consolidated Appropriations Act 2021

Client expense: $1,070,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, Treasury, Dept of, White House Office

H.R. 3502, Protecting People from Surprise Medical Bills Act, all provisions H.R. 5826, Consumer Protections Against Surprise Medical Bills Act of 2020, all provisions H.R. 3630, No Surprises Act, all provisions S. 1895, Lower Health Care Costs Act, provisions relating to surprise billing S. 1531, Stopping The Outrageous Practice of (STOP) Surprise Medical Bills Act of 2019, all provisions S. 4421, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act, all provisions H.R. 6644, To require group health plans and health insurance issuers offering group or individual health insurance coverage to provide coverage for services furnished via telehealth if such services would be covered if furnished in-person during the COVID-19 emergency, all provisions S. 3741, Health Care at Home Act of 2020, all provisions S. 4666, National Coronavirus Commission Act of 2020, all provisions S. 4507, Getting Early Treatment and Comprehensive Assessments Reduces Emergencies (GET CARE) Act of 2020, all provisions H.R. 8441, Frontline Heroes Act, all provisions S. 4317, SAFE TO WORK Act, all provisions H.R. 925, The Heroes Act, all provisions S. 3749, Public Health Emergency Privacy Act, all provisions S. 3861, Exposure Notification Privacy Act, all provisions H.R. 6585, Equitable Data Collection and Disclosure on COVID-19 Act, all provisions H.R. 7510, Assimilating Health and Equity Assessments into Decision-making (AHEAD Act) of 2020, all provisions S. 4919, Assimilating Health and Equity Assessments into Decision-making (AHEAD Act) of 2020, all provisions H.R. 6808, Health Force and Resilience Force Act of 2020, all provisions S. 3606, Health Force and Resilience Force Act of 2020, all provisions H.R. 7255, Coronavirus Health Care Worker Wellness Act of 2020, all provisions H.R. 8094, Dr. Lorna Breen Health Care Provider Protection Act, all provisions S. 4349, Dr. Lorna Breen Health Care Provider Protection Act, all provisions H.R. 3884, Marijuana Opportunity Reinvestment and Expungement (MORE) Act of 2020, all provisions S. 2032, Cannabidiol and Marihuana Research Expansion Act, all provisions H.R. 1503, Orange Book Transparency Act of 2019, provisions related to PBM and prescription drug price transparency H.R. 1520, Purple Book Continuity Act of 2019, provisions related to PBM and prescription drug price transparency H.R. 987, Strengthening Health Care and Lowering Prescription Drug Costs Act, provisions related to PBM and prescription drug price transparency H.R. 3, Elijah E. Cummings Lower Drug Costs Now Act, provisions related to PBM and prescription drug price transparency H.R. 4995, Maternal Health Quality Improvement Act of 2020, all provisions H.R. 7120, George Floyd Justice in Policing Act of 2020, provisions relating to police reform Affordable Care Act stabilization Expansion of Paycheck Protection Program for 501(c)6s Public Health and Social Services Emergency Fund Marginalized and minoritized communities/COVID-19 disproportionate impact COVID-19 long haulers COVID-19 testing/vaccines/health care prior authorization COVID-19/treatment and prescribing flexibilities COVID-19/Expanded PPE/clearinghouses E/M services Surprise medical billing executive orders Surprise Medical Billing, generally Clinical and administrative data intersection State Medical Boards/Interstate Medical Licensure Compact Pharmacists and COVID-19 testing Mental health parity Digital therapeutics Physician practice financial impact 21st Century Cures Act/health data and privacy 42 CFR Part 2, HIPAA Patent reform CPT - digital Most favored nation drug pricing Drug pricing Health Information Technology/information blocking Dietary guidelines/alcohol consumption Data privacy Cyber security best practices Race and sex stereotyping executive order

Client expense: $4,170,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Bureau of Citizenship & Immigration Services (BCIS), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), SENATE, Veterans Affairs, Dept of (VA), White House Office

(S. 3595/H.R. 6701) - Ensuring Understanding of Covid-19 to Protect Public Health Act - Expressed support for the Ensuring Understanding of Covid-19 to Protect Public Health Act. This legislation would authorize a longitudinal study of a diverse set of covid-19 patients to ensure that we are able to gain a full understanding of the disease, including long-term health impacts and the best options for treating it. Such an understanding will be essential to ensuring that health providers such as ours are able to best meet the needs of covid-19 survivors in the future. Urged the Senate to support S. 4160 - A bill to enable certain hospitals that were participating in or applied for the drug discount program under section 340B of the Public Health Service Act prior to the COVID-19 public health emergency to temporarily maintain eligibility for such program, and for other purposes. Urged the House to support H.R. 2271, the Scarlett's Sunshine on Sudden Unexpected Death Act which would strengthen existing efforts to better understand Sudden Unexplained Death in Childhood (SUDC) and Sudden Unexpected Infant Death (SUID), facilitate data collection and analysis to improve prevention efforts, and support children and families. Urged the House to support H.R. 2468, the School-Based Allergies and Asthma Management Program Act which would encourage schools receiving asthma-related grants to have trained personnel and a comprehensive school-based allergies and asthma management program. Urged the House to support H.R. 7539, the Strengthening Behavioral Parity Act contains numerous provisions to improve existing law, most notable prohibiting health insurance plans from imposing less favorable benefit limitations on mental and substance use disorder treatments than on medical and surgical benefits. Urged the House to support H.R. 1646, the Helping Emergency Responders Overcome (HERO) Act of 2019 which would support the mental health of our first responders by authorizing grants for peer support behavioral health and wellness programs within fire departments and emergency medical service agencies. Urged the House to support H.R. 4564, the Suicide Prevention Lifeline Improvement Act of 2019 which would significantly increase the funding levels for the National Suicide Prevention Lifeline while also directing HHS to conduct research and analysis on best practices to ensure continued success of the program. Urged the House to support H.R. 4585, the Campaign to Prevent Suicide Act whick would direct HHS, in coordination with Centers for Disease Control and Prevention (CDC) and the Substance Abuse and Mental Health Services Administration (SAMHSA), to carry out a national suicide prevention media campaign to advertise the new 9-8-8 number, when it becomes effective, raise awareness for suicide prevention resources, and cultivate a more effective discourse on how to prevent suicide. Urged the House to support H.R. 5619, the Suicide Prevention Act which would establish grant programs at the CDC and SAMHSA to prevent self-harm and suicide to be awarded to public health departments and to hospital emergency departments. Urged the House to support H.R. 4194, the National Suicide Hotline Designation Act of 2019 which amends the Communications Act to designate 9-8-8 as the universal dialing code for the National Suicide Prevention Lifeline. (S. 3721/ H.R. 6763) COVID-19 Racial and Ethnic Disparities Task Force Act - Expressed support for the COVID-19 Racial and Ethnic Disparities Task Force Act. This legislation would address the health disparities faced by minority communities during the pandemic and would establish a permanent Infectious Disease Racial Disparities task force to ensure that in future pandemics, our health care system and emergency response addresses the issues of racial and ethnic health disparities. (H.R. 6638) Reducing COVID-19 Disparities by Investing in Public Health Act - Expressed support for the Reducing COVID-19 Disparities by Investing in Public Health Act. This legislation would increase the annual funding for the Chronic Disease Prevention and Health Promotion Fund, the National Institute on Minority Health and Health Disparities, and the various offices of Minority Health within the Office of the Secretary of HHS, the Agency for Healthcare Research and Quality, the Centers for Disease Control and Prevention, the Centers for Medicare & Medicaid Services, the Food and Drug Administration, the Health Resources and Services Administration, and the Substance Abuse and Mental Health Services Administration. These agencies play a major role in understanding racial and ethnic health disparities, while also engaging in policy solutions towards their elimination. (H.R 1425) Patient Protection and Affordable Care Enhancement Act - Urged House to vote for passage of this bill. This legislation provides several necessary additions and improvements to the landmark Affordable Care Act (ACA), ensuring that accessible and affordable care is available for all those who need it in our country. Senate Committee on Finance requested information and solutions for improving maternal health. Responded to the committee with ways to identify and implement high-quality and effective health care services and gave a specific example of a tool developed by a CHA member. Coronavirus Immigrant Families Protection Act (H.R. 6437) - Supports modifying immigration policies that would deter immigrants from seeking health services for the duration of the coronavirus emergency and for 60 days after the emergency ends, ensure that everyone has access to covid-19 testing, treatment, and vaccines, and provide $100 million for the Centers for Disease Control and Prevention to provide language access and public outreach. Improve Childrens Access to Care: Increase Funding for the Childrens Hospitals Graduate Medical Education (CHGME) Program - Requested Congress support for childrens health and provide $465 million in funding for CHGME for FY 2021. Urged the House to support H.R. 3398, the Pathways to Health Careers Act of 2019, which includes legislation that extends the current Health Profession Opportunity Grant (HPOG) demonstration grants and aims to increase the pipeline of the health care workforce, including in rural areas and the territories. No Surprises Act (H.R. 3630) - Opposed the establishment of a statutory payment rate. Palliative Care and Hospice Education and Training Act (H.R. 647, S.2080) - Urged Congress to support palliative care education for medical providers and reduce barriers to care for patients with serious or life-threatening illnesses. Protecting Americans with Pre-existing Conditions Act (H.R. 986) - Supported affordable health care coverage and consumer protections for patients with pre-existing conditions. Health Care Affordability Act of 2019 (H.R. 1868) - Supported reducing insurance premiums and out-of-pocket costs in the insurance marketplace for low-income families not eligible for tax credits. Strengthening Health Care and Lowering Prescription Drug Costs Act (H.R. 987) - Supported lowering prescription drug costs and strengthening the Affordable Care Act exchange market. Overdose Prevention and Safety Act (H.R. 2062) - Supported the alignment of substance use disorder health records with HIPAA protections. Supported the 340B outpatient drug pricing program for safety net hospitals. Lower Health Care Costs Act (S. 1895) - Opposed the proposed bill amendment which would reduce the scope and effectiveness of the 340B outpatient drug pricing program. Supported protection against surprise medical bills. Opposed a statue payment rate. The Resident Physician Shortage Reduction Act of 2019 (H.R. 1763, S. 348) - Supported increased physician training in geriatric care and telemedicine to improve patient health care access.

Client expense: $196,341 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Internal Revenue Service (IRS), Natl Institutes of Health (NIH), Office of the Vice President of the United States, President of the U.S., SENATE, Securities & Exchange Commission (SEC), Treasury, Dept of

S. 4840 Ensuring Parity in MA for Audio-Only Telehealth Act of 2020 HR 133 The Consolidated Appropriations Act HR 6800 the HEROES Act re COVID relief S. 4163 re COVID Testing (Gardner) S. 4329 Continuous Health Coverage for Workers Act (McSally) HR 7472 re contract tracing (Speier) S. 4230 Telehealth Expansion Act (Wyden) HR 6395, National Defense Authorization Act S. 4049, National Defense Authorization Act HR 6666, COVID 19 Testing, Reaching and Contacting Everyone Act (TRACE Act) HR 1425, Patient Protection and Affordable Care Enhancement Act HR 6514, Worker Health Coverage Protection Act HR 6568, Coverage for COVID 19 Treatment Act HR 5438, Cox, The End Valley Fever Now Act S. 2897, Warner, regarding the reauthorization of PCORI HR 5201, Matsui, regarding telehealth and behavioral health HR 2328, the No Surprises Act S. 1895, the Lower Health Care Costs Act HR 987 and S. 455, regarding outreach and education activities under the ACA HR 3439, regarding the reauthorization of PCORI House Resolution 271, regarding the Justice Departments position in Texas v. United States HR 2062 & S. 1012, regarding 42 CFR Part 2 and confidentiality of certain health information HR 1884, with provisions to stabilize and strengthen the ACA and the nongroup insurance market. S. 470, regarding a Medicare buy-in option for individuals aged 50-64 S. 489 and HR 1277, regarding a Medicaid buy-in option S. 1129, to establish a single payer system based on Medicare for All. HR 1384, to establish a single payer health care system HR 1425, regarding reinsurance funding under the ACA HR 986 and S. 466, regarding Section 1332 state waiver guidance. HR 1010, regarding Short Term Limited Duration Insurance policies HR 1143, regarding Short Term Limited Duration Insurance policies HR 861, regarding surprise billing

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

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

H.R. 1781, Payment Commission Data Act; H.R. 1503, Orange Book Transparency Act of 2019; H.R. 1520, Purple Book Continuity Act of 2019; H.R. 965 and S. 340, the CREATES Act; H.R. 2113, STAR Act; S. 474, SPIKE Act/Wyden; S. 1391, FAIR Drug Pricing Act; S. 1895, Lower Health Care Costs Act of 2019; H.R. 2296, FAIR/More Efficient Tools to Realize Information for Consumers Act; H.R. 987, Strengthening Health Care and Lowering Prescription Drug Costs Act; H.R. 3, Lower Drug Costs Now Act; H.R. 19, Lower Costs More Cures Act and related legislation; S. 2543, Prescription Drug Pricing Reduction Act

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

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

Affordable Healthcare Act (ACA)Regulations; ACA Stabilization; American Health Care Act (AHCA); Health Care Reform; Reinsurance; Health Savings Accounts; Repeal and Replace; Grace Periods; SEPs; Medicare Cost plan; Marketplace Stability; Individual Marketplace Reform; Better Care Reconciliation Act (BCRA), mental health, transparency, HSA, Opioids, CREATES Act, Drug Pricing; Prescription Drug Costs Rebates, Telehealth,Surprise Billing, COVID19-Response Relief Packages; Healthcare Access/privacy,COVID-19 Response and Relief Packages, COVID-19 Testing, COVID-19 Vaccine Strategy and Treatment HR 1346 -Medicare Buy-In and Health Care Stabilization Act of 2019 HR1384 Medicare for All Act of 2019 HR 986 Protecting People from Preexisting Conditions Act HR 965 CREATES Act of 2019 HR 3502 Protecting people from Surprise Medical Bills HR 987 Strengthening Health Care and Lowering Prescription Drug Costs HR 1499 Patient Consumer Access to Generic Drugs Act HR 1425 State Health Care Premium Reduction Act S 1895 Lower Health Care Costs Act HR 3630 No Surprises Act Public Law 116-123 First Coronavirus Response Act HR6545 Health Insurance Marketplace Affordability Act of 2020

Client expense: $24,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

340B Drug Pricing Program; Medicare Shared Savings Program; Medicare Advantage; Alternative Payment Models; Graduate Medical Education; Centers for Medicare and Medicaid Innovation; Stark Law Reform/Modernization; Value-Based Purchasing Payments; Post-Acute and Home Health Care Payments; Drug Pricing and Medicare Parts B and D; Medicare Regulatory Reform; Medicaid Funding; Health Care Innovation; Telehealth/Digital Health; S 433/HR 2753 Home Health Payment Innovation Act of 2019; S 296/HR 2150 Home Health Care Planning Improvement Act of 2019; Maternal Mortality; H.R. 1897/S. 916 - Mothers and Offspring Mortality and Morbidity Awareness Act (MOMMAs Act); Surprise Billing; Anti-Kickback Statute Reform; CREATES Act; HR 1499 Protecting Consumer Access to Generic Drugs; Accountable Care Organizations; HR 987 Strengthening Health Care and Lowering Prescription Drug Costs; COVID-19; Value in Health Care Act

Client expense: $580,000 · Firm income: Not reported

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

340B Drug Pricing Program; Medicare Shared Savings Program; Medicare Advantage; Alternative Payment Models; Graduate Medical Education; Centers for Medicare and Medicaid Innovation; Stark Law Reform/Modernization; Value-Based Purchasing Payments; Post-Acute and Home Health Care Payments; Drug Pricing and Medicare Parts B and D; Medicare Regulatory Reform; Medicaid Funding; Health Care Innovation; Telehealth/Digital Health; S 433/HR 2753 Home Health Payment Innovation Act of 2019; S 296/HR 2150 Home Health Care Planning Improvement Act of 2019; Maternal Mortality; Surprise Billing; Anti-Kickback Statute Reform; CREATES Act; HR 1499 Protecting Consumer Access to Generic Drugs; Accountable Care Organizations; HR 987 Strengthening Health Care and Lowering Prescription Drug Costs; COVID-19; Value in Health Care Act.

Client expense: $580,000 · Firm income: Not reported

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

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

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

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

S.1895 - Lower Health Care Costs Act H.R.987 - Strengthening Health Care and Lowering Prescription Drug Costs Act Health coverage related to COVID diagnosis and treatment

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

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

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

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

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

Legislative and administrative monitoring and outreach on healthcare policy. Legislative and administrative monitoring and outreach on prescription drug pricing/PBMs. Legislative and administrative monitoring and outreach on policy issues affecting Medicaid programs. Legislative and administrative monitoring and outreach on the implementation of the Affordable Care Act (ACA) (P.L. 111-148) Legislative and administrative monitoring and outreach on issues regarding the health insurance tax (HIT). Legislative outreach related to executive action surrounding the HHS Rebate rule. S. 4775, Delivering Immediate Relief to America's Families, Schools and Small Businesses Act. Legislative outreach and monitoring the implementation of H.R. 259, Medicaid Extenders Act of 2019 (P.L. 116-3). H.R. 3 Lower Drug Costs Now Act of 2019 H.R. 987 Strengthening Health Care and Lowering Prescription Drug Costs Act H.R. 1398 Health Insurance Tax Relief Act of 2019 H.R. 2447 Jobs and Premium Protection Act S. 172 Health Insurance Tax Relief Act of 2019 S. 1895 Lower Health Care Costs Act HR 6926 MIND Act H.R. 133, Consolidated Appropriations Act, 2021 (P.L. 116-260).

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

Government targets: HOUSE OF REPRESENTATIVES

S. 2543, Prescription Drug Pricing Reduction Act (PDPRA) of 2019 and H.R. 3, Lower Drug Costs Now Act of 2019; Issues concerning BARDA funding; S. 551, Recovering Excessive Funds for Unused and Needless Drugs Act 2019; Drug importation including S. 61 and H.R. 478, Safe and Affordable Drugs from Canada Act of 2019; S. 97 and H.R. 447, Affordable and Safe Prescription Drug Importation Act; Legislation affecting pharmaceutical pricing including the Lower Heath Care Costs Act of 2019 (S.1895), Affordable Prescriptions for Patients Act of 2019 (S. 1416), Fair Accountability and Innovative Research Drug Pricing Act of 2019 (S. 1391, Transparent Drug Pricing Act of 2019 (S. 977), CREATES Act of 2019 (H.R. 965, S. 340), Medicare Negotiation and Competitive Licensing Act of 2019 (H.R. 1046), Strengthening Health Care and Lowering Prescription Drug Costs Act (H.R. 987). Policies impacting the U.S. response to the COVID-19 pandemic including H.R. 604, the Coronavirus Preparedness and Response Supplemental Appropriations Act, Public Law No. 116-123; H.R. 6201, Families First Coronavirus Response Act, Public Law No. 116-127; H.R. 748, the Coronavirus Aid, Relief, and Economic Security Act (CARES Act"), Public Law No. 116-136; and H.R. 6800, the Health and Economic Recovery Omnibus Emergency Solutions Act (HEROES Act"). H.R. 2279/S.2546, the Safe Step Act. Policies to ensure an adequate supply of plasma generally and for the development of therapies for COVID-19. Education regarding Executive Orders impacting drug pricing including Medicare rebate reform, the 340B drug discount program, Buy America requirements, drug importation, and imposition of most favored nation pricing on drugs under Medicare Parts B and D. Legislation to increase awareness of need for plasma donations including H.R. 7783/S. 4179, the Plasma Donation Awareness Act of 2020. H.R. 133, Consolidated Appropriations Act, 2021, Pub. L. No. 116-260.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

1. Patient Protection and Affordable Health Care Act, implementation of provisions regarding high risk insurance pools, implementation of state based health exchanges, eligibility for health insurance premium subsidies, cost sharing subsidies, proposals for special enrollment period 2. Proposals to repeal the Patient Protection and Affordable Health Care Act 3. Stabilization of Affordable Care Act insurance marketplaces 4. Administration proposals on prescription drug pricing 5. Proposals for long term care health policies 6. H.R. 6800, Health and Economic Recovery Omnibus Emergency Solutions Act or the HEROES Act, provisions regarding COBRA subsidies 7. S. 102, Prescription Drug Price Relief Act of 2019, entire bill 8. H.R. 987, Strengthening Health Care and Lowering Prescription Drug Costs Act, entire bill 9. H.R. 3630, No Surprises Act, entire bill 10. H.R. 3, Lower Drug Costs Now Act of 2019, entire bill 11. H.R. 3162, Affordable Drug Manufacturing Act of 2019, entire bill 12. S. 3162, Affordable Drug Manufacturing Act of 2019, entire bill 13. H.R. 748, Coronavirus Aid, Relief, and Economic Security Act or the CARES Act, entire bill 14. S. 995, Lifespan Respite Care Reauthorization Act of 2019, entire bill 15. H.R.6487, Advancing Connectivity during the Coronavirus to Ensure Support for Seniors Act or the ACCESS Act, entire bill 16. S. 3517, Advancing Connectivity during the Coronavirus to Ensure Support for Seniors Act or the ACCESS Act, entire bill 17. S. 3768, Nursing Home COVID-19 Protection and Prevention Act of 2020, entire bill 18. Prescription Drug User Fee Act reauthorization proposals 19. Implementation of the Biosimilar User Fee Act and proposed uses of user fees 20. Extension of COBRA coverage during the COVID-19 pandemic

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

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

H.R. 987: Strengthening Health Care and Lowering Prescription Drug Costs Act - Provisions related to prescription drug pricing, patent settlements, and other issues H.R. 3666: STRONGER Patents Act of 2019 - Provisions related to prescription drug patents H.R. 6196: Trademark Modernization Act of 2020 - Provisions related to trademarks H.R. 7288: Taxpayer Research and Coronavirus Knowledge Act of 2020 - Provisions related to prescription drug research and development and transparency H.R. 7296: MMAPPP Act of 2020 - Provisions related to prescription drug pricing and transparency Biopharmaceutical innovation and patent policy issues Trademark legislative proposals Bayh-Dole march-in rights policy issues

Client expense: $1,210,000 · Firm income: Not reported

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

Affordable prescription drugs, 340B Program, HR985 FAST Generics Act of 2019, Appropriate and accurate payment for healthcare, Site Neutral payment policies, S. 1895 - Lower Health Care Costs Act, S. 340 - CREATES Act, H.R. 987 - Strengthening Health Care and Lowering Prescription Drug Costs Act, S. 1391 - Fair Accountability and Innovative Research Drug Pricing Act of 2019, Surprise billing: S. 1531 - Stop the Outrageous Practice of Surprise Medical Bills Act of 2019; HR 3, the Lower Drug Costs Now Act; H.R.2149 - Exposing the Financing of Human Trafficking Act; H.R.508 - Trafficking Victims Housing Act of 2019; H.R. 1520 - Purple Book Continuity At of 2019; H.R. 1503 - Orange Book Transparency Act of 2019; S.2543 - Prescription Drug Pricing Reduction Act of 2019; Health care privacy; H.R. 647, S.2080 - Palliative Care and Hospice Education and Training Act; Conrad 30 and the Physician Access Reauthorization Act, S 948; Issues related to the Medicaid Fiscal Accountability Regulation (MFAR); HR 6074 - Coronavirus Preparedness and Response Supplemental Appropriations Act; HR 6201 - Families First Coronavirus Response Act; HR 748 - Coronavirus Aid, Relief, and Economic Security (CARES) Act; response to the COVID-19 public health emergency; S. 178 - HEALS Act; H.R. 1425, Patient Protection and Affordable Care Enhancement Act; H.R. 6800 - HEROES Act; H.R. 266, Paycheck Protection Program and Health Care Enhancement Act; issues related to coverage of virtual care

Client expense: $370,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA), Vice President of the U.S.

Legislative and administrative monitoring and outreach on healthcare policy. Legislative and administrative monitoring and outreach on prescription drug pricing/PBMs. Legislative and administrative monitoring and outreach on policy issues affecting Medicaid programs. Legislative and administrative monitoring and outreach on the implementation of the Affordable Care Act (ACA) (P.L. 111-148) Legislative and administrative monitoring and outreach on issues regarding the health insurance tax (HIT). Legislative outreach related to executive action surrounding the HHS Rebate rule. Legislative outreach and monitoring regarding COVID-19 response, including the implementation of: HR 748 CARES Act (PL 116-136); HR 6201 Families First Coronavirus Act (PL 116-127); and HR 1425 Patient Protection and Affordable Care Enhancement Act. HR 6800 The HEROES Act The HEALS Act (S. 4317 - S 4324) S. 4775, Delivering Immediate Relief to America's Families, Schools and Small Businesses Act. Legislative outreach and monitoring the implementation of H.R. 259, Medicaid Extenders Act of 2019 (P.L. 116-3). H.R. 3 Lower Drug Costs Now Act of 2019 H.R. 987 Strengthening Health Care and Lowering Prescription Drug Costs Act H.R. 1398 Health Insurance Tax Relief Act of 2019 H.R. 2447 Jobs and Premium Protection Act S. 172 Health Insurance Tax Relief Act of 2019 S. 1895 Lower Health Care Costs Act HR 6926 MIND Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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

Drug safety issues; Prescription drug abuse; Monitor drug pricing legislation; H.R. 987, Strengthening Health Care and Lowering Prescription Drug Costs Act; S. 1895, Lower Health Care Costs Act; S. 1416, Affordable Prescriptions for Patients Act of 2019; H.R. 5133, Affordable Prescriptions for Patients Through Promoting Competition Act of 2019; H.R. 3, Elijah E. Cummings Lower Drug Costs Now Act; Public Law 116-136, CARES Act; H.R. 1425, Patient Protection and Affordable Care Enhancement Act (PPACEA); Issues related to Priority Review Voucher extension; H.R. 6800, The Heroes Act; H.R. 925, The Heroes Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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

CMS-9115-P Interoperability and Patient Access Proposed Rule HHS ONC RIN-0955-AA01 -- 21st Century Cures Interoperability and Information Blocking Proposed Rule Senate HELP - Lower Health Care Costs Act H.R. 3630, No Surprises Act H.R. 987, Strengthening Health Care and Lowering Prescription Drug Costs Act S. 1280/H.R. 2477, BENES Act H.R. 3, Lower Drug Costs Now Act of 2019 S. 2543, Prescription Drug Pricing Reduction Act of 2019 H.R. 6074, Coronavirus Preparedness and Response Supplemental Appropriations Act of 2020 H.R. 6201, Families First Coronavirus Response Act of 2020 H.R. 748/S. 3548, Coronavirus Aid, Recovery, and Economic Security (CARES) Act of 2020 H.R. 6800 - Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act Health, Economic Assistance, Liability Protection and Schools (HEALS) Act Delivering Immediate Relief to America's Families, Schools and Small Business Act (Senate Amendment No. 2652 to the House Amendment S. 178)

Client expense: $780,000 · 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), SENATE, Treasury, Dept of, White House Office

H.R. 1781, Payment Commission Data Act; H.R. 1503, Orange Book Transparency Act of 2019; H.R. 1520, Purple Book Continuity Act of 2019; H.R. 965 and S. 340, the CREATES Act; H.R. 2113, Prescription Drug STAR Act of 2019; H.R. 2069/S. 474, Stopping the Pharmaceutical Industry from Keeping Drugs Expensive (SPIKE) Act of 2019; H.R. 2296/S. 1391, FAIR Drug Pricing Act of 2019; S. 1895, Lower Health Care Costs Act of 2019; H.R. 2296, More Efficient Tools to Realize Information for Consumers (METRIC) Act of 2019; H.R. 987, Strengthening Health Care and Lowering Prescription Drug Costs Act; H.R. 4712, Fairness in Orphan Drug Exclusivity Act.

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

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

Urged the Senate to support S. 4160 - A bill to enable certain hospitals that were participating in or applied for the drug discount program under section 340B of the Public Health Service Act prior to the COVID-19 public health emergency to temporarily maintain eligibility for such program, and for other purposes. Urged the House to support H.R. 2271, the Scarlett's Sunshine on Sudden Unexpected Death Act which would strengthen existing efforts to better understand Sudden Unexplained Death in Childhood (SUDC) and Sudden Unexpected Infant Death (SUID), facilitate data collection and analysis to improve prevention efforts, and support children and families. Urged the House to support H.R. 2468, the School-Based Allergies and Asthma Management Program Act which would encourage schools receiving asthma-related grants to have trained personnel and a comprehensive school-based allergies and asthma management program. Urged the House to support H.R. 7539, the Strengthening Behavioral Parity Act contains numerous provisions to improve existing law, most notable prohibiting health insurance plans from imposing less favorable benefit limitations on mental and substance use disorder treatments than on medical and surgical benefits. Urged the House to support H.R. 1646, the Helping Emergency Responders Overcome (HERO) Act of 2019 which would support the mental health of our first responders by authorizing grants for peer support behavioral health and wellness programs within fire departments and emergency medical service agencies. Urged the House to support H.R. 4564, the Suicide Prevention Lifeline Improvement Act of 2019 which would significantly increase the funding levels for the National Suicide Prevention Lifeline while also directing HHS to conduct research and analysis on best practices to ensure continued success of the program. Urged the House to support H.R. 4585, the Campaign to Prevent Suicide Act whick would direct HHS, in coordination with Centers for Disease Control and Prevention (CDC) and the Substance Abuse and Mental Health Services Administration (SAMHSA), to carry out a national suicide prevention media campaign to advertise the new 9-8-8 number, when it becomes effective, raise awareness for suicide prevention resources, and cultivate a more effective discourse on how to prevent suicide. Urged the House to support H.R. 5619, the Suicide Prevention Act which would establish grant programs at the CDC and SAMHSA to prevent self-harm and suicide to be awarded to public health departments and to hospital emergency departments. Urged the House to support H.R. 4194, the National Suicide Hotline Designation Act of 2019 which amends the Communications Act to designate 9-8-8 as the universal dialing code for the National Suicide Prevention Lifeline. (S. 3721/ H.R. 6763) COVID-19 Racial and Ethnic Disparities Task Force Act - Expressed support for the COVID-19 Racial and Ethnic Disparities Task Force Act. This legislation would address the health disparities faced by minority communities during the pandemic and would establish a permanent Infectious Disease Racial Disparities task force to ensure that in future pandemics, our health care system and emergency response addresses the issues of racial and ethnic health disparities. (H.R. 6638) Reducing COVID-19 Disparities by Investing in Public Health Act - Expressed support for the Reducing COVID-19 Disparities by Investing in Public Health Act. This legislation would increase the annual funding for the Chronic Disease Prevention and Health Promotion Fund, the National Institute on Minority Health and Health Disparities, and the various offices of Minority Health within the Office of the Secretary of HHS, the Agency for Healthcare Research and Quality, the Centers for Disease Control and Prevention, the Centers for Medicare & Medicaid Services, the Food and Drug Administration, the Health Resources and Services Administration, and the Substance Abuse and Mental Health Services Administration. These agencies play a major role in understanding racial and ethnic health disparities, while also engaging in policy solutions towards their elimination. (H.R 1425) Patient Protection and Affordable Care Enhancement Act - Urged House to vote for passage of this bill. This legislation provides several necessary additions and improvements to the landmark Affordable Care Act (ACA), ensuring that accessible and affordable care is available for all those who need it in our country. Senate Committee on Finance requested information and solutions for improving maternal health. Responded to the committee with ways to identify and implement high-quality and effective health care services and gave a specific example of a tool developed by a CHA member. Coronavirus Immigrant Families Protection Act (H.R. 6437) - Supports modifying immigration policies that would deter immigrants from seeking health services for the duration of the coronavirus emergency and for 60 days after the emergency ends, ensure that everyone has access to covid-19 testing, treatment, and vaccines, and provide $100 million for the Centers for Disease Control and Prevention to provide language access and public outreach. Improve Childrens Access to Care: Increase Funding for the Childrens Hospitals Graduate Medical Education (CHGME) Program - Requested Congress support for childrens health and provide $465 million in funding for CHGME for FY 2021. Urged the House to support H.R. 3398, the Pathways to Health Careers Act of 2019, which includes legislation that extends the current Health Profession Opportunity Grant (HPOG) demonstration grants and aims to increase the pipeline of the health care workforce, including in rural areas and the territories. No Surprises Act (H.R. 3630) - Opposed the establishment of a statutory payment rate. Palliative Care and Hospice Education and Training Act (H.R. 647, S.2080) - Urged Congress to support palliative care education for medical providers and reduce barriers to care for patients with serious or life-threatening illnesses. Protecting Americans with Pre-existing Conditions Act (H.R. 986) - Supported affordable health care coverage and consumer protections for patients with pre-existing conditions. Health Care Affordability Act of 2019 (H.R. 1868) - Supported reducing insurance premiums and out-of-pocket costs in the insurance marketplace for low-income families not eligible for tax credits. Strengthening Health Care and Lowering Prescription Drug Costs Act (H.R. 987) - Supported lowering prescription drug costs and strengthening the Affordable Care Act exchange market. Overdose Prevention and Safety Act (H.R. 2062) - Supported the alignment of substance use disorder health records with HIPAA protections. Supported the 340B outpatient drug pricing program for safety net hospitals. Lower Health Care Costs Act (S. 1895) - Opposed the proposed bill amendment which would reduce the scope and effectiveness of the 340B outpatient drug pricing program. Supported protection against surprise medical bills. Opposed a statue payment rate. The Resident Physician Shortage Reduction Act of 2019 (H.R. 1763, S. 348) - Supported increased physician training in geriatric care and telemedicine to improve patient health care access.

Client expense: $181,961 · 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), Homeland Security, Dept of (DHS), Internal Revenue Service (IRS), Natl Institutes of Health (NIH), Office of the Vice President of the United States, President of the U.S., SENATE, Securities & Exchange Commission (SEC), Treasury, Dept of

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

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

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

H.R. 1781, Payment Commission Data Act; H.R. 1503, Orange Book Transparency Act of 2019; H.R. 1520, Purple Book Continuity Act of 2019; H.R. 965 and S. 340, the CREATES Act; H.R. 2113, STAR Act; S. 474, SPIKE Act/Wyden; S. 1391, FAIR Drug Pricing Act; S. 1895, Lower Health Care Costs Act of 2019; H.R. 2296, FAIR/More Efficient Tools to Realize Information for Consumers Act; H.R. 987, Strengthening Health Care and Lowering Prescription Drug Costs Act; H.R. 3, Lower Drug Costs Now Act; H.R. 19, Lower Costs More Cures Act and related legislation; S. 2543, Prescription Drug Pricing Reduction Act

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

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

H.R. 987: Strengthening Health Care and Lowering Prescription Drug Costs Act - Provisions related to prescription drug pricing, patent settlements, and other issues H.R. 3666: STRONGER Patents Act of 2019 - Provisions related to prescription drug patents H.R. 6196: Trademark Modernization Act of 2020 - Provisions related to trademarks H.R. 7288: Taxpayer Research and Coronavirus Knowledge Act of 2020 - Provisions related to prescription drug research and development and transparency H.R. 7296: MMAPPP Act of 2020 - Provisions related to prescription drug pricing and transparency Biopharmaceutical innovation and patent policy issues Trademark legislative proposals Bayh-Dole march-in rights policy issues

Client expense: $5,960,000 · Firm income: Not reported

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

S. 4421, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act, all provisions H.R. 5172, Non-Opioids Prevent Addiction In the Nation (NOPAIN) Act, all provisions S. 3067, Non-Opioids Prevent Addiction In the Nation (NOPAIN) Act\, all provisions H.R. 1503, Orange Book Transparency Act of 2019, all provisions H.R. 1520, Purple Book Continuity Act of 2019, all provisions H.R. 987, Strengthening Health Care and Lowering Prescription Drug Costs Act, all provisions H.R. 3, Elijah E. Cummings Lower Drug Costs Now Act, all provisions H.R. 3502, Protecting People From Surprise Medical Bills Act, all provisions S. 1895, Lower Health Care Costs Act, provisions related to surprise billing H.R. 5826, Consumer Protections Against Surprise Medical Bills Act of 2020, all provisions H.R. 3630, No Surprises Act, all provisions S. 1531, Stopping The Outrageous Practice of (STOP) Surprise Medical Bills Act of 2019, all provisions S. 4666, A bill to establish the Commission on the Coronavirus Pandemic in the United States, all provisions S. 44507, Getting Early Treatment and Comprehensive Assessments Reduces Emergencies (GET CARE) Act of 2020, all provisions H.R. 8441, To establish certain protections and benefits for front line workers, and for other purposes, all provisions H.R. 925, The Heroes Act, provisions related to COVID-19 H.R. 6644, Health Care at Home Act of 2020, all provisions S. 3741, Health Care at Home Act of 2020, all provisions S. 3749, Public Health Emergency Privacy Act, all provisions S. 3861, Exposure Notification Privacy Act, all provisions H.R. 6585, Equitable Data Collection and Disclosure on COVID-19 Act, all provisions H.R. 7510, Assimilating Health and Equity Assessments into Decision-making (AHEAD) Act of 2020, all provisions H.R. 7255, Coronavirus Health Care Worker Wellness Act of 2020, all provisions H.R. 8094, Dr. Lorna Breen Health Care Provider Protection Act, all provisions S. 4349, Dr. Lorna Breen Health Care Provider Protection Act, all provisions H.R. 4995, Maternal Health Quality Improvement Act of 2020, all provisions H.R. 7120, George Floyd Justice in Policing Act of 2020, all provisions H.R. 2279, Safe Step Act, all provisions S. 4055, Strengthening America's Health Care Readiness Act, all provisions S. 2032, Cannabidiol and Marihuana Research Expansion Act, all provisions Essential Workforce Parity Act Affordable Care Act (ACA) stabilization Georgia's ACA Section 1332 waiver Public Health Emergency Fund/physician financial assistance/healthcare workforce support 21st Century Cures Act/health data and privacy Surprise medical billing Expanded Personal Protective Equipment (PPE)/clearinghouses Health equity Maternal mortality Marginalized and minoritized communities/COVID-19 disproportionate impact COVID-19/serology testing supply chain COVID-19/response strategy COVID-19/social distancing COVID-19/data collection COVID-19/ PPE/federal funding COVID-19/Vaccines COVID-19/pediatric vaccines/pharmacists and pharmacy interns COVID-19/Coding Pharmacists and COVID-19 testing Mental health parity 42 CFR Part 2, HIPAA Funding for pandemic planning and preparedness Physician burnout/suicide Telehealth waivers Augmented Intelligence (AI) Drug pricing/Executive Orders Health Quality Roadmap Datablocking Health breach notification rule Electronic health record (EHR) certification

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Federal Trade Commission (FTC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Natl Institutes of Health (NIH), Office of Natl Drug Control Policy (NDCP), President of the U.S., SENATE, State, Dept of (DOS), U.S. Immigration & Customs Enforcement (ICE), Veterans Affairs, Dept of (VA), White House Office

S.2543 - Prescription Drug Pricing Reduction Act of 2019 HR 1499: Protecting Consumer Access to Generic Drugs Act Cell, gene and radioligand therapies 340B Drug Discount Program Drug Importation Outcomes based Contracting/Value based arrangements Orphan Drugs Medicaid Payment Reform AMP Cap S 1895 - Lower Health Care Costs Act HR 987 - Strengthening Health Care and Lowering Prescription Drug Costs Act H.R.478 - Safe and Affordable Drugs from Canada Act of 2019 H.R.2011 - Protecting Access to Biosimilars Act of 2019 H.R.2296 - FAIR Drug Pricing Act of 2019 S.61 - Safe and Affordable Drugs from Canada Act of 2019 S.1140 - Protecting Access to Biosimilars Act of 2019 S.1384 - Prescription Drug Rebate Reform Act of 2019 S.1391 - Fair Accountability and Innovative Research Drug Pricing Act of 2019 S.1227 - Prescription Pricing for the People Act of 2019 H.R.447 - Affordable and Safe Prescription Drug Importation Act H.R.1922 - Restoring Access to Medication Act of 2019 H.R.2064 - To amend title XI of the Social Security Act to require manufacturers of certain drugs, devices, biologicals, and medical supplies to report on product samples provided to certain health care providers, and for other purposes H.R.5304 - PBM Transparency in Prescription Drug Costs Act S.97 - Affordable and Safe Prescription Drug Importation Act S.657 - A bill to amend title XXVII of the Public Health Service Act to establish requirements with respect to prescription drug benefits Transparency policy issues Drug cost and pricing policy issues PDUFA, BSUFA, GDUFA Drug vial size policy issues Pharmaceutical supply chain HR 6800 - Health and Economic Recovery Omnibus Emergency Solutions Act (HEROES Act) H.R. 4710 - Pharmaceutical Independence Long-Term Readiness Reform Act S. 3635 - Protecting our Pharmaceutical Supply Chain from China Act of 2020 S. 3538 - Strengthening Americas Supply Chain and Medical Security Act H.R. 6431 - Made in America Emergency Preparedness Act HR 6080 - Prevent Drug Shortages Act S. 3432 - Securing Americas Medicine Cabinet Act of 2020 H.R. 6670 - Prescription for American Drug Independence Act of 2020 H.R. 6930 - MADE in America Act HR 4439 - Creating Hope Reauthorization Act Pharmaceutical quality COVID 19 H.R 6074 - Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 H.R. 6201 - Families First Coronavirus Response Act H.R. 748 and S. 3548 - Coronavirus Aid, Relief, and Economic Security Act (CARES Act) H.R. 3772 - Medicare Diagnostic Radiopharmaceutical Payment Equity Act of 2019 S. 3370 - Coronavirus Vaccine Act S. 3548 - CARES Act H.R. 6080 - Preventing Drug Shortages Act Buy America and other associated issues related to procurement and sourcing of finished product and active pharmaceutical ingredients Drug shortages policy issues Proposed Rule; Importation of Prescription Drugs (RIN 0910-AI45) Diversity in Clinical Trials FY 2021 Labor-HHS Appropriations Cures 2.0 Energy and Commerce RFI Part B Home Infusion Notice of Benefit Payment Parameters (NBPP) Priority Review Voucher (PRV) H.R. 4400 - The Advancing Education on Biosimilars Act of 2019 Vaccines Executive Order 13948, Lowering Drug Prices by Putting America First (September 13, 2020) - Provisions on Part B and D, Most Favored Nation, and other issues Executive Order 13944, Ensuring Essential Medicines, Medical Countermeasures, and Critical Inputs Are Made in the United States (August 6, 2020) Executive Order 13938, Increasing Drug Importation to Lower Prices for American Patients (July 24, 2020) Medicaid Generics Penalty fix HR 8337 - Continuing Appropriations Act, 2021 and Other Extensions Act

Client expense: $1,190,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, State, Dept of (DOS), U.S. Agency for International Development (USAID), U.S. Trade Representative (USTR), White House Office

Biopharmaceutical Intellectual Property Data exclusivity Patent Litigation Reform and Issues Related to Post Grant Proceedings at PTO BPCIA Patents Inter Partes Review at PTO Biosimilars S 1416 - Affordable Prescriptions for Patients Act of 2019 H.R.465 - Prescription Drug Price Relief Act of 2019 H.R.938 - BLOCKING Act of 2019 H.R.987 - Strengthening Health Care and Lowering Prescription Drug Costs Act H.R.1046 - Medicare Negotiation and Competitive Licensing Act of 2019 Bayh-Dole Act Section 101 H.R.3991 - Affordable Prescriptions for Patients Through Improvements to Patent Litigation Act of 2019 H.R.4398 - Affordable Prescriptions for Patients Through Promoting Competition Act of 2019 S.1617 - Second Look at Drug Patents Act of 2019 HR 4712 - Fairness in Orphan Drug Exclusivity Act HR 4850 - Biologic Patent Transparency Act - Provisions related to prescription drug patent disclosures HR 5133 - Affordable Prescriptions for Patients Through Promoting Competition Act of 2019 Intellectual Property Issues in Response to coronavirus S.2387 - We Protect American Investment in Drugs Act of 2019 S.64 - Preserve Access to Affordable Generics & Biosimilars Act of 2019

Client expense: $1,190,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, State, Dept of (DOS), U.S. Agency for International Development (USAID), U.S. Trade Representative (USTR), White House Office

The Blocking Act (H.R. 938); Strengthening Health Care and Lowering Prescription Drug Costs (H.R. 987); Lower Health Care Costs Act (Sec.205) (S. 1895).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to health insurance and prescription drug pricing. S.1895 - Lower Health Care Costs Act S.340 - CREATES Act of 2019 S.1391 - Fair Accountability and Innovative Research Drug Pricing Act of 2019 S.1416 - Affordable Prescriptions for Patients Act of 2019 S.1224 - Stop STALLING Act H.R.965 - CREATES Act of 2019 H.R.1499 - Protecting Consumer Access to Generic Drugs Act of 2019 H.R.938 - BLOCKING Act of 2019 H.R.987 - Strengthening Health Care and Lowering Prescription Drug Costs Act S. 2543 - Prescription Drug Pricing Reduction Act of 2019 H.R. 3 - Elijah E. Cummings Lower Drug Costs Now Act H.R. 6074, the Coronavirus Preparedness and Response Supplemental Appropriations Act - Public Law No: 116-123 H.R. 6201, the Families First Coronavirus Response Act - Public Law No: 116-127 H.R. 748, the Coronavirus Aid, Relief, and Economic Security (CARES) Act - Public Law No: 116-136 H.R. 600 - Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act Health, Economic Assistance, Liability Protection and Schools (HEALS) Act Delivering Immediate Relief to America's Families, Schools and Small Business Act (Senate Amendment No. 2652 to the House Amendment S. 178)

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

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

Medicare Advantage, Health Insurance Tax and Cost-sharing reductions. Prescription Drug Pricing. ACA stabilization (re-insurance). S.1129 - Medicare for All Act of 2019 H.R.1384 - Medicare for All Act of 2019 H.R.2452 - Medicare for America Act of 2019 S.1895 - Lower Health Care Costs Act H.R.987 - Strengthening Health Care and Lowering Prescription Drug Costs Act S.2543 - Prescription Drug Pricing Reduction Act of 2019 H.R. 3 - Elijah E. Cummings Lower Drug Costs Now Act HR 1425 - Patient Protection and Affordable Care Enhancement Act 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 H.R. 266 - Paycheck Protection Program and Health Care Enhancement Act H.R. 6800 - HEROES Act H.R. 3 - Elijah E. Cummings Lower Drug Costs Now Act

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

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

Affordable Healthcare Act (ACA)Regulations; ACA Stabilization; American Health Care Act (AHCA); Health Care Reform; Reinsurance; Health Savings Accounts; Repeal and Replace; Grace Periods; SEPs; Medicare Cost plan; Marketplace Stability; Individual Marketplace Reform; Better Care Reconciliation Act (BCRA), mental health, transparency, HSA, Opioids, CREATES Act, Drug Pricing; Prescription Drug Costs Rebates, Telehealth,Surprise Billing, COVID19-Response Relief Packages; Healthcare Access/privacy,COVID-19 Response and Relief Packages HR 1346 -Medicare Buy-In and Health Care Stabilization Act of 2019 HR1384 Medicare for All Act of 2019 HR 986 Protecting People from Preexisting Conditions Act HR 965 CREATES Act of 2019 HR 3502 Protecting people from Surprise Medical Bills HR 987 Strengthening Health Care and Lowering Prescription Drug Costs HR 1499 Patient Consumer Access to Generic Drugs Act HR 1425 State Health Care Premium Reduction Act S 1895 Lower Health Care Costs Act HR 3630 No Surprises Act Public Law 116-123 First Coronavirus Response Act HR6545 Health Insurance Marketplace Affordability Act of 2020

Client expense: $28,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

1. Patient Protection and Affordable Health Care Act, implementation of provisions regarding high risk insurance pools, implementation of state based health exchanges, eligibility for health insurance premium subsidies, cost sharing subsidies, proposals for special enrollment period 2. Proposals to repeal the Patient Protection and Affordable Health Care Act 3. Stabilization of Affordable Care Act insurance marketplaces 4. Administration proposals on prescription drug pricing 5. Proposals for long term care health policies 6. H.R. 6800, Health and Economic Recovery Omnibus Emergency Solutions Act or the HEROES Act, provisions regarding COBRA subsidies 7. S. 102, Prescription Drug Price Relief Act of 2019, entire bill 8. H.R. 987, Strengthening Health Care and Lowering Prescription Drug Costs Act, entire bill 9. H.R. 3630, No Surprises Act, entire bill 10. H.R. 3, Lower Drug Costs Now Act of 2019, entire bill 11. H.R. 3162, Affordable Drug Manufacturing Act of 2019, entire bill 12. S. 3162, Affordable Drug Manufacturing Act of 2019, entire bill 13. H.R. 748, Coronavirus Aid, Relief, and Economic Security Act or the CARES Act, entire bill 14. S. 995, Lifespan Respite Care Reauthorization Act of 2019, entire bill 15. H.R.6487, Advancing Connectivity during the Coronavirus to Ensure Support for Seniors Act or the ACCESS Act, entire bill 16. S. 3517, Advancing Connectivity during the Coronavirus to Ensure Support for Seniors Act or the ACCESS Act, entire bill 17. S. 3768, Nursing Home COVID-19 Protection and Prevention Act of 2020, entire bill 18. Prescription Drug User Fee Act reauthorization proposals

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

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

S. 2543, Prescription Drug Pricing Reduction Act (PDPRA) of 2019 and H.R. 3, Lower Drug Costs Now Act of 2019; Issues concerning BARDA funding; S. 551, Recovering Excessive Funds for Unused and Needless Drugs Act 2019; Drug importation including S. 61 and H.R. 478, Safe and Affordable Drugs from Canada Act of 2019; S. 97 and H.R. 447, Affordable and Safe Prescription Drug Importation Act; Legislation affecting pharmaceutical pricing including the Lower Heath Care Costs Act of 2019 (S.1895), Affordable Prescriptions for Patients Act of 2019 (S. 1416), Fair Accountability and Innovative Research Drug Pricing Act of 2019 (S. 1391, Transparent Drug Pricing Act of 2019 (S. 977), CREATES Act of 2019 (H.R. 965, S. 340), Medicare Negotiation and Competitive Licensing Act of 2019 (H.R. 1046), Strengthening Health Care and Lowering Prescription Drug Costs Act (H.R. 987). Policies impacting the U.S. response to the COVID-19 pandemic including H.R. 604, the Coronavirus Preparedness and Response Supplemental Appropriations Act, Public Law No. 116-123; H.R. 6201, Families First Coronavirus Response Act, Public Law No. 116-127; H.R. 748, the Coronavirus Aid, Relief, and Economic Security Act (CARES Act"), Public Law No. 116-136; and H.R. 6800, the Health and Economic Recovery Omnibus Emergency Solutions Act (HEROES Act"). H.R. 2279/S.2546, the Safe Step Act. Policies to ensure an adequate supply of plasma generally and for the development of therapies for COVID-19. Education regarding Executive Orders impacting drug pricing including Medicare rebate reform, the 340B drug discount program, Buy America requirements, drug importation, and imposition of most favored nation pricing on drugs under Medicare Parts B and D. Legislation to increase awareness of need for plasma donations including H.R. 7783/S. 4179, the Plasma Donation Awareness Act of 2020.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE