Association Health Plans Act

Access to AEDs Act (H.R. 2370/S. 1024) Cardiac Arrest Survival Act (H.R. 1012) Easy Enrollment in Healthcare Act (H.R. 1113/S. 423) Palliative Care and Hospice Education and Training Act (S.2243) Self-Insurance Protection Act (H.R. 2813) Telehealth Benefit Expansion for Workers Act (H.R. 824) Association Health Plans Act (H.R. 2868) Improving Whole Health for Veterans with Chronic Conditions Act (S. 1954) FAMILY Act (S. 1714/H.R. 3481) Social Determinants of Health Act of 2023 (no bill number) Preventing Maternal Deaths Reauthorization Act of 2023 (H.R. 3838/S. 2415) PREEMIE Reauthorization Act of 2023 (H.R. 3226/S. 1573) Charles Rochester Blood Clot Prevention and Treatment Act (H.R. 5699) Cardiomyopathy Health Education, Awareness, Research, and Training in the Schools (HEARTS) Act (H.R. 6829) Stroke Act (no bill number) Harold B. Kohl Physical Activity for Americans Act (no bill number) Congenital Heart Futures Reauthorization Act of 2024 (H.R.7189) Living Donor Protection Act (H.R. 2923/S.1384) Health Care Affordability Act (H.R. 9774/S. 5194) Implementation of the No Surprises Act Credit for Caring Act (H.R. 7165/S. 3702) Legislation to allow Medicare to reimburse services provided by mobile stroke units (no bill number) HEARTS Act (H.R. 6829)

Client expense: $300,000 · Firm income: Not reported

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

H.R. 485 - Protecting Health Care For All Patients Act of 2023 - Rep. McMorris Rodgers, Cathy - federal programs using prices based on quality-adjusted life years H.R. 824 - Telehealth Benefit Expansion for Workers Act of 2023 - Rep. Walberg, Tim - telehealth and ERISA amendments H.R. 830 - HELP Copays Act - Rep. Carter, Earl - health insurers responsibility for payments made by or on behalf of a plan enrollee toward a plans cost-sharing requirements H.R. 1488 - Affordable Insulin Now Act of 2023 - Rep. Craig, Angie - cost-sharing for insulin products H.R. 2666 - MVP Act - Rep. Guthrie, Brett - value-based purchasing arrangements under Medicaid program and reforms to price reporting H.R. 2691 - Transparent Price Act - Rep. McMorris Rodgers, Cathy - health insurer price transparency H.R. 2813 - Self-Insurance Protection Act - Rep. Good, Bob - ERISA amendments H.R. 2868 - Association Health Plans Act - Rep. Walberg, Tim - ERISA amendments H.R. 3305 - Black Maternal Health Momnibus Act - Rep. Underwood, Lauren - maternal health including in Medicaid and CHIP H.R. 3561 - PATIENT Act - Rep. McMorris Rodgers, Cathy - PBM transparency, PBM contract design, health insurance transparency, hospital transparency H.R. 3799 - Custom Health Option and Individual Care Expense Arrangement Act- Rep. Hern, Kevin - health reimbursement arrangements H.R. 7623 - Telehealth Modernization Act of 2024- Rep. Carter, Buddy - including requirements for Part D plan contracts with PBMs including transparency and delinking provisions H.R. 7858 - Telehealth Enhancement for Mental Health Act of 2024 - Rep. James, John - Medicare, behavioral health, telehealth H.R. 9572 - Enhanced Enforcement of Health Coverage Act - Rep. Murphy, Gregory - increased penalties of surprise billing violations H.R. 10445 - Further Continuing Appropriations and Disaster Relief Supplement Appropriations Act, 2025 - Rep. Cole, Tom - to fund the federal government through March 14, 2025 as well as extension of several health care policies S. 3393 - SUPPORT for Patients and Communities Reauthorization Act. - Sen. Sanders, Bernie - SUD treatment S. 3430 - Better Mental Health Care, Lower-Cost Drugs, and Extenders Act of 2023 - Sen. Wyden, Ron - mental health, telehealth, health workforce S. 3612 - Access to Family Building Act- Sen. Duckworth, Tammy- right to access reproductive technology (ex. IVF) S. 3805 - A bill to amend title XI of the Social Security Act to prohibit health plans from imposing fees on health care providers for electronic funds transfers and health care payment and remittance advice transactions, and for other purposes. - Sen. Cassidy, Bill - SSA, healthcare, electronic funds, payments, remittance S. 4357 - Comprehensive Dental Reform Act of 2024- Sen. Sanders, Bernie - promotes access to oral health care S. 4358 - Preventing and Treating Substance Use Disorders Among Older Adults Act- Sen. Casey, Robert - SAMHSA grant program for SUDs S. 4554 - Reproductive Freedom for Women Act- Sen. Murray, Patty - protecting abortion and reproductive rights Issues related to broadband and public health infrastructure; mental health and telehealth; behavioral health; rural health; substance use disorder treatments; Health Savings Accounts; provider directories; artificial intelligence and privacy; insurance industry response to and support for providers regarding the Change Healthcare cyberattack and broader cyber security issues; ACA Marketplace; and Mental Health Parity Proposed Rule.

Client expense: $2,610,000 · Firm income: Not reported

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

National Flood Insurance Program (NFIP) Conversations with the House Financial Services Committee on reauthorizing and reforming the National Flood Insurance Program H.R.634 - Fixing Announcements for Intermittent Remapping and Notification Expectations to Stop Surprises in Flood Insurance Act of 2023 H.R.900 - To amend the National Flood Insurance Act of 1968 to allow for the consideration of private flood insurance for the purposes of applying continuous coverage requirements, and for other purposes H.R.1309 - To require the use of replacement cost value in determining the premium rates for flood insurance coverage under the National Flood Insurance Act, and for other purposes. H.R.1392 - National Flood Insurance Program Extension Act of 2023 H.R.1540 - National Flood Insurance Program Affordability Act H.R.5860 - Continuing Appropriations Act, 2024 and Other Extensions Act H.R.6304 - Increased Cost of Compliance Modernization Act of 2003 H.R.6363 - Further Continuing Appropriations and Other Extensions Act, 2024 H.R. 4366 Consolidated Appropriations Act, 2024 S.485 - Hazard and Flooding Mitigation Funding Assurance Act S.601 - Flood Insurance Affordability Act S.721 - Homeowner Flood Insurance Transparency and Protection Act S.1039 - National Flood Insurance Program Consultant Accountability Act of 2023 S.2968 - National Flood Insurance Program Extension through 2023 Act Discussions with the House of Representatives, Senate and White House to extend the National Flood Insurance Program. Discussions with the Senate Banking Committee on flood insurance reform. Commercial Real Estate Flood Insurance H.R. 1307 - To repeal the mandatory flood insurance coverage requirement for commercial properties located in flood hazard areas, and for other purposes. Association Health Plans (AHPs) HR2868 - Association Health Plans Act Discussions with the House of Representatives, the Senate and Department of Labor about AHPs. Discussions with the Federal Emergency Management Agency (FEMA) in the Department of Homeland Security (DHS) regarding flood insurance, flood maps, and disaster mitigation. Discussions with the Federal Housing Finance Agency (FHFA) on climate risk. Discussions with Fannie Mae on climate risk and insurance disclosures. Communications with the Department of Labor opposing their proposal to rescind the 2018 Association Health Plans (AHP) rule. Communications with the House of Representatives supporting the HR 7849 Disaster Resiliency and Coverage Act. Discussions with National Oceanic and Atmospheric Administration on flood mapping and disaster intelligence.

Client expense: $22,840,000 · Firm income: Not reported

Government targets: Federal Emergency Management Agency (FEMA), Federal Housing Finance Agency (FHFA), HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Labor, Dept of (DOL), Natl Oceanic & Atmospheric Administration (NOAA), SENATE, White House Office

H.R. 2851/ S. 2464 - Access to Breast Cancer Diagnosis Act of 2023; bill to prohibit group health plans and health insurance issuers offering group or individual health insurance coverage from imposing cost-sharing requirements with respect to diagnostic and supplemental breast examinations H.R. 6301/ S. 2039 - Cancer Drug Parity Act; a bill to amend the Employee Retirement Income Security Act of 1974 to require a group health plan (or health insurance coverage offered in connection with such a plan) to provide for cost-sharing for oral anticancer drugs on terms no less favorable than the cost-sharing provided for anticancer medications administered by a health care provider. H.R. 830/S. 1375 -Help Ensure Lower Patient (HELP) Copays Act; bill requires health insurance plans to apply certain payments made by, or on behalf of, a plan enrollee toward a plan's cost-sharing requirements. Specifically, plans must apply third-party payments, financial assistance, discounts, product vouchers, and other reductions in out-of-pocket expenses toward the requirements. H.R. 2630/S. 652 -Safe Step Act; bill to require a group health plan or health insurance coverage offered in connection with such a plan to provide an exceptions process for any medication step therapy protocol, and for other purposes H.R. 3086 - Find It Early Act; a bill to provide for health coverage with no cost-sharing for additional breast screenings for certain individuals at greater risk for breast cancer. H.R. 4189/S. 2016 - Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023; a bill to amend title XVIII of the Social Security Act to expand access to telehealth services, and for other purposes. H.R. 824 - Telehealth Benefit Expansion for Workers Act of 2023; bill expanding exception for stand-alone telehealth benefits plans from certain requirements that generally apply to private health insurance plans under the Patient Protection and Affordable Care Act; under the bill employers may offer stand-alone telehealth benefits to all employees including those who are eligible for enrollment in their employers group health plan H.R. 2868 - Association Health Plans Act; a bill to amend the Employee Retirement Income Security Act of 1974 to clarify the treatment of certain association health plans as employers, and for other purposes S.4767 - Insurance Fraud Accountability Act; a bill to amend the Patient Protection and Affordable Care Act to reduce fraudulent enrollments in qualified health plans, and for other purposes H.J. Res. 181- Congressional Review Act resolution to stop Biden-Harris rule limiting access to Association Health Plans (AHPs) S. 8 - Improving Health Insurance Affordability Act of 2023; a bill to expand the eligibility of taxpayers for the refundable tax credit for coverage under a qualified health plan and increases cost-sharing subsidies under the Patient Protection and Affordable Care Act H.R. 1692 - Health Care Affordability Act of 2023; a bill to revise the tax credit for health care premium assistance to expand the eligibility of low-income taxpayers for such credit and reduce the cost of health care premiums H.R. 9774/ S. 5194 - Health Care Affordability Act; a bill to amend the Internal Revenue Code of 1986 to expand eligibility for the refundable credit for coverage under a qualified health plan Administration actions necessary to reduce out-of-pocket costs for medically necessary diagnostic and supplemental breast imaging Implementation of the Affordable Care Act and coverage of preventive services with no cost-sharing Issues related to regulation of short-term limited duration plans Issues related to prescription drug affordability for patients Policies regarding White House Cancer Moonshot implementation Policies related to copay accumulator and adjustor programs Comments related to the 2026 Notice on Benefit and Payment Parameters Comments related in response to a House Committee on Ways and Means Request for Information on tax legislation in favor of the extension of the Affordable Care Acts enhanced advance premium tax credits

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

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

Issues related to lung disease treatment, prevention and research; Issues related to public health; Issues related asthma, COPD, influenza, lung cancer, pneumonia, pulmonary fibrosis, 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 Medicaid; Issues related to ERISA; Issues related to COVID-19 Response; Issues related to vaccines; Issues related to infrastructure; Issues related to supplemental oxygen; Issues related to the implementation of the No Surprises Act; Issues related to Medicare sequestration; Issues related to Cancer Moonshot; Issues related to short-term limited duration plans; Issues related to Healthy Future Taskforce; Issues related to regulatory reform; Issues relating to FY25 appropriations; Issues relating to the Presidents FY26 budget; HR 277 REINS Act; S 184 REINS Act; HR 1075 Medicaid Work Requirements Act; S. 1063 A bill to amend title XIX of the Social Security Act to implement a minimum work requirement for able-bodied adults enrolled in State Medicaid programs; HR 1551 Jobs and Opportunities for Medicaid Act; H.R. 2583 Increasing Access to Quality Cardiac Rehabilitation Care Act of 2023; H.R. 1114 Long COVID RECOVERY NOW Act; H.R. 1692 Health Care Affordability Act of 2023; HR 3073 Community Mental Wellness and Resilience Act; S 1452 Community Mental Wellness and Resilience Act; HR 2811 Limit Save Grow Act; HR 442 Regulatory Accountability Act; S 1615 Regulatory Accountability Act;; HR 288 Separation of Powers Restoration Act of 2023; S 1411, Prove It Act of 2023; S 1995 Public Health Infrastructure Saves Lives Act; HR 824 Telehealth Benefit Expansion for Workers Act of 2023; HR 4286 Increasing Access to Lung Cancer Screening Act; HR 2813 The Self-Insurance Protec􀆟on Act; HR 3799 CHOICE Arrangement Act; HR 2868 Association Health Plans Act; S 2213 Comprehensive Cancer Survivorship Act; HR 4363 Comprehensive Cancer Survivorship Act; S. 2016 CONNECT for Health Act of 2023; HR 4189 CONNECT for Health Act of 2023;; HR 5749 Family Asthma Act; HR 4286 Increasing Access to Lung Cancer Screening Act; HR 890 The Guidance Out of Darkness Act; S 791 The Guidance Out of Darkness Act; S 2245 Women and Lung Cancer Research and Preventive Services Act; HR 4534 Women and Lung Cancer Research and Preventive Services Act; S 2333 Pandemic and All Hazards Preparedness and Response Act; HR 4420 Pandemic and All-Hazards Preparedness and Response Act; S 1489 National Task Force on the COVID-19 Pandemic Act;; HR 6302 Health Share Transparency Act; HR 357 Ensuring Accountability in Agency Rulemaking;; S3821 Supplemental Oxygen Access Reform (SOAR) Act; HR7829 Supplemental Oxygen Access Reform (SOAR) Act; HR 485 Protecting Health Care for All Patients Act of 2023; HR 7867 Renewing Efficiency in Government by Budgeting Act; HR 115 Midnight Rules Relief Act, HR 1602, Health Care Affordability Act of 2023; S. 8 Improving Health Insurance Affordability Act of 2023; HR 9029 Departments of Labor, Health and Human Services, and Education and Related Agencies Appropriations Act, 2025; H.R. 8774 Department of Defense Appropriations Act 2025; S. 4942 Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2025; S 4921 Department of Defense Appropriations Act 2025; HR 890 Guidance out of Regulatory Darkness Act; H.R. 9774, Health Care Affordability Act of 2024; S. 5194 Health Care Affordability Act of 2024; S. 652 Safe Step Act; HR 2630 Safe Step Act; HR 10515, American Relief Act, 2025; HR 10545, American Relief Act, 2025

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

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

H.R. 1264, Commonsense Reporting Act of 2023 H.R. 2813, Self-Insurance Protection Act H.R. 2868, Association Health Plans Act H.R. 3800, Chronic Disease Flexible Coverage Act H.R. 4307/S. 2115, Medical Supply Chain Resiliency Act H.R. 6363, Further Continuing Appropriations and Other Extensions Act of 2024, and issues pertaining to H.R. 1843/S. 1001, The Telehealth Expansion Act of 2023 H.R. 6860, Restore Protections for Dialysis Patients Act H.R. 9029, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2025 S. 127, Pharmacy Benefit Manager Transparency Act of 2023 S. 142, Preserve Access to Affordable Generics and Biosimilars Act S. 148, Stop Significant and Time-wasting Abuse Limiting Legitimate Innovation of New Generics (Stop STALLING) Act S. 150, Affordable Prescriptions for Patients Act of 2023 S. 1067, Ensuring Timely Access to Generics Act of 2023 S. 1114, Expanding Access to Low-Cost Generics Act of 2023 S. 1214, Retaining Access and Restoring Exclusivity (RARE) Act S. 1339, Pharmacy Benefit Manager Reform Act S. 2624, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2024 S. 2780, The Medication Affordability and Patent Integrity Act Proposed Rule, Internal Revenue Service, the Employee Benefits Security Administration, and the Health and Human Services Department; Requirements Related to the Mental Health Parity and Addiction Equity Act (88 Fed. Reg. 51,552-51,669, August 3, 2023) Proposed Rule, Employee Benefits Security Administration, Department of Labor; Definition of Employer-Association Health Plans (88 Fed. Reg. 87,968-87,981, December 20, 2023) Various issues relating to the employer-sponsored health care system, implementation of regulatory process, provider network adequacy, health savings account (HSAs), health reimbursement account (HRAs), employer mandate; Medicare Drug Price Negotiation Program: Initial Memorandum, Implementation of Sections 1191 - 1198 of the Social Security Act for Initial Price Applicability Year 2026, and Solicitation of Comments; implementation of the American Rescue Plan Act (P.L. 117-2); implementation of the Inflation Reduction Act (P.L. 117-169); balance or surprise billing and related issues; single-payer health care options; health reimbursement arrangements and other account-based group health plans; Health and Human Services international pricing index (IPI) model; mental health parity; drug pricing; COBRA subsidies; Federal Trade Commissions multilateral pharmaceutical merger taskforce; telehealth, including coverage of telehealth under High Deductible Health Plans (HDHPs) and expanding telehealth options for employees; impact of Pharmacy Benefit Managers Practices; FTC-2022-0015; petition to HHS to grant march-in rights for the patents on the drug Xtandi; legislative proposals to tax employer-provided health care coverage; artificial price caps on providing insulin; Reasonable Price Clause in reauthorization draft of the Pandemic and All Hazards Preparedness Act (PAHPA, P.L. 109-417); over-the-counter preventive services; ERISA preemption protections including information on constructive changes/modifications to ERISA; efforts to reform the World Health Organizations (WHO) engagement with private sector; support for necessary market conditions to incentivize health sector investment from private sector; support for private sector involvement in health systems strengthening; promote greater harmonization of standards and investment in digital health; health-related policy issues in the G20/G7 forums and other multilateral forums; support for improving access to health products and technologies globally, including via regulatory alignment, addressing trade barriers, strengthening the global supply chain, and raising awareness on potential pitfalls of local manufacturing; combatting anti-microbial resistance; Advance Notice of Methodological Changes for Calendar Year (CY) 2025 for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies, U.S. Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services (2025 Advance Notice, January 31, 2024)

Client expense: $22,410,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, State, Dept of (DOS), U.S. Agency for International Development (USAID), U.S. Trade & Development Agency (USTDA), U.S. Trade Representative (USTR)

S.127, Pharmacy Benefit Manager Transparency Act of 2023; S.954, Affordable Insulin Now Act; S.1339, Pharmacy Benefit Manager Reform Act; S.1664, Healthy Families Act; S.1869, SITE Act; H.R.824, Telehealth Benefit Expansion for Works Act of 2023; H.R.1264, Commonsense Reporting Act; H.R.1843, Telehealth Expansion Act of 2023; H.R.2813, Self Insurance Protection Act; H.R.2868, Association Health Plan Act; H.R.3797, Paperwork Burden Reduction Act; H.R.3798, Small Business Flexibility Act; H.R.3799, CHOICE Arrangement Act; H.R.3801, Employer Reporting Improvement Act; Issues related to dialysis coverage; Issues related to health sector consolidation; Issues related to ERISA pre-emption; Issues related to employer sponsored health coverage

Client expense: $410,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation and regulation related to health care delivery and health insurance coverage, mental health and substance use disorder care and coverage, the transition out of the COVID-19 pandemic and electronic health information/technology. H.R. 4527 Health DATA Act S. 3679, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act H.R. 5378 the Lower Costs, More Transparency Act S.3548 - Health Care Prices Revealed and Information to Consumers Explained Transparency Act S.3430 - An original bill to amend titles XVIII and XIX of the Social Security Act to expand the mental health care workforce and services, reduce prescription drug costs, and extend certain expiring provisions under Medicare and Medicaid, and for other purposes. HR 3305 & S. 1606 Black Maternal Health Momnibus Act HR 4822 Health Care Price Transparency Act HR 3284 Providers and Payers COMPETE Act HR 2840 Bipartisan Primary Care and Health Workforce Act HR 4818 Treat and Reduce Obesity Act of 2023 S. 2333 Pandemic and All Hazards Preparedness and Response Act H.R. 4421 Preparing for All Hazards and Pathogens Reauthorization Act H.R. 3561, PATIENT Act of 2023 H.R. 3281, the Transparent PRICE Act H.R. 3262, To amend title XI of the Social Security Act to increase transparency of certain health-related ownership information H.R. 2868 Association Health Plans Act H.R. 2813 Self-Insurance Protection Act H.R. 3799 CHOICE Arrangement Act H.R. 3432, Telemental Health Care Access Act H.R.824, Telehealth Benefit Expansion for Workers Act of 2023 H.R. 4189, S. 2016, CONNECT for Health Act S. 923, Better Mental Health Care for Americans Act H.R. 3120, Healthy Competition for Better Care Act H.R. 1843 Telehealth Expansion Act of 2023 S.954 - 118th Congress (2023-2024)A bill to provide for appropriate cost-sharing for insulin products covered under private health plans, and to establish a program to support health care providers and pharmacies in providing discounted insulin products to uninsured individuals. H.R.10445 - Further Continuing Appropriations and Disaster Relief Supplemental Appropriations Act, 2025 H.R.10515 - American Relief Act, 2025 H.R.10545 - American Relief Act, 2025 H.R. 9774 & S. 5194 - Health Care Affordability Act of 2024 H.R. 3120 & S. 1451 - Healthy Competition for Better Care Act

Client expense: $220,000 · Firm income: Not reported

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

HR 1692 / S 8, the Health Care Affordability Act; HR 2630 / S 652, the Safe Step Act; HR 3433 / S 2897, the Give Kids a Chance Act; HR 3503 / S 1701, The NIH Clinical Trial Diversity Act; HR 3991 / S 1624, the Gabriella Miller Kids First Act; HR 4363 / S 2213, Comprehensive Cancer Survivorship Act; HR 6003 / S 3103, the Medical Debt Relief Act; HR 6301 / S. 2039, The Cancer Drug Parity Act; HR 7383 / S 1214, the RARE Act; HR 8311 / S 4289, Medical Debt Cancellation Act; HR 824, the Telehealth Benefit Expansion for Workers Act; HR 1773, the Consumer Protection for Medical Debt Collections Act; HR 2813, Self-Insurance Protection Act; HR 2868, the Association Health Plans; HR 2880, the Protecting Patients Against PBM Abuses Act; HR 3799, CHOICE Arrangement Act; HR 3800, the Chronic Disease Flexible Coverage Act; HR 5609, the Advancing Health Savings Act; HR 5688, the Bipartisan HSA Improvement Act; HR 5687, the HSA Modernization Act; HR 6664, the Innovation in Pediatric Drugs Act; HR 6963, the Pediatric Cancer Drug Supply Chain Act; HR 7384, the Creating Hope Reauthorization Act; HR 8261, Preserving Telehealth, Hospital, and Ambulance Access Act; HR 8412, the Clinical Trial Modernization Act; HR 8574, the 340B ACCESS Act; HR 9129, Patient Debt Relief Act; S 113, the Prescription Pricing for the People Act; S 127, the Pharmacy Benefit Manager Transparency Act; S 1339, the Pharmacy Benefit Manager Reform Act; S 1542, the DRUG Act; S 1967 the Patients Before Middlemen Act; S 2243, the Palliative Care and Hospice Education and Training Act; S 2483, the Strengthening Consumer Protections and Medical Debt Transparency Act; S 2973, the Modernizing and Ensuring PBM Accountability Act; S 3167, Multiple Employer Welfare Arrangement (MEWA) Act; HR 9774 / S 5194, the Health Care Affordability Act; Legislation to protect insurance purchasers interacting with insurance brokers; Implementation of the No Surprises Act; Federal rulemaking related to Short-term Limited Duration Insurance (STLDI) plans; Efforts to extend and make permanent the current enhanced Advance Premium Tax Credits; Insurance appeals and denials; Federal rulemaking related to Association Health Plans; Consumer protections related to consumers who will lose insurance due to the end of certain federal Medicaid maintenance-of-effort requirements; FDA draft guidance related to dose optimization studies in clinical trials

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

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

Access to AEDs Act (H.R. 2370/S. 1024) Cardiac Arrest Survival Act (H.R. 1012) Easy Enrollment in Healthcare Act (H.R. 1113/S. 423) Palliative Care and Hospice Education and Training Act (S.2243) Self-Insurance Protection Act (H.R. 2813) Telehealth Benefit Expansion for Workers Act (H.R. 824) Association Health Plans Act (H.R. 2868) Improving Whole Health for Veterans with Chronic Conditions Act (S. 1954) FAMILY Act (S. 1714/H.R. 3481) Social Determinants of Health Act of 2023 (no bill number) Preventing Maternal Deaths Reauthorization Act of 2023 (H.R. 3838/S. 2415) PREEMIE Reauthorization Act of 2023 (H.R. 3226/S. 1573) Charles Rochester Blood Clot Prevention and Treatment Act (H.R. 5699) Cardiomyopathy Health Education, Awareness, Research, and Training in the Schools (HEARTS) Act (H.R. 6829) Stroke Act (no bill number) Harold B. Kohl Physical Activity for Americans Act (no bill number) Congenital Heart Futures Reauthorization Act of 2024 (H.R.7189) A resolution designating September 2024 as "National Cholesterol Education Month" and September 30, 2024, as "LDL-C Awareness Day"(S.Res.566) Living Donor Protection Act (H.R. 2923/S.1384) Health Care Affordability Act (H.R. 9774/S. 5194) Opposed H.J. Res. 181 - Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Department of Labor relating to "Definition of 'Employer'-Association Health Plans" Implementation of the No Surprises Act HHS finalization of proposed rule on Short-Term, Limited-Duration Insurance; Independent, Non- coordinated Excepted Benefits Coverage; Level-Funded Plan Arrangements; and Tax Treatment of Certain Accident and Health Insurance (CMS-9904-P)

Client expense: $200,000 · Firm income: Not reported

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

H.R. 485 - Protecting Health Care For All Patients Act of 2023 - Rep. McMorris Rodgers, Cathy - federal programs using prices based on quality-adjusted life years H.R. 824 - Telehealth Benefit Expansion for Workers Act of 2023 - Rep. Walberg, Tim - telehealth and ERISA amendments H.R. 830 - HELP Copays Act - Rep. Carter, Earl - health insurers responsibility for payments made by or on behalf of a plan enrollee toward a plans cost-sharing requirements H.R. 1488 - Affordable Insulin Now Act of 2023 - Rep. Craig, Angie - cost-sharing for insulin products H.R. 2666 - MVP Act - Rep. Guthrie, Brett - value-based purchasing arrangements under Medicaid program and reforms to price reporting H.R. 2691 - Transparent Price Act - Rep. McMorris Rodgers, Cathy - health insurer price transparency H.R. 2813 - Self-Insurance Protection Act - Rep. Good, Bob - ERISA amendments H.R. 2868 - Association Health Plans Act - Rep. Walberg, Tim - ERISA amendments H.R. 2872 - Further Additional Continuing Appropriations and Other Extensions Act, 2024 - Rep. Graves, Garret - extends FY24 funding and program authorities through March 8, 2024 H.R. 2882 - Further Consolidated Appropriations Act, 2024 - Rep. Ciscomani, Juan - provides annual funding through September 30, 2024, for the Departments of Labor, Health and Human Services, and Education, and Related Agencies H.R. 3305 - Black Maternal Health Momnibus Act - Rep. Underwood, Lauren - maternal health including in Medicaid and CHIP H.R. 3561 - PATIENT Act - Rep. McMorris Rodgers, Cathy - PBM transparency, PBM contract design, health insurance transparency, hospital transparency H.R. 3799 - Custom Health Option and Individual Care Expense Arrangement Act- Rep. Hern, Kevin - health reimbursement arrangements H.R. 3801 - Employer Reporting Improvement Act - Rep. Smith, Adrian - ACA reporting requirements H.R. 6956 - Opioid Settlement Accountability Act - Rep. Kaptur, Marcy - funding for opioid prevention and treatment services, training, equipment, and social support services H.R. 6960 - Emergency Medical Services for Children Reauthorization Act of 2024 - Rep. Carter, Earl L. Buddy - funding for emergency medical services for children program H.R. 7513 - Protecting Americas Seniors Access to Care Act - Rep. Fischbach, Michelle - regarding minimum staffing for nursing facilities H.R. 7623 - Telehealth Modernization Act of 2024- Rep. Carter, Buddy - including requirements for Part D plan contracts with PBMs including transparency and delinking provisions H.R. 7858 - Telehealth Enhancement for Mental Health Act of 2024 - Rep. James, John - Medicare, behavioral health, telehealth H.R. 7899 - To direct the Attorney General, in consultation with the Secretary of Health and Human Services, to promulgate the final regulations relating to special registration for telemedicine. - Rep. Ezell, Mike - telehealth H.R. 7907 - Welcome Back to the Health Care Workforce Act - Rep. Krishnamoorthi, Raja- grants/funding, health care workforce H.R. 7929 - Nursing Home Workforce Support and Expansion Act of 2024 - Rep. Horsford, Steven - grants/funding, health care workforce H.R. 7994 - Long-Term Care Workforce Support Act - Rep. Dingell, Debbie - health care workforce H.R. 8444 - Mental Health in Schools Act - Rep. Napolitano, Grace - grant to promote mental health S. 1606 - A bill to end preventable maternal mortality, severe maternal morbidity, and maternal health disparities in the United States, and for other purposes. - Sen. Booker, Cory - maternal mortality S. 3393 - SUPPORT for Patients and Communities Reauthorization Act. - Sen. Sanders, Bernie - SUD treatment S. 3430 - Better Mental Health Care, Lower-Cost Drugs, and Extenders Act of 2023 - Sen. Wyden, Ron - mental health, telehealth, health workforce S. 3612 - Access to Family Building Act- Sen. Duckworth, Tammy- right to access reproductive technology (ex. IVF) S. 3756 - At HOME Services Act of 2024- Sen. Rubio, Marco- pilot program for outpatient observation, acute care at home S. 3775 - BOLD Infrastructure for Alzheimers Reauthorization Act of 2024- Sen. Collins, Susan - healthcare infrastructure, Alzheimers S. 3805 - A bill to amend title XI of the Social Security Act to prohibit health plans from imposing fees on health care providers for electronic funds transfers and health care payment and remittance advice transactions, and for other purposes. - Sen. Cassidy, Bill - SSA, healthcare, electronic funds, payments, remittance S. 3847 - Improving Social Determinants of Health Act of 2024- Sen. Smith, Tina- CDC authorization S. 4088 - Welcome Back to the Health Care Workforce Act - Sen. Kaine, Tim - grants/funding, health care workforce S. 4120 - Long-Term Care Workforce Support Act - Sen. Casey, Robert P., Jr. - health care workforce S. 4195 - Childhood Diabetes Reduction Act of 2024 - Sen. Sanders, Bernie - nutrition labeling S. 4357 - Comprehensive Dental Reform Act of 2024- Sen. Sanders, Bernie - promotes access to oral health care S. 4358 - Preventing and Treating Substance Use Disorders Among Older Adults Act- Sen. Casey, Robert - SAMHSA grant program for SUDs S. 4554 - Reproductive Freedom for Women Act- Sen. Murray, Patty - protecting abortion and reproductive rights Issues related to broadband and public health infrastructure; mental health and telehealth; behavioral health; rural health; substance use disorder treatments; Health Savings Accounts; provider directories; artificial intelligence and privacy; insurance industry response to and support for providers regarding the Change Healthcare cyberattack and broader cyber security issues; ACA Marketplace; and Mental Health Parity Proposed Rule.

Client expense: $2,560,000 · Firm income: Not reported

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

H.R. 2851/ S. 2464 - Access to Breast Cancer Diagnosis Act of 2023; bill to prohibit group health plans and health insurance issuers offering group or individual health insurance coverage from imposing cost-sharing requirements with respect to diagnostic and supplemental breast examinations H.R. 6301/ S. 2039 - Cancer Drug Parity Act; a bill to amend the Employee Retirement Income Security Act of 1974 to require a group health plan (or health insurance coverage offered in connection with such a plan) to provide for cost-sharing for oral anticancer drugs on terms no less favorable than the cost-sharing provided for anticancer medications administered by a health care provider. H.R. 830/S. 1375 -Help Ensure Lower Patient (HELP) Copays Act; bill requires health insurance plans to apply certain payments made by, or on behalf of, a plan enrollee toward a plan's cost-sharing requirements. Specifically, plans must apply third-party payments, financial assistance, discounts, product vouchers, and other reductions in out-of-pocket expenses toward the requirements. H.R. 2630/S. 652 -Safe Step Act; bill to require a group health plan or health insurance coverage offered in connection with such a plan to provide an exceptions process for any medication step therapy protocol, and for other purposes H.R. 3086 - Find It Early Act; a bill to provide for health coverage with no cost-sharing for additional breast screenings for certain individuals at greater risk for breast cancer. H.R. 4189/S. 2016 - Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023; a bill to amend title XVIII of the Social Security Act to expand access to telehealth services, and for other purposes. H.R. 824 - Telehealth Benefit Expansion for Workers Act of 2023; bill expanding exception for stand-alone telehealth benefits plans from certain requirements that generally apply to private health insurance plans under the Patient Protection and Affordable Care Act; under the bill employers may offer stand-alone telehealth benefits to all employees including those who are eligible for enrollment in their employers group health plan H.R. 2868 - Association Health Plans Act; a bill to amend the Employee Retirement Income Security Act of 1974 to clarify the treatment of certain association health plans as employers, and for other purposes S.4767 - Insurance Fraud Accountability Act; a bill to amend the Patient Protection and Affordable Care Act to reduce fraudulent enrollments in qualified health plans, and for other purposes H.J. Res. 181- Congressional Review Act resolution to stop Biden-Harris rule limiting access to Association Health Plans (AHPs) S. 8 - Improving Health Insurance Affordability Act of 2023; a bill to expand the eligibility of taxpayers for the refundable tax credit for coverage under a qualified health plan and increases cost-sharing subsidies under the Patient Protection and Affordable Care Act H.R. 1692 - Health Care Affordability Act of 2023; a bill to revise the tax credit for health care premium assistance to expand the eligibility of low-income taxpayers for such credit and reduce the cost of health care premiums H.R. 9774/ S. 5194 - Health Care Affordability Act; a bill to amend the Internal Revenue Code of 1986 to expand eligibility for the refundable credit for coverage under a qualified health plan Administration actions necessary to reduce out-of-pocket costs for medically necessary diagnostic and supplemental breast imaging Implementation of the Affordable Care Act and coverage of preventive services with no cost-sharing Issues related to regulation of short-term limited duration plans Issues related to prescription drug affordability for patients Policies regarding White House Cancer Moonshot implementation Policies related to copay accumulator and adjustor programs Comments related to the 2026 Notice on Benefit and Payment Parameters

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Consumer Financial Protection Bureau (CFPB), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Personnel Management (OPM), SENATE, Treasury, Dept of, White House Office

H.R. 4527 Health DATA Act S. 3679, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act H.R. 5378 the Lower Costs, More Transparency Act S.3548 - Health Care Prices Revealed and Information to Consumers Explained Transparency Act S.3430 - An original bill to amend titles XVIII and XIX of the Social Security Act to expand the mental health care workforce and services, reduce prescription drug costs, and extend certain expiring provisions under Medicare and Medicaid, and for other purposes. HR 3305 & S. 1606 Black Maternal Health Momnibus Act HR 4822 Health Care Price Transparency Act HR 3284 Providers and Payers COMPETE Act HR 2840 Bipartisan Primary Care and Health Workforce Act HR 4818 Treat and Reduce Obesity Act of 2023 S. 2333 Pandemic and All Hazards Preparedness and Response Act H.R. 4421 Preparing for All Hazards and Pathogens Reauthorization Act H.R. 3561, PATIENT Act of 2023 H.R. 3281, the Transparent PRICE Act H.R. 3262, To amend title XI of the Social Security Act to increase transparency of certain health-related ownership information H.R. 2868 Association Health Plans Act H.R. 2813 Self-Insurance Protection Act H.R. 3799 CHOICE Arrangement Act H.R. 3432, Telemental Health Care Access Act H.R.824, Telehealth Benefit Expansion for Workers Act of 2023 H.R. 4189, S. 2016, CONNECT for Health Act S. 923, Better Mental Health Care for Americans Act H.R. 3120, Healthy Competition for Better Care Act H.R. 1843 Telehealth Expansion Act of 2023 Legislation and regulation related to health care delivery and health insurance coverage, mental health and substance use disorder care and coverage, the transition out of the COVID-19 pandemic and electronic health information/technology. S.954 - 118th Congress (2023-2024)A bill to provide for appropriate cost-sharing for insulin products covered under private health plans, and to establish a program to support health care providers and pharmacies in providing discounted insulin products to uninsured individuals. a

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

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

National Flood Insurance Program (NFIP) Conversations with the House Financial Services Committee on reauthorizing and reforming the National Flood Insurance Program H.R.634 - Fixing Announcements for Intermittent Remapping and Notification Expectations to Stop Surprises in Flood Insurance Act of 2023 H.R.900 - To amend the National Flood Insurance Act of 1968 to allow for the consideration of private flood insurance for the purposes of applying continuous coverage requirements, and for other purposes H.R.1309 - To require the use of replacement cost value in determining the premium rates for flood insurance coverage under the National Flood Insurance Act, and for other purposes. H.R.1392 - National Flood Insurance Program Extension Act of 2023 H.R.1540 - National Flood Insurance Program Affordability Act H.R.5860 - Continuing Appropriations Act, 2024 and Other Extensions Act H.R.6304 - Increased Cost of Compliance Modernization Act of 2003 H.R.6363 - Further Continuing Appropriations and Other Extensions Act, 2024 H.R. 4366 Consolidated Appropriations Act, 2024 S.485 - Hazard and Flooding Mitigation Funding Assurance Act S.601 - Flood Insurance Affordability Act S.721 - Homeowner Flood Insurance Transparency and Protection Act S.1039 - National Flood Insurance Program Consultant Accountability Act of 2023 S.2968 - National Flood Insurance Program Extension through 2023 Act Discussions with the House of Representatives, Senate and White House to extend the National Flood Insurance Program. Discussions with the Senate Banking Committee on flood insurance reform. Commercial Real Estate Flood Insurance H.R. 1307 - To repeal the mandatory flood insurance coverage requirement for commercial properties located in flood hazard areas, and for other purposes. Association Health Plans (AHPs) HR2868 - Association Health Plans Act Discussions with the House of Representatives, the Senate and Department of Labor about AHPs. Discussions with the Federal Emergency Management Agency (FEMA) in the Department of Homeland Security (DHS) regarding flood insurance, flood maps, and disaster mitigation. Discussions with the Federal Housing Finance Agency (FHFA) on climate risk. Discussions with Fannie Mae on climate risk and insurance disclosures. Communications with the Department of Labor opposing their proposal to rescind the 2018 Association Health Plans (AHP) rule. Communications with the House of Representatives supporting the HR 7849 Disaster Resiliency and Coverage Act. Discussions with National Oceanic and Atmospheric Administration on flood mapping and disaster intelligence.

Client expense: $32,010,000 · Firm income: Not reported

Government targets: Federal Emergency Management Agency (FEMA), Federal Housing Finance Agency (FHFA), HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Labor, Dept of (DOL), Natl Oceanic & Atmospheric Administration (NOAA), SENATE, White House Office

H.R. 1264, Commonsense Reporting Act of 2023 H.R. 2813, Self-Insurance Protection Act H.R. 2868, Association Health Plans Act H.R. 3800, Chronic Disease Flexible Coverage Act H.R. 4307/S. 2115, Medical Supply Chain Resiliency Act H.R. 6860, Restore Protections for Dialysis Patients Act H.R. 9029, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2025 S. 127, Pharmacy Benefit Manager Transparency Act of 2023 S. 142, Preserve Access to Affordable Generics and Biosimilars Act S. 148, Stop Significant and Time-wasting Abuse Limiting Legitimate Innovation of New Generics (Stop STALLING) Act S. 150, Affordable Prescriptions for Patients Act of 2023 S. 1067, Ensuring Timely Access to Generics Act of 2023 S. 1114, Expanding Access to Low-Cost Generics Act of 2023 S. 1214, Retaining Access and Restoring Exclusivity (RARE) Act S. 1339, Pharmacy Benefit Manager Reform Act S. 2624, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2024 S. 2780, The Medication Affordability and Patent Integrity Act Proposed Rule, Internal Revenue Service, the Employee Benefits Security Administration, and the Health and Human Services Department; Requirements Related to the Mental Health Parity and Addiction Equity Act (88 Fed. Reg. 51,552-51,669, August 3, 2023) Proposed Rule, Employee Benefits Security Administration, Department of Labor; Definition of Employer-Association Health Plans (88 Fed. Reg. 87,968-87,981, December 20, 2023) Various issues relating to the employer-sponsored health care system, implementation of regulatory process, provider network adequacy, health savings account (HSAs), health reimbursement account (HRAs), employer mandate; Medicare Drug Price Negotiation Program: Initial Memorandum, Implementation of Sections 1191-1198 of the Social Security Act for Initial Price Applicability Year 2026, and Solicitation of Comments; implementation of the American Rescue Plan Act (P.L. 117-2); implementation of the Inflation Reduction Act (P.L. 117-169); balance or surprise billing and related issues; single-payer health care options; health reimbursement arrangements and other account-based group health plans; Health and Human Services international pricing index (IPI) model; mental health parity; drug pricing; COBRA subsidies; Federal Trade Commissions multilateral pharmaceutical merger taskforce; telehealth, including coverage of telehealth under High Deductible Health Plans (HDHPs) and expanding telehealth options for employees; impact of Pharmacy Benefit Managers Practices; FTC-2022-0015; petition to HHS to grant march-in rights for the patents on the drug Xtandi; legislative proposals to tax employer-provided health care coverage; artificial price caps on providing insulin; Reasonable Price Clause in reauthorization draft of the Pandemic and All Hazards Preparedness Act(PAHPA, P.L. 109-417); over-the-counter preventive services; ERISA preemption protections including information on constructive changes/modifications to ERISA; efforts to reform the World Health Organizations (WHO) engagement with private sector; support for necessary market conditions to incentivize health sector investment from private sector; support for private sector involvement in health systems strengthening; promote greater harmonization of standards and investment in digital health; health-related policy issues in the G20/G7 forums and other multilateral forums; support for improving access to health products and technologies globally, including via regulatory alignment, addressing trade barriers, strengthening the global supply chain, and raising awareness on potential pitfalls of local manufacturing; Advance Notice of Methodological Changes for Calendar Year (CY) 2025 for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies, U.S. Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services (2025 Advance Notice, January 31, 2024)

Client expense: $14,750,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, State, Dept of (DOS), U.S. Agency for International Development (USAID), U.S. Trade & Development Agency (USTDA), U.S. Trade Representative (USTR)

S.127, Pharmacy Benefit Manager Transparency Act of 2023; S.954, Affordable Insulin Now Act; S.1339, Pharmacy Benefit Manager Reform Act; S.1664, Healthy Families Act; S.1869, SITE Act; H.R.824, Telehealth Benefit Expansion for Works Act of 2023; H.R.1264, Commonsense Reporting Act; H.R.1843, Telehealth Expansion Act of 2023; H.R.2813, Self Insurance Protection Act; H.R.2868, Association Health Plan Act; H.R.3797, Paperwork Burden Reduction Act; H.R.3798, Small Business Flexibility Act; H.R.3799, CHOICE Arrangement Act; H.R.3801, Employer Reporting Improvement Act; Issues related to dialysis coverage; Issues related to health sector consolidation; Issues related to ERISA pre-emption; Issues related to employer sponsored health coverage

Client expense: $120,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to lung disease treatment, prevention and research; Issues related to public health; Issues related asthma, COPD, influenza, lung cancer, pneumonia, pulmonary fibrosis, 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 Medicaid; Issues related to ERISA; Issues related to COVID-19 Response; Issues related to vaccines; Issues related to infrastructure; Issues related to supplemental oxygen; Issues related to the implementation of the No Surprises Act; Issues related to Medicare sequestration; Issues related to Cancer Moonshot; Issues related to short-term limited duration plans; Issues related to Healthy Future Taskforce; Issues related to regulatory reform; Issues relating to FY25 appropriations; Issues relating to the Presidents FY26 budget; HR 277 REINS Act; S 184 REINS Act; HR 1075 Medicaid Work Requirements Act; S. 1063 A bill to amend title XIX of the Social Security Act to implement a minimum work requirement for able-bodied adults enrolled in State Medicaid programs; HR 1551 Jobs and Opportunities for Medicaid Act; H.R. 2583 Increasing Access to Quality Cardiac Rehabilitation Care Act of 2023; H.R. 1114 Long COVID RECOVERY NOW Act; H.R. 1692 Health Care Affordability Act of 2023; HR 3073 Community Mental Wellness and Resilience Act; S 1452 Community Mental Wellness and Resilience Act; HR 2811 Limit Save Grow Act; HR 442 Regulatory Accountability Act; S 1615 Regulatory Accountability Act;; HR 288 Separation of Powers Restoration Act of 2023; S 1411, Prove It Act of 2023; S 1995 Public Health Infrastructure Saves Lives Act; HR 824 Telehealth Benefit Expansion for Workers Act of 2023; HR 4286 Increasing Access to Lung Cancer Screening Act; HR 2813 The Self-Insurance Protec􀆟on Act; HR 3799 CHOICE Arrangement Act; HR 2868 Association Health Plans Act; S 2213 Comprehensive Cancer Survivorship Act; HR 4363 Comprehensive Cancer Survivorship Act; S. 2016 CONNECT for Health Act of 2023; HR 4189 CONNECT for Health Act of 2023;; HR 5749 Family Asthma Act; HR 4286 Increasing Access to Lung Cancer Screening Act; HR 890 The Guidance Out of Darkness Act; S 791 The Guidance Out of Darkness Act; S 2245 Women and Lung Cancer Research and Preventive Services Act; HR 4534 Women and Lung Cancer Research and Preventive Services Act; S 2333 Pandemic and All Hazards Preparedness and Response Act; HR 4420 Pandemic and All-Hazards Preparedness and Response Act; S 1489 National Task Force on the COVID-19 Pandemic Act;; HR 6302 Health Share Transparency Act; HR 357 Ensuring Accountability in Agency Rulemaking;; S3821 Supplemental Oxygen Access Reform (SOAR) Act; HR7829 Supplemental Oxygen Access Reform (SOAR) Act; HR 485 Protecting Health Care for All Patients Act of 2023; HR 7867 Renewing Efficiency in Government by Budgeting Act; HR 115 Midnight Rules Relief Act, HR 1602, Health Care Affordability Act of 2023; S. 8 Improving Health Insurance Affordability Act of 2023; HR 9029 Departments of Labor, Health and Human Services, and Education and Related Agencies Appropriations Act, 2025; H.R. 8774 Department of Defense Appropriations Act 2025; S. 4942 Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2025; S 4921 Department of Defense Appropriations Act 2025; HR 890 Guidance out of Regulatory Darkness Act; HR 9747 Continuing Appropriations and Extensions Act, 2025; HR 9494 Continuing Appropriations and Other Matters Act 2025; H.R. 9774, Health Care Affordability Act of 2024; S. 5194 Health Care Affordability Act of 2024; S. 652 Safe Step Act; HR 2630 Safe Step Act

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

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

H.R. 2851/ S. 2464 - Access to Breast Cancer Diagnosis Act of 2023; bill to prohibit group health plans and health insurance issuers offering group or individual health insurance coverage from imposing cost-sharing requirements with respect to diagnostic and supplemental breast examinations H.R. 6301/ S. 2039 - Cancer Drug Parity Act; a bill to amend the Employee Retirement Income Security Act of 1974 to require a group health plan (or health insurance coverage offered in connection with such a plan) to provide for cost-sharing for oral anticancer drugs on terms no less favorable than the cost-sharing provided for anticancer medications administered by a health care provider. H.R. 830/S. 1375 -Help Ensure Lower Patient (HELP) Copays Act; bill requires health insurance plans to apply certain payments made by, or on behalf of, a plan enrollee toward a plan's cost-sharing requirements. Specifically, plans must apply third-party payments, financial assistance, discounts, product vouchers, and other reductions in out-of-pocket expenses toward the requirements. H.R. 2630/S. 652 -Safe Step Act; bill to require a group health plan or health insurance coverage offered in connection with such a plan to provide an exceptions process for any medication step therapy protocol, and for other purposes H.R. 3086 - Find It Early Act; a bill to provide for health coverage with no cost-sharing for additional breast screenings for certain individuals at greater risk for breast cancer. H.R. 4189/S. 2016 - Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023; a bill to amend title XVIII of the Social Security Act to expand access to telehealth services, and for other purposes. H.R. 824 - Telehealth Benefit Expansion for Workers Act of 2023; bill expanding exception for stand-alone telehealth benefits plans from certain requirements that generally apply to private health insurance plans under the Patient Protection and Affordable Care Act; under the bill employers may offer stand-alone telehealth benefits to all employees including those who are eligible for enrollment in their employers group health plan H.R. 2868 - Association Health Plans Act; a bill to amend the Employee Retirement Income Security Act of 1974 to clarify the treatment of certain association health plans as employers, and for other purposes Administration actions necessary to reduce out-of-pocket costs for medically necessary diagnostic and supplemental breast imaging Implementation of the Affordable Care Act and coverage of preventive services with no cost-sharing Issues related to regulation of short-term limited duration plans Issues related to prescription drug affordability for patients Policies regarding White House Cancer Moonshot implementation Policies related to copay accumulator and adjustor programs Comments in response to House Education & Workforce RFI on Employee Retirement Income Security Act (ERISA) Comments related to the 2026 Notice on Benefit and Payment Parameters Efforts to introduce the Broker Accountability Act

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Consumer Financial Protection Bureau (CFPB), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Personnel Management (OPM), SENATE, Treasury, Dept of, White House Office

S.127, Pharmacy Benefit Manager Transparency Act of 2023; S.954, Affordable Insulin Now Act; S.1339, Pharmacy Benefit Manager Reform Act; S.1664, Healthy Families Act; S.1869, SITE Act; HR.824, Telehealth Benefit Expansion for Works Act of 2023; HR.1264, Commonsense Reporting Act; HR.1843, Telehealth Expansion Act of 2023; HR.2813, Self Insurance Protection Act; HR.2868, Association Health Plan Act; HR.3797, Paperwork Burden Reduction Act; HR.3798, Small Business Flexibility Act; HR.3799, CHOICE Arrangement Act; HR.3801, Employer Reporting Improvement Act; Issues related to dialysis coverage; Issues related to health sector consolidation; Issues related to ERISA pre-emption; Issues related to employer sponsored health coverage

Client expense: $101,954 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.127, Pharmacy Benefit Manager Transparency Act of 2023; S.954, Affordable Insulin Now Act; S.1339, Pharmacy Benefit Manager Reform Act; S.1664, Healthy Families Act; S.1869, SITE Act; HR.824, Telehealth Benefit Expansion for Works Act of 2023; HR.1264, Commonsense Reporting Act; HR.1843, Telehealth Expansion Act of 2023; HR.2813, Self Insurance Protection Act; HR.2868, Association Health Plan Act; HR.3797, Paperwork Burden Reduction Act; HR.3798, Small Business Flexibility Act; HR.3799, CHOICE Arrangement Act; HR.3801, Employer Reporting Improvement Act; Issues related to dialysis coverage; Issues related to health sector consolidation; Issues related to ERISA pre-emption; Issues related to employer sponsored health coverage

Client expense: $101,954 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Access to AEDs Act (H.R. 2370/S. 1024) Cardiac Arrest Survival Act (H.R. 1012) Easy Enrollment in Healthcare Act (H.R. 1113/S. 423) Palliative Care and Hospice Education and Training Act (S.2243) Self-Insurance Protection Act (H.R. 2813) Telehealth Benefit Expansion for Workers Act (H.R. 824) Association Health Plans Act (H.R. 2868) Improving Whole Health for Veterans with Chronic Conditions Act (S. 1954) FAMILY Act (S. 1714/H.R. 3481) Social Determinants of Health Act of 2023 (no bill number) Preventing Maternal Deaths Reauthorization Act of 2023 (H.R. 3838/S. 2415) PREEMIE Reauthorization Act of 2023 (H.R. 3226/S. 1573) Charles Rochester Blood Clot Prevention and Treatment Act (H.R. 5699) Cardiomyopathy Health Education, Awareness, Research, and Training in the Schools (HEARTS) Act (HR 6829) Alleviating Barriers to Caregiving (ABC) Act (S. 3109) Legislation to enhance research, data collection, and education about stroke (no bill number) Harold B. Kohl Physical Activity for Americans Act (no bill number) Congenital Heart Futures Reauthorization Act of 2024 (H.R.7189) A resolution designating September 2023 as "National Cholesterol Education Month" and September 30, 2023, as LDL-C Awareness Day (S.Res.496) A resolution designating September 2024 as "National Cholesterol Education Month" and September 30, 2024, as "LDL-C Awareness Day" (S.Res.566) Expressing support for the goals and ideals of National Stroke Awareness Month (H. Res. 1216) A resolution designating May 2024 as American Stroke Month (S. Res. 711) Implementation of the No Surprises Act Department of Labor action to rescind Association Health Plan Final Rule (RIN 1210-AC16) HHS finalization of proposed rule on Section 1557; Nondiscrimination in Health Programs and Activities (RIN Number 0945AA17) HHS finalization of proposed rule on Clarifying Eligibility for a Qualified Health Plan (CMS-9894-P) HHS finalization of proposed rule on Short-Term, Limited-Duration Insurance; Independent, Non- coordinated Excepted Benefits Coverage; Level-Funded Plan Arrangements; and Tax Treatment of Certain Accident and Health Insurance (CMS-9904-P)

Client expense: $670,000 · Firm income: Not reported

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

Access to Breast Cancer Diagnosis (ABCD) Act (H.R.3851/S. 2464) Cancer Drug Parity Act (S. 2039) Telehealth Benefit Expansion for Workers Act (H.R. 824) Association Health Plans Act (H.R. 2868) Safe Step Act (H.R.2630/S. 652) Implementation of the Affordable Care Act Policies related to insurance coverage and COVID-19 HELP Copays Act (H.R.830/S.1375) Cancer survivorship issues Issues related to prescription drug affordability for patients Administrative actions necessary to reduce out-of-pocket costs for medical-necessary diagnostic breast imaging Congressional action to reduce out-of-pocket costs for medically necessary diagnostic breast imaging Issues related to regulation of short-term limited duration plans Implementation of the No Surprises Act, including comments on proposed rule re: Federal Independent Dispute Resolution Operations Find It Early Act (H.R.3086); a bill to provide for health coverage with no cost-sharing for additional breast screenings for certain individuals Policies related to coverage of preventive services with no cost-sharing Polices regarding White House Cancer Moonshot implementation Policies related to copay accumulator adjustors Letter to Committee on Education and the Workforce Request for Information on Employer-Sponsored Insurance and Employee Retirement Income Security Act (ERISA)

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Personnel Management (OPM), Office of Science & Technology Policy (OSTP), SENATE, Treasury, Dept of, White House Office

H.R. 485 - Protecting Health Care For All Patients Act of 2023 - Rep. McMorris Rodgers, Cathy - federal programs using prices based on quality-adjusted life years H.R. 824 - Telehealth Benefit Expansion for Workers Act of 2023 - Rep. Walberg, Tim - telehealth and ERISA amendments H.R. 830 - HELP Copays Act - Rep. Carter, Earl - health insurers responsibility for payments made by or on behalf of a plan enrollee toward a plans cost-sharing requirements H.R. 1488 - Affordable Insulin Now Act of 2023 - Rep. Craig, Angie - cost-sharing for insulin products H.R. 2666 - MVP Act - Rep. Guthrie, Brett - value-based purchasing arrangements under Medicaid program and reforms to price reporting H.R. 2691 - Transparent Price Act - Rep. McMorris Rodgers, Cathy - health insurer price transparency H.R. 2813 - Self-Insurance Protection Act - Rep. Good, Bob - ERISA amendments H.R. 2868 - Association Health Plans Act - Rep. Walberg, Tim - ERISA amendments H.R. 2872 - Further Additional Continuing Appropriations and Other Extensions Act, 2024 - Rep. Graves, Garret - extends FY24 funding and program authorities through March 8, 2024 H.R. 2882 - Further Consolidated Appropriations Act, 2024 - Rep. Ciscomani, Juan - provides annual funding through September 30, 2024, for the Departments of Labor, Health and Human Services, and Education, and Related Agencies H.R. 3305 - Black Maternal Health Momnibus Act - Rep. Underwood, Lauren - maternal health including in Medicaid and CHIP H.R. 3561 - PATIENT Act - Rep. McMorris Rodgers, Cathy - PBM transparency, PBM contract design, health insurance transparency, hospital transparency H.R. 3799 - Custom Health Option and Individual Care Expense Arrangement Act- Rep. Hern, Kevin - health reimbursement arrangements H.R. 3801 - Employer Reporting Improvement Act - Rep. Smith, Adrian - ACA reporting requirements H.R. 6956 - Opioid Settlement Accountability Act - Rep. Kaptur, Marcy - funding for opioid prevention and treatment services, training, equipment, and social support services H.R. 6960 - Emergency Medical Services for Children Reauthorization Act of 2024 - Rep. Carter, Earl L. Buddy - funding for emergency medical services for children program H.R. 7513 - Protecting Americas Seniors Access to Care Act - Rep. Fischbach, Michelle - regarding minimum staffing for nursing facilities H.R. 7858 - Telehealth Enhancement for Mental Health Act of 2024 - Rep. James, John - Medicare, behavioral health, telehealth H.R. 7899 - To direct the Attorney General, in consultation with the Secretary of Health and Human Services, to promulgate the final regulations relating to special registration for telemedicine. - Rep. Ezell, Mike - telehealth H.R. 7907 - Welcome Back to the Health Care Workforce Act - Rep. Krishnamoorthi, Raja- grants/funding, health care workforce H.R. 7929 - Nursing Home Workforce Support and Expansion Act of 2024 - Rep. Horsford, Steven - grants/funding, health care workforce H.R. 7994 - Long-Term Care Workforce Support Act - Rep. Dingell, Debbie - health care workforce H.R. 8444 - Mental Health in Schools Act - Rep. Napolitano, Grace - grant to promote mental health S. 1606 - A bill to end preventable maternal mortality, severe maternal morbidity, and maternal health disparities in the United States, and for other purposes. - Sen. Booker, Cory - maternal mortality S. 3393 - SUPPORT for Patients and Communities Reauthorization Act. - Sen. Sanders, Bernie - SUD treatment S. 3430 - Better Mental Health Care, Lower-Cost Drugs, and Extenders Act of 2023 - Sen. Wyden, Ron - mental health, telehealth, health workforce S. 3612 - Access to Family Building Act- Sen. Duckworth, Tammy- right to access reproductive technology (ex. IVF) S. 3756 - At HOME Services Act of 2024- Sen. Rubio, Marco- pilot program for outpatient observation, acute care at home S. 3775 - BOLD Infrastructure for Alzheimers Reauthorization Act of 2024- Sen. Collins, Susan - healthcare infrastructure, Alzheimers S. 3805 - A bill to amend title XI of the Social Security Act to prohibit health plans from imposing fees on health care providers for electronic funds transfers and health care payment and remittance advice transactions, and for other purposes. - Sen. Cassidy, Bill - SSA, healthcare, electronic funds, payments, remittance S. 3847 - Improving Social Determinants of Health Act of 2024- Sen. Smith, Tina- CDC authorization S. 4088 - Welcome Back to the Health Care Workforce Act - Sen. Kaine, Tim - grants/funding, health care workforce S. 4120 - Long-Term Care Workforce Support Act - Sen. Casey, Robert P., Jr. - health care workforce S. 4195 - Childhood Diabetes Reduction Act of 2024 - Sen. Sanders, Bernie - nutrition labeling S. 4357 - Comprehensive Dental Reform Act of 2024- Sen. Sanders, Bernie - promotes access to oral health care S. 4358 - Preventing and Treating Substance Use Disorders Among Older Adults Act- Sen. Casey, Robert - SAMHSA grant program for SUDs S. 4554 - Reproductive Freedom for Women Act- Sen. Murray, Patty - protecting abortion and reproductive rights Issues related to broadband and public health infrastructure; mental health and telehealth; behavioral health; rural health; substance use disorder treatments; Health Savings Accounts; provider directories; artificial intelligence and privacy; insurance industry response to and support for providers regarding the Change Healthcare cyberattack; ACA Marketplace; and Mental Health Parity Proposed Rule.

Client expense: $2,390,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, SENATE, White House Office

National Flood Insurance Program (NFIP) Conversations with the House Financial Services Committee on reauthorizing and reforming the National Flood Insurance Program H.R.634 - Fixing Announcements for Intermittent Remapping and Notification Expectations to Stop Surprises in Flood Insurance Act of 2023 H.R.900 - To amend the National Flood Insurance Act of 1968 to allow for the consideration of private flood insurance for the purposes of applying continuous coverage requirements, and for other purposes H.R.1309 - To require the use of replacement cost value in determining the premium rates for flood insurance coverage under the National Flood Insurance Act, and for other purposes. H.R.1392 - National Flood Insurance Program Extension Act of 2023 H.R.1540 - National Flood Insurance Program Affordability Act H.R.5860 - Continuing Appropriations Act, 2024 and Other Extensions Act H.R.6304 - Increased Cost of Compliance Modernization Act of 2003 H.R.6363 - Further Continuing Appropriations and Other Extensions Act, 2024 H.R. 4366 Consolidated Appropriations Act, 2024 S.485 - Hazard and Flooding Mitigation Funding Assurance Act S.601 - Flood Insurance Affordability Act S.721 - Homeowner Flood Insurance Transparency and Protection Act S.1039 - National Flood Insurance Program Consultant Accountability Act of 2023 S.2968 - National Flood Insurance Program Extension through 2023 Act Discussions with the House of Representatives, Senate and White House to extend the National Flood Insurance Program. Discussions with the Senate Banking Committee on flood insurance reform. Commercial Real Estate Flood Insurance H.R. 1307 - To repeal the mandatory flood insurance coverage requirement for commercial properties located in flood hazard areas, and for other purposes. Association Health Plans (AHPs) HR2868 - Association Health Plans Act Discussions with the House of Representatives, the Senate and Department of Labor about AHPs. Discussions with the Federal Emergency Management Agency (FEMA) in the Department of Homeland Security (DHS) regarding flood insurance and flood maps. Discussions with the Federal Housing Finance Agency (FHFA) on climate risk. Discussions with Fannie Mae on climate risk and insurance disclosures. Communications with the Department of Labor opposing their proposal to rescind the 2018 Association Health Plans (AHP) rule. Communications with the House of Representatives supporting the HR 7849 Disaster Resiliency and Coverage Act.

Client expense: $16,500,000 · Firm income: Not reported

Government targets: Federal Emergency Management Agency (FEMA), Federal Housing Finance Agency (FHFA), HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Labor, Dept of (DOL), SENATE, White House Office

S. 3679, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act H.R. 5378 the Lower Costs, More Transparency Act S.3548 - Health Care Prices Revealed and Information to Consumers Explained Transparency Act S.3430 - An original bill to amend titles XVIII and XIX of the Social Security Act to expand the mental health care workforce and services, reduce prescription drug costs, and extend certain expiring provisions under Medicare and Medicaid, and for other purposes. HR 3305 & S. 1606 Black Maternal Health Momnibus Act HR 4822 Health Care Price Transparency Act HR 3284 Providers and Payers COMPETE Act HR 2840 Bipartisan Primary Care and Health Workforce Act HR 4818 Treat and Reduce Obesity Act of 2023 S. 2333 Pandemic and All Hazards Preparedness and Response Act H.R. 4421 Preparing for All Hazards and Pathogens Reauthorization Act H.R. 3561, PATIENT Act of 2023 H.R. 3281, the Transparent PRICE Act H.R. 3262, To amend title XI of the Social Security Act to increase transparency of certain health-related ownership information H.R. 2868 Association Health Plans Act H.R. 2813 Self-Insurance Protection Act H.R. 3799 CHOICE Arrangement Act H.R. 3432, Telemental Health Care Access Act H.R.824, Telehealth Benefit Expansion for Workers Act of 2023 H.R. 4189, S. 2016, CONNECT for Health Act S. 923, Better Mental Health Care for Americans Act H.R. 3120, Healthy Competition for Better Care Act H.R. 1843 Telehealth Expansion Act of 2023 Legislation and regulation related to health care delivery and health insurance coverage, mental health and substance use disorder care and coverage, the transition out of the COVID-19 pandemic and electronic health information/technology. S.954 - 118th Congress (2023-2024)A bill to provide for appropriate cost-sharing for insulin products covered under private health plans, and to establish a program to support health care providers and pharmacies in providing discounted insulin products to uninsured individuals. a

Client expense: $680,000 · Firm income: Not reported

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

HR 1692 / S 8, the Health Care Affordability Act; HR 2630 / S 652, the Safe Step Act; HR 3433 / S 2897, the Give Kids a Chance Act; HR 3503 / S 1701, The NIH Clinical Trial Diversity Act; HR 3991 / S 1624, the Gabriella Miller Kids First Act; HR 4363 / S 2213, Comprehensive Cancer Survivorship Act; HR 6003 / S 3103, the Medical Debt Relief Act; HR 6301 / S. 2039, The Cancer Drug Parity Act; HR 7383 / S 1214, the RARE Act; HR 824, the Telehealth Benefit Expansion for Workers Act; HR 1773, the Consumer Protection for Medical Debt Collections Act; HR 2813, Self-Insurance Protection Act; HR 2868, the Association Health Plans; HR 2880, the Protecting Patients Against PBM Abuses Act; HR 3799, CHOICE Arrangement Act; HR 3800, the Chronic Disease Flexible Coverage Act; HR 5609, the Advancing Health Savings Act; HR 5688, the Bipartisan HSA Improvement Act; HR 5687, the HSA Modernization Act; HR 6664, the Innovation in Pediatric Drugs Act; HR 6963, the Pediatric Cancer Drug Supply Chain Act; HR 7384, the Creating Hope Reauthorization Act; S 113, the Prescription Pricing for the People Act; S 127, the Pharmacy Benefit Manager Transparency Act; S 1339, the Pharmacy Benefit Manager Reform Act; S 1542, the DRUG Act; S 1967 the Patients Before Middlemen Act; S 2243, the Palliative Care and Hospice Education and Training Act; S 2483, the Strengthening Consumer Protections and Medical Debt Transparency Act; S 2973, the Modernizing and Ensuring PBM Accountability Act; S 3167, Multiple Employer Welfare Arrangement (MEWA) Act; Legislation to protect insurance purchasers interacting with insurance brokers; Implementation of the No Surprises Act; Federal rulemaking related to Short-term Limited Duration Insurance (STLDI) plans; Insurance appeals and denials; Federal rulemaking related to Association Health Plans; Consumer protections related to consumers who will lose insurance due to the end of certain federal Medicaid maintenance-of-effort requirements; FDA draft guidance related to dose optimization studies in clinical trials

Client expense: $570,000 · Firm income: Not reported

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

Issues related to lung disease treatment, prevention and research; Issues related to public health; Issues related asthma, COPD, influenza, lung cancer, pneumonia, pulmonary fibrosis, 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 Medicaid; Issues related to ERISA; Issues related to COVID-19 Response; Issues related to vaccines; Issues related to infrastructure; Issues related to supplemental oxygen; Issues related to the implementation of the No Surprises Act; Issues related to Medicare sequestration; Issues related to Cancer Moonshot; Issues related to short-term limited duration plans; Issues related to Healthy Future Taskforce; Issues related to regulatory reform; Issues relating to FY25 appropriations; Issues relating to the Presidents FY26 budget; HR 277 REINS Act; S 184 REINS Act; HR 1075 Medicaid Work Requirements Act; S. 1063 A bill to amend title XIX of the Social Security Act to implement a minimum work requirement for able-bodied adults enrolled in State Medicaid programs; HR 1551 Jobs and Opportunities for Medicaid Act; H.R. 2583 Increasing Access to Quality Cardiac Rehabilitation Care Act of 2023; H.R. 1114 Long COVID RECOVERY NOW Act; H.R. 1692 Health Care Affordability Act of 2023; HR 3073 Community Mental Wellness and Resilience Act; S 1452 Community Mental Wellness and Resilience Act; HR 2811 Limit Save Grow Act; HR 442 Regulatory Accountability Act; S 1615 Regulatory Accountability Act;; HR 288 Separation of Powers Restoration Act of 2023; S 1411, Prove It Act of 2023; S 1995 Public Health Infrastructure Saves Lives Act; HR 824 Telehealth Benefit Expansion for Workers Act of 2023; HR 4286 Increasing Access to Lung Cancer Screening Act; HR 2813 The Self-Insurance Protec􀆟on Act; HR 3799 CHOICE Arrangement Act; HR 2868 Association Health Plans Act; S 2213 Comprehensive Cancer Survivorship Act; HR 4363 Comprehensive Cancer Survivorship Act; S. 2016 CONNECT for Health Act of 2023; HR 4189 CONNECT for Health Act of 2023;; HR 5749 Family Asthma Act; HR 4286 Increasing Access to Lung Cancer Screening Act; HR 890 The Guidance Out of Darkness Act; S 791 The Guidance Out of Darkness Act; S 2245 Women and Lung Cancer Research and Preventive Services Act; HR 4534 Women and Lung Cancer Research and Preventive Services Act; S 2333 Pandemic and All Hazards Preparedness and Response Act; HR 4420 Pandemic and All-Hazards Preparedness and Response Act; S 1489 National Task Force on the COVID-19 Pandemic Act;; HR 6302 Health Share Transparency Act; HR 357 Ensuring Accountability in Agency Rulemaking;; S3821 Supplemental Oxygen Access Reform (SOAR) Act; HR7829 Supplemental Oxygen Access Reform (SOAR) Act; HR 485 Protecting Health Care for All Patients Act of 2023; HR 7867 Renewing Efficiency in Government by Budgeting Act; HR 115 Midnight Rules Relief Act, HR 1602, Health Care Affordability Act of 2023; S. 8 Improving Health Insurance Affordability Act of 2023; Departments of Labor, Health and Human Services, and Education and Related Agencies Appropriations Act, 2025; H.R. 8774 Department of Defense Appropriations Act 2025

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

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

H.R. 1264, Commonsense Reporting Act of 2023 H.R. 2813, Self-Insurance Protection Act H.R. 2868, Association Health Plans Act H.R. 4307/S. 2115, Medical Supply Chain Resiliency Act H.R. 6860, Restore Protections for Dialysis Patients Act S. 127, Pharmacy Benefit Manager Transparency Act of 2023 S. 142, Preserve Access to Affordable Generics and Biosimilars Act S. 148, Stop Significant and Time-wasting Abuse Limiting Legitimate Innovation of New Generics (Stop STALLING) Act S. 150, Affordable Prescriptions for Patients Act of 2023 S. 1067, Ensuring Timely Access to Generics Act of 2023 S. 1114, Expanding Access to Low-Cost Generics Act of 2023 S. 1214, Retaining Access and Restoring Exclusivity (RARE) Act S. 1339, Pharmacy Benefit Manager Reform Act S. 2624, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2024 Draft legislation titled Fiscal Year 2025 Labor, Health and Human Services, Education, and Related Agencies Appropriations Act Request for Extension of Time for Comments, on Proposed Rule, Consumer Financial Protection Bureau; Prohibition on Creditors and Consumer Reporting Agencies Concerning Medical Information (Regulation V) (89 Fed. Reg. 51,682-51,736, June 18, 2024) Proposed Rule, Internal Revenue Service, the Employee Benefits Security Administration, and the Health and Human Services Department; Requirements Related to the Mental Health Parity and Addiction Equity Act (88 Fed. Reg. 51,552-51,669, August 3, 2023) Proposed Rule, Employee Benefits Security Administration, Department of Labor; Definition of Employer-Association Health Plans (88 Fed. Reg. 87,968-87,981, December 20, 2023) Various issues relating to the employer-sponsored health care system, implementation of regulatory process, provider network adequacy, health savings account (HSAs), health reimbursement account (HRAs), employer mandate; Medicare Drug Price Negotiation Program: Initial Memorandum, Implementation of Sections 1191 - 1198 of the Social Security Act for Initial Price Applicability Year 2026, and Solicitation of Comments; implementation of the American Rescue Plan Act (P.L. 117-2); implementation of the Inflation Reduction Act (P.L. 117-169); balance or surprise billing and related issues; single-payer health care options; health reimbursement arrangements and other account-based group health plans; Health and Human Services international pricing index (IPI) model; mental health parity; drug pricing; COBRA subsidies; Federal Trade Commissions multilateral pharmaceutical merger taskforce; telehealth, including coverage of telehealth under High Deductible Health Plans (HDHPs) and expanding telehealth options for employees; impact of Pharmacy Benefit Managers Practices; FTC-2022-0015; petition to HHS to grant march-in rights for the patents on the drug Xtandi; legislative proposals to tax employer-provided health care coverage; artificial price caps on providing insulin; Reasonable Price Clause in reauthorization draft of the Pandemic and All Hazards Preparedness Act (PAHPA, P.L. 109-417); over-the-counter preventive services; ERISA preemption protections including information on constructive changes/modifications to ERISA; artificial price caps on providing insulin; efforts to reform the World Health Organizations (WHO) engagement with private sector; continued U.S. membership to the World Health Organization (WHO); support for necessary market conditions to incentivize health sector investment from private sector; support for private sector involvement in health systems strengthening; promote greater harmonization of standards and investment in digital health; health-related policy issues in the G20/G7 forums and other multilateral forums; support for improving access to health products and technologies globally, including via regulatory alignment and addressing trade barriers; Advance Notice of Methodological Changes for Calendar Year (CY) 2025 for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies, U.S. Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services (2025 Advance Notice, January 31, 2024)

Client expense: $13,930,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, State, Dept of (DOS), U.S. Agency for International Development (USAID), U.S. Trade & Development Agency (USTDA), U.S. Trade Representative (USTR)

House H.R. 572, the Ensuring Workers Get PAID Act - support. H.R. 1843, the Telehealth Expansion Act - support. H.R. 824, the Telehealth Benefit Expansion for Workers Act of 2023 - support. H.R. 2811, the Limit, Save, Grow Act of 2023 - support. H.R. 4721, the Main Street Tax Certainty Act - support. H.R. 3881, the Credit Card Competition Act - support. H.R. 3799, the CHOICE Arrangement Act - support. S.J.Res.11, CRA resolution of disapproval for the EPA final rule relating to increased emissions standards for new heavy duty trucks - support. H.R. 2868, the Association Health Plan Act - support. H.R. 2813, the Self-Insurance Protection Act - support. H.R. 4428, the Guidance Clarity Act - support. H.R. 890, the Guidance Out Of Darkness (GOOD) Act - support. H.R. 5378, the Lower Costs, More Transparency Act - support. Norcross amendment (submitted as #144) to the National Defense Authorization Act for 2024 - oppose. H.R. 3417, FAIR Act - support. H.R. 1163, the Protecting Taxpayers and Victims of Unemployment Fraud Act - support. H.R. 4035, the Protecting Small Business Information Act of 2023 - support. H.J.Res. 98, Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the National Labor Relations Board relating to "Standard for Determining Joint Employer Status. - support. S.J. Res. 32, providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Bureau of Consumer Financial Protection relating to Small Business Lending Under the Equal Credit Opportunity Act (Regulation B). - support. H.R. 6514, Holding Agencies Accountable Act - support. H.R. 906, the REPAIR Act - support. H.R. 7198, Prove It Act - support. H.R. 7035, the Death Tax Repeal Act - support. H.J.Res. 147, providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Occupational Safety and Health Administration relating to "Worker Walkaround Representative Designation Process - support. H.R. 358, the Small Business Regulatory Flexibility Improvements Act (SBRFIA) - support H.R. 8639, Warehouse Worker Protection Act - oppose. H. J. RES. 129, the Congressional Review Act (CRA) resolution to repeal the Departments of Labor, the Treasury, and Health and Human Services Short-Term, Limited Duration Insurance and Independent, Noncoordinated Excepted Benefits Coverage rule - support. H.R. 8147, Repealing Big Brother Overreach Act - support. H.J.Res.116, Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Department of the Labor relating to "Employee or Independent Contractor Classification Under the Fair Labor Standards Act" - support Senate S. 1108, the Death Tax Repeal Act - support. S. 122, the Ensuring Workers Get PAID Act - support. S. 954, the Affordable Insulin NOW Act of 2023 - oppose. S. 1001, the Telehealth Expansion Act - support. H.J.Res. 27, the Congressional Review Act (CRA) resolution of disapproval for the Waters of the United States (WOTUS) final rule - support. S.J.Res. 8, the Congressional Review Act (CRA) resolution of disapproval for the Department of Labor (DOL) final rule relating to environmental, social, and governance (ESG) factors for investment decisions - support. S. 1706, the Main Street Tax Certainty Act - support. S. 1838, the Credit Card Competition Act - support. Nomination of Acting Secretary Julie Sus for Secretary of DOL - oppose. S. 1339, the Pharmacy Benefit Manager Reform Act - support. S. 567, the Richard L. Trumka Protecting the Right to Organize (PRO) Act of 2023 - oppose. S. 728, the Paycheck Fairness Act - oppose. S. 1664, the Healthy Families Act - oppose. Marshall amendment to H.R. 4366, the Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2024 - support. S. 1869, Site-based Invoicing and Transparency Enhancement (SITE) Act - support. S. 3167, the Multiple Employer Welfare Arrangement Act (MEWA Act) - support. the Employer Reporting Improvement Act and the Paperwork Burden Reduction Act - support. S. 2033, the American Innovation and Choice Online Act - support. S. 3227, Paperwork Burden Reduction Act - support. S. 3673, Commonsense Reporting Act - support. S. 1411, Prove It Act of 2023 - support. S. 1108, Death Tax Repeal Act - support. H.J.Res. 98, Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the National Labor Relations Board relating to "Standard for Determining Joint Employer Status. - support. Extending the $7.5 million debt cap under Subchapter V of the Chapter 11 Bankruptcy code - support. H.R. 1147, Whole Milk for Healthy Kids Act - support. S. 3204, the Employer Reporting Improvement Act - support. S. 3202, the Paperwork Burden Reduction Act - support. S.J. Res. 61, the Congressional Review Act (CRA) Joint Resolution of Disapproval to nullify the Federal Highway Administrations (FHWA) final rule imposing greenhouse gas (GHG) emissions performance measures on state departments of transportation and metropolitan planning organizations - support. S.J. Res. 58, the Congressional Review Act (CRA) resolution to repeal the Department of Energy (DOE) final rule on gas furnace efficiency standards - support. S. 4297, Repealing Big Brother Overreach Act - support. S.J. Res. 76, the Congressional Review Act (CRA) resolution to repeal the Departments of Labor, the Treasury, and Health and Human Services Short-Term, Limited Duration Insurance and Independent, Noncoordinated Excepted Benefits Coverage rule - support. S.J.Res.63, A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Department of Labor relating to "Employee or Independent Contractor Classification Under the Fair Labor Standards Act" - support. S.4260, Warehouse Worker Protection Act - oppose. Nomination (PN1789) of Lauren McGarity McFerran, of the District of Columbia, to be a Member of the National Labor Relations Board for the term of five years expiring December 16, 2029 - oppose. Testimony NFIB Statement for the Record, House Committee on Small Business, hearing titled, Under the Microscope: Examining FinCENs Implementation of the Corporate Transparency Act. April 30, 2024 Other Healthcare reform Joint trade letter - request for abandonment or at least postponement of DOLs anticipated overtime regulations under the FLSA Joint trade letter - support of the pending proposal to amend the Federal Rules of Civil Procedure to require disclosure of third-party litigation funding (TPLF) investment arrangements in any civil action filed in federal court Restoration of R&D expensing (Section 174) - support. Regulatory Flexibility Act reform - support. Joint trade letter - Congressional Review Act resolution to repeal the U.S. Department of Labor final rule, Updating the Davis-Bacon and Related Acts Regulations - support. Joint trade letter - H.R. 4035, Small Business Information Act - support. Joint trade letter - Thirty-Two Hour Workweek Act - oppose. Nomination of Acting Secretary Julie Su for Secretary of Labor (DOL) - oppose. Paid leave - oppose. American Privacy Rights Act. ENABLERS Act - oppose.

Client expense: $1,261,000 · Firm income: Not reported

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

HR 3991 / S 1624, the Gabriella Miller Kids First Act; HR 3503 / S 1701, The NIH Clinical Trial Diversity Act; HR 6301 / S. 2039, The Cancer Drug Parity Act; HR 824, the Telehealth Benefit Expansion for Workers Act; HR 2868, the Association Health Plans; HR 2813, Self-Insurance Protection Act; HR 3799, CHOICE Arrangement Act; HR 4363 / S 2213, Comprehensive Cancer Survivorship Act; HR 2630 / S 652, the Safe Step Act; HR 7383 / S 1214, the RARE Act; S 2243, the Palliative Care and Hospice Education and Training Act; S 3167, Multiple Employer Welfare Arrangement (MEWA) Act; HR 1692 / S 8, the Health Care Affordability Act; HR 3800, the Chronic Disease Flexible Coverage Act; HR 5688 the Bipartisan HSA Improvement Act; HR 5687, the HSA Modernization Act; HR 5609, the Advancing Health Savings Act; HR 1773, the Consumer Protection for Medical Debt Collections Act; S 2483, the Strengthening Consumer Protections and Medical Debt Transparency Act; HR 6003 / S 3103, the Medical Debt Relief Act; HR 7384, the Creating Hope Reauthorization Act; HR 6664, the Innovation in Pediatric Drugs Act; HR 6963, the Pediatric Cancer Drug Supply Chain Act; HR 3433 / S 2897, the Give Kids a Chance Act; S 127, the Pharmacy Benefit Manager Transparency Act; S 113, the Prescription Pricing for the People Act; HR 2880, the Protecting Patients Against PBM Abuses Act; S 1967 the Patients Before Middlemen Act; S 2973, the Modernizing and Ensuring PBM Accountability Act; S 1339, the Pharmacy Benefit Manager Reform Act; S 1542, the DRUG Act; Implementation of the FY23 omnibus, specifically provisions related to increasing access to clinical trials; Implementation of the No Surprises Act; Federal rulemaking related to Short-term Limited Duration Insurance (STLDI) plans; Insurance appeals and denials; Federal rulemaking related to Association Health Plans; Consumer protections related to consumers who will lose insurance due to the end of certain federal Medicaid maintenance-of-effort requirements; Legislation to increase federal investment in Consumer Assistance Programs; FDA draft guidance related to dose optimization studies in clinical trials

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

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

H.R.4366 - Consolidated Appropriations Act, 2024 H.R. 2882, the Further Consolidated Appropriations Act, 2024 H.R. 7463, the Extension of Continuing Appropriations and Other Matters Act, 2024 H.R. 6363 Further Continuing Appropriations and Other Extensions Act of 2024 H.R. 5378 the Lower Costs, More Transparency Act S.3548 - Health Care Prices Revealed and Information to Consumers Explained Transparency Act S.3430 - An original bill to amend titles XVIII and XIX of the Social Security Act to expand the mental health care workforce and services, reduce prescription drug costs, and extend certain expiring provisions under Medicare and Medicaid, and for other purposes. S.1378 - Connecting Our Medical Providers with Links to Expand Tailored and Effective Care HR 3305 & S. 1606 Black Maternal Health Momnibus Act HR 4822 Health Care Price Transparency Act HR 3284 Providers and Payers COMPETE Act HR 2840 Bipartisan Primary Care and Health Workforce Act HR 4818 Treat and Reduce Obesity Act of 2023 S. 2333 Pandemic and All Hazards Preparedness and Response Act H.R. 4421 Preparing for All Hazards and Pathogens Reauthorization Act H.R. 3561, PATIENT Act of 2023 H.R. 3281, the Transparent PRICE Act H.R. 3262, To amend title XI of the Social Security Act to increase transparency of certain health-related ownership information H.R. 2868 Association Health Plans Act H.R. 2813 Self-Insurance Protection Act H.R. 3799 CHOICE Arrangement Act H.R. 3432, Telemental Health Care Access Act H.R.824, Telehealth Benefit Expansion for Workers Act of 2023 H.R. 4189, S. 2016, CONNECT for Health Act S. 923, Better Mental Health Care for Americans Act H.R. 3120, Healthy Competition for Better Care Act H.R. 1843 Telehealth Expansion Act of 2023 Legislation and regulation related to health care delivery and health insurance coverage, mental health and substance use disorder care and coverage, the transition out of the COVID-19 pandemic and electronic health information/technology. S.954 - 118th Congress (2023-2024)A bill to provide for appropriate cost-sharing for insulin products covered under private health plans, and to establish a program to support health care providers and pharmacies in providing discounted insulin products to uninsured individuals. a

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

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

H.R. 2851/S. 2464 - Access to Breast Cancer Diagnosis Act of 2023; bill to prohibit group health plans and health insurance issuers offering group or individual health insurance coverage from imposing cost-sharing requirements with respect to diagnostic and supplemental breast examinations H.R. 6301/S. 2039 - Cancer Drug Parity Act; a bill to amend the Employee Retirement Income Security Act of 1974 to require a group health plan (or health insurance coverage offered in connection with such a plan) to provide for cost-sharing for oral anticancer drugs on terms no less favorable than the cost-sharing provided for anticancer medications administered by a health care provider. H.R. 830/S. 1375 -Help Ensure Lower Patient (HELP) Copays Act; bill requires health insurance plans to apply certain payments made by, or on behalf of, a plan enrollee toward a plan's cost-sharing requirements. Specifically, plans must apply third-party payments, financial assistance, discounts, product vouchers, and other reductions in out-of-pocket expenses toward the requirements. H.R. 2630/S. 652 -Safe Step Act; bill to require a group health plan or health insurance coverage offered in connection with such a plan to provide an exceptions process for any medication step therapy protocol, and for other purposes H.R. 3086 - Find It Early Act; a bill to provide for health coverage with no cost-sharing for additional breast screenings for certain individuals at greater risk for breast cancer. H.R. 4189/S. 2016 - Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023; a bill to amend title XVIII of the Social Security Act to expand access to telehealth services, and for other purposes. H.R. 824 - Telehealth Benefit Expansion for Workers Act of 2023; bill expanding exception for stand-alone telehealth benefits plans from certain requirements that generally apply to private health insurance plans under the Patient Protection and Affordable Care Act; under the bill employers may offer stand-alone telehealth benefits to all employees including those who are eligible for enrollment in their employers group health plan H.R. 2868 - Association Health Plans Act; a bill to amend the Employee Retirement Income Security Act of 1974 to clarify the treatment of certain association health plans as employers, and for other purposes Comments regarding US District Court Decision on 2021 Notice on Benefit and Payment Parameters Implementation of the No Surprises Act including comments on proposed rule re: Federal Independent Dispute Resolution Operations Comments related to the 2025 Notice on Benefit and Payment Parameters (CMS-9895-P) Comments in response to House Education & Workforce RFI on Employee Retirement Income Security Act (ERISA) Administration actions necessary to reduce out-of-pocket costs for medically necessary diagnostic and supplemental breast imaging Administrative actions necessary to reduce out-of-pocket costs for medically-necessary diagnostic breast imaging Implementation of the Affordable Care Act and coverage of preventive services with no cost-sharing Issues related to regulation of short-term limited duration plans Issues related to prescription drug affordability for patients Policies regarding White House Cancer Moonshot implementation Policies related to copay accumulator and adjustor programs

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Personnel Management (OPM), Office of Science & Technology Policy (OSTP), SENATE, Treasury, Dept of, White House Office

National Flood Insurance Program (NFIP) Conversations with the House Financial Services Committee on reauthorizing and reforming the National Flood Insurance Program H.R.634 - Fixing Announcements for Intermittent Remapping and Notification Expectations to Stop Surprises in Flood Insurance Act of 2023 H.R.900 - To amend the National Flood Insurance Act of 1968 to allow for the consideration of private flood insurance for the purposes of applying continuous coverage requirements, and for other purposes H.R.1309 - To require the use of replacement cost value in determining the premium rates for flood insurance coverage under the National Flood Insurance Act, and for other purposes. H.R.1392 - National Flood Insurance Program Extension Act of 2023 H.R.1540 - National Flood Insurance Program Affordability Act H.R.5860 - Continuing Appropriations Act, 2024 and Other Extensions Act H.R.6304 - Increased Cost of Compliance Modernization Act of 2003 H.R.6363 - Further Continuing Appropriations and Other Extensions Act, 2024 H.R. 4366 Consolidated Appropriations Act, 2024 S.485 - Hazard and Flooding Mitigation Funding Assurance Act S.601 - Flood Insurance Affordability Act S.721 - Homeowner Flood Insurance Transparency and Protection Act S.1039 - National Flood Insurance Program Consultant Accountability Act of 2023 S.2968 - National Flood Insurance Program Extension through 2023 Act Discussions with the House of Representatives, Senate and White House to extend the National Flood Insurance Program. Discussions with the Senate Banking Committee on flood insurance reform. Commercial Real Estate Flood Insurance H.R. 1307 - To repeal the mandatory flood insurance coverage requirement for commercial properties located in flood hazard areas, and for other purposes. Association Health Plans (AHPs) HR2868 - Association Health Plans Act Discussions with the House of Representatives, the Senate and Department of Labor about AHPs. Discussions with the Federal Emergency Management Agency (FEMA) in the Department of Homeland Security (DHS) regarding flood insurance and flood maps. Discussions with the Federal Housing Finance Agency (FHFA) on climate risk. Discussions with Fannie Mae on climate risk and insurance disclosures. Communications with the Department of Labor opposing their proposal to rescind the 2018 Association Health Plans (AHP) rule.

Client expense: $14,740,000 · Firm income: Not reported

Government targets: Federal Emergency Management Agency (FEMA), Federal Housing Finance Agency (FHFA), HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Labor, Dept of (DOL), SENATE, White House Office

Access to Breast Cancer Diagnosis (ABCD) Act (H.R.3851/S. 2464) Cancer Drug Parity Act (S. 2039) Telehealth Benefit Expansion for Workers Act (H.R. 824) Association Health Plans Act (H.R. 2868) Safe Step Act (H.R.2630/S. 652) Implementation of the Affordable Care Act Policies related to insurance coverage and COVID-19 HELP Copays Act (H.R.830/S.1375) Cancer survivorship issues Issues related to prescription drug affordability for patients Administrative actions necessary to reduce out-of-pocket costs for medical-necessary diagnostic breast imaging Congressional action to reduce out-of-pocket costs for medically necessary diagnostic breast imaging Issues related to regulation of short-term limited duration plans Implementation of the No Surprises Act, including comments on proposed rule re: Federal Independent Dispute Resolution Operations Find It Early Act (H.R.3086); a bill to provide for health coverage with no cost-sharing for additional breast screenings for certain individuals Policies related to coverage of preventive services with no cost-sharing Polices regarding White House Cancer Moonshot implementation Policies related to copay accumulator adjustors Comments related to the Mental Health Parity and Addiction Equity Act Letter to Committee on Education and the Workforce Request for Information on Employer-Sponsored Insurance and Employee Retirement Income Security Act (ERISA)

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Personnel Management (OPM), Office of Science & Technology Policy (OSTP), SENATE, Treasury, Dept of, White House Office

Issues related to lung disease treatment, prevention and research; Issues related to public health; Issues related asthma, COPD, influenza, lung cancer, pneumonia, pulmonary fibrosis, 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 Medicaid; Issues related to ERISA; Issues related to COVID-19 Response; Issues related to vaccines; Issues related to infrastructure; Issues related to supplemental oxygen; Issues related to the implementation of the No Surprises Act; Issues related to Medicare sequestration; Issues related to Cancer Moonshot; Issues related to short-term limited duration plans; Issues related to Healthy Future Taskforce; Issues related to regulatory reform; Issues relating to the Presidents FY25 budget; Issues relating to FY25 appropriations; HR 277 REINS Act; S 184 REINS Act; HR 1075 Medicaid Work Requirements Act; S. 1063 A bill to amend title XIX of the Social Security Act to implement a minimum work requirement for able-bodied adults enrolled in State Medicaid programs; HR 1551 Jobs and Opportunities for Medicaid Act; H.R. 2583 Increasing Access to Quality Cardiac Rehabilitation Care Act of 2023; H.R. 1114 Long COVID RECOVERY NOW Act; H.R. 1692 Health Care Affordability Act of 2023; HR 3073 Community Mental Wellness and Resilience Act; S 1452 Community Mental Wellness and Resilience Act; HR 2811 Limit Save Grow Act; HR 442 Regulatory Accountability Act; S 1615 Regulatory Accountability Act;; HR 288 Separation of Powers Restoration Act of 2023; Issues related to Labor, Health and Human Services, Education and Related Agencies Appropriations Act, 2024; S 1411, Prove It Act of 2023; S 1995 Public Health Infrastructure Saves Lives Act; HR 824 Telehealth Benefit Expansion for Workers Act of 2023; HR 4286 Increasing Access to Lung Cancer Screening Act; HR 2813 The Self-Insurance Protec􀆟on Act; HR 3799 CHOICE Arrangement Act; HR 2868 Association Health Plans Act; S 2213 Comprehensive Cancer Survivorship Act; HR 4363 Comprehensive Cancer Survivorship Act; S. 2016 CONNECT for Health Act of 2023; HR 4189 CONNECT for Health Act of 2023; S 2624 Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2024;; HR 5749 Family Asthma Act; HR 4286 Increasing Access to Lung Cancer Screening Act; HR 890 The Guidance Out of Darkness Act; S 791 The Guidance Out of Darkness Act; S 2245 Women and Lung Cancer Research and Preventive Services Act; HR 4534 Women and Lung Cancer Research and Preventive Services Act; S 2333 Pandemic and All Hazards Preparedness and Response Act; HR 4420 Pandemic and All-Hazards Preparedness and Response Act; S 1489 National Task Force on the COVID-19 Pandemic Act; HR 5894 Making appropriations for the Departments of Labor, Health and Human Services, and Education, and related agencies for the fiscal year ending September 30, 2024, and for other purposes; HR 6302 Health Share Transparency Act; HR 357 Ensuring Accountability in Agency Rulemaking; ; HR 7463 Extension of Continuing Appropriations and Other Matters Act, 2024; HR 2872 Further Additional Continuing Appropriations and Other Extensions Act, 2024; HR4366 Consolidated Appropriations Act, 2024; HR 2882 Further Consolidated Appropriations Act, 2024; S3821 Supplemental Oxygen Access Reform (SOAR) Act; HR7829 Supplemental Oxygen Access Reform (SOAR) Act; HR 485 Protecting Health Care for All Patients Act of 2023

Client expense: $220,000 · Firm income: Not reported

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

Access to AEDs Act (H.R. 2370/S. 1024) Cardiac Arrest Survival Act (H.R. 1012) Easy Enrollment in Healthcare Act (H.R. 1113/S. 423) Palliative Care and Hospice Education and Training Act (S.2243) Self-Insurance Protection Act (H.R. 2813) Telehealth Benefit Expansion for Workers Act (H.R. 824) Association Health Plans Act (H.R. 2868) Improving Whole Health for Veterans with Chronic Conditions Act (S. 1954) FAMILY Act (S. 1714/H.R. 3481) Social Determinants of Health Act of 2023 (no bill number) Preventing Maternal Deaths Reauthorization Act of 2023 (H.R. 3838/S. 2415) PREEMIE Reauthorization Act of 2023 (H.R. 3226/S. 1573) Charles Rochester Blood Clot Prevention and Treatment Act (H.R. 5699) Cardiomyopathy Health Education, Awareness, Research, and Training in the Schools (HEARTS) Act (HR 6829) Alleviating Barriers to Caregiving (ABC) Act (S. 3109) Legislation to enhance research, data collection, and education about stroke (no bill number) Harold B. Kohl Physical Activity for Americans Act (still no bill number) Congenital Heart Futures Reauthorization Act of 2024 (H.R.7189) A resolution designating September 2023 as "National Cholesterol Education Month" and September 30, 2023, as LDL-C Awareness Day (S.R.496) A resolution designating September 2024 as "National Cholesterol Education Month" and September 30, 2024, as "LDL-C Awareness Day" (S.R.566) Implementation of the No Surprises Act Department of Labor action to rescind Association Health Plan Final Rule (RIN 1210-AC16) HHS finalization of proposed rule on Section 1557; Nondiscrimination in Health Programs and Activities (RIN Number 0945AA17) HHS finalization of proposed rule on Clarifying Eligibility for a Qualified Health Plan (CMS-9894-P) HHS finalization of proposed rule on Short-Term, Limited-Duration Insurance; Independent, Non- coordinated Excepted Benefits Coverage; Level-Funded Plan Arrangements; and Tax Treatment of Certain Accident and Health Insurance (CMS-9904-P)

Client expense: $200,000 · Firm income: Not reported

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

H.R. 485 - Protecting Health Care For All Patients Act of 2023 - Rep. McMorris Rodgers, Cathy - federal programs using prices based on quality-adjusted life years H.R. 824 - Telehealth Benefit Expansion for Workers Act of 2023 - Rep. Walberg, Tim - treating benefits for telehealth services offered under a group health plan or group health insurance coverage as excepted benefits H.R. 830 - HELP Copays Act - Rep. Carter, Earl - health insurers responsibility for payments made by or on behalf of a plan enrollee toward a plans cost-sharing requirements H.R. 1488 - Affordable Insulin Now Act of 2023 - Rep. Craig, Angie - cost-sharing for insulin products H.R. 2666 - MVP Act - Rep. Guthrie, Brett - value-based purchasing arrangements under Medicaid program and reforms to price reporting H.R. 2691 - Transparent Price Act - Rep. McMorris Rodgers, Cathy - health insurer price transparency H.R. 2813 - Self-Insurance Protection Act - Rep. Good, Bob - ERISA amendments H.R. 2868 - Association Health Plans Act - Rep. Walberg, Tim - ERISA amendments H.R. 2872 - Further Additional Continuing Appropriations and Other Extensions Act, 2024 - Rep. Graves, Garret - extends FY24 funding and program authorities through March 8, 2024 H.R. 2882- Further Consolidated Appropriations Act, 2024 - Rep. Ciscomani, Juan - provides annual funding through September 30, 2024, for the Departments of Labor, Health and Human Services, and Education, and Related Agencies H.R. 3305 - Black Maternal Health Momnibus Act - Rep. Underwood, Lauren - maternal health including in Medicaid and CHIP H.R. 3561 - PATIENT Act - Rep. McMorris Rodgers, Cathy - PBM transparency, PBM contract design, health insurance transparency, hospital transparency H.R. 3799 - Custom Health Option and Individual Care Expense Arrangement Act- Rep. Hern, Kevin - health reimbursement arrangements H.R. 3801 - Employer Reporting Improvement Act - Rep. Smith, Adrian - ACA reporting requirements H.R. 6956 - Opioid Settlement Accountability Act - Rep. Kaptur, Marcy - funding for opioid prevention and treatment services, training, equipment, and social support services H.R. 6960 - Emergency Medical Services for Children Reauthorization Act of 2024 - Rep. Carter, Earl L. - funding for emergency medical services for children program H.R. 7513 - Protecting Americas Seniors Access to Care Act - Rep. Fischbach, Michelle - regarding minimum staffing for nursing facilities S. 1606 - A bill to end preventable maternal mortality, severe maternal morbidity, and maternal health disparities in the United States, and for other purposes. - Sen. Booker, Cory - maternal mortality S. 3393 - SUPPORT for Patients and Communities Reauthorization Act - Sen. Sanders, Bernie - SUD treatment S. 3430 - Better Mental Health Care, Lower-Cost Drugs, and Extenders Act of 2023 - Sen. Wyden, Ron - mental health, telehealth, health workforce S. 3612- Access to Family Building Act- Sen. Duckworth, Tammy- right to access reproductive technology (ex. IVF) S. 3756- At HOME Services Act of 2024- Sen. Rubio, Marco- pilot program for outpatient observation, acute care at home S. 3775- BOLD Infrastructure for Alzheimer's Reauthorization Act of 2024- Sen. Collins, Susan - healthcare infrastructure, Alzheimers S. 3805- A bill to amend title XI of the Social Security Act to prohibit health plans from imposing fees on health care providers for electronic funds transfers and health care payment and remittance advice transactions, and for other purposes. - Sen. Cassidy, Bill - SSA, healthcare, electronic funds, payments, remittance S. 3847- Improving Social Determinants of Health Act of 2024- Sen. Smith, Tina- CDC authorization Issues related to broadband and public health infrastructure; mental health and telehealth; COVID-19 testing; public option programs; behavioral health; rural health; substance use disorder treatments; Health Savings Accounts; provider directories; and artificial intelligence and privacy. Regulatory Issues: HIPAA administrative simplification issues, including standards for privacy, security, and electronic transactions and code sets (including ICD-10 and ICD-11), identifiers, enforcement; cybersecurity; issues related to Medicare Secondary Payer requirements; issues related to health care price transparency; issues related to all payor claims databases; issues related to implementation of the National Health Information Infrastructure; electronic health records, personal health records, and similar technologies; issues relating to market consolidation; issues related to hospital and provider consolidation; issues related to medical management; issues relating to quality improvement; issues relating to the national health data stewardship; issues relating to hospital outpatient measurement and reporting; issues relating to COVID-19, including testing, vaccines and therapeutics; issues related to the end of the public health emergency; issues related to health equity; issues related to vaccination; issues related to addressing the social determinants of health, including housing, transportation, nutrition, and educational opportunities; prescription drug pricing; telehealth; issues related to the cost of insulin, including price, copays, rebates, and medical management tools; rural health; issues related to behavioral health benefits; issues related to Managed Long Term Services and Supports (MLTSS); issues related to the collection of race and ethnicity data; issues related to medical loss ratios; reference pricing; review of rates for reasonableness; preexisting condition insurance plans; issues relating to antitrust; issues relating to surprise medical bills; accountable care organizations; provider non-discrimination; coverage of preventive services; contraceptive coverage and reproductive health; pre-existing condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; issues related to health insurance tax; health plan automatic enrollment requirements; issues related to qualified health plans including certification and rate filing templates; health insurance market rules; ACA risk adjustment; dependent coverage; summary of benefits and coverage disclosures; benefit and payment parameters; essential health benefits, actuarial value, and accreditation; NQF reauthorization; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations; issues related to supplemental products; issues related to HIPAA excepted benefits; issues related to short term limited duration products; issues related to the federally-facilitated marketplaces (i.e., Exchanges/formerly referred to as the web portal); issues related to business continuity in relation to pandemics or natural events (e.g., hurricane, tornado, etc.); issues related to association health plans; issues related to cost-sharing reductions (CSRs); issues related to the refundable credit for coverage under a qualified health plan and enhancements included in the American Rescue Plan Act (ARPA); issues related to Medicaid coverage gap; issues related to small employer group size; issues related to Certificate of Public Advantage; issues relating to veterans health care; issues relating to caregivers; and other issues relating to health care reform implementation.

Client expense: $4,210,000 · Firm income: Not reported

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

H.R. 1264, Commonsense Reporting Act of 2023 H.R. 2813, Self-Insurance Protection Act H.R. 2868, Association Health Plans Act H.R. 4307/S. 2115, Medical Supply Chain Resiliency Act H.R. 6860, Restore Protections for Dialysis Patients Act S. 127, Pharmacy Benefit Manager Transparency Act of 2023 S. 142, Preserve Access to Affordable Generics and Biosimilars Act S. 148, Stop Significant and Time-wasting Abuse Limiting Legitimate Innovation of New Generics (Stop STALLING) Act S. 150, Affordable Prescriptions for Patients Act of 2023 S. 1067, Ensuring Timely Access to Generics Act of 2023 S. 1114, Expanding Access to Low-Cost Generics Act of 2023 S. 1214, Retaining Access and Restoring Exclusivity (RARE) Act S. 1339, Pharmacy Benefit Manager Reform Act S. 2624, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2024 Proposed Rule by the Internal Revenue Service, the Employee Benefits Security Administration, and the Health and Human Services Department; Requirements Related to the Mental Health Parity and Addiction Equity Act (88 Fed. Reg. 51,552-51,669, August 3, 2023) Proposed Rule, Employee Benefits Security Administration, Department of Labor; Definition of Employer-Association Health Plans (88 Fed. Reg. 87,968-87,981, December 20, 2023) Various issues relating to the employer-sponsored health care system, implementation of regulatory process, provider network adequacy, health savings account (HSAs), health reimbursement account (HRAs), employer mandate; Medicare Drug Price Negotiation Program: Initial Memorandum, Implementation of Sections 1191 - 1198 of the Social Security Act for Initial Price Applicability Year 2026, and Solicitation of Comments; implementation of the American Rescue Plan Act (P.L. 117-2); implementation of the Inflation Reduction Act (P.L. 117-169); "Reasonable Price Clause" in reauthorization draft of the Pandemic and All Hazards Preparedness Act (PAHPA, P.L. 109-417); balance or surprise billing and related issues; single-payer health care options; health reimbursement arrangements and other account-based group health plans; Health and Human Services international pricing index (IPI) model; mental health parity; drug pricing; COBRA subsidies; Federal Trade Commissions multilateral pharmaceutical merger taskforce; telehealth, including coverage of telehealth under High Deductible Health Plans (HDHPs) and expanding telehealth options for employees; impact of Pharmacy Benefit Managers Practices; FTC-2022-0015; petition to HHS to grant march-in rights for the patents on the drug Xtandi; Over-the-counter preventive services; ERISA preemption protections including information on constructive changes/modifications to ERISA; artificial price caps on providing insulin; efforts to reform the World Health Organizations (WHO) engagement with private sector; continued U.S. membership to the World Health Organization (WHO); support for necessary market conditions to incentivize health sector investment from private sector; support for private sector involvement in health systems strengthening; promote greater harmonization of standards and investment in digital health; health-related policy issues in the G20/G7 forums and other multilateral forums; support for improving access to health products and technologies globally, including via regulatory alignment and addressing trade barriers; Advance Notice of Methodological Changes for Calendar Year (CY) 2025 for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies, U.S. Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services (2025 Advance Notice, January 31, 2024)

Client expense: $23,370,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, State, Dept of (DOS), U.S. Agency for International Development (USAID), U.S. Trade & Development Agency (USTDA), U.S. Trade Representative (USTR)

LD 2 Q1 2024 House H.R. 1843, the Telehealth Expansion Act - support. H.R. 824, the Telehealth Benefit Expansion for Workers Act of 2023 - support. H.R. 4721, the Main Street Tax Certainty Act - support. H.R. 3881, the Credit Card Competition Act - support. H.R. 3799, the CHOICE Arrangement Act - support. S.J.Res.11, CRA resolution of disapproval for the EPA final rule relating to increased emissions standards for new heavy duty trucks - support. H.R. 2868, the Association Health Plan Act - support. H.R. 2813, the Self-Insurance Protection Act - support. H.R. 4428, the Guidance Clarity Act - support. H.R. 890, the Guidance Out Of Darkness (GOOD) Act - support. H.R. 5378, the Lower Costs, More Transparency Act - support. Norcross amendment (submitted as #144) to the National Defense Authorization Act for 2024 - oppose. H.R. 3417, FAIR Act - support. H.R. 1163, the Protecting Taxpayers and Victims of Unemployment Fraud Act - support. H.R. 4035, the Protecting Small Business Information Act of 2023 - support. H.J.Res. 98, Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the National Labor Relations Board relating to "Standard for Determining Joint Employer Status. - support. S.J. Res. 32, providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Bureau of Consumer Financial Protection relating to Small Business Lending Under the Equal Credit Opportunity Act (Regulation B). - support. H.R. 6514, Holding Agencies Accountable Act - support. H.R. 906, the REPAIR Act - support. H.R. 3493, ADA Improvement Act of 2023 - support. H.R. 7198, Prove It Act - support. H.R. 7035, the Death Tax Repeal Act - support. Corporate Transparency Act Repeal legislation Senate S. 1108, the Death Tax Repeal Act - support. S. 122, the Ensuring Workers Get PAID Act - support. S. 954, the Affordable Insulin NOW Act of 2023 - oppose. S. 1001, the Telehealth Expansion Act - support. H.J.Res. 27, the Congressional Review Act (CRA) resolution of disapproval for the Waters of the United States (WOTUS) final rule - support. S.J.Res. 8, the Congressional Review Act (CRA) resolution of disapproval for the Department of Labor (DOL) final rule relating to environmental, social, and governance (ESG) factors for investment decisions - support. S. 1706, the Main Street Tax Certainty Act - support. S. 1838, the Credit Card Competition Act - support. Nomination of Acting Secretary Julie Sus for Secretary of DOL - oppose. S. 1339, the Pharmacy Benefit Manager Reform Act - support. S. 567, the Richard L. Trumka Protecting the Right to Organize (PRO) Act of 2023 - oppose. S. 3167, the Multiple Employer Welfare Arrangement Act (MEWA Act) - support. the Employer Reporting Improvement Act and the Paperwork Burden Reduction Act - support. S. 2033, the American Innovation and Choice Online Act - support. S. 3227, Paperwork Burden Reduction Act - support. S. 3673, Commonsense Reporting Act - support. S. 1411, Prove It Act of 2023 - support. S. 1108, Death Tax Repeal Act - support. H.J.Res. 98, Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the National Labor Relations Board relating to "Standard for Determining Joint Employer Status. - support. Extending the $7.5 million debt cap under Subchapter V of the Chapter 11 Bankruptcy code - support. H.R. 1147, Whole Milk for Healthy Kids Act - support. S. 3204, the Employer Reporting Improvement Act - support. S. 3202, the Paperwork Burden Reduction Act - support. S.J. Res. 61, the Congressional Review Act (CRA) Joint Resolution of Disapproval to nullify the Federal Highway Administrations (FHWA) final rule imposing greenhouse gas (GHG) emissions performance measures on state departments of transportation and metropolitan planning organizations - support. Corporate Transparency Act - repeal legislation. Testimony NFIB Statement for the Record, House Energy and Commerce Health Subcommittee, hearing titled, Health Care Spending In The United States: Unsustainable For Patients, Employers, And, Taxpayers, January 31, 2024. NFIB Statement for the Record, House Committee on Education and the Workforce, comments to the Committee on Education and the Workforce request for information on ways to build upon and strengthen ERISA (Employee Retirement Income Security Act of 1974) the foundation of employer-sponsored health care, March 15, 2024. NFIB Statement for the Record, House Committee on Financial Services, hearing titled, Oversight of the Financial Crimes Enforcement Network (FinCEN) and the Office of Terrorism and Financial Intelligence (TFI), February 14, 2024. Other Healthcare reform Joint trade letter - request for abandonment or at least postponement of DOLs anticipated overtime regulations under the FLSA Joint trade letter - support of the pending proposal to amend the Federal Rules of Civil Procedure to require disclosure of third-party litigation funding (TPLF) investment arrangements in any civil action filed in federal court Restoration of R&D expensing (Section 174) - support. Regulatory Flexibility Act reform - support. Beneficial ownership information reporting requirements - oppose. Joint trade letter - Congressional Review Act resolution to repeal the U.S. Department of Labor final rule, Updating the Davis-Bacon and Related Acts Regulations - support. ADA lawsuit abuse Joint trade letter - H.R. 4035, Small Business Information Act - support. Joint trade letter - Thirty-Two Hour Workweek Act - oppose. Nomination of Acting Secretary Julie Su for Secretary of Labor (DOL) - oppose. Paid leave - oppose.

Client expense: $1,296,000 · Firm income: Not reported

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

Advocated in favor of expanding Association Health Plans. The Association Health Plans Act (H.R. 2868), introduced in April by Reps. Tim Walberg (R-MI), Rick Allen (R-GA), Michael Burgess (R-TX), Dan Crenshaw (R-TX), Virginia Foxx (R-NC) and Bob Good (R-VA), would give employees of small employers and self-employed individuals with no employees much-needed access to comprehensive, affordable health coverage through AHPs.

Client expense: $270,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), SENATE

ACCA supported H.R. 2868, the Association Health Plans Act. This bill would allow associations like ACCA to provide health plans to members.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.127, Pharmacy Benefit Manager Transparency Act of 2023; S.954, Affordable Insulin Now Act; S.1339, Pharmacy Benefit Manager Reform Act; S.1664, Healthy Families Act; S.1869, SITE Act; HR.824, Telehealth Benefit Expansion for Works Act of 2023; HR.1264, Commonsense Reporting Act; HR.1843, Telehealth Expansion Act of 2023; HR.2813, Self Insurance Protection Act; HR.2868, Association Health Plan Act; HR.3797, Paperwork Burden Reduction Act; HR.3798, Small Business Flexibity Act; HR.3799, CHOICE Arrangement Act; HR.3801, Employer Reporting Improvement Act; Issues related to dialysis coverage; Issues related to health sector consolidation; Issues related to ERISA pre-emption

Client expense: $126,007 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 711, the Throw Away Junk Plans Act; HR 3991 / S 1624, the Gabriella Miller Kids First Act; HR 3503 / S 1701, The NIH Clinical Trial Diversity Act; S. 2039, The Cancer Drug Parity Act; HR 824, the Telehealth Benefit Expansion Act; HR 2868, the Association Health Plans; HR 2813, Self-Insurance Protection Act; HR 3799, CHOICE Arrangement Act; HR 4363 / S 2213, Comprehensive Cancer Survivorship Act; S 652, the Safe Step Act; S 1214, the RARE Act; S 2243, the Palliative Care and Hospice Education and Training Act; draft legislation regarding Health Care Sharing Ministry transparency; Implementation of the FY23 omnibus, specifically provisions related to increasing access to clinical trials; Implementation of the No Surprises Act; Federal rulemaking related to Short-term Limited Duration Insurance (STLDI) plans; Insurance appeals and denials; Federal rulemaking related to Association Health Plans; Consumer protections related to consumers who will lose insurance due to the end of certain federal Medicaid maintenance-of-effort requirements; Legislation to increase federal investment in Consumer Assistance Programs; FDA draft guidance related to dose optimization studies in clinical trials

Client expense: $440,000 · Firm income: Not reported

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

H.R. 485 - Protecting Health Care For All Patients Act of 2023 - Rep. McMorris Rodgers, Cathy - federal programs using prices based on quality-adjusted life years H.R. 824 - Telehealth Benefit Expansion for Workers Act of 2023 - Rep. Walberg, Tim - telehealth and ERISA amendments H.R. 830 - HELP Copays Act - Rep. Carter, Earl - health insurers responsibility for payments made by or on behalf of a plan enrollee toward a plans cost-sharing requirements H.R. 1488 - Affordable Insulin Now Act of 2023 - Rep. Craig, Angie - cost-sharing for insulin products H.R. 1613 - Drug Price Transparency in Medicaid Act of 2023 - Rep. Carter, Earl -spread-pricing by PBMs for Medicaid H.R. 2666 - MVP Act - Rep. Guthrie, Brett - value-based purchasing arrangements under Medicaid program and reforms to price reporting H.R. 2691 - Transparent Price Act - Rep. McMorris Rodgers, Cathy - health insurer price transparency H.R. 2813 - Self-Insurance Protection Act - Rep. Good, Bob - ERISA amendments H.R. 2868 - Association Health Plans Act - Rep. Walberg, Tim - ERISA amendments H.R. 3305 - Black Maternal Health Momnibus Act - Rep. Underwood, Lauren - maternal health including in Medicaid and CHIP H.R. 3561 - PATIENT Act - Rep. McMorris Rodgers, Cathy - PBM transparency, PBM contract design, health insurance transparency, hospital transparency H.R. 3799 - Custom Health Option and Individual Care Expense Arrangement Act- Rep. Hern, Kevin - health reimbursement arrangements H.R. 3801 - Employer Reporting Improvement Act - Rep. Smith, Adrian - ACA reporting requirements S. 113 - Prescription Pricing for the People Act of 2023 - Sen. Grassley, Chuck - preventing anti-competitive tactics for prescription drugs S. 127 - Pharmacy Benefit Manager Transparency Act of 2023 - Sen. Cantwell, Maria - pharmacy benefit manager transparency S. 652 - Safe Step Act - Sen. Murkowski, Lisa - medication step therapy protocol S. 954 - Affordable Insulin Now Act of 2023 - Sen. Warnock, Raphael - cost-sharing for insulin products S. 1038 - Drug Price Transparency in Medicaid Act of 2023 - Sen. Welch, Peter - prohibits spread-pricing by PBMs in Medicaid S. 1606 - A bill to end preventable maternal mortality, severe maternal morbidity, and maternal health disparities in the United States, and for other purposes. - Sen. Booker, Cory - maternal mortality S. 3393 - SUPPORT for Patients and Communities Reauthorization Act. - Sen. Sanders, Bernie - SUD treatment S. 3430 - Better Mental Health Care, Lower-Cost Drugs, and Extenders Act of 2023 - Sen. Wyden, Ron - mental health, telehealth, health workforce Issues related to broadband and public health infrastructure; mental health and telehealth; COVID-19 testing; public option programs; behavioral health; rural health; substance use disorder treatments; Health Savings Accounts; provider directories; and artificial intelligence and privacy. Regulatory Issues: HIPAA administrative simplification issues, including standards for privacy, security, and electronic transactions and code sets (including ICD-10 and ICD-11), identifiers, enforcement; cybersecurity; issues related to Medicare Secondary Payer requirements; issues related to health care price transparency; issues related to all payor claims databases; issues related to implementation of the National Health Information Infrastructure; electronic health records, personal health records, and similar technologies; issues relating to market consolidation; issues related to hospital and provider consolidation; issues related to medical management; issues relating to quality improvement; issues relating to the national health data stewardship; issues relating to hospital outpatient measurement and reporting; issues relating to COVID-19, including testing, vaccines and therapeutics; issues related to the end of the public health emergency; issues related to health equity; issues related to vaccination; issues related to addressing the social determinants of health, including housing, transportation, nutrition, and educational opportunities; prescription drug pricing; telehealth; issues related to the cost of insulin, including price, copays, rebates, and medical management tools; rural health; issues related to behavioral health benefits; issues related to Managed Long Term Services and Supports (MLTSS); issues related to the collection of race and ethnicity data; issues related to medical loss ratios; reference pricing; review of rates for reasonableness; preexisting condition insurance plans; issues relating to antitrust; issues relating to surprise medical bills; accountable care organizations; provider non-discrimination; coverage of preventive services; contraceptive coverage and reproductive health; pre-existing condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; issues related to health insurance tax; health plan automatic enrollment requirements; issues related to qualified health plans including certification and rate filing templates; health insurance market rules; ACA risk adjustment; dependent coverage; summary of benefits and coverage disclosures; benefit and payment parameters; essential health benefits, actuarial value, and accreditation; NQF reauthorization; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations; issues related to supplemental products; issues related to HIPAA excepted benefits; issues related to short term limited duration products; issues related to the federally-facilitated marketplaces (i.e., Exchanges/formerly referred to as the web portal); issues related to business continuity in relation to pandemics or natural events (e.g., hurricane, tornado, etc.); issues related to association health plans; issues related to cost-sharing reductions (CSRs); issues related to the refundable credit for coverage under a qualified health plan and enhancements included in the American Rescue Plan Act (ARPA); issues related to Medicaid coverage gap; issues related to small employer group size; issues related to Certificate of Public Advantage; issues relating to veterans health care; issues relating to caregivers; and other issues relating to health care reform implementation.

Client expense: $2,400,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE, Treasury, Dept of, White House Office

National Flood Insurance Program (NFIP) Conversations with the House Financial Services Committee on reauthorizing and reforming the National Flood Insurance Program H.R.634 - Fixing Announcements for Intermittent Remapping and Notification Expectations to Stop Surprises in Flood Insurance Act of 2023 H.R.900 - To amend the National Flood Insurance Act of 1968 to allow for the consideration of private flood insurance for the purposes of applying continuous coverage requirements, and for other purposes H.R.1309 - To require the use of replacement cost value in determining the premium rates for flood insurance coverage under the National Flood Insurance Act, and for other purposes. H.R.1392 - National Flood Insurance Program Extension Act of 2023 H.R.1540 - National Flood Insurance Program Affordability Act H.R.5860 - Continuing Appropriations Act, 2024 and Other Extensions Act H.R.6304 - Increased Cost of Compliance Modernization Act of 2003 H.R.6363 - Further Continuing Appropriations and Other Extensions Act, 2024 S.485 - Hazard and Flooding Mitigation Funding Assurance Act S.601 - Flood Insurance Affordability Act S.721 - Homeowner Flood Insurance Transparency and Protection Act S.1039 - National Flood Insurance Program Consultant Accountability Act of 2023 S.2968 - National Flood Insurance Program Extension through 2023 Act Discussions with the House of Representatives, Senate and White House to extend the National Flood Insurance Program. Commercial Real Estate Flood Insurance H.R. 1307 - To repeal the mandatory flood insurance coverage requirement for commercial properties located in flood hazard areas, and for other purposes. Association Health Plans (AHPs) HR2868 - Association Health Plans Act Discussions with the House of Representatives, the Senate and Department of Labor about AHPs. Discussions with the Federal Emergency Management Agency (FEMA) in the Department of Homeland Security (DHS) regarding flood insurance and flood maps. Discussions with the Federal Housing Finance Agency (FHFA) on climate risk. Discussions with Fannie Mae on climate risk and insurance disclosures.

Client expense: $18,360,000 · Firm income: Not reported

Government targets: Federal Emergency Management Agency (FEMA), Federal Housing Finance Agency (FHFA), HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Labor, Dept of (DOL), SENATE, White House Office