Small Business Flexibility Act

H.R. 1421 - Child Care for Working Families Act. H.R. 1843 - The Telehealth Expansion Act of 2023. H.R. 3798 - The Small Business Flexibility Act. H.R. 3799 - The Custom Health Option and Individual Care Expense Arrangement Act. Issues related to employer provided benefits such as HSAs, FSAs, HRAs, ICHRAs, DCFSAs and commuter benefits.

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

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; 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

Tax Relief and Reform Tax Relief for American Families and Workers Act of 2024 - SBE Council continues to support U.S. Senate passage. R&D Tax Credit-Immediate Expensing: Continue to support restoring and making permanent full expensing for R&D expenditures for small businesses. Support "American Innovation and Jobs Act" (S. 866) in the Senate and "American Innovation and R&D Competitiveness Act" (H.R. 2673) in the House. Main Street Tax Certainty Act of 2023 (S. 1706, H.R. 4721) - Support House and Senate versions of the legislation to make permanent the 20-percent deduction for small-and individually-owned businesses (Section 199A). Death Tax Repeal Act of 2023 (S. 1108): Support House and Senate bills to permanent repeal the death tax and continue to support action by Congress. Regulation Basel III Endgame Implementation - SBE Council has expressed concern and opposition to the proposal by the U.S. Federal Reserve and Federal Deposit and Insurance Corporation in regard to the impact on small business capital access and affordability. Regulation II as Proposed by the Federal Reserve: Opposed the notice of proposed rulemaking to amend Regulation II, which sets standards for debit card fee regulation. Urged the Federal Reserve to withdraw the proposal. Expressed opposition to further lower the cap on debit card interchange fees from 21 cents to 14.4 cents per transaction, which would harm small financial institutions and small business consumers. Congressional Review Act (CRA) Resolution to Overturn the Department of Labors Independent Contractor Rule: SBE Council supported H.J. Res 116 and S.J. Res 63 to nullify the rule. Continue to express concern about the effects of the final rule on entrepreneurship and the economy, and support general efforts in the House and Senate to promote and strengthen independent work and self-employment. DOL's Proposed Overtime Rule: Expressed concern about the final rule, support of the CRA to overturn the rule, and communicated to the Department of Labor Wage and Hour Division about the need to delay implementation due to sudden and painful impact on small businesses and legal challenges to the rule. OSHA Walkaround Rule - Oppose the final rule, and efforts in the Congress to implement the rule. Save Local Businesses Act (S.1261, HR 2826) - Support the legislation. Protecting the Right to Organize (PRO) Act (S. 567) - Continue to oppose the legislation. The Protect Small Business and Prevent Illicit Financial Activity Act - SBE Council supports S. 3625 to delay implementation of the Corporate Transparency Act, and continue to communicate concerns about widespread non-compliance due to lack of knowledge in the small business community. Federal Acquisition Regulation: Use of Project Labor Agreements for Federal Construction Projects - SBE Council opposed the final rule. SBE Council continues to educate lawmakers about the effects of PLA's on small business competition, to taxpayers and the efficacy of completing federal construction and infrastructure projects. Federal Trade Commission (FTC) Hart-Scott-Rodino (HSR) Pre-Merger Reporting Requirement Proposed Rule - SBE Council continue to oppose the rule and to point out that the FTC mistakenly certified that small businesses will not be affected by the significant changes being proposed, therefore the rule needs to be pulled. National Labor Relation Board (NLRB) Funding - SBE Council supports efforts by House and Senate appropriators to hold the line on increased funding for the NLRB. Voiced support for language that would disallow funds to be used for implementation of the final "joint employer" rule. Consumer Financial Protection Bureaus (CFPBs) Rule Capping Credit-Card Late Fees - SBE Council continues to voice concern about the rules unintended consequences for small businesses. Prove-It Act (H.R. 7198) - SBE Council continues to support House passage of the legislation, which gives small businesses a more effectual voice in federal rulemakings and strengthens federal government accountability when proposed regulations impact small businesses. Federal Communications Commission (FCC) Safeguarding and Securing the Open Internet Rule - SBE Council continues to express concerns about intrusive government control of the internet as proposed by the rule and Section 214 regulations under the proposal. The Credit Card Competition Act - SBE Council continues to oppose the legislation. Railway Safety Act (S. 576) - SBE Council continues to express concern about the legislation as well as proposals to further regulate the railroad industry, which is dominated by small businesses. The Small Business Regulatory Reduction Act - Continue to support full House passage. The Fishery Improvement to Streamline Untimely Regulatory Hurdles post Emergency Situation Act (FISHES Act) - Support the legislation in the House and Senate. Privacy Policy - Continue to express the need for a national regulatory framework, but for Congress to consider a framework that avoids adding to the growing patchwork burden of state privacy laws, and to carefully consider unintended consequences on small businesses. SBE Council expressed opposition to H.R. 8818, the American Rights Privacy Act. Access to Capital Expanding Access to Capital Act (H.R. 2799) - SBE Council supported House passage and action by the U.S. Senate. Affordable Health Coverage and Health Care Innovation Voiced ongoing concerns about the rising costs of health coverage, lack of choices, and dwindling choices in many markets against the backdrop of challenging economic conditions. Voiced support for these various reforms: enhancing tax credits for small businesses, expanding and making additional fixes to HSAs, reforming QSEHRAs, and making CARESs Act telehealth provisions permanent. CHOICE Arrangement Act (H.R. 2799) - Supported House passage and continue to support Senate action on the legislation. Tax Credit for Small Businesses: Support making reforms to the restrictive and temporary health care tax credit for small businesses to make it more practical for small businesses. HSA Modernization Act (H.R. 5687) and Bipartisan HSA Improvement Act (H.R. 5688) - Continue to support full House passage. Telehealth Expansion Act of 2023 (H.R. 1843) (S. 1001)- Continue to support full House and Senate passage. Telehealth Coverage: Urged the Drug Enforcement Administration to expedite the release of a revised proposed rule to permit and regulate the prescribing of controlled substances through telehealth, which is crucial for access to mental health, substance use disorder, and other telehealth care. Chronic Disease Flexible Coverage Act (H.R. 3800) - Support full House passage. Paperwork Burden Reduction Act (H.R. 3797) - Supported full House passage. Employer Reporting Improvement Act (H.R. 3801) - Support full House passage. Small Business Flexibility Act (H.R. 3798) - Support full House passage. Custom Health Option and Individual Care Expense Arrangement Act (H.R. 3799) - Support full House passage. SMART Prices Act (S. 1264) - Continue to oppose the legislation. Property Rights and IP Commented on U.S. Patent and Trademark Office (USPTO) Notice of Proposed Rulemaking concerning proposed modifications to the rules of practice for inter partes review (IPR) and post-grant review (PGR) proceedings before the Patent Trial and Appeal Board (PTAB). Urged USPTO to consider the input of small inventors and innovative entrepreneurial firms. Trade and Global Market Access Digital Trade Principles - Continue to express concern about the U.S. pulling away from the principles and the need for President Biden to revisit the United State Trade Representatives action to withdraw from for foundational positions on digital trade policy within the World Trade Organization (WTO). Supporting Business Competitiveness and Startup Activity Comprehensive Resources for Entrepreneurs in the Arts to Transform the Economy (CREATE) Act - SBE Council supports the legislation. Access to Broadband and Next Gen Technology BEAD Program Implementation - SBE Council continues to voice concern about the National Telecommunications and Information Administrations rate regulation provisions for broadband internet service that was specifically prohibited by Congress as part of the Infrastructure Investment and Jobs Act. Rural Internet Improvement Act of 2023 (S.130) (H.R. 3216) - Continue to support the legislation. Development of a National Spectrum Strategy (NSS) - Continue to express support for such a policy and the need for more spectrum to deploy next Gen technologies and 5G.

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

H.R. 1421 - Child Care for Working Families Act. H.R. 1843 - The Telehealth Expansion Act of 2023. H.R. 3798 - The Small Business Flexibility Act. H.R. 3799 - The Custom Health Option and Individual Care Expense Arrangement Act. Issues related to employer provided benefits such as HSAs, FSAs, HRAs, ICHRAs, DCFSAs and commuter benefits.

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

Tax Relief and Reform Tax Relief for American Families and Workers Act of 2024 - SBE Council supported U.S. House passage of the legislation and advocated for passage by the U.S. Senate. R&D Tax Credit: Continue to support extending and making permanent full expensing for R&D expenditures for small businesses. Voiced Support for "American Innovation and Jobs Act" (S. 866) in the Senate and "American Innovation and R&D Competitiveness Act" (H.R. 2673) in the House. Main Street Tax Certainty Act of 2023 (S. 1706, H.R. 4721) - Support House and Senate versions of the legislation to make permanent the 20-percent deduction for small-and individually-owned businesses (Section 199A). Death Tax Repeal Act of 2023 (S. 1108): Support House and Senate bills to permanent repeal the death tax and continue to support action by Congress. Capital Gains Tax Indexing - Voiced support for this reform measure and continue to support action by Congress. Regulation Resolution of Disapproval to Overturn NLRBs Joint Employer Rule (HJ. Res 98) - SBE Council supported U.S. House passage and for the U.S. Senate to quickly follow suit. Basel III Endgame Implementation - SBE Council expressed concern and opposition to the proposal to the U.S. Federal Reserve and Federal Deposit and Insurance Corporation regarding the impact on small business capital access and affordability. Congressional Review Act (CRA) Resolution to Overturn the Department of Labors Independent Contractor Rule: SBE Council supported H.J. Res 116 and S.J. Res 63 to nullify the rule. DOL's Proposed Overtime Rule: Continue to express concern about the proposed rule. Save Local Businesses Act (S.1261, HR 2826) - Continue to support the legislation. Protecting the Right to Organize (PRO) Act (S. 567) - Continue to oppose the legislation. The Protect Small Business and Prevent Illicit Financial Activity Act - SBE Council supports S. 3625 to delay implementation of the Corporate Transparency Act. Federal Acquisition Regulation: Use of Project Labor Agreements for Federal Construction Projects - SBE Council opposed the final rule. Federal Trade Commission (FTC) Hart-Scott-Rodino (HSR) Pre-Merger Reporting Requirement Proposed Rule - SBE Council opposes the rule and pointed out that the FTC mistakenly certified that small businesses will not be affected by the significant changes being proposed, therefore the rule needs to be pulled. National Labor Relation Board (NLRB) Funding - SBE Council urged House and Senate appropriators to hold the line on increased funding for the NLRB. Consumer Financial Protection Bureaus (CFPBs) Rule Capping Credit-Card Late Fees - SBE Council voiced concern about the rules unintended consequences. That is, backfiring on small business consumers who use credit responsibly and make their payments on time. Prove-It Act (H.R. 7198) - SBE Council supported House Judiciary Committee action that advanced the legislation, which gives small businesses a more effectual voice in federal rulemakings and strengthens federal government accountability when proposed regulations impact small businesses. Federal Communications Commission (FCC) Safeguarding and Securing the Open Internet Rule - SBE Council continues to express concerns about intrusive government control of the internet as proposed by the rule and Section 214 regulations under the proposal. The Credit Card Competition Act - SBE Council continues to oppose the legislation. Railway Safety Act (S. 576) - SBE Council continues to express concern about the heavy-handedness of the legislation as well as proposals to further regulate the railroad industry, which is dominated by small businesses. Centers for Medicare and Medicaid Services (CMS) Proposal on Medicare Advantage Plans - SBE Council expressed concerns about the proposal that would significantly alter the marketing and broker compensation structures of the plans. The Small Business Regulatory Reduction Act - Continue to supported full House passage. Privacy Policy - Continue to express the need for a national regulatory framework, but for Congress to consider a framework that avoids adding to the growing patchwork burden of state privacy laws, and to carefully consider unintended consequences on small businesses. Access to Capital Expanding Access to Capital Act (H.R. 2799) - SBE Council supported House passage. The Budget Further Consolidated Appropriations Act for 2024 - SBE Council supported House passage. Republican FY 2025 Budget Resolution - SBE Council supported the budget resolution framework. President Bidens Budget Proposal - SBE Council voiced concern about the excessive spending in the proposal as well as the various tax increases that would fall on small businesses, investors and the business community. Affordable Health Coverage and Health Care Innovation Voiced ongoing concerns about the rising costs of health coverage, lack of choices, and dwindling choices in many markets against the backdrop of challenging economic conditions. Voiced support for these various reforms: enhancing tax credits for small businesses, expanding and making additional fixes to HSAs, reforming QSEHRAs, and making CARESs Act telehealth provisions permanent. CHOICE Arrangement Act (H.R. 2799) - Supported House passage and continue to support Senate action on the legislation. Tax Credit for Small Businesses: Support making reforms to the restrictive and temporary health care tax credit for small businesses to make it more practical for small businesses. HSA Modernization Act (H.R. 5687) and Bipartisan HSA Improvement Act (H.R. 5688) - Continue to support full House passage. Telehealth Expansion Act of 2023 (H.R. 1843) (S. 1001)- Continue to support full House and Senate passage. Chronic Disease Flexible Coverage Act (H.R. 3800) - Support full House passage. Paperwork Burden Reduction Act (H.R. 3797) - Support full House passage. Employer Reporting Improvement Act (H.R. 3801) - Support full House passage. Small Business Flexibility Act (H.R. 3798) - Support full House passage. Custom Health Option and Individual Care Expense Arrangement Act (H.R. 3799) - Support full House passage. SMART Prices Act (S. 1264) - Continue to oppose the legislation. Property Rights and IP Submitted Comments to the National Institutes of Standards and Technology (NIST) Regarding the Draft Interagency Guidance Framework for Considering the Exercise of March-in Rights-SBE Council urged NIST to withdraw the proposed guidance. Submitted Comments to United States Patent and Trademark Office (USPTO) on WIPO IGC Negotiations on Genetic Resources and Associated Traditional Knowledge - SBE Council expressed concern regarding the IGCs proposed mandatory patent disclosure requirements (PDRs) for the origin of genetic resources and traditional knowledge, which would irreparably harm the startup and small business ecosystems that drive innovation. Trade and Global Market Access Digital Trade - The Moratorium on Customs Duties on Electronic Transmissions permanent during the 13th WTO Ministerial Conference (MC13) - SBE Council urged World Trade Organization members to support an extension of the moratorium. Digital Trade Principles - Continue to express concern about the U.S. pulling away from the principles and the need for President Biden to revisit the United State Trade Representatives action to withdraw from for foundational positions on digital trade policy within the World Trade Organization (WTO). Supporting Business Competitiveness and Startup Activity Comprehensive Resources for Entrepreneurs in the Arts to Transform the Economy (CREATE) Act - SBE Council supported Senate introduction of the bill. Paid Leave Policy in U.S. House: Continue to express support for bipartisan exploration in identifying paid leave policy solutions that help support business owners and working families. Access to Broadband and Next Gen Technology BEAD Program Implementation - SBE Council expressed concern about the National Telecommunications and Information Administrations rate regulation provisions for broadband internet service that was specifically prohibited by Congress as part of the Infrastructure Investment and Jobs Act. Rural Internet Improvement Act of 2023 (S.130) (H.R. 3216) - Continue to support the legislation. Development of a National Spectrum Strategy (NSS) - Continue to express support for such a policy and the need for more spectrum to deploy next Gen technologies and 5G.

H.R. 1421 - Child Care for Working Families Act. H.R. 1843 - The Telehealth Expansion Act of 2023. H.R. 3798 - The Small Business Flexibility Act. H.R. 3799 - The Custom Health Option and Individual Care Expense Arrangement Act. Issues related to employer provide benefits such as HSAs, FSAs, HRAs, ICHRAs, DCFSAs and commuter benefits.

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

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

Taxes and Tax Reform R&D Tax Credit: Continue to support extending and making permanent full expensing for R&D expenditures for small businesses. Voiced Support for "American Innovation and Jobs Act" (S. 866) in the Senate and "American Innovation and R&D Competitiveness Act" (H.R. 2673) in the House. Main Street Tax Certainty Act of 2023 (S. 1706, H.R. 4721) - Support House and Senate versions of the legislation to make permanent the 20-percent deduction for small-and individually-owned businesses (Section 199A). "Small Business Jobs Act" (HR 3937) - Continue to support House passage of the legislation. "Build It in America Act" (HR 3938) - Continue to support House passage of the legislation. "Small Business Investment Act" (H.R. 2767) - Continue to support full House Action. "Death Tax Repeal Act of 2023" (S. 1108): Support House and Senate bills to permanent repeal the death tax and continue to support action by Congress. Capital Gains Tax Indexing - Voiced support for this reform measure and continue to support action by Congress. Affordable Health Coverage and Health Care Innovation "CHOICE Arrangement Act" (H.R. 2799) - Supported House passage and continue to support Senate action on the legislation. Tax Credit for Small Businesses: Support making reforms to the restrictive and temporary health care tax credit for small businesses to make it more practical for small businesses. Voiced ongoing concerns about the rising costs of health coverage, lack of choices, and dwindling choices in many markets against the backdrop of challenging economic conditions. Voiced support for these various reforms: enhancing tax credits for small businesses, expanding and making additional fixes to HSAs, reforming QSEHRAs, and making CARESs Act telehealth provisions permanent. "HSA Modernization Act" (H.R. 5687) and "Bipartisan HSA Improvement Act" (H.R. 5688) - Continue to support full House passage. "Telehealth Expansion Act of 2023" (H.R. 1843) (S. 1001) - Voiced support for Ways and Means Committee passage and continue to support full House and Senate passage. Chronic Disease Flexible Coverage Act (H.R. 3800) - Continue to support full House passage. Paperwork Burden Reduction Act (H.R. 3797) - Continue to support full House passage. Employer Reporting Improvement Act (H.R. 3801) - Continue to support full House passage. Small Business Flexibility Act (H.R. 3798) - Continue to support full House passage. Custom Health Option and Individual Care Expense Arrangement Act (H.R. 3799) - Continue to support full House passage. Preserving Telehealth: Joined coalition comments to the Centers for Medicare and Medicaid Services (CMS) take action on preserving the benefits of telehealth by ensuring telehealth practitioners working from a home-based (or other) location do not need to report that private residence to the federal government for purposes of either enrollment or billing. "Inflation Reduction Act": Continue to express concern about the impact of price controls on drug innovation, especially for small bio-pharmaceutical firms, urging congressional oversight. "SMART Prices Act" (S. 1264) - Continue to oppose the legislation. Access to Broadband and Digital Policy Rural Internet Improvement Act of 2023 (S.130) (H.R. 3216) - Continue to support the legislation. Development of a National Spectrum Strategy (NSS) - Continue to express support for such a policy and the need for more spectrum to deploy next Gen technologies and 5G. Broadband Infrastructure: Continue to support efforts in the Congress to provide oversight and track Broadband Equity, Access and Deployment (BEAD) Program funding to ensure the tens of billions of taxpayer dollars being allocated will be used efficiently to connect those lacking access with high-speed broadband. Also expressed concern to U.S. Commerce about possible price controls for broadband. Access to Capital "Small Business Technological Advancement Act" (S.2330): Support the legislation which would help end the digital gap for many small businesses by allowing SBA Loans to be used for investments in eligible technologies. Basel III Endgame Rule: Provided written testimony to Senate Finance Committee on the downstream negative effects regarding the cost and availability of capital and credit of this proposed Federal Reserve rule. Proposed CFPB Rule on Credit Card Price Caps: Urged the Consumer Financial Protection Bureau and President Biden to pull back on this proposed rule given the negative impact on small business access to credit and small financial institutions. Regulation "Providing Opportunities to Show Transparency via Information Technology Act" (POST IT Act): Supported full House passage of the bill. "The Small Business Regulatory Reduction Act": Continue to supported full House passage. "Regulations from the Executive in Need of Scrutiny (REINS) Act" (H.R. 277) - Supported House passage and continue to support Senate action. Privacy Policy in General: Continue to express the need for a national framework, but for Congress to consider a framework that avoid adding to the growing patchwork burden of state privacy laws, and to carefully consider unintended consequences on small businesses. PLA Mandates for Clean Energy Credits: Joined comments to U.S. Treasury/IRS expressing opposition and concern about the mandated use of Project Labor Agreements (PLAs) in order to qualify for the clean energy tax credit used in conjunction with Inflation Reduction Act projects. "Prove It Act" (S. 1411) - Continue to voice support and passage of this bill requiring agencies to conduct due diligence on how proposed regulations impact small businesses. Filed comments with the North American Securities Administrators Associations (NASAA) on proposed revisions to its model rule on Dishonest or Unethical Business Practices of Broker-Dealers and Agents, expressing concern about impact on small businesses in the sector and the impact on retail investors. Filed comments with the Federal Communications Commission (FCC) opposing the Proposed Rulemaking (NPRM), Safeguarding and Securing the Open Internet, given its negative impact on small providers, costs, investment, innovation and access to affordable broadband. Trade and Globa Market Access EU and Digital Trade: Urged President Biden, ahead of the October 20 U.S.-EU Summit, to push back against regulatory overreach and protectionist actions in Europe that threaten to restrict trade, undermine U.S. competitiveness, and stifle innovation. These actions include one that undermine intellectual property rights and regulatory initiatives that discriminate against U.S. companies. Digital Trade Principles: Urged President Biden to revisit the United State Trade Representatives action to withdraw from for foundational positions on digital trade policy within the World Trade Organization (WTO). Labor and Workforce Policy DOL's Proposed Overtime Rule: Continue to express concern about the proposed rule. "Save Local Businesses Act" (S.1261, HR 2826) - Continue to support the legislation. Paid Leave Policy in U.S. House: Continue to express support for bipartisan exploration in identifying paid leave policy solutions that help support business owners and working families. Proposed Independent Contractor Rules: Continued to express opposition to independent contractor rules being proposed and advanced by the Department of Labor that would disrupt this critical model for entrepreneurship. "Protecting the Right to Organize (PRO) Act" (S. 567) - Continue to oppose the legislation. "Railway Safety Act" (S. 576): Expressed concern about the legislation to all members of Congress.

H.R. 1421 - Child Care for Working Families Act. H.R. 1843 - The Telehealth Expansion Act of 2023. H.R. 3798 - The Small Business Flexibility Act. H.R. 3799 - The Custom Health Option and Individual Care Expense Arrangement Act. Issues related to employer provide benefits such as HSAs, FSAs, HRAs, ICHRAs, DCFSAs and commuter benefits.

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

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: $64,788 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 485 - Protecting Health Care For All Patients Act of 2023 - Rep. Rodgers, Cathy McMorris - 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, Buddy - prohibits spread-pricing by PBMs in 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. Rodgers, Cathy McMorris - 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. Rodgers, Cathy McMorris - PBM transparency, PBM contract design, health insurance transparency, hospital transparency H.R. 3797 - Paperwork Burden Reduction Act - Rep. Smith, Jason - employers mailing 1095 physical tax forms H.R. 3798 - Small Business Flexibility Act - Rep. Tenney, Claudia - small business coverage notifications 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 Accessible, Affordable Internet for All Act (no bill number) - broadband Advancing Integration in Medicare and Medicaid (AIM) Act (no bill number) - coordinating full-benefits for dual eligible individuals Advancing Telehealth Beyond COVID-19 Act (no bill number) - telehealth American Data Privacy and Protection Act (no bill number) - data privacy American Rescue Plan Act (no bill number) - COVID-19 relief Behavioral Health Integration Awareness Act (no bill number) - mental health and Medicare Better Health Care Directories Act (no bill number) - commercial plans Building COVID-19 Vaccine Confidence Act (no bill number) - COVID-19 CHOICE Act (no bill number) - public option CONNECT for Health Act (no bill number) - expansion of telehealth for Medicare Consolidated Appropriations Act (no bill number) - continued Medicaid and Medicare provisions and funding for FY2023 Consumer Online Privacy Rights Act (no bill number) - data privacy Continuing Appropriations and Ukraine Supplemental Appropriations Act (no bill number) - continued funding for Medicare and Medicaid Improving Seniors Timely Access to Care Act (no bill number) - prior authorization in Medicare Advantage Medicaid Saves Lives Act (no bill number) - Medicaid expansion Medicare for All Act (no bill number) - public option Medicare Multi-Cancer Early Detection Screening Coverage Act (no bill number) - Cancer screening in Medicare Mental Health Matters Act (no bill number) - changes to the procedure around MHPEA litigation MOMMAs Act (no bill number) - maternal health Moms Matter Act (no bill number) - maternal mental health conditions and SUD MORE Health Education Act (no bill number) - Federal Exchange outreach and educational activities NO PAIN Act (no bill number) - non-opioid treatment No Surprises for Survivors Act (no bill number) - requirements for group health plans and health insurance issuers offering group or individual health insurance coverage to provide coverage for forensic medical exams with no cost sharing Nursing Home Reform Modernization Act (no bill number) - nursing home quality and transparency Parity Enforcement Act (no bill number) - mental health and SUD Parity Implementation Assistance Act (no bill number) - mental health parity PATCH Act (no bill number) - privacy and cybersecurity Patients Before Middlemen Act (no bill number) - pharmacy benefit managers Physician Wellness Program Act (no bill number) - mental health and Medicare Prevent Pandemics Act (no bill number) - pandemic preparedness Preventing Mental Health and Substance Use Crises During Emergencies Act (no bill number) - mental health and SUD national strategy Promoting Clarity in Mental Health and Substance Use Disorder Treatment Act (no bill number) - commercial plans Protecting Americans with Pre-Existing Conditions Act (no bill number) - state innovation waivers Protecting Patients from Deceptive Health Plans Act (no bill number) - excepted benefits coverage Protecting Personal Health Data Act (no bill number) - privacy Public Health Infrastructure Saves Lives Act (no bill number) - public health infrastructure Public Option Deficit Reduction Act (no bill number) - public option Restore Protections for Dialysis Patients Act (no bill number) - reform of MSP Secondary Payer Act Restoring Hope for Mental Health and Well-Being Act (no bill number) - reauthorization of several behavioral health programs RICE Act (no bill number) - commercial plans SAFE DATA Act (no bill number) - consumer data privacy and data transparency and security Safe Step Act (no bill number) -commercial plans and medication step-therapy requirements Secure Data and Privacy for Contact Tracing Act (no bill number) - digital contact tracing for COVID-19 Social Determinants for Moms Act (no bill number) - SDOH and maternal health Strengthen Kids Mental Health Now Act (no bill number) - mental health and Medicaid Supporting Best Practices for Healthy Moms Act (no bill number) - maternal health Tech to Save Moms Act (no bill number) - maternal health The Jackie Walorski Maternal and Child Home Visiting Reauthorization Act (no bill number) - funding for maternal and early childhood health programs To amend the Consolidated Appropriations Act, 2021 to authorize additional funds for the Emergency Broadband Connectivity Fund, to provide grants to States and Tribal Entities to strengthen the National Lifeline Eligibility Verifier, to provide for Federal coordination between the National Lifeline Eligibility Verifier and the National Accuracy Clearinghouse (no bill number) - Broadband To amend the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to require group health plans and health insurance issuers offering group or individual health insurance coverage to disclose the percentage of in-network participation for certain provider types, and for other purposes. (no bill number) - commercial plans To amend title XI of the Social Security Act to require CMI testing of incentive payments for behavioral health providers and certain other providers for adoption and use of certified electronic health record technology, and for other purposes. (no bill number) - behavioral health and electronic health records To amend title XVIII of the Social Security Act to ensure adequate coverage of outpatient mental health services under the Medicare program. (no bill number) - mental health and Medicare To direct the Secretary of Health and Human Services to conduct a public outreach campaign to inform individuals covered under a group health plan or group or individual health insurance coverage of Federal requirements relating to mental health and substance use disorder crisis services, and for other purposes. (no bill number) - commercial plans To direct the Secretary of Health and Human Services to provide outreach and reporting on opioid use disorder treatment services furnished by opioid treatment programs under the Medicare program. (no bill number) - mental health and Medicare TREATS Act (no bill number) - increase use of telehealth for SUD treatment Turn the Tide Act (no bill number) - Substance Use Disorder Virtual Community Support Act (no bill number) - mental health and SUD grants for community peer support Issues related to benefits, design, or structure of HIPAA-excepted benefits and supplemental benefits; mental health parity; surprise billing; 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; and provider directories. 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.

Taxes and Tax Reform R&D Tax Credit: Continue to support extending and making permanent full expensing for R&D expenditures for small businesses. Voiced Support for "American Innovation and Jobs Act" in the Senate and "American Innovation and R&D Competitiveness Act" in the House. Main Street Tax Certainty Act of 2023 - Support House and Senate versions of the legislation to make permanent the 20-percent deduction for small-and individually-owned businesses (Section 199A). "Small Business Jobs Act" (HR 3937) - Voiced support for Ways and Means passage of the legislation and continue to support House passage of the legislation. "Build It in America Act" (HR 3938) - Voiced support for Ways and Means passage of the legislation and continue to support House passage of the legislation. "Small Business Investment Act" - Voiced support for the bill and reforming Section 1202 of the tax code and continue to advocate for action on the bill. "Death Tax Repeal Act of 2023": Support House and Senate bills to permanent repeal the death tax and continue to support action by Congress. Capital Gains Tax Indexing - Voiced support for this reform measure and continue to support action by Congress. Affordable Health Coverage and Health Care Innovation "CHOICE Arrangement Act" (H.R. 2799) - Supported House passage and continue to support Senate action on the legislation. Tax Credit for Small Businesses: Support making reforms to the restrictive and temporary health care tax credit for small businesses to make it more practical for small businesses. Voiced ongoing concerns about the rising costs of health coverage, lack of choices, and dwindling choices in many markets against the backdrop of challenging economic conditions. Voiced support for these various reforms: enhancing tax credits for small businesses, expanding and making additional fixes to HSAs, reforming QSEHRAs, and making CARESs Act telehealth provisions permanent. "HSA Modernization Act" (H.R. 5687) and "Bipartisan HSA Improvement Act" (H.R. 5688) - supported House Ways and Means passage of the legislation. "Telehealth Expansion Act of 2023" (H.R. 1843) - Voiced support for Ways and Means Committee passage. Chronic Disease Flexible Coverage Act (H.R. 3800) - Voiced support for Ways and Means Committee passage and support full House Action. Paperwork Burden Reduction Act (H.R. 3797) - Voiced support for Ways and Means Committee passage and support full House passage. Employer Reporting Improvement Act (H.R. 3801) - Voiced support for Ways and Means Committee passage and support full House passage. Small Business Flexibility Act (H.R. 3798) - Voiced support for Ways and Means Committee passage and support full House passage. Custom Health Option and Individual Care Expense Arrangement Act (H.R. 3799) - Voiced support for Ways and Means Committee passage and support full House passage. "Inflation Reduction Act": Continue to express concern about the impact of price controls on drug innovation, especially for small bio-pharmaceutical firms. "SMART Prices Act" (S. 1264) - Continue to oppose the legislation. Senate HELP Committee: Provided input on the new draft legislation to reauthorize the Pandemic and All-Hazards Preparedness Act (PAHPA), urging Committee members to remove the suggested reasonable pricing language from the bill. Provided written comments to CMS on proposed rule on the Misclassification of Drugs, Program Administration and Program Integrity Updates Under the Medicaid Drug Rebate Program, and voiced concern about impact on small bio-pharmaceutical companies and not to finalize the proposed rule. Access to Broadband and Digital Policy Rural Internet Improvement Act of 2023 (S.130) (H.R. 3216) - Voiced support for the legislation. Development of a National Spectrum Strategy (NSS) - Continue to express support for such a policy and the need for more spectrum to deploy next Gen technologies and 5G. Broadband Infrastructure: Continue to support efforts in the Congress to provide oversight and track Broadband Equity, Access and Deployment (BEAD) Program funding to ensure the tens of billions of taxpayer dollars being allocated will be used efficiently to connect those lacking access with high-speed broadband. Access to Capital "Small Business Technological Advancement Act" (S.2330): Support the legislation which would help end the digital gap for many small businesses by allowing SBA Loans to be used for investments in eligible technologies. Regulation Comments to Federal Trade Commission (FTC) and Department of Justice (DOJ) on Proposed Merger Guidelines: Voiced concern about the merger guidelines and urged the agencies to pull back on this effort and to not move forward with the proposed guidelines. "Providing Opportunities to Show Transparency via Information Technology Act" (POST IT Act): Supported passage of the bill by House Small Business Committee. "The Small Business Regulatory Reduction Act": Supported passage by House Small Business Committee. "Regulations from the Executive in Need of Scrutiny (REINS) Act" (H.R. 277) - Supported House passage and continue to support Senate action. Privacy Policy in General: Continue to express the need for a national framework, but for Congress to consider a framework that avoid adding to the growing patchwork burden of state privacy laws, and to carefully consider unintended consequences on small businesses. "Prove It Act" (Senate) - Voiced support for the bill to require agencies to conduct due diligence on how proposed regulations impact small businesses. "American Innovation and Choice Online Act" (S.2033): Continue to oppose the legislation that would break up various platforms that serve small businesses in the digital space. Arbitration and Class Action Waivers: Voiced opposition to numerous bills introduced in the Congress that attempt to prohibit arbitration and class action waiver provisions. Labor and Workforce Policy DOL's Proposed Overtime Rule: Continue to express concern about the proposed rule and requested a 60 extension of the comment period to full evaluate the rule's impact on small businesses. "Save Local Businesses Act" (S.1261, HR 2826) - Support the legislation. Paid Leave Policy in U.S. House: Continue to express support for bipartisan exploration in identifying paid leave policy solutions that help support business owners and working families. Nomination of Gwynn Wilcox to serve another term on the National Labor Relations Board: Urged Senate Health, Education, Labor, and Pensions (HELP) Committee members to delay a vote in order to fully explore nominee's record. Proposed Independent Contractor Rules: Continued to express opposition to independent contractor rules being proposed and advanced by the Department of Labor that would disrupt this critical model for entrepreneurship. "Protecting the Right to Organize (PRO) Act" (S. 567) - Continue to oppose the legislation. "Railway Safety Act" (S. 576): Expressed concern about the legislation to all members of Congress.

H.R. 1421 - Child Care for Working Families Act. H.R. 1843 - The Telehealth Expansion Act of 2023. H.R. 3798 - The Small Business Flexibility Act. H.R. 3799 - The Custom Health Option and Individual Care Expense Arrangement Act. Issues related to employer provide benefits such as HSAs, FSAs, HRAs, ICHRAs, DCFSAs and commuter benefits.

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

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: $59,268 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, 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. 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. 3797 - Paperwork Burden Reduction Act - Rep. Smith, Jason - employers mailing 1095 physical tax forms H.R. 3798 - Small Business Flexibility Act - Rep. Tenney, Claudia - small business coverage notifications 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. 1339 - Pharmacy Benefit Manager Reform Act - Sen. Sanders, Bernard - pharmacy benefit managers 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 Accessible, Affordable Internet for All Act (no bill number) - broadband Advancing Integration in Medicare and Medicaid (AIM) Act (no bill number) - coordinating full-benefits for dual eligible individuals Advancing Telehealth Beyond COVID-19 Act (no bill number) - telehealth American Data Privacy and Protection Act (no bill number) - data privacy American Rescue Plan Act (no bill number) - COVID-19 relief Behavioral Health Integration Awareness Act (no bill number) - mental health and Medicare Better Health Care Directories Act (no bill number) - commercial plans Building COVID-19 Vaccine Confidence Act (no bill number) - COVID-19 CHOICE Act (no bill number) - public option CONNECT for Health Act (no bill number) - expansion of telehealth for Medicare Consolidated Appropriations Act (no bill number) - continued Medicaid and Medicare provisions and funding for FY2023 Consumer Online Privacy Rights Act (no bill number) - data privacy Continuing Appropriations and Ukraine Supplemental Appropriations Act (no bill number) - continued funding for Medicare and Medicaid COVID Community Care Act (no bill number) - COVID-19 response COVID-19 Emergency Telehealth Impact Reporting Act (no bill number) - telehealth and COVID-19 COVID-19 Health Disparities Action Act (no bill number) -COVID-19 and health disparities Data Mapping to Save Moms Lives Act (no bill number) - maternal health data Equitable Data Collection and Disclosure on COVID-19 Act (no bill number) - COVID-19 Data Collection Fighting Stimulant and other Substance Use Disorders Act (no bill number) - mental health and Medicare Food and Drug Amendments (no bill number) - reauthorization of user fee programs Health Care Improvement Act (no bill number) - care costs and coverage Hospital Competition Act (no bill number) - procedural changes around The Mental Health Parity and Addiction Equity Act (MHPEA) litigation IMPACT to Save Moms Act (no bill number) - maternal health Improving Access to Behavioral Health Integration Act (no bill number) - behavioral health Improving Access to Health Care in Rural and Underserved Areas Act (no bill number)- rural health Improving Seniors Timely Access to Care Act (no bill number) - prior authorization in Medicare Advantage Improving Social Determinants of Health Act (no bill number) - health disparities Inpatient Psychiatric Facility Improvement Act (no bill number) - mental health and Medicare Kira Johnson Act (no bill number) - maternal health LIFT America Act (no bill number) - broadband and public health infrastructure Lower Costs, More Cures Act (no bill number) - prescription drug prices for Medicare and Medicaid Maternal Vaccinations Act (no bill number) - maternal health Medicaid Saves Lives Act (no bill number) - Medicaid expansion Medicare for All Act (no bill number) - public option Medicare Multi-Cancer Early Detection Screening Coverage Act (no bill number) - Cancer screening in Medicare Mental Health Matters Act (no bill number) - changes to the procedure around MHPEA litigation MOMMAs Act (no bill number) - maternal health Moms Matter Act (no bill number) - maternal mental health conditions and SUD MORE Health Education Act (no bill number) - Federal Exchange outreach and educational activities NO PAIN Act (no bill number) - non-opioid treatment No Surprises for Survivors Act (no bill number) - requirements for group health plans and health insurance issuers offering group or individual health insurance coverage to provide coverage for forensic medical exams with no cost sharing Nursing Home Reform Modernization Act (no bill number) - nursing home quality and transparency Parity Enforcement Act (no bill number) - mental health and SUD Parity Implementation Assistance Act (no bill number) - mental health parity PATCH Act (no bill number) - privacy and cybersecurity Patients Before Middlemen Act (no bill number) - pharmacy benefit managers Physician Wellness Program Act (no bill number) - mental health and Medicare Prevent Pandemics Act (no bill number) - pandemic preparedness Preventing Mental Health and Substance Use Crises During Emergencies Act (no bill number) - mental health and SUD national strategy Promoting Clarity in Mental Health and Substance Use Disorder Treatment Act (no bill number) - commercial plans Protecting Americans with Pre-Existing Conditions Act (no bill number) - state innovation waivers Protecting Patients from Deceptive Health Plans Act (no bill number) - excepted benefits coverage Protecting Personal Health Data Act (no bill number) - privacy Public Health Infrastructure Saves Lives Act (no bill number) - public health infrastructure Public Option Deficit Reduction Act (no bill number) - public option Restore Protections for Dialysis Patients Act (no bill number) - reform of MSP Secondary Payer Act Restoring Hope for Mental Health and Well-Being Act (no bill number) - reauthorization of several behavioral health programs RICE Act (no bill number) - commercial plans SAFE DATA Act (no bill number) - consumer data privacy and data transparency and security Safe Step Act (no bill number) -commercial plans and medication step-therapy requirements Secure Data and Privacy for Contact Tracing Act (no bill number) - digital contact tracing for COVID-19 Social Determinants for Moms Act (no bill number) - SDOH and maternal health Strengthen Kids Mental Health Now Act (no bill number) - mental health and Medicaid Supporting Best Practices for Healthy Moms Act (no bill number) - maternal health Tech to Save Moms Act (no bill number) - maternal health The Jackie Walorski Maternal and Child Home Visiting Reauthorization Act (no bill number) - funding for maternal and early childhood health programs To amend the Consolidated Appropriations Act, 2021 to authorize additional funds for the Emergency Broadband Connectivity Fund, to provide grants to States and Tribal Entities to strengthen the National Lifeline Eligibility Verifier, to provide for Federal coordination between the National Lifeline Eligibility Verifier and the National Accuracy Clearinghouse (no bill number) - Broadband To amend the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to require group health plans and health insurance issuers offering group or individual health insurance coverage to disclose the percentage of in-network participation for certain provider types, and for other purposes. (no bill number) - commercial plans To amend title XI of the Social Security Act to require CMI testing of incentive payments for behavioral health providers and certain other providers for adoption and use of certified electronic health record technology, and for other purposes. (no bill number) - behavioral health and electronic health records To amend title XVIII of the Social Security Act to ensure adequate coverage of outpatient mental health services under the Medicare program. (no bill number) - mental health and Medicare To direct the Secretary of Health and Human Services to conduct a public outreach campaign to inform individuals covered under a group health plan or group or individual health insurance coverage of Federal requirements relating to mental health and substance use disorder crisis services, and for other purposes. (no bill number) - commercial plans To direct the Secretary of Health and Human Services to provide outreach and reporting on opioid use disorder treatment services furnished by opioid treatment programs under the Medicare program. (no bill number) - mental health and Medicare TREATS Act (no bill number) - increase use of telehealth for SUD treatment Turn the Tide Act (no bill number) - Substance Use Disorder Virtual Community Support Act (no bill number) - mental health and SUD grants for community peer support 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; and provider directories. 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.

H.R. 1421 - Child Care for Working Families Act. H.R. 1843 - The Telehealth Expansion Act of 2023. H.R. 3798 - The Small Business Flexibility Act. H.R. 3799 - The Custom Health Option and Individual Care Expense Arrangement Act. Issues related to employer provide benefits such as HSAs, FSAs, HRAs, ICHRAs, DCFSAs and commuter benefits."

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

Taxes and Tax Reform R&D Tax Credit: Continue to support extending and making permanent full expensing for R&D expenditures for small businesses. Voiced Support for "American Innovation and Jobs Act" in the Senate and "American Innovation and R&D Competitiveness Act" in the House. "Small Business Jobs Act" (HR 3937) - Voiced support for Ways and Means passage of the legislation. "Build It in America Act" (HR 3938) - Voiced support for Ways and Means passage of the legislation. "Small Business Investment Act" - Voiced support for the bill and reforming Section 1202 of the tax code. Death Tax Repeal Act of 2023: Support House and Senate bills to permanent repeal the death tax. Capital Gains Tax Indexing - Voiced support for this reform measure. Fiscal Policy and Debt Ceiling "Fiscal Accountability Act" - Supported House and Senate passage. Affordable Health Coverage and Health Care Innovation "CHOICE Arrangement Act" (H.R. 2799) - Supported House passage. Tax Credit for Small Businesses: Support making reforms to the restrictive and temporary health care tax credit for small businesses to make it more practical for small businesses. Provided House Ways and Means Testimony on Health Care and Small Business: Voiced ongoing concerns about the rising costs of health coverage, lack of choices, and dwindling choices in many markets against the backdrop of challenging economic conditions. Voiced support for these various reforms: enhancing tax credits for small businesses, expanding and making additional fixes to HSAs, reforming QSEHRAs, and making CARESs Act telehealth provisions permanent. "Telehealth Expansion Act of 2023" (H.R. 1843) - Voiced support for Ways and Means Committee passage. Chronic Disease Flexible Coverage Act (H.R. 3800) - Voiced support for Ways and Means Committee passage. Paperwork Burden Reduction Act (H.R. 3797) - Voiced support for Ways and Means Committee passage. Employer Reporting Improvement Act (H.R. 3801) - Voiced support for Ways and Means Committee passage. Small Business Flexibility Act (H.R. 3798) - Voiced support for Ways and Means Committee passage. Custom Health Option and Individual Care Expense Arrangement Act (H.R. 3799) - Voiced support for Ways and Means Committee passage. Inflation Reduction Act and Pharmaceuticals: Expressed concern about the impact of price controls on drug innovation, especially for small bio-pharmaceutical firms. SMART Prices Act (S. 1264) - Oppose the legislation. Expressed concern about initial implementation guidance for the Medicare Drug Price Negotiation Program established by the Inflation Reduction Act (IRA) by the Centers for Medicare & Medicaid Services (CMS) and its impact on small bio-pharmaceutical firms. Waiver Expansion for U.S. Developed Covid-19 Diagnostics and Therapeutics - Opposed such a waiver in comments to U.S. International Trade Commission in its Investigation No. 332-596. Access to Broadband and Digital Policy Development of a National Spectrum Strategy (NSS) - Expressed support for such a policy to the National Telecommunications Information Administration (NTIA). Broadband Infrastructure: Support efforts in the Congress to provide oversight and track Broadband Equity, Access and Deployment (BEAD) Program funding to ensure the tens of billions of taxpayer dollars being allocated will be used efficiently to connect those lacking access with high-speed broadband. Regulation "Regulations from the Executive in Need of Scrutiny (REINS) Act" (H.R. 277) - Supported House passage. Save Our Gas Stoves Act (H.R. 1640)- Supported House passage. "American Innovation and Choice Online Act" (S.2033): Oppose the legislation. Cloud Computing: Provided comments to the Federal Trade Commission on the Business Practices of Cloud Computing Providers, urging caution and understanding about the small business role in this industry and the benefits of cloud computing to small businesses, which have voiced no concerns about the purpose of the FTC's review of this issue. Labor and Workforce Policy "Save Local Businesses Act" (S.1261, HR 2826) - Support the legislation. Paid Leave Policy in U.S. House: Continue to express support for bipartisan exploration in identifying paid leave policy solutions that help support business owners and working families. Nomination of Julie Su as DOL Labor Secretary: Oppose the nomination. Proposed Independent Contractor Rules: Continued to express opposition to independent contractor rules being proposed and advanced by the Department of Labor. "Protecting the Right to Organize (PRO) Act" (S. 567) - Oppose the legislation. "Healthy Families Act" (S.1664) - Oppose the legislation. "Paycheck Fairness Act" (S. 728) - Oppose the legislation. Intellectual Property Provided input to the United States Patent and Trademark Office on an Advance Notice of Proposed Rulemaking (ANPRM) on potential reforms to Patent Trial and Appeal Board (PTAB) proceedings, urging USPTO to return PTAB to its original purpose.

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: $45,591 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE