Bipartisan HSA Improvement Act of 2023

S.128, Primary Care Enhancement Act H.R.5688, the Bipartisan HSA Improvement Act of 2023 H.R. 548, HSA Modernization Act CARES Act provision reinstating the HDHP-HSA telehealth safe harbor National Flood Insurance Program H.R.5535, Insurance Data Protection Act

Client expense: $1,960,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.128, Primary Care Enhancement Act H.R.5688, the Bipartisan HSA Improvement Act of 2023 H.R.5687, the HSA Modernization Act of 2023 CARES Act provision reinstating the HDHP-HSA telehealth safe harbor National Flood Insurance Program H.R.5535, Insurance Data Protection Act

Client expense: $1,730,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to tax advantaged savings vehicles for health expenses Issues related to HSA Modernization Act of 2023 - H.R. 5687 Issues related to Bipartisan HSA Improvement Act of 2023 - H.R. 5688 Issues related to Health Out-of-Pocket Expense Act of 2024 - H.R. 9394 Issues related to Health Out-of-Pocket Expense Act of 2025 - H.R. 955

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to tax advantaged savings vehicles for health expenses Issues related to HSA Modernization Act of 2023 - H.R. 5687 Issues related to Bipartisan HSA Improvement Act of 2023 - H.R. 5688 Issues related to Health Out-of-Pocket Expense Act of 2024 - H.R. 9394 Issues related to Health Out-of-Pocket Expense Act of 2025 - H.R. 955

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

Government targets: HOUSE OF REPRESENTATIVES, 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: $180,000 · Firm income: Not reported

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

Tax Relief and Reform Tax Cuts and Jobs Act of 2017: Support extending/making permanent the expiring provisions of the legislation that terminate in 2025 and have expressed opposition to raising taxes on small businesses. Submitted comments to the House Ways and Means Tax Working group detailing the benefits of the TCJA and our support for permanency. 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 businesses (Section 199A). Death Tax Repeal Act of 2023 (S. 1108): Support House and Senate bills to permanently repeal the death tax and continue to support action by Congress. Regulation Basel III Endgame Implementation: Continue to express concern about 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. 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 and H.R. 9278, legislation to delay the Corporate Transparency Acts year-end compliance deadline. We have also supported repeal of this measure via the "Repeal Big Brother Overreach Act." Consumer Financial Protection Bureaus (CFPBs) Rule Capping Credit-Card Late Fees: Continue to voice concern about the rules unintended consequences for small businesses. Prove-It Act (H.R. 7198): Supported House passage of the legislation. Midnight Rules Relief Act (H.R. 115): Supported House passage of the legislation. The Credit Card Competition Act (S.1838): Continue to oppose the legislation. Railway Safety Act (S. 576): SBE Council continues to express concern about the legislation as well as proposals to intrusively regulate the railroad industry, which is dominated by small businesses. The Small Business Regulatory Reduction Act (H.R. 3995): Continue to support full House passage. The Fishery Improvement to Streamline Untimely Regulatory Hurdles post Emergency Situation Act (FISHES Act): Supported House passage of the legislation. Warehouse Worker Protection Act (S.4260): Opposed the introduction of legislation in the U.S. Senate. DOLs Overtime Rule: Requested Wage and Hour Division to delay implementation of the second increase to the minimum salary threshold as mandated by the Final Rule from January 1, 2025 to at least May 1, 2025 pending judicial review, which was currently underway. Federal Trade Commission: SBE Council commented on the Reopening of Solicitation for Public Comments on Provisions of Franchise Agreements and Franchisor Business Practices {Docket No: FTC-2023-0026) because of its one-size-fits-all approach and that it has been pursued and advanced without empirical data or the required cost-benefit analysis. Moreover, reopening the rule in the hopes of acquiring more anecdote to justify it does not address its primary flaws. Federal Deposit Insurance Corporation: SBE Council submitted comments outlining the unnecessary actions proposed by the Change in Bank Control Act proposal (RIN 3064-AG04). Blacklisting: Expressed opposition to the unrelated blacklisting provision in the Workforce Innovation and Opportunity Act (WIOA). 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 and action by the U.S. Senate. Affordable Health Coverage and Health Care Innovation Continue to voice ongoing concerns about the rising costs of health coverage and lack of choices in many markets. 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 action. Telehealth Expansion Act of 2023 (H.R. 1843) (S. 1001): Continue to support full House and Senate action. Telehealth: Joined allies in urging the Centers for Medicare and Medicaid Services (CMS) to expedite the creation of permanent policy related to telehealth practitioners and requirements related to the reporting of their location at the time of service. Chronic Disease Flexible Coverage Act (H.R. 3800): Supported full House passage and Senate action. Paperwork Burden Reduction Act (H.R. 3797): Supported full House passage and Senate action. Employer Reporting Improvement Act (H.R. 3801): Supported full House passage and Senate action. 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 March-In and the Bayh Dole Act: Continue to express opposition to a regulatory guidance proposal via the National Institutes of Health (NIST) that considers price as a basis for invalidating the patents of research and innovations seeded with federal government dollars. Patent Eligibility Restoration Act (S.2140): Support the legislation. Promoting and Respecting Economically Vital American Innovation Leadership Act (PREVAIL Act) (S.2220): Support the legislation. Trade and Global Market Access Digital Trade Principles: Continue to express concern about the U.S. pulling away from these global 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 (S.3759): Support the legislation. Small Business Technological Advancement Act (S.2330/H.R. 10269): SBE Council supports the legislation. Access to Broadband and Next Gen Technology 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. Nominations National Labor Relations Board Nomination (NLRB): SBE Council opposed the nomination and Senate confirmation of Lauren McFerran to serve another term as Chair of the NLRB.

Client expense: $10,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Deposit Insurance Corporation (FDIC), Federal Reserve System, Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), SENATE

HR 7024 - Tax Relief for American Families and Workers Act of 2024 including issues related to providing tax incentives to promote economic growth, specifically the provision related to the immediate deduction of the cost of U.S. based research and investment investments; S 866 - American Innovation and Jobs Act including issues related to revising and expanding the deductibility of research and development expenditures to allow for the immediate expensing of such expenditures; HR 2673 - American Innovation and R&D Competitiveness Act of 2023 including issues related to eliminating the five-year amortization requirement for research and experimental expenditures, thus allowing continued expensing of such expenditures in the taxable years in which they are incurred; HR 5688 - Bipartisan HSA Improvement Act of 2023 including issues related to Health Savings Account modernization; HR 5687 - HSA Modernization Act of 2023 including issues related to Health Savings Account modernization; S 127/HR 3561 - Pharmacy Benefit Manager Transparency Act of 2023 including issues related to reform and prescription drug pricing

Client expense: $2,980,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.10545 - American Relief Act, 2025 Division C - Health H.R.824 - Telehealth Benefit Expansion for Workers Act of 2023. H.R.1843 & S.1001 - Telehealth Expansion Act of 2023. H.R.3029 & S.628 - Primary Care Enhancement Act of 2023. S.1339 - Pharmacy Benefit Manager Reform Act. H.R.5378 - Lower Costs, More Transparency Act. H.R.5688 - Bipartisan HSA Improvement Act of 2023. H.R.3836 - Medicaid Primary Care Improvement Act. General health care and employee benefits issues; health care coverage, regulatory implementation, transparency, delivery and payment reform, cost containment, and telehealth. Proposals related to ERISA preemption.

Client expense: $2,510,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.128, Primary Care Enhancement Act H.R.5688, the Bipartisan HSA Improvement Act of 2023 H.R.5687, the HSA Modernization Act of 2023 CARES Act provision reinstating the HDHP-HSA telehealth safe harbor H.R.1392, National Flood Insurance Program Extension Act of 2023 H.R.5535, Insurance Data Protection Act

Client expense: $1,570,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related health savings accounts (HSAs) and individual coverage health reimbursement arrangements (ICHRAs) including in H.R.3799 - CHOICE Arrangement Act, H.R. 3800/S. 3224 - Chronic Disease Flexible Coverage Act, H.R. 1843/S. 1001 - Telehealth Expansion Act of 2023, H.R. 722/s. 3254 - Lowering Costs for Caregivers Act, and H.R. 5687 - HSA Modernization Act of 2023 H.R. 5688, the Bipartisan HSA Improvement Act of 2023

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to tax advantaged savings vehicles for health expenses Issues related to HSA Modernization Act of 2023 - H.R. 5687 Issues related to Bipartisan HSA Improvement Act of 2023 - H.R. 5688 Issues related to Health Out-of-Pocket Expense Act of 2024 - H.R. 9394

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to tax advantaged savings vehicles for health expenses Issues related to HSA Modernization Act of 2023 - H.R. 5687 Issues related to Bipartisan HSA Improvement Act of 2023 - H.R. 5688 Issues related to Health Out-of-Pocket Expense Act of 2024 - H.R. 9394

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Protect the current FSA/HSA list of products and support expanding the list of allowable products for FSA/HSA. Monitor FSA/HSA legislation. Lobby for legislation that would expand the definition of prevention for FSA/HSA. Support the inclusion of vitamins and supplements in FSA/HSAs. Support legislation that would make diapers FSA/HSA eligible. Support legislation that would make exercise expenses eligible. S.786 - A bill to amend the Internal Revenue Code of 1986 to treat certain amounts paid for physical activity, fitness, and exercise as amounts paid for medical care. H.R.1582 - To amend the Internal Revenue Code of 1986 to treat certain amounts paid for physical activity, fitness, and exercise as amounts paid for medical care. S. 371: Telehealth HSA Act OF 2023. S.655 - Chronic Disease Management Act of 2023. S.628 - Primary Care Enhancement Act of 2023. H.R.1795 - To amend the Internal Revenue Code of 1986 to allow qualified distributions from health savings accounts for certain home care expenses. H.R.478 - To amend the Internal Revenue Code of 1986 to allow for the inclusion of additional expenses in dependent care FSAs, and for other purposes. HR 4794 - "Dietary Supplements Access Act" HR 6279 - "WEAR IT Act" HR 824 - "Telehealth Benefit Expansion for Workers Act of 2023" Support legislation that would make oral care products FSA and HSA eligible. HR 5688 - "Bipartisan HSA Improvement Act of 2023" HR 5687 - "HSA Modernization Act of 2023" HR 824 - "Telehealth Benefit Expansion for Workers Act of 2023"; HR 4189 "CONNECT for Health Act of 2023"; S. 2016 "CONNECT for Health Act of 2023"; HR 1843 - "Telehealth Expansion Act of 2023"; S. 1001 - "Telehealth Expansion Act of 2023"; HR 3432 - "Telemental Health Care Access Act of 2023"; H.R.1582 - Personal Health Investment Today Act of 2023 (PHIT ACT). HR 8599 "To amend the Internal Revenue Code of 1986 to include over-the-counter oral healthcare products as qualified medical expenses which can be purchased with HSA and FSA funds." Advocate for legislation that would allow for the FSA/HSA product eligibility list to be updated on a regular basis.

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

Government targets: HOUSE OF REPRESENTATIVES, Internal Revenue Service (IRS), SENATE, Treasury, Dept of

Protect the current FSA/HSA list of products and support expanding the list of allowable products for FSA/HSA. Monitor FSA/HSA legislation. Lobby for legislation that would expand the definition of prevention for FSA/HSA. Support the inclusion of vitamins and supplements in FSA/HSAs. Support legislation that would make diapers FSA/HSA eligible. Support legislation that would make exercise expenses eligible. S.786 - A bill to amend the Internal Revenue Code of 1986 to treat certain amounts paid for physical activity, fitness, and exercise as amounts paid for medical care. H.R.1582 - To amend the Internal Revenue Code of 1986 to treat certain amounts paid for physical activity, fitness, and exercise as amounts paid for medical care. S. 371: Telehealth HSA Act OF 2023. S.655 - Chronic Disease Management Act of 2023. S.628 - Primary Care Enhancement Act of 2023. H.R.1795 - To amend the Internal Revenue Code of 1986 to allow qualified distributions from health savings accounts for certain home care expenses. H.R.478 - To amend the Internal Revenue Code of 1986 to allow for the inclusion of additional expenses in dependent care FSAs, and for other purposes. HR 4794 - "Dietary Supplements Access Act" HR 6279 - "WEAR IT Act" HR 824 - "Telehealth Benefit Expansion for Workers Act of 2023" Support legislation that would make oral care products FSA and HSA eligible. HR 5688 - "Bipartisan HSA Improvement Act of 2023" HR 5687 - "HSA Modernization Act of 2023" HR 824 - "Telehealth Benefit Expansion for Workers Act of 2023"; HR 4189 "CONNECT for Health Act of 2023"; S. 2016 "CONNECT for Health Act of 2023"; HR 1843 - "Telehealth Expansion Act of 2023"; S. 1001 - "Telehealth Expansion Act of 2023"; HR 3432 - "Telemental Health Care Access Act of 2023"; H.R.1582 - Personal Health Investment Today Act of 2023 (PHIT ACT). HR 8599 "To amend the Internal Revenue Code of 1986 to include over-the-counter oral healthcare products as qualified medical expenses which can be purchased with HSA and FSA funds." Advocate for legislation that would allow for the FSA/HSA product eligibility list to be updated on a regular basis.

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

Government targets: HOUSE OF REPRESENTATIVES, Internal Revenue Service (IRS), SENATE, Treasury, Dept of

HR.5687 - HSA Modernization Act of 2023 HR.5688 - Bipartisan HSA Improvement Act of 2023 HR.5378 - Lower Costs, More Transparency Act HR.1843/S.1001 - Telehealth Expansion Act of 2023

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.5194 - A bill to amend the Internal Revenue Code of 1986 to expand eligibility for the refundable credit for coverage under a qualified health plan. H.R.9774 - Health Care Affordability Act of 2024 HR 5688 Bipartisan HSA Improvement Act of 2023 HR 5687 The HSA Modernization Act of 2023

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Health Savings Account issues; S. 655, Chronic Disease Management Act; S. 1001 / H.R. 1843, Telehealth Expansion Act of 2023; S. 731, TELEHEALTH HSA Act of 2023; H.R. 3800 / S. 3224, the Chronic Disease Flexible Coverage Act; H.R. 5688, Bipartisan HSA Improvements Act of 2023; H.R. 5687, HSA Modernization Act of 2023; H.R. 10445, Further Continuing Appropriations and Disaster Relief Supplemental Appropriations Act, 2025; H.R. 10545, American Relief Act, 2025.

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

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), SENATE, Treasury, Dept of

Health Savings Account issues; S. 655, Chronic Disease Management Act; S. 1001 / H.R. 1843, Telehealth Expansion Act of 2023; S. 731, TELEHEALTH HSA Act of 2023; H.R. 3800 / S. 3224, the Chronic Disease Flexible Coverage Act; H.R. 5688, Bipartisan HSA Improvements Act of 2023; H.R. 5687, HSA Modernization Act of 2023; H.R. 10445, Further Continuing Appropriations and Disaster Relief Supplemental Appropriations Act, 2025; H.R. 10545, American Relief Act, 2025.

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

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), SENATE, Treasury, Dept of

Legislative and regulatory issues, including: Health care reform; Legislative and regulatory policy proposals to protect employer-sponsored health care coverage; S. 655, Chronic Disease Management Act; S. 1001 / H.R. 1843, Telehealth Expansion Act of 2023; S. 731, TELEHEALTH HSA Act of 2023; H.R. 3800 / S. 3224, the Chronic Disease Flexible Coverage Act; H.R. 824, the Telehealth Benefit Expansion for Workers Act of 2023; H.R. 3237, to amend title XVIII of the Social Security Act to require each off-campus outpatient department of a provider to include a unique identifier on claims for items and services, and to require providers with a department of a provider to submit to the Centers for Medicare & Medicaid Services an attestation with respect to each such department; H.R. 3417, the FAIR Act; H.R. 3561, the Promoting Access to Treatments and Increasing; Extremely Needed Transparency Act of 2023 or the PATIENT Act of 2023; S. 1869, the Site-based Invoicing and Transparency Enhancement Act; S. 1451 / H.R. 3120, the Healthy Competition for Better Care Act; S. 1339, the Pharmacy Benefit Manager Reform Act; Legislative and regulatory issues related to preventing surprise medical bills and lowering health care costs, including implementation of H.R.133, Consolidated Appropriations Act, 2021 (P.L.116-260); H.R. 5688, Bipartisan HSA Improvements Act of 2023; H.R. 5687, HSA Modernization Act of 2023; H.R. 5378, the Lower Costs, More Transparency Act; S. 2840, the Bipartisan Primary Care and Health Workforce Act; H.R. 9572, Enhanced Enforcement of Health Coverage Act; H.R. 10445, Further Continuing Appropriations and Disaster Relief Supplemental Appropriations Act, 2025; H.R. 10545, American Relief Act, 2025; S. 5535, A bill to amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to increase penalties for group health plans and health insurance issuers for practices that violate balance billing requirements, and for other purposes.

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

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Treasury, Dept of

Legislative and regulatory issues, including: Health care reform; Legislative and regulatory policy proposals to protect employer-sponsored health care coverage; S. 655, Chronic Disease Management Act; S. 1001 / H.R. 1843, Telehealth Expansion Act of 2023; S. 731, TELEHEALTH HSA Act of 2023; H.R. 3800 / S. 3224, the Chronic Disease Flexible Coverage Act; H.R. 824, the Telehealth Benefit Expansion for Workers Act of 2023; H.R. 3237, to amend title XVIII of the Social Security Act to require each off-campus outpatient department of a provider to include a unique identifier on claims for items and services, and to require providers with a department of a provider to submit to the Centers for Medicare & Medicaid Services an attestation with respect to each such department; H.R. 3417, the FAIR Act; H.R. 3561, the Promoting Access to Treatments and Increasing; Extremely Needed Transparency Act of 2023 or the PATIENT Act of 2023; S. 1869, the Site-based Invoicing and Transparency Enhancement Act; S. 1451 / H.R. 3120, the Healthy Competition for Better Care Act; S. 1339, the Pharmacy Benefit Manager Reform Act; Legislative and regulatory issues related to preventing surprise medical bills and lowering health care costs, including implementation of H.R.133, Consolidated Appropriations Act, 2021 (P.L.116-260); H.R. 5688, Bipartisan HSA Improvements Act of 2023; H.R. 5687, HSA Modernization Act of 2023; H.R. 5378, the Lower Costs, More Transparency Act; S. 2840, the Bipartisan Primary Care and Health Workforce Act; H.R. 9572, Enhanced Enforcement of Health Coverage Act; H.R. 10445, Further Continuing Appropriations and Disaster Relief Supplemental Appropriations Act, 2025; H.R. 10545, American Relief Act, 2025; S. 5535, A bill to amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to increase penalties for group health plans and health insurance issuers for practices that violate balance billing requirements, and for other purposes.

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

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Treasury, Dept of

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

Tax Relief and Reform Tax Relief for American Families and Workers Act of 2024: SBE Council supported U.S. Senate passage (which failed) of the House-passed bill. 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. Tax Cuts and Jobs Act of 2017: Support extending the expiring provisions of the legislation that terminate in 2025 and have expressed opposition to raising taxes on small businesses. Regulation Regulatory Pause and Review: In light of the Supreme Court decision in Loper Bright Enterprises et al. v. Raimondo, urged President Biden and the Administration to pause all current rulemakings and stop new rules from taking effect until there is a thorough legal review of each agencys constitutional and statutory authority to regulate in the way it proposes. Joint Employer Standard: Supported the specific provision in Fiscal Year 2025 Labor, Health and Human Services, Education and Related Agencies (LHHS) Appropriations Act to prevent federal funds from being used to administer, implement, or enforce the recent National Labor Relations Board (NLRB) rule entitled Standard for Determining Joint Employer Status. Blacklisting: Expressed opposition to the unrelated blacklisting provision in the Workforce Innovation and Opportunity Act (WIOA). Basel III Endgame Implementation: Continue to express 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. 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 and H.R. 9278, legislation to delay the Corporate Transparency Acts year-end compliance deadline. We have also supported repeal of this measure. Consumer Financial Protection Bureaus (CFPBs) Rule Capping Credit-Card Late Fees: Continue to voice concern about the rules unintended consequences for small businesses. Prove-It Act (H.R. 7198): Continue to support the legislation. Federal Communications Commission (FCC) Safeguarding and Securing the Open Internet Rule: Continues to express concern about intrusive government control of the internet as advanced by the rule and Section 214 regulations under the proposal. The Credit Card Competition Act: Continue to oppose the legislation. Railway Safety Act (S. 576): SBE Council continues to express concern about the legislation as well as proposals to intrusively 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): Continue to support House and Senate passage of the legislation. 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 Continue to voice ongoing concerns about the rising costs of health coverage and lack of choices in many markets. 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 action. Telehealth Expansion Act of 2023 (H.R. 1843) (S. 1001): Continue to support full House and Senate action. Telehealth Coverage and Extension: Urged Congress to intervene in Drug Enforcement Administrations non-action on allowing virtual prescriptions and other telehealth for a two-year extension. Chronic Disease Flexible Coverage Act (H.R. 3800): Supported full House passage and Senate action. Paperwork Burden Reduction Act (H.R. 3797): Supported full House passage and Senate action. Employer Reporting Improvement Act (H.R. 3801): Supported full House passage and Senate action. 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 March-In and the Bayh Dole Act: Continue to express opposition to a regulatory guidance proposal via the National Institutes of Health (NIST) that considers price as a basis for invalidating the patents of research and innovations seeded with federal government dollars. Trade and Global Market Access Digital Trade Principles: Continue to express concern about the U.S. pulling away from these global 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). Global Trade Agreements and Access to Global Markets: Continue to advocate to the Administration the need to advance a positive and proactive U.S. trade policy that benefits all U.S. enterprises and citizens. Supporting Business Competitiveness and Startup Activity Comprehensive Resources for Entrepreneurs in the Arts to Transform the Economy (CREATE) Act: Support the legislation. Access to Broadband and Next Gen Technology BEAD Program Implementation: 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. Nominations NLRB Chair Lauren McFerran: Urge the Senate Health, Education, Labor, and Pensions (HELP) Committee to reject Chair Lauren McFerrans re-nomination to the National Labor Relations Board (NLRB), and expressed concern about the fact that there was no confirmation hearing.

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

Government targets: Consumer Financial Protection Bureau (CFPB), Council of Economic Advisers (CEA), Federal Deposit Insurance Corporation (FDIC), Federal Reserve System, HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), SENATE, White House Office

Issues related to tax advantaged savings vehicles for health expenses Issues related to HSA Modernization Act of 2023 - H.R. 5687 Issues related to Bipartisan HSA Improvement Act of 2023 - H.R. 5688 Issues related to Hope Act - H.R. 9394

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to tax advantaged savings vehicles for health expenses Issues related to HSA Modernization Act of 2023 - H.R. 5687 Issues related to Bipartisan HSA Improvement Act of 2023 - H.R. 5688 Issues related to Hope Act - H.R. 9394

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.5194 - A bill to amend the Internal Revenue Code of 1986 to expand eligibility for the refundable credit for coverage under a qualified health plan. H.R.9774 - Health Care Affordability Act of 2024 HR 5688 Bipartisan HSA Improvement Act of 2023 HR 5687 The HSA Modernization Act of 2023

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to Direct-to-Consumer Prescription Drug Advertisements; Issues related to Cybersecurity; Health care issues related to P.L. 118-42, the Consolidated Appropriations Act 2024, and P.L. 118-47, the Further Consolidated Appropriations Act 2024; Issues related to P.L. 117-328, the Consolidated Appropriations Act 2023; Issues related to P.L. 117-169, the Inflation Reduction Act of 2022, including enhanced advance premium tax credits (APTCs) and Medicare Part D redesign; Issues related to P.L. 93-406, Employee Retirement Income Security Act of 1974 (ERISA), preemption; S. 727, Insulin for All Act of 2023; S. 1269, Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act of 2023; S. 146, Cap Insulin Prices Act; S 954, Affordable Insulin Now Act of 2023; HR 1488, Affordable Insulin Now Act; HR 1587, Making Insulin Affordable for All Children Act; HR 1485, Insulin for all Act of 2023; H.R. 3290, To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program; S. 464/ H.R. 2630, the Safe Step Act; H.R. 5688, the Bipartisan HSA Improvement Act of 2023; H.R. 5687, the HSA Modernization Act of 2023; H.R. 1843/S. 1001, Telehealth Expansion Act; H.R. 824, Telehealth Benefit Expansion for Workers Act of 2023; Issues related to mental health coverage, workforce, and mental health parity; Issues related to surprise billing law and regulation; Issues related to artificial intelligence and health care issues; Issues related to removing barriers to biosimilar medicine access; H.R. 4189/S. 2016, The Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023; H.R. 3432/S.3651, Telemental Health Care Access Act of 2023; H.R. 1692, The Health Care Affordability Act; H.R. 8152, the American Privacy Rights Act (APRA) of 2024.

Client expense: $1,720,000 · Firm income: Not reported

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

HR 7024 - Tax Relief for American Families and Workers Act of 2024 including issues related to providing tax incentives to promote economic growth, specifically the immediate deduction of the cost of U.S. based research and investment investments; S 866/HR 2673 - American Innovation and R&D Competitiveness Act including issues related to revising and expanding the deductibility of research and development expenditures to allow for the immediate expensing of such expenditures, eliminating the five-year amortization requirement for research and experimental expenditures; HR 5688 - Bipartisan HSA Improvement Act of 2023 including issues related to Health Savings Account modernization; HR 5687 - HSA Modernization Act of 2023 including issues related to Health Savings Account modernization; S 127/HR 3561 - Pharmacy Benefit Manager Transparency Act of 2023 including issues related to reform and prescription drug pricing

Client expense: $3,040,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.128, Primary Care Enhancement Act H.R.5688, the Bipartisan HSA Improvement Act of 2023 H.R.5687, the HSA Modernization Act of 2023 CARES Act provision reinstating the HDHP-HSA telehealth safe harbor H.R.1392, National Flood Insurance Program Extension Act of 2023 H.R.5535, Insurance Data Protection Act

Client expense: $1,760,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.824 - Telehealth Benefit Expansion for Workers Act of 2023. H.R.1843 & S.1001 - Telehealth Expansion Act of 2023. H.R.3029 & S.628 - Primary Care Enhancement Act of 2023. S.1339 - Pharmacy Benefit Manager Reform Act. H.R.5378 - Lower Costs, More Transparency Act. H.R.5688 - Bipartisan HSA Improvement Act of 2023. H.R.3836 - Medicaid Primary Care Improvement Act. General health care and employee benefits issues; health care coverage, regulatory implementation, transparency, delivery and payment reform, cost containment, and telehealth. Proposals related to ERISA preemption.

Client expense: $3,180,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related health savings accounts (HSAs) and individual coverage health reimbursement arrangements (ICHRAs) including in H.R.3799 - CHOICE Arrangement Act, H.R. 3800/S. 3224 - Chronic Disease Flexible Coverage Act, H.R. 1843/S. 1001 - Telehealth Expansion Act of 2023, H.R. 722/s. 3254 - Lowering Costs for Caregivers Act, and H.R. 5687 - HSA Modernization Act of 2023 H.R. 5688, the Bipartisan HSA Improvement Act of 2023

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislative and regulatory issues, including: Health care reform; Legislative and regulatory policy proposals to protect employer-sponsored health care coverage; S. 655, Chronic Disease Management Act; S. 1001 / H.R. 1843, Telehealth Expansion Act of 2023; S. 731, TELEHEALTH HSA Act of 2023; H.R. 3800 / S. 3224, the Chronic Disease Flexible Coverage Act; H.R. 824, the Telehealth Benefit Expansion for Workers Act of 2023; H.R. 3237, to amend title XVIII of the Social Security Act to require each off-campus outpatient department of a provider to include a unique identifier on claims for items and services, and to require providers with a department of a provider to submit to the Centers for Medicare & Medicaid Services an attestation with respect to each such department; H.R. 3417, the FAIR Act; H.R. 3561, the Promoting Access to Treatments and Increasing; Extremely Needed Transparency Act of 2023 or the PATIENT Act of 2023; S. 1869, the Site-based Invoicing and Transparency Enhancement Act; S. 1451 / H.R. 3120, the Healthy Competition for Better Care Act; S. 1339, the Pharmacy Benefit Manager Reform Act; Legislative and regulatory issues related to preventing surprise medical bills and lowering health care costs, including implementation of H.R.133, Consolidated Appropriations Act, 2021 (P.L.116-260); H.R. 5688, Bipartisan HSA Improvements Act of 2023; H.R. 5687, HSA Modernization Act of 2023; H.R. 5378, the Lower Costs, More Transparency Act; S. 2840, the Bipartisan Primary Care and Health Workforce Act; H.R. 9572, Enhanced Enforcement of Health Coverage Act

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

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Treasury, Dept of

Legislative and regulatory issues, including: Health care reform; Legislative and regulatory policy proposals to protect employer-sponsored health care coverage; S. 655, Chronic Disease Management Act; S. 1001 / H.R. 1843, Telehealth Expansion Act of 2023; S. 731, TELEHEALTH HSA Act of 2023; H.R. 3800 / S. 3224, the Chronic Disease Flexible Coverage Act; H.R. 824, the Telehealth Benefit Expansion for Workers Act of 2023; H.R. 3237, to amend title XVIII of the Social Security Act to require each off-campus outpatient department of a provider to include a unique identifier on claims for items and services, and to require providers with a department of a provider to submit to the Centers for Medicare & Medicaid Services an attestation with respect to each such department; H.R. 3417, the FAIR Act; H.R. 3561, the Promoting Access to Treatments and Increasing; Extremely Needed Transparency Act of 2023 or the PATIENT Act of 2023; S. 1869, the Site-based Invoicing and Transparency Enhancement Act; S. 1451 / H.R. 3120, the Healthy Competition for Better Care Act; S. 1339, the Pharmacy Benefit Manager Reform Act; Legislative and regulatory issues related to preventing surprise medical bills and lowering health care costs, including implementation of H.R.133, Consolidated Appropriations Act, 2021 (P.L.116-260); H.R. 5688, Bipartisan HSA Improvements Act of 2023; H.R. 5687, HSA Modernization Act of 2023; H.R. 5378, the Lower Costs, More Transparency Act; S. 2840, the Bipartisan Primary Care and Health Workforce Act; H.R. 9572, Enhanced Enforcement of Health Coverage Act

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

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Treasury, Dept of

Health Savings Account issues; S. 655, Chronic Disease Management Act; S. 1001 / H.R. 1843, Telehealth Expansion Act of 2023; S. 731, TELEHEALTH HSA Act of 2023; H.R. 3800 / S. 3224, the Chronic Disease Flexible Coverage Act; H.R. 5688, Bipartisan HSA Improvements Act of 2023; H.R. 5687, HSA Modernization Act of 2023.

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

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), SENATE, Treasury, Dept of

Health Savings Account issues; S. 655, Chronic Disease Management Act; S. 1001 / H.R. 1843, Telehealth Expansion Act of 2023; S. 731, TELEHEALTH HSA Act of 2023; H.R. 3800 / S. 3224, the Chronic Disease Flexible Coverage Act; H.R. 5688, Bipartisan HSA Improvements Act of 2023; H.R. 5687, HSA Modernization Act of 2023.

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

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), SENATE, Treasury, Dept of

Issues related to tax advantaged savings vehicles for health expenses Issues related to HSA Modernization Act of 2023 - H.R. 5687 Issues related to Bipartisan HSA Improvement Act of 2023 - H.R. 5688

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to tax advantaged savings vehicles for health expenses Issues related to HSA Modernization Act of 2023 - H.R. 5687 Issues related to Bipartisan HSA Improvement Act of 2023 - H.R. 5688

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR.5687 - HSA Modernization Act of 2023 HR.5688 - Bipartisan HSA Improvement Act of 2023 HR.5378 - Lower Costs, More Transparency Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Protect the current FSA/HSA list of products and support expanding the list of allowable products for FSA/HSA. Monitor FSA/HSA legislation. Lobby for legislation that would expand the definition of prevention for FSA/HSA. Support the inclusion of vitamins and supplements in FSA/HSAs. Support legislation that would make diapers FSA/HSA eligible. Support legislation that would make exercise expenses eligible. S.786 - A bill to amend the Internal Revenue Code of 1986 to treat certain amounts paid for physical activity, fitness, and exercise as amounts paid for medical care. H.R.1582 - To amend the Internal Revenue Code of 1986 to treat certain amounts paid for physical activity, fitness, and exercise as amounts paid for medical care. S. 371: Telehealth HSA Act OF 2023. S.655 - Chronic Disease Management Act of 2023. S.628 - Primary Care Enhancement Act of 2023. H.R.1795 - To amend the Internal Revenue Code of 1986 to allow qualified distributions from health savings accounts for certain home care expenses. H.R.478 - To amend the Internal Revenue Code of 1986 to allow for the inclusion of additional expenses in dependent care FSAs, and for other purposes. HR 4794 - "Dietary Supplements Access Act" HR 6279 - "WEAR IT Act" HR 824 - "Telehealth Benefit Expansion for Workers Act of 2023" Support legislation that would make oral care products FSA and HSA eligible. HR 5688 - "Bipartisan HSA Improvement Act of 2023" HR 5687 - "HSA Modernization Act of 2023" HR 824 - "Telehealth Benefit Expansion for Workers Act of 2023"; HR 4189 "CONNECT for Health Act of 2023"; S. 2016 "CONNECT for Health Act of 2023"; HR 1843 - "Telehealth Expansion Act of 2023"; S. 1001 - "Telehealth Expansion Act of 2023"; HR 3432 - "Telemental Health Care Access Act of 2023"; H.R.1582 - Personal Health Investment Today Act of 2023 (PHIT ACT). HR 8599 "To amend the Internal Revenue Code of 1986 to include over-the-counter oral healthcare products as qualified medical expenses which can be purchased with HSA and FSA funds." Advocate for legislation that would allow for the FSA/HSA product eligibility list to be updated on a regular basis.

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

Government targets: HOUSE OF REPRESENTATIVES, Internal Revenue Service (IRS), SENATE, Treasury, Dept of

Protect the current FSA/HSA list of products and support expanding the list of allowable products for FSA/HSA. Monitor FSA/HSA legislation. Lobby for legislation that would expand the definition of prevention for FSA/HSA. Support the inclusion of vitamins and supplements in FSA/HSAs. Support legislation that would make diapers FSA/HSA eligible. Support legislation that would make exercise expenses eligible. S.786 - A bill to amend the Internal Revenue Code of 1986 to treat certain amounts paid for physical activity, fitness, and exercise as amounts paid for medical care. H.R.1582 - To amend the Internal Revenue Code of 1986 to treat certain amounts paid for physical activity, fitness, and exercise as amounts paid for medical care. S. 371: Telehealth HSA Act OF 2023. S.655 - Chronic Disease Management Act of 2023. S.628 - Primary Care Enhancement Act of 2023. H.R.1795 - To amend the Internal Revenue Code of 1986 to allow qualified distributions from health savings accounts for certain home care expenses. H.R.478 - To amend the Internal Revenue Code of 1986 to allow for the inclusion of additional expenses in dependent care FSAs, and for other purposes. HR 4794 - "Dietary Supplements Access Act" HR 6279 - "WEAR IT Act" HR 824 - "Telehealth Benefit Expansion for Workers Act of 2023" Support legislation that would make oral care products FSA and HSA eligible. HR 5688 - "Bipartisan HSA Improvement Act of 2023" HR 5687 - "HSA Modernization Act of 2023" HR 824 - "Telehealth Benefit Expansion for Workers Act of 2023"; HR 4189 "CONNECT for Health Act of 2023"; S. 2016 "CONNECT for Health Act of 2023"; HR 1843 - "Telehealth Expansion Act of 2023"; S. 1001 - "Telehealth Expansion Act of 2023"; HR 3432 - "Telemental Health Care Access Act of 2023"; H.R.1582 - Personal Health Investment Today Act of 2023 (PHIT ACT). HR 8599 "To amend the Internal Revenue Code of 1986 to include over-the-counter oral healthcare products as qualified medical expenses which can be purchased with HSA and FSA funds." Advocate for legislation that would allow for the FSA/HSA product eligibility list to be updated on a regular basis.

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

Government targets: HOUSE OF REPRESENTATIVES, Internal Revenue Service (IRS), SENATE, Treasury, Dept of

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.

Client expense: $35,000 · Firm income: Not reported

Government targets: Consumer Financial Protection Bureau (CFPB), Federal Deposit Insurance Corporation (FDIC), Federal Reserve System, HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), Patent & Trademark Office (PTO), SENATE

Issues related to Direct-to-Consumer Prescription Drug Advertisements; Issues related to Cybersecurity; Health care issues related to P.L. 118-42, the Consolidated Appropriations Act 2024, and P.L. 118-47, the Further Consolidated Appropriations Act 2024; Issues related to P.L. 117-328, the Consolidated Appropriations Act 2023; Issues related to P.L. 117-169, the Inflation Reduction Act of 2022, including enhanced advance premium tax credits (APTCs) and Medicare Part D redesign; Issues related to P.L. 93-406, Employee Retirement Income Security Act of 1974 (ERISA), preemption; S. 727, Insulin for All Act of 2023; S. 1269, Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act of 2023; S. 146, Cap Insulin Prices Act; S 954, Affordable Insulin Now Act of 2023; HR 1488, Affordable Insulin Now Act; H.R. 1587, Making Insulin Affordable for All Children Act; H.R. 1485, Insulin for all Act of 2023; H.R. 3290, To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program; S. 464/ H.R. 2630, the Safe Step Act; H.R. 5688, the Bipartisan HSA Improvement Act of 2023; H.R. 5687, the HSA Modernization Act of 2023; H.R. 1843/S. 1001, Telehealth Expansion Act; H.R. 824, Telehealth Benefit Expansion for Workers Act of 2023; Issues related to mental health coverage, workforce, and mental health parity; Issues related to surprise billing law and regulation; Issues related to artificial intelligence and health care issues; Issues related to removing barriers to biosimilar medicine access; H.R. 4189/S. 2016, The Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023; H.R. 3432/S.3651, Telemental Health Care Access Act of 2023; H.R. 1692, The Health Care Affordability Act; H.R. 8152, the American Privacy Rights Act (APRA) of 2024.

Client expense: $2,200,000 · Firm income: Not reported

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

S 127/HR 3561 - Pharmacy Benefit Manager Transparency Act of 2023 including issues related Pharmacy Benefit Manager reform and prescription drug pricing; HR 5688 - Bipartisan HSA Improvement Act of 2023 including issues related to Health Savings Account modernization; HR 5687 - HSA Modernization Act of 2023 including issues related to Health Savings Account modernization; HR 7024 - Tax Relief for American Families and Workers Act of 2024 including issues related to providing tax incentives for economic growth, improvements for the child tax credit, and eliminate the five-year amortization requirement for research and development; S 866/HR 2673 - American Innovation and Jobs Act including issues related to revising and expanding the deductibility of research and development expenditures to allow for the immediate expensing of such expenditures and eliminating the five-year amortization requirement for research and experimental expenditures

Client expense: $3,100,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 5688 Bipartisan HSA Improvement Act of 2023 HR 5687 The HSA Modernization Act of 2023

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

Government targets: HOUSE OF REPRESENTATIVES, 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

H.R.824 - Telehealth Benefit Expansion for Workers Act of 2023. H.R.1843 & S.1001 - Telehealth Expansion Act of 2023. H.R.3029 & S.628 - Primary Care Enhancement Act. S.1339 - Pharmacy Benefit Manager Reform Act. H.R.5378 - Lower Costs, More Transparency Act. H.R.5688 - Bipartisan HSA Improvement Act. H.R.6860 - Restore Protections for Dialysis Patients Act. H.R.3836 - Medicaid Primary Care Improvement Act. General health care and employee benefits issues; health care coverage, regulatory implementation, transparency, delivery and payment reform, cost containment, and telehealth. Proposals related to ERISA preemption.

Client expense: $3,310,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE