Obamacare Taxpayer Bailout Prevention Act

H.R. 4, Jobs for America Act (Camp) - ACA provisions. H.R. 99, Health Insurance Industry Antitrust Enforcement Act (Conyers) - antitrust policy. H.R. 544, LIBERTY Act (Gingrey-Matheson) - age rating rules. H.R. 743, Health Insurance Industry Fair Competition Act (DeFazio) - antitrust policy. H.R. 762, Health Care Choice Act (Blackburn) - national marketplace for individual coverage. H.R. 911, Competitive Health Insurance Reform Act (Gosar) - antitrust policy. H.R. 1019, Health Insurance Rate Review Act (Schakowsky) - rate review. H.R. 1188, Preserving Our Hometown Independent Pharmacies Act (Marino) - antitrust policy. H.R. 1205, Patients Right to Know Act (Walden) - disclosures on SBC documents. H.R. 1558, Small Business Health Relief Act (Collins) - HIT repeal, other ACA changes. H.R. 2328, Access to Professional Health Insurance Advisors Act (Rogers-Barrow) - MLR impact on agents and brokers. H.R. 2668, Fairness for American Families Act (Young) - delay of ACA individual mandate. H.R. 2698, Federal Employee Short-Term Disability Insurance Act (Norton) - short-term disability program for federal employees. H.R. 3121, American Health Care Reform Act (Roe) - replacement health reforms. H.R. 3350, Keep Your Health Plan Act (Upton) - continuation of existing plans. H.R. 3425, Health Care Access Fairness and Penalty Delay Act (Lipinski-Sinema) - delay of open enrollment and individual mandate penalties. H.R. 3489, (Tiberi) - repeal of ACA transitional reinsurance fee. H.R. 3504, Consumer Protection and Rate Review Act (Schakowsky) - rate review. H.R. 3517, Federal and State Insurance Exchange Access Fairness and Penalty Delay Act (Schrader) - individual mandate delay. H.R. 3522, Employee Health Care Protection Act (Cassidy) - continuation of current group coverage. H.R. 3541, Obamacare Taxpayer Bailout Prevention Act (Griffin) - repeal of ACA risk corridor program. H.R. 3598, Catastrophic Plan Bill (Fortenberry) - expanded access to catastrophic plans. H.R. 3745, Coverage Protection Act (Kirkpatrick) - continuation of coverage for consumers unable to enroll in QHPs. H.R. 3812, No Bailouts for Insurance Industry Act (Coffman) - ACA reinsurance and risk corridor programs. H.R. 3851, No Bailouts for Insurance Industry Act (Lance) - ACA reinsurance and risk corridor programs. H.R. 3985, Stop ACA's Risky Provisions Act (Westmoreland) - ACAs reinsurance, risk corridor, and risk adjustment programs. H.R. 4118, SIMPLE Fairness Act (Jenkins) - delay in ACA individual mandate penalties. H.R. 4302, Protecting Access to Medicare Act (Pitts) - ACA Limits on Deductibles for Plans in Small Group Market. H.R. 4354, ACA Taxpayer Bailout Protection Act (Griffin) - ACA risk corridor program. H.R. 4406, Taxpayer Bailout Protection Act (Lance) - ACA risk corridor program. H.R. 4414, Expatriate Health Coverage Clarification Act (Carney) - relief from ACA for expatriate health plans. H.R. 4735, Health Care Fairness and Stability Act (Nolan-McKinley) - ACA transitional reinsurance program. H.R. 5175, Protecting Americans from Illegal Bailouts Act (Lance) - ACA risk corridor program. S. 24, Small Business Health Relief Act (Portman) - HIT repeal, other ACA changes. S. 482, Health Insurance Rate Review Act (Feinstein) - rate review. S. 650, Access to Independent Health Insurance Advisors Act (Landrieu) - MLR impact on agents and brokers. S. 764, Patients Right to Know Act (Cornyn) - disclosures on SBC documents. S. 1473, Long-Term Care Insurance Consumer Right-to-Know Act (Klobuchar) - model disclosure forms. S. 1481, Long Term Care Insurance Integrity Act (Klobuchar) - third party review of disputed claims. S. 1642, Keeping the ACA Promise Act (Landrieu-Manchin) - continuation of existing plans, notification requirements. S. 1671, (Manchin-Kirk) - individual mandate delay. S. 1693, ACA Enrollment Extension Act (Shaheen) - extending open enrollment, delaying individual mandate penalties. S. 1699, Continuous Coverage Act (Mark Udall) - continuation of existing plans. S. 1726, Obamacare Taxpayer Bailout Prevention Act (Rubio) - repeal of ACA risk corridor program. S. 1729, Expanded Consumer Choice Act (Begich) - adding copper level of coverage to ACA Exchanges. S. 1866, Coverage Protection Act (Merkley) - continuation of coverage, retroactive coverage. S. 2166, Treating Families Fairly Act (Manchin) - ACA determinations of full-time equivalent employees. S. 2168, Small Business Stability Act (Heitkamp) - ACA definition of a large employer. S. 2173, Consumers Having Options in Choosing Enrollment Act (Landrieu) - ACA direct enrollment. S. 2174, Commonsense Competition and Access to Health Insurance Act (Warner) - offering health insurance coverage across state lines. S. 2175, Enhancing Access for Agents and Brokers Act (Landrieu) - access for independent agents and brokers to information about Exchange enrollment. S. 2176, Commonsense Reporting Act (Warner) - ACA reporting requirements. S. 2214, ACA Taxpayer Bailout Protection Act (Rubio) - ACA risk corridor program. S. 2253, Health Care Fairness and Stability Act (Franken-Kirk) - ACA transitional reinsurance program. S. 2578, Protect Women's Health From Corporate Interference Act (Murray) - contraceptive coverage. S. 2733, Obamacare Opt-Out Act (McCain-Barrasso) - certification process for opting out of ACA individual mandate. S. 2801, Health Care Consumer Choices Preservation Act (Enzi) - conditions on automatic renewals.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Affordable Private Health Care: Effect of the Health Insurance Tax, defined Essential Health Benefits, and Age Rating on premiums; Healthcare Delivery System Reforms. Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM. See attached addendum.ACA Risk Mitigation, S. 1726, H.R. 3541, 3812, 3851. 4406 S. 1486 Introduced August 1, 2013 by Sen. Carper, Thomas R. (D-DE) Postal Reform Act of 2013 - Amends provisions of federal law relating to the funding of the U.S. Postal Service

Client expense: $81,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Affordable Private Health Care: Effect of the Health Insurance Tax, defined Essential Health Benefits, and Age Rating on premiums; Healthcare Delivery System Reforms Medical Loss Ratios: Level Playing Field for MLRs; Consistent reporting requirements for all insurers; MLR Broker Fees: Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Evidence Based Care; Wellness; Chronic Care Management Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM FEHBP Modernization Act circulation draft President's budget, regional PPOs, government contributions Bailouts for Insurance Companies, S. 1726, H.R. 3541, 3812, 3851. 4406 HR 2328 Introduced in House June 12, 2013 Rep. Rogers, Mike J. (R-MI) HR 3541 introduced by Tim Griffin November 19,2013 Obamacare Taxpayer Bailout Prevention Act - Repeals the provision of the Patient Protection and Affordable Care Act that directs the Secretary of Health and Human Services (HHS) to establish and administer a program of risk corridors for calendar years 2014, 2015, and 2016 under which a qualified health plan offered in the individual or small group market is required to participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums. Other general Affordable Care Act topics related to multiple parts of legislation: ACA Implementation and back-end issues; Multi-State Plan Program Implementation; Risk Corridors and Risk Mitigation; Reinsurance; Electronic Health Records (EHRs); Health IT Roadmap; HR 1701 Introduced April 24, 2013 by Ted Poe (R-TX) Cutting Costly Codes Act of 2013 - Prohibits the Secretary of Health and Human Services (HHS) from implementing,administering, or enforcing specified regulations insofar as they would replace International Classification of Diseases (ICD)-9 with ICD-10 as a standard for code sets for appropriate data elements for financial and administrative transactions involving the electronic exchange of health information. HR 3750 Introduced December 12, 2013 by Donna Matsui (D-CA) Telehealth Modernization Act of 2013 - Calls for states to authorize health care professionals to deliver health care to individuals through telehealth and to consider adopting conditions under which such a professional should: have access to the individual's medical history.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

See attached addendum for General Lobbying Issue Area: HCR - HealthcareAffordable Private Health Care: Effect of the Health Insurance Tax, defined Essential Health Benefits, and Age Rating on premiums; Healthcare Delivery System Reforms State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; Multi-State Health Plans; Centralized All-Payer Database Medical Loss Ratios: Level Playing Field for MLRs; Consistent reporting requirements for all insurers; MLR Broker Fees: Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Evidence Based Care; Wellness; Chronic Care Management Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM FEHBP Modernization Act circulation draft President's budget, regional PPOs, government contributions HR 2667 Introduced by Griffin (R-AR) on July 11, 2013 Authority for Mandate Delay Act HR 2668 Introduced by Young (R-IN) on July 17, 2013 Fairness for Families Act Bailouts for Insurance Companies, S. 1726, H.R. 3541, 3812, 3851. 4406 HR 2328 Introduced in House June 12, 2013 Rep. Rogers, Mike J. (R-MI) Access to Professional Health Insurance Advisors Act of 2013 - Amends the Public Health Service Act to exclude remuneration paid for licensed independent insurance producers from administrative cost calculations for purposes of calculating the medical-loss ratio of a health insurance plan. HR 3541 introduced by Tim Griffin November 19,2013 Obamacare Taxpayer Bailout Prevention Act - Repeals the provision of the Patient Protection and Affordable Care Act that directs the Secretary of Health and Human Services (HHS) to establish and administer a program of risk corridors for calendar years 2014, 2015, and 2016 under which a qualified health plan offered in the individual or small group market is required to participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums. Other general Affordable Care Act topics related to multiple parts of legislation: ACA Implementation and back-end issues; Multi-State Plan Program Implementation; Risk Corridors and Risk Mitigation; Reinsurance; Small Business Health Options Program (SHOP) implementation; Third-party payment of premiums; Electronic Health Records (EHRs); Health IT Roadmap; Contraception Rule; Expatriate Legislation. See following page on Health Care Reform issuesS. 1486 Introduced August 1, 2013 by Sen. Carper, Thomas R. (D-DE) Postal Reform Act of 2013 - Amends provisions of federal law relating to the funding of the U.S. Postal Service (USPS) retirement and health care systems, operations, revenue, and governance.. Section 104 Substitute Amendment. HR 3362 Introduced October 29, 2013 by Rep. Terry, Lee (R-NE) Exchange Information Disclosure Act - Amends the Patient Protection and Affordable Care Act to expand reporting requirements related to health care exchanges. Requires the Secretary of Health and Human Services (HHS) to publish reports weekly through March 31, 2015, on: (1) consumer interactions with healthcare.gov or subsequent sites and any efforts undertaken to remedy problems that impact taxpayers and consumers, (2) calls to the federal customer service call center, including the number of calls received by the call center, problems identified by users, and referrals of those calls; (3) all navigators and certified application counselors that have been trained and certified by health care exchanges; and (4) all agents and brokers who have been trained and certified by the federal health care exchange. HR 762 Introduced in House February 15, 2013 by Rep. Blackburn, Marsha (R-TN) Health Care Choice Act of 2013 - Repeals the health insurance and health coverage expansion requirements of the Patient Protection and Affordable Care Act and related requirements of the Health Care and Education Reconciliation Act of 2010. Restores provisions of law amended or repealed by such provisions. HR 1701 Introduced April 24, 2013 by Ted Poe (R-TX) Cutting Costly Codes Act of 2013 - Prohibits the Secretary of Health and Human Services (HHS) from implementing, administering, or enforcing specified regulations insofar as they would replace International Classification of Diseases (ICD)-9 with ICD-10 as a standard for code sets for appropriate data elements for financial and administrative transactions involving the electronic exchange of health information. HR 3985 Introduced February 3, 2014 by Lynn Westmoreland (R-GA) Prohibits health insurance issuers and third-party administrators, for any period after December 31, 2014, from being required to make payments under the Patient Protection and Affordable Care Act (PPACA) for a transitional reinsurance program for the individual health insurance market in each state. Allows payments to issuers, as limited by this Act, only to the extent of available funds. Limits to 2014 the applicability of the program of risk corridors, under which a qualified health plan offered in the individual or small group market shall participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums . HR 4496 Introduced April 28, 2014 by Cory Gardner (R-CO) Covering People With Pre-Existing Conditions Act of 2014 - Requires each state to mitigate the health costs of high risk individuals in the state through a state reinsurance program or a state high risk pool HR 4777 Introduced May 30, 2014 by Michael Burgess (R-TX) To amend the Internal Revenue Code of 1986 to modify rules relating to health savings accounts. HR 3522 Introduced November 18, 2013 by Bill Cassidy (R-LA) To authorize health insurance issuers to continue to offer for sale current group health insurance coverage in satisfaction of the minimum essential health insurance coverage requirement, and for other purposes. HR 5214 Introduced July 28, 2014 by Pete Olsen (R-TX) To require the Secretary of Health and Human Services to provide for recommendations for the development and use of clinical data registries for the improvement of patient care. See following page on Health Care Reform issuesHR 3750 Introduced December 12, 2013 by Donna Matsui (D-CA) Telehealth Modernization Act of 2013 - Calls for states to authorize health care professionals to deliver health care to individuals through telehealth and to consider adopting conditions under which such a professional should: have access to the individual's medical history. HR 4633 Introduced May 9, 2014 by H. Griffith (R-VA) Insurance Rate Transparency Act - Amends the Public Health Service Act to require that specific health insurance premium increase information submitted to the Secretary of Health and Human Services (HHS) be disclosed to Congress no later than 30 days after receipt of the information. HR 5453 Introduced September 11, 2014 by Bruce Braley (D-IA) To authorize health insurance issuers to continue to offer for sale current group health insurance coverage in satisfaction of the minimum essential health insurance coverage requirement, and for other purposes.

Client expense: $2,030,000 · 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), Office of Management & Budget (OMB), Office of Personnel Management (OPM), SENATE, Treasury, Dept of, White House Office

Health Care Issues S.1726, Obamacare Taxpayer Bailout Prevention Act H.R.3541, Obamacare Taxpayer Bailout Prevention Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Affordable Private Health Care: Effect of the Health Insurance Tax, defined Essential Health Benefits, and Age Rating on premiums; Healthcare Delivery System Reforms State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; Multi-State Health Plans; Centralized All-Payer Database Medical Loss Ratios: Level Playing Field for MLRs; Consistent reporting requirements for all insurers; MLR Broker Fees: Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Evidence Based Care; Wellness; Chronic Care Management Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM. FEHBP Modernization Act circulation draft President's budget, regional PPOs, government contributions HR 2667 Introduced by Griffin (R-AR) on July 11, 2013 Authority for Mandate Delay Act HR 2668 Introduced by Young (R-IN) on July 17, 2013 Fairness for Families Act Bailouts for Insurance Companies, S. 1726, H.R. 3541, 3812, 3851, 4406 HR 2328 Introduced in House June 12, 2013 Rep. Rogers, Mike J. (R-MI) Access to Professional Health Insurance Advisors Act of 2013 - Amends the Public Health Service Act to exclude remuneration paid for licensed independent insurance producers from administrative cost calculations for purposes of calculating the medical-loss ratio of a health insurance plan. HR 3541 introduced by Tim Griffin November 19, 2013 Obamacare Taxpayer Bailout Prevention Act - Repeals the provision of the Patient Protection and Affordable Care Act that directs the Secretary of Health and Human Services (HHS) to establish and administer a program of risk corridors for calendar years 2014, 2015, and 2016 under which a qualified health plan offered in the individual or small group market is required to participate in a payment adjustment system based on the ration of the allowable costs of the plan to the plan's aggregate premiums. Other general Affordable Care Act topics related to multiple parts of legislation: ACA Implementation and back-end issues; Multi-State Plan Program Implementation; Risk Corridors and Risk Mitigation; Reinsurance; Small Business Health Options Program (SHOP) implementation; Third-Party payment of premiums; Electronic Health Records (EHRs); Health IT Roadmap; Contraception Rule; Expatriate Legislation. S. 1486 Introduced August 1, 2013 by Sen. Carper,Thomas R. (D-DE) Postal Reform Act of 2013 - Amends provisions of federal law relating to the funding of the U.S.Postal Service (USPS) retirement and health care systems, operations, revenue, and governance. Section 104 Substitute Amendment. HR 3362 Introduced October 29, 2013 by Rep. Terry, Lee (R-NE) Exchange Information Disclosure Act - Amends the Patient Protection and Affordable Care Act to expand reporting requirements related to health care exchanges. Requires the Secretary of Health and Human Services (HHS) to publish reports weekly through March 31, 2015, on: (1) consumer interactions with healthcare.gov or subsequent sites and any efforts undertaken to remedy problems that impact taxpayers and consumers, (2) calls to the federal customer service call center, including the number of calls received by the call center, problems identified by users, and referrals of those calls; (3) all navigators and certified application counselors that have been trained and certified by health care exchanges; and (4) all agents and brokers who have been trained and certified by the federal health care exchange. HR 762 Introduced in House February 15, 2013 by Rep. Blackburn, Marsha (R-TN) Health Care Choice Act of 2013 - Prohibits the Secretary of Health and Human Services (HHS) from implementing, administering, or enforcing specified regulations insofar as they would replace International Classification of Diseases (ICD-9) with ICD-10 as a standard for code sets for appropriate data elements for financial and administrative transactions involving the electronic exchange of health information. HR 3985 Introduced February 3, 2014 by Lynn Westmoreland (R-GA) Prohibits health insurance issuers and third-party administrators, or any period after December 31, 2014, from being requirement to make payments under the Patient Protection and Affordable Care Act (PPACA) for a transitional reinsurance program for the individual health insurance market in each state. Allows payments to issuers, as limited by this Act, only to the extent of available funds. Limits to 2014 the applicability of the program of risk corridors, under which a qualified health plan offered in the individual or small group market shall participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums. HR 4496 Introduced April 28, 2014 by Cory Gardner (R-CO) Covering People With Pre-Existing Conditions Act of 2014 - Requires each state to mitigate the health costs of high risk individuals in the state through a state reinsurance program or a state high risk pool. HR 4777 Introduced May 30, 2014 by Michael Burgess (R-TX) To amend the Internal Revenue Code of 1986 to modify rules relating to health savings accounts. HR 3522 Introduced November 18, 2013 by Bill Cassidy (R-LA) To authorize health insurance issuers to continue to offer for sale current group health insurance coverage in satisfaction of the minimum essential health insurance coverage requirement, and for other purposes. HR 5214 Introduced July 28, 2014 by Pete Olsen (R-TX) To require the Secretary of Health and Human Services to provide for recommendations for the development and use of clinical data registries for the improvement of patient care. HR 3750 Introduced December 12, 2013 by Donna Matsui (D-CA) Telehealth Modernization Act of 2013 - Calls for states to authorize health care professionals to deliver health care to individuals through telehealth and to consider adopting conditions under which such a professional should have access to the individual's medical history. HR 4633 Introduced May 9, 2014 by H. Griffith (R-VA) Insurance Rate Transparency Act - Amends the Public Health Service Act to require that specific health insurance premium increase information submitted to the Secretary of Health and Human Services (HHS) be disclosed to Congress no later than 30 days after receipt of the information. HR 5453 Introduced September 11, 2014 by Bruce Braley (D-IA) To authorize health insurance issuers to continue to offer for sale current group health insurance coverage in satisfaction of the minimum essential health insurance coverage requirement, and for other purposes.

Client expense: Not reported · Firm income: Not reported

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

HR 83 - Consolidated and Further Continuing Appropriations Act, 2015. HR 416 - Health Insurance Rate Review Act:A bill to amend the Public Health Service Act to provide protection for consumers against excessive, unjustified or unfairly discriminatory increases in premium rates. HR 979 - FEHBP Prescription Drug Integrity, Transparency, and Cost Savings Act: To amend chapter of title 5, United States Code to ensure program integrity, transparency and cost savings in the pricing and contracting of prescription drug benefits under the Federal Employees Health Benefits Program. HR 1370 - To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act. HR 2577 - SAFE Data Act: A bill to protect consumers by requiring reasonable security policies and procedures to protect data containing personal information and to provide for nationwide notice in the event of a security breach. HR 2676 - Small Business Health Relief Act of 2011: To lower health premiums and increase choice for small business. HR 3350 - Keep your Health Plan Act of 2013: To authorize health insurance issuers to continue to offer for sale current individual health insurance coverage in satisfaction of the minimum essential health insurance coverage requirement, and for other purposes. HR 3522 - Employee Health Care Protection Act of 2013: To authorize health insurance issuers to continue to offer for sale current individual health insurance coverage in satisfaction of the minimum essential health insurance coverage requirement and for other purposes. HR 3541 - Obamacare Taxpayer Bailout Prevention Act: To prevent a taxpayer bailout of health insurance issuers. HR 4805 - No subsidies Without Verification Process Act of 2014: To delay the provision of the Affordable Care Act premium and cost-sharing subsidies until the eligibility verification process for such subsidies is complete and for other purposes. HR 5214 - Clinical Data Registries: To require the Secretary of Health & Human Services to provide for recommendations for the development and use of clinical data registries for the improvement of patient care. HR 5364 - CHIP Extension & Improvement Act of 2014: To amend title XXI of the Social Security Act to extend and improve Childrens Health Insurance Program and for other purposes. S 24 - Small Business Health Relief Act of 2013: To lower health premiums and increase choice for small business. S 40 - American Liberty Restoration Act: To restore Americans individual liberty by striking the federal mandate to purchase insurance. S 482 - Health Insurance Rate Review Act: To amend the Public Health Service to provide protections for consumers against excessive, unjustified or unfairly discriminatory increases in premium rates. S 1726 - Obamacare Taxpayer Bailout Prevention Act: To prevent a taxpayer bailout of health insurance issuers. S 1729 - Expanded Consumer Choice Act: To amend the Patient Protection and Affordable Care Act to provide further options with respect to levels of coverage under qualified health plans. S 1880 - Jobs and Premium Protection Act: To repeal the annual fee on health care laws job-killing health insurance tax. S 2174 - Commonsense Competition and Access to Health Insurance Act: To amend the Patient Protection and Affordable Care Act to provide greater flexibility in offering health insurance coverage across state lines. S 2461 - CHIP Extension Act of 2014: Amend title XXI of the Social Security Act to extend & improve the Childrens Health Insurance Program and for other purposes. Department of Health & Human Services Implementation of Medical Loss Ratio arrangements; Implementation of health insurance exchanges; Implementation of Qualified Health Plans, Implementation Essential Health Benefits.

Client expense: $1,510,000 · Firm income: Not reported

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

Affordable Private Health Care: Effect of the Health Insurance Tax, defined Essential Health Benefits, and Age Rating on premiums; Healthcare Delivery System Reforms State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; Multi-State Health Plans; Centralized All-Payer Database Medicare Cost Contract Extension Medical Loss Ratios: Level Playing Field for MLRs; Consistent reporting requirements for all insurers; Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Evidence Based Care; Wellness; Chronic Care Management HR 2667 Introduced by Griffin (R-AR) on July 11, 2013 Authority for Mandate Delay Act Bailouts for Insurance Companies, S. 1726, H.R. 3541, 3812, 3851. 4406 HR 3541 introduced by Tim Griffin November 19,2013 Obamacare Taxpayer Bailout Prevention Act - Repeals the provision of the Patient Protection and Affordable Care Act that directs the Secretary of Health and Human Services (HHS) to establish and administer a program of risk corridors for calendar years 2014, 2015, and 2016 under which a qualified health plan offered in the individual or small group market is required to participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums. Other general Affordable Care Act topics related to multiple parts of legislation: ACA Implementation and back-end issues; Risk Corridors and Risk Mitigation; Reinsurance; Small Business Health Options Program (SHOP) implementation; Third-party payment of premiums; HR 3985 Introduced February 3, 2014 by Lynn Westmoreland (R-GA) Prohibits health insurance issuers and third-party administrators, for any period after December 31, 2014, from being required to make payments under the Patient Protection and Affordable Care Act (PPACA) for a transitional reinsurance program for the individual health insurance market in each state. Allows payments to issuers, as limited by this Act, only to the extent of available funds. Limits to 2014 the applicability of the program of risk corridors, under which a qualified health plan offered in the individual or small group market shall participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums .

Client expense: $44,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Obamacare Taxpayer Bailout Prevention Act- H.R.3541 and S. 1726 Repeals the provision of the Patient Protection and Affordable Care Act that directs the Secretary of Health and Human Services (HHS) to establish and administer a program of risk corridors for calendar years 2014, 2015, and 2016 under which a qualified health plan offered in the individual or small group market is required to participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums. Taxpayer Bailout Protection Act - H.R.4406 Related to the risk corridor program, requires the Secretary of Health and Human Services (HHS) to ensure that the amount of payments to plans for a plan year beginning during calendar years 2014 through 2016 does not exceed the amount of payments to the Secretary for such plan year. No Bailouts for Insurance Industry Act of 2014 - H.R. 3812, 3851 Repeals requirements under the ACA for: (1) a transitional reinsurance program for the individual health insurance market in each state, and (2) a program of risk corridors for calendar years 2014-2016.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM FEHBP Modernization Act circulation draft President's budget, regional PPOs, government contributions Bailouts for Insurance Companies, S. 1726, H.R. 3541, 3812, 3851. 4406

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Affordable Private Health Care: Effect of the Health Insurance Tax, defined Essential Health Benefits, and Age Rating on premiums; Healthcare Delivery System Reforms State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; Multi-State Health Plans; Centralized All-Payer Database Medical Loss Ratios: Level Playing Field for MLRs; Consistent reporting requirements for all insurers; MLR Broker Fees: Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Evidence Based Care; Wellness; Chronic Care Management Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM FEHBP Modernization Act circulation draft President's budget, regional PPOs, government contributions HR 2667 Introduced by Griffin (R-AR) on July 11, 2013 Authority for Mandate Delay Act HR 2668 Introduced by Young (R-IN) on July 17, 2013 Fairness for Families Act Bailouts for Insurance Companies, S. 1726, H.R. 3541, 3812, 3851. 4406 HR 3541 introduced by Tim Griffin November 19,2013 Obamacare Taxpayer Bailout Prevention Act - Repeals the provision of the Patient Protection and Affordable Care Act that directs the Secretary of Health and Human Services (HHS) to establish and administer a program of risk corridors for calendar years 2014, 2015, and 2016 under which a qualified health plan offered in the individual or small group market is required to participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums. Other general Affordable Care Act topics related to multiple parts of legislation: ACA Implementation and back-end issues; Multi-State Plan Program Implementation; Risk Corridors and Risk Mitigation; Reinsurance; Small Business Health Options Program (SHOP) implementation; Third-party payment of premiums; Electronic Health Records (EHRs); Health IT Roadmap;Contraception Rule; Expatriate Legislation. S. 1486 Introduced August 1, 2013 by Sen. Carper, Thomas R. (D-DE) Postal Reform Act of 2013 - Amends provisions of federal law relating to the funding of the U.S. Postal Service (USPS) retirement and health care systems, operations, revenue, and governance.. Section 104 Substitute Amendment. HR 4777 Introduced May 30, 2014 by Michael Burgess (R-TX) To amend the Internal Revenue Code of 1986 to modify rules relating to health savings accounts. HR 3522 Introduced November 18, 2013 by Bill Cassidy (R-LA) To authorize health insurance issuers to continue to offer for sale current group health insurance coverage in satisfaction of the minimum essential health insurance coverage requirement,and for other purposes. HR 5214 Introduced July 28, 2014 by Pete Olsen (R-TX) To require the Secretary of Health and Human Services to provide for recommendations for the development and use of clinical data registries for the improvement of patient care. HR 5453 Introduced September 11, 2014 by Bruce Braley (D-IA) To authorize health insurance issuers to continue to offer for sale current group health insurance coverage in satisfaction of the minimum essential health insurance coverage requirement, and for other purposes.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Insurance Market Reform, General Issues; Grandfathered Policies/Continuation of Existing Coverage (H.R. 335); State Based Regulations: Exchanges/Medicaid; Healthcare Quality: Delivery System Incentives to Promote Better Care; Patient Safety and Quality Improvement; Payment Reforms; Patient-Centered Primary/Medical Home; Bundled Payments; Wellness/Health Disparities; Chronic Care & Medical Management; Childhood Obesity; Infant Mortality; Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM (H.R. 779; President's Budget); S. 1486, Postal Reform Act of 2013; Risk Mitigation Legislation: S. 1726, H.R. 3541, H.R. 3812, H.R. 3851, H.R. 4406; ACA Implementation and back-end issues; Small Business Health Options Program (SHOP) implementation; ICD-10 implementation.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation and regulations affecting health plans. H.R.763, To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act. H.R.3350, Keep Your Health Plan Act of 2013. H.R.3541/S.1726, Obamacare Taxpayer Bailout Prevention Act. H.R.647, ABLE Act of 2014. H.R.83, Consolidated and Further Continuing Appropriations Act, 2015. S.1439, Care Planning Act of 2013.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Affordable Private Health Care: Effect of the Health Insurance Tax, defined Essential Health Benefits, and Age Rating on premiums; Healthcare Delivery System Reforms State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; Multi-State Health Plans; Centralized All-Payer Database Medical Loss Ratios: Level Playing Field for MLRs; Consistent reporting requirements for all insurers; MLR Broker Fees: Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Evidence Based Care; Wellness; Chronic Care Management HR 2667 Introduced by Griffin (R-AR) on July 11, 2013 Authority for Mandate Delay Act HR 2668 Introduced by Young (R-IN) on July 17, 2013 Fairness for Families Act Bailouts for Insurance Companies, S. 1726, H.R. 3541, 3812, 3851. 4406 HR 2328 Introduced in House June 12, 2013 Rep. Rogers, Mike J. (R-MI) HR 3541 introduced by Tim Griffin November 19,2013 Obamacare Taxpayer Bailout Prevention Act - Repeals the provision of the Patient Protection and Affordable Care Act that directs the Secretary of Health and Human Services (HHS) to establish and administer a program of risk corridors for calendar years 2014, 2015, and 2016 under which a qualified health plan offered in the individual or small group market is required to participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums. Other general Affordable Care Act topics related to multiple parts of legislation: ACA Implementation and back-end issues; Multi-State Plan Program Implementation; Risk Corridors and Risk Mitigation; Reinsurance; Small Business Health Options Program (SHOP) implementation; Third-party payment of premiums; Electronic Health Records (EHRs); Health IT Roadmap; Contraception Rule; Expatriate Legislation. HR 3362 Introduced October 29, 2013 by Rep. Terry, Lee (R-NE) Exchange Information Disclosure Act - Amends the Patient Protection and Affordable Care Act to expand reporting requirements related to health care exchanges. Requires the Secretary of Health and Human Services (HHS) to publish reports weekly through March 31, 2015, on: (1) consumer interactions with healthcare.gov or subsequent sites and any efforts undertaken to remedy problems that impact taxpayers and consumers, (2) calls to the federal customer service call center,including the number of calls received by the call center, problems identified by users, and referrals of those calls; (3) all navigators and certified application counselors that have been trained and certified by health care exchanges; and (4) all agents and brokers who have been trained and certified by the federal health care exchange. HR 762 Introduced in House February 15, 2013 by Rep. Blackburn, Marsha (R-TN) Health Care Choice Act of 2013 - Repeals the health insurance and health coverage expansion requirements of the Patient Protection and Affordable Care Act and related requirements of the Health Care and Education Reconciliation Act of 2010. Restores provisions of law amended or repealed by such provisions. HR 1701 Introduced April 24, 2013 by Ted Poe (R-TX) Cutting Costly Codes Act of 2013 - Prohibits the Secretary of Health and Human Services (HHS) from implementing,administering, or enforcing specified regulations insofar as they would replace International Classification of Diseases (ICD)-9 with ICD-10 as a standard for code sets for appropriate data elements for financial and administrative transactions involving the electronic exchange of health information. HR 4777 Introduced May 30, 2014 by Michael Burgess (R-TX) To amend the Internal Revenue Code of 1986 to modify rules relating to health savings accounts. HR 3522 Introduced November 18, 2013 by Bill Cassidy (R-LA) To authorize health insurance issuers to continue to offer for sale current group health insurance coverage in satisfaction of the minimum essential health insurance coverage requirement, and for other purposes. HR 3750 Introduced December 12, 2013 by Donna Matsui (D-CA) Telehealth Modernization Act of 2013 - Calls for states to authorize health care professionals to deliver health care to individuals through telehealth and to consider adopting conditions under which such a professional should: have access to the individual's medical history. HR 5453 Introduced September 11, 2014 by Bruce Braley (D-IA) To authorize health insurance issuers to continue to offer for sale current group health insurance coverage in satisfaction of the minimum essential health insurance coverage requirement, and for other purposes.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

See attached addendum for General Lobbying Area; HCR - Healthcare H.R.H.R. 460 Introduced by Rep. David McKinley (02/04/2013) Patients' Access to Treatments Act of 2013 - Amends the Public Health Service Act to establish cost-sharing limits for health plans that cover prescription drugs and use a formulary or other tiered cost-sharing structure. Prohibits such a health plan from imposing cost-sharing requirements, including co-payment and co-insurance, applicable to prescription drugs in a specialty drug tier that exceed the dollar amount of cost-sharing requirements applicable to prescription drugs in a non-preferred brand drug tier. Applies the non-preferred brand drug tier for which beneficiary cost-sharing is lowest, if a formulary used by the health plan contains more than one non-preferred brand drug tier. Affordable Private Health Care: Effect of the Health Insurance Tax, defined Essential Health Benefits, and Age Rating on premiums; Healthcare Delivery System Reforms Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Evidence Based Care; Wellness; Chronic Care Management Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM FEHBP Modernization Act circulation draft President's budget, regional PPOs, government contributions Bailouts for Insurance Companies, S. 1726, H.R. 3541, 3812, 3851. 4406 HR 3541 introduced by Tim Griffin November 19, 2013 Obamacare Taxpayer Bailout Prevention Act - Repeals the provision of the Patient Protection and Affordable Care Act that directs the Secretary of Health and Human Services (HHS) to establish and administer a program of risk corridors for calendar years 2014, 2015, and 2016 under which a qualified health plan offered in the individual or small group market is required to participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums. Other general Affordable Care Act topics related to multiple parts of legislation: ACA Implementation and back-end issues; Risk Corridors and Risk Mitigation; Reinsurance; Small Business Health Options Program (SHOP) implementation; Electronic Health Records (EHRs); Health IT Roadmap; Expatriate Legislation. See following page on Health Care Reform issuesS. 1486 Introduced August 1, 2013 by Sen. Carper, Thomas R. (D-DE) Postal Reform Act of 2013 - Amends provisions of federal law relating to the funding of the U.S. Postal Service (USPS) retirement and health care systems, operations, revenue, and governance.. Section 104 Substitute Amendment. HR 3522 Introduced November 18, 2013 by Bill Cassidy (R-LA) To authorize health insurance issuers to continue to offer for sale current group health insurance coverage in satisfaction of the minimum essential health insurance coverage requirement, and for other purposes. HR 3750 Introduced December 12, 2013 by Donna Matsui (D-CA) Telehealth Modernization Act of 2013 - Calls for states to authorize health care professionals to deliver health care to individuals through telehealth and to consider adopting conditions under which such a professional should: have access to the individual's medical history.

Client expense: $94,700 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 4, Jobs for America Act (Camp) - ACA provisions H.R. 99, Health Insurance Industry Antitrust Enforcement Act (Conyers) - antitrust policy H.R. 544, LIBERTY Act (Gingrey-Matheson) - age rating rules H.R. 743, Health Insurance Industry Fair Competition Act (DeFazio) - antitrust policy H.R. 762, Health Care Choice Act (Blackburn) - national marketplace for individual coverage H.R. 911, Competitive Health Insurance Reform Act (Gosar) - antitrust policy H.R. 1019, Health Insurance Rate Review Act (Schakowsky) - rate review H.R. 1188, Preserving Our Hometown Independent Pharmacies Act (Marino) - antitrust policy H.R. 1205, Patients Right to Know Act (Walden) - disclosures on SBC documents H.R. 1558, Small Business Health Relief Act (Collins) - HIT repeal, other ACA changes H.R. 2328, Access to Professional Health Insurance Advisors Act (Rogers-Barrow) - MLR impact on agents and brokers H.R. 2668, Fairness for American Families Act (Young) - delay of ACA individual mandate H.R. 2698, Federal Employee Short-Term Disability Insurance Act (Norton) - short-term disability program for federal employees H.R. 3121, American Health Care Reform Act (Roe) - replacement health reforms H.R. 3350, Keep Your Health Plan Act (Upton) - continuation of existing plans H.R. 3425, Health Care Access Fairness and Penalty Delay Act (Lipinski-Sinema) - delay of open enrollment and individual mandate penalties H.R. 3489, (Tiberi) - repeal of ACA transitional reinsurance fee H.R. 3504, Consumer Protection and Rate Review Act (Schakowsky) - rate review H.R. 3517, Federal and State Insurance Exchange Access Fairness and Penalty Delay Act (Schrader) - individual mandate delay H.R. 3522, Employee Health Care Protection Act (Cassidy) - continuation of current group coverage H.R. 3541, Obamacare Taxpayer Bailout Prevention Act (Griffin) - repeal of ACA risk corridor program H.R. 3598, Catastrophic Plan Bill (Fortenberry) - expanded access to catastrophic plans H.R. 3745, Coverage Protection Act (Kirkpatrick) - continuation of coverage for consumers unable to enroll in QHPs H.R. 3812, No Bailouts for Insurance Industry Act (Coffman) - ACA reinsurance and risk corridor programs H.R. 3851, No Bailouts for Insurance Industry Act (Lance) - ACA reinsurance and risk corridor programs H.R. 3985, Stop ACA's Risky Provisions Act (Westmoreland) - ACAs reinsurance, risk corridor, and risk adjustment programs H.R. 4118, SIMPLE Fairness Act (Jenkins) - delay in ACA individual mandate penalties H.R. 4302, Protecting Access to Medicare Act (Pitts) - ACA Limits on Deductibles for Plans in Small Group Market H.R. 4354, ACA Taxpayer Bailout Protection Act (Griffin) - ACA risk corridor program H.R. 4406, Taxpayer Bailout Protection Act (Lance) - ACA risk corridor program H.R. 4414, Expatriate Health Coverage Clarification Act (Carney) - relief from ACA for expatriate health plans H.R. 4735, Health Care Fairness and Stability Act (Nolan-McKinley) - ACA transitional reinsurance program H.R. 5175, Protecting Americans from Illegal Bailouts Act (Lance) - ACA risk corridor program S. 24, Small Business Health Relief Act (Portman) - HIT repeal, other ACA changes S. 482, Health Insurance Rate Review Act (Feinstein) - rate review S. 650, Access to Independent Health Insurance Advisors Act (Landrieu) - MLR impact on agents and brokers S. 764, Patients Right to Know Act (Cornyn) - disclosures on SBC documents S. 1473, Long-Term Care Insurance Consumer Right-to-Know Act (Klobuchar) - model disclosure forms S. 1481, Long Term Care Insurance Integrity Act (Klobuchar) - third party review of disputed claims S. 1642, Keeping the ACA Promise Act (Landrieu-Manchin) - continuation of existing plans, notification requirements S. 1671, (Manchin-Kirk) - individual mandate delay S. 1693, ACA Enrollment Extension Act (Shaheen) - extending open enrollment, delaying individual mandate penalties S. 1699, Continuous Coverage Act (Mark Udall) - continuation of existing plans S. 1726, Obamacare Taxpayer Bailout Prevention Act (Rubio) - repeal of ACA risk corridor program S. 1729, Expanded Consumer Choice Act (Begich) - adding copper level of coverage to ACA Exchanges S. 1866, Coverage Protection Act (Merkley) - continuation of coverage, retroactive coverage S. 2166, Treating Families Fairly Act (Manchin) - ACA determinations of full-time equivalent employees S. 2168, Small Business Stability Act (Heitkamp) - ACA definition of a large employer S. 2173, Consumers Having Options in Choosing Enrollment Act (Landrieu) - ACA direct enrollment S. 2174, Commonsense Competition and Access to Health Insurance Act (Warner) - offering health insurance coverage across state lines S. 2175, Enhancing Access for Agents and Brokers Act (Landrieu) - access for independent agents and brokers to information about Exchange enrollment S. 2176, Commonsense Reporting Act (Warner) - ACA reporting requirements S. 2214, ACA Taxpayer Bailout Protection Act (Rubio) - ACA risk corridor program S. 2253, Health Care Fairness and Stability Act (Franken-Kirk) - ACA transitional reinsurance program S. 2578, Protect Women's Health From Corporate Interference Act (Murray) - contraceptive coverage S. 2733, Obamacare Opt-Out Act (McCain-Barrasso) - certification process for opting out of ACA individual mandate S. 2801, Health Care Consumer Choices Preservation Act (Enzi) - conditions on automatic renewals Insurance regulatory reform; issues related to the coordination of private and public disability income benefits; disability risk management; disability income insurance enrollment and awareness; issues related to the continuation of reporting requirements for state LTCI partnership programs; issues relating to the coordination of benefits between private health insurance plans and Medicaid; Medigap claims processing and crossover fees; Medigap cross-over claim issues, Medigap coverage, implementation of Medigap standardized plan offerings; Medigap carrier recoveries related to CMS fraud and abuse enforcement activities, and issues related to Medigap educational materials, and other Medigap issues; fraud and abuse issues affecting public and private insurance coverage; issues relating to antitrust; implementation of the Mental Health Parity Act requirements; summary of benefits and coverage disclosures; pre-existing condition insurance plans; accountable care organizations; coverage of preventive services; preexisting condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; health insurance web portal requirements; dependent coverage; treatment of expatriate plans; compliance with the transitional reinsurance program; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations, non-discriminatory wellness programs; and issues related to supplemental products, and other issues relating to health care reform implementation.

Client expense: $2,010,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Federal Bureau of Investigation (FBI), Federal Trade Commission (FTC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of Personnel Management (OPM), SENATE, Social Security Administration (SSA), Treasury, Dept of, White House Office

Affordable Private Health Care: Effect of the Health Insurance Tax, defined Essential Health Benefits, and Age Rating on premiums; Healthcare Delivery System Reforms State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; Multi-State Health Plans; Centralized All-Payer Database Medical Loss Ratios: Level Playing Field for MLRs; Consistent reporting requirements for all insurers; Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Evidence Based Care; Wellness; Chronic Care Management Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM FEHBP Modernization Act circulation draft President's budget, regional PPOs, government contributions HR 2667 Introduced by Griffin (R-AR) on July 11, 2013 Authority for Mandate Delay Act HR 2668 Introduced by Young (R-IN) on July 17, 2013 Fairness for Families Act Bailouts for Insurance Companies, S. 1726, H.R. 3541, 3812, 3851, 4406 HR 3541 introduced by Tim Griffin November 19, 2013 Obamacare Taxpayer Bailout Prevention Act - Repeals the provision of the Patient Protection and Affordable Care Act that directs the Secretary of Health and Human Services (HHS) to establish and administer a program of risk corridors for calendar years 2014, 2015, and 2016 under which a qualified health plan offered in the individual or small group market is required to participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums. Other general Affordable Care Act topics related to multiple parts of legislation: ACA Implementation and back-end issues; Multi-State Plan Program Implementation; Risk Corridors and Risk Mitigation; Reinsurance; Small Business Health Options Program (SHOP) implementation; Third-party payment of premiums; Electronic Health Records (EHRs); Health IT Roadmap; Contraception Rule; Expatriate Legislation. S. 1486 Introduced August 1, 2013 by Sen. Carper, Thomas R. (D-DE) Postal Reform Act of 2013 - Amends provisions of federal law relating nto the funding of the U.S. Postal Service (USPS) retirement and health care systems, operations, revenue, and governance. Section 104 Substitute Amendment. HR 3362 Introduced October 29, 2013 by Rep. Terry, Lee (R-NE) Exchange Information Disclosure Act - Amends the Patient Protection and Affordable Care Act to expand reporting requirements related to health care exchanges. Requires the Secretary of Health and Human Services (HHS) to publish reports weekly through March 31, 2015, on: (1) consumer interactions with healthcare.gov or subsequent sites and any efforts undertaken to remedy problems that impact taxpayers and consumers, (2) calls to the federal customer service call center, including the number of calls received by the call center, problems identified by users, and referrals of those calls; (3) all navigators and certified application counselors that have been trained and certified by health care exchanges; and (4) all agents and brokers who have been trained and certified by the federal health care exchange. HR 762 Introduced in House February 15, 2013 by Rep. Blackburn, Marsha (R-TN) Health Care Choice Act of 2013 - Repeals the health insurance and health coverage expansion requirements of the Patient Protection and Affordable Care Act and related requirements of the Health Care and Education Reconciliation Act of 2010. Restores provisions of law amended or repealed by such provisions. HR 4496 Introduced April 28, 2014 by Cory Gardner (R-CO) Covering People With Pre-Existing Conditions Act of 2014 - Requires each state to mitigate the health costs of high risk individuals in the state through a state reinsurance program or a state high risk pool. HR 3522 Introduced November 18, 2013 by Bill Cassidy (R-LA) To authorize health insurance issuers to continue to offer for sale current group health insurance coverage in satisfaction of the minimum essential health insurance coverage requirement, and for other purposes. HR 3750 Introduced December 12, 2013 by Donna Matsui (D-CA) Telehealth Modernization Act of 2013 - Calls for states to authorize health care professionals to deliver health care to individuals through telehealth and to consider adopting conditions under which such a professional should: have access to the individual's medical history. HR 5453 Introduced September 11, 2014 by Bruce Braley (D-IA) To authorize health insurance issuers to continue to offer for sale current group health insurance coverage in satisfaction of the minimum essential health insurance coverage requirement, and for other purposes.

Client expense: Not reported · Firm income: Not reported

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

HR 3367, a bill introduced by Boustany (R-LA ) on 10.29.13 to amend section 9010 of the Patient Protection and Affordable Care Act to delay the application of the health insurance provider annual fee until 2016 and to provide a process to return to consumers any amounts attributable to the expected application of the annual fee to 2014 and 2015. Elimination or reduction of ACA Risk corridor funding. S. 1726, HR 3541, 3812, 3851 and through regulations. Federal Employee Health Benefit Program (FEHBP)regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM. Stability of individual health insurance market

Client expense: $354,875 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 4, Jobs for America Act (Camp) - ACA provisions. H.R. 99, Health Insurance Industry Antitrust Enforcement Act (Conyers) - antitrust policy. H.R. 544, LIBERTY Act (Gingrey-Matheson) - age rating rules. H.R. 743, Health Insurance Industry Fair Competition Act (DeFazio) - antitrust policy. H.R. 762, Health Care Choice Act (Blackburn) - national marketplace for individual coverage. H.R. 911, Competitive Health Insurance Reform Act (Gosar) - antitrust policy. H.R. 1019, Health Insurance Rate Review Act (Schakowsky) - rate review. H.R. 1188, Preserving Our Hometown Independent Pharmacies Act (Marino) - antitrust policy. H.R. 1205, Patients Right to Know Act (Walden) - disclosures on SBC documents. H.R. 1558, Small Business Health Relief Act (Collins) - HIT repeal, other ACA changes. H.R. 2328, Access to Professional Health Insurance Advisors Act (Rogers-Barrow) - MLR impact on agents and brokers. H.R. 2668, Fairness for American Families Act (Young) - delay of ACA individual mandate. H.R. 2698, Federal Employee Short-Term Disability Insurance Act (Norton) - short-term disability program for federal employees. H.R. 3121, American Health Care Reform Act (Roe) - replacement health reforms. H.R. 3350, Keep Your Health Plan Act (Upton) - continuation of existing plans. H.R. 3425, Health Care Access Fairness and Penalty Delay Act (Lipinski-Sinema) - delay of open enrollment and individual mandate penalties. H.R. 3489, (Tiberi) - repeal of ACA transitional reinsurance fee. H.R. 3504, Consumer Protection and Rate Review Act (Schakowsky) - rate review. H.R. 3517, Federal and State Insurance Exchange Access Fairness and Penalty Delay Act (Schrader) - individual mandate delay. H.R. 3522, Employee Health Care Protection Act (Cassidy) - continuation of current group coverage. H.R. 3541, Obamacare Taxpayer Bailout Prevention Act (Griffin) - repeal of ACA risk corridor program. H.R. 3598, Catastrophic Plan Bill (Fortenberry) - expanded access to catastrophic plans. H.R. 3745, Coverage Protection Act (Kirkpatrick) - continuation of coverage for consumers unable to enroll in QHPs. H.R. 3812, No Bailouts for Insurance Industry Act (Coffman) - ACA reinsurance and risk corridor programs. H.R. 3851, No Bailouts for Insurance Industry Act (Lance) - ACA reinsurance and risk corridor programs. H.R. 3985, Stop ACA's Risky Provisions Act (Westmoreland) - ACAs reinsurance, risk corridor, and risk adjustment programs. H.R. 4118, SIMPLE Fairness Act (Jenkins) - delay in ACA individual mandate penalties. H.R. 4302, Protecting Access to Medicare Act (Pitts) - ACA Limits on Deductibles for Plans in Small Group Market. H.R. 4354, ACA Taxpayer Bailout Protection Act (Griffin) - ACA risk corridor program. H.R. 4406, Taxpayer Bailout Protection Act (Lance) - ACA risk corridor program. H.R. 4414, Expatriate Health Coverage Clarification Act (Carney) - relief from ACA for expatriate health plans. H.R. 4735, Health Care Fairness and Stability Act (Nolan-McKinley) - ACA transitional reinsurance program. H.R. 5175, Protecting Americans from Illegal Bailouts Act (Lance) - ACA risk corridor program. S. 24, Small Business Health Relief Act (Portman) - HIT repeal, other ACA changes. S. 482, Health Insurance Rate Review Act (Feinstein) - rate review. S. 650, Access to Independent Health Insurance Advisors Act (Landrieu) - MLR impact on agents and brokers. S. 764, Patients Right to Know Act (Cornyn) - disclosures on SBC documents. S. 1473, Long-Term Care Insurance Consumer Right-to-Know Act (Klobuchar) - model disclosure forms. S. 1481, Long Term Care Insurance Integrity Act (Klobuchar) - third party review of disputed claims. S. 1642, Keeping the ACA Promise Act (Landrieu-Manchin) - continuation of existing plans, notification requirements. S. 1671, (Manchin-Kirk) - individual mandate delay. S. 1693, ACA Enrollment Extension Act (Shaheen) - extending open enrollment, delaying individual mandate penalties. S. 1699, Continuous Coverage Act (Mark Udall) - continuation of existing plans. S. 1726, Obamacare Taxpayer Bailout Prevention Act (Rubio) - repeal of ACA risk corridor program. S. 1729, Expanded Consumer Choice Act (Begich) - adding copper level of coverage to ACA Exchanges. S. 1866, Coverage Protection Act (Merkley) - continuation of coverage, retroactive coverage. S. 2166, Treating Families Fairly Act (Manchin) - ACA determinations of full-time equivalent employees. S. 2168, Small Business Stability Act (Heitkamp) - ACA definition of a large employer. S. 2173, Consumers Having Options in Choosing Enrollment Act (Landrieu) - ACA direct enrollment. S. 2174, Commonsense Competition and Access to Health Insurance Act (Warner) - offering health insurance coverage across state lines. S. 2175, Enhancing Access for Agents and Brokers Act (Landrieu) - access for independent agents and brokers to information about Exchange enrollment. S. 2176, Commonsense Reporting Act (Warner) - ACA reporting requirements. S. 2214, ACA Taxpayer Bailout Protection Act (Rubio) - ACA risk corridor program. S. 2253, Health Care Fairness and Stability Act (Franken-Kirk) - ACA transitional reinsurance program. S. 2578, Protect Women's Health From Corporate Interference Act (Murray) - contraceptive coverage. S. 2733, Obamacare Opt-Out Act (McCain-Barrasso) - certification process for opting out of ACA individual mandate. S. 2801, Health Care Consumer Choices Preservation Act (Enzi) - conditions on automatic renewals.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation and regulations affecting health plans. H.R.763, To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act. H.R.3350, Keep Your Health Plan Act of 2013. H.R.3541/S.1726, Obamacare Taxpayer Bailout Prevention Act.

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

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

See attached addendum for General Lobbying Issue Area: HCR - HealthcareState-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; Multi-State Health Plans; Centralized All-Payer Database Medical Loss Ratios: Level Playing Field for MLRs; Consistent reporting requirements for all insurers; MLR Broker Fees: Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Evidence Based Care; Wellness; Chronic Care Management Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM FEHBP Modernization Act circulation draft President's budget, regional PPOs, government contributions Bailouts for Insurance Companies, S. 1726, H.R. 3541, 3812, 3851. 4406 HR 2328 Introduced in House June 12, 2013 Rep. Rogers, Mike J. (R-MI) Access to Professional Health Insurance Advisors Act of 2013 - Amends the Public Health Service Act to exclude remuneration paid for licensed independent insurance producers from administrative cost calculations for purposes of calculating the medical-loss ratio of a health insurance plan. HR 3541 introduced by Tim Griffin November 19,2013 Obamacare Taxpayer Bailout Prevention Act - Repeals the provision of the Patient Protection and Affordable Care Act that directs the Secretary of Health and Human Services (HHS) to establish and administer a program of risk corridors for calendar years 2014, 2015, and 2016 under which a qualified health plan offered in the individual or small group market is required to participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums. Other general Affordable Care Act topics related to multiple parts of legislation: ACA Implementation and back-end issues; Multi-State Plan Program Implementation; Risk Corridors and Risk Mitigation; Reinsurance; Small Business Health Options Program (SHOP) implementation; Third-party payment of premiums; Electronic Health Records (EHRs); Health IT Roadmap; Contraception Rule; Expatriate Legislation. S. 1486 Introduced August 1, 2013 by Sen. Carper, Thomas R. (D-DE) Postal Reform Act of 2013 - Amends provisions of federal law relating to the funding of the U.S. Postal Service (USPS) retirement and health care systems, operations, revenue, and governance.. Section 104 Substitute Amendment. HR 3362 Introduced October 29, 2013 by Rep. Terry, Lee (R-NE) Exchange Information Disclosure Act - Amends the Patient Protection and Affordable Care Act to expand reporting requirements related to health care exchanges. Requires the Secretary of Health and Human Services (HHS) to publish reports weekly through March 31, 2015, on: (1) consumer interactions with healthcare.gov or subsequent sites and any efforts undertaken to remedy problems that impact taxpayers and consumers, (2) calls to the federal customer service call center, including the number of calls received by the call center, problems identified by users, and referrals of those calls; (3) all navigators and certified application counselors that have been trained and certified by health care exchanges; and (4) all agents and brokers who have been trained and certified by the federal health care exchange. HR 1701 Introduced April 24, 2013 by Ted Poe (R-TX) Cutting Costly Codes Act of 2013 - Prohibits the Secretary of Health and Human Services (HHS) from implementing, administering, or enforcing specified regulations insofar as they would replace International Classification of Diseases (ICD)-9 with ICD-10 as a standard for code sets for appropriate data elements for financial and administrative transactions involving the electronic exchange of health information. See following page on Health Care Reform issuesHR 3985 Introduced February 3, 2014 by Lynn Westmoreland (R-GA) Prohibits health insurance issuers and third-party administrators, for any period after December 31, 2014, from being required to make payments under the Patient Protection and Affordable Care Act (PPACA) for a transitional reinsurance program for the individual health insurance market in each state. Allows payments to issuers, as limited by this Act, only to the extent of available funds. Limits to 2014 the applicability of the program of risk corridors, under which a qualified health plan offered in the individual or small group market shall participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums . HR 4496 Introduced April 28, 2014 by Cory Gardner (R-CO) Covering People With Pre-Existing Conditions Act of 2014 - Requires each state to mitigate the health costs of high risk individuals in the state through a state reinsurance program or a state high risk pool HR 4777 Introduced May 30, 2014 by Michael Burgess (R-TX) To amend the Internal Revenue Code of 1986 to modify rules relating to health savings accounts. HR 3522 Introduced November 18, 2013 by Bill Cassidy (R-LA) To authorize health insurance issuers to continue to offer for sale current group health insurance coverage in satisfaction of the minimum essential health insurance coverage requirement, and for other purposes. HR 5214 Introduced July 28, 2014 by Pete Olsen (R-TX) To require the Secretary of Health and Human Services to provide for recommendations for the development and use of clinical data registries for the improvement of patient care. HR 3750 Introduced December 12, 2013 by Donna Matsui (D-CA) Telehealth Modernization Act of 2013 - Calls for states to authorize health care professionals to deliver health care to individuals through telehealth and to consider adopting conditions under which such a professional should: have access to the individual's medical history. HR 4633 Introduced May 9, 2014 by H. Griffith (R-VA) Insurance Rate Transparency Act - Amends the Public Health Service Act to require that specific health insurance premium increase information submitted to the Secretary of Health and Human Services (HHS) be disclosed to Congress no later than 30 days after receipt of the information. HR 5453 Introduced September 11, 2014 by Bruce Braley (D-IA) To authorize health insurance issuers to continue to offer for sale current group health insurance coverage in satisfaction of the minimum essential health insurance coverage requirement, and for other purposes.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

See attached addendum for General Lobbying Issue Area: HCR - HealthcareAffordable Private Health Care: Effect of the Health Insurance Tax, defined Essential Health Benefits, and Age Rating on premiums; Healthcare Delivery System Reforms State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; Multi-State Health Plans; Centralized All-Payer Database Medical Loss Ratios: Level Playing Field for MLRs; Consistent reporting requirements for all insurers; MLR Broker Fees: Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Evidence Based Care; Wellness; Chronic Care Management Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM FEHBP Modernization Act circulation draft President's budget, regional PPOs, government contributions HR 2667 Introduced by Griffin (R-AR) on July 11, 2013 Authority for Mandate Delay Act HR 2668 Introduced by Young (R-IN) on July 17, 2013 Fairness for Families Act Bailouts for Insurance Companies, S. 1726, H.R. 3541, 3812, 3851. 4406 HR 2328 Introduced in House June 12, 2013 Rep. Rogers, Mike J. (R-MI) Access to Professional Health Insurance Advisors Act of 2013 - Amends the Public Health Service Act to exclude remuneration paid for licensed independent insurance producers from administrative cost calculations for purposes of calculating the medical-loss ratio of a health insurance plan. HR 3541 introduced by Tim Griffin November 19,2013 Obamacare Taxpayer Bailout Prevention Act - Repeals the provision of the Patient Protection and Affordable Care Act that directs the Secretary of Health and Human Services (HHS) to establish and administer a program of risk corridors for calendar years 2014, 2015, and 2016 under which a qualified health plan offered in the individual or small group market is required to participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums. Other general Affordable Care Act topics related to multiple parts of legislation: ACA Implementation and back-end issues; Multi-State Plan Program Implementation; Risk Corridors and Risk Mitigation; Reinsurance; Small Business Health Options Program (SHOP) implementation; Third-party payment of premiums; Electronic Health Records (EHRs); Health IT Roadmap; Contraception Rule; Expatriate Legislation. See following page on Health Care Reform issuesS. 1486 Introduced August 1, 2013 by Sen. Carper, Thomas R. (D-DE) Postal Reform Act of 2013 - Amends provisions of federal law relating to the funding of the U.S. Postal Service (USPS) retirement and health care systems, operations, revenue, and governance.. Section 104 Substitute Amendment. HR 3362 Introduced October 29, 2013 by Rep. Terry, Lee (R-NE) Exchange Information Disclosure Act - Amends the Patient Protection and Affordable Care Act to expand reporting requirements related to health care exchanges. Requires the Secretary of Health and Human Services (HHS) to publish reports weekly through March 31, 2015, on: (1) consumer interactions with healthcare.gov or subsequent sites and any efforts undertaken to remedy problems that impact taxpayers and consumers, (2) calls to the federal customer service call center, including the number of calls received by the call center, problems identified by users, and referrals of those calls; (3) all navigators and certified application counselors that have been trained and certified by health care exchanges; and (4) all agents and brokers who have been trained and certified by the federal health care exchange. HR 762 Introduced in House February 15, 2013 by Rep. Blackburn, Marsha (R-TN) Health Care Choice Act of 2013 - Repeals the health insurance and health coverage expansion requirements of the Patient Protection and Affordable Care Act and related requirements of the Health Care and Education Reconciliation Act of 2010. Restores provisions of law amended or repealed by such provisions. HR 1701 Introduced April 24, 2013 by Ted Poe (R-TX) Cutting Costly Codes Act of 2013 - Prohibits the Secretary of Health and Human Services (HHS) from implementing, administering, or enforcing specified regulations insofar as they would replace International Classification of Diseases (ICD)-9 with ICD-10 as a standard for code sets for appropriate data elements for financial and administrative transactions involving the electronic exchange of health information. HR 3985 Introduced February 3, 2014 by Lynn Westmoreland (R-GA) Prohibits health insurance issuers and third-party administrators, for any period after December 31, 2014, from being required to make payments under the Patient Protection and Affordable Care Act (PPACA) for a transitional reinsurance program for the individual health insurance market in each state. Allows payments to issuers, as limited by this Act, only to the extent of available funds. Limits to 2014 the applicability of the program of risk corridors, under which a qualified health plan offered in the individual or small group market shall participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums . HR 4496 Introduced April 28, 2014 by Cory Gardner (R-CO) Covering People With Pre-Existing Conditions Act of 2014 - Requires each state to mitigate the health costs of high risk individuals in the state through a state reinsurance program or a state high risk pool HR 4777 Introduced May 30, 2014 by Michael Burgess (R-TX) To amend the Internal Revenue Code of 1986 to modify rules relating to health savings accounts. HR 3522 Introduced November 18, 2013 by Bill Cassidy (R-LA) To authorize health insurance issuers to continue to offer for sale current group health insurance coverage in satisfaction of the minimum essential health insurance coverage requirement, and for other purposes. HR 5214 Introduced July 28, 2014 by Pete Olsen (R-TX) To require the Secretary of Health and Human Services to provide for recommendations for the development and use of clinical data registries for the improvement of patient care. See following page on Health Care Reform issuesHR 3750 Introduced December 12, 2013 by Donna Matsui (D-CA) Telehealth Modernization Act of 2013 - Calls for states to authorize health care professionals to deliver health care to individuals through telehealth and to consider adopting conditions under which such a professional should: have access to the individual's medical history. HR 4633 Introduced May 9, 2014 by H. Griffith (R-VA) Insurance Rate Transparency Act - Amends the Public Health Service Act to require that specific health insurance premium increase information submitted to the Secretary of Health and Human Services (HHS) be disclosed to Congress no later than 30 days after receipt of the information. HR 5453 Introduced September 11, 2014 by Bruce Braley (D-IA) To authorize health insurance issuers to continue to offer for sale current group health insurance coverage in satisfaction of the minimum essential health insurance coverage requirement, and for other purposes.

Client expense: $1,540,000 · 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), Office of Management & Budget (OMB), Office of Personnel Management (OPM), SENATE, Treasury, Dept of, White House Office

Insurance Market Reform, General issues; Grandfathered Policies / Continuation of Existing Coverage (H.R. 335); Risk Corridors(S. 1726 and H.R. 3541); State Based Regulations: Exchanges/Medicaid; Healthcare Quality: Delivery System Incentives to Promote Better Care; Patient Safety and Quality Improvement; Payment Reforms; Patient-Centered Primary/Medical Home; Bundled Payments; Wellness/Health Disparities; Chronic Care & Medical Management; Childhood Obesity; Infant Mortality; Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM (H.R. 779; President's Budget); S.1486, Postal Reform Act of 2013; Risk mitigation legislation: S.1726, H.R.3541, H.R.3812, H.R.3851, H.R.4406; ACA Implementation and back-end issues.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Affordable Private Health Care: Effect of the Health Insurance Tax, defined Essential Health Benefits, and Age Rating on premiums; Healthcare Delivery System Reforms State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; ; Multi-State Health Plans; Centralized All-Payer Database Medical Loss Ratios: Level Playing Field for MLRs; Consistent reporting requirements for all insurers; Medicare Cost Contract Extension MLR Broker Fees:Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Evidence Based Care; Wellness; Chronic Care Management Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM FEHBP Modernization Act circulation draft President's budget, regional PPOs, government contributions HR 2667 Introduced by Griffin (R-AR) on July 11, 2013 Authority for Mandate Delay Act HR 2668 Introduced by Young (R-IN) on July 17, 2013 Fairness for Families Act Bailouts for Insurance Companies, S. 1726, H.R. 3541, 3812, 3851. 4406 HR 2328 Introduced in House June 12, 2013 Rep. Rogers, Mike J. (R-MI) Access to Professional Health Insurance Advisors Act of 2013 - Amends the Public Health Service Act to exclude remuneration paid for licensed independent insurance producers from administrative cost calculations for purposes of calculating the medical-loss ratio of a health insurance plan. HR 3541 introduced by Tim Griffin November 19,2013 Obamacare Taxpayer Bailout Prevention Act - Repeals the provision of the Patient Protection and Affordable Care Act that directs the Secretary of Health and Human Services (HHS) to establish and administer a program of risk corridors for calendar years 2014, 2015, and 2016 under which a qualified health plan offered in the individual or small group market is required to participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums. Other general Affordable Care Act topics related to multiple parts of legislation: ACA Implementation and back-end issues; Multi-State Plan Program Implementation; Risk Corridors and Risk Mitigation; Reinsurance; Small Business Health Options Program (SHOP) implementation; Third-party payment of premiums; Electronic Health Records (EHRs); Health IT Roadmap; Exchange Information Disclosure Act - Amends the Patient Protection and Affordable Care Act to expand reporting requirements related to health care exchanges. Requires the Secretary of Health and Human Services (HHS) to publish reports weekly through March 31, 2015, on: (1) consumer interactions with healthcare.gov or subsequent sites and any efforts undertaken to remedy problems that impact taxpayers and consumers, (2) calls to the federal customer service call center, including the number of calls received by the call center, problems identified by users, and referrals of those calls; (3) all navigators and certified application counselors that have been trained and certified by health care exchanges; and (4) all agents and brokers who have been trained and certified by the federal health care exchange. HR 762 Introduced in House February 15, 2013 by Rep. Blackburn, Marsha (R-TN) Health Care Choice Act of 2013 - Repeals the health insurance and health coverage expansion requirements of the Patient Protection and Affordable Care Act and related requirements of the Health Care and Education Reconciliation Act of 2010. Restores provisions of law amended or repealed by such provisions. HR 1701 Introduced April 24, 2013 by Ted Poe (R-TX) Cutting Costly Codes Act of 2013 - Prohibits the Secretary of Health and Human Services (HHS) from implementing, administering, or enforcing specified regulations insofar as they would replace International Classification of Diseases (ICD)-9 with ICD-10 as a standard for code sets for appropriate data elements for financial and administrative transactions involving the electronic exchange of health information. HR 3985 Introduced February 3, 2014 by Lynn Westmoreland (R-GA) Prohibits health insurance issuers and third-party administrators, for any period after December 31, 2014, from being required to make payments under the Patient Protection and Affordable Care Act (PPACA) for a transitional reinsurance program for the individual health insurance market in each state. Allows payments to issuers, as limited by this Act, only to the extent of available funds. Limits to 2014 the applicability of the program of risk corridors, under which a qualified health plan offered in the individual or small group market shall participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums . HR 4496 Introduced April 28, 2014 by Cory Gardner (R-CO) Covering People With Pre-Existing Conditions Act of 2014 - Requires each state to mitigate the health costs of high risk individuals in the state through a state reinsurance program or a state high risk pool HR 5453 Introduced September 11, 2014 by Bruce Braley (D-IA) To authorize health insurance issuers to continue to offer for sale current group health insurance coverage in satisfaction of the minimum essential health insurance coverage requirement, and for other purpos

Client expense: $43,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Federal Employee Health Benefit Program (FEHBP) - proposals to allow the inclusion of regional PPO carriers to be included as an option for coverage offered by OPM. Risk Mitigation Repeal and Modification Legislation to repeal or amend provisions of the risk corridor, risk adjustment or reinsurance programs established under the Patient Protection and Affordable Care Act. Bailouts for Insurance Companies - S. 1726, H.R. 3541, H.R. 3812, H.R. 3851, H.R. 4406 and related legislation

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 416 - Health Insurance Rate Review Act:A bill to amend the Public Health Service Act to provide protection for consumers against excessive, unjustified or unfairly discriminatory increases in premium rates. HR 979 - FEHBP Prescription Drug Integrity, Transparency, and Cost Savings Act: To amend chapter of title 5, United States Code to ensure program integrity, transparency and cost savings in the pricing and contracting of prescription drug benefits under the Federal Employees Health Benefits Program. HR 1370 - To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act. HR 2577 - SAFE Data Act: A bill to protect consumers by requiring reasonable security policies and procedures to protect data containing personal information and to provide for nationwide notice in the event of a security breach. HR 2676 - Small Business Health Relief Act of 2011: To lower health premiums and increase choice for small business. HR 3350 - Keep your Health Plan Act of 2013: To authorize health insurance issuers to continue to offer for sale current individual health insurance coverage in satisfaction of the minimum essential health insurance coverage requirement, and for other purposes. HR 3522 - Employee Health Care Protection Act of 2013: To authorize health insurance issuers to continue to offer for sale current individual health insurance coverage in satisfaction of the minimum essential health insurance coverage requirement and for other purposes. HR 3541 - Obamacare Taxpayer Bailout Prevention Act: To prevent a taxpayer bailout of health insurance issuers. HR 4805 - No subsidies Without Verification Process Act of 2014:To delay the provision of the Affordable Care Act premium and cost-sharing subsidies until the eligibility verification process for such subsidies is complete and for other purposes. HR 5214 - Clinical Data Registries: To require the Secretary of Health & Human Services to provide for recommendations for the development and use of clinical data registries for the improvement of patient care. HR 5364 - CHIP Extension & Improvement Act of 2014: To amend title XXI of the Social Security Act to extend and improve Childrens Health Insurance Program and for other purposes. S 24 - Small Business Health Relief Act of 2013: To lower health premiums and increase choice for small business. S 40 - American Liberty Restoration Act: To restore Americans individual liberty by striking the federal mandate to purchase insurance. S 482 - Health Insurance Rate Review Act: To amend the Public Health Service to provide protections for consumers against excessive, unjustified or unfairly discriminatory increases in premium rates. S 1726 - Obamacare Taxpayer Bailout Prevention Act: To prevent a taxpayer bailout of health insurance issuers. S 1729 - Expanded Consumer Choice Act:To amend the Patient Protection and Affordable Care Act to provide further options with respect to levels of coverage under qualified health plans. S 1880 - Jobs and Premium Protection Act: To repeal the annual fee on health care laws job-killing health insurance tax. S 2174 - Commonsense Competition and Access to Health Insurance Act: To amend the Patient Protection and Affordable Care Act to provide greater flexibility in offering health insurance coverage across state lines. S 2461 - CHIP Extension Act of 2014: Amend title XXI of the Social Security Act to extend & improve the Childrens Health Insurance Program and for other purposes. Department of Health & Human Services Implementation of Medical Loss Ratio arrangements; Implementation of health insurance exchanges; Implementation of Qualified Health Plans, Implementation Essential Health Benefits.

Client expense: $130,000 · Firm income: Not reported

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

Health Care Issues S.1726, Obamacare Taxpayer Bailout Prevention Act H.R.3541, Obamacare Taxpayer Bailout Prevention Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Implementation of the Affordable Care Act - HR 3541, Obamacare Taxpayer Bailout Prevention Act; S 540, Temporary Debt Limit Extension Act. Reinsurance provisions in the Affordable Care Act - S 540, Temporary Debt Limit Extension Act; S 1726, Obamacare Taxpayer Bailout Prevention Act; HR 3541, Obamacare Taxpayer Bailout Prevention Act;HR 3851, No Bailouts for Insurance Industry Act of 2014.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

See atddendum page.Affordable Private Health Care: Effect of the Health Insurance Tax, defined Essential Health Benefits, and Age Rating on premiums; Healthcare Delivery System Reforms State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; Multi-State Health Plans; Medical Loss Ratios: Level Playing Field for MLRs; Consistent reporting requirements for all insurers Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Evidence Based Care; Wellness; Chronic Care Management Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM FEHBP Modernization Act circulation draft President's budget, regional PPOs, government contributions HR 2667 Introduced by Griffin (R-AR) on July 11, 2013 Authority for Mandate Delay Act Bailouts for Insurance Companies, S. 1726, H.R. 3541, 3812, 3851. 4406 HR 3541 introduced by Tim Griffin November 19,2013 Obamacare Taxpayer Bailout Prevention Act - Repeals the provision of the Patient Protection and Affordable Care Act that directs the Secretary of Health and Human Services (HHS) to establish and administer a program of risk corridors for calendar years 2014, 2015, and 2016 under which a qualified health plan offered in the individual or small group market is required to participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums. Other general Affordable Care Act topics related to multiple parts of legislation: ACA Implementation and back-end issues; Multi-State Plan Program Implementation; Risk Corridors and Risk Mitigation; Reinsurance; Small Business Health Options Program (SHOP) implementation; Third-party payment of premiums; Electronic Health Records (EHRs); Health IT Roadmap; Contraception Rule HR 762 Introduced in House February 15, 2013 by Rep. Blackburn, Marsha (R-TN) Health Care Choice Act of 2013 - Repeals the health insurance and health coverage expansion requirements of the Patient Protection and Affordable Care Act and related requirements of the Health Care and Education Reconciliation Act of 2010. Restores provisions of law amended or repealed by such provisions. HR 3985 Introduced February 3, 2014 by Lynn Westmoreland (R-GA) Prohibits health insurance issuers and third-party administrators, for any period after December 31, 2014, from being required to make payments under the Patient Protection and Affordable Care Act (PPACA) for a transitional reinsurance program for the individual health insurance market in each state. Allows payments to issuers, as limited by this Act, only to the extent of available funds. Limits to 2014 the applicability of the program of risk corridors, under which a qualified health plan offered in the individual or small group market shall participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums.

Client expense: $309,446 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Affordable Private Health Care: Effect of the Health Insurance Tax, defined Essential Health Benefits, and Age Rating on premiums; Healthcare Deliver System Reforms. State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; Multi-State Health Plans; Centralized All-Payer Database. Medical Loss Ratios: Level Playing Field for MLRs; Consistent reporting requirements for all insurers; MLR Broker Fees. Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Evidence Based Care; Wellness; Chronic Care Management Federal Employee Health BEnefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM FEHBP Modernization Act circulation draft President's budget, regional PPOs, government contributions HR 2667 Introduced by Griffin (R-AR) on July 11, 2013 Authority for Mandate Delay Act HR 2668 Introduced by Young (R-IN) on July 17, 2013 Fairness for Families Act Bailouts for Insurance Companies, S. 1726, H.R. 3541, 3812, 3851, 4406 HR 2328 Introduced in House June 12, 2013 Rep. Rogers, Mike J. (R-MI) Access to Professional Health Insurance Advisors Act of 2013 - Amends the Public Health Service Act to exclude remuneration paid for licensed independent insurance producers from administrative cost calculations for purposes of calculating the medical-loss ratio of a health insurance plan. HR 3541 introduced by Tim Griffin November 19, 2013 Obamacare Taxpayer Bailout Prevention Act - Repeals the provision of the Patient Protection and Affordable Care Act that directs the Secretary of Health and Human Services (HHS) to establish and administer a program of risk corridors for calendar years 2014, 2015, and 2016 under which a qualified health plan offered in the individual or small group market is required to participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums. Other general Affordable Care Act topics related to multiple parts of legislation: ACA Implementation and back-end issues; Multi-State Plan Program Implementation; Risk Corridors and Risk Mitigation; Reinsurance; Small Business Health Options Program (SHOP) implementation; Third-party payment of premiums; Electronic Health Records (EHRs); Health IT Roadmap; Contraception Rule S. 1486 Introduced August 1, 2013 by Sen. Carper, Thomas R. (D-DE) Postal Reform Act of 2013 - Amends provisions of federal law relating to the funding of the U.S. Postal Service (USPS) retirement and health care systems, operations, revenue and governance. Section 104 Substitute Amendment. HR 3362 Introduced October 29, 2013 by Rep. Terry, Lee (R-NE) Exchange Information Disclosure Act - Amends the Patient Protection and Affordable Care Act to expand reporting requirements related to health care exchanges. Requires the Secretary of Health an Human Services (HHS) to publish reports weekly through March 31, 2015, on: (1) consumer interactions with healthcare.gov or subsequent sites and any efforts undertaken to remedy problems that impact taxpayers and consumers, (2) calls to the federal customer service call center, including the number of calls received by the call center, problems identified by users, and referrals of those calls; (3) all navigators and certified application counselors that have been trained and certified b health care exchanges; and (4) all agents and brokers who have been trained and certified by the federal health care exchange. HR 762 Introduced in House February 15, 2013 by Rep. Blackburn, Marsha (R-TN) Health Care Choice Act of 2013 - Repeals the health insurance and health coverage expansion requirements of the Patient Protection and Affordable Care Act and related requirements of the Health Care and Education Reconciliation Act of 2010. Restores provisions of law amended or repealed by such provisions. HR 1701 Introduced April 24, 2013 by Ted Poe (T-TX) Cutting Costly Codes Act of 2013 - Prohibits the Secretary of Health and Human Services (HHS) from implementing, administering, or enforcing specified regulations insofar as they would replace International Classification of Diseases (ICD-9) with ICD-10 as a standard for code sets for appropriate data elements for financial and administrative transactions involving the elecronic exchange of health information. HR 3985 Introduced February 3, 2014 by Lynn Westmoreland (R-GA) Prohibits health insurance issuers and third-party administrators, for any period after December 31, 2014, from being required to make payments under the Patient PRotection and Affordable Care Act (PPACA) for a transitional reinsurance program for the individual health insurance market in each state. Allows payments to issuers, as limited by this Act, only to the extent of available funds. Limits to 2014 the applicability of the program of risk corridors, under which a qualified health plan offered in the individual or small group market shall participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums. HR 4496 Introduced April 28, 2014 by Cory Gardner (R-CO) Covering People With Pre-Existing Conditions Act of 2014 - Requires each state to mitigate th health costs of high risk individuals in the state through a state reinsurance program or a state high risk pool.

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

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

H.R. 99, Health Insurance Industry Antitrust Enforcement Act (Conyers) antitrust policy16. Specific Lobbying Issues (continued): H.R. 544, LIBERTY Act (Gingrey-Matheson) age rating rules H.R. 743, Health Insurance Industry Fair Competition Act (DeFazio) antitrust policy H.R. 762, Health Care Choice Act (Blackburn) national marketplace for individual coverage H.R. 911, Competitive Health Insurance Reform Act (Gosar) antitrust policy H.R. 1019, Health Insurance Rate Review Act (Schakowsky) rate review H.R. 1188, Preserving Our Hometown Independent Pharmacies Act (Marino) antitrust policy H.R. 1205, Patients Right to Know Act (Walden) disclosures on SBC documents H.R. 1558, Small Business Health Relief Act (Collins) HIT repeal, other ACA changes H.R. 2328, Access to Professional Health Insurance Advisors Act (Rogers-Barrow) MLR impact on agents and brokers H.R. 2668, Fairness for American Families Act (Young) delay of ACA individual mandate H.R. 2698, Federal Employee Short-Term Disability Insurance Act (Norton) short-term disability program for federal employees H.R. 3121, American Health Care Reform Act (Roe) replacement health reforms H.R. 3350, Keep Your Health Plan Act (Upton) continuation of existing plans H.R. 3425, Health Care Access Fairness and Penalty Delay Act (Lipinski-Sinema) delay of open enrollment and individual mandate penalties H.R. 3489, (Tiberi) repeal of ACA transitional reinsurance fee H.R. 3504, Consumer Protection and Rate Review Act (Schakowsky) rate review H.R. 3517, Federal and State Insurance Exchange Access Fairness and Penalty Delay Act (Schrader) individual mandate delay H.R. 3522, Employee Health Care Protection Act (Cassidy) continuation of current group coverage H.R. 3541, Obamacare Taxpayer Bailout Prevention Act (Griffin) repeal of ACA risk corridor program H.R. 3598, Catastrophic Plan Bill (Fortenberry) expanded access to catastrophic plans H.R. 3745, Coverage Protection Act (Kirkpatrick) continuation of coverage for consumers unable to enroll in QHPs H.R. 3812, No Bailouts for Insurance Industry Act (Coffman) ACA reinsurance and risk corridor programs H.R. 3851, No Bailouts for Insurance Industry Act (Lance) ACA reinsurance and risk corridor programs H.R. 3985, Stop ACA's Risky Provisions Act (Westmoreland) ACAs reinsurance, risk corridor, and risk adjustment programs H.R. 4118, SIMPLE Fairness Act (Jenkins) delay in ACA individual mandate penalties H.R. 4302, Protecting Access to Medicare Act (Pitts) ACA Limits on Deductibles for Plans in Small Group Market H.R. 4354, ACA Taxpayer Bailout Protection Act (Griffin) ACA risk corridor program H.R. 4406, Taxpayer Bailout Protection Act (Lance) ACA risk corridor program H.R. 4414, Expatriate Health Coverage Clarification Act (Carney) relief from ACA for expatriate health plans H.R. 4735, Health Care Fairness and Stability Act (Nolan-McKinley) ACA transitional reinsurance program S. 24, Small Business Health Relief Act (Portman) HIT repeal, other ACA changes S. 482, Health Insurance Rate Review Act (Feinstein) rate review S. 650, Access to Independent Health Insurance Advisors Act (Landrieu) MLR impact on agents and brokers S. 764, Patients Right to Know Act (Cornyn) disclosures on SBC documents S. 1473, Long-Term Care Insurance Consumer Right-to-Know Act (Klobuchar) model disclosure forms S. 1481, Long Term Care Insurance Integrity Act (Klobuchar) third party review of disputed claims S. 1642, Keeping the ACA Promise Act (Landrieu-Manchin) continuation of existing plans, notification requirements S. 1671, (Manchin-Kirk) individual mandate delay S. 1693, ACA Enrollment Extension Act (Shaheen) extending open enrollment, delaying individual mandate penalties S. 1699, Continuous Coverage Act (Mark Udall) continuation of existing plans S. 1726, Obamacare Taxpayer Bailout Prevention Act (Rubio) repeal of ACA risk corridor program S. 1729, Expanded Consumer Choice Act (Begich) adding copper level of coverage to ACA Exchanges S. 1866, Coverage Protection Act (Merkley) continuation of coverage, retroactive coverage S. 2166, Treating Families Fairly Act (Manchin) ACA determinations of full-time equivalent employees S. 2168, Small Business Stability Act (Heitkamp) ACA definition of a large employer S. 2173, Consumers Having Options in Choosing Enrollment Act (Landrieu) ACA direct enrollment16. Specific Lobbying Issues (continued): S. 2174, Commonsense Competition and Access to Health Insurance Act (Warner) offering health insurance coverage across state lines S. 2175, Enhancing Access for Agents and Brokers Act (Landrieu) access for independent agents and brokers to information about Exchange enrollments. S. 2176, Commonsense Reporting Act (Warner) ACA reporting requirements S. 2214, ACA Taxpayer Bailout Protection Act (Rubio) ACA risk corridor program S. 2253, Health Care Fairness and Stability Act (Franken-Kirk) ACA transitional reinsurance program Regulatory Issues: Insurance regulatory reform; issues related to the coordination of private and public disability income benefits; disability risk management; disability income insurance enrollment and awareness; issues related to the continuation of reporting requirements for state LTCI partnership programs; issues relating to the coordination of benefits between private health insurance plans and Medicaid; Medigap claims processing and crossover fees; Medigap cross-over claim issues, Medigap coverage, implementation of Medigap standardized plan offerings; Medigap carrier recoveries related to CMS fraud and abuse enforcement activities, and issues related to Medigap educational materials, and other Medigap issues; fraud and abuse issues affecting public and private insurance coverage; issues relating to antitrust; implementation of the Mental Health Parity Act requirements; summary of benefits and coverage disclosures; pre-existing condition insurance plans; accountable care organizations; coverage of preventive services; preexisting condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; health insurance web portal requirements; dependent coverage; treatment of expatriate plans; compliance with the transitional reinsurance program; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations, non-discriminatory wellness programs; and issues related to supplemental products, and other issues relating to health care reform implementation.

Client expense: $2,530,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Pension & Welfare Benefits Administration, SENATE, Social Security Administration (SSA), Treasury, Dept of, White House Office

Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM FEHBP Modernization ACT circulation draft President's budget, regional PPOs, government contributions S.1726, HR 3541, 3812, 3851, 4406 - Bailouts for Insurance Companies Risk Corridors and Risk Mitigation, Reinsurance

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

See attached addendum for General Lobbying Issue Area: HCR - HealthcareAffordable Private Health Care: Effect of the Health Insurance Tax, defined Essential Health Benefits, and Age Rating on premiums; Healthcare Delivery System Reforms State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; Multi-State Health Plans; Centralized All-Payer Database Medical Loss Ratios: Level Playing Field for MLRs; Consistent reporting requirements for all insurers; MLR Broker Fees: Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Evidence Based Care; Wellness; Chronic Care Management Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM FEHBP Modernization Act circulation draft President's budget, regional PPOs, government contributions HR 2667 Introduced by Griffin (R-AR) on July 11, 2013 Authority for Mandate Delay Act HR 2668 Introduced by Young (R-IN) on July 17, 2013 Fairness for Families Act Bailouts for Insurance Companies, S. 1726, H.R. 3541, 3812, 3851. 4406 HR 2328 Introduced in House June 12, 2013 Rep. Rogers, Mike J. (R-MI) Access to Professional Health Insurance Advisors Act of 2013 - Amends the Public Health Service Act to exclude remuneration paid for licensed independent insurance producers from administrative cost calculations for purposes of calculating the medical-loss ratio of a health insurance plan. HR 3541 introduced by Tim Griffin November 19,2013 Obamacare Taxpayer Bailout Prevention Act - Repeals the provision of the Patient Protection and Affordable Care Act that directs the Secretary of Health and Human Services (HHS) to establish and administer a program of risk corridors for calendar years 2014, 2015, and 2016 under which a qualified health plan offered in the individual or small group market is required to participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums. Other general Affordable Care Act topics related to multiple parts of legislation: ACA Implementation and back-end issues; Multi-State Plan Program Implementation; Risk Corridors and Risk Mitigation; Reinsurance; Small Business Health Options Program (SHOP) implementation; Third-party payment of premiums; Electronic Health Records (EHRs); Health IT Roadmap; Contraception Rule See following page on Health Care Reform issuesS. 1486 Introduced August 1, 2013 by Sen. Carper, Thomas R. (D-DE) Postal Reform Act of 2013 - Amends provisions of federal law relating to the funding of the U.S. Postal Service (USPS) retirement and health care systems, operations, revenue, and governance.. Section 104 Substitute Amendment. HR 3362 Introduced October 29,2013 by Rep. Terry, Lee (R-NE) Exchange Information Disclosure Act - Amends the Patient Protection and Affordable Care Act to expand reporting requirements related to health care exchanges. Requires the Secretary of Health and Human Services (HHS) to publish reports weekly through March 31, 2015, on: (1) consumer interactions with healthcare.gov or subsequent sites and any efforts undertaken to remedy problems that impact taxpayers and consumers, (2) calls to the federal customer service call center, including the number of calls received by the call center, problems identified by users, and referrals of those calls; (3) all navigators and certified application counselors that have been trained and certified by health care exchanges; and (4) all agents and brokers who have been trained and certified by the federal health care exchange. HR 762 Introduced in House February 15, 2013 by Rep. Blackburn, Marsha (R-TN) Health Care Choice Act of 2013 - Repeals the health insurance and health coverage expansion requirements of the Patient Protection and Affordable Care Act and related requirements of the Health Care and Education Reconciliation Act of 2010. Restores provisions of law amended or repealed by such provisions. HR 1701 Introduced April 24, 2013 by Ted Poe (R-TX) Cutting Costly Codes Act of 2013 - Prohibits the Secretary of Health and Human Services (HHS) from implementing, administering, or enforcing specified regulations insofar as they would replace International Classification of Diseases (ICD)-9 with ICD-10 as a standard for code sets for appropriate data elements for financial and administrative transactions involving the electronic exchange of health information. HR 3985 Introduced February 3, 2014 by Lynn Westmoreland (R-GA) Prohibits health insurance issuers and third-party administrators, for any period after December 31, 2014, from being required to make payments under the Patient Protection and Affordable Care Act (PPACA) for a transitional reinsurance program for the individual health insurance market in each state. Allows payments to issuers, as limited by this Act, only to the extent of available funds. Limits to 2014 the applicability of the program of risk corridors, under which a qualified health plan offered in the individual or small group market shall participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums . HR 4496 Introduced April 28, 2014 by Cory Gardner (R-CO) Covering People With Pre-Existing Conditions Act of 2014 - Requires each state to mitigate the health costs of high risk individuals in the state through a state reinsurance program or a state high risk pool HR 4777 Introduced May 30, 2014 by Michael Burgess (R-TX) To amend the Internal Revenue Code of 1986 to modify rules relating to health savings accounts.

Client expense: $1,820,000 · Firm income: Not reported

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

Legislation and regulations affecting health plans. H.R.763, To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act. H.R.3350, Keep Your Health Plan Act of 2013. H.R.3541/S.1726, Obamacare Taxpayer Bailout Prevention Act.

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

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

Affordable Private Health Care: Effect of the Health Insurance Tax, defined Essential Health Benefits, and Age Rating on premiums; Healthcare Delivery System Reforms State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; Multi-State Health Plans; Centralized All-Payer Database Medical Loss Ratios: Level Playing Field for MLRs; Consistent reporting requirements for all insurers; MLR Broker Fees: Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Evidence Based Care; Wellness; Chronic Care Management Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM FEHBP Modernization Act circulation draft President's budget, regional PPOs, government contributions HR 2667 Introduced by Griffin (R-AR) on July 11, 2013 Authority for Mandate Delay Act HR 2668 Introduced by Young (R-IN) on July 17, 2013 Fairness for Families Act Bailouts for Insurance Companies, S. 1726, H.R. 3541, 3812, 3851. 4406 HR 2328 Introduced in House June 12, 2013 Rep. Rogers, Mike J. (R-MI) Access to Professional Health Insurance Advisors Act of 2013 - Amends the Public Health Service Act to exclude remuneration paid for licensed independent insurance producers from administrative cost calculations for purposes of calculating the medical-loss ratio of a health insurance plan. HR 3541 introduced by Tim Griffin November 19,2013 Obamacare Taxpayer Bailout Prevention Act - Repeals the provision of the Patient Protection and Affordable Care Act that directs the Secretary of Health and Human Services (HHS) to establish and administer a program of risk corridors for calendar years 2014, 2015, and 2016 under which a qualified health plan offered in the individual or small group market is required to participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums. Other general Affordable Care Act topics related to multiple parts of legislation: ACA Implementation and back-end issues; Multi-State Plan Program Implementation; Risk Corridors and Risk Mitigation; Reinsurance; Small Business Health Options Program (SHOP) implementation; Third-party payment of premiums; Electronic Health Records (EHRs); Health IT Roadmap; Contraception Rule S. 1486 Introduced August 1, 2013 by Sen. Carper, Thomas R. (D-DE) Postal Reform Act of 2013 - Amends provisions of federal law relating to the funding of the U.S. Postal Service (USPS) retirement and health care systems, operations, revenue, and governance.. Section 104 Substitute Amendment. HR 3362 Introduced October 29,2013 by Rep. Terry, Lee (R-NE) Exchange Information Disclosure Act - Amends the Patient Protection and Affordable Care Act to expand reporting requirements related to health care exchanges. Requires the Secretary of Health and Human Services (HHS) to publish reports weekly through March 31, 2015, on: (1) consumer interactions with healthcare.gov or subsequent sites and any efforts undertaken to remedy problems that impact taxpayers and consumers, (2) calls to the federal customer service call center, including the number of calls received by the call center, problems identified by users, and referrals of those calls; (3) all navigators and certified application counselors that have been trained and certified by health care exchanges; and (4) all agents and brokers who have been trained and certified by the federal health care exchange. HR 762 Introduced in House February 15, 2013 by Rep. Blackburn, Marsha (R-TN) Health Care Choice Act of 2013 - Repeals the health insurance and health coverage expansion requirements of the Patient Protection and Affordable Care Act and related requirements of the Health Care and Education Reconciliation Act of 2010. Restores provisions of law amended or repealed by such provisions. HR 1701 Introduced April 24, 2013 by Ted Poe (R-TX) Cutting Costly Codes Act of 2013 - Prohibits the Secretary of Health and Human Services (HHS) from implementing, administering, or enforcing specified regulations insofar as they would replace International Classification of Diseases (ICD)-9 with ICD-10 as a standard for code sets for appropriate data elements for financial and administrative transactions involving the electronic exchange of health information. HR 3985 Introduced February 3, 2014 by Lynn Westmoreland (R-GA) Prohibits health insurance issuers and third-party administrators, for any period after December 31, 2014, from being required to make payments under the Patient Protection and Affordable Care Act (PPACA) for a transitional reinsurance program for the individual health insurance market in each state. Allows payments to issuers, as limited by this Act, only to the extent of available funds. Limits to 2014 the applicability of the program of risk corridors, under which a qualified health plan offered in the individual or small group market shall participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums . HR 4496 Introduced April 28, 2014 by Cory Gardner (R-CO) Covering People With Pre-Existing Conditions Act of 2014 - Requires each state to mitigate the health costs of high risk individuals in the state through a state reinsurance program or a state high risk pool HR 4777 Introduced May 30, 2014 by Michael Burgess (R-TX) To amend the Internal Revenue Code of 1986 to modify rules relating to health savings accounts.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 99, Health Insurance Industry Antitrust Enforcement Act (Conyers) - antitrust policy. H.R. 544, LIBERTY Act (Gingrey-Matheson) - age rating rules. H.R. 743, Health Insurance Industry Fair Competition Act (DeFazio) - antitrust policy. H.R. 762, Health Care Choice Act (Blackburn) - national marketplace for individual coverage. H.R. 911, Competitive Health Insurance Reform Act (Gosar) - antitrust policy. H.R. 1019, Health Insurance Rate Review Act (Schakowsky) - rate review. H.R. 1188, Preserving Our Hometown Independent Pharmacies Act (Marino) - antitrust policy. H.R. 1205, Patients Right to Know Act (Walden) - disclosures on SBC documents. H.R. 1558, Small Business Health Relief Act (Collins) - HIT repeal, other ACA changes. H.R. 2328, Access to Professional Health Insurance Advisors Act (Rogers-Barrow) - MLR impact on agents and brokers. H.R. 2668, Fairness for American Families Act (Young) - delay of ACA individual mandate. H.R. 2698, Federal Employee Short-Term Disability Insurance Act (Norton) - short-term disability program for federal employees. H.R. 3121, American Health Care Reform Act (Roe) - replacement health reforms. H.R. 3350, Keep Your Health Plan Act (Upton) - continuation of existing plans. H.R. 3425, Health Care Access Fairness and Penalty Delay Act (Lipinski-Sinema) - delay of open enrollment and individual mandate penalties. H.R. 3489, (Tiberi) - repeal of ACA transitional reinsurance fee. H.R. 3504, Consumer Protection and Rate Review Act (Schakowsky) - rate review. H.R. 3517, Federal and State Insurance Exchange Access Fairness and Penalty Delay Act (Schrader) - individual mandate delay. H.R. 3522, Employee Health Care Protection Act (Cassidy) - continuation of current group coverage. H.R. 3541, Obamacare Taxpayer Bailout Prevention Act (Griffin) - repeal of ACA risk corridor program. H.R. 3598, Catastrophic Plan Bill (Fortenberry) - expanded access to catastrophic plans. H.R. 3745, Coverage Protection Act (Kirkpatrick) - continuation of coverage for consumers unable to enroll in QHPs. H.R. 3812, No Bailouts for Insurance Industry Act (Coffman) - ACA reinsurance and risk corridor programs. H.R. 3851, No Bailouts for Insurance Industry Act (Lance) - ACA reinsurance and risk corridor programs. H.R. 3985, Stop ACA's Risky Provisions Act (Westmoreland) - ACAs reinsurance, risk corridor, and risk adjustment programs. H.R. 4118, SIMPLE Fairness Act (Jenkins) - delay in ACA individual mandate penalties. H.R. 4302, Protecting Access to Medicare Act (Pitts) - ACA Limits on Deductibles for Plans in Small Group Market. H.R. 4354, ACA Taxpayer Bailout Protection Act (Griffin) - ACA risk corridor program. H.R. 4406, Taxpayer Bailout Protection Act (Lance) - ACA risk corridor program. H.R. 4414, Expatriate Health Coverage Clarification Act (Carney) - relief from ACA for expatriate health plans. H.R. 4735, Health Care Fairness and Stability Act (Nolan-McKinley) - ACA transitional reinsurance program. S. 24, Small Business Health Relief Act (Portman) - HIT repeal, other ACA changes. S. 482, Health Insurance Rate Review Act (Feinstein) - rate review. S. 650, Access to Independent Health Insurance Advisors Act (Landrieu) - MLR impact on agents and brokers. S. 764, Patients Right to Know Act (Cornyn) - disclosures on SBC documents. S. 1473, Long-Term Care Insurance Consumer Right-to-Know Act (Klobuchar) - model disclosure forms. S. 1481, Long Term Care Insurance Integrity Act (Klobuchar) - third party review of disputed claims. S. 1642, Keeping the ACA Promise Act (Landrieu-Manchin) - continuation of existing plans, notification requirements. S. 1671, (Manchin-Kirk) - individual mandate delay. S. 1693, ACA Enrollment Extension Act (Shaheen) - extending open enrollment, delaying individual mandate penalties. S. 1699, Continuous Coverage Act (Mark Udall) - continuation of existing plans. S. 1726, Obamacare Taxpayer Bailout Prevention Act (Rubio) - repeal of ACA risk corridor program. S. 1729, Expanded Consumer Choice Act (Begich) - adding copper level of coverage to ACA Exchanges. S. 1866, Coverage Protection Act (Merkley) - continuation of coverage, retroactive coverage. S. 2166, Treating Families Fairly Act (Manchin) - ACA determinations of full-time equivalent employees. S. 2168, Small Business Stability Act (Heitkamp) - ACA definition of a large employer. S. 2173, Consumers Having Options in Choosing Enrollment Act (Landrieu) - ACA direct enrollment. S. 2174, Commonsense Competition and Access to Health Insurance Act (Warner) - offering health insurance coverage across state lines. S. 2175, Enhancing Access for Agents and Brokers Act (Landrieu) - access for independent agents and brokers to information about Exchange enrollment. S. 2176, Commonsense Reporting Act (Warner) - ACA reporting requirements. S. 2214, ACA Taxpayer Bailout Protection Act (Rubio) - ACA risk corridor program. S. 2253, Health Care Fairness and Stability Act (Franken-Kirk) - ACA transitional reinsurance program.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

See addendum page.H.R.3367, a bill introduced by Boustany (R-LA) on 10/29/13 to amend section 9010 of the Patient Protection and Affordable Care Act to delay the application of the health insurance provider annual fee until 2016 and to provide a process to return to consumers any amounts attributable to the expected application of the annual fee to 2014 and 2015. Elimination or reduction of ACA Risk corridor funding. S. 1726, HR 3541, 3812, 3851 and through regulations. Federal Employee Health Benefit Program (FEHBP)regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM. Stability of individual health insurance market

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

See attached addendum for general issue area code: HCR - Health IssuesAffordable Private Health Care: Effect of the Health Insurance Tax, defined Essential Health Benefits, and Age Rating on premiums; Healthcare Delivery System Reforms State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; Multi-State Health Plans; Centralized All-Payer Database Medical Loss Ratios: Level Playing Field for MLRs; Consistent reporting requirements for all insurers; MLR Broker Fees: Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Evidence Based Care; Wellness; Chronic Care Management Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM FEHBP Modernization Act circulation draft President's budget, regional PPOs, government contributions HR 2667 Introduced by Griffin (R-AR) on July 11, 2013 Bailouts for Insurance Companies, S. 1726, H.R. 3541, 3812, 3851. 4406 HR 3541 introduced by Tim Griffin November 19,2013 Obamacare Taxpayer Bailout Prevention Act - Repeals the provision of the Patient Protection and Affordable Care Act that directs the Secretary of Health and Human Services (HHS) to establish and administer a program of risk corridors for calendar years 2014, 2015, and 2016 under which a qualified health plan offered in the individual or small group market is required to participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums. Other general Affordable Care Act topics related to multiple parts of legislation: ACA Implementation and back-end issues; Multi-State Plan Program Implementation; Risk Corridors and Risk Mitigation; Reinsurance; Small Business Health Options Program (SHOP) implementation; Third-party payment of premiums; Electronic Health Records (EHRs); Health IT Roadmap; Contraception Rule HR 762 Introduced in House February 15, 2013 by Rep. Blackburn, Marsha (R-TN) Health Care Choice Act of 2013 - Repeals the health insurance and health coverage expansion requirements of the Patient Protection and Affordable Care Act and related requirements of the Health Care and Education Reconciliation Act of 2010. Restores provisions of law amended or repealed by such provisions. HR 1701 Introduced April 24, 2013 by Ted Poe (R-TX) Cutting Costly Codes Act of 2013 - Prohibits the Secretary of Health and Human Services (HHS) from implementing, administering, or enforcing specified regulations insofar as they would replace International Classification of Diseases (ICD)-9 with ICD-10 as a standard for code sets for appropriate data elements for financial and administrative transactions involving the electronic exchange of health information. HR 3985 Introduced February 3, 2014 by Lynn Westmoreland (R-GA) Prohibits health insurance issuers and third-party administrators, for any period after December 31, 2014, from being required to make payments under the Patient Protection and Affordable Care Act (PPACA) for a transitional reinsurance program for the individual health insurance market in each state. Allows payments to issuers, as limited by this Act, only to the extent of available funds. Limits to 2014 the applicability of the program of risk corridors, under which a qualified health plan offered in the individual or small group market shall participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums .

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Insurance Market Reform, General Issues; Grandfathered Policies / Continuation of Existing Coverage (H.R. 335); Risk Corridors (S. 1726 and H.R. 3541); State Based Regulations: Exchanges/Medicaid Healthcare Quality: Delivery System Incentives to Promote Better Care; Patient Safety and Quality Improvement; Payment Reforms; Patient-Centered Primary/Medical Home; Bundled Payments; Wellness-Health DisparitiesChronic Care & Medical Management; Childhood Obesity; Infant Mortality Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM (H.R. 779; President's Budget). S. 1486, Postal Reform Act of 2013 Risk mitigation legislation: S. 1726, H.R. 3541, H.R. 3812, H.R. 3851. H.R. 4406 ACA Implementation and back-end issues

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Health Care Issues S.1726, Obamacare Taxpayer Bailout Prevention Act H.R.3541, Obamacare Taxpayer Bailout Prevention Act

Client expense: Not reported · Firm income: $45,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

See addendum page.Affordable Private Health Care: Effect of the Health Insurance Tax, defined Essential Health Benefits, and Age Rating on premiums; Healthcare Delivery System Reforms State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; Multi-State Health Plans; Centralized All-Payer Database Medical Loss Ratios: Level Playing Field for MLRs; Consistent reporting requirements for all insurers; MLR Broker Fees: Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Evidence Based Care; Wellness; Chronic Care Management Insurance Market Reform; Individual Market Reform; Small Group Market Reform; Guaranteed Issue; Community Rating; Age Rating; Health Savings Accounts Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM Bailouts for Insurance Companies, S. 1726, H.R. 3541, 3812, 3851 HR 3541 introduced by Tim Griffin November 19,2013 Obamacare Taxpayer Bailout Prevention Act - Repeals the provision of the Patient Protection and Affordable Care Act that directs the Secretary of Health and Human Services (HHS) to establish and administer a program of risk corridors for calendar years 2014, 2015, and 2016 under which a qualified health plan offered in the individual or small group market is required to participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums. Other general Affordable Care Act topics related to multiple parts of legislation: Delay of Individual Mandate; ACA Implementation; Multi-State Plan Program Implementation; Risk Corridors and Risk Mitigation; Reinsurance; Small Business Health Options Program (SHOP) implementation See following pages on Health Care Reform issues

Client expense: $240,700 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

See attached addendum for General Lobbying Issue Area: HCR - HealthcareAffordable Private Health Care: Effect of the Health Insurance Tax, defined Essential Health Benefits, and Age Rating on premiums; Healthcare Delivery System Reforms State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; Multi-State Health Plans; Centralized All-Payer Database Medical Loss Ratios: Level Playing Field for MLRs; Consistent reporting requirements for all insurers; MLR Broker Fees: Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Evidence Based Care; Wellness; Chronic Care Management Insurance Market Reform; Individual Market Reform; Small Group Market Reform; Guaranteed Issue; Community Rating; Age Rating; Health Savings Accounts Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM FEHBP Modernization Act circulation draft President's budget, regional PPOs, government contributions HR 2667 Introduced by Griffin (R-AR) on July 11, 2013 Authority for Mandate Delay Act HR 2668 Introduced by Young (R-IN) on July 17, 2013 Fairness for Families Act Bailouts for Insurance Companies, S. 1726, H.R. 3541, 3812, 3851 HR 2328 Introduced in House June 12, 2013 Rep. Rogers, Mike J. (R-MI) Access to Professional Health Insurance Advisors Act of 2013 - Amends the Public Health Service Act to exclude remuneration paid for licensed independent insurance producers from administrative cost calculations for purposes of calculating the medical-loss ratio of a health insurance plan. HR 3541 introduced by Tim Griffin November 19,2013 Obamacare Taxpayer Bailout Prevention Act - Repeals the provision of the Patient Protection and Affordable Care Act that directs the Secretary of Health and Human Services (HHS) to establish and administer a program of risk corridors for calendar years 2014, 2015, and 2016 under which a qualified health plan offered in the individual or small group market is required to participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums. Other general Affordable Care Act topics related to multiple parts of legislation: Delay of Individual Mandate; ACA Implementation; Multi-State Plan Program Implementation; Risk Corridors and Risk Mitigation; Reinsurance; Small Business Health Options Program (SHOP) implementation See following pages on Health Care Reform issuesS. 1486 Introduced August 1, 2013 by Sen. Carper, Thomas R. (D-DE) Postal Reform Act of 2013 - Amends provisions of federal law relating to the funding of the U.S. Postal Service (USPS) retirement and health care systems, operations, revenue, and governance.. Section 104 Substitute Amendment. HR 3362 Introduced October 29,2013 by Rep. Terry, Lee (R-NE) Exchange Information Disclosure Act - Amends the Patient Protection and Affordable Care Act to expand reporting requirements related to health care exchanges. Requires the Secretary of Health and Human Services (HHS) to publish reports weekly through March 31, 2015, on: (1) consumer interactions with healthcare.gov or subsequent sites and any efforts undertaken to remedy problems that impact taxpayers and consumers, (2) calls to the federal customer service call center, including the number of calls received by the call center, problems identified by users, and referrals of those calls; (3) all navigators and certified application counselors that have been trained and certified by health care exchanges; and (4) all agents and brokers who have been trained and certified by the federal health care exchange. HR 762 Introduced in House February 15, 2013 by Rep. Blackburn, Marsha (R-TN) Health Care Choice Act of 2013 - Repeals the health insurance and health coverage expansion requirements of the Patient Protection and Affordable Care Act and related requirements of the Health Care and Education Reconciliation Act of 2010. Restores provisions of law amended or repealed by such provisions. HR 1701 Introduced April 24, 2013 by Ted Poe (R-TX) Cutting Costly Codes Act of 2013 - Prohibits the Secretary of Health and Human Services (HHS) from implementing, administering, or enforcing specified regulations insofar as they would replace International Classification of Diseases (ICD)-9 with ICD-10 as a standard for code sets for appropriate data elements for financial and administrative transactions involving the electronic exchange of health information.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation and regulations affecting health plans. H.R. 763, To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act. H.R. 3350, Keep Your Health Plan Act of 2013. H.R. 3541 / S. 1726, Obamacare Taxpayer Bailout Prevention Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

See attached addendum for General Lobbying Issue Area: HCR - HealthcareAffordable Private Health Care: Effect of the Health Insurance Tax, defined Essential Health Benefits, and Age Rating on premiums; Healthcare Delivery System Reforms State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; Multi-State Health Plans; Centralized All-Payer Database Medical Loss Ratios: Level Playing Field for MLRs; Consistent reporting requirements for all insurers; MLR Broker Fees: Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Evidence Based Care; Wellness; Chronic Care Management Insurance Market Reform; Individual Market Reform; Small Group Market Reform; Guaranteed Issue; Community Rating; Age Rating; Health Savings Accounts Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM FEHBP Modernization Act circulation draft President's budget, regional PPOs, government contributions HR 2667 Introduced by Griffin (R-AR) on July 11, 2013 Authority for Mandate Delay Act HR 2668 Introduced by Young (R-IN) on July 17, 2013 Fairness for Families Act Bailouts for Insurance Companies, S. 1726, H.R. 3541, 3812, 3851 HR 2328 Introduced in House June 12, 2013 Rep. Rogers, Mike J. (R-MI) Access to Professional Health Insurance Advisors Act of 2013 - Amends the Public Health Service Act to exclude remuneration paid for licensed independent insurance producers from administrative cost calculations for purposes of calculating the medical-loss ratio of a health insurance plan. HR 3541 introduced by Tim Griffin November 19,2013 Obamacare Taxpayer Bailout Prevention Act - Repeals the provision of the Patient Protection and Affordable Care Act that directs the Secretary of Health and Human Services (HHS) to establish and administer a program of risk corridors for calendar years 2014, 2015, and 2016 under which a qualified health plan offered in the individual or small group market is required to participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums. Other general Affordable Care Act topics related to multiple parts of legislation: Delay of Individual Mandate; ACA Implementation; Multi-State Plan Program Implementation; Risk Corridors and Risk Mitigation; Reinsurance; Small Business Health Options Program (SHOP) implementation See following pages on Health Care Reform issuesS. 1486 Introduced August 1, 2013 by Sen. Carper, Thomas R. (D-DE) Postal Reform Act of 2013 - Amends provisions of federal law relating to the funding of the U.S. Postal Service (USPS) retirement and health care systems, operations, revenue, and governance.. Section 104 Substitute Amendment. HR 3362 Introduced October 29,2013 by Rep. Terry, Lee (R-NE) Exchange Information Disclosure Act - Amends the Patient Protection and Affordable Care Act to expand reporting requirements related to health care exchanges. Requires the Secretary of Health and Human Services (HHS) to publish reports weekly through March 31, 2015, on: (1) consumer interactions with healthcare.gov or subsequent sites and any efforts undertaken to remedy problems that impact taxpayers and consumers, (2) calls to the federal customer service call center, including the number of calls received by the call center, problems identified by users, and referrals of those calls; (3) all navigators and certified application counselors that have been trained and certified by health care exchanges; and (4) all agents and brokers who have been trained and certified by the federal health care exchange. HR 762 Introduced in House February 15, 2013 by Rep. Blackburn, Marsha (R-TN) Health Care Choice Act of 2013 - Repeals the health insurance and health coverage expansion requirements of the Patient Protection and Affordable Care Act and related requirements of the Health Care and Education Reconciliation Act of 2010. Restores provisions of law amended or repealed by such provisions. HR 1701 Introduced April 24, 2013 by Ted Poe (R-TX) Cutting Costly Codes Act of 2013 - Prohibits the Secretary of Health and Human Services (HHS) from implementing, administering, or enforcing specified regulations insofar as they would replace International Classification of Diseases (ICD)-9 with ICD-10 as a standard for code sets for appropriate data elements for financial and administrative transactions involving the electronic exchange of health information.

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

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

H.R. 3795 OH NO Act of 2013; H.R. 7 No Taxpayer Funding for Abortion and Abortion Insurance Full Disclosure Act of 2014; H.R. 3362 Exchange Information Disclosure Act; H.R. 3541 Obamacare Taxpayer Bailout Prevention Act; S. 1726 Obamacare Taxpayer Bailout Prevention Act

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

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