Family Health Care Flexibility Act

H.R. 763, Jobs and Premium Protection Act (Boustany-Matheson) -repeal of ACA health insurance tax H.R. 1248, Family Health Care Flexibility Act (Paulsen) - HSA and FSA issues H.R. 1342, Helping Save Americans Health Care Choices Act (Fleming) - HSA and FSA issues H.R. 2194, Family and Retirement Health Investment Act (Paulsen) - HSA and FSA issues H.R. 2835, Restoring Access to Medication Act (Jenkins) - HSA and FSA issues H.R. 3367, HIT Delay Bill (Boustany-Bera) - delay of ACA health insurance tax H.R. 4600, Tax Free Health Insurance Act (King) - tax treatment of health insurance premiums H.R. 4777, Health Savings Act (Burgess) - HSA issues S. 24, Small Business Health Relief Act (Portman) - HIT repeal, HSA and FSA changes S. 603, Jobs and Premium Protection Act (Barrasso-Hatch) - repeal of ACA health insurance tax S. 610, Family Health Care Flexibility Act (Johanns) - HSA and FSA issues S. 1031, Family and Retirement Health Investment Act (Hatch) - HSA and FSA issues S. 1485, Americans Giving Care to Elders Act (Klobuchar) - tax credits for family caregivers S. 2260, EXPIRE Act (Wyden) - tax provisions Barrasso Amendment to S. 2569, Bring Jobs Home Act - repeal of ACA health insurance tax Annual insurer provider fees; issues concerning the patient-centered outcomes research fee; employer and individual coverage mandate, W-2 reporting requirements, health reimbursement accounts, deductibility limits for insurer compensation, health insurer and employer reporting of health coverage, 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

Monitored HR 344, the Competitive Health Insurance Act Monitored HR 1254, to repeal a requirement that new employees of certain employers be automatically enrolled in their employers health benefit plans Monitored HR 1326, the Health Care Price Transparency Act Monitored HR 1342, to Helping Save Americans Health Care Choices Act Monitored HR 1558, to lower health premiums and increase choice for small business Monitored HR 1990/S 983, the Keep the IRS Off Your Health Care Act Monitored HR 2667, the Authority for Mandate Delay Act Monitored HR 2700, the Health Care Waiver Fairness Act Monitored HR 3046, the Small Business Health Care Tax Credit Improvement Act Monitored HR 4244, the Small Business Health Insurance Affordability Act Monitored S 24, the Small Business Health Relief Act Monitored S 479, the Health Insurance Rate Review Act Monitored S 560, to construe the Individual Mandate of the Patient Protection and Affordable Care Act as a tax Monitored S 610, the Family Health Care Flexibility Act Monitored S 603, the Jobs and Premium Protection Act Monitored S 701, modifying the definition of full time employee for the purposes of the Patient Protection and Affordable Care Act Monitored HR 762, the Health Care Choice Act Monitored S 1154/HR 2938, the Exchange Sunset Act Monitored HR 3350, the Keep Your Health Plan Act Monitored S 1735/HR 3462, the Self-insurance Protection Act Monitored HR 3522, the Employee Health Care Protection Act Monitored S 1894, the Health Insurance Accountability Act Supported S 2205, the Small Business Fairness in Health Care Act

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

Government targets: Bureau of Land Management (BLM), HOUSE OF REPRESENTATIVES, SENATE, U.S. Forest Service

H.R. 4745, S. 2438 - FY2015 Transportation Appropriations, regarding streetcar/rail funding and manufacturing and Tiger Grant Funding. S. 610, H.R. 3080: Water Resources Development Act: Corp of Engineers cost-sharing policies. S.____,HR.____, Transportation Reauthorization transit issues.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 647 / H.R. 5771, ABLE Act - ABLE accounts for individuals with severe disabilities H.R. 763, Jobs and Premium Protection Act (Boustany-Matheson) -repeal of ACA health insurance tax H.R. 1248, Family Health Care Flexibility Act (Paulsen) - HSA and FSA issues H.R. 1342, Helping Save Americans Health Care Choices Act (Fleming) - HSA and FSA issues H.R. 2194, Family and Retirement Health Investment Act (Paulsen) - HSA and FSA issues H.R. 2835, Restoring Access to Medication Act (Jenkins) - HSA and FSA issues H.R. 3367, HIT Delay Bill (Boustany-Bera) - delay of ACA health insurance tax H.R. 4600, Tax Free Health Insurance Act (King) - tax treatment of health insurance premiums H.R. 4777, Health Savings Act (Burgess) - HSA issues S. 24, Small Business Health Relief Act (Portman) - HIT repeal, HSA and FSA changes S. 603, Jobs and Premium Protection Act (Barrasso-Hatch) - repeal of ACA health insurance tax S. 610, Family Health Care Flexibility Act (Johanns) - HSA and FSA issues S. 1031, Family and Retirement Health Investment Act (Hatch) - HSA and FSA issues S. 1485, Americans Giving Care to Elders Act (Klobuchar) - tax credits for family caregivers Annual insurer provider fees; issues concerning the patient-centered outcomes research fee; employer and individual coverage mandate, W-2 reporting requirements, health reimbursement accounts, deductibility limits for insurer compensation, health insurer and employer reporting of health coverage, and other issues relating to health care reform implementation.

Client expense: $2,230,000 · 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, Treasury, Dept of, White House Office

Family Health Care Flexibility Act (HR 1248/S 610) Prevention of Prescription Drug Shortages Coordination of Pro Bono Medically Recommended Dental Care Act (HR 963/S 466) Action for Dental Health Act (HR 4395)

Client expense: $19,972 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H.R. 647 / H.R. 5771, ABLE Act - ABLE accounts for individuals with severe disabilities. H.R. 763, Jobs and Premium Protection Act (Boustany-Matheson) -repeal of ACA health insurance tax. H.R. 1248, Family Health Care Flexibility Act (Paulsen) - HSA and FSA issues. H.R. 1342, Helping Save Americans Health Care Choices Act (Fleming) - HSA and FSA issues. H.R. 2194, Family and Retirement Health Investment Act (Paulsen) - HSA and FSA issues. H.R. 2835, Restoring Access to Medication Act (Jenkins) - HSA and FSA issues. H.R. 3367, HIT Delay Bill (Boustany-Bera) - delay of ACA health insurance tax. H.R. 4600, Tax Free Health Insurance Act (King) - tax treatment of health insurance premiums. H.R. 4777, Health Savings Act (Burgess) - HSA issues. H.R. 5860, Small Business Healthcare Relief Act of 2014 - use of Health Reimbursement Accounts and other employer funding of premiums. S. 24, Small Business Health Relief Act (Portman) - HIT repeal, HSA and FSA changes. S. 603, Jobs and Premium Protection Act (Barrasso-Hatch) - repeal of ACA health insurance tax. S. 610, Family Health Care Flexibility Act (Johanns) - HSA and FSA issues. S. 1031, Family and Retirement Health Investment Act (Hatch) - HSA and FSA issues. S. 1485, Americans Giving Care to Elders Act (Klobuchar) - tax credits for family caregivers.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 4, Jobs for America Act H.R. 45, To repeal the Patient Protection and Affordable Care Act and health care-related provisions in the Health Care and Education Reconciliation Act of 2010 H.R. 523, Protect Medical Innovation Act of 2013 H.R. 581, First Responder Medical Device Tax Relief Act H.R. 582, Healthcare Tax Relief and Mandate Repeal Act H.R. 763, To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act H.R. 781, Medicare Identity Theft Prevention Act of 2013 H.R. 903 / S. 399, American Job Protection Act H.R. 1248 / S. 610, Family Health Care Flexibility Act H.R. 1254, Auto Enroll Repeal Act H.R. 1295, Medical Device Tax Elimination Act H.R. 1558 / S. 24, Small Business Health Relief Act of 2013 H.R. 1735, In It All Together Act H.R. 1780, To provide that the only health plans that the Federal Government may make available to the President, Vice President, Members of Congress, and Federal employees are those created under the Patient Protection and Affordable Care Act or offered through a health insurance exchange H.R. 2575, Save American Workers Act H.R. 2667, Authority for Mandate Delay Act H.R. 2668, Fairness for American Families Act H.R. 2674, Job Creation Act of 2013 H.R. 2835, Restoring Access to Medication Act of 2013 H.R. 2925, Strengthening Medicare Anti-Fraud Measures Act of 2013 H.R. 2988 / S. 701 / S. 1188, Forty Hours Is Full Time Act of 2013 H.R. 3077, TELE-MED Act of 2013 H.R. 3121, American Health Care Reform Act of 2013 H.R. 3124, Investing in Permanency for Youth in Foster Care Act H.R. 3204, Drug Quality and Security Act H.R. 3367, 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 or 2015 H.R. 3419, Small Business Fairness in Obamacare Act H.R. 3462 / S. 1735, Self-Insurance Protection Act H.R. 3522, Employee Health Care Protection Act of 2013 H.R. 4118, Suspending the Individual Mandate Penalty Law Equals Fairness (SIMPLE) Act H.R. 4160, Keep the Promise to Seniors Act of 2014 H.R. 4302, Protecting Access to Medicare Act of 2014 H.R. 4414, Expatriate Health Coverage Clarification Act of 2014 H.R. 5183 / S. 2783, Value Based Insurance Design for Better Care Act of 2014 H.R. 5557, Streamlining Verification for Americans Act H.R. 5860, Small Business Healthcare Relief Act of 2014 S. 232, Medical Device Access and Innovation Protection Act S. 603, Jobs and Premium Protection Act S. 612, Social Security Number Protection Act of 2011 S. 1031, Family and Retirement Health Investment Act of 2013 S. 1488, A bill to delay the application of the individual health insurance mandate, to delay the application of the employer health insurance mandate, and for other purposes S. 1647, Restoring Access to Medication Act Final Regulation on Incentives for Nondiscriminatory Wellness Programs in Group Health Plans (78 Fed. Reg. 33,157-33,176, June 3, 2013) (to be codified at 26 C.F.R. pt. 54) Proposed Regulation on the Patient Protection and Affordable Care Act; standards related to Essential Health Benefits, Actuarial Value, and Accreditation (77 Fed. Reg. 70,644-70,676, November 26, 2012) (to be codified at 45 C.F.R. pts. 147, 155, 156) Proposed Regulation on the Health Insurance Market Rules; Rate Review (77 Fed. Reg. 70,584-70,617, November 26, 2012) (to be codified at 45 C.F.R. pts. 144, 147, 150) Proposed Regulation on the HHS Notice of Benefit and Payment Parameters for 2014 (77 Fed. Reg. 73,118-73,218, December 7, 2012) (to be codified at 45 C.F.R. pts. 153, 155, 156, 157, 158) Proposed Regulation on Medicaid, Children's Health Insurance Programs, and Exchanges: Essential Health Benefits in Alternative Benefit Plans, Eligibility Notices, Fair Hearing and Appeal Processes for Medicaid and Exchange Eligibility Appeals and Other Provisions Related to Eligibility and Enrollment for Exchanges, Medicaid and CHIP, and Medicaid Premiums and Cost Sharing (78 Fed. Reg. 4,594-4,724, January 22, 2013) (to be codified at 42 C.F.R. Parts 430, 431, 433, 435, 440, 447, 457) Proposed Regulation on Shared Responsibility for Employers Regarding Health Coverage (78 Fed. Reg. 218-253, January 2, 2013) (to be codified at 26 C.F.R. pts. 1, 54, 301) Proposed Regulation on Information Reporting of Minimum Essential Coverage (78 Fed. Reg. 54,986-54,996, September 9, 2013) (to be codified at 26 C.F.R. pts. 1, 301) Proposed Regulation on Information Reporting by Applicable Large Employers on Health Insurance Coverage Offered Under Employer-Sponsored Plans (78 Fed. Reg. 54,996-55,013, September 9, 2013) (to be codified at 26 C.F.R. pt. 301) Proposed Regulation regarding the Establishment of Exchanges and Qualified Health Plans; Small Business Health Options Program (78 Fed. Reg. 15,553-15,558, March 11, 2013) (to be codified at 45 C.F.R. pts. 155, 156) Proposed Regulation on the Health Insurance Providers Fee (78 Fed. Reg. 14,034-14,046, March 4, 2013) (to be codified at 26 C.F.R. pt. 57) Proposed Regulation on Minimum Value of Eligible Employer-Sponsored Plans and Other Rules Regarding the Health Insurance Premium Tax Credit (78 Fed. Reg. 25,909-25,916, May 3, 2013) (to be codified at 26 C.F.R. pt. 1) Proposed Regulation on Contract Year 2015 Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Program, (79 Fed. Reg. 1,918-2,073, January 10, 2014) (to be codified at 42 C.F.R. pts. 409, 417, 422 et al.) Proposed Regulation on Exchange and Insurance Market Standards for 2015 and Beyond (79 Fed. Reg. 15,808-15,879, March 21, 2014) (to be codified at 45 C.F.R. pts. 146, 147, 148 et al.) Proposed Regulation on Minimum Essential Coverage and Other Rules Regarding Shared Responsibility Payment for Individuals (79 Fed. Reg. 4,302-4,308, January 27, 2014) (to be codified at 26 C.F.R. pt. 1) Proposed Regulation on HHS Notice of Benefit and Payment Parameters for 2016 (79 Fed. Reg. 70,674-70,760, November 26, 2014) (to be codified at 45 C.F.R. pts. 144, 147 et al.) Various issues relating to the Patient Protection and Affordable Care Act (P.L. 111-148) and the Health Care and Education Reconciliation Act of 2010 (P.L. 111-152), including caps on compensation deductibility required under section 9014, implementation of regulatory process, legislative corrections, coverage, financing, delivery reform, 1099 reporting, Grandfathering, health savings accounts (HSAs) and flexible spending accounts (FSAs) changes, CMS claims database, IPAB, CLASS program, employer mandate, medical loss ratio, medical malpractice reform, exchanges, impact on small business, provider network adequacy, definition of small group market, reporting requirements for issuers and applicable large employers, premium stabilization programs, the Small Business Tax Credit, incompleteness or inaccuracy of cost impact analyses, lack of quantified benefit analysis, need for empirical data sources on which to base costs and benefits, ERISA preemption, HSA and FSA accounts; Public Health Service Act (P.L. 78-410), Internal Revenue Code and the Employee Retirement Income Security Act (ERISA) (P.L. 93-406), including regulatory process and legislative corrections to the ERISA preemption; deliver reform changes to Medicare Advantage and Medicare Prescription Drug (Part D) programs, including rebates and non-interference with prescription drug prices; entitlement reform; health information technology; legal protections against certain self-referral to physician owned hospitals

Client expense: $21,250,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Army, Dept of (Corps of Engineers), Commerce, Dept of (DOC), Commodity Futures Trading Commission (CFTC), Consumer Product Safety Commission (CPSC), Council on Environmental Quality (CEQ), Defense, Dept of (DOD), Education, Dept of, Energy, Dept of, Environmental Protection Agency (EPA), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Federal Bureau of Investigation (FBI), Federal Deposit Insurance Corporation (FDIC), Federal Housing Finance Agency (FHFA), Federal Reserve System, Federal Trade Commission (FTC), Food & Drug Administration (FDA), General Services Administration (GSA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Interior, Dept of (DOI), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Economic Council (NEC), Natl Institute of Standards & Technology (NIST), Natl Labor Relations Board (NLRB), Natl Security Council (NSC), Occupational Safety & Health Administration (OSHA), Office of Management & Budget (OMB), Office of the Comptroller of the Currency (OCC), Patent & Trademark Office (PTO), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Small Business Administration (SBA), State, Dept of (DOS), Transportation Security Administration (TSA), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Copyright Office, U.S. Customs & Border Protection, U.S. Fish & Wildlife Service (USFWS), U.S. Forest Service, U.S. Trade Representative (USTR), White House Office

S. 1031/H.R. 2194, the Family and Retirement Health Investment Act of 2013 H.R. 207, a bill to amend the Internal Revenue Code of 1986 to make members of health care sharing ministries eligible to establish health savings accounts S. 24, the Small Business Health Relief Act of 2013 H.R. 956, the Personal Health Investment Today Act of 2013 H.R. 1140, the Family Friendly HSA Improvement Act of 2013 H.R. 1342, the Helping American's Health Care Choices Act of 2013 H.R. 1326, the Health Care Price Transparency Promotion Act of 2013 S. 610/H.R. 1248, the Family Health Care Flexibility Act H.R. 1552, the Health Freedom for Seniors Act S. 728/H.R. 2499, the Tax Parity for Health Plan Beneficiaries Act of 2013 H.R. 2688, the PATIENT Health Care Act H.R. 2835, the Restoring Access to Medication Act of 2013 H.R. 3498, a bill to allow individuals to choose to opt out of the Medicare part A benefit and to allow individuals opting out of such benefit to be eligible for health savings accounts

Client expense: $2,418,000 · Firm income: Not reported

Government targets: Federal Reserve System, HOUSE OF REPRESENTATIVES, SENATE, Treasury, Dept of

Financial management and other issues tied to the successful operation of a dental practice as a small business. H.R. 523 Protect Medical Innovation Act of 2013 H.R. 1248 Family Health Care Flexibility Act H.R. 1295 Medical Device Tax Elimination ActH.R. 1527 Student Loan Interest Deduction Act of 2013 H.R. 3391 Indian Health Service Health Professions Tax Fairness Act S. 232 Medical Device Access and Innovation Protection Act S. 610 Family Health Care Flexibility Act S. 966 Medical FSA Improvement Act of 2013 Section 1202 stock Tax on medical devices Tax Exclusion for Contribution to Savings and Retirement Plans Taxation of Small Business: Section 179 Deduction Taxation of Pass-through Entities Cash Method of Accounting Accelerated depreciation Business interest expense deductibility Charitable contribution deduction Estate tax levels Mortgage interest deduction

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Air Force, Dept of, Army, Dept of (Other), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Indian Health Service, Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Navy, Dept of, Occupational Safety & Health Administration (OSHA), Office of Natl Drug Control Policy (NDCP), SENATE, U.S. Coast Guard (USCG), Veterans Affairs, Dept of (VA), White House Office

Flexible spending arrangements (FSA) and health savings accounts (HSA) - H.R. 2835/S. 1647 - Restoring Access to Medication Act. Repeals prohibition in Patient Protection and Affordable Care Act (P.L. 111-148, P.L. 111-152) against use of flexible spending arrangement (FSA) and health savings account (HSA) funds on over-the-counter medications; all sections. H.R. 1248/S. 610 - Family Health Care Flexibility Act. Would also repeal prohibition in Patient Protection and Affordable Care Act (P.L. 111-148, P.L. 111-152) against use of flexible spending arrangement (FSA) and health savings account (HSA) funds on over-the-counter medications; all sections. Senate bill "Expiring Provisions Improvement Reform and Efficiency (EXPIRE) Act." Would renew and extend certain expired and expiring tax provisions for an additional year; all sections. Companion legislation not yet introduced in House.

Client expense: $230,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Flexible spending arrangements (FSA) and health savings accounts (HSA)H.R. 2835/S. 1647 - Restoring Access to Medication Act. Repeals prohibition in Patient Protection and Affordable Care Act (P.L. 111-148, P.L. 111-152) against use of flexible spending arrangement (FSA) and health savings account (HSA) funds on over-the-counter medications; all sections. H.R. 1248/S. 610 - Family Health Care Flexibility Act. Would also repeal prohibition in Patient Protection and Affordable Care Act (P.L. 111-148, P.L. 111-152) against use of flexible spending arrangement (FSA) and health savings account (HSA) funds on over-the-counter medications; all sections. Senate bill "Expiring Provisions Improvement Reform and Efficiency (EXPIRE) Act." Would renew and extend certain expired and expiring tax provisions for an additional year; all sections. Companion legislation not yet introduced in House.

Client expense: $230,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1074 - National Diabetes Clinical Care Commission Act H.R. 1248 - Family Health Care Flexibility Act; provisions relating to reimbursement of OTC drugs under flexible spending and health savings accounts H.R. 1281 - Newborn Screening Saves Lives Reauthorization Act H.R. 3230 - Veterans' Access to Care through Choice, Accountability, and Transparency Act H.R. 3742 - Antibiotic Development to Advance Patient Treatment Act; provisions related to antibiotics and drug approval H.R. 4260 - Ryan White Patient Equity and Choice Act; provisions related to ADAP H.R. 4847 - End Neglected Tropical Diseases Act S. 539 - National Diabetes Clinical Care Commission Act S. 610 - Family Health Care Flexibility Act; provisions relating to reimbursement of OTC drugs under flexible spending and health savings accounts S. 1165 - Access to Appropriate Immunizations for Veterans Act of 2013; provisions related to extending VA performance measure to include all federally recommended vaccine S. 1417 - Newborn Screening Saves Lives Reauthorization Act S. 2917 - Adding Ebola to the FDA Priority Review Voucher Program Act No bill # assigned - Implementation issues relating to the Patient Protection and Affordable Care Act (PPACA) (Public Law 111-148), including Standards Related to Essential Health Benefits, Actuarial Value, and Accreditation rulemaking No bill # assigned - 21st Century Cures Initiative and related policy issues No bill # assigned - FDA special medical use; issues related to limited population antibacterial drug approval pathway No bill # assigned - FDA accelerated approval policy issues No bill # assigned - Comparative effectiveness policy issues No bill # assigned - Biopharmaceutical innovation policy issues No bill # assigned - Pharmaceutical supply chain security issues No bill # assigned - 340B policy issues No bill # assigned - Implementation issues relating to the Physician Payment Sunshine Act No bill # assigned - Support for COPD national action plan No bill # assigned - FDA proposed rule regarding generic drug labeling under the 1984 Hatch-Waxman amendments to the FDCA No bill # assigned - FDA proposed rule regarding Electronic Distribution of Content of Labeling for Human Prescription Drug and Biological Products

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE, U.S. Trade Representative (USTR)

Health LegislationH.R. 1248 - Family Health Care Flexibility Act; provisions relating to reimbursement of OTC drugs under flexible spending and health savings accounts H.R. 1281 - Newborn Screening Saves Lives Reauthorization Act H.R. 3742 - Antibiotic Development to Advance Patient Treatment Act; provisions related to antibiotics and drug approval H.R. 4260 - Ryan White Patient Equity and Choice Act; provisions related to ADAP H.R. 4847 - End Neglected Tropical Diseases Act S. 539 - National Diabetes Clinical Care Commission Act S. 610 - Family Health Care Flexibility Act; provisions relating to reimbursement of OTC drugs under flexible spending and health savings accounts S. 1165 - Access to Appropriate Immunizations for Veterans Act of 2013; provisions related to extending VA performance measure to include all federally recommended vaccine S. 1417 - Newborn Screening Saves Lives Reauthorization Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 4745, S. 2438 - FY2015 Transportation, Appropriations, regarding streetcar/rail funding and manufacturing and Tiger Grant Funding. S. 610, H.R. 3080: Water Resources Development Act: Corp of Engineers cost-sharing policies. S.____, H.R. _____, Transportation Reauthorization transit issues.

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

Government targets: SENATE

Monitored HR 344, the Competitive Health Insurance Act Monitored HR 1254, to repeal a requirement that new employees of certain employers be automatically enrolled in their employers health benefit plans Monitored HR 1326, the Health Care Price Transparency Act Monitored HR 1342, to Helping Save Americans Health Care Choices Act Monitored HR 1558, to lower health premiums and increase choice for small business Monitored HR 1990/S 983, the Keep the IRS Off Your Health Care Act Monitored HR 2667, the Authority for Mandate Delay Act Monitored HR 2700, the Health Care Waiver Fairness Act Monitored HR 3046, the Small Business Health Care Tax Credit Improvement Act Monitored HR 4244, the Small Business Health Insurance Affordability Act Monitored S 24, the Small Business Health Relief Act Monitored S 479, the Health Insurance Rate Review Act Monitored S 560, to construe the Individual Mandate of the Patient Protection and Affordable Care Act as a tax Monitored S 610, the Family Health Care Flexibility Act Monitored S 603, the Jobs and Premium Protection Act Monitored S 701, modifying the definition of full time employee for the purposes of the Patient Protection and Affordable Care Act Monitored HR 762, the Health Care Choice Act Monitored S 1154/HR 2938, the Exchange Sunset Act Monitored HR 3350, the Keep Your Health Plan Act Monitored S 1735/HR 3462, the Self-insurance Protection Act Monitored HR 3522, the Employee Health Care Protection Act Monitored S 1894, the Health Insurance Accountability Act Supported S 2205, the Small Business Fairness in Health Care Act

Client expense: $110,000 · Firm income: Not reported

H.R. 4, Jobs for America Act H.R. 45, To repeal the Patient Protection and Affordable Care Act and health care-related provisions in the Health Care and Education Reconciliation Act of 2010 H.R. 523, Protect Medical Innovation Act of 2013 H.R. 581, First Responder Medical Device Tax Relief Act H.R. 582, Healthcare Tax Relief and Mandate Repeal Act H.R. 763, To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act H.R. 781, Medicare Identity Theft Prevention Act of 2013 H.R. 903 / S. 399, American Job Protection Act H.R. 1248 / S. 610, Family Health Care Flexibility Act H.R. 1254 /S. 2546, Auto Enroll Repeal Act H.R. 1295, Medical Device Tax Elimination Act H.R. 1558 / S. 24, Small Business Health Relief Act of 2013 H.R. 1735, In It All Together Act H.R. 1780, To provide that the only health plans that the Federal Government may make available to the President, Vice President, Members of Congress, and Federal employees are those created under the Patient Protection and Affordable Care Act or offered through a health insurance exchange H.R. 2194 / S. 1031, Family and Retirement Health Investment Act of 2013 H.R. 2575, Save American Workers Act H.R. 2667, Authority for Mandate Delay Act H.R. 2668, Fairness for American Families Act H.R. 2674, Job Creation Act of 2013 H.R. 2835, Restoring Access to Medication Act of 2013 H.R. 2925, Strengthening Medicare Anti-Fraud Measures Act of 2013 H.R. 2988 / S. 701 / S. 1188, Forty Hours Is Full Time Act of 2013 H.R. 3077, TELE-MED Act of 2013 H.R. 3121, American Health Care Reform Act of 2013 H.R. 3124, Investing in Permanency for Youth in Foster Care Act H.R. 3204, Drug Quality and Security Act H.R. 3367, 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 or 2015 H.R. 3419, Small Business Fairness in Obamacare Act H.R. 3462 / S. 1735, Self-Insurance Protection Act H.R. 3522, Employee Health Care Protection Act of 2013 H.R. 4118, Suspending the Individual Mandate Penalty Law Equals Fairness (SIMPLE) Act H.R. 4160, Keep the Promise to Seniors Act of 2014 H.R. 4302, Protecting Access to Medicare Act of 2014 H.R. 4414, Expatriate Health Coverage Clarification Act of 2014 H.R. 5183 / S. 2783, Value Based Insurance Design for Better Care Act of 2014 H.R. 5213, Simplifying Technical Aspects Regarding Seasonality (STARS) Act of 2014 H.R. 5557, Streamlining Verification for Americans Act S. 232, Medical Device Access and Innovation Protection Act S. 603, Jobs and Premium Protection Act S. 612, Social Security Number Protection Act of 2011 S. 1031, Family and Retirement Health Investment Act of 2013 S. 1488, A bill to delay the application of the individual health insurance mandate, to delay the application of the employer health insurance mandate, and for other purposes S. 1647, Restoring Access to Medication Act Proposed Regulation on the Patient Protection and Affordable Care Act; standards related to Essential Health Benefits, Actuarial Value, and Accreditation (77 Fed. Reg. 70,644-70,676, November 26, 2012) (to be codified at 45 C.F.R. pts. 147, 155, 156) Proposed Regulation on the Health Insurance Market Rules; Rate Review (77 Fed. Reg. 70,584-70,617, November 26, 2012) (to be codified at 45 C.F.R. pts. 144, 147, 150) Proposed Regulation on the HHS Notice of Benefit and Payment Parameters for 2014 (77 Fed. Reg. 73,118-73,218, December 7, 2012) (to be codified at 45 C.F.R. pts. 153, 155, 156, 157, 158) Proposed Regulation on the Standards Related to Essential Health Benefits, Actuarial Value, and Accreditation, (77 Fed. Reg. 70,644-70,676, November 26, 2012) (to be codified at 45 C.F.R. pts. 147, 155, 156) Proposed Regulation on Medicaid, Children's Health Insurance Programs, and Exchanges: Essential Health Benefits in Alternative Benefit Plans, Eligibility Notices, Fair Hearing and Appeal Processes for Medicaid and Exchange Eligibility Appeals and Other Provisions Related to Eligibility and Enrollment for Exchanges, Medicaid and CHIP, and Medicaid Premiums and Cost Sharing (78 Fed. Reg. 4,594-4,724, January 22, 2013) (to be codified at 42 C.F.R. pts. 430, 431, 433, 435, 440, 447, 457) Proposed Regulation on Incentives for Nondiscriminatory Wellness Programs in Group Health Plans (77 Fed. Reg. 70,620-70,642, November 26, 2012) (to be codified at 26 C.F.R. pt. 54) Proposed Regulation on Shared Responsibility for Employers Regarding Health Coverage (78 Fed. Reg. 218-253, January 2, 2013) (to be codified at 26 C.F.R. pts. 1, 54, 301) Proposed Regulation on Information Reporting of Minimum Essential Coverage (78 Fed. Reg. 54,986-54,996, September 9, 2013) (to be codified at 26 C.F.R. pts. 1, 301) Proposed Regulation on Information Reporting by Applicable Large Employers on Health Insurance Coverage Offered Under Employer-Sponsored Plans (78 Fed. Reg. 54,996-55,013, September 9, 2013) (to be codified at 26 C.F.R. pt. 301) Proposed Regulation regarding the Establishment of Exchanges and Qualified Health Plans; Small Business Health Options Program (78 Fed. Reg. 15,553-15,558, March 11, 2013) (to be codified at 45 C.F.R. pts. 155, 156) Proposed Regulation on the Health Insurance Providers Fee (78 Fed. Reg. 14,034-14,046, March 4, 2013) (to be codified at 26 C.F.R. pt. 57) Proposed Regulation on Minimum Value of Eligible Employer-Sponsored Plans and Other Rules Regarding the Health Insurance Premium Tax Credit (78 Fed. Reg. 25,909-25,916, May 3, 2013) (to be codified at 26 C.F.R. pt. 1) Proposed Regulation on HHS Notice of Benefit and Payment Parameters for 2015 (78 Fed. Reg. 72,322-72,392, December 2, 2013) (to be codified at 45 C.F.R. pts. 144, 147, 153, 155, 156) Proposed Regulation on Amendments to Excepted Benefits (78 Fed. Reg. 77,632-77,642, December 24, 2013) (to be codified at 29 C.F.R. pt. 2590) Proposed Regulation on Contract Year 2015 Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Program, (79 Fed. Reg. 1,918-2,073, January 10, 2014) (to be codified at 42 C.F.R. pts. 409, 417, 422 et. al.) Proposed Regulation on Exchange and Insurance Market Standards for 2015 and Beyond (79 Fed. Reg. 15,808-15,879, March 21, 2014) (to be codified at 45 C.F.R. pts. 146, 147, 148 et al.) Proposed Regulation on Ninety-Day Waiting Period Limitation (79 Fed. Reg. 10,320-10,325, February 24, 2014) (to be codified at 29 C.F.R. pt. 2590; 45 C.F.R. pt. 147; and 26 C.F.R. pt. 147) Proposed Regulation on Minimum Essential Coverage and Other Rules Regarding Shared Responsibility Payment for Individuals (79 Fed. Reg. 4,302-4,308, January 27, 2014) (to be codified at 26 C.F.R. pt. 1) Draft Guidance Notices on Self-Monitoring Blood Glucose Test Systems for Over-the-Counter Use (79 Fed. Reg. 829-830, January 7, 2014) Statement for the Record in Response to a Notice of Meeting on Employee welfare and Pension Benefit Plans (79 Fed. Reg. 28,555-28,556, May 16, 2014) Various issues relating to the Patient Protection and Affordable Care Act (P.L. 111-148), including implementation of regulatory process, legislative corrections, coverage, financing, delivery reform, 1099 reporting, ERISA preemption, Grandfathering, health savings accounts (HSAs), health reimbursement accounts (HRAs), and flexible spending accounts (FSAs) changes, CMS claims database, IPAB, CLASS program, employer mandate, reporting requirements, medical loss ratio, medical malpractice reform, exchanges, the impact on small business, the Small Business Tax Credit, caps on compensation deductibility required under section 9014; Health Care and Education Affordability Reconciliation Act of 2010 (P.L. 111-152), including regulatory process and legislative corrections to the ERISA preemption, the impact on small business, the small business tax credit, insurance coverage, financing, delivery reform; changes to Medicare Advantage and Medicare Prescription Drug (Part D) programs non-interference with prescription drug prices; entitlement reform; forty-hour work week; health information technology

Client expense: $28,350,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Army, Dept of (Corps of Engineers), Commerce, Dept of (DOC), Commodity Futures Trading Commission (CFTC), Consumer Product Safety Commission (CPSC), Council on Environmental Quality (CEQ), Defense, Dept of (DOD), Education, Dept of, Energy, Dept of, Environmental Protection Agency (EPA), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Federal Bureau of Investigation (FBI), Federal Deposit Insurance Corporation (FDIC), Federal Housing Finance Agency (FHFA), Federal Reserve System, Federal Trade Commission (FTC), Food & Drug Administration (FDA), General Services Administration (GSA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Interior, Dept of (DOI), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Economic Council (NEC), Natl Institute of Standards & Technology (NIST), Natl Labor Relations Board (NLRB), Natl Security Council (NSC), Occupational Safety & Health Administration (OSHA), Office of Management & Budget (OMB), Office of the Comptroller of the Currency (OCC), Patent & Trademark Office (PTO), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Small Business Administration (SBA), State, Dept of (DOS), Transportation Security Administration (TSA), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Copyright Office, U.S. Customs & Border Protection, U.S. Fish & Wildlife Service (USFWS), U.S. Forest Service, U.S. Trade Representative (USTR), White House Office

H.R. 763, Jobs and Premium Protection Act (Boustany-Matheson) -repeal of ACA health insurance tax H.R. 1248, Family Health Care Flexibility Act (Paulsen) - HSA and FSA issues H.R. 1342, Helping Save Americans Health Care Choices Act (Fleming) - HSA and FSA issues H.R. 2194, Family and Retirement Health Investment Act (Paulsen) - HSA and FSA issues H.R. 2835, Restoring Access to Medication Act (Jenkins) - HSA and FSA issues H.R. 3367, HIT Delay Bill (Boustany-Bera) - delay of ACA health insurance tax H.R. 4600, Tax Free Health Insurance Act (King) - tax treatment of health insurance premiums H.R. 4777, Health Savings Act (Burgess) - HSA issues S. 24, Small Business Health Relief Act (Portman) - HIT repeal, HSA and FSA changes S. 603, Jobs and Premium Protection Act (Barrasso-Hatch) - repeal of ACA health insurance tax S. 610, Family Health Care Flexibility Act (Johanns) - HSA and FSA issues S. 1031, Family and Retirement Health Investment Act (Hatch) - HSA and FSA issues S. 1485, Americans Giving Care to Elders Act (Klobuchar) - tax credits for family caregivers S. 2260, EXPIRE Act (Wyden) - tax provisions Barrasso Amendment to S. 2569, Bring Jobs Home Act - repeal of ACA health insurance tax Annual insurer provider fees; issues concerning the patient-centered outcomes research fee; employer and individual coverage mandate, W-2 reporting requirements, health reimbursement accounts, deductibility limits for insurer compensation, health insurer and employer reporting of health coverage, 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

H.R. 763, Jobs and Premium Protection Act (Boustany-Matheson) -repeal of ACA health insurance tax. H.R. 1248, Family Health Care Flexibility Act (Paulsen) - HSA and FSA issues. H.R. 1342, Helping Save Americans Health Care Choices Act (Fleming) - HSA and FSA issues. H.R. 2194, Family and Retirement Health Investment Act (Paulsen) - HSA and FSA issues. H.R. 2835, Restoring Access to Medication Act (Jenkins) - HSA and FSA issues. H.R. 3367, HIT Delay Bill (Boustany-Bera) - delay of ACA health insurance tax. H.R. 4600, Tax Free Health Insurance Act (King) - tax treatment of health insurance premiums. H.R. 4777, Health Savings Act (Burgess) - HSA issues. S. 24, Small Business Health Relief Act (Portman) - HIT repeal, HSA and FSA changes. S. 603, Jobs and Premium Protection Act (Barrasso-Hatch) - repeal of ACA health insurance tax. S. 610, Family Health Care Flexibility Act (Johanns) - HSA and FSA issues. S. 1031, Family and Retirement Health Investment Act (Hatch) - HSA and FSA issues. S. 1485, Americans Giving Care to Elders Act (Klobuchar) - tax credits for family caregivers. S. 2260, EXPIRE Act (Wyden) - tax provisions. Barrasso Amendment to S. 2569, Bring Jobs Home Act - repeal of ACA health insurance tax

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 4745, S. 2438 - FY2015 Transportation Appropriations, regarding streetcar/rail funding and manufacturing and Tiger Grant Funding. S. 610, H.R. 3080: Water Resources Development Act: Corp of Engineers cost-sharing policies. S.___,H.R.___, Transportation Reauthorization transit issues.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Financial management and other issues tied to the successful operation of a dental practice as a small business. H.R. 523 Protect Medical Innovation Act of 2013 H.R. 1248 Family Health Care Flexibility Act H.R. 1295 Medical Device Tax Elimination ActH.R. 1527 Student Loan Interest Deduction Act of 2013 H.R. 3391 Indian Health Service Health Professions Tax Fairness Act S. 232 Medical Device Access and Innovation Protection Act S. 610 Family Health Care Flexibility Act S. 966 Medical FSA Improvement Act of 2013 Section 1202 stock Tax on medical devices Tax Exclusion for Contribution to Savings and Retirement Plans Taxation of Small Business: Section 179 Deduction Taxation of Pass-through Entities Cash Method of Accounting Accelerated depreciation Business interest expense deductibility Charitable contribution deduction Estate tax levels Mortgage interest deduction

Client expense: $590,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Air Force, Dept of, Army, Dept of (Other), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Indian Health Service, Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Navy, Dept of, Occupational Safety & Health Administration (OSHA), Office of Natl Drug Control Policy (NDCP), SENATE, U.S. Coast Guard (USCG), Veterans Affairs, Dept of (VA), White House Office

H.R. 4745, S. 2438; FY 2015 Transportation Appropriations, regarding streetcar/rail funding and manufacturing and Tiger Grant Funding. H.R. 3080, S. 610; Water Resources Reform and Development Act, Corps of Engineers cost-sharing policies. H.R. ____, S. ____; Transportation Reauthorization; transit issues.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE, Transportation, Dept of (DOT)

Financial management and other issues tied to the successful operation of a dental practice as a small business. H.R. 523 Protect Medical Innovation Act of 2013 H.R. 1248 Family Health Care Flexibility Act H.R. 1295 Medical Device Tax Elimination ActH.R. 1527 Student Loan Interest Deduction Act of 2013 H.R. 3391 Indian Health Service Health Professions Tax Fairness Act S. 232 Medical Device Access and Innovation Protection Act S. 610 Family Health Care Flexibility Act S. 966 Medical FSA Improvement Act of 2013 Section 1202 stock Tax on medical devices Tax Exclusion for Contribution to Savings and Retirement Plans Taxation of Small Business: Section 179 Deduction Taxation of Pass-through Entities Cash Method of Accounting Accelerated depreciation Business interest expense deductibility Charitable contribution deduction Estate tax levels Mortgage interest deduction

Client expense: $590,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Air Force, Dept of, Army, Dept of (Other), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Indian Health Service, Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Navy, Dept of, Occupational Safety & Health Administration (OSHA), Office of Natl Drug Control Policy (NDCP), SENATE, U.S. Coast Guard (USCG), Veterans Affairs, Dept of (VA), White House Office

H.R. 1074- National Diabetes Clinical Care Commission Act H.R. 1248 - Family Health Care Flexibility Act; provisions relating to reimbursement of OTC drugs under flexible spending and health savings accounts H.R. 1281 - Newborn Screening Saves Lives Reauthorization Act H.R. 3230 - Veterans' Access to Care through Choice, Accountability, and Transparency Act H.R. 3742 - Antibiotic Development to Advance Patient Treatment Act; provisions related to antibiotics and drug approval H.R. 4260 - Ryan White Patient Equity and Choice Act; provisions related to ADAP H.R. 4847 - End Neglected Tropical Diseases Act S. 539 - National Diabetes Clinical Care Commission Act S. 610 - Family Health Care Flexibility Act; provisions relating to reimbursement of OTC drugs under flexible spending and health savings accounts S. 1165 - Access to Appropriate Immunizations for Veterans Act of 2013; provisions related to extending VA performance measure to include all federally recommended vaccine S. 1417 - Newborn Screening Saves Lives Reauthorization Act No bill # assigned - Implementation issues relating to the Patient Protection and Affordable Care Act (PPACA) (Public Law 111-148), including Standards Related to Essential Health Benefits, Actuarial Value, and Accreditation rulemaking No bill # assigned - 21st Century Cures Initiative and related policy issues No bill # assigned - FDA special medical use; issues related to limited population antibacterial drug approval pathway No bill # assigned - FDA accelerated approval policy issues No bill # assigned - Comparative effectiveness policy issues No bill # assigned - Biopharmaceutical innovation policy issues No bill # assigned - Pharmaceutical supply chain security issues No bill # assigned - 340B policy issues No bill # assigned - Implementation issues relating to the Physician Payment Sunshine Act No bill # assigned - Support for COPD national action plan No bill # assigned - FDA proposed rule regarding generic drug labeling under the 1984 Hatch-Waxman amendments to the FDCA No bill # assigned - FDA proposed rule regarding electronic distribution of cContent of Labeling for Human Prescription Drug and Biological products

Client expense: $1,140,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE, U.S. Trade Representative (USTR)

See addendum.S. 1031/H.R. 2194, the Family and Retirement Health Investment Act of 2013 H.R. 207, a bill to amend the Internal Revenue Code of 1986 to make members of health care sharing ministries eligible to establish health savings accounts. S. 24, the Small Business Health Relief Act of 2013 H.R. 956, the Personal Health Investment Today Act of 2013 H.R. 1140, the Family Friendly HSA Improvement Act of 2013 H.R. 1342, the Helping American's Health Care Choices Act of 2013 H.R. 1326, the Health Care Price Transparency Promotion Act of 2013 S. 610/H.R. 1248, the Family Health Care Flexibility Act H.R. 1552, the Health Freedom for Seniors Act S. 728/H.R. 2499, the Tax Parity for Health Plan Beneficiaries Act of 2013 H.R. 2688, the PATIENT Health Care Act H.R. 2835, the Restoring Access to Medication Act of 2013 H.R. 3498, a bill to allow individuals to choose to opt out of the Medicare part A benefit and to allow individuals opting out of such benefit to be eligible for health savings accounts.

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

Government targets: Federal Reserve System, HOUSE OF REPRESENTATIVES, SENATE, Treasury, Dept of

Flexible spending arrangements (FSA) and health savings accounts (HSA)H.R. 2835/S. 1647 - Restoring Access to Medication Act. Repeals prohibition in Patient Protection and Affordable Care Act (P.L. 111-148, P.L. 111-152) against use of flexible spending arrangement (FSA) and health savings account (HSA) funds on over-the-counter medications; all sections. H.R. 1248/S. 610 - Family Health Care Flexibility Act. Would also repeal prohibition in Patient Protection and Affordable Care Act (P.L. 111-148, P.L. 111-152) against use of flexible spending arrangement (FSA) and health savings account (HSA) funds on over-the-counter medications; all sections. Senate bill "Expiring Provisions Improvement Reform and Efficiency (EXPIRE) Act." Would renew and extend certain expired and expiring tax provisions for an additional year; all sections. Companion legislation not yet introduced in House.

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

Government targets: Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, SENATE

Financial management and other issues tied to the successful operation of a dental practice as a small business. H.R. 523 Protect Medical Innovation Act of 2013 H.R. 1248 Family Health Care Flexibility Act H.R. 1295 Medical Device Tax Elimination ActH.R. 1527 Student Loan Interest Deduction Act of 2013 H.R. 3391 Indian Health Service Health Professions Tax Fairness Act S. 232 Medical Device Access and Innovation Protection Act S. 610 Family Health Care Flexibility Act S. 966 Medical FSA Improvement Act of 2013 Section 1202 stock Tax on medical devices Tax Exclusion for Contribution to Savings and Retirement Plans Taxation of Small Business: Section 179 Deduction Taxation of Pass-through Entities Cash Method of Accounting Accelerated depreciation Business interest expense deductibility Charitable contribution deduction Estate tax levels Mortgage interest deduction

Client expense: $780,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Air Force, Dept of, Army, Dept of (Other), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Indian Health Service, Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Navy, Dept of, Occupational Safety & Health Administration (OSHA), Office of Natl Drug Control Policy (NDCP), SENATE, U.S. Coast Guard (USCG), Veterans Affairs, Dept of (VA), White House Office

Monitored HR 344, the Competitive Health Insurance Act Monitored HR 1254, to repeal a requirement that new employees of certain employers be automatically enrolled in their employers health benefit plans Monitored HR 1326, the Health Care Price Transparency Act Monitored HR 1342, to Helping Save Americans Health Care Choices Act Monitored HR 1558, to lower health premiums and increase choice for small business Monitored HR 1990/S 983, the Keep the IRS Off Your Health Care Act Monitored HR 2667, the Authority for Mandate Delay Act Monitored HR 2700, the Health Care Waiver Fairness Act Monitored HR 3046, the Small Business Health Care Tax Credit Improvement Act Monitored HR 4244, the Small Business Health Insurance Affordability Act of 2014 Monitored S 24, the Small Business Health Relief Act Monitored S 479, the Health Insurance Rate Review Act Monitored S 560, to construe the Individual Mandate of the Patient Protection and Affordable Care Act as a tax Monitored S 610, the Family Health Care Flexibility Act Monitored S 603, the Jobs and Premium Protection Act Monitored S 701, modifying the definition of full time employee for the purposes of the Patient Protection and Affordable Care Act Monitored HR 762, the Health Care Choice Act Monitored S 1154/HR 2938, the Exchange Sunset Act Monitored HR 3350, the Keep Your Health Plan Act Monitored S 1735/HR 3462, the Self-insurance Protection Act Monitored HR 3522, the Employee Health Care Protection Act Monitored S 1894, the Health Insurance Accountability Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 4745, S. 2438 - FY2015 Transportation Appropriations, regarding streetcar/rail funding and manufacturing and Tiger Grant Funding. S. 610, H.R. 3080: Water Resources Development Act: Corp of Engineers cost-sharing policies. S.___, HR. ___, Transportation Reauthorization transit issues.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE, Transportation, Dept of (DOT)

H.R. 4745, S. 2438; FY 2015 Transportation Appropriations, regarding streetcar/rail funding and manufacturing and Tiger Grant Funding. H.R. 3080, S. 610; Water Resources Reform and Development Act, Corps of Engineers cost-sharing policies. H.R. ____, S. ____; Transportation Reauthorization; transit issues.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE, Transportation, Dept of (DOT)

H.R. 763, Jobs and Premium Protection Act (Boustany-Matheson) repeal of ACA health insurance tax16. Specific Lobbying Issues (continued): H.R. 1248, Family Health Care Flexibility Act (Paulsen) HSA and FSA issues H.R. 1342, Helping Save Americans Health Care Choices Act (Fleming) HSA and FSA issues H.R. 2194, Family and Retirement Health Investment Act (Paulsen) HSA and FSA issues H.R. 2835, Restoring Access to Medication Act (Jenkins) HSA and FSA issues H.R. 3367, HIT Delay Bill (Boustany-Bera) delay of ACA health insurance tax H.R. 4600, Tax Free Health Insurance Act (King) tax treatment of health insurance premiums H.R. 4777, Health Savings Act (Burgess) HSA issues S. 24, Small Business Health Relief Act (Portman) HIT repeal, HSA and FSA changes S. 603, Jobs and Premium Protection Act (Barrasso-Hatch) repeal of ACA health insurance tax S. 610, Family Health Care Flexibility Act (Johanns) HSA and FSA issues S. 1031, Family and Retirement Health Investment Act (Hatch) HSA and FSA issues S. 1485, Americans Giving Care to Elders Act (Klobuchar) tax credits for family caregivers S. 2260, EXPIRE Act (Wyden) tax provisions Hatch-Barrasso Amendment to H.R. 3474, Tax Extenders Bill two-year delay in ACA health insurance tax Regulatory Issues: Annual insurer provider fees; issues concerning the patient-centered outcomes research fee; employer and individual coverage mandate, W-2 reporting requirements, health reimbursement accounts, deductibility limits for insurer compensation, health insurer and employer reporting of health coverage, 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

H.R. 45, To repeal the Patient Protection and Affordable Care Act and health care-related provisions in the Health Care and Education Reconciliation Act of 2010 H.R. 523, Protect Medical Innovation Act of 2013 H.R. 581, First Responder Medical Device Tax Relief Act H.R. 582, Healthcare Tax Relief and Mandate Repeal Act H.R. 763, To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act H.R. 781, Medicare Identity Theft Prevention Act of 2013 H.R. 903 / S. 399, American Job Protection Act H.R. 1248 / S. 610, Family Health Care Flexibility Act H.R. 1254, Auto Enroll Repeal Act H.R. 1295, Medical Device Tax Elimination Act H.R. 1558 / S. 24, Small Business Health Relief Act of 2013 H.R. 1735, In It All Together Act H.R. 1780, To provide that the only health plans that the Federal Government may make available to the President, Vice President, Members of Congress, and Federal employees are those created under the Patient Protection and Affordable Care Act or offered through a health insurance exchange H.R. 2575, Save American Workers Act H.R. 2667, Authority for Mandate Delay Act H.R. 2668, Fairness for American Families Act H.R. 2674, Job Creation Act of 2013 H.R. 2835 / S. 1647, Restoring Access to Medication Act of 2013 H.R. 2925, Strengthening Medicare Anti-Fraud Measures Act of 2013 H.R. 2988 / S. 701 / S. 1188, Forty Hours Is Full Time Act of 2013 H.R. 3077, TELE-MED Act of 2013 H.R. 3121, American Health Care Reform Act of 2013 H.R. 3124, Investing in Permanency for Youth in Foster Care Act H.R. 3204, Drug Quality and Security Act H.R. 3367, 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 or 2015 H.R. 3419, Small Business Fairness in Obamacare Act H.R. 3462 / S. 1735, Self-Insurance Protection Act H.R. 4118, SIMPLE Fairness Act H.R. 4160, Keep the Promise to Seniors Act of 2014 H.R. 4302, Protecting Access to Medicare Act of 2014 H.R. 4414, Expatriate Health Coverage Clarification Act of 2014 S. 232, Medical Device Access and Innovation Protection Act S. 603, Jobs and Premium Protection Act S. 612, Social Security Number Protection Act of 2011 S. 1031, Family and Retirement Health Investment Act of 2013 S. 1488, A bill to delay the application of the individual health insurance mandate, to delay the application of the employer health insurance mandate, and for other purposes S. 1647, Restoring Access to Medication Act Proposed Regulation on the Patient Protection and Affordable Care Act: standards related to Essential Health Benefits, Actuarial Value, and Accreditation (77 Fed. Reg. 70,644-70,676, November 26, 2012) (to be codified at 45 C.F.R. pts. 147, 155, 156) Proposed Regulation on the Health Insurance Market Rules: Rate Review (77 Fed. Reg. 70,584-70,617, November 26, 2012) (to be codified at 45 C.F.R. pts. 144, 147, 150) Proposed Regulation on the HHS Notice of Benefit and Payment Parameters for 2014 (77 Fed. Reg. 73,118-73,218, December 7, 2012) (to be codified at 45 C.F.R. pts. 153, 155, 156, 157, 158) Proposed Regulation on the Standards Related to Essential Health Benefits, Actuarial Value, and Accreditation (77 Fed. Reg. 70,644-70,676, November 26, 2012) (to be codified at 45 C.F.R. pts. 147, 155, 156) Proposed Regulation on Medicaid, Children's Health Insurance Programs, and Exchanges: Essential Health Benefits in Alternative Benefit Plans, Eligibility Notices, Fair Hearing and Appeal Processes for Medicaid and Exchange Eligibility Appeals and Other Provisions Related to Eligibility and Enrollment for Exchanges, Medicaid and CHIP, and Medicaid Premiums and Cost Sharing (78 Fed. Reg. 4,594-4,724, January 22, 2013) (to be codified at 42 C.F.R. pts. 430, 431, 433, 435, 440, 447, 457) Proposed Regulation on Incentives for Nondiscriminatory Wellness Programs in Group Health Plans (77 Fed. Reg. 70,620-70,642, November 26, 2012) (to be codified at 26 C.F.R. pt. 54) Proposed Regulation on Shared Responsibility for Employers Regarding Health Coverage (78 Fed. Reg. 218-253, January 2, 2013) (to be codified at 26 C.F.R. pts. 1, 54, 301) Proposed Rule on Information Reporting of Minimum Essential Coverage (78 Fed. Reg. 54,986-54,996, September 9, 2013) (to be codified at 26 C.F.R. pts. 1, 301) Proposed Rule on Information Reporting by Applicable Large Employers on Health Insurance Coverage Offered Under Employer-Sponsored Plans (78 Fed. Reg. 54,996-55,013, September 9, 2013) (to be codified at 26 C.F.R. pt. 301) Proposed Rule regarding the Establishment of Exchanges and Qualified Health Plans: Small Business Health Options Program (78 Fed. Reg. 15,553-15,558, March 11, 2013) (to be codified at 45 C.F.R. pts. 155, 156) Interim Final Rule on Procedures for the Handling of Retaliation Complaints under Section 1558 of the Affordable Care Act (78 Fed. Reg. 13,222-13,236, February 27, 2013) (to be codified at 29 C.F.R. pt. 1984) Response to the Department of Labors document FAQs about Affordable Care Act Implementation Part XI issued on January 24, 2013, regarding the Patient Protection and Affordable Care Act, on the Legality of Employer Subsidies for Individual Health Insurance Proposed Rule on the Health Insurance Providers Fee (78 Fed. Reg. 14,034-14,046, March 4, 2013) (to be codified at 26 C.F.R. pt. 57) Proposed Rule on The $500,000 Deduction Limitation for Remuneration Provided by Certain Health Insurance Providers (78 Fed. Reg. 19,950-19,977, April 2, 2013) (to be codified at 26 C.F.R. pt. 1) Proposed Rule on Minimum Value of Eligible Employer-Sponsored Plans and Other Rules Regarding the Health Insurance Premium Tax Credit (78 Fed. Reg. 25,909-25,916, May 3, 2013) (to be codified at 26 C.F.R. pt. 1) Proposed Rule on Federal Employees Health Benefits Program: Members of Congress and Congressional Staff (78 Fed. Reg. 48,337-48,339, August 8, 2013) (to be codified at 5 C.F.R. pt. 890) Proposed Rule on HHS Notice of Benefit and Payment Parameters for 2015 (78 Fed. Reg. 72,322-72,392, December 2, 2013) (to be codified at 45 C.F.R. pts. 144, 147, 153, 155, 156) Proposed Rule on Amendments to Excepted Benefits (78 Fed. Reg. 77,632-77,642, December 24, 2013) (to be codified at 29 C.F.R. pt. 2590) Draft 2015 Letter to Issuers in the Federally-facilitated Marketplace (issued on February 4, 2014, from the Center for Consumer Information and Insurance Oversight, Centers for Medicare and Medicaid Services) Proposed Rule on Contract Year 2015 Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Program (79 Fed. Reg. 1,918-2,073, January 10, 2014) (to be codified at 42 C.F.R. pts. 409, 417, 422 et. al.) Proposed Rule on Administrative Simplification: Certification of Compliance for Health Plans (79 Fed. Reg. 298-324, January 2, 2014) (to be codified at 45 C.F.R. pts. 160, 162) Proposed Rule on Exchange and Insurance Market Standards for 2015 and Beyond (79 Fed. Reg. 15,808-15,879, March 21, 2014) (to be codified at 45 C.F.R. pts. 146, 147, 148 et al.) Proposed Rule on Ninety-Day Waiting Period Limitation (79 Fed. Reg. 10,320-10,325, February 24, 2014) (to be codified at 29 C.F.R. pt. 2590; 45 C.F.R. pt. 147; and 26 C.F.R. pt. 54) Proposed Rule on Minimum Essential Coverage and Other Rules Regarding Shared Responsibility Payment for Individuals (79 Fed. Reg. 4,302-4,308, January 27, 2014) (to be codified at 26 C.F.R. pt. 1) Draft Guidance Notices on Self-Monitoring Blood Glucose Test Systems for Over-the-Counter Use (79 Fed. Reg. 829-830, January 7, 2014) Statement for the Record in Response to a Notice of Meeting on Employee Welfare and Pension Benefit Plans (79 Fed. Reg. 28,555-28,556, May 16, 2014) Various issues relating to the Patient Protection and Affordable Care Act (P.L. 111-148), including implementation of regulatory process, legislative corrections, coverage, financing, delivery reform, 1099 reporting, Grandfathering, HSA and FSA changes, CMS claims database, IPAB, CLASS program, employer mandate, reporting requirements, medical loss ratio, medical malpractice reform, exchanges, the impact on small business, the Small Business Tax Credit, caps on compensation deductibility required under section 9014, incompleteness or inaccuracy of cost impact analyses, lack of quantified benefit analysis, and need for empirical data sources on which to base costs and benefits; the Health Care and Education Affordability Reconciliation Act of 2010 (P.L. 111-152), including regulatory process and legislative corrections to the ERISA preemption, the impact on small business, the small business tax credit, insurance coverage, financing, delivery reform; changes to Medicare Advantage and Medicare Prescription Drug (Part D) programs including rebates and non-interference with prescription drug prices; entitlement reform; health information technology

Client expense: $21,610,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Army, Dept of (Corps of Engineers), Commerce, Dept of (DOC), Commodity Futures Trading Commission (CFTC), Consumer Product Safety Commission (CPSC), Council on Environmental Quality (CEQ), Defense, Dept of (DOD), Education, Dept of, Energy, Dept of, Environmental Protection Agency (EPA), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Federal Bureau of Investigation (FBI), Federal Deposit Insurance Corporation (FDIC), Federal Housing Finance Agency (FHFA), Federal Reserve System, Federal Trade Commission (FTC), Food & Drug Administration (FDA), General Services Administration (GSA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Interior, Dept of (DOI), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Economic Council (NEC), Natl Institute of Standards & Technology (NIST), Natl Labor Relations Board (NLRB), Natl Security Council (NSC), Office of Management & Budget (OMB), Office of the Comptroller of the Currency (OCC), Patent & Trademark Office (PTO), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Small Business Administration (SBA), State, Dept of (DOS), Transportation Security Administration (TSA), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Copyright Office, U.S. Customs & Border Protection, U.S. Fish & Wildlife Service (USFWS), U.S. Trade Representative (USTR), White House Office

H.R. 4745, S. 2438 - FY2015 Transportation Appropriations, regarding streetcar/rail funding and manufacturing and Tiger Grant Funding. S. 610, H.R. 3080: Water Resources Development Act: Corp of Engineers cost-sharing policies. S.___,H.R.___, Transportation Reauthorization transit issues.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE, Transportation, Dept of (DOT)

Flexible spending arrangements (FSA) and health savings accounts (HSA)H.R. 2835/S. 1647 - Restoring Access to Medication Act. Repeals prohibition in Patient Protection and Affordable Care Act (P.L. 111-148, P.L. 111-152) against use of flexible spending arrangement (FSA) and health savings account (HSA) funds on over-the-counter medications; all sections. H.R. 1248/S. 610 - Family Health Care Flexibility Act. Would also repeal prohibition in Patient Protection and Affordable Care Act (P.L. 111-148, P.L. 111-152) against use of flexible spending arrangement (FSA) and health savings account (HSA) funds on over-the-counter medications; all sections. Senate bill "Expiring Provisions Improvement Reform and Efficiency (EXPIRE) Act." Would renew and extend certain expired and expiring tax provisions for an additional year; all sections. Companion legislation not yet introduced in House.

Client expense: $230,000 · Firm income: Not reported

Government targets: Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, SENATE

H.R. 1074 - National Diabetes Clinical Care Commission Act H.R. 1248 - Family Health Care Flexibility Act; provisions relating to reimbursement of OTC drugs under flexible spending and health savings accounts H.R. 3204 - Drug Quality and Security Act; provisions relating to pharmacy compounding and supply chain H.R. 3742 - Antibiotic Development to Advance Patient Treatment Act; provisions related to antibiotics and drug approval H.R. 4260 - Ryan White Patient Equity and Choice Act; provisions related to ADAP H.R. 4847 - End Neglected Tropical Diseases Act S. 539 - National Diabetes Clinical Care Commission Act S. 610 - Family Health Care Flexibility Act; provisions relating to reimbursement of OTC drugs under flexible spending and health savings accounts S. 957 - Drug Supply Chain Security Act; provisions related to supply chain security S. 959 - Pharmaceutical Compounding Quality and Accountability Act; provisions related to pharmaceutical compounding S. 1165 - Access to Appropriate Immunizations for Veterans Act of 2013; provisions related to extending VA performance measure to include all federally recommended vaccine No bill # assigned - Implementation issues relating to the Patient Protection and Affordable Care Act (PPACA) (Public Law 111-148), including Standards Related to Essential Health Benefits, Actuarial Value, and Accreditation rulemaking No bill # assigned - FDA special medical use; issues related to limited population antibacterial drug approval pathway No bill # assigned - FDA accelerated approval policy issues No bill # assigned - Comparative effectiveness policy issues No bill # assigned - Biopharmaceutical innovation policy issues No bill # assigned - Pharmaceutical supply chain security issues No bill # assigned - 340B policy issues No bill # assigned - Implementation issues relating to the Physician Payment Sunshine Act

Client expense: $1,020,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, SENATE, State, Dept of (DOS), U.S. Trade Representative (USTR)

Issues related to comprehensive tax reform including sect. 179 expensing, employer provided benefits, cash method of accounting, sect. 1202 stock, taxation of pass-through entities, and issues affecting small businesses. H.R. 1527, the Student Loan Interest Deduction Act of 2013. S. 232, the Medical Device Access and Innovation Protection Act and issues related to the repeal of the medical device tax. S. 610 and H.R. 1248, the Family Health Care Flexibility Act and issues related to flexible spending accounts.Issues related to the taxation of Indian Health service scholarship benefits for dental health professionals. S. 2260, Expire Act and H.R. 4457, America's Small Business Tax Relief Act, as it relates to Sect. 179 expensing. H.R. 3393, the Student and Family Tax Simplification Act, as it relates to the Lifetime Learning Credit and the Tuition Deduction.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Family Health Care Flexibility Act (HR 1248/S 610) Prescription Drug Shortages Coordination of Pro Bono Medically Recommended Dental Care Act (HR 963/S 466) Action for Dental Health Act (HR 4395)

Client expense: $112,893 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H.R. 763, Jobs and Premium Protection Act (Boustany-Matheson) -repeal of ACA health insurance tax. H.R. 1248, Family Health Care Flexibility Act (Paulsen) - HSA and FSA issues. H.R. 1342, Helping Save Americans Health Care Choices Act (Fleming) - HSA and FSA issues. H.R. 2194, Family and Retirement Health Investment Act (Paulsen) - HSA and FSA issues. H.R. 2835, Restoring Access to Medication Act (Jenkins) - HSA and FSA issues. H.R. 3367, HIT Delay Bill (Boustany-Bera) - delay of ACA health insurance tax. H.R. 4600, Tax Free Health Insurance Act (King) - tax treatment of health insurance premiums. H.R. 4777, Health Savings Act (Burgess) - HSA issues. S. 24, Small Business Health Relief Act (Portman) - HIT repeal, HSA and FSA changes. S. 603, Jobs and Premium Protection Act (Barrasso-Hatch) - repeal of ACA health insurance tax. S. 610, Family Health Care Flexibility Act (Johanns) - HSA and FSA issues. S. 1031, Family and Retirement Health Investment Act (Hatch) - HSA and FSA issues. S. 1485, Americans Giving Care to Elders Act (Klobuchar) - tax credits for family caregivers. S. 2260, EXPIRE Act (Wyden) - tax provisions Hatch-Barrasso Amendment to H.R. 3474, Tax Extenders Bill - two-year delay in ACA health insurance tax.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

See addendum.S. 1031/H.R. 2194, the Family and Retirement Health Investment Act of 2013 H.R. 207, a bill to amend the Internal Revenue Code of 1986 to make members of health care sharing ministries eligible to establish health savings accounts S. 24, the Small Business Health Relief Act of 2013 H.R. 956, the Personal Health Investment Today Act of 2013 H.R. 1140, the Family Friendly HSA Improvement Act of 2013 H.R. 1342, the Helping American's Health Care Choices Act of 2013 H.R. 1326, the Health Care Price Transparency Promotion Act of 2013 S. 610/H.R. 1248, the Family Health Care Flexibility Act H.R. 1552, the Health Freedom for Seniors Act S. 728/H.R. 2499, the Tax Parity for Health Plan Beneficiaries Act of 2013 H.R. 2688, the PATIENT Health Care Act H.R. 2835, the Restoring Access to Medication Act of 2013 H.R. 3498, a bill to allow individuals to choose to opt out of the Medicare part A benefit and to allow individuals opting out of such benefit to be eligible for health savings accounts

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

Government targets: Federal Reserve System, HOUSE OF REPRESENTATIVES, SENATE, Treasury, Dept of

See attached.Monitored HR 344, the Competitive Health Insurance Act Monitored HR 1254, to repeal a requirement that new employees of certain employers be automatically enrolled in their employers health benefit plans Monitored HR 1326, the Health Care Price Transparency Act Monitored HR 1342, to Helping Save Americans Health Care Choices Act Monitored HR 1558, to lower health premiums and increase choice for small business Monitored HR 1990/S 983, the Keep the IRS Off Your Health Care Act Monitored HR 2667, the Authority for Mandate Delay Act Monitored HR 2700, the Health Care Waiver Fairness Act Monitored HR 3046, the Small Business Health Care Tax Credit Improvement Act Monitored HR 4244, the Small Business Health Insurance Affordability Act of 2014 Monitored S 24, the Small Business Health Relief Act Monitored S 479, the Health Insurance Rate Review Act Monitored S 560, to construe the Individual Mandate of the Patient Protection and Affordable Care Act as a tax Monitored S 610, the Family Health Care Flexibility Act Monitored S 603, the Jobs and Premium Protection Act Monitored S 701, modifying the definition of full time employee for the purposes of the Patient Protection and Affordable Care Act Monitored HR 762, the Health Care Choice Act Monitored S 1154/HR 2938, the Exchange Sunset Act Monitored HR 3350, the Keep Your Health Plan Act Monitored S 1735/HR 3462, the Self-insurance Protection Act Monitored HR 3522, the Employee Health Care Protection Act Monitored S 1894, the Health Insurance Accountability Act

Client expense: $110,000 · Firm income: Not reported

Government targets: Bureau of Land Management (BLM), HOUSE OF REPRESENTATIVES, SENATE, U.S. Forest Service

HR 1248 Patients Freedom to Choose S. 610 Patients Freedom to Choose HR 2835 Restoring Access to Medications Act S 1647 Restoring Access to Medications Act

Client expense: Not reported · Firm income: $25,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. ____, S. ____; FY 2015 Transportation Appropriations, regarding streetcar/rail funding and manufacturing and Tiger Grant Funding. H.R. 3080, S. 610; Water Resources Reform and Development Act, Corps of Engineers cost-sharing policies. H.R. ____, S. ____; Transportation Reauthorization; transit issues.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE, Transportation, Dept of (DOT)

Financial management and other issues tied to the successful operation of a dental practice as a small business. H.R. 523 Protect Medical Innovation Act of 2013 H.R. 1248 Family Health Care Flexibility Act H.R. 1295 Medical Device Tax Elimination ActH.R. 1527 Student Loan Interest Deduction Act of 2013 S. 232 Medical Device Access and Innovation Protection Act S. 610 Family Health Care Flexibility Act S. 966 Medical FSA Improvement Act of 2013 Section 1202 stock Tax on medical devices Tax Exclusion for Contribution to Savings and Retirement Plans Tax Exempt Status for Indian Health Service Loan Repayments Taxation of Small Business: Section 179 Deduction Taxation of Pass-through Entities Cash Method of Accounting Accelerated depreciation Business interest expense deductibility Charitable contribution deduction Estate tax levels Mortgage interest deduction

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Air Force, Dept of, Army, Dept of (Other), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Indian Health Service, Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Navy, Dept of, Occupational Safety & Health Administration (OSHA), Office of Natl Drug Control Policy (NDCP), SENATE, U.S. Coast Guard (USCG), Veterans Affairs, Dept of (VA), White House Office

See AddendumS. 1031/H.R. 2194, the Family and Retirement Health Investment Act of 2013 H.R. 207, a bill to amend the Internal Revenue Code of 1986 to make members of health care sharing ministries eligible to establish health savings accounts S. 24, the Small Business Health Relief Act of 2013 H.R. 956, the Personal Health Investment Today Act of 2013 H.R. 1140, the Family Friendly HSA Improvement Act of 2013 H.R. 1342, the Helping American's Health Care Choices Act of 2013 H.R. 1326, the Health Care Price Transparency Promotion Act of 2013 S. 610/H.R. 1248, the Family Health Care Flexibility Act H.R. 1552, the Health Freedom for Seniors Act S. 728/H.R. 2499, the Tax Parity for Health Plan Beneficiaries Act of 2013 H.R. 2688, the PATIENT Health Care Act H.R. 2835, the Restoring Access to Medication Act of 2013 H.R. 3498, a bill to allow individuals to choose to opt out of the Medicare part A benefit and to allow individuals opting out of such benefit to be eligible for health savings accounts

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

Government targets: Federal Reserve System, HOUSE OF REPRESENTATIVES, SENATE, Treasury, Dept of

H.R. 45, To repeal the Patient Protection and Affordable Care Act and health care-related provisions in the Health Care and Education Reconciliation Act of 2010 H.R. 523, Protect Medical Innovation Act of 2013 H.R. 581, First Responder Medical Device Tax Relief Act H.R. 582, Healthcare Tax Relief and Mandate Repeal Act H.R. 763, To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act H.R. 781, Medicare Identity Theft Prevention Act of 2013 H.R. 903 / S. 399, American Job Protection Act H.R. 1248 / S. 610, Family Health Care Flexibility Act H.R. 1254, Auto Enroll Repeal Act H.R. 1295, Medical Device Tax Elimination Act H.R. 1558 / S. 24, Small Business Health Relief Act of 2013 H.R. 1735, In It All Together Act H.R. 1780, To provide that the only health plans that the Federal Government may make available to the President, Vice President, Members of Congress, and Federal employees are those created under the Patient Protection and Affordable Care Act or offered through a health insurance exchange H.R. 2575, Save American Workers Act H.R. 2667, Authority for Mandate Delay Act H.R. 2668, Fairness for American Families Act H.R. 2674, Job Creation Act of 2013 H.R. 2835 / S. 1647, Restoring Access to Medication Act of 2013 H.R. 2925, Strengthening Medicare Anti-Fraud Measures Act of 2013 H.R. 2988 / S. 701 / S. 1188, Forty Hours Is Full Time Act of 2013 H.R. 3121, American Health Care Reform Act of 2013 H.R. 3124, Investing in Permanency for Youth in Foster Care Act H.R. 3204, Drug Quality and Security Act H.R. 3367, 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 or 2015 H.R. 3419, Small Business Fairness in Obamacare Act H.R. 3462 / S. 1735, Self-Insurance Protection Act H.R. 3541 / S. 1726, Obamacare Taxpayer Bailout Prevention Act H.R. 3812, No Bailouts for Insurance Industry Act of 2014 H.R. 4118, SIMPLE Fairness Act H.R. 4160, Keep the Promise to Seniors Act of 2014 H.R. 4302, Protecting Access to Medicare Act of 2014, including provisions relating to section 213 S. 232, Medical Device Access and Innovation Protection Act S. 603, Jobs and Premium Protection Act S. 612, Social Security Number Protection Act of 2011 S. 1031, Family and Retirement Health Investment Act of 2013 S. 1488, A bill to delay the application of the individual health insurance mandate, to delay the application of the employer health insurance mandate, and for other purposes Proposed Regulation on the Patient Protection and Affordable Care Act; standards related to Essential Health Benefits, Actuarial Value, and Accreditation, (77 Fed. Reg. 70,644-70,676, November 26, 2012) (to be codified at 45 C.F.R. pts 147, 155, and 156) Proposed Regulation on the Health Insurance Market Rules; Rate Review (77 Fed. Reg. 70,584-70,617, November 26, 2012) (to be codified at 45 C.F.R. pts 144, 147, and 150) Proposed Regulation on the HHS Notice of Benefit and Payment Parameters for 2014 (77 Fed. Reg. 73,118-73,218, December 7, 2012) (to be codified at 45 C.F.R. pts 153, 155, 156, 157 and 158) Proposed Regulation on the Standards Related to Essential Health Benefits, Actuarial Value, and Accreditation, (77 Fed. Reg. 70,644-70,676, November 26, 2012) (to be codified at 45 C.F.R. pts 147, 155, and 156) Proposed Regulation on Medicaid, Children's Health Insurance Programs, and Exchanges: Essential Health Benefits in Alternative Benefit Plans, Eligibility Notices, Fair Hearing and Appeal Processes for Medicaid and Exchange Eligibility Appeals and Other Provisions Related to Eligibility and Enrollment for Exchanges, Medicaid and CHIP, and Medicaid Premiums and Cost Sharing ( 78 Fed. Reg. 4,594-4,724, January 22, 2013) (to be codified at 42 C.F.R. pts 430, 431, 433, 435, 440, 447, and 457) Proposed Regulation on Incentives for Nondiscriminatory Wellness Programs in Group Health Plans, (77 Fed. Reg. 70,620-70,642, November 26, 2012) (to be codified at 26 C.F.R. pt 54) Proposed Regulation on Shared Responsibility for Employers Regarding Health Coverage, (78 Fed. Reg. 218-253, January 2, 2013) (to be codified at 26 C.F.R. pts 1, 54 and 301) Proposed Rule on Information Reporting of Minimum Essential Coverage, (78 Fed. Reg. 54,986-54,996, September 9, 2013) (to be codified at 26 C.F.R. pts 1 and 301) Proposed Rule on Information Reporting by Applicable Large Employers on Health Insurance Coverage Offered Under Employer-Sponsored Plans, (78 Fed. Reg. 54,996-55,013, September 9, 2013) (to be codified at 26 C.F.R. pt 301) Proposed Rule regarding the Establishment of Exchanges and Qualified Health Plans; Small Business Health Options Program, (78 Fed. Reg. 15,553-15,558, March 11, 2013) (to be codified at 45 C.F.R. pts 155 and 156) Interim Final Rule on Procedures for the Handling of Retaliation Complaints under Section 1558 of the Affordable Care Act, (78 Fed. Reg. 13,222-13,236, February 27, 2013) (to be codified at 29 C.F.R. pt 1984) Response to the Department of Labors document FAQs about Affordable Care Act Implementation Part XI issued on January 24, 2013, regarding the Patient Protection and Affordable Care Act, on the Legality of Employer Subsidies for Individual Health Insurance Comments for the Record on the Equal Employment Opportunity Commissions public meeting on Wellness Programs under Federal Equal Employment Opportunity Laws, held on May 8, 2013 Proposed Rule on the Health Insurance Providers Fee, (78 Fed. Reg. 14,034-14,046, March 4, 2013) (to be codified at 26 C.F.R. pt 57) Proposed Rule on The $500,000 Deduction Limitation for Remuneration Provided by Certain Health Insurance Providers, (78 Fed. Reg. 19,950-19,977, April 2, 2013) (to be codified at 26 C.F.R. pt 1) Proposed Rule on Minimum Value of Eligible Employer-Sponsored Plans and Other Rules Regarding the Health Insurance Premium Tax Credit, (78 Fed. Reg. 25,909-25,916, May 3, 2013) (to be codified at 26 C.F.R. pt 1) Proposed Rule on Federal Employees Health Benefits Program: Members of Congress and Congressional Staff, (78 Fed. Reg. 48,337-48,339, August 8, 2013) (to be codified at 5 C.F.R. pt 890) Proposed Rule on HHS Notice of Benefit and Payment Parameters for 2015, (78 Fed. Reg. 72,322-72,392, December 2, 2013) (to be codified at 45 C.F.R. pts 144, 147, 153, 155, and 156). Proposed Rule on Amendments to Excepted Benefits, (78 Fed. Reg. 77,632-77,642, December 24, 2013) (to be codified at 29 C.F.R. pt 2590) Draft 2015 Letter to Issuers in the Federally-facilitated Marketplace (issued on February 4, 2014, from the Center for Consumer Information and Insurance Oversight, Centers for Medicare and Medicaid Services) Proposed Rule on Contract Year 2015 Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Program, (79 Fed. Reg. 1918-2073, January 10, 2014) (to be codified at 42 C.F.R. pts 409, 417, 422 et. al.) Various issues relating to proposed and final regulations (HHS and IRS) implementing provisions of the Patient Protection and Affordable Care Act (P.L. 111-148), including implementation of regulatory process, legislative corrections, insurance coverage, financing, delivery reform, 1099 reporting, grandfathering, HSA and FSA changes, CMS claims database, IPAB, CLASS program, employer mandate, medical loss ratio, full time worker definition, 30 hour work week, reporting requirements, medical malpractice reform, exchanges, incompleteness or inaccuracy of cost impact analyses, lack of quantified benefit analysis, need for empirical data sources on which to base costs and benefits, the impact on small business, the Small Business Tax Credit, caps on compensation deductibility required under section 9014, repeal of risk mitigation programs including the risk corridor transitional reinsurance and risk adjustment programs; changes to Medicare Advantage; Medicare Part D including rebates and non-interference with prescription drug prices; entitlement reform; regulatory process and legislative corrections to Health Care and Education Affordability Reconciliation Act of 2010 (P.L. 111-152), including ERISA preemption and the impact on small business

Client expense: $18,960,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Commerce, Dept of (DOC), Commodity Futures Trading Commission (CFTC), Consumer Product Safety Commission (CPSC), Council on Environmental Quality (CEQ), Defense, Dept of (DOD), Education, Dept of, Energy, Dept of, Environmental Protection Agency (EPA), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Federal Aviation Administration (FAA), Federal Deposit Insurance Corporation (FDIC), Federal Housing Finance Agency (FHFA), Federal Reserve System, Federal Trade Commission (FTC), General Services Administration (GSA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Interior, Dept of (DOI), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Economic Council (NEC), Natl Institute of Standards & Technology (NIST), Natl Labor Relations Board (NLRB), Natl Security Council (NSC), Office of Management & Budget (OMB), Patent & Trademark Office (PTO), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Small Business Administration (SBA), State, Dept of (DOS), Transportation Security Administration (TSA), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Copyright Office, U.S. Customs & Border Protection, U.S. Trade Representative (USTR), White House Office

FY2015 Transportation Appropriations, regarding streetcar/rail funding and manufacturing and Tiger Grant Funding. S. 610, H.R. 3080: Water Resources Development Act: Corp of Engineers cost-sharing policies. S.___,H.R.___, Transportation Reauthorization transit issues.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE, Transportation, Dept of (DOT)