Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2016

S. 1465 / HR 2799: Furthering Access to Stroke Telemedicine (FAST) Act S. 2484 / HR 4442: CONNECT for Health Act; Section 303 S.3504: CHRONIC Care Act of 2016 HR 2948: Medicare Telehealth Parity Act of 2015, Section 105(a)(1) HR 5122: To prohibit further action on the proposed rule regarding testing of Medicare part B prescription drug models. Preservation of the in-office ancillary exception to the Stark law; urging changes to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Outreach and monitoring related to health, Medicaid and Medicare issues. H.R. 34, 21st Century Cures Act. H.R. 2300, Empowering Patients First Act of 2015. S.3504, Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2016.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Outreach and monitoring related to health, Medicaid and Medicare issues. H.R. 34, 21st Century Cures Act. H.R. 2300, Empowering Patients First Act of 2015. S.3504, Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2016.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 1674, Preventing Diabetes in Medicare Act of 2015 HR 2090, Medicare Diabetes Prevention Act of 2015 HR 3386, CURE Act of 2015 S.1131, Medicare Diabetes Prevention Act of 2015 S.1345, Access to Quality Diabetes Education Act of 2015 S. 3082, To reduce the occurrence of diabetes in Medicare beneficiaries by extending coverage under Medicare for medical nutrition therapy services to such beneficiaries with pre-diabetes or with risk factors for developing type 2 diabetes. S. 3361, Pulmonary Hypertension Research and Diagnosis Act of 2016 S. 3504, To amend the Social Security Act to implement Medicare payment policies designed to improve management of chronic disease, streamline care coordination, and improve quality outcomes without adding to the deficit.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3943, the Physician Assistant Education Public Health Initiatives Act of 2015 Public Law No: 114-225/H.R. 34: 21st Century Cures Act S.1455, H.R. 2536 Recovery Enhancement for Addiction Treatment (TREAT) Act Public Law No: 114-198, S.524/ H.R. 953 Comprehensive Addiction and Recovery (CARA) Act of 2016 Opioid Epidemic Health care issues impacting PA education and the PA profession Public Health Initiatives Chronic Care: S.3504 - Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2016

Client expense: $90,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), SENATE

Medicare Advantage risk adjustment; Medicare Advantage Special Needs Plans (SNPs); SNP reauthorization and chronic condition special needs plans (C-SNPs); S. 3504, The Chronic Care Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues concerning hospital reimbursement. Issues related to S. 3504, The Chronic Care Act of 2016. Issues related to Unique Device Identifiers (UDIs); H.R. 5273, The Helping Hospitals Improve Care Act; issues related hospital outpatient departments.

Client expense: Not reported · Firm income: $78,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Monitoring Congressional activities in MA plans; issues related S. 3504, Chronic Care Act of 2016; issues related to ESRD.

Client expense: Not reported · Firm income: $60,750

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Support for Home Health Planning Improvement Act, H.R. 1342/S. 578. Support for the Nurse and Health Care Worker Protection Act, H.R. 4266 Support for the Registered Nurse Safe Staffing Act, HR 2083/S.1132 Opposition to the Restoring America's Access to Freedom Reconciliation Act, H.R. 3762 Support for the CONNECT for Health Act, S. 2484/H.R. 4442 Support for H.R. 2948, the Medicare Telehealth Parity Act Support for S. 2873, the Expanding Capacity for Health Outcomes (ECHO) Act Support for S. 3504, the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act

Client expense: $430,200 · Firm income: Not reported

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

S. 3040, H.R. 5926, H.R. 5325, H.R. 2028, Labor, Health and Human Services Appropriations bill, FY2017 - Lobbied in support of increased funding for CMS' state survey and certification program. Discussed Medicaid per capita caps and block grants. Discussed DOJ investigation regarding findings of Olmstead and ADA violations by South Dakota. Discussed Olmstead and older adults roundtable and next steps (Administration for Community Living). Discussed arbitration provision in long-term care facility requirements final rule and related issues (no bill, Senate) and discussed final rule in general (CMS webinar). Provided information regarding Medicaid managed long-term services and supports and discussed family caregiver assessment in Medicaid home and community-based services. Discussed impending nursing home closure and resident relocation in the Virgin Islands and related issues. Discussed extension of the Money Follows the Person Rebalancing Demonstration Program. Discussed long-term services and supports financing, Social Security Caregiver Credit Act of 2015 (H.R. 3377), and family caregiving. S. 3504, Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act - Discussed and provided feedback on draft bill. PL 113-185, Participated in CMS call on the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014. Discussed caregiver-focused health risk assessment in Medicare physician fee schedule final rule. Discussed AARP statement on Medicare physician fee schedule. S. 843, H.R. 1571, Improving Access to Medicare Coverage Act of 2015 - Discussed bill. Discussed health care quality and measurement. Discussed changes to the Medicare benefit design, such as copays, premiums, and deductibles. Discussed MACRA implementation. P.L. 111-148, P.L. 111-152 - Discussed potential repeal of Affordable Care Act. S. 9 - Sent endorsement letter for the Over the Counter Hearing Aid Act of 2016.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Equal Employment Opportunity Commission (EEOC), Federal Transit Administration (FTA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Trade Representative (USTR), White House Office

H.R. 34, 21st Century Cures Act (Upton) - Medicare Advantage and Medicaid issues H.R. 546, ACE Kids Act (Barton) - Medicaid Childrens Care Coordination Program H.R. 588, Medicare Beneficiary Preservation of Choice Act (Rothfus-Schrader) - MA enrollment opportunities H.R. 818, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Roskam-Carney) - reducing fraud H.R. 1021, Protecting the Integrity of Medicare Act (Brady) - reducing fraud H.R. 2488, Medicare Beneficiary Preservation of Choice Act (Rothfus-Schrader) - MA open enrollment period H.R. 2505, Increasing Access to Data in Medicare Advantage Act (Kelly) - annual reporting of MA enrollment data H.R. 2506, Preventing Unnecessary Plan Terminations Act (Buchanan) - preventing certain MA plan terminations H.R. 2507, Increasing Regulatory Fairness Act (Brady) - schedule for MA rates H.R. 2570, Strengthening Medicare Advantage through Innovation and Transparency for Seniors Act (Black) - Value-Based Insurance Design demonstration H.R. 2579, Securing Care for Seniors Act (Black) - MA risk adjustment model H.R. 2581, Preservation of Access for Seniors in Medicare Advantage Act (Brady) - Value-Based Insurance Design demonstration and MA open enrollment period H.R. 2582, Seniors Health Care Plan Protection Act (Buchanan) - preventing certain MA plan terminations, MA risk adjustment model H.R. 3718, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Roskam-Carney) - reducing fraud H.R. 3716, Ensuring Access to Quality Medicaid Providers Act (Bucshon) - oversight of terminated Medicaid providers H.R. 4275, Medicare Advantage Quality Payment Relief Act (Kelly) - calculation of MA benchmark cap H.R. 4442, CONNECT for Health Act (Black-Welch) - telehealth, remote patient monitoring services H.R. 4589, Excellence in Medicare Act (MacArthur) - MA payment cap H.R. 5273, Helping Hospitals Improve Patient Care Act (Tiberi) - MA issues, site-neutral payments H.R. 5506, Dialysis PATIENT Demonstration Act (Young) - demonstration program for Medicare beneficiaries with ESRD H.R. 5659, ESRD Choice Act (Smith) - option for ESRD patients to enroll in MA plans H.R. 5942, Dialysis PATIENTS Demonstration Act (Young) - demonstration program for Medicare beneficiaries with ESRD H.R. 6265, Medigap Reforms (McDermott) S. 298, ACE Kids Act (Grassley) - Medicaid Childrens Care Coordination Program S. 524, Comprehensive Addiction and Recovery Act (Whitehouse) - Medicare Part D lock-in programs S. 861, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Carper-Enzi) - reducing fraud S. 1347, Electronic Health Fairness Act - preventing certain MA plan terminations, annual reporting of MA enrollment data S. 1396, Value-Based Insurance Design Seniors Copayment Reduction Act (Thune-Stabenow) - VBID demonstration S. 1549, Care Planning Act (Warner) - advanced illness care coordination for Medicare beneficiaries S. 1913, Stopping Medication Abuse and Protecting Seniors Act (Toomey) - Medicare Part D lock-in programs S. 2104, Preserving Medicare Advantage for all Medicare Beneficiaries Act (Portman-Casey) - preventing certain MA plan terminations, MA demonstration program S. 2349, Medicare Advantage Coverage Transparency Act (Heller) - MA enrollment data S. 2484, CONNECT for Health Act (Schatz-Wicker) - telehealth, remote patient monitoring services S. 2864, RxCAP Act (Wyden) - Medicare Part D cost-sharing S. 3090, Dialysis PATIENT Demonstration Act (Heller) - demonstration program for Medicare beneficiaries with ESRD S. 3504, Chronic Care Act (Hatch-Wyden-Isakson-Warner) - chronic care reforms, Medicare Advantage provisions Regulatory Issues: Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, network adequacy and provider directories, encounter data and other data-related issues, and audit issues; bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, Part D direct and indirect remuneration (DIR), and audits); in-home health risk assessments; Medicare Medical Loss Ratio issues; implementation of sequestration under the Medicare Advantage and Part D programs; implications of the health insurer fee for MA and Part D plans; application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, enrollment rules, requirements for notice and denial forms, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible SNPs; Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, Part D coverage gap discount program, including employer group waiver plan (EGWP) issues, and other operational issues; issues raised by Part D coverage of new specialty drugs, the Part D non-interference policy and related issues (e.g., preferred pharmacy and any willing pharmacy requirements, standards for network pharmacy reimbursement, and policies regarding sponsor negotiation of pharmacy price concessions); CMS's proposed Part B drug demonstration program; Medication Therapy Management Program requirements and the Center for Medicare and Medicaid Innovation (CMMI) Demonstration; MA EGWP issues; CMMI's value-based insurance design (VBID) demonstration; Part D requirements for offering basic and enhanced alternative plans; MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; issues relating to MA and Part D Star Rating system including measures, the methodology for calculating ratings, and the role of the ratings for payment purposes; implementation of the Affordable Care Act (ACA) changes to the Part D coverage gap; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education Program; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; new payment system for physicians under MACRA, including implications for MA and Part D plans; Medicare clinical trials; Medicare/Medicaid integration for dual eligibles, including implementation of the Capitated Financial Alignment Demonstration and related issues (e.g., quality ratings); Medicaid managed care regulations and policies, including CMS' proposed substantial revisions to the managed care regulations, new mental health parity rules, the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, fraud and abuse compliance, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including block grants, the calculation of the federal medical assistance (federal matching) percentage (FMAP), and intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost issues affecting Medicaid health plans including issues raised by Medicaid coverage of new specialty drugs; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues and CHIP reauthorization; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including Medicaid managed care organization provider tax issues; standards for electronic prescribing; implementation of Medicaid changes of interest to Medicaid health plans made in the ACA including Medicaid expansion, the managed care organization (MCO) prescription drug rebate provisions, minimum payments to primary care providers (PCPs), interactions between the Medicaid program and health insurance exchanges, and Medicaid and CHIP maintenance of effort (MOE) requirements; implications of the health insurer fee for Medicaid health plans; issues related to Medicaid Managed long-term care including home and community-based waiver services (HCBS); expanding the availability of Medicare Advantage and Medicaid health plan telemedicine programs; implications of the new non-discrimination rules for health plans participating in public programs; issues related to Medigap coverage; issues related to business continuity in relation to pandemics or natural events (e.g., hurricane, tornado, etc.); cybersecurity; provider directories; value-based insurance design models; Part D prescriber enrollment requirements; Part D recovery audit contractor programs; issues relating to enrollment of beneficiaries with ESRD into MA plans; socioeconomic status impacts on star ratings related to MA and Part D programs; and other issues relating to health care reform implementation. *Add MACPAC to Agency List.

Client expense: $1,330,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of Personnel Management (OPM), SENATE, Treasury, Dept of, White House Office

H.R. 4499, Promoting Responsible Opioid Prescribing (PROP) Act of 2016, provisions relating to payment and delivery reform S. 2758, Promoting Responsible Opioid Prescribing (PROP) Act of 2016, provisions relating to payment and delivery reform S. 3130, Independence at Home Act of 2016, all provisions H.R. 3220, Medicare Common Access Card Act of 2015, all provisions S. 3504, Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2016, all provisions H.R.6333, To amend title XVIII of the Social Security Act with respect to the accreditation of osteopathic residency training programs for purposes of graduate medical education payments under the Medicare program, all provisions H.R. 976, Patient Access to Higher Quality Health Care Act of 2015, all provisions H.R. 2, Medicare Access and CHIP Reauthorization Act of 2015, provisions relating to payment and delivery reform H.R. 1470, SGR Repeal and Medicare Provider Payment Modernization Act of 2015, provisions relating to payment and delivery reform S. 810, SGR Repeal and Medicare Provider Payment Modernization Act of 2015, provisions relating to payment and delivery reform H.R. 1190, Protecting Seniors' Access to Medicare Act of 2015, all provisions S.141, Protecting Seniors' Access to Medicare Act of 2015, all provisions H.R. 4442, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act, provisions relating to telehealth S. 2484, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act, provisions relating to telehealth S. 1131, Medicare Diabetes Prevention Act of 2015, all provisions H.R. 2646, Helping Families in Mental Health Crisis Act of 2016, all provisions S. 1945, Mental Health Reform Act of 2015, all provisions S. 1913, Stopping Medication Abuse and Protecting Seniors Act of 2015, all provisions Medicare program: MACRA Implementation Medicare program: PAMA implementation Medicare program: ACO Improvement Act Medicare program: The Center for Medicare and Medicaid Innovation (CMMI) Medicare program: Repeal of the Independent Payment Advisory Board (IPAB) Medicare program: Medicare Part B Drug Demonstration Medicare program: Regulatory Relief Medicare program: CY 2017 Medicare Physician Fee Schedule Medicare program: In-Office Ancillary Services Exception (IOASE) Medicare program: Merit-Based Incentive Payment System (MIPS) Medicare program: Value-Based Payment Modifier (VPM) Medicare program: Physician Compare Medicare program: Alternate Payment Models Medicare program: Physician Quality Reporting System (PQRS) Medicare program: Graduate Medical Education (GME) Medicare program: Electronic Health Records/Meaningful Use (EHR/MU) Medicare program: Quality Reporting Medicare program: ICD-10 Medicare program: Prescription Drug Diversion Medicare program: Physician data Medicare program: Telemedicine Medicare program: Patient Relationship Codes Medicare program: Social Security Number Removal Initiative Medicaid program: Amendment to New York's section 1115 demonstration waiver

Client expense: $3,990,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA), White House Office

Raise awareness with legislators about the barriers to and the importance of protecting access for home dialysis. S. 598 / H.R. 1130, "Chronic Kidney Disease Improvement in Research and Treatment Act of 2015", regarding all provisions. H.R. 2948, "Medicare Tele-health Parity Act of 2015", regarding all provisions. H.R. 5659, "ESRD Choice Act of 2016", regarding all provisions. S. 2484, "CONNECT for Health Act", regarding all provisions. S. 3504, "Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2016", regarding all provisions.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 1465 / HR 2799: Furthering Access to Stroke Telemedicine (FAST) Act S. 2484 / HR 4442: CONNECT for Health Act; Section 303 S.3504: CHRONIC Care Act of 2016 HR 2948: Medicare Telehealth Parity Act of 2015, Section 105(a)(1) HR 5122: To prohibit further action on the proposed rule regarding testing of Medicare part B prescription drug models. Preservation of the in-office ancillary exception to the Stark law; urging changes to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).

Client expense: Not reported · Firm income: $196,982

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Various issues in the 21st Century Cures Act (H.R. 34), including: -Interoperability and Regulation of Health IT -Food and Drug Administration: drug, medical device, and agency reforms including improving scientific capacity at FDA and use of public-private partnerships; use of real-world evidence and drug development tools such as biomarkers and patient-reported outcomes; and the approval process for certain items such as antibiotics, combination products, and regenerative cell therapies. Medicare, including chronic care coordination (CHRONIC Care Act of 2016; S. 3504), prevention, and health care delivery and payment reform Long-term care financing and Medicaid Money Follows the Person Rebalancing Demonstration program reauthorization Beneficiaries dually eligible for Medicare and Medicaid

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation and policies relating to: Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Section 2706 of the ACA regarding provider non-discrimination Policies affecting nurse practitioner education and workforce Definition of essential health benefits and provider network adequacy Health information technology and electronic health records Telehealth provisions of draft medical innovation legislation Mental health services and violence prevention Lead contamination of drinking water H.R. 6/H.R. 34 - 21st Century Cures Act H.R. 30 - Save American Workers Act H.R. 248/S. 305 - American Job Protection Act H.R. 512 - Developing an Innovative Strategy for Antimicrobial Resistant Microorganisms (DISARM) Act H.R. 596 - 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. 609/S. 287 - Safe Food Act H.R. 879 - Ax the Tax on Middle Class Americans' Health Plans Act H.R. 897 - Zika Vector Control Act H.R. 931 - Helping Effective Antibiotics Last (HEAL) Act H.R. 932/S. 497 - Healthy Families Act H.R. 933/S. 486 - Head Start on Vaccinations Act H.R. 1151 - USPSTF Transparency and Accountability Act of 2015 H.R 1189/S. 620 - Preserving Employee Wellness Programs Act H.R. 1209/S. 628 - Improving Access to Maternity Care Act H.R. 1372 - Home Visiting Extension Act H.R. 1462/S. 799 - Protecting Our Infants Act H.R 1517 - Stop Selling and Marketing to Our Kids E-Cigarettes (SMOKE) Act H.R. 1552 - Preservation of Antibiotics for Medical Treatment Act H.R. 1599 - Safe and Accurate Food Labeling Act H.R 1624 - Protecting Affordable Coverage for Employees (PACE) Act H.R. 2017/S. 2217 - Common Sense Nutrition Disclosure Act H.R. 2300/S. 2519 - Empowering Patients First Act of 2015 H.R. 2646 - Helping Families in Mental Health Crisis Act H.R. 2653 - American Health Care Reform Act H.R. 2690 - Including Families in Mental Health Recovery Act H.R. 2713 - Title VIII Nursing Workforce Reauthorization Act H.R. 2948 - Medicare Telehealth Parity Act H.R. 3081/S. 1778 - Telemedicine for Medicare (TELE-MED) Act H.R. 3299 - Strengthening Public Health Emergency Response Act of 2015 H.R. 3379 - Airplane Kits Act H.R. 3463 - Aligning Childrens Dental Coverage Act H.R. 3495 - Women's Public Health and Safety Act H.R. 3660 - Preventive Health Savings Act H.R. 3659 - Exchange Inclusion for a Healthy America Act H.R. 3762 - Restoring Americans Healthcare Freedom Reconciliation Act H.R. 3865/S. 2542 - Cradle Act H.R. 4276 - Behavioral Health Coverage Transparency Act H.R. 4400/S. 2512 - Adding Zika Virus to the FDA Priority Review Voucher Program Act H.R. 4479 - Families of Flint Act H.R. 4723 - Protecting Taxpayers by Recovering Improper Obamacare Subsidy Overpayments Act H.R. 4724 - Reducing Duplicative and Ineffective Federal Funding Act H.R. 4771 - Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2016 H.R. 5001/S. 2822 - Flexibility in Health IT Reporting (Flex-IT) Act H.R. 5003 - Improving Child Nutrition and Education Act of 2016 H.R. 5065/S. 3299 - Bottles and Breastfeeding Equipment Screening (BABES) Act H.R. 5284 - Worlds Greatest Healthcare Plan Act of 2016 H.R. 5456/S. 3065 - Family First Prevention Services Act S. 30 - Forty Hours Is Full Time Act S. 142/H.R. 1375/H.R. 3242 - Child Nicotine Poisoning Prevention Act S. 185 - Promise for Antibiotics and Therapeutics for Health (PATH) Act S. 203 - American Liberty Restoration Act S. 339 - ObamaCare Repeal Act S. 481 - Improving Regulatory Transparency for New Medical Therapies Act S. 522 - Protecting & Retaining Our Children's Health Insurance Program (PRO-CHIP) Act S. 612 - Water Infrastructure Improvements for the Nation Act S. 621 - Prevention of Antibiotic Resistance Act S. 673 - Winding Down Obamacare Act S. 674 - 21st Century Womens Health Act S. 764 - National Bioengineered Food Disclosure Standard S. 971 - Medicare Independence at Home Medical Practice Demonstration Improvement Act S. 993/H.R. 1854 - Comprehensive Justice and Mental Health Act S. 1014 - Personal Care Products Safety Act S. 1016 - Preserving Freedom and Choice in Health Care Act S. 1456 - Rural ACO Improvement Act S. 1549 - Care Planning Act S. 1793 - Promoting Physical Activity for Americans Act S. 1893 - Mental Health Awareness and Improvement Act S. 1945 - Mental Health Reform Act S. 2002/H.R. 3722 - Mental Health and Safe Communities Act S. 2045/H.R. 2050 - Middle Class Health Benefits Tax Repeal Act S. 2075 - American Worker Health Care Tax Relief Act S. 2100 - Tobacco to 21 Act S. 2153 - Provider Payment Sunshine Act S. 2173/H.R. 3712 - Improving Access to Mental Health Act S. 2218/H.R. 1218 - Personal Health Investment (PHIT) Act S. 2259 - ACO Assignment Improvement Act S. 2261 - Rural ACO Provider Equity Act S. 2343/H.R. 4155 - Telehealth Innovation and Improvement Act S. 2380 - Public Health Emergency Response and Accountability Act S. 2408/H.R. 4266 - Nurse and Health Care Worker Protection Act S. 2484 - Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act S. 2525/H.R. 4567 - Expand Excellence in Mental Health Act of 2016 S. 2609 - An original bill to amend the Agricultural Marketing Act of 1946 to require the Secretary of Agriculture to establish a national voluntary labeling standard for bioengineered foods S. 2680 - Mental Health Reform Act of 2016 S. 2687 - Plan of Safe Care Improvement Act S. 2821 - Testing, Removal, and Updated Evaluations of Lead Everywhere in America for Dramatic Enhancements that Restore Safety to Homes, Infrastructure, and Pipes (True LEADership) Act of 2016 S. 2848/H.R. 5303 - Water Resources Development Act of 2016 S. 2873/H.R. 5395 - Expanding Capacity for Health Outcomes (ECHO) Act S. 3136 - Improving Child Nutrition Integrity and Access Act of 2016 S. 3190 - Strengthening Our Rural Health Workforce Act of 2016 S. 3239 - Research to Accelerate Cures and Equity (RACE) for Children Act S. 3245 - Nursing Workforce Reauthorization Act of 2016 S. 3504 - Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act

Client expense: Not reported · Firm income: $23,450

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA), White House Office

Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, reauthorization of chronic special need plans, and star ratings) ESRD Choice Act of 2016 (H.R. 5659) Medicaid managed care Section 1115 waivers Medicare Part D Creating High-Quality Results and Outcomes Necessary to Improve Chronic Care Act of 2016 (S. 3504) Pre-Claims Undermine Seniors Health Act of 2016 (H.R. 6226) Medicaid reform (block grants, per capita caps) Medicaid program integrity Fraud, waste, and abuse Medicaid and CHIP Reauthorization subregulatory guidance

Client expense: $1,140,000 · 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), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

H.R.6 - 21st Century Cures Act - provisions related to medical innovation, technology and medical device regulatory reforms. S. 2187 - FDA Regulatory Efficiency Act, Efforts - provisions in support of third-party quality system programs. S. 1622 - The FDA Device Accountability Act of 2015 - provisions in support for centralized IRBs. S. 1767 - The Combination Product Regulatory Fairness Act - provisions related to combination product issues. S. 2737 - Improving Medical Device Innovation Act - provisions related to medical device innovation. S. 2998/H.R. 5009 - Ensuring Patient Access to Critical Breakthrough Products Act of 2016. H.R. 34 - 21st Century Cures Act - provisions related to medical innovation, technology and medical devices. S. 3504 - Chronic Care Act of 2017 - provisions related to teleheath and diabetes. S. 2873 - Echo Act - provisions related to telehealth. H.R. 2020 - Short Term Continuing Resolution - provisions related to federal funding of the government through April 28, 2017. Issues related to VA procurement and devices.

Client expense: $540,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 3504, the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2016

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

Government targets: SENATE

Mental Health Reform Legislation - encouraging passage of comprehensive mental health reform that addresses 42 CFR Part 2, expansion of telehealth, parity implementation without going too far in adding increased parity requirements. Specific bills lobbied on include S. 2680, the Mental Health Reform Act of 2016; H.R. 2646, the Helping Families in Mental Health Crisis Act; S. 1945, the Mental Health Reform Act; S. 1893, the Mental Health Awareness and Improvement Act; H.R. 34, the 21st Century Cures Act. 42 CFR Part 2 - advocating to align 42 CFR Part 2 (substance use privacy regulations) with HIPAA to allow appropriate access to patient information that is essential for providing whole-person care. Behavioral Health Information Technology, extending health information technology assistance eligibility to more mental health and substance use disorder professionals and facilities. Telehealth, reforming barriers to Medicare reimbursement; provisions in the 21st Century Cures bill. Specifically, the CONNECT for Health Act, S. 2484/H.R. 4442 and the ECHO Act, S.2873/H.R. 5395. Medicare coverage of Mental Health Counselors and Marriage and Family Therapists - S. 1830, the Seniors Mental Health Access Improvement Act Mental Health Parity, White House Mental Health and Substance Use Disorder Parity Task Force Behavioral Health Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2016, S. 3504

Client expense: $100,000 · 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 Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Treasury, Dept of, White House Office

Mental Health Reform Legislation - encouraging passage of comprehensive mental health reform that addresses 42 CFR Part 2, expansion of telehealth, parity implementation without going too far in adding increased parity requirements. Specific bills lobbied on include S. 2680, the Mental Health Reform Act of 2016; H.R. 2646, the Helping Families in Mental Health Crisis Act; S. 1945, the Mental Health Reform Act; S. 1893, the Mental Health Awareness and Improvement Act; H.R. 34, the 21st Century Cures Act. Behavioral Health Information Technology, extending health information technology assistance eligibility to more mental health and substance use disorder professionals and facilities. Telehealth, reforming barriers to Medicare reimbursement; provisions in the 21st Century Cures bill. Specifically, the CONNECT for Health Act, S. 2484/H.R. 4442 and the ECHO Act, S.2873/H.R. 5395. Medicare coverage of Mental Health Counselors and Marriage and Family Therapists - S. 1830, the Seniors Mental Health Access Improvement Act Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2016, S. 3504 National Drug Abuse Crisis and related bills, including encouraging the passage of the conference report to S. 524, the Comprehensive Addiction and Recovery Act. 42 CFR Part 2 - advocating to align 42 CFR Part 2 (substance use privacy regulations) with HIPAA to allow appropriate access to patient information that is essential for providing whole-person care. Mental Health Parity, White House Mental Health and Substance Use Disorder Parity Task Force Behavioral Health

Client expense: $100,000 · 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 Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Treasury, Dept of, White House Office

Public Law No: 114-225/ H.R. 34: 21st Century Cures Act H.R. 2713 Title VIII Nursing Workforce Reauthorization Act of 2015 S. 3245 Title VIII Nursing Workforce Reauthorization Act of 2016 S. 578, H.R. 1342 The Home Health Care Planning Improvement Act of 2015 S. 257, H.R. 1611 Protecting Access to Rural Therapy Services (PARTS) Act S. 628, H.R. 1209 The Improving Access to Maternity Care Act H.R. 1021 Protecting the Integrity of Medicare Act of 2015 (PIMA) H.R. 2253, S. 737 Ensuring Access to Primary Care for Women & Children Act S.1456 Rural ACO Improvement Act of 2015 S. 2259 ACO Assignment Improvement Act of 2015 H.R.6261 - To amend title XVIII of the Social Security Act to improve the way beneficiaries are assigned under the Medicare shared savings program by also basing such assignment on primary care services furnished by nurse practitioners, physician assistants, and clinical nurse specialists. H.R.2948 - Medicare Telehealth Parity Act of 2015 H.R. 2646 Helping Families in Mental Health Crisis Act of 2015 S.1945 Mental Health Reform Act of 2015 S.2680 Mental Health Reform Act of 2016 H.R. 4756 Promoting Access to Diabetic Shoes Act S.1641 Jason Simcakoski Memorial Opioid Safety Act H.R.4981 - Opioid Use Disorder Treatment Expansion and Modernization Act S. 2562, H.R. 4396 Heroin and Prescription Drug Abuse Prevention and Reduction Act S.1455, H.R. 2536 Recovery Enhancement for Addiction Treatment (TREAT) Act Public Law No: 114-198, S.524/ H.R. 953 Comprehensive Addiction and Recovery (CARA) Act of 2016 S.488/H.R.3355 - To amend title XVIII of the Social Security Act to allow physician assistants, nurse practitioners, and clinical nurse specialists to supervise cardiac, intensive cardiac, and pulmonary rehabilitation programs. Chronic Care: S.3504 - Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2016 Medication Assisted Therapies (MATs) Accountable Care Organizations (ACOs) Opioid Abuse Epidemic

Client expense: Not reported · Firm income: Not reported

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

H.R. 3762, Restoring Americans Healthcare Freedom Reconciliation Act H.R. 592/S. 314, Pharmacy and Medically Underserved Areas Enhancement Act H.R. 954, CO-OP Consumer Protection Act of 2016 H.R. 1190/S. 141, The Protecting Seniors Access to Medicare Act of 2015 H.R. 1192, National Clinical Care Commission Act H.R. 1270, Restoring Access to Medication and Improving Health Savings Act H.R. 1427, Medicare CGM Access Act H.R. 1686/S. 3082, Preventing Diabetes in Medicare Act H.R. 1707, Access to Frontline Health Care Act of 2015 H.R. 1726, Access to Quality Diabetes Education Act H.R. 1807, Sickle Cell Disease Research, Surveillance, Prevention, and Treatment Act of 2015 H.R. 2102, Medicare Diabetes Prevention Act H.R. 2124/S. 1148, Resident Physician Shortage Act H.R. 2603/S. 1475, Saving Lives, Saving Costs Act H.R. 2646, Helping Families in Mental Crisis Act H.R. 2713/S. 3245, Title VIII Nursing Workforce Reauthorization Act of 2016 H.R. 3081/S. 1778, Telemedicine for Medicare Act H.R. 3119/S. 2748, Palliative Care and Hospice Education and Training Act H.R. 3660/S. 3126,Preventive Health Savings Act H.R. 3952/S. 2248, Congenital Heart Future Reauthorization Act of 2015 H.R. 4212/S. 704, Community Based Independence for Seniors Act of 2015 H.R. 4442/S. 2484, CONNECT for Health Act H.R. 4732/S. 2671, Advancing Medical Resident Training in Community Hospitals Act H.R. 4774, Training Tomorrows Doctors Today Act H.R. 4909/S. 2943, National Defense Authorization Act H.R. 5273, Helping Hospitals Improve Patient Care Act H.R. 5414, FDA Cross-Center Collaboration Act H.R. 5447/S. 3060, The Small Business Health Care Relief Act H.R. 5652,Access to Better Care Act H.R. 5681/S. 3137, Alzheimers Beneficiary and Caregiver Support Act H.R. 5713, Sustaining Healthcare Integrity and Fair Treatment Act of 2016 H.R.5926 - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2017 H.R. 6043/S. 3335, The Fair Accountability and Innovative Research Drug Pricing Act of 2016 H.R. 6109/S. 3371, Medicare Affordability and Enrollment Act S. 524, Comprehensive Addiction and Recovery Act S. 586, National Diabetes Clinical Care Commission Act S. 603, Jobs and Premium Protection Act S. 776,Medication Therapy Management Empowerment Act S. 1077,Advancing Breakthrough Medical Devices for Patients Act S. 1101,Medical Electronic Data Technology Enhancement for Consumers Health (MEDTECH) Act S. 1622,FDA Device Accountability Act S. 2511,Improving Health Information Technology Act S. 2680,Mental Health Reform Act of 2016 S. 2864,Reducing Existing Costs Associated with Pharmaceuticals for Seniors Act of 2016 S. 3326,State Flexibility to Provide Affordable Health Options Act S. 3504, Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2016 Pub. L. 111-5, The American Recovery and Reinvestment Act of 2009 (Health Information Technology for Economic and Clinical Health Act (HITECH) Pub. L. 111-148, Patient Protection and Affordable Care Act (PPACA) Pub. L. 114-10, Medicare Access and CHIP Reauthorization Act (MACRA) Pub. L. 114-255,21st Century Cures Pub. L. 114-270, Expanding Capacity for Health Outcomes Act (ECHO) Pub. L. 114-328, National Defense Authorization Act for Fiscal Year 2017

Client expense: $150,000 · Firm income: Not reported

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

Medicare and Medicaid dual integration, Medicare Advantage star quality rating system, Special Needs Plans reauthoriza S. 3504 the CHRONIC Care Act Medicare Advantage/CMS-Hierarchical Condition Category Risk Assessment (CMS-HCC RA) payment model; Medicare and Medicaid dual eligible integration;

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare coverage, coding and reimbursement of pharmaceuticals, including implementation of related provisions included in the Affordable Care Act; and Medicare reimbursement for physicians, including reimbursement adequacy and patient access issues associated with potential CMMI implementation of the proposed Medicare Part B Drug Payment Model, including related provisions in H.R.5122, to prohibit further action on the proposed rule regarding testing of Medicare part B prescription drug models; S. 31/H.R. 3016, the Medicare Prescription Drug Price Negotiation Act; Medicare Part D Program; Medicare chronic care reform, including related provisions in S. 3504, the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act.

Client expense: Not reported · Firm income: $90,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medigap & chronic care reform, including related provisions in S. 3504, the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act.

Client expense: Not reported · Firm income: $90,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 578, H.R. 1342 The Home Health Care Planning Improvement Act of 2015 S. 257, H.R. 1611 Protecting Access to Rural Therapy Services (PARTS) Act S. 628, H.R. 1209 The Improving Access to Maternity Care Act Public Law No: 114-225/ H.R. 34: 21st Century Cures Act H.R. 1021 Protecting the Integrity of Medicare Act of 2015 (PIMA) H.R. 2253, S. 737 Ensuring Access to Primary Care for Women & Children Act S.1456 Rural ACO Improvement Act of 2015 S.1641 Jason Simcakoski Memorial Opioid Safety Act S. 2259, H.R. 6261 ACO Assignment Improvement Act of 2015 H.R. 2646 Helping Families in Mental Health Crisis Act of 2015 S.1945 Mental Health Reform Act of 2015 S.2680 Mental Health Reform Act of 2016 H.R. 4756 Promoting Access to Diabetic Shoes Act Medication Assisted Therapies (MATs) S. 1455, H.R. 2536 Recovery Enhancement for Addiction Treatment Act (TREAT) Public Law No: 114-198, S.524/ H.R. 953 Comprehensive Addiction and Recovery (CARA) Act of 2016 S. 2562, H.R. 4396 Heroin and Prescription Drug Abuse Prevention and Reduction Act H.R.2948 Medicare Telehealth Parity Act of 2015 S.488, H.R. 3355 A bill to amend title XVIII of the Social Security Act to allow physician assistants, nurse practitioners, and clinical nurse specialists to supervise cardiac, intensive cardiac, and pulmonary rehabilitation programs. S. 3245 Title VIII Nursing Workforce Reauthorization Act of 2016 H.R. 2713 Title VIII Nursing Workforce Reauthorization Act of 2015 H.R. 4981 Opioid Use Disorder Treatment Expansion and Modernization Act Opioid Abuse Epidemic Chronic Care: S.3504 - Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2016 Accountable Care Organization (ACO)

Client expense: $153,601 · Firm income: Not reported

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

End stage renal disease (ESRD) rebasing, Medicare reimbursement and payment reform. CMS's Center for Medicare and Medicaid Innovation's comprehensive ESRD Care Initiative and improving overall ESRD patient health quality. Improved policies on chronic kidney disease. Chronic care management reform legislation. ESRD Integrated Care legislation. Transplant Initiatives. Implementation of the Medicare Access and CHIP Reauthorization Act. Living Donor Protection Act (H.R. 4616/S. 2584) ESRD Choice Act (H.R. 5659) Dialysis PATIENT Demonstration Act (H.R. 5506/S. 3090/H.R. 5942) Creating High-Quality Results & Outcomes Necessary to Improve Chronic (CHRONIC) Care Act (S. 3504) 21st Century Cures Act, provisions related to ESRD coverage in Medicare Advantage Medicare Third Party Payment

Client expense: Not reported · Firm income: $80,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), Natl Economic Council (NEC), Office of Science & Technology Policy (OSTP), SENATE

End stage renal disease (ESRD) rebasing, Medicare reimbursement and payment reform. CMS's Center for Medicare and Medicaid Innovation's comprehensive ESRD Care Initiative and improving overall patient health quality. Improved policies on chronic kidney disease. Chronic Care management reform legislation. ESRD Integrated Care Legislation. Transplant Initiatives. Living Donor Protection Act (H.R. 4616/S. 2584) ESRD Choice Act (H.R. 5659) Dialysis PATIENT Demonstration Act (H.R. 5506/S. 3090/H.R. 5942) Implementation of the Medicare Access and CHIP Reauthorization Act Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act(S. 3504) 21st Century Cures Act, provisions related to ESRD coverage in Medicare Advantage

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

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

H.R. 3943, the Physician Assistant Education Public Health Initiatives Act of 2015 Public Law No: 114-225/ H.R. 34: 21st Century Cures Act S.1455, H.R. 2536 Recovery Enhancement for Addiction Treatment (TREAT) Act Public Law No: 114-198, S.524/ H.R. 953 Comprehensive Addiction and Recovery (CARA) Act of 2016 Opioid Epidemic Health care issues impacting PA education and the PA profession Public Health Initiatives Chronic Care: S.3504 - Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2016

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

Government targets: Education, Dept of, HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), SENATE, White House Office

Public Law No: 114-225/ H.R. 34: 21st Century Cures Act H.R. 2646 Helping Families in Mental Health Crisis Act of 2015 S.1945 Mental Health Reform Act of 2015 S.2680 Mental Health Reform Act of 2016 H.R. 1378, S. 789 - Dorothy I. Height and Whitney M. Young, Jr., Social Work Reinvestment Act Public Law No: 114-144, S. 192 - Older Americans Act Reauthorization Act of 2015 S. 993/H.R. 1854 Comprehensive Justice and Mental Health Act of 2015 S. 1893 Mental Health Awareness and Improvement Act of 2015 S. 2691 Integrating Behavioral Health Through Technology Act of 2016 H.R. 1559/S.857 Health Outcomes, Planning, and Education (HOPE) for Alzheimers Act S. 1719/H.R. 3099 the Recognize, Assist, Include, Support, and Engagement (RAISE) Family Caregivers Act H.R. 2515/S. 1865 Anna Westin Act of 2015 H.R. 3913 the Lifespan Respite Care Reauthorization Act S.2691 Integrating Behavioral Health through Technology Act of 2016 S.3130 Independence at Home Act of 2016 S.1455, H.R. 2536 Recovery Enhancement for Addiction Treatment (TREAT) Act S.3236/H.R. 5772 the Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act. Public Law No: 114-198, S.524/ H.R. 953 Comprehensive Addiction and Recovery (CARA) Act of 2016 Opioid Abuse Epidemic Affordable Care Act Integration Practice and Reimbursement issues related to clinical social workers Chronic Care: S.3504 - Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2016

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

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

Public Law No: 114-225/ H.R. 34: 21st Century Cures Act H.R. 2713 Title VIII Nursing Workforce Reauthorization Act of 2015 S. 3245 Title VIII Nursing Workforce Reauthorization Act of 2016 S. 578, H.R. 1342 The Home Health Care Planning Improvement Act of 2015 S. 257, H.R. 1611 Protecting Access to Rural Therapy Services (PARTS) Act S. 628, H.R. 1209 The Improving Access to Maternity Care Act H.R. 1021 Protecting the Integrity of Medicare Act of 2015 (PIMA) H.R. 2253, S. 737 Ensuring Access to Primary Care for Women & Children Act S.1456 Rural ACO Improvement Act of 2015 S. 2259 ACO Assignment Improvement Act of 2015 H.R.6261 - To amend title XVIII of the Social Security Act to improve the way beneficiaries are assigned under the Medicare shared savings program by also basing such assignment on primary care services furnished by nurse practitioners, physician assistants, and clinical nurse specialists. H.R.2948 - Medicare Telehealth Parity Act of 2015 H.R. 2646 Helping Families in Mental Health Crisis Act of 2015 S.1945 Mental Health Reform Act of 2015 S.2680 Mental Health Reform Act of 2016 H.R. 4756 Promoting Access to Diabetic Shoes Act S.1641 Jason Simcakoski Memorial Opioid Safety Act H.R.4981 - Opioid Use Disorder Treatment Expansion and Modernization Act S. 2562, H.R. 4396 Heroin and Prescription Drug Abuse Prevention and Reduction Act S.1455, H.R. 2536 Recovery Enhancement for Addiction Treatment (TREAT) Act Public Law No: 114-198, S.524/ H.R. 953 Comprehensive Addiction and Recovery (CARA) Act of 2016 S.488/H.R.3355 - To amend title XVIII of the Social Security Act to allow physician assistants, nurse practitioners, and clinical nurse specialists to supervise cardiac, intensive cardiac, and pulmonary rehabilitation programs. Chronic Care: S.3504 - Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2016 Medication Assisted Therapies (MATs) Accountable Care Organizations (ACOs) Opioid Abuse Epidemic

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

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

Public Law No: 114-225/ H.R. 34: 21st Century Cures Act H.R. 2713 Title VIII Nursing Workforce Reauthorization Act of 2015 S. 3245 Title VIII Nursing Workforce Reauthorization Act of 2016 S. 578, H.R. 1342 Home Health Care Planning Improvement Act of 2015 S. 628, H.R. 1209 The Improving Access to Maternity Care Act S. 737, H.R. 2253 Ensuring Access to Primary Care and Children Act H.R. 2948 Medicare Telehealth Parity Act of 2015 S. 2153 Provider Payment Sunshine Act H.R. 2646 Helping Families in Mental Health Crisis Act of 2015 H.R. 5164, Rural Hospital Regulatory Relief Act of 2016 Public Law No: 114-198, S.524/ H.R. 953 Comprehensive Addiction and Recovery (CARA) Act of 2016 S.1455, H.R. 2536 Recovery Enhancement for Addiction Treatment (TREAT) Act Chronic Care: S.3504 - Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2016 Opioid Abuse Epidemic

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

Government targets: Education, Dept of, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Veterans Affairs, Dept of (VA), White House Office

S. 3504 - Creating High Quality Results and Outcome Necessary to Improve Chronic Care Act of 2016 - Issues related to palliative care, telemedicine and other issues related to better serving Medicare beneficiaries. PL - 114- 255 - 21st Century Cures Act. Provisions to include help fight against opioid abuse. H.R. 5447 - The Small Business Health Care Relief Act - a bill to permit small employers to pay health reimbursement arrangements to employees who purchase insurance through the individual market place. Understanding how this policy impacts states with state based marketplaces. Opportunities to innovate through CMMI and its demonstrations.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 3504 - Creating High Quality Results and Outcome Necessary to Improve Chronic Care Act of 2016 - Issues related to palliative care, telemedicine and other issues related to better serving Medicare beneficiaries. PL - 114- 255 - 21st Century Cures Act. Provisions to include help fight against opioid abuse. H.R. 5327 - Continuing Appropriations and Military Construction, VA and Related Agencies Appropriations Act of 2017 and Zika Response and Preparedness Act. Issues regarding the funding of opioid related programs. S. 524 - the Comprehensive Addition and Recovery Act- issues related to ensuring best prescribing practices for opioids in the country and solutions developed by BCBSMA to combat abuse. H.R. 5447 - the Small Business Health Care Relief Act - issues regarding allowing small business owners the option to allow employees to purchase insurance in the individual market and the impact policies would have on state based marketplaces (SBMs) Work on alternative payment models developed by BCBSMA and how they can apply nationally. Issues related to advancing policies to improve end of life care for seriously ill individuals. Issues related to delivery system reform. Issues related to state-based marketplaces. Issues related to Medicare coverage. Issues related to post-enrollment support for newly insured. Issues related to delivery system reform and innovation within the Medicare program. Regulations on civil rights and non discrimination based on section 1557 of the ACA. Issues related to ACA waivers - section 1332 of the law.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 3504 - Creating High Quality Results and Outcome Necessary to Improve Chronic Care Act of 2016 - Issues related to palliative care, telemedicine and other issues related to better serving Medicare beneficiaries. PL - 114- 255 - 21st Century Cures Act. Provisions to include help fight against opioid abuse. H.R. 5327 - Continuing Appropriations and Military Construction, VA and Related Agencies Appropriations Act of 2017 and Zika Response and Preparedness Act. Issues regarding the funding of opioid related programs for Medicare and Medicaid beneficiaries. Work on alternative payment models developed by BCBSMA and how they can apply nationally. Issues related to advancing policies to improve end of life care for seriously ill individuals. Issues related to delivery system reform in Medicare and the private insurance market. Issues related to delivery system reform and innovation within the Medicare program.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 3504 - Creating High Quality Results and Outcome Necessary to Improve Chronic Care Act of 2016 - Issues related to socioeconomic status, palliative care, telemedicine and other issues related to better serving Medicare beneficiaries with End Stage Renal Disease. PL - 114- 255 - 21st Century Cures Act. Provisions to include factors of socioeconomic status as an element in risk adjustment measures and processes. Issues related to programs through CMMI including: Pioneer ACOs, Shared Savings PCP+ and other related projects focused on delivery system reform. Issues related to the Senate Finance Committee's work related to chronic care in the Medicare program. Impact of recent proposed and final regulations issued by CMS focused on IPPS, OPPS, PFS and Medicaid Managed Care. Issues related to best practices and related reimbursement structures for treating vulnerable patients. Issues impacting federally qualified community health centers. Issues related to HRSA and UNOS' work to reform the organ allocation program in the nation.

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

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

S. 3504 - Creating High Quality Results and Outcome Necessary to Improve Chronic Care Act of 2016 - Issues related to socioeconomic status, palliative care, telemedicine and other issues related to better serving Medicare beneficiaries with End Stage Renal Disease. PL - 114- 255 - 21st Century Cures Act. Provisions to include factors of socioeconomic status as an element in risk adjustment measures and processes. H.R. 5273 - Helping Hospitals Improve Patient Care Act (HIP-C) - Issues related to factoring in socioeconomic status as a measurement for quality and performance with regard readmissions. Issues related to programs through CMMI including: Pioneer ACOs, Shared Savings PCP+ and other related projects focused on delivery system reform. Issues related to the Senate Finance Committee's work related to chronic care in the Medicare program. Impact of recent proposed and final regulations issued by CMS focused on IPPS, OPPS, PFS and Medicaid Managed Care. Issues related to best practices and related reimbursement structures for treating vulnerable patients.

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

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

Independence at Home Program (Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2016, S. 3504), oral health coverage for seniors

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

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

S. 3504 - Creating High Quality Results and Outcome Necessary to Improve Chronic Care Act of 2016 - Issues related to ESRD, palliative care, telemedicine and other issues related to better serving Medicare beneficiaries with End Stage Renal Disease. H.R.1130/S.598 - Chronic Kidney Disease Improvement in Research and Treatment Act of 2015 - Issues related to giving ESRD patients greater choice in their Medicare coverage. H.R.5506/S. 3090 - Dialysis PATIENT Demonstration Act - legislation to create a comprehensive care model for individuals living with End Stage Renal Disease. Work on current and potential demonstration projects in Medicare to support better integration of care for ESRD patients with both CMS and Members of Congress. Issues focused on ESRD and Risk Adjustment for chronically ill patients and related work being conducted by the Senate Finance Committee. Legislative and Administrative actions related to factoring in Socio Economic Status into policies impacting all beneficiaries and their providers.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 3504 - Creating High Quality Results and Outcome Necessary to Improve Chronic Care Act of 2016 - Issues related to ESRD, palliative care, telemedicine and other issues related to better serving Medicare beneficiaries with End Stage Renal Disease. H.R.1130/S.598 - Chronic Kidney Disease Improvement in Research and Treatment Act of 2015 - Issues related to giving ESRD patients greater choice in their Medicare coverage. H.R.5506/S. 3090 - Dialysis PATIENT Demonstration Act - legislation to create a comprehensive care model for individuals living with End Stage Renal Disease. Work on current and potential demonstration projects in Medicare to support better integration of care for ESRD patients with both CMS and Members of Congress. Issues focused on ESRD and Risk Adjustment for chronically ill patients and related work being conducted by the Senate Finance Committee. CMS policies related to Medicare Advantage with specific focus on the formula asserted for the Medicare Advantage Risk Adjustment factor and its impact on beneficiaries, plans and providers who serve Medicare Beneficiaries who live with multiple chronic conditions. Legislative and Administrative actions related to factoring in SocioEconomic Status into policies impacting all beneficiaries and their providers.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 3504 - Creating High Quality Results and Outcome Necessary to Improve Chronic Care Act of 2016 - Issues related to palliative care, telemedicine and other issues related to better serving Medicare beneficiaries. H.R. 5327 - Continuing Appropriations and Military Construction, VA and Related Agencies Appropriations Act of 2017 and Zika Response and Preparedness Act. Issues regarding the funding of opioid related programs. S. 1549 - The Care Planning Act - supporting advances in End-of-Life Care throughout the nation. H.R. 5555 "Personalize Your Care Act 2.0" - focused on improving end of life and palliative care in America. Work surrounding the consumer experience across the private and public insurance spectrum. Focus on elements of the Senate Finance Committee's work related to chronic care coverage in the Medicare program, with an emphasis on end of life and palliative care data provisions. Issues related to Health Reform Law implementation with a specific focus on the regulations to govern insurance cover in and outside of the Exchanges. Potential upcoming regulations applying to insurers in the Affordable Care Act. Issues regarding strengthening, advancing and improving patient and provider options for palliative and end of life care in Medicare, Medicaid and private insurance. Both legislative and regulatory work. Regulatory issues regarding coverage, payment and plan design issues related to Medicare ACA-related regulations promulgated by the Department of Health and Human Services and CMS regarding program integrity within the Exchanges with regard to product design. Issues related to participation and coverage in state based market places. Issues related to the treatment of the 3 Rs in the current ACA-environment.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 3504 - Creating High Quality Results and Outcome Necessary to Improve Chronic Care Act of 2016 - Issues related to palliative care, telemedicine and other issues related to better serving Medicare beneficiaries. S. 1549 - The Care Planning Act - supporting advances in End-of-Life Care throughout the nation. H.R. 5555 "Personalize Your Care Act 2.0" - focused on improving end of life and palliative care in America. Focus on elements of the Senate Finance Committee's work related to chronic care coverage in the Medicare program, with an emphasis on end of life and palliative care data provisions. Issues regarding strengthening, advancing and improving patient and provider options for palliative and end of life care in Medicare, Medicaid and private insurance. Both legislative and regulatory work. Regulatory issues regarding coverage, payment and plan design issues related to Medicare Parts C and D. ACA-related regulations promulgated by the Department of Health and Human Services and CMS regarding program integrity within the Exchanges with regard to product design. Issues related to participation and coverage in state based market places. Issues related to the treatment of the 3 Rs in the current ACA-environment.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

P.L. 111-148/P.L. 111-152, Affordable Care Act, chronic kidney disease, end-stage renal disease Medicare payment and quality, drug shortages, Chronic Kidney Disease Improvement in Research and Treatment Act; Pediatric subspecialty and Mental Health Workforce Reauthorization Act, Telehealth Modernization Act, Living Donor Protection Act; Medicare physician payment; immunosuppressive drug coverage; S. 3504 CHRONIC Care Act

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), Natl Institutes of Health (NIH), SENATE