EMPOWER Care Act

Legislation and policies related to: Physician/nurse practitioner reimbursement Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Implementation of the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 (P.L. 114-10) including policies related to the Quality Payment Program Adoption of recommendations of the Institute of Medicine report, The Future of Nursing: Leading Change, Advancing Health Medicare Shared Savings Program beneficiary assignment requirements Medicare-Medicaid hospital conditions of participation Evaluation of the Medicare Graduate Nurse Education demonstration Medicare-Medicaid Program Integrity policies Medicaid maintenance of effort requirements Medicaid eligibility expansion and state options Medicaid waiver application procedures Medicaid per capita cap policy options H.R. 1160 - ACO Assignment Improvement Act of 2017 H.R. 3178 - Medicare Part B Improvement Act of 2017 H.R. 3635 - Local Coverage Determination Clarification Act of 2017 H.R. 5306/S. 2227 - Ensuring Medicaid Provides Opportunities for Widespread Equity, Resources (EMPOWER) and Care Act H.R. 7217 - Improving Medicaid Programs and Opportunities for Eligible Beneficiaries (IMPROVE) Act S. 445/H.R. 1825 - Home Health Care Planning Improvement Act of 2017 S. 428/H.R. 3325 - Advancing Care for Exceptional Kids (ACE Kids) Act S. 870 - Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017 S. 1227/H.R. 2628 - Stabilize Medicaid and CHIP Coverage Act of 2017 S. 3067/H.R. 1617 - Promoting Access to Diabetic Shoes Act

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

Government targets: Agriculture, Dept of (USDA), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Justice, Dept of (DOJ), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA)

Health insurance market stabilization, including the Bipartisan Health Care Stabilization Act of 2017, Lower Premiums Through Reinsurance Act of 2017 (S. 1835), and provisions to encourage automatic enrollment as alternative to Affordable Care Act individual mandate. Combatting the national opioids crisis, including the S. 2680, The Opioid Crisis Response Act of 2018 and S. 3120, the HEAL Act of 2018 Improving nutrition in the Supplemental Nutrition Assistance Program (SNAP) authorized under the Farm Bill (Agriculture and Nutrition Act of 2018 (H.R. 2)) Reauthorization of the Pandemic and All-Hazards Preparedness and Advancing Innovation Act (S. 2852/H.R. 6378) Reauthorization of the Presidents Emergency Plan for AIDS Relief (PEPFAR) EMPOWER Care Act (S.2227 and H.R.5306)

Client expense: $240,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation: S.103-Local Zoning Decisions Protection Act of 2017-Issues Lobbied: Racial justice, housing. S.367-Probation Officer Protection Act of 2017-Issues Lobbied: Law enforcement. S.411-End Racial and Religious Profiling Act of 2017 (ERRPA)-Issues Lobbied: Racial justice, racial profiling. S.642-Fifth Amendment Integrity Restoration Act-Issues Lobbied: Civil asset forfeiture. S.811-Child Welfare Provider Inclusion Act-Issues Lobbied: LGBT rights, religious liberty. S.860-Juvenile Justice and Delinquency Prevention Reauthorization Act of 2017-Issues Lobbied: Juvenile justice, racial justice. S.1006-Equality Act-Issues Lobbied: LGBT rights, womens rights, reproductive freedom, racial justice. S.1419-Voting Rights Advancement Act-Issue Lobbied: Voting rights. S.1588-Democracy Restoration Act-Issue Lobbied: Racial justice, voting. S.1593-Pretrial Integrity and Safety Act-Issue Lobbied: Bail Reform. S.1820-A bill to provide for the retention and service of transgender members of the Armed Forces-Issues Lobbied: LGBT rights. S.1856-Stop Militarizing Law Enforcement Act-Issues Lobbied: Law enforcement. S.1917-Sentencing Reform and Corrections Act of 2017-Issues Lobbied: Criminal justice reform. S.2525-First Amendment Defense Act-Issues Lobbied: LGBT rights, religious liberty. S.2584-Student Non-Discrimination Act of 2018-Issues Lobbied: LGBT rights. S.J. Res. 59-Authorization for Use of Military Force of 2018 - Issues Lobbied: National security. S.3195-Law Enforcement Trust and Integrity Act-Issues Lobbied: Law enforcement. S.2918-Do No Harm Act-Issues Lobbied: Religious liberty, LGBT rights, reproductive freedom. S.170 - Combating BDS Act of 2017-Issues Lobbied: Free speech. S.3109-DHS Appropriations for FY 2019-Issues Lobbied: Immigration, border enforcement. S.1519-National Defense Authorization Act for FY 2019-Issues Lobbied: National security. S.3158- Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act of 2019-Issues Lobbied: Racial justice, education, desegregation, reproductive rights, abortion coverage restrictions, Title X family planning program, Conscience Protection Act, fetal tissue research, sexual health education. S.2754-Handle with Care Act of 2018-Issues Lobbied: Racial justice, juvenile justice. S.2227-EMPOWER Care Act-Issues Lobbied: Disability rights. S.2952 - Congressional Accountability Act of 1995 Reform Act-Issues Lobbied: Sexual harassment and discrimination, womens rights. S.2795 and S.756-FIRST STEP Act-Issues Lobbied: Criminal law reform, religious liberty, immigrant rights. S.2261-Secure Elections Act-Issues Lobbied: Racial justice, voting. S.3271 - No Money Bail Act-Issues Lobbied: Bail reform. S.1918-Police CAMERA Act of 2017-Issues Lobbied: Law enforcement. S.1305-CBP HiRe Act-Issues Lobbied: CBP enforcement. S.720-Israel Anti-Boycott Act-Issues Lobbied: Free speech. S.3538-DHS Body-Worn Camera Act of 2018-Issues Lobbied: CBP accountability. S.1101-Pregnant Workers Fairness Act-Issues Lobbied: Womens rights. S.3744-Data Care Act of 2018-Issues Lobbied: Privacy. S.3749-Congressional Accountability Act of 1995 Reform Act-Issues Lobbied: Sexual harassment and discrimination. S.3626-Keeping All Students Safe Act-Issues Lobbied: Disability rights. S.3107-Financial Services and General Government Appropriations Act, 2019-Issues Lobbied: Reproductive rights, abortion coverage restrictions, Reproductive Health Non-Discrimination Act. S.3112- Dignity for Detained Immigrants Act of 2018-Issues Lobbied: Immigration detention, due process for immigrants. S.2520- Inmate Calling Technical Corrections Act of 2018-Issues Lobbied: Prison phone rates, affordable telephone calls from prisons. S.2-Effective Prosecution of Possession of Biological Toxins and Agents Act of 2018-Issues Lobbied: Possession of dangerous chemical and biological agents. H.R.482-Local Zoning Decisions Protection Act of 2017-Issues Lobbied: Racial justice, housing. H.R.1039-Probation Officer Protection Act of 2017-Issues Lobbied: Law enforcement. H.R.1498-End Racial Profiling Act of 2017-Issues Lobbied: Racial justice, racial profiling. H.R.1555-Fifth Amendment Integrity Restoration Act-Issues Lobbied: Civil asset forfeiture. H.R.1556-Stop Militarizing Law Enforcement Act-Issues Lobbied: Law enforcement militarization. H.R.1809-Juvenile Justice Reform Act of 2017-Issues Lobbied: Juvenile justice, racial justice. H.R.1881-Child Welfare Provider Inclusion Act of 2017-Issues Lobbied: LGBT rights, religious liberty. H.R.2133-Community Lending Enhancement and Regulatory Relief (CLEARR) Act of 2017-Issues Lobbied: Housing, racial justice. H.R.2152- Citizens Right to Know Act of 2018-Issues Lobbied: Bail reform. H.R.2228-Law Enforcement Mental Health and Wellness Act of 2017-Issues Lobbied: Law enforcement. H.R.2282-Equality Act-Issues Lobbied: LGBT rights, womens rights, reproductive freedom, racial justice. H.R.2437-Back the Blue Act of 2017-Issue Lobbied: Law enforcement. H.R.2676-Police Reporting Information, Data, and Evidence (PRIDE) Act of 2017-Issues Lobbied: Law enforcement. H.R.2899-Second Chance Act Reauthorization Act of 2017-Issues Lobbied: Reentry. H.R.2978-Voting Rights Advancement Act of 2017-Issues Lobbied: Voting rights. H.R.3060-Preventing Tragedies Between Police and Communities Act of 2017-Issues Lobbied: Law enforcement. H.R.3222-Do No Harm Act-Issues Lobbied: Religious liberty, LGBT rights, reproductive freedom. H.R.3354-Make America Secure and Prosperous Appropriations Act-Issues Lobbied: Racial justice, census, desegregation. H.R.3944-Police CAMERA Act of 2017-Issues Lobbied: Law enforcement. H.R.4019-Pretrial Integrity and Safety Act of 2017-Issues Lobbied: Bail reform. H.R.4041-A bill to provide for the retention and service of transgender members of the Armed Forces-Issues Lobbied: LGBT rights. H.R.4508-The Promoting Real Opportunity, Success, and Prosperity through Education Reform (PROSPER) Act-Issues Lobbied: Racial justice, higher education. H.R.4833-The Bail Fairness Act of 2018-Issues Lobbied: Bail. H.R.5374-Student Non-Discrimination Act of 2018-Issues Lobbied: LGBT rights. H.R.5682 - FIRST STEP Act-Issues Lobbied: Prison reform, intersection of criminal justice and immigration. H.R.1437- No Money Bail Act-Issue Lobbied: Bail reform. H.R.5698 - Protect and Serve Act of 2018-Issues Lobbied: Law enforcement. H.R.3249-Protect Safe Neighborhoods Grant Program Authorization Act of 2018-Issues lobbied: Law enforcement. H.R.5515- John S. McCain National Defense Authorization Act for FY 19-Issues Lobbied: National security. H.R.5199-Education Savings Accounts for Military Families Act of 2018-Issues Lobbied: Racial justice, education. H.R.5242- School Resource Officer Assessment Act of 2018- Issues Lobbied: Racial justice, school-to-prison pipeline. H.R.6122-Save Voters Act-Issues Lobbied: Racial justice, voting. H.R.5306-EMPOWER Care Act-Issues Lobbied: Disability rights. H.R.4924-Congressional Accountability Act of 1995 Reform Act-Issues Lobbied: Sexual harassment and discrimination, womens rights. H.R.6659-Screening with Dignity Act of 2018-Issues Lobbied: LGBT rights, privacy & technology. H.R.12-Voter Empowerment Act of 2017-Issues Lobbied: Racial justice, voting. H.R.2840-Automatic Voter Registration Act-Issues Lobbied: Racial justice, voting. H.R.5011-Election Security Act-Issues Lobbied: Racial justice, voting. H.R.5793-Housing Choice Voucher Mobility Demonstration Act of 2018-Issues Lobbied: Racial justice, housing. H.R.6723-Ensuring American Voters Act of 2018-Issues Lobbied: Racial justice, voting. H.R.6011-To amend title 18, United States Code, to authorize a court to reduce the term of imprisonment imposed on certain defendants convicted as an adult for an offense committed and completed before the defendant attained 18 years of age, and for other purposes.-Issues Lobbied: Racial justice, juvenile justice. H.R.1697-Israel Anti-Boycott Act-Issues Lobbied: Free speech. H.R.5952- Commerce, Justice, Science, and Related Agencies Appropriations Act, 2019-Issues Lobbied: Census. H.R.2-Agriculture Improvement Act of 2018-Issues Lobbied: SNAP benefits, reentry. H.R.3799- Demanding Oversight from Justice Act-Issues Lobbied: Law enforcement. H.R.6776-Department of Homeland Security Appropriations Act, 2019-Issues Lobbied: Appropriations, immigration, border enforcement. H.R.6470-Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2019-Issues Lobbied: Reproductive rights, abortion coverage restrictions, Title X family planning program, Conscience Protection Act, fetal tissue research, sexual health education. H.R.6157-Department of Defense and Labor, Health and Human Services, and Education Appropriations Act of 2019 and Continuing Appropriations Act, 2019-Issues Lobbied: Reproductive rights, abortion coverage restrictions, Title X family planning program, Conscience Protection Act, fetal tissue research, sexual health education. H.R.6545- Violence Against Women Reauthorization Act of 2018-Issues Lobbied: Womens rights. HR 2417-Pregnant Workers Fairness Act-Issues Lobbied: Womens rights. H.R.1-To expand Americans' access to the ballot box, reduce the influence of big money in politics, and strengthen ethics rules for public servants, and for other purposes-Issues Lobbied: Racial justice, voting rights, campaign finance. H.R.7156-Federal Police Camera and Accountability Act of 2018-Issues Lobbied: Law enforcement, criminal justice reform. H.R.7281-Driver and Officer Safety Education Act-Issues Lobbied: Law enforcement. H.R.7209-School Resource Officer Act of 2018-Issues Lobbied: Juvenile justice, school safety, school-to-prison pipeline. H.R.7124- Keeping All Students Safe Act-Issues Lobbied: Disability rights. H.R.7217-IMPROVE Act-Issues Lobbied: Disability rights. H.R.6258-Financial Services and General Government Appropriations Act, 2019-Issues Lobbied: Reproductive rights, abortion coverage restrictions, Reproductive Health Non-Discrimination Act. H.R.6714-Electronic Court Records Reform Act of 2018-Issues Lobbied: Transparency. H.R.2856-Combating BDS Act of 2017-Issues Lobbied: Free speech. H.R.7059-Build the Wall, Enforce the Law Act of 2018-Issues Lobbied: Border wall. H.R.3923-Dignity for Detained Immigrants Act of 2017-Issues Lobbied: Immigration detention, due process for immigrants. H.R.7093- Clean Up the Code Act of 2018-Issues Lobbied: Criminal penalties, criminal justice reform. H. Res.653- Recognizing the 69th anniversary of the Universal Declaration of Human Rights and the celebration of "Human Rights Day"-Issues Lobbied: Recognizing the 70th Anniversary of UNDHR. H.R.2825-DHS Authorization Act-Issues Lobbied: Immigration and border enforcement. Amendment to H.R.695-Department of Defense Appropriations Act of 2018, Further Additional Continuing Appropriations Act-Issues Lobbied: Department of Homeland Security Budget Continuing Resolution. H.R.5896- Border Patrol Agent Pay Reform Amendments Act of 2018-Issues Lobbied: CBP enforcement. H.R.505-Border Security Technology Accountability Act of 2017-Issues Lobbied: Border security. H.R.6691-Community Safety and Security Act of 2018-Issues Lobbied: Intersection of criminal justice and immigration. Legislation with No Bill Number: House bill version - Law Enforcement Trust and Integrity Act-Issues Lobbied: Law enforcement. Brett Kavanaugh nomination-Issues Lobbied: Civil liberties and civil rights, abortion. Amendment to Immigration and Nationality Act-Issues Lobbied: Muslim Ban, immigration. Oversight over counterterrorism policy and practices-Issues Lobbied: Torture, detention, drones, war authority. Draft legislation on Congressional Ethics-Issues Lobbied: Ethics, free speech. Draft House bill-Voter signature mismatch-Issues Lobbied: Voting rights. Draft Senate bill-Prosecutorial Reform-Issues Lobbied: Prosecutorial reform. Federal court-related disclosure form-Issues Lobbied: Ethics. Consumer Data Protection Act of 2017-Issues Lobbied: Privacy. Section 215 Reauthorization-Issues Lobbied: National security, surveillance. Possible changes to the Family Educational Rights and Privacy Act-Issues Lobbied: Student privacy. Continuing resolution for FY19 spending-Issues Lobbied: Civil liberties and civil rights. Appropriations Act for FY20-Issues Lobbied: Abortion coverage restrictions. Election Assistance Commission-Issues Lobbied: Juvenile life without parole. NO BAN Act-Issues Lobbied: Immigration. Administration Legislative Proposal-Making Affordable Housing Work Act of 2018-Issues Lobbied: Racial justice, fair housing, rent increase. Additional legislation not yet introduced - online privacy reform, use of force by federal law enforcement, immigration. Agencies: Agency-Defense-Issues Lobbied: LGBT rights, Guantanamo detention policy. Agency-Education-Issues Lobbied: Racial justice, equal education, CRDC data collection, school-to-prison pipeline, Every Student Succeeds Act, Workforce Innovation and Opportunity Act, student loans, civil rights investigations, sex discrimination, disability rights, LGBT rights, Affirmative Action. Agency-Health and Human Services-Issues Lobbied: Reproductive rights, abortion coverage, birth control, Patient Protection and Affordable Care Act, Exchange Program Integrity, Religious Exemptions and Accommodations for Coverage of Certain Preventive Services Under the Affordable Care Act, Moral Exemptions and Accommodations for Coverage of Certain Preventive Services Under the Affordable Care Act, Compliance with Statutory Program Integrity Requirements, religious liberty, LGBT rights, Medicaid Home and Community Based Services Settings Rule. Agency-Homeland Security-Issues Lobbied: Womens rights, disability rights, Build the Wall, Enforce the Law Act of 2018, border wall, Dignity for Detained Immigrants Act, immigration detention, due process for immigrants, DHS budget, immigration, denaturalization, Custom and Border Protection - border enforcement, CBP oversight, Immigration and Customs Enforcement - deportation and detention practices. Agency-Housing and Urban Development-Issues Lobbied: Fair housing, the disparate impact rule, AFFH rule, regulatory reform, discriminatory lending, disaster relief, rent increases. Agency-Justice-Issues Lobbied: LGBT rights, Dignity for Detained Immigrants Act, immigrant detention, due process for immigrants, First Step Act, Community Safety and Security Act of 2018, immigration, denaturalization, law enforcement, racial profiling, juvenile justice, school-to-prison pipeline, Bureau of Prisons - changes to the transgender offender manual, LGBT rights and prisoners rights. Agency-EOP-Issues Lobbied: Civil rights enforcement. Agency-OMB-Issues Lobbied: Preschool suspensions, school-to-prison pipeline, data collection. Agency-Commerce-Issues Lobbied: Racial justice, census. Agency-Labor-Issues Lobbied: Religious liberty, LGBT rights, drug testing. Agency-U.S. Commission on Civil Rights-Issues Lobbied: Womens rights, disability rights.

Client expense: $380,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Defense, Dept of (DOD), Education, Dept of, Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Justice, Dept of (DOJ), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, U.S. Commission on Civil Rights

H.R. 2, Agriculture Improvement Act of 2018, issues relating to opioids; H.R. 3325, Advancing Care for Exceptional (ACE) Kids Act; H.R. 5306/S. 2227, Ensuring Medicaid Provides Opportunities for Widespread Equity, Resources, and (EMPOWER) Care Act, issues relating to medicaid; Issues relating to opioids; Issues relating to drug pricing.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 413, Improving Transparency and Accuracy in Medicare Part D Spending Act (Capito) - PDP/MA-PD payments on clean claims from pharmacies S. 428, ACE Kids Act (Grassley) - coordinated care for children with complex medical conditions S. 1016, CONNECT For Health Act (Schatz) - telehealth S. 1169, Medicaid CARE Act (Durbin-Portman) - changes to Medicaid IMD exclusion S. 1688, Empowering Medicare Seniors to Negotiate Drug Prices Act (Klobuchar) - Part D price negotiations S. 1804, Medicare for All Act (Sanders) - single payer health system S. 1890, Chronic Kidney Disease Improvement in Research and Treatment and Medigap Access (Cardin) - Medigap coverage for beneficiaries with end-stage renal disease S. 1909, BENES Act (Casey) - notifications of Medicare eligibility S. 2027, Medicaid Third Party Liability Act (Portman) - Medicaid third party liability S. 2051, Medicare Care Coordination Improvement Act of 2017 (Portman) - barriers to payment reform models S. 2227, EMPOWER Care Act (Portman-Cantwell) - Medicaid Money Follows the Person Demonstration S. 2707, Informing Seniors About Opioids Act (Nelson) - opioid issues S. 2901, Expanding Telehealth Response to Ensure Addiction Treatment Act (Thune) - opioid issues S. 2904, Medicaid Substance Use Disorder Treatment Via Telehealth Act (Carper) - opioid issues S. 2908, Electronic Prior Authorization in Medicare Part D Act (Roberts) - opioid issues S. 3327, SENIOR Communities Protection Act (Cortez Masto) - preventing fraudulent opioid prescriptions S. 3496, Improving Seniors Access to Quality Benefits Act (Daines-King) - study on MA benchmark cap S. 3497, Medicare Advantage Quality Payment Relief Act (Daines-King) - MA benchmark cap S. 3702, Right Rebate Act (Wyden-Grassley) - Medicaid drug rebate program Draft Bill: Medicare Long-Term Care Services and Supports Act (Pallone) - Long-Term Services and Supports Program H.R. 6, SUPPORT Patients and Families Act (Walden) - opioid initiatives, Medicare and Medicaid issues, budget offsets H.R. 695, Continuing Appropriations Act (Schiff) - Money Follows the Person demonstration, spousal impoverishment protections H.R. 849, Protecting Seniors Access to Medicare Act (Roe) - Independent Payment Advisory Board H.R. 908, Medicare Advantage Quality Payment Relief Act (Kelly) - MA payment cap H.R. 1038, Improving Transparency and Accuracy in Medicare Part D Spending Act (Griffith) - PDP/MA-PD payments on clean claims from pharmacies H.R. 1148, FAST Act (Griffith) - access to telehealth-eligible stroke services under Medicare H.R. 1316, Prescription Drug Price Transparency Act (Collins) - PBM standards for MA and PDP plans H.R. 1995, V-BID for Better Care Act (Black) - value-based insurance design in Medicare Advantage H.R. 2556, CONNECT For Health Act (Black) - telehealth H.R. 2575, BENES Act (Ruiz) - notifications of Medicare eligibility H.R. 2644, Chronic Kidney Disease Improvement in Research and Treatment and Medigap Access (Marino) - Medigap coverage for beneficiaries with end-stage renal disease H.R. 2687, Medicaid CARE Act (Foster-Fitzpatrick) - changes to Medicaid IMD exclusion H.R. 3044, Supplemental Benefits for Chronically Ill Medicare Advantage Enrollees (Meehan) H.R. 3263, Medicare Independence at Home Model of Care (Burgess) - demonstration program H.R. 3325, ACE Kids Act (Barton) - health homes for children with complex medical conditions H.R. 3360, Telehealth Enhancement Act (Harper) - telehealth in Medicare H.R. 3635, Local Coverage Determination Clarification Act (Jenkins) - procedures for Medicare administrative contractors H.R. 3727, Increasing Telehealth Access in Medicare Act (Black) - telehealth in MA plans H.R. 4143, Dialysis PATIENTS Demonstration Act (Smith) - alternative care delivery models and payment methodologies for patients with end-stage renal disease H.R. 4952, Improving Seniors Access to Quality Benefits Act (Kelly) - MA benchmark cap study H.R. 5306, EMPOWER Care Act (Guthrie) - extension of Money Follows the Person demonstration H.R. 5603, Access to Telehealth Services for Substance Use Disorders Act (Matsui) - opioid issues H.R. 5605, Advancing High Quality Treatment for Opioid Use Disorders in Medicare Act (Ruiz) - opioid issues H.R. 5675, drug management programs for at-risk Medicare beneficiaries (Bilirakis) - opioid issues H.R. 5676, SENIOR Communities Protection Act (MacArthur) - preventing fraudulent opioid prescriptions H.R. 5684, Protecting Seniors from Opioid Abuse Act (Kelly) - opioid issues H.R. 5685, Medicare Opioid Safety Education Act (Faso) - opioid issues H.R. 5686, Medicare Clear Health Options in Care for Enrollees Act (Paulsen) - opioid issues H.R. 5715, Strengthening Partnerships to Prevent Opioid Abuse Act (Renacci) - communication between Medicare plan sponsors and CMS H.R. 5773, Preventing Addiction for Susceptible Seniors Act (Roskam) - opioid issues H.R. 5797, IMD CARE Act (Walters) - Medicaid IMD exclusion H.R. 5798, Opioid Screening and Chronic Pain Management Alternatives for Seniors Act (Bucshon) - opioid issues H.R. 5799, Medicaid Drug Review, Utilization, Good Governance Improvement Act (Blackburn) - opioid issues H.R. 5800, Medicaid IMD ADDITIONAL INFO Act (Upton) - opioid issues H.R. 5804, Post-Surgical Injections as an Opioid Alternative Act (Shimkus) - opioid issues H.R. 5808, Medicaid Pharmaceutical Home Act (Bilirakis) - opioid issues H.R. 5809, Postoperative Opioid Prevention Act (Peters) - opioid issues H.R. 5810, Medicaid Health Homes for Opioid-Use-Disorder Medicaid Enrollees Encouraged Act (Lance) - opioid issues H.R. 5812, Improving Medicaid Data Timeliness Act (Griffith) - opioid issues H.R. 6431, Medigap Consumer Protection Act (Levin) - reforms to Medicare supplemental insurance H.R. 6561, Comprehensive Care for Seniors Act (Walorski) -- Program of All-Inclusive Care for the Elderly H.R. 6563, Lower Out-of-Pocket Costs for Seniors Act (Pallone-Neal) - Medicare Part D cliff H.R. 6662, Empowering Seniors Decision Enrollment Act (Paulsen) - special enrollment period for non-deemed Medicare Cost Plan enrollees H.R. 6690, Fighting Fraud to Protect Care for Seniors Act (Roskam) - Medicare pilot program for smart card technology H.R. 7122, Shared Accountability for Improved Patient Outcomes Act (Paulsen) - value-based payment and delivery arrangements H.R. 7217, IMPROVE Act (Barton) - Money Follows the Person demonstration, ACE Kids Act, Medicare drug rebate program, spousal impoverishment protections H.R. 7223, Right Rebate Act (Schrader-Welch) - Medicaid drug rebate program H.R. 7247, Incentivizing Shared Risk in Medicare Advantage Act (Brady) - MA prior authorization H.R. 7249, Better Prior Authorization Notification Act (Reed) - MA prior authorization H.R. 7250, Prior Authorization Improvement Act (Kelly) - MA prior authorization 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); calendar year 2020 policy and technical regulation for MA and Part D; MA and Part D proposed rule on drug pricing changes for 2020; CMSs price transparency proposal for direct-to-consumer advertisements; issues relating to 2019 Rate Notice and Call Letter; 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; Bipartisan Budget Act of 2018 changes to 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) and the Bipartisan Budget Act of 2018 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's substantial revisions to the managed care regulations, 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; issues relating to prescription drug price blueprint; 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.

Client expense: $1,540,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Treasury, Dept of, White House Office

H.R.5306/S.2227 Empower Care Act; H.R.7217 IMPROVE Act; H.R.181 re: Medicaid annuities; general education around home and community-based waiver and long-term services and supports issues.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 3458/H.R. 6932, Medicare Home Health Payment Reform Legislation. S. 3545, Home Health Payment Innovation Act. Modifications to the Medicare home health provisions in the Bipartisan Budget Act. Oppose home health and hospice payments cuts and co-pays. Home health, rural add on payment adjustments. Value based purchasing and bundling. Appropriations for family caregiver support programs. Hospice payment policy. H.R. 1825/S. 445, Home Health Care Planning Improvement Act. H.R. 1676/S. 693, Palliative Care and Hospice Education and Training Act. H.R. 1828/S. 980, Rural Access to Hospice Act. H.R. 2663, Home Health Documentation and Program Improvement Act. Medicare Advantage hospice proposals. Home Health Review Choice Demonstration Program. H.R. 2797/S. 1334, Patient Choice and Quality Care Act of 2017. S. 2227/H.R. 5306, EMPOWER Act. Medicaid Money Follows the Person. Medicaid Spousal Impoverishment Protections. Labor-HHS Appropriations.

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

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

Public Law 111-48, "Patient Protection and Affordable Care Act" and "Public Law 111-52, "Health Care and Education Reconciliation Act 2010"-monitored implementation of key Medicaid and health insurance market provisions. HR 246, Jobs and Premium Protection Act. S3063, Health Insurance Tax Relief Act of 2018. HR 4620, The Protecting Families and Small Businesses Act of 2017 (health insurer fee suspension). Issues related to the opioid epidemic pertinent to Medicaid and Medicare. HR 6, Support for Patients and Communities Act and related Opioid Bills. HR 3325/S 428, Advancing Care for Exceptional Kids Act. HR 5306/S 2227, Ensuring Medicaid Provides Opportunities for Widespread Equity, Resources and Care Act. ACA Marketplace and Medicaid Reform

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Ensuring Medicaid Provides Opportunities for Widespread Equity, Resources, and Care Act (H.R.5306/S.2227) - Supported the re-authorization of funding for the Money Follows the Person Medicaid demonstration program. Support for Patients and Communities Act (H.R. 6) - Supported the expansion and availability of substance use disorder treatment to recipients in the Medicaid, Medicare, and Children's Health Insurance Program as well as the inclusion of an IMD exception.

Client expense: $240,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), President of the U.S., SENATE

Discussed nursing home bill (Senate, no bill number). P.L. 115-123, Bipartisan Budget Act- discussed longitudinal chronic care planning services (GAO). Submitted comments to CMS regarding the Massachusetts Medicare-Medicaid Integration Demonstration: Duals Demonstration 2.0. Discussed issues affecting dual eligibles and the Bipartisan Budget Act of 2018 (P.L. 115-123) - discussed provisions of the law and other issues affecting dual eligibles (CMS, ACL). Discussed CY 2020 Medicare Advantage and Part D Flexibility Proposed Rule (CMS, no bill number). Discussed comments regarding Medicare and Medicaid Programs; Regulatory Provisions To Promote Program Efficiency, Transparency, and Burden Reduction proposed rule (Senate, no bill number). Discussed end of year package and Medicaid home and community-based services (HCBS) spousal impoverishment protections (no bill number at the time). H.R. 7217, The IMPROVE Act - discussed support for the legislation. S. 2227/H.R. 5306, EMPOWER Care Act - signed onto letter in support of the Ensuring Medicaid Provides Opportunities for Widespread Equity, Resources, and Care Act. Signed onto letter in support of extending the Money Follows the Person Demonstration Project and the Medicaid home and community-based services (HCBS) spousal impoverishment protections (no bill number). H.R. 7149, Protecting Married Seniors from Impoverishment Act - Discussed Medicaid HCBS spousal impoverishment protections and extending them or making them permanent (Senate/House). Discussed proposed rule regarding nursing homes, Medicare and Medicaid requirements (OMB). Submitted comments to CMS regarding Medicare and Medicaid Programs; Regulatory Provisions To Promote Program Efficiency, Transparency, and Burden Reduction proposed rule. H.J.R. 143, H.R. 695, Short-term Continuing Appropriations Act Resolution, 2019, H.R.6157, Department of Defense and Labor, Health and Human Services, and Education Appropriations Act, 2019 and Continuing Appropriations Act, 2019 - Lobbied in support of increased funding for CMS' state survey and certification program and in opposition to hostile policy riders regarding Patient Protection and Affordable Care Act, and various related medical care research and Older Americans Act programs. Sent letter of support to Senate regarding the Protecting Patients from Surprise Medical Bills Act (no bill number). Discussed Medicare Part D improvements and policies with House and Senate staff. Discussed Medicare Part B prescription drug policies with House and Senate staff.

Client expense: $2,140,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Medicare and Medicaid Services (CMS), Equal Employment Opportunity Commission (EEOC), Federal Highway Administration (FHA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Natl Highway Traffic Safety Administration (NHTSA), SENATE, Securities & Exchange Commission (SEC), Treasury, Dept of, White House Office

PL 109442: Lifespan Respite Care Act; PL 109365: Older Americans Act Amendments of 2006; PL 111148: The Patient Protection and Affordable Care Act; PL 111152: Affordable Health Care for America Act; PHS 42 USC 254C8: Healthy Start Reauthorization of 2007; PL 111192: Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act; PL 111-152, 124 Stat. 1029: Health Care & Education Reconciliation Act; HR 1628: American Health Care Act of 2017; S 253/HR 807: Medicaid Access to Rehabilitation Services Act of 2017; FY 2017/2018 Labor, Health and Human Services, Education Appropriations; HR 3758/S 1028: Recognize, Assist, Include, Support and Engage (RAISE) Family Caregivers Act (PL 11-119); HR 2824: Increasing Opportunity and Success for Children and Parents through Evidence-Based Home Visiting Act; S 1827/HR 3921: Children's Health Insurance Program (CHIP); S 1829/HR 2824: Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program; HR 3778: Direct CARE (Creation, Advancement, and Retention of Employment) Opportunity Act; HR 5306/S 2227: Ensuring Medicaid Provides Opportunities for Widespread Equality, Resources (EMPOWER) Care Act; HR 3493: Care Corps Demonstration Act; HR 6: SUPPORT (Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment) for Patients and Communities Act (PL 115-271); S 1091/HR 3105: Supporting Grandparents Raising Grandchildren Act (PL 115-196); and HR 6157: Department of Defense and Labor, Health and Human Services, and Education Appropriations Act, 2019 and Continuing Appropriations Act, 2019 (PL 115-245); S 2227/H 5306: EMPOWER (Ensuring Medicaid Provides Opportunities for Widespread Equity, Resources) Care Act; and HR 7217: Improving Medicaid Programs and Opportunities for Eligible Beneficiaries (IMPROVE) Act.

Client expense: $55,061 · Firm income: Not reported

Government targets: Administration for Children & Families (ACF), Defense, Dept of (DOD), Education, Dept of, Equal Employment Opportunity Commission (EEOC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Council on Disability, SENATE, Social Security Administration (SSA), Transportation, Dept of (DOT), U.S. Architectural & Transportation Barriers Compliance Board (ACCESS), Veterans Affairs, Dept of (VA), White House Office

PL 108173: Medicare Prescription Drug and Modernization Act of 2003; PL 111148: Patient Protection and Affordable Care Act; PL 111-152, 124 Stat. 1029: Health Care and Education Reconciliation Act of 2010; PL 113157: Autism CARES (Collaboration, Accountability, Research, Education and Support) Act of 2014; HR 1628: American Health Care Act of 2017; FY 2019 Labor, Health and Human Services, Education Appropriations; HR 1628: American Health Care Act of 2017/Better Care Reconciliation Act of 2017; HR 2824: Increasing Opportunity and Success for Children and Parents through Evidence-Based Home Visiting Act; HR 3759/S 1028: Recognize, Assist, Include, Support and Engage (RAISE) Family Caregivers Act (PL 115-119); S 1827/HR 3921: Children's Health Insurance Program (CHIP); S 1829/HR 2824: Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program; HR 3778: Direct CARE (Creation, Advancement, and Retention of Employment) Opportunity Act; HR 5306/S 2227: Ensuring Medicaid Provides Opportunities for Widespread Equality, Resources (EMPOWER) Care Act; and H.R. 5912/S. 2897: To amend title XIX of the Social Security Act to delay the reduction in Federal medical assistance percentage for Medicaid personal care services and home health services furnished without an electronic visit verification system, and for other purposes.

Client expense: $55,061 · Firm income: Not reported

Government targets: Administration for Children & Families (ACF), Defense, Dept of (DOD), Education, Dept of, Equal Employment Opportunity Commission (EEOC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Council on Disability, SENATE, Social Security Administration (SSA), Transportation, Dept of (DOT), U.S. Architectural & Transportation Barriers Compliance Board (ACCESS), Veterans Affairs, Dept of (VA), White House Office

1. Proposals to change the Social Security annual Cost of Living Adjustment formula 2. Proposals to raise the Social Security normal retirement age 3. Proposals to "means test" Social Security benefits 4. Beneficiary information available through Social Security Administration field offices 5. Status of the Social Security Disability Insurance Trust Fund 6. Closing of Social Security Administration field offices 7. H.R. 1251,CPI-E Act of 2017, entire bill 8. H.R. 1637, Save Social Security Act of 2017, entire bill 9. Implementation of the Multiemployer Pension Reform Act of 2014 10. S. 427, Social Security Expansion Act, entire bill 11. H.R. 1114, Social Security Expansion Act, entire bill 12. S. 1255, Social Security Caregiver Credit Act of 2017, entire bill 13. H.R. 2896, Fair COLA for Seniors Act of 2017, entire bill 14. Status of Social Security Disability claims backlog 15. S. 2147, Butch Lewis Act of 2017, entire bill 16. S. 2227, EMPOWER Care Act, entire bill 17. H.R. 5306, EMPOWER Care Act, entire bill 18. S. 3147, Social Security Administration Fairness Act, entire bill 19. U.S. House and Senate Expand Social Security Caucuses 20. Social Security Administration online COLA notifications 21. S. 3457, Surviving Widow(er) Income Fair Treatment Act of 2018, or the SWIFT Act," entire bill 22. H.R. 6929, Strengthening Social Security Act of 2018, entire bill 23. Proposals for loan guarantees for multi-employer pension plans 24. Proposals for multiple employer retirement accounts 25. Proposals for Social Security online Cost of Living Adjustment statements 26. H.R. 1902, Social Security 2100 Act, entire bill

Client expense: $80,000 · 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), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Social Security Administration (SSA)

Advocate for the reauthorization of the Money Follows the Person program (H.R. 5306 and S. 2227). Advocate for appropriations for all state Medicaid and Medicare effecting aging and disability programs (H.R. 6157).

Client expense: Not reported · Firm income: $19,500

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1289 - Dorothy I. Height and Whitney M. Young, Jr., Social Work Reinvestment Act S. 1188/H.R.2535 - Lifespan Respite Care Reauthorization Act of 2017 H.R. 6 [P.L. No: 115-271] - SUPPORT for Patients and Communities Act S.2524/H.R. 5102 - Substance Use Disorder Workforce Loan Repayment Act of 2018 H.Res.1099 - Providing for the concurrence by the House in the Senate amendment to H.R. 6, with an amendment H.R.3331 - To amend title XI of the Social Security Act to promote testing of incentive payments for behavioral health providers for adoption and use of certified electronic health record technology. S.1732 - Improving Access to Behavioral Health Information Technology Act S. 1905/ H.R.3931 - Excellence in Mental Health and Addiction Treatment Expansion Act S.1016/H.R. 2556 - CONNECT for Health Act of 2017 S.2120/H.R. 5034 - International Violence Against Women Act of 2017 S.2164/H.R.2953 - To amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings. S.1334/H.R.2797 - Patient Choice and Quality Care Act of 2017 H.R.620 - ADA Education and Reform Act of 2017 S.Res.427 - A resolution supporting the goals and ideals of Social Work Month during March 2018 and World Social Work Day on March 20, 2018. H.Res.770 - Supporting the goals and ideals of Social Work Month during March 2018 and World Social Work Day on March 20, 2018. H.R.3713 - Geriatrics Workforce and Caregiver Enhancement Act S. 2456/H.R. 5311 - CARA 2.0 Act of 2018 S.2301/H.R. 4778- Behavioral Health Coverage Transparency Act of 2018 S. 1015/H.R.2345 [P.L. No: 115-233] - National Suicide Hotline Improvement Act of 2017 H.R.4704 - Nursing Home CARE Act S.2227/H.R. 5306 - EMPOWER Care Act S.2076/H.R. 4256 [P.L. No: 115-406] - BOLD Infrastructure for Alzheimer's Act S.2680 - Opioid Crisis Response Act of 2018 Improving Parity for Mental Health and Substance Use Disorder Coverage. H.R. 5942 - Health Equity and Accountability Act of 2018 Preserve ACA Essential Health Benefits, cost sharing subsidies, state waivers, and funding for navigators and assisters. Health care access Reduce Gun Violence: Comprehensive Legislative Solutions to firearm-related injuries and fatalities Opioid Epidemic 340B drug pricing issues Section 1115 waiver approval issues Medicare Part D program issues Medicaid non-emergency medical transportation (NEMT) issues H.R.6597 - Mental Health Professionals Workforce Shortage Loan Repayment Act of 2018 H.R.5202/S.916 - Ensuring Patient Access to Substance Use Disorder Treatments Act of 2018 S.1370/H.R.2913 - Mental Health in Schools Act of 2017 S.3337 - Mental Health Services for Students Act of 2018

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Education, Dept of, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

Support passage of S. 2227/H.R. 5306 the Empower Care Act; H.R. 7149, Protecting Married Seniors from Impoverishment Act; and H.R. 7217, the Improve Act (extending money follows the person and spousal impoverishment protections for HCBS) Support for Medicaid extenders in H.R. 695, as amended Pre-proposed rule for LTC facilities as a condition of participation in Medicaid and Medicare

Client expense: $66,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), SENATE

Medicaid block grant/per capita caps; Medicaid Funding Threats/Reform; ABLE Age Adjustment Act (H.R. 1874/S. 817); Extension of Money Follows the Person Rebalancing Demonstration Project and support for the Ensuring Medicaid Provides Opportunities for Widespread Equity, Resources, and Care Act (also known as the EMPOWER Care Act, S.2227/H.R. 5306); Spousal Impoverishment Protections in the IMPROVE Act (H.R. 7217); Improving Access to Behavioral Health Information Technology Act (S. 1732/H.R. 3331) as included in H.R. 6, the Opioid package (the SUPPORT for Patients and Communities Act); Administration efforts regarding Opioid Use; Medicaid 1115 Waiver Applications to the Department of Health & Human Services; and Disabled Access Credit Expansion Act (S. 3469), Disability Employment Incentive Act (S. 3260).

Client expense: $192,770 · Firm income: Not reported

Government targets: Administration for Children & Families (ACF), Administration on Aging, Education, Dept of, Federal Emergency Management Agency (FEMA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Office of Management & Budget (OMB), SENATE, State, Dept of (DOS), Treasury, Dept of, White House Office

Legislation and policies related to: Physician/nurse practitioner reimbursement Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Implementation of the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 (P.L. 114-10) including policies related to the Quality Payment Program Adoption of recommendations of the Institute of Medicine report, The Future of Nursing: Leading Change, Advancing Health Medicare Shared Savings Program beneficiary assignment requirements Medicare-Medicaid hospital conditions of participation Evaluation of the Medicare Graduate Nurse Education demonstration Medicare-Medicaid Program Integrity policies Medicaid maintenance of effort requirements Medicaid eligibility expansion and state options Medicaid waiver application procedures Medicaid per capita cap policy options H.R. 1160 - ACO Assignment Improvement Act of 2017 H.R. 3178 - Medicare Part B Improvement Act of 2017 H.R. 3635 - Local Coverage Determination Clarification Act of 2017 H.R. 5306/S. 2227 - Ensuring Medicaid Provides Opportunities for Widespread Equity, Resources (EMPOWER) and Care Act S. 445/H.R. 1825 - Home Health Care Planning Improvement Act of 2017 S. 428/H.R. 3325 - Advancing Care for Exceptional Kids (ACE Kids) Act S. 870 - Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017 S. 1227/H.R. 2628 - Stabilize Medicaid and CHIP Coverage Act of 2017 S. 3067/H.R. 1617 - Promoting Access to Diabetic Shoes Act

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

Government targets: Agriculture, Dept of (USDA), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Justice, Dept of (DOJ), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA)

Modifications to the Medicare home health provisions in the Bipartisan Budget Act. Oppose home health and hospice payment cuts and co-pays. Home health rural add on payment adjustment. Hospice payment policy. H.R. 1825/S. 445, Home Health Care Planning Improvement Act. H.R. 1676/S. 693, Palliative Care and Hospice Education and Training Act. H.R. 1284/S. 2214, Medicare Patient Access to Hospice Act. H.R. 1828/S. 980, Rural Access to Hospice Act. H.R. 2663, Home Health Documentation and Program Improvement Act. Chronic care management proposals. Long-term services and supports coverage under Medicare. Medicare Advantage hospice proposals. Home Health Pre-Claim Review Demonstration program. H.R. 2797/S. 1334, Patient Choice and Quality Care Act of 2017. H.R. 6042 (EVV Delay) To amend title XIX of the Social Security Act to delay the reduction in Federal medical assistance percentage for Medicaid personal care services furnished without an electronic visit verification system, and for other purposes. H.R. 3992, Rural Health Extension and Regulatory Relief Act. 1115 Waivers eliminating retroactive coverage in Florida and Arizona. Labor-HHS Appropriations. Proposed amendments to the Bipartisan Budget Act (Pub. L. No. 115-123) including provisions related to physician assistants as hospice attending physicians and hospital early discharge to hospice care. HHGM regulatory proposal. S. 3458/H.R. 6932, Medicare home health payment reform legislation. Appropriations for family caregiver support programs. S. 2227/H.R. 5306, EMPOWER Act. RAISE Family Caregivers Act - HHS implementation. Medicare Part B Time-limited equitable relief issues. Value based purchasing and bundling.

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

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

H.R. 2, Agriculture Improvement Act of 2018, issues relating to opioids; H.R. 3325, Advancing Care for Exceptional (ACE) Kids Act; H.R. 5306/S. 2227, Ensuring Medicaid Provides Opportunities for Widespread Equity, Resources, and (EMPOWER) Care Act, issues relating to medicaid; Issues relating to opioids; Issues relating to drug pricing.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation: S103-Local Zoning Decisions Protection Act of 2017-Issues Lobbied: Racial justice, housing. S367-Probation Officer Protection Act of 2017-Issues Lobbied: Law enforcement. S411-End Racial and Religious Profiling Act of 2017 (ERRPA)-Issues Lobbied: Racial justice, racial profiling. S642-Fifth Amendment Integrity Restoration Act-Issues Lobbied: Civil asset forfeiture. S811-Child Welfare Provider Inclusion Act-Issues Lobbied: LGBT rights, religious liberty. S860-Juvenile Justice and Delinquency Prevention Reauthorization Act of 2017-Issues Lobbied: Juvenile justice, racial justice. S1006-Equality Act-Issues Lobbied: LGBT rights, womens rights, reproductive freedom, racial justice. S1134-Back the Blue Act of 2017-Issues Lobbied: Law enforcement. S1419-Voting Rights Advancement Act-Issue Lobbied: Voting rights. S1588-Democracy Restoration Act-Issue Lobbied: Racial justice, voting. S1593-Pretrial Integrity and Safety Act-Issue Lobbied: Bail Reform. S1820-A bill to provide for the retention and service of transgender members of the Armed Forces-Issues Lobbied: LGBT rights. S1856-Stop Militarizing Law Enforcement Act-Issues Lobbied: Law enforcement. S1917-Sentencing Reform and Corrections Act of 2017-Issues Lobbied: Criminal justice reform. S2525-First Amendment Defense Act-Issues Lobbied: LGBT rights, religious liberty. S2584-Student Non-Discrimination Act of 2018-Issues Lobbied: LGBT rights. S.J. Res. 59 - Authorization for Use of Military Force of 2018 - Issues Lobbied: National security. S3195 - Law Enforcement Trust and Integrity Act-Issues Lobbied: Law enforcement. S2918 - Do No Harm Act-Issues Lobbied: Religious liberty, LGBT rights, reproductive freedom. S2836 - Preventing Emerging Threats Act of 2018-Issues Lobbied: Privacy, surveillance. S170 - Combating BDS Act of 2017-Issues Lobbied: Free speech. S3109 - DHS Appropriations for FY 2019-Issues Lobbied: Immigration, border enforcement. S2832 - DATA Act-Issues Lobbied: DHS data collection. S3162- Border Zone Reasonableness Restoration Act of 2018-Issues Lobbied: CBP accountability. S1519 - National Defense Authorization Act for FY 2018-Issues Lobbied: Border enforcement, national security. S3158 - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act of 2019-Issues Lobbied: Racial justice, education, desegregation, Aderholt Amendment, LGBT rights, religious liberty, reproductive rights, abortion coverage restrictions, Title X family planning program, Conscience Protection Act, fetal tissue research, sexual health education. S2754 - Handle with Care Act of 2018-Issues Lobbied: Racial justice, juvenile justice. S2227 - EMPOWER Care Act-Issues Lobbied: Disability rights. S2952 - Congressional Accountability Act of 1995 Reform Act-Issues Lobbied: Sexual harassment and discrimination. S2795 - FIRST STEP Act-Issues Lobbied: Criminal law reform. S2261 - Secure Elections Act-Issues Lobbied: Racial justice, voting. S3271 - No Money Bail Act-Issues Lobbied: Bail reform. S1918 - Police CAMERA Act of 2017-Issues Lobbied: Law enforcement. S3049 - Protecting American Votes and Elections Act of 2018-Issues Lobbied: Voting rights. S1305 - CBP HiRe Act-Issues Lobbied: Hiring and retention of CBP personnel. S3478 - FAMILIES Act-Issues Lobbied: Immigration detention. S3474 - Responsibility for Unaccompanied Minors Act-Issues Lobbied: Immigration. S720 - Israel Anti-Boycott Act-Issues Lobbied: Free speech. S1872 - TSA Modernization Act-Issues Lobbied: Biometrics. S3170 - CyberTipline Modernization Act of 2018-Issues Lobbied: Privacy. S3538 - DHS Body-Worn Camera Act of 2018-Issues Lobbied: CBP accountability. S595 - Anti-Border Corruption Reauthorization Act of 2017-Issues Lobbied: CBP accountability. S1101 - Pregnant Workers Fairness Act-Issues Lobbied: Womens rights. S1655 - Transportation, Housing and Urban Development, and Related Agencies Appropriations Act, 2018 - Fair Housing and Violence Against Women Amendment-Issues Lobbied: Womens rights. S3567 - No Internment Camps Act-Issues Lobbied: Immigration detention. HR 482-Local Zoning Decisions Protection Act of 2017-Issues Lobbied: Racial justice, housing. HR 1039-Probation Officer Protection Act of 2017-Issues Lobbied: Law enforcement. HR 1498-End Racial Profiling Act of 2017-Issues Lobbied: Racial justice, racial profiling. HR 1555-Fifth Amendment Integrity Restoration Act-Issues Lobbied: Civil asset forfeiture. HR 1556-Stop Militarizing Law Enforcement Act-Issues Lobbied: Law enforcement militarization. HR 1809-Juvenile Justice Reform Act of 2017-Issues Lobbied: Juvenile justice, racial justice. HR 1881-Child Welfare Provider Inclusion Act of 2017-Issues Lobbied: LGBT rights, religious liberty. HR 2133-Community Lending Enhancement and Regulatory Relief (CLEARR) Act of 2017-Issues Lobbied: Housing. HR 2152- Citizens Right to Know Act of 2018-Issues Lobbied: Bail reform, police reform. HR 2228-Law Enforcement Mental Health and Wellness Act of 2017-Issues Lobbied: Law enforcement. HR 2282-Equality Act-Issues Lobbied: LGBT rights, womens rights, reproductive freedom, racial justice. HR 2437-Back the Blue Act of 2017-Issue Lobbied: Law enforcement. HR 2676-Police Reporting Information, Data, and Evidence (PRIDE) Act of 2017-Issues Lobbied: Law enforcement. HR 2899-Second Chance Act Reauthorization Act of 2017-Issues Lobbied: Reentry. HR 2978-Voting Rights Advancement Act of 2017-Issues Lobbied: Voting rights. HR 3060-Preventing Tragedies Between Police and Communities Act of 2017-Issues Lobbied: Law enforcement. HR 3222-Do No Harm Act-Issues Lobbied: Religious liberty, LGBT rights, reproductive freedom. HR 3354-Make America Secure and Prosperous Appropriations Act-Issues Lobbied: Racial justice, census. HR 3944-Police CAMERA Act of 2017-Issues Lobbied: Law enforcement. HR 4019-Pretrial Integrity and Safety Act of 2017-Issues Lobbied: Bail reform. HR 4041-A bill to provide for the retention and service of transgender members of the Armed Forces-Issues Lobbied: LGBT rights. HR 4508-The Promoting Real Opportunity, Success, and Prosperity through Education Reform (PROSPER) Act-Issues Lobbied: Racial justice, higher education. HR 4833-The Bail Fairness Act of 2018-Issues Lobbied: Bail. HR 5374-Student Non-Discrimination Act of 2018-Issues Lobbied: LGBT rights. HR 5682 - FIRST STEP Act-Issues Lobbied: Prison reform, intersection of criminal justice and immigration. HR 4447-CyberTipline Modernization Act of 2017-Issues Lobbied: Criminal justice, privacy. HR 1437- No Money Bail Act-Issue Lobbied: Bail reform. HR 5698 - Protect and Serve Act of 2018-Issues Lobbied: Law enforcement. HR 3249 - Protect Safe Neighborhoods Grant Program Authorization Act of 2018-Issues lobbied: Law enforcement. HR 5515 - John S. McCain National Defense Authorization Act for FY 19-Issues Lobbied: Border enforcement, womens rights, national security. HR 5199 - Education Savings Accounts for Military Families Act of 2018-Issues Lobbied: School vouchers - racial justice, disability rights, religious liberty, education. HR 5242 - School Resource Officer Assessment Act of 2018- Issues Lobbied: Racial justice, school-to-prison pipeline. HR 6122 - Save Voters Act-Issues Lobbied: Racial justice, voting. HR 5306 - EMPOWER Care Act-Issues Lobbied: Disability rights. HR 4924, H. Res. 724 - Congressional Accountability Act of 1995 Reform Act-Issues Lobbied: Sexual harassment and discrimination. HR 6691 - Community Safety and Security Act of 2018-Issues Lobbied: Criminal justice reform. HR 6659 - Screening with Dignity Act of 2018-Issues Lobbied: LGBT rights, privacy & technology. HR 12 - Voter Empowerment Act of 2017-Issues Lobbied: Racial justice, voting. HR 2840 - Automatic Voter Registration Act-Issues Lobbied: Racial justice, voting. HR 5011 - Election Security Act-Issues Lobbied: Racial justice, voting. HR 5793 - Housing Choice Voucher Mobility Demonstration Act of 2018-Issues Lobbied: Racial justice, housing. HR 6723 - Ensuring American Voters Act of 2018-Issues Lobbied: Racial justice, voting. HR 6011 - To amend title 18, United States Code, to authorize a court to reduce the term of imprisonment imposed on certain defendants convicted as an adult for an offense committed and completed before the defendant attained 18 years of age, and for other purposes.-Issues Lobbied: Racial justice, juvenile justice. HR 6896 - United States Parole Commission Extension Act of 2018-Issues Lobbied: DC Parole Commission. HR 1697 - Israel Anti-Boycott Act-Issues Lobbied: Free speech. HR 6311 - Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act of 2018-Issues Lobbied: Health savings plans. HR 6147 - Interior, Environment, Financial Services and General Government, Agriculture, Rural Development, Food and Drug Administration, and Transportation, Housing and Urban Development Appropriations Act, 2019-Issues Lobbied: DC Reproductive Health Non-Discrimination Amendment Act (RHNDA). HR 5952 - Commerce, Justice, Science, and Related Agencies Appropriations Act, 2019-Issues Lobbied: Civil asset forfeiture. HR 2 - Agriculture Improvement Act of 2018-Issues Lobbied: SNAP benefits, reentry. HR 5634 - Medical Cannabis Research Act of 2018-Issues Lobbied: Collateral consequences. HR 3799 - Demanding Oversight from Justice Act-Issues Lobbied: Law enforcement. HR 6093 - Protecting American Votes and Elections Act of 2018-Issues Lobbied: Voting rights. HR 6527 - Funding Attorneys for Indigent Removal (FAIR) Proceedings Act-Issues Lobbied: Immigration. HR 6692 - Alternatives to Detention Act of 2018-Issues Lobbied: Immigrant detention. HR 6776 - Department of Homeland Security Appropriations Act, 2019-Issues Lobbied: Appropriations, immigration, border enforcement. HR 6439 - Biometric Identification Transnational Migration Alert Program Authorization Act of 2018-Issues Lobbied: Biometrics/surveillance. HR 4219 - Workflex in the 21st Century Act-Issues Lobbied: Womens rights, paid family leave. HR 6470 - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2019-Issues Lobbied: LGBT discrimination, exclusions/suspensions, school vouchers. HR 6332 - Improving Strategies to Counter Weapons Proliferation Act-Issues Lobbied: Privacy. HR 4943 - CLOUD Act-Issues Lobbied: Privacy. HR 6401 - Preventing Emerging Threats Act of 2018-Issues Lobbied: Privacy, free press. HR 6729 - Empowering Financial Institutions to Fight Human Trafficking Act of 2018-Issues Lobbied: Privacy. HR 6743 - Consumer Information Notification Requirement Act-Issues Lobbied: Privacy, state preemption. HR 6157 - Department of Defense and Labor, Health and Human Services, and Education Appropriations Act of 2019 and Continuing Appropriations Act, 2019-Issues Lobbied: Office of Refugee Resettlement, immigrant children, border wall - Amendment No. 4004 to Amendment No. 3887-Issues Lobbied: Juvenile justice, school safety, ICE funding, immigration detention. HR 6462 - Border Zone Reasonableness Restoration Act of 2018-Issues Lobbied: CBP accountability. HR 1608 - ICE and CBP Body Camera Accountability Act-Issues Lobbied: CBP and ICE accountability. HR 6545 Violence Against Women Reauthorization Act of 2018-Issues Lobbied: Womens rights. HR 2417 - Pregnant Workers Fairness Act-Issues Lobbied: Womens rights. HR 6509 - Eleanor Smith Inclusive Home Design Act of 2018-Issues Lobbied: Disability rights. Legislation with No Bill Number and Nominations: Abortion restrictions for unaccompanied minors in ORR care-Issues Lobbied: Reproductive rights - abortion. ICE detention of pregnant women-Issues Lobbied: Reproductive rights, immigrant rights. Administrative Legislative Proposal - Making Affordable Housing Work Act of 2018-Issues Lobbied: Racial justice, fair housing, rent increases. HHS notice of rulemaking on Compliance with Statutory Program Integrity Requirements-Issues Lobbied: Reproductive rights, Title X family planning program. House bill version - Law Enforcement Trust and Integrity Act-Issues Lobbied: Law enforcement. Driver and Officer Safety Education Act-Issues Lobbied: Law enforcement. Federal Police Camera and Accountability Act-Issues Lobbied: Law enforcement. Draft proposal to give Puerto Rico and other territories federal voting representation-Issues Lobbied: Voting rights. Brett Kavanaugh nomination-Issues Lobbied: Civil liberties and civil rights, abortion. Draft House bill recognizing Human Rights Day-Issues Lobbied: Human rights. Amendment to Immigration and Nationality Act-Issues Lobbied: Muslim Ban, immigration. Executive Order 13780 - Protecting the Nation from Foreign Terrorist Entry into the United States-Issues Lobbied: AMENSA, immigration. Oversight over counterterrorism policy and practices-Issues Lobbied: Torture, detention, drones, war authority. Draft legislation on Congressional Ethics-Issues Lobbied: Ethics, free speech. Keep All Students Safe Act-Issues Lobbied: Disability rights. Appropriations generally - Issues Lobbied: ICE and CBP appropriations. Additional legislation not yet introduced - sexual harassment reforms, violence against women in the military, workplace harassment reform, prosecutorial reform, use of force by federal law enforcement, immigration, commercial privacy, face recognition, biometrics, encryption, prison reform. Agencies: Agency-Defense-Issues Lobbied: Trans Military Ban; Guantanamo detention policy. Agency-Education-Issues Lobbied: Racial justice, equal education, CRDC data collection, school-to-prison pipeline, Every Student Succeeds Act, student loans, civil rights investigations, weapons in schools. Agency-Health and Human Services-Issues Lobbied: Title X Rulemaking - HHS-OS-2018-0008, Compliance with Statutory Program Integrity Requirements, RIN 0937-ZA00 - reproductive rights; womens rights, disability rights. Agency-Veterans Affairs-Issues Lobbied: exclusion of gender alterations from medical benefits, LGBT rights. Agency-Homeland Security-Issues Lobbied: Custom and Border Protection - border enforcement, CBP oversight, Immigration and Customs Enforcement - deportation and detention practices. Agency-Housing and Urban Development-Issues Lobbied: Fair housing, the disparate impact rule, AFFH rule, regulatory reform, discriminatory lending, disaster relief, rent increases, Title X, Medicaid sterilization, Medicaid waiver. Agency-Justice-Issues Lobbied: LGBT rights, Death in Custody Reporting Act, law enforcement, racial profiling, juvenile justice, school-to-prison pipeline, Bureau of Prisons - changes to the transgender offender manual, LGBT rights and prisoners rights. Agency-EOP-Issues Lobbied: Civil rights enforcement. Agency-OMB-Issues Lobbied: Preschool suspensions, school-to-prison pipeline, data collection. Agency-Commerce-Issues Lobbied: Racial justice, 2020 census. Agency-NSA -Issues Lobbied: Office of the Director of National Intelligence -Section 215 reauthorization. Agency-Labor-Issues Lobbied: Directive 2018-03, religious liberty, LGBT rights. Agency-Internal Revenue Service-Issues Lobbied: Male sterilization and health plan coverage. Agency-State-Issues Lobbied: Committee on the Elimination of Racial Discrimination (CERD) - racial discrimination, CLOUD Act - Privacy.

Client expense: $270,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Defense, Dept of (DOD), Education, Dept of, Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Security Agency (NSA), Office of Management & Budget (OMB), SENATE, State, Dept of (DOS), Veterans Affairs, Dept of (VA)

Supports H.R. 750 The Ensuring Access to Quality Complex Rehabilitation Technology (CRT) Act. Supports S. 486 Protecting Beneficiary Access to Complex Rehab Technology Act of 2017 Supports H.R. 3730 (To amend title XVIII of the Social Security Act to provide for the non-application of Medicare competitive acquisition rates to complex rehabilitative manual wheelchairs and accessories) was introduced by Representatives Lee Zeldin (R-NY) and John Larson (D-CT) to stop CMS from using Competitive Bid pricing for accessories used with CRT manual wheelchairs. Supports H.R. 626, the Access to Inpatient Rehabilitation Therapy Act of 2017, which would amend the Social Security Act to include recreational therapy among the therapy methods that can be considered part of an intensive rehabilitation therapy program in an inpatient rehabilitation hospital or unit. Myomos MyoPro support letter to CMS Policy staff, as members of United Spinal Association, wrote the Centers for Medicare and Medicaid Services (CMS) in strong support of an application to CMS for a unique Healthcare Common Procedure Coding System (HCPCS) code for the MyoPro device, created by the medical technology company, Myomo. Support of S. 2227/H.R.5306 Empower Care Act which reinstates the Money Follows the Person program and facilitates smooth transitions out of nursing facilities and into the community. Signed onto letters to Congress in support of including functional quality measures in rehabilitation metrics. United Spinal supports this letter but CCD Task Force co-chairs: The co-chairs of the Consortium for Citizens with Disabilities (CCD) Health, Long-Term Services and Supports, and Rights Task Forces write in opposition to proposals that expand coverage of institutional services in Medicaid without addressing gaps in Medicaid community services. CCD is the largest coalition of national organizations working together to advocate for Federal public policy that ensures the self-determination, independence, empowerment, integration and inclusion of children and adults with disabilities in all aspects of society.

Client expense: Not reported · Firm income: $75,000

Government targets: AMTRAK - Natl Railroad Passenger Corporation, Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, Federal Communications Commission (FCC), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

S. 413, Improving Transparency and Accuracy in Medicare Part D Spending Act (Capito) - PDP/MA-PD payments on clean claims from pharmacies S. 428, ACE Kids Act (Grassley) - coordinated care for children with complex medical conditions S. 1016, CONNECT For Health Act (Schatz) - telehealth S. 1169, Medicaid CARE Act (Durbin-Portman) - changes to Medicaid IMD exclusion S. 1688, Empowering Medicare Seniors to Negotiate Drug Prices Act (Klobuchar) - Part D price negotiations S. 1804, Medicare for All Act (Sanders) - single payer health system S. 1827, Keep Kids Insurance Dependable and Secure Act (Hatch-Wyden) - federal CHIP funding S. 1890, Chronic Kidney Disease Improvement in Research and Treatment and Medigap Access (Cardin) - Medigap coverage for beneficiaries with end-stage renal disease S. 2027, Medicaid Third Party Liability Act (Portman) - Medicaid third party liability S. 2227, EMPOWER Care Act (Portman-Cantwell) - Medicaid Money Follows the Person Demonstration S. 2707, Informing Seniors About Opioids Act (Nelson) - opioid issues S. 2901, Expanding Telehealth Response to Ensure Addiction Treatment Act (Thune) - opioid issues S. 2904, Medicaid Substance Use Disorder Treatment Via Telehealth Act (Carper) - opioid issues S. 2908, Electronic Prior Authorization in Medicare Part D Act (Roberts) - opioid issues S. 3327, SENIOR Communities Protection Act (Cortez Masto) - preventing fraudulent opioid prescriptions S. 3496, Improving Seniors Access to Quality Benefits Act (Daines-King) - study on MA benchmark cap S. 3497, Medicare Advantage Quality Payment Relief Act (Daines-King) - MA benchmark cap Draft Bill: Medicare Long-Term Care Services and Supports Act (Pallone) - Long-Term Services and Supports Program Draft Bills: Prior Authorization in Medicare Advantage (House Ways and Means Committee) - prior authorization notifications, report to Congress S. 2051: Medicare Care Coordination Improvement Act of 2017 (Portman) - barriers to payment reform models H.R. 849, Protecting Seniors Access to Medicare Act (Roe) - Independent Payment Advisory Board H.R. 908, Medicare Advantage Quality Payment Relief Act (Kelly) - MA payment cap H.R. 1038, Improving Transparency and Accuracy in Medicare Part D Spending Act (Griffith) - PDP/MA-PD payments on clean claims from pharmacies H.R. 1148, FAST Act (Griffith) - access to telehealth-eligible stroke services under Medicare H.R. 1316, Prescription Drug Price Transparency Act (Collins) - PBM standards for MA and PDP plans H.R. 1995, V-BID for Better Care Act (Black) - value-based insurance design in Medicare Advantage H.R. 2556, CONNECT For Health Act (Black) - telehealth H.R. 2644, Chronic Kidney Disease Improvement in Research and Treatment and Medigap Access (Marino) - Medigap coverage for beneficiaries with end-stage renal disease H.R. 2687, Medicaid CARE Act (Foster-Fitzpatrick) - changes to Medicaid IMD exclusion H.R. 3044, Supplemental Benefits for Chronically Ill Medicare Advantage Enrollees (Meehan) H.R. 3168, Special Needs Plans (Tiberi-Levin) - SNP reauthorization H.R. 3263, Medicare Independence at Home Model of Care (Burgess) - demonstration program H.R. 3325, ACE Kids Act (Barton) - health homes for children with complex medical conditions H.R. 3360, Telehealth Enhancement Act (Harper) - telehealth in Medicare H.R. 3635, Local Coverage Determination Clarification Act (Jenkins) - procedures for Medicare administrative contractors H.R. 3727, Increasing Telehealth Access in Medicare Act (Black) - telehealth in MA plans H.R. 4143, Dialysis PATIENTS Demonstration Act of 2017 (Smith) - alternative care delivery models and payment methodologies for patients with end-stage renal disease H.R. 4952, Improving Seniors Access to Quality Benefits Act (Kelly) - MA benchmark cap study H.R. 5306, EMPOWER Care Act (Guthrie) - extension of Money Follows the Person Act H.R. 5603, Access to Telehealth Services for Substance Use Disorders Act (Matsui) - opioid issues H.R. 5605, Advancing High Quality Treatment for Opioid Use Disorders in Medicare Act (Ruiz) - opioid issues H.R. 5675, drug management programs for at-risk Medicare beneficiaries (Bilirakis) - opioid issues H.R. 5676, SENIOR Communities Protection Act (MacArthur) - preventing fraudulent opioid prescriptions H.R. 5684, Protecting Seniors from Opioid Abuse Act (Kelly) - opioid issues H.R. 5685, Medicare Opioid Safety Education Act (Faso) - opioid issues H.R. 5686, Medicare Clear Health Options in Care for Enrollees Act (Paulsen) - opioid issues H.R. 5715, Strengthening Partnerships to Prevent Opioid Abuse Act (Renacci) - communication between Medicare plan sponsors and CMS H.R. 5773, Preventing Addiction for Susceptible Seniors Act (Roskam) - opioid issues H.R. 5797, IMD CARE Act (Walters) - Medicaid IMD exclusion H.R. 5798, Opioid Screening and Chronic Pain Management Alternatives for Seniors Act (Bucshon) - opioid issues H.R. 5799, Medicaid Drug Review, Utilization, Good Governance Improvement Act (Blackburn) - opioid issues H.R. 5800, Medicaid IMD ADDITIONAL INFO Act (Upton) - opioid issues H.R. 5804, Post-Surgical Injections as an Opioid Alternative Act (Shimkus) - opioid issues H.R. 5808, Medicaid Pharmaceutical Home Act (Bilirakis) - opioid issues H.R. 5809, Postoperative Opioid Prevention Act (Peters) - opioid issues H.R. 5810, Medicaid Health Homes for Opioid-Use-Disorder Medicaid Enrollees Encouraged Act (Lance) - opioid issues H.R. 5812, Improving Medicaid Data Timeliness Act (Griffith) - opioid issues H.R. 6431, Medigap Consumer Protection Act (Levin) - reforms to Medicare supplemental insurance H.R. 6561, Comprehensive Care for Seniors Act (Walorski) -- Program of All-Inclusive Care for the Elderly H.R. 6563, Lower Out-of-Pocket Costs for Seniors Act (Pallone-Neal) - Medicare Part D cliff H.R. 6662, Empowering Seniors Decision Enrollment Act (Paulsen) - special enrollment period for non-deemed Medicare Cost Plan enrollees H.R. 6690, Fighting Fraud to Protect Care for Seniors Act (Roskam) - Medicare pilot program for smart card technology 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); calendar year 2019 policy and technical regulation for MA and Part D; issues relating to 2019 Rate Notice and Call Letter; 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; Bipartisan Budget Act of 2018 changes to 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) and the Bipartisan Budget Act of 2018 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' substantial revisions to the managed care regulations, 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; issues relating to prescription drug price blueprint; 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: $1,500,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Treasury, Dept of

S. 413, Improving Transparency and Accuracy in Medicare Part D Spending Act (Capito) -PDP/MA-PD payments on clean claims from pharmacies S. 428, ACE Kids Act (Grassley) - coordinated care for children with complex medical conditions S. 1016, CONNECT For Health Act (Schatz) - telehealth S. 1169, Medicaid CARE Act (Durbin-Portman) - changes to Medicaid IMD exclusion S. 1688, Empowering Medicare Seniors to Negotiate Drug Prices Act (Klobuchar) - Part D price negotiations S. 1804, Medicare for All Act (Sanders) - single payer health system S. 1827, Keep Kids Insurance Dependable and Secure Act (Hatch-Wyden) - federal CHIP funding S. 1890, Chronic Kidney Disease Improvement in Research and Treatment and Medigap Access (Cardin) - Medigap coverage for beneficiaries with end-stage renal disease S. 2027, Medicaid Third Party Liability Act (Portman) - Medicaid third party liability S. 2227, EMPOWER Care Act (Portman-Cantwell) - Medicaid Money Follows the Person Demonstration S. 2707, Informing Seniors About Opioids Act (Nelson) - opioid issues S. 2901, Expanding Telehealth Response to Ensure Addiction Treatment Act (Thune) - opioid issues S. 2904, Medicaid Substance Use Disorder Treatment Via Telehealth Act (Carper) - opioid issues S. 2908, Electronic Prior Authorization in Medicare Part D Act (Roberts) - opioid issues Draft Medicare Long-Term Care Services and Supports Act (Pallone) - Long-Term Services and Supports Program H.R. 195, Extension of Continuing Appropriations Act - CHIP funding extension for 2018-2023 and related provisions H.R. 849, Protecting Seniors Access to Medicare Act (Roe) - Independent Payment Advisory Board H.R. 908, Medicare Advantage Quality Payment Relief Act (Kelly) - MA payment cap H.R. 1038, Improving Transparency and Accuracy in Medicare Part D Spending Act (Griffith) - PDP/MA-PD payments on clean claims from pharmacies H.R. 1148, FAST Act (Griffith) - access to telehealth-eligible stroke services under Medicare H.R. 1316, Prescription Drug Price Transparency Act (Collins) - PBM standards for MA and PDP plans H.R. 1892, Bipartisan Budget Act (Larson) - permanent authorization of Medicare Advantage Special Needs Plans; MA chronic care reforms: telehealth, supplemental benefits, value-based insurance design, star ratings; changes to Medicare Part D coverage gap and related discounts; CHIP funding extension for 2024-2027; funding for Puerto Ricos Medicaid program H.R. 1995, V-BID for Better Care Act (Black) - value-based insurance design in Medicare Advantage H.R. 2556, CONNECT For Health Act (Black) - telehealth H.R. 2644, Chronic Kidney Disease Improvement in Research and Treatment and Medigap Access (Marino) - Medigap coverage for beneficiaries with end-stage renal disease H.R. 2687, Medicaid CARE Act (Foster-Fitzpatrick) - changes to Medicaid IMD exclusion H.R. 3044, Supplemental Benefits for Chronically Ill Medicare Advantage Enrollees (Meehan) H.R. 3168, Special Needs Plans (Tiberi-Levin) - SNP reauthorization H.R. 3263, Medicare Independence at Home Model of Care (Burgess) - demonstration program H.R. 3325, ACE Kids Act (Barton) - coordinated care for children with complex medical conditions H.R. 3360, Telehealth Enhancement Act (Harper) - telehealth in Medicare H.R. 3727, Increasing Telehealth Access in Medicare Act (Black) - telehealth in MA plans H.R. 3921, HEALTHY KIDS Act (Burgess) - CHIP funding H.R. 4952, Improving Seniors Access to Quality Benefits Act (Kelly) - MA benchmark cap study H.R. 5603, Access to Telehealth Services for Substance Use Disorders Act (Matsui) - opioid issues H.R. 5605, Advancing High Quality Treatment for Opioid Use Disorders in Medicare Act (Ruiz) - opioid issues H.R. 5675, drug management programs for at-risk Medicare beneficiaries (Bilirakis) - opioid issues H.R. 5676, SENIOR Communities Protection Act (MacArthur) - preventing fraudulent opioid prescriptions H.R. 5684, Protecting Seniors from Opioid Abuse Act (Kelly) - opioid issues H.R. 5685, Medicare Opioid Safety Education Act (Faso) - opioid issues H.R. 5686, Medicare Clear Health Options in Care for Enrollees Act (Paulsen) - opioid issues H.R. 5715, Strengthening Partnerships to Prevent Opioid Abuse Act (Renacci) - communication between Medicare plan sponsors and CMS H.R. 5773, Preventing Addiction for Susceptible Seniors Act (Roskam) - opioid issues H.R. 5797, IMD CARE Act (Walters) - Medicaid IMD exclusion H.R. 5798, Opioid Screening and Chronic Pain Management Alternatives for Seniors Act (Bucshon) - opioid issues H.R. 5799, Medicaid Drug Review, Utilization, Good Governance Improvement Act (Blackburn) - opioid issues H.R. 5800, Medicaid IMD ADDITIONAL INFO Act (Upton) - opioid issues H.R. 5804, Post-Surgical Injections as an Opioid Alternative Act (Shimkus) - opioid issues H.R. 5808, Medicaid Pharmaceutical Home Act (Bilirakis) - opioid issues H.R. 5809, Postoperative Opioid Prevention Act (Peters) - opioid issues H.R. 5810, Medicaid Health Homes for Opioid-Use-Disorder Medicaid Enrollees Encouraged Act (Lance) - opioid issues H.R. 5812, Improving Medicaid Data Timeliness Act (Griffith) - opioid issues 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); calendar year 2019 policy and technical regulation for MA and Part D; issues relating to 2019 Rate Notice and Call Letter; 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; Bipartisan Budget Act of 2018 changes to 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) and the Bipartisan Budget Act of 2018 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' substantial revisions to the managed care regulations, 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; issues relating to prescription drug price blueprint; 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.

Client expense: $1,410,000 · Firm income: Not reported

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

1. Proposals to change the Social Security annual Cost of Living Adjustment formula 2. Proposals to raise the Social Security normal retirement age 3. Proposals to "means test" Social Security benefits 4. Beneficiary information available through Social Security Administration field offices 5. Status of the Social Security Disability Insurance Trust Fund 6. Closing of Social Security Administration field offices 7. H.R. 1251,CPI-E Act of 2017, entire bill 8. H.R. 1637, Save Social Security Act of 2017, entire bill 9. Implementation of the Multiemployer Pension Reform Act of 2014 10. S. 427, Social Security Expansion Act, entire bill 11. H.R. 1114, Social Security Expansion Act, entire bill 12. S. 1255, Social Security Caregiver Credit Act of 2017, entire bill 13. H.R. 2896, Fair COLA for Seniors Act of 2017, entire bill 14. Status of Social Security Disability claims backlog 15. S. 2147, Butch Lewis Act of 2017, entire bill 16. S. 2227, EMPOWER Care Act, entire bill 17. H.R. 5306, EMPOWER Care Act, entire bill 18. S. 3147, Social Security Administration Fairness Act, entire bill 19. U.S. House and Senate Expand Social Security Caucuses 20. Social Security Administration online COLA notifications 21. S. 3457, Surviving Widow(er) Income Fair Treatment Act of 2018, or the SWIFT Act," entire bill 22. H.R. 6929, Strengthening Social Security Act of 2018, entire bill 23. Proposals for loan guarantees for multi-employer pension plans 24. Proposals for multiple employer retirement accounts

Client expense: $80,000 · 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), Pension Benefit Guaranty Corporation (PBGC), President of the U.S., SENATE, Securities & Exchange Commission (SEC), Social Security Administration (SSA)

Public Law 111-48, "Patient Protection and Affordable Care Act" and "Public Law 111-52, "Health Care and Education Reconciliation Act 2010"-monitored implementation of key Medicaid and health insurance market provisions. HR 246, Jobs and Premium Protection Act. S3063, Health Insurance Tax Relief Act of 2018. HR 4620, The Protecting Families and Small Businesses Act of 2017 (health insurer fee suspension). Issues related to the opioid epidemic pertinent to Medicaid and Medicare. HR 6, Support for Patients and Communities Act and related Opioid Bills. HR 3325/S 428, Advancing Care for Exceptional Kids Act. HR 5306/S 2227, Ensuring Medicaid Provides Opportunities for Widespread Equity, Resources and Care Act. ACA Marketplace and Medicaid Reform

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

General issues relating to Medicare and Medicaid, S 2227 and HR 5306 EMPOWER Care Act, HR 3331, and issues relating to opioid legislation (HR 6)

Client expense: Not reported · Firm income: $15,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

General issues relating to Medicare and Medicaid, S 2227 and HR 5306 EMPOWER Care Act, HR 3331, and issues relating to opioid legislation (HR 6)

Client expense: Not reported · Firm income: $15,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

General issues relating to Medicare and Medicaid, HR 6042 (To amend title XIX of the Social Security Act to delay the reduction in Federal medical assistance percentage for Medicaid personal care services furnished without an electronic visit verification system, and for other purposes), issues relating to electronic visit verification, S 2227 and HR 5306 EMPOWER Care Act

Client expense: Not reported · Firm income: $15,000

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, SENATE

General issues relating to Medicare and Medicaid, HR 6042 (To amend title XIX of the Social Security Act to delay the reduction in Federal medical assistance percentage for Medicaid personal care services furnished without an electronic visit verification system, and for other purposes), issues relating to electronic visit verification, S 2227 and HR 5306 EMPOWER Care Act

Client expense: Not reported · Firm income: $15,000

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, SENATE

PL 109442: Lifespan Respite Care Act; PL 109365: Older Americans Act Amendments of 2006; PL 111148: The Patient Protection and Affordable Care Act; PL 111152: Affordable Health Care for America Act; PHS 42 USC 254C8: Healthy Start Reauthorization of 2007; PL 111192: Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act; PL 111-152, 124 Stat. 1029: Health Care & Education Reconciliation Act; HR 1628: American Health Care Act of 2017; S 253/HR 807: Medicaid Access to Rehabilitation Services Act of 2017; FY 2017/2018 Labor, Health and Human Services, Education Appropriations; HR 3758/S 1028: Recognize, Assist, Include, Support and Engage (RAISE) Family Caregivers Act (PL 11-119); HR 2824: Increasing Opportunity and Success for Children and Parents through Evidence-Based Home Visiting Act; S 1827/HR 3921: Children's Health Insurance Program (CHIP); S 1829/HR 2824: Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program; HR 3778: Direct CARE (Creation, Advancement, and Retention of Employment) Opportunity Act; HR 5306/S 2227: Ensuring Medicaid Provides Opportunities for Widespread Equality, Resources (EMPOWER) Care Act; HR 3493: Care Corps Demonstration Act; HR 6: SUPPORT (Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment) for Patients and Communities Act; S 1091/HR 3105: Supporting Grandparents Raising Grandchildren Act (PL 115-196); and HR 6157: Department of Defense and Labor, Health and Human Services, and Education Appropriations Act, 2019 and Continuing Appropriations Act, 2019 (PL 115-245); and S 2227/H 5306: EMPOWER (Ensuring Medicaid Provides Opportunities for Widespread Equity, Resources) Care Act.

Client expense: $46,018 · Firm income: Not reported

Government targets: Administration for Children & Families (ACF), Defense, Dept of (DOD), Education, Dept of, Equal Employment Opportunity Commission (EEOC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Council on Disability, SENATE, Social Security Administration (SSA), Transportation, Dept of (DOT), U.S. Architectural & Transportation Barriers Compliance Board (ACCESS), Veterans Affairs, Dept of (VA), White House Office

PL 108173: Medicare Prescription Drug and Modernization Act of 2003; PL 111148: Patient Protection and Affordable Care Act; PL 111-152, 124 Stat. 1029: Health Care and Education Reconciliation Act of 2010; PL 113157: Autism CARES (Collaboration, Accountability, Research, Education and Support) Act of 2014; HR 1628: American Health Care Act of 2017; FY 2019 Labor, Health and Human Services, Education Appropriations; HR 1628: American Health Care Act of 2017/Better Care Reconciliation Act of 2017; HR 2824: Increasing Opportunity and Success for Children and Parents through Evidence-Based Home Visiting Act; HR 3759/S 1028: Recognize, Assist, Include, Support and Engage (RAISE) Family Caregivers Act (PL 115-119); S 1827/HR 3921: Children's Health Insurance Program (CHIP); S 1829/HR 2824: Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program; HR 3778: Direct CARE (Creation, Advancement, and Retention of Employment) Opportunity Act; and HR 5306/S 2227: Ensuring Medicaid Provides Opportunities for Widespread Equality, Resources (EMPOWER) Care Act; and H.R. 5912/S. 2897: To amend title XIX of the Social Security Act to delay the reduction in Federal medical assistance percentage for Medicaid personal care services and home health services furnished without an electronic visit verification system, and for other purposes.

Client expense: $46,018 · Firm income: Not reported

Government targets: Administration for Children & Families (ACF), Defense, Dept of (DOD), Education, Dept of, Equal Employment Opportunity Commission (EEOC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Council on Disability, SENATE, Social Security Administration (SSA), Transportation, Dept of (DOT), U.S. Architectural & Transportation Barriers Compliance Board (ACCESS), Veterans Affairs, Dept of (VA), White House Office

Advocate for the reauthorization of the Money Follows the Person program (H.R. 5306 and S. 2227). Advocate for appropriations for all state Medicaid and Medicare effecting aging and disability programs (H.R. 6157).

Client expense: Not reported · Firm income: $19,500

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicaid block grant/per capita caps; Medicaid Funding Threats/Reform; ABLE Age Adjustment Act (H.R. 1874/S. 817); Extension of Money Follows the Person Demonstration Project and support for the Ensuring Medicaid Provides Opportunities for Widespread Equity, Resources, and Care Act (also known as the EMPOWER Care Act, S.2227/H.R. 5306); Improving Access to Behavioral Health Information Technology Act (S. 1732/H.R. 3331) as included in H.R. 6, the Opioid package (the SUPPORT for Patients and Communities Act); Administration efforts regarding Opioid Use; Medicaid 1115 Waiver Applications to the Department of Health & Human Services; and Disabled Access Credit Expansion Act (S. 3469), Disability Employment Incentive Act (S. 3260).

Client expense: $203,078 · Firm income: Not reported

Government targets: Administration for Children & Families (ACF), Administration on Aging, Education, Dept of, Federal Emergency Management Agency (FEMA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Office of Management & Budget (OMB), SENATE, State, Dept of (DOS), Treasury, Dept of, White House Office

H.R. 181, on Medicaid annuities; S.2227 / H.R. 5306 Empower Care Act; Home and Community Based waiver issues; Long-Term Services and Supports issues.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1289 - Dorothy I. Height and Whitney M. Young, Jr., Social Work Reinvestment Act S. 1188/H.R.2535 - Lifespan Respite Care Reauthorization Act of 2017 H.R. 6 - SUPPORT for Patients and Communities Act S.2524/H.R. 5102 - Substance Use Disorder Workforce Loan Repayment Act of 2018 H.Res.1099 - Providing for the concurrence by the House in the Senate amendment to H.R. 6, with an amendment H.R.3331 - To amend title XI of the Social Security Act to promote testing of incentive payments for behavioral health providers for adoption and use of certified electronic health record technology. S.1732 - Improving Access to Behavioral Health Information Technology Act S. 1905/ H.R.3931 - Excellence in Mental Health and Addiction Treatment Expansion Act S.1016/H.R. 2556 - CONNECT for Health Act of 2017 S.2120/H.R. 5034 - International Violence Against Women Act of 2017 S.2164/H.R.2953 - To amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings. S.1334/H.R.2797 - Patient Choice and Quality Care Act of 2017 H.R.620 - ADA Education and Reform Act of 2017 S.Res.427 - A resolution supporting the goals and ideals of Social Work Month during March 2018 and World Social Work Day on March 20, 2018. H.Res.770 - Supporting the goals and ideals of Social Work Month during March 2018 and World Social Work Day on March 20, 2018. H.R.3713 - Geriatrics Workforce and Caregiver Enhancement Act S. 2456/H.R. 5311 - CARA 2.0 Act of 2018 S.2301/H.R. 4778- Behavioral Health Coverage Transparency Act of 2018 S. 1015/H.R.2345 [P.L. No: 115-233] - National Suicide Hotline Improvement Act of 2017 H.R.4704 - Nursing Home CARE Act S.2227/H.R. 5306 - EMPOWER Care Act S.2076/H.R. 4256 - BOLD Infrastructure for Alzheimer's Act S.2680 - Opioid Crisis Response Act of 2018 Improving Parity for Mental Health and Substance Use Disorder Coverage. H.R. 5942 - Health Equity and Accountability Act of 2018 Preserve ACA Essential Health Benefits, cost sharing subsidies, state waivers, and funding for navigators and assisters. Reduce Gun Violence: Comprehensive Legislative Solutions to firearm-related injuries and fatalities Opioid Epidemic 340B drug pricing issues Section 1115 waiver approval issues Medicare Part D program issues Medicaid non-emergency medical transportation (NEMT) issues H.R.6597 - Mental Health Professionals Workforce Shortage Loan Repayment Act of 2018 H.R.5202/S.916 - Ensuring Patient Access to Substance Use Disorder Treatments Act of 2018 S.1370/H.R.2913 - Mental Health in Schools Act of 2017 S.3337 - Mental Health Services for Students Act of 2018

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, Substance Abuse & Mental Health Services Administration (SAMHSA)

Support passage of S. 2227/H.R. 5306 the Empower Care Act Sec. 2404 of the Affordable Care Act, which temporarily mandates that the spousal impoverishment protections in 42 USC 1936r-5 apply to home and community based services.

Client expense: $66,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Supports H.R. 750 The Ensuring Access to Quality Complex Rehabilitation Technology (CRT) Act. Supports S. 486 Protecting Beneficiary Access to Complex Rehab Technology Act of 2017 Supports H.R. 3730 (To amend title XVIII of the Social Security Act to provide for the non-application of Medicare competitive acquisition rates to complex rehabilitative manual wheelchairs and accessories) was introduced by Representatives Lee Zeldin (R-NY) and John Larson (D-CT) to stop CMS from using Competitive Bid pricing for accessories used with CRT manual wheelchairs. Supports H.R. 626, the Access to Inpatient Rehabilitation Therapy Act of 2017, which would amend the Social Security Act to include recreational therapy among the therapy methods that can be considered part of an intensive rehabilitation therapy program in an inpatient rehabilitation hospital or unit. Myomos MyoPro support letter to CMS Policy staff, as members of United Spinal Association, wrote the Centers for Medicare and Medicaid Services (CMS) in strong support of an application to CMS for a unique Healthcare Common Procedure Coding System (HCPCS) code for the MyoPro device, created by the medical technology company, Myomo. Support of S. 2227/H.R.5306 Empower Care Act which reinstates the Money Follows the Person program and facilitates smooth transitions out of nursing facilities and into the community. Signed onto letters to Congress in support of including functional quality measures in rehabilitation metrics. United Spinal supports this letter but CCD Task Force co-chairs: The co-chairs of the Consortium for Citizens with Disabilities (CCD) Health, Long-Term Services and Supports, and Rights Task Forces write in opposition to proposals that expand coverage of institutional services in Medicaid without addressing gaps in Medicaid community services. CCD is the largest coalition of national organizations working together to advocate for Federal public policy that ensures the self-determination, independence, empowerment, integration and inclusion of children and adults with disabilities in all aspects of society.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Aviation Administration (FAA), HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), SENATE, Social Security Administration (SSA)

Legislation: S103-Local Zoning Decisions Protection Act of 2017-Issues Lobbied: Racial justice, housing. S367-Probation Officer Protection Act of 2017-Issues Lobbied: Law enforcement. S411-End Racial and Religious Profiling Act of 2017 (ERRPA)-Issues Lobbied: Racial justice, racial profiling. S642-Fifth Amendment Integrity Restoration Act-Issues Lobbied: Civil asset forfeiture. S811-Child Welfare Provider Inclusion Act-Issues Lobbied: LGBT rights, religious liberty. S860-Juvenile Justice and Delinquency Prevention Reauthorization Act of 2017-Issues Lobbied: Juvenile justice, racial justice. S1006-Equality Act-Issues Lobbied: LGBT rights, womens rights, reproductive freedom, racial justice. S1134-Back the Blue Act of 2017-Issues Lobbied: Law enforcement. S1419-Voting Rights Advancement Act-Issue Lobbied: Voting rights. S1588-Democracy Restoration Act-Issue Lobbied: Voting. S1593-Pretrial Integrity and Safety Act-Issue Lobbied: Bail Reform. S1654-Email Privacy Act-Issues Lobbied: Privacy. S1820-A bill to provide for the retention and service of transgender members of the Armed Forces-Issues Lobbied: LGBT rights. S1856-Stop Militarizing Law Enforcement Act-Issues Lobbied: Law enforcement. S1917-Sentencing Reform and Corrections Act of 2017-Issues Lobbied: Criminal justice reform. S2383-CLOUD Act-Issues Lobbied: Privacy/surveillance. S2525-First Amendment Defense Act-Issues Lobbied: LGBT rights, religious liberty. S2584-Student Non-Discrimination Act of 2018-Issues Lobbied: LGBT rights. S.J. Res. 59 - Authorization for Use of Military Force of 2018 - Issues Lobbied: National security. S1614 - Video Visitation and Inmate Calling in Prisons Act of 2017-Issues Lobbied: Prison reform. S3032 - STATES Act-Issues Lobbied: Legalization of marijuana. S3174 - Marijuana Freedom and Opportunity Act-Issues Lobbied: Legalization of marijuana. S3195 - Law Enforcement Trust and Integrity Act-Issues Lobbied: Law enforcement. S1918 - Police CAMERA Act of 2017-Issues Lobbied: Law enforcement. S2918 - Do No Harm Act-Issues Lobbied: Religious liberty, LGBT rights, reproductive freedom. S2836 - Preventing Emerging Threats Act of 2018-Issues Lobbied: Privacy, surveillance. S2124 - Consumer Privacy Protection Act-Issues Lobbied: Privacy. S170 - Combating BDS Act of 2017-Issues Lobbied: Free speech. S994 - Protecting Religiously Affiliated Institutions Act of 2018- Issues Lobbied: Death penalty. S2897 - A bill to amend title XIX of the Social Security Act - Issues Lobbied: Disability rights, electronic visit verification. S3109 - DHS Appropriations for FY 2019-Issues Lobbied: DHS budget. S2832 - DATA Act-Issues Lobbied: DHS data collection. S3162- Border Zone Reasonableness Restoration Act of 2018-Issues Lobbied: 100-mile zone. S1519 - National Defense Authorization Act for FY 2018-Issues Lobbied: National security, border issues. S3158 - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act of 2019-Issues Lobbied: Racial justice, education, desegregation, reproductive rights - abortion coverage restrictions, Title X family planning program, Conscience Protection Act, fetal tissue research, sexual health education. S2754 - Handle with Care Act of 2018-Issues Lobbied: Racial justice, juvenile justice. S510 - Womens Health Protection Act of 2017-Issues Lobbied: Reproductive rights, abortion. S3225 - Stop Shackling and Detaining Pregnant Women Act-Issues Lobbied: Immigration detention, reproductive rights. S3112 - Dignity for Detained Immigrants Act of 2018-Issues Lobbied: Immigration detention, enforcement. S3036 - Keep Families Together Act - Issues Lobbied: Immigration (family separation), border issues. S2940 - Anti-Semitism Awareness Act of 2018-Issues Lobbied: Free speech/expression. S2227 - EMPOWER Care Act-Issues Lobbied: Disability rights. S2952 - Congressional Accountability Act of 1995 Reform Act-Issues Lobbied: Sexual harassment and discrimination. S2988 - EMPOWER Act-Issues Lobbied: Womens rights. S337 - FAMILY Act-Issues Lobbied: Womens rights. HR 387-Email Privacy Act-Issues Lobbied: Privacy. HR 482-Local Zoning Decisions Protection Act of 2017-Issues Lobbied: Racial justice, housing. HR 1039-Probation Officer Protection Act of 2017-Issues Lobbied: Law enforcement. HR 1498-End Racial Profiling Act of 2017-Issues Lobbied: Racial justice, racial profiling. HR 1555-Fifth Amendment Integrity Restoration Act-Issues Lobbied: Civil asset forfeiture. HR 1556-Stop Militarizing Law Enforcement Act-Issues Lobbied: Law enforcement militarization. HR 1809-Juvenile Justice Reform Act of 2017-Issues Lobbied: Juvenile justice, racial justice. HR 1881-Child Welfare Provider Inclusion Act of 2017-Issues Lobbied: LGBT rights, religious liberty. HR 2133-Community Lending Enhancement and Regulatory Relief (CLEARR) Act of 2017-Issues Lobbied: Housing. HR 2152- Citizens Right to Know Act of 2018-Issues Lobbied: Bail reform, police reform. HR 2228-Law Enforcement Mental Health and Wellness Act of 2017-Issues Lobbied: Law enforcement. HR 2282-Equality Act-Issues Lobbied: LGBT rights, womens rights, reproductive freedom, racial justice. HR 2437-Back the Blue Act of 2017-Issue Lobbied: Law enforcement. HR 2676-Police Reporting Information, Data, and Evidence (PRIDE) Act of 2017-Issues Lobbied: Law enforcement. HR 2899-Second Chance Act Reauthorization Act of 2017-Issues Lobbied: Reentry. HR 2978-Voting Rights Advancement Act of 2017-Issues Lobbied: Voting rights. HR 3060-Preventing Tragedies Between Police and Communities Act of 2017-Issues Lobbied: Law enforcement. HR 3222-Do No Harm Act-Issues Lobbied: Religious liberty, LGBT rights, reproductive freedom. HR 3354-Make America Secure and Prosperous Appropriations Act-Issues Lobbied: Racial justice, census. HR 3356-Prison Reform and Redemption Act -Issues Lobbied: Prison reform. HR 3548-Border Security for America Act of 2017-Issues Lobbied: Privacy, surveillance. HR 3944-Police CAMERA Act of 2017-Issues Lobbied: Law enforcement. HR 3799-Demanding Oversight from Justice Act of 2017-Issuse Lobbied: Law enforcement. HR 4019-Pretrial Integrity and Safety Act of 2017-Issues Lobbied: Bail reform. HR 4041-A bill to provide for the retention and service of transgender members of the Armed Forces-Issues Lobbied: LGBT rights. HR 4508-The Promoting Real Opportunity, Success, and Prosperity through Education Reform (PROSPER) Act-Issues Lobbied: Racial justice, higher education. HR 4760-Securing Americas Future Act of 2018-Issues Lobbied: Immigration enforcement, immigration detention. HR 4833-The Bail Fairness Act of 2018-Issues Lobbied: Bail. HR 4943-CLOUD Act-Issues Lobbied: Privacy/surveillance. HR 5374-Student Non-Discrimination Act of 2018-Issues Lobbied: LGBT rights. HR 5682 - FIRST STEP Act-Issues Lobbied: Prison reform, intersection of criminal justice and immigration. HR 4447-CyberTipline Modernization Act of 2017-Issues Lobbied: Criminal justice, privacy. HR 5710 - The Solitary Confinement Study and Reform Act of 2018-Issues Lobbied: Prison reform. HR 4963 - Amy, Vicky, and Andy Child Pornography Victim Assistance Act of 2018-Issues Lobbied: Criminal justice. HR 1437- No Money Bail Act-Issue Lobbied: Bail reform. HR 5698 - Protect and Serve Act of 2018-Issues Lobbied: Law enforcement. HR2 - Agriculture Improvement Act of 2018-Issues Lobbied: Reentry, SNAP. HR 3249 - Protect Safe Neighborhoods Grant Program Authorization Act of 2018-Issues lobbied: Law enforcement. HR 5515 - John S. McCain National Defense Authorization Act for FY 19-Issues Lobbied: Privacy, torture and war authority, school vouchers - racial justice, disability rights, religious liberty, border issues, reproductive rights - contraception, womens combat gear, domestic violence, MST. HR 2520 - BROWSER Act-Issues Lobbied: Privacy. HR 3896 - Secure and Protect Americans Data Act-Issues Lobbied: Privacy. HR 5199 - Education Savings Accounts for Military Families Act of 2018-Issues Lobbied: School vouchers - racial justice, disability rights, religious liberty, education. HR 6042/5912 - Bill to amend title XIX of the Social Security Act - Issues Lobbied: Disability rights, electronic visit verification. HR 5004 - Air Carrier Access Amendments Act of 2018-Issues Lobbied: Disability rights. HR 5242 - School Resource Officer Assessment Act of 2018- Issues Lobbied: Racial justice, school-to-prison pipeline. HR 6122 - Save Voters Act-Issues Lobbied: Racial justice, voting. HR 1322 - Womens Health Protection Act of 2017-Issues Lobbied: Reproductive rights, abortion. HR 6136 - Border Security and Immigration Reform Act of 2018-Issues Lobbied: Immigration detention, immigration enforcement. HR 3923 - Dignity for Detained Immigrants Act of 2017-Issues Lobbied: Immigration detention, enforcement. HR 6135 - Keep Families Together Act - Issues Lobbied: Immigration (family separation), border issues. HR 5924 - Anti-Semitism Awareness Act of 2018 -Issues Lobbied: Free speech/expression. HR 5306 - EMPOWER Care Act-Issues Lobbied: Disability rights. HR 4924, H. Res. 724 - Congressional Accountability Act of 1995 Reform Act-Issues Lobbied: Sexual harassment and discrimination. HR 620 - ADA Education and Reform Act of 2017-Issues Lobbied: Disability accessibility. HR 5654 - VAWA Protections for Rural Women Act of 2018-Issues Lobbied: Violence against women, rural housing. HR 947- FAMILY Act-Issues Lobbied: Womens rights. Legislation with No Bill Number and Nominations: RESPECT Resolution-Issues Lobbied: Legalization of marijuana. Restoring Oversight for Members of Congress Act- Issues Lobbied: Prison reform, national security, transparency. Senate bill version - No Money Bail Act-Issue Lobbied: Bail reform. Facial recognition and DNA testing-Issues Lobbied: Privacy. CONSENT Act - Issue Lobbied: Privacy. Gina Haspel nomination-Issues Lobbied: Torture, national security. Mike Pompeo nomination-Issues Lobbied: Torture; national security. Abortion restrictions for unaccompanied minors in ORR care-Issues Lobbied: Reproductive rights - abortion. ICE detention of pregnant women-Issues Lobbied: Reproductive rights, immigrant rights. The Counter Terrorism and Illicit Finance Act-Issues Lobbied: Privacy. Young amendment to opioid bill- Issues Lobbied: Privacy. Corker Draft Authorization for Use of Military Force of 2018-Issues Lobbied: War powers, authorizing military force. Administrative Legislative Proposal - Making Affordable Housing Work Act of 2018-Issues Lobbied: Racial justice, fair housing, rent increases. HHS notice of rulemaking on Compliance with Statutory Program Integrity Requirements-Issues Lobbied: Reproductive rights, Title X family planning program. FY 19 Appropriations - Financial Services and General Government-Issues Lobbied: Reproductive rights, abortion coverage restrictions, Reproductive Health Non-Discrimination Act. House bill version - Law Enforcement Trust and Integrity Act-Issues Lobbied: Law enforcement. Driver and Officer Safety Education Act-Issues Lobbied: Law enforcement. Appropriations generally - Issues Lobbied: ICE and CBP appropriations. Additional legislation not yet introduced - sexual harassment reforms, violence against women in the military. Agencies: Agency-Defense-Issues Lobbied: Trans Military Ban; Guantanamo detention policy. Agency-Education-Issues Lobbied: Racial justice, equal education, CRDC data collection, school-to-prison pipeline, Every Student Succeeds Act, student loans, civil rights investigations, Racial Justice Case Processing Manual, delay of significant disproportionality rule. Agency-Health and Human Services-Issues Lobbied: Adoption and Foster Care Analysis and Reporting System Final Rule (RIN 0970-AC72), LGBT rights, SNAP and domestic gag rule, organ transplant discrimination, disability rights. Agency-Veterans Affairs-Issues Lobbied: Abortion coverage. Agency-Homeland Security-Issues Lobbied: Interior and border enforcement, family separation, Custom and Border Protection - border enforcement, CBP oversight, Immigration and Customs Enforcement - deportation and detention practices, detention of pregnant women. Agency-Housing and Urban Development-Issues Lobbied: Fair housing, the disparate impact rule, AFFH rule, regulatory reform, discriminatory lending, disaster relief, rent increases. Agency-Justice-Issues Lobbied: Law enforcement, racial profiling, juvenile justice, school-to-prison pipeline, Bureau of Prisons - changes to the transgender offender manual, LGBT rights and prisoners rights, Bureau of Justice Statistics - changes to the National Crime Victimization Survey, LGBT rights. Agency-EOP-Issues Lobbied: Civil rights enforcement; Faith and Opportunity Initiative, religious liberty. Agency-OMB-Issues Lobbied: Preschool suspensions, school-to-prison pipeline, data collection. Agency-Commerce-Issues Lobbied: Racial justice, census. Agency-Agriculture-Issue Lobbied: changes to SNAP time limit waivers (RIN 0584-AE57), LGBT rights, criminal law reform, disability rights, womens rights.

Client expense: $320,000 · Firm income: Not reported

Government targets: Administration for Children & Families (ACF), Agriculture, Dept of (USDA), Commerce, Dept of (DOC), Defense, Dept of (DOD), Education, Dept of, Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Justice, Dept of (DOJ), Office of Management & Budget (OMB), SENATE, State, Dept of (DOS), Veterans Affairs, Dept of (VA)

1. Proposals to change the Social Security annual Cost of Living Adjustment formula 2. Proposals to raise the Social Security normal retirement age 3. Proposals to "means test" Social Security benefits 4. Beneficiary information available through Social Security Administration field offices 5. Status of the Social Security Disability Insurance Trust Fund 6. Closing of Social Security Administration field offices 7. H.R. 1251,CPI-E Act of 2017, entire bill 8. H.R. 1637, Save Social Security Act of 2017, entire bill 9. Implementation of the Multiemployer Pension Reform Act of 2014 10. S. 427, Social Security Expansion Act, entire bill 11. H.R. 1114, Social Security Expansion Act, entire bill 12. S. 1255, Social Security Caregiver Credit Act of 2017, entire bill 13. H.R. 2896, Fair COLA for Seniors Act of 2017, entire bill 14. Status of Social Security Disability claims backlog 15. S. 2147, Butch Lewis Act of 2017, entire bill 16. S. 2227, EMPOWER Care Act, entire bill 17. H.R. 5306, EMPOWER Care Act, entire bill 18. S. 3147, Social Security Administration Fairness Act, entire bill

Client expense: $70,000 · 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), Pension Benefit Guaranty Corporation (PBGC), President of the U.S., SENATE, Social Security Administration (SSA)

S. 3158, Labor-HHS Appropriations bill for FY 2019 - Lobbied in support of increased funding for CMS' state survey and certification program and in opposition to hostile policy riders regarding Patient Protection and Affordable Care Act, and various related medical care research and Older Americans Act programs. Submitted comments on Medicare Direct Provider Contracting request for information to the Center for Medicare and Medicaid Innovation (CMMI). Submitted comments on alternative payment models to the Physician-focused Payment Model Technical Advisory Committee (PTAC). Submitted comments on the Hospital Inpatient Prospective Payment System to the Centers for Medicare and Medicaid Services (CMS). Family Caregiving: Medicare and Medicaid Hill briefing - Discussed family caregiving, Medicare and Medicaid including RAISE Family Caregivers Act (P.L. 115-119). Discussed access to Medicare home health with ACL. Sent letter to CMS on federal nursing home regulation, oversight, and enforcement. Discussed nursing homes, quality, and enforcement, nursing home abuses with Senate staff. Discussed RAISE Family Caregivers Act implementation (P.L. 115-119). Discussed ways to support family caregivers caring for Medicare beneficiaries, prescription drugs, Medicare, and fraud and abuse. S. 1091, Supporting Grandparents Raising Grandchildren Act - Discussed bill. Discussed rural health care and certified nurse aide training programs in nursing homes. S. 445/H.R. 1825, Home Health Planning Improvement Act - Discussed support for the bill. H.R. 1421/S. 568, Improving Access to Medicare Coverage Act - Discussed the legislation and possible next steps. Discussed supporting family caregivers in Medicare and Medicaid. Submitted comment letters to CMS on proposed Medicare payment rules regarding skilled nursing facilities, hospice, and inpatient rehabilitation facilities. Responded to inquiry regarding Medicare funding being used for various purposes and noted relevant legislation and regulatory action including the Bipartisan Budget Act (P.L. 115-123), Independence at Home Act (S. 464), Independence at Home Demonstration Improvement and Extension Act (H.R. 3263), CHRONIC Care Act (S. 870), and Medicare Advantage supplemental benefits. H.R. 5306/S. 2227, EMPOWER Care Act - Discussed support for bill. Submitted federal comments to CMS on New Jersey 1115 waiver amendment regarding a caregiving program. Discussed Medicare post-acute care, family caregivers and ways to support them. Discussed Medicare and Diabetes Prevention Program with CMS and CDC staff. Provided feedback on Medicare Long-Term Care Services and Supports Act. Discussed Medicare Advantage (MA) benchmark caps and the impact on certain states. Filed comments on 1115 waiver applications or 1115 waiver amendment applications for Arizona, and Florida. Filed a comment letter in response to an RFI on D-SNP appeals and grievance processes. Filed a comment letter on a proposed Medicaid Access Rule.

Client expense: $2,220,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Consumer Financial Protection Bureau (CFPB), Federal Communications Commission (FCC), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), Natl Highway Traffic Safety Administration (NHTSA), Office of Management & Budget (OMB), SENATE, Securities & Exchange Commission (SEC), Social Security Administration (SSA), U.S. Trade Representative (USTR), Veterans Affairs, Dept of (VA), White House Office

General issues relating to Medicare and Medicaid, S. 2227 EMPOWER Care Act, H.R. 3331, and issues relating to opioid legislation (H.R. 6).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

General issues relating to Medicare and Medicaid, S. 2227 EMPOWER Care Act, H.R. 3331, and issues relating to opioid legislation (H.R. 6).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

General issues relating to Medicare and Medicaid, H.R. 6042 (To amend title XIX of the Social Security Act to delay the reduction in Federal medical assistance percentage for Medicaid personal care services furnished without an electronic visit verification system, and for other purposes), issues relating to electronic visit verification, S. 2227 EMPOWER Care Act.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, SENATE

General issues relating to Medicare and Medicaid, H.R. 6042 (To amend title XIX of the Social Security Act to delay the reduction in Federal medical assistance percentage for Medicaid personal care services furnished without an electronic visit verification system, and for other purposes), issues relating to electronic visit verification, S. 2227 EMPOWER Care Act.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, SENATE