Every Prescription Conveyed Securely Act

Monitor legislative and administrative action related to health care policy; Monitor legislative activity related to H.R. 1628, the American Health Care Act; H.R. 592 and S. 109, The Pharmacy and Medically Underserved Areas Enhancement Act; H.R. 3528 and S. 2460, Every Prescription Conveyed Securely Act; H.R. 6 SUPPORT for Patients and Communities Act; and H.R. 4190, House Provider Status Bill.

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

Government targets: Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, Internal Revenue Service (IRS), Labor, Dept of (DOL), Pension Benefit Guaranty Corporation (PBGC), SENATE, Treasury, Dept of

S. 483 (114th Congress) legislation to prevent and reduce prescription drug abuse. H.R. 592 & S. 109, provide for coverage under Medicare program of pharmacist services. Medication Therapy Management. H.R. 1038 and S. 413, legislation to prohibit prescription drug plan sponsors and MAPD organizations under Medicare program from retroactively reducing payment on clean claims submitted by pharmacies. Pharmaceutical compounding and the implementation of Drug Quality Security Act; FDA implementation of Section 503B of the Food, Drug, and Cosmetic Act; House & Senate Agriculture, FDA & Related Agency Appropriations bills; H.R. 2871, Preserving Patient Access to Compounded Medications Act of 2017. Prescription Drug Importation including S. 771 and H.R. 1776, the Improving Access to Affordable Prescription Drugs Act and S.469, the Affordable and Safe Prescription Drug Importation Act. E-Prescribing bills including H.R. 3528 and S. 2460, the Every Prescription Conveyed Securely (EPCS) Act. H.R. 5958, Phair Pricing Act of 2018. HHS Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs. S. 3282 and H.R. 6600, the DEA Order Clearinghouse Act of 2018. H.R. 6, SUPPORT for Patients and Communities Act.

Client expense: $450,000 · 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), SENATE, White House Office

H.R. 6, Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act, all provisions H.R. 930, Lymphedema Treatment Act, all provisions S. 497, Lymphedema Treatment Act, all provisions H.R. 6836, CLINICAL TREATMENT Act, all provisions S. 3592, No More Surprise Medical Bills Act of 2018, all provisions H.R. 7122, Shared Accountability for Improved Patient Outcomes Act of 2018, all provisions H.R. 6, SUPPORT for Patients and Communities Act, all provisions S. 3120, HEAL Act of 2018, all provisions H.R.3528 - Every Prescription Conveyed Securely Act, all provisions S. 2460, Every Prescription Conveyed Securely Act, all provisions H.R. 2687, Medicaid Coverage for Addiction Recovery Expansion Act, all provisions S. 1169, Medicaid Coverage for Addiction Recovery Expansion Act, all provisions S. 1016, CONNECT for Health Act of 2017, provisions relating to telehealth Medicare program: Protecting Patients from Surprise Medical Bills Act Medicare program: Protecting Access to Medicare Act (PAMA)/physician office labs Medicare program: Medicare Access and Chip Reauthorization Act (MACRA) implementation Medicare program: Merit-based Incentive Payment System (MIPS) Medicare program: MIPS cost measures Medicare program: MIPS impact on Part B drugs and DME Medicare program: Physician-Focused Payment Model Technical Advisory Committee (PTAC) Medicare program: Diabetes Prevention Program/virtual coverage Medicare program: Evaluation and Management Codes/documentation Medicare program: Medicare physician fee schedule Medicare program: Medicare Advantage (MA) and Part D Medicare program: Quality Payment Program Medicare program: Shared Savings Program Medicare program: Health IT burdens Medicare program: Surprise billing Medicare program: Graduate Medical Education (GME) Medicare program: Alternative Payment Models (APMs) Medicare program: Appropriate Use Criteria Medicare program: Cybersecurity Medicare program: Interoperability Medicare program: Stark/Anti-kickback Medicare program: Privacy Medicare program: Regulatory relief Medicare program: Step therapy Medicare program: Residents/minor procedures Medicare program: Prior authorization and utilization management Medicare program: Medicare for all Medicare program: Open Payments Medicare program: PECOS/Medicare Enrollment/Revocations/Revalidations Medicare program: Pharmacy Benefit Manager (PBM)/drug price transparency Medicare program: Misvalued codes Medicare program: List price for drugs Medicare program: Drug pricing transparency

Client expense: $4,740,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Bureau of Citizenship & Immigration Services (BCIS), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Natl Drug Control Policy (NDCP), SENATE, U.S. Customs & Border Protection, U.S. Trade Representative (USTR), Veterans Affairs, Dept of (VA), White House Office

S. 1850, Legacy Act (Manchin-Capito) -- confidentiality of drug and alcohol treatment and prevention records S. 2460, Every Prescription Conveyed Securely Act (Bennet) - opioid issues S. 2680, Opioid Crisis Response Act (Alexander) - opioid initiatives, mental health parity S. 2789, Substance Abuse Prevention Act (Cornyn) - opioid initiatives, restrictions on step therapy S. 2812, Air Ambulance Consumer Protection Act (McCaskill) - air ambulance S. 2828, Sober Home Fraud Detection Act (Rubio) - best practices for identifying fraud in recovery housing S. 2891, Fighting the Opioid Epidemic with Sunshine Act (Grassley) - opioid issues S. 2892, Peer Support Enhancement and Evaluation Review Act (Cardin) - opioid issues S. 2898, Medication-Assisted Treatment Improvement Act (Casey) - opioid issues S. 2899, Caring Recovery for Infants and Babies Act (Brown) - opioid issues S. 2900, Comprehensive Screenings for Seniors Act (Brown) - opioid issues S. 2902, Better Data Sharing to Combat the Opioid Crisis Act (Cassidy) - opioid issues S. 2905, Strengthening Partnerships to Prevent Opioid Abuse Act (Toomey) - opioid issues S. 2910, Telehealth for Childrens Access to Services and Treatment Act (Roberts) - opioid issues S. 2911, Enhancing Patient Access to Non-Opioid Treatment Options (Heller) - opioid issues S. 2912, Opioid Addiction Treatment Programs Enhancement Act (Cassidy) - opioid issues S. 2920, Commit to Opioid Medical Prescriber Accountability and Safety for Seniors Act (McCaskill) - opioid issues S. 2922, Help for Moms and Babies Act (Stabenow) - opioid issues S. 2923, Building Capacity for Family-Focused Residential Treatment Act (Grassley) - opioid issues S. 2924, Supporting Family-Focused Residential Treatment Act (Scott) - opioid issues S. 3016, Action for Dental Health Act (Booker) - grants for oral health programs S. 3120, the HEAL Substance Use Disorders Act (Hatch) - opioid initiatives S. 3158, Labor-HHS-Education Appropriations Act (Blunt) - HHS funding S. 3254, Eliminating Kickbacks in Recovery Act (Rubio) - anti-kickback penalties for body brokers Draft Bill: Protecting Patients From Surprise Medical Bills Act (Cassidy) - surprise medical bills H.R. 6, SUPPORT Patients and Families Act (Walden) - opioid initiatives, Medicare and Medicaid issues, budget offsets H.R. 302, FAA Reauthorization Act - air ambulance issues H.R. 1215, Protecting Access to Care Act (King) - medical liability reform H.R. 1313, Preserving Employee Wellness Programs Act (Foxx) - employee wellness programs H.R. 2422, Action for Dental Health Act (Kelly) - oral health services and education for underserved populations H.R. 3331, adoption and use of EHR technology by behavioral health providers (Jenkins) - opioid issues H.R. 3528, Every Prescription Conveyed Securely Act (Clark) - opioid issues H.R. 4684, Ensuring Access to Quality Sober Living Act (Chu) - best practices for recovery housing H.R. 4841, Standardizing Electronic Prior Authorization for Safe Prescribing Act (Schweikert) - opioid issues H.R. 4998, Health Insurance for Former Foster Youth Act (Bass) - opioid issues H.R. 5100, Recovery Home Certification Act (Knight) -- anti-kickback penalties for body brokers H.R. 5477, Rural DOCS Act (O'Halleran) - opioid issues H.R. 5515, National Defense Authorization Act (Thornberry) H.R. 5562, Protecting NAS Babies Act (Jenkins) - opioid issues H.R. 5582, Abuse Deterrent Access Act (Carter) - opioid issues H.R. 5583, State reporting on certain adult health quality measures (Clarke) - opioid issues H.R. 5590, CMS Action Plan (Kinzinger) - opioid issues H.R. 5714, Education for Disposal of Unused Opioids Act (Black) - opioid issues H.R. 5715, Strengthening Partnerships to Prevent Opioid Abuse Act (Renacci) - opioid issues H.R. 5716, COMPASS Act (Roskam) - opioid issues H.R. 5723, Expanding Oversight of Opioid Prescribing and Payment Act (Tenney) - opioid issues H.R. 5725, BEST Act (Roskam) - opioid issues H.R. 5774, Combating Opioid Abuse for Care in Hospitals Act (Curbelo) - opioid issues H.R. 5775, Providing Reliable Options for Patients and Educational Resources Act (Paulsen) - opioid issues H.R. 5776, MOST Act (Neal) - opioid issues H.R. 5789, protections for pregnant and post-partum women (Foster) - opioid issues H.R. 5795, Overdose Prevention and Patient Safety Act (Blumenauer) - confidential sharing of substance use disorder information H.R. 5796, Responsible Education Achieves Care and Healthy Outcomes for Users' Treatment Act (Fitzpatrick) - opioid issues H.R. 5801, PARTNERSHIP Act (Griffith) - opioid issues H.R. 6082, Overdose Prevention and Patient Safety Act (Mullin) - confidential sharing of substance use disorder information H.R. 6147, Interior, Environment, Financial Services, Agriculture, FDA, Transportation, and Housing Appropriations Act (Calvert) - FDA funding H.R. 6157, Defense-Labor-HHS-Education Appropriations Act (Granger) - HHS funding H.R. 6753, Strengthening the Health Care Fraud Prevention Task Force Act (Walden) - codification of Healthcare Fraud Prevention Partnership H.R. 6878, Eliminating Kickbacks in Recovery Act (Deutch) - anti-kickback penalties for body brokers H.R. 6902, Eliminating Kickbacks in Recovery Act (Knight) - anti-kickback penalties for body brokers Regulatory Issues: HIPAA administrative simplification issues, including standards for privacy, security, and electronic transactions and code sets (including ICD-10), identifiers including the health plan identifier, enforcement; cybersecurity; FEHBP enrollment data clearinghouse initiative, the enrollment reconciliation process, and a related OPM reimbursement factor for records that cannot be reconciled; issues relating to health insurance plan participation in FEHBP, including contract requirements; issues relating to similarly sized subscriber group (SSSG) and MLR requirements under the FEHBP; implementation of the health savings account provisions of the Medicare Act; issues related to Medicare Secondary Payer requirements; issues related to implementation of the National Health Information Infrastructure; electronic health records, personal health records, and similar technologies; issues relating to market consolidation; issues related to hospital consolidation; issues relating to quality improvement; issues relating to the national health data stewardship; issues relating to hospital outpatient measurement and reporting; prescription drug pricing; issues related to the collection of race and ethnicity data; issues related to medical loss ratios; reference pricing; review of rates for reasonableness; preexisting condition insurance plans; issues relating to antitrust; accountable care organizations; provider non-discrimination; coverage of preventive services; contraceptive coverage; pre-existing condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; issues relating to the annual fee on health insurance providers; health plan automatic enrollment requirements; issues related to qualified health plans including certification and rate filing templates; health insurance market rules; reinsurance, risk corridors, and risk adjustment; dependent coverage; summary of benefits and coverage disclosures; benefit and payment parameters; essential health benefits, actuarial value, and accreditation; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations; issues related to supplemental products; issues related to HIPAA excepted benefits; issues related to short term limited duration products; issues related to the federally-facilitated marketplaces (i.e., Exchanges/formerly referred to as the web portal); issues related to business continuity in relation to pandemics or natural events (e.g., hurricane, tornado, etc.); issues related to association health plans; issues related to cost-sharing reductions (CSRs); issues related to the refundable credit for coverage under a qualified health plan; issues related to small employer group size; issues related to Certificate of Public Advantage; issues relating to veterans health care; issues relating to family caregivers; 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

340B Drug Pricing Program Opioid issues (S. 2680, the Opioid Crisis Response Act of 2018; H.R. 5176, Preventing Overdoses While in Emergency Rooms (POWER) Act; H.R. 5197, Alternatives to Opioids (ALTO) in the Emergency Department Act; H.R. 5009, Jessies Law; H.R. 5818 / S. 2843, the Opioid Workforce Act; H.R. 5797, the IMD CARE Act; H.R. 6082/H.R. 5795, the Overdose Prevention and Patient Safety Act; S. 2905, Strengthening Partnerships to Prevent Opioid Abuse Act; S. 2460, Every Prescription Conveyed Securely Act; S. 2920, Commit to Opioid Medical Prescriber Accountability and Safety for Seniors Act; H.R. 5582, the Abuse Deterrent Access Act; H.R. 5685, the Medicare Opioid Safety Education Act; Helping to End Addiction and Lessen (HEAL) Substance Use Disorders Act of 2018; H.R. 6, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act; S. 2899, Caring Recovery for Infants and Babies Act; S. 2898, Medication-Assisted Treatment Improvement Act; S.2911, Enhancing Patient Access to Non-Opioid Treatment Options) Draft Protecting Patients from Surprise Medical Bills Act HIPAA policy in mental and behavioral health information sharing 21st Century Cures Act implementation Pandemic and All Hazards Preparedness Reauthorization, including Hospital Preparedness Program (S. 2852 / H.R. 6378, H.R. 7328, the Pandemic and All-Hazards Preparedness and Advancing Innovation Act (PAHPAI) of 2018) S.781/ HR 1876. Good Samaritan Health Professional Act of 2017 Health workforce reauthorizations (H.R. 959, the Title VIII Nursing Workforce Reauthorization Act; H.R. 3728, the Educating Medical Professionals and Optimizing Workforce Efficiency Readiness (EMPOWER) Act; H.R. 1676, the Palliative Care and Hospice Education and Training Act Liver allocation policy S.2554, Patient Right to Know Drug Prices Act Consumer-directed health care proposals (Associations Health Plans, Short-term Limited Duration Insurance plans, Section 1332 waivers) Maternal health legislation (H.R. 315, Improving Access to Maternity Care Act and H.R. 1318, Preventing Maternal Deaths Act)

Client expense: $70,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Implementation of Public Law 114-198 pharmacy provisions; Implementation of Public Law 114-255 pharmacy provisions; H.R. 1854/S. 778, Prescription Drug Monitoring Act of 2017; S 892 / H.R. 4408, Opioid Addiction Prevention Act of 2017; HR 3528 / S.2460, Every Prescription Conveyed Securely Act; H.R. 3545, Overdose Prevention and Patient Safety Act; S. 1850, Protecting Jessica Grubbs Legacy Act; H.R. 1271, DXM Abuse Prevention Act of 2017; H.R. 1375, Prescriber Support Act of 2017; S. 523, Budgeting for Opioid Addiction Treatment Act; S. 581 / H.R. 5009, Jessies Law; S 1079, Protecting Americans from Dangerous Opioids Act; H.R. 4236, MONITOR Act of 2017; H.R. 3991, Expanded Access to Opioid Abuse Treatment Act of 2017; H.R. 4275, Empowering Pharmacists in the Fight Against Opioid Abuse Act; H.R. 5219, Opioid Prescription Verification Act of 2018; H.R. 5676, SENIOR Communities Protection Act of 2018; H.R. 5773, PASS Act of 2018; Draft legislation, Medicare Care Coordination Improvement Act of 2017; Draft legislation, Pain Care Coordination Act of 2018; S. 2456/H.R. 5311, CARA 2.0 Act of 2018; H.R. 5687, SOUND Disposal and Packaging Act; H.R. 5202, Ensuring Patient Access to Substance Use Disorder Treatments Act of 2018; H.R. 5812, CONNECTIONS Act; H.R. 5801, Medicaid PARTNERSHIP Act; H.R. 6, SUPPORT for Patients and Communities Act; H.R. 5808, Medicaid Pharmaceutical Home Act of 2018; H.R. 5675, To amend title XVIII of the Social Security Act to require prescription drug plan sponsors under the Medicare program to establish drug management programs for at-risk beneficiaries; S. 2680, Opioid Crisis Response Act of 2018; S. 2645 / H.R. 5628, Access to Increased Drug Disposal Act of 2018; H.R. 6600 / S. 3282, the DEA Order Clearinghouse Act of 2018; H.R. 6688, ALERT Act of 2018

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

Government targets: Agriculture, Dept of (USDA), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), Office of Personnel Management (OPM), SENATE, Small Business Administration (SBA), Substance Abuse & Mental Health Services Administration (SAMHSA), White House Office

H.R. 592/S. 109, The Pharmacy and Medically Underserved Areas Enhancement Act, all provisions. H.R. 1038/S. 413, Improving Transparency and Accuracy in Medicare Part D Spending Act, all provisions. H.R. 6 - Support for Patients and Communities Act, provisions related to pharmacy operations S. 2460/H.R. 3528, Every Prescription Conveyed Securely Act, all provisions. H.R. 6199 - Restoring Access to Medication and Modernizing Health Savings Accounts Act of 2018, provisions related to over-the-counter medications Implementation of 2017 NDAA Tricare Pilot. CMS Medicare Part D Final Rule, provisions related to DIR fees.

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

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

Implementation of the 21st Century Cures Act (P.L.114-255); Patient Matching issues. H.R.3528/S.2460, Every Prescription Conveyed Securely Act; Electronic Prescribing of Controlled Substances issues. Cybersecurity issues. Health Information Technology issues. H.R.6, SUPPORT for Patients and Communities Act (P.L.115-271).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 592 / S. 109 - The Pharmacy and Medically Underserved Areas Enhancement Act, all provisions related to amending the Social Security Act to allow pharmacists to be reimbursed under Medicare Part B for services provided to patients in medically underserved communities, consistent with state scope of practice laws. H.R. 3528 / S. 2460 and H.R. 6 - These bills would amend title XVIII of the Social Security Act to require e-prescribing under Part D of the Medicare program of prescription drugs that are controlled substances. Issues related to American Patients First: The Trump Administration Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs; no legislation.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 592/S. 109, Pharmacy and Medically Underserved Areas Enhancement Act. H.R. 6, SUPPORT for Patients and Communities Act. H.R. 5684, Protecting Seniors from Opioid Abuse Act. H.R. 3528/S. 2460, Every Prescription Conveyed Securely Act.

Client expense: $440,000 · Firm income: Not reported

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, SENATE, Treasury, Dept of

H.R. 1776/S. 771 - Improving Access To Affordable Prescription Drugs Act H.R. 592/S. 109 - Pharmacy and Medically Underserved Areas Enhancement Act H.R. 394/S. 85 - Restoring Access to Medication Act H.R.3528 - Every Prescription Conveyed Securely Act S.2460- Every Prescription Conveyed Securely Act H.R. 5799, Medicaid DRUG Improvement Act H.R. 5801, Medicaid PARTNERSHIP Act H.R. 5808, Medicaid Pharmaceutical Home Act of 2018 H.R. 3325 - Advancing Care for Exceptional (ACE) Kids Act

Client expense: $640,000 · Firm income: Not reported

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

S.892 Opioid Addiction Prevention Act of 2017 H.R.4408 - Opioid Addiction Prevention Act of 2017 H.R.3964 - Opioid Addiction Prevention Act of 2017 H.R. 5219 - Opioid Prescription Verification Act H.R. 4275 - Empowering Pharmacists in the Fight Against Opioids Act H.R. 4275 - Safe Disposal of Unused Medication Act H.R. 2063 - Opioid Preventing Abuse through Continuing Education Act S. 3120 Helping to End Addiction and Lessen (HEAL) Substance Use Disorders Act of 2018 S. 2789, Substance Abuse Prevention Act of 2018 S. 2838, Using Data to Prevent Opioid Diversion Act of 2018 S. 2460, Every Prescription Conveyed Security Act of 2018 H.R. 5812, Creating Opportunities that Necessitate New and Enhanced Connections That Improve Opioid Navigation Strategies Act (CONNECTIONS) Act H.R. 4275, Empowering Pharmacists in the Fight Against Opioid Abuse Act H.R. 3528, Every Prescription Conveyed Securely Act H.R. 4841, Standardizing Electronic Prior Authorization for Safe Prescribing Act H.R. 5675, To amend title XVIII of the Social Security Act to require prescription drug plan sponsors under the Medicare program to establish drug management programs for at-risk beneficiaries H.R. 5333, Over-the-Counter Monograph Safety, Innovation, and Reform Act H.R. 5687, Securing Opioids and Unused Narcotics with Deliberate Disposal and Packaging Act H.R.6 - SUPPORT for Patients and Communities Act S. 2465 - AIDD Act S 2837 - Preventing Drug Diversion Act S. 3282 - DEA Order Clearinghouse Act S. 2383 - Using Data to Prevent Opioid Diversion Act

Client expense: $640,000 · Firm income: Not reported

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

H.R. 6 - Support for Patients and Communities Act - Support for policies that help to fight the opioid epidemic with a focus on safe prescriptions. S. 3120 - Helping to End Addiction and Lessen Substance Use Disorders Act - Support for policies that help to fight the opioid epidemic with a focus on safe prescriptions. H.R. 3528/S. 2460 - Every Prescription Conveyed Securely Act - Support for electronic prescribing of opioids to enhance patient safety. S. 2553 - Know the Lowest Price Act of 2018 - Support for the elimination of " gag clauses" in the Medicare Part D program. S. 2554 - Patient Right to Know Act Drug Prices Act of 2018 - Support for for the elimination of "gag clauses" in the private insurance market. CMS Regulations related to the Medicare Part D program and Prescription Drug Plans(PDPs). FDA work on addressing drug shortages in the U.S. S. 637 - Creating Transparency to Have Prescription Drug Rebates Unlocked - Issues related to the alleged relationship between rebates and drug prices. S. 771 - A Bill to Improve Access to Affordable Prescription Drugs - Issues related to bringing drug prices down including strengthening policies in the Part D coverage gap, couponing and advancing biosimilars. Education activities for Members and staff related to Direct and Indirect Renumeration(DIR)policies. Education activities related to the cross referencing of certain data related to Medicare Parts A, B and D. Trump Administration's Blueprint for lowering the price of prescription medications in the United States and the role that PBMs can play in doing so.

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

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

H.R. 6 - Support for Patients and Communities Act - Support for policies that help to fight the opioid epidemic with a focus on safe prescriptions. S. 3120 - Helping to End Addiction and Lessen Substance Use Disorders Act - Support for policies that help to fight the opioid epidemic with a focus on safe prescriptions. H.R. 3528/S. 2460 - Every Prescription Conveyed Securely Act - Support for electronic prescribing of opioids to enhance patient safety. S. 2553 - Know the Lowest Price Act of 2018 - Support for the elimination of " gag clauses" in the Medicare Part D program. S. 2554 - Patient Right to Know Act Drug Prices Act of 2018 - Support for for the elimination of "gag clauses" in the private insurance market. CMS Regulations related to the Medicare Part D program and Prescription Drug Plans(PDPs). FDA work on drug shortages and solutions. S. 637 - Creating Transparency to Have Prescription Drug Rebates Unlocked - Issues related to the alleged relationship between rebates and drug prices. S. 771 - A Bill to Improve Access to Affordable Prescription Drugs - Issues related to bringing drug prices down including strengthening policies in the Part D coverage gap, couponing and advancing biosimilars. Education activities for Members and staff related to Direct and Indirect Renumeration(DIR)policies. Education activities related to the cross referencing of certain data related to Medicare Parts A, B and D. Trump Administration's Blueprint for lowering the price of prescription medications in the United States and the role that PBMs can play in doing so.

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

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

H.R. 6 - Support for Patients and Communities Act - Support for policies that help to fight the opioid epidemic with a focus on safe prescriptions in the Medicare program. S. 3120 - Helping to End Addiction and Lessen Substance Use Disorders Act - Support for policies that help to fight the opioid epidemic with a focus on safe prescriptions in the Medicare program. H.R. 3528/S. 2460 - Every Prescription Conveyed Securely Act - Support for electronic prescribing of opioids to enhance patient safety. S. 2553 - Know the Lowest Price Act of 2018 - Support for the elimination of " gag clauses" in the Medicare Part D program. CMS Regulations related to the Medicare Part D program and Prescription Drug Plans(PDPs). S. 637 - Creating Transparency to Have Prescription Drug Rebates Unlocked - Issues related to the alleged relationship between rebates and drug prices. S. 771 - A Bill to Improve Access to Affordable Prescription Drugs - Issues related to bringing drug prices down including strengthening policies in the Part D coverage gap, couponing and advancing biosimilars. Education activities for Members and staff related to Direct and Indirect Renumeration(DIR)policies. Education activities related to the cross referencing of certain data related to Medicare Parts A, B and D. Trump Administration's Blueprint for lowering the price of prescription medications in the United States and the role that PBMs can play in doing so.

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

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

S. 2553 - Know the Lowest Price Act of 2018- Support of the elimination of "gag clauses" in Medicare Part D. H.R. 6 - Support for Patients and Communities Act - Issues related to ensuring safe prescribing of opioids and other pharmaceuticals that can drive addiction. S. 3120 - Helping to End Addition and Lessen Substance Use Disorders Act - Issues related to ensuring safe prescribing of opioids and other pharmaceuticals that can drive addiction. S. 2460/H.R. 3528 - Every Prescription Conveyed Securely Act - support for a bill that would require electronic prescribing for opioids. CMS regulations related to the Medicare Part D program and role of Prescription Drug Plans. S. 637 - Creating Transparency to have Prescription Drug Rebates Unlocked - Issues related to the alleged relationship between rebates and drug prices. S. 771 - A bill to Improve Access to Affordable Prescription Drugs - Issues related to bringing drug pricing down including better policies in the Part D coverage gap, couponing and advancing biosimilars. H.R. 3447 - Furthering Access to Coordinated Treatment for Seniors (FACTS) Act of 2017 - Working to explain the need for safe and confidential data sharing between Medicare part A, B, and D to ensure better coordination of patient care. Issues related to Direct and Indirect Renumeration policies and their impact on consumers. The Trump Administration's Blueprint for Controlling Prescription Drug Prices - Issues related to the role PBMs can play in controlling the price of prescription medications in the United States.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 2553 - Know the Lowest Price Act of 2018- Support of the elimination of "gag clauses" in Medicare Part D. S. 2554 - Patient Right to Know Act - Support of the elimination of "gag clauses" in private market drug benefits. H.R. 6 - Support for Patients and Communities Act - Issues related to ensuring safe prescribing of opioids and other pharmaceuticals that can drive addiction. S. 3120 - Helping to End Addition and Lessen Substance Use Disorders Act - Issues related to ensuring safe prescribing of opioids and other pharmaceuticals that can drive addiction. S. 2460/H.R. 3528 - Every Prescription Conveyed Securely Act - support for a bill that would require electronic prescribing for opioids. CMS regulations related to the Medicare Part D program and role of Prescription Drug Plans. S. 637 - Creating Transparency to have Prescription Drug Rebates Unlocked - Issues related to the alleged relationship between rebates and drug prices. S. 771 - A bill to Improve Access to Affordable Prescription Drugs - Issue related to bringing drug pricing down including better policies in the Part D coverage gap, couponing and advancing biosimilars. H.R. 3447 - Furthering Access to Coordinated Treatment for Seniors (FACTS) Act of 2017 - Working to explain the need for safe and confidential data sharing between Medicare part A, B, and D to ensure better coordination of patient care. Issues related to Direct and Indirect Renumeration policies and their impact on consumers. The Trump Administration's Blueprint for Controlling Prescription Drug Prices - Issues related to the role PBMs can play in controlling the price of prescription medications in the United States.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 2553 - Know the Lowest Price Act of 2018- Support of the elimination of "gag clauses" in Medicare Part D. S. 2554 - Patient Right to Know Act - Support of the elimination of "gag clauses" in private market drug benefits. H.R. 6 - Support for Patients and Communities Act - Issues related to ensuring safe prescribing of opioids and other pharmaceuticals that can drive addiction. S. 3120 - Helping to End Addition and Lessen Substance Use Disorders Act - Issues related to ensuring safe prescribing of opioids and other pharmaceuticals that can drive addiction. S. 2460/H.R. 3528 - Every Prescription Conveyed Securely Act - support for a bill that would require electronic prescribing for opioids. CMS regulations related to the Medicare Part D program and role of Prescription Drug Plans. S. 637 - Creating Transparency to have Prescription Drug Rebates Unlocked - Issues related to the alleged relationship between rebates and drug prices. S. 771 - A bill to Improve Access to Affordable Prescription Drugs - Issue related to bringing drug pricing down including better policies in the Part D coverage gap, couponing and advancing biosimilars. H.R. 3447 - Furthering Access to Coordinated Treatment for Seniors (FACTS) Act of 2017 - Working to explain the need for safe and confidential data sharing between Medicare part A, B, and D to ensure better coordination of patient care. Issues related to Direct and Indirect Renumeration policies and their impact on consumers. The Trump Administration's Blueprint for Controlling Prescription Drug Prices - Issues related to the role PBMs can play in controlling the price of prescription medications in the United States.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 1316 To amend title XVIII of the Social Security Act to provide for pharmacy benefits manager standards under the Medicare prescription drug program and Medicare Advantage program to further transparency of payment methodologies to pharmacies, and for other purposes. HR 1939 To amend title XVIII of the Social Security Act to ensure equal access of Medicare beneficiaries to community pharmacies in underserved areas as network pharmacies under Medicare prescription drug coverage, and for other purposes. HR 592, S 109 To amend title XVIII of the Social Security Act to provide for coverage under the Medicare program of pharmacist services. HR 3528/S 2460 Every Prescription Conveyed Securely Act -- To amend title XVIII of the Social Security Act to require e-prescribing for coverage under part D of the Medicare program of prescription drugs that are controlled substances. HR 7083 This Act may be cited as the Access to Genetic Counselor Services Act of 2018. To amend title XVIII of the Social Security Act to provide for expanded coverage of services furnished by genetic counselors under part B of the Medicare program, and for other purposes.

Client expense: $34,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 1038, S 413 Improving Transparency and Accuracy in Medicare Part D Spending Act HR 1939 To amend title XVIII of the Social Security Act to ensure equal access of Medicare beneficiaries to community pharmacies in underserved areas as network pharmacies under Medicare prescription drug coverage, and for other purposes. HR 592/S 109 To amend title XVIII of the Social Security Act to provide for coverage under the Medicare program of pharmacist services. HR 2871 Preserving Patient Access to Compounded Medications Act of 2017 HR 1939/S 1044 Ensuring Seniors Access to Local Pharmacies Act of 2017 HR 3528/S 2460 Every Prescription Conveyed Securely Act HR 6 Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act HR 4275 To provide for the development and dissemination of programs and materials for training pharmacists, health care providers, and patients on indicators that a prescription is fraudulent, forged, or otherwise indicative of abuse or diversion, and for other purposes. S 3120 Helping to End Addiction and Lessen Substance Use Disorders Act of 2018

Client expense: $34,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to pharmaceutical manufacturer and pharmacy contracting with respect to drug pricing. Issues included in the Proposed Part D Rule and accompanying RFI and the Administrations Blueprint on drug pricing RFI . Issues related to Medicaid Provider Enrollment. Issues related to prescription drug abuse. Issues related to the Medicare Coverage Gap Discount. Regulatory design and coverage of pharmacy benefits in health reform exchanges and the commercial market (essential health benefits, e-prescribing, PBM disclosure requirements, specialty pharmacy, mail-service pharmacy, formulary transparency, and medical loss ratio). H.R.749/S.297, Lower Drug Costs through Competition Act HR.1038/S.413, Improving Transparency and Accuracy in Part D Spending Act H.R.1316, Prescription Drug Price Transparency Act S.637, Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2017 S.771, Improving Access to Affordable Prescription Drug Act H.R.1939/S.1044, Ensuring Seniors Access to Local Pharmacies Act H.R. 2026, Pharmaceutical Information Exchange Act H.R.2051, FAST Generics Act H.R.2212/S.974, Creating and Restoring Equal Access To Equivalent Samples Act of 2017 H.R.2077 Restoring the Patient's Voice Act of 2017 S.2553/H.R.6144, Know the Lowest Price Act of 2018 S.2554/H.R.6143, Patient Right to Know Drug Prices Act H.R.3528/S.2460, The Every Prescription Carried Safely Act H.R.5343, Prescription Transparency Act of 2018 H.R.4841, Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018 Issues related to the affordability of prescription drugs and competitive marketplace, including: pedigree, manufacturer market and data exclusivity, REMS, accelerated generic approval, biosimilars.

Client expense: $656,680 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE

Issues related to pharmaceutical manufacturer and pharmacy contracting with respect to drug pricing. Regulatory and proposed legislative changes to Medicare Part D including non-interference, Direct and Indirect Remuneration (DIR), pharmacy networks, classes of clinical concern, mail-service pharmacy and safe harbors related to manufacturer rebates. Issues related to the management of Medicaid prescription drug benefits. Issues related to prescription drug abuse in Medicare and Medicaid. Provisions of PL 111-148 and PL 111-152 impacting Medicare Part D such as formulary requirements, PBM disclosure provisions, implementation of the prescriber registration rules and definition of negotiated price. Regulatory design and coverage of pharmacy benefits. Issues related to Medicaid Provider Enrollment. Issues related to the Medicare Coverage Gap Discount. H.R.1038/S.413, Improving Transparency and Accuracy in Part D Spending Act H.R.1316, Prescription Drug Price Transparency Act S.637, Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2017 S.771, Improving Access to Affordable Prescription Drug ActH.R.1939/S.1044, Ensuring Seniors Access to Local Pharmacies ActH.R.3528/S.2460, The Every Prescription Carried Safely Act S.2553/H.R.6144, Know the Lowest Price Act of 2018 S.2554/H.R.6143, Patient Right to Know Drug Prices Act H.R.4841, Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018 H.R.5958, Fair Pricing Act of 2018 H.R.5343, Prescription Transparency Act of 2018

Client expense: $656,680 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE

H.R. 3528/S. 2460, Every Prescription Conveyed Securely Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Monitor legislative and administrative action related to health care policy; Monitor legislative activity related to H.R. 1628, the American Health Care Act; H.R. 592 and S. 109, The Pharmacy and Medically Underserved Areas Enhancement Act; H.R. 3528 and S. 2460, Every Prescription Conveyed Securely Act; H.R. 6 SUPPORT for Patients and Communities Act; and H.R. 4190, House Provider Status Bill.

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

Government targets: Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, Internal Revenue Service (IRS), Labor, Dept of (DOL), Pension Benefit Guaranty Corporation (PBGC), SENATE, Treasury, Dept of

H.R. 592 / S. 109 - The Pharmacy and Medically Underserved Areas Enhancement Act, all provisions related to amending the Social Security Act to allow pharmacists to be reimbursed under Medicare Part B for services provided to patients in medically underserved communities, consistent with state scope of practice laws. H.R. 3528 / S. 2460 and H.R. 6 - These bills would amend title XVIII of the Social Security Act to require e-prescribing under Part D of the Medicare program of prescription drugs that are controlled substances. Issues related to American Patients First: The Trump Administration Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs; no legislation.

Client expense: $470,000 · Firm income: Not reported

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

Insurance market policies (Bipartisan Health Care Stabilization Act; Short-term, Limited Duration Health Insurance rule; Association Health Plans rule) Risk adjustment payments Cost sharing reduction payments Insurance navigator funding 340B Drug Pricing Program (H.R. 4392; H.R. 4710, 340B PAUSE Act; S. 2453, Ensuring the Value of the 340B Program Act; H.R. 6071, Stretching Entity Resources for Vulnerable Communities Act; H.R. 2889, Closing Loopholes for Orphan Drugs Act; H.R. 5598, 340B Optimization Act; H.R. 6240, Drug Discount Accountability Act; H.R. 6273, Creating Access to Rape Kit Exams (CARE) for Survivors Act) Opioid issues (S. 2680, the Opioid Crisis Response Act of 2018; H.R. 5176, Preventing Overdoses While in Emergency Rooms (POWER) Act; H.R. 5197, Alternatives to Opioids (ALTO) in the Emergency Department Act; H.R. 5009, Jessies Law; H.R. 5818 / S. 2843, the Opioid Workforce Act; H.R. 5797, the IMD CARE Act; H.R. 6082/H.R. 5795, the Overdose Prevention and Patient Safety Act; S. 2905, Strengthening Partnerships to Prevent Opioid Abuse Act; S. 2460, Every Prescription Conveyed Securely Act; S. 2920, Commit to Opioid Medical Prescriber Accountability and Safety for Seniors Act; H.R. 5582, the Abuse Deterrent Access Act; H.R. 5685, the Medicare Opioid Safety Education Act; Helping to End Addiction and Lessen (HEAL) Substance Use Disorders Act of 2018; H.R. 6, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act; S. 2899, Caring Recovery for Infants and Babies Act; S. 2898, Medication-Assisted Treatment Improvement Act; S.2911, Enhancing Patient Access to Non-Opioid Treatment Options) IV and medication shortages Drug prices (American Patients First, Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs; S. 2554 / H.R. 6143, Patient Right to Know Drug Prices Act; S. 2553, Know the Lowest Price Act; H.R. 6733, Know the Cost Act) Draft Protecting Patients from Surprise Medical Bills Act HIPAA policy in mental and behavioral health information sharing 21st Century Cures Act implementation Pandemic and All Hazards Preparedness Reauthorization, including Hospital Preparedness Program (S. 2852, the Pandemic and All-Hazards Preparedness and Advancing Innovation Act (PAHPAI) of 2018) S.781/ HR 1876. Good Samaritan Health Professional Act of 2017 Health workforce reauthorizations (H.R. 959, the Title VIII Nursing Workforce Reauthorization Act; H.R. 3728, the Educating Medical Professionals and Optimizing Workforce Efficiency Readiness (EMPOWER) Act; H.R. 1676, the Palliative Care and Hospice Education and Training Act Consumer Directed Health Plans Legislation (H.R. 6311 would modify the definition of a qualified health plan and allow individuals purchasing health insurance in the individual market to purchase a "copper" plan or use the premium tax credit to buy off-marketplace coverage; H.R. 6301 to allow CDHPs to provide coverage for services like telehealth, chronic disease management, or primary care visits below the minimum deductible; H.R. 6317 to allow coverage of direct primary care service arrangements; H.R. 6305 to permit use of CDHPs to receive certain employment-related health services like onsite clinics; H.R. 6309 to allow individuals only enrolled in Medicare Part A to contribute to health savings accounts; H.R. 6199 to include certain over-the-counter medical products as qualified medical expenses; H.R. 6306 to increase the current contribution limits for HSAs; H.R. 6312, Personal Health Investment Today (PHIT) Act to count sports equipment and exercise costs toward medical expenses; H.R. 6313 to allow carry-forward of flexible spending account balances each year; H.R. 6314 to allow bronze and catastrophic plans in connection with health savings accounts, allowing plans categorized as catastrophic and bronze in the individual and small group markets to qualify for HSA contributions) H.R. 4616 to delay the implementation of the excise tax on high cost employer-sponsored health coverage; and place a moratorium on the employer mandate Liver allocation policy

Client expense: $70,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 2460, Every Prescription Conveyed Securely Act (Bennet) - opioid issues S. 2680, Opioid Crisis Response Act (Alexander) - opioid initiatives, mental health parity S. 2789, Substance Abuse Prevention Act (Cornyn) - opioid initiatives, restrictions on step therapy S. 2812, Air Ambulance Consumer Protection Act (McCaskill) - air ambulance S. 2828, Sober Home Fraud Detection Act (Rubio) - best practices for identifying fraud in recovery housing S. 2891, Fighting the Opioid Epidemic with Sunshine Act (Grassley) - opioid issues S. 2892, Peer Support Enhancement and Evaluation Review Act (Cardin) - opioid issues S. 2898, Medication-Assisted Treatment Improvement Act (Casey) - opioid issues S. 2899, Caring Recovery for Infants and Babies Act (Brown) - opioid issues S. 2900, Comprehensive Screenings for Seniors Act (Brown) - opioid issues S. 2902, Better Data Sharing to Combat the Opioid Crisis Act (Cassidy) - opioid issues S. 2905, Strengthening Partnerships to Prevent Opioid Abuse Act (Toomey) - opioid issues S. 2910, Telehealth for Childrens Access to Services and Treatment Act (Roberts) - opioid issues S. 2911, Enhancing Patient Access to Non-Opioid Treatment Options (Heller) - opioid issues S. 2912, Opioid Addiction Treatment Programs Enhancement Act (Cassidy) - opioid issues S. 2920, Commit to Opioid Medical Prescriber Accountability and Safety for Seniors Act (McCaskill) - opioid issues S. 2922, Help for Moms and Babies Act (Stabenow) - opioid issues S. 2923, Building Capacity for Family-Focused Residential Treatment Act (Grassley) - opioid issues S. 2924, Supporting Family-Focused Residential Treatment Act (Scott) - opioid issues S. 3016, Action for Dental Health Act (Booker) - grants for oral health programs S. 3120, the HEAL Substance Use Disorders Act (Hatch) - opioid initiatives S. 3158, Labor-HHS-Education Appropriations Act (Blunt) - HHS funding S. 3254, Eliminating Kickbacks in Recovery Act (Rubio) - anti-kickback penalties for body brokers Draft Bill: Protecting Patients From Surprise Medical Bills Act (Cassidy) - surprise medical bills H.R. 6, SUPPORT Patients and Families Act (Walden) - opioid initiatives, Medicare and Medicaid issues, budget offsets H.R. 302, FAA Reauthorization Act - air ambulance issues H.R. 1215, Protecting Access to Care Act (King) - medical liability reform H.R. 1313, Preserving Employee Wellness Programs Act (Foxx) - employee wellness programs H.R. 2422, Action for Dental Health Act (Kelly) - oral health services and education for underserved populations H.R. 3331, adoption and use of EHR technology by behavioral health providers (Jenkins) - opioid issues H.R. 3528, Every Prescription Conveyed Securely Act (Clark) - opioid issues H.R. 4684, Ensuring Access to Quality Sober Living Act (Chu) - best practices for recovery housing H.R. 4841, Standardizing Electronic Prior Authorization for Safe Prescribing Act (Schweikert) - opioid issues H.R. 4998, Health Insurance for Former Foster Youth Act (Bass) - opioid issues H.R. 5100, Recovery Home Certification Act (Knight) -- anti-kickback penalties for body brokers H.R. 5477, Rural DOCS Act (O'Halleran) - opioid issues H.R. 5515, National Defense Authorization Act (Thornberry) H.R. 5562, Protecting NAS Babies Act (Jenkins) - opioid issues H.R. 5582, Abuse Deterrent Access Act (Carter) - opioid issues H.R. 5583, State reporting on certain adult health quality measures (Clarke) - opioid issues H.R. 5590, CMS Action Plan (Kinzinger) - opioid issues H.R. 5714, Education for Disposal of Unused Opioids Act (Black) - opioid issues H.R. 5715, Strengthening Partnerships to Prevent Opioid Abuse Act (Renacci) - opioid issues H.R. 5716, COMPASS Act (Roskam) - opioid issues H.R. 5723, Expanding Oversight of Opioid Prescribing and Payment Act (Tenney) - opioid issues H.R. 5725, BEST Act (Roskam) - opioid issues H.R. 5774, Combating Opioid Abuse for Care in Hospitals Act (Curbelo) - opioid issues H.R. 5775, Providing Reliable Options for Patients and Educational Resources Act (Paulsen) - opioid issues H.R. 5776, MOST Act (Neal) - opioid issues H.R. 5789, protections for pregnant and post-partum women (Foster) - opioid issues H.R. 5795, Overdose Prevention and Patient Safety Act (Blumenauer) - confidential sharing of substance use disorder information H.R. 5796, Responsible Education Achieves Care and Healthy Outcomes for Users' Treatment Act (Fitzpatrick) - opioid issues H.R. 5801, PARTNERSHIP Act (Griffith) - opioid issues H.R. 6082, Overdose Prevention and Patient Safety Act (Mullin) - confidential sharing of substance use disorder information H.R. 6147, Interior, Environment, Financial Services, Agriculture, FDA, Transportation, and Housing Appropriations Act (Calvert) - FDA funding H.R. 6157, Defense-Labor-HHS-Education Appropriations Act (Granger) - HHS funding H.R. 6753, Strengthening the Health Care Fraud Prevention Task Force Act (Walden) - codification of Healthcare Fraud Prevention Partnership H.R. 6878, Eliminating Kickbacks in Recovery Act (Deutch) - anti-kickback penalties for body brokers H.R. 6902, Eliminating Kickbacks in Recovery Act (Knight) - anti-kickback penalties for body brokers Regulatory Issues: HIPAA administrative simplification issues, including standards for privacy, security, and electronic transactions and code sets (including ICD-10), identifiers including the health plan identifier, enforcement; cybersecurity; FEHBP enrollment data clearinghouse initiative, the enrollment reconciliation process, and a related OPM reimbursement factor for records that cannot be reconciled; issues relating to health insurance plan participation in FEHBP, including contract requirements; issues relating to similarly sized subscriber group (SSSG) and MLR requirements under the FEHBP; implementation of the health savings account provisions of the Medicare Act; issues related to Medicare Secondary Payer requirements; issues related to implementation of the National Health Information Infrastructure; electronic health records, personal health records, and similar technologies; issues relating to market consolidation; issues related to hospital consolidation; issues relating to quality improvement; issues relating to the national health data stewardship; issues relating to hospital outpatient measurement and reporting; prescription drug pricing; issues related to the collection of race and ethnicity data; issues related to medical loss ratios; reference pricing; review of rates for reasonableness; preexisting condition insurance plans; issues relating to antitrust; accountable care organizations; provider non-discrimination; coverage of preventive services; contraceptive coverage; pre-existing condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; issues relating to the annual fee on health insurance providers; health plan automatic enrollment requirements; issues related to qualified health plans including certification and rate filing templates; health insurance market rules; reinsurance, risk corridors, and risk adjustment; dependent coverage; summary of benefits and coverage disclosures; benefit and payment parameters; essential health benefits, actuarial value, and accreditation; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations; issues related to supplemental products; issues related to HIPAA excepted benefits; issues related to short term limited duration products; issues related to the federally-facilitated marketplaces (i.e., Exchanges/formerly referred to as the web portal); issues related to business continuity in relation to pandemics or natural events (e.g., hurricane, tornado, etc.); issues related to association health plans; issues related to cost-sharing reductions (CSRs); issues related to the refundable credit for coverage under a qualified health plan; issues related to small employer group size; issues related to Certificate of Public Advantage; issues relating to veterans health care; issues relating to family caregivers; and other issues relating to health care reform implementation.

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. 1625, FY 2018 Consolidated Appropriations Act (Royce) - funding for HHS programs and agencies, opioid initiatives, ACA risk corridors S. 2460, Every Prescription Conveyed Securely Act (Bennet) - opioid issues S. 2680, Opioid Crisis Response Act (Alexander) - opioid initiatives, mental health parity S. 2789, Substance Abuse Prevention Act (Cornyn) - opioid initiatives, restrictions on step therapy S. 2812, Air Ambulance Consumer Protection Act (McCaskill) - air ambulance S. 2891, Fighting the Opioid Epidemic with Sunshine Act (Grassley) - opioid issues S. 2892, Peer Support Enhancement and Evaluation Review Act (Cardin) - opioid issues S. 2898, Medication-Assisted Treatment Improvement Act (Casey) - opioid issues S. 2899, Caring Recovery for Infants and Babies Act (Brown) - opioid issues S. 2900, Comprehensive Screenings for Seniors Act (Brown) - opioid issues S. 2902, Better Data Sharing to Combat the Opioid Crisis Act (Cassidy) - opioid issues S. 2905, Strengthening Partnerships to Prevent Opioid Abuse Act (Toomey) - opioid issues S. 2910, Telehealth for Childrens Access to Services and Treatment Act (Roberts) - opioid issues S. 2911, Enhancing Patient Access to Non-Opioid Treatment Options (Heller) - opioid issues S. 2912, Opioid Addiction Treatment Programs Enhancement Act (Cassidy) - opioid issues S. 2920, Commit to Opioid Medical Prescriber Accountability and Safety for Seniors Act (McCaskill) - opioid issues S. 2922, Help for Moms and Babies Act (Stabenow) - opioid issues S. 2923, Building Capacity for Family-Focused Residential Treatment Act (Grassley) - opioid issues S. 2924, Supporting Family-Focused Residential Treatment Act (Scott) - opioid issues S. 2987, National Defense Authorization Act (Inhofe) S. 3120, the HEAL Substance Use Disorders Act (Hatch) - opioid initiatives S. 3158, FY 2019 Labor, HHS, Education Appropriations Act (Blunt) - HHS funding, ACA issues House version of FY 2019 Labor, HHS, Education Appropriations Act (Cole) - HHS funding, ACA issues H.R. 6, SUPPORT Patients and Families Act (Walden) - opioid initiatives, budget offsets H.R. 1215, Protecting Access to Care Act (King) - medical liability reform H.R. 1313, Preserving Employee Wellness Programs Act (Foxx) - employee wellness programs H.R. 2422, Action for Dental Health Act (Kelly) - oral health services and education for underserved populations H.R. 3331, adoption and use of EHR technology by behavioral health providers (Jenkins) - opioid issues H.R. 3528, Every Prescription Conveyed Securely Act (Clark) - opioid issues H.R. 3759, RAISE Family Caregivers Act (Harper-Castor) - support for family caregivers H.R. 4841, Standardizing Electronic Prior Authorization for Safe Prescribing Act (Schweikert) - opioid issues H.R. 4998, Health Insurance for Former Foster Youth Act (Bass) - opioid issues H.R. 5477, Rural DOCS Act (O'Halleran) - opioid issues H.R. 5562, Protecting NAS Babies Act (Jenkins) - opioid issues H.R. 5582, Abuse Deterrent Access Act (Carter) - opioid issues H.R. 5583, State reporting on certain adult health quality measures (Clarke) - opioid issues H.R. 5590, CMS Action Plan (Kinzinger) - opioid issues H.R. 5515, National Defense Authorization Act (Thornberry) H.R. 5714, Education for Disposal of Unused Opioids Act (Black) - opioid issues H.R. 5715, Strengthening Partnerships to Prevent Opioid Abuse Act (Renacci) - opioid issues H.R. 5716, COMPASS Act (Roskam) - opioid issues H.R. 5723, Expanding Oversight of Opioid Prescribing and Payment Act (Tenney) - opioid issues H.R. 5725, BEST Act (Roskam) - opioid issues H.R. 5774, Combating Opioid Abuse for Care in Hospitals Act (Curbelo) - opioid issues H.R. 5775, Providing Reliable Options for Patients and Educational Resources Act (Paulsen) - opioid issues H.R. 5776, MOST Act (Neal) - opioid issues H.R. 5789, protections for pregnant and post-partum women (Foster) - opioid issues H.R. 5795, Overdose Prevention and Patient Safety Act (Blumenauer) - confidential sharing of substance use disorder information H.R. 5796, Responsible Education Achieves Care and Healthy Outcomes for Users' Treatment Act (Fitzpatrick) - opioid issues H.R. 5801, PARTNERSHIP Act (Griffith) - opioid issues H.R. 6082, Overdose Prevention and Patient Safety Act (Mullin) - confidential sharing of substance use disorder information Regulatory Issues: HIPAA administrative simplification issues, including standards for privacy, security, and electronic transactions and code sets (including ICD-10), identifiers including the health plan identifier, enforcement; cybersecurity; FEHBP enrollment data clearinghouse initiative, the enrollment reconciliation process, and a related OPM reimbursement factor for records that cannot be reconciled; issues relating to health insurance plan participation in FEHBP, including contract requirements; issues relating to similarly sized subscriber group (SSSG) and MLR requirements under the FEHBP; implementation of the health savings account provisions of the Medicare Act; issues related to Medicare Secondary Payer requirements; issues related to implementation of the National Health Information Infrastructure; electronic health records, personal health records, and similar technologies; issues relating to market consolidation; issues related to hospital consolidation; issues relating to quality improvement; issues relating to the national health data stewardship; issues relating to hospital outpatient measurement and reporting; prescription drug pricing; issues related to the collection of race and ethnicity data; issues related to medical loss ratios; reference pricing; review of rates for reasonableness; preexisting condition insurance plans; issues relating to antitrust; accountable care organizations; provider non-discrimination; coverage of preventive services; contraceptive coverage; pre-existing condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; issues relating to the annual fee on health insurance providers; health plan automatic enrollment requirements; issues related to qualified health plans including certification and rate filing templates; health insurance market rules; reinsurance, risk corridors, and risk adjustment; dependent coverage; summary of benefits and coverage disclosures; benefit and payment parameters; essential health benefits, actuarial value, and accreditation; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations; issues related to supplemental products; issues related to HIPAA excepted benefits; issues related to short term limited duration products; issues related to the federally-facilitated marketplaces (i.e., Exchanges/formerly referred to as the web portal); issues related to business continuity in relation to pandemics or natural events (e.g., hurricane, tornado, etc.); issues related to association health plans; issues related to cost-sharing reductions (CSRs); issues related to the refundable credit for coverage under a qualified health plan; issues related to small employer group size; issues related to Certificate of Public Advantage; issues relating to veterans health care; issues relating to family caregivers; 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

S. 483 (114th Congress) legislation to prevent and reduce prescription drug abuse. H.R. 592 & S. 109, provide for coverage under Medicare program of pharmacist services. Medication Therapy Management. H.R. 1038 and S. 413, legislation to prohibit prescription drug plan sponsors and MAPD organizations under Medicare program from retroactively reducing payment on clean claims submitted by pharmacies. Pharmaceutical compounding and the implementation of Drug Quality Security Act; FDA implementation of Section 503B of the Food, Drug, and Cosmetic Act; House & Senate Agriculture, FDA & Related Agency Appropriations bills; H.R. 2871, Preserving Patient Access to Compounded Medications Act of 2017. Prescription Drug Importation including S. 771 and H.R. 1776, the Improving Access to Affordable Prescription Drugs Act and S.469, the Affordable and Safe Prescription Drug Importation Act. E-Prescribing bills including H.R. 3528 and S. 2460, the Every Prescription Conveyed Securely (EPCS) Act. H.R. 5958, Phair Pricing Act of 2018. HHS Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs. S. 3282 and H.R. 6600, the DEA Order Clearinghouse Act of 2018.

Client expense: $470,000 · 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), SENATE, White House Office

H.R. 592/S. 109, The Pharmacy and Medically Underserved Areas Enhancement Act, all provisions. H.R. 1038/S. 413, Improving Transparency and Accuracy in Medicare Part D Spending Act, all provisions. H.R. 6 - Support Patients and Communities Act, provisions related to pharmacy operations S. 2460/H.R. 3528, Every Prescription Conveyed Securely Act, all provisions. H.R. 6199 - Restoring Access to Medication and Modernizing Health Savings Accounts Act of 2018, provisions related to over-the-counter medications Implementation of 2017 NDAA Tricare Pilot. CMS Medicare Part D Final Rule, provisions related to DIR fees.

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

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

Implementation of the 21st Century Cures Act (P.L.114-255); Patient Matching issues. H.R.3528/S.2460, Every Prescription Conveyed Securely Act; Electronic Prescribing of Controlled Substances issues. Cybersecurity issues. Health Information Technology issues. H.R.6, SUPPORT for Patients and Communities Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 6, Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act, all provisions H.R. 4143, Dialysis Patient Access To Integrated-care, Empowerment, Nephrologists, Treatment, and Services (PATIENTS) Demonstration Act of 2017, all provisions S. 2065, Dialysis Patient Access To Integrated-care, Empowerment, Nephrologists, Treatment, and Services (PATIENTS) Demonstration Act of 2017, all provisions H.R. 4554, Medicare Common Access Card Act of 2017, all provisions H.R. 6309, Allowing Working Seniors to Keep Their Health Savings Accounts Act of 2018, all provisions H.R. 6733, Know the Cost Act of 2018, all provisions S. 2553, Know the Lowest Price Act of 2018, all provisions S. 3120, Helping to End Addiction and Lessen (HEAL) Substance Use Disorders Act of 2018, provisions relating to Medicare and Medicaid S. 2904, Medicaid Substance Use Disorder Treatment via Telehealth Act, provision relating to telehealth definition S. 2910, Telehealth for Children's Access to Services and Treatment (TeleCAST) Act, provision relating to telehealth definition H.R. 3528, Every Prescription Conveyed Securely Act, all provisions S. 2460, Every Prescription Conveyed Securely Act, all provisions H.R. 2687, Medicaid Coverage for Addiction Recovery Expansion Act, all provisions S. 1169, Medicaid Coverage for Addiction Recovery Expansion Act, all provisions S. 1291, Advancing Medical Resident Training in Community Hospitals Act of 2017, all provisions S. 1016, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2017, provisions relating to telehealth Medicare program: Medicare Access and Chip Reauthorization (MACRA) implementation Medicare program: Merit-based Incentive Payment System (MIPS) Medicare program: Regulatory Relief Medicare program: Quality Payment Program (QPP)/Interoperability Medicare program: QPP cost measures Medicare program: Protecting Access to Medicare Act (PAMA) clinical lab issues/physician office labs Medicare program: Part B drug reimbursement Medicare program: Outpatient Prospective Payment System (OPPS)/Ambulatory Surgical Center (ASC) Payment System Medicare program: Appropriate Use Criteria Medicare program: Health IT Medicare program: Office visit codes Medicare program: Alternative Payment Models (APMs) Medicare program: Accountable Care Organization (ACO)/Medicare Shared Savings Program (MSSP) Medicare program: Graduate Medical Education (GME) Medicare program: 2019 Medicare Physician Fee Schedule Medicare program: Drug pricing/Competitive Acquisition Program, Part B to Part D, Medicare Advantage Step Therapy Medicare program: Open Payments Medicare program: Clinical laboratory fee schedule cuts Medicare program: Evaluation & Management Codes Medicare program: Misvalued codes Medicare program: Outpatient Prospective Payment System (OPPS)/Ambulatory Surgical Centers (ASC) Payment System Medicare program: Prior Authorization Medicare program: Electronic Health Records (EHR) Medicare program: Inpatient Prospective Payment System Medicare program: Diabetes/payment Medicare program: Diabetes Prevention Program Medicare program: Opioids Medicare program: Smart Cards Medicare program: Value-based arrangements Medicare program: Evaluation and Management proposals Medicare program: Payment Model Technical Advisory Committee (PTAC)/model approval process Medicare program: Medicare Advantage Qualifying Payment Arrangement Incentive (MAQI) demonstration Medicare program: Pharmacy Benefit Managers (PBMs) Medicare and Medicaid programs: Appropriate Use Criteria Medicare and Medicaid programs: Cybersecurity Medicare and Medicaid programs: Stark/Anti-Kickback/Value-based arrangements Medicare and Medicaid programs: Electronic Health Records/certification Medicare and Medicaid programs: Provider Enrollment, Chain and Ownership System (PECOS)/Medicare Enrollment/Revocations/Revalidations Medicaid program: Marylands Medicaid Demonstration Waiver Amendment

Client expense: $4,120,000 · Firm income: Not reported

Government targets: Bureau of Citizenship & Immigration Services (BCIS), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), SENATE, Veterans Affairs, Dept of (VA), White House Office

HR 1038, S 413 Improving Transparency and Accuracy in Medicare Part D Spending Act HR 1939 To amend title XVIII of the Social Security Act to ensure equal access of Medicare beneficiaries to community pharmacies in underserved areas as network pharmacies under Medicare prescription drug coverage, and for other purposes. HR 592, S 109 To amend title XVIII of the Social Security Act to provide for coverage under the Medicare program of pharmacist services. HR 1480 Safe and Affordable Drugs from Canada Act of 2017 S 778 Prescription Drug Monitoring Act of 2017 HR 934 Personal Drug Importation Fairness Act of 2017 HR 2871 Preserving Patient Access to Compounded Medications Act of 2017 HR 1939/S 1044 Ensuring Seniors Access to Local Pharmacies Act of 2017 S 469 Affordable and Safe Prescription Drug Importation Act HR 3528/S 2460 Every Prescription Conveyed Securely Act HR 6 Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act HR 4275 To provide for the development and dissemination of programs and materials for training pharmacists, health care providers, and patients on indicators that a prescription is fraudulent, forged, or otherwise indicative of abuse or diversion, and for other purposes. S 3120 Helping to End Addiction and Lessen Substance Use Disorders Act of 2018

Client expense: $34,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 1316 To amend title XVIII of the Social Security Act to provide for pharmacy benefits manager standards under the Medicare prescription drug program and Medicare Advantage program to further transparency of payment methodologies to pharmacies, and for other purposes. HR 1038, S 413 Improving Transparency and Accuracy in Medicare Part D Spending Act HR 1939 To amend title XVIII of the Social Security Act to ensure equal access of Medicare beneficiaries to community pharmacies in underserved areas as network pharmacies under Medicare prescription drug coverage, and for other purposes. HR 592, S 109 To amend title XVIII of the Social Security Act to provide for coverage under the Medicare program of pharmacist services. HR 3528/S 2460 Every Prescription Conveyed Securely Act -- To amend title XVIII of the Social Security Act to require e-prescribing for coverage under part D of the Medicare program of prescription drugs that are controlled substances.

Client expense: $34,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3528/S. 2460, Every Prescription Conveyed Securely Act.

Client expense: $160,000 · Firm income: Not reported

Government targets: Environmental Protection Agency (EPA), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, Treasury, Dept of

Legislation to address abuses of the REMS program to allow generic drugs to come to market faster. H.R.2212/S.974: CREATES Act--provisions related to removing barriers to generic competition. H.R.1316: The Prescription Drug Price Transparency Act--issues related to ensuring the continuity of MAC pricing. S.2460/H.R.3528: Every Prescription Conveyed Securely Act--provisions requiring electronic prescribing of controlled substances in Medicare Part D; provisions added through amendment to H.R. 6 that limit who can use analgesic prescribing guidelines (became HR 6; awaiting President's signature). S.2554: "Patient Right to Know Drug Prices Act,"--provisions to prohibit the use of gag clauses or require that beneficiaries be charged lower prices (now PL 115-263). H.R.5343: "Prescription Transparency Act of 2018,"-- provisions to prohibit the use of gag clauses or require that beneficiaries be charged lower prices. H.R.5958: The Phair Pricing Act of 2018, provisions related to the use of quality provisions and provisions to prohibit the use of gag clauses or require that beneficiaries be charged lower prices. H.R.6144: Know the Lowest Price Act -provisions to prohibit the use of gag clauses or require that beneficiaries be charged lower prices. Request for Information: HHS Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs, provisions affecting market competition for prescription drugs and the drug supply chain. H.R.5675: To amend title XVIII of the Social Security Act to require prescription drug plan sponsors under the Medicare program to establish drug management programs for at-risk beneficiaries Provisions mandating a Medicare lock-in program for Medicare beneficiaries at risk for opioid abuse.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.2460/H.R.3528: Every Prescription Conveyed Securely Act--provisions requiring electronic prescribing of controlled substances in Medicare Part D; provisions added through amendment to H.R. 6 that limit who can use analgesic prescribing guidelines(became HR 6, which is awaiting President's signature). S.2554: "Patient Right to Know Drug Prices Act,"--provisions to prohibit the use of gag clauses or require that beneficiaries be charged lower prices (now PL 115-263). H.R.5343: "Prescription Transparency Act of 2018,"-- provisions to prohibit the use of gag clauses or require that beneficiaries be charged lower prices. H.R.5958: The Phair Pricing Act of 2018, provisions related to the use of quality provisions and provisions to prohibit the use of gag clauses or require that beneficiaries be charged lower prices. H.R.6144: Know the Lowest Price Act -provisions to prohibit the use of gag clauses or require that beneficiaries be charged lower prices. Request for Information: HHS Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs, provisions affecting market competition for prescription drugs and the drug supply chain. H.R.5675: To amend title XVIII of the Social Security Act to require prescription drug plan sponsors under the Medicare program to establish drug management programs for at-risk beneficiaries; provisions mandating a Medicare lock-in program for Medicare beneficiaries at risk for opioid abuse.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.413/H.R.1038: Improving Transparency and Accuracy in Medicare Part D Spending Act--provisions restricting payer quality payment programs in Medicare Part D. S.771/H.R.1776: Improving Access to Affordable Prescription Drugs Act--issues related to ensuring a competitive marketplace for prescription drugs. H.R.1316: The Prescription Drug Price Transparency Act--issues related to ensuring the continuity of MAC pricing. S.2460/H.R.3528: Every Prescription Conveyed Securely Act--provisions requiring electronic prescribing of controlled substances in Medicare Part D; provisions added through amendment to H.R. 6 that limit who can use analgesic prescribing guidelines (became HR 6, awaiting President's signature). Medicare Program; Contract Year 2019 Policy and Technical Changes to the Medicare Advantage, Medicare Cost Plan, Medicare Fee-for-Service, the Medicare Prescription Drug Benefit Programs, and the PACE Program Proposed Rule & Request for Information --Provisions on Part D. H.R.5343: "Prescription Transparency Act of 2018,"-- provisions to prohibit the use of gag clauses or require that beneficiaries be charged lower prices. S.2553: "Know the Lowest Price Act," --"-- provisions to prohibit the use of gag clauses or require that beneficiaries be charged lower prices (now PL 115-262). H.R.5958: The Phair Pricing Act of 2018, provisions related to the use of quality provisions and provisions to prohibit the use of gag clauses or require that beneficiaries be charged lower prices. H.R.6144: Know the Lowest Price Act -provisions to prohibit the use of gag clauses or require that beneficiaries be charged lower prices. Request for Information: HHS Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs, provisions affecting market competition for prescription drugs and the drug supply chain. H.R.5675: To amend title XVIII of the Social Security Act to require prescription drug plan sponsors under the Medicare program to establish drug management programs for at-risk beneficiaries Provisions mandating a Medicare lock-in program for Medicare beneficiaries at risk for opioid abuse. CMS Proposed and Final Policy Changes and Updates for Medicare Advantage and the Prescription Drug Benefit Program for Contract Year 2019 (CMS-4182-P), provisions in a Request for Information related to rebates at the point-of-sale and pharmacist direct and indirect renumeration. H.R.6641: True Cost-sharing of Seniors Drugs Transparency Act provisions related to pharmacy gag clause. Proposed HHS-OIG rule currently under OMB review entitled, Removal of Safe Harbor Protections for Rebates to Plans or PBMs Involving Prescription Pharmaceuticals and Creation of New Safe Harbor Protection, RIN-936-AAO8. (See https://www.reginfo.gov/public/do/eoReviewSearch for questions). Outreach and education on pharmacy Direction and Indirection Remuneration in Medicare.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.2460/H.R.3528: Every Prescription Conveyed Securely Act - provisions requiring electronic prescribing of controlled substances in Medicare Part D; provisions added through amendment to H.R. 6 that limit who can use analgesic prescribing guidelines (became HR 6, awaiting President's signature).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Implementation of Public Law 114-198 pharmacy provisions; Implementation of Public Law 114-255 pharmacy provisions; H.R. 1854/S. 778, Prescription Drug Monitoring Act of 2017; S 892 / H.R. 4408, Opioid Addiction Prevention Act of 2017; HR 3528 / S.2460, Every Prescription Conveyed Securely Act; H.R. 3545, Overdose Prevention and Patient Safety Act; S. 1850, Protecting Jessica Grubbs Legacy Act; H.R. 1271, DXM Abuse Prevention Act of 2017; H.R. 1375, Prescriber Support Act of 2017; S. 523, Budgeting for Opioid Addiction Treatment Act; S. 581 / H.R. 5009, Jessies Law; S 1079, Protecting Americans from Dangerous Opioids Act; H.R. 4236, MONITOR Act of 2017; H.R. 3991, Expanded Access to Opioid Abuse Treatment Act of 2017; H.R. 4275, Empowering Pharmacists in the Fight Against Opioid Abuse Act; H.R. 5219, Opioid Prescription Verification Act of 2018; H.R. 5676, SENIOR Communities Protection Act of 2018; H.R. 5773, PASS Act of 2018; Draft legislation, Medicare Care Coordination Improvement Act of 2017; Draft legislation, Pain Care Coordination Act of 2018; S. 2456/H.R. 5311, CARA 2.0 Act of 2018; H.R. 5687, SOUND Disposal and Packaging Act; H.R. 5202, Ensuring Patient Access to Substance Use Disorder Treatments Act of 2018; H.R. 5812, CONNECTIONS Act; H.R. 5801, Medicaid PARTNERSHIP Act; H.R. 6, SUPPORT for Patients and Communities Act; H.R. 5808, Medicaid Pharmaceutical Home Act of 2018; H.R. 5675, To amend title XVIII of the Social Security Act to require prescription drug plan sponsors under the Medicare program to establish drug management programs for at-risk beneficiaries; S. 2680, Opioid Crisis Response Act of 2018; S. 2645 / H.R. 5628, Access to Increased Drug Disposal Act of 2018; H.R. 6600 / S. 3282, the DEA Order Clearinghouse Act of 2018; H.R. 6688, ALERT Act of 2018

Client expense: $290,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), Office of Personnel Management (OPM), SENATE, Small Business Administration (SBA), Substance Abuse & Mental Health Services Administration (SAMHSA), White House Office

H.R. 1776/S. 771 - Improving Access To Affordable Prescription Drugs Act H.R. 592/S. 109 - Pharmacy and Medically Underserved Areas Enhancement Act H.R. 394/S. 85 - Restoring Access to Medication Act H.R.3528 - Every Prescription Conveyed Securely Act S.2460- Every Prescription Conveyed Securely Act H.R. 5799, Medicaid DRUG Improvement Act H.R. 5801, Medicaid PARTNERSHIP Act H.R. 5808, Medicaid Pharmaceutical Home Act of 2018 H.R. 3325 - Advancing Care for Exceptional (ACE) Kids Act

Client expense: $440,000 · Firm income: Not reported

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

S.892 Opioid Addiction Prevention Act of 2017 H.R.4408 - Opioid Addiction Prevention Act of 2017 H.R.3964 - Opioid Addiction Prevention Act of 2017 H.R. 5219 - Opioid Prescription Verification Act H.R. 4275 - Empowering Pharmacists in the Fight Against Opioids Act H.R. 4275 - Safe Disposal of Unused Medication Act H.R. 2063 - Opioid Preventing Abuse through Continuing Education Act S. 3120 Helping to End Addiction and Lessen (HEAL) Substance Use Disorders Act of 2018 S. 2789, Substance Abuse Prevention Act of 2018 S. 2838, Using Data to Prevent Opioid Diversion Act of 2018 S. 2460, Every Prescription Conveyed Security Act of 2018 H.R. 5812, Creating Opportunities that Necessitate New and Enhanced Connections That Improve Opioid Navigation Strategies Act (CONNECTIONS) Act H.R. 4275, Empowering Pharmacists in the Fight Against Opioid Abuse Act H.R. 3528, Every Prescription Conveyed Securely Act H.R. 4841, Standardizing Electronic Prior Authorization for Safe Prescribing Act H.R. 5675, To amend title XVIII of the Social Security Act to require prescription drug plan sponsors under the Medicare program to establish drug management programs for at-risk beneficiaries H.R. 5333, Over-the-Counter Monograph Safety, Innovation, and Reform Act H.R. 5687, Securing Opioids and Unused Narcotics with Deliberate Disposal and Packaging Act H.R.6 - SUPPORT for Patients and Communities Act S. 2465 - AIDD Act S 2837 - Preventing Drug Diversion Act S. 3282 - DEA Order Clearinghouse Act S. 2383 - Using Data to Prevent Opioid Diversion Act

Client expense: $440,000 · Firm income: Not reported

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

H.R. 1316-The Prescription Drug Price Transparency Act (MAC);H.R. 1038 & S.413-Improving Transparency and Accuracy in Medicare Part D Drug Spending Act (DIR);S. 2553-Know the Lowest Price Act;Proposed HHS-OIG rule RIN -936-AAO8 under OMB review entitled, Removal of Safe Harbor Protections for Rebates to Plans or PBMs Involving Prescription Pharmaceuticals and Creation of New Safe Harbor Protection.;H.R. 6-SUPPORT for Patients and Communities Act relating to S.2460 & H.R. 3528 (Every Prescription Controlled Securely Act);

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

-Advocacy on behalf of broadening and improving opportunities for alternative payment model participation under MACRA, including population-based models, advanced primary care models, and episodic bundled payment models; -Advocacy on behalf of establishing a new advanced physician group practice model; and -Advocacy on behalf of HR 4006 a bill establishing a CBI-SNP demonstration. -Advocacy related to a potential legislative response to the opioid and substance abuse crisis, including but not limited to advocacy in support of S.1169/H.R.2687 the Medicaid Coverage for Addiction Recovery Expansion Act, S.2460/H.R. 3528 the Every Prescription Conveyed Securely Act, and S.2317/H.R.3692 the Addiction Treatment Access Improvement Act.

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

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

-Advocacy on behalf of expanding the preventive services safe harbor for Health Savings Account-eligible High-Deductible Health Plans to provide for better coverage of chronic care services -Advocacy related to a potential legislative response to the opioid and substance abuse crisis, including but not limited to advocacy in support of S.1169/H.R.2687 the Medicaid Coverage for Addiction Recovery Expansion Act, S.2460/H.R. 3528 the Every Prescription Conveyed Securely Act, and S.2317/H.R.3692 the Addiction Treatment Access Improvement Act.

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

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