Protecting Seniors' Access to Medicare Act of 2017

H.R. 4508, the PROSPER Act and Reauthorization of the Higher Education Act: issues include regulations, accreditation, Title IV student aid, data and consumer information, Title III and V programs, Direct Loan program, Pell Grants, postsecondary cohort default rates, and risk sharing. S. 2231, Student Protection and Success Act, and risk sharing proposals S. 2028, Protect Student Borrowers Act of 2017 S. 260, Jumpstart Our Businesses by Supporting Students (JOBS) Act S. 1136, H.R. 2451, Pell Grant Preservation and Expansion Act S. 1121, H.R. 2434, College Transparency Act of 2017 H.R. 2353, Strengthening Career and Technical Education for the 21st Century Act; and Senate bill - Strengthening Career and Technical Education for the 21st Century Act (no bill number) H.R. 6543, Aim Higher Act

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

Government targets: Education, Dept of, HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), SENATE, White House Office

Monitor implementation of the Patient Protection and Affordable Care Act (P.L. 111-148). Monitor federal and legislative activity related to Medicare Reimbursement. Monitor federal issues and legislation associated with health care policy. Monitor implementation of Medicare Access and CHIP Reauthorization Act of 2015 (P.L. 114-10). Monitor implementation of 21st Century Cures Act (P.L. 114-255). H.J. Res. 143, Continuing appropriations for fiscal year 2019. (P.L. 115-298) H.R. 6, SUPPORT for Patients and Communities Act. (P.L. 115-271) H.R. 849, Protecting Seniors' Access to Medicare Act of 2017. H.R. 1038, Improving Transparency and Accuracy in Medicare Part D Spending Act. H.R. 1316, Prescription Drug Price Transparency Act. H.R. 1628, American Health Care Act of 2017. H.R. 1703, Medical Product Communications Act of 2017. H.R. 1898, To improve access to, and utilization of, bone mass measurement benefits. H.R. 1920, To amend part B of title XVIII of the Social Security Act to exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price for drugs and biologicals under Medicare, and for other purposes. H.R.2077, Restoring the Patient's Voice Act of 2017. H.R. 2141, Conrad State 30 and Physician Access Reauthorization Act. H.R. 2267, Resident Physician Shortage Reduction Act of 2017. H.R. 2641, Promoting Life-Saving New Therapies for Neonates Act of 2017. H.R. 2999, Patients' Access to Treatments Act of 2017. H.R. 3635, Local Coverage Determination Clarification Act of 2017. H.R. 3728, EMPOWER Act of 2017. H.R. 3767, Ensuring Children's Access to Specialty Care Act of 2017. H.R. 4841, Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018. H.R. 5150, Protecting Medicare from Excessive Price Increases Act of 2018. H.R.6157, Defense and Labor, Health and Human Services Consolidated Appropriations Act, 2019. (P.L. 115-245) H.R. 6470, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2019. S. 251, Protecting Medicare from Executive Action Act of 2017. S. 260, Protecting Seniors' Access to Medicare Act of 2017. S. 637, Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2017. S. 794, Local Coverage Determination Clarification Act of 2017. S. 898, Conrad State 30 and Physician Access Reauthorization Act. S. 989, Ensuring Children's Access to Specialty Care Act of 2017. S. 1301, Resident Physician Shortage Reduction Act of 2017. S. 1304, A bill to amend part B of title XVIII of the Social Security Act to exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price for drugs and biologicals under Medicare, and for other purposes. S. 2553, Know the Lowest Price Act of 2018 (P.L. 115-262). S. 2554, Patient Right to Know Drug Prices Act (P.L. 115-263). S. 2908, To provide for electronic prior authorization under Medicare part D for covered part D drugs, and for other purposes. S. 3158, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2019. S. 3159, Department of Defense Appropriations Act, 2019. S. 3160, To improve access to, and utilization of, bone mass measurement benefits.

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

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

Monitor implementation of the Patient Protection and Affordable Care Act (P.L. 111-148). Monitor federal and legislative activity related to Medicare Reimbursement. Monitor federal issues and legislation associated with health care policy. Monitor implementation of Medicare Access and CHIP Reauthorization Act of 2015 (P.L. 114-10). Monitor implementation of 21st Century Cures Act (P.L. 114-255). H.R. 6, SUPPORT for Patients and Communities Act. H.R. 849, Protecting Seniors' Access to Medicare Act of 2017. H.R. 1038, Improving Transparency and Accuracy in Medicare Part D Spending Act. H.R. 1316, Prescription Drug Price Transparency Act. H.R. 1628, American Health Care Act of 2017. H.R. 1703, Medical Product Communications Act of 2017. H.R. 1898, To improve access to, and utilization of, bone mass measurement benefits. H.R. 1920, To amend part B of title XVIII of the Social Security Act to exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price for drugs and biologicals under Medicare, and for other purposes. H.R.2077, Restoring the Patient's Voice Act of 2017. H.R. 2141, Conrad State 30 and Physician Access Reauthorization Act. H.R. 2267, Resident Physician Shortage Reduction Act of 2017. H.R. 2641, Promoting Life-Saving New Therapies for Neonates Act of 2017. H.R. 2999, Patients' Access to Treatments Act of 2017. H.R. 3635, Local Coverage Determination Clarification Act of 2017. H.R. 3728, EMPOWER Act of 2017. H.R. 3767, Ensuring Children's Access to Specialty Care Act of 2017. H.R. 4841, Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018. H.R. 5150, Protecting Medicare from Excessive Price Increases Act of 2018. H.R.6157, Defense and Labor, Health and Human Services Consolidated Appropriations Act, 2019. H.R. 6470, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2019. S. 251, Protecting Medicare from Executive Action Act of 2017. S. 260, Protecting Seniors' Access to Medicare Act of 2017. S. 637, Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2017. S. 794, Local Coverage Determination Clarification Act of 2017. S. 898, Conrad State 30 and Physician Access Reauthorization Act. S. 989, Ensuring Children's Access to Specialty Care Act of 2017. S. 1301, Resident Physician Shortage Reduction Act of 2017. S. 1304, A bill to amend part B of title XVIII of the Social Security Act to exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price for drugs and biologicals under Medicare, and for other purposes. S. 2553, Know the Lowest Price Act of 2018 (P.L. 115-262). S. 2554, Patient Right to Know Drug Prices Act (P.L. 115-263). S. 2908, To provide for electronic prior authorization under Medicare part D for covered part D drugs, and for other purposes. S. 3158, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2019. S. 3160, To improve access to, and utilization of, bone mass measurement benefits.

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

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

Monitor implementation of the Patient Protection and Affordable Care Act (P.L. 111-148). Monitor federal and legislative activity related to Medicare Reimbursement. Monitor federal issues and legislation associated with health care policy. Monitor implementation of Medicare Access and CHIP Reauthorization Act of 2015 (P.L. 114-10). Monitor implementation of 21st Century Cures Act (P.L. 114-255). H.J. Res. 143, Continuing appropriations for fiscal year 2019. (P.L. 115-298) H.R. 6, SUPPORT for Patients and Communities Act. (P.L. 115-271) H.R. 849, Protecting Seniors' Access to Medicare Act of 2017. H.R. 1038, Improving Transparency and Accuracy in Medicare Part D Spending Act. H.R. 1316, Prescription Drug Price Transparency Act. H.R. 1628, American Health Care Act of 2017. H.R. 1703, Medical Product Communications Act of 2017. H.R. 1898, To improve access to, and utilization of, bone mass measurement benefits. H.R. 1920, To amend part B of title XVIII of the Social Security Act to exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price for drugs and biologicals under Medicare, and for other purposes. H.R.2077, Restoring the Patient's Voice Act of 2017. H.R. 2141, Conrad State 30 and Physician Access Reauthorization Act. H.R. 2267, Resident Physician Shortage Reduction Act of 2017. H.R. 2641, Promoting Life-Saving New Therapies for Neonates Act of 2017. H.R. 2999, Patients' Access to Treatments Act of 2017. H.R. 3635, Local Coverage Determination Clarification Act of 2017. H.R. 3728, EMPOWER Act of 2017. H.R. 3767, Ensuring Children's Access to Specialty Care Act of 2017. H.R. 4841, Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018. H.R. 5150, Protecting Medicare from Excessive Price Increases Act of 2018. H.R.6157, Defense and Labor, Health and Human Services Consolidated Appropriations Act, 2019. (P.L. 115-245) H.R. 6470, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2019. S. 251, Protecting Medicare from Executive Action Act of 2017. S. 260, Protecting Seniors' Access to Medicare Act of 2017. S. 637, Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2017. S. 794, Local Coverage Determination Clarification Act of 2017. S. 898, Conrad State 30 and Physician Access Reauthorization Act. S. 989, Ensuring Children's Access to Specialty Care Act of 2017. S. 1301, Resident Physician Shortage Reduction Act of 2017. S. 1304, A bill to amend part B of title XVIII of the Social Security Act to exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price for drugs and biologicals under Medicare, and for other purposes. S. 2553, Know the Lowest Price Act of 2018 (P.L. 115-262). S. 2554, Patient Right to Know Drug Prices Act (P.L. 115-263). S. 2908, To provide for electronic prior authorization under Medicare part D for covered part D drugs, and for other purposes. S. 3158, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2019. S. 3159, Department of Defense Appropriations Act, 2019. S. 3160, To improve access to, and utilization of, bone mass measurement benefits.

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

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

Medicare Diabetes Prevention Program; diabetes self-management education; H.R. 3124/S. 1299/Preventing Diabetes in Medicare Act; H.R. 1953/S. 830 Treat and Reduce Obesity Act; Issues related to Medicare Part D included in Section 53116 of H.R. 1892 (Pub. L. 115-123), Bipartisan Budget Act and H.R. 1625 (Pub. L. 115-141), Consolidated Appropriations Act; H.R. 849/S. 260 including coverage gap ("donut hole") access and averting catastrophic coverage Out of Pocket (OOP) "cliff"; Protecting Seniors' Access to Medicare Act of 2017 and S. 251 Protecting Medicare from Executive Action Act of 2017 (IPAB Repeal); H.R. 3921 HEALTHY KIDS Act (CHIP Reauthorization).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to the repeal of the Independent Payment Advisory Board (IPAB); Protecting Seniors' Access to Medicare Act of 2017 (H.R. 849/S. 260); Protecting Medicare from Executive Action Act of 2017 (S. 251) Treat and Reduce Obesity Act (H.R. 1953/S. 830) Medicare Diabetes Prevention Program; diabetes self-management education; Preventing Diabetes in Medicare Act (H.R. 3124/S. 1299) Issues related to Medicare Part D included in the Bipartisan Budget Act (H.R. 1892); and the Consolidated Appropriations Act (H.R. 1625), including coverage gap ("donut hole") access and averting catastrophic coverage Out of Pocket (OOP) "cliff

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

PL 114-255 - 21st Century Cures, implementation S. 771 - Improving Access to Affordable Prescription Drugs Act S. 637 - Creating Transparency to Have Drug Rebates Unlocked Act of 2017 Stopping the Pharmaceutical Industry From Keeping Drugs Expensive Act of 2017 S. 469 - Affordable and Safe Prescription Drug Importation act H.R. 749 - Lower Drug Costs Through Competition Act H.R. 878/S. 204 - Right to Try Act H.R. 2430 - FDA Reauthorization Act of 2017 S. 260/H.R. 849 - Protecting Seniors' Access to Medicare Act of 2017 S. 2852 - Pandemic and All Hazards Preparedness Act H.R. 6 - SUPPORT for Patients and Communities Act no specific bil1s, innovation, non-interference, 340B, Hepatitis C, HPV, Shingles, anti-microbial resistance, transparency, Pandemic All Hazards Preparedness Act reauthorization

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

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

Monitor legislative and administrative action related to Medicare policy. Monitor legislative and administrative action related to Medicaid policy. H.R. 849, Protecting Seniors Access to Medicare Act of 2017. S. 251, Protecting Medicare for Executive Action Act of 2017. S. 260, Protecting Seniors Access to Medicare Act of 2017.

Client expense: $1,320,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Commerce, Dept of (DOC), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Natl Security Council (NSC), SENATE, Treasury, Dept of, U.S. Trade Representative (USTR), White House Office

H.R. 6, Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act H.R. 35, Health Savings Act of 2017 H.R. 143, Health Insurance Industry Antitrust Enforcement Act of 2017 H.R. 173/S. 40/S. 58, Middle Class Health Benefits Tax Repeal Act of 2017 H.R. 184, Protect Medical Innovation Act of 2017 H.R. 195, Making further continuing appropriations for the fiscal year ending September 30, 2018, and for other purposes H.R. 246, To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act H.R. 394/S. 85, Restoring Access to Medication Act of 2017 H.R. 620, ADA Education and Reform Act of 2017 H.R. 849/S. 260, Protecting Seniors Access to Medicare Act H.R. 1101, Small Business Health Fairness Act of 2017 H.R. 1175/S. 403, Health Savings Act of 2017 H.R. 1215, Protecting Access to Care Act of 2017 H.R. 1313, Preserving Employee Wellness Programs Act H.R. 1625, Consolidated Appropriations Act, 2018 H.R. 1892, Bipartisan Budget Act of 2018 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 H.R. 3798, Save American Workers Act of 2017 H.R. 4284, Indexing Narcotics, Fentanyl, and Opioids (INFO) Act of 2018 H.R. 4616, To amend the Patient Protection and Affordable Care Act to provide for a temporary moratorium on the employer mandate and to provide for a delay in the implementation of the excise tax on high cost employer-sponsored health coverage H.R. 4617, To amend the Internal Revenue Code of 1986 to provide for a temporary moratorium on the medical device excise tax H.R. 4618, To amend the Internal Revenue Code of 1986 to provide for a temporary moratorium on certain taxes affecting purchases of prescription medication H.R. 4619, To amend the Patient Protection and Affordable Care Act to provide temporary relief from the annual fee imposed on health insurance providers, to the extent that such fee is due to Puerto Rican health insurance H.R. 4620, Protecting Families and Small Businesses Act of 2017 H.R. 4978/S. 2410, Chronic Disease Management Act of 2018 H.R. 5009, Jessies Law H.R. 5041, Safe Disposal of Unused Medication Act H.R. 5138, Bipartisan HSA Improvement Act of 2018 H.R. 5272, To provide additional guidance to grantees seeking funding to treat or prevent mental health or substance use disorders H.R. 5582, Abuse Deterrent Access Act of 2018 H.R. 5788, Synthetics Trafficking and Overdose Prevention (STOP) Act of 2018 H.R. 5892, To establish an Advisory Committee on Opioids and the Workplace to advise the Secretary of Labor on actions the Department of Labor can take to address the impact of opioid abuse on the workplace H.R. 6199, Restoring Access to Medication and Modernizing Health Savings Accounts Act of 2018 H.R. 6311, Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act of 2018 S. 108, Medical Device Access and Innovation Protection Act S. 191, Patient Freedom Act of 2017 S. 222, Obamacare Replacement Act S. 251, Protecting Medicare from Executive Action Act of 2017 S. 974, Creating and Restoring Equal Access To Equivalent Samples (CREATES) Act of 2017 S. 1835, Lower Premiums Through Reinsurance Act of 2017 S. 1850, Protecting Jessica Grubb's Legacy Act S. 1859, Healthcare Tax Relief Act S. 1978, Small Business and Family Health Tax Relief Act of 2017 S. 2004, Combating the Opioid Epidemic Act S. 2164, To amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings S. 3057, Synthetics Trafficking and Overdose Prevention (STOP) Act of 2018 Draft legislation to stabilize individual market premiums for the 2018 and 2019 plan years and provide meaningful State flexibility (Alexander-Murray) Proposed regulation on health reimbursement arrangements and other account-based group health plans (83 Fed. Reg. 54,420-54,477, October 29, 2018) Final Regulation, definition of employer under Section 3(5) of ERISA - association health plans (83 Fed. Reg. 28912-28964, June 21, 2018) Various issues relating to Patient Protection and Affordable Care Act (P.L. 111-148) and the Health Care and Education Affordability Reconciliation Act of 2010 (P.L. 111-152), including the employer-sponsored health care system, implementation of regulatory process, provider network adequacy, delivery system reform, health savings account (HSAs), health reimbursement account (HRAs), and flexible spending account (FSAs) changes, IPAB, employer mandate, reporting requirements for issuers and applicable large employers, premium stabilization programs, medical loss ratio, medical malpractice reform, exchanges, the impact on small business, the Small Business Tax Credit, section 1332 waivers, section 1557 on nondiscrimination, caps on compensation deductibility required under section 9014, incompleteness or inaccuracy of cost impact analysis, lack of quantified benefit analysis, and need for empirical data sources on which to base costs and benefits, the Cost Sharing Reduction (CSR) program, the section 9010 Health Insurance Providers Fee or Health Insurance Tax (HIT), 40% excise tax on high-cost employer-sponsored health coverage (Cadillac tax); medical device tax; protect Medicare Part D's Non-Interference Clause from repeal Public Health Services Act (P.L.78-410), Internal Revenue Code and the Employee Retirement Income Security Act (ERISA) (P.L. 93-406), regarding regulatory process and legislative corrections to ERISA preemption, changes to Medicare Advantage and Parts B, C, and D, including rebates and non-interference with prescription drug prices, entitlement reform, health information technology, telemedicine services in Medicare, and coordination and disease management programs; House Republican Taskforce on Health Care report; A Better Way to Fix Health Care; association health plans; importation of foreign pharmaceuticals into the United States and preemptive authority of federal food and drug regulations; Executive Order 13813, Promoting Healthcare Choice and Competition; addressing the opioids crisis, including end-stage renal disease; balance or surprise billing; single-payer health care options; aligning 42 CFR Part 2 with the Health Insurance Portability and Accountability Act (P.L. 104-191) for the purposes of treatment, payment, and health car operation (TPO); inclusion of prescription drug pricing on 2019 congressional agenda; general advocacy for Congress to reach a working quorum for the board of the Export-Import Bank; section 301 of the Trade Act of 1974; U.N. Convention on the Assignment of Receivables in Int'l Trade

Client expense: $15,950,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Army, Dept of (Corps of Engineers), Commerce, Dept of (DOC), Commodity Futures Trading Commission (CFTC), Consumer Financial Protection Bureau (CFPB), Council on Environmental Quality (CEQ), Defense, Dept of (DOD), Education, Dept of, Energy, Dept of, Environmental Protection Agency (EPA), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Federal Communications Commission (FCC), Federal Deposit Insurance Corporation (FDIC), Federal Energy Regulatory Commission (FERC), Federal Reserve System, Federal Trade Commission (FTC), General Services Administration (GSA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Interior, Dept of (DOI), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Economic Council (NEC), Natl Labor Relations Board (NLRB), Natl Security Council (NSC), Natl Telecommunications & Information Administration (NTIA), Office of Management & Budget (OMB), Office of the Comptroller of the Currency (OCC), Office of the Vice President of the United States, Patent & Trademark Office (PTO), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Small Business Administration (SBA), Social Security Administration (SSA), State, Dept of (DOS), Transportation Security Administration (TSA), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Copyright Office, U.S. Customs & Border Protection, U.S. Trade Representative (USTR), White House Office

Monitor implementation of the Patient Protection and Affordable Care Act (P.L. 111-148). Monitor federal and legislative activity related to Medicare Reimbursement. Monitor federal issues and legislation associated with health care policy. Monitor implementation of Medicare Access and CHIP Reauthorization Act of 2015 (P.L. 114-10). Monitor implementation of 21st Century Cures Act (P.L. 114-255). H.J. Res. 143, Continuing appropriations for fiscal year 2019. (P.L. 115-298) H.R. 6, SUPPORT for Patients and Communities Act. (P.L. 115-271) H.R. 849, Protecting Seniors' Access to Medicare Act of 2017. H.R. 1038, Improving Transparency and Accuracy in Medicare Part D Spending Act. H.R. 1316, Prescription Drug Price Transparency Act. H.R. 1628, American Health Care Act of 2017. H.R. 1703, Medical Product Communications Act of 2017. H.R. 1898, To improve access to, and utilization of, bone mass measurement benefits. H.R. 1920, To amend part B of title XVIII of the Social Security Act to exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price for drugs and biologicals under Medicare, and for other purposes. H.R.2077, Restoring the Patient's Voice Act of 2017. H.R. 2141, Conrad State 30 and Physician Access Reauthorization Act. H.R. 2267, Resident Physician Shortage Reduction Act of 2017. H.R. 2641, Promoting Life-Saving New Therapies for Neonates Act of 2017. H.R. 2999, Patients' Access to Treatments Act of 2017. H.R. 3635, Local Coverage Determination Clarification Act of 2017. H.R. 3728, EMPOWER Act of 2017. H.R. 3767, Ensuring Children's Access to Specialty Care Act of 2017. H.R. 4841, Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018. H.R. 5150, Protecting Medicare from Excessive Price Increases Act of 2018. H.R.6157, Defense and Labor, Health and Human Services Consolidated Appropriations Act, 2019. (P.L. 115-245) H.R. 6470, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2019. S. 251, Protecting Medicare from Executive Action Act of 2017. S. 260, Protecting Seniors' Access to Medicare Act of 2017. S. 637, Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2017. S. 794, Local Coverage Determination Clarification Act of 2017. S. 898, Conrad State 30 and Physician Access Reauthorization Act. S. 989, Ensuring Children's Access to Specialty Care Act of 2017. S. 1301, Resident Physician Shortage Reduction Act of 2017. S. 1304, A bill to amend part B of title XVIII of the Social Security Act to exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price for drugs and biologicals under Medicare, and for other purposes. S. 2553, Know the Lowest Price Act of 2018 (P.L. 115-262). S. 2554, Patient Right to Know Drug Prices Act (P.L. 115-263). S. 2908, To provide for electronic prior authorization under Medicare part D for covered part D drugs, and for other purposes. S. 3158, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2019. S. 3159, Department of Defense Appropriations Act, 2019. S. 3160, To improve access to, and utilization of, bone mass measurement benefits.

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

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

Monitor implementation of the Patient Protection and Affordable Care Act (P.L. 111-148). Monitor federal and legislative activity related to Medicare Reimbursement. Monitor federal issues and legislation associated with health care policy. Monitor implementation of Medicare Access and CHIP Reauthorization Act of 2015 (P.L. 114-10). Monitor implementation of 21st Century Cures Act (P.L. 114-255). H.J. Res. 143, Continuing appropriations for fiscal year 2019. (P.L. 115-298) H.R. 6, SUPPORT for Patients and Communities Act. (P.L. 115-271) H.R. 849, Protecting Seniors' Access to Medicare Act of 2017. H.R. 1038, Improving Transparency and Accuracy in Medicare Part D Spending Act. H.R. 1316, Prescription Drug Price Transparency Act. H.R. 1628, American Health Care Act of 2017. H.R. 1703, Medical Product Communications Act of 2017. H.R. 1898, To improve access to, and utilization of, bone mass measurement benefits. H.R. 1920, To amend part B of title XVIII of the Social Security Act to exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price for drugs and biologicals under Medicare, and for other purposes. H.R.2077, Restoring the Patient's Voice Act of 2017. H.R. 2141, Conrad State 30 and Physician Access Reauthorization Act. H.R. 2267, Resident Physician Shortage Reduction Act of 2017. H.R. 2641, Promoting Life-Saving New Therapies for Neonates Act of 2017. H.R. 2999, Patients' Access to Treatments Act of 2017. H.R. 3635, Local Coverage Determination Clarification Act of 2017. H.R. 3728, EMPOWER Act of 2017. H.R. 3767, Ensuring Children's Access to Specialty Care Act of 2017. H.R. 4841, Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018. H.R. 5150, Protecting Medicare from Excessive Price Increases Act of 2018. H.R.6157, Defense and Labor, Health and Human Services Consolidated Appropriations Act, 2019. (P.L. 115-245) H.R. 6470, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2019. S. 251, Protecting Medicare from Executive Action Act of 2017. S. 260, Protecting Seniors' Access to Medicare Act of 2017. S. 637, Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2017. S. 794, Local Coverage Determination Clarification Act of 2017. S. 898, Conrad State 30 and Physician Access Reauthorization Act. S. 989, Ensuring Children's Access to Specialty Care Act of 2017. S. 1301, Resident Physician Shortage Reduction Act of 2017. S. 1304, A bill to amend part B of title XVIII of the Social Security Act to exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price for drugs and biologicals under Medicare, and for other purposes. S. 2553, Know the Lowest Price Act of 2018 (P.L. 115-262). S. 2554, Patient Right to Know Drug Prices Act (P.L. 115-263). S. 2908, To provide for electronic prior authorization under Medicare part D for covered part D drugs, and for other purposes. S. 3158, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2019. S. 3159, Department of Defense Appropriations Act, 2019. S. 3160, To improve access to, and utilization of, bone mass measurement benefits.

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

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

- S. 469/H.R. 1245, "Affordable and Safe Prescription Drug Importation Act", regarding all provisions. - S. 771/H.R. 1776, "Improving Access To Affordable Prescription Drugs Act", regarding all provisions. - H.R. 575, "Cosmetic Modernization Amendments of 2017", regarding all provisions. - H.R. 1271, "DXM Abuse Prevention Act of 2017", regarding all provisions. - S. 404/H.R. 1736, "To amend the Federal Food, Drug, and Cosmetic Act to improve the process for inspections of device establishments and for granting export certifications.", regarding all provisions. - Issues regarding drug pricing. - Issues related to diagnostic reform. - S 260/SJ Res 17/HR 849, Protecting Seniors' Access to Medicare Act of 2017, regarding all provisions - S 251/SJ Res 16, Protecting Medicare from Executive Action Act of 2017, regarding all provisions - S 204/HR 878, Right to Try Act of 2017, regarding all provisions - HR 2026, Pharmaceutical Information Exchange Act, regarding all provisions - HR 1703, Medical Product Communications Act of 2017, regarding all provisions - Issues related to VA procurement of medical devices - HR 2474, Medical Product Review Harmonization Act, regarding all provisions - HR 2144, Risk Based Classification of Accessories Act - Issues related to AMA resolution 208(A-16) regarding attorney ads on drug side effects - S.1113, "Personal Care Products Safety Act", regarding all provisions - HR 2790, "Humane Cosmetics Act", regarding all provisions - HR 3271, "Protecting Access to Diabetes Supplies Act", regarding all provisions - Issues regarding medical device repeal - Issues regarding NIH Funding - HR 2164, "Medical Device Safety Act", regarding all provisions - Issues related to 340B - Issues related to HIV vaccines - S. 2852, "Pandemic & All Hazards Preparedness and Advancing Innovations Act of 2018", regarding all provisions. - Issues related to reauthorization of the Pandemic All-Hazards Preparedness Act programs. (House version) - HR 5492, "MOTHER Act of 2018", regarding all provisions. - Issues related to access to essential surgery - Issues related to contact lens safety - HR 6, "SUPPORT for Patients and Communities Act", regarding all provisions. - S. 2315, "Over-the-Counter Drug Safety, Innovation, and Reform Act", regarding all provisions. - HR 5333 "Over-the-Counter Monograph Safety, Innovation, and Reform Act of 2018", regarding all provisions. - Issues related to antimicrobial resistance - Issues related to regulations on medication product packaging - H.R. 6294, " Re-Valuing Anti-Microbial Products Act of 2018", regarding all provisions - H.R. 1318, "Preventing Maternal Deaths Act of 2018", regarding all provisions

Client expense: $2,340,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA), White House Office

Medicaid access and coverage, Sunshine implementation, EXPERT, medically complex children S. 260/H.R. 849 - Protecting Seniors' Access to Medicare Act of 2017 S. 1827 - Kids Act of 2017 H.R. 3921 - Healthy Kids Act

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

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

drug coverage and reimbursement value based contracting, access and affordability S. 260/H.R. 849 - Protecting Seniors' Access to Medicare Act of 2017 H.R. 3921 - Healthy Kids Act S. 1827 - Kids Act of 2017 Stark

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

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

PL 114-255 - 21st Century Cures, implementation H.R. 878/S. 204 - Right to Try Act H.R. 1231/S. 456 - RACE for Children Act H.R. 2430 - FDA Reauthorization Act of 2017 H.R. 849/S. 260 - Protecting Seniors' Access to Medicare Act S. 2852 - Pandemic and All Hazards Preparedness Act S.2315 - Over-the-Counter Drug Safety, Innovation, and Reform Act H.R. 6 - SUPPORT for Patients and Communities Act ***no specific bills, importation, supply chain integrity, 304b, biosimilars, orphan drugs, newborn screening, expanded access, priority review, transparency, drug shortages, IPAB

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

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

Medicare priorities, coverage and payment policies, discount cards, MedPAC S. 260/H.R. 849 - Protecting Seniors' Access to Medicare Act of 2017 H.R. 3921 - Healthy Kids Act S. 1827 - Kids Act of 2017 no specific bill, Sunshine implementation, biosimilars, Part B, Medicare Part D, Smoking cessation, donut hole, Part D cliff

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

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

S. 870 - Chronic Care S. 251 - Protecting Medicare from Executive Action of 2017 H.R. 849/S. 260 - Protecting Seniors' Access to Medicare Act of 2017 H.R. 242/S. 41 - Medicare Prescription Drug Price Negotiation Act of 2017 S. 348 - Prescription Drug and Health Improvement Act of 2017 H.R. 1316 - Prescription Drug Price Transparency Act H.J.Res. 51/S.J.Res. 16 - IPAB discontinuation H.R. 3921 - Healthy Kids Act S. 1827 - Kids Act of 2017 ***, no specific bill(s), Medicare and Medicaid Drug Reimbursement, Medicaid Rebate, dual eligibles, Sunshine, discount cards, MedPAC, biosimilars, Alternative Payment Models, Value based Purchasing, coding, CMMI, Part B, Part D, non-interference, IPAB, donut hole, Part D cliff, prescription drug access and affordability

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

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

prescription drug abuse and deterrence, non-interference PL 114-255 - 21st Century Cures, implementation Multi-modal analgesics S. 771 - Improving Access to Affordable Prescription Drugs Act S. 637 - Creating Transparency to Have Drug Rebates Unlocked Act of 2017 Stopping the Pharmaceutical Industry From Keeping Drugs Expensive Act of 2017 S. 469 - Affordable and Safe Prescription Drug Importation act H.R. 749 - Lower Drug Costs Through Competition Act H.R. 2430 - FDA Reauthorization Act of 2017 H.R. 3921 - Healthy Kids Act S. 1827 - Kids Act of 2017 S. 260/H.R. 849 - Protecting Seniors' Access to Medicare Act of 2017 H.R. 6 - SUPPORT for Patients and Communities Act S. 3120 - HEAL Substance Use Disorders Act S. 2680 - Opioid Crisis Response Act S. 2852 - Pandemic and All Hazards Preparedness Act S. 3282 - DEA Clearinghouse Act of 2018

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 260/H.R. 849 - Protecting Seniors' Access to Medicare Act of 2017 H.R. 3921 - Healthy Kids Act S. 1827 - Kids Act of 2017 no specific bills, Medicare Part D, Value based purchasing, Medicare Part B, 340B, IPAB repeal, Donut hole, Part D cliff

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare and Medicaid Drug Reimbursement, Medicaid Rebate, Medicare Part D Non-Interference, health care reform, biosimilars, 340B, Sunshine, discount cards, MedPAC, coding, ASP, Part B, donut hole, Part D cliff, prescription drug access and affordability S. 870 - Chronic Care H.R. 3921 - Healthy Kids Act S. 1827 - Kids Act of 2017 S. 260/H.R. 849 - Protecting Seniors' Access to Medicare Act of 2017

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), SENATE

S. 870 - Chronic Care H.R. 3921 - Healthy Kids Act S. 1827 - Kids Act of 2017 S. 260/H.R. 849 - Protecting Seniors' Access to Medicare Act of 2017 ***, no specific bill(s), Medicare and Medicaid Drug Reimbursement, Medicaid Rebate, Medicare Part D, Non-Interference, health care reform implementation, AMP, Sunshine, conditions of participation, care transitions, immunizations, pipeline, Innovation Center, Part B, Medicaid coverage, ESRD, coverage, innovative payments, diabetes and cardiometabolic health

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

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

discount programs, pipeline, biosimilars, Part B demonstration, Part D, Noninterference, donut hole, Part D cliff, Rebates, CMM1 S. 251 - Protecting Medicare from Executive Action of 2017 S. 260/H.R. 849 - Protecting Seniors' Access to Medicare Act of 2017 H.R. 242/S. 41 - Medicare Prescription Drug Price Negotiation Act of 2017

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

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

H.R. 849, S. 260, S. 251 Protecting Seniors Access to Medicare Act, lobbied regarding all biopharmaceutical related provisions. S.771, Improving Access To Affordable Prescription Drugs Act, lobbied regarding all biopharmaceutical related provisions. S.348, Prescription Drug and Health Improvement Act of 2017, lobbied regarding all biopharmaceutical related provisions. S.637, Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2017, lobbied regarding all biopharmaceutical related provisions. No bill, American Patients First Prescription Drug Blueprint, regarding all biopharmaceutical related provisions. H.R. 6505, Medicare Negotiation and Competitive Licensing Act of 2018, regarding all biopharmaceutical related provisions. H.R. 6642, to amend title XIX of the Social Security Act to sunset the limit on the maximum rebate amount for single source drugs and innovator multiple source drugs, regarding all biopharmaceutical related provisions. S. 2553, H.R. 6144, Know the Lowest Price Act of 2018, regarding all biopharmaceutical related provisions.

Client expense: $940,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE, U.S. Trade Representative (USTR)

PL 109-417 - Pandemic and All-Hazards Preparedness Act (PAHPA) PL 114-10 - Medicare and CHIP Reauthorization Act of 2017 Implementation H.R. 6 - SUPPORT for Patients and Communities Act H.R. 5507 - Critical Access Hospital Relief Act of 2018 H. R. 5809 - Postoperative Opioid Prevention Act of 2018 H.R 4143/S. 2065 - Dialysis PATIENTS Demonstration Act of 2017 S. 2852/H.R. 6378 - Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018 (PAHPAI) H.R. 5385 - Children's Hospital GME Support Reauthorization Act of 2018 S. 2809 - A bill to amend title XVIII of the Social Security Act to provide for electronic prior authorization under Medicare part D for covered part D drugs, and for other purposes. H.R. 5106 - Investor Choice Against Gun Proliferation Act H.R.1057 - STOP Act of 2017 H.R. 1822, 1876/S. 781 - Good Samaritan Health Professionals Act of 2017 H.R. 880/S. 1022 - Mission Zero Act H.R. 1017/S. 479 - Removing Barriers to Colorectal Cancer Screening Act of 2017 H.R. 820/S. 292 - Childhood Cancer STAR Act H.R. 5160 - Cancer Care Planning and Communications Act of 2018 H.R. 1704 - ACCESS Act of 2017 H.R. 2267 - Resident Physician Shortage Reduction Act of 2017 H.R. 1676/S. 693 - Palliative Care and Hospice Education and Training Act H.R. 4909/S. 2495 - STOP School Violence Act of 2018 H.R. 4841 - Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018 H.R. 4206/S. 2051 - Medicare Care Coordination Improvement Act H.R. 1892 - Bipartisan Budget Act of 2018 H.R. 1625 - Omnibus H.R. 2906/S. 1351 - Ensuring Access to General Surgery Act of 2017 H.R. 4434/S.2135 - Fix NICS Act of 2017 H.R. 548/S. 527 - Health Care Safety Net Enhancement Act of 2017 H.R. 849/S. 260, S. 251 - Protecting Seniors' Access to Medicare Act of 2017 H.R. 2843/S.1317 - Medicaid and CHIP Quality Improvement Act of 2017 H.R. 3120 - Electronic Health Record Meaningful Use H.R. 2276/S.2575 - Audiology Patient Choice Act of 2018 H.R. 6157 - Department of Defense and Labor, Health and Human Services, and Education Appropriations Act, 2019 and Continuing Appropriations Act, 2019 H.R. 6545 - Violence Against Women Reauthorization Act of 2018 H.R. 6808 - Patient Navigation Assistance Act of 2018 H.R.4897 - Women and Lung Cancer Research and Preventive Services Act of 2018 H.R. 930/S. 497 - Lymphedema Treatment Act H.R. 7083 - Access to Genetic Counselor Services Act of 2018 H.R. 1318 - Preventing Maternal Deaths Act of 2018 Medicaid GME Transparency Act Bleeding Control for the Injured (Stop The Bleed campaign) Injury Prevention Initiatives Childrens Health Insurance Program Reauthorization Cancer Research and Funding Opioids EHR Clinician Burden/Administrative Burden Mis-valued Codes Medicare Sequestration Congenital Anomalies Global Codes Qualified clinical data registry (QCDR) Consumer Assessment of Healthcare Providers and Systems Surgical Care Survey (S-CAHPS) VA Health Issues DOD Health Issues The Emergency Medical Services for Children Program MIPS cost measure development E-Prior Authorization Digital health systems Sports Medicine Firearms Research Hospital-based violence intervention programs National Trauma System (Military-Civilian Trauma Care) Visa Denial Medicare Fraud Surprise Billing Draft Legislation Stark Law Reform and Medicare Administrative Burden relief Alternative Payment Models (APMs) Physician Fee Schedule Quality Payment Program (QPP) Out-of-Network billing Narrow networks/Network Adequacy Hospital-based Violence Intervention Programs Out of the Crucible: U.S. Military Combat Casualty Care principles

Client expense: $16,092 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Veterans Affairs, Dept of (VA)

PL 109-417 - Pandemic and All-Hazards Preparedness Act (PAHPA) PL 114-10 - Medicare and CHIP Reauthorization Act of 2017 Implementation H.R. 6 - SUPPORT for Patients and Communities Act H.R. 5507 - Critical Access Hospital Relief Act of 2018 H. R. 5809 - Postoperative Opioid Prevention Act of 2018 H.R 4143/S. 2065 - Dialysis PATIENTS Demonstration Act of 2017 S. 2852/H.R. 6378 - Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018 (PAHPAI) H.R. 5385 - Children's Hospital GME Support Reauthorization Act of 2018 S. 2809 - A bill to amend title XVIII of the Social Security Act to provide for electronic prior authorization under Medicare part D for covered part D drugs, and for other purposes. H.R. 5106 - Investor Choice Against Gun Proliferation Act H.R.1057 - STOP Act of 2017 H.R. 1822, 1876/S. 781 - Good Samaritan Health Professionals Act of 2017 H.R. 880/S. 1022 - Mission Zero Act H.R. 1017/S. 479 - Removing Barriers to Colorectal Cancer Screening Act of 2017 H.R. 820/S. 292 - Childhood Cancer STAR Act H.R. 5160 - Cancer Care Planning and Communications Act of 2018 H.R. 1704 - ACCESS Act of 2017 H.R. 2267 - Resident Physician Shortage Reduction Act of 2017 H.R. 1676/S. 693 - Palliative Care and Hospice Education and Training Act H.R. 4909/S. 2495 - STOP School Violence Act of 2018 H.R. 4841 - Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018 H.R. 4206/S. 2051 - Medicare Care Coordination Improvement Act H.R. 1892 - Bipartisan Budget Act of 2018 H.R. 1625 - Omnibus H.R. 2906/S. 1351 - Ensuring Access to General Surgery Act of 2017 H.R. 4434/S.2135 - Fix NICS Act of 2017 H.R. 548/S. 527 - Health Care Safety Net Enhancement Act of 2017 H.R. 849/S. 260, S. 251 - Protecting Seniors' Access to Medicare Act of 2017 H.R. 2843/S.1317 - Medicaid and CHIP Quality Improvement Act of 2017 H.R. 3120 - Electronic Health Record Meaningful Use H.R. 2276/S.2575 - Audiology Patient Choice Act of 2018 H.R. 6157 - Department of Defense and Labor, Health and Human Services, and Education Appropriations Act, 2019 and Continuing Appropriations Act, 2019 H.R. 6545 - Violence Against Women Reauthorization Act of 2018 H.R. 6808 - Patient Navigation Assistance Act of 2018 H.R.4897 - Women and Lung Cancer Research and Preventive Services Act of 2018 H.R. 930/S. 497 - Lymphedema Treatment Act H.R. 7083 - Access to Genetic Counselor Services Act of 2018 H.R. 1318 - Preventing Maternal Deaths Act of 2018 Medicaid GME Transparency Act Bleeding Control for the Injured (Stop The Bleed campaign) Injury Prevention Initiatives Childrens Health Insurance Program Reauthorization Cancer Research and Funding Opioids EHR Clinician Burden/Administrative Burden Mis-valued Codes Medicare Sequestration Congenital Anomalies Global Codes Qualified clinical data registry (QCDR) Consumer Assessment of Healthcare Providers and Systems Surgical Care Survey (S-CAHPS) VA Health Issues DOD Health Issues The Emergency Medical Services for Children Program MIPS cost measure development E-Prior Authorization Digital health systems Sports Medicine Firearms Research Hospital-based violence intervention programs National Trauma System (Military-Civilian Trauma Care) Visa Denial Medicare Fraud Surprise Billing Draft Legislation Stark Law Reform and Medicare Administrative Burden relief Alternative Payment Models (APMs) Physician Fee Schedule Quality Payment Program (QPP) Out-of-Network billing Narrow networks/Network Adequacy Hospital-based Violence Intervention Programs Out of the Crucible: U.S. Military Combat Casualty Care principles

Client expense: $16,092 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Veterans Affairs, Dept of (VA)

PL 109-417 - Pandemic and All-Hazards Preparedness Act (PAHPA) PL 114-10 - Medicare and CHIP Reauthorization Act of 2017 Implementation H.R. 6 - SUPPORT for Patients and Communities Act H.R. 5507 - Critical Access Hospital Relief Act of 2018 H. R. 5809 - Postoperative Opioid Prevention Act of 2018 H.R 4143/S. 2065 - Dialysis PATIENTS Demonstration Act of 2017 S. 2852/H.R. 6378 - Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018 (PAHPAI) H.R. 5385 - Children's Hospital GME Support Reauthorization Act of 2018 S. 2809 - A bill to amend title XVIII of the Social Security Act to provide for electronic prior authorization under Medicare part D for covered part D drugs, and for other purposes. H.R. 5106 - Investor Choice Against Gun Proliferation Act H.R.1057 - STOP Act of 2017 H.R. 1822, 1876/S. 781 - Good Samaritan Health Professionals Act of 2017 H.R. 880/S. 1022 - Mission Zero Act H.R. 1017/S. 479 - Removing Barriers to Colorectal Cancer Screening Act of 2017 H.R. 820/S. 292 - Childhood Cancer STAR Act H.R. 5160 - Cancer Care Planning and Communications Act of 2018 H.R. 1704 - ACCESS Act of 2017 H.R. 2267 - Resident Physician Shortage Reduction Act of 2017 H.R. 1676/S. 693 - Palliative Care and Hospice Education and Training Act H.R. 4909/S. 2495 - STOP School Violence Act of 2018 H.R. 4841 - Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018 H.R. 4206/S. 2051 - Medicare Care Coordination Improvement Act H.R. 1892 - Bipartisan Budget Act of 2018 H.R. 1625 - Omnibus H.R. 2906/S. 1351 - Ensuring Access to General Surgery Act of 2017 H.R. 4434/S.2135 - Fix NICS Act of 2017 H.R. 548/S. 527 - Health Care Safety Net Enhancement Act of 2017 H.R. 849/S. 260, S. 251 - Protecting Seniors' Access to Medicare Act of 2017 H.R. 2843/S.1317 - Medicaid and CHIP Quality Improvement Act of 2017 H.R. 3120 - Electronic Health Record Meaningful Use H.R. 2276/S.2575 - Audiology Patient Choice Act of 2018 H.R. 6157 - Department of Defense and Labor, Health and Human Services, and Education Appropriations Act, 2019 and Continuing Appropriations Act, 2019 H.R. 6545 - Violence Against Women Reauthorization Act of 2018 H.R. 6808 - Patient Navigation Assistance Act of 2018 H.R.4897 - Women and Lung Cancer Research and Preventive Services Act of 2018 H.R. 930/S. 497 - Lymphedema Treatment Act H.R. 7083 - Access to Genetic Counselor Services Act of 2018 H.R. 1318 - Preventing Maternal Deaths Act of 2018 Medicaid GME Transparency Act Bleeding Control for the Injured (Stop The Bleed campaign) Injury Prevention Initiatives Childrens Health Insurance Program Reauthorization Cancer Research and Funding Opioids EHR Clinician Burden/Administrative Burden Mis-valued Codes Medicare Sequestration Congenital Anomalies Global Codes Qualified clinical data registry (QCDR) Consumer Assessment of Healthcare Providers and Systems Surgical Care Survey (S-CAHPS) VA Health Issues DOD Health Issues The Emergency Medical Services for Children Program MIPS cost measure development E-Prior Authorization Digital health systems Sports Medicine Firearms Research Hospital-based violence intervention programs National Trauma System (Military-Civilian Trauma Care) Visa Denial Medicare Fraud Surprise Billing Draft Legislation Stark Law Reform and Medicare Administrative Burden relief Alternative Payment Models (APMs) Physician Fee Schedule Quality Payment Program (QPP) Out-of-Network billing Narrow networks/Network Adequacy Hospital-based Violence Intervention Programs Out of the Crucible: U.S. Military Combat Casualty Care principles

Client expense: $169,817 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Veterans Affairs, Dept of (VA)

PL 109-417 - Pandemic and All-Hazards Preparedness Act (PAHPA) PL 114-10 - Medicare and CHIP Reauthorization Act of 2017 Implementation H.R. 6 - SUPPORT for Patients and Communities Act H.R. 5507 - Critical Access Hospital Relief Act of 2018 H. R. 5809 - Postoperative Opioid Prevention Act of 2018 H.R 4143/S. 2065 - Dialysis PATIENTS Demonstration Act of 2017 S. 2852/H.R. 6378 - Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018 (PAHPAI) H.R. 5385 - Children's Hospital GME Support Reauthorization Act of 2018 S. 2809 - A bill to amend title XVIII of the Social Security Act to provide for electronic prior authorization under Medicare part D for covered part D drugs, and for other purposes. H.R. 5106 - Investor Choice Against Gun Proliferation Act H.R.1057 - STOP Act of 2017 H.R. 1822, 1876/S. 781 - Good Samaritan Health Professionals Act of 2017 H.R. 880/S. 1022 - Mission Zero Act H.R. 1017/S. 479 - Removing Barriers to Colorectal Cancer Screening Act of 2017 H.R. 820/S. 292 - Childhood Cancer STAR Act H.R. 5160 - Cancer Care Planning and Communications Act of 2018 H.R. 1704 - ACCESS Act of 2017 H.R. 2267 - Resident Physician Shortage Reduction Act of 2017 H.R. 1676/S. 693 - Palliative Care and Hospice Education and Training Act H.R. 4909/S. 2495 - STOP School Violence Act of 2018 H.R. 4841 - Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018 H.R. 4206/S. 2051 - Medicare Care Coordination Improvement Act H.R. 1892 - Bipartisan Budget Act of 2018 H.R. 1625 - Omnibus H.R. 2906/S. 1351 - Ensuring Access to General Surgery Act of 2017 H.R. 4434/S.2135 - Fix NICS Act of 2017 H.R. 548/S. 527 - Health Care Safety Net Enhancement Act of 2017 H.R. 849/S. 260, S. 251 - Protecting Seniors' Access to Medicare Act of 2017 H.R. 2843/S.1317 - Medicaid and CHIP Quality Improvement Act of 2017 H.R. 3120 - Electronic Health Record Meaningful Use H.R. 2276/S.2575 - Audiology Patient Choice Act of 2018 H.R. 6157 - Department of Defense and Labor, Health and Human Services, and Education Appropriations Act, 2019 and Continuing Appropriations Act, 2019 H.R. 6545 - Violence Against Women Reauthorization Act of 2018 H.R. 6808 - Patient Navigation Assistance Act of 2018 H.R.4897 - Women and Lung Cancer Research and Preventive Services Act of 2018 H.R. 930/S. 497 - Lymphedema Treatment Act H.R. 7083 - Access to Genetic Counselor Services Act of 2018 H.R. 1318 - Preventing Maternal Deaths Act of 2018 Medicaid GME Transparency Act Bleeding Control for the Injured (Stop The Bleed campaign) Injury Prevention Initiatives Childrens Health Insurance Program Reauthorization Cancer Research and Funding Opioids EHR Clinician Burden/Administrative Burden Mis-valued Codes Medicare Sequestration Congenital Anomalies Global Codes Qualified clinical data registry (QCDR) Consumer Assessment of Healthcare Providers and Systems Surgical Care Survey (S-CAHPS) VA Health Issues DOD Health Issues The Emergency Medical Services for Children Program MIPS cost measure development E-Prior Authorization Digital health systems Sports Medicine Firearms Research Hospital-based violence intervention programs National Trauma System (Military-Civilian Trauma Care) Visa Denial Medicare Fraud Surprise Billing Draft Legislation Stark Law Reform and Medicare Administrative Burden relief Alternative Payment Models (APMs) Physician Fee Schedule Quality Payment Program (QPP) Out-of-Network billing Narrow networks/Network Adequacy Hospital-based Violence Intervention Programs Out of the Crucible: U.S. Military Combat Casualty Care principles

Client expense: $169,817 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Veterans Affairs, Dept of (VA)

H.R. 2276/S. 2575, the "Audiology Patient Choice Act," all provisions. Medicare physician payment reform and implementation of the Medicare and CHIP Reauthorization Act of 2015, in general. Medicare physician payment reform and implementation of the Medicare and CHIP Reauthorization Act of 2015 related to the cost domain of the Merit-based Incentive Payment System. H.R. 1156, the "Patient Access to Higher Quality Health Care Act of 2017," all provisions. H.R. 849/S. 260, the "Protecting Seniors' Access to Medicare Act of 2017," all provisions. Comments outlining concern with the November 2017 Medicare Payment Advisory Commission (MedPAC) discussion titled, "Rebalancing the physician fee schedule towards primary care services." Issues pertaining to scope of practice, in general. Comments urging the Centers for Medicare and Medicaid Services (CMS) to reduce the 2018 Merit-based Incentive Payment System (MIPS) reporting period from a calendar year to a minimum of 90 consecutive days. Comments on the Medicare Hospital IPPS FY 2019 Proposed Rule communicating concerns about the agencys plans to remove the Public Health and Clinical Data Exchange objective by 2022. Comments urging leaders of the U.S. Senate Committee on Finance not to co-sponsor and oppose any efforts to advance the "Audiology Patient Choice Act" (S. 2575). Comments to the Centers for Medicare and Medicaid Services (CMS) regarding Medicare's designation of CPT Code 31241 Nasal/sinus endoscopy, surgical; with ligation of sphenopalatine artery. Coalition letter to leaders of the U.S. House Committees on Ways & Means and Energy & Commerce regarding the Medicare Appropriate Use Criteria (AUC) Program for Advanced Diagnostic Imaging. Coalition letter to leaders of the U.S. Senate Committee on Finance regarding the Medicare Appropriate Use Criteria (AUC) Program for Advanced Diagnostic Imaging. Coalition letter to U.S. House Committees on Ways & Means and Energy and Commerce and U.S. Senate Committee on Finance regarding payment cuts for clinical lab tests in the Medicare program. Coalition letter to the CMS Administrator urging HHS to allow eligible clinicians utilizing a certified electronic health record to participate in a clinician-led qualified clinical data registry to qualify them as fully achieving all points from the MIPS program. Coalition letter to the CMS Administrator regarding the Evaluation and Management coding and payment recommendations included in the CY19 Medicare Physician Fee Schedule Proposed Rule. Coalition letter to U.S. House of Representatives requesting support of a letter to HHS Secretary Alex Azar regarding data information blocking guidelines as related to Qualified Clinical Data Registries. Comments on the CY19 Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System proposed rule communicating support for proposed changes to reduce site of service disparities, as well as removal of CPT 31241 (Nasal/sinus endoscopy, surgical; with ligation of sphenopalatine artery) from the Inpatient Only List. Comments on the CY19 Medicare Physician Fee Schedule Proposed Rule regarding the proposed changes to documentation requirements, coding and payment for Evaluation and Management (E/M) services, application of the MPPR to E/M services, and the pricing and composition of balloon sinus surgery kits. Coalition Letter to leaders of the U.S. Senate Committee on Finance and U.S. House Committees on Ways and Means and Energy and Commerce regarding cuts to clinical laboratory services implemented by the Protecting Access to Medicare Act (PAMA) of 2014. Coalition letter to U.S. Senate Finance Committee and U.S. House Committees on Ways and Means and Energy and Commerce expressing concerns with CMS proposal to require Qualified Clinical Data Registry (QCDR) measure owners to enter into licensing agreements with CMS that would permit any other approved QCDR to submit data on the licensed measure for purposes of MIPS reporting. Comments on the CY19 Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Final Rule regarding changes to reduce site of service disparities, as well as removal of CPT 31241 (Nasal/sinus endoscopy, surgical; with ligation of sphenopalatine artery) from the Inpatient Only List. Comments on the CY 2019 Physician Fee Schedule Final Rule regarding the changes to documentation requirements, coding and payment for Evaluation and Management (E/M) services, application of the MPPR to E/M services, and the pricing and composition of balloon sinus surgery kits. Coalition letter to CMS expressing several concerns with Qualified Clinical Data Registries and MIPS. Coalition letter to CMS in response to an RFI regarding reporting requirements under the Open Payments Program for educational materials.

Client expense: $230,000 · 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), Medicare Payment Advisory Commission (MedPAC), SENATE, U.S. Trade Representative (USTR), Veterans Affairs, Dept of (VA)

Supporting Independent Payment Advisory Board Repeal - H.R.849/S.260, Protecting Seniors' Access to Medicare Act and S.251, Protecting Medicare from Executive Action, enacted into law Supporting Medical Liability Reform - H.R.1215, Protecting Access to Care Act ACA Repeal and Replace - not supporting Supporting H.R.4206, Medicare Care Coordination Improvement Act Comments on FY 2018 Hospital Outpatient Prospective Payment System Final Rule submitted to CMS, the agency corrected placement of vascular ultrasound codes Supporting H.R.2267, Resident Physician Shortage Reduction Act Supporting H.R.1876/S.781 - Good Samaritan Health Professionals Act Opposing Medicare Payment Advisory Commission's proposal to rebalance the physician fee schedule towards primary care Following opioid legislation, Stark Act Reform to allow for physician self referral under alternative payment models

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA)

Supporting Independent Payment Advisory Board Repeal - H.R.849/S.260, Protecting Seniors' Access to Medicare Act and S.251, Protecting Medicare from Executive Action, enacted into law Supporting Medical Liability Reform - H.R.1215, Protecting Access to Care Act ACA Repeal and Replace - not supporting Supporting H.R.4206, Medicare Care Coordination Improvement Act Comments on FY 2018 Hospital Outpatient Prospective Payment System Final Rule submitted to CMS, the agency corrected placement of vascular ultrasound codes Supporting H.R.2267, Resident Physician Shortage Reduction Act Supporting H.R.1876/S.781 - Good Samaritan Health Professionals Act Opposing Medicare Payment Advisory Commission's proposal to rebalance the physician fee schedule towards primary care Following opioid legislation, Stark Act Reform to allow for physician self referral under alternative payment models

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA)

H.R. 4508, the PROSPER Act and Reauthorization of the Higher Education Act: issues include regulations, accreditation, Title IV student aid, data and consumer information, Title III and V programs, Direct Loan program, Pell Grants, postsecondary cohort default rates, and risk sharing. S. 2231, Student Protection and Success Act, and risk sharing proposals S. 2028, Protect Student Borrowers Act of 2017 S. 260, Jumpstart Our Businesses by Supporting Students (JOBS) Act S. 1136, H.R. 2451, Pell Grant Preservation and Expansion Act S. 1121, H.R. 2434, College Transparency Act of 2017 H.R. 2353, Strengthening Career and Technical Education for the 21st Century Act; and Senate bill - Strengthening Career and Technical Education for the 21st Century Act (no bill number) H.R. 6543, Aim Higher Act Gainful employment and Borrower Defense regulations

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

Government targets: Education, Dept of, HOUSE OF REPRESENTATIVES, SENATE, White House Office

Monitor implementation of the Patient Protection and Affordable Care Act (P.L. 111-148). Monitor federal and legislative activity related to Medicare Reimbursement. Monitor federal issues and legislation associated with health care policy. Monitor implementation of Medicare Access and CHIP Reauthorization Act of 2015 (P.L. 114-10). Monitor implementation of 21st Century Cures Act (P.L. 114-255). H.R. 6, SUPPORT for Patients and Communities Act. H.R. 849, Protecting Seniors' Access to Medicare Act of 2017. H.R. 1038, Improving Transparency and Accuracy in Medicare Part D Spending Act. H.R. 1316, Prescription Drug Price Transparency Act. H.R. 1628, American Health Care Act of 2017. H.R. 1703, Medical Product Communications Act of 2017. H.R. 1898, To improve access to, and utilization of, bone mass measurement benefits. H.R. 1920, To amend part B of title XVIII of the Social Security Act to exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price for drugs and biologicals under Medicare, and for other purposes. H.R.2077, Restoring the Patient's Voice Act of 2017. H.R. 2141, Conrad State 30 and Physician Access Reauthorization Act. H.R. 2267, Resident Physician Shortage Reduction Act of 2017. H.R. 2641, Promoting Life-Saving New Therapies for Neonates Act of 2017. H.R. 2999, Patients' Access to Treatments Act of 2017. H.R. 3635, Local Coverage Determination Clarification Act of 2017. H.R. 3728, EMPOWER Act of 2017. H.R. 3767, Ensuring Children's Access to Specialty Care Act of 2017. H.R. 4841, Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018. H.R. 5150, Protecting Medicare from Excessive Price Increases Act of 2018. H.R.6157, Defense and Labor, Health and Human Services Consolidated Appropriations Act, 2019. H.R. 6470, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2019. S. 251, Protecting Medicare from Executive Action Act of 2017. S. 260, Protecting Seniors' Access to Medicare Act of 2017. S. 637, Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2017. S. 794, Local Coverage Determination Clarification Act of 2017. S. 898, Conrad State 30 and Physician Access Reauthorization Act. S. 989, Ensuring Children's Access to Specialty Care Act of 2017. S. 1301, Resident Physician Shortage Reduction Act of 2017. S. 1304, A bill to amend part B of title XVIII of the Social Security Act to exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price for drugs and biologicals under Medicare, and for other purposes. S. 2553, Know the Lowest Price Act of 2018 (P.L. 115-262). S. 2554, Patient Right to Know Drug Prices Act (P.L. 115-263). S. 2908, To provide for electronic prior authorization under Medicare part D for covered part D drugs, and for other purposes. S. 3158, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2019. S. 3159, Department of Defense Appropriations Act, 2019. S. 3160, To improve access to, and utilization of, bone mass measurement benefits.

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

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

Monitor implementation of the Patient Protection and Affordable Care Act (P.L. 111-148). Monitor federal and legislative activity related to Medicare Reimbursement. Monitor federal issues and legislation associated with health care policy. Monitor implementation of Medicare Access and CHIP Reauthorization Act of 2015 (P.L. 114-10). Monitor implementation of 21st Century Cures Act (P.L. 114-255). H.R. 6, SUPPORT for Patients and Communities Act. H.R. 849, Protecting Seniors' Access to Medicare Act of 2017. H.R. 1038, Improving Transparency and Accuracy in Medicare Part D Spending Act. H.R. 1316, Prescription Drug Price Transparency Act. H.R. 1628, American Health Care Act of 2017. H.R. 1703, Medical Product Communications Act of 2017. H.R. 1898, To improve access to, and utilization of, bone mass measurement benefits. H.R. 1920, To amend part B of title XVIII of the Social Security Act to exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price for drugs and biologicals under Medicare, and for other purposes. H.R.2077, Restoring the Patient's Voice Act of 2017. H.R. 2141, Conrad State 30 and Physician Access Reauthorization Act. H.R. 2267, Resident Physician Shortage Reduction Act of 2017. H.R. 2641, Promoting Life-Saving New Therapies for Neonates Act of 2017. H.R. 2999, Patients' Access to Treatments Act of 2017. H.R. 3635, Local Coverage Determination Clarification Act of 2017. H.R. 3728, EMPOWER Act of 2017. H.R. 3767, Ensuring Children's Access to Specialty Care Act of 2017. H.R. 4841, Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018. H.R. 5150, Protecting Medicare from Excessive Price Increases Act of 2018. H.R.6157, Defense and Labor, Health and Human Services Consolidated Appropriations Act, 2019. H.R. 6470, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2019. S. 251, Protecting Medicare from Executive Action Act of 2017. S. 260, Protecting Seniors' Access to Medicare Act of 2017. S. 637, Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2017. S. 794, Local Coverage Determination Clarification Act of 2017. S. 898, Conrad State 30 and Physician Access Reauthorization Act. S. 989, Ensuring Children's Access to Specialty Care Act of 2017. S. 1301, Resident Physician Shortage Reduction Act of 2017. S. 1304, A bill to amend part B of title XVIII of the Social Security Act to exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price for drugs and biologicals under Medicare, and for other purposes. S. 2553, Know the Lowest Price Act of 2018 (P.L. 115-262). S. 2554, Patient Right to Know Drug Prices Act (P.L. 115-263). S. 2908, To provide for electronic prior authorization under Medicare part D for covered part D drugs, and for other purposes. S. 3158, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2019. S. 3159, Department of Defense Appropriations Act, 2019. S. 3160, To improve access to, and utilization of, bone mass measurement benefits.

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

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

Monitor implementation of the Patient Protection and Affordable Care Act (P.L. 111-148). Monitor federal and legislative activity related to Medicare Reimbursement. Monitor federal issues and legislation associated with health care policy. Monitor implementation of Medicare Access and CHIP Reauthorization Act of 2015 (P.L. 114-10). Monitor implementation of 21st Century Cures Act (P.L. 114-255). H.R. 6, SUPPORT for Patients and Communities Act. H.R. 849, Protecting Seniors' Access to Medicare Act of 2017. H.R. 1038, Improving Transparency and Accuracy in Medicare Part D Spending Act. H.R. 1316, Prescription Drug Price Transparency Act. H.R. 1628, American Health Care Act of 2017. H.R. 1703, Medical Product Communications Act of 2017. H.R. 1898, To improve access to, and utilization of, bone mass measurement benefits. H.R. 1920, To amend part B of title XVIII of the Social Security Act to exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price for drugs and biologicals under Medicare, and for other purposes. H.R.2077, Restoring the Patient's Voice Act of 2017. H.R. 2141, Conrad State 30 and Physician Access Reauthorization Act. H.R. 2267, Resident Physician Shortage Reduction Act of 2017. H.R. 2641, Promoting Life-Saving New Therapies for Neonates Act of 2017. H.R. 2999, Patients' Access to Treatments Act of 2017. H.R. 3635, Local Coverage Determination Clarification Act of 2017. H.R. 3728, EMPOWER Act of 2017. H.R. 3767, Ensuring Children's Access to Specialty Care Act of 2017. H.R. 4841, Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018. H.R. 5150, Protecting Medicare from Excessive Price Increases Act of 2018. H.R.6157, Defense and Labor, Health and Human Services Consolidated Appropriations Act, 2019. H.R. 6470, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2019. S. 251, Protecting Medicare from Executive Action Act of 2017. S. 260, Protecting Seniors' Access to Medicare Act of 2017. S. 637, Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2017. S. 794, Local Coverage Determination Clarification Act of 2017. S. 898, Conrad State 30 and Physician Access Reauthorization Act. S. 989, Ensuring Children's Access to Specialty Care Act of 2017. S. 1301, Resident Physician Shortage Reduction Act of 2017. S. 1304, A bill to amend part B of title XVIII of the Social Security Act to exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price for drugs and biologicals under Medicare, and for other purposes. S. 2553, Know the Lowest Price Act of 2018 (P.L. 115-262). S. 2554, Patient Right to Know Drug Prices Act (P.L. 115-263). S. 2908, To provide for electronic prior authorization under Medicare part D for covered part D drugs, and for other purposes. S. 3158, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2019. S. 3159, Department of Defense Appropriations Act, 2019. S. 3160, To improve access to, and utilization of, bone mass measurement benefits.

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

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

Issues related to the repeal of the Independent Payment Advisory Board (IPAB); Protecting Seniors' Access to Medicare Act of 2017 (H.R. 849/S. 260); Protecting Medicare from Executive Action Act of 2017 (S. 251) Diabetes prevention, generally Implementation of the Clinical Care Commission Act (Pub.L. 115-80) World Hemophilia Day Issues related to medication affordability and access, generally American Health Care Act/Better Care Reconciliation Act (H.R. 1628)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

PL 114-255 - 21st Century Cures, implementation S. 771 - Improving Access to Affordable Prescription Drugs Act S. 637 - Creating Transparency to Have Drug Rebates Unlocked Act of 2017 Stopping the Pharmaceutical Industry From Keeping Drugs Expensive Act of 2017 S. 469 - Affordable and Safe Prescription Drug Importation act H.R. 749 - Lower Drug Costs Through Competition Act H.R. 878/S. 204 - Right to Try Act H.R. 2430 - FDA Reauthorization Act of 2017 S. 260/H.R. 849 - Protecting Seniors' Access to Medicare Act of 2017 S. 2852 - Pandemic and All Hazards Preparedness Act H.R. 6 - SUPPORT for Patients and Communities Act no specific bil1s, innovation, non-interference, 340B, Hepatitis C, HPV, Shingles, anti-microbial resistance, transparency, Pandemic All Hazards Preparedness Act reauthorization

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

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

drug coverage and reimbursement value based contracting, access and affordability S. 260/H.R. 849 - Protecting Seniors' Access to Medicare Act of 2017 H.R. 3921 - Healthy Kids Act S. 1827 - Kids Act of 2017 Stark

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

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

- S. 469/H.R. 1245, "Affordable and Safe Prescription Drug Importation Act", regarding all provisions. - S. 771/H.R. 1776, "Improving Access To Affordable Prescription Drugs Act", regarding all provisions. - H.R. 575, "Cosmetic Modernization Amendments of 2017", regarding all provisions. - H.R. 1271, "DXM Abuse Prevention Act of 2017", regarding all provisions. - S. 404/H.R. 1736, "To amend the Federal Food, Drug, and Cosmetic Act to improve the process for inspections of device establishments and for granting export certifications.", regarding all provisions. - Issues regarding drug pricing. - Issues related to diagnostic reform. - S 260/SJ Res 17/HR 849, Protecting Seniors' Access to Medicare Act of 2017, regarding all provisions - S 251/SJ Res 16, Protecting Medicare from Executive Action Act of 2017, regarding all provisions - S 204/HR 878, Right to Try Act of 2017, regarding all provisions - HR 2026, Pharmaceutical Information Exchange Act, regarding all provisions - HR 1703, Medical Product Communications Act of 2017, regarding all provisions - Issues related to VA procurement of medical devices - HR 2474, Medical Product Review Harmonization Act, regarding all provisions - HR 2144, Risk Based Classification of Accessories Act - Issues related to AMA resolution 208(A-16) regarding attorney ads on drug side effects - S.1113, "Personal Care Products Safety Act", regarding all provisions - HR 2790, "Humane Cosmetics Act", regarding all provisions - HR 3271, "Protecting Access to Diabetes Supplies Act", regarding all provisions - Issues regarding medical device repeal - Issues regarding NIH Funding - HR 2164, "Medical Device Safety Act", regarding all provisions - Issues related to 340B - Issues related to HIV vaccines - S. 2852, "Pandemic & All Hazards Preparedness and Advancing Innovations Act of 2018", regarding all provisions. - Issues related to reauthorization of the Pandemic All-Hazards Preparedness Act programs. (House version) - HR 5492, "MOTHER Act of 2018", regarding all provisions. - Issues related to access to essential surgery - Issues related to contact lens safety - HR 6, "SUPPORT for Patients and Communities Act", regarding all provisions. - S. 2315, "Over-the-Counter Drug Safety, Innovation, and Reform Act", regarding all provisions. - HR 5333 "Over-the-Counter Monograph Safety, Innovation, and Reform Act of 2018", regarding all provisions. - Issues related to antimicrobial resistance - Issues related to regulations on medication product packaging - H.R. 6294, " Re-Valuing Anti-Microbial Products Act of 2018", regarding all provisions

Client expense: $1,980,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA), White House Office

H.R. 6, Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act H.R. 35, Health Savings Act of 2017 H.R. 143, Health Insurance Industry Antitrust Enforcement Act of 2017 H.R. 173/S. 40/S. 58, Middle Class Health Benefits Tax Repeal Act of 2017 H.R. 184, Protect Medical Innovation Act of 2017 H.R. 195, Making further continuing appropriations for the fiscal year ending September 30, 2018, and for other purposes H.R. 246, To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act H.R. 394/S. 85, Restoring Access to Medication Act of 2017 H.R. 620, ADA Education and Reform Act of 2017 H.R. 849/S. 260, Protecting Seniors Access to Medicare Act H.R. 1101, Small Business Health Fairness Act of 2017 H.R. 1175/S. 403, Health Savings Act of 2017 H.R. 1215, Protecting Access to Care Act of 2017 H.R. 1313, Preserving Employee Wellness Programs Act H.R. 1625, Consolidated Appropriations Act, 2018 H.R. 1892, Bipartisan Budget Act of 2018 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 H.R. 3798, Save American Workers Act of 2017 H.R. 4284, Indexing Narcotics, Fentanyl, and Opioids (INFO) Act of 2018 H.R. 4616, To amend the Patient Protection and Affordable Care Act to provide for a temporary moratorium on the employer mandate and to provide for a delay in the implementation of the excise tax on high cost employer-sponsored health coverage H.R. 4617, To amend the Internal Revenue Code of 1986 to provide for a temporary moratorium on the medical device excise tax H.R. 4618, To amend the Internal Revenue Code of 1986 to provide for a temporary moratorium on certain taxes affecting purchases of prescription medication H.R. 4619, To amend the Patient Protection and Affordable Care Act to provide temporary relief from the annual fee imposed on health insurance providers, to the extent that such fee is due to Puerto Rican health insurance H.R. 4620, Protecting Families and Small Businesses Act of 2017 H.R. 4978/S. 2410, Chronic Disease Management Act of 2018 H.R. 5009, Jessies Law H.R. 5041, Safe Disposal of Unused Medication Act H.R. 5138, Bipartisan HSA Improvement Act of 2018 H.R. 5272, To provide additional guidance to grantees seeking funding to treat or prevent mental health or substance use disorders H.R. 5582, Abuse Deterrent Access Act of 2018 H.R. 5788, Synthetics Trafficking and Overdose Prevention (STOP) Act of 2018 H.R. 5892, To establish an Advisory Committee on Opioids and the Workplace to advise the Secretary of Labor on actions the Department of Labor can take to address the impact of opioid abuse on the workplace H.R. 6199, Restoring Access to Medication and Modernizing Health Savings Accounts Act of 2018 H.R. 6311, Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act of 2018 S. 108, Medical Device Access and Innovation Protection Act S. 191, Patient Freedom Act of 2017 S. 222, Obamacare Replacement Act S. 251, Protecting Medicare from Executive Action Act of 2017 S. 974, Creating and Restoring Equal Access To Equivalent Samples (CREATES) Act of 2017 S. 1835, Lower Premiums Through Reinsurance Act of 2017 S. 1850, Protecting Jessica Grubb's Legacy Act S. 1859, Healthcare Tax Relief Act S. 1978, Small Business and Family Health Tax Relief Act of 2017 S. 2004, Combating the Opioid Epidemic Act S. 2164, To amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings S. 3057, Synthetics Trafficking and Overdose Prevention (STOP) Act of 2018 Draft legislation to stabilize individual market premiums for the 2018 and 2019 plan years and provide meaningful State flexibility (Alexander-Murray) Proposed regulations on definition of employer under section 3(5) of ERISA-association health plans (83 Fed. Reg. 614-636, January 5, 2018) Various issues relating to Patient Protection and Affordable Care Act (P.L. 111-148) and the Health Care and Education Affordability Reconciliation Act of 2010 (P.L. 111-152), including the employer-sponsored health care system, implementation of regulatory process, provider network adequacy, delivery system reform, health savings account (HSAs), health reimbursement account (HRAs), and flexible spending account (FSAs) changes, IPAB, employer mandate, reporting requirements for issuers and applicable large employers, premium stabilization programs, medical loss ratio, medical malpractice reform, exchanges, the impact on small business, the Small Business Tax Credit, section 1332 waivers, section 1557 on nondiscrimination, caps on compensation deductibility required under section 9014, incompleteness or inaccuracy of cost impact analysis, lack of quantified benefit analysis, and need for empirical data sources on which to base costs and benefits, the Cost Sharing Reduction (CSR) program, the section 9010 Health Insurance Providers Fee or Health Insurance Tax (HIT), 40% excise tax on high-cost employer-sponsored health coverage (Cadillac tax); Public Health Services Act (P.L.78-410), Internal Revenue Code and the Employee Retirement Income Security Act (ERISA) (P.L. 93-406), regarding regulatory process and legislative corrections to ERISA preemption, changes to Medicare Advantage and Parts B, C, and D, including rebates and non-interference with prescription drug prices, entitlement reform, health information technology, telemedicine services in Medicare, and coordination and disease management programs; House Republican Taskforce on Health Care report, A Better Way to Fix Health Care; association health plans; importation of foreign pharmaceuticals into the United States and preemptive authority of federal food and drug regulations; Executive Order 13813, Promoting Healthcare Choice and Competition; addressing the opioids crisis, including end-stage renal disease; balance or surprise billing; single-payer health care options

Client expense: $17,560,000 · Firm income: Not reported

Government targets: Agency for Toxic Substances & Disease Registry, Agriculture, Dept of (USDA), Army, Dept of (Corps of Engineers), Commerce, Dept of (DOC), Commodity Futures Trading Commission (CFTC), Consumer Financial Protection Bureau (CFPB), Council on Environmental Quality (CEQ), Defense, Dept of (DOD), Education, Dept of, Energy, Dept of, Environmental Protection Agency (EPA), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Federal Communications Commission (FCC), Federal Deposit Insurance Corporation (FDIC), Federal Energy Regulatory Commission (FERC), Federal Reserve System, Federal Trade Commission (FTC), General Services Administration (GSA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Interior, Dept of (DOI), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Economic Council (NEC), Natl Labor Relations Board (NLRB), Natl Security Council (NSC), Natl Telecommunications & Information Administration (NTIA), Office of Management & Budget (OMB), Office of the Comptroller of the Currency (OCC), Office of the Vice President of the United States, Patent & Trademark Office (PTO), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Small Business Administration (SBA), Social Security Administration (SSA), State, Dept of (DOS), Transportation Security Administration (TSA), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Copyright Office, U.S. Customs & Border Protection, U.S. Fish & Wildlife Service (USFWS), U.S. Trade Representative (USTR), White House Office

Medicare Diabetes Prevention Program; diabetes self-management education; H.R. 3124/S. 1299/Preventing Diabetes in Medicare Act; H.R. 1953/S. 830 Treat and Reduce Obesity Act; Issues related to Medicare Part D included in Section 53116 of H.R. 1892 (Pub. L. 115-123), Bipartisan Budget Act and H.R. 1625 (Pub. L. 115-141), Consolidated Appropriations Act; H.R. 849/S. 260 including coverage gap ("donut hole") access and averting catastrophic coverage Out of Pocket (OOP) "cliff"; Protecting Seniors' Access to Medicare Act of 2017 and S. 251 Protecting Medicare from Executive Action Act of 2017 (IPAB Repeal); H.R. 3921 HEALTHY KIDS Act (CHIP Reauthorization).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicaid access and coverage, Sunshine implementation, EXPERT, medically complex children S. 260/H.R. 849 - Protecting Seniors' Access to Medicare Act of 2017 S. 1827 - Kids Act of 2017 H.R. 3921 - Healthy Kids Act

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

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

PL 114-255 - 21st Century Cures, implementation H.R. 878/S. 204 - Right to Try Act H.R. 1231/S. 456 - RACE for Children Act H.R. 2430 - FDA Reauthorization Act of 2017 H.R. 849/S. 260 - Protecting Seniors' Access to Medicare Act S. 2852 - Pandemic and All Hazards Preparedness Act S.2315 - Over-the-Counter Drug Safety, Innovation, and Reform Act H.R. 6 - SUPPORT for Patients and Communities Act ***no specific bills, importation, supply chain integrity, 304b, biosimilars, orphan drugs, newborn screening, expanded access, priority review, transparency, drug shortages, IPAB

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

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

S. 870 - Chronic Care S. 251 - Protecting Medicare from Executive Action of 2017 H.R. 849/S. 260 - Protecting Seniors' Access to Medicare Act of 2017 H.R. 242/S. 41 - Medicare Prescription Drug Price Negotiation Act of 2017 S. 348 - Prescription Drug and Health Improvement Act of 2017 H.R. 1316 - Prescription Drug Price Transparency Act H.J.Res. 51/S.J.Res. 16 - IPAB discontinuation H.R. 3921 - Healthy Kids Act S. 1827 - Kids Act of 2017 ***, no specific bill(s), Medicare and Medicaid Drug Reimbursement, Medicaid Rebate, dual eligibles, Sunshine, discount cards, MedPAC, biosimilars, Alternative Payment Models, Value based Purchasing, coding, CMMI, Part B, Part D, non-interference, IPAB, donut hole, Part D cliff, prescription drug access and affordability

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

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

Medicare priorities, coverage and payment policies, discount cards, MedPAC S. 260/H.R. 849 - Protecting Seniors' Access to Medicare Act of 2017 H.R. 3921 - Healthy Kids Act S. 1827 - Kids Act of 2017 no specific bill, Sunshine implementation, biosimilars, Part B, Medicare Part D, Smoking cessation, donut hole, Part D cliff

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

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