Opioid Crisis Response Act of 2018

S.3548, CARES Act: To provide emergency assistance and health care response for individuals, families, and businesses affected by the 2020 coronavirus pandemic; Practice Support/Grants to Practice S.3599, Healthcare Workforce Resilience Act: Foreign physician immigration status H.R. 7059, Coronavirus Provider Protection Act: Liability protection for healthcare providers Public Law No: 116-142, Paycheck Protection Program Flexibility Act of 2020 S.3201, Temporary Reauthorization and Study of the Emergency Scheduling of Fentanyl Analogues Act: Letter to Congressional Leadership regarding Fentanyl S.2723, Mitigating Emergency Drug Shortages Act: reducing drug shortages H.R. 3502, Protecting People From Surprise Medical Bills Act: Surprise Medical Bills H.R. 2500, National Defense Authorization Act for Fiscal Year 2020: Krishnamoorthi amdt on drug shortages H.R. 3107, Improving Seniors' Timely Access to Care Act of 2019: pre-authorization S. 1895, Lower Health Care Costs Act H.R. 3692, Addiction Treatment Access Improvement Act of 2017: Medically assisted treatment; opioids H.R. 5761, Ending Maternal Mortality Act of 2018: Maternal mortality H.R. 5718, Perioperative Reduction of Opioids Act: Opioids H.R. 5197, Alternatives to Opioids (ALTO) in the Emergency Department Act: Medically assisted treatment; opioids S. 2516, Alternatives to Opioids (ALTO) in the Emergency Department Act: Medically assisted treatment; opioids S.2680, Opioid Crisis Response Act of 2018: Medically assisted treatment; opioids S.2456, CARA 2.0 Act of 2018: Medically assisted treatment; opioids H.R. 1565, Saving Lives, Saving Costs S.1475, Saving Lives, Saving Costs Comprehensive Addiction and Recovery Act of 2016 (PL 114-198) FY 2021 LHHS Appropriations: Fiscal Year 2021 Appropriations for Subcommittee on Labor, Health and Human Services Outside Witness Testimony Affordable Care Act reform efforts H.R. 1628, American Health Care Act of 2017 S. Amdt. 1030 to H.R. 1628, "Graham-Cassidy" Better Care Reconciliation Act of 2017 H.R. 1492, Medical Controlled Substances Transportation Act of 2017 H.R. 1215, Protecting Access to Care Act of 2017 H.R. 3545, Overdose Prevention and Patient Safety Act H.R. 3446, Restoring Board Immunity Act of 2017: Professional Licensing S.2260, Opioids and STOP Pain Initiative ACT:opioids 42 CFR Part 2, Confidentiality of Substance Use Disorder Patient Records: appropriate access to patient information essential for providing whole-person care H.R.3928, Truth in Healthcare Marketing Act of 2017 H.R. 1554, REDI Act: student loan debt repayment for residents 21st Century Cures Initiative Drug Shortages - FDA, DEA, HHS, CMS, GAO, House Energy and Commerce Committee, Senate HELP Committee DEA Scheduling Propofol Comparative Effectiveness Research - PCORI HITECH Implementation, Electronic Health Records, Final and Proposed Rules, HIT Meaningful Use HHS/OIG Anesthesia Practice Arrangements, Company Model FDA Safe Use Initiative Pain Management FTC Letters to States re: Interventional Pain Medicine & Advanced Practice Nurses & Competition in Healthcare Anesthesia Research Funding (Pediatric and others) Scope of Practice FDA Operating Room Fires Naloxone FDA Opioids Prescription Drug Abuse FDA Network of Experts NIH Interagency Pain Research Coordinating Committee FDA SMART TOTS - pediatric anesthesia research USP - US Pharmacopeia National Pain Strategy Nondiscrimination Compounding FDA Nominations to Advisory Committees (Anesthesia Drugs, Anesthesia Devices, Compounding) Agency for Healthcare Research and Quality (AHRQ) funding Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Sequestration Opioids and opioid abuse; Brain health Certified Anesthesiologist Assistants Blood management COVID-19: Increased supply of PPE and ventilators, Funding for physician practices impacted by the cancellation of elective surgeries, unique role of anesthesiologists in responding to COVID-19 pandemic, medical liability, Scope of Practice (Waiver of federal supervision requirement under the Emergency Declaration), insurance moratorium; COVID Update Memorandum 4/21/20

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Natl Institutes of Health (NIH), Occupational Safety & Health Administration (OSHA), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA), White House Office

Lobbying Issues Description: Budget and appropriations for disease and injury prevention, including obesity and related diseases; pandemic influenza and emerging infectious diseases; physical activity; public health bioterrorism preparedness; food safety, environmental health; paid sick days; womens and childrens health; community-based public health interventions, and substance misuse/behavioral health issues. Specific Legislation: 1. Implementation of the Patient Protection and Affordable Care Act (Public Law 111-148) 2. Implementation of Pandemic and All-Hazards Preparedness Reauthorization Act and Pandemic and All-Hazards Preparedness and Advancing Innovation Act (Public Law 113-5, 116-22) 3. Implementation of Healthy, Hunger-Free Kids Act of 2010 (Public Law 111- 296) 4. Implementation of Every Student Succeeds Act (Public Law 114-95) 5. Implementation of the Comprehensive Addition and Recovery Act (Public Law 114-98) 6. Midnight Rules Relief Act (S.34/H.R. 21) 7. Regulations from the Executive in Need of Scrutiny Act (S. 21/H.R. 26) 8. Regulatory Accountability Act (S.951/H.R. 5/H.R. 45/H.Res.33) 9. Searching for and Cutting Regulations that are Unnecessarily Burdensome (SCRUB) Act (H.R. 998) 10. Regulatory Integrity Act (H.R. 1004) 11. OIRA Insight, Reform, and Accountability Act (S. 676/H.R. 1009) 12. A concurrent resolution setting forth the congressional budget for the United States Government for fiscal year 2017 and setting forth the appropriate budgetary levels for fiscal years 2018 through 2026 (S.Con.Res. 3) 13. American Health Care Act (H.R. 1628/H.Res. 228) 14. Ozone Standards Implementation Act (S. 263/H.R. 806) 15. Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the final rule of the Bureau of Land Management relating to "Waste Prevention, Production Subject to Royalties, and Resource Conservation" (S.J. Res. 11/H.J.Res.36) 16. Common Sense Nutrition Disclosure Act (S. 261/H.R. 772) 17. Reinvigorating Antibiotic and Diagnostic Innovation (READI) Act (H.R. 1840) 18. Preservation of Antibiotics for Medical Treatment Act (H.R. 1587) 19. Preventing Antibiotic Resistance Act (S. 629) 20. Better Care Reconciliation Act (H.R. 1628) and related amendments 21. Public Health Emergency Response Act (S. 196) 22. Recognizing the importance of vaccinations and immunizations in the United States (H.Res.327) 23. Treat and Reduce Obesity Act (S. 830/H.R. 1953) 24. Community Health and Medical Professionals Improve Our Nation (CHAMPION) Act (H.R. 3922) 25. Community Health Investment, Modernization, and Excellence Act of 2017 (S. 1899) 26. Tobacco Tax Equity Act (S. 1837) 27. Healthy Kids Act (S. 1821/H.R. 3921) 28. Implementation of the Drug Quality and Security Act (P.S. 113-54) 29. Continuing Appropriations Act, 2018 and Supplemental Appropriations for Disaster Relief Requirements Act, 2017 (Public Law 115-56) 30. Friendly Airports for Mothers Act (S. 1110/H.R. 2375) 31. Lead-Safe Housing for Kids Act (S. 1845) 32. Supporting Working Moms Act (S. 2122/H.R. 3255) 33. Championing Healthy Kids Act (H.R. 3922) 34. Making further continuing appropriations for fiscal year 2018, and for other purposes (Public Law 115-90) 35. An Act to amend the Homeland Security Act of 2002 to require the Secretary of Homeland Security to issue Department of Homeland Security-wide guidance and develop training programs as part of the Department of Homeland Security Blue Campaign, and for other purposes (Public Law 115- 96) 36. Tax Cuts and Jobs Act (Public Law 115-97) 37. Pandemic and All-Hazards Preparedness Advancing Innovation Act (S. 2852/H.R. 6378/H.R. 7328/S. 1379/H.R. 269) 38. Vaccine Access Improvement Act (H.R. 4993) 39. Relief from New Source Performance Standards Act (H.R. 453) 40. Strategies to Address Antimicrobial Resistance (S. 2469) 41. Opioid Quota Reform Act (S. 2535) 42. Hospital Preparedness Program Reauthorization Act (H.R. 4776) 43. Blocking Regulatory Interference from Closing Kilns Act (H.R. 1917) 44. Opioid Crisis Response Act of 2018 (S. 2680) 45. Agriculture and Nutrition Act (H.R. 2) 46. Agriculture Improvement Act (S. 3042) 47. SECURE Act (H.R. 5998) 48. Trauma-Informed Care for Children and Families Act (S. 774) 49. SUPPORT for Patients and Communities Act (H.R. 6) 50. Centers for Disease Control Emergency Response Act (S. 3161) 51. LABEL Opioids Act (S. 3428) 52. Relief from New Source Performance Standards Act (S. 1857) 53. Outdoors for All Act (S. 3499) 54. The MOMMA Act (H.R. 5977) 55. Preventing Maternal Deaths Act (H.R. 1318) 56. Medicare Access to Vaccines Equity Act (not yet introduced) 57. The Support Act (H.R. 6) 58. Climate Change Health Protection and Promotion Act (S. 529) 59. NURSE Act (H.R. 1597) 60. Investing for the People Act (H.R. 2021) 61. Child Care for Working Families Act (H.R. 365/S. 568) 62. FAMILY Act (H.R. 1185/S. 463) 63. Transportation Alternatives Enhancement Act (S. 1098) 64. Lower Health Care Costs Act (S. 1895) 65. LIFT America Act (H.R 2479) 66. Public Health Funding Restoration Act (H.R. 3447/S. 1944) 67. Supporting Older Americans Act of 2020 (HR 4334) 68. Campus Prevention and Recovery Services for Students Act (H.R. 3591) 69. Healthier Students for Stronger Campuses Act (S. 1281) 70. Saving Lives Through Better Data Act (S. 1793) 71. VACCINES Act (H.R. 2862) 72. DISARM Act (H.R. 4100/S. 1712) 73. Community Access, Resources, and Education for Families Act (H.R. 3117) 74. Protecting Seniors Through Immunization Act (S. 1872) 75. Tobacco-Free Youth Act (S. 1541) 76. Tobacco to 21 Act (H.R. 2411/S. 1258) 77. Investing for People Act (H.R. 2021) 78. School Based Health Centers Reauthorization Act (H.R.2075/S.1013) 79. Reversing the Youth Tobacco Epidemic Act of 2019 (H.R. 2339) 80. Social Determinants Accelerator Act (H.R. 4004) 81. Mental Health Professionals Workforce Shortage Loan Repayment Act (H.R. 2431) 82. The UNDERSTAND Act (S. 1323) 83. Americas Transportation Infrastructure Act (S. 2302) 84. Barriers to Suicide Act of 2019 (H.R. 4309) 85. Promoting Physical Activity for Americans Act (S. 1608/H.R. 2891) 86. Public Health Infrastructure Modernization Act of 2019 (H.R. 5321) 87. Supporting Healthy Mothers and Infants Act (H.R. 5249) 88. Lead-Free Future Act (H.R. 4416) 89. Home Visiting to Reduce Maternal Mortality and Morbidity Act (H.R. 4768) 90. Recognizing the anniversary of the eradication of smallpox and the importance of vaccination in the United States and worldwide (H. Res. 592) 91. Coronavirus Preparedness and Response Supplemental Appropriations Act (H.R. 6074) 92. Families First Coronavirus Response Act (H.R. 6201) 93. Coronavirus Aid, Relief, and Economic Security (CARES) Act (H.R. 748) 94. Connecting Americas Transportation Infrastructure Act (S. 2302) 95. Improving Access to Remote Behavioral Health Treatment Act (S. 2244/H.R. 4131) 96. National Suicide Hotline Designation Act (S. 2661/H.R. 4194) 97. Suicide Prevention Lifeline Improvement Act (H.R. 4564) 98. Campaign to Prevent Suicide Act (H.R. 4585) 99. Medicaid Reentry Act (H.R. 1329) 100. Excellence in Mental Health and Addiction Treatment Expansion Act (S. 824/H.R. 1767) 101. Mental Health Services for Students Act (S. 1122/H.R. 1109) 102. Suicide Training and Awareness Nationally Delivered for Universal Prevention (STANDUP) Act (S. 2492/H.R. 2599) 103. Mental Health Parity Compliance Act (S. 1737/H.R. 3165) 104. Behavioral Health Transparency Act (S. 1576/H.R. 2874) 105. Medicare Mental Health Access Act (S. 2772/H.R. 884) 106. Public Health Emergency Response and Accountability Act (S. 3309) 107. Family Violence Prevention and Services Improvement Act (H.R. 5041) 108. Protecting the Health of Americas Older Adults During COVID-19 and Beyond Act (H.R. 6935) 109. Improving Social Determinants Act (H.R. 6561) 110. Urging the establishment of a United States Commission on Truth, Racial Healing, and Transformation (H.Con.Res.100) 111. FY 2021 Departments of Labor, Health and Human Services, and Education and Related Agencies Appropriations (TBD) 112. Better Tools for Healthy Living Act (S. 1805) 113. The WIC Act (S. 2358) 114. Health Equity and Accountability Act (H.R. 6637) 115. Paycheck Protection Program and Health Care Enhancement Act (H.R. 266) 116. The HEROES Act (H.R.6800) 117. Community Solutions for COVID-19 Act (H.R.7077/S.3877) 118. The Black Maternal Health Momnibus Act of 2020 (H.R. 6142) 119. COVID-19 Bias and Anti-Racism Training Act (S.___) 120. Urging the establishment of a United States Commission on Truth, Racial Healing, and Transformation (H. Con. Res. 100) 121. Community Immunity During COVID-19 Act of 2020 (H.R._____) 122. Public Safety Officer Support Act (H.R. 7568) 123. COVID-19 Behavioral Health Support Act (S. 4059) 124. Public Health Workforce Loan Repayment Act (H.R. 6578) 125. Strengthening the Public Health Workforce Act (S. 3737) House(s) of Congress and Federal Agencies lobbied during the quarter: House, Senate, Exec Office of Pres, HHS, CDC, FDA, CMS, OMB, DOT, HUD, EPA, NIMH, Education, USDA, DHS, FEMA, and SAMHSA

Client expense: $32,208 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Environmental Protection Agency (EPA), Executive Office of the President (EOP), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Office of Management & Budget (OMB), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Transportation, Dept of (DOT)

S.3548, CARES Act: To provide emergency assistance and health care response for individuals, families, and businesses affected by the 2020 coronavirus pandemic; Practice Support/Grants to Practice H.R. 7059, Coronavirus Provider Protection Act: Liability protection for healthcare providers Public Law No: 116-142, Paycheck Protection Program Flexibility Act of 2020 S.3201, Temporary Reauthorization and Study of the Emergency Scheduling of Fentanyl Analogues Act: Letter to Congressional Leadership regarding Fentanyl Surprise Medical Bills S.2723, Mitigating Emergency Drug Shortages Act: reducing drug shortages H.R. 3502, Protecting People From Surprise Medical Bills Act H.R. 2500, National Defense Authorization Act for Fiscal Year 2020: Krishnamoorthi amdt on drug shortages H.R. 3107, Improving Seniors' Timely Access to Care Act of 2019: pre-authorization S. 1895, Lower Health Care Costs Act H.R. 3692, Addiction Treatment Access Improvement Act of 2017: Medically assisted treatment; opioids H.R. 5761, Ending Maternal Mortality Act of 2018: Maternal mortality H.R. 5718, Perioperative Reduction of Opioids Act: Opioids H.R. 5197, Alternatives to Opioids (ALTO) in the Emergency Department Act: Medically assisted treatment; opioids S. 2516, Alternatives to Opioids (ALTO) in the Emergency Department Act: Medically assisted treatment; opioids S.2680, Opioid Crisis Response Act of 2018: Medically assisted treatment; opioids S.2456, CARA 2.0 Act of 2018: Medically assisted treatment; opioids H.R. 1565, Saving Lives, Saving Costs S.1475, Saving Lives, Saving Costs Comprehensive Addiction and Recovery Act of 2016 (PL 114-198) FY 2021 LHHS Appropriations: Fiscal Year 2021 Appropriations for Subcommittee on Labor, Health and Human Services Outside Witness Testimony Affordable Care Act reform efforts H.R. 1628, American Health Care Act of 2017 S. Amdt. 1030 to H.R. 1628, "Graham-Cassidy" Better Care Reconciliation Act of 2017 H.R. 1492, Medical Controlled Substances Transportation Act of 2017 H.R. 1215, Protecting Access to Care Act of 2017 H.R. 3545, Overdose Prevention and Patient Safety Act H.R. 3446, Restoring Board Immunity Act of 2017: Professional Licensing S.2260, Opioids and STOP Pain Initiative ACT:opioids 42 CFR Part 2, Confidentiality of Substance Use Disorder Patient Records: appropriate access to patient information essential for providing whole-person care H.R.3928, Truth in Healthcare Marketing Act of 2017 H.R. 1554, REDI Act: student loan debt repayment for residents 21st Century Cures Initiative Drug Shortages - FDA, DEA, HHS, CMS, GAO, House Energy and Commerce Committee, Senate HELP Committee DEA Scheduling Propofol Comparative Effectiveness Research - PCORI HITECH Implementation, Electronic Health Records, Final and Proposed Rules, HIT Meaningful Use HHS/OIG Anesthesia Practice Arrangements, Company Model FDA Safe Use Initiative Pain Management FTC Letters to States re: Interventional Pain Medicine & Advanced Practice Nurses & Competition in Healthcare Anesthesia Research Funding (Pediatric and others) Scope of Practice FDA Operating Room Fires Naloxone FDA Opioids Prescription Drug Abuse FDA Network of Experts NIH Interagency Pain Research Coordinating Committee FDA SMART TOTS - pediatric anesthesia research USP - US Pharmacopeia National Pain Strategy Nondiscrimination Compounding FDA Nominations to Advisory Committees (Anesthesia Drugs, Anesthesia Devices, Compounding) Agency for Healthcare Research and Quality (AHRQ) funding Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Sequestration Opioids and opioid abuse; Brain health Anesthesiologist Assistants Blood management COVID-19: Increased supply of PPE and ventilators,Funding for physician practices impacted by the cancellation of elective surgeries, unique role of anesthesiologists in responding to COVID-19 pandemic, medical liability, Scope of Practice (Waiver of federal supervision requirement under the Emergency Declaration), insurance moratorium; COVID Update Memorandum 4/21/20 Immigration: Foreign physician immigration status

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Natl Institutes of Health (NIH), Occupational Safety & Health Administration (OSHA), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA), White House Office

Lobbying Issues Description: Budget and appropriations for disease and injury prevention, including obesity and related diseases; pandemic influenza and emerging infectious diseases; physical activity; public health bioterrorism preparedness; food safety, environmental health; paid sick days; womens and childrens health; community-based public health interventions, and substance misuse/behavioral health issues. Specific Legislation: 1. Implementation of the Patient Protection and Affordable Care Act (Public Law 111-148) 2. Implementation of the FDA Food Safety Modernization Act (Public Law 111353) 3. Implementation of Pandemic and All-Hazards Preparedness Reauthorization Act and Pandemic and All-Hazards Preparedness and Advancing Innovation Act (Public Law 113-5, 116-22) 4. Implementation of Healthy, Hunger-Free Kids Act of 2010 (Public Law 111296) 5. Implementation of Child Care and Development Block Grant Act of 2014 (Public Law 113-186) 6. Implementation of Every Student Succeeds Act (Public Law 114-95) 7. Implementation of the Comprehensive Addition and Recovery Act (Public Law 114-98) 8. FY 2020 Departments of Labor, Health and Human Services, and Education and Related Agencies Appropriations (H.R. 2740/Not Yet Introduced)) 9. FY 2020 Departments of Agriculture, Rural Development, Food and Drug Administration and Related Agencies Appropriations (H.R. 3164/Not yet introduced) 10. FY2020 Departments of Transportation, HUD and related agencies Appropriations (H.R. 3163/Not Yet Introduced) 11. FY2020 Further Consolidated Appropriations Act (H.R. 1865/P.L. 116-94) 12. Midnight Rules Relief Act (S.34/H.R. 21) 13. Regulations from the Executive in Need of Scrutiny Act (S. 21/H.R. 26) 14. Regulatory Accountability Act (S.951/H.R. 5/H.R. 45/H.Res.33) 15. Searching for and Cutting Regulations that are Unnecessarily Burdensome (SCRUB) Act (H.R. 998) 16. Regulatory Integrity Act (H.R. 1004) 17. OIRA Insight, Reform, and Accountability Act (S. 676/H.R. 1009) 18. A concurrent resolution setting forth the congressional budget for the United States Government for fiscal year 2017 and setting forth the appropriate budgetary levels for fiscal years 2018 through 2026 (S.Con.Res. 3) 19. American Health Care Act (H.R. 1628/H.Res. 228) 20. Ozone Standards Implementation Act (S. 263/H.R. 806) 21. Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the final rule of the Bureau of Land Management relating to "Waste Prevention, Production Subject to Royalties, and Resource Conservation" (S.J. Res. 11/H.J.Res.36) 22. Common Sense Nutrition Disclosure Act (S. 261/H.R. 772) 23. Reinvigorating Antibiotic and Diagnostic Innovation (READI) Act (H.R. 1840) 24. Preservation of Antibiotics for Medical Treatment Act (H.R. 1587) 25. Preventing Antibiotic Resistance Act (S. 629) 26. Better Care Reconciliation Act (H.R. 1628) and related amendments 27. Public Health Emergency Response Act (S. 196) 28. Recognizing the importance of vaccinations and immunizations in the United States (H.Res.327) 29. Consolidated Appropriations Act, 2017 (Public Law 115-31) 30. Treat and Reduce Obesity Act (S. 830/H.R. 1953) 31. Community Health and Medical Professionals Improve Our Nation (CHAMPION) Act (H.R. 3922) 32. Community Health Investment, Modernization, and Excellence Act of 2017 (S. 1899) 33. Tobacco Tax Equity Act (S. 1837) 34. Healthy Kids Act (S. 1821/H.R. 3921) 35. Implementation of the Drug Quality and Security Act (P.S. 113-54) 36. Continuing Appropriations Act, 2018 and Supplemental Appropriations for Disaster Relief Requirements Act, 2017 (Public Law 115-56) 37. Friendly Airports for Mothers Act (S. 1110/H.R. 2375) 38. Lead-Safe Housing for Kids Act (S. 1845) 39. Supporting Working Moms Act (S. 2122/H.R. 3255) 40. Championing Healthy Kids Act (H.R. 3922) 41. Making further continuing appropriations for fiscal year 2018, and for other purposes (Public Law 115-90) 42. An Act to amend the Homeland Security Act of 2002 to require the Secretary of Homeland Security to issue Department of Homeland Security-wide guidance and develop training programs as part of the Department of Homeland Security Blue Campaign, and for other purposes (Public Law 11596) 43. Tax Cuts and Jobs Act (Public Law 115-97) 44. Pandemic and All-Hazards Preparedness Advancing Innovation Act (S. 2852/H.R. 6378/H.R. 7328/S. 1379/H.R. 269) 45. Vaccine Access Improvement Act (H.R. 4993) 46. Relief from New Source Performance Standards Act (H.R. 453) 47. Strategies to Address Antimicrobial Resistance (S. 2469) 48. Opioid Quota Reform Act (S. 2535) 49. Hospital Preparedness Program Reauthorization Act (H.R. 4776) 50. Blocking Regulatory Interference from Closing Kilns Act (H.R. 1917) 51. Opioid Crisis Response Act of 2018 (S. 2680) 52. Agriculture and Nutrition Act (H.R. 2) 53. Agriculture Improvement Act (S. 3042) 54. SECURE Act (H.R. 5998) 55. Trauma-Informed Care for Children and Families Act (S. 774) 56. SUPPORT for Patients and Communities Act (H.R. 6) 57. Centers for Disease Control Emergency Response Act (S. 3161) 58. LABEL Opioids Act (S. 3428) 59. Relief from New Source Performance Standards Act (S. 1857) 60. Outdoors for All Act (S. 3499) 61. The MOMMA Act (H.R. 5977) 62. Preventing Maternal Deaths Act (H.R. 1318) 63. Medicare Access to Vaccines Equity Act (note yet introduced) 64. The Support Act (H.R. 6) 65. Climate Change Health Protection and Promotion Act (S. 529) 66. FY 2020 Departments of the Interior, Environment, and Related Agencies Appropriations Act (H.R. 3052/Not Yet Introduced) 67. NURSE Act (H.R. 1597) 68. Investing for the People Act (H.R. 2021) 69. Child Care for Working Families Act (H.R. 365/S. 568) 70. FAMILY Act (H.R. 1185/S. 463) 71. Transportation Alternatives Enhancement Act (S. 1098) 72. Lower Health Care Costs Act (S. 1895) 73. LIFT America Act (H.R 2479) 74. Public Health Funding Restoration Act (H.R. 3447/S. 1944) 75. Older Americans Act reauthorization (not yet introduced) 76. Campus Prevention and Recovery Services for Students Act (H.R. 3591) 77. Healthier Students for Stronger Campuses Act (S. 1281) 78. Saving Lives Through Better Data Act (S. 1793) 79. VACCINES Act (H.R. 2862) 80. DISARM Act (H.R. 4100/S. 1712) 81. Community Access, Resources, and Education for Families Act (H.R. 3117) 82. Protecting Seniors Through Immunization Act (S. 1872) 83. Tobacco-Free Youth Act (S. 1541) 84. Tobacco to 21 Act (H.R. 2411/S. 1258) 85. Investing for People Act (H.R. 2021) 86. School Based Health Centers Reauthorization Act (H.R.2075/S.1013) 87. Reversing the Youth Tobacco Epidemic Act of 2019 (H.R. 2339) 88. Social Determinants Accelerator Act (H.R. 4004) 89. Mental Health Professionals Workforce Shortage Loan Repayment Act (H.R. 2431) 90. The UNDERSTAND Act (S. 1323) 91. Americas Transportation Infrastructure Act (S. 2302) 92. Health Equity and Accountability Act (Not yet introduced) 93. Barriers to Suicide Act of 2019 (H.R. 4309) 94. Promoting Physical Activity for Americans Act (S. 1608/H.R. 2891) 95. Public Health Infrastructure Modernization Act of 2019 (H.R. 5321) 96. Supporting Healthy Mothers and Infants Act (H.R. 5249) 97. Lead-Free Future Act (H.R. 4416) 98. Home Visiting to Reduce Maternal Mortality and Morbidity Act (H.R. 4768) 99. Recognizing the anniversary of the eradication of smallpox and the importance of vaccination in the United States and worldwide (H. Res. 592) 100. Coronavirus Preparedness and Response Supplemental Appropriations Act (H.R. 6074) 101. Families First Coronavirus Response Act (H.R. 6201) 102. Coronavirus Aid, Relief, and Economic Security (CARES) Act (H.R. 748) 103. Connecting Americas Transportation Infrastructure Act (S. 2302) 104. Improving Access to Remote Behavioral Health Treatment Act (S. 2244/H.R. 4131) 105. National Suicide Hotline Designation Act (S. 2661/H.R. 4194) 106. Suicide Prevention Lifeline Improvement Act (H.R. 4564) 107. Campaign to Prevent Suicide Act (H.R. 4585) 108. Medicaid Reentry Act (H.R. 1329) 109. Excellence in Mental Health and Addiction Treatment Expansion Act (S. 824/H.R. 1767) 110. Mental Health Services for Students Act (S. 1122/H.R. 1109) 111. Suicide Training and Awareness Nationally Delivered for Universal Prevention (STANDUP) Act (S. 2492/H.R. 2599) 112. Mental Health Parity Compliance Act (S. 1737/H.R. 3165) 113. Behavioral Health Transparency Act (S. 1576/H.R. 2874) 114. Medicare Mental Health Access Act (S. 2772/H.R. 884) 115. Public Health Emergency Response and Accountability Act (S. 3309) 116. Family Violence Prevention and Services Improvement Act (H.R. 5041) House(s) of Congress and Federal Agencies lobbied during the quarter: House, Senate, Exec Office of Pres, HHS, CDC, FDA, CMS, OMB, DOT, HUD, EPA, NIMH, Education, USDA, DHS, FEMA, and SAMHSA

Client expense: $35,610 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Environmental Protection Agency (EPA), Executive Office of the President (EOP), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Office of Management & Budget (OMB), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Transportation, Dept of (DOT)

S.3548, CARES Act: To provide emergency assistance and health care response for individuals, families, and businesses affected by the 2020 coronavirus pandemic; Practice Support/Grants to Practice S.3201, Temporary Reauthorization and Study of the Emergency Scheduling of Fentanyl Analogues Act: Letter to Congressional Leadership regarding Fentanyl Surprise Medical Bills S.2723, Mitigating Emergency Drug Shortages Act: reducing drug shortages H.R. 3502, Protecting People From Surprise Medical Bills Act H.R. 2500, National Defense Authorization Act for Fiscal Year 2020: Krishnamoorthi amdt on drug shortages H.R. 3107, Improving Seniors' Timely Access to Care Act of 2019: pre-authorization S. 1895, Lower Health Care Costs Act H.R. 3692, Addiction Treatment Access Improvement Act of 2017: Medically assisted treatment; opioids H.R. 5761, Ending Maternal Mortality Act of 2018: Maternal mortality H.R. 5718, Perioperative Reduction of Opioids Act: Opioids H.R. 5197, Alternatives to Opioids (ALTO) in the Emergency Department Act: Medically assisted treatment; opioids S. 2516, Alternatives to Opioids (ALTO) in the Emergency Department Act: Medically assisted treatment; opioids S.2680, Opioid Crisis Response Act of 2018: Medically assisted treatment; opioids S.2456, CARA 2.0 Act of 2018: Medically assisted treatment; opioids H.R. 1565, Saving Lives, Saving Costs S.1475, Saving Lives, Saving Costs Comprehensive Addiction and Recovery Act of 2016 (PL 114-198) FY 2021 LHHS Appropriations: Fiscal Year 2021 Appropriations for Subcommittee on Labor, Health and Human Services Outside Witness Testimony Affordable Care Act reform efforts H.R. 1628, American Health Care Act of 2017 S. Amdt. 1030 to H.R. 1628, "Graham-Cassidy" Better Care Reconciliation Act of 2017 H.R. 1492, Medical Controlled Substances Transportation Act of 2017 H.R. 1215, Protecting Access to Care Act of 2017 H.R. 3545, Overdose Prevention and Patient Safety Act H.R. 3446, Restoring Board Immunity Act of 2017: Professional Licensing S.2260, Opioids and STOP Pain Initiative ACT:opioids 42 CFR Part 2, Confidentiality of Substance Use Disorder Patient Records: appropriate access to patient information essential for providing whole-person care H.R.3928, Truth in Healthcare Marketing Act of 2017 H.R. 1554, REDI Act: student loan debt repayment for residents 21st Century Cures Initiative Drug Shortages - FDA, DEA, HHS, CMS, GAO, House Energy and Commerce Committee, Senate HELP Committee DEA Scheduling Propofol Comparative Effectiveness Research - PCORI HITECH Implementation, Electronic Health Records, Final and Proposed Rules, HIT Meaningful Use HHS/OIG Anesthesia Practice Arrangements, Company Model FDA Safe Use Initiative Pain Management FTC Letters to States re: Interventional Pain Medicine & Advanced Practice Nurses & Competition in Healthcare Anesthesia Research Funding (Pediatric and others) Scope of Practice FDA Operating Room Fires Naloxone FDA Opioids Prescription Drug Abuse FDA Network of Experts NIH Interagency Pain Research Coordinating Committee FDA SMART TOTS - pediatric anesthesia research USP - US Pharmacopeia National Pain Strategy Nondiscrimination Compounding FDA Nominations to Advisory Committees (Anesthesia Drugs, Anesthesia Devices, Compounding) Agency for Healthcare Research and Quality (AHRQ) funding Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Sequestration Opioids and opioid abuse; Brain health Anesthesiologist Assistants Blood management Immigration: Foreign Physician Immigration Status COVID-19: Increased supply of PPE and ventilators,Funding for physician practices impacted by the cancellation of elective surgeries, unique role of anesthesiologists in responding to COVID-19 pandemic, medical liability, Scope of Practice (Waiver of federal supervision requirement under the Emergency Declaration)

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Natl Institutes of Health (NIH), Occupational Safety & Health Administration (OSHA), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA)

Lobbying Issues Description: Budget and appropriations for disease and injury prevention, including obesity and related diseases; pandemic influenza and emerging infectious diseases; physical activity; public health bioterrorism preparedness; food safety, environmental health; paid sick days; womens and childrens health; community-based public health interventions, and substance misuse/behavioral health issues. Specific Legislation: 1.Implementation of the Patient Protection and Affordable Care Act (Public Law 111-148) 2.Implementation of the FDA Food Safety Modernization Act (Public Law 111-353) 3.Implementation of Pandemic and All-Hazards Preparedness Reauthorization Act and Pandemic and All-Hazards Preparedness and Advancing Innovation Act (Public Law 113-5, 116-22) 4.Implementation of Healthy, Hunger-Free Kids Act of 2010 (Public Law 111-296) 5.Implementation of Child Care and Development Block Grant Act of 2014 (Public Law 113-186) 6.Implementation of Every Student Succeeds Act (Public Law 114-95) 7.Implementation of the Comprehensive Addition and Recovery Act (Public Law 114-98) 8.FY 2020 Departments of Labor, Health and Human Services, and Education and Related Agencies Appropriations (H.R. 2740/Not Yet Introduced)) 9.FY 2020 Departments of Agriculture, Rural Development, Food and Drug Administration and Related Agencies Appropriations (H.R. 3164/Not yet introduced) 10.FY2020 Departments of Transportation, HUD and related agencies Appropriations (H.R. 3163/Not Yet Introduced) 11.FY2020 Further Consolidated Appropriations Act (H.R. 1865/P.L. 116-94) 12.Midnight Rules Relief Act (S.34/H.R. 21) 13.Regulations from the Executive in Need of Scrutiny Act (S. 21/H.R. 26) 14.Regulatory Accountability Act (S.951/H.R. 5/H.R. 45/H.Res.33) 15.Searching for and Cutting Regulations that are Unnecessarily Burdensome (SCRUB) Act (H.R. 998) 16.Regulatory Integrity Act (H.R. 1004) 17.OIRA Insight, Reform, and Accountability Act (S. 676/H.R. 1009) 18.A concurrent resolution setting forth the congressional budget for the United States Government for fiscal year 2017 and setting forth the appropriate budgetary levels for fiscal years 2018 through 2026 (S.Con.Res. 3) 19.American Health Care Act (H.R. 1628/H.Res. 228) 20.Ozone Standards Implementation Act (S. 263/H.R. 806) 21.Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the final rule of the Bureau of Land Management relating to "Waste Prevention, Production Subject to Royalties, and Resource Conservation" (S.J. Res. 11/H.J.Res.36) 22.Common Sense Nutrition Disclosure Act (S. 261/H.R. 772) 23.Reinvigorating Antibiotic and Diagnostic Innovation (READI) Act (H.R. 1840) 24.Preservation of Antibiotics for Medical Treatment Act (H.R. 1587) 25.Preventing Antibiotic Resistance Act (S. 629) 26.Better Care Reconciliation Act (H.R. 1628) and related amendments 27.Public Health Emergency Response Act (S. 196) 28.Recognizing the importance of vaccinations and immunizations in the United States (H.Res.327) 29.Consolidated Appropriations Act, 2017 (Public Law 115-31) 30.Treat and Reduce Obesity Act (S. 830/H.R. 1953) 31.Community Health and Medical Professionals Improve Our Nation (CHAMPION) Act (H.R. 3922) 32.Community Health Investment, Modernization, and Excellence Act of 2017 (S. 1899) 33.Tobacco Tax Equity Act (S. 1837) 34.Healthy Kids Act (S. 1821/H.R. 3921) 35.Implementation of the Drug Quality and Security Act (P.S. 113-54) 36.Continuing Appropriations Act, 2018 and Supplemental Appropriations for Disaster Relief Requirements Act, 2017 (Public Law 115-56) 37.Friendly Airports for Mothers Act (S. 1110/H.R. 2375) 38.Lead-Safe Housing for Kids Act (S. 1845) 39.Supporting Working Moms Act (S. 2122/H.R. 3255) 40.Championing Healthy Kids Act (H.R. 3922) 41.Making further continuing appropriations for fiscal year 2018, and for other purposes (Public Law 115-90) 42.An Act to amend the Homeland Security Act of 2002 to require the Secretary of Homeland Security to issue Department of Homeland Security-wide guidance and develop training programs as part of the Department of Homeland Security Blue Campaign, and for other purposes (Public Law 115-96) 43.Tax Cuts and Jobs Act (Public Law 115-97) 44.Pandemic and All-Hazards Preparedness Advancing Innovation Act (S. 2852/H.R. 6378/H.R. 7328/S. 1379/H.R. 269) 45.Vaccine Access Improvement Act (H.R. 4993) 46.Relief from New Source Performance Standards Act (H.R. 453) 47.Strategies to Address Antimicrobial Resistance (S. 2469) 48.Opioid Quota Reform Act (S. 2535) 49.Hospital Preparedness Program Reauthorization Act (H.R. 4776) 50.Blocking Regulatory Interference from Closing Kilns Act (H.R. 1917) 51.Opioid Crisis Response Act of 2018 (S. 2680) 52.Agriculture and Nutrition Act (H.R. 2) 53.Agriculture Improvement Act (S. 3042) 54.SECURE Act (H.R. 5998) 55.Trauma-Informed Care for Children and Families Act (S. 774) 56.SUPPORT for Patients and Communities Act (H.R. 6) 57.Centers for Disease Control Emergency Response Act (S. 3161) 58.LABEL Opioids Act (S. 3428) 59.Relief from New Source Performance Standards Act (S. 1857) 60.Outdoors for All Act (S. 3499) 61.The MOMMA Act (H.R. 5977) 62.Preventing Maternal Deaths Act (H.R. 1318) 63.Medicare Access to Vaccines Equity Act (note yet introduced) 64.The Support Act (H.R. 6) 65.Climate Change Health Protection and Promotion Act (S. 529) 66.FY 2020 Departments of the Interior, Environment, and Related Agencies Appropriations Act (H.R. 3052/Not Yet Introduced) 67.NURSE Act (H.R. 1597) 68.Investing for the People Act (H.R. 2021) 69.Child Care for Working Families Act (H.R. 365/S. 568) 70.FAMILY Act (H.R. 1185/S. 463) 71.Transportation Alternatives Enhancement Act (S. 1098) 72.Lower Health Care Costs Act (S. 1895) 73.LIFT America Act (H.R 2479) 74.Public Health Funding Restoration Act (H.R. 3447/S. 1944) 75.Older Americans Act reauthorization (not yet introduced) 76.Campus Prevention and Recovery Services for Students Act (H.R. 3591) 77.Healthier Students for Stronger Campuses Act (S. 1281) 78.Saving Lives Through Better Data Act (S. 1793) 79.VACCINES Act (H.R. 2862) 80.DISARM Act (H.R. 4100/S. 1712) 81.Community Access, Resources, and Education for Families Act (H.R. 3117) 82.Protecting Seniors Through Immunization Act (S. 1872) 83.Tobacco-Free Youth Act (S. 1541) 84.Tobacco to 21 Act (H.R. 2411/S. 1258) 85.Investing for People Act (H.R. 2021) 86.School Based Health Centers Reauthorization Act (H.R.2075/S.1013) 87.Reversing the Youth Tobacco Epidemic Act of 2019 (H.R. 2339) 88.Social Determinants Accelerator Act (H.R. 4004) 89.Mental Health Professionals Workforce Shortage Loan Repayment Act (H.R. 2431) 90.The UNDERSTAND Act (S. 1323) 91.Americas Transportation Infrastructure Act (S. 2302) 92.Health Equity and Accountability Act (Not yet introduced) 93.Barriers to Suicide Act of 2019 (H.R. 4309) 94.Promoting Physical Activity for Americans Act (S. 1608) 95.Public Health Infrastructure Modernization Act of 2019 (H.R. 5321) 96.Supporting Healthy Mothers and Infants Act (H.R. 5249) 97.Lead-Free Future Act (H.R. 4416) 98.Home Visiting to Reduce Maternal Mortality and Morbidity Act (H.R. 4768) 99.Recognizing the anniversary of the eradication of smallpox and the importance of vaccination in the United States and worldwide (H.Res. 592) House(s) of Congress and Federal Agencies lobbied during the quarter: House, Senate, Exec Office of Pres, HHS, CDC, FDA, CMS, OMB, DOT, HUD, EPA, NIMH, Education, USDA, DHS, FEMA, and SAMHSA.

Client expense: $35,486 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Environmental Protection Agency (EPA), Executive Office of the President (EOP), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Office of Management & Budget (OMB), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Transportation, Dept of (DOT)

Lobbying Issues Description: Budget and appropriations for disease and injury prevention, including obesity and related diseases; pandemic influenza and emerging infectious diseases; physical activity; public health bioterrorism preparedness; food safety, environmental health; paid sick days; womens and childrens health; community-based public health interventions, and substance misuse/behavioral health issues. Specific Legislation: 1.Implementation of the Patient Protection and Affordable Care Act (Public Law 111-148) 2.Implementation of the FDA Food Safety Modernization Act (Public Law 111-353) 3.Implementation of Pandemic and All-Hazards Preparedness Reauthorization Act and Pandemic and All-Hazards Preparedness and Advancing Innovation Act (Public Law 113-5, 116-22) 4.Implementation of Healthy, Hunger-Free Kids Act of 2010 (Public Law 111-296) 5.Implementation of the Budget Control Act of 2011 (Public Law 112-25) 6.Implementation of Child Care and Development Block Grant Act of 2014 (Public Law 113-186) 7.Implementation of Every Student Succeeds Act (Public Law 114-95) 8.Implementation of the Comprehensive Addition and Recovery Act (Public Law 114-98) 9.FY 2020 Departments of Labor, Health and Human Services, and Education and Related Agencies Appropriations (H.R. 2740/Not Yet Introduced)) 10.FY 2020 Departments of Agriculture, Rural Development, Food and Drug Administration and Related Agencies Appropriations (H.R. 3164/Not yet introduced) 11.FY2020 Departments of Transportation, HUD and related agencies Appropriations (H.R. 3163/Not Yet Introduced) 12.Midnight Rules Relief Act (S.34/H.R. 21) 13.Regulations from the Executive in Need of Scrutiny Act (S. 21/H.R. 26) 14.Regulatory Accountability Act (S.951/H.R. 5/H.R. 45/H.Res.33) 15.Searching for and Cutting Regulations that are Unnecessarily Burdensome (SCRUB) Act (H.R. 998) 16.Regulatory Integrity Act (H.R. 1004) 17.OIRA Insight, Reform, and Accountability Act (S. 676/H.R. 1009) 18.A concurrent resolution setting forth the congressional budget for the United States Government for fiscal year 2017 and setting forth the appropriate budgetary levels for fiscal years 2018 through 2026 (S.Con.Res. 3) 19.American Health Care Act (H.R. 1628/H.Res. 228) 20.Ozone Standards Implementation Act (S. 263/H.R. 806) 21.Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the final rule of the Bureau of Land Management relating to "Waste Prevention, Production Subject to Royalties, and Resource Conservation" (S.J. Res. 11/H.J.Res.36) 22.Common Sense Nutrition Disclosure Act (S. 261/H.R. 772) 23.Reinvigorating Antibiotic and Diagnostic Innovation (READI) Act (H.R. 1840) 24.Preservation of Antibiotics for Medical Treatment Act (H.R. 1587) 25.Preventing Antibiotic Resistance Act (S. 629) 26.Better Care Reconciliation Act (H.R. 1628) and related amendments 27.Public Health Emergency Response Act (S. 196) 28.Recognizing the importance of vaccinations and immunizations in the United States (H.Res.327) 29.Consolidated Appropriations Act, 2017 (Public Law 115-31) 30.Treat and Reduce Obesity Act (S. 830/H.R. 1953) 31.Community Health and Medical Professionals Improve Our Nation (CHAMPION) Act (H.R. 3922) 32.Community Health Investment, Modernization, and Excellence Act of 2017 (S. 1899) 33.Tobacco Tax Equity Act (S. 1837) 34.Healthy Kids Act (S. 1821/H.R. 3921) 35.Implementation of the Drug Quality and Security Act (P.S. 113-54) 36.Continuing Appropriations Act, 2018 and Supplemental Appropriations for Disaster Relief Requirements Act, 2017 (Public Law 115-56) 37.Friendly Airports for Mothers Act (S. 1110/H.R. 2375) 38.Lead-Safe Housing for Kids Act (S. 1845) 39.Supporting Working Moms Act (S. 2122/H.R. 3255) 40.Championing Healthy Kids Act (H.R. 3922) 41.Making further continuing appropriations for fiscal year 2018, and for other purposes (Public Law 115-90) 42.An Act to amend the Homeland Security Act of 2002 to require the Secretary of Homeland Security to issue Department of Homeland Security-wide guidance and develop training programs as part of the Department of Homeland Security Blue Campaign, and for other purposes (Public Law 115-96) 43.Tax Cuts and Jobs Act (Public Law 115-97) 44.Pandemic and All-Hazards Preparedness Advancing Innovation Act (S. 2852/H.R. 6378/H.R. 7328/S. 1379/H.R. 269) 45.Vaccine Access Improvement Act (H.R. 4993) 46.Relief from New Source Performance Standards Act (H.R. 453) 47.Strategies to Address Antimicrobial Resistance (S. 2469) 48.Opioid Quota Reform Act (S. 2535) 49.Hospital Preparedness Program Reauthorization Act (H.R. 4776) 50.Blocking Regulatory Interference from Closing Kilns Act (H.R. 1917) 51.Health Equity and Accountability Act (H.R. 5942) 52.Opioid Crisis Response Act of 2018 (S. 2680) 53.Agriculture and Nutrition Act (H.R. 2) 54.Agriculture Improvement Act (S. 3042) 55.SECURE Act (H.R. 5998) 56.Trauma-Informed Care for Children and Families Act (S. 774) 57.SUPPORT for Patients and Communities Act (H.R. 6) 58.Centers for Disease Control Emergency Response Act (S. 3161) 59.LABEL Opioids Act (S. 3428) 60.Relief from New Source Performance Standards Act (S. 1857) 61.Outdoors for All Act (S. 3499) 62.The MOMMA Act (H.R. 5977) 63.Preventing Maternal Deaths Act (H.R. 1318) 64.Medicare Access to Vaccines Equity Act (note yet introduced) 65.The Support Act (H.R. 6) 66.Climate Change Health Protection and Promotion Act (S. 529) 67.FY 2020 Departments of the Interior, Environment, and Related Agencies Appropriations Act (H.R. 3052/Not Yet Introduced) 68.NURSE Act (H.R. 1597) 69.Investing for the People Act (H.R. 2021) 70.Child Care for Working Families Act (H.R. 365/S. 568) 71.FAMILY Act (H.R. 1185/S. 463) 72.Transportation Alternatives Enhancement Act (S. 1098) 73.Lower Health Care Costs Act (S. 1895) 74.LIFT America Act (H.R 2479) 75.Public Health Funding Restoration Act (H.R. 3447/S. 1944) 76.Older Americans Act reauthorization (not yet introduced) 77.Campus Prevention and Recovery Services for Students Act (H.R. 3591) 78.Healthier Students for Stronger Campuses Act (S. 1281) 79.Saving Lives Through Better Data Act (S. 1793) 80.VACCINES Act (H.R. 2862) 81.DISARM Act (S. 1712/not yet introduced) 82.Community Access, Resources, and Education for Families Act (H.R. 3117) 83.Protecting Seniors Through Immunization Act (S. 1872) 84.Tobacco-Free Youth Act (S. 1541) 85.Tobacco to 21 Act (H.R. 2411/S. 1258) 86.Investing for People Act (H.R. 2021) 87.School Based Health Centers Reauthorization Act (H.R.2075/S.1013) 88.Reversing the Youth Tobacco Epidemic Act of 2019 (H.R. 2339) House(s) of Congress and Federal Agencies lobbied during the quarter: House, Senate, Exec Office of Pres, HHS, CDC, FDA, CMS, OMB, DOT, HUD, EPA, Education, USDA, DHS, FEMA, and SAMHSA.

Client expense: $40,118 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Environmental Protection Agency (EPA), Executive Office of the President (EOP), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Office of Management & Budget (OMB), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Transportation, Dept of (DOT)

Surprise Medical Bills S.2723, Mitigating Emergency Drug Shortages Act: reducing drug shortages H.R. 3502, Protecting People From Surprise Medical Bills Act H.R. 2500, National Defense Authorization Act for Fiscal Year 2020: Krishnamoorthi amdt on drug shortages H.R. 3107, Improving Seniors' Timely Access to Care Act of 2019: pre-authorization S. 1895, Lower Health Care Costs Act H.R. 3692, Addiction Treatment Access Improvement Act of 2017: Medically assisted treatment; opioids H.R. 5761, Ending Maternal Mortality Act of 2018: Maternal mortality H.R. 5718, Perioperative Reduction of Opioids Act: Opioids H.R. 5197, Alternatives to Opioids (ALTO) in the Emergency Department Act: Medically assisted treatment; opioids S. 2516, Alternatives to Opioids (ALTO) in the Emergency Department Act: Medically assisted treatment; opioids S.2680, Opioid Crisis Response Act of 2018: Medically assisted treatment; opioids S.2456, CARA 2.0 Act of 2018: Medically assisted treatment; opioids H.R. 1565, Saving Lives, Saving Costs S.1475, Saving Lives, Saving Costs Comprehensive Addiction and Recovery Act of 2016 (PL 114-198) Affordable Care Act reform efforts H.R. 1628, American Health Care Act of 2017 S. Amdt. 1030 to H.R. 1628, "Graham-Cassidy" Better Care Reconciliation Act of 2017 H.R. 1492, Medical Controlled Substances Transportation Act of 2017 H.R. 1215, Protecting Access to Care Act of 2017 H.R. 3545, Overdose Prevention and Patient Safety Act H.R. 3446, Restoring Board Immunity Act of 2017: Professional Licensing S.2260, Opioids and STOP Pain Initiative ACT:opioids 42 CFR Part 2, Confidentiality of Substance Use Disorder Patient Records: appropriate access to patient information essential for providing whole-person care H.R.3928, Truth in Healthcare Marketing Act of 2017 H.R. 1554, REDI Act: student loan debt repayment for residents 21st Century Cures Initiative Drug Shortages - FDA, DEA, HHS, CMS, GAO, House Energy and Commerce Committee, Senate HELP Committee DEA Scheduling Propofol Comparative Effectiveness Research - PCORI HITECH Implementation, Electronic Health Records, Final and Proposed Rules, HIT Meaningful Use HHS/OIG Anesthesia Practice Arrangements, Company Model FDA Safe Use Initiative Pain Management FTC Letters to States re: Interventional Pain Medicine & Advanced Practice Nurses & Competition in Healthcare Anesthesia Research Funding (Pediatric and others) Scope of Practice FDA Operating Room Fires Naloxone FDA Opioids Prescription Drug Abuse FDA Network of Experts NIH Interagency Pain Research Coordinating Committee FDA SMART TOTS - pediatric anesthesia research USP - US Pharmacopeia National Pain Strategy Nondiscrimination Compounding FDA Nominations to Advisory Committees (Anesthesia Drugs, Anesthesia Devices, Compounding) Agency for Healthcare Research and Quality (AHRQ) funding Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Sequestration Opioids and opioid abuse; Brain health Anesthesiologist Assistants Blood management

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Natl Institutes of Health (NIH), Occupational Safety & Health Administration (OSHA), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA)

Lobbying Issues Description: Budget and appropriations for disease and injury prevention, including obesity and related diseases; pandemic influenza and emerging infectious diseases; physical activity; public health bioterrorism preparedness; food safety, environmental health; paid sick days; womens and childrens health; community-based public health interventions, and substance misuse/behavioral health issues. Specific Legislation: 1.Implementation of the Patient Protection and Affordable Care Act (Public Law 111-148) 2.Implementation of the FDA Food Safety Modernization Act (Public Law 111-353) 3.Implementation of Pandemic and All-Hazards Preparedness Reauthorization Act and Pandemic and All-Hazards Preparedness and Advancing Innovation Act (Public Law 113-5, 116-22) 4.Implementation of Healthy, Hunger-Free Kids Act of 2010 (Public Law 111-296) 5.Implementation of the Budget Control Act of 2011 (Public Law 112-25) 6.Implementation of Child Care and Development Block Grant Act of 2014 (Public Law 113-186) 7.Implementation of Every Student Succeeds Act (Public Law 114-95) 8.Implementation of the Comprehensive Addition and Recovery Act (Public Law 114-98) 9.FY 2020 Departments of Labor, Health and Human Services, and Education and Related Agencies Appropriations (H.R. 2740/Not Yet Introduced)) 10.FY 2020 Departments of Agriculture, Rural Development, Food and Drug Administration and Related Agencies Appropriations (H.R. 3164/Not yet introduced) 11.FY2020 Departments of Transportation, HUD and related agencies Appropriations (H.R. 3163/Not Yet Introduced) 12.Midnight Rules Relief Act (S.34/H.R. 21) 13.Regulations from the Executive in Need of Scrutiny Act (S. 21/H.R. 26) 14.Regulatory Accountability Act (S.951/H.R. 5/H.R. 45/H.Res.33) 15.Searching for and Cutting Regulations that are Unnecessarily Burdensome (SCRUB) Act (H.R. 998) 16.Regulatory Integrity Act (H.R. 1004) 17.OIRA Insight, Reform, and Accountability Act (S. 676/H.R. 1009) 18.A concurrent resolution setting forth the congressional budget for the United States Government for fiscal year 2017 and setting forth the appropriate budgetary levels for fiscal years 2018 through 2026 (S.Con.Res. 3) 19.American Health Care Act (H.R. 1628/H.Res. 228) 20.Ozone Standards Implementation Act (S. 263/H.R. 806) 21.Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the final rule of the Bureau of Land Management relating to "Waste Prevention, Production Subject to Royalties, and Resource Conservation" (S.J. Res. 11/H.J.Res.36) 22.Common Sense Nutrition Disclosure Act (S. 261/H.R. 772) 23.Reinvigorating Antibiotic and Diagnostic Innovation (READI) Act (H.R. 1840) 24.Preservation of Antibiotics for Medical Treatment Act (H.R. 1587) 25.Preventing Antibiotic Resistance Act (S. 629) 26.Better Care Reconciliation Act (H.R. 1628) and related amendments 27.Public Health Emergency Response Act (S. 196) 28.Recognizing the importance of vaccinations and immunizations in the United States (H.Res.327) 29.Consolidated Appropriations Act, 2017 (Public Law 115-31) 30.Treat and Reduce Obesity Act (S. 830/H.R. 1953) 31.Community Health and Medical Professionals Improve Our Nation (CHAMPION) Act (H.R. 3922) 32.Community Health Investment, Modernization, and Excellence Act of 2017 (S. 1899) 33.Tobacco Tax Equity Act (S. 1837) 34.Healthy Kids Act (S. 1821/H.R. 3921) 35.Implementation of the Drug Quality and Security Act (P.S. 113-54) 36.Continuing Appropriations Act, 2018 and Supplemental Appropriations for Disaster Relief Requirements Act, 2017 (Public Law 115-56) 37.Friendly Airports for Mothers Act (S. 1110/H.R. 2375) 38.Lead-Safe Housing for Kids Act (S. 1845) 39.Supporting Working Moms Act (S. 2122/H.R. 3255) 40.Championing Healthy Kids Act (H.R. 3922) 41.Making further continuing appropriations for fiscal year 2018, and for other purposes (Public Law 115-90) 42.An Act to amend the Homeland Security Act of 2002 to require the Secretary of Homeland Security to issue Department of Homeland Security-wide guidance and develop training programs as part of the Department of Homeland Security Blue Campaign, and for other purposes (Public Law 115-96) 43.Tax Cuts and Jobs Act (Public Law 115-97) 44.Pandemic and All-Hazards Preparedness Advancing Innovation Act (S. 2852/H.R. 6378/H.R. 7328/S. 1379/H.R. 269) 45.Vaccine Access Improvement Act (H.R. 4993) 46.Relief from New Source Performance Standards Act (H.R. 453) 47.Strategies to Address Antimicrobial Resistance (S. 2469) 48.Opioid Quota Reform Act (S. 2535) 49.Hospital Preparedness Program Reauthorization Act (H.R. 4776) 50.Blocking Regulatory Interference from Closing Kilns Act (H.R. 1917) 51.Health Equity and Accountability Act (H.R. 5942) 52.Opioid Crisis Response Act of 2018 (S. 2680) 53.Agriculture and Nutrition Act (H.R. 2) 54.Agriculture Improvement Act (S. 3042) 55.SECURE Act (H.R. 5998) 56.Trauma-Informed Care for Children and Families Act (S. 774) 57.SUPPORT for Patients and Communities Act (H.R. 6) 58.Centers for Disease Control Emergency Response Act (S. 3161) 59.LABEL Opioids Act (S. 3428) 60.Relief from New Source Performance Standards Act (S. 1857) 61.Outdoors for All Act (S. 3499) 62.The MOMMA Act (H.R. 5977) 63.Preventing Maternal Deaths Act (H.R. 1318) 64.Medicare Access to Vaccines Equity Act (note yet introduced) 65.The Support Act (H.R. 6) 66.Climate Change Health Protection and Promotion Act (S. 529) 67.FY 2020 Departments of the Interior, Environment, and Related Agencies Appropriations Act (H.R. 3052/Not Yet Introduced) 68.NURSE Act (H.R. 1597) 69.Investing for the People Act (H.R. 2021) 70.Child Care for Working Families Act (H.R. 365/S. 568) 71.FAMILY Act (H.R. 1185/S. 463) 72.Transportation Alternatives Enhancement Act (S. 1098) 73.Lower Health Care Costs Act (S. 1895) 74.LIFT America Act (H.R 2479) 75.Public Health Funding Restoration Act (H.R. 3447/S. 1944) 76.Older Americans Act reauthorization (not yet introduced) 77.Campus Prevention and Recovery Services for Students Act (H.R. 3591) 78.Healthier Students for Stronger Campuses Act (S. 1281) 79.Saving Lives Through Better Data Act (S. 1793) 80.VACCINES Act (H.R. 2862) 81.DISARM Act (S. 1712/not yet introduced) 82.Community Access, Resources, and Education for Families Act (H.R. 3117) 83.Protecting Seniors Through Immunization Act (S. 1872) 84.Tobacco-Free Youth Act (S. 1541) 85.Tobacco to 21 Act (H.R. 2411/S. 1258) 86.Investing for People Act (H.R. 2021) 87.School Based Health Centers Reauthorization Act (H.R.2075/S.1013) 88.Reversing the Youth Tobacco Epidemic Act of 2019 (H.R. 2339) House(s) of Congress and Federal Agencies lobbied during the quarter: House, Senate, Exec Office of Pres, HHS, CDC, FDA, CMS, OMB, DOT, HUD, EPA, Education, USDA, DHS, FEMA, and SAMHSA.

Client expense: $44,350 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Environmental Protection Agency (EPA), Executive Office of the President (EOP), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Office of Management & Budget (OMB), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Transportation, Dept of (DOT)

Surprise Medical Bills H.R. 3502, Protecting People From Surprise Medical Bills Act H.R. 2500, National Defense Authorization Act for Fiscal Year 2020: Krishnamoorthi amdt on drug shortages H.R. 3107, Improving Seniors' Timely Access to Care Act of 2019: pre-authorization S. 1895, Lower Health Care Costs Act H.R. 3692, Addiction Treatment Access Improvement Act of 2017: Medically assisted treatment; opioids H.R. 5761, Ending Maternal Mortality Act of 2018: Maternal mortality H.R. 5718, Perioperative Reduction of Opioids Act: Opioids H.R. 5197, Alternatives to Opioids (ALTO) in the Emergency Department Act: Medically assisted treatment; opioids S. 2516, Alternatives to Opioids (ALTO) in the Emergency Department Act: Medically assisted treatment; opioids S.2680, Opioid Crisis Response Act of 2018: Medically assisted treatment; opioids S.2456, CARA 2.0 Act of 2018: Medically assisted treatment; opioids H.R. 1565, Saving Lives, Saving Costs S.1475, Saving Lives, Saving Costs Comprehensive Addiction and Recovery Act of 2016 (PL 114-198) Affordable Care Act reform efforts H.R. 1628, American Health Care Act of 2017 S. Amdt. 1030 to H.R. 1628, "Graham-Cassidy" Better Care Reconciliation Act of 2017 H.R. 1492, Medical Controlled Substances Transportation Act of 2017 H.R. 1215, Protecting Access to Care Act of 2017 H.R. 3545, Overdose Prevention and Patient Safety Act H.R. 3446, Restoring Board Immunity Act of 2017: Professional Licensing S.2260, Opioids and STOP Pain Initiative ACT:opioids 42 CFR Part 2, Confidentiality of Substance Use Disorder Patient Records: appropriate access to patient information essential for providing whole-person care H.R.3928, Truth in Healthcare Marketing Act of 2017 H.R. 1554, REDI Act: student loan debt repayment for residents 21st Century Cures Initiative Drug Shortages - FDA, DEA, HHS, CMS, GAO, House Energy and Commerce Committee, Senate HELP Committee DEA Scheduling Propofol Comparative Effectiveness Research - PCORI HITECH Implementation, Electronic Health Records, Final and Proposed Rules, HIT Meaningful Use HHS/OIG Anesthesia Practice Arrangements, Company Model FDA Safe Use Initiative Pain Management FTC Letters to States re: Interventional Pain Medicine & Advanced Practice Nurses & Competition in Healthcare Anesthesia Research Funding (Pediatric and others) Scope of Practice FDA Operating Room Fires Naloxone FDA Opioids Prescription Drug Abuse FDA Network of Experts NIH Interagency Pain Research Coordinating Committee FDA SMART TOTS - pediatric anesthesia research USP - US Pharmacopeia National Pain Strategy Nondiscrimination Compounding FDA Nominations to Advisory Committees (Anesthesia Drugs, Anesthesia Devices, Compounding) Agency for Healthcare Research and Quality (AHRQ) funding Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Sequestration Opioids and opioid abuse; Brain health Anesthesiologist Assistants Blood management

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Natl Institutes of Health (NIH), Occupational Safety & Health Administration (OSHA), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA)

Lobbying Issues Description: Budget and appropriations for disease and injury prevention, including obesity and related diseases; pandemic influenza and emerging infectious diseases; physical activity; public health bioterrorism preparedness; food safety, environmental health; paid sick days; womens and childrens health; community-based public health interventions, and substance misuse/behavioral health issues. Specific Legislation: 1.Implementation of the Patient Protection and Affordable Care Act (Public Law 111-148) 2.Implementation of the FDA Food Safety Modernization Act (Public Law 111-353) 3.Implementation of Pandemic and All-Hazards Preparedness Reauthorization Act and Pandemic and All-Hazards Preparedness and Advancing Innovation Act (Public Law 113-5, 116-22) 4.Implementation of Healthy, Hunger-Free Kids Act of 2010 (Public Law 111-296) 5.Implementation of the Budget Control Act of 2011 (Public Law 112-25) 6.Implementation of Child Care and Development Block Grant Act of 2014 (Public Law 113-186) 7.Implementation of Every Student Succeeds Act (Public Law 114-95) 8.Implementation of the Comprehensive Addition and Recovery Act (Public Law 114-98) 9.FY 2020 Departments of Labor, Health and Human Services, and Education and Related Agencies Appropriations (H.R. 2740/Not Yet Introduced)) 10.FY 2020 Departments of Agriculture, Rural Development, Food and Drug Administration and Related Agencies Appropriations (H.R. 3164/Not yet introduced) 11.FY2020 Departments of Transportation, HUD and related agencies Appropriations (H.R. 3163/Not Yet Introduced) 12.Midnight Rules Relief Act (S.34/H.R. 21) 13.Regulations from the Executive in Need of Scrutiny Act (S. 21/H.R. 26) 14.Regulatory Accountability Act (S.951/H.R. 5/H.R. 45/H.Res.33) 15.Searching for and Cutting Regulations that are Unnecessarily Burdensome (SCRUB) Act (H.R. 998) 16.Regulatory Integrity Act (H.R. 1004) 17.OIRA Insight, Reform, and Accountability Act (S. 676/H.R. 1009) 18.A concurrent resolution setting forth the congressional budget for the United States Government for fiscal year 2017 and setting forth the appropriate budgetary levels for fiscal years 2018 through 2026 (S.Con.Res. 3) 19.American Health Care Act (H.R. 1628/H.Res. 228) 20.Ozone Standards Implementation Act (S. 263/H.R. 806) 21.Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the final rule of the Bureau of Land Management relating to "Waste Prevention, Production Subject to Royalties, and Resource Conservation" (S.J. Res. 11/H.J.Res.36) 22.Common Sense Nutrition Disclosure Act (S. 261/H.R. 772) 23.Reinvigorating Antibiotic and Diagnostic Innovation (READI) Act (H.R. 1840) 24.Preservation of Antibiotics for Medical Treatment Act (H.R. 1587) 25.Preventing Antibiotic Resistance Act (S. 629) 26.Better Care Reconciliation Act (H.R. 1628) and related amendments 27.Public Health Emergency Response Act (S. 196) 28.Recognizing the importance of vaccinations and immunizations in the United States (H.Res.327) 29.Consolidated Appropriations Act, 2017 (Public Law 115-31) 30.Treat and Reduce Obesity Act (S. 830/H.R. 1953) 31.Community Health and Medical Professionals Improve Our Nation (CHAMPION) Act (H.R. 3922) 32.Community Health Investment, Modernization, and Excellence Act of 2017 (S. 1899) 33.Tobacco Tax Equity Act (S. 1837) 34.Healthy Kids Act (S. 1821/H.R. 3921) 35.Implementation of the Drug Quality and Security Act (P.S. 113-54) 36.Continuing Appropriations Act, 2018 and Supplemental Appropriations for Disaster Relief Requirements Act, 2017 (Public Law 115-56) 37.Friendly Airports for Mothers Act (S. 1110/H.R. 2375) 38.Lead-Safe Housing for Kids Act (S. 1845) 39.Supporting Working Moms Act (S. 2122/H.R. 3255) 40.Championing Healthy Kids Act (H.R. 3922) 41.Making further continuing appropriations for fiscal year 2018, and for other purposes (Public Law 115-90) 42.An Act to amend the Homeland Security Act of 2002 to require the Secretary of Homeland Security to issue Department of Homeland Security-wide guidance and develop training programs as part of the Department of Homeland Security Blue Campaign, and for other purposes (Public Law 115-96) 43.Tax Cuts and Jobs Act (Public Law 115-97) 44.Pandemic and All-Hazards Preparedness Advancing Innovation Act (S. 2852/H.R. 6378/H.R. 7328/S. 1379/H.R. 269) 45.Vaccine Access Improvement Act (H.R. 4993) 46.Relief from New Source Performance Standards Act (H.R. 453) 47.Strategies to Address Antimicrobial Resistance (S. 2469) 48.Opioid Quota Reform Act (S. 2535) 49.Hospital Preparedness Program Reauthorization Act (H.R. 4776) 50.Blocking Regulatory Interference from Closing Kilns Act (H.R. 1917) 51.Health Equity and Accountability Act (H.R. 5942) 52.Opioid Crisis Response Act of 2018 (S. 2680) 53.Agriculture and Nutrition Act (H.R. 2) 54.Agriculture Improvement Act (S. 3042) 55.SECURE Act (H.R. 5998) 56.Trauma-Informed Care for Children and Families Act (S. 774) 57.SUPPORT for Patients and Communities Act (H.R. 6) 58.Centers for Disease Control Emergency Response Act (S. 3161) 59.LABEL Opioids Act (S. 3428) 60.Relief from New Source Performance Standards Act (S. 1857) 61.Outdoors for All Act (S. 3499) 62.The MOMMA Act (H.R. 5977) 63.Preventing Maternal Deaths Act (H.R. 1318) 64.Medicare Access to Vaccines Equity Act (note yet introduced) 65.The Support Act (H.R. 6) 66.Climate Change Health Protection and Promotion Act (S. 529) 67.FY 2020 Departments of the Interior, Environment, and Related Agencies Appropriations Act (H.R. 3052/Not Yet Introduced) 68.NURSE Act (H.R. 1597) 69.Investing for the People Act (H.R. 2021) 70.Child Care for Working Families Act (H.R. 365/S. 568) 71.FAMILY Act (H.R. 1185/S. 463) 72.Transportation Alternatives Enhancement Act (S. 1098) 73.Lower Health Care Costs Act (S. 1895) 74.LIFT America Act (H.R 2479) 75.Public Health Funding Restoration Act (H.R. 3447/S. 1944) 76.Older Americans Act reauthorization (not yet introduced) 77.Campus Prevention and Recovery Services for Students Act (H.R. 3591) 78.Healthier Students for Stronger Campuses Act (S. 1281) 79.Saving Lives Through Better Data Act (S. 1793) 80.VACCINES Act (H.R. 2862) 81.DISARM Act (S. 1712/not yet introduced) 82.Community Access, Resources, and Education for Families Act (H.R. 3117) 83.Protecting Seniors Through Immunization Act (S. 1872) 84.Tobacco-Free Youth Act (S. 1541) 85.Tobacco to 21 Act (H.R. 2411/S. 1258) 86.Investing for People Act (H.R. 2021) 87.School Based Health Centers Reauthorization Act (H.R.2075/S.1013) 88.Reversing the Youth Tobacco Epidemic Act of 2019 (H.R. 2339) House(s) of Congress and Federal Agencies lobbied during the quarter: House, Senate, Exec Office of Pres, HHS, CDC, FDA, CMS, OMB, DOT, HUD, EPA, Education, USDA, DHS, FEMA, and SAMHSA.

Client expense: $38,304 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Environmental Protection Agency (EPA), Executive Office of the President (EOP), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Office of Management & Budget (OMB), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Transportation, Dept of (DOT)

Surprise Medical Bills H.R. 3502, Protecting People From Surprise Medical Bills Act S. 1895, Lower Health Care Costs Act H.R. 3692, Addiction Treatment Access Improvement Act of 2017: Medically assisted treatment; opioids H.R. 5761, Ending Maternal Mortality Act of 2018: Maternal mortality H.R. 5718, Perioperative Reduction of Opioids Act: Opioids H.R. 5197, Alternatives to Opioids (ALTO) in the Emergency Department Act: Medically assisted treatment; opioids S. 2516, Alternatives to Opioids (ALTO) in the Emergency Department Act: Medically assisted treatment; opioids S.2680, Opioid Crisis Response Act of 2018: Medically assisted treatment; opioids S.2456, CARA 2.0 Act of 2018: Medically assisted treatment; opioids H.R. 1565, Saving Lives, Saving Costs S.1475, Saving Lives, Saving Costs Comprehensive Addiction and Recovery Act of 2016 (PL 114-198) Affordable Care Act reform efforts H.R. 1628, American Health Care Act of 2017 S. Amdt. 1030 to H.R. 1628, "Graham-Cassidy" Better Care Reconciliation Act of 2017 H.R. 1492, Medical Controlled Substances Transportation Act of 2017 H.R. 1215, Protecting Access to Care Act of 2017 H.R. 3545, Overdose Prevention and Patient Safety Act H.R. 3446, Restoring Board Immunity Act of 2017: Professional Licensing S.2260, Opioids and STOP Pain Initiative ACT:opioids 42 CFR Part 2, Confidentiality of Substance Use Disorder Patient Records: appropriate access to patient information essential for providing whole-person care H.R.3928, Truth in Healthcare Marketing Act of 2017 H.R. 1554, REDI Act: student loan debt repayment for residents 21st Century Cures Initiative Drug Shortages - FDA, DEA, HHS, CMS, GAO, House Energy and Commerce Committee, Senate HELP Committee DEA Scheduling Propofol Comparative Effectiveness Research - PCORI HITECH Implementation, Electronic Health Records, Final and Proposed Rules, HIT Meaningful Use HHS/OIG Anesthesia Practice Arrangements, Company Model FDA Safe Use Initiative Pain Management FTC Letters to States re: Interventional Pain Medicine & Advanced Practice Nurses & Competition in Healthcare Anesthesia Research Funding (Pediatric and others) Scope of Practice FDA Operating Room Fires Naloxone FDA Opioids Prescription Drug Abuse FDA Network of Experts NIH Interagency Pain Research Coordinating Committee FDA SMART TOTS - pediatric anesthesia research USP - US Pharmacopeia National Pain Strategy Nondiscrimination Compounding FDA Nominations to Advisory Committees (Anesthesia Drugs, Anesthesia Devices, Compounding) Agency for Healthcare Research and Quality (AHRQ) funding Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Sequestration Opioids and opioid abuse; Brain health Anesthesiologist Assistants

Client expense: $310,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Natl Institutes of Health (NIH), Occupational Safety & Health Administration (OSHA), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA)

Lobbying Issues Description: Budget and appropriations for disease and injury prevention, including obesity and related diseases; pandemic influenza and emerging infectious diseases; physical activity; public health bioterrorism preparedness; food safety, environmental health; paid sick days; womens and childrens health; community-based public health interventions, and substance misuse/behavioral health issues. Specific Legislation: 1. Implementation of the Patient Protection and Affordable Care Act (Public Law 111-148) 2. Implementation of the FDA Food Safety Modernization Act (Public Law 111-353) 3. Implementation of Pandemic and All-Hazards Preparedness Reauthorization Act (Public Law 113-5) 4. Implementation of Healthy, Hunger-Free Kids Act of 2010 (Public Law 111-296) 5. Implementation of the Budget Control Act of 2011 (Public Law 112-25) 6. Implementation of the Drug Quality and Security Act of 2013 (Public Law 113-54) 7. Implementation of Animal Drug and Animal Generic Drug User Fee Act (Public Law 113-14) 8. Implementation of Child Care and Development Block Grant Act of 2014 (Public Law 113-186) 9. Implementation of Every Student Succeeds Act (Public Law 114-95) 10. Implementation of the Comprehensive Addition and Recovery Act (Public Law 114-98) 11. FY 2018 Departments of Labor, Health and Human Services, and Education and Related Agencies Appropriations (S. 1771/H.R. 3358) 12. FY 2018 Departments of Agriculture, Rural Development, Food and Drug Administration and Related Agencies Appropriations (S. 1603/H.R. 3268) 13. Consolidated Appropriations Act 2018 (Public Law 115-141) 14. Midnight Rules Relief Act (S.34/H.R. 21) 15. Regulations from the Executive in Need of Scrutiny Act (S. 21/H.R. 26) 16. Regulatory Accountability Act (S.951/H.R. 5/H.R. 45/H.Res.33) 17. Searching for and Cutting Regulations that are Unnecessarily Burdensome (SCRUB) Act (H.R. 998) 18. Regulatory Integrity Act (H.R. 1004) 19. OIRA Insight, Reform, and Accountability Act (S. 676/H.R. 1009) 20. A concurrent resolution setting forth the congressional budget for the United States Government for fiscal year 2017 and setting forth the appropriate budgetary levels for fiscal years 2018 through 2026 (S.Con.Res. 3) 21. American Health Care Act (H.R. 1628/H.Res. 228) 22. Ozone Standards Implementation Act (S. 263/H.R. 806) 23. Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the final rule of the Bureau of Land Management relating to "Waste Prevention, Production Subject to Royalties, and Resource Conservation" (S.J. Res. 11/H.J.Res.36) 24. Common Sense Nutrition Disclosure Act (S. 261/H.R. 772) 25. Reinvigorating Antibiotic and Diagnostic Innovation (READI) Act (H.R. 1840) 26. Preservation of Antibiotics for Medical Treatment Act (H.R. 1587) 27. Preventing Antibiotic Resistance Act (S. 629) 28. Better Care Reconciliation Act (H.R. 1628) and related amendments 29. Public Health Emergency Response Act (S. 196) 30. Recognizing the importance of vaccinations and immunizations in the United States (H.Res.327) 31. Consolidated Appropriations Act, 2017 (Public Law 115-31) 32. Treat and Reduce Obesity Act (S. 830/H.R. 1953) 33. Community Health and Medical Professionals Improve Our Nation (CHAMPION) Act (H.R. 3922) 34. Community Health Investment, Modernization, and Excellence Act of 2017 (S. 1899) 35. Tobacco Tax Equity Act (S. 1837) 36. Healthy Kids Act (S. 1821/H.R. 3921) 37. Implementation of the Drug Quality and Security Act (P.S. 113-54) 38. Continuing Appropriations Act, 2018 and Supplemental Appropriations for Disaster Relief Requirements Act, 2017 (Public Law 115-56) 39. Friendly Airports for Mothers Act (S. 1110/H.R. 2375) 40. Lead-Safe Housing for Kids Act (S. 1845) 41. Supporting Working Moms Act (S. 2122/H.R. 3255) 42. Championing Healthy Kids Act (H.R. 3922) 43. Making further continuing appropriations for fiscal year 2018, and for other purposes (Public Law 115-90) 44. An Act to amend the Homeland Security Act of 2002 to require the Secretary of Homeland Security to issue Department of Homeland Security-wide guidance and develop training programs as part of the Department of Homeland Security Blue Campaign, and for other purposes (Public Law 115-96) 45. Tax Cuts and Jobs Act (Public Law 115-97) 46. Pandemic and All-Hazards Preparedness Advancing Innovation Act (S. 2852/H.R. 6378/H.R. 7328) 47. Vaccine Access Improvement Act (H.R. 4993) 48. Relief from New Source Performance Standards Act (H.R. 453) 49. Strategies to Address Antimicrobial Resistance (S. 2469) 50. Opioid Quota Reform Act (S. 2535) 51. Hospital Preparedness Program Reauthorization Act (H.R. 4776) 52. Blocking Regulatory Interference from Closing Kilns Act (H.R. 1917) 53. Health Equity and Accountability Act (H.R. 5942) 54. Opioid Crisis Response Act of 2018 (S. 2680) 55. Agriculture and Nutrition Act (H.R. 2) 56. Agriculture Improvement Act (S. 3042) 57. SECURE Act (H.R. 5998) 58. FY 2019 Departments of Labor, Health and Human Services, and Education and Related Agencies Appropriations (S. 3158) 59. FY 2019 Departments of the Interior, Environment, and Related Agencies Appropriations Act (H.R. 6147/S. 3073) 60. FY 2019 Departments of Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations (H.R. 5961/ S. 2976) 61. Trauma-Informed Care for Children and Families Act (S. 774) 62. SUPPORT for Patients and Communities Act (H.R. 6) 63. Centers for Disease Control Emergency Response Act (S. 3161) 64. LABEL Opioids Act (S. 3428) 65. Relief from New Source Performance Standards Act (S. 1857) 66. Outdoors for All Act (S. 3499) 67. The MOMMA Act (H.R. 5977) 68. The WIC Act (not yet introduced) 69. Preventing Maternal Deaths Act (H.R. 1318) 70. Medicare Access to Vaccines Equity Act (note yet introduced) 71. The Support Act (H.R. 6) 72. Climate Change Health Protection and Promotion Act (S. 529) 73. FY 2020 Departments of the Interior, Environment, and Related Agencies Appropriations Act 74. NURSE Act (H.R. 1597) 75. Investing for the People Act (H.R. 2021) 76. Child Care for Working Families Act (H.R. 365/S. 568) 77. FAMILY Act (H.R. 1185/S. 463) 78. Transportation Alternatives Enhancement Act (S. 1098) House(s) of Congress and Federal Agencies lobbied during the quarter: House, Senate, Exec Office of Pres, HHS, CDC, FDA, CMS, OMB, DOT, HUD, EPA, Education, USDA, DHS, FEMA, and SAMHSA

Client expense: $33,373 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Environmental Protection Agency (EPA), Executive Office of the President (EOP), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Office of Management & Budget (OMB), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Transportation, Dept of (DOT)

Valid Act discussion draft (LDTs) HR 5812 - Creating Opportunities that Necessitate ew and Enhance Connections that Improve Opioid Navigation Strategies Act of 2018 S 2680 - Opioid Crisis Response Act of 2018 HR 3635 - Local Coverage Determination (LCD) Clarification Act of 2017 Promoting Integrity in Medicare Act (HR 2066) Protecting Seniors' Access to Medicare Act (HR849) Protecting Access to Medicare Act Protecting Patients from Surprise Medical Bills (Cassidy Language) FDA Technical Assistance to DAIA S 2582 - Consumer Health Insurance Protection Act S 284- End Surprise Billing Act CMS Physician Fee Schedule Registry Measures

Client expense: $312,556 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3692, Addiction Treatment Access Improvement Act of 2017: Medically assisted treatment; opioids H.R. 5761, Ending Maternal Mortality Act of 2018: Maternal mortality H.R. 5718, Perioperative Reduction of Opioids Act: Opioids H.R. 5197, Alternatives to Opioids (ALTO) in the Emergency Department Act: Medically assisted treatment; opioids S. 2516, Alternatives to Opioids (ALTO) in the Emergency Department Act: Medically assisted treatment; opioids S.2680, Opioid Crisis Response Act of 2018: Medically assisted treatment; opioids S.2456, CARA 2.0 Act of 2018: Medically assisted treatment; opioids H.R. 1565, Saving Lives, Saving Costs S.1475, Saving Lives, Saving Costs Comprehensive Addiction and Recovery Act of 2016 (PL 114-198) Affordable Care Act reform efforts H.R. 1628, American Health Care Act of 2017 S. Amdt. 1030 to H.R. 1628, "Graham-Cassidy" Better Care Reconciliation Act of 2017 H.R. 1492, Medical Controlled Substances Transportation Act of 2017 H.R. 1215, Protecting Access to Care Act of 2017 H.R. 3545, Overdose Prevention and Patient Safety Act H.R. 3446, Restoring Board Immunity Act of 2017: Professional Licensing S.2260, Opioids and STOP Pain Initiative ACT:opioids 42 CFR Part 2, Confidentiality of Substance Use Disorder Patient Records: appropriate access to patient information essential for providing whole-person care H.R.3928, Truth in Healthcare Marketing Act of 2017 H.R. 5734, Resident Education Deferred Interest Act: student loan debt repayment for residents 21st Century Cures Initiative Drug Shortages - FDA, DEA, HHS, CMS, GAO, House Energy and Commerce Committee, Senate HELP Committee DEA Scheduling Propofol Comparative Effectiveness Research - PCORI HITECH Implementation, Electronic Health Records, Final and Proposed Rules, HIT Meaningful Use HHS/OIG Anesthesia Practice Arrangements, Company Model FDA Safe Use Initiative Pain Management FTC Letters to States re: Interventional Pain Medicine & Advanced Practice Nurses & Competition in Healthcare Anesthesia Research Funding (Pediatric and others) Scope of Practice FDA Operating Room Fires Naloxone FDA Opioids Prescription Drug Abuse FDA Network of Experts NIH Interagency Pain Research Coordinating Committee FDA SMART TOTS - pediatric anesthesia research USP - US Pharmacopeia National Pain Strategy Nondiscrimination Compounding FDA Nominations to Advisory Committees (Anesthesia Drugs, Anesthesia Devices, Compounding) Agency for Healthcare Research and Quality (AHRQ) funding Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Sequestration Opioids and Opioid abuse; Brain health

Client expense: $190,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Natl Institutes of Health (NIH), Occupational Safety & Health Administration (OSHA), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA)

S.1109/H.R.959 - Title VIII Nursing Workforce Reauthorization Act of 2017 S. 445/ H.R.1825 - Home Health Care Planning Improvement Act of 2017 H.R. 6 - SUPPORT for Patients and Communities Act S.2524/H.R. 5102 - Substance Use Disorder Workforce Loan Repayment Act of 2018 H.R. 3692 - Addiction Treatment Access Improvement Act of 2017 S. 2317 - Addiction Treatment Access Improvement Act of 2018 S. 2456/H.R. 5311- CARA 2.0 Act of 2018 H.R.1478 - Gun Violence Research Act Public Law No: 115-119 (S.1028/H.R. 3759) RAISE Family Caregivers Act Priorities for health care reform Opioid Abuse Epidemic S.2680 - Opioid Crisis Response Act of 2018 S. 2891 - Fighting the Opioid Epidemic with Sunshine Act of 2018

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

Government targets: Education, Dept of, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), SENATE

H.R. 2, Agriculture Improvement Act of 2018; H.R. 5, Regulatory Accountability Act of 2017; H.R. 6, SUPPORT for Patients and Communities Act; H.R. 21, Midnight Rules Relief Act; H.R. 26, Regulations from the Executive in Need of Scrutiny (REINS) Act; H.R. 33 Small Business Regulatory Flexibility Improvements Act of 2017; H.R. 45, Regulatory Accountability Act of 2017; H.R. 1029, Pesticide Registration Improvement Extension Act of 2017; H.R. 1430, Honest and Open New EPA Science Treatment (HONEST) Act of 2017; H.R. 1431, EPA Science Advisory Board Reform Act of 2017; H.R. 2811, Foreign Agents Registration Modernization and Enforcement Act; H.R. 3268, Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, 2018; H.R. 3381, Child Poverty Reduction Act 2017; H.R. 4170, Disclosing Foreign Influence Act; H.R. 4460, Disaster Recovery Reform Act; H.R. 4667, Making further supplemental appropriations for the FY ending 9/30/18, for disaster assistance for Hurricanes Harvey, Irma, and Maria, and calendar year 2017 wildfires, and for other purposes; H.R. 5228, Stop Counterfeit Drugs by Regulation and Enhancing Enforcement Now (SCREEN)Act H.R. 5310, Municipal Infrastructure Savings and Transparency Act; H.R. 5752, Stop Illicit Drug Importation Act of 2018; H.R. 6022, Accurate Labels Act; H.R. 6653, IMAGINE Act; H. Res 71, Providing for consideration of the joint resolution (H.J. Res. 41) providing for congressional disapproval under chapter 8 of title 5, United States Code, of a rule submitted by the Securities and Exchange Commission relating to "Disclosure of Payments by Resource Extraction Issuers", and providing for consideration of the joint resolution (H.J. Res. 40) providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Social Security Administration relating to Implementation of the NICS Improvement Amendments Act of 2007; H. Res. 223; H. Res. 229; H. Res. 1082, Providing for the concurrence by the House in the Senate amendment to H.R. 302, with an amendment. (Sec. 1234 Natl. Public Infrastructure Predisaster Hazard Mitigation, and Sec. 1235 Addl. Mitigation Activities); S. 584, Small Business Regulatory Flexibility Improvements Act; S. 625 Foreign Agents Registration Modernization and Enforcement Act; S. 1113, Personal Care Products Safety Act; S. 1679, Foreign Agent Lobbying Transparency Enforcement Act; S. 1794, HONEST Act; S. 1866, Hurricanes Harvey, Irma, and Maria Education Relief Act of 2017; S. 2039, Disclosing Foreign Influence Act; S. 2482, Foreign Agents Registration Amendments Act of 2018; S. 2680, Opioid Crisis Response Act of 2018; S. 3019, Accurate Labels Act; S. 3042, Agriculture Improvement Act of 2018; S. 3041, Disaster Recovery Reform Act of 2018; S. 3296, Sustainable Chemistry Research and Development Act of 2018; S. 3341, IMAGINE Act; S. 3381, PFAS Accountability Act of 2018; S. 3382, PFAS Detection Act of 2018; S. 3508, Save Our Seas Act 2018; S. 3551, SOFFA; S. 3671 A bill to require the Administrator of the Environmental Protection Agency to revise certain ethylene oxide emissions standards under the Clean Air Act, and for other purposes; S. Res. 301; S. Resolution Establishing the congressional budget; FY 2018 Appropriations of Department of Interior; FY 2018 Appropriations of Environmental Protection Agency; FY 2018 Appropriations Financial Services and General Government FY 2018 Appropriations of Transportation, Housing and Urban Development, and Related Agencies; FY 2018 Appropriations of Commerce, Justice, Science and Related Agencies; FY 2018 Appropriations of Department of Labor, Health and Human Services; FY 2019 Appropriations of Department of the Interior, environment, and related agencies; FY 2019 Appropriations of Department of Labor, Health and Human Services; Alternative Fuel Tax Assessment; Antimicrobials; Bisphenol-A; Building and Construction water infrastructure; Chemical Assessment; Chemical Safety Board; Chemistry Caucus; Chlorinated Paraffins; Chlorine; CPSC, including Phthalates, Flame Retardants, Nominations, and CHAP; Design for the Environment; Energy Recovery; EPA Nomination; Flame Retardants; Fluorotechnology including PFOA/PFOS/PFAS Formaldehyde; Hexavalent Chromium; Integrated Risk Information System; International Agency for Research of Cancer, including Report on Carcinogens Labeling and Packaging, including GMOs; Lautenberg Chemical Safety Act Implementation (LCSA) and regulations; Microbeads; Microplastics; Nanotechnology; NIOSH studies; OSHA Letters of Interpretation (Chemical Concentrations, Process Safety, RAGAGEP); Permitting Reform; Phthalates; Plastics; Rare Earths; Risk Assessment Improvements; Science Advisory Board; Sustainability including report on innovation and Research and Development Styrene; T-TIP, MTB and Trade Promotion Authority; Titanium Dioxide

Client expense: $1,940,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Commerce, Dept of (DOC), Consumer Product Safety Commission (CPSC), Council on Environmental Quality (CEQ), Energy, Dept of, Environmental Protection Agency (EPA), Federal Aviation Administration (FAA), Federal Railroad Administration, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Interior, Dept of (DOI), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Economic Council (NEC), Natl Highway Traffic Safety Administration (NHTSA), Office of Management & Budget (OMB), Pipeline & Hazardous Materials Safety Administration, SENATE, Surface Transportation Board (STB), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Trade Representative (USTR), White House Office

H.R. 2, Agriculture Improvement Act of 2018; H.R. 5, Regulatory Accountability Act of 2017; H.R. 6, SUPPORT for Patients and Communities Act; H.R. 21, Midnight Rules Relief Act; H.R. 26, Regulations from the Executive in Need of Scrutiny (REINS) Act; H.R. 33 Small Business Regulatory Flexibility Improvements Act of 2017; H.R. 45, Regulatory Accountability Act of 2017; H.R. 1029, Pesticide Registration Improvement Extension Act of 2017; H.R. 1430, Honest and Open New EPA Science Treatment (HONEST) Act of 2017; H.R. 1431, EPA Science Advisory Board Reform Act of 2017; H.R. 2811, Foreign Agents Registration Modernization and Enforcement Act; H.R. 3268, Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, 2018; H.R. 3381, Child Poverty Reduction Act 2017; H.R. 4170, Disclosing Foreign Influence Act; H.R. 4460, Disaster Recovery Reform Act; H.R. 4667, Making further supplemental appropriations for the FY ending 9/30/18, for disaster assistance for Hurricanes Harvey, Irma, and Maria, and calendar year 2017 wildfires, and for other purposes; H.R. 5228, Stop Counterfeit Drugs by Regulation and Enhancing Enforcement Now (SCREEN)Act H.R. 5310, Municipal Infrastructure Savings and Transparency Act; H.R. 5752, Stop Illicit Drug Importation Act of 2018 H.R. 6022, Accurate Labels Act H. Res 71, Providing for consideration of the joint resolution (H.J. Res. 41) providing for congressional disapproval under chapter 8 of title 5, United States Code, of a rule submitted by the Securities and Exchange Commission relating to "Disclosure of Payments by Resource Extraction Issuers", and providing for consideration of the joint resolution (H.J. Res. 40) providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Social Security Administration relating to Implementation of the NICS Improvement Amendments Act of 2007; H. Res. 223; H. Res. 229; H. Res. 1082, Providing for the concurrence by the House in the Senate amendment to H.R. 302, with an amendment. (Sec. 1234 Natl. Public Infrastructure Predisaster Hazard Mitigation, and Sec. 1235 Addl. Mitigation Activities); S. 584, Small Business Regulatory Flexibility Improvements Act; S. 625 Foreign Agents Registration Modernization and Enforcement Act; S. 1113, Personal Care Products Safety Act; S. 1679, Foreign Agent Lobbying Transparency Enforcement Act; S. 1794, HONEST Act; S. 1866, Hurricanes Harvey, Irma, and Maria Education Relief Act of 2017; S. 2039, Disclosing Foreign Influence Act; S. 2482, Foreign Agents Registration Amendments Act of 2018; S. 2680, Opioid Crisis Response Act of 2018; S. 3019, Accurate Labels Act; S. 3042, Agriculture Improvement Act of 2018; S. 3041, Disaster Recovery Reform Act of 2018; S. 3296, Sustainable Chemistry Research and Development Act of 2018; S. 3382, PFAS Detection Act of 2018; S. 3508, Save Our Seas Act 2018; S. 3551, SOFFA; S. Res. 301; S. Resolution Establishing the congressional budget; FY 2018 Appropriations of Department of Interior; FY 2018 Appropriations of Environmental Protection Agency; FY 2018 Appropriations Financial Services and General Government FY 2018 Appropriations of Transportation, Housing and Urban Development, and Related Agencies; FY 2018 Appropriations of Commerce, Justice, Science and Related Agencies; FY 2018 Appropriations of Department of Labor, Health and Human Services; FY 2019 Appropriations of Department of the Interior, environment, and related agencies; FY 2019 Appropriations of Department of Labor, Health and Human Services; Alternative Fuel Tax Assessment; Antimicrobials; Bisphenol-A; Building and Construction water infrastructure; Chemical Assessment; Chemical Safety Board; Chemistry Caucus; Chlorinated Paraffins; Chlorine; CPSC, including Phthalates, Flame Retardants, Nominations, and CHAP; Design for the Environment; Energy Recovery; EPA Nomination; Flame Retardants; Fluorotechnology including PFOA/PFOS/PFAS Formaldehyde; Hexavalent Chromium; Integrated Risk Information System; International Agency for Research of Cancer, including Report on Carcinogens Labeling and Packaging, including GMOs; Lautenberg Chemical Safety Act Implementation (LCSA) and regulations; Microbeads; Microplastics; Nanotechnology; NIOSH studies; OSHA Letters of Interpretation (Chemical Concentrations, Process Safety, RAGAGEP); Permitting Reform; Phthalates; Plastics; Rare Earths; Risk Assessment Improvements; Science Advisory Board; Sustainability including report on innovation and Research and Development Styrene; T-TIP, MTB and Trade Promotion Authority; Titanium Dioxide

Client expense: $2,250,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Commerce, Dept of (DOC), Consumer Product Safety Commission (CPSC), Council on Environmental Quality (CEQ), Energy, Dept of, Environmental Protection Agency (EPA), Federal Aviation Administration (FAA), Federal Railroad Administration, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Interior, Dept of (DOI), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Economic Council (NEC), Natl Highway Traffic Safety Administration (NHTSA), Office of Management & Budget (OMB), Pipeline & Hazardous Materials Safety Administration, SENATE, Surface Transportation Board (STB), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Trade Representative (USTR), White House Office

Lobbying Issues Description: Budget and appropriations for disease and injury prevention, including obesity and related diseases; pandemic influenza and emerging infectious diseases; physical activity; public health bioterrorism preparedness; food safety, environmental health; paid sick days; womens and childrens health; community-based public health interventions, and substance misuse/behavioral health issues. Specific Legislation: 1.Implementation of the Patient Protection and Affordable Care Act (Public Law 111-148) 2.Implementation of the FDA Food Safety Modernization Act (Public Law 111-353) 3.Implementation of Pandemic and All-Hazards Preparedness Reauthorization Act (Public Law 113-5) 4.Implementation of Healthy, Hunger-Free Kids Act of 2010 (Public Law 111-296) 5.Implementation of the Budget Control Act of 2011 (Public Law 112-25) 6.Implementation of the Drug Quality and Security Act of 2013 (Public Law 113-54) 7.Implementation of Animal Drug and Animal Generic Drug User Fee Act (Public Law 113-14) 8.Implementation of Child Care and Development Block Grant Act of 2014 (Public Law 113-186) 9.Implementation of Every Student Succeeds Act (Public Law 114-95) 10.Implementation of the Comprehensive Addition and Recovery Act (Public Law 114-98) 11.FY 2018 Departments of Labor, Health and Human Services, and Education and Related Agencies Appropriations (S. 1771/H.R. 3358) 12.FY 2018 Departments of Agriculture, Rural Development, Food and Drug Administration and Related Agencies Appropriations (S. 1603/H.R. 3268) 13.Consolidated Appropriations Act 2018 (Public Law 115-141) 14.Midnight Rules Relief Act (S.34/H.R. 21) 15.Regulations from the Executive in Need of Scrutiny Act (S. 21/H.R. 26) 16.Regulatory Accountability Act (S.951/H.R. 5/H.R. 45/H.Res.33) 17.Searching for and Cutting Regulations that are Unnecessarily Burdensome (SCRUB) Act (H.R. 998) 18.Regulatory Integrity Act (H.R. 1004) 19.OIRA Insight, Reform, and Accountability Act (S. 676/H.R. 1009) 20.A concurrent resolution setting forth the congressional budget for the United States Government for fiscal year 2017 and setting forth the appropriate budgetary levels for fiscal years 2018 through 2026 (S.Con.Res. 3) 21.American Health Care Act (H.R. 1628/H.Res. 228) 22.Ozone Standards Implementation Act (S. 263/H.R. 806) 23.Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the final rule of the Bureau of Land Management relating to "Waste Prevention, Production Subject to Royalties, and Resource Conservation" (S.J. Res. 11/H.J.Res.36) 24.Common Sense Nutrition Disclosure Act (S. 261/H.R. 772) 25.Reinvigorating Antibiotic and Diagnostic Innovation (READI) Act (H.R. 1840) 26.Preservation of Antibiotics for Medical Treatment Act (H.R. 1587) 27.Preventing Antibiotic Resistance Act (S. 629) 28.Better Care Reconciliation Act (H.R. 1628) and related amendments 29.Public Health Emergency Response Act (S. 196) 30.Recognizing the importance of vaccinations and immunizations in the United States (H.Res.327) 31.Consolidated Appropriations Act, 2017 (Public Law 115-31) 32.Treat and Reduce Obesity Act (S. 830/H.R. 1953) 33.Community Health and Medical Professionals Improve Our Nation (CHAMPION) Act (H.R. 3922) 34.Community Health Investment, Modernization, and Excellence Act of 2017 (S. 1899) 35.Tobacco Tax Equity Act (S. 1837) 36.Healthy Kids Act (S. 1821/H.R. 3921) 37.Implementation of the Drug Quality and Security Act (P.S. 113-54) 38.Continuing Appropriations Act, 2018 and Supplemental Appropriations for Disaster Relief Requirements Act, 2017 (Public Law 115-56) 39.Friendly Airports for Mothers Act (S. 1110/H.R. 2375) 40.Lead-Safe Housing for Kids Act (S. 1845) 41.Supporting Working Moms Act (S. 2122/H.R. 3255) 42.Championing Healthy Kids Act (H.R. 3922) 43.Making further continuing appropriations for fiscal year 2018, and for other purposes (Public Law 115-90) 44.An Act to amend the Homeland Security Act of 2002 to require the Secretary of Homeland Security to issue Department of Homeland Security-wide guidance and develop training programs as part of the Department of Homeland Security Blue Campaign, and for other purposes (Public Law 115-96) 45.Tax Cuts and Jobs Act (Public Law 115-97) 46.Pandemic and All-Hazards Preparedness Advancing Innovation Act (S. 2852/H.R. 6783) 47.Vaccine Access Improvement Act (H.R. 4993) 48.Relief from New Source Performance Standards Act (H.R. 453) 49.Strategies to Address Antimicrobial Resistance (S. 2469) 50.Opioid Quota Reform Act (S. 2535) 51.Hospital Preparedness Program Reauthorization Act (H.R. 4776) 52.Relief from New Source Performance Standards Act (H.R. 453) 53.Blocking Regulatory Interference from Closing Kilns Act (H.R. 1917) 54.Health Equity and Accountability Act (H.R. 5942) 55.Opioid Crisis Response Act of 2018 (S. 2680) 56.Agriculture and Nutrition Act (H.R. 2) 57.Agriculture Improvement Act (S. 3042) 58.SECURE Act (H.R. 5998) 59.FY 2019 Departments of Labor, Health and Human Services, and Education and Related Agencies Appropriations (S. 3158) 60.FY 2019 Departments of the Interior, Environment, and Related Agencies Appropriations Act (H.R. 6147/S. 3073) 61.FY 2019 Departments of Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations (H.R. 5961/ S. 2976) 62.Trauma-Informed Care for Children and Families Act (S. 774) House(s) of Congress and Federal Agencies lobbied during the quarter: House, Senate, Exec Office of Pres, HHS, CDC, FDA, CMS, OMB, DOT, HUD, EPA, Education, USDA, DHS, FEMA, and SAMHSA.

Client expense: $30,059 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Environmental Protection Agency (EPA), Executive Office of the President (EOP), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Office of Management & Budget (OMB), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Transportation, Dept of (DOT)

H.R. 2051: "FAST Generics Act of 2017", To amend the Federal Food, Drug, and Cosmetic Act to ensure that eligible product developers have competitive access to approved drugs and licensed biological products, so as to enable eligible product developers to develop and test new products, issues pertaining to drug pricing. S. 974, H.R. 2212: "CREATES Act of 2017", regarding all provisions. H.R. 3976: "Access to Marketplace Insurance Act", issues pertaining to Third Party Payment Premiums (TPPs). S. 2680, H.R. 6: "The Opioid Crisis Response Act of 2018", regarding all provisions. S. 3042, H.R. 2: "Agriculture Improvement Act of 2018", issues pertaining to federal funding for AHPs. H.R. 302, FAA Reauthorization Act of 2018, issues pertaining to air ambulance pricing transparency. H.R. 6294: "REVAMP Act" - To amend the Federal Food, Drug and Cosmetic Act to encourage the development of priority antimicrobial products through the award of transferable exclusivity extension period, regarding all provisions. H.R. 6733: "Know the Cost Act" - To amend title XXVII of the Public Health Service Act and title XVIII of the Social Security Act to prohibit group health plans, health insurance issuers, prescription drug plan sponsors and Medicare Advantage organizations from limiting certain information on drug prices, regarding all provisions. Issues pertaining to the Affordable Care Act; Annual Appropriations; Reinsurance; Cost Sharing Reductions (CSRs); Individual Market; Short Term Limited Duration Plans; Part D Donut Hole fix; Free standing ERs; ESRD coverage by private health plans; Risk adjustment.

Client expense: $1,280,000 · Firm income: Not reported

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

S.1109/H.R.959 - Title VIII Nursing Workforce Reauthorization Act of 2017 S. 445/ H.R.1825 - Home Health Care Planning Improvement Act of 2017 H.R. 6 [P.L. No. 115-271]- SUPPORT for Patients and Communities Act H. Res. 1099 - Providing for the concurrence by the House in the Senate amendment to H.R. 6, with an amendment S.2524/H.R. 5102 - Substance Use Disorder Workforce Loan Repayment Act of 2018 H.R. 3692 - Addiction Treatment Access Improvement Act of 2017 S. 2317 - Addiction Treatment Access Improvement Act of 2018 S. 2456/H.R. 5311- CARA 2.0 Act of 2018 H.R.1478 - Gun Violence Research Act Priorities for health care reform Opioid Abuse Epidemic S.2680 - Opioid Crisis Response Act of 2018 S. 2891 - Fighting the Opioid Epidemic with Sunshine Act of 2018 S. 3065/H.R. 6156 - Protecting JOBs Act H.R. 315 [P.L. No: 115-320] Improving Access to Maternity Care Act S. 3685 Nurse WIN Act

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

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

H.R. 807/S.253 Medicare Access to Rehabilitation Services Act (Medicare Appeals Procedures) QPP Prevention Initiatives for Fraud and Abuse in The Medicare program Accountable health care organizations/patient centered medical homes Electronic health records/health information technology incentives for Physical Therapists Local coverage determinations/EMG NCCI Edits Protection of programs related to physical therapy in deficit reduction Medicare Advantage PCORI National priority for research and research agenda Health information technology Functional Limitation Reporting Therapy Cap: Targeted Medical Review Essential Health Benefits MIPS/PPP Medicaid essential health benefits EHR/LTPAC settings: transitions of care Medicare improvement standards Bundled payment models/CJR Common assessment tool for Medicare post-acute care Medicare appeals process Inclusion of physical therapists in quality programs Self-referral Coverage of telehealth APTA Registry Quality Programs Accelerating Innovation in Medicine Act (AIM) IMPACT Medicare Pilot Programs Chronic Care Management New evaluation and reevaluation CPT codes & misvalued codes Orthotics and Prosthetics Medicare Private Contracting S.870 - Chronic Care Act SNF 3-Day Rule Registry- ACI HR 2042 - Frontline Act Youth Concussion Management DME HR 3446 RBI Act H.R. 5261 Teach Act Opioid related H.R. 5197 Alto Act Opioid related Administrative Burden H.R. 5686, Medicare Clear Health Options in Care for Enrollees Act H.R. 5773, Preventing Addiction for Susceptible Seniors Act H.R. 5774, Combating Opioid Abuse for Care in Hospitals Act H.R. 5718, Perioperative Reduction for Opioids Act H.R. 5719, Reduce Overprescribing Opioids in Treatment Act H.R. 5722, Dr. Todd Graham Pain Management Improvement Act H.R. 6, Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act. S. 3120, HEAL Act S. 2680, Opioid Crisis Response Act PTA Differential in Medicare Prior Authorization in Medicare Advantage Plans Alternative payment models Certified EHR technology HR 7217 Improving Medicaid Programs and Opportunities for Eligible Beneficiaries Act (IMPROVE ACT) S. 3458: Improvements to Home Health HR 3635: Local Coverage Determination Clarification Act of 2018

Client expense: $252,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Small Business Administration (SBA), Veterans Affairs, Dept of (VA), White House Office

Implementation/Expansion of CDC Falls Program Implementation of Affordable Care Act - provisions pertaining to Essential Health Benefits & Health Insurance Exchanges AHRQ provisions pertaining to PT Physician self-referra/Stark Law American Cures Act H.R. 930/S.497 Lymphadema Treatment Act Health Information Technology Nominations to PCORI Methodology Committees Medicaid Expansion HR. 1639/S.619 Physical Therapist Workforce & Patient Access Act Physician owned distributerships H.R. 302/S.808 Sports Medicine Licensure Clarity Act MACRA/MIPS APMS IMPACT/PAC reform Network adequacy Insurance Benefit parameters H.R. 1361/S.486 Ensuring Access to Quality CRT Medicare Telehealth Parity Act HR2550 American Healthcare Act of 2017/CONNECT - H.R. 2556/S1016 H.R. 1628 - American Health Care Action of 2017 Opioid Epidemic/Pain Management Better Care Reconciliation Act of 2017 H.R.2066 Promoting Integrity in Medicare H.R. 2063 Opioid Pace Act of 2017 H.R. 5261 Teach Act H.R. 5197 Alto Act H.R. 5686, Medicare Clear Health Options in Care for Enrollees Act H.R. 5773, Preventing Addiction for Susceptible Seniors Act H.R. 5774, Combating Opioid Abuse for Care in Hospitals Act H.R. 5718, Perioperative Reduction for Opioids Act H.R. 5719, Reduce Overprescribing Opioids in Treatment Act H.R. 5722, Dr. Todd Graham Pain Management Improvement Act H.R. 6, Substance-Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act S. 3120, the HEAL Act S. 2680, Opioid Crisis Response Act Association Retirement Plans State Relief and Empowerment Waivers D.O.L Information Collection Request Extensions Health Reimbursement Accounts HR 7217: Improve Act

Client expense: $252,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Small Business Administration (SBA), Veterans Affairs, Dept of (VA), White House Office

H.R. 2, Agriculture Improvement Act of 2018; H.R. 5, Regulatory Accountability Act of 2017; H.R. 6, SUPPORT for Patients and Communities Act; H.R. 21, Midnight Rules Relief Act; H.R. 26, Regulations from the Executive in Need of Scrutiny (REINS) Act; H.R. 33 Small Business Regulatory Flexibility Improvements Act of 2017; H.R. 45, Regulatory Accountability Act of 2017; H.R. 1029, Pesticide Registration Improvement Extension Act of 2017; H.R. 1430, Honest and Open New EPA Science Treatment (HONEST) Act of 2017; H.R. 1431, EPA Science Advisory Board Reform Act of 2017; H.R. 2811, Foreign Agents Registration Modernization and Enforcement Act; H.R. 3268, Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, 2018; H.R. 3381, Child Poverty Reduction Act 2017; H.R. 4170, Disclosing Foreign Influence Act; H.R. 4460, Disaster Recovery Reform Act; H.R. 4667, Making further supplemental appropriations for the FY ending 9/30/18, for disaster assistance for Hurricanes Harvey, Irma, and Maria, and calendar year 2017 wildfires, and for other purposes; H.R. 5228, Stop Counterfeit Drugs by Regulation and Enhancing Enforcement Now (SCREEN)Act H.R. 5310, Municipal Infrastructure Savings and Transparency Act; H.R. 5752, Stop Illicit Drug Importation Act of 2018; H.R. 6022, Accurate Labels Act; H.R. 6653, IMAGINE Act; H. Res 71, Providing for consideration of the joint resolution (H.J. Res. 41) providing for congressional disapproval under chapter 8 of title 5, United States Code, of a rule submitted by the Securities and Exchange Commission relating to "Disclosure of Payments by Resource Extraction Issuers", and providing for consideration of the joint resolution (H.J. Res. 40) providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Social Security Administration relating to Implementation of the NICS Improvement Amendments Act of 2007; H. Res. 223; H. Res. 229; H. Res. 1082, Providing for the concurrence by the House in the Senate amendment to H.R. 302, with an amendment. (Sec. 1234 Natl. Public Infrastructure Predisaster Hazard Mitigation, and Sec. 1235 Addl. Mitigation Activities); S. 584, Small Business Regulatory Flexibility Improvements Act; S. 625 Foreign Agents Registration Modernization and Enforcement Act; S. 1113, Personal Care Products Safety Act; S. 1679, Foreign Agent Lobbying Transparency Enforcement Act; S. 1794, HONEST Act; S. 1866, Hurricanes Harvey, Irma, and Maria Education Relief Act of 2017; S. 2039, Disclosing Foreign Influence Act; S. 2482, Foreign Agents Registration Amendments Act of 2018; S. 2680, Opioid Crisis Response Act of 2018; S. 3019, Accurate Labels Act; S. 3042, Agriculture Improvement Act of 2018; S. 3041, Disaster Recovery Reform Act of 2018; S. 3296, Sustainable Chemistry Research and Development Act of 2018; S. 3341, IMAGINE Act; S. 3381, PFAS Accountability Act of 2018; S. 3382, PFAS Detection Act of 2018; S. 3508, Save Our Seas Act 2018; S. 3551, SOFFA; S. 3671 A bill to require the Administrator of the Environmental Protection Agency to revise certain ethylene oxide emissions standards under the Clean Air Act, and for other purposes; S. Res. 301; S. Resolution Establishing the congressional budget; FY 2018 Appropriations of Department of Interior; FY 2018 Appropriations of Environmental Protection Agency; FY 2018 Appropriations Financial Services and General Government FY 2018 Appropriations of Transportation, Housing and Urban Development, and Related Agencies; FY 2018 Appropriations of Commerce, Justice, Science and Related Agencies; FY 2018 Appropriations of Department of Labor, Health and Human Services; FY 2019 Appropriations of Department of the Interior, environment, and related agencies; FY 2019 Appropriations of Department of Labor, Health and Human Services; Alternative Fuel Tax Assessment; Antimicrobials; Bisphenol-A; Building and Construction water infrastructure; Chemical Assessment; Chemical Safety Board; Chemistry Caucus; Chlorinated Paraffins; Chlorine; CPSC, including Phthalates, Flame Retardants, Nominations, and CHAP; Design for the Environment; Energy Recovery; EPA Nomination; Flame Retardants; Fluorotechnology including PFOA/PFOS/PFAS Formaldehyde; Hexavalent Chromium; Integrated Risk Information System; International Agency for Research of Cancer, including Report on Carcinogens Labeling and Packaging, including GMOs; Lautenberg Chemical Safety Act Implementation (LCSA) and regulations; Microbeads; Microplastics; Nanotechnology; NIOSH studies; OSHA Letters of Interpretation (Chemical Concentrations, Process Safety, RAGAGEP); Permitting Reform; Phthalates; Plastics; Rare Earths; Risk Assessment Improvements; Science Advisory Board; Sustainability including report on innovation and Research and Development Styrene; T-TIP, MTB and Trade Promotion Authority; Titanium Dioxide

Client expense: $1,940,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Commerce, Dept of (DOC), Consumer Product Safety Commission (CPSC), Council on Environmental Quality (CEQ), Energy, Dept of, Environmental Protection Agency (EPA), Federal Aviation Administration (FAA), Federal Railroad Administration, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Interior, Dept of (DOI), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Economic Council (NEC), Natl Highway Traffic Safety Administration (NHTSA), Office of Management & Budget (OMB), Pipeline & Hazardous Materials Safety Administration, SENATE, Surface Transportation Board (STB), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Trade Representative (USTR), White House Office

H.R. 2, Agriculture Improvement Act of 2018; H.R. 5, Regulatory Accountability Act of 2017; H.R. 6, SUPPORT for Patients and Communities Act; H.R. 21, Midnight Rules Relief Act; H.R. 26, Regulations from the Executive in Need of Scrutiny (REINS) Act; H.R. 33 Small Business Regulatory Flexibility Improvements Act of 2017; H.R. 45, Regulatory Accountability Act of 2017; H.R. 1029, Pesticide Registration Improvement Extension Act of 2017; H.R. 1430, Honest and Open New EPA Science Treatment (HONEST) Act of 2017; H.R. 1431, EPA Science Advisory Board Reform Act of 2017; H.R. 2811, Foreign Agents Registration Modernization and Enforcement Act; H.R. 3268, Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, 2018; H.R. 3381, Child Poverty Reduction Act 2017; H.R. 4170, Disclosing Foreign Influence Act; H.R. 4460, Disaster Recovery Reform Act; H.R. 4667, Making further supplemental appropriations for the FY ending 9/30/18, for disaster assistance for Hurricanes Harvey, Irma, and Maria, and calendar year 2017 wildfires, and for other purposes; H.R. 5228, Stop Counterfeit Drugs by Regulation and Enhancing Enforcement Now (SCREEN)Act H.R. 5310, Municipal Infrastructure Savings and Transparency Act; H.R. 5752, Stop Illicit Drug Importation Act of 2018 H.R. 6022, Accurate Labels Act H. Res 71, Providing for consideration of the joint resolution (H.J. Res. 41) providing for congressional disapproval under chapter 8 of title 5, United States Code, of a rule submitted by the Securities and Exchange Commission relating to "Disclosure of Payments by Resource Extraction Issuers", and providing for consideration of the joint resolution (H.J. Res. 40) providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Social Security Administration relating to Implementation of the NICS Improvement Amendments Act of 2007; H. Res. 223; H. Res. 229; H. Res. 1082, Providing for the concurrence by the House in the Senate amendment to H.R. 302, with an amendment. (Sec. 1234 Natl. Public Infrastructure Predisaster Hazard Mitigation, and Sec. 1235 Addl. Mitigation Activities); S. 584, Small Business Regulatory Flexibility Improvements Act; S. 625 Foreign Agents Registration Modernization and Enforcement Act; S. 1113, Personal Care Products Safety Act; S. 1679, Foreign Agent Lobbying Transparency Enforcement Act; S. 1794, HONEST Act; S. 1866, Hurricanes Harvey, Irma, and Maria Education Relief Act of 2017; S. 2039, Disclosing Foreign Influence Act; S. 2482, Foreign Agents Registration Amendments Act of 2018; S. 2680, Opioid Crisis Response Act of 2018; S. 3019, Accurate Labels Act; S. 3042, Agriculture Improvement Act of 2018; S. 3041, Disaster Recovery Reform Act of 2018; S. 3296, Sustainable Chemistry Research and Development Act of 2018; S. 3382, PFAS Detection Act of 2018; S. 3508, Save Our Seas Act 2018; S. 3551, SOFFA; S. Res. 301; S. Resolution Establishing the congressional budget; FY 2018 Appropriations of Department of Interior; FY 2018 Appropriations of Environmental Protection Agency; FY 2018 Appropriations Financial Services and General Government FY 2018 Appropriations of Transportation, Housing and Urban Development, and Related Agencies; FY 2018 Appropriations of Commerce, Justice, Science and Related Agencies; FY 2018 Appropriations of Department of Labor, Health and Human Services; FY 2019 Appropriations of Department of the Interior, environment, and related agencies; FY 2019 Appropriations of Department of Labor, Health and Human Services; Alternative Fuel Tax Assessment; Antimicrobials; Bisphenol-A; Building and Construction water infrastructure; Chemical Assessment; Chemical Safety Board; Chemistry Caucus; Chlorinated Paraffins; Chlorine; CPSC, including Phthalates, Flame Retardants, Nominations, and CHAP; Design for the Environment; Energy Recovery; EPA Nomination; Flame Retardants; Fluorotechnology including PFOA/PFOS/PFAS Formaldehyde; Hexavalent Chromium; Integrated Risk Information System; International Agency for Research of Cancer, including Report on Carcinogens Labeling and Packaging, including GMOs; Lautenberg Chemical Safety Act Implementation (LCSA) and regulations; Microbeads; Microplastics; Nanotechnology; NIOSH studies; OSHA Letters of Interpretation (Chemical Concentrations, Process Safety, RAGAGEP); Permitting Reform; Phthalates; Plastics; Rare Earths; Risk Assessment Improvements; Science Advisory Board; Sustainability including report on innovation and Research and Development Styrene; T-TIP, MTB and Trade Promotion Authority; Titanium Dioxide

Client expense: $2,250,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Commerce, Dept of (DOC), Consumer Product Safety Commission (CPSC), Council on Environmental Quality (CEQ), Energy, Dept of, Environmental Protection Agency (EPA), Federal Aviation Administration (FAA), Federal Railroad Administration, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Interior, Dept of (DOI), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Economic Council (NEC), Natl Highway Traffic Safety Administration (NHTSA), Office of Management & Budget (OMB), Pipeline & Hazardous Materials Safety Administration, SENATE, Surface Transportation Board (STB), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Trade Representative (USTR), White House Office

Issues relating to P.L. 111-148, the Patient Protection and Affordable Care Act, and P.L. 111-152, the Health Care and Education Reconciliation Act, including exchanges, cost sharing reduction, market reforms, and non-discrimination provisions. The high cost employer health insurance excise tax, including H.R. 173 and S. 58, the Middle Class Health Benefits Tax Repeal Act of 2017, and H.R. 4616, the Employer Relief Act of 2018, regarding a one-year delay of the Cadillac Tax. H.R. 4620, the Protecting Families and Small Businesses Act of 2017, regarding relief from the Health Insurance Tax. Substance use disorders and 42 CFR Part 2 - Confidentiality of Substance Use Disorder Patient Records, specifically H.R. 3545, H.R. 5795, and H.R.6082, the Overdose Prevention and Patient Safety Act (OPPS Act), H.R. 6, the SUPPORT for Patients and Communities Act, and S. 2680, the Opioid Crisis Response Act of 2018. Issues related to proposed changes to the definition of Employer Under Section 3(5) of ERISA for Association Health Plans. 21st Century Cures Act, section 4004, Reducing Regulatory and Administrative Burden Relating to the Use of Health IT and EHRs, information blocking and interoperability.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Ongoing implementation of payment and regulatory issues for the Medicare Advantage program. CMS-4182-P/CMS-4182-CN: Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2019. Issues related to the opioid epidemic, including H.R. 6, SUPPORT for Patients and Communities Act, and S. 2680, the Opioid Crisis Response Act of 2018. Issues related to the drug pricing RFI, the Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 1112 Maternal Health Accountability Act S. 2070 Kevin and Avontes Law S. 2680 Opioid Crisis Response Act S. 3029/H.R. 6085 PREEMIE Reauthorization Act S. 3660 Health Equity & Accountability Act H.R. 6 Support for Patients and Communities Act H.R. 1318 Preventing Maternal Deaths Act H.R. 5102 Substance Use Disorder Workforce Loan Repayment Act FY2019 Defense Appropriations FY2019 Veterans Appropriations

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE, White House Office

H.R. 6 Support for Patients and Communities Act S. 2680 Opioid Crisis Response Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE, White House Office

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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 H.R.1057-Synthetics Trafficking and Overdose Prevention Act of 2017 H.R.1492-Medical Controlled Substances Transportation Act of 2017 H.R.2851-Stop the Importation and Trafficking of Synthetic Analogues (SITSA) Act of 2017 H.R.3545-Overdose Prevention and Patient Safety (OPPS) Act H.R.4922-Stopping Overdoses of Fentanyl Analogues Act H.R.5176-Preventing Overdoses While in Emergency Rooms Act of 2018 H.R.5197-Alternatives to Opioids (ALTO) in the Emergency Department Act H.R.5531-Opioid Emergency Response Act H.R.5558-Alternatives to Opioids Prescribing Act H.R.6082-Overdose Prevention and Patient Safety (OPPS) Act S.372-Synthetics Trafficking and Overdose Prevention Act of 2017 S.1327-Stop the Importation and Trafficking of Synthetic Analogues (SITSA) Act of 2017 S.1553-Stopping Overdoses of Fentanyl Analogues Act S.2516-Alternatives to Opioids (ALTO) in the Emergency Department Act S.2609-Recovery Coaches Offer Addiction Counseling and Healing (COACH) Act S.2610-Preventing Overdoses While in Emergency Departments Act of 2018 S.2680-Opioid Crisis Response Act of 2018

Client expense: $549,617 · Firm income: Not reported

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

Essential emergency medication shortages Mental health services for emergency psychiatric patients Price transparency, out-of-network reimbursement of emergency medical services H.Res.906-Congratulating the American College of Emergency Physicians on its 50th anniversary H.R.6-Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act H.R.372-Competetive Health Insurance Reform Act of 2017 H.R.548-Health Care Safety Net Enhancement Act of 2017 H.R.767-Stop, Observe, Ask, and Respond (SOAR) to Health and Wellness Act of 2017 H.R.817-End Surprise Billing Act of 2017 H.R.880-Military Injury Surgical Systems Integrated Operationally Nationwide to Achieve ZERO Preventable Deaths Act H.R.1057-Synthetics Trafficking and Overdose Prevention Act of 2017 H.R.1215-Protecting Access to Care Act of 2017 H.R.1323-Reducing Unnecessary Emergency Room Visits under Medicaid Act H.R.1492-Medical Controlled Substances Transportation Act of 2017 H.R.1565-Saving Lives, Saving Costs Act H.R.1822-Good Samaritan Health Professionals Act of 2017 H.R.1876-Good Samaritan Health Professionals Act of 2017 H.R.2200-Frederick Douglass Trafficking Victims Prevention and Protection Reauthorization Act of 2017 H.R.2410-Sickle Cell Disease Research, Surveillance, Prevention, and Treatment Act of 2017 H.R.2851-Stop the Importation and Trafficking of Synthetic Analogues (SITSA) Act of 2017 H.R.2957-Save Rural Hospitals Act H.R.3181-Medicare Choices Empowerment and Protection Act H.R.3258-Marketplace Certainty Act H.R.3545-Overdose Prevention and Patient Safety (OPPS) Act H.R.4922-Stopping Overdoses of Fentanyl Analogues Act H.R.5176-Preventing Overdoses While in Emergency Rooms Act of 2018 H.R.5197-Alternatives to Opioids (ALTO) in the Emergency Department Act H.R.5531-Opioid Emergency Response Act H.R.5558-Alternatives to Opioids Prescribing Act H.R.5678-Rural Emergency Medical Center Act of 2018 H.R.5734-Resident Education Deferred Interest Act H.R.6082-Overdose Prevention and Patient Safety (OPPS) Act H.R.6143-Patient Right to Know Drug Prices Act H.R.6144-Know the Lowest Price Act of 2018 H.R.6372-To require the Secretary of Health and Human Services issue regulations to ensure due process rights for physicians furnishing emergency medical services H.R.6502-Reducing Unnecessary Senior Hospitalizations Act of 2018 H.R.6615-Traumatic Brain Injury Program Reauthorization Act of 2018 H.R.6733-Know the Cost Act of 2018 H.R.6748-Emergency Medical Services for Children Program Reauthorization Act of 2018 H.R.7223-Right Rebate Act of 2018 Senate resolution congratulating the American College of Emergency Physicians on its 50th anniversary S.191-Patient Freedom Act of 2017 S.256-SOAR to Health and Wellness Act of 2017 S.284-End Surprise Billing Act of 2017 S.372- Synthetics Trafficking and Overdose Prevention Act of 2017 S.527-Health Care Safety Net Enhancement Act of 2017 S.568-Improving Access to Medicare Coverage Act of 2017 S.781-Good Samaritan Health Professionals Act of 2017 S.1016-Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2017 S.1022-Military Injury Surgical Systems Integrated Operationally Nationwide to Achieve ZERO Preventable Deaths Act S.1130-Rural Emergency Acute Care Hospital (REACH) Act S.1462-Marketplace Certainty Act S.1530- Medicare Choices Empowerment and Protection Act S.1553-Stopping Overdoses of Fentanyl Analogues Act S.1835-Lower Premiums Through Reinsurance Act of 2017 S.2465-Sickle Cell Disease Research, Surveillance, Prevention, and Treatment Act of 2018 S.2516-Alternatives to Opioids (ALTO) in the Emergency Department Act S.2544-Patient Right to Know Drug Prices Act S.2553-Know the Lowest Price Act of 2018 S.2609-Recovery Coaches Offer Addiction Counseling and Healing (COACH) Act S.2610-Preventing Overdoses While in Emergency Departments Act of 2018 S.2680-Opioid Crisis Response Act of 2018 S.3482-Emergency Medical Services for Children Program Reauthorization Act of 2018 S.3531-Emergency Care Improvement Act S.3657-Traumatic Brain Injury Program Reauthorization Act of 2018 S.3702-Right Rebate Act of 2018

Client expense: $549,617 · Firm income: Not reported

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

H.R. 6 Support for Patients and Communities Act S. 2680 Opioid Crisis Response Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE, White House Office

S. 1112 Maternal Health Accountability Act S. 2070 Kevin and Avontes Law S. 2680 Opioid Crisis Response Act S. 3029/H.R. 6085 PREEMIE Reauthorization Act S. 3660 Health Equity & Accountability Act H.R. 6 Support for Patients and Communities Act H.R. 1318 Preventing Maternal Deaths Act H.R. 5102 Substance Use Disorder Workforce Loan Repayment Act FY2019 Defense Appropriations FY2019 Veterans Appropriations

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE, 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: $1,550,000 · 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

Ongoing implementation of payment and regulatory issues for the Medicare Advantage program. CMS-4182-P/CMS-4182-CN: Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2019. Issues related to the opioid epidemic, including H.R. 6, SUPPORT for Patients and Communities Act and and S. 2680, the Opioid Crisis Response Act of 2018. Issues related to the drug pricing RFI, the Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs. Issues related to implementation of provisions in the Bipartisan Budget Act of 2018 that require increased integration of Medicare and Medicaid benefits by Dual-Eligible Special Needs Plans (D-SNPs) beginning in 2021.

Client expense: $1,460,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, U.S. Trade Representative (USTR), White House Office

Issues relating to P.L. 111-148, the Patient Protection and Affordable Care Act and P.L. 111-152, the Health Care and Education Reconciliation Act, including exchanges, cost sharing reduction, market reforms, and non-discrimination provisions. The high cost employer health insurance excise tax, including H.R. 173 and S. 58, the Middle Class Health Benefits Tax Repeal Act of 2017, and H.R. 4616, the Employer Relief Act of 2018, regarding a one-year delay of the Cadillac Tax. H.R. 4620, the the Protecting Families and Small Businesses Act of 2017, regarding relief from the Health Insurance Tax. Substance use disorders and 42 CFR Part 2 - Confidentiality of Substance Use Disorder Patient Records, specifically H.R. 3545, H.R. 5795, and H.R.6082, the Overdose Prevention and Patient Safety Act (OPPS Act), H.R. 6, the SUPPORT for Patients and Communities Act and S. 2680, the Opioid Crisis Response Act of 2018. Issues related to proposed changes to the definition of Employer Under Section 3(5) of ERISA for Association Health Plans.

Client expense: $1,460,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, U.S. Trade Representative (USTR), White House Office

S. 92: Safe and Affordable Drugs from Canada Act S. 469: Affordable and Safe Prescription Drug Importation Act S. 1131/ H.R. 2439: FAIR Drug Pricing Act S. 1348: SPIKE Act of 2017 S. 1369/ H.R. 2974: Stop Price Gouging Act S. 1803/H.R. 4825, the Marijuana Effective Drug Studies (MEDS) Act S. 2076/H.R. 4256: BOLD Infrastructure for Alzheimer's Act S. 2406: Advancing Cutting Edge (ACE) Research Act S. 2478: End Taxpayer Subsidies for Drug Ads Act S. 2680: Opioid Crisis Response Act S. 2891: Fighting the Opioid Epidemic with Sunshine Act S. 3369/ HR 6689: Ensuring Lasting Smiles Act S. 3411/H.R. 6689: Affordable Medications Act S. 3657/ H.R. 6615: Traumatic Brain Injury Program Reauthorization Act S. 3686/ H.R. 3580: Protecting Student Athletes from Concussions Act H.R. 6: SUPPORT for Patients and Communities Act: Sections 6062 and 6111; Subtitle E H.R. 1776: Improving Access to Affordable Prescription Drugs Act H.R. 2077: Restoring the Patient's Voice Act H.R. 3391, Medical Marijuana Research Act of 2017 H.R. 4116: Transparent Drug Pricing Act H.R. 5634: Medical Cannabis Research Act H.R. 6340: Capping Prescription Costs Act Disclosure of drug prices in prescription drug direct-to-consumer advertising; Sustained fetal tissue research; Orphan Drug Act Reform; Interoperability, including for Qualified Clinical Data Registries; NIH funding including the BRAIN Initiative; Congressionally-Directed Medical Research Program funding; concussion related issues; loan repayment for pediatric specialists.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 92: Safe and Affordable Drugs from Canada Act S. 469: Affordable and Safe Prescription Drug Importation Act S. 1131/ H.R. 2439: FAIR Drug Pricing Act S. 1348: SPIKE Act of 2017 S. 1369/ H.R. 2974: Stop Price Gouging Act S. 2260 / H.R. 4733: Opioids and STOP Pain Initiative Act S. 2406: Advancing Cutting Edge (ACE) Research Act S. 2478: End Taxpayer Subsidies for Drug Ads Act S. 2680: Opioid Crisis Response Act S. 2891: Fighting the Opioid Epidemic with Sunshine Act S. 3369/ H.R. 6689: Ensuring Lasting Smiles Act S. 3411: Affordable Medications Act H.R. 6: SUPPORT for Patients and Communities Act: Sections 6062 and 6111; Subtitle E H.R. 1776: Improving Access to Affordable Prescription Drugs Act H.R. 2077: Restoring the Patient's Voice Act H.R. 4116: Transparent Drug Pricing Act H.R. 5634: Medical Cannabis Research Act H.R. 6340: Capping Prescription Costs Act Interoperability, including for Qualified Clinical Data Registries; Appropriations for the CDC National Neurological Conditions Surveillance System; Maintenance/expansion of Graduate Medical Education (GME); NIH funding including the BRAIN Initiative; Congressionally-Directed Medical Research Program funding; concussion related issues.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 92: Safe and Affordable Drugs from Canada Act S. 201 / H.R. 5247: Trickett Wendler, Frank Mongiello, Jordan McLinn, and Matthew Bellina Right to Try Act of 2017 S. 469: Affordable and Safe Prescription Drug Importation Act S. 1131/ H.R. 2439: FAIR Drug Pricing Act S. 2260 / H.R. 4733: Opioids and STOP Pain Initiative Act H.R. 1776: Improving Access to Affordable Prescription Drugs Act H.R. 1876: Good Samaritan Health Professionals Act of 2017 H.R. 2077: the Restoring the Patient's Voice Act of 2017 H.R. 4116: Transparent Drug Pricing Act of 2017 S. 2387 / H.R. 4957: Concentrating on High-Value Alzheimers Needs to Get to an End (CHANGE) Act S. 2406: Advancing Cutting Edge (ACE) Research Act S. 2478: End Taxpayer Subsidies for Drug Ads Act S. 2680: Opioid Crisis Response Act of 2018 S. 2891: Fighting the Opioid Epidemic with Sunshine Act H.R. 5634: Medical Cannabis Research Act Maintenance/expansion of Graduate Medical Education (GME); encouraging drug price transparency; NIH funding including the BRAIN Initiative; Congressionally-Directed Medical Research Program funding; concussion related issues.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 2680, The Opioid Crisis Response Act of 2018

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

Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Education, Dept of, Environmental Protection Agency (EPA), Federal Emergency Management Agency (FEMA), Federal Highway Administration (FHA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), Interior, Dept of (DOI), Natl Oceanic & Atmospheric Administration (NOAA), Natl Park Service (NPS), Office of Juvenile Justice & Delinquency Prevention, SENATE, Transportation, Dept of (DOT)

S. 2680, The Opioid Crisis Response Act of 2018

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

Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Education, Dept of, Federal Emergency Management Agency (FEMA), Federal Highway Administration (FHA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), Interior, Dept of (DOI), Natl Oceanic & Atmospheric Administration (NOAA), Natl Park Service (NPS), SENATE, Transportation, Dept of (DOT)

H.R.1605 - Physician Assistant Education Public Health Initiatives Act of 2017 H.R. 3728 Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness Act of 2017 (EMPOWER Act) Reauthorization of Title VII of the Public Health Service Act S. 3095/H.R. 2574 - the Building a Health Care Workforce for the Future Act H.R. 6 [P.L. No: 115-271] - SUPPORT for Patients and Communities Act H.Res.1099 - Providing for the concurrence by the House in the Senate amendment to H.R. 6, with an amendment S.2524/H.R. 5102 - Substance Use Disorder Workforce Loan Repayment Act of 2018 H.R.3692 - Addiction Treatment Access Improvement Act of 2017 S. 2317 - Addiction Treatment Access Improvement Act of 2018 S. 2456/H.R. 5311 - CARA 2.0 Act of 2018 S.2680 - Opioid Crisis Response Act of 2018 Workforce development and clinical training site issues

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

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

S. 2680, The Opioid Crisis Response Act of 2018

Client expense: Not reported · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Education, Dept of, Environmental Protection Agency (EPA), Federal Emergency Management Agency (FEMA), Federal Highway Administration (FHA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), Interior, Dept of (DOI), Natl Oceanic & Atmospheric Administration (NOAA), Natl Park Service (NPS), Office of Juvenile Justice & Delinquency Prevention, SENATE, Transportation, Dept of (DOT)