Ensuring Coverage for Patients with Pre-Existing Conditions Act

H.R. 2: Agriculture Improvement Act of 2018; provisions related to Association Health Plans H.R. 7295: Medial Records Access Fairness Act; all provisions S. 3042: Agriculture Improvement Act of 2018; provisions related to Association Health Plans S. 3388: Ensuring Coverage for Patients with Pre-Existing Conditions Act; all provisions Centers for Medicare & Medicaid Services Regulation# CMS-9936-NC: Provisions related to section 1332 of the Patient Protection and Affordable Care Act (PPACA) - State Relief and Empowerment Waivers

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), SENATE

S. 3388: Ensuring Coverage for Patients with Pre-Existing Conditions Act; all provisions Centers for Medicare & Medicaid Services Regulation# CMS-9936-NC: Provisions related to section 1332 of the Patient Protection and Affordable Care Act (PPACA) - State Relief and Empowerment Waivers

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), SENATE

H.R. 2: Agriculture Improvement Act of 2018; provisions related to Association Health Plans H.R. 7295: Medial Records Access Fairness Act; all provisions S. 3042: Agriculture Improvement Act of 2018; provisions related to Association Health Plans S. 3388: Ensuring Coverage for Patients with Pre-Existing Conditions Act; all provisions Centers for Medicare & Medicaid Services Regulation# CMS-9936-NC: Provisions related to section 1332 of the Patient Protection and Affordable Care Act (PPACA) - State Relief and Empowerment Waivers

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), SENATE

Implementation of the Affordable Care Act S. 3388 - Ensuring Coverage for People with Pre-Existing Conditions Act

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Institutes of Health (NIH), SENATE

Issues related to lung disease treatment, prevention and research; public health; Issues related asthma; COPD; influenza; lung cancer; pneumonia; tuberculosis and other lung diseases; Issues related to tobacco cessation; Issues related to the Affordable Care Act; Issues related to the Childrens Health Insurance Program; Issues related to the President's Budget; H.R.774 Medicaid Coverage of Tobacco Cessation Nonprescription Drugs Act H.R.1121 Pre-existing Conditions Protection Act of 2017; H.R.2550 Medicare Telehealth Parity Act of 2017; H.R.4695 Bipartisan Market Stabilization and Innovation Act of 2017; H.R.4897 Women and Lung Cancer Research and Preventive Services Act of 2018; S.974 CREATES Act of 2017; S.1462 Marketplace Certainty Act; S.2494 Fair Care Act; S.2507 Improving Choices in Health Care Coverage Act; S. 2507, Improving Choices in Health Care Coverage Act (Codification of Short Term Limited Duration Health Plans); H.Con.Res.128 - Establishing the congressional budget for the United States Government for fiscal year 2019 and setting forth the appropriate budgetary levels for fiscal years 2020 through 2028 H.R.2 Agriculture and Nutrition Act of 2018; S.3388 - Ensuring Coverage for Patients with Pre-Existing Conditions Act; H.R.4229 - Protecting HOME Access Act of 2017; S.J.Res.63 - A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Secretary of the Treasury, Secretary of Labor, and Secretary of Health and Human Services relating to "Short-Term, Limited Duration Insurance

Client expense: $100,000 · 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), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), Natl Highway Traffic Safety Administration (NHTSA), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Postal Regulatory Commission, SENATE, Transportation, Dept of (DOT), Veterans Affairs, Dept of (VA), White House Office

Bipartisan Health Care Stabilization Act (Alexander-Murray) - funding for cost sharing reduction benefits, stabilization of individual market Bipartisan Health Care Stabilization Act; updated version (Alexander-Walden-Collins-Costello) - funding for cost sharing reduction benefits and reinsurance, stabilization of individual market S. 147, Obamacare Taxpayer Bailout Prevention Act (Rubio) - ACA risk corridors program S. 581, Jessies Law (Manchin-Capito) - patient history of opioid use disorder S. 1201, Health Care Options for All Act (McCaskill) - coverage options in bare counties S. 1354, Individual Health Insurance Marketplace Improvement Act (Carper-Kaine) - individual market reinsurance fund, outreach and enrollment activities S. 1462, Marketplace Certainty Act (Shaheen) - funding for cost-sharing reduction benefits S. 1516, Coverage Across State Lines (Heller) S. 1667, Protecting Consumers from Unreasonable Rates Act (Feinstein) - rate review S. 1835, Lower Premiums Through Reinsurance Act (Collins-Nelson) - invisible high risk pool and reinsurance programs S. 1976, Increasing Access to Care Act (Scott) - copper plan S. 1985, Protect Access to Birth Control Act (Murray) - coverage of contraceptive services S. 2052, Healthcare Market Certainty and Mandate Relief Act (Hatch) - funding for cost sharing reduction benefits, HSA improvements, ACA individual mandate S. 2241 (King) - fees on excepted benefits and standalone dental plans S. 2303, Access to Independent Health Insurance Advisors Act (Isakson-Coons) - calculation of medical loss ratios S. 3388, Ensuring Coverage for Patients with Pre-Existing Conditions Act (Tillis) - protections for individuals with pre-existing conditions S. 3541, Reducing Costs for Out-of-Network Services Act (Shaheen) -cost-sharing for out-of-network services S. 3592, No More Surprise Medical Bills Act (Hassan) - surprise medical bills S. 3742, Cancer Drug Parity Act (Smith) - cost sharing for cancer drugs H.R. 2, Agriculture and Nutrition Act (Conaway) - agricultural association health plans H.R. 314, Health Care Choice Act (Blackburn) - selling insurance across state lines H.R. 372, Competitive Health Insurance Reform Act (Gosar) - McCarran-Ferguson Act H.R. 421, Allowing Greater Access to Safe and Effective Contraception Act (Love) - non-prescription contraceptives, HSA flexibility H.R. 706, Plan Verification and Fairness Act (Blackburn) - verifying eligibility for special enrollment periods H.R. 708, State Age Rating Flexibility Act (Buchson) - age rating bands H.R. 710, Health Coverage State Flexibility Act (Flores) - grace period for premium payments H.R. 1101, Small Business Health Fairness Act (Johnson) - association health plans H.R. 1121, Pre-existing Conditions Protection Act (Walden) - protections for patients with pre-existing conditions H.R. 1304, Self-Insurance Protection Act (Roe) - medical stop-loss insurance H.R. 1409, Cancer Drug Parity Act (Lance) - coverage of oral anti-cancer drugs H.R. 1606, DOC Access Act (Carter) - reimbursement for dental and vision providers H.R. 3450, Protecting Consumers from Unreasonable Rates Act (Schakowsky) - rate review H.R. 3545, Overdose Prevention and Patient Safety Act (Murphy- Blumenauer) -- confidentiality of drug and alcohol treatment and prevention records H.R. 3976, Access to Marketplace Insurance Act (Cramer) - third party payments H.R. 4082, Protect Access to Birth Control Act (DeGette) - coverage of contraceptive services H.R. 4200, Healthcare Market Certainty and Mandate Relief Act (Brady) - funding for cost sharing reduction benefits, HSA improvements H.R. 4225 (Hudson) - fees on excepted benefits and standalone dental plans H.R. 4575, Access to Independent Health Insurance Advisors Act (Long-Schrader) - calculation of medical loss ratios H.R. 4666, Premium Relief Act (Costello) - Patient and State Stability Fund H.R. 4695, Bipartisan Market Stabilization and Innovation Act (Schrader) - stabilization of individual market H.R. 6311, Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act (Roskam) - access to catastrophic plans, definition of qualified health plans H.R. 6314, Health Savings Act (Burgess) - definition of high-deductible health plan H.R. 6496, Continuing Coverage for Preexisting Conditions Act (Joyce) - protections for individuals with pre-existing conditions H.R. 7003, Federal Invisible Risk Sharing Program (Schweikert) Regulatory Issues: Insurance regulatory reform; issues related to the coordination of private and public disability income benefits; disability risk management; disability income insurance enrollment and awareness; issues related to encouraging impaired workers to stay in/return to the workforce; issues related to expanding long-term care insurance coverage; issues relating to the coordination of benefits between private health insurance plans and Medicaid; Medigap claims processing and crossover fees; Medigap cross-over claim issues, Medigap coverage, implementation of Medigap standardized plan offerings; Medigap carrier recoveries related to CMS fraud and abuse enforcement activities, and issues related to Medigap educational materials, and other Medigap issues; fraud and abuse issues affecting public and private insurance coverage; issues relating to antitrust; implementation of the Mental Health Parity Act requirements; implementation of the 21st Century Cures Act requirements; summary of benefits and coverage disclosures; pre-existing condition insurance plans; accountable care organizations; coverage of preventive services; preexisting condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; health reimbursement accounts; dependent coverage; treatment of expatriate plans; issues related to all payor claims databases; issues related to association health plans; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations, non-discriminatory wellness programs; issues related to supplemental products; issues relating to dental coverage; issues relating to proposals for single-payer and Medicare/Medicaid buy-in options; issues related to implementation of the Telephone Consumer Protection Act; issues relating to third party payment of premiums; issues related to cost-sharing reductions (CSRs); issues relating to the individual market; and other issues relating to health care reform implementation.

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

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

Issues relating to access to care, health disparities, childhood cancer, quality of life and palliative care, federal health care programs, genetic information, cancer, nutrition, tanning beds, clinical trials, skin cancer, and wellness, including: H.R.1676 & S.693, the Palliative Care and Hospice Education and Training Act; H.R. 4122 & S. 2006, the Breast Density & Mammography Reporting Act; and H.R.820 & S.292, the Childhood Cancer STAR Act. Issues relating to anti-cancer medication cost-sharing parity respecting H.R. 1409. Issues regarding a national family caregiving strategy respecting S. 1719 and H.R. 1028. Issues regarding access to medicines respecting S.204, the Trickett Wendler, Frank Mongiello, Jordan McLinn, and Matthew Bellina Right to Try Act of 2017, as well as H.R.878, the Right to Try Act of 2017. Issues regarding lymphedema treatment respecting The Lymphedema Treatment Act, H.R. 930 and S. 497. The proposed Medical Records Fairness Act (no number yet). Issues regarding the Affordable Care Act premium tax credits and catastrophic plans, HR 6311. Issues regarding protections for people with pre-existing conditions, including S. 3388, HR 6898, and H. Res. 1066. Resolutions to disapprove the short-term rule, H.J. Res 140 and S. J. Res. 63. Advocacy against including the Association Health Plan provision of the House Farm bill in the conference report, H.R. 2 and s. 3042 (section 6004 of the House-passed version of the legislation). Issues involving patient navigation, including the Patient Navigation Assistance Act, HR 6808. H.R. 6, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act, respecting Medicaid, Medicare, and public health reforms to combat the opioid crisis by advancing treatment and recovery initiatives, improving prevention, and protecting communities. Draft legislation on patient access to medical records. Draft legislation on FDA regulation of laboratory tests, Verifying Accurate Leading-edge IVCT Development Act of 2018 or the VALID Act of 2018. H.R. 4897 & S. 2358 Women and Lung Cancer Research and Preventive Services Act of 2018. Issues related to caregiving, including H.R. 3759/S. 1028, the RAISE Family Caregivers Act, H. Res. 282, supporting initiatives to encourage parents and guardians to take measures to prevent sunburns in minors they care for.

Client expense: $1,610,710 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), SENATE, State, Dept of (DOS), U.S. Agency for International Development (USAID), U.S. Trade Representative (USTR), Veterans Affairs, Dept of (VA), White House Office

Conversion Therapy Ending Discrimination Against Gay and Bisexual Blood and Tissue Donors Financial Services and General Government Appropriations Funding for HIV/AIDS Education, Prevention, and Research Funding for and Education Regarding Comprehensive Sexual Health Education Health Insurance Privacy HIV Organ Policy Equity (HOPE) Act Implementation Implementation of Section 1557 Nondiscrimination regulations Implementation and Protection of the Patient Protection and Affordable Care Act Interpretation of the Older Americans Act Labor, HHS, and Education Appropriations LGBTQ Data Collection Planned Parenthood funding Preventing Prohibitions on Gender Transition-Related Care Privacy in Health Insurance Explanation of Benefits Religious Refusals in Healthcare Repeal of Federal Ban on Funding for Syringe Exchange Programs Ryan White CARE program Reauthorization Unfair Drug Pricing Practices American Health Care Act (H.R. 1628) Graham Cassidy Amendment to H.R. 1628 Better Care Reconciliation Act Disapproving Title X Regulations (H.J. Res. 43) Ensuring Coverage for Patients with Pre-Existing Conditions Act (S. 3388) Healthy Families Act (H.R. 1516; S. 636) Healthy Relationships Act (H.R. 2028) LGBT Data Inclusion Act (H.R. 3273; S.1570) Preserving Employee Wellness Programs Act (H.R.1313) Real Education for Healthy Youth Act (H.R. 3602; S. 1653) REPEAL (Repeal Existing Policies that Encourage and Allow Legal) HIV Discrimination Act (H.R. 1739, S. 2186) Therapeutic Fraud Prevention Act (H.R. 2119; S. 928) Youth Access to Sexual Health Services Act (H.R. 3559; S.1650)

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

Government targets: Administration for Children & Families (ACF), Administration on Aging, Centers For Disease Control & Prevention (CDC), Commerce, Dept of (DOC), Defense, Dept of (DOD), Education, Dept of, 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), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Office of Natl AIDS Policy, Office of Personnel Management (OPM), Office on Violence Against Women, SENATE, Social Security Administration (SSA), State, Dept of (DOS), Treasury, Dept of, U.S. Agency for International Development (USAID), Veterans Affairs, Dept of (VA), White House Office

H.R. 1409 Cancer Drug Parity Act of 2017 H.R. 4978 Chronic Disease Management Act of 2018 S. 3388 Ensuring Coverage for Patients with Pre-Existing Conditions Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

To Congress: - Reauthorization of Emergency Medical Services for Children grant program (support for) - S.3388 re: pre-existing conditions (concerns about) - To the administration: - ACA risk adjustment payments (concern about withholding) - Navigator funding (urging restoration of funding)

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

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

Legislation and policies relating to: Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Reauthorization of funding for the Childrens Health Insurance Program Reauthorization of the Child Nutrition Act Section 2706 of the ACA regarding provider non-discrimination Policies related to health insurance market stabilization Policies affecting nurse practitioner education and workforce Definition, evaluation and enforcement of essential health benefits and provider network adequacy Health information technology and electronic health records Mental health services and violence prevention Human and child trafficking H.R. 315/S. 783 - Improving Access to Maternity Care Act H.R. 767/S. 256 - Stop, Observe, Ask, and Respond (SOAR) to Health and Wellness Act of 2017 H.R. 772/S. 261 - Common Sense Nutrition Disclosure Act H.R. 959/S. 1109 - Title VIII Nursing Workforce Reauthorization Act of 2017 H.R. 1174/S. 1497 - Fairness For Breastfeeding Mothers Act of 2017 H.R. 1215 - Protecting Access to Care Act of 2017 H.R. 1318 - Preventing Maternal Deaths Act of 2017 H.R. 1865 - Allow States and Victims to Fight Online Sex Trafficking Act of 2017 H.R. 2742/S. 1257 - Modernizing the Interstate Placement of Children in Foster Care Act H.R. 2824 - Increasing Opportunity through Evidence-Based Home Visiting Act H.R. 2857 - Supporting Families in Substance Abuse Treatment Act H.R. 2834 - Partnership Grants to Strengthen Families Affected by Parental Substance Abuse Act H.R. 2866 - Reducing Barriers for Relative Foster Parents Act H.R. 2847 - Improving Services for Older Youth in Foster Care Act H.R. 3192 - CHIP Mental Health Parity Act H.R. 3291 - Alleviating Adverse Childhood Experiences (ACES) Act H.R. 3387 - Drinking Water System Improvement Act of 2017 H.R. 3525 - Home Visiting Works Act of 2017 H.R. 3728 - Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness (EMPOWER) Act of 2017 H.R. 3921 - Helping Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable (HEALTHY KIDS) Act H.R. 3922 - Continuing Community Health And Medical Professional Programs to Improve Our Nation, Increase National Gains, and Help Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable (CHAMPIONING HEALTHY KIDS) Act of 2017 H.R. 3928 - Truth in Healthcare Marketing Act of 2017 H.R. 4695 - Bipartisan Market Stabilization and Innovation Act of 2017 H.R. 4978/S. 2410 - Chronic Disease Management Act of 2018 H.R. 4998 - Health Insurance for Former Foster Youth Act H.R. 5385/S. 2597 - Childrens Hospital GME Support Reauthorization Act of 2018 H.R. 5425/S. 2647 - Food Labeling Modernization Act of 2018 H.R. 5977 - Mothers and Offspring Mortality and Morbidity Awareness (MOMMAs) Act H.R. 6199 - Restoring Access to Medication and Modernizing Health Savings Accounts Act of 2018 H.R. 6560 - ChiPACC Act of 2018 S. 761/H.R. 1933 - Health Care Options Act of 2017 S. 920 - National Clinical Care Commission Act S. 1016/H.R. 2556 - Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2017 S. 1028 - Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act S. 1091/H.R. 3105 - Supporting Grandparents Raising Grandchildren Act S. 1112 - Maternal Health Accountability Act of 2017 S. 1268 - Child Protection and Family Support Act of 2017 S.1377 - Reaching Underserved Rural Areas to Lead on Telehealth Act S. 1441/H.R. 3059 - Community Health Center and Primary Care Workforce Expansion Act of 2017 S. 1693 - Stop Enabling Sex Traffickers Act of 2017 S. 1827 - Keeping Kids Insurance Dependable and Secure (KIDS) Act S. 1829 - Strong Families Act of 2017 S. 2415 - Accelerating Kids Access to Care Act S. 2852/H.R. 3678 - Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018 S. 3029 - Prematurity Research Expansion and Education for Mothers who deliver Infants Early (PREEMIE) Reauthorization Act of 2018 S. 3319 - Stopping Appealing Flavors in E-Cigarettes (SAFE) for Kids Act S. 3388 - Ensuring Coverage for Patients with Pre-Existing Conditions Act S. J. Res. 63 - A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Secretary of the Treasury, Secretary of Labor, and Secretary of Health and Human Services relating to Short-Term, Limited Duration Insurance"

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

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

H.R. 2: Agriculture Improvement Act of 2018; provisions related to Association Health Plans H.R. 2587: Medical Nutrition Equity Act of 2017; all provisions H.R. 3325: Advancing Care for Exceptional (ACE) Kids Act; All provisions H.R. 6261: Improving Choices in Health Care Coverage Act; All provisions S. 428: ACE Kids Act of 2017; all provisions S. 1194: Medical Nutrition Equity Act of 2017; all provisions S. 2507: Improving Choices in Health Care Coverage Act; all provisions S. 3042: Agriculture Improvement Act of 2018; provisions related to Association Health Plans S. 3388: Ensuring Coverage for Patients with Pre-Existing Conditions Act; all provisions H.J. Res. 140 - Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the final rule of the Department of the Treasury, the Department of Labor, and the Department of Health and Human Services relating to "Short-Term, Limited-Duration Insurance; all provisions S.J. Res. 63 - A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Secretary of the Treasury, Secretary of Labor, and Secretary of Health and Human Services relating to "Short-Term, Limited Duration Insurance"; all provisions Draft Bill: To amend the HITECH Act to allow an individual to obtain a copy of such individuals protected health information at no cost in certain circumstances, and for other purposes; all provisions of draft Centers for Medicare & Medicaid Services Regulation# CMS-1693-P: Medicare Program: Revisions to Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY 2019; Medicare Shared Savings Program Requirements; Quality Payment Program, and Medicaid Promoting Interoperability Program.; all provisions Centers for Medicare & Medicaid Services Regulation# CMS-9920-F: Adoption of Methodology for HHS-operated Permanent Risk Adjustment Program under the Patient Protection and Affordable Care Act for the 2017 Benefit Year; all provisions Centers for Medicare & Medicaid Services Regulation# CMS-9924-F: Short-term, Limited-Duration Insurance; all provisions Centers for Medicare & Medicaid Services Health Plan Management System Memo Re: Prohibition on Imposing Mandatory Step Therapy for Access to Part B Drugs and Services; all provisions Centers for Medicare & Medicaid Services - Section 1332: State Innovation Waivers; Provisions regarding Michigans Waiver Application Centers for Medicare & Medicaid Services - Section 1332: State Innovation Waivers; Provisions regarding New Hampshires Waiver Application Centers for Medicare & Medicaid Services - Section 1115: State Innovation Waivers; Provisions regarding Kentuckys Health Waiver Application work requirements to Medicaid

Client expense: $130,000 · Firm income: Not reported

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

H.R. 2: Agriculture Improvement Act of 2018; provisions related to Association Health Plans H.R. 2587: Medical Nutrition Equity Act of 2017; all provisions H.R. 3325: Advancing Care for Exceptional (ACE) Kids Act; All provisions H.R. 6261: Improving Choices in Health Care Coverage Act; All provisions S. 428: ACE Kids Act of 2017; all provisions S. 1194: Medical Nutrition Equity Act of 2017; all provisions S. 2507: Improving Choices in Health Care Coverage Act; all provisions S. 3042: Agriculture Improvement Act of 2018; provisions related to Association Health Plans S. 3388: Ensuring Coverage for Patients with Pre-Existing Conditions Act; all provisions H.J. Res. 140 - Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the final rule of the Department of the Treasury, the Department of Labor, and the Department of Health and Human Services relating to "Short-Term, Limited-Duration Insurance; all provisions S.J. Res. 63 - A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Secretary of the Treasury, Secretary of Labor, and Secretary of Health and Human Services relating to "Short-Term, Limited Duration Insurance"; all provisions Draft Bill: To amend the HITECH Act to allow an individual to obtain a copy of such individuals protected health information at no cost in certain circumstances, and for other purposes; all provisions of draft Centers for Medicare & Medicaid Services Regulation# CMS-1693-P: Medicare Program: Revisions to Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY 2019; Medicare Shared Savings Program Requirements; Quality Payment Program, and Medicaid Promoting Interoperability Program.; all provisions Centers for Medicare & Medicaid Services Regulation# CMS-9920-F: Adoption of Methodology for HHS-operated Permanent Risk Adjustment Program under the Patient Protection and Affordable Care Act for the 2017 Benefit Year; all provisions Centers for Medicare & Medicaid Services Regulation# CMS-9924-F: Short-term, Limited-Duration Insurance; all provisions Centers for Medicare & Medicaid Service - Section 1332: State Innovation Waivers; Provisions regarding Michigans Waiver Application Centers for Medicare & Medicaid Service - Section 1332: State Innovation Waivers; Provisions regarding New Hampshires Waiver Application Centers for Medicare & Medicaid Services - Section 1115: State Innovation Waivers; Provisions regarding Kentuckys Health Waiver Application work requirements to Medicaid

Client expense: $130,000 · Firm income: Not reported

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

H.R. 2587: Medical Nutrition Equity Act of 2017; all provisions H.R. 3325: Advancing Care for Exceptional (ACE) Kids Act; All provisions S. 428: ACE Kids Act of 2017; all provisions S. 1194: Medical Nutrition Equity Act of 2017; all provisions S. 3388: Ensuring Coverage for Patients with Pre-Existing Conditions Act; all provisions Centers for Medicare & Medicaid Services Regulation# CMS-1693-P: Medicare Program: Revisions to Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY 2019; Medicare Shared Savings Program Requirements; Quality Payment Program, and Medicaid Promoting Interoperability Program.; all provisions Centers for Medicare & Medicaid Services - Section 1332: State Innovation Waivers; Provisions regarding Michigans Waiver Application Centers for Medicare & Medicaid Service - Section 1115: State Innovation Waivers; Provisions regarding Kentuckys Waiver Application work requirements to Medicaid Centers for Medicare & Medicaid Service - Section 1332: State Innovation Waivers; Provisions regarding New Jerseys Waiver Application-Reinsurance Centers for Medicare & Medicaid Service - Section 1115: State Innovation Waivers; Provisions regarding Utahs Waiver Application work requirements to Medicaid

Client expense: $130,000 · Firm income: Not reported

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

Issues relating to access to care, health disparities, childhood cancer, quality of life and palliative care, federal health care programs, genetic information, cancer, nutrition, tanning beds, skin cancer, and wellness, including: H.R.1676 & S.693, the Palliative Care and Hospice Education and Training Act; H.R. 4122 & S. 2006, the Breast Density & Mammography Reporting Act; H.R.820 & S.292, the Childhood Cancer STAR Act; and, H.R. 1231 & S. 456, the RACE for Children Act. In addition, issues related to reform of laboratory and diagnostic tests and the development of a new discussion draft for the Diagnostic Accuracy and Innovation Act; and H.R.772 and S.261, the Common Sense Nutrition Disclosure Act. Issues relating to anti-cancer medication cost-sharing parity respecting H.R. 1409. Issues regarding a national family caregiving strategy respecting S. 1719 and H.R. 1028. Issues regarding access to medicines respecting S.204, the Trickett Wendler, Frank Mongiello, Jordan McLinn, and Matthew Bellina Right to Try Act of 2017, as well as H.R.878, the Right to Try Act of 2017. Issues regarding lymphedema treatment respecting The Lymphedema Treatment Act, H.R. 930 and S. 497. The proposed Medical Records Fairness Act (no number yet). Issues regarding the Affordable Care Act premium tax credits and catastrophic plans, HR 6311. Issues regarding protections for people with pre-existing conditions, including S. 3388, HR 6898, and H. Res. 1066. Resolutions to disapprove the short-term rule, H.J. Res 140 and S. J. Res. 63. Advocacy against including the Association Health Plan provision of the House Farm bill in the conference report, H.R. 2 and s. 3042 (section 6004 of the House-passed version of the legislation). Issues involving patient navigation, including the Patient Navigation Assistance Act, HR 6808. H.R. 6, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act, respecting Medicaid, Medicare, and public health reforms to combat the opioid crisis by advancing treatment and recovery initiatives, improving prevention, and protecting communities. Draft legislation on patient access to medical records. Draft legislation on FDA regulation of laboratory tests. H.R. 4897 & S. 2358 Women and Lung Cancer Research and Preventive Services Act of 2018. Issues related to caregiving, including H.R. 3759/S. 1028, the RAISE Family Caregivers Act.

Client expense: $1,230,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Energy, Dept of, Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Institutes of Health (NIH), SENATE, State, Dept of (DOS), U.S. Agency for International Development (USAID), U.S. Trade Representative (USTR), Veterans Affairs, Dept of (VA), White House Office

Issues related to lung disease treatment, prevention and research; public health; Issues related asthma; COPD; influenza; lung cancer; pneumonia; tuberculosis and other lung diseases; Issues related to tobacco cessation; Issues related to the Affordable Care Act; Issues related to the Childrens Health Insurance Program; Issues related to the President's Budget; H.R.774 Medicaid Coverage of Tobacco Cessation Nonprescription Drugs Act H.R.1121 Pre-existing Conditions Protection Act of 2017; H.R.2550 Medicare Telehealth Parity Act of 2017; H.R.4695 Bipartisan Market Stabilization and Innovation Act of 2017; H.R.4897 Women and Lung Cancer Research and Preventive Services Act of 2018; H.RES.827 Expressing support for the designation of April 2018 as "National Donate Life Month"; S.974 CREATES Act of 2017; S.1462 Marketplace Certainty Act; S.2494 Fair Care Act; S.2507 Improving Choices in Health Care Coverage Act;S. 2507, Improving Choices in Health Care Coverage Act (Codification of Short Term Limited Duration Health Plans); House Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2019; S.3158 - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2019; H.Con.Res.128 - Establishing the congressional budget for the United States Government for fiscal year 2019 and setting forth the appropriate budgetary levels for fiscal years 2020 through 2028H.R.6157 - Department of Defense and Labor, Health and Human Services, and Education Appropriations Act, 2019 and Continuing Appropriations Act, 2019; H.R.2 Agriculture and Nutrition Act of 2018; S.3388 - Ensuring Coverage for Patients with Pre-Existing Conditions Act; S.J.Res.63 - A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Secretary of the Treasury, Secretary of Labor, and Secretary of Health and Human Services relating to "Short-Term, Limited Duration Insurance

Client expense: $90,000 · 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), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), Natl Highway Traffic Safety Administration (NHTSA), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Postal Regulatory Commission, SENATE, Transportation, Dept of (DOT), Veterans Affairs, Dept of (VA), White House Office

Bipartisan Health Care Stabilization Act (Alexander-Murray) - funding for cost sharing reduction benefits, stabilization of individual market Bipartisan Health Care Stabilization Act; updated version (Alexander-Walden-Collins-Costello) - funding for cost sharing reduction benefits and reinsurance, stabilization of individual market S. 147, Obamacare Taxpayer Bailout Prevention Act (Rubio) - ACA risk corridors program S. 581, Jessies Law (Manchin-Capito) - patient history of opioid use disorder S. 1201, Health Care Options for All Act (McCaskill) - coverage options in bare counties S. 1354, Individual Health Insurance Marketplace Improvement Act (Carper-Kaine) - individual market reinsurance fund, outreach and enrollment activities S. 1462, Marketplace Certainty Act (Shaheen) - funding for cost-sharing reduction benefits S. 1516, Coverage Across State Lines (Heller) S. 1667, Protecting Consumers from Unreasonable Rates Act (Feinstein) - rate review S. 1835, Lower Premiums Through Reinsurance Act (Collins-Nelson) - invisible high risk pool and reinsurance programs S. 1850, Legacy Act (Manchin-Capito) -- confidentiality of drug and alcohol treatment and prevention records S. 1976, Increasing Access to Care Act (Scott) - copper plan S. 1985, Protect Access to Birth Control Act (Murray) - coverage of contraceptive services S. 2052, Healthcare Market Certainty and Mandate Relief Act (Hatch) - funding for cost sharing reduction benefits, HSA improvements, ACA individual mandate S. 2241 (King) - fees on excepted benefits and standalone dental plans S. 2303, Access to Independent Health Insurance Advisors Act (Isakson-Coons) - calculation of medical loss ratios S. 3388, Ensuring Coverage for Patients with Pre-Existing Conditions Act (Tillis) - protections for individuals with pre-existing conditions H.R. 2, Agriculture and Nutrition Act (Conaway) - agricultural association health plans H.R. 314, Health Care Choice Act (Blackburn) - selling insurance across state lines H.R. 372, Competitive Health Insurance Reform Act (Gosar) - McCarran-Ferguson Act H.R. 421, Allowing Greater Access to Safe and Effective Contraception Act (Love) - non-prescription contraceptives, HSA flexibility H.R. 706, Plan Verification and Fairness Act (Blackburn) - verifying eligibility for special enrollment periods H.R. 708, State Age Rating Flexibility Act (Buchson) - age rating bands H.R. 710, Health Coverage State Flexibility Act (Flores) - grace period for premium payments H.R. 1101, Small Business Health Fairness Act (Johnson) - association health plans H.R. 1121, Pre-existing Conditions Protection Act (Walden) - protections for patients with pre-existing conditions H.R. 1304, Self-Insurance Protection Act (Roe) - medical stop-loss insurance H.R. 1409, Cancer Drug Parity Act (Lance) - coverage of oral anti-cancer drugs H.R. 1606, DOC Access Act (Carter) - reimbursement for dental and vision providers H.R. 3450, Protecting Consumers from Unreasonable Rates Act (Schakowsky) - rate review H.R. 3545, Overdose Prevention and Patient Safety Act (Murphy- Blumenauer) -- confidentiality of drug and alcohol treatment and prevention records H.R. 3976, Access to Marketplace Insurance Act (Cramer) - third party payments H.R. 4082, Protect Access to Birth Control Act (DeGette) - coverage of contraceptive services H.R. 4200, Healthcare Market Certainty and Mandate Relief Act (Brady) - funding for cost sharing reduction benefits, HSA improvements H.R. 4225 (Hudson) - fees on excepted benefits and standalone dental plans H.R. 4575, Access to Independent Health Insurance Advisors Act (Long-Schrader) - calculation of medical loss ratios H.R. 4666, Premium Relief Act (Costello) - Patient and State Stability Fund H.R. 4695, Bipartisan Market Stabilization and Innovation Act (Schrader) - stabilization of individual market H.R. 6311, Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act (Roskam) - access to catastrophic plans, definition of qualified health plans H.R. 6314, Health Savings Act (Burgess) - definition of high-deductible health plan H.R. 6496, Continuing Coverage for Preexisting Conditions Act (Joyce) - protections for individuals with pre-existing conditions H.R. 7003, Federal Invisible Risk Sharing Program (Schweikert) Regulatory Issues: Insurance regulatory reform; issues related to the coordination of private and public disability income benefits; disability risk management; disability income insurance enrollment and awareness; issues related to encouraging impaired workers to stay in/return to the workforce; issues related to expanding long-term care insurance coverage; issues relating to the coordination of benefits between private health insurance plans and Medicaid; Medigap claims processing and crossover fees; Medigap cross-over claim issues, Medigap coverage, implementation of Medigap standardized plan offerings; Medigap carrier recoveries related to CMS fraud and abuse enforcement activities, and issues related to Medigap educational materials, and other Medigap issues; fraud and abuse issues affecting public and private insurance coverage; issues relating to antitrust; implementation of the Mental Health Parity Act requirements; implementation of the 21st Century Cures Act requirements; summary of benefits and coverage disclosures; pre-existing condition insurance plans; accountable care organizations; coverage of preventive services; preexisting condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; dependent coverage; treatment of expatriate plans; issues related to all payor claims databases; issues related to association health plans; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations, non-discriminatory wellness programs; issues related to supplemental products; issues relating to dental coverage; issues relating to proposals for single-payer and Medicare/Medicaid buy-in options; issues related to implementation of the Telephone Consumer Protection Act; issues relating to third party payment of premiums; issues related to cost-sharing reductions (CSRs); issues relating to the individual market; and other issues relating to health care reform implementation.

Client expense: $1,500,000 · Firm income: Not reported

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

Medicare Part D Step therapy in Medicare Advantage plans Restoring the Patient's Voice Act of 2017; H.R.2077 Rare disease Advancement, Research, and Education Act of 2018; H.R.5115 National Institutes of Health funding Food and Drug Administration appropriations Orphan Drug Act Senator Cassidy's "Ideas to Make Health Care Affordable Again" white paper Medical Nutrition Equity Act; H.R.2587, S.1194 Short-term, limited-duration health plans Association health plans Medicaid waivers Section 1332 waivers Copay accumulator programs Patient-focused drug development Biological products marketplace Slowly progressive low-prevalence rare diseases HHS Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs FY19 Labor, Health and Human Services, Education/Defense appropriations conference report; H.R.6157 Ensuring Coverage for Patients with Pre-Existing Conditions Act; S.3388 Medicaid expansion Pediatric subspecialty loan repayment reauthorization Medical expense deduction Humanitarian Device Exemption (HDE) program Risk adjustment payments

Client expense: Not reported · Firm income: Not reported

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

Conversion Therapy Ending Discrimination Against Gay and Bisexual Blood and Tissue Donors Financial Services and General Government Appropriations Funding for HIV/AIDS Education, Prevention, and Research Funding for and Education Regarding Comprehensive Sexual Health Education Health Insurance Privacy HIV Organ Policy Equity (HOPE) Act Implementation Implementation of Section 1557 Nondiscrimination regulations Implementation and Protection of the Patient Protection and Affordable Care Act Interpretation of the Older Americans Act Labor, HHS, and Education Appropriations LGBTQ Data Collection Planned Parenthood funding Preventing Prohibitions on Gender Transition-Related Care Privacy in Health Insurance Explanation of Benefits Religious Refusals in Healthcare Repeal of Federal Ban on Funding for Syringe Exchange Programs Ryan White CARE program Reauthorization Unfair Drug Pricing Practices American Health Care Act (H.R. 1628) Graham Cassidy Amendment to H.R. 1628 Better Care Reconciliation Act Disapproving Title X Regulations (H.J. Res. 43) Ensuring Coverage for Patients with Pre-Existing Conditions Act (S. 3388) Healthy Families Act (H.R. 1516; S. 636) Healthy Relationships Act (H.R. 2028) LGBT Data Inclusion Act (H.R. 3273; S.1570) Preserving Employee Wellness Programs Act (H.R.1313) Real Education for Healthy Youth Act (H.R. 3602; S. 1653) REPEAL (Repeal Existing Policies that Encourage and Allow Legal) HIV Discrimination Act (H.R. 1739, S. 2186) Therapeutic Fraud Prevention Act (H.R. 2119; S. 928) Youth Access to Sexual Health Services Act (H.R. 3559; S.1650)

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

Government targets: Administration for Children & Families (ACF), Administration on Aging, Centers For Disease Control & Prevention (CDC), Commerce, Dept of (DOC), Defense, Dept of (DOD), Education, Dept of, 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), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Office of Natl AIDS Policy, Office of Personnel Management (OPM), Office on Violence Against Women, SENATE, Social Security Administration (SSA), State, Dept of (DOS), Treasury, Dept of, U.S. Agency for International Development (USAID), Veterans Affairs, Dept of (VA), White House Office

Common Sense Nutrition Disclosure Act(S.261/H.R.772) Congenital Heart Futures Reauthorization Act of 2017(H.R.1222/S.477) H.Res 827- Expressing Support for designation of April 2018 as "National Donate Life Month" Health equity and accountability Act of 2018(no bill # introduced 5/23) H.R.3592 South Asian Heart Health Awareness and Research Act of 2017 H.R.1313, the Preserving Employer Wellness Programs Act Prevention and Public Health Fund(ACA Section 4002) Personal Health Investment Today Act(PHIT)(S.482/H.R.1267) Regulatory Accountability Act(S.951) S.3388- Ensuring Coverage for Patients with Pre-Existing Conditions Act S.Res479- A resolution designating April 2018 as "National Donate Life Month"

Client expense: $110,535 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Education, Dept of, Environmental Protection Agency (EPA), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Transportation, Dept of (DOT), Treasury, Dept of, U.S. Trade Representative (USTR), White House Office

H.R. 1409 Cancer Drug Parity Act of 2017 H.R. 4978 Chronic Disease Management Act of 2018 S. 3388 Ensuring Coverage for Patients with Pre-Existing Conditions Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Implementation of the Affordable Care Act S. 3388 - Ensuring Coverage for People with Pre-Existing Conditions Act

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Institutes of Health (NIH), SENATE

ALS Disability Insurance Access Act (S.379/H.R.1171) to waive the five-month waiting period for patients with ALS before receiving benefits under Social Security Disability Insurance. Ensuring Coverage for Patients with Pre-Existing Conditions Act (S.3388) to oppose the legislation and go further in supporting protections for insurance coverage for people with pre-existing conditions.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE