No More Surprise Medical Bills Act of 2018

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

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

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

S. 3592, and other legislation regarding the use of ADR in the healthcare field.

Client expense: $25,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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.

S.3592 No More Surprise Bills

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

Government targets: SENATE

Legislative Opioids Crisis Response Act - S. 2680/H.R. 6 Health Care Reform - ongoing legislative and regulatory implementation of the Patient Protection and Affordable Care Act (ACA), Cadillac tax on health benefits Continuing Appropriations Act of 2018 - H.J. Res. 125 - two year delay of the Cadillac Tax Middle Class Health Benefits Tax Repeal Act of 2017 - S. 58/H.R. 173 Health Savings Act of 2017 - S. 403/H.R. 1175 Creating High Quality-Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act - S. 870 Save American Workers Act - H.R. 3798 Chronic Disease Management Act of 2018 - S. 2410/H.R. 4978 Broader Options for Americans Act - H.R. 2579 Commonsense Reporting Act of 2017 - S. 1908/H.R. 3919 Workflex in the 21st Century Act - H.R. 4219 ACA Relief Legislation - H.R. 4616 Bipartisan HSA Improvements Act of 2018 - H.R. 5138 HSA Employer Flexibility Act - H.R. 6128 Restoring Access to Medication and Modernizing Health Savings Accounts Act - S. 6199 Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act - H.R. 6311 Patient Right to Know Drug Prices Act - S. 2554 Paid Family Leave Pilot Extension Act of 2018 - S. 3412 Reducing Costs for Out-of-Network Service Act of 2018 - S. 3541 No More Surprise Medical Bills Act of 2018 - S. 3592 Retirement, Savings, and Other Tax Relief Act of 2018 Protecting Patients from Surprise Medical Bills Act - Legislative Discussion Draft The Bipartisan Budget Act of 2018 Consolidated Appropriations Act of 2018 Fiscal Year 2019 budget proposal - provisions affecting employer-sponsored benefits Cost transparency and out-of-network billing Regulatory and Other Cost transparency Association Health Plans (AHPs) Health Reimbursement Accounts (HRAs) - Proposed regulations to use HRAs to purchase health insurance on the individual markets High Deductible Health Plans (HDHPs) Health Savings Accounts (HSAs) Department of Health & Human Services - Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs Federal disaster tax, filing and reporting relief for employers and individuals Presidential Executive Order: Reducing Regulation and Controlling Regulatory Cost Presidential Executive Order: Minimizing the Economic Burden of the Patient Protection and Affordable Care Act Pending Repeal Presidential Executive Order Promoting Healthcare Choice and Competition Across the United States - STLDI Employer wellness programs - nondiscrimination rules: Americans with Disabilities ACT (ADA) & Genetic Information Nondiscrimination Act (GINA) - Final regulations Medicare Advantage Program State health care requirements affecting self-insured plans FAQs - proposed guidance regarding implementation the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) - as amended by the Affordable Care Act (ACA) and the 21st Century Cures Act Electronic communication and disclosure of benefits information Paid leave proposals and issues

S.356/H.R. 1027 - Hallways to Health Act - school-based health centers 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" S. 3592 - No More Surprise Medical Bills Act of 2018 - protect patients with medical emergencies from surprise billing by prohibiting hospitals and providers from charging more than the in-network amount; protects patients in non-emergency situations by requiring hospitals and providers to notify patients if services will be out-of-network and get their consent S.3775 - Affordable Drug Manufacturing Act of 2018 - public manufacturing of generic drugs in cases where the market has failed S. 3754 - CURE High Drug Prices Act - prevent price gouging by pharmaceutical companies S.3660 - Health Equity and Accountability Act of 2018; TITLE IV-IMPROVING HEALTH CARE ACCESS AND QUALITY - Subtitle C-Advancing Health Equity Through Payment And Delivery Reform. H.R.2422 - Action for Dental Health Act of 2018 - reauthorize oral health promotion and disease prevention programs through FY2022 S.974 - CREATES Act of 2017 - facilitate the timely entry of lower-cost generic and biosimilar versions of drugs and biological products S.Res.581 - A resolution authorizing the Senate Legal Counsel to represent the Senate in Texas v. United States, No. 4:18-cv-00167-O (N.D. Tex.) H.R.5977/S.3776 - MOMMA's Act - improve Federal efforts with respect to the prevention of maternal mortality S.2582 - Consumer Health Insurance Protection Act- comprehensive insurance reform proposals including provisions pegging consumer assistance to plans with higher actuarial value, lowering out-of-pocket maximums, extending eligibility for subsidies, fixing family glitch, investing in enrollment outreach, requiring insurers to cover emergency services at in-network costs, making short-term limited duration plans subject to ACAs consumer protections S.2700 - Comprehensive Addiction Resources Emergency Act of 2018 - provide emergency assistance to States, territories, Tribal nations, and local areas affected by the opioid epidemic and to make financial assistance available to States, territories, Tribal nations, local areas, and public or private nonprofit entities to provide for the development, organization, coordination, and operation of more effective and cost efficient systems for the delivery of essential services to individuals with substance use disorder and their families Surprise billing - draft legislation to prevent surprise medical billing of patients. Auto-enrollment - create a federal platform encouraging states to experiment with auto-enrollment strategies, including resources to develop necessary information-technology infrastructure

Hospital and physician payments under Medicare and Medicaid, general. Medicare/ Medicaid Reform- (Bundling of Medicare acute and post-acute hospital payments, payments for readmissions, value-based purchasing, physician self-referral)- Implementation of the Health Care and Education Reconciliation Act of 2012 (Pub. Law 111-143). Medicare site neutral payments Federal exchange subsidies under The Affordable Care Act Medicare and Medicaid Disproportionate Share Hospital funding 2017 Medicare Outpatient Payment Rule American Health Care Act of 2017 (H.R. 1628) Mission Act Accountable Care Organization (ACO) programs American Health Care Act Better Care Reconciliation Act Repeal of Affordable Care Act Stark Law Reform HR 1017: Removing Barriers to Colorectal Cancer Screening HR 3806: The Personal Data Notification and Protection Act HR 2683: The Protecting Veterans Credit Act CMS ALOS hospital definition rule Opioids Drug Pricing Drug Shortages Site neutral payments S.3592 - No More Surprise Medical Bills Act of 2018 HR 676: The Expanded and Improved Medicare For All Act

Client expense: $360,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Consumer Financial Protection Bureau (CFPB), Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

Hospital and physician payments under Medicare and Medicaid, general. Medicare/ Medicaid Reform- (Bundling of Medicare acute and post-acute hospital payments, payments for readmissions, value-based purchasing, physician self-referral)- Implementation of the Health Care and Education Reconciliation Act of 2012 (Pub. Law 111-143). Medicare site neutral payments Federal exchange subsidies under The Affordable Care Act Medicare and Medicaid Disproportionate Share Hospital funding 2017 Medicare Outpatient Payment Rule American Health Care Act of 2017 (H.R. 1628) Better Care Reconciliation Act Repeal of Affordable Care Act Stark law reform HR 1017: Removing Barriers to Colorectal Cancer Screening HR 3806: The Personal Data Notification and Protection Act HR 2683: The Protecting Veterans Credit Act CMS ALOS hospital definition rule Opioids Drug Pricing Drug Shortages Site neutral payments S.3592 - No More Surprise Medical Bills Act of 2018 HR 676: The Expanded and Improved Medicare For All Act

Client expense: $360,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Consumer Financial Protection Bureau (CFPB), Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

1 and 2.) Federal Legislation and Issues (H.R. designates work with House of Representatives; S. designates work with Senate) H.R. 5768/S. 3366, the Expanding Access to Diabetes Self-Management Training (DSMT) Act. The Association supports this legislation to reduce barriers and increase the utilization of DSMT, which is a covered benefit under Medicare. S. 2554, the Patient Right to Know Drug Prices Act. The Association supports this legislation which would prohibit pharmacy gag clauses in contracts between a pharmacy and an insurer or pharmacy benefit manager (PBM). S.3592, the No More Surprise Medical Bills Act of 2018. At the request of Senator Maggie Hassans office, the Association provided feedback on this legislation which seeks to help people avoid paying large and unnecessary medical bills.

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

Government targets: Centers For Disease Control & Prevention (CDC), 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

Hospital and physician payments under Medicare and Medicaid, general. Medicare/ Medicaid Reform- (Bundling of Medicare acute and post-acute hospital payments, payments for readmissions, value-based purchasing, physician self-referral)- Implementation of the Health Care and Education Reconciliation Act of 2012 (Pub. Law 111-143). Medicare site neutral payments Federal exchange subsidies under The Affordable Care Act Medicare and Medicaid Disproportionate Share Hospital funding 2017 Medicare Outpatient Payment Rule American Health Care Act of 2017 (H.R. 1628) Better Care Reconciliation Act Repeal of Affordable Care Act Stark law reform HR 1838: ASC Quality and Access Act HR 1017: Removing Barriers to Colorectal Cancer Screening CHGME Reauthorization and Appropriations HR 3806: The Personal Data Notification and Protection Act HR 2683: The Protecting Veterans Credit Act CMS ALOS hospital definition rule Opioids Drug Pricing Drug Shortages Site neutral payments S.3592 - No More Surprise Medical Bills Act of 2018

Client expense: $370,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Consumer Financial Protection Bureau (CFPB), Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

Hospital and physician payments under Medicare and Medicaid, general. Medicare/ Medicaid Reform- (Bundling of Medicare acute and post-acute hospital payments, payments for readmissions, value-based purchasing, physician self-referral)- Implementation of the Health Care and Education Reconciliation Act of 2012 (Pub. Law 111-143). Medicare site neutral payments Federal exchange subsidies under The Affordable Care Act Medicare and Medicaid Disproportionate Share Hospital funding 2017 Medicare Outpatient Payment Rule American Health Care Act of 2017 (H.R. 1628) VA Choice Act Accountable Care Organization (ACO) programs American Health Care Act Better Care Reconciliation Act Repeal of Affordable Care Act Stark Law Reform HR 1838: ASC Quality and Access Act HR 1017: Removing Barriers to Colorectal Cancer Screening CHGME Reauthorization and Appropriations HR 3806: The Personal Data Notification and Protection Act HR 2683: The Protecting Veterans Credit Act CMS ALOS hospital definition rule Opioids Drug Pricing Drug Shortages Site neutral payments S.3592 - No More Surprise Medical Bills Act of 2018

Client expense: $370,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Consumer Financial Protection Bureau (CFPB), Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office