Health Savings Act of 2017

H.R. 35 / S. 403 - Health Savings Act of 2017. Support for H.R. 4616 - To amend the Patient Protection and Affordable Care Act to provide for a temporary moratorium on the employer mandate and to provide for a delay in the implementation of the excise tax on high-cost employer-sponsored health coverage. Support for H.R. 3798 - Save American Workers Act of 2018.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 35 - Health Savings Act of 2017; entire bill H.R. 1175 - Health Savings Act of 2017; entire bill H.R. 5138 - Bipartisan HSA Improvement Act of 2018; entire bill S. 403 - Health Savings Act of 2017; entire bill

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 28, Health Savings Account Expansion Act (Flake) - HSA improvements S. 85, Restoring Access to Medications Act (Roberts) - paying for OTC products with HSA funds S. 403, Health Savings Act (Hatch) - HSA and FSA improvements S. 761, Health Care Options Act (Alexander) - using premiums for off-Exchange plans S. 1859, Healthcare Tax Relief Act (Gardner) - suspension of ACA health insurance tax S. 1978, Small Business and Family Health Tax Relief Act (Heitkamp) - suspension of ACA health insurance tax S. 2410, Chronic Disease Management Act (Thune) - flexibility for high-deductible health plans S. 3063, Health Insurance Tax Relief Act (Barrasso) - suspension of ACA health insurance tax H.R. 88, Retirement, Savings, and Other Tax Relief Act - relief from health insurance tax and Cadillac tax H.R. 246, Jobs and Premium Protection Act (Noem-Sinema) - repeal of ACA health insurance tax H.R. 247, Health Savings Account Expansion Act (Brat) - HSA improvements H.R. 394, Restoring Access to Medications Act (Jenkins) - paying for OTC products with HSA funds H.R. 1175, Health Savings Act (Paulsen) - HSA and FSA improvements H.R. 3798, Save American Workers Act (Walorski) - delay in Cadillac tax H.R. 4616 (Nunes) - delay in ACA excise tax on employer-provided health coverage H.R. 4618 (Jenkins) - use of HSA funds for OTC medications H.R. 4620, Protecting Families and Small Businesses Act (Noem) - relief from ACA health insurance tax H.R. 4894, Harmful Tax Prevention Act (Noem) - relief from ACA health insurance tax H.R. 4978, Chronic Disease Management Act (Black) - flexibility for high-deductible health plans H.R. 5138, Bipartisan HSA Improvement Act (Kelly) - HSA changes H.R. 5963, Health Insurance Premium Reduction Act (Noem) - suspension of ACA health insurance tax H.R. 6199, Restoring Access to Medication Act (Jenkins) - OTC medical products as qualified medical expense, HSA improvements H.R. 6301, Promoting High-Value Health Care Through Flexibility for High Deductible Health Plans Act (Roskam) - flexibility on first dollar coverage for HSA plans H.R. 6305, Bipartisan HSA Improvement Act (Kelly) - HSA flexibility; treatment of certain employment-related services; FSA and HRA conversions H.R. 6306, Health Care Security Act (Paulsen) - HSA contribution limits, spousal catch-up contributions, grace period for medical expenses H.R. 6309, Allowing Working Seniors to Keep Their Health Savings Accounts Act (Paulsen) - HSA contributions by Medicare-eligible individuals H.R. 6311, Increasing Access to Lower Premium Plans and Expanding HSAs Act (Roskam) - suspension of health insurance tax, HSA improvements H.R. 6312, Personal Health Investment Today Act (Smith) - medical care tax deduction for qualified sports and fitness expenses H.R. 6313, RAISE Health Benefits Act (Stivers) - Health FSA rollovers H.R. 6314, Health Savings Act (Burgess) - definition of high-deductible health plan H.R. 6317, Primary Care Enhancement Act (Paulsen) - participation by HSA-eligible individuals in direct primary care (DPC) arrangements Regulatory Issues: Annual insurer provider fees; issues concerning the patient-centered outcomes research fee; employer and individual coverage mandate; W-2 reporting requirements; health reimbursement accounts; deductibility limits for insurer compensation; health insurer and employer reporting of health coverage; issues related to implementation of health insurance tax; issues related to the refundable credit for coverage under a qualified health plan; issues related to coverage of chronic conditions in high deductible health plans; issues related to health savings accounts; issues related to the deductibility of employer-sponsored health coverage; issues related to enhancing tax treatment of long-term care insurance; issues related to qualified small employer health reimbursement accounts (QSEHRAs); issues related to implementation of the excise tax on high cost employer-sponsored health coverage; 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 related to health and wellness coaches; H Res 733, designating February 12, 2018, through February 18, 2018, as "National Health and Wellness Coach Recognition Week"; HR 1175/S 403, Health Savings Act of 2017.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Implementation of H.R. 1, Public Law No. 115-97, Tax Cuts and Jobs Act, H.R.195 Medical Device Tax Repeal S.108 Medical Device Access and Innovation Protection Act H.R. 184 Protect Medical Innovation Act of 2018 HR 1204 Responsible Additions and Increases to Sustain Employee Health Benefits Act HR 1175, S.403 Health Savings Act The Technologies for Energy Security Act, H.R.1090/H.R.1625

Client expense: $670,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Environmental Protection Agency (EPA), Executive Office of the President (EOP), Federal Highway Administration (FHA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Highway Traffic Safety Administration (NHTSA), Office of Management & Budget (OMB), SENATE, Securities & Exchange Commission (SEC), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Trade Representative (USTR), White House Office

Affordable Care Act, all provisions and related regulations, including repeal of ACA 40% excise tax; ACA Reporting (IRC 6055 and 6056); Employer mandate; wellness issues; out-of-pocket (OOP) limits related to cost sharing, nondiscrimination, 1332 waivers, Health Insurance Tax ADA and GINA (in conjunction with employer-based wellness programs), H.R. 1313 - Preserving Employee Wellness Programs Act HIPAA compliance, Privacy, Claims data and all payers claims databases Mental Health Parity, Substance use disorders, Opiods mitigation Tax Treatment of Employer-Sponsored Health Insurance, H.R. 173 / S. 58 - Middle Class Health Benefits Tax Repeal Act of 2017, Continuing resolutions with health tax provisions, H.R. 3798 - Save American Workers Act Prescription Drug Costs, Pharmacy gag clauses, Rebates & Point-of-Sale requirements, Biosimilars Value-Driven Care in Public and Private Coverage, Patient Safety Medicare Advantage, Medicare Secondary Payer, Kidney dialysis, End Stage Renal Disease (ESRD) COBRA, Retiree health HSAs, including S. 403 - Health Savings Act of 2017, H.R. 5138 the Bipartisan HSA Improvement Act, H.R. 365 the Primary Care Enhancement Act, HSA limit changes, H.R. 6199 the Restoring Access to Medication & Modernizing HSA Act ERISA Preemption, Balance and Surprise billing, State mandates & assessments

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Council of Economic Advisers (CEA), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Economic Council (NEC), Pension Benefit Guaranty Corporation (PBGC), SENATE, Treasury, Dept of

H.R. 6, Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act H.R. 35, Health Savings Act of 2017 H.R. 143, Health Insurance Industry Antitrust Enforcement Act of 2017 H.R. 173/S. 40/S. 58, Middle Class Health Benefits Tax Repeal Act of 2017 H.R. 184, Protect Medical Innovation Act of 2017 H.R. 195, Making further continuing appropriations for the fiscal year ending September 30, 2018, and for other purposes H.R. 246, To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act H.R. 394/S. 85, Restoring Access to Medication Act of 2017 H.R. 620, ADA Education and Reform Act of 2017 H.R. 849/S. 260, Protecting Seniors Access to Medicare Act H.R. 1101, Small Business Health Fairness Act of 2017 H.R. 1175/S. 403, Health Savings Act of 2017 H.R. 1215, Protecting Access to Care Act of 2017 H.R. 1313, Preserving Employee Wellness Programs Act H.R. 1625, Consolidated Appropriations Act, 2018 H.R. 1892, Bipartisan Budget Act of 2018 H.R. 3331, To amend title XI of the Social Security Act to promote testing of incentive payments for behavioral health providers for adoption and use of certified electronic health record technology H.R. 3798, Save American Workers Act of 2017 H.R. 4284, Indexing Narcotics, Fentanyl, and Opioids (INFO) Act of 2018 H.R. 4616, To amend the Patient Protection and Affordable Care Act to provide for a temporary moratorium on the employer mandate and to provide for a delay in the implementation of the excise tax on high cost employer-sponsored health coverage H.R. 4617, To amend the Internal Revenue Code of 1986 to provide for a temporary moratorium on the medical device excise tax H.R. 4618, To amend the Internal Revenue Code of 1986 to provide for a temporary moratorium on certain taxes affecting purchases of prescription medication H.R. 4619, To amend the Patient Protection and Affordable Care Act to provide temporary relief from the annual fee imposed on health insurance providers, to the extent that such fee is due to Puerto Rican health insurance H.R. 4620, Protecting Families and Small Businesses Act of 2017 H.R. 4978/S. 2410, Chronic Disease Management Act of 2018 H.R. 5009, Jessies Law H.R. 5041, Safe Disposal of Unused Medication Act H.R. 5138, Bipartisan HSA Improvement Act of 2018 H.R. 5272, To provide additional guidance to grantees seeking funding to treat or prevent mental health or substance use disorders H.R. 5582, Abuse Deterrent Access Act of 2018 H.R. 5788, Synthetics Trafficking and Overdose Prevention (STOP) Act of 2018 H.R. 5892, To establish an Advisory Committee on Opioids and the Workplace to advise the Secretary of Labor on actions the Department of Labor can take to address the impact of opioid abuse on the workplace H.R. 6199, Restoring Access to Medication and Modernizing Health Savings Accounts Act of 2018 H.R. 6311, Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act of 2018 S. 108, Medical Device Access and Innovation Protection Act S. 191, Patient Freedom Act of 2017 S. 222, Obamacare Replacement Act S. 251, Protecting Medicare from Executive Action Act of 2017 S. 974, Creating and Restoring Equal Access To Equivalent Samples (CREATES) Act of 2017 S. 1835, Lower Premiums Through Reinsurance Act of 2017 S. 1850, Protecting Jessica Grubb's Legacy Act S. 1859, Healthcare Tax Relief Act S. 1978, Small Business and Family Health Tax Relief Act of 2017 S. 2004, Combating the Opioid Epidemic Act S. 2164, To amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings S. 3057, Synthetics Trafficking and Overdose Prevention (STOP) Act of 2018 Draft legislation to stabilize individual market premiums for the 2018 and 2019 plan years and provide meaningful State flexibility (Alexander-Murray) Proposed regulation on health reimbursement arrangements and other account-based group health plans (83 Fed. Reg. 54,420-54,477, October 29, 2018) Final Regulation, definition of employer under Section 3(5) of ERISA - association health plans (83 Fed. Reg. 28912-28964, June 21, 2018) Various issues relating to Patient Protection and Affordable Care Act (P.L. 111-148) and the Health Care and Education Affordability Reconciliation Act of 2010 (P.L. 111-152), including the employer-sponsored health care system, implementation of regulatory process, provider network adequacy, delivery system reform, health savings account (HSAs), health reimbursement account (HRAs), and flexible spending account (FSAs) changes, IPAB, employer mandate, reporting requirements for issuers and applicable large employers, premium stabilization programs, medical loss ratio, medical malpractice reform, exchanges, the impact on small business, the Small Business Tax Credit, section 1332 waivers, section 1557 on nondiscrimination, caps on compensation deductibility required under section 9014, incompleteness or inaccuracy of cost impact analysis, lack of quantified benefit analysis, and need for empirical data sources on which to base costs and benefits, the Cost Sharing Reduction (CSR) program, the section 9010 Health Insurance Providers Fee or Health Insurance Tax (HIT), 40% excise tax on high-cost employer-sponsored health coverage (Cadillac tax); medical device tax; protect Medicare Part D's Non-Interference Clause from repeal Public Health Services Act (P.L.78-410), Internal Revenue Code and the Employee Retirement Income Security Act (ERISA) (P.L. 93-406), regarding regulatory process and legislative corrections to ERISA preemption, changes to Medicare Advantage and Parts B, C, and D, including rebates and non-interference with prescription drug prices, entitlement reform, health information technology, telemedicine services in Medicare, and coordination and disease management programs; House Republican Taskforce on Health Care report; A Better Way to Fix Health Care; association health plans; importation of foreign pharmaceuticals into the United States and preemptive authority of federal food and drug regulations; Executive Order 13813, Promoting Healthcare Choice and Competition; addressing the opioids crisis, including end-stage renal disease; balance or surprise billing; single-payer health care options; aligning 42 CFR Part 2 with the Health Insurance Portability and Accountability Act (P.L. 104-191) for the purposes of treatment, payment, and health car operation (TPO); inclusion of prescription drug pricing on 2019 congressional agenda; general advocacy for Congress to reach a working quorum for the board of the Export-Import Bank; section 301 of the Trade Act of 1974; U.N. Convention on the Assignment of Receivables in Int'l Trade

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

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

Affordable Care Act, all provisions and related regulations, including repeal of ACA 40% excise tax; ACA Reporting (IRC 6055 and 6056); Employer mandate; wellness issues; out-of-pocket (OOP) limits related to cost sharing, nondiscrimination, 1332 waivers, Health Insurance Tax ADA and GINA (in conjunction with employer-based wellness programs, H.R. 1313 - Preserving Employee Wellness Programs Act HIPAA compliance, Privacy, Claims data and all payers claims databases Mental Health Parity, Substance use disorders, Opiods mitigation Tax Treatment of Employer-Sponsored Health Insurance, H.R. 173 / S. 58 - Middle Class Health Benefits Tax Repeal Act of 2017, Continuing resolutions with health tax provisions, H.R. 3798 - Save American Workers Act Prescription Drug Costs, Pharmacy gag clauses, Rebates & Point-of-Sale requirements, Biosimilars Value-Driven Care in Public and Private Coverage, Patient Safety Medicare Advantage, Medicare Secondary Payer, Kidney dialysis, End Stage Renal Disease (ESRD) COBRA, Retiree health HSAs, including S. 403 - Health Savings Act of 2017, H.R. 5138 the Bipartisan HSA Improvement Act, and H.R. 365 the Primary Care Enhancement Act HSA limit changes, H.R. 6199 the Restoring Access to Medication & Modernizing HSA Act ERISA Preemption, Balance and Surprise billing, State mandates & assessments

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Council of Economic Advisers (CEA), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Economic Council (NEC), Pension Benefit Guaranty Corporation (PBGC), SENATE, Treasury, Dept of

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

Client expense: $286,066 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Equal Employment Opportunity Commission (EEOC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Treasury, Dept of, White House Office

S.403/H.R.1175, Health Savings Act of 2017. Tax treatment of nutritional and dietary supplements.

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

Government targets: Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), SENATE, Treasury, Dept of

Legislative and regulatory issues including: Health care reform Implementation of the Affordable Care Act -- PL 111-148 Bipartisan Budget Act of 2018 -- H.R. 1892/PL 115-123 Middle Class Health Benefits Tax Repeal Act of 2017 - S. 58/H.R. 173 Save American Workers Act -- H.R. 3798 Restoring Access to Medication and Modernizing Health Savings Accounts Act (H.R. 6199) Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act (H.R. 6311) Health Savings Act of 2017 - S. 403/H.R. 1175 Chronic Disease Management Act - S. 2410/H.R. 4978 Bipartisan HSA Improvement Act of 2018 - H.R. 5138/H.R. 6305 Mental Health Parity H.R. 6301, to provide high deductible health plans with first dollar coverage flexibility H.R. 6317, to provide that direct primary care service arrangements do not disqualify deductible health savings account contributions H.R. 6309, to allow individuals entitled to Medicare Part A by reason of being over age 65 to contribute to health savings accounts H.R. 6306, to increase the contribution limitation for health savings accounts, and for other purposes H.R. 4616, to provide for a temporary moratorium on the employer mandate and to provide for a delay in the implementation of the excise tax on high cost employer-sponsored health coverage H.R. 6, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act S. 2554, the Patient Right to Know Drug Prices Act S. 2553, the Know the Lowest Price Act HHS Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs, RIN 0991-ZA49

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

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Economic Council (NEC), SENATE, Treasury, Dept of

Legislative and regulatory issues including: Health care reform Implementation of the Affordable Care Act -- PL 111-148 Bipartisan Budget Act of 2018 -- H.R. 1892/PL 115-123 Middle Class Health Benefits Tax Repeal Act of 2017 - S. 58/H.R. 173 Save American Workers Act -- H.R. 3798 Restoring Access to Medication and Modernizing Health Savings Accounts Act (H.R. 6199) Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act (H.R. 6311) Health Savings Act of 2017 - S. 403/H.R. 1175 Chronic Disease Management Act - S. 2410/H.R. 4978 Bipartisan HSA Improvement Act of 2018 - H.R. 5138/H.R. 6305 Mental Health Parity H.R. 6301, to provide high deductible health plans with first dollar coverage flexibility H.R. 6317, to provide that direct primary care service arrangements do not disqualify deductible health savings account contributions H.R. 6309, to allow individuals entitled to Medicare Part A by reason of being over age 65 to contribute to health savings accounts H.R. 6306, to increase the contribution limitation for health savings accounts, and for other purposes H.R. 4616, to provide for a temporary moratorium on the employer mandate and to provide for a delay in the implementation of the excise tax on high cost employer-sponsored health coverage H.R. 6, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act S. 2554, the Patient Right to Know Drug Prices Act S. 2553, the Know the Lowest Price Act HHS Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs, RIN 0991-ZA49

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

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Economic Council (NEC), SENATE, Treasury, Dept of

Legislative and regulatory issues including: improvements to Health Savings Accounts coupled with high deductible health plans, Medicare and Medicare Advantage, payment reform, Food and Drug Administration, and wellness. Health Savings Act of 2017 - S. 403/H.R. 1175 H.R. 6199, Restoring Access to Medication and Modernizing Health Savings Accounts Act Chronic Disease Management Act - S.2410/H.R. 4978 Bipartisan HSA Improvement Act of 2018 - H.R. 5138 and H.R. 6305 H.R. 6301, to provide high deductible health plans with first dollar coverage flexibility HHS Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs, RIN 0991-ZA49

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Natl Economic Council (NEC), SENATE, Treasury, Dept of

Legislative and regulatory issues including: improvements to Health Savings Accounts coupled with high deductible health plans, Medicare and Medicare Advantage, payment reform, Food and Drug Administration, and wellness. Health Savings Act of 2017 - S. 403/H.R. 1175 H.R. 6199, Restoring Access to Medication and Modernizing Health Savings Accounts Act Chronic Disease Management Act - S.2410/H.R. 4978 Bipartisan HSA Improvement Act of 2018 - H.R. 5138 and H.R. 6305 H.R. 6301, to provide high deductible health plans with first dollar coverage flexibility HHS Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs, RIN 0991-ZA49

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Natl Economic Council (NEC), SENATE, Treasury, Dept of

Legislative and regulatory issues including: improvements to Health Savings Accounts coupled with high deductible health plans, Medicare and Medicare Advantage, payment reform, Food and Drug Administration, and wellness. Health Savings Act of 2017 - S. 403/H.R. 1175 H.R. 6199, Restoring Access to Medication and Modernizing Health Savings Accounts Act Chronic Disease Management Act - S.2410/H.R. 4978 Bipartisan HSA Improvement Act of 2018 - H.R. 5138 and H.R. 6305 H.R. 6301, to provide high deductible health plans with first dollar coverage flexibility HHS Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs, RIN 0991-ZA49

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Natl Economic Council (NEC), SENATE, Treasury, Dept of

Health Savings Act of 2017 - S. 403/H.R. 1175 Chronic Disease Management Act - S. 2410/H.R. 4978 Bipartisan HSA Improvement Act of 2018 - H.R. 5138/H.R. 6305 H.R. 6301, to provide high deductible health plans with first dollar coverage flexibility H.R. 6317, to provide that direct primary care service arrangements do not disqualify deductible health savings account contributions H.R. 6309, to allow individuals entitled to Medicare Part A by reason of being over age 65 to contribute to health savings accounts H.R. 6306, to increase the contribution limitation for health savings accounts, and for other purposes H.R. 6199, Restoring Access to Medication and Modernizing Health Savings Accounts Act H.R. 6311, Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act

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

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Natl Economic Council (NEC), SENATE, Treasury, Dept of

Health Savings Act of 2017 - S. 403/H.R. 1175 Chronic Disease Management Act - S. 2410/H.R. 4978 Bipartisan HSA Improvement Act of 2018 - H.R. 5138/H.R. 6305 H.R. 6301, to provide high deductible health plans with first dollar coverage flexibility H.R. 6317, to provide that direct primary care service arrangements do not disqualify deductible health savings account contributions H.R. 6309, to allow individuals entitled to Medicare Part A by reason of being over age 65 to contribute to health savings accounts H.R. 6306, to increase the contribution limitation for health savings accounts, and for other purposes H.R. 6199, Restoring Access to Medication and Modernizing Health Savings Accounts Act H.R. 6311, Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act

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

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Natl Economic Council (NEC), SENATE, Treasury, Dept of

H.R. 1175 - Health Savings Act, a bill to amend the Internal Revenue Code of 1986 to improve access to health care through expanded health savings accounts; all provisions relating to dietary supplements S. 403 - Health Savings Act, a bill to amend the Internal Revenue Code of 1986 to improve access to health care through expanded health savings accounts; all provisions relating to dietary supplements

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

Government targets: Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, SENATE

protecting access to preventive care and wellness through Health Savings Accounts protecting access to healthcare sharing ministries S 403, Health Savings Act of 2017 HR 1175, Health Savings Act of 2017 HR 277, American Healthcare Reform Act of 2017 HR 1628, American Healthcare Act HR 1, the Tax Cuts and Jobs Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Americans with Disabilities Act Tailored Regulation H.J.Res.111/S.J.Res.47 S.J.Res.57 H.R. 394/S.85, Restoring Access to Medication Act of 2017 H.R.35, Health Savings Act of 2017 H.R.1476, The Native American Health Savings Improvement Act H.R.1457, MOBILE Act of 2017 H.R. 1175/ S. 403, The Health Savings Act of 2017 H.R. 4028, PROTECT Act of 2017 H.R. 4978 / S. 2410, Chronic Disease Management Act of 2018 H.R. 6199, Restoring Access to Medication and Modernizing Health Savings Accounts Act of 2018 H.R. 6311, Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act of 2018 H.R. 6743, Consumer Information Notification Requirement Act Arbitration Clauses in Financial Contracts Fair Lending Laws Small Dollar Lending Military Lending Act

Client expense: $2,130,000 · Firm income: Not reported

Government targets: Consumer Financial Protection Bureau (CFPB), Federal Reserve System, HOUSE OF REPRESENTATIVES, Housing & Urban Development, Dept of (HUD), Labor, Dept of (DOL), Natl Economic Council (NEC), Office of Management & Budget (OMB), SENATE, Treasury, Dept of

Flexible spending arrangements (FSA) and health savings accounts (HSA) Graham-Cassidy Bill, no bill number. Graham-Cassidy contained a provision (section 108) to repeal the Affordable Care Act (ACA) requirement that patients obtain a prescriptions prior to using an FSA or HSA to purchase OTC medicine. Better Care Reconciliation Act (H.R. 1628). BCRA contained a provision(section 209)to repeal the Affordable Care Act (ACA) requirement that patients obtain a prescription prior to using an FSA or HSA to purchase OTC Medicines. American Healthcare Act (AHCA), no bill number. AHCA contained a provision(section 208)to repeal the Affordable Care Act (ACA) requirement that patients obtain a prescription prior to using an FSA or HSA to purchase OTC Medicines. H.R. 394/S. 85 - Restoring Access to Medication Act of 2017. Repeals prohibition in Patient Protection and Affordable Care Act (P.L. 111-148, P.L. 111-152) against use of flexible spending arrangement (FSA) and health savings account (HSA) funds on over-the-counter (OTC) medications; all sections. H.R. 1175/S.403 - Health Savings Act of 2017 - Codifies OTC medications as qualified medical expenses; Section 301 H.R.4618 - To amend the Internal Revenue Code of 1986 to provide for a temporary moratorium on certain taxes affecting purchases of prescription medication. Temporarily repeals prohibition in Patient Protection and Affordable Care Act (P.L. 111-148, P.L. 111-152) against use of flexible spending arrangement (FSA) and health savings account (HSA) funds on over-the-counter (OTC) medications. H.R.1625 - Consolidated Appropriations Act, 2018. Omnibus appropriations package. H.R. 6199 -- To amend the Internal Revenue Code of 1986 to include certain over-the-counter medical products as qualified medical expenses. Repeals provisions of the Internal Revenue Code, as added by the Patient Protection and Affordable Care Act, that limit payments for medications from health savings accounts, medical savings accounts, health flexible spending arrangements, and health reimbursement arrangements to only prescription drugs or insulin (thus allowing distributions from such accounts for over-the-counter drugs). The bill also allows the accounts to be used for menstrual care products.

Client expense: $197,000 · Firm income: Not reported

Government targets: Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, SENATE, Treasury, Dept of

S 3702/HR 7223 - Tax legislation, provisions regarding generic drugs S 3738/HR 7251 - Patent legislation regarding inter partes review HR 302 - FAA Re-authorization (provisions related to air ambulance services HR 7217 - IMPROVE Act Blueprint on Drug Pricing State Reinsurance Program H.R. 6 - The Support for Patients and Communities Act S 1835 - Lower Premiums through Reinsurance Act of 2017. Collins (R-ME) HR 3545 - Overdose Prevention and Patient Safety Act. Murphy (R-PA) S 1850 - Protecting Jessica Grubbs Legacy Act. Manchin (D-WV) HR 4200 & S 2052 - To provide for temporary funding for health insurance cost-sharing reduction payments and provide targeted tax relief, and for other purposes. HR 2212 & S 974 - Creating and Restoring Equal Access To Equivalent Samples Act of 2017: A bill to promote competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products. Marino (R-PA) & Leahy (D-VT) S 1354 - Individual Health Insurance Marketplace Improvement Act: A bill to establish an individual market reinsurance fund to provide funding for state individual market stabilization reinsurance programs. Carper (D-DE) S 1859 - Healthcare Tax Relief Act: A bill to extend the moratorium on the annual fee on health insurance providers. Gardner (R-CO) H.R. 1215 - Protecting Access to Care Act of 2017: To improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system. King (R-IA) H.R.1101 - Small Business Health Fairness Act of 2017: To amend title I of the Employee Retirement Income Security Act of 1974 to improve access and choice for entrepreneurs with small businesses with respect to medical care for their employees. Johnson (R-TX). S. 974 and H.R. 2212 - Creates Act of 2017: To promote competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products. Leahy (D-VT) & Marino (R-PA). HR 173 and S 40 - Middle Class Health Benefits Tax Repeal Act of 2017: To amend the Internal Revenue Code of 1986 to repeal the excise tax on high cost employer-sponsored health coverage. Kelly (R-PA) & Heller (R-NV). HR 708 - State Age Rating Flexibility Act of 2017: To amend title XXVII of the Public Health Service Act to change the permissible age variation in health insurance premium rates. Buschon (R-IN). HR 710 -Health Coverage State Flexibility Act of 2017: To amend the Patient Protection and Affordable Care Act to better align the grace period required for non-payment of premiums before discontinuing coverage under qualified health plans with such grace periods provided for under State law. Flores (R-TX). HR 749 - Lower Drug Costs through Competition Act: To increase competition in the pharmaceutical industry. Schrader (D-OR) H.R.1121 - Pre-existing Conditions Protection Act of 2017: To amend the Public Health Service Act to prohibit application of pre-existing condition exclusions and to guarantee availability of health insurance coverage in the individual and group market, contingent on the enactment of legislation repealing the Patient Protection and Affordable Care Act, and for other purposes. Walden (R-OR). HR 1175 and S 403 - Health Savings Act of 2017: To amend the Internal Revenue Code of 1986 to improve access to health care through expanded health savings accounts, and for other purposes. Paulsen (R-MN) & Hatch (R-UT). HR 1304 - Self-Insurance Protection Act: To amend the Employee Retirement Income Security Act of 1974, the Public Health Service Act, and the Internal Revenue Code of 1986 to exclude from the definition of health insurance coverage certain medical stop-loss insurance obtained by certain plan sponsors of group health plans. Roe (R-TN) HR 1776 & S 771 Improving Access To Affordable Prescription Drugs Act: To improve access to affordable prescription drugs. Schakowsky (D-IL) & Franken (D-MN) HR 2051 - 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, and for other purposes. McKinley (R-WV) S 191 - Patient Freedom Act of 2017: To improve patient choice by allowing States to adopt market based alternatives to the Affordable Care Act that increase access to affordable health insurance and reduce costs while ensuring important consumer protections and improving patient care. Cassidy (R-LA) S 637 - Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2017: To amend titles XI and XVIII of the Social Security Act to provide greater transparency of discounts provided by drug manufacturers. Wyden (D-OR) HR - 6082 Overdose Prevention and Patient Safety Act S 2554 Patient Right to Know Drug Prices Act

Client expense: $150,000 · Firm income: Not reported

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

Treatment of tax-preferred savings accounts, transit benefits and the employer exclusion for health benefits. Implementation of PL 115-97 (H.R. 1/tax reform). Excise Tax. H.R. 5138 - The Bipartisan HSA Improvement Act. H.R. 1175/S. 403 - The Health Savings Act of 2017. H.R. 6199 - Restoring Access to Medication and Modernizing Health Savings Accounts Act of 2018. H.R. 6311 - Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act of 2018.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE, Treasury, Dept of

H.R. 173/S. 58 - Middle Class Health Benefits Tax Repeal Act of 2017 H.R. 1175/S. 403 - Health Savings Act of 2017. Excise Tax

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE, Treasury, Dept of

S.445/H.R.1825 - Home Health Care Planning Improvement Act of 2017 H.R.1617/S.3067 - Promoting Access to Diabetic Shoes Act S.1109/H.R.959 - Title VIII Nursing Workforce Reauthorization Act of 2017 H.R.1160 - ACO Assignment Improvement Act of 2017 H.R. 1155 - To amend title XVIII of the Social Security Act to allow physician assistants, nurse practitioners, and clinical nurse specialists to supervise cardiac, intensive cardiac, and pulmonary rehabilitation programs. S.1361 - Improving Access to Cardiac and Pulmonary Rehabilitation Act of 2017 S.783/H.R.315 [P.L. No: 115-320] - Improving Access to Maternity Care Act H.R.3692 - Addiction Treatment Access Improvement Act of 2017 S. 2317 - Addiction Treatment Access Improvement Act of 2018 S.2004 / H.R. 4501- Combating the Opioid Epidemic Act S. 2456/H.R. 5311 - CARA 2.0 Act of 2018 S.2524/H.R. 5102 - Substance Use Disorder Workforce Loan Repayment Act of 2018 H.R. 3922 - CHAMPIONING HEALTHY KIDS Act S. 1827: KIDS Act of 2017 Alexander-Murray Bipartisan Health Care Stabilization Act of 2017 S.1835 - Lower Premiums Through Reinsurance Act of 2017 H.R. 1478 - Gun Violence Research Act Graham-Cassidy-Heller-Johnson Amendment in the nature of a substitute to H.R. 1628 - American Health Care Act of 2017 H.R. 1628 - American Health Care Act of 2017 Better Care Reconciliation Act Discussion Draft S. 222 - Obamacare Replacement Act H.R. 372 - Competitive Health Insurance Reform Act of 2017 S. 934 - FDA Reauthorization Act of 2017 S. 870 - Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017 H.R. 449 - The Synthetic Drug Awareness Act of 2017 S. 191 - Patient Freedom Act of 2017 S. 403 - Health Savings Act of 2017 H.R. 1136 - FDA Deeming Authority Clarification Act of 2017 S.2680 - Opioid Crisis Response Act of 2018 S. 2891 - Fighting the Opioid Epidemic with Sunshine Act of 2018 H.R. 6 [P.L. No: 115-271] - SUPPORT for Patients and Communities Act H.R. 5605 - Advancing High Quality Treatment for Opioid Use Disorders in Medicare Act H.R. 3331/S.1732 - To amend title XI of the Social Security Act to promote testing of incentive payments for behavioral health providers for adoption and use of certified electronic health record technology H.R. 5002/S.2406 - Advancing Cutting-Edge (ACE) Research Act H.R. 5796 - Responsible Education Achieves Care and Healthy Outcomes for Users Treatment Act H.R. 5798 - Opioid Screening and Chronic Pain Management Alternatives for Seniors Act S.3120 - Helping to End Addiction and Lessen (HEAL) Substance Use Disorders Act of 2018 H.Res 1099 - Providing for the concurrence by the House in the Senate amendment to H.R. 6, with an amendment H.R. 6310/H.R. 6317 - Primary Care Enhancement Act of 2018 H.R. 6199 - Restoring Access to Medication and Modernizing Health Savings Accounts Act of 2018 H.R. 6502 - Reducing Unnecessary Senior Hospitalizations Act of 2018 Medical Record Documentation Medicare Extenders Home Infusion Therapy Medication-Assisted Therapies (MATs) Opioid Abuse Epidemic Medicare Carrier Advisory Committees Reducing Regulatory Burdens

Client expense: $206,455 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Justice, Dept of (DOJ), SENATE, Veterans Affairs, Dept of (VA), White House Office

Regulation of dietary supplements and natural food products. Full implementation and enforcement of Dietary Supplement Health and Education Act. S.403/H.R. 1175, the Health Savings Act. H.R. 2, Farm Bill, specifically regarding inclusion of multi-vitamin in the SNAP program.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.403/H.R. 1175, the Health Savings Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 5961/S. 2976 FY2019 Appropriations for the Department of Agriculture and Related Agencies. Specifically for adequate funding for dietary supplement regulation. Full implementation and enforcement of legislation and regulations pertaining to dietary supplements. Full implementation of Designer Anabolic Steroids Control Act. H.R. 2, Farm Bill, regarding inclusion of multi-vitamin in SNAP program. H.R. 3841, SNAP Vitamin and Mineral Improvement Act. H.R. 1175/S.403 The Health Savings Act of 2017. General concerns about impact of trade policies.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 5961/S. 2976 FY2019 Appropriations for the Department of Agriculture and Related Agencies. Specifically for adequate funding for dietary supplement regulation. Full implementation and enforcement of legislation and regulations pertaining to dietary supplements. Full implementation of Designer Anabolic Steroids Control Act. H.R. 2, Farm Bill, regarding inclusion of multi-vitamin in SNAP program. H.R. 3841, SNAP Vitamin and Mineral Improvement Act. H.R. 1175/S.403 The Health Savings Act of 2017. General concerns about impact of trade policies.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 173/S. 58 - Middle Class Health Benefits Tax Repeal Act of 2017 H.R. 1175/S. 403 - Health Savings Act of 2017. Excise Tax

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE, Treasury, Dept of

Treatment of tax-preferred savings accounts, transit benefits and the employer exclusion for health benefits. Implementation of PL 115-97 (H.R. 1/tax reform). Excise Tax. H.R. 5138 - The Bipartisan HSA Improvement Act. H.R. 1175/S. 403 - The Health Savings Act of 2017. H.R. 6199 - Restoring Access to Medication and Modernizing Health Savings Accounts Act of 2018. H.R. 6311 - Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act of 2018.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE, Treasury, Dept of

H.R. 35 - Health Savings Act of 2017; entire bill H.R. 1175 - Health Savings Act of 2017; entire bill H.R. 5138 - Bipartisan HSA Improvement Act of 2018; entire bill S. 403 - Health Savings Act of 2017; entire bill

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 28, Health Savings Account Expansion Act (Flake) - HSA improvements S. 85, Restoring Access to Medications Act (Roberts) - paying for OTC products with HSA funds S. 403, Health Savings Act (Hatch) - HSA and FSA improvements S. 761, Health Care Options Act (Alexander) - using premiums for off-Exchange plans S. 1859, Healthcare Tax Relief Act (Gardner) - suspension of ACA health insurance tax S. 1978, Small Business and Family Health Tax Relief Act (Heitkamp) - suspension of ACA health insurance tax S. 2410, Chronic Disease Management Act (Thune) - flexibility for high-deductible health plans S. 3063, Health Insurance Tax Relief Act (Barrasso) - suspension of ACA health insurance tax H.R. 246, Jobs and Premium Protection Act (Noem-Sinema) - repeal of ACA health insurance tax H.R. 247, Health Savings Account Expansion Act (Brat) - HSA improvements H.R. 394, Restoring Access to Medications Act (Jenkins) - paying for OTC products with HSA funds H.R. 1175, Health Savings Act (Paulsen) - HSA and FSA improvements H.R. 3798, Save American Workers Act (Walorski) - delay in Cadillac tax H.R. 4616 (Nunes) - delay in ACA excise tax on employer-provided health coverage H.R. 4618 (Jenkins) - use of HSA funds for OTC medications H.R. 4620, Protecting Families and Small Businesses Act (Noem) - relief from ACA health insurance tax H.R. 4894, Harmful Tax Prevention Act (Noem) - relief from ACA health insurance tax H.R. 4978, Chronic Disease Management Act (Black) - flexibility for high-deductible health plans H.R. 5138, Bipartisan HSA Improvement Act (Kelly) - HSA changes H.R. 5963, Health Insurance Premium Reduction Act (Noem) - suspension of ACA health insurance tax H.R. 6199, Restoring Access to Medication Act (Jenkins) - OTC medical products as qualified medical expense, HSA improvements H.R. 6301, Promoting High-Value Health Care Through Flexibility for High Deductible Health Plans Act (Roskam) - flexibility on first dollar coverage for HSA plans H.R. 6305, Bipartisan HSA Improvement Act (Kelly) - HSA flexibility; treatment of certain employment-related services; FSA and HRA conversions H.R. 6306, Health Care Security Act (Paulsen) - HSA contribution limits, spousal catch-up contributions, grace period for medical expenses H.R. 6309, Allowing Working Seniors to Keep Their Health Savings Accounts Act (Paulsen) - HSA contributions by Medicare-eligible individuals H.R. 6311, Increasing Access to Lower Premium Plans and Expanding HSAs Act (Roskam) - suspension of health insurance tax, HSA improvements H.R. 6312, Personal Health Investment Today Act (Smith) - medical care tax deduction for qualified sports and fitness expenses H.R. 6313, RAISE Health Benefits Act (Stivers) - Health FSA rollovers H.R. 6314, Health Savings Act (Burgess) - definition of high-deductible health plan H.R. 6317, Primary Care Enhancement Act (Paulsen) - participation by HSA-eligible individuals in direct primary care (DPC) arrangements Regulatory Issues: Annual insurer provider fees; issues concerning the patient-centered outcomes research fee; employer and individual coverage mandate; W-2 reporting requirements; health reimbursement accounts; deductibility limits for insurer compensation; health insurer and employer reporting of health coverage; issues related to implementation of health insurance tax; issues related to the refundable credit for coverage under a qualified health plan; issues related to coverage of chronic conditions in high deductible health plans; issues related to health savings accounts; issues related to the deductibility of employer-sponsored health coverage; issues related to enhancing tax treatment of long-term care insurance; issues related to qualified small employer health reimbursement accounts (QSEHRAs); issues related to implementation of the excise tax on high cost employer-sponsored health coverage; and other issues relating to health care reform implementation.

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

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

S. 28, Health Savings Account Expansion Act (Flake) - HSA improvements S. 85, Restoring Access to Medications Act (Roberts) - paying for OTC products with HSA funds S. 403, Health Savings Act (Hatch) - HSA and FSA improvements S. 761, Health Care Options Act (Alexander) - using premiums for off-Exchange plans S. 1859, Healthcare Tax Relief Act (Gardner) - suspension of ACA health insurance tax S. 1978, Small Business and Family Health Tax Relief Act (Heitkamp) - suspension of ACA health insurance tax S. 2410, Chronic Disease Management Act (Thune) - flexibility for high-deductible health plans S. 3063, Health Insurance Tax Relief Act (Barrasso) - suspension of ACA health insurance tax H.R. 195, Extension of Continuing Appropriations Act - one-year suspension of ACA health insurance tax, two-year delay in ACA excise tax on employer-sponsored health plans H.R. 246, Jobs and Premium Protection Act (Noem-Sinema) - repeal of ACA health insurance tax H.R. 247, Health Savings Account Expansion Act (Brat) - HSA improvements H.R. 394, Restoring Access to Medications Act (Jenkins) - paying for OTC products with HSA funds H.R. 1175, Health Savings Act (Paulsen) - HSA and FSA improvements H.R. 4616 (Nunes) - delay in ACA excise tax on employer-provided health coverage H.R. 4618 (Jenkins) - use of HSA funds for OTC medications H.R. 4620, Protecting Families and Small Businesses Act (Noem) - relief from ACA health insurance tax H.R. 4894, Harmful Tax Prevention Act (Noem) - relief from ACA health insurance tax H.R. 4978, Chronic Disease Management Act (Black) - flexibility for high-deductible health plans H.R. 5138, Bipartisan HSA Improvement Act (Kelly) - HSA changes H.R. 5963, Health Insurance Premium Reduction Act (Noem) - suspension of ACA health insurance tax H.R. 6199, Restoring Access to Medication Act (Jenkins) -- OTC medical products as qualified medical expense H.R. 6301, Promoting High-Value Health Care Through Flexibility for High Deductible Health Plans Act (Roskam) - flexibility on first dollar coverage for HSA plans H.R. 6305, Bipartisan HSA Improvement Act (Kelly) - HSA flexibility H.R. 6314, Health Savings Act (Burgess) - definition of high-deductible health plan Regulatory Issues: Annual insurer provider fees; issues concerning the patient-centered outcomes research fee; employer and individual coverage mandate; W-2 reporting requirements; health reimbursement accounts; deductibility limits for insurer compensation; health insurer and employer reporting of health coverage; issues related to implementation of health insurance tax; issues related to the refundable credit for coverage under a qualified health plan; issues related to coverage of chronic conditions in high deductible health plans; issues related to health savings accounts; issues related to the deductibility of employer-sponsored health coverage; issues related to qualified small employer health reimbursement accounts (QSEHRAs); issues related to implementation of the excise tax on high cost employer-sponsored health coverage; and other issues relating to health care reform implementation.

Client expense: $1,410,000 · Firm income: Not reported

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

Implementation of H.R. 1, Public Law No. 115-97, Tax Cuts and Jobs Act, H.R.195 Medical Device Tax Repeal S.108 Medical Device Access and Innovation Protection Act H.R. 184 Protect Medical Innovation Act of 2018 HR 1204 Responsible Additions and Increases to Sustain Employee Health Benefits Act HR 1175, S.403 Health Savings Act The Technologies for Energy Security Act, H.R.1090/H.R.1625

Client expense: $1,100,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Defense, Dept of (DOD), Environmental Protection Agency (EPA), Executive Office of the President (EOP), Federal Highway Administration (FHA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Highway Traffic Safety Administration (NHTSA), Office of Management & Budget (OMB), SENATE, Securities & Exchange Commission (SEC), State, Dept of (DOS), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Trade Representative (USTR), White House Office

protecting access to preventive care and wellness through Health Savings Accounts protecting access to healthcare sharing ministries S 403, Health Savings Act of 2017 HR 1175, Health Savings Act of 2017 HR 277, American Healthcare Reform Act of 2017 HR 1628, American Healthcare Act HR 1, the Tax Cuts and Jobs Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Affordable Care Act, all provisions and related regulations, including repeal of ACA 40% excise tax; ACA Reporting (IRC 6055 and 6056); Employer mandate; wellness issues; out-of-pocket (OOP) limits related to cost sharing, nondiscrimination, 1332 waivers, Health Insurance Tax ADA and GINA (in conjunction with employer-based wellness programs), H.R. 1313 - Preserving Employee Wellness Programs Act HIPAA compliance, Privacy, Claims data and all payers claims databases Mental Health Parity, Substance use disorders, Opiods mitigation Tax Treatment of Employer-Sponsored Health Insurance, H.R. 173 / S. 58 - Middle Class Health Benefits Tax Repeal Act of 2017, Continuing resolutions with health tax provisions, H.R. 3798 - Save American Workers Act Prescription Drug Costs, Pharmacy gag clauses, Rebates & Point-of-Sale requirements, Biosimilars Value-Driven Care in Public and Private Coverage, Patient Safety Medicare Advantage, Medicare Secondary Payer, Kidney dialysis, End Stage Renal Disease (ESRD) COBRA, Retiree health HSAs, including S. 403 - Health Savings Act of 2017, H.R. 5138 the Bipartisan HSA Improvement Act, H.R. 365 the Primary Care Enhancement Act, HSA limit changes, H.R. 6199 the Restoring Access to Medication & Modernizing HSA Act, HSA limit changes ERISA Preemption, Balance billing, State mandates & assessments

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Council of Economic Advisers (CEA), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Economic Council (NEC), Pension Benefit Guaranty Corporation (PBGC), SENATE, Treasury, Dept of

Legislation related to the taxation of employer-provided health benefits: Health Savings Act of 2017 - S. 403/H.R. 1175 Chronic Disease Management Act - S. 2410/H.R. 4978 Bipartisan HSA Improvement Act of 2018 - H.R. 5138/H.R. 6305 H.R. 6301, to provide high deductible health plans with first dollar coverage flexibility H.R. 6317, to provide that direct primary care service arrangements do not disqualify deductible health savings account contributions H.R. 6309, to allow individuals entitled to Medicare Part A by reason of being over age 65 to contribute to health savings accounts H.R. 6306, to increase the contribution limitation for health savings accounts, and for other purposes H.R. 6199, Restoring Access to Medication and Modernizing Health Savings Accounts Act H.R. 6311, Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act

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

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Natl Economic Council (NEC), SENATE, Treasury, Dept of

Legislation related to the taxation of employer-provided health benefits: Health Savings Act of 2017 - S. 403/H.R. 1175 Chronic Disease Management Act - S. 2410/H.R. 4978 Bipartisan HSA Improvement Act of 2018 - H.R. 5138/H.R. 6305 H.R. 6301, to provide high deductible health plans with first dollar coverage flexibility H.R. 6317, to provide that direct primary care service arrangements do not disqualify deductible health savings account contributions H.R. 6309, to allow individuals entitled to Medicare Part A by reason of being over age 65 to contribute to health savings accounts H.R. 6306, to increase the contribution limitation for health savings accounts, and for other purposes H.R. 6199, Restoring Access to Medication and Modernizing Health Savings Accounts Act H.R. 6311, Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act

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

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Natl Economic Council (NEC), SENATE, Treasury, Dept of

Legislative and regulatory issues including: improvements to Health Savings Accounts coupled with high deductible health plans, Medicare and Medicare Advantage, payment reform, Food and Drug Administration, and wellness. Health Savings Act of 2017 - S. 403/H.R. 1175 H.R. 6199, Restoring Access to Medication and Modernizing Health Savings Accounts Act Chronic Disease Management Act - S.2410/H.R. 4978 Bipartisan HSA Improvement Act of 2018 - H.R. 5138 and H.R. 6305 H.R. 6301, to provide high deductible health plans with first dollar coverage flexibility HHS Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs, RIN 0991-ZA49

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Natl Economic Council (NEC), SENATE, Treasury, Dept of

Legislative and regulatory issues including: improvements to Health Savings Accounts coupled with high deductible health plans, Medicare and Medicare Advantage, payment reform, Food and Drug Administration, and wellness. Health Savings Act of 2017 - S. 403/H.R. 1175 H.R. 6199, Restoring Access to Medication and Modernizing Health Savings Accounts Act Chronic Disease Management Act - S.2410/H.R. 4978 Bipartisan HSA Improvement Act of 2018 - H.R. 5138 and H.R. 6305 H.R. 6301, to provide high deductible health plans with first dollar coverage flexibility HHS Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs, RIN 0991-ZA49

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Natl Economic Council (NEC), SENATE, Treasury, Dept of

Legislative and regulatory issues including: improvements to Health Savings Accounts coupled with high deductible health plans, Medicare and Medicare Advantage, payment reform, Food and Drug Administration, and wellness. Health Savings Act of 2017 - S. 403/H.R. 1175 H.R. 6199, Restoring Access to Medication and Modernizing Health Savings Accounts Act Chronic Disease Management Act - S.2410/H.R. 4978 Bipartisan HSA Improvement Act of 2018 - H.R. 5138 and H.R. 6305 H.R. 6301, to provide high deductible health plans with first dollar coverage flexibility HHS Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs, RIN 0991-ZA49

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Natl Economic Council (NEC), SENATE, Treasury, Dept of

Legislative and regulatory issues including: Health care reform Implementation of the Affordable Care Act -- PL 111-148 Bipartisan Budget Act of 2018 -- H.R. 1892/PL 115-123 Middle Class Health Benefits Tax Repeal Act of 2017 - S. 58/H.R. 173 Save American Workers Act -- H.R. 3798 Restoring Access to Medication and Modernizing Health Savings Accounts Act (H.R. 6199) Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act (H.R. 6311) Health Savings Act of 2017 - S. 403/H.R. 1175 Chronic Disease Management Act - S. 2410/H.R. 4978 Bipartisan HSA Improvement Act of 2018 - H.R. 5138/H.R. 6305 Mental Health Parity H.R. 6301, to provide high deductible health plans with first dollar coverage flexibility H.R. 6317, to provide that direct primary care service arrangements do not disqualify deductible health savings account contributions H.R. 6309, to allow individuals entitled to Medicare Part A by reason of being over age 65 to contribute to health savings accounts H.R. 6306, to increase the contribution limitation for health savings accounts, and for other purposes H.R. 4616, to provide for a temporary moratorium on the employer mandate and to provide for a delay in the implementation of the excise tax on high cost employer-sponsored health coverage H.R. 6, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act S. 2554, the Patient Right to Know Drug Prices Act S. 2553, the Know the Lowest Price Act HHS Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs, RIN 0991-ZA49

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

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Natl Economic Council (NEC), SENATE, Treasury, Dept of

Legislative and regulatory issues including: Health care reform Implementation of the Affordable Care Act -- PL 111-148 Bipartisan Budget Act of 2018 -- H.R. 1892/PL 115-123 Middle Class Health Benefits Tax Repeal Act of 2017 - S. 58/H.R. 173 Save American Workers Act -- H.R. 3798 Restoring Access to Medication and Modernizing Health Savings Accounts Act (H.R. 6199) Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act (H.R. 6311) Health Savings Act of 2017 - S. 403/H.R. 1175 Chronic Disease Management Act - S. 2410/H.R. 4978 Bipartisan HSA Improvement Act of 2018 - H.R. 5138/H.R. 6305 Mental Health Parity H.R. 6301, to provide high deductible health plans with first dollar coverage flexibility H.R. 6317, to provide that direct primary care service arrangements do not disqualify deductible health savings account contributions H.R. 6309, to allow individuals entitled to Medicare Part A by reason of being over age 65 to contribute to health savings accounts H.R. 6306, to increase the contribution limitation for health savings accounts, and for other purposes H.R. 4616, to provide for a temporary moratorium on the employer mandate and to provide for a delay in the implementation of the excise tax on high cost employer-sponsored health coverage H.R. 6, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act S. 2554, the Patient Right to Know Drug Prices Act S. 2553, the Know the Lowest Price Act HHS Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs, RIN 0991-ZA49

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

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Natl Economic Council (NEC), SENATE, Treasury, Dept of

Coverage of multivitamins in Health Savings Act of 2017 (HR 1175/S 403)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE