ACE Kids Act of 2017

S. 413, Improving Transparency and Accuracy in Medicare Part D Spending Act (Capito) - PDP/MA-PD payments on clean claims from pharmacies S. 428, ACE Kids Act (Grassley) - coordinated care for children with complex medical conditions S. 1016, CONNECT For Health Act (Schatz) - telehealth S. 1169, Medicaid CARE Act (Durbin-Portman) - changes to Medicaid IMD exclusion S. 1688, Empowering Medicare Seniors to Negotiate Drug Prices Act (Klobuchar) - Part D price negotiations S. 1804, Medicare for All Act (Sanders) - single payer health system S. 1890, Chronic Kidney Disease Improvement in Research and Treatment and Medigap Access (Cardin) - Medigap coverage for beneficiaries with end-stage renal disease S. 1909, BENES Act (Casey) - notifications of Medicare eligibility S. 2027, Medicaid Third Party Liability Act (Portman) - Medicaid third party liability S. 2051, Medicare Care Coordination Improvement Act of 2017 (Portman) - barriers to payment reform models S. 2227, EMPOWER Care Act (Portman-Cantwell) - Medicaid Money Follows the Person Demonstration S. 2707, Informing Seniors About Opioids Act (Nelson) - opioid issues S. 2901, Expanding Telehealth Response to Ensure Addiction Treatment Act (Thune) - opioid issues S. 2904, Medicaid Substance Use Disorder Treatment Via Telehealth Act (Carper) - opioid issues S. 2908, Electronic Prior Authorization in Medicare Part D Act (Roberts) - opioid issues S. 3327, SENIOR Communities Protection Act (Cortez Masto) - preventing fraudulent opioid prescriptions S. 3496, Improving Seniors Access to Quality Benefits Act (Daines-King) - study on MA benchmark cap S. 3497, Medicare Advantage Quality Payment Relief Act (Daines-King) - MA benchmark cap S. 3702, Right Rebate Act (Wyden-Grassley) - Medicaid drug rebate program Draft Bill: Medicare Long-Term Care Services and Supports Act (Pallone) - Long-Term Services and Supports Program H.R. 6, SUPPORT Patients and Families Act (Walden) - opioid initiatives, Medicare and Medicaid issues, budget offsets H.R. 695, Continuing Appropriations Act (Schiff) - Money Follows the Person demonstration, spousal impoverishment protections H.R. 849, Protecting Seniors Access to Medicare Act (Roe) - Independent Payment Advisory Board H.R. 908, Medicare Advantage Quality Payment Relief Act (Kelly) - MA payment cap H.R. 1038, Improving Transparency and Accuracy in Medicare Part D Spending Act (Griffith) - PDP/MA-PD payments on clean claims from pharmacies H.R. 1148, FAST Act (Griffith) - access to telehealth-eligible stroke services under Medicare H.R. 1316, Prescription Drug Price Transparency Act (Collins) - PBM standards for MA and PDP plans H.R. 1995, V-BID for Better Care Act (Black) - value-based insurance design in Medicare Advantage H.R. 2556, CONNECT For Health Act (Black) - telehealth H.R. 2575, BENES Act (Ruiz) - notifications of Medicare eligibility H.R. 2644, Chronic Kidney Disease Improvement in Research and Treatment and Medigap Access (Marino) - Medigap coverage for beneficiaries with end-stage renal disease H.R. 2687, Medicaid CARE Act (Foster-Fitzpatrick) - changes to Medicaid IMD exclusion H.R. 3044, Supplemental Benefits for Chronically Ill Medicare Advantage Enrollees (Meehan) H.R. 3263, Medicare Independence at Home Model of Care (Burgess) - demonstration program H.R. 3325, ACE Kids Act (Barton) - health homes for children with complex medical conditions H.R. 3360, Telehealth Enhancement Act (Harper) - telehealth in Medicare H.R. 3635, Local Coverage Determination Clarification Act (Jenkins) - procedures for Medicare administrative contractors H.R. 3727, Increasing Telehealth Access in Medicare Act (Black) - telehealth in MA plans H.R. 4143, Dialysis PATIENTS Demonstration Act (Smith) - alternative care delivery models and payment methodologies for patients with end-stage renal disease H.R. 4952, Improving Seniors Access to Quality Benefits Act (Kelly) - MA benchmark cap study H.R. 5306, EMPOWER Care Act (Guthrie) - extension of Money Follows the Person demonstration H.R. 5603, Access to Telehealth Services for Substance Use Disorders Act (Matsui) - opioid issues H.R. 5605, Advancing High Quality Treatment for Opioid Use Disorders in Medicare Act (Ruiz) - opioid issues H.R. 5675, drug management programs for at-risk Medicare beneficiaries (Bilirakis) - opioid issues H.R. 5676, SENIOR Communities Protection Act (MacArthur) - preventing fraudulent opioid prescriptions H.R. 5684, Protecting Seniors from Opioid Abuse Act (Kelly) - opioid issues H.R. 5685, Medicare Opioid Safety Education Act (Faso) - opioid issues H.R. 5686, Medicare Clear Health Options in Care for Enrollees Act (Paulsen) - opioid issues H.R. 5715, Strengthening Partnerships to Prevent Opioid Abuse Act (Renacci) - communication between Medicare plan sponsors and CMS H.R. 5773, Preventing Addiction for Susceptible Seniors Act (Roskam) - opioid issues H.R. 5797, IMD CARE Act (Walters) - Medicaid IMD exclusion H.R. 5798, Opioid Screening and Chronic Pain Management Alternatives for Seniors Act (Bucshon) - opioid issues H.R. 5799, Medicaid Drug Review, Utilization, Good Governance Improvement Act (Blackburn) - opioid issues H.R. 5800, Medicaid IMD ADDITIONAL INFO Act (Upton) - opioid issues H.R. 5804, Post-Surgical Injections as an Opioid Alternative Act (Shimkus) - opioid issues H.R. 5808, Medicaid Pharmaceutical Home Act (Bilirakis) - opioid issues H.R. 5809, Postoperative Opioid Prevention Act (Peters) - opioid issues H.R. 5810, Medicaid Health Homes for Opioid-Use-Disorder Medicaid Enrollees Encouraged Act (Lance) - opioid issues H.R. 5812, Improving Medicaid Data Timeliness Act (Griffith) - opioid issues H.R. 6431, Medigap Consumer Protection Act (Levin) - reforms to Medicare supplemental insurance H.R. 6561, Comprehensive Care for Seniors Act (Walorski) -- Program of All-Inclusive Care for the Elderly H.R. 6563, Lower Out-of-Pocket Costs for Seniors Act (Pallone-Neal) - Medicare Part D cliff H.R. 6662, Empowering Seniors Decision Enrollment Act (Paulsen) - special enrollment period for non-deemed Medicare Cost Plan enrollees H.R. 6690, Fighting Fraud to Protect Care for Seniors Act (Roskam) - Medicare pilot program for smart card technology H.R. 7122, Shared Accountability for Improved Patient Outcomes Act (Paulsen) - value-based payment and delivery arrangements H.R. 7217, IMPROVE Act (Barton) - Money Follows the Person demonstration, ACE Kids Act, Medicare drug rebate program, spousal impoverishment protections H.R. 7223, Right Rebate Act (Schrader-Welch) - Medicaid drug rebate program H.R. 7247, Incentivizing Shared Risk in Medicare Advantage Act (Brady) - MA prior authorization H.R. 7249, Better Prior Authorization Notification Act (Reed) - MA prior authorization H.R. 7250, Prior Authorization Improvement Act (Kelly) - MA prior authorization Regulatory Issues: Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, network adequacy and provider directories, encounter data and other data-related issues, and audit issues; bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, Part D direct and indirect remuneration (DIR), and audits); calendar year 2020 policy and technical regulation for MA and Part D; MA and Part D proposed rule on drug pricing changes for 2020; CMSs price transparency proposal for direct-to-consumer advertisements; issues relating to 2019 Rate Notice and Call Letter; in-home health risk assessments; Medicare Medical Loss Ratio issues; implementation of sequestration under the Medicare Advantage and Part D programs; implications of the health insurer fee for MA and Part D plans; application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, enrollment rules, requirements for notice and denial forms, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible SNPs; Bipartisan Budget Act of 2018 changes to SNPs; Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, Part D coverage gap discount program, including employer group waiver plan (EGWP) issues, and other operational issues; issues raised by Part D coverage of new specialty drugs, the Part D non-interference policy and related issues (e.g., preferred pharmacy and any willing pharmacy requirements, standards for network pharmacy reimbursement, and policies regarding sponsor negotiation of pharmacy price concessions); CMS's proposed Part B drug demonstration program; Medication Therapy Management Program requirements and the Center for Medicare and Medicaid Innovation (CMMI) Demonstration; MA EGWP issues; CMMI's value-based insurance design (VBID) demonstration; Part D requirements for offering basic and enhanced alternative plans; MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; issues relating to MA and Part D Star Rating system including measures, the methodology for calculating ratings, and the role of the ratings for payment purposes; implementation of the Affordable Care Act (ACA) and the Bipartisan Budget Act of 2018 changes to the Part D coverage gap; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education Program; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; new payment system for physicians under MACRA, including implications for MA and Part D plans; Medicare clinical trials; Medicare/Medicaid integration for dual eligibles, including implementation of the Capitated Financial Alignment Demonstration and related issues (e.g., quality ratings); Medicaid managed care regulations and policies, including CMS's substantial revisions to the managed care regulations, mental health parity rules, the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, fraud and abuse compliance, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including block grants, the calculation of the federal medical assistance (federal matching) percentage (FMAP), and intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost issues affecting Medicaid health plans including issues raised by Medicaid coverage of new specialty drugs; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues and CHIP reauthorization; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including Medicaid managed care organization provider tax issues; standards for electronic prescribing; implementation of Medicaid changes of interest to Medicaid health plans made in the ACA including Medicaid expansion, the managed care organization (MCO) prescription drug rebate provisions, minimum payments to primary care providers (PCPs), interactions between the Medicaid program and health insurance exchanges, and Medicaid and CHIP maintenance of effort (MOE) requirements; implications of the health insurer fee for Medicaid health plans; issues related to Medicaid Managed long-term care including home and community-based waiver services (HCBS); expanding the availability of Medicare Advantage and Medicaid health plan telemedicine programs; implications of the new non-discrimination rules for health plans participating in public programs; issues related to Medigap coverage; issues related to business continuity in relation to pandemics or natural events (e.g., hurricane, tornado, etc.); cybersecurity; provider directories; value-based insurance design models; issues relating to prescription drug price blueprint; Part D prescriber enrollment requirements; Part D recovery audit contractor programs; issues relating to enrollment of beneficiaries with ESRD into MA plans; socioeconomic status impacts on star ratings related to MA and Part D programs; and other issues relating to health care reform implementation.

Client expense: $1,550,000 · Firm income: Not reported

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

ACE Kids: Support for the ACE Kids Act, S 428 and HR 3325, which seeks to make it easier for children with medical complexity to seek treatment across state lines. 340B: Sought the reversal of cuts to 340B reimbursements in the final Medicare Outpatient Prospective Payment System - H.R. 4392. Opposed measures that would limit expansions of the 340B program and require burdensome, irrelevant and unnecessary reporting by 340B covered entities - H.R. 4710, S. 2312, and S. 2453. Supported H.R. 6071 (Matsui) to require HHS to audit drug manufacturers and publish 340B ceiling prices. Opposed the proposed public charge rule and adding Medi-Cal to the list of programs that would be considered in making a public charge determination.

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

Government targets: HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), SENATE

ACE Kids: Support for the ACE Kids Act, S 428 and HR 3325, which seeks to make it easier for children with medical complexity to seek treatment across state lines. 340B: Sought the reversal of cuts to 340B reimbursements in the final Medicare Outpatient Prospective Payment System - H.R. 4392. Opposed measures that would limit expansions of the 340B program and require burdensome, irrelevant and unnecessary reporting by 340B covered entities - H.R. 4710, S. 2312, and S. 2453. Supported H.R. 6071 (Matsui) to require HHS to audit drug manufacturers and publish 340B ceiling prices. Opposed proposed public charge rule, which would punish children with disabilities and complex medical conditions, and make it harder for them to pursue lawful citizenship.

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

Government targets: HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), SENATE

H.R. 3325, ACE Kids Act. S. 428, ACE Kids Act of 2017.

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

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

Monitor federal activity related to quality indications and specialty requirements for pediatric hospitals. Monitor movement toward alternative payment methodologies for childrens hospitals providing services. H.R. 3325, ACE Kids Act. S. 428, ACE Kids Act of 2017.

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

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

CLINICAL TREATMENT Act(H.R.6836) Furthering Access to Coordinated Treatment for Seniors Act of 2017(H.R.3447) Medicare Choice Empowerment and Protection Act(H.R.3181/S.1530) Palliative Care and Hospital Education and Training Act(H.R.1676/S.693) Patient Choice and Quality Care Act of 2017(S.1334/H.R.2797) S.3028- Americans Giving Care to Elders(AGE)Act of 2018 The ACE Kids Act (S.428/H.R.3325)

Client expense: $168,587 · 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

Boston Children's Hospital focuses on child health access (Medicaid/CHIP), pediatric workforce education, and public health issues impacting children. In the current Congress, we have advocated for reauthorization and funding through the appropriations process for the Children's Hospital Graduate Medical Education program (CHGME), and sought to insure that ACA repeal and replace efforts do not threaten children's' access to care. We have sought to insure that complex pediatric patients can travel across state lines through the ACE Kids Act (S428) and have been actively involved in efforts to simplify screening and enrollment for out of state providers treating these children (S2415). We have also provided information on the impact of opioid abuse on adolescents and treatment approaches addressing these concerns. In this calendar year, we opposed Medicaid cuts included in the American Health Care Recovery Act, the Better Care Reconciliation Act and the Graham-Cassidy legislation.

Client expense: $160,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Natl Institutes of Health (NIH), SENATE

Legislation and policies related to: Physician/nurse practitioner reimbursement Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Implementation of the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 (P.L. 114-10) including policies related to the Quality Payment Program Adoption of recommendations of the Institute of Medicine report, The Future of Nursing: Leading Change, Advancing Health Medicare Shared Savings Program beneficiary assignment requirements Medicare-Medicaid hospital conditions of participation Evaluation of the Medicare Graduate Nurse Education demonstration Medicare-Medicaid Program Integrity policies Medicaid maintenance of effort requirements Medicaid eligibility expansion and state options Medicaid waiver application procedures Medicaid per capita cap policy options H.R. 1160 - ACO Assignment Improvement Act of 2017 H.R. 3178 - Medicare Part B Improvement Act of 2017 H.R. 3635 - Local Coverage Determination Clarification Act of 2017 H.R. 5306/S. 2227 - Ensuring Medicaid Provides Opportunities for Widespread Equity, Resources (EMPOWER) and Care Act H.R. 7217 - Improving Medicaid Programs and Opportunities for Eligible Beneficiaries (IMPROVE) Act S. 445/H.R. 1825 - Home Health Care Planning Improvement Act of 2017 S. 428/H.R. 3325 - Advancing Care for Exceptional Kids (ACE Kids) Act S. 870 - Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017 S. 1227/H.R. 2628 - Stabilize Medicaid and CHIP Coverage Act of 2017 S. 3067/H.R. 1617 - Promoting Access to Diabetic Shoes Act

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)

HR 3325 The ACE Kids Act to provide improved Medicaid services to children. S428. The ACE Kids Act to provide improved Medicaid services to children. Children's Health Graduate Medical reauthorization. General Medicaid support.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Monitor federal activity related to quality indications and specialty requirements for pediatric hospitals. Monitor movement toward alternative payment methodologies for childrens hospitals providing services. H.R. 3325, ACE Kids Act. S. 428, ACE Kids Act of 2017.

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

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

H.R. 3325, ACE Kids Act. S. 428, ACE Kids Act of 2017.

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

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

Medicare physician payment; new/alternative payment models; Medicare coverage, including coverage policies pertaining to transcatheter aortic valve replacement, transcathether mitral valve repair, and ambulatory blood pressure monitoring; Medicare hospital payment; access to Medicare claims data; Ways & Means Committee hospital payment project; physician and hospital quality; electronic health record incentive program; clinical data registries; health care quality; medical imaging and prior authorization, including HR 4841, Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018; the Stark Law and the in-office ancillary services exception, including HR 4206/S 2051, the Medicare Care Coordination Improvement Act; Promoting Integrity in Medicare Act, HR 2066; Medicare Access and CHIP Reauthorization Act implementation and oversight; Bipartisan Budget Act of 2015 and Medicare site of service policy; HR 1155/S 1361, a bill 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 46, the Strengthening Medicare Intensive Cardiac Rehabilitation Programs Act of 2017; HR 3325/S 428, The Advancing Care for Exceptional Kids Act of 2017 (or ACE Kids Act), a bill to allow a state, at its option, to elect to provide medical assistance for items and services furnished to eligible children with medically complex conditions enrolled in a Medicaid Children's Care Coordination (MCCC) program; Senate Finance Committee chronic care project; graduate medical education policy including HR 2267/S 1301, Resident Physician Shortage Reduction Act of 2017; end of life care, including HR 2797/S 1334, the Patient Choice and Quality Care Act of 2017; Puerto Rico Oversight, Management, and Economic Stability Act (PROMESA) implementation; oversight and implementation of the Protecting Access to Medicare Act of 2014, including Appropriate Use Criteria; physician-owned hospital policy, including HR 1156/S 1133, the Patient Access to High Quality Care Act of 2017; Medicaid coverage and eligibility, including HR 829, Prioritizing the Most Vulnerable Over Lottery Winners Act of 2017, HR 181, Close Annuity Loopholes in Medicaid Act, and HR 705, Verify Eligibility Coverage Act; HR 3163, Medicare Part B Home Infusion Services Temporary Transitional Payment Act; Affordable Care Act repeal/replace/reform efforts; HR 3767 and S 989, the Ensuring Childrens Access to Specialty Care Act of 2017; HR 3635, the Local Coverage Determination Clarification Act of 2017; Ways and Means Committee Medicare extenders policy/legislation.

Client expense: $480,000 · 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), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, White House Office

Graduate medical education payments and resident caps for hospitals with rotating residents; 340B issues, including proposed cuts to Medicare payment for 340B hospitals; funding for behavioral health and opioid addiction; H.R. 3325, S.428, ACE Kids Act.

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

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

Support statutory reauthorization of the Children's Health Insurance and Medicaid reform issues generally; Medicaid issues affecting children's access to health care; support for Children's Health Insurance Program; H.R. 3325/S.428, Support for ACE Kids Act legislation.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.3325, S.428 ACE Kids Act H.R.659 Standard Merger and Acquisition Reviews Through Equal Rules (SMARTER) Act H.R. 2852 Pandemic and All-Hazards Preparedness Act - Provisions regarding Academic Medical Centers eligibility Issues related to UNOS Organ Transplant policy changes

Client expense: Not reported · Firm income: $7,900

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

H.R. 3325: ACE KIDS ACT; ALL PROVISIONS OF THE BILL H.R. 6524: ACCELERATING KIDS' ACCESS TO CARE ACT; ALL PROVISIONS OF THE BILL S 428: ACE KIDS ACT OF 2017; ALL PROVISIONS OF THE BILL S 2415: ACCELERATING KIDS' ACCESS TO CARE ACT; ALL PROVISIONS OF THE BILL

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Repeal of the Affordable Care Act H.R. 1628 The American Health Care Act Development of legislation to protect essential hospitals Issues related to telehealth Mental Health Essential Health Benefits created by the Affordable Care Act Access to hospital emergency services Issues related to the 340B Drug Pricing Program HR1628 Better Care Reconciliation Act ACA Cost Sharing Reduction Subsidies Graham-Cassidy Amendment to HR 1628 340B drug pricing program HR3545-Overdose, Prevention and Patient Advocacy Act HR4392 CMS OPPS 340b rule moratorium HR4710 340b PAUSE Act Bipartisan Healthcare Stabilization Act of 2017 Opioid Crisis Response Act of 2018 42 CFR Part 2 IMD Exclusion Prescription drug monitoring programs H.R. 5197, S. 2516, Alternatives to opioids in the emergency dept Act H.R. 5102, Substance Use Disorder Workforce Loan Repayment Act H.R. 5261, Treatment, Education, and Community Help to Combat Opioid Addiction Act Poison Center Network Enhancement Act A Bill to support the peer support specialist workforce HR6 Support for Patients and Communities Act H.R. 4710 PAUSE Act HELP Act S. 2312 HR6378 Pandemic and All Hazards Preparedness and Advancing Innovation Act S.974 CREATES Act S.2843 Opioid Workforce Act HEAL Act S.3120 SERV Communities Act H. R. 6071 S.428, H.R. 3325 The Advancing Care for Exceptional (ACE) Kids Act Cassidy Surprise Billing Draft H.R.6 Support for Patients and Communities Act Protecting Patients from Surprise Medical Bills Hassan Surprise Billing-S. 3592, No more Surprise Medical Bills Act H.R. 7328, Pandemic and All-Hazards Preparedness and Advancing Innovation Act

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

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

FY2018 Labor-HHS-ED Appropriations HR 2235/S. 428 ACE Kids Act S. 3029 PREEMIE Act

Client expense: $185,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3325, S.428 ACE Kids Act H.R. 659 Standard Merger and Acquisition Reviews Through Equal Rules (SMARTER) Act H.R. 2852 Pandemic and All-Hazards Preparedness Act- Provisions regarding Academic Medical Center eligibility Issues related to UNOS Organ Transplant policy changes

Client expense: Not reported · Firm income: $37,000

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

H.R.3325, S.428 ACE Kids Act H.R.659 Standard Merger and Acquisition Reviews Through Equal Rules (SMARTER) Act H.R. 2852 Pandemic and All-Hazards Preparedness Act - Provisions regarding Academic Medical Centers eligibility Issues related to UNOS Organ Transplant policy changes

Client expense: $141,000 · Firm income: Not reported

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

H.R. 2267/ S. 1301, Resident Shortage Physician Reduction Act of 2017 Issue: Support additional funding of graduate medical education H.R. 5818/S.2843, Opioid Workforce Act of 2018 Issue: Support additional funding for graduate medical education for addiction medicine, addiction psychiatry, and pain management residency programs S. 3014 Rural Physician Workforce Production Act of 2018 Issue: Oppose legislation redesigning Medicare GME payment formulas Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments Issue: Oppose reduction of Medicare GME/IME payments Issue: Oppose reduction in Medicare hospital outpatient department reimbursement. Issue: Oppose Medicare hospital cuts Issue: Support Medicare Graduate Medical Education (GME) per resident amount technical corrections and administrative relief. Issue: Oppose redesign of Medicare Indirect Medical Education financing and redistribution. Issue: Oppose overly burdensome discussion draft Medicaid GME transparency legislation. Issue: Educate Congress on role of academic medicine as it relates to price transparency initiatives S. 455, Restoring Rural Residencies Act of 2017 Issue: Support technical correction to increase access to physician services in rural communities by allowing teaching hospitals to count resident time spent in critical access hospitals for purposes of Medicare GME payments. Issue: Development and implementation of new Medicaid Disproportionate Share Hospital (DSH) formula required under the ACA. Issue: Support extension of Medicaid Disproportionate Share Hospital (DSH) cuts delay Issue: Support allowing providers in new delivery models (e.g., ACOs, bundled payments, etc.) to access medical records with information on substance use disorders Issue: Support aligning 42 CFR Part 2 regulations with the Health Insurance Portability and Accountability Act (HIPAA) for the purposes of treatment, payment, and healthcare operations. Issue: Modify CMS Hospital Compare Star Ratings to allow stakeholders time to work together to address concerns with methodology. Support inclusion of sociodemographic status as part of quality programs Issue: ACA Section 1115 and 1332 Medicaid Waivers Issue: ACA Medicaid expansion. Maintain commitment to match State spending on medical care for Medicaid beneficiaries without limits, caps, or block grants. Maintain and enforce network adequacy requirements and mandate sufficient payments to providers. Issue: Support a third agreement period for certain Accountable Care Organizations in Medicare Shared Savings Program Issue: Support a delay in CMS issuing a final national coverage decision until the agency has an opportunity to receive and consider alternatives to limiting coverage to FDA-approved diagnostic tests developed using Next Generation Sequencing technology. H.R. 7217, Improving Medicaid Programs and Opportunities for Eligible Beneficiaries (IMPROVE) Act, Title I H.R. 3325/S. 428, ACE Kids Act Issue: Support legislation to improve health care for children with complex medical conditions on Medicaid Issue: Oppose Physician Fee Schedule rule proposal to collapse Medicare E/M coding

Client expense: $892,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Bureau of Citizenship & Immigration Services (BCIS), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Natl Science Foundation (NSF), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), Office of Science & Technology Policy (OSTP), Patent & Trademark Office (PTO), SENATE, State, Dept of (DOS), Substance Abuse & Mental Health Services Administration (SAMHSA), Veterans Affairs, Dept of (VA), Vice President of the U.S., White House Office

S. 413, Improving Transparency and Accuracy in Medicare Part D Spending Act (Capito) - PDP/MA-PD payments on clean claims from pharmacies S. 428, ACE Kids Act (Grassley) - coordinated care for children with complex medical conditions S. 1016, CONNECT For Health Act (Schatz) - telehealth S. 1169, Medicaid CARE Act (Durbin-Portman) - changes to Medicaid IMD exclusion S. 1688, Empowering Medicare Seniors to Negotiate Drug Prices Act (Klobuchar) - Part D price negotiations S. 1804, Medicare for All Act (Sanders) - single payer health system S. 1890, Chronic Kidney Disease Improvement in Research and Treatment and Medigap Access (Cardin) - Medigap coverage for beneficiaries with end-stage renal disease S. 1909, BENES Act (Casey) - notifications of Medicare eligibility S. 2027, Medicaid Third Party Liability Act (Portman) - Medicaid third party liability S. 2051, Medicare Care Coordination Improvement Act of 2017 (Portman) - barriers to payment reform models S. 2227, EMPOWER Care Act (Portman-Cantwell) - Medicaid Money Follows the Person Demonstration S. 2707, Informing Seniors About Opioids Act (Nelson) - opioid issues S. 2901, Expanding Telehealth Response to Ensure Addiction Treatment Act (Thune) - opioid issues S. 2904, Medicaid Substance Use Disorder Treatment Via Telehealth Act (Carper) - opioid issues S. 2908, Electronic Prior Authorization in Medicare Part D Act (Roberts) - opioid issues S. 3327, SENIOR Communities Protection Act (Cortez Masto) - preventing fraudulent opioid prescriptions S. 3496, Improving Seniors Access to Quality Benefits Act (Daines-King) - study on MA benchmark cap S. 3497, Medicare Advantage Quality Payment Relief Act (Daines-King) - MA benchmark cap S. 3702, Right Rebate Act (Wyden-Grassley) - Medicaid drug rebate program Draft Bill: Medicare Long-Term Care Services and Supports Act (Pallone) - Long-Term Services and Supports Program H.R. 6, SUPPORT Patients and Families Act (Walden) - opioid initiatives, Medicare and Medicaid issues, budget offsets H.R. 695, Continuing Appropriations Act (Schiff) - Money Follows the Person demonstration, spousal impoverishment protections H.R. 849, Protecting Seniors Access to Medicare Act (Roe) - Independent Payment Advisory Board H.R. 908, Medicare Advantage Quality Payment Relief Act (Kelly) - MA payment cap H.R. 1038, Improving Transparency and Accuracy in Medicare Part D Spending Act (Griffith) - PDP/MA-PD payments on clean claims from pharmacies H.R. 1148, FAST Act (Griffith) - access to telehealth-eligible stroke services under Medicare H.R. 1316, Prescription Drug Price Transparency Act (Collins) - PBM standards for MA and PDP plans H.R. 1995, V-BID for Better Care Act (Black) - value-based insurance design in Medicare Advantage H.R. 2556, CONNECT For Health Act (Black) - telehealth H.R. 2575, BENES Act (Ruiz) - notifications of Medicare eligibility H.R. 2644, Chronic Kidney Disease Improvement in Research and Treatment and Medigap Access (Marino) - Medigap coverage for beneficiaries with end-stage renal disease H.R. 2687, Medicaid CARE Act (Foster-Fitzpatrick) - changes to Medicaid IMD exclusion H.R. 3044, Supplemental Benefits for Chronically Ill Medicare Advantage Enrollees (Meehan) H.R. 3263, Medicare Independence at Home Model of Care (Burgess) - demonstration program H.R. 3325, ACE Kids Act (Barton) - health homes for children with complex medical conditions H.R. 3360, Telehealth Enhancement Act (Harper) - telehealth in Medicare H.R. 3635, Local Coverage Determination Clarification Act (Jenkins) - procedures for Medicare administrative contractors H.R. 3727, Increasing Telehealth Access in Medicare Act (Black) - telehealth in MA plans H.R. 4143, Dialysis PATIENTS Demonstration Act (Smith) - alternative care delivery models and payment methodologies for patients with end-stage renal disease H.R. 4952, Improving Seniors Access to Quality Benefits Act (Kelly) - MA benchmark cap study H.R. 5306, EMPOWER Care Act (Guthrie) - extension of Money Follows the Person demonstration H.R. 5603, Access to Telehealth Services for Substance Use Disorders Act (Matsui) - opioid issues H.R. 5605, Advancing High Quality Treatment for Opioid Use Disorders in Medicare Act (Ruiz) - opioid issues H.R. 5675, drug management programs for at-risk Medicare beneficiaries (Bilirakis) - opioid issues H.R. 5676, SENIOR Communities Protection Act (MacArthur) - preventing fraudulent opioid prescriptions H.R. 5684, Protecting Seniors from Opioid Abuse Act (Kelly) - opioid issues H.R. 5685, Medicare Opioid Safety Education Act (Faso) - opioid issues H.R. 5686, Medicare Clear Health Options in Care for Enrollees Act (Paulsen) - opioid issues H.R. 5715, Strengthening Partnerships to Prevent Opioid Abuse Act (Renacci) - communication between Medicare plan sponsors and CMS H.R. 5773, Preventing Addiction for Susceptible Seniors Act (Roskam) - opioid issues H.R. 5797, IMD CARE Act (Walters) - Medicaid IMD exclusion H.R. 5798, Opioid Screening and Chronic Pain Management Alternatives for Seniors Act (Bucshon) - opioid issues H.R. 5799, Medicaid Drug Review, Utilization, Good Governance Improvement Act (Blackburn) - opioid issues H.R. 5800, Medicaid IMD ADDITIONAL INFO Act (Upton) - opioid issues H.R. 5804, Post-Surgical Injections as an Opioid Alternative Act (Shimkus) - opioid issues H.R. 5808, Medicaid Pharmaceutical Home Act (Bilirakis) - opioid issues H.R. 5809, Postoperative Opioid Prevention Act (Peters) - opioid issues H.R. 5810, Medicaid Health Homes for Opioid-Use-Disorder Medicaid Enrollees Encouraged Act (Lance) - opioid issues H.R. 5812, Improving Medicaid Data Timeliness Act (Griffith) - opioid issues H.R. 6431, Medigap Consumer Protection Act (Levin) - reforms to Medicare supplemental insurance H.R. 6561, Comprehensive Care for Seniors Act (Walorski) -- Program of All-Inclusive Care for the Elderly H.R. 6563, Lower Out-of-Pocket Costs for Seniors Act (Pallone-Neal) - Medicare Part D cliff H.R. 6662, Empowering Seniors Decision Enrollment Act (Paulsen) - special enrollment period for non-deemed Medicare Cost Plan enrollees H.R. 6690, Fighting Fraud to Protect Care for Seniors Act (Roskam) - Medicare pilot program for smart card technology H.R. 7122, Shared Accountability for Improved Patient Outcomes Act (Paulsen) - value-based payment and delivery arrangements H.R. 7217, IMPROVE Act (Barton) - Money Follows the Person demonstration, ACE Kids Act, Medicare drug rebate program, spousal impoverishment protections H.R. 7223, Right Rebate Act (Schrader-Welch) - Medicaid drug rebate program H.R. 7247, Incentivizing Shared Risk in Medicare Advantage Act (Brady) - MA prior authorization H.R. 7249, Better Prior Authorization Notification Act (Reed) - MA prior authorization H.R. 7250, Prior Authorization Improvement Act (Kelly) - MA prior authorization Regulatory Issues: Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, network adequacy and provider directories, encounter data and other data-related issues, and audit issues; bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, Part D direct and indirect remuneration (DIR), and audits); calendar year 2020 policy and technical regulation for MA and Part D; MA and Part D proposed rule on drug pricing changes for 2020; CMSs price transparency proposal for direct-to-consumer advertisements; issues relating to 2019 Rate Notice and Call Letter; in-home health risk assessments; Medicare Medical Loss Ratio issues; implementation of sequestration under the Medicare Advantage and Part D programs; implications of the health insurer fee for MA and Part D plans; application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, enrollment rules, requirements for notice and denial forms, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible SNPs; Bipartisan Budget Act of 2018 changes to SNPs; Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, Part D coverage gap discount program, including employer group waiver plan (EGWP) issues, and other operational issues; issues raised by Part D coverage of new specialty drugs, the Part D non-interference policy and related issues (e.g., preferred pharmacy and any willing pharmacy requirements, standards for network pharmacy reimbursement, and policies regarding sponsor negotiation of pharmacy price concessions); CMS's proposed Part B drug demonstration program; Medication Therapy Management Program requirements and the Center for Medicare and Medicaid Innovation (CMMI) Demonstration; MA EGWP issues; CMMI's value-based insurance design (VBID) demonstration; Part D requirements for offering basic and enhanced alternative plans; MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; issues relating to MA and Part D Star Rating system including measures, the methodology for calculating ratings, and the role of the ratings for payment purposes; implementation of the Affordable Care Act (ACA) and the Bipartisan Budget Act of 2018 changes to the Part D coverage gap; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education Program; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; new payment system for physicians under MACRA, including implications for MA and Part D plans; Medicare clinical trials; Medicare/Medicaid integration for dual eligibles, including implementation of the Capitated Financial Alignment Demonstration and related issues (e.g., quality ratings); Medicaid managed care regulations and policies, including CMS's substantial revisions to the managed care regulations, mental health parity rules, the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, fraud and abuse compliance, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including block grants, the calculation of the federal medical assistance (federal matching) percentage (FMAP), and intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost issues affecting Medicaid health plans including issues raised by Medicaid coverage of new specialty drugs; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues and CHIP reauthorization; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including Medicaid managed care organization provider tax issues; standards for electronic prescribing; implementation of Medicaid changes of interest to Medicaid health plans made in the ACA including Medicaid expansion, the managed care organization (MCO) prescription drug rebate provisions, minimum payments to primary care providers (PCPs), interactions between the Medicaid program and health insurance exchanges, and Medicaid and CHIP maintenance of effort (MOE) requirements; implications of the health insurer fee for Medicaid health plans; issues related to Medicaid Managed long-term care including home and community-based waiver services (HCBS); expanding the availability of Medicare Advantage and Medicaid health plan telemedicine programs; implications of the new non-discrimination rules for health plans participating in public programs; issues related to Medigap coverage; issues related to business continuity in relation to pandemics or natural events (e.g., hurricane, tornado, etc.); cybersecurity; provider directories; value-based insurance design models; issues relating to prescription drug price blueprint; Part D prescriber enrollment requirements; Part D recovery audit contractor programs; issues relating to enrollment of beneficiaries with ESRD into MA plans; socioeconomic status impacts on star ratings related to MA and Part D programs; 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

implementation of health care reform generally pertaining to pediatric health care and autism services Medicaid program reforms, including hospital outpatient department regulations S.3770 (Medicaid Drug Decisions Transparency Act), all provisions Section 340B Drug Pricing Program, including H.R. 4710 (340B PAUSE Act), All provisions, and H.R. 5598 (340B Optimization Act), all provisions and H.R. 6240 (drug Discount accountability act), all provisions Sickle Cell Disease Research funding generally Drug pricing reforms generally Department of Justice implementation of grant program for missing individuals with autism and developmental disabilities Department of Homeland Security rulemaking regarding public charge rule and Medicaid program implications S. 3429 (Neonatal Abstinence Intervention Act), all provisions H.R. 2410 (Sickle Cell Disease research, Surveillance, prevention and treatment act of 2017), all provisions S. 2465 (Sickle cell disease and other heritable blood disorders research, surveillance, Prevention and treatment act of 2018), all provisions H.R. 3325 (ACE kids Act), all provisions S. 428 (Ace Kids Act of 2017), all provisions H.R. 1676 (Palliative Care and Hospice Education and Training Act), all provisions Organ Transplant policy generally, including transplant distribution methodology H.R. 7217 (Improving Medicaid Programs and Opportunities for Eligible Beneficiaries Act - IMPROVE act), Title I, regarding coordinated care

Client expense: $132,091 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Public Law 111-48, "Patient Protection and Affordable Care Act" and "Public Law 111-52, "Health Care and Education Reconciliation Act 2010"-monitored implementation of key Medicaid and health insurance market provisions. HR 246, Jobs and Premium Protection Act. S3063, Health Insurance Tax Relief Act of 2018. HR 4620, The Protecting Families and Small Businesses Act of 2017 (health insurer fee suspension). Issues related to the opioid epidemic pertinent to Medicaid and Medicare. HR 6, Support for Patients and Communities Act and related Opioid Bills. HR 3325/S 428, Advancing Care for Exceptional Kids Act. HR 5306/S 2227, Ensuring Medicaid Provides Opportunities for Widespread Equity, Resources and Care Act. ACA Marketplace and Medicaid Reform

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare and Medicaid payment quality programs and policies, including: healthcare associated complications, infections, readmission, payment bundling, potentially preventable events and outcomes, transparency and value based purchasing Medicare and Medicaid data, Medicaid Scorecards, health information exchanges (HIEs), interoperability, and patient-centered medical records policies Opioid epidemic related policies Implementation of the Patient Protection and Affordable Care Act (PL 111-148) Implementation of the Helping Hospitals Improve Patient Care Act 21st Century Cures Act (Public Law No: 114-255) Implementation of the Medicare Access CHIP Reauthorization Act (MACRA)(PL 114-10) Implementation of The Health Information Technology for Economic an Clinical Health Act (HITECH Act - part of the American Recovery and Reinvestment Act of 2009, PL 111-5) Regulations and legislation related to International Classification of Diseases, version 10 (ICD-10) S.428, ACE Kids Act H.R. 3325, ACE Kids Act H.R.3611, The Healthcare Outcomes Act H.R.3922 Championing Healthy Kids Act S.1827, Kids' Insurance Dependable and Secure (KIDS) S.497 Lymphedema Treatment Act H.R. 930 Lymphedema Treatment Act

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

H.R.184 Protect Medical Innovation Act of 2018 S.108 Medical Device Access and Innovation Protection Act Medicare and Medicaid payment quality programs and policies, including: healthcare associated complications, infections, readmission, payment bundling, potentially preventable events and outcomes, transparency, and value based purchasing Medicare and Medicaid data, Medicaid Scorecards, health information exchanges (HIEs), interoperability, and patient-centered medical records policies Opioid epidemic related policies Implementation of the Patient Protection and Affordable Care Act (PL 111-148) Implementation of the Helping Hospitals Improve Patient Care Act 21st Century Cures Act (Public Law No: 114-255) Implementation of the Medicare Access CHIP Reauthorization Act (MACRA)(PL 114-10) Implementation of The Health Information Technology for Economic and Clinical Health Act (HITECH Act - part of the American Recovery and Reinvestment Act of 2009, PL 111-5) Regulations and legislation related to International Classification of Diseases, version 10 (ICD-10) S.428, ACE Kids Act H.R. 3325, ACE Kids Act H.R.3611 The Healthcare Outcomes Act H.R.3922 Championing Healthy Kids Act S.1827 Kids' Insurance Dependable and Secure (KIDS) S.497 Lymphedema Treatment Act H.R. 930 Lymphedema Treatment Act

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

Medicare and Medicaid payment quality programs and policies, including: healthcare associated complications, infections, readmission, payment bundling, potentially preventable events and outcomes, transparency and value based purchasing Medicare and Medicaid data, Medicaid Scorecards, health information exchanges (HIEs), interoperability, and patient-centered medical records policies Opioid epidemic related policies Implementation of the Patient Protection and Affordable Care Act (PL 111-148) Implementation of the Helping Hospitals Improve Patient Care Act 21st Century Cures Act (Public Law No: 114-255) Implementation of the Medicare Access CHIP Reauthorization Act (MACRA)(PL 114-10) Implementation of The Health Information Technology for Economic and Clinical Health Act (HITECH Act - part of the American Recovery and Reinvestment Act of 2009, PL 111-5) Regulations and legislation related to International Classification of Diseases, version 10 (ICD-10) S.428, ACE Kids Act H.R. 3325, ACE Kids Act H.R.3611, the Healthcare Outcomes Act H.R.3922 Championing Healthy Kids Act S.1827, Kids' Insurance Dependable and Secure (KIDS)

Client expense: $160,000 · Firm income: Not reported

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

Medicare and Medicaid payment quality programs and policies, including: healthcare associated complications, infections, readmission, payment bundling, potentially preventable events and outcomes, transparency, and value based purchasing Medicare and Medicaid data, Medicaid Scorecards, health information exchanges (HIEs), interoperability, and patient-centered medical records policies Opioid epidemic related policies Implementation of the Patient Protection and Affordable Care Act (PL 111-148) Implementation of the Helping Hospitals Improve Patient Care Act 21st Century Cures Act (Public Law No: 114-255) Implementation of the Medicare Access CHIP Reauthorization Act (MACRA)(PL 114-10) Implementation of The Health Information Technology for Economic and Clinical Health Act (HITECH Act - part of the American Recovery and Reinvestment Act of 2009, PL 111-5) Regulations and legislation related to International Classification of Diseases, version 10 (ICD-10) S.428, ACE Kids Act H.R. 3325 ACE Kids Act H.R. 3922 Championing Healthy Kids Act H.R.3611, The Healthcare Outcomes Act S.1827, Kids' Insurance Dependable and Secure (KIDS)

Client expense: $160,000 · Firm income: Not reported

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

Medicaid program reforms, including possible regulations involving hospital outpatient departments Implementation of health care reform Section 340B Drug Pricing Program Healthcare disparities issues generally Drug pricing reforms generally H.R. 6524 and S. 2415 (Accelerating Kids' Access to Care Act), all provisions H.R. 3325 (ACE Kids Act), all provisions S. 428 (ACE Kids Act of 2017), all provisions Department of Homeland Security rulemaking regarding public charge rule and Medicaid program implications S. 3429 (Neonatal Abstinence Intervention Act), all provisions H.R. 7217 (Improving Medicaid Programs and Opportunities for Eligible Beneficiaries Act - IMPROVE Act), Title I, regarding coordinated care S. 3770 (Medicaid Drug Decisions Transparency Act), all provisions Poison Control Center funding programs generally Implementation of Public Law 115-91 (National Defense Authorization Act for Fiscal Year 2018), Section 708, regarding TRICARE policies for patient referrals regarding pregnant women Medical interpreters and patient language access issues generally

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare and Medicaid payment quality programs and policies, including: healthcare associated complications, infections, readmission, payment bundling, potentially preventable events and outcomes, and value based purchasing. Medicare and Medicaid data and patient-centered medical records policies. Implementation of PL 111-148 -- The Patient Protection and Affordable Care Act. Implementation of the Helping Hospitals Improve Patient Care Act. Implementation of PL 114-10 -- Medicare Access CHIP Reauthorization Act (MACRA). Regulations and legislation related to International Classification of Diseases, version 10 (ICD-10). S. 428 - ACE Kids Act. H.R. 3611 - The Healthcare Outcomes Act.

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

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

Medicare and Medicaid payment quality programs and policies, including: healthcare associated complications, infections, readmission, payment bundling, potentially preventable events and outcomes, and value based purchasing. Medicare and Medicaid data and patient-centered medical records policies. Implementation of PL 111-148 -- The Patient Protection and Affordable Care Act. Implementation of the Helping Hospitals Improve Patient Care Act. Implementation of PL 114-10 -- Medicare Access CHIP Reauthorization Act (MACRA). Regulations and legislation related to International Classification of Diseases, version 10 (ICD-10). S. 428 - ACE Kids Act. H.R. 3611 - The Healthcare Outcomes Act.

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

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

H.R. 7217 - IMPROVE Act; H.R. 3325/S. 428; Issues pertaining to Part D rebates; 2020 NBPP. H.R. 3325/S. 428 - "ACE Kids Act" - to amend title XIX of the Social Security Act to provide states with the option of providing coordinated care for children with complex medical conditions through a health home, regarding all provisions. S. 2554 - "Patients' Right to Know Drug Price Act of 2018", issues pertaining to drug pricing.

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

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

340B Program rules; HR1628; S428; S1016 / HR2556; S870; S445 / HR1825; S1361; S1628;HConRes 71; HR4710; HR4392;OPPS CY2019 Proposed Rule;

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicaid provider issues; Surprise billing issues, Senate price transparency working group draft legislation; S. 428/H.R. 3325, ACE Kids Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.428/H.R. 3325, the ACE Kids Act. H.R. 7217, the IMPROVE Act Issues related to OPPS reimbursement cuts to 340B hospitals. Issues related to reforms of the Stark Law and Anti-Kickback statute. Issues related to site-neutral payment reductions for hospital providers.

Client expense: $135,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

General support for the Medicaid program; Accelerating Kids' Access to Care Act (S. 2415), all provisions; The ACE Kids Act (H.R. 3325, S. 428), all provisions.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Implementation of health care reform generally pertaining to pediatric health care and autism services Medicaid program reforms, including hospital outpatient department regulations S. 3770 (Medicaid Drug Decisions Transparency Act), all provisions Section 340B Drug Pricing Program, including H.R. 4710 (340B PAUSE Act), all provisions, H.R. 5598 (340B Optimization Act), all provisions, and H.R. 6240 (Drug Discount Accountability Act), all provisions Sickle cell disease research funding generally Drug pricing reforms generally Department of Justice implementation of grant program for missing individuals with autism and developmental disabilities Department of Homeland Security rulemaking regarding public charge rule and Medicaid program implications S. 3429 (Neonatal Abstinence Intervention Act), all provisions H.R. 2410 (Sickle Cell Disease Research, Surveillance, Prevention, and Treatment Act of 2017), all provisions S. 2465 (Sickle Cell Disease and Other Heritable Blood Disorders Research, Surveillance, Prevention, and Treatment Act of 2018), all provisions H.R. 3325 (ACE Kids Act), all provisions S. 428 (ACE Kids Act of 2017), all provisions H.R. 1676 (Palliative Care and Hospice Education and Training Act), all provisions Organ transplant policy generally, including liver transplant distribution methodology H.R. 7217 (Improving Medicaid Programs and Opportunities for Eligible Beneficiaries Act - IMPROVE Act), Title I, regarding coordinated care

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicaid program reforms, including possible regulations involving hospital outpatient departments Implementation of health care reform Section 340B Drug Pricing program Healthcare disparities issues generally Drug pricing reforms generally H.R. 6524 and S. 2415 (Accelerating Kids' Access to Care Act), all provisions H.R. 3325 (ACE Kids Act), all provisions S. 428 (ACE Kids Act of 2017), all provisions Department of Homeland Security rulemaking regarding public charge rule and Medicaid program implications S. 3429 (Neonatal Abstinence Intervention Act), all provisions H.R. 7217 (Improving Medicaid Programs and Opportunities for Eligible Beneficiaries Act - IMPROVE Act), Title I, regarding coordinated care S. 3770 (Medicaid Drug Decisions Transparency Act), all provisions Poison Control Center funding programs generally Implementation of Public Law 115-91 (National Defense Authorization Act for Fiscal Year 2018), Section 708, regarding TRICARE policies for patient referrals involving pregnant women

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Health Insurer Tax (HIT); 42 CFR Part 2- Confidentiality of Substance Use Disorder Patient Records; H.R. 5795, Overdose Prevention and Patient Safety Act Medicaid IMD (Institutes for Mental Disease) Exclusion; Opioids, in general; H.R. 6, SUPPORT for Patients and Communities Act; H.R. 3325/S. 428, Advancing Care for Exceptional Kids Act (ACE Kids Act), included in H.R. 7217, Improving Medicaid Programs and Opportunities for Eligible Beneficiaries Act (IMPROVE Act); Medicaid Extenders Package

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicaid policy issues affecting children's hospitals. S. 428, the "Advancing Care for Exceptional Kids Act". H.R. 5385, the Childrens Hospital GME Support Reauthorization Act. S. 2897, the Childrens Hospital GME Support Reauthorization Act".

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

-S. 428, HR 3325 - ACE Kids Act of 2017: improving delivery of health services to medically complex children. -OPPS Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment -H.R. 4392 - Issues pertaining to 340B -H.R. 1892 - Health Provisions of the Bipartisan Budget Act of 2018, including CHIP reauthorization -H.R. 7217 - IMPROVE Act

Client expense: $211,558 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), SENATE

Health reform issues related to children's hospitals, including reimbursement for children's hospitals and providers; Medicaid reform and reimbursement issues; House and Senate legislation to fund CHGME program; Childrens Health Insurance Program funding and reauthorization; Advancing Care for Exceptional kids Act HR 3325 & S. 428.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3325/S. 428 - ACE Kids Act. H.R. 6524/S. 2415 - Accelerating Kids' Access to Care Act and Medicaid Pediatric Policies.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1173: Medicare Mental Health Access Act. Legislation to amend Medicares Physician Definition, to provide for treatment of clinical psychologists as physicians for purposes of furnishing clinical psychologist services under the Medicare Program S. 448: Medicare Mental Health Access Act. Legislation to amend Medicares Physician Definition, to provide for treatment of clinical psychologists as physicians for purposes of furnishing clinical psychologist services under the Medicare Program H.R. 2509: Medicare Mental Health Inpatient Equity Act of 2017. Legislation To amend title XVIII of the Social Security Act to eliminate the 190-day lifetime limit on inpatient psychiatric hospital services under the Medicare Program S.1169: Medicaid Coverage for Addiction Recovery Expansion Act. A bill to amend title XIX of the Social Security Act to provide States with an option to provide medical assistance to individuals between the ages of 22 and 64 for inpatient services to treat substance use disorders at certain facilities, and for other purposes H.R. 1953: Treat and Reduce Obesity Act of 2017. To amend title XVIII of the Social Security Act to provide for the coordination of programs to prevent and treat obesity, and for other purposes S. 3797, H.R. 6781: Mental Health Telemedicine Expansion Act S. 830: Treat and Reduce Obesity Act of 2017. To amend title XVIII of the Social Security Act to provide for the coordination of programs to prevent and treat obesity, and for other purposes 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 S. 1732: Improving Access to Behavioral Health Information Technology Act H.R. 2337: To amend title XIX of the Social Security Act to provide for a State Medicaid option to enhance administrative matching funds to support statewide behavioral health access program activities for children under 21 years of age, and for other purposes S. 1905, HR 3931: Excellence in Mental Health and Addiction Treatment Expansion Act. To increase the number of States that may conduct Medicaid demonstration programs to improve access to community mental health services S. 1169, H.R. 2687: Medicaid Coverage for Addiction Recovery Expansion Act. A bill to amend title XIX of the Social Security Act to provide States with an option to provide medical assistance to individuals between the ages of 22 and 64 for inpatient services to treat substance use disorders at certain facilities, and for other purposes S. 3383, H.R. 5477: Rural DOCS Act. To provide incentives for state Medicaid expenditures related to the expansion of substance-use treatment and recovery services targeting provider capacity S. 428, H.R. 3325: Advancing Care for Exceptional Kids Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE