BENES Act of 2019

Implementation issues regarding Patient Protection and Affordable Health Care Act - Public law 111-14 A Issues relating to notice under the BENES Act of 2019 (H.R. 2477/S. 1280) Issues relating to healthcare.gov under the Labor/HHS Appropriations Act Issues relating to broker commission disclosure under the Lower Healthcare Costs Act (S.1895) Issues related to efficient online enrollment into Medicare Advantage and Medicare Advantage Prescription Drug Plans. Issues relating to the requirement for insurance carriers to display provider directories on the internet and issues relating to the requirement for insurance brokers to disclose Commissions (HR 133 - Consolidated Appropriations Act 2021) Issues relating to a so-called public option health insurance policy Issues related to auto-enrollment Issues relating to lowering the age eligibility for Medicare.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), Office of the Vice President of the United States, SENATE, White House Office

S. 2574 Protects Act H.R. 3398 Pathways to Health Careers Act H.R.4468- Nursing Home Workforce Quality Act Outreach to Hill on GAO Report "Federal Requirements for Oversight in Nursing Homes and Assisted Living Facilities Differ" Outreach to CMS: PDPM Implementation The Improving Access to Medicare Coverage Act of 2019 (H.R. 1682/S. 753) Observation Stays Issue Outreach to HHS/CMS/Administration Skilled Nursing Facility Requirements of Participation, RIN 0938-AR61 Survey Relief/Civil Monetary Penalties Payroll Based Journal - Section 6106 of the Affordable Care Act Outreach to HHS/ACL on Implementation of the Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (Public Law No: 115-119). Allow Secretarial discretion of CNA Training termination pertaining to Sec. 1819 (f)(2)(B)(iii)(l)(c). S. 2993- Ensuring Seniors Access to Quality Care Act S 2943/HR 5216 Quality Care for Nursing Home Residents Act of 2019 HR 5326 Fairness in Nursing Home Arbitration Act H.R.5897/S.3297 - Preventing Abuse and Neglect of Vulnerable Americans Act of 2020 Public Law 116-136, CARES Act Public Law 116-127 (H.R. 6201) Families First Coronavirus Response Act HR 6800 HEROES Act S. 3768/H.R. 6972 Nursing Home COVID-19 Protection and Prevention Act of 2020. S. 4108 A bill to amend title XIX of the Social Security Act to increase Federal support to State Medicaid programs during economic downturns, and for other purposes. S.3644 Quality Care for Nursing Home Residents and Workers During COVID-19 Act of 2020. H.R. 7048 Nursing Home Pandemic Protection Act H.R.6872 - SOS Act of 2020 H.R. 6849 Nursing Facility Quality Reporting Act of 2020 H.R. 6847 COHORT Act of 2020 Public Health Fund Distribution to HHS as agency CMS on Public Health Waiver and other waivers RUSH Act H.R. 6209/S.3447 H.R. 8574 amend titles XVIII and XIX of the Social Security Act to increase enforcement under Medicare and Medicaid for skilled nursing facilities and nursing facilities during the COVID-19 emergency period and other infectious disease outbreak periods, and for other purposes. S. 4666 National Coronavirus Commission Act of 2020 AHCA response to Ways and Means Committee report Under-Enforced and Over Prescribed: The Antipsychotic Drug Epidemic Ravings Americas Nursing Homes. BENES Act (S 1280/HR 2477) H.R.8874 - Nurses CARE Act of 2020

Client expense: $1,260,000 · 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), Housing & Urban Development, Dept of (HUD), SENATE, Treasury, Dept of, Veterans Affairs, Dept of (VA)

Implementation issues regarding Patient Protection and Affordable Health Care Act - Public law 111-14 A Issues relating to notice under the BENES Act of 2019 (H.R. 2477/S. 1280) Issues relating to healthcare.gov under the Labor/HHS Appropriations Act Issues relating to broker commission disclosure under the Lower Healthcare Costs Act (S.1895) Issues related to efficient online enrollment into Medicare Advantage and Medicare Advantage Prescription Drug Plans. Issues relating to the requirement for insurance carriers to display provider directories on the internet. (HR 133 - Consolidated Appropriations Act, 2021)

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), Office of the Vice President of the United States, SENATE, White House Office

Medicare Sequestration COVID-19 Response Medicare Advantage Policy and Reimbursement 2021 Medicare Advantage Advance Rate Notice S. 1280/H.R. 2477, BENES Act CMS-4180-P - Modernizing Part D and Medicare Advantage to Lower Drug Prices and Reduce Medicaid and Dual Eligible Issues CMS 4190-P, 2021 and 2022 Policy and Technical Changes for Medicare Advantage, Part D, Medicaid, and PACE Proposed Rule Medicare Part D Issues CMS 4185-P Policy and Technical Changes in Medicare Advantage Program for 2020/2021 Medicaid and Dual Eligible Issues Pharmacy Reimbursement Issues Medicare Home Health Issues H.R. 6800, Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act Health, Economic Assistance, Liability Protection and Schools (HEALS) Act Delivering Immediate Relief to America's Families, Schools and Small Business Act (Senate Amendment No. 2652 to the House Amendment S. 178) Rebate Rule H.R. 133, Consolidated Appropriations Act, 2021 S. 4840/H.R. 7659, Ensuring Parity in MA for Audio Only Telehealth Act of 2020

Client expense: $1,070,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, Treasury, Dept of, White House Office

H.R. 3215/ S. 1754 - Disaster Relief Medicaid Act, support passage H.R. 7647, To provide for a COVID-19-related delay regarding annual limitation on cost-sharing for group health plans and individual and small group health insurance coverage, support passage H.R. 2293, the Protecting Access to Wheelchairs Act, support passage H.R. 3107, Improving Seniors Timely Access to Care Act of 2019, support passage S. 1223, the Protecting Beneficiary Access to Complex Rehab Technology Act, support passage S. 1280/HR 2477 - Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act, support passage S. 691 - Medicare Extra Rx Help Act- support passage S. 2543 - Prescription Drug Price Reduction Act of 2019 - support passage oMenendez - Lankford- Cardin-Daines Amendment 1 Incentivizing Generic and Biosimilar Use in Medicare Part D - support adoption oMenendez -Lankford - Cardin --Daines Amendment 2 Incentivizing Generic Use in Medicare Part D, support adoption S.2911, the Seniors Prescription Drug Relief Act of 2019, support passage. S.4468, COVID-19 Treatment Coverage Act, support passage

Client expense: $48,803 · Firm income: Not reported

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

H.R. 884, the Medicare Mental Health Access Act H.R. 2293, the Protecting Access to Wheelchairs Act H.R. 2408, the Ensuring Access to Quality Complex Rehabilitation Technology Act of 2019 H.R. 3429, the HEARTS and Rural Relief Act (Section 4) H.R. 4386/S. 2496, the Stop the Wait Act H.R. 4945, the Safeguarding Medicare Access to Respiratory Therapy (SMART) Act H.R. 5262, the Medicare Orthotic and Prosthetics Patient Centered Care Act H.R. 5429/S. 3010, the SENIOR CARE Act S. 1223, the Protecting Beneficiary Access to Complex Rehabilitation Technology Act of 2019 S. 1280/H.R. 2477, the BENES Act of 2019 S. 3277, the HCBS Infrastructure Improvement Act S. 3544, the Coronavirus Relief for Seniors and People with Disabilities Act of 2020 Medicaid block grants Potential expansion of Medicare Discussions on interaction between Medicare Part B and Tricare for medically retired veterans

Client expense: $74,880 · Firm income: Not reported

Government targets: AMTRAK - Natl Railroad Passenger Corporation, Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Federal Emergency Management Agency (FEMA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Institutes of Health (NIH), SENATE, Social Security Administration (SSA), Transportation Security Administration (TSA), Transportation, Dept of (DOT), U.S. Architectural & Transportation Barriers Compliance Board (ACCESS), Veterans Affairs, Dept of (VA), Veterans Employment & Training Service

H.R. 133, Consolidated Appropriations Act, 2021. H.R. 6201, Families First Coronavirus Response Act. S. 2543, the Prescription Drug Pricing Reduction Act. H.R. 3, the Elijah E. Cummings Lower Drug Costs Now Act. S. 3548/H.R. 748, CARES Act. No bill number. Discussed vaccine development, coverage, approval, distribution and prioritization. No bill number. Discussed Medicaid FMAP increases. No bill number. Discussed the Money Follows the Person Rebalancing Demonstration supplemental funds. No bill number. Comment letter on Medicare and Medicaid Programs, Clinical Laboratory Improvement Amendments (CLIA), and Patient Protection and Affordable Care Act; Additional Policy and Regulatory Revisions in Response to the COVID- 19 Public Health Emergency. No bill number. Comment letter on CMS COVID-19 interim final rule. No bill number. Discussed nursing home testing, CMS guidance on visitation and voting for nursing homes and their residents, and visitation. No bill number. Discussed requirements for family notification of nursing home residents related to COVID-19. No bill number. Comment letter to the Center for Medicare & Medicaid Services (CMS) on a request for information pertaining to Recommended Measure Set for Medicaid-Funded Home and Community-Based Services (HCBS). H.R. 925/H.R. 6800, Heroes Act. S. 3768/H.R. 6972, Nursing Home COVID-19 Protection and Prevention Act. S. 4182, Emergency Support for Nursing Homes and Elder Justice Reform Act of 2020. S. 4866, Nursing Home Reform Modernization Act. H.R. 6487/S. 3517, Advancing Connectivity during the Coronavirus to Ensure Support for Seniors Act (ACCESS Act). No bill number. Comment letter to CMS on the state of New Yorks Section 1115 Medicaid Redesign Team Waiver amendment on managed long-term care plan eligibility and voluntary mainstream enrollment for certain dual eligibles. S. 4182, Emergency Support for Nursing Homes and Elder Justice Reform Act of 2020. No bill number. Discussed COVID-19 vaccines and vaccinations in nursing homes and other long-term care settings. H.R. 2730/S. 1443, Credit for Caring Act. Shared upcoming health care priorities with House staff. H.R. 5821, HOSPICE Act and H.R. 2477 BENES Act. Discussed bills, changes to hospice bill, and advancing of bills in the House with House staff. H.R. 8874, Nurses CARE Act No bill number. Discussed Medicaid home and community-based services bill. No bill number. Discussed the federal Pharmacy Partnership for Long-Term Care Program, COVID-19 vaccines, and the 50 percent rule. H.R. 2477/S. 1280 - BENES Act. No bill number. Discussed Medicare financial situation and solvency. No bill number. Discussed medically necessary dental coverage in Medicare. No bill number. Discussed Medicare direct contracting payment model. No bill number. Letter to Food and Drug Administration calling for release of over-the-counter hearing aid regulations.

Client expense: $2,400,000 · Firm income: Not reported

Government targets: Administration for Children & Families (ACF), Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Consumer Financial Protection Bureau (CFPB), Corporation for Natl & Community Service, Defense, Dept of (DOD), Federal Communications Commission (FCC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Indian Health Service, Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Natl Transportation Safety Board (NTSB), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Office of the Comptroller of the Currency (OCC), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Social Security Administration (SSA), Transportation, Dept of (DOT), Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

CMS-9115-P Interoperability and Patient Access Proposed Rule HHS ONC RIN-0955-AA01 -- 21st Century Cures Interoperability and Information Blocking Proposed Rule Senate HELP - Lower Health Care Costs Act H.R. 3630, No Surprises Act H.R. 987, Strengthening Health Care and Lowering Prescription Drug Costs Act S. 1280/H.R. 2477, BENES Act H.R. 3, Lower Drug Costs Now Act of 2019 S. 2543, Prescription Drug Pricing Reduction Act of 2019 H.R. 6074, Coronavirus Preparedness and Response Supplemental Appropriations Act of 2020 H.R. 6201, Families First Coronavirus Response Act of 2020 H.R. 748/S. 3548, Coronavirus Aid, Recovery, and Economic Security (CARES) Act of 2020 H.R. 6800 - Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act Health, Economic Assistance, Liability Protection and Schools (HEALS) Act Delivering Immediate Relief to America's Families, Schools and Small Business Act (Senate Amendment No. 2652 to the House Amendment S. 178)

Client expense: $780,000 · Firm income: Not reported

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

S. 2574 Protects Act H.R. 3398 Pathways to Health Careers Act H.R.4468- Nursing Home Workforce Quality Act Outreach to Hill on GAO Report "Federal Requirements for Oversight in Nursing Homes and Assisted Living Facilities Differ" Outreach to CMS: PDPM Implementation The Improving Access to Medicare Coverage Act of 2019 (H.R. 1682/S. 753) Observation Stays Issue Outreach to HHS/CMS/Administration Skilled Nursing Facility Requirements of Participation, RIN 0938-AR61 Survey Relief/Civil Monetary Penalties Payroll Based Journal - Section 6106 of the Affordable Care Act Outreach to HHS/ACL on Implementation of the Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (Public Law No: 115-119). Allow Secretarial discretion of CNA Training termination pertaining to Sec. 1819 (f)(2)(B)(iii)(l)(c). S. 2993- Ensuring Seniors Access to Quality Care Act S 2943/HR 5216 Quality Care for Nursing Home Residents Act of 2019 HR 5326 Fairness in Nursing Home Arbitration Act H.R.5897/S.3297 - Preventing Abuse and Neglect of Vulnerable Americans Act of 2020 Public Law 116-136, CARES Act Public Law 116-127 (H.R. 6201) Families First Coronavirus Response Act HR 6800 HEROES Act S. 3768/H.R. 6972 Nursing Home COVID-19 Protection and Prevention Act of 2020. S. 4108 A bill to amend title XIX of the Social Security Act to increase Federal support to State Medicaid programs during economic downturns, and for other purposes. S.3644 Quality Care for Nursing Home Residents and Workers During COVID-19 Act of 2020. H.R. 7048 Nursing Home Pandemic Protection Act H.R.6872 - SOS Act of 2020 H.R. 6849 Nursing Facility Quality Reporting Act of 2020 H.R. 6847 COHORT Act of 2020 Public Health Fund Distribution to HHS as agency CMS on Public Health Waiver and other waivers RUSH Act H.R. 6209/S.3447 H.R. 8574 amend titles XVIII and XIX of the Social Security Act to increase enforcement under Medicare and Medicaid for skilled nursing facilities and nursing facilities during the COVID-19 emergency period and other infectious disease outbreak periods, and for other purposes. S. 4666 National Coronavirus Commission Act of 2020 AHCA response to Ways and Means Committee report Under-Enforced and Over Prescribed: The Antipsychotic Drug Epidemic Ravings Americas Nursing Homes. BENES Act (S 1280/HR 2477)

Client expense: $910,000 · 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), Housing & Urban Development, Dept of (HUD), SENATE, Treasury, Dept of, Veterans Affairs, Dept of (VA)

Implementation issues regarding Patient Protection and Affordable Health Care Act - Public law 111-14 A Issues relating to notice under the BENES Act of 2019 (H.R. 2477/S. 1280) Issues relating to healthcare.gov under the Labor/HHS Appropriations Act Issues relating to broker commission disclosure under the Lower Healthcare Costs Act (S.1895) Issues related to efficient online enrollment into Medicare Advantage and Medicare Advantage Prescription Drug Plans.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), Office of the Vice President of the United States, SENATE, White House Office

H.R. 3215/ S. 1754 - Disaster Relief Medicaid Act, support passage H.R. 7647 H.R. 2293, the Protecting Access to Wheelchairs Act, support passage H.R. 3107, Improving Seniors Timely Access to Care Act of 2019, support passage S. 1223, the Protecting Beneficiary Access to Complex Rehab Technology Act, support passage S. 1280/HR 2477 - Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act, support passage S. 691 - Medicare Extra Rx Help Act- support passage S. 2543 - Prescription Drug Price Reduction Act of 2019 - support passage oMenendez - Lankford- Cardin-Daines Amendment 1 Incentivizing Generic and Biosimilar Use in Medicare Part D - support adoption oMenendez -Lankford - Cardin --Daines Amendment 2 Incentivizing Generic Use in Medicare Part D, support adoption S.2911, the Seniors Prescription Drug Relief Act of 2019, support passage. S.4468, COVID-19 Treatment Coverage Act, support passage

Client expense: $57,579 · Firm income: Not reported

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

COVID-19 Relief. H.R. 6800, the Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act: Proposals to increase the federal medical assistance percentage (FMAP), increase FMAP funding specifically for home and community based services; improve nursing home oversight, provide funding for COVID testing; ensure televisitation for nursing home residents, and eliminate cost sharing for COVID treatment. COVID Relief. H.R. 6514, the Worker Health Coverage Protection Act: Proposal to subsidize the Consolidated Omnibus Budget Reconciliation Act (COBRA) coverage premiums for individuals who lose employer coverage due to COVID-19. Drug Pricing. H.R. 7296, the Make Medications Affordable by Preventing Pandemic Price Gouging Act of 2020: Proposal to require that drugs developed with government funding have open and not exclusive license in order to promote more competition to bring drug prices down. Drug Pricing. H.R. 7288, the Taxpayer Research and Coronavirus Knowledge Act: Proposal to establish a database of all taxpayer investments in COVID-19 drugs. Long-Term Services and Supports During the COVID-19 Pandemic. H.R. 6698, the Quality of Care for Nursing Home Residents During COVID-19 Act of 2020: Proposals to require facilities to have a full-time infection interventionist on staff; regularly test residents and staff; provide enough personal protective equipment (PPE) for all employees and report PPE shortages at least 24 hours before shortage is expected to occur; offer at least two weeks of paid sick leave to each employee; and facilitate virtual visits for residents who cannot receive visitors to look in on them during lockdown. Long-Term Services and Supports Telehealth. H.R. 6487, the Advancing Connectivity during the Coronavirus to Ensure Support for Seniors (ACCESS) Act: Proposals to provide an emergency supplemental appropriation of $50 million to the Department of Health and Human Services to assist nursing homes expand their use of telehealth services and to establish a grant program to allow nursing home residents to participate in virtual visits. Medicare Enrollment. S. 1280 and H.R. 2477, the Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act: Proposals which would improve Medicare beneficiary notification of enrollment rules, align enrollment periods, and eliminate coverage gaps for those who miss their initial enrollment period and sign up during the general enrollment period. Medicare Savings Program and Medicaid Long-Term Services and Supports: S. 3544 and H.R. 6305, the Coronavirus Relief for Seniors and People with Disabilities Act: Proposals to increase funding for Medicaid home and community-based services including improving rates for homecare workers and funding sick leave; and to streamline processes so that more low-income beneficiaries would get assistance with their Medicare premiums and cost sharing through the Medicare Savings Program. Medicaid. (No bill): Proposal by the State of Oklahoma to obtain a waiver from the Centers for Medicare and Medicaid Services to turn their state Medicaid program into a block grant program. Medicaid. S. 4108, the Coronavirus Medicaid Response Act: Proposal to make FMAP increases automatic when there is an economic downturn. Drug Costs. H.R. 6649, the Lower Drug Costs for Seniors During COVID-19: Proposal to allow individuals to spread out the upfront costs for a 90-day refill during the COVID-19 emergency period.

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

Government targets: Administration on Aging, Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Social Security Administration (SSA), Treasury, Dept of

- H.R. 985, Fair Access for Safe and Timely Generics Act of 2017 (FAST Generics Act), support passage. -H.R. 2035/S. 995, Lifespan Respite Care Reauthorization Act, support reauthorization - H.R. 3208/ S.1755 - Real Emergency Access for Aging and Disability Inclusion for Disasters Act, support passage - H.R. 3215/ S. 1754 - Disaster Relief Medicaid Act, support passage - S.2400/ H.R. 4322 - Expanding Cannabis Research and Information Act, support passage - H.R. 3439 - Reauthorization of the Patient Centered Outcomes Research Institute, support reauthorization. -H.R. 2781 - Empower for Health Act of 2019, support passage -H.R. 2296/S.1391 - FAIR Drug Pricing Act of 2019, support passage - H.R. 3630 - No Surprises Act, support passage -H.R. 1010, To provide that the rule entitled Short-Term, Limited Duration Insurance shall have no force or effect, support passage. -H.R. 986, The Protecting Americans with Preexisting Conditions Act of 2019, support passage. -H.R.1386, Expand Navigators Resources for Outreach, Learning, and Longevity (ENROLL) Act of 2019, support passage. -H.R. 2293, the Protecting Access to Wheelchairs Act, support passage. -H.R. 2408, the Ensuring Access to Quality Complex Rehabilitation technology Act, support passage. -H.R 3 - Lower Drug Costs Now Act of 2019, support passage -H.R. 19 - Lower Costs, More Cures Act of 2019, support passage - H.R. 2387, the Stop The Overuse of Petitions and Get Affordable Medicines to Enter Soon (STOP GAMES) Act of 2019, support passage - H.R. 3107, Improving Seniors Timely Access to Care Act of 2019, support passage - H.R. 6417, Protecting Cures Act of 2020, support passage - H.R. 5800, Ban Surprise Billing Act, support passage H.R. 1595, Secure and Fair Enforcement Banking Act (SAFE Banking Act), support passage -S. 1935, Family Coverage Act, support passage. -S.1556, No Junk Plans Act, support passage. -S. 1223, the Protecting Beneficiary Access to Complex Rehab Technology Act, support passage - S.475, Reducing Existing Costs Associated with Pharmaceuticals for Seniors Act of 2019 (RX Cap Act), support passage - S. 637, Combatting Unreasonable Rises and Excessively High Drug Prices Act (CURE High Drug Prices Act), support passage - S.366, Forcing Limits on Abusive and Tumultuous Prices (FLAT Prices) Act, support passage -S. 63, Preserve Access to Affordable Generics and Biosimilars Act, support passage -S. 659, Biologic Patent Transparency Act, support passage -S.1895 - Lower Health Care Costs Act, support passage - S. 1280/HR 2477 - Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act, support passage - S. 691 - Medicare Extra Rx Help Act- support passage - S. 2543 - Prescription Drug Price Reduction Act of 2019 - support passage - Menendez - Lankford- Cardin-Daines Amendment 1 Incentivizing Generic and Biosimilar Use in Medicare Part D - support adoption Menendez -Lankford - Cardin --Daines Amendment 2 Incentivizing Generic Use in Medicare Part D - support adoption S, 1801, Low Cost Generics Act of 2019, support passage S.2911, the Seniors Prescription Drug Relief Act of 2019, support passage. - H.R. 1425 Patient Protection and Affordable Care Enhancement Act, support - H.R. 6514, Worker Health Coverage Protection Act, Support - H.R. 3832, S. 1257, Legacy IRA Act, Support - H.R. 6408 - Save the Organizations that Serve America Act - S.3544/H.R.6305 - Coronavirus Relief for Seniors and People with Disabilities Act of 2020, support -RESTART Act (S. 3814), Oppose - Paycheck Protection Program Flexibility Act of 2020(S. 3833/H.R. 7010/H.R.6886) Support -Help Charities Protect Communities Act (Rep. Beatty), bill number to be determined. Support - S.Amdt. 1566 to the CARES Act,Charitable Giving Amendment.Increases the $300 limit on the charitable giving deduction to one-third of the standard deduction ($4,000 for an individual filer/$8,000 for married joint filers) for the remainder of 2020. Support.

Client expense: $85,876 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

CMS-9115-P Interoperability and Patient Access Proposed Rule HHS ONC RIN-0955-AA01 -- 21st Century Cures Interoperability and Information Blocking Proposed Rule Senate HELP - Lower Health Care Costs Act H.R. 3630, No Surprises Act H.R. 987, Strengthening Health Care and Lowering Prescription Drug Costs Act S. 1280/H.R. 2477, BENES Act H.R. 3, Lower Drug Costs Now Act of 2019 S. 2543, Prescription Drug Pricing Reduction Act of 2019 H.R. 6074, Coronavirus Preparedness and Response Supplemental Appropriations Act of 2020 H.R. 6201, Families First Coronavirus Response Act of 2020 H.R. 748/S. 3548, Coronavirus Aid, Recovery, and Economic Security (CARES) Act of 2020 H.R. 6800, Heroes Act

Client expense: $1,340,000 · Firm income: Not reported

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

Implementation issues regarding Patient Protection and Affordable Health Care Act - Public law 111-14 A Issues relating to notice under the BENES Act of 2019 (H.R. 2477/S. 1280) Issues relating to healthcare.gov under the Labor/HHS Appropriations Act Issues relating to broker commission disclosure under the Lower Healthcare Costs Act (S.1895) Issues related to efficient online enrollment into Medicare Advantage and Medicare Advantage Prescription Drug Plans.

Client expense: $600,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), Office of the Vice President of the United States, SENATE, White House Office

CMS-9115-P Interoperability and Patient Access Proposed Rule HHS ONC RIN-0955-AA01 -- 21st Century Cures Interoperability and Information Blocking Proposed Rule Senate HELP - Lower Health Care Costs Act S. 340/H.R. 965 CREATES Act H.R. 3630, No Surprises Act H.R. 2296, Fair Accountability and Innovative Research Act H.R. 2113, Prescription Drug Sunshine, Transparency, Accountability, and Reporting Act H.R. 987, Strengthening Health Care and Lowering Prescription Drug Costs Act S. 1280/H.R. 2477, BENES Act H.R. 3, Lower Drug Costs Now Act of 2019 S. 2543, Prescription Drug Pricing Reduction Act of 2019 H.R. 6074, Coronavirus Preparedness and Response Supplemental Appropriations Act of 2020 H.R. 6201, Families First Coronavirus Response Act of 2020 H.R. 748/S. 3548, Coronavirus Aid, Recovery, and Economic Security (CARES) Act of 2020

Client expense: $450,000 · Firm income: Not reported

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

Implementation issues regarding Patient Protection and Affordable Health Care Act - Public law 111-14 A Issues relating to notice under the BENES Act of 2019 (H.R. 2477/S. 1280) Issues relating to healthcare.gov under the Labor/HHS Appropriations Act Issues relating to broker commission disclosure under the Lower Healthcare Costs Act (S.1895) Issues related to efficient online enrollment into Medicare Advantage and Medicare Advantage Prescription Drug Plans.

Client expense: $570,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), Office of the Vice President of the United States, SENATE, White House Office

- H.R. 985, Fair Access for Safe and Timely Generics Act of 2017 (FAST Generics Act), support passage. -H.R. 2035/S. 995, Lifespan Respite Care Reauthorization Act, support reauthorization - H.R. 3208/ S.1755 - Real Emergency Access for Aging and Disability Inclusion for Disasters Act, support passage - H.R. 3215/ S. 1754 - Disaster Relief Medicaid Act, support passage - S.2400/ H.R. 4322 - Expanding Cannabis Research and Information Act, support passage - H.R. 3439 - Reauthorization of the Patient Centered Outcomes Research Institute, support reauthorization. -H.R. 2781 - Empower for Health Act of 2019, support passage -H.R. 2296/S.1391 - FAIR Drug Pricing Act of 2019, support passage - H.R. 3630 - No Surprises Act, support passage -H.R. 1010, To provide that the rule entitled Short-Term, Limited Duration Insurance shall have no force or effect, support passage. -H.R. 986, The Protecting Americans with Preexisting Conditions Act of 2019, support passage. -H.R.1386, Expand Navigators Resources for Outreach, Learning, and Longevity (ENROLL) Act of 2019, support passage. -H.R. 2293, the Protecting Access to Wheelchairs Act, support passage. -H.R. 2408, the Ensuring Access to Quality Complex Rehabilitation technology Act, support passage. -H.R 3 - Lower Drug Costs Now Act of 2019, support passage -H.R. 19 - Lower Costs, More Cures Act of 2019, support passage - H.R. 2387, the Stop The Overuse of Petitions and Get Affordable Medicines to Enter Soon (STOP GAMES) Act of 2019, support passage - H.R. 3107, Improving Seniors Timely Access to Care Act of 2019, support passage - H.R. 6417, Protecting Cures Act of 2020, support passage - H.R. 5800, Ban Surprise Billing Act, support passage H.R. 1595, Secure and Fair Enforcement Banking Act (SAFE Banking Act), support passage -S. 1935, Family Coverage Act, support passage. -S.1556, No Junk Plans Act, support passage. -S. 1223, the Protecting Beneficiary Access to Complex Rehab Technology Act, support passage - S.475, Reducing Existing Costs Associated with Pharmaceuticals for Seniors Act of 2019 (RX Cap Act), support passage - S. 637, Combatting Unreasonable Rises and Excessively High Drug Prices Act (CURE High Drug Prices Act), support passage - S.366, Forcing Limits on Abusive and Tumultuous Prices (FLAT Prices) Act, support passage -S. 63, Preserve Access to Affordable Generics and Biosimilars Act, support passage -S. 659, Biologic Patent Transparency Act, support passage -S.1895 - Lower Health Care Costs Act, support passage - S. 1280/HR 2477 - Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act, support passage - S. 691 - Medicare Extra Rx Help Act- support passage - S. 2543 - Prescription Drug Price Reduction Act of 2019 - support passage - Menendez - Lankford- Cardin-Daines Amendment 1 Incentivizing Generic and Biosimilar Use in Medicare Part D - support adoption Menendez -Lankford - Cardin --Daines Amendment 2 Incentivizing Generic Use in Medicare Part D - support adoption S, 1801, Low Cost Generics Act of 2019, support passage S.2911, the Seniors Prescription Drug Relief Act of 2019, support passage.

Client expense: $132,919 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

- H.R. 965/ S. 340, Creating and Restoring Equal Access To Equivalent Samples Act of 2017 (CREATES Act), support passage. - H.R. 985, Fair Access for Safe and Timely Generics Act of 2017 (FAST Generics Act), support passage. -H.R. 2035/S. 995, Lifespan Respite Care Reauthorization Act, support reauthorization - H.R. 3208/ S.1755 - Real Emergency Access for Aging and Disability Inclusion for Disasters Act, support passage - H.R. 3215/ S. 1754 - Disaster Relief Medicaid Act, support passage - S.2400/ H.R. 4322 - Expanding Cannabis Research and Information Act, support passage - H.R. 3439 - Reauthorization of the Patient Centered Outcomes Research Institute, support reauthorization. -H.R. 2781 - Empower for Health Act of 2019, support passage -H.R. 2035, Lifespan Respite Care Reauthorization Act of 2019, support passage -H.R. 2296/S.1391 - FAIR Drug Pricing Act of 2019, support passage - H.R. 3630 - No Surprises Act, support passage -H.R. 1010, To provide that the rule entitled Short-Term, Limited Duration Insurance shall have no force or effect, support passage. -H.R. 986, The Protecting Americans with Preexisting Conditions Act of 2019, support passage. -H.R.1386, Expand Navigators Resources for Outreach, Learning, and Longevity (ENROLL) Act of 2019, support passage. -H.R. 2293, the Protecting Access to Wheelchairs Act, support passage. -H.R. 2408, the Ensuring Access to Quality Complex Rehabilitation technology Act, support passage. -H.R 3 - Lower Drug Costs Now Act of 2019, support passage - H.R. 2387, the Stop The Overuse of Petitions and Get Affordable Medicines to Enter Soon (STOP GAMES) Act of 2019, support passage - H.R. 3107, Improving Seniors Timely Access to Care Act of 2019, support passage -S. 1935, Family Coverage Act, support passage. -S.1556, No Junk Plans Act, support passage. -S. 1223, the Protecting Beneficiary Access to Complex Rehab Technology Act, support passage - S.475, Reducing Existing Costs Associated with Pharmaceuticals for Seniors Act of 2019 (RX Cap Act), support passage - S. 637, Combatting Unreasonable Rises and Excessively High Drug Prices Act (CURE High Drug Prices Act), support passage - S.366, Forcing Limits on Abusive and Tumultuous Prices (FLAT Prices) Act, support passage -S. 63, Preserve Access to Affordable Generics and Biosimilars Act, support passage -S. 659, Biologic Patent Transparency Act, support passage -S.1895 - Lower Health Care Costs Act, support passage - S. 1280/HR 2477 - Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act, support passage - S. 691 - Medicare Extra Rx Help Act- support passage - S. 2543 - Prescription Drug Price Reduction Act of 2019 - support passage - Menendez - Lankford- Cardin-Daines Amendment 1 Incentivizing Generic and Biosimilar Use in Medicare Part D - support adoption -Menendez -Lankford - Cardin --Daines Amendment 2 Incentivizing Generic Use in Medicare Part D - support adoption -S, 1801, Low Cost Generics Act of 2019, support passage -S.2911, the Seniors Prescription Drug Relief Act of 2019, support passage.

Client expense: $83,990 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Implementation of and improving the Achieving a Better Life Experience Act, P.L. 113-295, provisions added in P.L. 115-97. Implementation of the Affordable Care Act, P.L. 111-148 and P.L. 111-192. HCBS Setting Rules ABLE Age Adjustment Act, S.651 and H.R. 1814 Medicare Prescription drug benefit (HR3) Medicare benefits improvements including complex rehabilitation technology, respitory therapy, seat elevation and improve appeals and notice provisions (S.1280, H.R. 2477)

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

Government targets: Bureau of Citizenship & Immigration Services (BCIS), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), SENATE, Transportation, Dept of (DOT)

H.R. 1398/S. 172 - Health Insurance Tax Relief Act CMS-9115-P Interoperability and Patient Access Proposed Rule HHS ONC RIN-0955-AA01 -- 21st Century Cures Interoperability and Information Blocking Proposed Rule Senate HELP - Lower Health Care Costs Act S. 340/H.R. 965 CREATES Act H.R. 3630, No Surprises Act H.R. 2296, Fair Accountability and Innovative Research Act H.R. 2113, Prescription Drug Sunshine, Transparency, Accountability, and Reporting Act H.R. 987, Strengthening Health Care and Lowering Prescription Drug Costs Act S. 1280/H.R. 2477, BENES Act H.R. 3, Lower Drug Costs Now Act of 2019 S. 2543, Prescription Drug Pricing Reduction Act of 2019 H.R. 1865, Consolidated Appropriations Act, 2020

Client expense: $2,860,000 · Firm income: Not reported

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

Balanced Billing issues. Prescription drug pricing H.R. 1398/S. 172 - Health Insurance Tax Relief Act S. 3063 - Health Insurance Tax Relief Act of 2018 H.R. 2447 - Jobs and Premium Protection Act CMS-9115-P/HHS ONC RIN-0955-AA01 - 21st Century Cures Interoperability and Information Blocking Proposed Rules Senate HELP - Lower Health Care Costs Act S. 340/H.R. 965 CREATES Act H.R. 2296 - Fair Accountability and Innovative Research Act H.R. 2113 - Prescription Drug Sunshine, Transparency, Accountability, and Reporting Act H.R. 987 - Strengthening Health Care and Lowering Prescription Drug Costs Act S. 1280/H.R. 2477 - BENES Act S. 2543 - Prescription Drug Pricing Reduction Act of 2019 H.R. 3 - Elijah E. Cummings Lower Drug Costs Now Act H.R. 1865 - Further Consolidated Appropriations Act, 2020

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

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

Implementation issues regarding Patient Protection and Affordable Health Care Act - Public law 111-14 A Issues relating to notice under the BENES Act of 2019 (H.R. 2477/S. 1280) Issues relating to healthcare.gov under the Laabor/HHS Appropriations Act, 2020 (H.R. 2740) Issues relating to broker commission disclosure under the Lower Healthcare Costs Act (S.1895) Issues related to efficient online enrollment into Medicare Advantage and Medicare Advantage Prescription Drug Plans.

Client expense: $820,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), Office of the Vice President of the United States, SENATE, White House Office

HR 3: A bill to establish a fair price negotiation program, protect the Medicare program from excessive price increases, and establish an out-of-pocket maximum for Medicare part D enrollees, and for other purposes. S 2543: A bill to amend titles XI, XVIII, and XIX of the Social Security Act to lower prescription drug prices in the Medicare and Medicaid programs, to improve transparency related to pharmaceutical prices and transactions, to lower patients' out-of-pocket costs, and to ensure accountability to taxpayers, and for other purposes. HR 3276: A bill to amend title XIX of the Social Security Act to exclude authorized generic drugs from calculation of the average manufacturer price for purposes of the Medicaid drug rebate program, and for other purposes. H.R. 1346: To amend title XVIII of the Social Security Act to provide for an option for individuals who are ages 50 to 64 to buy into Medicare, to provide for health insurance market stabilization, and for other purposes. S. 470: To amend title XVIII of the Social Security Act to provide for an option for any citizen or permanent resident of the United States age 50 to 64 to buy into Medicare. H.R.2564: This bill creates a special Medicare enrollment period for individuals enrolled in, or transitioning out of, continuation coverage under the Consolidated Omnibus Budget Reconciliation Act (COBRA)-a federal law that allows an individual to maintain health coverage following loss of coverage due to termination of employment or another qualifying event. S 753: A bill to amend title XVIII of the Social Security Act to count a period of receipt of outpatient observation services in a hospital toward satisfying the 3-day inpatient hospital requirement for coverage of skilled nursing facility services under Medicare. HR (No Bill #) Payment Commission Data Act of 2019: A bill to amend titles XVIII and XIX of the Social Security Act to provide the Medicare Payment Advisory Commission and the Medicaid and CHIP Payment and Access Commission with access to certain drug payment information, including certain rebate information. H.R. 1158: An act making consolidated appropriations for the fiscal year ending September 30, 2020, and for other purposes. H.R. 1865: An act making consolidated appropriations for the fiscal year ending September 30, 2020, and for other purposes. H.R. 2477: A bill to amend title XVIII of the Social Security Act to establish a system to notify individuals approaching Medicare eligibility, to simplify and modernize the eligibility enrollment process, and for other purposes. S. 1280: A bill to amend title XVIII of the Social Security Act to establish a system to notify individuals approaching Medicare eligibility, to simplify and modernize the eligibility enrollment process, and for other purposes. H.R. 3: An act to establish a fair price negotiation program, protect the Medicare program from excessive price increases, and establish an out-of-pocket maximum for Medicare part D enrollees, and for other purposes. S. 2543: A bill to amend titles XI, XVIII, and XIX of the Social Security Act to lower prescription drug prices in the Medicare and Medicaid programs, to improve transparency related to pharmaceutical prices and transactions, to lower patients' out-of-pocket costs, and to ensure accountability to taxpayers, and for other purposes. H.R. 1277: A bill to establish a State public option through Medicaid to provide Americans with the choice of a high-quality, low-cost health insurance plan S. 489: A bill to establish a State public option through Medicaid to provide Americans with the choice of a high-quality, low-cost health insurance plan H.R. 2000: A bill to establish a public health plan H.R. 2452: A bill to amend the Social Security Act to establish a Medicare for America health program to provide for comprehensive health coverage for all Americans. H.R. 2463: A bill to provide for the establishment of Medicare part E public health plans, and for other purposes. H.R. 4527: A bill to amend title XVIII of the Social Security Act to provide an option for first responders age 50 to 64 who are separated from service due to retirement or disability to buy into Medicare. H.R. 2085: A bill to amend the Public Health Service Act to establish a public health insurance option, and for other purposes.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Treasury, Dept of, White House Office

HR 3: A bill to establish a fair price negotiation program, protect the Medicare program from excessive price increases, and establish an out-of-pocket maximum for Medicare part D enrollees, and for other purposes. S 2543: A bill to amend titles XI, XVIII, and XIX of the Social Security Act to lower prescription drug prices in the Medicare and Medicaid programs, to improve transparency related to pharmaceutical prices and transactions, to lower patients' out-of-pocket costs, and to ensure accountability to taxpayers, and for other purposes. HR 4070: A bill to streamline the employer reporting process and strengthen the eligibility verification process for the premium assistance tax credit and cost-sharing subsidy. HR 3796: A bill to amend the Internal Revenue Code of 1986 to provide that coverage under Medicare is permissible for purposes of contributions to health savings accounts. HR 861: A bill to amend title XVIII of the Social Security Act to prevent surprise billing practices, and for other purposes. HR 3276: A bill to amend title XIX of the Social Security Act to exclude authorized generic drugs from calculation of the average manufacturer price for purposes of the Medicaid drug rebate program, and for other purposes. HR 2113: A bill to a mend titles XI and XVIII of the Social Security Act to provide for drug manufacturer price transparency, to require certain manufacturers to report on product samples provided to certain health care providers, and for other purposes. H.R. 2447: A bill to fully repeal the Health Insurance Tax S. 80: A bill to fully repeal the Health Insurance Tax H.R. 2782: This bill increases the hours of service required for an employee to be classified as a full-time employee for purposes of the employer mandate under the Patient Protection and Affordable Care Act to provide minimum essential health care coverage to full-time employees. The bill increases the hours of service threshold from an average of at least 30 hours of service a week to an average of at least 40 hours of service a week. S. 1510: This bill increases the hours of service required for an employee to be classified as a full-time employee for purposes of the employer mandate under the Patient Protection and Affordable Care Act to provide minimum essential health care coverage to full-time employees. The bill increases the hours of service threshold from an average of at least 30 hours of service a week to an average of at least 40 hours of service a week. H.R.2564: This bill creates a special Medicare enrollment period for individuals enrolled in, or transitioning out of, continuation coverage under the Consolidated Omnibus Budget Reconciliation Act (COBRA)-a federal law that allows an individual to maintain health coverage following loss of coverage due to termination of employment or another qualifying event. H.R. 1682: This bill deems an individual receiving outpatient observation services in a hospital as an inpatient for purposes of satisfying the three-day inpatient hospital-stay requirement with respect to Medicare coverage of skilled nursing facility services. H.R. 1384: This bill establishes a national health insurance program that is administered by the Department of Health and Human Services (HHS). S. 1129: This bill establishes a national health insurance program that is administered by the Department of Health and Human Services (HHS). S. 981: A bill to establish a public health plan. H.R. 1346: To amend title XVIII of the Social Security Act to provide for an option for individuals who are ages 50 to 64 to buy into Medicare, to provide for health insurance market stabilization, and for other purposes. S. 470: To amend title XVIII of the Social Security Act to provide for an option for any citizen or permanent resident of the United States age 50 to 64 to buy into Medicare. S. 1895: A bill to lower health care costs by preventing surprise medical bills, reducing prescription drug prices, improving transparency in health care, investing in public health and improving health information exchange. H.R. 3630: To amend title XXVII of the Public Health Service Act to protect health care consumers from surprise billing practices, and for other purposes. HR 1682: A bill to amend title XVIII of the Social Security Act to count a period of receipt of outpatient observation services in a hospital toward satisfying the 3-day inpatient hospital stay requirement for coverage of skilled nursing facility services under Medicare, and for other purposes. S 753: A bill to amend title XVIII of the Social Security Act to count a period of receipt of outpatient observation services in a hospital toward satisfying the 3-day inpatient hospital requirement for coverage of skilled nursing facility services under Medicare. HR 748: A bill to amend the Internal Revenue Code of 1986 to repeal the excise tax on high cost employer-sponsored health coverage. S 684: A bill to amend the Internal Revenue Code of 1986 to repeal the excise tax on high cost employer-sponsored health coverage. HR 1884: A bill to amend the Patient Protection and Affordable Care Act to improve affordability of, undo sabotage with respect to, and increase access to health insurance coverage, and for other purposes. S 172: A bill to delay the reimposition of the annual fee on health insurance providers until after 2021. HR 1398: A bill to delay the reimposition of the annual fee on health insurance providers until after 2021. S 80: A bill to repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act. HR 1385: A bill to amend the Patient Protection and Affordable Care Act to preserve the option of States to implement health care marketplaces, and for other purposes HR 1386: A bill to amend the Patient Protection and Affordable Care Act to provide for additional requirements with respect to the navigator program, and for other purposes. HR 987: A bill to amend the Patient Protection and Affordable Care Act to provide for Federal Exchange outreach and educational activities. HR 986: A bill to provide that certain guidance related to waivers for State innovation under the Patient Protection and Affordable Care Act shall have no force or effect. HR 100: A bill to provide that the rule entitled Short-Term, Limited Duration Insurance shall have no force or effect. HR 1425: A bill to amend the Patient Protection and Affordable Care Act to provide for a Improve Health Insurance Affordability Fund to provide for certain reinsurance payments to lower premiums in the individual health insurance market. HR 938: A bill to amend the Federal Food, Drug, and Cosmetic Act, with respect to eligibility for approval of a subsequent generic drug, to remove the barrier to that approval posed by the 180-day exclusivity period afforded to a first generic applicant that has not yet received final approval, and for other purposes HR 1520: A bill to amend the Public Health Service Act to provide for the publication of a list of licensed biological products, and for other purposes. HR 1503: A bill to amend the Federal Food, Drug, and Cosmetic Act regarding the list under section 505(j)(7) of the Federal Food, Drug, and Cosmetic Act, and for other purposes. HR (No Bill #) Payment Commission Data Act of 2019: A bill to amend titles XVIII and XIX of the Social Security Act to provide the Medicare Payment Advisory Commission and the Medicaid and CHIP Payment and Access Commission with access to certain drug payment information, including certain rebate information. HR 1499: A bill prohibit brand name drug manufacturers from compensating generic drug manufacturers to delay the entry of a generic drug into the market, and to prohibit biological product manufacturers from compensating biosimilar and interchangeable product manufacturers to delay entry of biosimilar and interchangeable products, and for other purposes. HR 965: 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. H.R. 1158: An act making consolidated appropriations for the fiscal year ending September 30, 2020, and for other purposes. H.R. 1865: An act making consolidated appropriations for the fiscal year ending September 30, 2020, and for other purposes. H.R. 2477: A bill to amend title XVIII of the Social Security Act to establish a system to notify individuals approaching Medicare eligibility, to simplify and modernize the eligibility enrollment process, and for other purposes. S. 1280: A bill to amend title XVIII of the Social Security Act to establish a system to notify individuals approaching Medicare eligibility, to simplify and modernize the eligibility enrollment process, and for other purposes. H.R. 3708: A bill to amend the Internal Revenue Code of 1986 to allow individuals with direct primary care service arrangements to remain eligible individuals for purposes of health savings accounts, and for other purposes. S. 2999: A bill to amend the Internal Revenue Code of 1986 to allow individuals with direct primary care service arrangements to remain eligible individuals for purposes of health savings accounts. H.R. 3: An act to establish a fair price negotiation program, protect the Medicare program from excessive price increases, and establish an out-of-pocket maximum for Medicare part D enrollees, and for other purposes. S. 2543: A bill to amend titles XI, XVIII, and XIX of the Social Security Act to lower prescription drug prices in the Medicare and Medicaid programs, to improve transparency related to pharmaceutical prices and transactions, to lower patients' out-of-pocket costs, and to ensure accountability to taxpayers, and for other purposes. H.R. 1277: A bill to establish a State public option through Medicaid to provide Americans with the choice of a high-quality, low-cost health insurance plan S. 489: A bill to establish a State public option through Medicaid to provide Americans with the choice of a high-quality, low-cost health insurance plan H.R. 2000: A bill to establish a public health plan H.R. 2452: A bill to amend the Social Security Act to establish a Medicare for America health program to provide for comprehensive health coverage for all Americans. H.R. 2463: A bill to provide for the establishment of Medicare part E public health plans, and for other purposes. H.R. 4527: A bill to amend title XVIII of the Social Security Act to provide an option for first responders age 50 to 64 who are separated from service due to retirement or disability to buy into Medicare. H.R. 2085: A bill to amend the Public Health Service Act to establish a public health insurance option, and for other purposes.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Treasury, Dept of, White House Office

- H.R. 965/ S. 340, Creating and Restoring Equal Access To Equivalent Samples Act of 2017 (CREATES Act), support passage. - H.R. 985, Fair Access for Safe and Timely Generics Act of 2017 (FAST Generics Act), support passage. -H.R. 2035/S. 995, Lifespan Respite Care Reauthorization Act, support reauthorization - H.R. 3208/ S.1755 - Real Emergency Access for Aging and Disability Inclusion for Disasters Act, support passage - H.R. 3215/ S. 1754 - Disaster Relief Medicaid Act, support passage - S.2400/ H.R. 4322 - Expanding Cannabis Research and Information Act, support passage - H.R. 3439 - Reauthorization of the Patient Centered Outcomes Research Institute, support reauthorization. -H.R. 2781 - Empower for Health Act of 2019, support passage -H.R. 2035, Lifespan Respite Care Reauthorization Act of 2019, support passage -H.R. 2296/S.1391 - FAIR Drug Pricing Act of 2019, support passage - H.R. 3630 - No Surprises Act, support passage -H.R. 1010, To provide that the rule entitled Short-Term, Limited Duration Insurance shall have no force or effect, support passage. -H.R. 986, The Protecting Americans with Preexisting Conditions Act of 2019, support passage. -H.R.1386, Expand Navigators Resources for Outreach, Learning, and Longevity (ENROLL) Act of 2019, support passage. -H.R. 2293, the Protecting Access to Wheelchairs Act, support passage. -H.R. 2408, the Ensuring Access to Quality Complex Rehabilitation technology Act, support passage. -H.R 3 - Lower Drug Costs Now Act of 2019, support passage - H.R. 2387, the Stop The Overuse of Petitions and Get Affordable Medicines to Enter Soon (STOP GAMES) Act of 2019, support passage - H.R. 3107, Improving Seniors Timely Access to Care Act of 2019, support passage -S. 1935, Family Coverage Act, support passage. -S.1556, No Junk Plans Act, support passage. -S. 1223, the Protecting Beneficiary Access to Complex Rehab Technology Act, support passage - S.475, Reducing Existing Costs Associated with Pharmaceuticals for Seniors Act of 2019 (RX Cap Act), support passage - S. 637, Combatting Unreasonable Rises and Excessively High Drug Prices Act (CURE High Drug Prices Act), support passage - S.366, Forcing Limits on Abusive and Tumultuous Prices (FLAT Prices) Act, support passage -S. 63, Preserve Access to Affordable Generics and Biosimilars Act, support passage -S. 659, Biologic Patent Transparency Act, support passage -S.1895 - Lower Health Care Costs Act, support passage - S. 1280/HR 2477 - Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act, support passage - S. 691 - Medicare Extra Rx Help Act- support passage - S. 2543 - Prescription Drug Price Reduction Act of 2019 - support passage - Menendez - Lankford- Cardin-Daines Amendment 1 Incentivizing Generic and Biosimilar Use in Medicare Part D - support adoption -Menendez -Lankford - Cardin --Daines Amendment 2 Incentivizing Generic Use in Medicare Part D - support adoption -S, 1801, Low Cost Generics Act of 2019, support passage -S.2911, the Seniors Prescription Drug Relief Act of 2019, support passage.

Client expense: $83,990 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Balanced Billing issues. Prescription drug pricing H.R. 1398/S. 172 - Health Insurance Tax Relief Act S. 3063 - Health Insurance Tax Relief Act of 2018 H.R. 2447 - Jobs and Premium Protection Act CMS-9115-P/HHS ONC RIN-0955-AA01 - 21st Century Cures Interoperability and Information Blocking Proposed Rules Senate HELP - Lower Health Care Costs Act S. 340/H.R. 965 CREATES Act H.R. 2296 - Fair Accountability and Innovative Research Act H.R. 2113 - Prescription Drug Sunshine, Transparency, Accountability, and Reporting Act H.R. 987 - Strengthening Health Care and Lowering Prescription Drug Costs Act S. 1280/H.R. 2477 - BENES Act H.R. 3 - Lower Drug Costs Now Act of 2019 S. 2543 - Prescription Drug Pricing Reduction Act of 2019

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

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

H.R. 1398/S. 172 - Health Insurance Tax Relief Act CMS-9115-P Interoperability and Patient Access Proposed Rule HHS ONC RIN-0955-AA01 -- 21st Century Cures Interoperability and Information Blocking Proposed Rule Senate HELP - Lower Health Care Costs Act S. 340/H.R. 965 CREATES Act H.R. 3630, No Surprises Act H.R. 2296, Fair Accountability and Innovative Research Act H.R. 2113, Prescription Drug Sunshine, Transparency, Accountability, and Reporting Act H.R. 987, Strengthening Health Care and Lowering Prescription Drug Costs Act S. 1280/H.R. 2477, BENES Act H.R. 3, Lower Drug Costs Now Act of 2019 S. 2543, Prescription Drug Pricing Reduction Act of 2019

Client expense: $1,900,000 · Firm income: Not reported

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

- H.R. 965/ S. 340, Creating and Restoring Equal Access To Equivalent Samples Act of 2017 (CREATES Act), support passage. - H.R. 985, Fair Access for Safe and Timely Generics Act of 2017 (FAST Generics Act), support passage. -H.R. 2035/S. 995, Lifespan Respite Care Reauthorization Act, support reauthorization - H.R. 3208/ S.1755 - Real Emergency Access for Aging and Disability Inclusion for Disasters Act, support passage - H.R. 3215/ S. 1754 - Disaster Relief Medicaid Act, support passage - S.2400/ H.R. 4322 - Expanding Cannabis Research and Information Act, support passage - H.R. 3439 - Reauthorization of the Patient Centered Outcomes Research Institute, support reauthorization. -H.R. 2781 - Empower for Health Act of 2019, support passage -H.R. 2035, Lifespan Respite Care Reauthorization Act of 2019, support passage -H.R. 2296/S.1391 - FAIR Drug Pricing Act of 2019, support passage - H.R. 3630 - No Surprises Act, support passage -H.R. 1010, To provide that the rule entitled Short-Term, Limited Duration Insurance shall have no force or effect, support passage. -H.R. 986, The Protecting Americans with Preexisting Conditions Act of 2019, support passage. -H.R.1386, Expand Navigators Resources for Outreach, Learning, and Longevity (ENROLL) Act of 2019, support passage. -H.R. 2293, the Protecting Access to Wheelchairs Act, support passage. -H.R. 2408, the Ensuring Access to Quality Complex Rehabilitation Technology Act, support passage. -H.R 3 - Lower Drug Costs Now Act of 2019, support passage -S. 1935, Family Coverage Act, support passage. -S.1556, No Junk Plans Act, support passage. -S. 1223, the Protecting Beneficiary Access to Complex Rehab Technology Act, support passage - S.475, Reducing Existing Costs Associated with Pharmaceuticals for Seniors Act of 2019 (RX Cap Act), support passage - S. 637, Combatting Unreasonable Rises and Excessively High Drug Prices Act (CURE High Drug Prices Act), support passage - S.366, Forcing Limits on Abusive and Tumultuous Prices (FLAT Prices) Act, support passage -S. 63, Preserve Access to Affordable Generics and Biosimilars Act, support passage -S. 659, Biologic Patent Transparency Act, support passage -S.1895 - Lower Health Care Costs Act, support passage - S. 1280/HR 2477 - Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act, support passage - S. 691 - Medicare Extra Rx Help Act- support passage - S. 2543 - Prescription Drug Price Reduction Act of 2019 - support passage - Menendez - Lankford- Cardin-Daines Amendment 1 Incentivizing Generic and Biosimilar Use in Medicare Part D - support adoption -Menendez -Lankford - Cardin --Daines Amendment 2 Incentivizing Generic Use in Medicare Part D - support adoption

Client expense: $91,539 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Drug Pricing. H.R. 3, the Lower Drug Costs Now Act: Proposals to authorize the Secretary of Health and Human Services (HHS) to negotiate drug prices on behalf of Medicare with pharmaceutical manufactureres. Create a maximum price for any negotiated drug with an international price index (Average International Market price). Require drug manufacturers that refuse to negotiation with HHS to pay a Non-Compliance Fee of 65 percent of the gross sales of the drug in question. Require drug companies that raised the price of a drug in Medicare above the rate of inflation since 2016 to either lower the price or pay the entire price above inflation in a rebate back to the Treasury. Create a $2,000 Medicare beneficiary annual out-of-pocket cost cap for prescription drugs. Drug Pricing. S. 2543, the Prescription Drug Pricing Reduction Act of 2019: Require pharmaceutical manufacturers to rebate Medicare if they raise their prices for drugs covered by Medicare Parts B and D faster than inflation. Establish an out-of-pocket spending limit in which Medicare beneficiaries would pay no more than $3,100 a year on drug costs. Require Medicare Part D private insurers to pay 60 percent and, drug makers 20 percent, of the costs incurred over the out-of-pocket spending cap. Increase transparency into pharmacy benefit manager practices and manufacturer drug pricing decisions. Provide state Medicaid programs with more authority to contain drug prices. Drug Pricing. H.R. 1046, the Medicare Negotiation and Competitive Licensing Act: Proposal to allow the Secretary of Health and Human Services to directly negotiate prices for prescription drugs and issue a competitive license allowing other manufacturers to produce the drug for Medicare in the event negotiations fail. Drug Pricing. S. 1895, the Lower Health Care Costs Act of 2019: Proposals to reduce the cost of prescription drugs including allowing generic drug manufacturers to sue brand-name manufacturers for not selling them samples for testing necessary to get to market; and requiring a drug manufacturer to submit a report to the Secretary of Health and Human Services for each price increase of certain drugs of which the wholesale acquisition cost increase is equal to 10 percent or more over a 12-month period or 25 percent or moreover a 36-month period. Dementia and Alzheimers Disease. S. 2076/H.R. 4256, Building Our Largest Dementia Infrastructure for Alzheimers Act (BOLD Act): Proposal to apply a public health approach to combat Alzheimers disease and related dementias. Medicare Observation Status. H.R. 1682/S. 753, the Improving Access to Medicare Coverage Act of 2019: Proposal to count days in the hospital in observation status toward meeting the three-day prior hospitalization requirement for skilled nursing facility care eligibility. Generic Drug Introduction. Generic Drug Introduction. H.R. 965, the CREATES Act: Proposal to speed the introduction of generic competition by curbing brand drug maker abuses of safety procedures as a means to limit generic manufacturer access to the drug samples needed to obtain Food and Drug Administration approval. Health Care Rights Law. Proposed rule to the provision of the Affordable Care Act addressing discrimination based on age, race, color, national origin, English proficiency, disability or sex. Medicaid Home and Community-Based Services: H.R. 1839, the Medicaid Services Investment and Accountability Act of 2019: Proposal extending the spousal impoverishment protections for home and community-based services until September 2019. Medicare Prescription Drug Costs. (No bill.) Proposals to reduce amount drug manufacturers must contribute to closing the donut hole in 2019. Medicare Prescription Drug Costs. (No bill.) Provisions of the United States-Mexico-Canada Agreement (formerly the North American Free Trade Agreement) addressing countries having expansive regulatory approval monopolies for biologic drugs and restricting the ability of Congress to reform patent laws that drive up drug costs for Medicare. Medicare Coverage Expansion. H.R. 576, the Seniors Have Eyes, Ears, and Teeth Act of 2019; H.R. 1393, the Medicare Dental, Vision, and Hearing Benefit Act of 2019; H.R. 1518, the Medicare Hearing Aid Coverage Act of 2019: Proposals to expand Medicare coverage to include, vision, dental and hearing benefits. Medicare Open Enrollment. (No bill.) Proposals to ensure the Centers for Medicare and Medicaid Services conducts open enrollment in a way that is unbiased toward the traditional program. Medicare Part D. (No bill.) Proposals to add an out-of-pocket cap, rationalize the structure of the Part D program, and make the Part D low-income subsidy more generous. Medigap Reform: H.R. 1394, the Medigap Consumer Protection Act: Proposal to improve quality of coverage and access to Medigap by restoring first dollar coverage and extending guaranteed issue to disabled people and other beneficiairies. Drug Safety. S. 1895, the Lower Health Care Costs Act of 2019: Proposal to remove requirement that medicines marketed in the U.S. adhere to quality standards established by the U.S. Pharmacopeia. These standards allow biosimilar makers to achieve regulatory certainty and expedite biosimilars to market. Medicare Enrollment. H.R. 2477/S. 1280, the BENES Act of 2019: Proposal to improve beneficiary education tools and extend funding for state health insurance and assistance programs. Reducing Health Care Costs: S. 1895, the Lower Health Care Costs Act of 2019: Proposal to eliminate surprise medical billing including out-of-network charges in emergencies.

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

Government targets: Administration on Aging, Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Economic Council (NEC), Office of Management & Budget (OMB), SENATE, Social Security Administration (SSA), Treasury, Dept of

Drug Pricing. H.R. 3, the Lower Drug Costs Now Act: Proposals to authorize the Secretary of Health and Human Services (HHS) to negotiate drug prices on behalf of Medicare with pharmaceutical manufactureres. Create a maximum price for any negotiated drug with an international price index (Average International Market price). Require drug manufacturers that refuse to negotiation with HHS to pay a Non-Compliance Fee of 65 percent of the gross sales of the drug in question. Require drug companies that raised the price of a drug in Medicare above the rate of inflation since 2016 to either lower the price or pay the entire price above inflation in a rebate back to the Treasury. Create a $2,000 Medicare beneficiary annual out-of-pocket cost cap for prescription drugs. Drug Pricing. S. 2543, the Prescription Drug Pricing Reduction Act of 2019: Require pharmaceutical manufacturers to rebate Medicare if they raise their prices for drugs covered by Medicare Parts B and D faster than inflation. Establish an out-of-pocket spending limit in which Medicare beneficiaries would pay no more than $3,100 a year on drug costs. Require Medicare Part D private insurers to pay 60 percent and, drug makers 20 percent, of the costs incurred over the out-of-pocket spending cap. Increase transparency into pharmacy benefit manager practices and manufacturer drug pricing decisions. Provide state Medicaid programs with more authority to contain drug prices. Drug Pricing. H.R. 1046, the Medicare Negotiation and Competitive Licensing Act: Proposal to allow the Secretary of Health and Human Services to directly negotiate prices for prescription drugs and issue a competitive license allowing other manufacturers to produce the drug for Medicare in the event negotiations fail. Drug Pricing. S. 1895, the Lower Health Care Costs Act of 2019: Proposals to reduce the cost of prescription drugs including allowing generic drug manufacturers to sue brand-name manufacturers for not selling them samples for testing necessary to get to market; and requiring a drug manufacturer to submit a report to the Secretary of Health and Human Services for each price increase of certain drugs of which the wholesale acquisition cost increase is equal to 10 percent or more over a 12-month period or 25 percent or moreover a 36-month period. Dementia and Alzheimers Disease. S. 2076/H.R. 4256, Building Our Largest Dementia Infrastructure for Alzheimers Act (BOLD Act): Proposal to apply a public health approach to combat Alzheimers disease and related dementias. Medicare Observation Status. H.R. 1682/S. 753, the Improving Access to Medicare Coverage Act of 2019: Proposal to count days in the hospital in observation status toward meeting the three-day prior hospitalization requirement for skilled nursing facility care eligibility. Generic Drug Introduction. Generic Drug Introduction. H.R. 965, the CREATES Act: Proposal to speed the introduction of generic competition by curbing brand drug maker abuses of safety procedures as a means to limit generic manufacturer access to the drug samples needed to obtain Food and Drug Administration approval. Health Care Rights Law. Proposed rule to the provision of the Affordable Care Act addressing discrimination based on age, race, color, national origin, English proficiency, disability or sex. Medicaid Home and Community-Based Services: H.R. 1839, the Medicaid Services Investment and Accountability Act of 2019: Proposal extending the spousal impoverishment protections for home and community-based services until September 2019. Medicare Prescription Drug Costs. (No bill.) Proposals to reduce amount drug manufacturers must contribute to closing the donut hole in 2019. Medicare Prescription Drug Costs. (No bill.) Provisions of the United States-Mexico-Canada Agreement (formerly the North American Free Trade Agreement) addressing countries having expansive regulatory approval monopolies for biologic drugs and restricting the ability of Congress to reform patent laws that drive up drug costs for Medicare. Medicare Coverage Expansion. H.R. 576, the Seniors Have Eyes, Ears, and Teeth Act of 2019; H.R. 1393, the Medicare Dental, Vision, and Hearing Benefit Act of 2019; H.R. 1518, the Medicare Hearing Aid Coverage Act of 2019: Proposals to expand Medicare coverage to include, vision, dental and hearing benefits. Medicare Open Enrollment. (No bill.) Proposals to ensure the Centers for Medicare and Medicaid Services conducts open enrollment in a way that is unbiased toward the traditional program. Medicare Part D. (No bill.) Proposals to add an out-of-pocket cap, rationalize the structure of the Part D program, and make the Part D low-income subsidy more generous. Medigap Reform: H.R. 1394, the Medigap Consumer Protection Act: Proposal to improve quality of coverage and access to Medigap by restoring first dollar coverage and extending guaranteed issue to disabled people and other beneficiairies. Drug Safety. S. 1895, the Lower Health Care Costs Act of 2019: Proposal to remove requirement that medicines marketed in the U.S. adhere to quality standards established by the U.S. Pharmacopeia. These standards allow biosimilar makers to achieve regulatory certainty and expedite biosimilars to market. Medicare Enrollment. H.R. 2477/S. 1280, the BENES Act of 2019: Proposal to improve beneficiary education tools and extend funding for state health insurance and assistance programs. Reducing Health Care Costs: S. 1895, the Lower Health Care Costs Act of 2019: Proposal to eliminate surprise medical billing including out-of-network charges in emergencies.

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

Government targets: Administration on Aging, Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Economic Council (NEC), Office of Management & Budget (OMB), SENATE, Social Security Administration (SSA), Treasury, Dept of

H.R. 1398/S. 172 - Health Insurance Tax Relief Act CMS-9115-P Interoperability and Patient Access Proposed Rule HHS ONC RIN-0955-AA01 -- 21st Century Cures Interoperability and Information Blocking Proposed Rule Senate HELP - Lower Health Care Costs Act S. 340/H.R. 965 CREATES Act H.R. 3630, No Surprises Act H.R. 2296, Fair Accountability and Innovative Research Act H.R. 2113, Prescription Drug Sunshine, Transparency, Accountability, and Reporting Act H.R. 987, Strengthening Health Care and Lowering Prescription Drug Costs Act S. 1280/H.R. 2477, BENES Act

Client expense: $560,000 · Firm income: Not reported

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

Balanced Billing issues. Prescription drug pricing H.R. 1398/S. 172 - Health Insurance Tax Relief Act S. 3063 - Health Insurance Tax Relief Act of 2018 H.R. 2447 - Jobs and Premium Protection Act CMS-9115-P/HHS ONC RIN-0955-AA01 - 21st Century Cures Interoperability and Information Blocking Proposed Rules Senate HELP - Lower Health Care Costs Act S. 340/H.R. 965 CREATES Act H.R. 2296 - Fair Accountability and Innovative Research Act H.R. 2113 - Prescription Drug Sunshine, Transparency, Accountability, and Reporting Act H.R. 987 - Strengthening Health Care and Lowering Prescription Drug Costs Act S. 1280/H.R. 2477 - BENES Act

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

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

H.R. 2740 Labor-HHS Appropriations bill, FY 2020 - lobbied in support of increased funding for CMS' state survey and certification program and opposition to hostile policy riders re Patient Protection and Affordable Care Act. Discussed civil money penalties for enforcement in nursing homes. Lobbied CMS. Discussed nursing home quality and enforcement issues and shared relevant information. Discussed draft nursing home bill. Submitted and shared statement for the record for Senate Finance Committee nursing home hearing. Discussed nursing homes, including the Special Focus Facility Program (no bill number). Discussed emergency preparedness regulations for nursing homes. S. 117/H.R. 555, Disability Integration Act -discussed bill language, support for, and introduction of the bill. No bill number - discussed Money Follows the Person Rebalancing Demonstration Program and Medicaid home and community-based services (HCBS) spousal impoverishment protections and extending them. S. 753/H.R. 1682 - Improving Access to Medicare Coverage Act - shared AARP support letters for the legislation, discussed the bill, and shared related information. P.L. 114-42, NOTICE Act - discussed transparency/surprise medical billing, including observation issues and related prior legislation. S. 548/H.R. 1342, EMPOWER Care Act - discussed and shared AARPs support for the bill. H.R. 1343, Protecting Married Seniors from Impoverishment Act - discussed and shared AARPs support for the bill. S. 296, Home Health Planning Improvement Act - discussed and shared support for the bill. No bill number - discussed issues affecting dully eligible individuals. Discussed surprise billing and health care price transparency. Discussed oral health coverage in Medicare. S. 668/H.R. 1570 - Removing Barriers to Colorectal Cancer Screening Act of 2019 - joined letter of endorsement. S. 286/H.R. 945 - Mental Health Access Improvement Act - sent letter of endorsement. H.R. 1301 - Mental Health Telemedicine Expansion Act - sent letter of endorsement. S.1999 - Improving Low Income Access to Prescription Drugs Act. H.R. 1682/S. 753, Improving Access to Medicare Coverage Act - discussed support for bill and urged cosponsorship. H.R. 2150, Home Health Care Planning Improvement Act - discussed and shared support letter for bill. Discussed extension of Money Follows the Person Rebalancing Demonstration Program and Medicaid home and community-based services spousal impoverishment protections. Lobbied House and Senate staff. S. 2000, Protecting Married Spouses from Impoverishment Act - discussed and supported bill with Senate staff. H.R. 1342, EMPOWER Care Act - discussed support for the bill and provided information on the Money Follows the Person Rebalancing Demonstration Program. H.R. 555/S. 117, Disability Integration Act - discussed the bill and shared endorsement letter. S. 1895 - Lower Health Care Costs Act - Discussed and sent letter to HELP committee S. 1531 - Stopping The Outrages Practice (STOP) of Surprise Medical Bills Act - Discussed with bill sponsors S. 1280/H.R. 2477 - Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act - Sent letter of endorsement No bill number. Provided feedback on Home Health Care CAHPS survey (CMS). No bill number. Discussed nursing home bill regarding nursing home resident personal needs allowances. No bill number. Discussed Medicaid provisions in federal domestic worker bill of rights. No bill number. Discussed nursing home quality, regulation, enforcement, and arbitration. No bill number - discussed skilled nursing facility value-based purchasing. No bill number - responded to inquiry regarding Medicaid and Senior Care Act. S. 1202, Independence at Home Act of 2019 - discussed the bill. No bill number. Discussed Medicaid managed long-term services and supports and family caregiving. No bill number - Discussed draft No Surprises Act bill on surprise medical billing Discussed oral health coverage in Medicare

Client expense: $1,900,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), General Services Administration (GSA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Securities & Exchange Commission (SEC), Transportation, Dept of (DOT), Treasury, Dept of, White House Office

HR 2131 and S. 1114--Medicare Advantage Quality Payment Relief Act CMS-2018-0154-- Advance Notice of Methodological Changes for Calendar Year (CY) 2020 for Medicare Advantage (MA) Capitation Rates, Part C and Part D Payment Policies and 2020 Draft Call Letter CMS-4180-P--Modernizing Part D and Medicare Advantage to Lower Drug Prices and Reduce Out-of-Pocket Expenses S. 1280/H.R. 2477--BENES Act Expanding language access under Medicare OIG-0936-P--Fraud and Abuse; Removal of Safe Harbor Protection for Rebates Involving Prescription Pharmaceuticals and Creation of New Safe Harbor Protection for Certain Point-of-Sale Reductions in Price on Prescription Pharmaceuticals and Certain Pharmacy Benefit Manager Service Fees

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

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

- H.R. 965/ S. 340, Creating and Restoring Equal Access To Equivalent Samples Act of 2017 (CREATES Act), support passage. - H.R. 985, Fair Access for Safe and Timely Generics Act of 2017 (FAST Generics Act), support passage. -H.R. 2035/S. 995, Lifespan Respite Care Reauthorization Act, support reauthorization of the Lifespan Respite Care Program. - H.R. 3208/ S.1755 - Real Emergency Access for Aging and Disability Inclusion for Disasters Act, support passage - H.R. 3215/ S. 1754 - Disaster Relief Medicaid Act, support passage - H.R. 3439 - Reauthorization of the Patient Centered Outcomes Research Institute, support reauthorization. -H.R. 2781 - Empower for Health Act of 2019, support passage -H.R. 2035, Lifespan Respite Care Reauthorization Act of 2019, support passage -H.R. 2296/S.1391 - FAIR Drug Pricing Act of 2019, support passage - H.R. 3630 - No Surprises Act, support passage -H.R. 1010, To provide that the rule entitled Short-Term, Limited Duration Insurance shall have no force or effect, support passage. -H.R. 986, The Protecting Americans with Preexisting Conditions Act of 2019, support passage. -H.R.1386, Expand Navigators Resources for Outreach, Learning, and Longevity (ENROLL) Act of 2019, support passage. -H.R. 2293, the Protecting Access to Wheelchairs Act, support passage. H.R. 2408, the Ensuring Access to Quality Complex Rehabilitation Technology Act, support passage. -S. 1935, Family Coverage Act, support passage. -S.1556, No Junk Plans Act, support passage. -S. 1223, the Protecting Beneficiary Access to Complex Rehab Technology Act, support passage - S.475, Reducing Existing Costs Associated with Pharmaceuticals for Seniors Act of 2019 (RX Cap Act), support passage - S. 637, Combatting Unreasonable Rises and Excessively High Drug Prices Act (CURE High Drug Prices Act), support passage - S.366, Forcing Limits on Abusive and Tumultuous Prices (FLAT Prices) Act, support passage -S. 63, Preserve Access to Affordable Generics and Biosimilars Act, support passage -S. 659, Biologic Patent Transparency Act, support passage -S.1895 - Lower Health Care Costs Act, support passage - S. 1280 - Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act, support passage - S. 691 - Medicare Extra Rx Help Act- support passage

Client expense: $78,144 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.2757 Creating Lower Cost Alternative for Your (CLAY) Prescription Drug Act - would eliminate cost-sharing for generic drugs for low-income Medicare beneficiaries H.R.1393 Medicare Dental, Vision, and Hearing Benefit Act of 2019 - provide for coverage of dental, vision, and hearing care under the Medicare program. H.R.576 Seniors Have Eyes, Ears, and Teeth Act - expands Medicare coverage to include eyeglasses, hearing aids, and dental care. S.22 Medicare Dental Benefit Act of 2019 - coverage of dental services under Medicare Part B H.R.1342 EMPOWER Care Act - reauthorize the Money Follows the Person Demonstration Program H.R. 1343 - Protecting Married Seniors Act - provisions regarding Medicaid eligibility that protect against spousal impoverishment for recipients of home and community-based services. S.99 / H.R.448 - The Medicare Drug Price Negotiation Act - negotiation of lower covered part D drug prices on behalf of Medicare beneficiaries and the establishment and application of a formulary by the Secretary of Health and Human Services under Medicare part D H.R.1046 / S.377 Medicare Negotiation and Competitive Licensing Act of 2019 - requiring Secretary of Health and Human Services to negotiate prices of prescription drugs furnished under part D of the Medicare program S.470 Medicare at 50 Act - option for any citizen or permanent resident of the United States age 50 to 64 to buy into Medicare H.R.1329 Medicaid Reentry Act - allows Medicaid payment for medical services furnished to an incarcerated individual during the 30-day period preceding the individual's release H.R.1354 Territories Health Equity Act - make improvements to the treatment of the United States territories under the Medicare and Medicaid programs H.R.3215, S.1754 The Disaster Relief Medicaid Act - provide Medicaid assistance to individuals and families affected by a disaster or emergency H.R.1384, S.1129 Medicare for All Act - establishes a national health insurance program H.R.2477, S.1280 Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act - establish a system to notify individuals approaching Medicare eligibility, to simplify and modernize the eligibility enrollment process Medicare Prescription Drug Savings and Choice Act - public option for drug coverage within Medicare Part D H.R.2463, S.1261 Choose Medicare Act - establishment of Medicare part E public health plans S.1423 Medicare and Medicaid Dental, Vision, and Hearing Benefit Act of 2019 - provide for coverage of dental, vision, and hearing care under the Medicare and Medicaid programs

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

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

Implementation of and improving the Achieving a Better Life Experience Act, P.L. 113-295, provisions added in P.L. 115-97. Implementation of the Affordable Care Act, P.L. 111-148 and P.L. 111-192. HCBS Setting Rules ABLE Age Adjustment Act, S.651 and H.R. 1814 Benefit improvements to Medicare including oral health and access to wheelchairs and related technology. Improvements to Medicare appeals process and notice requirements (S.1280 and H.R. 2477)

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

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

Drug Pricing. H.R. 1046, the Medicare Negotiation and Competitive Licensing Act: Proposal to allow the Secretary of Health & Human Services to directly negotiate prices for prescription drugs and issue a competitive license allowing other manufacturers to produce the drug for Medicare in the event negotiations fail. Medicare Observation Status. H.R. 1682/S. 753, Improving Access to Medicare Coverage Act of 2019: Proposal to count days in the hospital in observation status toward meeting the three-day prior hospitalization requirement for skilled nursing facility care eligibility. Dementia and Alzheimers Disease. S. 2076/H.R. 4256, Building Our Largest Dementia Infrastructure for Alzheimers Act (BOLD Act): Proposal to apply a public health approach to combat Alzheimers disease and related dementias. Generic Drug Introduction. H.R. 965, CREATES Act: Proposal to speed the introduction of generic competition by curbing brand drug maker abuses of safety procedures as a means to limit generic manufacturer access to the drug samples needed to obtain Food and Drug Administration approval. Medicaid Home and Community-Based Services: H.R. 1839, the Medicaid Services Investment and Accountability Act of 2019: Proposal extending the spousal impoverishment protections for home and community-based services until September 2019. Medicare Prescription Drug Costs. (No bill): Proposals to reduce amount drug manufacturers must contribute to closing the donut hole in 2019. Medicare Prescription Drug Costs. (No bill): Provisions of the United States-Mexico-Canada Agreement (formerly the North American Free Trade Agreement) addressing countries having expansive regulatory approval monopolies for biologic drugs and restricting the ability of Congress to reform patent laws that drive up drug costs for Medicare. Medicare Prescription Drug Costs. (No bill): Proposal to remove safe harbor from anti-kickback laws for drug rebates under Medicare Part D. Medicare Coverage Expansion. H.R. 576, the Seniors Have Eyes, Ears, and Teeth Act of 2019; H.R. 1393, the Medicare Dental, Vision, and Hearing Benefit Act of 2019; H.R. 1518, the Medicare Hearing Aid Coverage Act of 2019: Proposals to expand Medicare coverage to include, vision, dental and hearing. Medicare Open Enrollment. (No bill): Proposals to ensure the Centers for Medicare and Medicaid Services conducts open enrollment in a way that is unbiased toward the traditional program. Medicare Part D. (No bill): Proposals to add an out-of-pocket cap and rationalize the structure of the program. Medicare Part D. (No bill) Proposal to add a cap to the Part D benefit, maintain the manufacturer discount in the calculation of the threshold to enter the catastrophic benefit so that seniors need to pay less out-of-pocket to move through the donut hole, and streamline the Part D coverage determination and appeals process. Drug Pricing. (No bill): Proposals to reduce the cost of prescription drugs. Affordable Care Act Stabilization. H.R. 987, the Strengthening Health Care and Lowering Prescription Drug Costs Act: Proposal to reduce drug costs for Americans including seniors and to stabilize the Affordable Care Acts marketplaces. Medicare Enrollment. H.R. 2477/S. 1280, BENES Act of 2019: proposal to improve beneficiary education tools and extend funding for state health insurance and assistance(SHIP) programs.

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

Government targets: Administration on Aging, Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Economic Council (NEC), Office of Management & Budget (OMB), SENATE, Social Security Administration (SSA), Treasury, Dept of

Reviewed bill language and prepared support letter for the Safe Step Act of 2019 (HR 2799) Reviewed bill language and prepared support letter for the BENES Act of 2019 (S.1280/HR 2477) Part D/lower HC Costs - Submit comments to Draft legislation on the Senate help House Ways & Means E&C

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE