STOP Surprise Medical Bills Act of 2019

Legislative and regulatory issues related to surprise medical bills: S. 1895, the Lower Health Care Cost Act; S.1531, Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019; 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. H.R. 3502, Protecting People From Surprise Medical Bills Act; Executive Order on Improving Price and Quality Transparency in American Healthcare to Put Patients First, published June 24, 2019.

Client expense: Not reported · Firm income: Not reported

HR 8702 & S 5007 - the Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020 HR 8505 - to amend Title XVIII of the SS Act to provide for a one-year waiver of budget neutrality adjustments under the Medicare Physician Fee Schedule, and for other purposes. HR 3502 - Protecting People from Surprise Medical Bills Act HR 3630 - to amend title XXVII of the Public Health Service Act HR 1384 - Medicare for All Act of 2019 HR 861 - End Surprise Billing Act of 2019 S 1266 - Protecting Patients from Surprise Medicare Bills Act S 1531 - Stopping the Outrageous Practice of Surprise Medical Act of 2019 S 1370 - Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019 HR 345 - SMASH Act S 1213 - Consumer Health Insurance Protection Act of 2019 Protecting Access to Medicare Act Gene Patents VALID - Verifying Accurate Leading Edge IVCT Development Prostate Cancer Misdiagnosis Elimination Act Eliminate Kickbacks in Recovery Act (EDRA) Resident Physician Shortage Reduction Act of 2019, S 348, HR 1763

Client expense: $137,521 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.80, Jobs and Premium Protection Act (all provisions) S.172, Health Insurance Tax Relief Act (all provisions) S.340, CREATES Act (all provisions) S.684, Middle Class Health Benefits Tax Repeal Act (all provisions) S.1531, Stopping the Outrageous Practice of Surprise Medical Bills Act (all provisions) S.1895, Lower Health Care Costs Act S.1510, Employee Flexibility Act (all provisions) S.2366, Commonsense Reporting Act (all provisions) HR 6800, Heroes Act HR 748, Middle Class Health Benefits Tax Repeal Act (all provisions) HR 861, End Surprise Billing Act (all provisions) HR 965, CREATES Act (all provisions) HR 1384, Medicare for All Act (all provisions) HR 1398, Health Insurance Tax Relief Act (all provisions) HR 3630, No Surprises Act HR 2782, Employee Flexibility Act (all provisions) HR 4070, Commonsense Reporting Act (all provisions) HR 3502, Protecting People From Surprise Medical Bills Act (all provisions) S.2543 Prescription Drug Pricing Reduction Act (all provisions) H.R. 3, the Elijah E. Cummings Lower Drug Costs Now Act (all provisions) H.R. 1994, the Setting Every Community Up for Retirement Enhancement (SECURE) Act (all provisions) H.R. 1865, Consolidated Appropriations Act (surprise billing provisions) H.R. 133, Coronavirus Response and Relief Supplemental Appropriations Act, 2021 (all provisions)

Client expense: $1,514,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Commerce, Dept of (DOC), Consumer Financial Protection Bureau (CFPB), Consumer Product Safety Commission (CPSC), Equal Employment Opportunity Commission (EEOC), Federal Maritime Commission, Federal Motor Carrier Safety Administration, Federal Reserve System, Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Maritime Administration (MARAD), Natl Economic Council (NEC), Natl Labor Relations Board (NLRB), Patent & Trademark Office (PTO), SENATE, Small Business Administration (SBA), State, Dept of (DOS), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Customs & Border Protection, U.S. Postal Service (USPS), U.S. Trade Representative (USTR), White House Office

Issues relating to access to care, health disparities, childhood cancer, quality of life and palliative care, cancer survivorship, federal health care programs, genetic information, cancer, nutrition, tanning beds, clinical trials, skin cancer, cannabis research, and wellness, including: HR 6514, Worker Health Coverage Protection Act HR 1425, Patient Protection and Affordable Care Enhancement Act Issues related to regulations for implementing section 1557 of the Affordable Care Act on anti-discrimination HR 6800, Health and Economic Recovery Omnibus Emergency Solutions Act or The HEROES Act Issues related to the Senate HELP Committee initiative on preparing for future pandemics. Regulatory issues related to telehealth Issues related to surprise medical billing, including HR 3630, the No Surprises Act; S 1895, the Lower Health Care Costs Act; S 1531, the Stopping the Outrageous Practice of Surprise Medical Bills Act of 2019; Issues relating to curbing health care costs; H.R.647 & S. 2080, the Palliative Care and Hospice Education and Training Act; Anti-cancer medication cost-sharing parity respecting H.R. 1409; A national family caregiving strategy respecting S. 1719 and H.R. 1028; Access to medicines respecting FDA implementation of right to try law; Introduction of the S. 3404 & H.R. 6102, Verifying Accurate Leading-edge IVCT Development Act of 2020 or the VALID Act of 2020; H. Res. 282, supporting initiatives to encourage parents and guardians to take measures to prevent sunburns in minors they care for; H.R. 1966 & S 946, the Henrietta Lacks Enhancing Cancer Research Act of 2019, regarding decreasing disparities in access to cancer clinical trials; Additional issues related to reducing health disparities in cancer clinical trials; Issues related to capturing racial and ethnic data demographic data for communities disproportionately affected by coronavirus; H.R. 2222 and S. 1107, the Women and Lung Cancer Research and Preventative Services Act; H.Res. 14 & S.Res. 223, Expressing support for the designation of DIPG Awareness Day H.R. 1730 and S. 741, the Cancer Drug Parity Act; Cannabis research issues, including S. 2032 Cannabidiol and Marihuana Research Expansion Act and S. 2400Expanding Cannabis Research and Information Act ; H.R. 4078 & S. 2424 EARLY Act Reauthorization of 2019 S. 2497, the Dependent Income Exclusion Act; Issues related to HHS regulation of prescription drug prices and costs; H.R. 4439, Creating Hope Reauthorization Act; H.R. 1730 and S. 741, the Cancer Drug Parity Act; H.R. 6556, the Gabriella Miller Kids First Research Act 2.0; H.R. 4439 & S. 4010, the Creating Hope Reauthorization Act; H.R.6666 & S. 4315, the COVID-19 Testing, Reaching, And Contacting Everyone (TRACE) Act, bill related to support needed data collection efforts to begin to contain coronavirus; Issues related to cancer survivorship and transitions of care from oncology treatment back to primary care; Issues related to improving data collection during the COVID-19 pandemic; and H.Res 1125, which expresses support for prioritizing racial and ethnic diversity in clinical trials for therapies, diagnostics in clinical trials for therapies, diagnostics, and vaccines for COVID -19. S 4557, COVID Enrollment Response Act (Sen. Baldwin)

Client expense: $490,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Energy, Dept of, Environmental Protection Agency (EPA), Federal Reserve System, Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), SENATE, Small Business Administration (SBA), State, Dept of (DOS), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Agency for International Development (USAID), Veterans Affairs, Dept of (VA), White House Office

H.R. 342 National Flood Insurance Program Mapping H.R. 420 Marijuana Products Regulation H.R. 469 Flood Insurance Coverage Rates H.R. 470 Mandatory Flood Insurance Coverage Repeal H.R. 471 Private Capital and Reinsurance Markets Risk Transfer H.R. 472 Alternative Flood Insurance Rate Maps H.R. 1402 Flood Maps Preparation Transfer H.R. 1418 Health Insurance Antitrust laws Application H.R. 1595 Cannabis Related Businesses Financial Services H.R. 1666 Private Flood Insurance Coverage H.R. 1689 Climate Change Advisory Commission Establishment H.R. 1756 Auto Insurance Consumer Reports Use Prohibition H.R. 1862 Federal Insurance Office Abolition S. 350 Health Insurance Federal Antitrust laws Application S. 420 Marijuana Products Taxation and Regulation S. 603 Financial Company Supervision Determination H.R. 2048 Consumer Products and Services Pricing H.R. 2318 National Flood Insurance Mapping H.R. 2479 Financial Stability Oversight Council Voting Member H.R. 2578 National Flood Insurance Program Extension Act of 2019 H.R. 2684 Auto Insurance Cost Disparities Study H.R. 3111 National Flood Insurance Reforms H.R. 3167 National Flood Insurance Program Reform H.R. 3183 Crop Insurance Eligibility H.R. 3258 Flood Insurance Rates Review S. 1108 Data Protection Impact Assessments S. 1144 National Flood Insurance Mapping S. 1200 Cannabis Related Business Financial Services Protection S. 1213 Health Insurance Reform Provision S. 1214 Individual and Collective Privacy Rights Protection S. 1520 National Flood Insurance Program Reauthorization S. 1531 Health Insurance Consumer Protections S. 1533 National Flood Insurance Program Reauthorization H.R. 3872 National Flood Insurance Program Reauthorization H.R. 4074 Cannabis Related Business Safe Harbor H.R. 4523 Risk Retention Groups Commercial Insurance Types S. 2088 Flood Area Community Accountability S. 2122 Flood Insurance Program Contract Termination Authority S. 2171 Flood Insurance Agents Continuing Education Requirement S. 2187 National Flood Insurance Program Reauthorization S. 2192 Flood Risk Reduction Funding Assistance S. 2201 Cannabis Related Business Insurers Safe Harbor H.R. 4634 Terrorism Risk Insurance Act Reauthorization H.R. 4652 Individual Market Reinsurance Fund Establishment S. 2877 Terrorism Risk Insurance Act S. 2964 Non Premium Aviation Insurance Authority Extension H.R. 1756 Auto Insurance Consumer Reports Use Prohibition H.R. 3693 Insurance Rate Income Proxies H.R. 5776 Flood Damaged Areas Accountability **Issues lobbied without specific bill number: COVID-19 Related Insurance Legislation, Business Interruption Insurance, Consumer Financial Protection Bureau Oversight of the Insurance Industry, Marijuana Financial Services H.R. 6494 Insurance Coverage for Business Interruption Losses H.R. 6497 Insurance Coverage for Business Interruption Losses H.R. 6800 HEROES Act Workers Compensation Provision H.R. 7011 Pandemic Risk Reinsurance Program H.R. 7412 Insurers Support Temporary Voluntary Program S. 3814 Loan Forgiveness Period Extension **Issues lobbied without specific bill number: Business Continuity Protection Program, COVID-19 personal and commercial insurance response and role, municipal services liability, judicial insurance antitrust consent decree

Client expense: $1,650,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Federal Aviation Administration (FAA), Federal Emergency Management Agency (FEMA), Federal Reserve System, HOUSE OF REPRESENTATIVES, Internal Revenue Service (IRS), Natl Economic Council (NEC), Natl Labor Relations Board (NLRB), SENATE, Transportation, Dept of (DOT), Treasury, Dept of, U.S. Trade Representative (USTR)

H.R. 342 National Flood Insurance Program Mapping H.R. 420 Marijuana Products Regulation H.R. 469 Flood Insurance Coverage Rates H.R. 470 Mandatory Flood Insurance Coverage Repeal H.R. 471 Private Capital and Reinsurance Markets Risk Transfer H.R. 472 Alternative Flood Insurance Rate Maps H.R. 1402 Flood Maps Preparation Transfer H.R. 1418 Health Insurance Antitrust laws Application H.R. 1595 Cannabis Related Businesses Financial Services H.R. 1666 Private Flood Insurance Coverage H.R. 1689 Climate Change Advisory Commission Establishment H.R. 1756 Auto Insurance Consumer Reports Use Prohibition H.R. 1862 Federal Insurance Office Abolition S. 350 Health Insurance Federal Antitrust laws Application S. 420 Marijuana Products Taxation and Regulation S. 603 Financial Company Supervision Determination H.R. 2048 Consumer Products and Services Pricing H.R. 2318 National Flood Insurance Mapping H.R. 2479 Financial Stability Oversight Council Voting Member H.R. 2578 National Flood Insurance Program Extension Act of 2019 H.R. 2684 Auto Insurance Cost Disparities Study H.R. 3111 National Flood Insurance Reforms H.R. 3167 National Flood Insurance Program Reform H.R. 3183 Crop Insurance Eligibility H.R. 3258 Flood Insurance Rates Review S. 1108 Data Protection Impact Assessments S. 1144 National Flood Insurance Mapping S. 1200 Cannabis Related Business Financial Services Protection S. 1213 Health Insurance Reform Provision S. 1214 Individual and Collective Privacy Rights Protection S. 1520 National Flood Insurance Program Reauthorization S. 1531 Health Insurance Consumer Protections S. 1533 National Flood Insurance Program Reauthorization H.R. 3872 National Flood Insurance Program Reauthorization H.R. 4074 Cannabis Related Business Safe Harbor H.R. 4523 Risk Retention Groups Commercial Insurance Types S. 2088 Flood Area Community Accountability S. 2122 Flood Insurance Program Contract Termination Authority S. 2171 Flood Insurance Agents Continuing Education Requirement S. 2187 National Flood Insurance Program Reauthorization S. 2192 Flood Risk Reduction Funding Assistance S. 2201 Cannabis Related Business Insurers Safe Harbor H.R. 4634 Terrorism Risk Insurance Act Reauthorization H.R. 4652 Individual Market Reinsurance Fund Establishment S. 2877 Terrorism Risk Insurance Act S. 2964 Non Premium Aviation Insurance Authority Extension H.R. 1756 Auto Insurance Consumer Reports Use Prohibition H.R. 3693 Insurance Rate Income Proxies H.R. 5776 Flood Damaged Areas Accountability **Issues lobbied without specific bill number: COVID-19 Related Insurance Legislation, Business Interruption Insurance, Consumer Financial Protection Bureau Oversight of the Insurance Industry, Marijuana Financial Services

Client expense: $1,710,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Federal Aviation Administration (FAA), Federal Emergency Management Agency (FEMA), Federal Reserve System, HOUSE OF REPRESENTATIVES, Internal Revenue Service (IRS), Natl Economic Council (NEC), Natl Labor Relations Board (NLRB), SENATE, Transportation, Dept of (DOT), Treasury, Dept of, U.S. Trade Representative (USTR)

S.80, Jobs and Premium Protection Act (all provisions) S.172, Health Insurance Tax Relief Act (all provisions) S.340, CREATES Act (all provisions) S.684, Middle Class Health Benefits Tax Repeal Act (all provisions) S.1531, Stopping the Outrageous Practice of Surprise Medical Bills Act (all provisions) S.1895, Lower Health Care Costs Act S.1510, Employee Flexibility Act (all provisions) S.2366, Commonsense Reporting Act (all provisions) HR 748, Middle Class Health Benefits Tax Repeal Act (all provisions) HR 861, End Surprise Billing Act (all provisions) HR 965, CREATES Act (all provisions) HR 1384, Medicare for All Act (all provisions) HR 1398, Health Insurance Tax Relief Act (all provisions) HR 3630, No Surprises Act HR 2782, Employee Flexibility Act (all provisions) HR 4070, Commonsense Reporting Act (all provisions) HR 3502, Protecting People From Surprise Medical Bills Act (all provisions) S.2543 Prescription Drug Pricing Reduction Act (all provisions) H.R. 3, the Elijah E. Cummings Lower Drug Costs Now Act (all provisions) H.R. 1994, the Setting Every Community Up for Retirement Enhancement (SECURE) Act (all provisions)

Client expense: $1,845,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Commerce, Dept of (DOC), Consumer Financial Protection Bureau (CFPB), Consumer Product Safety Commission (CPSC), Federal Maritime Commission, Federal Reserve System, Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Maritime Administration (MARAD), Natl Economic Council (NEC), Natl Labor Relations Board (NLRB), Patent & Trademark Office (PTO), SENATE, Small Business Administration (SBA), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Customs & Border Protection, U.S. Postal Service (USPS), U.S. Trade Representative (USTR), White House Office

Issues relating to access to care, health disparities, childhood cancer, quality of life and palliative care, cancer survivorship, federal health care programs, genetic information, cancer, nutrition, tanning beds, clinical trials, skin cancer, cannabis research, and wellness, including: HR 6514, Worker Health Coverage Protection Act HR 1425, Patient Protection and Affordable Care Enhancement Act Issues related to regulations for implementing section 1557 of the Affordable Care Act on anti-discrimination HR 6800, Health and Economic Recovery Omnibus Emergency Solutions Act or The HEROES Act Issues related to the Senate HELP Committee initiative on preparing for future pandemics. Regulatory issues related to telehealth Issues related to surprise medical billing, including HR 3630, the No Surprises Act; S 1895, the Lower Health Care Costs Act; S 1531, the Stopping the Outrageous Practice of Surprise Medical Bills Act of 2019; Issues relating to curbing health care costs; H.R.647 & S. 2080, the Palliative Care and Hospice Education and Training Act; Anti-cancer medication cost-sharing parity respecting H.R. 1409; A national family caregiving strategy respecting S. 1719 and H.R. 1028; Access to medicines respecting FDA implementation of right to try law; Introduction of the S. 3404 & H.R. 6102, Verifying Accurate Leading-edge IVCT Development Act of 2020 or the VALID Act of 2020; H. Res. 282, supporting initiatives to encourage parents and guardians to take measures to prevent sunburns in minors they care for; H.R. 1966 & S 946, the Henrietta Lacks Enhancing Cancer Research Act of 2019, regarding decreasing disparities in access to cancer clinical trials; Additional issues related to reducing health disparities in cancer clinical trials; Issues related to capturing racial and ethnic data demographic data for communities disproportionately affected by coronavirus; H.R. 2222 and S. 1107, the Women and Lung Cancer Research and Preventative Services Act; H.Res. 14 & S.Res. 223, Expressing support for the designation of DIPG Awareness Day H.R. 1730 and S. 741, the Cancer Drug Parity Act; Cannabis research issues, including S. 2032 Cannabidiol and Marihuana Research Expansion Act and S. 2400Expanding Cannabis Research and Information Act ; H.R. 4078 & S. 2424 EARLY Act Reauthorization of 2019 S. 2497, the Dependent Income Exclusion Act; Issues related to HHS regulation of prescription drug prices and costs; H.R. 4439, Creating Hope Reauthorization Act; H.R. 1730 and S. 741, the Cancer Drug Parity Act; H.R. 6556, the Gabriella Miller Kids First Research Act 2.0; H.R. 4439 & S. 4010, the Creating Hope Reauthorization Act; H.R.6666 & S. 4315, the COVID-19 Testing, Reaching, And Contacting Everyone (TRACE) Act, bill related to support needed data collection efforts to begin to contain coronavirus; Issues related to cancer survivorship and transitions of care from oncology treatment back to primary care; Issues related to improving data collection during the COVID-19 pandemic; and H.Res 1125, which expresses support for prioritizing racial and ethnic diversity in clinical trials for therapies, diagnostics in clinical trials for therapies, diagnostics, and vaccines for COVID -19. S 4557, COVID Enrollment Response Act (Sen. Baldwin)

Client expense: $490,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Energy, Dept of, Environmental Protection Agency (EPA), Federal Reserve System, Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), SENATE, Small Business Administration (SBA), State, Dept of (DOS), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Agency for International Development (USAID), Veterans Affairs, Dept of (VA), White House Office

Issues surrounding the enactment or repeal of the Affordable Care Act. Medicare reimbursement reform for providers including the Medicare Access and CHIP Reauthorization Act (MACRA). Medicare Part B Drug Reimbursement. FDA issues. The Palliative Care and Hospice Education and Training Act. Draft legislation to reform the FDA's regulation of cosmetics. Legislation to address physician workforce shortage (HR 1763/S.348). Ensuring Lasting Smiles Act (HR 1379/S. 560). Legislation to address out-of-network medical bills: HR 3630, HR 3502, HR 861, S.1895, S. 1531. Improving Seniors Access to Timely Care Act, HR 3107, Safe Step Act, HR 2279. Removing Barriers to Colorectal Cancer Screening Act of 2019, HR 1570. Financial relief and policy and regulatory changes for the provider community in COVID-19 legislation including the CARES Act. Regulation of Organ Procurement Networks (OPOs).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

General Issures regarding Executive Order 13950 - Combating Race and Sex Stereotyping H.R.1636 / S.2163 / Public Law 116-156 "Commission on the Social Status of Black Men and Boys Act"Section 2. (b) (3) S. 1531Stopping the Outrageous Practice of Surprise Medical Bills Act of 2019; provisions related to eliminate surprise billing S. 348/H.R. 1763 - Resident Physician Shortage Reduction Act of 2019; all provisions H.R. 3, Moving Forward Act H.R. 6201, Families First Coronavirus Response Act Eliminate Surprise billing (S 1895, HR 3630, HR 3502, S 1531, HR 5800, HR 5826) Support the Resident Physician Shortage Reduction Act of 2019 (S 348/HR1763) Support delaying the ACAs DSH cuts (HR2328) Opioid Workforce Act (H.R. 3414)

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

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

Price transparency, out-of-network reimbursement of emergency medical services, surprise medical bills Opioids, pain management Federal funding for Substance Use Disorder treatments Drug Shortages H.R.451-Dont Break Up the T-Band Act of 2020 H.R.501-Poison Center Network Enhancement Act of 2019 H.R.861-End Surprise Billing Act of 2019 H.R.925-The Heroes Act H.R.1301-Mental Health Telemedicine Expansion Act H.R.1309-Workplace Violence Prevention for Health Care and Social Service Workers Act H.R.1418-Competitive Health Insurance Reform Act of 2019 H.R.1554-Resident Education Deferred Interest (REDI) Act H.R.1646-Helping Emergency Responders Overcome (HERO) Act H.R.1682-Improving Access to Medicare Coverage Act of 2019 H.R.1767-Excellence in Mental Health and Addiction Treatment Expansion Act H.R.2281-Easy Medication Access and Treatment (MAT) for Opioid Addiction Act H.R.2328-Reauthorizing and Extending Americas Community Health Act H.R.2464-End the Cycle of Violence Act of 2019 H.R.2482-Mainstreaming Addiction Treatment Act of 2019 H.R.2519-Improving Mental Health Access from the Emergency Department Act of 2019 H.R.2550-Prevent Blood Loss with Emergency Equipment Devices Act of 2019 H.R.2569-Comprehensive Addiction Resources Emergency Act of 2019 H.R.3107-Improving Seniors Timely Access to Care Act of 2019 H.R.3417-Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act of 2019 H.R.3502-Protecting People From Surprise Medical Bills Act H.R.3630-No Surprises Act H.R.3935-Protecting Patients Transportation to Care Act H.R.3984-Health Care Safety Net Enhancement Act of 2019 H.R.4194-National Suicide Hotline Designation Act of 2019 H.R.4861-Effective Suicide Screening and Assessment in the Emergency Department Act of 2019 H.R.4932-Creating Opportunities Now for Necessary and Effective Care Technologies for Health Act of 2019 H.R.5619-Suicide Prevention Act H.R.5727-Research Empirical Solutions to End Ambulance Reversals from Closed Hospitals (RESEARCH) Act of 2020 H.R.5800-Ban Surprise Billing Act H.R.5826-Consumer Protections Against Surprise Medical Bills Act of 2020 H.R.5855-Bipartisan Solution to Cyclical Violence Act of 2020 H.R.6663-Truth in Healthcare Marketing Act of 2020 H.R.6800-Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act H.R.6910-Emergency Room Hero and Patient Safety Act H.R.6930-Manufacturing API, Drugs, and Excipients (MADE) in America Act of 2020 H.R.7059-Coronavirus Provider Protection Act H.R.7255-Coronavirus Health Care Worker Wellness Act of 2020 H.R.7574-Strengthening Americas Strategic National Stockpile Act of 2020 H.R.7819-Eliminating the Provider Relief Fund Tax Penalties Act of 2020 H.R.8094-Dr. Lorna Breen Health Care Provider Protection Act H.R.8441-Frontlines Heroes Act H.R.8505-To amend title XVIII of the Social Security Act to provide for a one-year waiver of budget neutrality adjustments under the Medicare physician fee schedule, and for other purposes H.R.8702-Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020 S.289-Rural Physician Workforce Production Act of 2019 S.299-Geriatrics Workforce Improvement Act S.350-Competitive Health Insurance Reform Act of 2019 S.618-Medicare Choices Empowerment and Protection Act S.753-Improving Access to Medicare Coverage Act of 2019 S.824-Excellence in Mental Health and Addiction Treatment Expansion Act S.851-Workplace Violence Prevention for Health Care and Social Service Workers Act S.1199-Poison Center Network Enhancement Act of 2019 S.1266-Protecting Patients from Surprise Medical Bills Act S.1334-Improving Mental Health Access from the Emergency Department S.1350-Good Samaritan Health Professionals Act of 2019 S.1365-Comprehensive Addiction Resources Emergency Act of 2019 S.1531-Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019 S.1895-Lower Health Care Costs Act S.2074-Mainstreaming Addiction Treatment Act of 2019 S.2661-National Suicide Hotline Designation Act of 2020 S.2741-Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019 S.3006-Effective Suicide Screening and Assessment in the Emergency Department Act of 2019 S.3143-Magnet Injury Prevention Act S.3198-Suicide Prevention Act S.3346-Prevent Blood Loss with Emergency Equipment Devices Act of 2020 S.4349-Dr. Lorna Breen Health Care Provider Protection Act S.5007-Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020

Client expense: $340,838 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Price transparency, out-of-network reimbursement of emergency medical services, surprise medical bills H.R.861-End Surprise Billing Act of 2019 H.R.1418-Competitive Health Insurance Reform Act of 2019 H.R.2328-Reauthorizing and Extending Americas Community Health Act H.R.3107-Improving Seniors Timely Access to Care Act of 2019 H.R.3502-Protecting People From Surprise Medical Bills Act H.R.3630-No Surprises Act H.R.5800-Ban Surprise Billing Act H.R.5826-Consumer Protections Against Surprise Medical Bills Act of 2020 S.350-Competitive Health Insurance Reform Act of 2019 S.1266-Protecting Patients from Surprise Medical Bills Act S.1531-Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019 S.1895-Lower Health Care Costs Act

Client expense: $340,838 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Price transparency, out-of-network reimbursement of emergency medical services, surprise medical bills H.R.861-End Surprise Billing Act of 2019 H.R.1418-Competitive Health Insurance Reform Act of 2019 H.R.2328-Reauthorizing and Extending Americas Community Health Act H.R.3107-Improving Seniors Timely Access to Care Act of 2019 H.R.3502-Protecting People From Surprise Medical Bills Act H.R.3630-No Surprises Act H.R.5800-Ban Surprise Billing Act H.R.5826-Consumer Protections Against Surprise Medical Bills Act of 2020 S.350-Competitive Health Insurance Reform Act of 2019 S.1266-Protecting Patients from Surprise Medical Bills Act S.1531-Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019 S.1895-Lower Health Care Costs Act

Client expense: $391,824 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Price transparency, out-of-network reimbursement of emergency medical services, surprise medical bills Opioids, pain management Federal funding for Substance Use Disorder treatments Drug Shortages H.R.451-Dont Break Up the T-Band Act of 2020 H.R.501-Poison Center Network Enhancement Act of 2019 H.R.861-End Surprise Billing Act of 2019 H.R.925-The Heroes Act H.R.1301-Mental Health Telemedicine Expansion Act H.R.1309-Workplace Violence Prevention for Health Care and Social Service Workers Act H.R.1418-Competitive Health Insurance Reform Act of 2019 H.R.1554-Resident Education Deferred Interest (REDI) Act H.R.1646-Helping Emergency Responders Overcome (HERO) Act H.R.1682-Improving Access to Medicare Coverage Act of 2019 H.R.1767-Excellence in Mental Health and Addiction Treatment Expansion Act H.R.2281-Easy Medication Access and Treatment (MAT) for Opioid Addiction Act H.R.2328-Reauthorizing and Extending Americas Community Health Act H.R.2464-End the Cycle of Violence Act of 2019 H.R.2482-Mainstreaming Addiction Treatment Act of 2019 H.R.2519-Improving Mental Health Access from the Emergency Department Act of 2019 H.R.2550-Prevent Blood Loss with Emergency Equipment Devices Act of 2019 H.R.2569-Comprehensive Addiction Resources Emergency Act of 2019 H.R.3107-Improving Seniors Timely Access to Care Act of 2019 H.R.3417-Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act of 2019 H.R.3502-Protecting People From Surprise Medical Bills Act H.R.3630-No Surprises Act H.R.3935-Protecting Patients Transportation to Care Act H.R.3984-Health Care Safety Net Enhancement Act of 2019 H.R.4194-National Suicide Hotline Designation Act of 2019 H.R.4861-Effective Suicide Screening and Assessment in the Emergency Department Act of 2019 H.R.4932-Creating Opportunities Now for Necessary and Effective Care Technologies for Health Act of 2019 H.R.5619-Suicide Prevention Act H.R.5727-Research Empirical Solutions to End Ambulance Reversals from Closed Hospitals (RESEARCH) Act of 2020 H.R.5800-Ban Surprise Billing Act H.R.5826-Consumer Protections Against Surprise Medical Bills Act of 2020 H.R.5855-Bipartisan Solution to Cyclical Violence Act of 2020 H.R.6663-Truth in Healthcare Marketing Act of 2020 H.R.6800-Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act H.R.6910-Emergency Room Hero and Patient Safety Act H.R.6930-Manufacturing API, Drugs, and Excipients (MADE) in America Act of 2020 H.R.7059-Coronavirus Provider Protection Act H.R.7255-Coronavirus Health Care Worker Wellness Act of 2020 H.R.7574-Strengthening Americas Strategic National Stockpile Act of 2020 H.R.7819-Eliminating the Provider Relief Fund Tax Penalties Act of 2020 H.R.8094-Dr. Lorna Breen Health Care Provider Protection Act S.289-Rural Physician Workforce Production Act of 2019 S.299-Geriatrics Workforce Improvement Act S.350-Competitive Health Insurance Reform Act of 2019 S.618-Medicare Choices Empowerment and Protection Act S.753-Improving Access to Medicare Coverage Act of 2019 S.824-Excellence in Mental Health and Addiction Treatment Expansion Act S.851-Workplace Violence Prevention for Health Care and Social Service Workers Act S.1199-Poison Center Network Enhancement Act of 2019 S.1266-Protecting Patients from Surprise Medical Bills Act S.1334-Improving Mental Health Access from the Emergency Department S.1350-Good Samaritan Health Professionals Act of 2019 S.1365-Comprehensive Addiction Resources Emergency Act of 2019 S.1531-Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019 S.1895-Lower Health Care Costs Act S.2074-Mainstreaming Addiction Treatment Act of 2019 S.2661-National Suicide Hotline Designation Act of 2020 S.2741-Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019 S.3006-Effective Suicide Screening and Assessment in the Emergency Department Act of 2019 S.3143-Magnet Injury Prevention Act S.3198-Suicide Prevention Act S.3346-Prevent Blood Loss with Emergency Equipment Devices Act of 2020 S.4349-Dr. Lorna Breen Health Care Provider Protection Act

Client expense: $391,824 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Monitor issues related to healthcare cost, surprise billing issues and transparency; S. 1531, Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019; S. 1895, Lower Health Care Costs Act of 2019; Monitored implementation of the following: Public Law 116-123, Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020; Public Law 116-127, Families First Coronavirus Response Act; Public Law 116-136, CARES Act - proposals related to physician and provider relief; Telehealth issues related to COVID-19; H.R. 925, The Heroes Act; H.R. 8337, Continuing Appropriations Act, 2021 and Other Extensions Act; Public Law 116-159

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

Government targets: SENATE, White House Office

Health care issues affecting individuals with neuromuscular disease including therapy development, newborn screening, screening and diagnosis, adequate insurance coverage, and access to care. Advocated for passage of H.R. 4393, the Advancing Access to Precision Medicine Act, provide for a State option under the State Medicaid plan to provide DNA sequencing clinical services for certain children. Advocated for funding for the FDA Orphan Products Grants Program. Advocated for passage of H.R. 3235, the Access to Genetic Counselor Services Act of 2019, to provide for expanded coverage of services provided by genetic counselors. Advocated for the passage of the Newborn Screening Saves Lives Reauthorization Act, H.R. 2507 / S. 2158, to encourage investment in the national newborn screening program in order to detect more neuromuscular conditions early to speed appropriate interventions for patients. Advocated for robust funding of the national newborn screening program. Advocated for increased funding for National Institutes of Health, Food and Drug Administration, Health Resources and Services Administration, and other health agencies that conduct research on neuromuscular disease and provide services to those with these conditions. Advocated for adequate, affordable, accessible health coverage for individuals with neuromuscular conditions. Issues related to surprise medical billing, including HR 3630, the No Surprises Act; S 1895, the Lower Health Care Costs Act; S 1531, the Stopping the Outrageous Practice of Surprise Medical Bills Act of 2019. Advocated for maintaining strong incentives for rare disease drug development included within the Orphan Drug Act (PL 97-414) Advocated on the Promising Pathway Act (S.3872) and the ACT for ALS Act (H.R.7071). Advocated for access to healthcare via telemedicine/telehealth throughout and after the COVID-19 public health emergency. H.R. 6800, HEROES Act and related COVID-19 packages, support various provisions relevant to people with NMDs including increased federal support for state Medicaid programs; Medicaid maintenance of effort provisions; nationwide reopening of Marketplace special enrollment period; expansion of paid sick leave and paid family and medical leave; making permanent flexibilities to allow Medicare beneficiaries to continue accessing healthcare through telehealth; more resources to enhance testing and contact tracing in underserved communities; opposing waivers from IDEA and the Rehab Act; and better data collection on the impact of COVID-19 on people with disabilities. Continuing to support passage of legislation and proposals to protect patients from surprise medical billing and hold patients harmless.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Aviation Administration (FAA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, SENATE, Transportation, Dept of (DOT)

H.R. 3502, Protecting People from Surprise Medical Bills Act, all provisions H.R. 5826, Consumer Protections Against Surprise Medical Bills Act of 2020, all provisions H.R. 3630, No Surprises Act, all provisions S. 1895, Lower Health Care Costs Act, provisions relating to surprise billing S. 1531, Stopping The Outrageous Practice of (STOP) Surprise Medical Bills Act of 2019, all provisions S. 4421, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act, all provisions H.R. 6644, To require group health plans and health insurance issuers offering group or individual health insurance coverage to provide coverage for services furnished via telehealth if such services would be covered if furnished in-person during the COVID-19 emergency, all provisions S. 3741, Health Care at Home Act of 2020, all provisions S. 4666, National Coronavirus Commission Act of 2020, all provisions S. 4507, Getting Early Treatment and Comprehensive Assessments Reduces Emergencies (GET CARE) Act of 2020, all provisions H.R. 8441, Frontline Heroes Act, all provisions S. 4317, SAFE TO WORK Act, all provisions H.R. 925, The Heroes Act, all provisions S. 3749, Public Health Emergency Privacy Act, all provisions S. 3861, Exposure Notification Privacy Act, all provisions H.R. 6585, Equitable Data Collection and Disclosure on COVID-19 Act, all provisions H.R. 7510, Assimilating Health and Equity Assessments into Decision-making (AHEAD Act) of 2020, all provisions S. 4919, Assimilating Health and Equity Assessments into Decision-making (AHEAD Act) of 2020, all provisions H.R. 6808, Health Force and Resilience Force Act of 2020, all provisions S. 3606, Health Force and Resilience Force Act of 2020, all provisions H.R. 7255, Coronavirus Health Care Worker Wellness Act of 2020, all provisions H.R. 8094, Dr. Lorna Breen Health Care Provider Protection Act, all provisions S. 4349, Dr. Lorna Breen Health Care Provider Protection Act, all provisions H.R. 3884, Marijuana Opportunity Reinvestment and Expungement (MORE) Act of 2020, all provisions S. 2032, Cannabidiol and Marihuana Research Expansion Act, all provisions H.R. 1503, Orange Book Transparency Act of 2019, provisions related to PBM and prescription drug price transparency H.R. 1520, Purple Book Continuity Act of 2019, provisions related to PBM and prescription drug price transparency H.R. 987, Strengthening Health Care and Lowering Prescription Drug Costs Act, provisions related to PBM and prescription drug price transparency H.R. 3, Elijah E. Cummings Lower Drug Costs Now Act, provisions related to PBM and prescription drug price transparency H.R. 4995, Maternal Health Quality Improvement Act of 2020, all provisions H.R. 7120, George Floyd Justice in Policing Act of 2020, provisions relating to police reform Affordable Care Act stabilization Expansion of Paycheck Protection Program for 501(c)6s Public Health and Social Services Emergency Fund Marginalized and minoritized communities/COVID-19 disproportionate impact COVID-19 long haulers COVID-19 testing/vaccines/health care prior authorization COVID-19/treatment and prescribing flexibilities COVID-19/Expanded PPE/clearinghouses E/M services Surprise medical billing executive orders Surprise Medical Billing, generally Clinical and administrative data intersection State Medical Boards/Interstate Medical Licensure Compact Pharmacists and COVID-19 testing Mental health parity Digital therapeutics Physician practice financial impact 21st Century Cures Act/health data and privacy 42 CFR Part 2, HIPAA Patent reform CPT - digital Most favored nation drug pricing Drug pricing Health Information Technology/information blocking Dietary guidelines/alcohol consumption Data privacy Cyber security best practices Race and sex stereotyping executive order

Client expense: $3,870,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Bureau of Citizenship & Immigration Services (BCIS), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), SENATE, Veterans Affairs, Dept of (VA), White House Office

Lobby members of Congress regarding issues related to telemedicine. Advocate for increased transparency regarding drug pricing. Lobby members of the House to join the Congressional Skin Cancer Caucus. Advocate for adequate and accurate network coverage for dermatologic care within health insurance exchange networks. Support H.R. 1959, Preserving Patient Access to Compounded Medications Act. Support H.R. 2077/S. 2546, Safe Step Act. Support H.R. 1035, Prescription Drug Price Transparency Act. Support H.R. 985, Fair Access for Safe and Timely Generics Act. Support S. 476, C-THRU Act. Support S. 989, Ensuring Childrens Access to Specialty Care Act. Support H.R. 1034/S. 640, Phair Pricing Act. Support S. 657, Drug Price Transparency Act Support H.R. 938, BLOCKING Act Support H.R. 2375/S. 64, Preserve Access to Affordable Generics & Biosimilars Act Support H.R. 1499, Protecting Consumer Access to Generic Drugs Act Support H.R. 2296/S. 1391, Fair Accountability & Innovative Research (FAIR) Drug Pricing Act Support H.R. 2069, Stopping the Pharmaceutical Industry from Keeping drugs Expensive (SPIKE) Act. Support H.R. 2115, Public Disclosure of Drug Discounts Act Support H.R. 2376/S. 1227, Prescription Pricing for the People Act Support H.R. 1379/S. 560, Ensuring Lasting Smiles Act. Advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans. Support H.R. 3107, Improving Seniors Timely Access to Care Act Support pediatric subspecialty loan repayment in any reauthorization of the Title VII programs. Support S. 2443 Investment in Tomorrows Pediatric Health Care Workforce Act Support H.R. 1554, Resident Education Deferred Interest (REDI) Act. Advocate for the continued and increased funding of Community Health Centers. Lobby members of Congress to cosponsor H. Res. 323, which would support state, local, and community initiatives to encourage parents, teachers, camp counselors, and childcare professionals to take measures to prevent sunburns in the minors they care for, and would express the sense of the House of Representatives that state, local, and community entities should continue to support efforts to curb the incidences of skin cancer beginning with childhood skin protection. In the context of legislation to address surprise medical bills, advocate for an independent dispute resolution (IDR) process to resolve disputes between payers and physicians and against provisions that would set out-of-network reimbursement rates at a benchmark level. (H.R. 2328, H.R. 3502, S. 1531, S. 1895, H.R. 133) Support H.R. 4575, Improving Provider Directories Act, which would require group health plans and health insurance issuers offering group or individual health insurance coverage to establish a process to address inaccurate information listed in publicly accessible provider directories of such plans and issuers. Support the Creating Opportunities Now for Necessary and Effect Care Technologies (CONNECT) for Health Act of 2019 (S. 2741/H.R. 4932), which would increase access to telehealth services. Support legislation to address drug shortages by providing additional authority to the Food and Drug Administration (FDA) to ensure a stable supply of medications (S. 2723, Mitigating Emergency Drug Shortages Act; H.R. 6080, Preventing Drug Shortages Act). Similar provisions to mitigate drug shortages included in CARES Act (H.R. 748, S. 3548). Request resources to provide personal protection equipment (PPE) and supplies and relief from Medicare payment sequester and relief from penalties in Merit-based Incentive Payment System (MIPS) under MACRA in the CARES Act (H.R. 748, S. 3548). Support the Coronavirus Health Care Worker Wellness Act (H.R. 7255) to help promote mental health wellness among physicians and other health care workers during the Public Health Emergency. Advocate for congressional action to hold health care professionals harmless from any cuts related to CMS Evaluation and Management Code proposals in any forthcoming legislative package (H.R. 8702/S. 5007, Holding Providers Harmless from Medicare Cuts During COVID-19 Act; S. 8505, a bill to provide a one-year waiver of budget neutrality adjustment under the Medicare Physician Fee Schedule; H.R. 133, Consolidated Appropriations Act, 2021). Support H.R. 7233, the KEEP Telehealth Options Act. Oppose H.R 884/S. 2772 the Medicare Mental Health Access Act

Client expense: $310,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Lobby members of Congress regarding issues related to telemedicine. Advocate for increased transparency regarding drug pricing. Lobby members of the House to join the Congressional Skin Cancer Caucus. Advocate for adequate and accurate network coverage for dermatologic care within health insurance exchange networks. Support H.R. 1959, Preserving Patient Access to Compounded Medications Act. Support H.R. 2077/S. 2546, Safe Step Act. Support H.R. 1035, Prescription Drug Price Transparency Act. Support H.R. 985, Fair Access for Safe and Timely Generics Act. Support S. 476, C-THRU Act. Support S. 989, Ensuring Childrens Access to Specialty Care Act. Support H.R. 1034/S. 640, Phair Pricing Act. Support S. 657, Drug Price Transparency Act Support H.R. 938, BLOCKING Act Support H.R. 2375/S. 64, Preserve Access to Affordable Generics & Biosimilars Act Support H.R. 1499, Protecting Consumer Access to Generic Drugs Act Support H.R. 2296/S. 1391, Fair Accountability & Innovative Research (FAIR) Drug Pricing Act Support H.R. 2069, Stopping the Pharmaceutical Industry from Keeping drugs Expensive (SPIKE) Act. Support H.R. 2115, Public Disclosure of Drug Discounts Act Support H.R. 2376/S. 1227, Prescription Pricing for the People Act Support H.R. 1379/S. 560, Ensuring Lasting Smiles Act. Advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans. Support H.R. 3107, Improving Seniors Timely Access to Care Act Support pediatric subspecialty loan repayment in any reauthorization of the Title VII programs. Support S. 2443 Investment in Tomorrows Pediatric Health Care Workforce Act Support H.R. 1554, Resident Education Deferred Interest (REDI) Act. Advocate for the continued and increased funding of Community Health Centers. Lobby members of Congress to cosponsor H. Res. 323, which would support state, local, and community initiatives to encourage parents, teachers, camp counselors, and childcare professionals to take measures to prevent sunburns in the minors they care for, and would express the sense of the House of Representatives that state, local, and community entities should continue to support efforts to curb the incidences of skin cancer beginning with childhood skin protection. In the context of legislation to address surprise medical bills, advocate for an independent dispute resolution (IDR) process to resolve disputes between payers and physicians and against provisions that would set out-of-network reimbursement rates at a benchmark level. (H.R. 2328, H.R. 3502, S. 1531, S. 1895, H.R. 133) Support H.R. 4575, Improving Provider Directories Act, which would require group health plans and health insurance issuers offering group or individual health insurance coverage to establish a process to address inaccurate information listed in publicly accessible provider directories of such plans and issuers. Support the Creating Opportunities Now for Necessary and Effect Care Technologies (CONNECT) for Health Act of 2019 (S. 2741/H.R. 4932), which would increase access to telehealth services. Support legislation to address drug shortages by providing additional authority to the Food and Drug Administration (FDA) to ensure a stable supply of medications (S. 2723, Mitigating Emergency Drug Shortages Act; H.R. 6080, Preventing Drug Shortages Act). Similar provisions to mitigate drug shortages included in CARES Act (H.R. 748, S. 3548). Request resources to provide personal protection equipment (PPE) and supplies and relief from Medicare payment sequester and relief from penalties in Merit-based Incentive Payment System (MIPS) under MACRA in the CARES Act (H.R. 748, S. 3548). Support the Coronavirus Health Care Worker Wellness Act (H.R. 7255) to help promote mental health wellness among physicians and other health care workers during the Public Health Emergency. Advocate for congressional action to hold health care professionals harmless from any cuts related to CMS Evaluation and Management Code proposals in any forthcoming legislative package (H.R. 8702/S. 5007, Holding Providers Harmless from Medicare Cuts During COVID-19 Act; S. 8505, a bill to provide a one-year waiver of budget neutrality adjustment under the Medicare Physician Fee Schedule; H.R. 133, Consolidated Appropriations Act, 2021). Support H.R. 7233, the KEEP Telehealth Options Act. Oppose H.R 884/S. 2772 the Medicare Mental Health Access Act

Client expense: $310,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Affordable prescription drugs, 340B Program; HR985 FAST Generics Act of 2019; Appropriate and accurate payment for healthcare; Site Neutral payment policies; S. 1895 - Lower Health Care Costs Act; S. 340 - CREATES Act, H.R. 987 - Strengthening Health Care and Lowering Prescription Drug Costs Act; S. 1391 - Fair Accountability and Innovative Research Drug Pricing Act of 2019; Surprise billing: S. 1531 - Stop the Outrageous Practice of Surprise Medical Bills Act of 2019; HR 3, the Lower Drug Costs Now Act; H.R.2149 - Exposing the Financing of Human Trafficking Act; H.R.508 - Trafficking Victims Housing Act of 2019; H.R. 1520 - Purple Book Continuity At of 2019; H.R. 1503 - Orange Book Transparency Act of 2019; S.2543 - Prescription Drug Pricing Reduction Act of 2019; Health care privacy; patient privacy; H.R. 647, S.2080 - Palliative Care and Hospice Education and Training Act; Conrad 30 and the Physician Access Reauthorization Act, S 948; Issues related to the Medicaid Fiscal Accountability Regulation (MFAR); HR 6074 - Coronavirus Preparedness and Response Supplemental Appropriations Act; HR 6201 - Families First Coronavirus Response Act - Public Law No: 116-127; HR 748 - Coronavirus Aid, Relief, and Economic Security (CARES) Act; response to the COVID-19 public health emergency; S. 178 - HEALS Act; H.R. 1425, Patient Protection and Affordable Care Enhancement Act; H.R. 6800 - HEROES Act; H.R. 266, Paycheck Protection Program and Health Care Enhancement Act; issues related to coverage of virtual car; Financial support for providers for diagnosis and treatment related to COVID-19, coverage of COVID-19 related conditions, and access to PPE and other materials and equipment related to the treatment of patients with COVID-19; H.R. 133 - Consolidated Appropriations Act; Issues related to social determinants of health; H.R. 6561 - Improving Social Determinants of Health Act ; S. 4421- Temporary Reciprocity to Ensure Access to Treatment Act; liability relief for health care providers

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA), Vice President of the U.S.

Issues related to employer, small group and individual insurance markets, including surprise billing and increasing COBRA subsidies for individuals to maintain coverage. H.R. 3107, The Improving Seniors Timely Access to Care Act of 2019 H.R. 3630, The No Surprises Act of 2019 H.R. 6800, The Health and Economic Recovery Omnibus Emergency Solutions Act of 2020 S. 1531, The Stopping the Outrageous Practice Of Surprise Medical Bills Act of 2019 S. 1895, The Lower Health Care Costs Act of 2019 H.R. 133, Consolidated Appropriations Act, 2021

Client expense: $2,300,000 · Firm income: Not reported

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

Support HR 1763/ S 348, Resident Physician Shortage Reduction Act of 2019, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; Oppose HR 506,Hospital Competition Act of 2019, a bill to amend title XVIII of the Social Security Act to increase hospital competition; Statement submitted to the House Judiciary on the hearing "Diagnosing the Problem: Exploring the Effects of Consolidation and Anticompetitive Conduct in Health Care Markets"; Support HR 965/ S340, Creating and Restoring Equal Access to Equivalent Samples Act of 2019 or the CREATES Act of 2019, a bill to promote competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products; Support HR 986/ S466 Protecting Americans with Preexisting Conditions Act of 2019, a bill provide that certain guidance related to waivers for State innovation under the Patient Protection and Affordable Care Act shall have no force or effect; Support HR 987 Strengthening Health Care and Lowering Prescription Drug Costs Act, a bill to amend the Patient Protection and Affordable Care Act to provide for Federal Exchange outreach and educational activities; Support HR 938 Bringing Low-cost Options and Competition while Keeping Incentives for New Generics Act of 2019 or the BLOCKING Act of 2019, 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; Support HR 1010, a bill to provide that the rule entitled Short-Term, Limited Duration Insurance shall have no force or effect; Support HR 1499 Protecting Consumer Access to Generic Drugs Act of 2019, a bill to 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; Support HR 1425 State Health Care Premium Reduction Act, 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; Support HR 1386/ S 1905 Expand Navigators Resources for Outreach, Learning, and Longevity Act of 2019 or the ENROLL Act of 2019,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; Support HR 1520 Purple Book Continuity Act of 2019, 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; Support HR 1503 Orange Book Transparency Act of 2019A bill that would increase transparency for the patent status of both approved biological products and approved drugs; Support HR 2439/ HR 3414 Opioid Workforce Act of 2019, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions to help combat the opioid crisis; Submitted statement to the House Committee on Ways and Means Overcoming Racial Disparities and Social Determinants in the Maternal Mortality Crisis sharing information regarding hospitals and health systems efforts to address maternal morbidity and mortality, as we seek ways to improve outcomes and reduce health inequities for expectant and new mothers, and give their children the best possible start in life; Submitted oral and written testimony to the House Committee on Ways and Means Subcommittee on Health Hearing on Protecting Patients from Surprise Medical Bills. Protecting patients from surprise medical bills is a top priority and we have adopted a set of guiding principles to use as we evaluate legislative proposals: Define surprise bills, Protect the patient financially, Ensure patient access to emergency care, Preserve the role of private negotiation, Remove the patient from health plan/provider negotiations, Educate patients about their health care coverage, Ensure patients have access to comprehensive provider networks and accurate network information, and Support state laws that work; Letters submitted to the Energy & Commerce Committee in response to the request for comments on their surprise billing discussion draft. Concerned with the Committees draft legislations approach to determining reimbursement for out-of-network providers. Once the patient is protected from surprise bills, providers and insurers should then be permitted to negotiate payment rates for services provided. We strongly oppose approaches that would impose arbitrary rates on providers. We look forward to continuing to work with the Committee on solutions to stop surprise medical bills; Letter sent to the HELP Committee in response to the Lower Health Care Costs Act of 2019 discussion draft about our concerns about several of the proposals that would allow the government to intrude into private commercial contracts between providers and insurers. For example, several of the provisions could undermine value-based purchasing arrangements aimed directly at improving the quality of care while reducing costs. We strongly urge the Committee to remove these provisions; Submitted oral and written testimony to the House Committee on Energy and Commerce, Subcommittee on Health Hearing on No More Surprises: Protecting Patients from Surprise Medical Bills asking that the Committee preserve the ability of providers and insurers to negotiate private contracts and not establish a fixed payment amount for out-of-network services; Oppose HR 1309 Workplace Violence Prevention for Health Care and Social Service Workers Act, a bill to direct the Secretary of Labor to issue an occupational safety and health standard that requires covered employers within the health care and social service industries to develop and implement a comprehensive workplace violence prevention plan, and for other purposes; Concerns about S.1531, Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019 or the STOP Surprise Medical Bills Act of 2019, to amend the Public Health Service Act to provide protections for health insurance consumers from surprise billing; Concerns about S. 1895 Lower Health Care Costs Act Letter addressed concerns about the legislative provision that sets a benchmark rate in statute for the out-of-network payments, as well as provisions that seek to change privately negotiated contracting arrangements between hospitals and insurance companies; Support HR 3425, Advancing Medical Resident Training in Community Hospitals Act of 2019, to amend title XVIII of the Social Security Act to establish rules for payment for graduate medical education (GME) costs for hospitals that establish a new medical residency training program after hosting resident rotators for short durations; Expressed concerns regarding the provisions that reduce reimbursements to providers and hospitals that administer drugs the Prescription Drug Pricing Reduction Act (PDPRA) of 2019: including about Section 107, Medicare Part B Rebate by Manufacturers for Drugs or Biologicals with Prices Increasing Faster than Inflation, Section 110, Establishment of Maximum Add-on Payment for Drugs, Biologicals, and Biosimilars, this provision would establish $1,000 as the maximum add-on amount that a provider can be paid for a separately payable drug, biological or biosimilar, Section 111, Treatment of Drug Administration Services Furnished by an Off-Campus Outpatient Department of a Provider, the site neutral payment reduction would cut aggregate hospital payments; Support S. 2091, Backlog Elimination, Legal Immigration, and Employment Visa Enhancement Act, this legislation would increase the total number of employment-based visas from 140,000 to 270,000 and ensure that critical health care workers needed in the U.S. have access to employment-based visas by carving out health care workers in designated shortage occupations from the limit; Support S 350, The Competitive Health Insurance Reform Act of 2019, a bill to restore the application of the Federal antitrust laws to the business of health insurance to protect competition and consumers; Submitted statement to Subcommittee on Health of the Committee on Energy and Commerce for the hearing on Improving Maternal Health: Legislation to Advance Prevention Efforts and Access to Care; Concerns with S. 386 and HR 1044, Fairness for High-Skilled Immigrants Act of 2019, this bill increases the per-country cap on family-based immigrant visas from 7% of the total number of such visas available that year to 15%, and eliminates the 7% cap for employment-based immigrant visas. It also removes an offset that reduced the number of visas for individuals from China; Support H.R. 4538, Closing Loopholes for Orphan Drugs Act, a bill to amend title III of the Public Health Service Act to limit the orphan drug exclusion under the drug discount program under section 340B of such title; Discussions of provisions we support and those we recommend be changes in a draft bill called the Mitigating Existing Drug Shortages (MEDS) Act; Discussions in support of the allowing states to designate hospitals as necessary providers for purposes of waiving the critical access hospital mileage requirements; Provided comments to W&M on legislation to expand Health Profession Opportunity Grants; Support S. 2723, The Mitigating Emergency Drug Shortages (MEDS) Act, a bill to amend Sec. 506C of the Federal Food, Drug, and Cosmetic Act which strengthens requirements for drug manufacturers to disclose the root causes and expected duration of shortages, extends reporting requirements to active pharmaceutical ingredients manufacturers, requires manufacturers have contingency plans to ensure ongoing supply, develops recommendations to incentivize manufacturers to enter the market for drugs in shortage and examines the national security risks of shortages; Discuss DEA reductions in annual quotas for opioid products used by hospitals for sedation and pain management; Meeting with the Office of the Assistant Secretary of Preparedness and Response (ASPR) to discuss developments in the hospital preparedness program, the pilot projects for the Regional Disaster Healthcare System and other issues; Rural access to health care, including identifying core services needed in rural communities, outlining approaches and considerations for delivering those services, and examining access and quality in the rural context; ONCs proposed rule to implement the 21st Century Cures provision on information blocking; Supported members serving on the HHS Quality Summit panel, which was convened by the Deputy Secretary to gather input regarding how to improve and energize quality and safety improvement activities across health care system; Discussion with HHS on drug pricing, 340b, and price transparency policies, as well as the International Pricing Index ANPRM; Discussion with HHS about the work of Aligning for Health to address social determinants of health; Support S 2902, Strengthening Our Rural Health Workforce Act of 2019, a bill to enhance the rural health workforce; Meetings and correspondence with staff members of Senate Financing Committee on a proposal to support rural health care access (REH, re-opening necessary provider CAH, infrastructure funding); Letter to Ways & Means committee Rural and Underserved Communities Health Task Force in response to RFI on factors that contribute to health outcomes in these areas, examples of successful models and lessons from the field that address access and outcomes, and considerations for the unique circumstances of rural and underserved communities; Letter to Energy and Commerce Members regarding health information technology priorities; Letter of Support to Senate Appropriations on funding for the Centers for Disease Control and Prevention and the National Institutes of Health to study gun violence; Support S.2741 and H.R. 4932,Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019, a bill to amend title XVIII of the Social Security Act to expand access to telehealth services, and for other purposes; Support S 2603, Resolving Extended Limbo for Immigrant Employees and Families (RELIEF) Act, a bill to amend the Immigration and Nationality Act to end the immigrant visa backlog, and for other purposes; Support HR 4995, Maternal Health Quality Improvement Act of 2019, a bill to amend the Public Health Service Act to improve obstetric care and maternal health outcomes, and for other purposes; Concerns with HR 5800,Ban Surprise Billing Act, a bill to address surprise medical bills that relies on a median in-network rate to resolve out-of-network payments and allows for an independent dispute resolution process to determine the final payment. Concerned with the Committee's legislative approach to determining reimbursement for out-of-network providers. Oppose approaches that would impose arbitrary rates on providers, which could have significant consequences far beyond the scope of surprise medical bills. It is the insurers' responsibility to maintain comprehensive provider networks, and a default payment rate would remove incentives for health plans to contract with providers or to offer fair terms; Support HR 5826, Consumer Protections Against Surprise Medical Bills Act, a bill that prohibits providers from balance billing patients for emergency services or medical care the patient reasonably could have expected to be in-network, and from charging patients more than the in-network cost-sharing amount. Rather than rely on a benchmark payment rate to determine out-of-network reimbursement, the legislation provides a period for health plans and providers to negotiate out-of-network reimbursement, followed by a mediated dispute resolution process if necessary; Letter urging HHS to take regulatory actions to help hospitals and health systems prepare and respond to COVID-19; Letter requesting $100 billion to prepare and respond to COVID-19; Letter urging the Department of Labor to accurately define health care provider when promulgating regulations implementing key sections of the Families First Coronavirus Response Act; Letter sent to the President asking for the use of the Defense Production Act to increase the production of medical supplies and equipment; Letter to HHS regarding $100 billion emergency fund, asking HHS and CMS to directly and expediently distribute to rural and urban hospitals and health systems funds from the Public Health and Social Services Emergency Fund that were designated for providers in the Coronavirus Aid, Relief, and Economic Security (CARES) Act. The CARES Act increased funding by $100 billion in order to reimburse eligible health care providers for health care-related expenses or lost revenues that are attributable to COVID-19. In the letter, we urged HHS and CMS to immediately distribute funding to all hospital types in the US - with additional funding going to COVID-19 hotspots; Letter urging Congress to modernize the Stafford Act as part of its next COVID-19 legislative package to allow all hospitals to recoup financial losses from this pandemic and future disasters; Letter to the Federal Reserve System, the Federal Deposit Insurance Corporation and the Office of the Comptroller of the Currency requesting they, as primary federal regulators for insured depository institutions, take prompt action to assist health care providers on the front line of the COVID-19 pandemic should the need to do so arise; Letter to the Secretary of the Treasury and the Federal Reserve Chair of the Board of Governors urging a supplement to the New Main Street Loan Facility term sheet with prompt guidance to ensure that access to this critically-necessary loan facility will be attainable for hospitals without delay; Letter was sent to the SBA urging it to ensure that small- and mid-size public hospitals, including those that have both nonprofit and public designations, are allowed to apply for and receive loans under the newly-authorized SBA Paycheck Protection Program; Letter in response to FEMAs request for input on establishing a voluntary agreement, under the Defense Production Act, of key private sector stakeholders relevant to responding to COVID-19, urging that such an agreement account for the full breadth of COVID-19 medical supply and equipment needs; Support H.R. 6474/S.3838 Healthcare Broadband Expansion During COVID-19 Act, a bill that would provide an additional $2 billion in funding for the FCC Rural Health Care program and increase the subsidy for health care providers from 65 to 85 percent. This legislation also simplifies the program to allow for more efficient application processes and disbursement of much needed funding; Support HR 6654 Emergency COVID-19 Telehealth Response Act, a bill that would codify an expanded list of providers to deliver and bill for telehealth services during the PHE; Support HR 7233Knowing the Efficiency and Efficacy of Permanent (KEEP) Telehealth Options Act of 2020, a bill that would require the Department of Health and Human Services and the Government Accountability Office (GAO) to conduct studies to provide information about the expanded use of telehealth during the COVID-19 pandemic; Letter to Senate HELP Committee in response to request for feedback on preparing for next pandemic; Discussion about telehealth waivers and flexibilities with HHS; Discussion about CARES provider relief fund distributions with HHS; Oppose HR 6559/ S 3677 COVID-19 Every Worker Protection Act of 2020, a bill to require the Occupational Safety and Health Administration to promulgate an emergency temporary standard to protect employees from occupational exposure to SARS-CoV-2, and for other purposes; Joint letter with ANA urging Congress to act quickly to get needed resources into the health care system, so that hospitals, nurses and physicians responding to COVID-19 are able to continue to provide treatments, front-line health care personnel are able to provide care and patients are able access health care services; Statement to Committee on Ways and Means for the hearing on The Disproportionate Impact of COVID-19 on Communities of Color urging Congress to employ the resources of the National Institute on Minority Health and Health Disparities - which is congressionally-mandated to coordinate the research of the other National Institutes of Healths centers and institutes related to minority health - to research and develop approaches to specifically address the COVID-19 needs of minority populations; Advocate with Congress for full forgiveness of COVID-19 related accelerated payments received by hospitals; Support S 3781Pharmaceutical Accountability, Responsibility, and Transparency (PART) Act, a bill to increase reporting of, help mitigate potential shortages related to, and promote, accountability and transparency for pharmaceuticals and medical devices; Support S 3780 Help Onshore Manufacturing Efficiencies (HOME) for Drugs and Devices Act, a bill to encourage domestic advanced manufacturing of critical drugs and devices in order to address economic, health, and security concerns, combat shortages of critical drugs and devices, and promote increased domestic diversification of, and independence from foreign reliance on, pharmaceutical and medical device supply chains; Support S.3763 Pandemic Responder Service Award Act, a bill to establish the Pandemic Responder Service Award program to express our gratitude to front-line health care workers; Support HR 6788/ S 3599 Healthcare Workforce Resilience Act, a bill to enhance our Nations nurse and physician workforce during the COVID-19 crisis by recapturing unused immigrant visas; Urged support for joint House and Senate letter to the Administration asking for flexibility for hospitals with respect to J-1 and H-1B visa programs; Letter to Senate Finance Committee to address the important issue of maternal health and the opportunity to provide suggestions regarding how to improve maternal health in this country; Support the Temporary Reciprocity to Ensure Access to Treatment Act, a bill that allows for the temporary reciprocity for treatment by medical professionals licensed in one state to patients in other states; Letter urging the Senate to include in the next COVID-19 relief bill provisions to strengthen the federal response for racial and ethnic minority and marginalized communities, which are disproportionately affected by the pandemic;Letter asking Congress to allocate as part of the next COVID-19 relief package at least an additional $100 billion to the emergency relief fund to provide direct funding to front line health care personnel and providers to continue to respond to this pandemic; Letter sent to HHS urging them to direct HRSA to take action to stop three drug manufacturers from limiting the distribution of 340B drugs to 340B covered entities. These drug manufacturers have taken separate actions to either limit the distribution of 340B drugs or require 340B covered entities provide claims level data for investigatory purposes if that 340B covered entity uses a contract pharmacy arrangement; Letter to the Congressional Leadership asking them to not to include in the next COVID-19 relief package any surprise medical billing legislation - such as a reimbursement rate set in statute - that would further destabilize hospitals finances during the pandemic; Support S 4507, Getting Early Treatment and Comprehensive Assessments Reduces Emergencies Act of 2020 or the GET CARE Act of 2020, a bill to amend the Public Health Service Act to provide for a national campaign to raise awareness of the importance of seeking preventive health services and the utilization of such services; Comment letter addressing concerns on the proposed rule from the Departments of the Treasury, Labor and Health and Human Services that would allow certain grandfathered health plans to increase patient cost-sharing beyond current limits, without losing their grandfathered status; Letter urging the Administration to work with the AHA and Congress to create a future for telehealth that allows not only clinicians, but also hospitals and health systems, to code and bill for virtual services. We further urge CMS and HHS to continue to provide hospitals with the flexibility for annual beneficiary consent to telehealth treatment to be obtained at the same time, and not necessarily before, services are furnished; Support HR 8061,Community Immunity During COVID-19 Act of 2020, a bill that would provide funding to state and local health departments to work with community providers and organizations to increase immunization rates for Advisory Committee on Immunization Practices (ACIP)-recommended vaccines during the COVID-19 public health emergency; Letter again expressing concern with recent actions taken by several major drug manufacturers to limit the distribution of certain 340B drugs to our hospital members. While we understand that the HRSA is further investigating these actions, we urge swift and decisive action to halt these pernicious tactics so as to prevent other manufacturers from following suit; Comment letter outlining our concerns about the ability of hospital systems to distribute provider relief funds among the parent and subsidiaries. HHS published certain FAQs that place problematic restrictions on the use of CARES Act provider relief fund dollars. Specifically, the FAQs restrict the ability of a hospital system to allocate the funds throughout its system where COVID-19 related expenses and lost revenues are occurring; Submitted comments in response to HRSAs RFI on Health Professional Shortage Area (HPSA) scoring. HPSA scores are important for rural hospitals and clinics ability to recruit physicians and other clinicians, namely from the National Health Service Corps (NHSC) program. Letter asking HHS to reinstate the COVID-19 Provider Relief Fund reporting requirements; Support S 4349, Dr. Lorna Breen Health Care Provider Protection Act, a bill to address behavioral health and well-being among health care professionals; Support S. 3595Ensuring Understanding of COVID-19 to Protect Public Health Act, a bill that directs the NIH to conduct a longitudinal study on mild, moderate, and severe cases of COVID-19 on a diverse patient population.

Client expense: $4,460,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA), White House Office

Q4 Lobbying Report (October 1 - December 31) Health Issues Healthcare and COVID-19 measures included in the Consolidated Appropriations Act of 2020 (H.R. 133) Public Health and Social Services Emergency Fund (coronavirus relief packages H.R. 1300; H.R. 7010, H.R. 6800) Regulatory relief in light of coronavirus (all coronavirus relief packages - H.R. 133; H.R. 6074; H.R. 6201; H.R. 748, H.R. 6800) Transparency (surprise medical bills; public posting of hospital charges; final price transparency rule; inpatient prospective payment system proposed rule; Transparency in Coverage Proposed Rule) Surprise medical billing (H.R. 133; H.R. 5826; H.R. 3630; S. 1531) Liability relief (all coronavirus relief packages - H.R. 133; H.R. 6800; S. 1624; S. 4775) 340B Drug Pricing Program Medicare/Medicaid Public Health Emergency designation Medicaid Fiscal Accountability Regulation Rural hospital policies Graduate Medical Education (GME) funding (H.R. 133; S. 348/H.R. 1763; Resident Physician Shortage Reduction Act of 2019; H.R. 2349/H.R. 3414 Opioid Workforce Act) Delay of Medicaid Disproportionate Share Hospital payment cuts (H.R. 133; H.R. 3022) Medicare sequestration relief (H.R. 133) Federal Medical Assistance Percentage increase (H.R. 133) Telehealth flexibilities and payment (all coronavirus relief packages - H.R. 133; H.R. 6800, S. 1624, S. 4775, physician fee schedule proposed rule) Post-acute care flexibilities (coronavirus relief packages - H.R. 133; H.R. 6800; S. 1624, S. 4775) Site neutral payment policy OPPS, IPPS and physician fee schedule rules Budget FY 2021 Appropriations bills Submitted Comments CMS-10752; Submissions of 1135 Waiver Request Automated Process; Notice, Federal Register (Vol. 85, No. 204) October 21, 2020 CMS-1734-P; Medicare Program; CY 2021 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment Policies; Medicare Shared Savings Program Requirements; Medicaid Promoting Interoperability Program Requirements for Eligible Professionals; Quality Payment Program; Coverage of Opioid Use Disorder Services Furnished by Opioid Treatment Programs; Medicare Enrollment of Opioid Treatment Programs; Electronic Prescribing for Controlled Substances for a Covered Part D Drug Under a Prescription Drug Plan or an MA-PD Plan; Payment for Office/Outpatient Evaluation and Management Services; Hospital IQR Program; Establish New Code Categories; and Medicare Diabetes Prevention Program (MDPP) Expanded Model Emergency Policy Proposed Rule, Federal Register (Vol. 85, No.159), August 17, 2020 CMS-1736-P; Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; New Categories for Hospital Outpatient Department Prior Authorization Process; Clinical Laboratory Fee Schedule: Laboratory Date of Service Policy; Overall Hospital Quality Star Rating Methodology; and Physician Owned Hospitals; Proposed Rule, Federal Register (Vol. 85, No.156), August 12, 2020

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), Medicare Payment Advisory Commission (MedPAC), SENATE, Social Security Administration (SSA)

Issue: Educate Congress and the administration on academic medicines missions, including education, research, patient care, GME, workforce, and physician shortages in rural and urban communities. Draft Bipartisan Emergency COVID Relief Act of 2020 H.R. 6650, S. 3634, Health Heroes 2020 Act S. 4055, Strengthening Americas Health Care Readiness Act Issue: Support increased funding for the National Health Service Corps, and National Disaster Medical Service (NDMS) demonstration pilot. Issues: Educate Congress and the administration about academic medicines response to the opioid epidemic. Support funding for training on substance use disorders, pain management, and safe prescribing practices. Support suspension of DATA waivers. Support continuation of telehealth flexibilities allowing authorized practitioners to prescribe buprenorphine. P.L. 116-22, Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019 Issues: Support the Hospital Preparedness Program and the reauthorization of the Pandemic and All-Hazards Preparedness Act. Support increased funding authorization levels. Issue: Support high-quality affordable health insurance. Support programs and funds for safety-net providers. Issue: Support measures to preserve and strengthen the 340B Drug Pricing Program and oppose efforts to reduce the scope of the program, including instituting a moratorium, increasing reporting requirements on covered entities, imposing user fees, changing the program from an up-front discount to a post-sale rebate, and not providing 340B discounts on covered drugs purchased at community pharmacies. Issue: Oppose efforts to create new requirements for FQHC grantees that participate in the 340B program. Issue: Oppose efforts to reduce OPPS reimbursements to hospitals for drugs acquired under the 340B program. Issue: Oppose efforts to allow certain grandfathered health care plans to increase consumer cost sharing without losing their grandfathered status. Issue: Oppose State relief and empowerment waivers that allow states to offer insurance plans that do not meet the requirements set forth under the Affordable Care Act. Issue: Oppose efforts to expand the availability of Association Health Plans. Issue: Oppose efforts to direct HHS to update the Medicare.gov Hospital Compare website. Issue: Support increased interoperability and exchange of electronic health information and delayed enforcement of information blocking rule until comprehensive guidance is issued. Issue: Oppose efforts to finalize two new mandatory alternative payment models, the Radiation Oncology Model and the End-stage Renal Disease Treatment Choices Model Issue: Oppose burdensome regulation of Laboratory Developed Tests S. 1895, Lower Health Care Costs Act H.R. 3630, No Surprises Act S. 1531, Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019 H.R. 3502, Protecting People From Surprise Medical Bills Act Issues: Educate Congress on surprise medical bills and price transparency or disclosure. Support general principles for surprise medical bills draft legislation. Oppose statutory benchmark rate setting. Oppose Senate hospital/insurer contracting provisions and onerous reporting burden. S. 1895, Lower Health Care Costs Act, Title IV Issue: Prescription drug pricing, public health, maternal mortality, and health information technology. Issue: Oppose restrictions on diversity training for federal grantees and employees. Issue: Development of Enhanced Primary Care Pilot Act proposal Issue: Educate Congress about medical education on nutrition, consent, implicit bias, and maternal health. H.R. 6637, Health Equity and Accountability Act Issue: Support programs to improve health equity and address social determinants of health. Issue: Support initiatives of hospitals to promote affordable housing in local communities and eliminate other social determinants of health to improve health equity. P.L. 116-260, Consolidated Appropriations Act, 2021 H.R. 4004, S. 2986 Social Determinants Accelerator Act of 2019 Issue: Support grants to address social determinants of health Issue: Support congressional investment in the Centers for Medicare and Medicaid Innovation (CMMI) models to reduce maternal mortality and improve maternal health. H.R. 4995 Maternal Health Quality Improvement Act of 2020 H.R. 4996 Helping MOMS Act of 2020 Issue: Support maternal health initiatives to expand coverage for postpartum women and expand demonstration project grants. S. 3750/H.R. 6837, Medicare Accelerated and Advance Payment Improvement Act of 2020 Issue: Support improvements to the Medicare Accelerated and Advance Payment Programs. Draft, firearm safety legislation Issue: Support universal background checks, violence prevention programs, extreme risks protection orders, child access safety laws, and reinstating assault weapons ban. H.R. 8, Bipartisan Background Checks Act of 2019 Issue: Support universal background checks Issue: Support aligning 42 CFR Part 2 regulations with the Health Insurance Portability and Accountability Act (HIPAA) for the purposes of treatment, payment, and healthcare operations. S. 4349/H.R. 8094, Dr. Lorna Breen Health Care Provider Protection Act Issue: Support grants directed at improving physician burnout and well-being. P.L. 116-260, Consolidated Appropriations Act, 2021 P.L. 116-123, Coronavirus Preparedness and Response Supplemental Appropriations Act of 2020 P.L. 116-127, Families First Coronavirus Response Act P.L. 116-136, Coronavirus Aid, Relief, and Economic Security Act (CARES) Act H.R.6379, Take Responsibility for Workers and Families Act H.R. 6800, the Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act Draft Health, Economic Assistance, Liability Protection and Schools (HEALS) Act S. 178 with Amendment No. 2652 HEALS Act S. 4322, Safely Back to School and Back to Work Act S. 178, Delivering Immediate Relief to Americas Families, Schools and Small Businesses Act H.R. 8406, The Heroes Act Draft Emergency Coronavirus Relief Act of 2020 Draft Bipartisan State and Local Support and Small Business Protection Act of 2020 Issues: Support emergency supplemental funding and policies for federal agencies to support coronavirus preparedness, response, relief, vaccine development and distribution, and testing and contact tracing. Ensure access to research samples. Support funding for and provide recommendations for disbursement of provider relief fund. Support revised Medicare and Medicaid reimbursement policies and increased provider flexibility. Support improvements to the Medicare Accelerated and Advance Payment Programs. Support inclusion of Medicare-supported graduate medical education positions. Support fixes to Medicare GME Rural Training Track programs. Support Medicare GME per resident amount and cap-setting technical corrections and administrative relief. Support an increase in the Federal Medicaid Assistance Program. Support for current telehealth waivers to be made permanent. Support for extension of Medicare sequester moratorium. Support changes to CY 2021 Physician Fee Schedule evaluation and management payments. Provide recommendations on personal protective equipment, testing, social distancing, clinical care, and other COVID related preparedness and response efforts of the federal government. Avoid imposing standards that would encourage depletion of scarce PPE and other resources. Support enhanced national COVID-19 data collection to better address health disparities. Support public health infrastructure. See other additions under BUD. Issue: Support extension of public health emergency declaration. Issue: Provide feedback on COVID-19 and pandemic response centers of excellence legislation. Issue: Support establishment of regional pandemic response centers, stronger linkages between public health and academic medicine, and the role of medical students in administering covid vaccines. Issue: Urge establishment and implementation of robust national COVID-19 testing strategy and functional and transparent supply chain. Urge CDC to update testing guidelines. Issue: Describe medical education approach on womens health and support efforts to promote trauma-informed care. Issue: Support science and data driven approach to HHS and EPA decision making. Issue: Support CDC mission S 4248 / HR 7618 COVID-19 Bias and Anti-Racism Training Act Issue: Support grant for anti-racism training in health professions programs. H.R. 8017, Mobile Options for Testing In Our Neighborhoods (MOTION) Act Issue: Support grants for mobile COVID-testing units. S. 4160, To enable certain hospitals that were participating in or applied for the drug discount program under section 340B of the Public Health Service Act prior to the COVID-19 public health emergency to temporarily maintain eligibility for such program, and for other purposes. Issue: Support protections for hospitals that participate in the 340B Drug Pricing Program to temporarily allow them to remain eligible for the program. H.R. 8283 S. 4421, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act Issue: Support for a temporary uniform licensing standard for all practitioners in all states throughout a national emergency. Issue: Support the rescission of the Department of Homeland Securitys Public Charge rule. Issue: Participate in Resilient American Communities initiative S. 4740 Public Health Infrastructure Saves Lives Act Issue: Support investments in core public health infrastructure. Issue: Rescind the Executive Order on Creating Schedule F in the Excepted Service. Issue: Rescind Executive Orders 13771 and 13777, and support re-implementation of directives under Executive Order 13563, Improving Regulation and Regulatory Review. Issue: Support establishment of a Presidential Bioethics Commission. Issue: Support ensuring patients are put first and that conscience protections align with medical professionalism standards. Issue: Support prompt establishment of the Research Policy Board and implementation of the additional reform efforts required by Section 2034 of the 21st Century Cures Act (P.L. 114-255). Issue: Support increased interoperability and exchange of electronic health information. Support delay of enforcement beyond April 2021. Issue: Support identification of specific federal regulations for review for disproportionate administrative impacts. Issue: Support independence of the US Food and Drug Administration. Issue: Support FDA rulemaking to harmonize protection of human research subjects. Issue: Support promotion of data sharing and clinical trials results reporting.

Client expense: $1,035,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Bureau of Citizenship & Immigration Services (BCIS), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Executive Office of the President (EOP), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Internal Revenue Service (IRS), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Natl Science Foundation (NSF), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), Office of Science & Technology Policy (OSTP), Office of the Vice President of the United States, SENATE, State, Dept of (DOS), Substance Abuse & Mental Health Services Administration (SAMHSA), Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

Ban Surprise Billing Act (H.R. 5800) The Clinical Treatment Act (H.R. 913 / S. 4742) Consolidated Appropriations Act, 2021 (H.R. 133) Consumer Protections Against Surprise Medical Bills Act of 2020 (H.R. 5826) Dependent Income Exclusion Act of 2019 (H.R.4417/S.2497) Educating Consumers on the Risks of Short-Term Plans Act of 2019 (H.R.1143) ENROLL Act of 2019 (H.R.1386/S.1905) Family Coverage Act (S.1935) HEARTS Act of 2020 (H.R. 6166) The Heroes Act (H.R. 6800) Home Visiting to Reduce Maternal Mortality and Morbidity Act (H.R.4768) Lower Health Care Costs Act (S.1895) Maternal Health Quality Improvement Act of 2020 (HR 4995) Marketing & Outreach Restoration to Empower Health Education Act (MORE) (H.R.987) No Surprises Act (H.R.3630) The Patient Protection and Affordable Care Enhancement Act (H.R. 1425) Personal Health Investment Today Act (PHIT) (S.680/H.R.1679) Physical Activity Recommendations (PAR) for Americans Act (S.1608/H.R.2891) Pre-existing Conditions Protection Act of 2019 (H.R.692) Protect Act (S.1125) Protecting Access to Post COVID-19 Telehealth Act of 2020 (H.R. 7663) Protecting Americans with Pre-existing Conditions Act of 2019 (H.R.986) Public Health Funding Restoration Act (S.1944/H.R.3447) Quit Because of COVID-19 Act (H.R. 7286) A Resolution Supporting the Designation of April 2019 as "National Donate Life Month"(H.Res 315/S.Res 162) State Allowance for a Variety of Exchanges Act (SAVE Act) (H.R.1385) States Achieve Medicaid Expansion (S.585) State Health Care Premium Reduction Act (H.R.1425) Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019 (S.1531) Sustaining Outpatient Services Act (H.R. 4838/S.4151) Implementation of: Menu Labeling Physical Activity Guidelines Recommendations Prevention and Public Health Fund (PL 111-148, Sec 4002)

Client expense: $125,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Federal Reserve System, Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Interior, Dept of (DOI), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Transportation, Dept of (DOT), Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

H.R. 748 - CARES Act -Courtney - COVID-19 coverage H.R. 1418 - Competitive Health Insurance Reform Act of 2020 - DeFazio - antitrust laws, health insurance, McCarran-Ferguson H.R. 3630 - No Surprises Act - Pallone - surprise medical billing H.R. 3784 - Air Ambulance Affordability Act of 2019 - Neguse - air ambulances H.R. 4223 - Protecting Patients from Surprise Medical Bills Act - Spano - surprise medical billing H.R. 5121 - Healthcare Cost Transparency Act - Beyer - provider price comparison tool H.R. 5239 - Prescription Drug Price Reporting Act - Joyce - reporting on drug expenditures and price changes under group health plans H.R. 5575 - Primary and Behavioral Health Care Access Act of 2020 -Underwood - coverage of primary care and behavioral health visits H.R. 6005 - Know the Price Act - Malinowski - health plan transparency H.R. 6173 - Covering Coronavirus Test Act of 2020 - DeGette - COVID-19 testing coverage H.R. 6193 - Medication Access in Emergencies Act of 2020 - Pappas - coverage of prescription drugs during emergency periods H.R. 6201 - Families First Coronavirus Response Act - Lowey - includes several provisions related to COVID-19 testing coverage H.R. 6213 - No Cost for COVID-19 Testing Act - Wilson - COVID-19 testing coverage H.R. 6214 - To amend title XVIII of the Social Security Act to provide for coverage of testing for COVID-19 at no cost sharing under the Medicare Advantage program - Kind - Medicare Advantage coverage of COVID-19 related visits and testing H.R. 6222 - Ensuring Affordable COVID-19 Preventive Care Act of 2020 - Schakowsky - coverage of certain new preventative services related to COVID-19 H.R. 6231 - Ensuring Access to COVID-19 Preventive Care Act of 2020 - Bucshon - coverage of certain vaccines and testing services during the COVID-19 emergency H.R. 6299 - Rapid Coverage of COVID-19 Vaccine Act of 2020 - Courtney - COVID-19 coverage H.R. 6317 - To provide for special enrollment periods during public health emergencies, coverage of services related to public health emergencies, and for other purposes - Doggett - special enrollment periods in public health emergency H.R. 6338 - To waive high deductible health plan requirements for health savings accounts -Budd - HDHP coverage during COVID H.R. 6486- Care for COVID-19 Act 2.0 -Ruiz - COVID H.R. 6514 - Worker Health Coverage Protection Act - Scott - COVID H.R. 6518 - Stop Health Premium Spikes Act of 2020 - Peters - risk corridors H.R. 6532 - COVID Special Enrollment Act of 2020 - Doggett - COVID H.R. 6568 - Coverage for COVID-19 Treatment Act of 2020 - Rochester - COVID H.R. 6644 - To require group health plans and health insurance issuers offering group or individual health insurance coverage to provide coverage for services furnished via telehealth if such services would be covered if furnished in-person during the COVID-19 emergency. -Schrier - COVID H.R. 6674 - Medicare Crisis Program Act of 2020 -Jayapal - COVID H.R. 6712 - American Healthshare Plans Act of 2020 - Curtis - health share pools H.R. 6810 - Health Care Protection Act -Davis - COVID H.R. 7006 - Improving Care in Home Health Agencies Act - Velazquez - home health services H.R. 7267 - To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to prohibit a group health plan and a health insurance issuer offering group or individual health insurance coverage from reducing contracted rates, or terminating contracts, with health care providers during a public health emergency. - Porter - ERISA H.R. 7475 - Ensuring FEHBP Coverage During Pandemic Act - Vela - special enrollment period H.R. 7539 - Strengthening Behavioral Health Parity Act - Kennedy - strengthen mental health and SUD benefits 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 - McEachin - drug manufacturer support applied to patient out-of-pocket limit H.R. 7659 - Ensuring Parity in MA for Audio-Only Telehealth Act of 2020 - Sewell - inclusion of certain audio-only diagnoses in the determination of risk adjustment for MA plans H.R. 7676 - Health Care Prices Revealed and Information to Consumers Explained Transparency Act - Flores - hospital and insurer price transparency H.R. 7722 - Matts Act - Fortenberry - limit price of insulin drugs accessible for those enrolled in group or indiv. health insurance coverage, group health plans, uninsured H.R. 7921 - Connecting Communities to Grant Opportunities Act of 2020 - Velazquez - navigator programs H.R. 7942 - Public Health Emergency COBRA Extension Act -Sanchez - COBRA extension H.R. 8060 - Tele-Mental Health Improvement Act - Trone - parity in mental health and SUD service under private insurance H.R. 8181 - Jack Reynolds Memory MediGap Expansion - Axne - Medigap coverage for Medicare ESRD H.R. 8308 - Telehealth Coverage and Payment Parity Act - Phillips - coverage for services furnished through telehealth H.R. 8330 - No Surprise Bills for New Moms Act - Porter - health coverage of newborns H.R. 8527 - Fair Care Act of 2020 - Westerman - health care costs and coverage H.R. 8573 - Helping Families Access Pediatric Care Act of 2020 - Schrier - deductibles and outpatient pediatric services H.R. 8615 - ARC Act of 2020 -Payne, Jr. - coverage of peripheral artery disease screening tests H.R. 8875 - Health Insurance Lemon Law Act - Kennedy - special enrollment period for non-compliant health plans S. 350 - Competitive Health Insurance Reform Act of 2019 - Daines - McCarran-Ferguson Act S. 1531 - STOP Surprise Medical Bills Act - Cassidy-Bennet - surprise medical billing S. 1948 - Chronic Disease Management Act - Thune - pre-deductible coverage of chronic disease prevention services S. 2546 - Safe Step Act - Murkowski - Step therapy exceptions S. 3200 - Chronic Disease Management Act of 2020 - Thune - coverage of chronic disease prevention services S. 3383 - Continuing Coverage for Preexisting Conditions Act of 2020 -Kennedy - preexisting conditions S. 3499 - A bill to amend coverage requirements to ensure that no person incurs cost sharing when receiving a test to confirm a COVID-19 infection - Smith - COVID-19 cost -sharing S. 3505 - A bill to require private health insurance to rapidly cover preventive services and vaccines related to the coronavirus - Jones - rapid COVID-19 coverage S. 3536 - A bill to provide for special enrollment periods during public health emergencies, coverage of services related to public health emergencies, and for other purposes - Casey - COVID-19 coverage S. 3610 - American Healthshare Plans Act of 2020 - Paul - health share pools S. 3631 - Relief for Rural Providers During Emergencies Act - Sasse - COVID S. 3741 - Health Care at Home Act of 2020 - Smith - COVID S. 3792 - Tele-Mental Health Improvement Act - Smith - parity S. 3821 - Affordable Health Care Options Act of 2020 - Loeffler - affordability S. 3991 - Coronavirus 2019 Special Enrollment Period Act - Duckworth - SEP S. 4106 - A bill to amend the Public Health Service Act to provide for hospital and insurer price transparency - Braun - price transparency S. 4185 - End Surprise Medical Bills for Air Ambulances Act of 2020 - Wicker - establish an IDR for air ambulance S. 4198 - Affordable Coronavirus Testing Act - Scott - coverage for COVID serology testing S. 4255 - Katherines Lung Cancer Early Detection and Survival Act of 2020 - Smith - group health plans, group and indiv coverage benefits for lung cancer screenings S. 4329 - Continuous Health Coverage for Workers Act - McSally - COBRA continuation coverage S. 4469 - COVID-19 Treatment Coverage Act - Smith - COVID treatment Medicaid/MA/Private/Medicare coverage S. 4506 - Pre-Existing Conditions Protection Act of 2020 - Gardner - coverage of pre-ex conditions under private insurance S. 4521 - Health Care Improvement Act of 2020 - Warner - expand ACA coverage S. 4557 - COVid Enrollment Response Act - Baldwin - assistance enrolling in health care coverage S. 4609 - Vaccine And Coverage Certainty Act - Wyden - coverage of COVID vaccine under Medicare/Medicaid, CHIP S. 4653 - A bill to prevent efforts of the Department of Justice to advocate courts to strike down the Patient Protection and Affordable Care Act - Schumer - ACA S. 4761 - Primary and Behavioral Health Care Access Act of 2020 - King - coverage and cost-sharing S. 4796 - Fair Care Act of 2020 - Braun - health care costs and coverage S. 4820 - Long-Term Care Affordability Act - Pat Toomey - long term care insurance S. 4894 - DOC Access Act of 2019 - Manchin - vision and dental insurance S. 4959 - A bill to increase transparency and access to group health plan and health insurance issuer reporting - Braun - Transparency on pharmacy benefits and drug costs S. 5084 - A bill to increase transparency and access to group health plan and health insurance issuer reporting - Braun - Transparency Regulatory Issues: Insurance regulatory reform; issues related to the coordination of private and public disability income benefits; disability risk management; disability income insurance enrollment and awareness; issues related to COBRA continuation coverage; issues related to behavioral health benefits; issues related to encouraging impaired workers to stay in/return to the workforce; issues related to expanding long-term care insurance coverage; issues relating to COVID-19, including testing, vaccines and therapeutics; issues related to addressing the social determinants of health, including housing, transportation, nutrition, and educational opportunities; issues related to changes to prior authorization regulations, electronic documentation, and related issues; issues relating to Medicaid best price; issues relating to the coordination of benefits between private health insurance plans and Medicaid; Medigap claims processing and crossover fees; Medigap cross-over claim issues, Medigap coverage, implementation of Medigap standardized plan offerings; Medigap carrier recoveries related to CMS fraud and abuse enforcement activities, and issues related to Medigap educational materials, and other Medigap issues; fraud and abuse issues affecting public and private insurance coverage; issues relating to antitrust; implementation of the Mental Health Parity Act requirements; implementation of the 21st Century Cures Act requirements; summary of benefits and coverage disclosures; prior authorization; accountable care organizations; coverage of preventive services; preexisting condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; health reimbursement accounts; dependent coverage; treatment of expatriate plans; issues related to surprise medical bills; issues related to all payor claims databases; issues related to association health plans; issues related to substance abuse and provider treatment records (42 CFR Part 2); issues related to medical management; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations, non-discriminatory wellness programs; issues related to supplemental products; issues relating to dental coverage; issues relating to proposals for single-payer and Medicare/Medicaid buy-in options; issues related to implementation of the Telephone Consumer Protection Act; issues relating to third party payment of premiums; issues related to cost-sharing reductions (CSRs); issues related to interoperability and price transparency; issues related to the employer market; issues relating to the individual market; and other issues relating to health care reform implementation.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Council of Economic Advisers (CEA), Executive Office of the President (EOP), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of the Vice President of the United States, SENATE, Treasury, Dept of, White House Office

H.R. 3630, No Surprises Act; S. 1531, Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019; S. 1895, Lower Health Care Costs Act; H.R. 5800, Ban Surprise Billing Act; H.R. 5826 Consumer Protections Against Surprise Medical Bills Act; H.R. 1730/S 741, the Cancer Drug Parity Act; Texas v US lawsuit implications for protections for people with pre-existing conditions; federal regulation of Short-Term Limited-Duration Insurance (STLDI) and other junk insurance;

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

-H.R. 6420 / S. 3652 All Dependents Count Act, support passage. -H.R. 6680 / S. 3619 Strengthening Unemployment Insurance for Coronavirus Impacted Workers and Students Act, support passage. -H.R. 6305 / S. 3544 Coronavirus Relief for Seniors and People with Disabilities, support passage. -H.R. 2279/S. 2546, Safe Step Act, support passage-H.R. 3630, No Surprises Act; S. 1895, Lower Health Care Costs Act; S. 1531, the Stopping the Outrageous Practice of Surprise Medical Bills Act of 2019; H.R. 5800, Ban Surprise Billing Act; H.R. 5826 Consumer Protections Against Surprise Medical Bills Act, support passage of legislation to protect patients from surprise medical billing that holds patients harmless-H.R. 2093/S. 1028, STATES Act, support passage-H.R. 127, Compassionate Access, Research Expansion and Respect States (CARERS) Act, support passage- H.R. 4322/S. 2400, Expanding Cannabis Research and Information Act, support passage -H.R. 1425, Patient Protection and Affordable Care Enhancement Act, support passage. -H.R. 133, Consolidated Appropriations Act, support funding for epilepsy programs and research, COVID-19 relief and ending surprise medical billing.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.133, Consolidated Appropriations Act, 2021 (All sections of full text) H.R. 3630 No Surprises Act (all sections of full text) HR 6800 Health and Economic Recovery Omnibus Emergency Solutions Act or the HEROES Act (Division C - Health Provisions) HR 3502 Protecting People From Surprise Medical Bills Act (all sections of full text)(support) S 1266 Protecting Patients from Surprise Medical Bills Act (all sections of full text)(support) S 1531 Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019 (all sections of full text)(support) S 1895 Lower Health Care Costs Act, Title I (all sections of full text)(oppose) HR 4932 Creating Opportunities Now for Necessary and Effective Care Technologies for Health Act of 2019 Discussions involving taxation of hospitals Monitored Presidential Executive Order actions related and subsequent to Executive Order 13813 of October 12, 2017 Monitored S 4329 Continuous Health Care Coverage for Workers Act Monitored S 2741 Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019 Monitored S 3537 Protecting our Pharmaceutical Supply Chain from China Act Monitored HR 3482 Protecting our Pharmaceutical Supply Chain from China Act Monitored S 3627 Medical Supply Transparency and Delivery Act Monitored HR 6711 Medical Supply Transparency and Delivery Act Monitored S 3847 COVID-19 Emergency Manufacturing Act of 2020 Monitored implementation of Sec. 6001 of the Affordable Care Act of 2010 Monitored discussions pertinent to health care group purchasing organizations (GPOs) Monitored Executive Order #13877 Improving Price Quality Transparency in American Healthcare To Put Patients First Monitored S 2408 Telehealth Across State Lines Act of 2019

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

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

The Safe Step Act, H.R. 2279; Surprise Billing Legislation, in general; Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019, S. 1531; Protecting People From Surprise Medical Bills Act, H.R. 3502; No Surprises Act, H.R. 3630; Lower Health Care Costs Act, S.1895; COVID-19 regulatory changes in general; Coronavirus Preparedness and Response Supplemental Appropriations (CPRSA) Act, the Families First Coronavirus Response Act (FFCRA), and the Coronavirus Aid, Relief, and Economic Security (CARES) Act - issues impacting GI patients, physicians and ambulatory surgery centers; H.R. 266/P.L. 116-139, the Paycheck Protection Program and Health Care Enhancement Act - provisions related to Public Health and Social Services Emergency Fund to provide further relief to physician practices.

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

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

medicare reimbursement rates and other related issues S.1531 - Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019 H.R.3630 - No Surprises Act H.R. 748 - CARES Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Monitoring discussions around healthcare costs, surprise billing and transparency; Issues related to healthcare costs and coverage; S. 1895, Lower Health Care Costs Act; S. 1531; Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019; H.R. 3630, No Surprises Act; H.R. 3502, Protecting People From Surprise Medical Bills Act; H.R. 861, End Surprise Billing Act of 2019; Surprise billing issues; Transparency: All-Payer Claims Database; H.R. 1425, Patient Protection and Affordable Care Enhancement Act (PPACEA); Continued monitoring of implementation of Public Law 116-123, Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020; Continued monitoring of implementation of Public Law 116-127, Families First Coronavirus Response Act; Continued monitoring of implementation of Public Law 116-136, CARES Act; H.R. 6800, The Heroes Act (funding for COVID and serology/public health testing, COBRA coverage, increased FMAP funding, additional funding for HHS Provider Relief Fund, issues related to cost sharing for COVID testing, treatment and vaccines); Telehealth issues related to COVID-19; H.R. 925, The Heroes Act; H.R. 8337, Continuing Appropriations Act, 2021 and Other Extensions Act (Public Law 116-159); H.R. 133, Consolidated Appropriations Act, 2021 (Public Law 116-260); Issues related to mental health benefits

Client expense: Not reported · Firm income: $90,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Monitor issues related to healthcare costs, surprise billing, transparency; S. 1895, Lower Health Care Costs Act; S. 1531; Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019; H.R. 3630, No Surprises Act; H.R. 3502, Protecting People From Surprise Medical Bills Act; H.R. 861, End Surprise Billing Act of 2019; H.R. 1865, Consolidated Domestic and International Assistance Bill; H.R. 8337, Continuing Appropriations Act, 2021 and Other Extensions Act (Public Law 116-159); S. 4230, Telehealth Expansion Act of 2020; S. 3750/H.R. 6837, Medicare Accelerated and Advance Payments Improvement Act of 2020; Issues related to evaluation and management (E&M) cuts contained in the CY2021 Medicare Physician Fee Schedule (MPFS) Proposed Rule; Extension of the Medicare Sequester; H.R. 133, Consolidated Appropriations Act, 2021 (Public Law 116-260); H.R. 8702, Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020 (Medicaid rates as related to Medicare conversion factor)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Stark Law modernization; S. 966, The Medicare Care Coordination Improvement Act of 2019; H.R. 2282, The Medicare Care Coordination Improvement Act of 2019; Monitor implementation of section 603 of the Bipartisan Budget Act of 2015 and site neutral policies; Issues related to Advance Notice of Proposed Rulemaking (ANPR) on International Pricing Index (IPI) and Part B reforms; S. 1895, Lower Health Care Costs Act; S. 1531; Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019; H.R. 3630, No Surprises Act; H.R. 3502, Protecting People From Surprise Medical Bills Act; H.R. 861, End Surprise Billing Act of 2019; CMS proposed rule to modernize physician self-referral law (Stark); OIG proposed rule to modernize the anti-kickback statute; H.R. 925, The Heroes Act; H.R. 8337, Continuing Appropriations Act, 2021 and Other Extensions Act (Public Law 116-159); S. 4230, Telehealth Expansion Act of 2020; S. 3750/H.R. 6837, Medicare Accelerated and Advance Payments Improvement Act of 2020; Issues related to evaluation and management (E&M) cuts contained in the CY2021 Medicare Physician Fee Schedule (MPFS) Proposed Rule; Extension of the Medicare Sequester; H.R. 133, Consolidated Appropriations Act, 2021 (Public Law 116-260)

Client expense: Not reported · Firm income: $60,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Health care reform including implementation of the Affordable Care Act; and a comprehensive approach to surprise medical billing/ensuring patients are not held responsible, including advocacy related to: H.R. 3502, the Protecting People From Surprise Medical Bills Act; H.R. 3630, the No Surprises Act; S. 1531, the STOP Surprise Medical Bills Act; S. 1895, the Lower Health Care Costs Act, and H.R. 2328, the REACH Act, H.R. 2328, the REACH Act; and H.R. 133, the Consolidated Appropriations Act, 2021 - P.L. 116-260. Coronavirus response efforts, including support for health care providers, patients and small business, and related provisions in H.R. 6800, the HEROES Act; H.R. 8406, the Heroes Act; S. 4318, the American Workers, Families, and Employers Assistance Act; S. 4320, the Coronavirus Response Additional Supplemental Appropriations Act, 2020; and S. 4322, the Safely Back to School and Back to Work Act; related provisions in Sec. 2501 of H.R. 8337, the Continuing Appropriations Act, 2021 and Other Extensions Act re: modifications to the Accelerated and Advance Payment Programs; and H.R. 133, the Consolidated Appropriations Act, 2021 - P.L. 116-260.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Lobby members of Congress regarding issues related to telemedicine. Advocate for increased transparency regarding drug pricing. Lobby members of the House to join the Congressional Skin Cancer Caucus. Advocate for adequate and accurate network coverage for dermatologic care within health insurance exchange networks. Support H.R. 1959, Preserving Patient Access to Compounded Medications Act. Support H.R. 2077/S. 2546, Safe Step Act. Support H.R. 1035, Prescription Drug Price Transparency Act. Support H.R. 985, Fair Access for Safe and Timely Generics Act. Support S. 476, C-THRU Act. Support S. 989, Ensuring Childrens Access to Specialty Care Act. Support H.R. 1034/S. 640, Phair Pricing Act. Support S. 657, Drug Price Transparency Act Support H.R. 938, BLOCKING Act Support H.R. 2375/S. 64, Preserve Access to Affordable Generics & Biosimilars Act Support H.R. 1499, Protecting Consumer Access to Generic Drugs Act Support H.R. 2296/S. 1391, Fair Accountability & Innovative Research (FAIR) Drug Pricing Act Support H.R. 2069, Stopping the Pharmaceutical Industry from Keeping drugs Expensive (SPIKE) Act. Support H.R. 2115, Public Disclosure of Drug Discounts Act Support H.R. 2376/S. 1227, Prescription Pricing for the People Act Support H.R. 1379/S. 560, Ensuring Lasting Smiles Act. Advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans. Support H.R. 3107, Improving Seniors Timely Access to Care Act Support pediatric subspecialty loan repayment in any reauthorization of the Title VII programs. Support S. 2443 Investment in Tomorrows Pediatric Health Care Workforce Act Support H.R. 1554, Resident Education Deferred Interest (REDI) Act. Advocate for the continued and increased funding of Community Health Centers. Lobby members of Congress to cosponsor H. Res. 323, which would support state, local, and community initiatives to encourage parents, teachers, camp counselors, and childcare professionals to take measures to prevent sunburns in the minors they care for, and would express the sense of the House of Representatives that state, local, and community entities should continue to support efforts to curb the incidences of skin cancer beginning with childhood skin protection. In the context of legislation to address surprise medical bills, advocate for an independent dispute resolution (IDR) process to resolve disputes between payers and physicians and against provisions that would set out-of-network reimbursement rates at a benchmark level. (H.R. 2328, H.R. 3502, S. 1531, S. 1895, H.R. 133) Support H.R. 4575, Improving Provider Directories Act, which would require group health plans and health insurance issuers offering group or individual health insurance coverage to establish a process to address inaccurate information listed in publicly accessible provider directories of such plans and issuers. Support the Creating Opportunities Now for Necessary and Effect Care Technologies (CONNECT) for Health Act of 2019 (S. 2741/H.R. 4932), which would increase access to telehealth services. Support legislation to address drug shortages by providing additional authority to the Food and Drug Administration (FDA) to ensure a stable supply of medications (S. 2723, Mitigating Emergency Drug Shortages Act; H.R. 6080, Preventing Drug Shortages Act). Similar provisions to mitigate drug shortages included in CARES Act (H.R. 748, S. 3548). Request resources to provide personal protection equipment (PPE) and supplies and relief from Medicare payment sequester and relief from penalties in Merit-based Incentive Payment System (MIPS) under MACRA in the CARES Act (H.R. 748, S. 3548). Support the Coronavirus Health Care Worker Wellness Act (H.R. 7255) to help promote mental health wellness among physicians and other health care workers during the Public Health Emergency. Advocate for congressional action to hold health care professionals harmless from any cuts related to CMS Evaluation and Management Code proposals in any forthcoming legislative package (H.R. 8702/S. 5007, Holding Providers Harmless from Medicare Cuts During COVID-19 Act; S. 8505, a bill to provide a one-year waiver of budget neutrality adjustment under the Medicare Physician Fee Schedule; H.R. 133, Consolidated Appropriations Act, 2021). Support H.R. 7233, the KEEP Telehealth Options Act. Oppose H.R 884/S. 2772 the Medicare Mental Health Access Act

Client expense: $310,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Proposed changes to Medicare hospital reimbursement policy Health care policy Proposals to strengthen the health care system and achieve Affordable Care Act (ACA) market stability H.R. 269, "Pandemic and All-Hazards Preparedness & Advancing Innovation Act" - provisions related to hospitals Funding for National Ebola Network H.R. 2113, Prescription Drug Sunshine, Transparency, Accountability and Reporting (STAR) Act" - provisions related to studying rising hospital drug prices and reporting of drug costs H.R. 965/S. 340, CREATES Act S. 2543, the Prescription Drug Pricing Reduction Act H.R. 3, "Elijah E. Cummings Lower Drug Costs Now Act" Additional legislative proposals to address rising drug costs H.R. 1559, "340B Protection and Accountability Act" Additional legislative proposals modifying the 340B program Surprise Billing S. 1895, Lower health Care Cost Act" H.R. 3630, "No Surprises Act" S. 1531, "STOP Surprise Medical Bills Act" H.R.5826, Consumer Protections Against Surprise Medical Bills Act of 2020 H.R. 925, Health and Economic Recovery Omnibus Emergency Solutions Act (HEROS Act 2.0) H.R. 133, "Consolidated Appropriations Act, 2021" - provisions related to combating COVID, surprise medical bills and health programs Legislative proposals aimed at combating coronavirus

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Lobby members of Congress regarding issues related to telemedicine. Advocate for increased transparency regarding drug pricing. Lobby members of the House to join the Congressional Skin Cancer Caucus. Advocate for adequate and accurate network coverage for dermatologic care within health insurance exchange networks. Support H.R. 1959, Preserving Patient Access to Compounded Medications Act. Support H.R. 2077/S. 2546, Safe Step Act. Support H.R. 1035, Prescription Drug Price Transparency Act. Support H.R. 985, Fair Access for Safe and Timely Generics Act. Support S. 476, C-THRU Act. Support S. 989, Ensuring Childrens Access to Specialty Care Act. Support H.R. 1034/S. 640, Phair Pricing Act. Support S. 657, Drug Price Transparency Act Support H.R. 938, BLOCKING Act Support H.R. 2375/S. 64, Preserve Access to Affordable Generics & Biosimilars Act Support H.R. 1499, Protecting Consumer Access to Generic Drugs Act Support H.R. 2296/S. 1391, Fair Accountability & Innovative Research (FAIR) Drug Pricing Act Support H.R. 2069, Stopping the Pharmaceutical Industry from Keeping drugs Expensive (SPIKE) Act. Support H.R. 2115, Public Disclosure of Drug Discounts Act Support H.R. 2376/S. 1227, Prescription Pricing for the People Act Support H.R. 1379/S. 560, Ensuring Lasting Smiles Act. Advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans. Support H.R. 3107, Improving Seniors Timely Access to Care Act Support pediatric subspecialty loan repayment in any reauthorization of the Title VII programs. Support S. 2443 Investment in Tomorrows Pediatric Health Care Workforce Act Support H.R. 1554, Resident Education Deferred Interest (REDI) Act. Advocate for the continued and increased funding of Community Health Centers. Lobby members of Congress to cosponsor H. Res. 323, which would support state, local, and community initiatives to encourage parents, teachers, camp counselors, and childcare professionals to take measures to prevent sunburns in the minors they care for, and would express the sense of the House of Representatives that state, local, and community entities should continue to support efforts to curb the incidences of skin cancer beginning with childhood skin protection. In the context of legislation to address surprise medical bills, advocate for an independent dispute resolution (IDR) process to resolve disputes between payers and physicians and against provisions that would set out-of-network reimbursement rates at a benchmark level. (H.R. 2328, H.R. 3502, S. 1531, S. 1895, H.R. 133) Support H.R. 4575, Improving Provider Directories Act, which would require group health plans and health insurance issuers offering group or individual health insurance coverage to establish a process to address inaccurate information listed in publicly accessible provider directories of such plans and issuers. Support the Creating Opportunities Now for Necessary and Effect Care Technologies (CONNECT) for Health Act of 2019 (S. 2741/H.R. 4932), which would increase access to telehealth services. Support legislation to address drug shortages by providing additional authority to the Food and Drug Administration (FDA) to ensure a stable supply of medications (S. 2723, Mitigating Emergency Drug Shortages Act; H.R. 6080, Preventing Drug Shortages Act). Similar provisions to mitigate drug shortages included in CARES Act (H.R. 748, S. 3548). Request resources to provide personal protection equipment (PPE) and supplies and relief from Medicare payment sequester and relief from penalties in Merit-based Incentive Payment System (MIPS) under MACRA in the CARES Act (H.R. 748, S. 3548). Support the Coronavirus Health Care Worker Wellness Act (H.R. 7255) to help promote mental health wellness among physicians and other health care workers during the Public Health Emergency. Advocate for congressional action to hold health care professionals harmless from any cuts related to CMS Evaluation and Management Code proposals in any forthcoming legislative package (H.R. 8702/S. 5007, Holding Providers Harmless from Medicare Cuts During COVID-19 Act; S. 8505, a bill to provide a one-year waiver of budget neutrality adjustment under the Medicare Physician Fee Schedule; H.R. 133, Consolidated Appropriations Act, 2021). Support H.R. 7233, the KEEP Telehealth Options Act. Oppose H.R 884/S. 2772 the Medicare Mental Health Access Act

Client expense: $310,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Stark Law modernization; S. 966, Medicare Care Coordination Improvement Act of 2019; H.R. 2282, Medicare Care Coordination Improvement Act of 2019; Monitor implementation of Section 603 of the Bipartisan Budget Act of 2015 and site neutral policies; Issues related to Advance Notice of Proposed Rulemaking (ANPR) on International Pricing Index (IPI) and Part B reforms; S. 1895, Lower Health Care Costs Act; H.R. 3, Elijah E. Cummings Lower Drug Costs Now Act; S. 1531; Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019; H.R. 3630, No Surprises Act; H.R. 3502, Protecting People From Surprise Medical Bills Act; H.R. 861, End Surprise Billing Act of 2019; S. 668/H.R. 1570, Removing Barriers to Colorectal Cancer Screening Act of 2019; S. 2543, Prescription Drug Pricing Reduction Act of 2019; H.R. 925, The Heroes Act; H.R. 8337, Continuing Appropriations Act, 2021 and Other Extensions Act, Public Law 116-159; S 4230, Telehealth Expansion Act of 2020; S.3750/HR 6837, Medicare Accelerated and Advance Payments Improvement Act of 2020; Issues related to evaluation and management (E&M) cuts contained in the CY2021 Medicare Physician Fee Schedule (MPFS) Proposed Rule; Extension of the Medicare Sequester; H.R. 133, Consolidated Appropriations Act, 2021 (Public Law 116-260)

Client expense: Not reported · Firm income: $60,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Cost sharing reduction subsidies, reinsurance and insurance market stabilization policies; Alexander-Murray healthcare cost package: transparency, surprise billing; S. 1895, Lower Health Care Costs Act; S. 1531, Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019; S. 2543, Prescription Drug Pricing Reduction Act of 2019; S. 2897, Patient-Centered Outcomes Research Institute Reauthorization Act - PCORI extension; H.R. 3, Elijah E. Cummings Lower Drug Costs Now Act; H.R. 3630, No Surprises Act; H.R. 3502, Protecting People From Surprise Medical Bills Act; H.R. 861, End Surprise Billing Act of 2019; Issues related to the Trump Administration's support for the Texas lawsuit that would rule the ACA unconstitutional; H.R. 1425, Patient Protection and Affordable Care Enhancement Act (PPACEA); Continued monitoring of implementation of Public Law 116-123, Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020; Continued monitoring of implementation of Public Law 116-127, Families First Coronavirus Response Act; Continued monitoring of implementation of Public Law 116-136, CARES Act; H.R. 6800 - The Heroes Act (funding for COVID and serology/public health testing, COBRA coverage, increased FMAP funding, additional funding for HHS Provider Relief Fund, issues related to cost sharing for COVID testing, treatment and vaccines); Telehealth issues related to COVID-19, including audio-only; H.R. 925, The Heroes Act (specifically issues related to testing); H.R. 133, Consolidated Appropriations Act, 2021 (Public Law 116-260); Extension of the Medicare Sequester

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to the Trump Administration's support for Texas lawsuit that would rule ACA unconstitutional; Monitor issues related to healthcare cost, surprise billing issues and transparency; S. 1531, Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019; S. 1895, Lower Health Care Costs Act of 2019; H.R. 3630, No Surprises Act; H.R. 3502, Protecting People From Surprise Medical Bills Act; H.R. 861, End Surprise Billing Act of 2019; S. 2741/H.R. 4932, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019; Continued monitoring of implementation of Public Law 116-123, Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020; Continued monitoring of implementation of Public Law 116-127, Families First Coronavirus Response Act; Continued monitoring of implementation of Public Law 116-136, CARES Act - proposals related to physician and provider relief; Telehealth issues related to COVID-19; H.R, 6800, The Heroes Act (including Medicare Accelerated Payment program, increased FMAP payments, COBRA, increased funding for HHS Provider Fund, changes to the Paycheck Protection Program, medical liability reform); Health disparities; H.R. 925, The Heroes Act; H.R. 8337, Continuing Appropriations Act, 2021 and Other Extensions Act (Public Law 116-159); H.R. 133, Consolidated Appropriations Act, 2021 (Public Law 116-260)

Client expense: Not reported · Firm income: $60,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Continued implementation of ACA Health care policy H.R. 2113, Prescription Drug Sunshine, Transparency, Accountability and Reporting (STAR) Act" - provisions related to studying rising hospital drug prices and reporting of drug costs H.R. 965/S. 340, CREATES Act H.R. 3, Elijah E. Cummings Lower Drug Costs Now Act S.2543, the Prescription Drug Pricing Reduction Act Additional legislative proposals to address rising drug costs H.R. 1559, "340B Protection and Accountability Act" Additional legislative proposals modifying the 340B program S. 1895, Lower Health Care Cost Act"- provisions related to surprise billing and payer/provider contracts S. 1531, "STOP Surprise Medical Bills Act" H.R. 3630, "No Surprises Act" H.R. 3502, "Protecting People from Surprise Medical Bills Act" H.R.5826, "Consumer Protections Against Surprise Medical Bills Act of 2020" H.R. 925, Health and Economic Recovery Omnibus Emergency Solutions Act (HEROS Act 2.0) H.R. 133, "Consolidated Appropriations Act, 2021" - provisions related to federal financial relief, including funding for healthcare providers, and health programs and related to surprise medical bills Legislative proposals aimed at combating coronavirus

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Health care payment and delivery system reform Health information technology and implementation of EHR meaningful use Policy related to health exchange risk corridors and cost-sharing reduction payments H.R. 269, "Pandemic and All-Hazards Preparedness& Advancing Innovation Act" - provisions related to hospitals H.R. 2113, Prescription Drug Sunshine, Transparency, Accountability and Reporting (STAR) Act" - provisions related to studying rising hospital drug prices and reporting of drug costs H.R. 965/S.340, CREATES Act S. 2543, the Prescription Drug Pricing Reduction Act H.R. 3, "Elijah E. Cummings Lower Drug Costs Now Act" Additional legislative proposals to address rising drug costs S. 1895, Lower Health Care Cost Act"- provisions related to surprise billing and payer/provider contracts S. 1531, "STOP Surprise Medical Bills Act" H.R. 3630 "No Surprises Act" H.R.5826, "Consumer Protections Against Surprise Medical Bills Act of 2020" H.R. 1559, "340B Protection and Accountability Act" Additional legislative proposals modifying the 340B program H.R. 925, Health and Economic Recovery Omnibus Emergency Solutions Act (HEROS Act 2.0) H.R. 133, "Consolidated Appropriations Act, 2021" - provisions related to federal financial relief, including funding for healthcare providers, health programs and surprise medical billing Legislative proposals aimed at combating coronavirus

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

: Issues related to lung disease treatment, prevention and research; public health; Issues related asthma; COPD; influenza; lung cancer; pneumonia; tuberculosis and other lung diseases; Issues related to tobacco cessation; Issues related to the Affordable Care Act; Issues related to the Childrens Health Insurance Program; Issues related to the President's Budget; Issues related to telehealth; Issues related to changing federal poverty line calculation; Issues related to COVID-19 Response;; H.R.986 Protecting Americans with Preexisting Conditions Act of 2019 H.R.987 Strengthening Health Care and Lowering Prescription Drug Costs Act H.R.1010 To provide that the rule entitled "Short-Term, Limited Duration Insurance" shall have no force or effect. H.R.1385 SAVE Act H.R.1386 ENROLL Act of 2019 H.R.1425 State Health Care Premium Reduction Act H.R.1499 Protecting Consumer Access to Generic Drugs Act of 2019 H.R.1884 Protecting Pre-Existing Conditions and Making Health Care More Affordable Act of 2019 H.R.2508 Better Respiration through Expanding Access to Tele-Health Act;H.R.2862 VACCINES Act of 2019; H.R.3630 No Surprises Act H.R.4622 Family Asthma Act S.466 Protecting Americans with Pre-existing Conditions Act of 2019 S.946 Henrietta Lacks Enhancing Cancer Research Act of 2019 S.1125 Protect Act S.1895 Lower Health Care Costs Act S.1944 Public Health Funding Restoration Act. HR 3 Elijah E. Cummings Lower Drug Costs Now Act; H.R.4716 I CAN Act; HR 5230 Elijah E. Cummings Family Asthma Act; HR 6201 - Families First Coronavirus Act; HR 6704 - Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020; HR 748 - CARES Act; S. 3548 - CARES Act; S. 1531 - Stopping the Outrageous Practice of Surprise Medical Bills Act of 2019; HR 6408 -- To extend the charitable deduction to all taxpayers regardless of whether a taxpayer itemizes deductions in order to encourage and increase charitable giving, and to provide for loans and loan guarantees to certain public charities; HR 7610 Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, 2021; HR 7667 Commerce, Justice, Science, and Related Agencies Appropriations Act, 2021; HR 7617 Department of Defense Appropriations Act, 2021; HR 7612 Department of the Interior, Environment, and Related Agencies Appropriations Act, 2021; HR 2468 School-Based Allergies and Asthma Management Program Act; HR 7614 Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2021; HR 7609 Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2021; HR 7616 Transportation, Housing and Urban Development, and Related Agencies Appropriations Act, 2021; HR 7608 Department of State, Foreign Operations, and Related Programs Appropriations Act, 2021; H.R.5076 Protecting Seniors Through Immunization Act of 2019; H.R.6561 Improving Social Determinants of Health Act of 2020; HR 6800 HEROES Act; H.R.6935 Protecting the Health of America's Older Adults During COVID-19 and Beyond Act; HR 7286 Quit Because of COVID-19 Act; S. 4775 Delivering Immediate Relief to Americas Families, Schools and Small Businesses Act; S. 4321 The Continuing Small Business Recovery and Paycheck Protection Program Act; S. 4318 The American Workers, Families, and Employers Assistance Act; S. 4317 SAFE TO WORK Act; S. 4322 The Safely Back to School and Back to Work Act; S. 4320 Coronavirus Response Additional Supplemental Appropriations Act, 2020; ;H.R.8061 Community Immunity During COVID-19 Act of 2020;H.R.8406 The Heroes Act; H.R.925 The Heroes Act; S.4557 COVER Act; S.4740 A bill to support public health infrastructure; H.RES.957 Expressing support for the designation of May as "National Asthma and Allergy Awareness Month"; H.R.7011 Pandemic Risk Insurance Act of 2020; H.R.8261 Presumptive Benefits for War Fighters Exposed to Burn Pits and Other Toxins Act of 2020; S.4572 Presumptive Benefits for War Fighters Exposed to Burn Pits and Other Toxins Act of 2020; S.4355 Katherine's Lung Cancer Early Detection and Survival Act of 2020; H.RES.1192 Expressing support for the goals of November National Lung Cancer Awareness Month and for the early detection of lung cancer; H.R.8158 To amend title XVIII of the Social Security Act to waive budget neutrality for oxygen under the Medicare program, and for other purposes.;H.R.7481 RESTART Act; S.4737 A bill to amend the Public Health Service Act to direct the Secretary of Health and Human Services to make grants to covered health departments to increase the rate of recommended immunizations, and for other purposes; S.Res.780 A resolution designating November 2020 as "National Lung Cancer Awareness Month" and expressing support for the early detection of lung cancer; H.R.8623 SAVE for Seniors Act; S.4864 HAPI Act; H.R.8725 HAPI Act; H.R.8595 To nullify the effect of Executive Order 13950 relating to combating race and sex stereotyping; Senate Labor HHS Appropriations bill; Senate Defense Appropriations bill; Senate Transportation, Housing and Urban Development and Related Agencies Appropriations bill; Senate Agriculture, Rural Development, FDA, and Related Agencies Appropriations bill; Senate Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2021H.R.133 Consolidated Appropriations Act, 2021; H.J.Res.110 - Extension of Continuing Appropriations Act, 2021

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Environmental Protection Agency (EPA), Federal Reserve System, Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Postal Regulatory Commission, SENATE, Small Business Administration (SBA), Treasury, Dept of, White House Office