EMPOWER Care Act

P.L. 111-375 National Alzheimer's Project Act, All Sections P.L. 115-119 Recognize, Assist, Include, Support and Engage (RAISE) Family Caregivers Act P.L. 115-406 Building Our Largest Dementia (BOLD) Infrastructure for Alzheimer's Act P.L. 116-131 Supporting Older Americans Act of 2020 S.591 Guardianship Accountability Act S.299 Geriatrics Workforce Improvement Act S.548/H.R.1342 EMPOWER Care Act H.R.1343 Protecting Married Seniors from Impoverishment Act S.740 Alzheimer's Caregiver Support Act H.R. 1955 Understanding Appropriate Alzheimer's Care Act of 2019 S.880/H.R.1873 Improving HOPE for Alzheimer's Act S.2080/H.R.647 Palliative Care and Hospice Education and Training Act S.1250/H.R.2401 American Cures Act S.1017 Supporting America's Caregivers and Families Act S.995/H.R.2035 Lifespan Respite Care Reauthorization Act of 2019 S.1126/H.R.2283 Concentrating on High-Value Alzheimer's Needs to Get to an End (CHANGE) Act of 2019 S.1361/H.R.2584 Preventive Health Savings Act of 2019 S.1628 Paid Family Leave Pilot Extension Act S.1618 Expanding Capacity for Health Outcomes (ECHO) Act of 2019 S.1202 Independence at Home Act of 2019 H.R.3644 Independence at Home Demonstration Act of 2019 H.R.3436 Improving Chronic Care Management Act H.R.3107 Improving Seniors' Timely Access to Care Act S.2469/H.R.4386 Stop the Wait Act H.R.2781 Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness (EMPOWER) for Health Act of 2019 S.2521/H.R.4397 Direct CARE Opportunity Act S.2677 Older Americans and Social Isolation and Loneliness Act H.R.4859 Protecting Older Americans from Social Isolation Act of 2019 H.Res.821 to establish a permanent select Committee in Aging in the House of Representatives H.R.6379 Families First Coronavirus Response Act S.3548/H.R.748 Coronavirus Aid, Relief, and Economic Security (CARES) Act; including provisions that would impact individuals living with Alzheimer's and other dementia and their caregivers. H.R.4334 Supporting Older Americans Act of 2020 S.3544/H.R.6305 Coronavirus Relief for Seniors and People with Disabilities Act S.3768 /H.R.6972 Nursing Home COVID-19 Protection and Prevention Act of 2020 H.R.7048 Nursing Home Pandemic Protection Act S.3644/H.R.6698 Quality Care for Nursing Home Residents and Workers During COVID-19 Act H.R.6638 Reducing COVID-19 Disparities by Investing in Public Health H.R.7158 Health Enterprise Zones Act H.R.6800 Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act S.3517/H.R.6487 ACCESS Act S.3740/H.R.6951 COVID-19 Recovery for Seniors and People with Disabilities Act H.R.8169 Elder Abuse Protection Act S.4182 Emergency Support for Nursing Homes and Elder Justice Reform Act of 2020 H.R.5958 Senior Health Planning Account Act S.4184/H.R.7463 Assisted Living Facility Coronavirus Reporting Act S.4682/H.R.8511 Care Corp Demonstration Act of 2020 H.R. 2477 Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act In forthcoming COVID-19 relief packages, the Alzheimer's Association is advocating for inclusion of policies that would impact those in the Alzheimer's and dementia community including: - Improving HOPE for Alzheimer's Act (S.880/H.R.1873) - Extension of the Independence at Home demonstration model - Promoting Alzheimer's Awareness to Prevent Elder Abuse Act, including Elder Justice Initiative training for professionals through the Department of Justice - Emergency Preparedness in long-term and community-based care settings - Expanding Capacity for Health Outcomes (Project ECHO) - Project VITAL: Virtual Inclusive Technology for ALL

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

Government targets: Administration on Aging, Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Indian Health Service, Interior, Dept of (DOI), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Natl Institutes of Health (NIH), SENATE, Social Security Administration (SSA), Veterans Affairs, Dept of (VA)

The Autism Cares Act of 2019 (S 427 / HR 1058) regarding funding for autism research, services, training and monitoring. The Empower Care Act (S 548 / HR 1342) regarding home and community based services to individuals with autism and their families. H.R.748 and S.3548 (CARES Act) regarding payroll protection plan for non-profits.

Client expense: Not reported · Firm income: $7,500

Government targets: HOUSE OF REPRESENTATIVES, SENATE

1. Patient Protection and Affordable Health Care Act, implementation of provisions regarding Medicare Part D coverage gap assistance, preventive care services, and dual eligible Medicare and Medicare beneficiaries 2. Proposals to create a premium support or voucher program under Medicare 3. Proposals to "means test" Medicare premiums and benefits 4. Proposals to change federal and state Medicaid cost sharing 5. Proposals to raise the Medicare eligibility age 6. Proposals regarding prescription drug costs for low income Medicare beneficiaries 7. Expansion of Medicare benefits to include hearing, vision, and dental benefits 8. Administration of the Medicare State Health Insurance Assistance Programs 9. Medicare Observation Status Regulations 10. Nursing Home Arbitration Regulations 11. Medicare 340(B) drug reimbursement policy 12. Home care workers and Medicare Reassignment Policy 13. Medicare equitable relief policy 14. S. 340, CREATES Act of 2019, entire bill 15. H.R. 965, CREATES Act of 2019, entire bill 16. H.R. 1046, Medicare Negotiation and Competitive Licensing Act of 2019, entire bill 17. CMS Proposals on Part D Drug Pricing 18. S. 691, Medicare Extra Rx HELP Act of 2019, entire bill 19. H.R. 1342, EMPOWER Care Act, entire bill 20. S. 548, EMPOWER Care Act, entire bill 21. H.R. 1343, Protecting Married Seniors from Impoverishment Act, entire bill 22. S. 97, Affordable and Safe Prescription Drug Importation Act, entire bill 23. S. 99, Medicare Drug Price Negotiation Act, entire bill 24. H.R. 3, Lower Drug Costs Now Act of 2019, entire bill 25. H.R. 1393, Medicare Dental, Vision and Hearing Benefit Act of 2019, entire bill 26. H.R. 1394, Medigap Consumer Protection Act of 2019, entire bill 27. H.R. 1682, Improving Access to Medicare Coverage Act of 2019, entire bill 28. H.R. 4386, Stop the Wait Act, entire bill 29. Proposals regarding the tiering generic drugs under Medicare Part D 30. Proposals regarding the use of Medicaid waivers during the COVID-19 pandemic 31. S. 3544, Coronavirus Relief for Seniors and People with Disabilities Act of 2020, entire bill 32. H.R. 6305, Coronavirus Relief for Seniors and People with Disabilities Act of 2020, entire bill 33. Oklahoma Medicaid waiver application 34. Proposals to streamline Medicare enrollment during the COVID-19 pandemic

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Pension & Welfare Benefits Administration, Pension Benefit Guaranty Corporation (PBGC), SENATE, Social Security Administration (SSA)

H.R. 2035/S. 995, the Lifespan Respite Care Reauthorization Act of 2019 H.R. 1342/S. 548, the Empower Act H.R. 3253, the Sustaining Excellence in Medicaid Act S. 4343, the Access to Assistive Technology and Devices for Americans Study Act or the Triple A Study Act Implementation of P.L. 111-148, the Patient Protection and Affordable Care Act Implementation of P.L. 115-119, the RAISE Family Caregivers Act

Client expense: $78,368 · Firm income: Not reported

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

HR 7616: Making appropriations for the Department of Transportation, and Housing and Urban Development, and related agencies for the fiscal year ending September 30, 2021, and for other purposes -- support increased funding for Community Development Block Grant and HOME programs at HUD; highway and transit formula programs at DOT. H.R.530: Accelerating Broadband Development by Empowering Local Communities Act of 2019 -- support legislation. HR 2: Moving Forward Act; support legislation to Promote creation of a federal infrastructure package. Support full implementation of federal Opportunity Zones program. Support reintroduction of Affordable Housing Credit Improvements Act of 2017 (S. 548) in 116th Congress Support federal emergency funding for local governments to assist with the impacts of the COVID-19 pandemic

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

EMPOWER Care Act, S. 548/HR 1342. HR 6042/S. 2897, Issues pertaining to Medicaid Electronic Visit Verification rules, Direct Support Professional standard occupational category; Direct Support Professional visas. Medicaid Services Investment and Accountability Act of 2019, HR 1839. FY2020 Further Consolidated Appropriations Act (LHHSED, AG, Energy Water, Interior, Leg. Branch, MCVA, State-For. Ops, T-HUD), H.R. 1865.Isaiah Baker and Margie Harris-Austin Act, HR 5443. CARES Act, HR 748. Families First Coronavirus Response Act, HR 6201. Ensuring Access to Direct Support Professionals Act, S. 3220. Recognizing the Role of Direct Support Professionals Act, S. 3369. The Heroes Act, HR 6800. Continuing Appropriations Act, 2021 and Other Extensions Act, HR 8337. American Workers, Families, and Employers Assistance Act, S. 4318.

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

Government targets: HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), SENATE

P.L. 111-375 National Alzheimer's Project Act, All Sections P.L. 115-119 Recognize, Assist, Include, Support and Engage (RAISE) Family Caregivers Act P.L. 115-406 Building Our Largest Dementia (BOLD) Infrastructure for Alzheimer's Act S.591 Guardianship Accountability Act S.299 Geriatrics Workforce Improvement Act S.548/H.R.1342 EMPOWER Care Act H.R.1343 Protecting Married Seniors from Impoverishment Act S.740 Alzheimer's Caregiver Support Act H.R. 1955 Understanding Appropriate Alzheimer's Care Act of 2019 S.880/H.R.1873 Improving HOPE for Alzheimer's Act H.R.1903/S.901 Younger-Onset Alzheimer's Disease Act of 2019 S.2080/H.R.647 Palliative Care and Hospice Education and Training Act S.1250/H.R.2401 American Cures Act S.1017 Supporting America's Caregivers and Families Act S.995/H.R.2035 Lifespan Respite Care Reauthorization Act of 2019 S.1126/H.R.2283 Concentrating on High-Value Alzheimer's Needs to Get to an End (CHANGE) Act of 2019 S.1361/H.R.2584 Preventive Health Savings Act of 2019 S.1628 Paid Family Leave Pilot Extension Act S.1618 Expanding Capacity for Health Outcomes (ECHO) Act of 2019 S.1202 Independence at Home Act of 2019 H.R.3644 Independence at Home Demonstration Act of 2019 H.R.3436 Improving Chronic Care Management Act H.R.3107 Improving Seniors' Timely Access to Care Act H.R.4334 Dignity in Aging Act of 2019 S.2469/H.R.4386 Stop the Wait Act H.R.2781 Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness (EMPOWER) for Health Act of 2019 S.2521/H.R.4397 Direct CARE Opportunity Act S.3057 Modernization of the Older Americans Act Amendments S.2677 Older Americans and Social Isolation and Loneliness Act H.R.4859 Protecting Older Americans from Social Isolation Act of 2019 H.Res.821 to establish a permanent select Committee in Aging in the House of Representatives H.R.6379 Families First Coronavirus Response Act S.3548/H.R.748 Coronavirus Aid, Relief, and Economic Security (CARES) Act; including provisions that would impact individuals living with Alzheimer's and other dementia and their caregivers. H.R.4334 Supporting Older Americans Act of 2020 S.3544/H.R.6305 Coronavirus Relief for Seniors and People with Disabilities Act S.3768 /H.R.6972 Nursing Home COVID-19 Protection and Prevention Act of 2020 H.R.7048 Nursing Home Pandemic Protection Act S.3644/H.R.6698 Quality Care for Nursing Home Residents and Workers During COVID-19 Act H.R.6638 Reducing COVID-19 Disparities by Investing in Public Health H.R.7158 Health Enterprise Zones Act H.R.6800 Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act S.3517/H.R.6487 ACCESS Act S.3740/H.R.6951 COVID-19 Recovery for Seniors and People with Disabilities Act In forthcoming COVID-19 relief packages, the Alzheimer's Association is advocating for inclusion of policies that would impact those in the Alzheimer's and dementia community including: - Improving HOPE for Alzheimer's Act (S.880/H.R.1873) - Extension of the Independence at Home demonstration model - Promoting Alzheimer's Awareness to Prevent Elder Abuse Act, including Elder Justice Initiative training for professionals through the Department of Justice - Emergency Preparedness in long-term and community-based care settings - Expanding Capacity for Health Outcomes (Project ECHO) - Project VITAL: Virtual Inclusive Technology for ALL

Client expense: $250,000 · Firm income: Not reported

Government targets: Administration on Aging, Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Indian Health Service, Interior, Dept of (DOI), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Natl Institutes of Health (NIH), SENATE, Social Security Administration (SSA), Veterans Affairs, Dept of (VA)

The Autism Cares Act of 2019 (S 427 / HR 1058) regarding funding for autism research, services, training and monitoring. The Empower Care Act (S 548 / HR 1342) regarding home and community based services to individuals with autism and their families. H.R.748 and S.3548 (CARES Act) regarding payroll protection plan for non-profits.

Client expense: Not reported · Firm income: $7,500

Government targets: HOUSE OF REPRESENTATIVES, SENATE

EMPOWER Care Act, S. 548/HR 1342. HR 6042/S. 2897, Issues pertaining to Medicaid Electronic Visit Verification rules, Direct Support Professional standard occupational category; Direct Support Professional visas. Medicaid Services Investment and Accountability Act of 2019, HR 1839. FY2020 Further Consolidated Appropriations Act (LHHSED, AG, Energy Water, Interior, Leg. Branch, MCVA, State-For. Ops, T-HUD), H.R. 1865.Isaiah Baker and Margie Harris-Austin Act, HR 5443. CARES Act, HR 748. Families First Coronavirus Response Act, HR 6201. Ensuring Access to Direct Support Professionals Act, S. 3220. Recognizing the Role of Direct Support Professionals Act, S. 3369. The Heroes Act, HR 6800.

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

Government targets: HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), SENATE

H.R. 2035/S. 995, the Lifespan Respite Care Reauthorization Act of 2019 H.R. 1342/S. 548, the Empower Act H.R. 3253, the Sustaining Excellence in Medicaid Act Implementation of P.L. 111-148, the Patient Protection and Affordable Care Act Implementation of P.L. 115-119, the RAISE Family Caregivers Act

Client expense: $71,212 · Firm income: Not reported

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

1. Patient Protection and Affordable Health Care Act, implementation of provisions regarding Medicare Part D coverage gap assistance, preventive care services, and dual eligible Medicare and Medicare beneficiaries 2. Proposals to create a premium support or voucher program under Medicare 3. Proposals to "means test" Medicare premiums and benefits 4. Proposals to change federal and state Medicaid cost sharing 5. Proposals to raise the Medicare eligibility age 6. Proposals regarding prescription drug costs for low income Medicare beneficiaries 7. Expansion of Medicare benefits to include hearing, vision, and dental benefits 8. Administration of the Medicare State Health Insurance Assistance Programs 9. Medicare Observation Status Regulations 10. Nursing Home Arbitration Regulations 11. Medicare 340(B) drug reimbursement policy 12. Home care workers and Medicare Reassignment Policy 13. Medicare equitable relief policy 14. S. 340, CREATES Act of 2019, entire bill 15. H.R. 965, CREATES Act of 2019, entire bill 16. H.R. 1046, Medicare Negotiation and Competitive Licensing Act of 2019, entire bill 17. CMS Proposals on Part D Drug Pricing 18. S. 691, Medicare Extra Rx HELP Act of 2019, entire bill 19. H.R. 1342, EMPOWER Care Act, entire bill 20. S. 548, EMPOWER Care Act, entire bill 21. H.R. 1343, Protecting Married Seniors from Impoverishment Act, entire bill 22. S. 97, Affordable and Safe Prescription Drug Importation Act, entire bill 23. S. 99, Medicare Drug Price Negotiation Act, entire bill 24. H.R. 3, Lower Drug Costs Now Act of 2019, entire bill 25. H.R. 1393, Medicare Dental, Vision and Hearing Benefit Act of 2019, entire bill 26. H.R. 1394, Medigap Consumer Protection Act of 2019, entire bill 27. H.R. 1682, Improving Access to Medicare Coverage Act of 2019, entire bill 28. H.R. 4386, Stop the Wait Act, entire bill 29. Proposals regarding the tiering generic drugs under Medicare Part D 30. Proposals regarding the use of Medicaid waivers during the COVID-19 pandemic 31. S. 3544, Coronavirus Relief for Seniors and People with Disabilities Act of 2020, entire bill 32. H.R. 6305, Coronavirus Relief for Seniors and People with Disabilities Act of 2020, entire bill 33. Oklahoma Medicaid waiver application 34. Proposals to streamline Medicare enrollment during the COVID-19 pandemic

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Pension & Welfare Benefits Administration, Pension Benefit Guaranty Corporation (PBGC), SENATE, Social Security Administration (SSA), U.S. Trade Representative (USTR)

No Bill Number: Making appropriations for the Department of Transportation, and Housing and Urban Development, and related agencies for the fiscal year ending September 30, 2021, and for other purposes -- support increased funding for Community Development Block Grant and HOME programs at HUD; highway and transit formula programs at DOT. H.R.530: Accelerating Broadband Development by Empowering Local Communities Act of 2019 -- support legislation. Promote creation of a federal infrastructure package. Support full implementation of federal Opportunity Zones program. Support reintroduction of Affordable Housing Credit Improvements Act of 2017 (S. 548) in 116th Congress Support federal emergency funding for local governments to assist with the impacts of the COVID-19 pandemic

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

P.L. 111-375 National Alzheimer's Project Act, All Sections P.L. 115-119 Recognize, Assist, Include, Support and Engage (RAISE) Family Caregivers Act P.L. 115-406 Building Our Largest Dementia (BOLD) Infrastructure for Alzheimer's Act S.591 Guardianship Accountability Act S.299 Geriatrics Workforce Improvement Act S.548/H.R.1342 EMPOWER Care Act H.R.1343 Protecting Married Seniors from Impoverishment Act S.740 Alzheimer's Caregiver Support Act H.R. 1955 Understanding Appropriate Alzheimer's Care Act of 2019 S.880/H.R.1873 Improving HOPE for Alzheimer's Act H.R.1903/S.901 Younger-Onset Alzheimer's Disease Act of 2019 S.2080/H.R.647 Palliative Care and Hospice Education and Training Act S.1250/H.R.2401 American Cures Act S.1017 Supporting America's Caregivers and Families Act S.995/H.R.2035 Lifespan Respite Care Reauthorization Act of 2019 S.1126/H.R.2283 Concentrating on High-Value Alzheimer's Needs to Get to an End (CHANGE) Act of 2019 S.1361/H.R.2584 Preventive Health Savings Act of 2019 S.1628 Paid Family Leave Pilot Extension Act S.1618 Expanding Capacity for Health Outcomes (ECHO) Act of 2019 S.1202 Independence at Home Act of 2019 H.R.3644 Independence at Home Demonstration Act of 2019 H.R.3436 Improving Chronic Care Management Act H.R.3107 Improving Seniors' Timely Access to Care Act H.R.4334 Dignity in Aging Act of 2019 S.2469/H.R.4386 Stop the Wait Act H.R.2781 Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness (EMPOWER) for Health Act of 2019 S.2521/H.R.4397 Direct CARE Opportunity Act S.3057 Modernization of the Older Americans Act Amendments S.2677 Older Americans and Social Isolation and Loneliness Act H.R.4859 Protecting Older Americans from Social Isolation Act of 2019 H.Res.821 to establish a permanent select Committee in Aging in the House of Representatives H.R.6379 Families First Coronavirus Response Act S.3548/H.R.748 Coronavirus Aid, Relief, and Economic Security (CARES) Act; including provisions that would impact individuals living with Alzheimer's and other dementia and their caregivers. H.R.4334 Supporting Older Americans Act of 2020 S.3544/H.R.6305 Coronavirus Relief for Seniors and People with Disabilities Act In forthcoming COVID-19 relief packages, the Alzheimer's Association is advocating for inclusion of policies that would impact those in the Alzheimer's and dementia community including: - Improving HOPE for Alzheimer's Act (S.880/H.R.1873) - Extension of the Independence at Home demonstration model - Promoting Alzheimer's Awareness to Prevent Elder Abuse Act, including Elder Justice Initiative training for professionals through the Department of Justice - Emergency Preparedness in long-term and community-based care settings - Expanding Capacity for Health Outcomes (Project ECHO) - Project VITAL: Virtual Inclusive Technology for ALL

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

Government targets: Administration on Aging, Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Indian Health Service, Interior, Dept of (DOI), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Natl Institutes of Health (NIH), SENATE, Social Security Administration (SSA), Veterans Affairs, Dept of (VA)

H.R. 2035/S. 995, the Lifespan Respite Care Reauthorization Act of 2019 H.R. 1342/S. 548, the Empower Act H.R. 3253, the Sustaining Excellence in Medicaid Act Implementation of P.L. 111-148, the Patient Protection and Affordable Care Act Implementation of P.L. 115-119, the RAISE Family Caregivers Act

Client expense: $74,586 · Firm income: Not reported

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

H.R. 748, CARES Act, provisions related to the Money Follows the Person Rebalancing Demonstration Program, possible waivers under the Individuals with Disabilities Education Act and other laws, and other provisions that could affect the autism community. S. 3277, HCBS Infrastructure Improvement Act, all provisions. H.R. 1342/ S.548 EMPOWER Care Act of 2019, provision related to the Money Follows the Person Rebalancing Demonstration. A bill not yet introduced relating to Fiscal Year 2021 appropriations for the Department of Health and Human Services, the Department of Defense, and other federal departments, provisions related to autism funding. A bill not yet introduced related to further COVID-19 relief, provisions that may benefit the autism community. A bill not yet introduced to improve direct services for individuals with autism and their families. A bill not yet introduced to improve interagency collaboration, based on the Promoting Readiness of Minors in SSI program. A bill not yet introduced related to apprenticeships for individuals with disabilities. A bill not yet introduced to improve professional development opportunities for educators. A bill not yet introduced to amend the Higher Education Act (P.L. 89-329) A bill not yet introduced to create Patient-Centered Health Reform Proposed Rulemaking - Strengthening the Program Integrity of the Medicaid Eligibility Determination Process (CMS-2421-P; RIN 0938-AU00) Implementation of 1905(r) of the Social Security Act, related to provisions of early and periodic screening, diagnostic, and treatment services. Implementation of the RAISE Family Caregivers Act

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), Natl Institute of Mental Health (NIMH), SENATE

1. Patient Protection and Affordable Health Care Act, implementation of provisions regarding Medicare Part D coverage gap assistance, preventive care services, and dual eligible Medicare and Medicare beneficiaries 2. Proposals to create a premium support or voucher program under Medicare 3. Proposals to "means test" Medicare premiums and benefits 4. Proposals to change federal and state Medicaid cost sharing 5. Proposals to raise the Medicare eligibility age 6. Proposals regarding prescription drug costs for low income Medicare beneficiaries 7. Expansion of Medicare benefits to include hearing, vision, and dental benefits 8. Administration of the Medicare State Health Insurance Assistance Programs 9. Medicare Observation Status Regulations 10. Nursing Home Arbitration Regulations 11. Medicare 340(B) drug reimbursement policy 12. Home care workers and Medicare Reassignment Policy 13. Medicare equitable relief policy 14. S. 340, CREATES Act of 2019, entire bill 15. H.R. 965, CREATES Act of 2019, entire bill 16. H.R. 1046, Medicare Negotiation and Competitive Licensing Act of 2019, entire bill 17. CMS Proposals on Part D Drug Pricing 18. S. 691, Medicare Extra Rx HELP Act of 2019, entire bill 19. H.R. 1342, EMPOWER Care Act, entire bill 20. S. 548, EMPOWER Care Act, entire bill 21. H.R. 1343, Protecting Married Seniors from Impoverishment Act, entire bill 22. S. 97, Affordable and Safe Prescription Drug Importation Act, entire bill 23. S. 99, Medicare Drug Price Negotiation Act, entire bill 24. H.R. 3, Lower Drug Costs Now Act of 2019, entire bill 25. H.R. 1393, Medicare Dental, Vision and Hearing Benefit Act of 2019, entire bill 26. H.R. 1394, Medigap Consumer Protection Act of 2019, entire bill 27. H.R. 1682, Improving Access to Medicare Coverage Act of 2019, entire bill 28. H.R. 4386, Stop the Wait Act, entire bill 29. Proposals regarding the tiering generic drugs under Medicare Part D 30. Proposals regarding the use of Medicaid waivers during the COVID-19 pandemic 31. S. 3544, Coronavirus Relief for Seniors and People with Disabilities Act of 2020, entire bill 32. H.R. 6305, Coronavirus Relief for Seniors and People with Disabilities Act of 2020, entire bill

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Pension & Welfare Benefits Administration, Pension Benefit Guaranty Corporation (PBGC), SENATE, Social Security Administration (SSA), U.S. Trade Representative (USTR)

The Autism Cares Act of 2019 (S 427 / HR 1058) regarding funding for autism research, services, training and monitoring; The Empower Care Act (S 548 / HR 1342) regarding home and community based services to individuals with autism and their families. H.R.748 and S.3548 (CARES Act) regarding payroll protection plan for non-profits.

Client expense: Not reported · Firm income: $7,500

Government targets: HOUSE OF REPRESENTATIVES, SENATE

No Bill Number: Making appropriations for the Department of Transportation, and Housing and Urban Development, and related agencies for the fiscal year ending September 30, 2021, and for other purposes -- support increased funding for Community Development Block Grant and HOME programs at HUD; highway and transit formula programs at DOT. H.R.530: Accelerating Broadband Development by Empowering Local Communities Act of 2019 -- support legislation. Promote creation of a federal infrastructure package. Support full implementation of federal Opportunity Zones program. Support reintroduction of Affordable Housing Credit Improvements Act of 2017 (S. 548) in 116th Congress Support federal emergency funding for local governments to assist with the impacts of the COVID-19 pandemic

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

EMPOWER Care Act, S. 548/HR 1342. HR 6042/S. 2897, Issues pertaining to Medicaid Electronic Visit Verification rules, Direct Support Professional standard occupational category; Direct Support Professional visas. Medicaid Services Investment and Accountability Act of 2019, HR 1839. FY2020 Further Consolidated Appropriations Act (LHHSED, AG, Energy Water, Interior, Leg. Branch, MCVA, State-For. Ops, T-HUD), H.R. 1865.Isaiah Baker and Margie Harris-Austin Act, HR 5443. CARES Act, HR 748. Families First Coronavirus Response Act, HR 6201. Ensuring Access to Direct Support Professionals Act, S. 3220. Recognizing the Role of Direct Support Professionals Act, S. 3369.

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

Government targets: HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), SENATE

H.R.582, the Raise the Wage Act, related to providing for increases in the Federal minimum wage, and for other purposes, all provisions; H.R.873 / S.260, the Transformation to Competitive Employment Act, related to assisting employers providing employment under special certificates issued under section 14(c) of the Fair Labor Standards Act of 1938 to transform their business and program models, to support individuals with disabilities to transition to competitive integrated employment, to phase out the use of such special certificates, and for other purposes, all provisions; H.R. 989, the Promoting Apprenticeships through Regional Training Networks for Employers Required Skills (PARTNERS) Act of 2019, related to promoting registered apprenticeships and other work-based learning programs for small and medium-sized businesses within in-demand industry sectors, through the establishment and support of industry or sector partnerships, all provisions; H.R.1058 / S.427, the Autism Collaboration, Accountability, Research, Education, and Support (Autism CARES) Act, related to amending the Public Health Service Act to enhance activities of the National Institutes of Health with respect to research on autism spectrum disorder and enhance programs relating to autism, and for other purposes, all provisions; H.R.1226 / S.317, the Advancing Care for Exceptional (ACE) Kids Act, related to amending title XIX of the Social Security Act to provide States with the option of providing coordinated care for children with complex medical conditions through a health home, all provisions; H.R. 1342 / S.548, the Ensuring Medicaid Provides Opportunities for Widespread Equity, Resources, and Care (EMPOWER Care) Act, related to reauthorizing the Money Follows the Person Demonstration Program, all provisions; H.R.1434 / S.634, the Education Freedom Scholarships and Opportunity Act, related to amending the Internal Revenue Code of 1986 to establish tax credits to encourage individual and corporate taxpayers to contribute to scholarships for elementary and secondary students through eligible scholarship-granting organizations, and for other purposes, all provisions; H.R. 1662, the Cultivating Learning Assistance for Student Success Act, related to directing the Secretary of Education to establish a pilot program to provide grants to secondary schools for assistive technology devices and assistive technology services and to create programs to benefit students with autism or apraxia, and for other purposes, all provisions; H.R. 21 / H.R. 264 / H.R.265 / H.R.266 / H.R.267 / H.R. 648, related to appropriations; A bill not yet introduced to amend the Small Business Act (P.L. 85-536) A bill not yet introduced to amend portions of the Individuals with Disabilities Education Act (P.L. 89-10) A bill not yet introduced to amend the Social Security Amendments of 1965 (P.L. 89-97); A bill not yet introduced to amend the Higher Education Act (P.L. 89-329); A bill not yet introduced to reauthorize the Education Sciences Reform Act (P.L. 107-279); A bill not yet introduced to prohibit and prevent the use of seclusion and reduce of the use of physical restraint in schools, and for other purposes; Implementation of the Individuals with Disabilities Education Act (P.L. 89-10); Implementation of the Social Security Amendments of 1965 (P.L. 89-97); Implementation of the National Apprenticeship Act (P.L. 89-554); Implementation of the Rehabilitation Act of 1973 (P.L. 93-112); Implementation of the Workforce Innovation and Opportunity Act (P.L. 113-128); and Implementation of the Elementary and Secondary Education Act (P.L. 114-95).

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Education, Dept of, HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), Natl Institute of Mental Health (NIMH), Natl Institutes of Health (NIH), SENATE

P.L. 111-375 National Alzheimer's Project Act, All Sections P.L. 115-119 Recognize, Assist, Include, Support and Engage (RAISE) Family Caregivers Act P.L. 115-406 Building Our Largest Dementia (BOLD) Infrastructure for Alzheimer's Act S.591 Guardianship Accountability Act S.299 Geriatrics Workforce Improvement Act S.548/H.R.1342 EMPOWER Care Act H.R.1343 Protecting Married Seniors from Impoverishment Act S.740 Alzheimer's Caregiver Support Act H.R. 1955 Understanding Appropriate Alzheimer's Care Act of 2019 S.880/H.R.1873 Improving HOPE for Alzheimer's Act H.R.1903/S.901 Younger-Onset Alzheimer's Disease Act of 2019 S.2080/H.R.647 Palliative Care and Hospice Education and Training Act S.1250/H.R.2401 American Cures Act S.1017 Supporting America's Caregivers and Families Act S.995/H.R.2035 Lifespan Respite Care Reauthorization Act of 2019 S.1126/H.R.2283 Concentrating on High-Value Alzheimer's Needs to Get to an End (CHANGE) Act of 2019 S.1361/H.R.2584 Preventive Health Savings Act of 2019 S.1628 Paid Family Leave Pilot Extension Act S.1618 Expanding Capacity for Health Outcomes (ECHO) Act of 2019 S.1202 Independence at Home Act of 2019 H.R.3644 Independence at Home Demonstration Act of 2019 H.R.3436 Improving Chronic Care Management Act H.R.3107 Improving Seniors' Timely Access to Care Act H.R.4334 Dignity in Aging Act of 2019 S.2469/H.R.4386 Stop the Wait Act H.R.2781 Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness (EMPOWER) for Health Act of 2019 S.2521/H.R.4397 Direct CARE Opportunity Act S.3057 Modernization of the Older Americans Act Amendments S.2677 Older Americans and Social Isolation and Loneliness Act H.R.4859 Protecting Older Americans from Social Isolation Act of 2019

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

Government targets: Administration on Aging, Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Indian Health Service, Interior, Dept of (DOI), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Natl Institutes of Health (NIH), SENATE, Social Security Administration (SSA), Veterans Affairs, Dept of (VA)

S. 62, Empowering Medicare Seniors to Negotiate Drug Prices Act (Klobuchar) - Part D price negotiations S. 99, Medicare Drug Price Negotiation Act (Sanders) - Part D price negotiations, formulary changes S. 205, Right Rebate Act (Wyden) - Medicaid drug rebate program S. 317, ACE Kids Act (Grassley) - health homes for children with medically complex conditions S. 377, Medicare Negotiation and Competitive Licensing Act (Brown) - Part D price negotiation S. 470, Medicare at 50 Act (Stabenow) - Medicare buy-in option S. 475, RxCAP Act (Wyden) - Part D cost-sharing S. 489, State Public Option Act (Schatz) - Medicaid buy-in option S. 516, Prescription Drug Monitoring Act (Klobuchar) - required use of PDMPs S. 548, EMPOWER Care Act (Portman) - MFP demonstration S. 640, Phair Pricing Act (Kennedy) -- Part D rebates at the point of sale S. 691, Medicare Extra Rx HELP Act (Casey) - Part D assistance for low-income seniors S. 709, Prescription Drug Pricing Dashboard Act (Casey) - interactive dashboard with drug price and utilization data for federal programs S. 773, Telehealth Innovation and Improvement Act (Gardner) - testing expanded coverage of telehealth services in Medicare S. 988, Improving Transparency and Accuracy in Medicare Part D Spending Act (Capito) - payments on clean claims S. 1114, Medicare Advantage Quality Payment Relief Act (Daines-King) - MA benchmark cap S. 2081, Stop Drug Companies from Overcharging Seniors in Medicare Part B Act of 2019 (Peters)- drugs in Part B S. 2252, Empowering States to Address Drug Costs Act (Van Hollen)- drug pricing S. 2446, Medicare Audiologist Access and Services Act of 2019 (Warren)-Medicare coverage of audiologist services S. 2650 - Medicare Prescription Drug Savings and Choice Act of 2019 (Durbin) - lowering prescription drug costs S. 2807, Hospice Care Improvement Act of 2019 (Portman) - Medicare hospice programs S. 2846, Protecting Patients Transportation to Care Act (Isakson) - Medicaid coverage of transportation S. 2911, Seniors Prescription Drug Relief Act of 2019 (Cassidy) - Part D smoothing S. 3000, Patient Shared Savings Act (Cassidy) - prescription drug plans S. 3001, Permanent Relief for Seniors and Medicare, Medicaid, Human Services Extension Act of 2019 (Toomey) - extensions S. 3029, Territories Medicare Prescription Drug Assistance Equity Act of 2019 (Menendez) - Territories, low-income Medicare part D beneficiaries S. 3078, Audit & Appeals Fairness, Integrity, and Reforms in Medicare Act of 2019 (Grassley) - Medicare appeals process S. 3129, Lower Costs, More Cures Act of 2019 (Crapo) - drug pricing H.R. 19, Lower Costs, More Cures Act of 2019 (Walden) - drug pricing H.R. 259, Medicaid Extenders Act (Pallone) - MFP demonstration, spousal impoverishment protections H.R. 448, Medicare Drug Price Negotiation Act (Cummings) - Part D price negotiations, formulary changes H.R. 789, Improving Transparency and Accuracy in Medicare Part D Spending Act (Welch) - payments on clean claims H.R. 937, Right Rebate Act (Schrader) - Medicaid drug rebate program H.R. 1034, Phair Pricing Act (Collins) - Part D rebates at the point of sale H.R. 1035, Prescription Drug Price Transparency Act (Collins) - Medicare PBM standards H.R. 1046, Medicare Negotiation and Competitive Licensing Act (Doggett) - Part D price negotiation H.R. 1226, ACE Kids Act (Castor) - health homes for children with medically complex conditions H.R. 1277, State Public Option Act (Lujan) - Medicaid buy-in option H.R. 1301, Mental Health Telemedicine Expansion Act (DelBene) - Medicare coverage of mental health telehealth services H.R. 1342, EMPOWER Care Act (Dingell) - MFP demonstration H.R. 1343, Protecting Married Seniors from Impoverishment Act (Dingell) - spousal impoverishment protections H.R. 1346, Medicare Buy-In and Health Care Stabilization Act (Higgins) - Medicare buy-in option H.R. 1375, PAID Act (Kind) - transparency of Medicare secondary payer information H.R. 1394, Medigap Consumer Protection Act (Doggett) - Medicare supplemental consumer protections H.R. 1551, Quality Care for Moms and Babies Act (Engel) - quality measures in Medicaid and CHIP H.R. 1781, Payment Commission Data Act (Carter) - MedPAC and MACPAC access to drug pricing and rebate data in Medicare and Medicaid H.R. 1839, Medicaid Services Investment and Accountability Act (Ruiz) - MFP demonstration, spousal impoverishment protections, ACE Kids Act, Medicaid drug rebate program, health homes for children with medically complex conditions H.R. 2131, Medicare Advantage Quality Payment Relief Act (Kind-Kelly) - MA benchmark cap H.R. 2757, Creating Lower Cost Alternatives for Your Prescription Drugs Act (Cunningham) - eliminate copay for generic drugs in Medicare Part D H.R. 3107, Improving Seniors' Timely Access to Care Act (DelBene) - Medicare Advantage prior authorization H.R. 3253, Empowering Beneficiaries, Ensuring Access, and Strengthening Accountability Act (Dingell) - MFP demonstration, spousal impoverishment protections, Medicaid drug rebate program H.R. 3417, Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act (Neal) - funding for quality measurement initiatives, Medicare coverage of mental health telehealth services, real-time benefit tools in Medicare Part D, Medicare eligibility and enrollment notices H.R. 3461, Community-Based Independence for Seniors Act (Sanchez-Kelly) - Community-Based Institutional Special Needs Plan H.R. 3613, State Accountability, Flexibility, and Equity for Hospitals Act of 2019 (Bilirakis) -Medicaid DSH payments H.R. 3631, Territories Health Care Improvement Act (Soto) -Medicaid funding H.R. 3644, Independence at Home Demonstration Act of 2019 (Burgess)-Medicare demonstration program H.R. 3925, Reducing Barriers to Substance Use Treatment Act (Tonko)- Opioids H.R. 3935, Protecting Patients Transportation to Care Act (Carter)-Medicaid coverage for transportation H.R. 4378, Continuing Appropriations Act, 2020, and Health Extenders Act of 2019 (Lowey)-Health extenders H.R. 4453, Protecting Seniors from Health Care Fraud Act of 2019 (Ruiz)-Distributing information to Medicare beneficiaries to prevent fraud H.R. 4527, Expanding Health Care Options for Early Retirees Act (Malinowski)-Option for first responders to buy-in to Medicare H.R. 4529, Promoting Access to Broadband Act of 2019 (Maloney)-Medicaid H.R. 4583, Medicare Extra Rx Higher Eligibility Limits in Part D Act of 2019 (Schneider) - prescription drug affordability H.R. 4597, Acting to Cancel Copays and Ensure Substantial Savings for Biosimilars Act of 2019 (Peters) - biosimilars, Part B H.R. 4618, Medicare Hearing Act of 2019 (McBath) - coverage for certain hearing items and services under part B H.R. 4619, Pharmaceutical Rebates for Excessive Pricing Above Inflation Act (Schakowsky) - drug rebates, Part D H.R. 4620, More Help for Seniors Act of 2019 (Rose) - expand eligibility for low-income subsidies under Part D of the Medicare program H.R. 4621, Collecting and Analyzing Resources Integral and Necessary for Guidance for Social Determinants Act of 2019 (Blunt Rochester) - best practices re social determinants of health H.R. 4628, Better Tools to Lower Costs Act of 2019 (Scanlon) - resource requirements H.R. 4629, Star Rating for Biosimilars Act (Tonko) - biosimilars H.R. 4632, Better Transparency in Information for Medicare Beneficiaries Act of 2019 (Kind) - provides consumers information regarding premiums under LIS benchmark plans H.R. 4649, Capping Drug Costs for Seniors Act of 2019 (Horsford) - cap on beneficiary liability under part D of the Medicare program H.R. 4650, Medicare Dental Act of 2019 (Kelly) - Medicare dental coverage H.R. 4655, Enhancing Retirement Security for Medicare Beneficiaries Act of 2019 (Lee) - eligibility of individuals for premium and cost-sharing subsidies under part D H.R. 4661, Advancing Enrollment and Reducing Drug Costs Act of 2019 (Pappas) - Medicaid in territories H.R. 4663, Freedom from Price Gouging Act (Porter) - drug rebates, Part B H.R. 4665, Medicare Vision Act of 2019 (Schrier) - vision items and services under part B H.R. 4666, To amend title XVIII of the Social Security Act to provide certain low-income territorial residents with automatic eligibility for premium and cost-sharing subsidies under the Medicare program, and for other purposes (Shalala) - Medicare in territories H.R. 4669, Maximizing Drug Coverage for Low-Income Seniors Act of 2019 (Stevens) - auto enrollment and intelligent assignment H.R. 4671, Helping Seniors Afford Health Care Act (Kim) - Medicare affordability and low income beneficiaries H.R. 4676, Protecting Medicare Beneficiaries with Pre-Existing Conditions Act (Schneider) - Medigap H.R. 4699, To amend title XIX of the Social Security Act to remove the matching requirement for a territory to use specially allocated Federal funds for Medicare covered part D drugs for low-income individuals (Gonzales-Colon) - Part D, territories H.R. 4769, Medicare Prescription Drug Savings and Choice Act of 2019 (Schakowsky) - lowering prescription drug costs H.R. 4946, Ensuring Seniors Access to Local Pharmacies Act of 2019 (Welch) - equal access of Medicare beneficiaries to community pharmacies in underserved areas H.R. 4996, Helping Medicaid Offer Maternity Services Act of 2019 (Kelly) - State extension of Medicaid H.R. 5006, Expanding Access to Inpatient Mental Health Act (Emmer) - Medicaid coverage for SUD/mental health for institutionalized H.R. 5039, Life Sustaining Prescription Drug Price Relief Act of 2019 (Lipinski) - part D H.R. 5057, Pass- Through Technical Corrections Act (Tonko) - drug pass-through status under Medicare outpatient payment H.R. 5201, Telemental Health Expansion Act of 2019 (Matsui) - Medicare coverage of mental telehealth H.R. 5232, Road to Recovery Act (Fitzpatrick) - Medicaid and CHIP SUD treatment H.R. 5281, Drug Price Transparency in Medicaid Act of 2019 (Carter) - transparency and spread pricing affordability Discussion Draft, Medicare Part D Reform (Neal-Pallone-Brady-Walden) - maximum out-of-pocket limit, federal reinsurance payments Regulatory Issues: Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, network adequacy and provider directories, encounter data and other data-related issues, and risk adjustment data validation (RADV) audit issues including proposed RADV regulation for MA; bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, Part D direct and indirect remuneration (DIR), and audits); calendar year 2021 policy and technical regulation for MA and Part D; MA and Part D proposed rule on drug pricing changes for 2020; Part D reform, out of pocket limits; issues related to Medicare for All, Medicare buy-in and public option; CMSs price transparency proposal for direct-to-consumer advertisements; issues relating to 2021 Rate Notice and Call Letter; issues related to MLTSS; issues related to proposed changes to removal of safe harbor protection for rebates (proposed rule); in-home health risk assessments; Medicare Medical Loss Ratio issues; implementation of sequestration under the Medicare Advantage and Part D programs; implications of the health insurer fee for MA and Part D plans; application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, enrollment rules, requirements for notice and denial forms, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible SNPs; Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, Part D coverage gap discount program, including employer group waiver plan (EGWP) issues, and other operational issues; issues raised by Part D coverage of new specialty drugs, the Part D non-interference policy and related issues (e.g., preferred pharmacy and any willing pharmacy requirements, standards for network pharmacy reimbursement, and policies regarding sponsor negotiation of pharmacy price concessions); issues related to the international price index; issues related to child and maternal health; issues related to Medicaid supplemental and disproportionate share hospital (DSH) funding; issues related to Medicaid funding for territories; issues related to medical management; issues relating to MA supplemental benefits; Medication Therapy Management Program requirements and the Center for Medicare and Medicaid Innovation (CMMI) Demonstration; MA EGWP issues; CMMI's value-based insurance design (VBID) demonstration; Part D requirements for offering basic and enhanced alternative plans; MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; issues relating to MA and Part D Star Rating system including measures, the methodology for calculating ratings, and the role of the ratings for payment purposes; implementation of the Affordable Care Act (ACA) and the Bipartisan Budget Act of 2018 changes to the Part D coverage gap; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education Program; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; new payment system for physicians under MACRA, including implications for MA and Part D plans; Medicare clinical trials; Medicare/Medicaid integration for dual eligibles, including implementation of the Capitated Financial Alignment Demonstration and related issues (e.g., quality ratings); Medicaid managed care regulations and policies, including CMS's substantial revisions to the managed care regulations, mental health parity rules, the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, fraud and abuse compliance, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including block grants, the calculation of the federal medical assistance (federal matching) percentage (FMAP), and intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost issues affecting Medicaid health plans including issues raised by Medicaid coverage of new specialty drugs; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues and CHIP reauthorization; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including Medicaid managed care organization provider tax issues; standards for electronic prescribing; implementation of Medicaid changes of interest to Medicaid health plans made in the ACA including Medicaid expansion, the managed care organization (MCO) prescription drug rebate provisions, minimum payments to primary care providers (PCPs), interactions between the Medicaid program and health insurance exchanges, and Medicaid and CHIP maintenance of effort (MOE) requirements; implications of the health insurer fee for Medicaid health plans; issues related to Medicaid Managed long-term care including home and community-based waiver services (HCBS); expanding the availability of Medicare Advantage and Medicaid health plan telemedicine programs; implications of the new non-discrimination rules for health plans participating in public programs; issues related to Medigap coverage; issues related to business continuity in relation to pandemics or natural events (e.g., hurricane, tornado, etc.); cybersecurity; provider directories; value-based insurance design models; issues relating to prescription drug price blueprint; Part D prescriber enrollment requirements; Part D recovery audit contractor programs; issues relating to enrollment of beneficiaries with ESRD into MA plans; issues related to health homes for children with medically complex conditions; socioeconomic status impacts on star ratings related to MA and Part D programs; and other issues relating to health care reform implementation.

Client expense: $2,340,000 · Firm income: Not reported

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

H.R. 2740 Labor-HHS Appropriations bill, FY 2020 - lobbied in support of increased funding for CMS' state survey and certification program and opposition to hostile policy riders re Patient Protection and Affordable Care Act. H.R. 2150/S. 296 - Home Health Care Planning Improvement Act. Discussed advancing supportive housing solutions that advance healthy aging in communities. H.R. 3 - Discussed inclusion of dental, hearing, and vision benefit in Medicare. Discussed changes to Medigap policy. S. 1895 - Discussed surprise billing. No bill number - Discussed Medicare late enrollment penalties, eligibility, and financing. S.1999 - Improving Low Income Access to Prescription Drugs Act. No bill number. Discussed Medicaid managed long-term services and supports, including grievances and appeals, with GAO. No bill number. Discussed Medicare and family caregiving. No bill number. Discussed nursing home issue. H.R. 3, Elijah E. Cummings Lower Drug Costs Now Act of 2019 and H.R. 1682, the Improving Access to Medicare Coverage Act. No bill number. Discussed Nursing Home Compare. No bill number. Discussed Medicare and respite. No bill number. Discussed hospice issues and legislation. S. 2807, Hospice Care Improvement Act. No bill number. Provided feedback on home and community-based services bill. S. 2574, Promote Responsible Oversight and Targeted Employee Background Check Transparency for Seniors Act. H.R. 5757 -The Fighting Medicare Fraud Act of 2018. H.R. 5326 - The Fairness in Nursing Home Arbitration Act. H.R. 1158, Consolidated Appropriations Act, 2020 and H.R. 1865, Further Consolidated Appropriations Act, 2020 - supported permanent extension of Money Follows the Person Rebalancing Demonstration Program and Medicaid home and community-based services spousal impoverishment protections No bill number. Provided feedback on long-term care pharmacy bill. S. 548/H.R. 1342, EMPOWER Care Act, and H.R. 3253, Sustaining Excellence in Medicaid Act - supported longer-term extensions of the Money Follows the Person Rebalancing Demonstration Program and Medicaid home and community-based services spousal impoverishment protections.

Client expense: $2,140,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Transportation, Dept of (DOT), Treasury, Dept of, White House Office

H.R. 1158/H.R. 1865 - The Consolidated Appropriations Act/Further Consolidated Appropriations Act. H.R. 2740 Labor-HHS Appropriations bill, FY 2020 - Lobbied in support of increased funding for CMS' state survey and certification program and opposition to hostile policy riders re ACA, and various related medical care research and supportive services. S.340/H.R. 965 - the CREATES Act. S.64/H.R. 2375 - The Preserve Access to Generics and Biosimilars Act. H.R. 1499 - The Preserving Consumer Access to Generics Act. H.R. 3 - The Lower Drug Costs Now Act. H.R. 2073/S.110 - Lobbied in support of a permanent extension of the 7.5% income threshold for the medical expense deduction. H.R. 1865/H.R. 1158 - Lobbied in support of 2 year extension of 7.5% income threshold for the medical expense deduction in the final FY 2020 Consolidated Appropriations Act. H.R. 19/S.3129 - The Lower Costs, More Cures Act H.R. 1682/S.753 - The Improving Access to Medicare Coverage Act H.R. 1342/S. 548 - The Empower Act S. 1921, Provider Training in Palliative Care Act. S. 1399, Title VIII Nursing Workforce Reauthorization Act. P.L. 115-119, RAISE Family Caregivers Act - Discussed family caregiving in Cures 2.0.

Client expense: $2,140,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Transportation, Dept of (DOT), Treasury, Dept of, White House Office

1. Patient Protection and Affordable Health Care Act, implementation of provisions regarding Medicare Part D coverage gap assistance, preventive care services, and dual eligible Medicare and Medicare beneficiaries 2. Proposals to create a premium support or voucher program under Medicare 3. Proposals to "means test" Medicare premiums and benefits 4. Proposals to change federal and state Medicaid cost sharing 5. Proposals to raise the Medicare eligibility age 6. Proposals regarding prescription drug costs for low income Medicare beneficiaries 7. Expansion of Medicare benefits to include hearing, vision, and dental benefits 8. Administration of the Medicare State Health Insurance Assistance Programs 9. Medicare Observation Status Regulations 10. Nursing Home Arbitration Regulations 11. Medicare 340(B) drug reimbursement policy 12. Home care workers and Medicare Reassignment Policy 13. Medicare equitable relief policy 14. S. 340, CREATES Act of 2019, entire bill 15. H.R. 965, CREATES Act of 2019, entire bill 16. H.R. 1046, Medicare Negotiation and Competitive Licensing Act of 2019, entire bill 17. CMS Proposals on Part D Drug Pricing 18. S. 691, Medicare Extra Rx HELP Act of 2019, entire bill 19. H.R. 1342, EMPOWER Care Act, entire bill 20. S. 548, EMPOWER Care Act, entire bill 21. H.R. 1343, Protecting Married Seniors from Impoverishment Act, entire bill 22. S. 97, Affordable and Safe Prescription Drug Importation Act, entire bill 23. S. 99, Medicare Drug Price Negotiation Act, entire bill 24. H.R. 3, Lower Drug Costs Now Act of 2019, entire bill 25. H.R. 1393, Medicare Dental, Vision and Hearing Benefit Act of 2019, entire bill 26. H.R. 1394, Medigap Consumer Protection Act of 2019, entire bill 27. H.R. 1682, Improving Access to Medicare Coverage Act of 2019, entire bill 28. H.R. 4386, Stop the Wait Act, entire bill 29. Proposals regarding the tiering generic drugs under Medicare Part D

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Pension & Welfare Benefits Administration, Pension Benefit Guaranty Corporation (PBGC), SENATE, Social Security Administration (SSA), U.S. Trade Representative (USTR)

The Autism Cares Act of 2019 (S 427 / HR 1058) regarding funding for autism research, services, training and monitoring; The Empower Care Act (S 548 / HR 1342) regarding home and community based services to individuals with autism and their families.

Client expense: Not reported · Firm income: $7,500

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 2035/S. 995, the Lifespan Respite Care Reauthorization Act of 2019 H.R. 1342/S. 548, the Empower Act H.R. 3253, the Sustaining Excellence in Medicaid Act Implementation of P.L. 111-148, the Patient Protection and Affordable Care Act Implementation of P.L. 115-119, the RAISE Family Caregivers Act

Client expense: $72,261 · Firm income: Not reported

Government targets: AMTRAK - Natl Railroad Passenger Corporation, Centers For Medicare and Medicaid Services (CMS), Federal Emergency Management Agency (FEMA), HOUSE OF REPRESENTATIVES, Housing & Urban Development, Dept of (HUD), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Institutes of Health (NIH), SENATE, Transportation, Dept of (DOT), U.S. Architectural & Transportation Barriers Compliance Board (ACCESS), Veterans Affairs, Dept of (VA)

H.R. 1865, Further Consolidated Appropriations Act, 2020, provisions related to autism funding at the Department of Health and Human Services, the Department of Defense, and other federal departments H.R. 1865, Further Consolidated Appropriations Act, 2020, provisions related to autism funding at the Department of Health and Human Services, the Department of Defense, and other federal departments Implementation of the RAISE Family Caregivers Act H.R. 1342/ S.548 EMPOWER Care Act of 2019 FY2021 LHHS Appropriations H.R. 4095 - Family Care Act of 2019 CHAMPVA coverage S.260/h.r.873 - Transformation to Competitive Employment Act H.R. 1865, Further Consolidated Appropriations Act, 2020, provisions related to autism funding at the Department of Health and Human Services, the Department of Defense, and other federal departments legislative proposals related to autism services Implementation of the Individuals with Disabilities Education Act (P.L. 89-10) Implementation of the Rehabilitation Act of 1973 (P.L. 93-112) Implementation of the Workforce Innovation and Opportunity Act (P.L. 113-128) Implementation of the National Apprenticeship Act (P.L. 89-554) Implementation of H.R. 1058/S. 427 - Autism CARES Act Implementation of 1905(r) of the Social Security Act, related to provisions of early and periodic screening, diagnostic, and treatment services. Implementation of Kevin and Avonte's Law of 2018 (H.R. 1625, Consolidated Appropriations Act, 2018, Division Q), all provisions A bill not yet introduced to improve inter-agency collaboration, based on the Promoting Readiness of Minors in SSI program A bill not yet introduced related to apprenticeships for individuals with disabilities A bill not yet introduced to amend the Higher Education Act (P.L. 89-329) A bill not yet introduced to prohibit and prevent the use of seclusion and reduce of the use of physical restraint in schools, and for other purposes; A bill not yet introduced to improve direct services for individuals with autism and their families A bill not yet introduced to improve professional development opportunities for educators A bill not yet introduced to create Patient-Centered Health Reform A bill not yet introduced to improve direct services for individuals with autism and their families Future HCBS Infrastructure Improvement Act of 2020 Future Inclusive Faith funding Future Autism Services Legislation Proposed Rule-making - CMS 2393 Medicaid Program; Medicaid Fiscal Accountability Regulation, all provisions.

Client expense: $82,892 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Education, Dept of, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE, Veterans Affairs, Dept of (VA)

EMPOWER Care Act, S. 548/HR 1342. HR 6042/S. 2897, Issues pertaining to Medicaid Electronic Visit Verification rules, Direct Support Professional standard occupational category; Direct Support Professional visas. Medicaid Services Investment and Accountability Act of 2019, HR 1839. FY2020 Further Consolidated Appropriations Act (LHHSED, AG, Energy Water, Interior, Leg. Branch, MCVA, State-For. Ops, T-HUD), H.R. 1865.Isaiah Baker and Margie Harris-Austin Act, HR 5443.

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

Government targets: HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), SENATE

HR 3163: Making appropriations for the Department of Transportation, and Housing and Urban Development, and related agencies for the fiscal year ending September 30, 2020, and for other purposes -- support increased funding for Community Development Block Grant and HOME programs at HUD; highway and transit formula programs at DOT. H.R.530: Accelerating Broadband Development by Empowering Local Communities Act of 2019 -- support legislation. Promote creation of a federal infrastructure package. Support full implementation of federal Opportunity Zones program. Support reintroduction of Affordable Housing Credit Improvements Act of 2017 (S. 548) in 116th Congress

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

P.L. 111-375 National Alzheimer's Project Act, All Sections P.L. 115-119 Recognize, Assist, Include, Support and Engage (RAISE) Family Caregivers Act P.L. 115-406 Building Our Largest Dementia (BOLD) Infrastructure for Alzheimer's Act S.591 Guardianship Accountability Act S.299 Geriatrics Workforce Improvement Act S.548/H.R.1342 EMPOWER Care Act H.R.1343 Protecting Married Seniors from Impoverishment Act S.740 Alzheimer's Caregiver Support Act H.R. 1955 Study on Use of Anti-Psychotics in Non-nursing Homes S.880/H.R.1873 Improving HOPE for Alzheimer's Act H.R.1903/S.901 Younger-Onset Alzheimer's Disease Act of 2019 S.2080/H.R.647 Palliative Care and Hospice Education and Training Act S.1250/H.R.2401 American Cures Act S.1017 Supporting America's Caregivers and Families Act S.995/H.R.2035 Lifespan Respite Care Reauthorization Act of 2019 S.1126/H.R.2283 Concentrating on High-Value Alzheimer's Needs to Get to an End (CHANGE) Act of 2019 S.1361/H.R.2584 Preventive Health Savings Act of 2019 S.1628 Paid Family Leave Pilot Extension Act H.R.2878 Homecare for Seniors Act S.1618 Expanding Capacity for Health Outcomes (ECHO) Act of 2019 S.1202 Independence at Home Act of 2019 H.R.3644 Independence at Home Demonstration Act of 2019 H.R.3436 Improving Chronic Care Management Act H.R.3107 Improving Seniors' Timely Access to Care Act H.R.4334 Dignity in Aging Act of 2019 S.2469/H.R.4386 Stop the Wait Act

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

Government targets: Administration on Aging, Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Indian Health Service, Interior, Dept of (DOI), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Natl Institutes of Health (NIH), SENATE, Social Security Administration (SSA), Veterans Affairs, Dept of (VA)

S. 62, Empowering Medicare Seniors to Negotiate Drug Prices Act (Klobuchar) - Part D price negotiations S. 99, Medicare Drug Price Negotiation Act (Sanders) - Part D price negotiations, formulary changes S. 205, Right Rebate Act (Wyden) - Medicaid drug rebate program S. 317, ACE Kids Act (Grassley) - health homes for children with medically complex conditions S. 377, Medicare Negotiation and Competitive Licensing Act (Brown) - Part D price negotiation S. 470, Medicare at 50 Act (Stabenow) - Medicare buy-in option S. 475, RxCAP Act (Wyden) - Part D cost-sharing S. 489, State Public Option Act (Schatz) - Medicaid buy-in option S. 516, Prescription Drug Monitoring Act (Klobuchar) - required use of PDMPs S. 548, EMPOWER Care Act (Portman) - MFP demonstration S. 640, Phair Pricing Act (Kennedy) -- Part D rebates at the point of sale S. 691, Medicare Extra Rx HELP Act (Casey) - Part D assistance for low-income seniors S. 709, Prescription Drug Pricing Dashboard Act (Casey) - interactive dashboard with drug price and utilization data for federal programs S. 773, Telehealth Innovation and Improvement Act (Gardner) - testing expanded coverage of telehealth services in Medicare S. 988, Improving Transparency and Accuracy in Medicare Part D Spending Act (Capito) - payments on clean claims S. 1114, Medicare Advantage Quality Payment Relief Act (Daines-King) - MA benchmark cap S. 2081, Stop Drug Companies from Overcharging Seniors in Medicare Part B Act of 2019 (Peters)- drugs in Part B S. 2252, Empowering States to Address Drug Costs Act (Van Hollen)- drug pricing S. 2446, Medicare Audiologist Access and Services Act of 2019 (Warren)-Medicare coverage of audiologist services H.R. 259, Medicaid Extenders Act (Pallone) - MFP demonstration, spousal impoverishment protections H.R. 448, Medicare Drug Price Negotiation Act (Cummings) - Part D price negotiations, formulary changes H.R. 789, Improving Transparency and Accuracy in Medicare Part D Spending Act (Welch) - payments on clean claims H.R. 937, Right Rebate Act (Schrader) - Medicaid drug rebate program H.R. 1034, Phair Pricing Act (Collins) - Part D rebates at the point of sale H.R. 1035, Prescription Drug Price Transparency Act (Collins) - Medicare PBM standards H.R. 1046, Medicare Negotiation and Competitive Licensing Act (Doggett) - Part D price negotiation H.R. 1226, ACE Kids Act (Castor) - health homes for children with medically complex conditions H.R. 1277, State Public Option Act (Lujan) - Medicaid buy-in option H.R. 1301, Mental Health Telemedicine Expansion Act (DelBene) - Medicare coverage of mental health telehealth services H.R. 1342, EMPOWER Care Act (Dingell) - MFP demonstration H.R. 1343, Protecting Married Seniors from Impoverishment Act (Dingell) - spousal impoverishment protections H.R. 1346, Medicare Buy-In and Health Care Stabilization Act (Higgins) - Medicare buy-in option H.R. 1375, PAID Act (Kind) - transparency of Medicare secondary payer information H.R. 1394, Medigap Consumer Protection Act (Doggett) - Medicare supplemental consumer protections H.R. 1551, Quality Care for Moms and Babies Act (Engel) - quality measures in Medicaid and CHIP H.R. 1781, Payment Commission Data Act (Carter) - MedPAC and MACPAC access to drug pricing and rebate data in Medicare and Medicaid H.R. 1839, Medicaid Services Investment and Accountability Act (Ruiz) - MFP demonstration, spousal impoverishment protections, ACE Kids Act, Medicaid drug rebate program, health homes for children with medically complex conditions H.R. 2131, Medicare Advantage Quality Payment Relief Act (Kind-Kelly) - MA benchmark cap H.R. 2757, Creating Lower Cost Alternatives for Your Prescription Drugs Act (Cunningham) - eliminate copay for generic drugs in Medicare Part D H.R. 3107, Improving Seniors' Timely Access to Care Act (DelBene) - Medicare Advantage prior authorization H.R. 3253, Empowering Beneficiaries, Ensuring Access, and Strengthening Accountability Act (Dingell) - MFP demonstration, spousal impoverishment protections, Medicaid drug rebate program H.R. 3417, Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act (Neal) - funding for quality measurement initiatives, Medicare coverage of mental health telehealth services, real-time benefit tools in Medicare Part D, Medicare eligibility and enrollment notices H.R. 3461, Community-Based Independence for Seniors Act (Sanchez-Kelly) - Community-Based Institutional Special Needs Plan Discussion Draft, Medicare Part D Reform (Neal-Pallone-Brady-Walden) - maximum out-of-pocket limit, federal reinsurance payments H.R. 3613, State Accountability, Flexibility, and Equity for Hospitals Act of 2019 (Bilirakis) -Medicaid DSH payments H.R. 3631, Territories Health Care Improvement Act (Soto) -Medicaid funding H.R. 3644, Independence at Home Demonstration Act of 2019 (Burgess)-Medicare demonstration program H.R. 3925, Reducing Barriers to Substance Use Treatment Act (Tonko)- Opioids H.R. 3935, Protecting Patients Transportation to Care Act (Carter)-Medicaid coverage for transportation H.R. 4378, Continuing Appropriations Act, 2020, and Health Extenders Act of 2019 (Lowey)-Health extenders H.R. 4453, Protecting Seniors from Health Care Fraud Act of 2019 (Ruiz)-Distributing information to Medicare beneficiaries to prevent fraud H.R. 4527, Expanding Health Care Options for Early Retirees Act (Malinowski)-Option for first responders to buy-in to Medicare H.R. 4529, Promoting Access to Broadband Act of 2019 (Maloney)-Medicaid Regulatory Issues: Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, network adequacy and provider directories, encounter data and other data-related issues, and risk adjustment data validation (RADV) audit issues; bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, Part D direct and indirect remuneration (DIR), and audits); calendar year 2020 policy and technical regulation for MA and Part D; MA and Part D proposed rule on drug pricing changes for 2020; Part D reform, out of pocket limits; issues related to Medicare for All, Medicare buy-in and public option; CMSs price transparency proposal for direct-to-consumer advertisements; issues relating to 2020 Rate Notice and Call Letter; issues related to proposed changes to removal of safe harbor protection for rebates (proposed rule); in-home health risk assessments; Medicare Medical Loss Ratio issues; implementation of sequestration under the Medicare Advantage and Part D programs; implications of the health insurer fee for MA and Part D plans; application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, enrollment rules, requirements for notice and denial forms, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible SNPs; Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, Part D coverage gap discount program, including employer group waiver plan (EGWP) issues, and other operational issues; issues raised by Part D coverage of new specialty drugs, the Part D non-interference policy and related issues (e.g., preferred pharmacy and any willing pharmacy requirements, standards for network pharmacy reimbursement, and policies regarding sponsor negotiation of pharmacy price concessions); issues related to the international price index; issues related to child and maternal health; issues related to Medicaid supplemental and disproportionate share hospital (DSH) funding; issues related to Medicaid funding for territories; issues related to medical management; issues relating to MA supplemental benefits; Medication Therapy Management Program requirements and the Center for Medicare and Medicaid Innovation (CMMI) Demonstration; MA EGWP issues; CMMI's value-based insurance design (VBID) demonstration; Part D requirements for offering basic and enhanced alternative plans; MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; issues relating to MA and Part D Star Rating system including measures, the methodology for calculating ratings, and the role of the ratings for payment purposes; implementation of the Affordable Care Act (ACA) and the Bipartisan Budget Act of 2018 changes to the Part D coverage gap; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education Program; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; new payment system for physicians under MACRA, including implications for MA and Part D plans; Medicare clinical trials; Medicare/Medicaid integration for dual eligibles, including implementation of the Capitated Financial Alignment Demonstration and related issues (e.g., quality ratings); Medicaid managed care regulations and policies, including CMS's substantial revisions to the managed care regulations, mental health parity rules, the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, fraud and abuse compliance, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including block grants, the calculation of the federal medical assistance (federal matching) percentage (FMAP), and intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost issues affecting Medicaid health plans including issues raised by Medicaid coverage of new specialty drugs; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues and CHIP reauthorization; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including Medicaid managed care organization provider tax issues; standards for electronic prescribing; implementation of Medicaid changes of interest to Medicaid health plans made in the ACA including Medicaid expansion, the managed care organization (MCO) prescription drug rebate provisions, minimum payments to primary care providers (PCPs), interactions between the Medicaid program and health insurance exchanges, and Medicaid and CHIP maintenance of effort (MOE) requirements; implications of the health insurer fee for Medicaid health plans; issues related to Medicaid Managed long-term care including home and community-based waiver services (HCBS); expanding the availability of Medicare Advantage and Medicaid health plan telemedicine programs; implications of the new non-discrimination rules for health plans participating in public programs; issues related to Medigap coverage; issues related to business continuity in relation to pandemics or natural events (e.g., hurricane, tornado, etc.); cybersecurity; provider directories; value-based insurance design models; issues relating to prescription drug price blueprint; Part D prescriber enrollment requirements; Part D recovery audit contractor programs; issues relating to enrollment of beneficiaries with ESRD into MA plans; issues related to health homes for children with medically complex conditions; socioeconomic status impacts on star ratings related to MA and Part D programs; and other issues relating to health care reform implementation.

Client expense: $2,110,000 · Firm income: Not reported

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

H.R. 2740 Labor-HHS Appropriations bill, FY 2020 - Lobbied in support of increased funding for CMS' state survey and certification program and opposition to hostile policy riders re ACA, and various related medical care research and supportive services. S.340/H.R. 965 - the CREATES Act. S.64/H.R. 2375 - the Preserve Access to Generics and Biosimilars Act. H.R. 1499 - the Preserving Consumer Access to Generics Act. H.R. 3 - The Lower Drug Costs Now Act. S. 2543 - the Prescription Drug Pricing Reduction Act. S. 1921, Discussed the Provider Training in Palliative Care Act. S. 299, Discussed the Geriatrics Workforce Improvement Act. No bill number - Discussed Medicare Advantage program. H.R. 1682/S.753 Improving Access to Medicare Coverage Act. H.R. 1342/S.548 Empower Act.

Client expense: $2,140,000 · Firm income: Not reported

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

H.R. 2740 Labor-HHS Appropriations bill, FY 2020 - lobbied in support of increased funding for CMS' state survey and certification program and opposition to hostile policy riders re Patient Protection and Affordable Care Act. No bill number - Discussed civil money penalties for enforcement in nursing homes. No bill number - Discussed nursing home quality and enforcement issues and shared relevant information. No bill number - Submitted and shared statement for the record for Senate Finance Committee nursing home hearing. No bill number - Discussed nursing homes, including the Special Focus Facility Program. Discussed emergency preparedness regulations for nursing homes. No bill number - Discussed mental health access challenges under the Medicare program with Senate staff. No bill number. Provided information related to anti-psychotic drug use in nursing homes and other nursing home issues to House staff. No bill number. Discussed Elder Justice Act reauthorization. No bill number. Discussed nursing home bill with Senate staff. H.R. 1334/S. 2000, Discussed the Protecting Married Seniors from Impoverishment Act. H.R. 1342/S. 548, Discussed the EMPOWER Care Act. No bill number. Discussed issues affecting dual eligibles. S. 2574, PROTECTS Act. No bill number. Discussed managed long-term services and supports with GAO, including grievances and appeals. Discussed Medicare Part D issues.

Client expense: $2,140,000 · Firm income: Not reported

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

1. Patient Protection and Affordable Health Care Act, implementation of provisions regarding Medicare Part D coverage gap assistance, preventive care services, and dual eligible Medicare and Medicare beneficiaries 2. Proposals to create a premium support or voucher program under Medicare 3. Proposals to "means test" Medicare premiums and benefits 4. Proposals to change federal and state Medicaid cost sharing 5. Proposals to raise the Medicare eligibility age 6. Proposals regarding prescription drug costs for low income Medicare beneficiaries 7. Expansion of Medicare benefits to include hearing, vision, and dental benefits 8. Administration of the Medicare State Health Insurance Assistance Programs 9. Medicare Observation Status Regulations 10. Nursing Home Arbitration Regulations 11. Medicare 340(B) drug reimbursement policy 12. Home care workers and Medicare Reassignment Policy 13. Medicare equitable relief policy 14. S. 340, CREATES Act of 2019, entire bill 15. H.R. 965, CREATES Act of 2019, entire bill 16. H.R. 1046, Medicare Negotiation and Competitive Licensing Act of 2019, entire bill 17. CMS Proposals on Part D Drug Pricing 18. S. 691, Medicare Extra Rx HELP Act of 2019, entire bill 19. H.R. 1342, EMPOWER Care Act, entire bill 20. S. 548, EMPOWER Care Act, entire bill 21. H.R. 1343, Protecting Married Seniors from Impoverishment Act, entire bill 22. S. 97, Affordable and Safe Prescription Drug Importation Act, entire bill 23. S. 99, Medicare Drug Price Negotiation Act, entire bill 24. H.R. 3, Lower Drug Costs Now Act of 2019, entire bill 25. H.R. 1393, Medicare Dental, Vision and Hearing Benefit Act of 2019, entire bill 26. H.R. 1394, Medigap Consumer Protection Act of 2019, entire bill 27. H.R. 1682, Improving Access to Medicare Coverage Act of 2019, entire bill 28. H.R. 4386, Stop the Wait Act, entire bill

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Pension Benefit Guaranty Corporation (PBGC), SENATE, Social Security Administration (SSA), U.S. Trade Representative (USTR)

H.R. 2035/S. 995, the Lifespan Respite Care Reauthorization Act of 2019 H.R. 1342/S. 548, the Empower Act H.R. 3253, the Sustaining Excellence in Medicaid Act Implementation of P.L. 111-148, the Patient Protection and Affordable Care Act Implementation of P.L. 115-119, the RAISE Family Caregivers Act

Client expense: $78,075 · Firm income: Not reported

Government targets: AMTRAK - Natl Railroad Passenger Corporation, Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Housing & Urban Development, Dept of (HUD), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Institutes of Health (NIH), SENATE, Transportation, Dept of (DOT), Veterans Affairs, Dept of (VA)

The Autism Cares Act of 2019 (S 427 / HR 1058) regarding funding for autism research, services, training and monitoring; The Empower Care Act (S 548 / HR 1342) regarding home and community based services to individuals with autism and their families.

Client expense: Not reported · Firm income: $7,500

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 3163: Making appropriations for the Department of Transportation, and Housing and Urban Development, and related agencies for the fiscal year ending September 30, 2020, and for other purposes -- support increased funding for Community Development Block Grant and HOME programs at HUD; highway and transit formula programs at DOT. H.R.530: Accelerating Broadband Development by Empowering Local Communities Act of 2019 -- support legislation. Promote creation of a federal infrastructure package. Support full implementation of federal Opportunity Zones program. Support reintroduction of Affordable Housing Credit Improvements Act of 2017 (S. 548) in 116th Congress

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

EMPOWER Care Act, S. 548/HR 1342. HR 6042/S. 2897, Issues pertaining to Medicaid Electronic Visit Verification rules, Direct Support Professional standard occupational category; Direct Support Professional visas. Medicaid Services Investment and Accountability Act of 2019, HR 1839.

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

Government targets: HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), SENATE

P.L. 111-375 National Alzheimer's Project Act, All Sections P.L. 115-119 Recognize, Assist, Include, Support and Engage (RAISE) Family Caregivers Act P.L. 115-406 Building Our Largest Dementia (BOLD) Infrastructure for Alzheimer's Act S.591 Guardianship Accountability Act S.299 Geriatrics Workforce Improvement Act S.548/H.R.1342 EMPOWER Care Act H.R.1343 Protecting Married Seniors from Impoverishment Act S.740 Alzheimer's Caregiver Support Act H.R. 1955 Study on Use of Anti-Psychotics in Non-nursing Homes S.880/H.R.1873 Improving HOPE for Alzheimer's Act H.R.1903/S.901 Younger-Onset Alzheimer's Disease Act of 2019 H.R.647 Palliative Care and Hospice Education and Training Act S.1250/H.R.2401 American Cures Act S.1017 Supporting America's Caregivers and Families Act S.995/H.R.2035 Lifespan Respite Care Reauthorization Act of 2019 S.1126/H.R.2283 Concentrating on High-Value Alzheimer's Needs to Get to an End (CHANGE) Act of 2019 S.1361/H.R.2584 Preventive Health Savings Act of 2019 S.1628 Paid Family Leave Pilot Extension Act H.R.2878 Homecare for Seniors Act S.1618 Expanding Capacity for Health Outcomes (ECHO) Act of 2019 S.1202 Independence at Home Act of 2019 H.R.3436 Improving Chronic Care Management Act

Client expense: $871,000 · Firm income: Not reported

Government targets: Administration on Aging, Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Indian Health Service, Interior, Dept of (DOI), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Natl Institutes of Health (NIH), SENATE, Social Security Administration (SSA), Veterans Affairs, Dept of (VA)

S. 62, Empowering Medicare Seniors to Negotiate Drug Prices Act (Klobuchar) - Part D price negotiations S. 99, Medicare Drug Price Negotiation Act (Sanders) - Part D price negotiations, formulary changes S. 205, Right Rebate Act (Wyden) - Medicaid drug rebate program S. 317, ACE Kids Act (Grassley) - health homes for children with medically complex conditions S. 377, Medicare Negotiation and Competitive Licensing Act (Brown) - Part D price negotiation S. 470, Medicare at 50 Act (Stabenow) - Medicare buy-in option S. 475, RxCAP Act (Wyden) - Part D cost-sharing S. 489, State Public Option Act (Schatz) - Medicaid buy-in option S. 516, Prescription Drug Monitoring Act (Klobuchar) - required use of PDMPs S. 548, EMPOWER Care Act (Portman) - MFP demonstration S. 640, Phair Pricing Act (Kennedy) -- Part D rebates at the point of sale S. 691, Medicare Extra Rx HELP Act (Casey) - Part D assistance for low-income seniors S. 709, Prescription Drug Pricing Dashboard Act (Casey) - interactive dashboard with drug price and utilization data for federal programs S. 773, Telehealth Innovation and Improvement Act (Gardner) - testing expanded coverage of telehealth services in Medicare S. 988, Improving Transparency and Accuracy in Medicare Part D Spending Act (Capito) - payments on clean claims S. 1114, Medicare Advantage Quality Payment Relief Act (Daines-King) - MA benchmark cap H.R. 259, Medicaid Extenders Act (Pallone) - MFP demonstration, spousal impoverishment protections H.R. 448, Medicare Drug Price Negotiation Act (Cummings) - Part D price negotiations, formulary changes H.R. 789, Improving Transparency and Accuracy in Medicare Part D Spending Act (Welch) - payments on clean claims H.R. 937, Right Rebate Act (Schrader) - Medicaid drug rebate program H.R. 1034, Phair Pricing Act (Collins) - Part D rebates at the point of sale H.R. 1035, Prescription Drug Price Transparency Act (Collins) - Medicare PBM standards H.R. 1046, Medicare Negotiation and Competitive Licensing Act (Doggett) - Part D price negotiation H.R. 1226, ACE Kids Act (Castor) - health homes for children with medically complex conditions H.R. 1277, State Public Option Act (Lujan) - Medicaid buy-in option H.R. 1301, Mental Health Telemedicine Expansion Act (DelBene) - Medicare coverage of mental health telehealth services H.R. 1342, EMPOWER Care Act (Dingell) - MFP demonstration H.R. 1343, Protecting Married Seniors from Impoverishment Act (Dingell) - spousal impoverishment protections H.R. 1346, Medicare Buy-In and Health Care Stabilization Act (Higgins) - Medicare buy-in option H.R. 1375, PAID Act (Kind) - transparency of Medicare secondary payer information H.R. 1394, Medigap Consumer Protection Act (Doggett) - Medicare supplemental consumer protections H.R. 1551, Quality Care for Moms and Babies Act (Engel) - quality measures in Medicaid and CHIP H.R. 1781, Payment Commission Data Act (Carter) - MedPAC and MACPAC access to drug pricing and rebate data in Medicare and Medicaid H.R. 1839, Medicaid Services Investment and Accountability Act (Ruiz) - MFP demonstration, spousal impoverishment protections, ACE Kids Act, Medicaid drug rebate program, health homes for children with medically complex conditions H.R. 2131, Medicare Advantage Quality Payment Relief Act (Kind-Kelly) - MA benchmark cap H.R. 2757, Creating Lower Cost Alternatives for Your Prescription Drugs Act (Cunningham) - eliminate copay for generic drugs in Medicare Part D H.R. 3107, Improving Seniors' Timely Access to Care Act (DelBene) - Medicare Advantage prior authorization H.R. 3253, Empowering Beneficiaries, Ensuring Access, and Strengthening Accountability Act (Dingell) - MFP demonstration, spousal impoverishment protections, Medicaid drug rebate program H.R. 3417, Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act (Neal) - funding for quality measurement initiatives, Medicare coverage of mental health telehealth services, real-time benefit tools in Medicare Part D, Medicare eligibility and enrollment notices H.R. 3461, Community-Based Independence for Seniors Act (Sanchez-Kelly) - Community-Based Institutional Special Needs Plan Discussion Draft, Medicare Part D Reform (Neal-Pallone-Brady-Walden) - maximum out-of-pocket limit, federal reinsurance payments Regulatory Issues: Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, network adequacy and provider directories, encounter data and other data-related issues, and risk adjustment data validation (RADV) audit issues; bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, Part D direct and indirect remuneration (DIR), and audits); calendar year 2020 policy and technical regulation for MA and Part D; MA and Part D proposed rule on drug pricing changes for 2020; Part D reform, out of pocket limits; issues related to Medicare for All, Medicare buy-in and public option; CMSs price transparency proposal for direct-to-consumer advertisements; issues relating to 2020 Rate Notice and Call Letter; issues related to proposed changes to removal of safe harbor protection for rebates (proposed rule); in-home health risk assessments; Medicare Medical Loss Ratio issues; implementation of sequestration under the Medicare Advantage and Part D programs; implications of the health insurer fee for MA and Part D plans; application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, enrollment rules, requirements for notice and denial forms, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible SNPs; Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, Part D coverage gap discount program, including employer group waiver plan (EGWP) issues, and other operational issues; issues raised by Part D coverage of new specialty drugs, the Part D non-interference policy and related issues (e.g., preferred pharmacy and any willing pharmacy requirements, standards for network pharmacy reimbursement, and policies regarding sponsor negotiation of pharmacy price concessions); CMS's proposed Part B drug demonstration program; Medication Therapy Management Program requirements and the Center for Medicare and Medicaid Innovation (CMMI) Demonstration; MA EGWP issues; CMMI's value-based insurance design (VBID) demonstration; Part D requirements for offering basic and enhanced alternative plans; MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; issues relating to MA and Part D Star Rating system including measures, the methodology for calculating ratings, and the role of the ratings for payment purposes; implementation of the Affordable Care Act (ACA) and the Bipartisan Budget Act of 2018 changes to the Part D coverage gap; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education Program; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; new payment system for physicians under MACRA, including implications for MA and Part D plans; Medicare clinical trials; Medicare/Medicaid integration for dual eligibles, including implementation of the Capitated Financial Alignment Demonstration and related issues (e.g., quality ratings); Medicaid managed care regulations and policies, including CMS's substantial revisions to the managed care regulations, mental health parity rules, the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, fraud and abuse compliance, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including block grants, the calculation of the federal medical assistance (federal matching) percentage (FMAP), and intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost issues affecting Medicaid health plans including issues raised by Medicaid coverage of new specialty drugs; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues and CHIP reauthorization; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including Medicaid managed care organization provider tax issues; standards for electronic prescribing; implementation of Medicaid changes of interest to Medicaid health plans made in the ACA including Medicaid expansion, the managed care organization (MCO) prescription drug rebate provisions, minimum payments to primary care providers (PCPs), interactions between the Medicaid program and health insurance exchanges, and Medicaid and CHIP maintenance of effort (MOE) requirements; implications of the health insurer fee for Medicaid health plans; issues related to Medicaid Managed long-term care including home and community-based waiver services (HCBS); expanding the availability of Medicare Advantage and Medicaid health plan telemedicine programs; implications of the new non-discrimination rules for health plans participating in public programs; issues related to Medigap coverage; issues related to business continuity in relation to pandemics or natural events (e.g., hurricane, tornado, etc.); cybersecurity; provider directories; value-based insurance design models; issues relating to prescription drug price blueprint; Part D prescriber enrollment requirements; Part D recovery audit contractor programs; issues relating to enrollment of beneficiaries with ESRD into MA plans; issues related to health homes for children with medically complex conditions; socioeconomic status impacts on star ratings related to MA and Part D programs; and other issues relating to health care reform implementation.

Client expense: $2,210,000 · Firm income: Not reported

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

Medicaid block grant/per capita caps; H.R. 1342, EMPOWER Care Act; S. 548, EMPOWER Care Act; S. 1202, Independence Home Act; reauthorization of the Independence at Home Medicare Demonstration, generally.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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

H.R. 2740 Labor-HHS Appropriations bill, FY 2020 - Lobbied in support of increased funding for CMS' state survey and certification program and opposition to hostile policy riders re ACA, and various related medical care research and supportive services. Discussed issue related to the Supplemental Nutrition Assistance Program. P.L. 114-42, NOTICE Act and no bill number, Improving Access to Medicare Coverage Act - discussed transparency/surprise medical billing, including observation issues and related prior legislation, in response to Senate request for information. S.340/H.R. 965 - the CREATES Act. S.64/H.R. 2375 - the Preserve Access to Generics and Biosimilars Act. H.R. 1499 - the Preserving Consumer Access to Generics Act. Endorsed H.R. 986, H.R. 987, and H.R. 1010, aimed at protecting the core consumer provisions of the ACA, including the prohibition on insurers engaging in an age tax and preexisting condition discrimination. S.1531- STOP Act. Discussed support for restoration and extension of the medical expense deduction. S.110/HR. 2073 Medical Expenses Permanency Legislation. S.617 Tax Extenders & Disaster Relief Act. H.R.2730/S. 1443 Credit for Caring Act. Medical Expense Deductions (included in H.R. 1628 and Better Care Reconciliation Act drafts) S.1209 REMEDY ACT. H.R.1373, Protecting Seniors from Poverty Act. H.R.2150/S. 296, Home Health Care Planning Improvement Act. H.R.1682/S.753 Improving Access to Medicare Coverage Act. H.R.1342/S.548 Empower Act. Better Care Reconciliation Act draft.

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

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