Affordable Insulin Now Act of 2023

H.R. 1613 - Drug Price Transparency in Medicaid Act of 2023 - Rep. Carter, Earl - spread-pricing by PBMs for Medicaid H.R. 2880 - Protecting Patients Against PBM Abuses Act - Rep. Carter, Earl - PBM transparency H.R. 4818 - Treat and Reduce Obesity Act - Rep. Wenstrup, Brad - weight loss coverage H.R. 5372 - Expanding Seniors Access to Lower Cost Medicines Act of 2023 - Rep. Joyce, John - generic drugs, biosimilars cost H.R. 5378 - Lower Costs, More Transparency Act - Rep. McMorris Rodgers, Cathy - PBM transparency H.R. 5385 - Medicare PBM Accountability Act - Rep. Landsman, Greg McMorris - PBM transparency H.R. 6283 - DRUG Act - Rep. Miller-Meeks, Mariannette - PBM contracts H.R. 10445 - Further Continuing Appropriations and Disaster Relief Supplemental Appropriations Act, 2025 - Rep. Cole, Tom - PBM regulation S. 79 - Interagency Patent Coordination and Improvement Act of 2023 - Sen. Durbin, Richard - prescription drug patenting S. 113 - Prescription Pricing for the People Act of 2023 - Sen. Grassley, Chuck - PBM transparency S. 127 - Pharmacy Benefit Manager Transparency Act of 2023 - Sen. Cantwell, Maria - PBM transparency S. 142 - Preserve Access to Affordable Generics and Biosimilars Act - Sen. Klobuchar, Amy - pharmacy and biosimilar prescription drugs S. 148 - Stop STALLING Act - Sen. Klobuchar, Amy - pharmacy market approval processes S. 150 - Affordable Prescriptions for Patients Act of 2023 - Sen. Cornyn, John - pharmacy and prescription drug prices, prevent patent thickets S. 574 - Increasing Prescription Drug Competition Act - Sen. Hassan, Maggie - closure of pharmaceutical patent loophole S. 652 - Safe Step Act - Sen. Murkowski, Lisa - medication step therapy protocol S. 954 - Affordable Insulin Now Act of 2023 - Sen. Warnock, Raphael - insulin pricing and cost sharing S. 1269 - INSULIN Act of 2023 - Sen. Shaheen, Jeanne - insulin pricing S. 1339 - Pharmacy Benefit Manager Reform Act - Sen. Sanders, Bernie - PBM transparency S. 1542 - DRUG Act - Sen. Marshall, Roger - PBM regulation S. 2973 - Modernizing and Ensuring PBM Accountability Act - Sen. Wyden, Ron - Plan implementation S. 3934 - Increasing Access to Biosimilars Act of 2023- Sen. Cornyn, John - Medicare drug access Issues related to the implementation of Inflation Reduction Act - Medicare negotiation; coverage of weight loss drugs; high priced drugs; patent reforms; Pharmacy Benefit Managers; and copay coupons.

Client expense: $2,610,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to Direct-to-Consumer Prescription Drug Advertisements; Issues related to Cybersecurity; Health care issues related to P.L. 118-42, the Consolidated Appropriations Act 2024, and P.L. 118-47, the Further Consolidated Appropriations Act 2024; Issues related to P.L. 117-328, the Consolidated Appropriations Act 2023; Issues related to P.L. 117-169, the Inflation Reduction Act of 2022, including enhanced advance premium tax credits (APTCs) and Medicare Part D redesign; Issues related to P.L. 93-406, Employee Retirement Income Security Act of 1974 (ERISA), preemption; S. 727, Insulin for All Act of 2023; S. 1269, Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act of 2023; S. 146, Cap Insulin Prices Act; S. 954, Affordable Insulin Now Act of 2023; H.R. 1488, Affordable Insulin Now Act; H.R. 1587, Making Insulin Affordable for All Children Act; H.R. 1485, Insulin for all Act of 2023; H.R. 3290, To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program; S. 464/H.R. 2630, the Safe Step Act; H.R. 1843/S. 1001, Telehealth Expansion Act; H.R. 824, Telehealth Benefit Expansion for Workers Act of 2023; Issues related to mental health coverage, workforce, and mental health parity; Issues related to surprise billing law and regulation; Issues related to artificial intelligence and health care issues; Issues related to removing barriers to biosimilar medicine access; H.R. 4189/S. 2016, The Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023; H.R. 3432/S.3651, Telemental Health Care Access Act of 2023; H.R. 1692, The Health Care Affordability Act; H.R. 8152, the American Privacy Rights Act (APRA) of 2024; P.L. No: 118-158 and draft FY2025 Continuing Resolution, issues related to telehealth.

Client expense: $1,420,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.127, Pharmacy Benefit Manager Transparency Act of 2023; S.954, Affordable Insulin Now Act; S.1339, Pharmacy Benefit Manager Reform Act; S.1664, Healthy Families Act; S.1869, SITE Act; H.R.824, Telehealth Benefit Expansion for Works Act of 2023; H.R.1264, Commonsense Reporting Act; H.R.1843, Telehealth Expansion Act of 2023; H.R.2813, Self Insurance Protection Act; H.R.2868, Association Health Plan Act; H.R.3797, Paperwork Burden Reduction Act; H.R.3798, Small Business Flexibility Act; H.R.3799, CHOICE Arrangement Act; H.R.3801, Employer Reporting Improvement Act; Issues related to dialysis coverage; Issues related to health sector consolidation; Issues related to ERISA pre-emption; Issues related to employer sponsored health coverage

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation and regulation related to health care delivery and health insurance coverage, mental health and substance use disorder care and coverage, the transition out of the COVID-19 pandemic and electronic health information/technology. H.R. 4527 Health DATA Act S. 3679, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act H.R. 5378 the Lower Costs, More Transparency Act S.3548 - Health Care Prices Revealed and Information to Consumers Explained Transparency Act S.3430 - An original bill to amend titles XVIII and XIX of the Social Security Act to expand the mental health care workforce and services, reduce prescription drug costs, and extend certain expiring provisions under Medicare and Medicaid, and for other purposes. HR 3305 & S. 1606 Black Maternal Health Momnibus Act HR 4822 Health Care Price Transparency Act HR 3284 Providers and Payers COMPETE Act HR 2840 Bipartisan Primary Care and Health Workforce Act HR 4818 Treat and Reduce Obesity Act of 2023 S. 2333 Pandemic and All Hazards Preparedness and Response Act H.R. 4421 Preparing for All Hazards and Pathogens Reauthorization Act H.R. 3561, PATIENT Act of 2023 H.R. 3281, the Transparent PRICE Act H.R. 3262, To amend title XI of the Social Security Act to increase transparency of certain health-related ownership information H.R. 2868 Association Health Plans Act H.R. 2813 Self-Insurance Protection Act H.R. 3799 CHOICE Arrangement Act H.R. 3432, Telemental Health Care Access Act H.R.824, Telehealth Benefit Expansion for Workers Act of 2023 H.R. 4189, S. 2016, CONNECT for Health Act S. 923, Better Mental Health Care for Americans Act H.R. 3120, Healthy Competition for Better Care Act H.R. 1843 Telehealth Expansion Act of 2023 S.954 - 118th Congress (2023-2024)A bill to provide for appropriate cost-sharing for insulin products covered under private health plans, and to establish a program to support health care providers and pharmacies in providing discounted insulin products to uninsured individuals. H.R.10445 - Further Continuing Appropriations and Disaster Relief Supplemental Appropriations Act, 2025 H.R.10515 - American Relief Act, 2025 H.R.10545 - American Relief Act, 2025 H.R. 9774 & S. 5194 - Health Care Affordability Act of 2024 H.R. 3120 & S. 1451 - Healthy Competition for Better Care Act

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

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

Patient protection; Pharmaceutical supply chain issues and shortages; Drug pricing, coverage, value, access and quality; Transparency; Intellectual property; Health insurance accessibility; Implementation of the "Inflation Reduction Act" (HR.5376); Prescription drug approval; Affordable Insulin Now Act (S.954/HR.1488), The INSULIN Act; Policy matters related to Artificial Intelligence in health care.

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

Government targets: Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, SENATE

Inflation Reduction Act of 2022, H.R. 5376; Affordable Insulin Now Act of 2023, S. 954; Improving Health Insurance Affordability Act of 2023, S. 8; SMART Prices Act, S. 1264; Black Maternal Health Momnibus Act, H.R. 3305; Perinatal Workforce Act, S.1710; CARE for Moms, S.2846; Health Care Affordability Act of 2024, H.R. 9774

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1613 - Drug Price Transparency in Medicaid Act of 2023 - Rep. Carter, Earl - spread-pricing by PBMs for Medicaid H.R. 2880 - Protecting Patients Against PBM Abuses Act - Rep. Carter, Earl - PBM transparency H.R. 4818 - Treat and Reduce Obesity Act - Rep. Wenstrup, Brad - weight loss coverage H.R. 5372 - Expanding Seniors Access to Lower Cost Medicines Act of 2023 - Rep. Joyce, John - generic drugs, biosimilars cost H.R. 5378 - Lower Costs, More Transparency Act - Rep. McMorris Rodgers, Cathy - PBM transparency H.R. 5385 - Medicare PBM Accountability Act - Rep. Landsman, Greg McMorris - PBM transparency H.R. 6283 - DRUG Act - Rep. Miller-Meeks, Mariannette - PBM contracts H.R. 6963 - Pediatric Cancer Drug Supply Act of 2024 - Rep. Eshoo, Anna - establishes agreements with drug manufacturers to establish reserve supplies of covered pediatric cancer drugs H.R. 7635 - The 340B PATIENTS Act of 2024- Rep. Matsui, Doris - ensures accessibility of drugs under 340B drug discount program S. 79 - Interagency Patent Coordination and Improvement Act of 2023 - Sen. Durbin, Richard - prescription drug patenting S. 113 - Prescription Pricing for the People Act of 2023 - Sen. Grassley, Chuck - PBM transparency S. 127 - Pharmacy Benefit Manager Transparency Act of 2023 - Sen. Cantwell, Maria - PBM transparency S. 142 - Preserve Access to Affordable Generics and Biosimilars Act - Sen. Klobuchar, Amy - pharmacy and biosimilar prescription drugs S. 148 - Stop STALLING Act - Sen. Klobuchar, Amy - pharmacy market approval processes S. 150 - Affordable Prescriptions for Patients Act of 2023 - Sen. Cornyn, John - pharmacy and prescription drug prices, prevent patent thickets S. 574 - Increasing Prescription Drug Competition Act - Sen. Hassan, Maggie - closure of pharmaceutical patent loophole S. 652 - Safe Step Act - Sen. Murkowski, Lisa - medication step therapy protocol S. 954 - Affordable Insulin Now Act of 2023 - Sen. Warnock, Raphael - insulin pricing and cost sharing S. 1038 - Drug Price Transparency in Medicaid Act of 2023 - Sen. Welch, Peter - drug pricing transparency S. 1269 - INSULIN Act of 2023 - Sen. Shaheen, Jeanne - insulin pricing S. 1339 - Pharmacy Benefit Manager Reform Act - Sen. Sanders, Bernie - PBM transparency S. 1542 - DRUG Act - Sen. Marshall, Roger - PBM regulation S. 2973 - Modernizing and Ensuring PBM Accountability Act - Sen. Wyden, Ron - Plan implementation S. 3934 - Increasing Access to Biosimilars Act of 2023- Sen. Cornyn, John - Medicare drug access Issues related to the implementation of Inflation Reduction Act - Medicare negotiation; coverage of weight loss drugs; high priced drugs; patent reforms; Pharmacy Benefit Managers; and copay coupons.

Client expense: $2,560,000 · Firm income: Not reported

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

H.R. 4527 Health DATA Act S. 3679, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act H.R. 5378 the Lower Costs, More Transparency Act S.3548 - Health Care Prices Revealed and Information to Consumers Explained Transparency Act S.3430 - An original bill to amend titles XVIII and XIX of the Social Security Act to expand the mental health care workforce and services, reduce prescription drug costs, and extend certain expiring provisions under Medicare and Medicaid, and for other purposes. HR 3305 & S. 1606 Black Maternal Health Momnibus Act HR 4822 Health Care Price Transparency Act HR 3284 Providers and Payers COMPETE Act HR 2840 Bipartisan Primary Care and Health Workforce Act HR 4818 Treat and Reduce Obesity Act of 2023 S. 2333 Pandemic and All Hazards Preparedness and Response Act H.R. 4421 Preparing for All Hazards and Pathogens Reauthorization Act H.R. 3561, PATIENT Act of 2023 H.R. 3281, the Transparent PRICE Act H.R. 3262, To amend title XI of the Social Security Act to increase transparency of certain health-related ownership information H.R. 2868 Association Health Plans Act H.R. 2813 Self-Insurance Protection Act H.R. 3799 CHOICE Arrangement Act H.R. 3432, Telemental Health Care Access Act H.R.824, Telehealth Benefit Expansion for Workers Act of 2023 H.R. 4189, S. 2016, CONNECT for Health Act S. 923, Better Mental Health Care for Americans Act H.R. 3120, Healthy Competition for Better Care Act H.R. 1843 Telehealth Expansion Act of 2023 Legislation and regulation related to health care delivery and health insurance coverage, mental health and substance use disorder care and coverage, the transition out of the COVID-19 pandemic and electronic health information/technology. S.954 - 118th Congress (2023-2024)A bill to provide for appropriate cost-sharing for insulin products covered under private health plans, and to establish a program to support health care providers and pharmacies in providing discounted insulin products to uninsured individuals. a

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

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

Issues related to Direct-to-Consumer Prescription Drug Advertisements; Issues related to Cybersecurity; Health care issues related to P.L. 118-42, the Consolidated Appropriations Act 2024, and P.L. 118-47, the Further Consolidated Appropriations Act 2024; Issues related to P.L. 117-328, the Consolidated Appropriations Act 2023; Issues related to P.L. 117-169, the Inflation Reduction Act of 2022, including enhanced advance premium tax credits (APTCs) and Medicare Part D redesign; Issues related to P.L. 93-406, Employee Retirement Income Security Act of 1974 (ERISA), preemption; S. 727, Insulin for All Act of 2023; S. 1269, Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act of 2023; S. 146, Cap Insulin Prices Act; S 954, Affordable Insulin Now Act of 2023; HR 1488, Affordable Insulin Now Act; HR 1587, Making Insulin Affordable for All Children Act; HR 1485, Insulin for all Act of 2023; H.R. 3290, To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program; S. 464/ H.R. 2630, the Safe Step Act; H.R. 5688, the Bipartisan HSA Improvement Act of 2023; H.R. 5687, the HSA Modernization Act of 2023; H.R. 1843/S. 1001, Telehealth Expansion Act; H.R. 824, Telehealth Benefit Expansion for Workers Act of 2023; Issues related to mental health coverage, workforce, and mental health parity; Issues related to surprise billing law and regulation; Issues related to artificial intelligence and health care issues; Issues related to removing barriers to biosimilar medicine access; H.R. 4189/S. 2016, The Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023; H.R. 3432/S.3651, Telemental Health Care Access Act of 2023; H.R. 1692, The Health Care Affordability Act; H.R. 8152, the American Privacy Rights Act (APRA) of 2024.

Client expense: $1,720,000 · Firm income: Not reported

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

-S. 4504 / H.R 8698 - SCREEN for Type 1 Diabetes Act (A bill to amend the Public Health Service Act to provide for a public awareness campaign with respect to screening for type 1 diabetes, and for other purposes) -S. 1855 - Special Diabetes Program Reauthorization Act of 2023 -S. 1269 - INSULIN Act of 2023 -H.R 1499 - Affordable Insulin Now Act -S. 954 - Affordable Insulin Now Act of 2023 -H.R. 3800 - Chronic Disease Flexible Coverage Act -Issues related to cell and gene therapies

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.127, Pharmacy Benefit Manager Transparency Act of 2023; S.954, Affordable Insulin Now Act; S.1339, Pharmacy Benefit Manager Reform Act; S.1664, Healthy Families Act; S.1869, SITE Act; H.R.824, Telehealth Benefit Expansion for Works Act of 2023; H.R.1264, Commonsense Reporting Act; H.R.1843, Telehealth Expansion Act of 2023; H.R.2813, Self Insurance Protection Act; H.R.2868, Association Health Plan Act; H.R.3797, Paperwork Burden Reduction Act; H.R.3798, Small Business Flexibility Act; H.R.3799, CHOICE Arrangement Act; H.R.3801, Employer Reporting Improvement Act; Issues related to dialysis coverage; Issues related to health sector consolidation; Issues related to ERISA pre-emption; Issues related to employer sponsored health coverage

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues: Insulin Copay Caps, Drug Pricing, Pharmacy Benefit Manager (PBM) Reform, Generic Drug Manufacturing, GLP-1s Bills: Senate Finance Committee PBM Reform Framework H.R. 5378 - The Lower Costs, More Transparency Act - A bill to require health care providers and insurers to disclose certain information about health care costs. It also establishes requirements for certain payment methodologies under Medicare and Medicaid and extends several public health programs. H.R. 1488/S. 954 - The Affordable Insulin Now Act -- A bill to provide for appropriate cost-sharing for insulin products covered under private health plans, and to establish a program to support health care providers and pharmacies in providing discounted insulin products to uninsured individuals. S. 127. - The Pharmacy Benefit Manager Transparency Act - This bill generally prohibits pharmacy benefit managers (PBMs) from engaging in certain practices when managing the prescription drug benefits under a health insurance plan, including charging the plan a different amount than the PBM reimburses the pharmacy. S.1339 - The Pharmacy Benefit Manager Reform Act - A bill to provide for increased oversight of entities that provide pharmacy benefit management services on behalf of group health plans and health insurance coverage. H.R.2679 - The Pharmacy Benefits Manager Accountability Act - A bill to amend the Public Health Service Act, the Employee Retirement Income Security Act, and the Internal Revenue Code of 1984 to increase oversight of pharmacy benefits manager services, and for other purposes. H.R. 3561 - PATIENT Act of 2023 - This bill expands hospital price transparency requirements and establishes additional reporting requirements with respect to prescription drugs and pharmacy benefit managers (PBMs). H.R. 2630/S. 652 - The Safe Step Act -- This bill requires a group health plan to establish an exception to medication step-therapy protocol in specified cases. A medication step-therapy protocol establishes a specific sequence in which prescription drugs are covered by a group health plan or a health insurance issuer. H.R. 830/S. 1375 - The HELP Copays Act -- This bill requires health insurance plans to apply certain payments made by, or on behalf of, a plan enrollee toward a plan's cost-sharing requirements. Specifically, plans must apply third-party payments, financial assistance, discounts, product vouchers, and other reductions in out-of-pocket expenses toward the requirements. H.R. 2880 - Protecting Patients Against PBM Abuses Act -- This bill establishes requirements for Medicare pharmacy benefit managers (PBMs) with respect to remuneration, payments, and fees. Specifically, the bill restricts PBMs that are under contract with plans under the Medicare prescription drug benefit or Medicare Advantage from (1) receiving income for their services other than flat dollar amount service fees; (2) basing any service fees on the prices of covered drugs or any associated discounts, rebates, or other remuneration; (3) charging plan sponsors for ingredient costs or dispensing fees in amounts that are different than what is reimbursed to the pharmacy; or (4) reimbursing network pharmacies for less than that what is reimbursed to PBM-affiliated pharmacies.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Patient protection; Pharmaceutical supply chain issues and shortages; Drug pricing, coverage, value, access and quality; Transparency; Intellectual property; Health insurance accessibility; Implementation of the "Inflation Reduction Act" (HR.5376); Prescription drug approval; Affordable Insulin Now Act (S.954/HR.1488), The INSULIN Act; Policy matters related to Artificial Intelligence in health care.

Client expense: $1,795,000 · Firm income: Not reported

Government targets: Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, SENATE

government support for flu vaccine development, government use patent licensing; S.954 Affordable Insulin Now Act, march-in rights; S.954, Medicare drug price negotiation and inflationary rebate expansion, pharmacy benefit managers; S.142 Preserve Access to Affordable Generics and Biosimilars Act; S.148 Stop STALLING Act; S.150 Affordable Prescriptions for Patients Act, vaccine disinformation, weight loss drug pricing, DTC pharmaceutical advertising, Medicare drug price negotiation and inflationary rebate expansion; government use patent licensing; march-in rights; reasonable pricing and access conditions, S.142 Preserve Access to Affordable Generics and Biosimilars Act; S.148 Stop STALLING Act; S.150 Affordable Prescriptions for Patients Act, GLP-1 pricing and licensing, DOD prescription drug international reference pricing; misleading social media prescription drug promotion penalties, social media prescription drug promotion harms, Improving Medicare Coverage Act.

Client expense: $65,265 · Firm income: Not reported

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

Inflation Reduction Act of 2022, H.R. 5376; Affordable Insulin Now Act of 2023, S. 954; Improving Health Insurance Affordability Act of 2023, S. 8; SMART Prices Act, S. 1264; Black Maternal Health Momnibus Act, H.R. 3305; Perinatal Workforce Act, S.1710; CARE for Moms, S.2846; Health Care Affordability Act of 2024, H.R. 9774

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.127, Pharmacy Benefit Manager Transparency Act of 2023; S.954, Affordable Insulin Now Act; S.1339, Pharmacy Benefit Manager Reform Act; S.1664, Healthy Families Act; S.1869, SITE Act; HR.824, Telehealth Benefit Expansion for Works Act of 2023; HR.1264, Commonsense Reporting Act; HR.1843, Telehealth Expansion Act of 2023; HR.2813, Self Insurance Protection Act; HR.2868, Association Health Plan Act; HR.3797, Paperwork Burden Reduction Act; HR.3798, Small Business Flexibility Act; HR.3799, CHOICE Arrangement Act; HR.3801, Employer Reporting Improvement Act; Issues related to dialysis coverage; Issues related to health sector consolidation; Issues related to ERISA pre-emption; Issues related to employer sponsored health coverage

Client expense: $101,954 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.127, Pharmacy Benefit Manager Transparency Act of 2023; S.954, Affordable Insulin Now Act; S.1339, Pharmacy Benefit Manager Reform Act; S.1664, Healthy Families Act; S.1869, SITE Act; HR.824, Telehealth Benefit Expansion for Works Act of 2023; HR.1264, Commonsense Reporting Act; HR.1843, Telehealth Expansion Act of 2023; HR.2813, Self Insurance Protection Act; HR.2868, Association Health Plan Act; HR.3797, Paperwork Burden Reduction Act; HR.3798, Small Business Flexibility Act; HR.3799, CHOICE Arrangement Act; HR.3801, Employer Reporting Improvement Act; Issues related to dialysis coverage; Issues related to health sector consolidation; Issues related to ERISA pre-emption; Issues related to employer sponsored health coverage

Client expense: $101,954 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

-H.R 8698, SCREEN for Type 1 Diabetes Act (A bill to amend the Public Health Service Act to provide for a public awareness campaign with respect to screening for type 1 diabetes, and for other purposes). -S. 4504, SCREEN Act (A bill to amend the Public Health Service Act to provide for a public awareness campaign with respect to screening for type 1 diabetes, and for other purposes). -S. 1269, INSULIN Act of 2023. -S. 1855, Special Diabetes Program Reauthorization Act of 2023. -H.R. 2550, Special Diabetes Program Reauthorization Act of 2023. -H.R 1499, Affordable Insulin Now Act. -S. 954, Affordable Insulin Now Act of 2023. -H.R. 5378, Lower Costs, More Transparency Act. -H.R. 1691, Ensuring Patient Access to Critical Breakthrough Products Act of 2023. -Issues related to cell and gene therapies.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to Direct-to-Consumer Prescription Drug Advertisements; Issues related to Cybersecurity; Health care issues related to P.L. 118-42, the Consolidated Appropriations Act 2024, and P.L. 118-47, the Further Consolidated Appropriations Act 2024; Issues related to P.L. 117-328, the Consolidated Appropriations Act 2023; Issues related to P.L. 117-169, the Inflation Reduction Act of 2022, including enhanced advance premium tax credits (APTCs) and Medicare Part D redesign; Issues related to P.L. 93-406, Employee Retirement Income Security Act of 1974 (ERISA), preemption; S. 727, Insulin for All Act of 2023; S. 1269, Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act of 2023; S. 146, Cap Insulin Prices Act; S 954, Affordable Insulin Now Act of 2023; HR 1488, Affordable Insulin Now Act; H.R. 1587, Making Insulin Affordable for All Children Act; H.R. 1485, Insulin for all Act of 2023; H.R. 3290, To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program; S. 464/ H.R. 2630, the Safe Step Act; H.R. 5688, the Bipartisan HSA Improvement Act of 2023; H.R. 5687, the HSA Modernization Act of 2023; H.R. 1843/S. 1001, Telehealth Expansion Act; H.R. 824, Telehealth Benefit Expansion for Workers Act of 2023; Issues related to mental health coverage, workforce, and mental health parity; Issues related to surprise billing law and regulation; Issues related to artificial intelligence and health care issues; Issues related to removing barriers to biosimilar medicine access; H.R. 4189/S. 2016, The Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023; H.R. 3432/S.3651, Telemental Health Care Access Act of 2023; H.R. 1692, The Health Care Affordability Act; H.R. 8152, the American Privacy Rights Act (APRA) of 2024.

Client expense: $2,200,000 · Firm income: Not reported

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

H.R. 1613 - Drug Price Transparency in Medicaid Act of 2023 - Rep. Carter, Earl - spread-pricing by PBMs for Medicaid H.R. 2880 - Protecting Patients Against PBM Abuses Act - Rep. Carter, Earl - PBM transparency H.R. 5372 - Expanding Seniors Access to Lower Cost Medicines Act of 2023 - Rep. Joyce, John - generic drugs, biosimilars cost H.R. 5378 - Lower Costs, More Transparency Act - Rep. McMorris Rodgers, Cathy - PBM transparency H.R. 5385 - Medicare PBM Accountability Act - Rep. Landsman, Greg McMorris - PBM transparency H.R. 6283 - DRUG Act - Rep. Miller-Meeks, Mariannette - PBM contracts H.R. 6963 - Pediatric Cancer Drug Supply Act of 2024 - Rep. Eshoo, Anna - establishes agreements with drug manufacturers to establish reserve supplies of covered pediatric cancer drugs H.R. 7635 - The 340B PATIENTS Act of 2024- Rep. Matsui, Doris - ensures accessibility of drugs under 340B drug discount program S. 79 - Interagency Patent Coordination and Improvement Act of 2023 - Sen. Durbin, Richard - prescription drug patenting S. 113 - Prescription Pricing for the People Act of 2023 - Sen. Grassley, Chuck - PBM transparency S. 127 - Pharmacy Benefit Manager Transparency Act of 2023 - Sen. Cantwell, Maria - PBM transparency S. 142 - Preserve Access to Affordable Generics and Biosimilars Act - Sen. Klobuchar, Amy - pharmacy and biosimilar prescription drugs S. 148 - Stop STALLING Act - Sen. Klobuchar, Amy - pharmacy market approval processes S. 150 - Affordable Prescriptions for Patients Act of 2023 - Sen. Cornyn, John - pharmacy and prescription drug prices, prevent patent thickets S. 574 - Increasing Prescription Drug Competition Act - Sen. Hassan, Maggie - closure of pharmaceutical patent loophole S. 652 - Safe Step Act - Sen. Murkowski, Lisa - medication step therapy protocol S. 954 - Affordable Insulin Now Act of 2023 - Sen. Warnock, Raphael - insulin pricing and cost sharing S. 1038 - Drug Price Transparency in Medicaid Act of 2023 - Sen. Welch, Peter - drug pricing transparency S. 1269 - INSULIN Act of 2023 - Sen. Shaheen, Jeanne - insulin pricing S. 1339 - Pharmacy Benefit Manager Reform Act - Sen. Sanders, Bernie - PBM transparency S. 2973 - Modernizing and Ensuring PBM Accountability Act - Sen. Wyden, Ron - Plan implementation S. 3934 - Increasing Access to Biosimilars Act of 2023- Sen. Cornyn, John - Medicare drug access Issues related to the implementation of Inflation Reduction Act - Medicare negotiation; coverage of weight loss drugs; patent reforms; Pharmacy Benefit Managers; and copay coupons.

Client expense: $2,390,000 · Firm income: Not reported

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

S. 3679, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act H.R. 5378 the Lower Costs, More Transparency Act S.3548 - Health Care Prices Revealed and Information to Consumers Explained Transparency Act S.3430 - An original bill to amend titles XVIII and XIX of the Social Security Act to expand the mental health care workforce and services, reduce prescription drug costs, and extend certain expiring provisions under Medicare and Medicaid, and for other purposes. HR 3305 & S. 1606 Black Maternal Health Momnibus Act HR 4822 Health Care Price Transparency Act HR 3284 Providers and Payers COMPETE Act HR 2840 Bipartisan Primary Care and Health Workforce Act HR 4818 Treat and Reduce Obesity Act of 2023 S. 2333 Pandemic and All Hazards Preparedness and Response Act H.R. 4421 Preparing for All Hazards and Pathogens Reauthorization Act H.R. 3561, PATIENT Act of 2023 H.R. 3281, the Transparent PRICE Act H.R. 3262, To amend title XI of the Social Security Act to increase transparency of certain health-related ownership information H.R. 2868 Association Health Plans Act H.R. 2813 Self-Insurance Protection Act H.R. 3799 CHOICE Arrangement Act H.R. 3432, Telemental Health Care Access Act H.R.824, Telehealth Benefit Expansion for Workers Act of 2023 H.R. 4189, S. 2016, CONNECT for Health Act S. 923, Better Mental Health Care for Americans Act H.R. 3120, Healthy Competition for Better Care Act H.R. 1843 Telehealth Expansion Act of 2023 Legislation and regulation related to health care delivery and health insurance coverage, mental health and substance use disorder care and coverage, the transition out of the COVID-19 pandemic and electronic health information/technology. S.954 - 118th Congress (2023-2024)A bill to provide for appropriate cost-sharing for insulin products covered under private health plans, and to establish a program to support health care providers and pharmacies in providing discounted insulin products to uninsured individuals. a

Client expense: $680,000 · Firm income: Not reported

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

House H.R. 572, the Ensuring Workers Get PAID Act - support. H.R. 1843, the Telehealth Expansion Act - support. H.R. 824, the Telehealth Benefit Expansion for Workers Act of 2023 - support. H.R. 2811, the Limit, Save, Grow Act of 2023 - support. H.R. 4721, the Main Street Tax Certainty Act - support. H.R. 3881, the Credit Card Competition Act - support. H.R. 3799, the CHOICE Arrangement Act - support. S.J.Res.11, CRA resolution of disapproval for the EPA final rule relating to increased emissions standards for new heavy duty trucks - support. H.R. 2868, the Association Health Plan Act - support. H.R. 2813, the Self-Insurance Protection Act - support. H.R. 4428, the Guidance Clarity Act - support. H.R. 890, the Guidance Out Of Darkness (GOOD) Act - support. H.R. 5378, the Lower Costs, More Transparency Act - support. Norcross amendment (submitted as #144) to the National Defense Authorization Act for 2024 - oppose. H.R. 3417, FAIR Act - support. H.R. 1163, the Protecting Taxpayers and Victims of Unemployment Fraud Act - support. H.R. 4035, the Protecting Small Business Information Act of 2023 - support. H.J.Res. 98, Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the National Labor Relations Board relating to "Standard for Determining Joint Employer Status. - support. S.J. Res. 32, providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Bureau of Consumer Financial Protection relating to Small Business Lending Under the Equal Credit Opportunity Act (Regulation B). - support. H.R. 6514, Holding Agencies Accountable Act - support. H.R. 906, the REPAIR Act - support. H.R. 7198, Prove It Act - support. H.R. 7035, the Death Tax Repeal Act - support. H.J.Res. 147, providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Occupational Safety and Health Administration relating to "Worker Walkaround Representative Designation Process - support. H.R. 358, the Small Business Regulatory Flexibility Improvements Act (SBRFIA) - support H.R. 8639, Warehouse Worker Protection Act - oppose. H. J. RES. 129, the Congressional Review Act (CRA) resolution to repeal the Departments of Labor, the Treasury, and Health and Human Services Short-Term, Limited Duration Insurance and Independent, Noncoordinated Excepted Benefits Coverage rule - support. H.R. 8147, Repealing Big Brother Overreach Act - support. H.J.Res.116, Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Department of the Labor relating to "Employee or Independent Contractor Classification Under the Fair Labor Standards Act" - support Senate S. 1108, the Death Tax Repeal Act - support. S. 122, the Ensuring Workers Get PAID Act - support. S. 954, the Affordable Insulin NOW Act of 2023 - oppose. S. 1001, the Telehealth Expansion Act - support. H.J.Res. 27, the Congressional Review Act (CRA) resolution of disapproval for the Waters of the United States (WOTUS) final rule - support. S.J.Res. 8, the Congressional Review Act (CRA) resolution of disapproval for the Department of Labor (DOL) final rule relating to environmental, social, and governance (ESG) factors for investment decisions - support. S. 1706, the Main Street Tax Certainty Act - support. S. 1838, the Credit Card Competition Act - support. Nomination of Acting Secretary Julie Sus for Secretary of DOL - oppose. S. 1339, the Pharmacy Benefit Manager Reform Act - support. S. 567, the Richard L. Trumka Protecting the Right to Organize (PRO) Act of 2023 - oppose. S. 728, the Paycheck Fairness Act - oppose. S. 1664, the Healthy Families Act - oppose. Marshall amendment to H.R. 4366, the Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2024 - support. S. 1869, Site-based Invoicing and Transparency Enhancement (SITE) Act - support. S. 3167, the Multiple Employer Welfare Arrangement Act (MEWA Act) - support. the Employer Reporting Improvement Act and the Paperwork Burden Reduction Act - support. S. 2033, the American Innovation and Choice Online Act - support. S. 3227, Paperwork Burden Reduction Act - support. S. 3673, Commonsense Reporting Act - support. S. 1411, Prove It Act of 2023 - support. S. 1108, Death Tax Repeal Act - support. H.J.Res. 98, Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the National Labor Relations Board relating to "Standard for Determining Joint Employer Status. - support. Extending the $7.5 million debt cap under Subchapter V of the Chapter 11 Bankruptcy code - support. H.R. 1147, Whole Milk for Healthy Kids Act - support. S. 3204, the Employer Reporting Improvement Act - support. S. 3202, the Paperwork Burden Reduction Act - support. S.J. Res. 61, the Congressional Review Act (CRA) Joint Resolution of Disapproval to nullify the Federal Highway Administrations (FHWA) final rule imposing greenhouse gas (GHG) emissions performance measures on state departments of transportation and metropolitan planning organizations - support. S.J. Res. 58, the Congressional Review Act (CRA) resolution to repeal the Department of Energy (DOE) final rule on gas furnace efficiency standards - support. S. 4297, Repealing Big Brother Overreach Act - support. S.J. Res. 76, the Congressional Review Act (CRA) resolution to repeal the Departments of Labor, the Treasury, and Health and Human Services Short-Term, Limited Duration Insurance and Independent, Noncoordinated Excepted Benefits Coverage rule - support. S.J.Res.63, A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Department of Labor relating to "Employee or Independent Contractor Classification Under the Fair Labor Standards Act" - support. S.4260, Warehouse Worker Protection Act - oppose. Nomination (PN1789) of Lauren McGarity McFerran, of the District of Columbia, to be a Member of the National Labor Relations Board for the term of five years expiring December 16, 2029 - oppose. Testimony NFIB Statement for the Record, House Committee on Small Business, hearing titled, Under the Microscope: Examining FinCENs Implementation of the Corporate Transparency Act. April 30, 2024 Other Healthcare reform Joint trade letter - request for abandonment or at least postponement of DOLs anticipated overtime regulations under the FLSA Joint trade letter - support of the pending proposal to amend the Federal Rules of Civil Procedure to require disclosure of third-party litigation funding (TPLF) investment arrangements in any civil action filed in federal court Restoration of R&D expensing (Section 174) - support. Regulatory Flexibility Act reform - support. Joint trade letter - Congressional Review Act resolution to repeal the U.S. Department of Labor final rule, Updating the Davis-Bacon and Related Acts Regulations - support. Joint trade letter - H.R. 4035, Small Business Information Act - support. Joint trade letter - Thirty-Two Hour Workweek Act - oppose. Nomination of Acting Secretary Julie Su for Secretary of Labor (DOL) - oppose. Paid leave - oppose. American Privacy Rights Act. ENABLERS Act - oppose.

Client expense: $1,261,000 · Firm income: Not reported

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, SENATE

Affordable Care Act (extending enhanced APTCs, unauthorized enrollments in Marketplace plans), Affordability, Behavioral Health, Health Equity, Maternal Health, Surprise Billing, Health IT, Cybersecurity, Interoperability, Value-Based Care, Health Care Innovation, Telehealth-extending flexibilities, Transparency & PBMs (S. 127, S. 1339, S. 3430, H.R. 3651, H.R. 4507, H.R. 4508, H.R. 4509, H.R. 4527, H.R. 4822, H.R. 5378), Provider Directories (S. 3430, Sec. 109), Insulin Affordability (S. 1269, S. 954), Prescription Drugs (S. 150, S. 1067, S. 1114, S. 2305)

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

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

Insulin Copay Caps, Drug Pricing, Pharmacy Benefit Manager (PBM) Reform, Generic Drug Manufacturing Senate Finance Committee PBM Reform Framework H.R. 5378 - The Lower Costs, More Transparency Act - A bill to require health care providers and insurers to disclose certain information about health care costs. It also establishes requirements for certain payment methodologies under Medicare and Medicaid and extends several public health programs. H.R. 1488/S. 954 - The Affordable Insulin Now Act -- A bill to provide for appropriate cost-sharing for insulin products covered under private health plans, and to establish a program to support health care providers and pharmacies in providing discounted insulin products to uninsured individuals. S. 127. - The Pharmacy Benefit Manager Transparency Act - This bill generally prohibits pharmacy benefit managers (PBMs) from engaging in certain practices when managing the prescription drug benefits under a health insurance plan, including charging the plan a different amount than the PBM reimburses the pharmacy. S.1339 - The Pharmacy Benefit Manager Reform Act - A bill to provide for increased oversight of entities that provide pharmacy benefit management services on behalf of group health plans and health insurance coverage. H.R.2679 - The Pharmacy Benefits Manager Accountability Act - A bill to amend the Public Health Service Act, the Employee Retirement Income Security Act, and the Internal Revenue Code of 1984 to increase oversight of pharmacy benefits manager services, and for other purposes. H.R. 3561 - PATIENT Act of 2023 - This bill expands hospital price transparency requirements and establishes additional reporting requirements with respect to prescription drugs and pharmacy benefit managers (PBMs). H.R. 2630/S. 652 - The Safe Step Act -- This bill requires a group health plan to establish an exception to medication step-therapy protocol in specified cases. A medication step-therapy protocol establishes a specific sequence in which prescription drugs are covered by a group health plan or a health insurance issuer. H.R. 830/S. 1375 - The HELP Copays Act -- This bill requires health insurance plans to apply certain payments made by, or on behalf of, a plan enrollee toward a plan's cost-sharing requirements. Specifically, plans must apply third-party payments, financial assistance, discounts, product vouchers, and other reductions in out-of-pocket expenses toward the requirements. H.R. 2880 - Protecting Patients Against PBM Abuses Act -- This bill establishes requirements for Medicare pharmacy benefit managers (PBMs) with respect to remuneration, payments, and fees. Specifically, the bill restricts PBMs that are under contract with plans under the Medicare prescription drug benefit or Medicare Advantage from (1) receiving income for their services other than flat dollar amount service fees; (2) basing any service fees on the prices of covered drugs or any associated discounts, rebates, or other remuneration; (3) charging plan sponsors for ingredient costs or dispensing fees in amounts that are different than what is reimbursed to the pharmacy; or (4) reimbursing network pharmacies for less than that what is reimbursed to PBM-affiliated pharmacies.

Client expense: $170,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Patient protection; Pharmaceutical supply chain issues and shortages; Drug pricing, coverage, value and access; Transparency; Intellectual property; Health insurance accessibility; Implementation of the "Inflation Reduction Act" (HR.5376); Prescription drug approval; Affordable Insulin Now Act (S.954/HR.1488), The INSULIN Act; Policy matters related to Artificial Intelligence in health care.

Client expense: $2,465,000 · Firm income: Not reported

Government targets: Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, SENATE

S. 954 Affordable Insulin Now Act of 2023 and related administrative action

Client expense: Not reported · Firm income: Not reported

Government targets: Federal Trade Commission (FTC), SENATE

Inflation Reduction Act of 2022, H.R. 5376; Affordable Insulin Now Act of 2023, S. 954; Improving Health Insurance Affordability Act of 2023, S. 8; SMART Prices Act, S. 1264; Black Maternal Health Momnibus Act, H.R. 3305; Perinatal Workforce Act, S.1710; CARE for Moms, S.2846;

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare drug price negotiation eligibility, providing negotiated prices to commercial market and other improvements, Medicare Part D noninterference clause, clinical trial cost transparency, march-in rights and other Bayh-Dole rights, PASTEUR Act, Plain Prescription Prices Act, public pharmaceutical manufacturing, .79 Interagency Patent Coordination and Improvement Act; S.113 Prescription Pricing for the People Act; S.142 Preserve Access to Affordable Generics and Biosimilars Act; S.148 Stop STALLING Act; S.150, S.954 Affordable Insulin Now Act, weight loss drug pricing.

Client expense: $73,300 · Firm income: Not reported

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

H.R.4366 - Consolidated Appropriations Act, 2024 H.R. 2882, the Further Consolidated Appropriations Act, 2024 H.R. 7463, the Extension of Continuing Appropriations and Other Matters Act, 2024 H.R. 6363 Further Continuing Appropriations and Other Extensions Act of 2024 H.R. 5378 the Lower Costs, More Transparency Act S.3548 - Health Care Prices Revealed and Information to Consumers Explained Transparency Act S.3430 - An original bill to amend titles XVIII and XIX of the Social Security Act to expand the mental health care workforce and services, reduce prescription drug costs, and extend certain expiring provisions under Medicare and Medicaid, and for other purposes. S.1378 - Connecting Our Medical Providers with Links to Expand Tailored and Effective Care HR 3305 & S. 1606 Black Maternal Health Momnibus Act HR 4822 Health Care Price Transparency Act HR 3284 Providers and Payers COMPETE Act HR 2840 Bipartisan Primary Care and Health Workforce Act HR 4818 Treat and Reduce Obesity Act of 2023 S. 2333 Pandemic and All Hazards Preparedness and Response Act H.R. 4421 Preparing for All Hazards and Pathogens Reauthorization Act H.R. 3561, PATIENT Act of 2023 H.R. 3281, the Transparent PRICE Act H.R. 3262, To amend title XI of the Social Security Act to increase transparency of certain health-related ownership information H.R. 2868 Association Health Plans Act H.R. 2813 Self-Insurance Protection Act H.R. 3799 CHOICE Arrangement Act H.R. 3432, Telemental Health Care Access Act H.R.824, Telehealth Benefit Expansion for Workers Act of 2023 H.R. 4189, S. 2016, CONNECT for Health Act S. 923, Better Mental Health Care for Americans Act H.R. 3120, Healthy Competition for Better Care Act H.R. 1843 Telehealth Expansion Act of 2023 Legislation and regulation related to health care delivery and health insurance coverage, mental health and substance use disorder care and coverage, the transition out of the COVID-19 pandemic and electronic health information/technology. S.954 - 118th Congress (2023-2024)A bill to provide for appropriate cost-sharing for insulin products covered under private health plans, and to establish a program to support health care providers and pharmacies in providing discounted insulin products to uninsured individuals. a

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

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

Issues related to prescription drug coverage and pharmacy benefits Issues related to the prescription drug marketplace, patents, and competition Regulatory and proposed legislative changes to Medicare Part D and Medicaid prescription drug benefits S.113 - Prescription Pricing for the People Act S.127 - Pharmacy Benefit Manager Transparency Act S.142 - Preserve Access to Affordable Generics and Biosimilars Act S.148 - Stop STALLING Act S.150 - Affordable Prescriptions for Patients Act S.652 - Safe Step Act S.655 - Chronic Disease Management Act S.727 - Insulin for All Act S.775 - Increasing Transparency in Generic Drug Applications Act S.954 - Affordable Insulin Now Act S.1038 - Drug Price Transparency in Medicaid Act S.1067 - Ensuring Timely Access to Generics Act S.1114 - Expanding Access to Low-Cost Generics Act S.1120 - Improved Access to Affordable Medications Act S.1128 - Ensuring Access to Generic Medications Act S.1130 - Health Care PRICE Transparency Act S.1131 - Drug Price Transparency Act S.1217 - Ending the Prescription Drug Kickback Act S.1218 - Fair Prescription Drug Prices for Americans Act S.1269 - INSULIN Act S.1339 - Pharmacy Benefit Manager Reform Act S.1375 - HELP Copays Act S.1497 - Emergency Access to Insulin Act S.1491 - Pharmacy and Medically Underserved Areas Enhancement Act S.1542 - Delinking Revenue from Unfair Gouging (DRUG) Act S.1543 - A bill to require regulations concerning the disclosure of direct and indirect compensation from entities providing pharmacy benefit management services or third party administration services S.1967 - Patients Before Middlemen (PBM) Act S.2052 - Protect Patient Access to Pharmacies Act S.2129 - Ensuring Access to Lower-Cost Medicines for Seniors Act S.2254 - Medicare PBM Accountability Act S.2405 - Strengthening Pharmacy Access for Seniors Act S.2406 - PBM Oversight Act S.2408 - IMPROVE Part D Regulations Act S.2436 - Neighborhood Options for Patients Buying Medicines (NO PBM) Act S.2456 - Protecting Seniors from High Drug Costs Act S.2474 - Share the Savings with Seniors Act S.2477 - Equitable Community Access to Pharmacist Services Act S.2493 - PBM Reporting Transparency Act S.2666 - EPCS 2.0 Act S.2840 - Bipartisan Primary Care and Health Workforce Act (Bruan Amendment #3 - Price Transparency Requirements) S.2939 - Pharmacy Access Oversight and Reporting Act S.2973 - Modernizing and Ensuring PBM Accountability Act S.3430 - Better Mental Health Care, Lower-Cost Drugs, and Extenders Act H.R.830 - HELP Copays Act H.R.1352 - Increasing Access to Biosimilars Act H.R.1488 - Affordable Insulin Now Act H.R.1587 - Making Insulin Affordable for All Children Act H.R.1613 - Drug Price Transparency in Medicaid Act H.R.1770 - Equitable Community Access to Pharmacists Act H.R.1790 - Biologics Competition Act H.R.2630 - Safe Step Act H.R.2666 - Medicaid VBPs for Patients (MVP) Act H.R.2670 - PBM Accountability Act H.R.2691 - Transparent PRICE Act H.R.2880 - Protecting Patients Against PBM Abuses Act H.R.3030 - Stop the Overuse of Petitions and Get Affordable Medicines to Enter Soon (STOP GAMES) Act H.R.3134 - Emergency Access to Insulin Act H.R.3262 - to amend title XI of the Social Security Act to increase transparency of certain health-related ownership information H.R.3281 - Transparent PRICE Act H.R.3282 - Promoting Transparency and Health Competition in Medicare Act H.R.3285 - Fairness for Patient Medications H.R.3561- Promoting Access to Treatments and Increasing Extremely Needed Transparency (PATIENT) Act H.R.3800 - Chronic Disease Flexible Coverage Act H.R.4011 - Timely Access to Clinical Treatment Act H.R.4507 - Transparency in Coverage Act H.R.4508 - Hidden Fee Disclosure Act H.R.4509 - Transparency in Billing Act H.R.4527 - Health Data Act H.R.4712 - Patient Right to Shop Act H.R.4822 - Health Care Price Transparency Act H.R.4846 - To amend the Internal Revenue Code of 1986, title XXVII of the Public Health Service Act, and the Employee Retirement Income Security Act of 1974 to provide for oversight of pharmacy benefit manager services H.R.4881 - To amend title XVIII of the Social Security Act to limit cost sharing for drugs under the Medicare program H.R.4883 - Medicare Common Ownership Transparency Act H.R.5372 - Expanding Seniors Access to Lower Cost Medicines Act H.R.5376 - Share the Savings with Seniors Act H.R.5378 - Lower Costs More Transparency Act H.R.5384 - Advancing Enrollment and Reducing Drug Costs Act H.R.5385 - Medicare PBM Accountability Act H.R.5386 - Cutting Copays Act H.R.5393 -Transparency and Fairness for Pharmacies Act H.R.5400 - Neighborhood Options for Patients Buying Medicines (NO PBM) Act H.R.5461 - Ensuring Access to Lower-Cost Medicines for Seniors Act Implementation of the Inflation Reduction Act of 2022, P.L. 169- Provisions on Medicare Part D modernization and drug price negotiation

Client expense: $4,803,802 · Firm income: Not reported

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

H.R. 167: Patient Access to Urgent-Use Pharmacy Compounding Act of 2023 H.R. 198: Drug Pricing Transparency and Accountability Act - Provisions related to the 340B Program H.R. 456: Fairness in Orphan Drug Exclusivity Act H.R. 830: HELP Copays Act - To amend title XXVII of the Public Health Service Act to apply additional payments, discounts, and other financial assistance towards the cost-sharing requirements of health insurance plans, and for other purposes H.R. 885: TRACK Act of 2023 H.R. 1503: Prescription Information Modernization Act of 2023 H.R. 1613: Drug Price Transparency in Medicaid Act of 2023 H.R. 1790: Biologics Competition Act of 2023 - To direct the Secretary of Health and Human Services to evaluate the extent to which the substitution of interchangeable biological products is impacted by differences between the system for determining a biological product to be interchangeable and the system for assigning therapeutic equivalence ratings to drugs, and for other purposes H.R. 2408: Access to Innovative Treatments Act of 2023 H.R. 2500: Protecting Americans from Unsafe Drugs Act of 2023 H.R. 2534: PROTECT 340B Act of 2023 - Provisions related to the 340B program H.R. 2679: Pharmacy Benefits Manager Accountability Act H.R. 2707: MADE in America Act H.R. 2816: Pharmacy Benefit Manager Sunshine and Accountability Act H.R. 2880: Protecting Patients Against PBM Abuses Act H.R. 2893: Seniors Securing Access to Vital and Essential Prescription Drugs Act H.R. 2959: Health Savings Act of 2023 H.R. 3008: Drug Shortage Prevention Act of 2023 H.R. 3093: Affordable Pricing for Taxpayer-Funded Prescription Drugs Act of 2023 H.R. 3285: Fairness for Patient Medications Act H.R. 3290: To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program H.R. 3433: Give Kids a Chance Act of 2023 H.R. 3561: Promoting Access to Treatments and Increasing Extremely Needed Transparency Act of 2023 or PATIENT Act of 2023 H.R. 3839: To amend the Federal Food, Drug, and Cosmetic Act to increase transparency in generic drug applications H.R. 4115: Lower Drug Costs for Families Act H.R. 4263: Allergen Disclosure in Non-food Articles Act (ADINA) H.R. 4421: Preparing for All Hazards and Pathogens Reauthorization Act H.R. 4895: Lowering Drug Costs for American Families Act - Provisions related to drug pricing H.R. 4988: Modern Authentication of Pharmaceuticals Act of 2023 H.R. 5376: Share the Savings with Seniors Act H.R. 5378: Lower Costs, More Transparency Act H.R. 5391: Protecting Patient Access to Cancer and Complex Therapies Act H.R. 5539: ORPHAN Cures Act H.R. 5547: Maintaining Investments in New Innovation Act H.R. 6283: Delinking Revenue from Unfair Gouging or DRUG Act H.R. 6664: Innovation in Pediatric Drugs Act of 2023 H.R. 7174: Ensuring Pathways to Innovative Cures (EPIC) Act: To amend title XI of the Social Security Act to equalize the negotiation period between small-molecule and biologic candidates under the Drug Price Negotiation Program H.R. 7248: FDA Modernization Act 3.0 S. 113: Prescription Pricing for the People Act of 2023 - Provisions related to PBMs S. 127: Pharmacy Benefit Manager Transparency Act of 2023 - Provisions related to PBMs S. 148: Stop STALLING Act - Provisions related to citizen petitions S. 775: Increasing Transparency in Generic Drug Applications Act S. 935: Fair Accountability and Innovative Research Drug Pricing Act of 2023 - Provisions related to drug pricing S. 954: Affordable Insulin Now Act of 2023 S. 1067: Ensuring Timely Access to Generics Act of 2023 S. 1114: Expanding Access to Low-Cost Generics Act 2023 S. 1130: Health Care PRICE Transparency Act S. 1128: Ensuring Access to Generic Medications Act S. 1214: RARE Act - To set forth limitations on exclusive approval or licensure of drugs designated for rare diseases or conditions S. 1250: Drug-price Transparency for Consumers Act of 2023 S. 1264: SMART Prices Act - Provisions related to drug pricing reform S. 1339: Pharmacy Benefit Manager Reform Act - Provisions related to PBMs S. 1355: PASTEUR Act of 2023 - Provisions related to antimicrobial resistance policy issues S. 1375: HELP Copays Act - To amend title XXVII of the Public Health Service Act to apply additional payments, discounts, and other financial assistance towards the cost-sharing requirements of health insurance plans, and for other purposes S. 1476: Pharmaceutical Research Transparency Act of 2023 S. 1497: Emergency Access to Insulin Act of 2023 S. 1542: Delinking Revenue from Unfair Gouging Act or DRUG Act - Provisions related to PBMs S. 1589: Safeguarding Patients and Taxpayers Act S. 1906: Promising Pathway Act - Approval pathway policy issues S. 1967: PBM Act S. 2305: Biosimilar Red Tape Elimination Act S. 2333: Pandemic and All-Hazards Preparedness and Response Act S. 2456: Protecting Seniors from High Drug Costs Act S. 2474: Share the Savings with Seniors Act S. 2973: Modernizing and Ensuring PBM Accountability Act (MEPA) S. 3393: SUPPORT for Patients and Communities Reauthorization Act S. 4953: Protect Drug Innovation Act Executive Order of February 28, 2024, Preventing Access to Americans' Bulk Sensitive Personal Data and United States Government-Related Data by Countries of Concern Supporting Underserved and Strengthening Transparency, Accountability, and Integrity Now and for the Future (SUSTAIN) 340B Act (draft) User fee policy issues Inflation Reduction Act of 2022 (P.L. 117-169) Pharmacy Benefit Manager reform and policy issues Pandemic and All-Hazards Preparedness Reauthorization Act (PAHPRA) Cancer Moonshot Initiative 21st Century Cures 2.0 Drug cost and pricing policy issues Principles for drug pricing reform Drug importation policy issues Accelerated approval policy issues FDA regulatory approval authority policy issues Competition policy issues Orphan Drug Act policy issues Antimicrobial resistance (AMR) policy issues Supply chain policy issues Mental health policy issues Real world evidence policy issues Clinical trial diversity policy issues 340B drug discount program policy issues Patient assistance program policy issues Biosimilar approval and reimbursement policy issues Drug shortages policy issues COVID-19 policy issues Pandemic preparedness policy issues Cybersecurity policy issues Artificial intelligence policy issues

Client expense: $9,600,000 · Firm income: Not reported

Government targets: Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, SENATE

H.R. 1613 - Drug Price Transparency in Medicaid Act of 2023 - Rep. Carter, Earl - spread-pricing by PBMs for Medicaid H.R. 2880 - Protecting Patients Against PBM Abuses Act - Rep. Carter, Earl - PBM transparency H.R. 5372 - Expanding Seniors Access to Lower Cost Medicines Act of 2023 - Rep. Joyce, John - generic drugs, biosimilars cost H.R. 5378 - Lower Costs, More Transparency Act - Rep. McMorris Rodgers, Cathy - PBM transparency H.R. 5385 - Medicare PBM Accountability Act - Rep. Landsman, Greg McMorris - PBM transparency H.R. 6283 - DRUG Act - Rep. Miller-Meeks, Mariannette - PBM contracts H.R. 6963 - Pediatric Cancer Drug Supply Act of 2024 - Rep. Eshoo, Anna - establishes agreements with drug manufacturers to establish reserve supplies of covered pediatric cancer drugs H.R. 7635- The 340B PATIENTS Act of 2024- Rep. Matsui, Doris - ensures accessibility of drugs under 340B drug discount program S. 79 - Interagency Patent Coordination and Improvement Act of 2023 - Sen. Durbin, Richard - prescription drug patenting S. 113 - Prescription Pricing for the People Act of 2023 - Sen. Grassley, Chuck - PBM transparency S. 127 - Pharmacy Benefit Manager Transparency Act of 2023 - Sen. Cantwell, Maria - PBM transparency S. 142 - Preserve Access to Affordable Generics and Biosimilars Act - Sen. Klobuchar, Amy - pharmacy and biosimilar prescription drugs S. 148 - Stop STALLING Act - Sen. Klobuchar, Amy - pharmacy market approval processes S. 150 - Affordable Prescriptions for Patients Act of 2023 - Sen. Cornyn, John - pharmacy and prescription drug prices S. 574 - Increasing Prescription Drug Competition Act - Sen. Hassan, Maggie - closure of pharmaceutical patent loophole S. 652 - Safe Step Act - Sen. Murkowski, Lisa - medication step therapy protocol S. 954 - Affordable Insulin Now Act of 2023 - Sen. Warnock, Raphael - insulin pricing and cost sharing S. 1038 - Drug Price Transparency in Medicaid Act of 2023 - Sen. Welch, Peter - drug pricing transparency S. 1269 - INSULIN Act of 2023 - Sen. Shaheen, Jeanne - insulin pricing S. 1339 - Pharmacy Benefit Manager Reform Act - Sen. Sanders, Bernie - PBM transparency S. 3934- Increasing Access to Biosimilars Act of 2023- Sen. Cornyn, John - Medicare drug access Regulatory Issues: Issues relating to long term safety and effectiveness of medical devices and drugs, including registries; issues relating to post-market surveillance of drugs and medical devices; issues relating to price of drugs and biologics and proposals to limit high prices; issues related to prescription drug coupons and discount programs; contraceptive coverage; issues relating to vaccines; issues related to health equity; issues related to vaccination; potential Medicare NCD relating to monoclonal antibodies for treatment of Alzheimers disease; issues related to coverage of EUA drugs under Medicare Part D; issues related to drug patents and market exclusivity; issues related to pharmacy benefit managers; issues related to biosimilars; issues related to approval of drugs and biologics; issues relating to opioids; issues relating to COVID-19, including testing, vaccines and therapeutics; issues related to health care price transparency; issues relating to prescription drug rebates; direct-to-consumer advertising for prescription drugs; issues relating to access for investigational drugs; issues related to comparative effectiveness research and quality-adjusted life years; issues related to health plan step-therapy; and other issues relating to health care reform implementation.

Client expense: $4,210,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to Direct-to-Consumer Prescription Drug Advertisements; Issues related to Cybersecurity; Health care issues related to P.L. 118-42, the Consolidated Appropriations Act 2024, and P.L. 118-47, the Further Consolidated Appropriations Act 2024; Issues related to P.L. 117-328, the Consolidated Appropriations Act 2023; Issues related to P.L. 117-169, the Inflation Reduction Act of 2022, including enhanced advance premium tax credits (APTCs) and Medicare Part D redesign; Issues related to P.L. 93-406, Employee Retirement Income Security Act of 1974 (ERISA), preemption; S. 727, Insulin for All Act of 2023; S. 1269, Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act of 2023; S. 146, Cap Insulin Prices Act; S 954, Affordable Insulin Now Act of 2023; HR 1488, Affordable Insulin Now Act; HR 1587, Making Insulin Affordable for All Children Act; HR 1485, Insulin for all Act of 2023; S. 5093, Behavioral Health Network and Directory Improvement Act; H.R. 3290, To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program; S. 464/ H.R. 2630, the Safe Step Act; H.R. 5688, the Bipartisan HSA Improvement Act of 2023; H.R. 5687, the HSA Modernization Act of 2023; H.R. 1843/S. 1001, Telehealth Expansion Act; H.R. 824, Telehealth Benefit Expansion for Workers Act of 2023; S. 3393 Support for Patients and Communities Reauthorization Act; Issues related to mental health coverage, workforce, and mental health parity; Issues related to surprise billing law and regulation; Issues related to artificial intelligence and health care issues; Issues related to removing barriers to biosimilar medicine access; Issues related to the proposed rule on Advancing Interoperability and Improving Prior Authorization Processes for Medicare Advantage Organizations, Medicaid Managed Care Plans, State Medicaid Agencies, Childrens Health Insurance Program (CHIP) Agencies and CHIP Managed Care Entities, Issuers of Qualified Health Plans on the Federally-facilitated Exchanges, Merit-based Incentive Payment System (MIPS) Eligible Clinicians, and Eligible Hospitals and Critical Access Hospitals in the Medicare Promoting Interoperability Program; H.R. 4189/S. 2016, The Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023; H.R. 3432/S.3651, Telemental Health Care Access Act of 2023.

Client expense: $2,910,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Healthcare affordability platform; Issues related to insulin out of pocket costs; S. 954, Affordable Insulin Now Act of 2023; S. 1269, INSULIN Act of 2023; Expiring healthcare extenders; S. 1339, Pharmacy Benefit Manager Reform Act; H.R. 4366, the Consolidated Appropriations Act, 2024 (P.L. 118-42); H.R. 2882, the Further Consolidated Appropriations Act, 2024 (P.L. 118-47); Issues related to CHANGE cyber attack; Issues related to cybersecurity, artificial intelligence, and healthcare data privacy

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

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

LD 2 Q1 2024 House H.R. 1843, the Telehealth Expansion Act - support. H.R. 824, the Telehealth Benefit Expansion for Workers Act of 2023 - support. H.R. 4721, the Main Street Tax Certainty Act - support. H.R. 3881, the Credit Card Competition Act - support. H.R. 3799, the CHOICE Arrangement Act - support. S.J.Res.11, CRA resolution of disapproval for the EPA final rule relating to increased emissions standards for new heavy duty trucks - support. H.R. 2868, the Association Health Plan Act - support. H.R. 2813, the Self-Insurance Protection Act - support. H.R. 4428, the Guidance Clarity Act - support. H.R. 890, the Guidance Out Of Darkness (GOOD) Act - support. H.R. 5378, the Lower Costs, More Transparency Act - support. Norcross amendment (submitted as #144) to the National Defense Authorization Act for 2024 - oppose. H.R. 3417, FAIR Act - support. H.R. 1163, the Protecting Taxpayers and Victims of Unemployment Fraud Act - support. H.R. 4035, the Protecting Small Business Information Act of 2023 - support. H.J.Res. 98, Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the National Labor Relations Board relating to "Standard for Determining Joint Employer Status. - support. S.J. Res. 32, providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Bureau of Consumer Financial Protection relating to Small Business Lending Under the Equal Credit Opportunity Act (Regulation B). - support. H.R. 6514, Holding Agencies Accountable Act - support. H.R. 906, the REPAIR Act - support. H.R. 3493, ADA Improvement Act of 2023 - support. H.R. 7198, Prove It Act - support. H.R. 7035, the Death Tax Repeal Act - support. Corporate Transparency Act Repeal legislation Senate S. 1108, the Death Tax Repeal Act - support. S. 122, the Ensuring Workers Get PAID Act - support. S. 954, the Affordable Insulin NOW Act of 2023 - oppose. S. 1001, the Telehealth Expansion Act - support. H.J.Res. 27, the Congressional Review Act (CRA) resolution of disapproval for the Waters of the United States (WOTUS) final rule - support. S.J.Res. 8, the Congressional Review Act (CRA) resolution of disapproval for the Department of Labor (DOL) final rule relating to environmental, social, and governance (ESG) factors for investment decisions - support. S. 1706, the Main Street Tax Certainty Act - support. S. 1838, the Credit Card Competition Act - support. Nomination of Acting Secretary Julie Sus for Secretary of DOL - oppose. S. 1339, the Pharmacy Benefit Manager Reform Act - support. S. 567, the Richard L. Trumka Protecting the Right to Organize (PRO) Act of 2023 - oppose. S. 3167, the Multiple Employer Welfare Arrangement Act (MEWA Act) - support. the Employer Reporting Improvement Act and the Paperwork Burden Reduction Act - support. S. 2033, the American Innovation and Choice Online Act - support. S. 3227, Paperwork Burden Reduction Act - support. S. 3673, Commonsense Reporting Act - support. S. 1411, Prove It Act of 2023 - support. S. 1108, Death Tax Repeal Act - support. H.J.Res. 98, Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the National Labor Relations Board relating to "Standard for Determining Joint Employer Status. - support. Extending the $7.5 million debt cap under Subchapter V of the Chapter 11 Bankruptcy code - support. H.R. 1147, Whole Milk for Healthy Kids Act - support. S. 3204, the Employer Reporting Improvement Act - support. S. 3202, the Paperwork Burden Reduction Act - support. S.J. Res. 61, the Congressional Review Act (CRA) Joint Resolution of Disapproval to nullify the Federal Highway Administrations (FHWA) final rule imposing greenhouse gas (GHG) emissions performance measures on state departments of transportation and metropolitan planning organizations - support. Corporate Transparency Act - repeal legislation. Testimony NFIB Statement for the Record, House Energy and Commerce Health Subcommittee, hearing titled, Health Care Spending In The United States: Unsustainable For Patients, Employers, And, Taxpayers, January 31, 2024. NFIB Statement for the Record, House Committee on Education and the Workforce, comments to the Committee on Education and the Workforce request for information on ways to build upon and strengthen ERISA (Employee Retirement Income Security Act of 1974) the foundation of employer-sponsored health care, March 15, 2024. NFIB Statement for the Record, House Committee on Financial Services, hearing titled, Oversight of the Financial Crimes Enforcement Network (FinCEN) and the Office of Terrorism and Financial Intelligence (TFI), February 14, 2024. Other Healthcare reform Joint trade letter - request for abandonment or at least postponement of DOLs anticipated overtime regulations under the FLSA Joint trade letter - support of the pending proposal to amend the Federal Rules of Civil Procedure to require disclosure of third-party litigation funding (TPLF) investment arrangements in any civil action filed in federal court Restoration of R&D expensing (Section 174) - support. Regulatory Flexibility Act reform - support. Beneficial ownership information reporting requirements - oppose. Joint trade letter - Congressional Review Act resolution to repeal the U.S. Department of Labor final rule, Updating the Davis-Bacon and Related Acts Regulations - support. ADA lawsuit abuse Joint trade letter - H.R. 4035, Small Business Information Act - support. Joint trade letter - Thirty-Two Hour Workweek Act - oppose. Nomination of Acting Secretary Julie Su for Secretary of Labor (DOL) - oppose. Paid leave - oppose.

Client expense: $1,296,000 · Firm income: Not reported

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, SENATE

Educate policymakers on health care issues related to P.L. 118-42, the Consolidated Appropriations Act 2024, and P.L. 118-47, the Further Consolidated Appropriations Act; Issues related to P.L. , the Inflation reduction Act of 2022, including enhanced advance premium tax creidts (APTCs) and Medicare Part D redisign; S. 727, Inslulin for All Act of 2023; S.1269, Improving Needed Safeguards for Uses of Lifesaving Insulin Now (INSULIN) Act of 2023; S. 146 Cap Insulin Prices Act; S. 954 Affordable Insulin Now Act of 2023; H.R. 1488, Affordable Insulin Now Act; H.R. 1587, Making Insulin Affordable for All Children Act; HR 1485, Insulin for All Act of 2023; H.R. 3290, To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program; H.R. 1843 / S.1001, Telehealth Expansion Act; H.R. 824, Telehealth Benefit Expnsion for Workers Act of 2023; Issues related to artificial intelligence and health care issues; Issues related to the proposed rule on Advancing Interoperability and Improving Prior Authorization Processes for Mediare Advantage Organizations, Medicaid Managed Care Plans, State Medicaid Agencies, Children's Health Insurance Program (CHIP) Agencies and CHIP Managed Care Entities, Issuers of Qualified Health Plans on the Federally-facilitated Exchanges, Merit-based Incentive Payment System (MIPS) Eligibile Clinicians, and Eligible Hospitals and Critical Access Hospitals in the Medicare Promoting Interoperability Program

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Insulin Copay Caps, Drug Pricing, Pharmacy Benefit Manager (PBM) Reform, Generic Drug Manufacturing Senate Finance Committee PBM Reform Framework H.R. 5378 - The Lower Costs, More Transparency Act - A bill to require health care providers and insurers to disclose certain information about health care costs. It also establishes requirements for certain payment methodologies under Medicare and Medicaid and extends several public health programs. H.R. 1488/S. 954 - The Affordable Insulin Now Act -- A bill to provide for appropriate cost-sharing for insulin products covered under private health plans, and to establish a program to support health care providers and pharmacies in providing discounted insulin products to uninsured individuals. S. 127. - The Pharmacy Benefit Manager Transparency Act - This bill generally prohibits pharmacy benefit managers (PBMs) from engaging in certain practices when managing the prescription drug benefits under a health insurance plan, including charging the plan a different amount than the PBM reimburses the pharmacy. S.1339 - The Pharmacy Benefit Manager Reform Act - A bill to provide for increased oversight of entities that provide pharmacy benefit management services on behalf of group health plans and health insurance coverage. H.R.2679 - The Pharmacy Benefits Manager Accountability Act - A bill to amend the Public Health Service Act, the Employee Retirement Income Security Act, and the Internal Revenue Code of 1984 to increase oversight of pharmacy benefits manager services, and for other purposes. H.R. 3561 - PATIENT Act of 2023 - This bill expands hospital price transparency requirements and establishes additional reporting requirements with respect to prescription drugs and pharmacy benefit managers (PBMs). H.R. 2630/S. 652 - The Safe Step Act -- This bill requires a group health plan to establish an exception to medication step-therapy protocol in specified cases. A medication step-therapy protocol establishes a specific sequence in which prescription drugs are covered by a group health plan or a health insurance issuer. H.R. 830/S. 1375 - The HELP Copays Act -- This bill requires health insurance plans to apply certain payments made by, or on behalf of, a plan enrollee toward a plan's cost-sharing requirements. Specifically, plans must apply third-party payments, financial assistance, discounts, product vouchers, and other reductions in out-of-pocket expenses toward the requirements. H.R. 2880 - Protecting Patients Against PBM Abuses Act -- This bill establishes requirements for Medicare pharmacy benefit managers (PBMs) with respect to remuneration, payments, and fees. Specifically, the bill restricts PBMs that are under contract with plans under the Medicare prescription drug benefit or Medicare Advantage from (1) receiving income for their services other than flat dollar amount service fees; (2) basing any service fees on the prices of covered drugs or any associated discounts, rebates, or other remuneration; (3) charging plan sponsors for ingredient costs or dispensing fees in amounts that are different than what is reimbursed to the pharmacy; or (4) reimbursing network pharmacies for less than that what is reimbursed to PBM-affiliated pharmacies.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Patient protection; Pharmaceutical supply chain issues and shortages; Drug pricing, coverage, value and access; Transparency; Intellectual property; Health insurance accessibility; Implementation of the "Inflation Reduction Act" (HR.5376); Prescription drug approval; Affordable Insulin Now Act (S.954/HR.1488), The INSULIN Act; Policy matters related to Artificial Intelligence in health care.

Client expense: $1,730,000 · Firm income: Not reported

Government targets: Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, SENATE

S.127, Pharmacy Benefit Manager Transparency Act of 2023; S.954, Affordable Insulin Now Act; S.1339, Pharmacy Benefit Manager Reform Act; S.1664, Healthy Families Act; S.1869, SITE Act; HR.824, Telehealth Benefit Expansion for Works Act of 2023; HR.1264, Commonsense Reporting Act; HR.1843, Telehealth Expansion Act of 2023; HR.2813, Self Insurance Protection Act; HR.2868, Association Health Plan Act; HR.3797, Paperwork Burden Reduction Act; HR.3798, Small Business Flexibity Act; HR.3799, CHOICE Arrangement Act; HR.3801, Employer Reporting Improvement Act; Issues related to dialysis coverage; Issues related to health sector consolidation; Issues related to ERISA pre-emption

Client expense: $126,007 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Affordable Care Act, Affordability, Behavioral Health, Health Equity, Maternal Health, Surprise Billing, Health IT, Interoperability, Value-Based Care, Health Care Innovation, COVID-19 Commercialization, Telehealth-extending flexibilities, Transparency & PBMs (S. 127, S. 1339, S. 3430, H.R. 3651, H.R. 4507, H.R. 4508, H.R. 4509, H.R. 4527, H.R. 4822, H.R. 5378), Provider Directories, Insulin Affordability (S. 1269, S. 954), Prescription Drugs (S. 150, S. 1067, S. 1114, S. 2305)

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

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

Inflation Reduction Act of 2022, H.R. 5376; Affordable Insulin Now Act of 2023, S. 954; Improving Health Insurance Affordability Act of 2023, S. 8; SMART Prices Act, S. 1264; Black Maternal Health Momnibus Act, H.R. 3305; Perinatal Workforce Act, S.1710; CARE for Moms, S.2846;

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to the Affordable Connectivity Program (ACP), the Affordable Insulin Now Act of 2023 (S.954), raising the overtime salary threshold, limiting or eliminating bank, credit card, and event junk fees, transparency in pricing, increasing appropriations funding for utilities, and issues relating to social security.

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

Government targets: Consumer Financial Protection Bureau (CFPB), HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), SENATE, White House Office

H.R. 1613 - Drug Price Transparency in Medicaid Act of 2023 - Rep. Carter, Earl - spread-pricing by PBMs for Medicaid H.R. 2880 - Protecting Patients Against PBM Abuses Act - Rep. Carter, Earl - PBM transparency H.R. 5372 - Expanding Seniors Access to Lower Cost Medicines Act of 2023 - Rep. Joyce, John - generic drugs, biosimilars cost H.R. 5378 - Lower Costs, More Transparency Act - Rep. McMorris Rodgers, Cathy - PBM transparency H.R. 5385 - Medicare PBM Accountability Act - Rep. Landsman, Greg McMorris - PBM transparency H.R. 6283 - DRUG Act - Rep. Miller-Meeks, Mariannette - PBM contracts S. 79 - Interagency Patent Coordination and Improvement Act of 2023 - Sen. Durbin, Richard - prescription drug patenting S. 113 - Prescription Pricing for the People Act of 2023 - Sen. Grassley, Chuck - PBM transparency S. 127 - Pharmacy Benefit Manager Transparency Act of 2023 - Sen. Cantwell, Maria - PBM transparency S. 142 - Preserve Access to Affordable Generics and Biosimilars Act - Sen. Klobuchar, Amy - pharmacy and biosimilar prescription drugs S. 148 - Stop STALLING Act - Sen. Klobuchar, Amy - pharmacy market approval processes S. 150 - Affordable Prescriptions for Patients Act of 2023 - Sen. Cornyn, John - pharmacy and prescription drug prices S. 574 - Increasing Prescription Drug Competition Act - Sen. Hassan, Maggie - closure of pharmaceutical patent loophole S. 954 - Affordable Insulin Now Act of 2023 - Sen. Warnock, Raphael - insulin pricing and cost sharing S. 1038 - Drug Price Transparency in Medicaid Act of 2023 - Sen. Welch, Peter - drug pricing transparency S. 1269 - INSULIN Act of 2023 - Sen. Shaheen, Jeanne - insulin pricing S. 1339 - Pharmacy Benefit Manager Reform Act - Sen. Sanders, Bernie - PBM transparency Regulatory Issues: Issues relating to long term safety and effectiveness of medical devices and drugs, including registries; issues relating to post-market surveillance of drugs and medical devices; issues relating to price of drugs and biologics and proposals to limit high prices; issues related to prescription drug coupons and discount programs; contraceptive coverage; issues relating to vaccines; issues related to health equity; issues related to vaccination; potential Medicare NCD relating to monoclonal antibodies for treatment of Alzheimers disease; issues related to coverage of EUA drugs under Medicare Part D; issues related to drug patents and market exclusivity; issues related to pharmacy benefit managers; issues related to biosimilars; issues related to approval of drugs and biologics; issues relating to opioids; issues relating to COVID-19, including testing, vaccines and therapeutics; issues related to health care price transparency; issues relating to prescription drug rebates; direct-to-consumer advertising for prescription drugs; issues relating to access for investigational drugs; issues related to comparative effectiveness research and quality-adjusted life years; issues related to health plan step-therapy; and other issues relating to health care reform implementation.

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

Government targets: HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), SENATE

H.R. 485 - Protecting Health Care For All Patients Act of 2023 - Rep. McMorris Rodgers, Cathy - federal programs using prices based on quality-adjusted life years H.R. 824 - Telehealth Benefit Expansion for Workers Act of 2023 - Rep. Walberg, Tim - telehealth and ERISA amendments H.R. 830 - HELP Copays Act - Rep. Carter, Earl - health insurers responsibility for payments made by or on behalf of a plan enrollee toward a plans cost-sharing requirements H.R. 1488 - Affordable Insulin Now Act of 2023 - Rep. Craig, Angie - cost-sharing for insulin products H.R. 1613 - Drug Price Transparency in Medicaid Act of 2023 - Rep. Carter, Earl -spread-pricing by PBMs for Medicaid H.R. 2666 - MVP Act - Rep. Guthrie, Brett - value-based purchasing arrangements under Medicaid program and reforms to price reporting H.R. 2691 - Transparent Price Act - Rep. McMorris Rodgers, Cathy - health insurer price transparency H.R. 2813 - Self-Insurance Protection Act - Rep. Good, Bob - ERISA amendments H.R. 2868 - Association Health Plans Act - Rep. Walberg, Tim - ERISA amendments H.R. 3305 - Black Maternal Health Momnibus Act - Rep. Underwood, Lauren - maternal health including in Medicaid and CHIP H.R. 3561 - PATIENT Act - Rep. McMorris Rodgers, Cathy - PBM transparency, PBM contract design, health insurance transparency, hospital transparency H.R. 3799 - Custom Health Option and Individual Care Expense Arrangement Act- Rep. Hern, Kevin - health reimbursement arrangements H.R. 3801 - Employer Reporting Improvement Act - Rep. Smith, Adrian - ACA reporting requirements S. 113 - Prescription Pricing for the People Act of 2023 - Sen. Grassley, Chuck - preventing anti-competitive tactics for prescription drugs S. 127 - Pharmacy Benefit Manager Transparency Act of 2023 - Sen. Cantwell, Maria - pharmacy benefit manager transparency S. 652 - Safe Step Act - Sen. Murkowski, Lisa - medication step therapy protocol S. 954 - Affordable Insulin Now Act of 2023 - Sen. Warnock, Raphael - cost-sharing for insulin products S. 1038 - Drug Price Transparency in Medicaid Act of 2023 - Sen. Welch, Peter - prohibits spread-pricing by PBMs in Medicaid S. 1606 - A bill to end preventable maternal mortality, severe maternal morbidity, and maternal health disparities in the United States, and for other purposes. - Sen. Booker, Cory - maternal mortality S. 3393 - SUPPORT for Patients and Communities Reauthorization Act. - Sen. Sanders, Bernie - SUD treatment S. 3430 - Better Mental Health Care, Lower-Cost Drugs, and Extenders Act of 2023 - Sen. Wyden, Ron - mental health, telehealth, health workforce Issues related to broadband and public health infrastructure; mental health and telehealth; COVID-19 testing; public option programs; behavioral health; rural health; substance use disorder treatments; Health Savings Accounts; provider directories; and artificial intelligence and privacy. Regulatory Issues: HIPAA administrative simplification issues, including standards for privacy, security, and electronic transactions and code sets (including ICD-10 and ICD-11), identifiers, enforcement; cybersecurity; issues related to Medicare Secondary Payer requirements; issues related to health care price transparency; issues related to all payor claims databases; issues related to implementation of the National Health Information Infrastructure; electronic health records, personal health records, and similar technologies; issues relating to market consolidation; issues related to hospital and provider consolidation; issues related to medical management; issues relating to quality improvement; issues relating to the national health data stewardship; issues relating to hospital outpatient measurement and reporting; issues relating to COVID-19, including testing, vaccines and therapeutics; issues related to the end of the public health emergency; issues related to health equity; issues related to vaccination; issues related to addressing the social determinants of health, including housing, transportation, nutrition, and educational opportunities; prescription drug pricing; telehealth; issues related to the cost of insulin, including price, copays, rebates, and medical management tools; rural health; issues related to behavioral health benefits; issues related to Managed Long Term Services and Supports (MLTSS); issues related to the collection of race and ethnicity data; issues related to medical loss ratios; reference pricing; review of rates for reasonableness; preexisting condition insurance plans; issues relating to antitrust; issues relating to surprise medical bills; accountable care organizations; provider non-discrimination; coverage of preventive services; contraceptive coverage and reproductive health; pre-existing condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; issues related to health insurance tax; health plan automatic enrollment requirements; issues related to qualified health plans including certification and rate filing templates; health insurance market rules; ACA risk adjustment; dependent coverage; summary of benefits and coverage disclosures; benefit and payment parameters; essential health benefits, actuarial value, and accreditation; NQF reauthorization; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations; issues related to supplemental products; issues related to HIPAA excepted benefits; issues related to short term limited duration products; issues related to the federally-facilitated marketplaces (i.e., Exchanges/formerly referred to as the web portal); issues related to business continuity in relation to pandemics or natural events (e.g., hurricane, tornado, etc.); issues related to association health plans; issues related to cost-sharing reductions (CSRs); issues related to the refundable credit for coverage under a qualified health plan and enhancements included in the American Rescue Plan Act (ARPA); issues related to Medicaid coverage gap; issues related to small employer group size; issues related to Certificate of Public Advantage; issues relating to veterans health care; issues relating to caregivers; and other issues relating to health care reform implementation.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE, Treasury, Dept of, White House Office

Insulin Out of Pocket Costs; Covid Therapeutics; Generics Access; Gene Therapy S. 150 - Affordable Prescriptions for Patients Act of 2023 A bill to amend the Federal Trade Commission Act to prohibit product hopping, and for other purposes. Sponsor: Sen. John Cornyn (R-TX) S. 127 - Pharmacy Benefit Manager Transparency Act of 2023 A bill to prevent unfair and deceptive acts or practices and the dissemination of false information related to pharmacy benefit management services for prescription drugs, and for other purposes. Sponsor: Sen. Maria Cantwell (D-WA) S.1269 - INSULIN Act of 2023 To reduce the price of insulin and provide for patient protections with respect to the cost of insulin. Sponsor: Sen. Shaheen, Jeanne [D-NH] S.1339 - Pharmacy Benefit Manager Reform Act To provide for increased oversight of entities that provide pharmacy benefit management services on behalf of group health plans and health insurance coverage. Sponsor: Sen. Sanders, Bernard [I-VT] S. 148 - Stop STALLING Act A bill to enable the Federal Trade Commission to deter filing of sham citizen petitions to cover an attempt to interfere with approval of a competing generic drug or biosimilar, to foster competition, and facilitate the efficient review of petitions filed in good faith to raise legitimate public health concerns, and for other purposes. Sponsor: Sen. Amy Klobuchar (D-MN) S. 142 - Preserve Access to Affordable Generics and Biosimilars Act A bill to prohibit brand name drug companies from compensating generic drug companies to delay the entry of a generic drug into the market, and to prohibit biological product manufacturers from compensating biosimilar and interchangeable companies to delay the entry of biosimilar biological products and interchangeable biological products. Sponsor: Sen. Amy Klobuchar (D-MN) S. 954 - Affordable Insulin Now Act of 2023 A bill to provide for appropriate cost-sharing for insulin products covered under private health plans, and to establish a program to support health care providers and pharmacies in providing discounted insulin products to uninsured individuals. Sponsor: Sen. Raphael Warnock (D-GA) H.R.5372 - Expanding Seniors' Access to Lower Cost Medicines Act of 2023 To amend Title XVIII of the Social Security Act to facilitate midyear formulary changes for biosimilars. Sponsor: Rep. Joyce, John [R-PA-13]

Client expense: $1,800,000 · Firm income: Not reported

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