Lobbying Disclosure Act of 1995 (Section 5) - All Filers Are Required to Complete This Page

9. Check if this filing amends a previously filed version of this report

LOBBYING ACTIVITY. Select as many codes as necessary to reflect the general issue areas in which the registrant engaged in lobbying on behalf of the client during the reporting period. Using a separate page for each code, provide information as requested. Add additional page(s) as needed.

15. General issue area code PHA

16. Specific lobbying issues

Opioid Epidemic

17. House(s) of Congress and Federal agencies Check if None

U.S. SENATE, U.S. HOUSE OF REPRESENTATIVES

18. Name of each individual who acted as a lobbyist in this issue area

19. Interest of each foreign entity in the specific issues listed on line 16 above Check if None

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LOBBYING ACTIVITY. Select as many codes as necessary to reflect the general issue areas in which the registrant engaged in lobbying on behalf of the client during the reporting period. Using a separate page for each code, provide information as requested. Add additional page(s) as needed.

15. General issue area code HCR

16. Specific lobbying issues

Postal Reform; Affordable Healthcare Act (ACA) Regulations; Amendment of the Food, Drug, and Cosmetic Act; American Health Care Act (AHCA); Health Care Reform; Implementation; Cost Sharing Reduction (CSR); Reinsurance; Health Savings Accounts (HSAs); Repeal and Replace; Grace Periods; SEPs; Marketplace Stability; Individual Marketplace Reform; Anti-trust; Automated Calls and Telephone Consumer Protection Act; Medical Malpractice Reform; Association Health Plans

HR 246 Introduced January 4, 2017 by Kristi Noem (R-SD) This bill repeals a provision of the Patient Protection and Affordable Care Act that imposes an annual fee on a health insurance provider based on its net premium income.

HR 633 Patient Fairness and Relief Act of 2017 Introduced January 24, 2017 by Gregg Harper (R-MS) To authorize health insurance issuers to continue to offer for sale health
insurance coverage offered in the individual market before the enactment of the Patient Protection and Affordable Care Act in satisfaction of the minimum essential health insurance coverage requirement, and for other purposes.

HR 708 State Age Rating Flexibility Act of 2017 Introduced by Larry Bucshon (R-IN) This bill amends the Public Health Service Act to increase the permissible variation based on age for health insurance premiums for coverage offered in the individual or small group market from a factor of three to a factor of five, or to a factor determined by the state. This applies to plan years starting on or after January 1, 2018.

HR 710 Health Coverage State Flexibility Act of 2017 Introduced January 17, 2017 by Bill Flores(R-TX) This bill amends the Patient Protection and Affordable Care Act to revise the grace period that health insurers must provide to recipients of premium subsidies before discontinuing health coverage for nonpayment of premiums. The grace period is shortened from 3 months to 30 days unless state law includes an applicable grace period.

HR 706 Plan Verification and Fairness Act of 2017 Introduced January 27, 2017 by Marsha Blackburn (R-TN) This bill amends the Patient Protection and Affordable Care Act to require health insurance exchanges to verify an individual's eligibility for a special enrollment period before coverage is made effective. Individuals seeking coverage through an exchange during a special enrollment period must submit to the exchange the documents necessary to verify their eligibility for the special enrollment period.

HR 661 Employee Fairness and Relief Act of 2017 Introduced January 24, 2017 by Brett Guthrie (R-KY) To authorize health insurance issuers to offer for sale previously available health insurance coverage in the small group market in satisfaction of the minimum essential health insurance coverage requirement, and for other purposes.

HR 749 Lower Drug Costs Through Competition Act Introduced January 30, 2017 by Kurt Schrader (D-OR) To increase competition in the pharmaceutical industry.

HR 756 Postal Service Reform Act of 2017 Introduced January 31, 2017by Jason Chaffetz (R-UT) To restore the financial solvency and improve the governance of the United States Postal Service in order to ensure the efficient and affordable nationwide delivery of mail, and for other purposes.

HR 1101 Small Business Health Fairness Act of 2017 Introduced February 16, 2017 by Sam Johnson (R-TX) To amend title I of the Employee Retirement Income Security Act of 1974 to improve access and choice for entrepreneurs with small businesses with respect to medical care for their employees.

17. House(s) of Congress and Federal agencies Check if None

U.S. SENATE, U.S. HOUSE OF REPRESENTATIVES, Health & Human Services - Dept of (HHS), White House Office, Office of Management & Budget (OMB), Executive Office of the President (EOP)

18. Name of each individual who acted as a lobbyist in this issue area

19. Interest of each foreign entity in the specific issues listed on line 16 above Check if None

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LOBBYING ACTIVITY. Select as many codes as necessary to reflect the general issue areas in which the registrant engaged in lobbying on behalf of the client during the reporting period. Using a separate page for each code, provide information as requested. Add additional page(s) as needed.

15. General issue area code MMM

16. Specific lobbying issues

Medigap; Medicare Advantage; CHIP Reform; Medicare Access & CHIP Reauthorization Act of 2015 (MACRA); Chronic Care Reform; Exchanges; Site-neutral Payments; Network Breadth Advisory Council; Rate Notice and Call Letter; Postal Reform

HR 756 Postal Service Reform Act of 2017 Introduced January 31, 2017by Jason Chaffetz (R-UT) To restore the financial solvency and improve the governance of the United States Postal Service in order to ensure the efficient and affordable nationwide delivery of mail, and for other purposes.

HR 1290 Improving Access to Mental Health Act Introduced March 1, 2017 by Barbara Lee (D-CA) To amend title XVIII of the Social Security Act to improve access to mental health services under the Medicare program.

HR 1298 CT Colonography Screening for Colorectal Cancer Act of 2017 Introduced March 1, 2017 by Brad Wenstrup (R-OH) To amend title XVIII of the Social Security Act to cover screening computed tomography colonography as a colorectal cancer screening test under the Medicare program.

HR 1361 Introduced March 2, 2017 by Lee Zeldin (R-NY) To amend title XVIII of the Social Security Act to provide for the non-application of Medicare competitive acquisition rates
HR 1369 Introduced March 6, 2017 by Tom Cole (R-OK) To amend the Indian Health Care Improvement Act to revise and extend that Act, and for other purposes.

HR 1381 Introduced March 7, 2017 by Morgan Griffith (R-VA) To amend title XIX of the Social Security Act to permit States to impose an individual responsibility requirement for nondisabled, nonelderly, non-pregnant individuals made eligible for medical assistance.
HR 1394 Introduced March 7, 2017 by Susan Brooks (R-IN) To amend title XIX of the Social Security Act to provide States with flexibility with respect to providing coverage for nonemergency transportation under Medicaid.

HR 1389 Increasing State Flexibility in Care Coordination for the Most Vulnerable Act of 2017 Introduced March 7, 2017 by Gus Bilirakis (R-FL) To amend title XIX of the Social Security Act to provide States with flexibility to provide care coordination under Medicaid for the most vulnerable through managed care.

HR 1395 MACPAC Improvement Act of 2017 Introduced March 7, 2017 by Michael Burgess (R-TX) To amend title XIX of the Social Security Act to improve the Medicaid and CHIP Payment and Access Commission (MACPAC).

HR 1421 Improving Access to Medicare Act of 2017 Introduced March 8, 2017 by Joe Courtney (D-CT) To amend title XVIII of the Social Security Act to count a period of receipt of outpatient observation services in a hospital toward satisfying the 3-day inpatient hospital stay requirement for coverage of skilled nursing facility services under Medicare, and for other purposes.

HR 1435 Exchange Inclusion for a Healthy America Act Introduced March 8, 2017 by Luis Gutierrez (D-IL) To amend the Patient Protection and Affordable Care Act to remove citizenship and immigration barriers to access the Exchanges under such Act.

HR 1469 Welfare Benefit Reform and Alignment Commission Act Introduced March 9, 2017 by Warren Davidson (R-OH) To establish the Benefit Reform and Alignment Commission to consolidate and realign means-tested direct spending program outlays.

HR 1542 HELLPP Act Introduced March 15, 2017 by Bill Johnson (R-OH) To amend title XIX of the Social Security Act to cover physician services delivered by podiatric physicians to ensure access by Medicaid beneficiaries to appropriate quality foot and ankle care, to amend title XVIII of such Act to modify the requirements for diabetic shoes to be included under Medicare, and for other purposes.

HR 1604 Health IT Modernization for Underserved Communities Act of 2017 Introduced March 17, 2017 by Karen Bass (D-CA) To amend title XIX of the Social Security Act to extend to physician assistants eligibility for Medicaid incentive payments for the adoption and use of certified electronic health records, whether or not such physician assistants practice at a rural health center or Federally qualified health center.

HR 1617 Promoting Access to Diabetic Shoes Act Introduced March 17, 2017 by Tom Reed II (R-NY) To amend title XVIII of the Social Security Act to permit nurse practitioners and physician assistants to satisfy the documentation requirement under the Medicare program for coverage of certain shoes for individuals with diabetes.

HR 1621 Protecting Seniors from Health Care Fraud Act of 2017 Introduced March 17, 2017 by Raul Ruiz (D-CA) This bill amends title XVIII (Medicare) of the Social Security Act to direct the Department of Health and Human Services (HHS) to report annually to Congress and the public on: (1) the ten most prevalent health care fraud schemes targeted to seniors, (2) steps being taken to combat such schemes, and (3) policy suggestions to improve protections for seniors. HHS may omit certain information from an annual report if public disclosure would compromise an ongoing investigation or educate criminals rather than seniors. HHS shall disseminate reports to Medicare beneficiaries as specified by the bill.

17. House(s) of Congress and Federal agencies Check if None

U.S. SENATE, U.S. HOUSE OF REPRESENTATIVES, Centers For Medicare and Medicaid Services (CMS), Health & Human Services - Dept of (HHS)

18. Name of each individual who acted as a lobbyist in this issue area

19. Interest of each foreign entity in the specific issues listed on line 16 above Check if None

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LOBBYING ACTIVITY. Select as many codes as necessary to reflect the general issue areas in which the registrant engaged in lobbying on behalf of the client during the reporting period. Using a separate page for each code, provide information as requested. Add additional page(s) as needed.

15. General issue area code TAX

16. Specific lobbying issues

833; Health Insurance Tax (HIT Tax); Cadillac Tax

17. House(s) of Congress and Federal agencies Check if None

U.S. SENATE, U.S. HOUSE OF REPRESENTATIVES

18. Name of each individual who acted as a lobbyist in this issue area

19. Interest of each foreign entity in the specific issues listed on line 16 above Check if None

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LOBBYING ACTIVITY. Select as many codes as necessary to reflect the general issue areas in which the registrant engaged in lobbying on behalf of the client during the reporting period. Using a separate page for each code, provide information as requested. Add additional page(s) as needed.

15. General issue area code BUD

16. Specific lobbying issues

ACA Reinsurance; Cost-sharing Reduction Payments under ACA

17. House(s) of Congress and Federal agencies Check if None

U.S. SENATE, U.S. HOUSE OF REPRESENTATIVES

18. Name of each individual who acted as a lobbyist in this issue area

19. Interest of each foreign entity in the specific issues listed on line 16 above Check if None

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Information Update Page - Complete ONLY where registration information has changed.

20. Client new address

21. Client new principal place of business (if different than line 20)

22. New General description of client’s business or activities

LOBBYIST UPDATE

23. Name of each previously reported individual who is no longer expected to act as a lobbyist for the client

ISSUE UPDATE

24. General lobbying issue that no longer pertains

AFFILIATED ORGANIZATIONS

25. Add the following affiliated organization(s)

Internet Address:

26. Name of each previously reported organization that is no longer affiliated with the registrant or client

FOREIGN ENTITIES

27. Add the following foreign entities:

28. Name of each previously reported foreign entity that no longer owns, or controls, or is affiliated with the registrant, client or affiliated organization